UNITED STATES ENVIRONMENTAL PROTECTION AGENCY

                               WASHINGTON, D.C. 20460                JL t ^ ,
                                                                     -'

                                                           —,
                                                                    c
                                                                 OFFICE OF
                                                             THE INSPECTOR GENERAL
                                        9 1989
        MEMORANDUM
        SUBJECT:
           Audit Report No. M5BFL9-11-0048-9100415
           Audit of Superfund Interagency Agreements with
           the Department of Health and  Human Services
           (Missouri Department of Health)
        FROM:
        TO:
           Kenneth D.
           Divisional Inspector General  for Audit
           Internal Audit Division  (A-109)

           Harvey G.  Pippen, Director
           Grants Administration -Division  (PM-216)
             I am transmitting  a  copy of the subject report prepared by a

        contractor for the Office of Inspector General, Department of

        Health and Human Services.  We are closing this report in our Prime

        Audit Tracking System upon issuance.   Should your staff have any

        questions concerning this report, please  have them call John Walsh

        on 475-6753.

        Attachment
        CD
        cn
                                 HEADQUARTERS LIBRARY
                                 ENVIRONMENTAL PROTECTION AGENCY
                                 WASHINGTON, D.C. 20460
fJP
•f-

-------
                                                  APPENDIX
                      DISTRIBUTION OF REPORT
Director, Office of Emergency and Remedial Response (OS-200)

Director, Office of Program Management, Office of Emergency
  and Remedial Response  (OS-240)

Chief, Financial and Administrative Management Section, Office
  of Emergency and Remedial Response (OS-240)

Comptroller (PM-225)

Director, Financial Management Division (PM-226)

Chief, Grants Information and Analysis Branch (PM-216F)

Agency Followup Official (PM-208)

Agency Followup Official (PM-225)
  Attn:  Resource Management Division

Audit Followup Coordinator (PM-208)
  Attn:  Program Operations Support Staff

Regional Administrator, Region 7

-------

-------
         Missouri Department of
                             in
    John Ashcroft
      Governor

 Robert Harmon, M.D.
      Director
P.O. Box 570, Jefferson City, MO 65102 • 314 / 751-6400
May 24, 1989
    Mr.  Elvin R. Hilyer
    Associate Director for Policy  Coordination
    Room 2419 - Mail Stop D-1 4
    Centers for Disease Control
    1600 Clifton Road, N.E.
    Atlanta, Georgia 30333

    Dear Mr. Hilyer:

    RE:  A-04-88-04068

         I have reviewed the  audit report pertaining to the above
    audit of cooperative agreements U61-CCU700563 and U61-CCU700735
    for  the period July 12, 1983 through March 31, 1987 and May  13,
    1985 through September 29, 1987.   My responses to the
    recommendations are as follows:

         1 . Equipment control system deficiencies

            We concur and have implemented stricter controls.

         2. No reconciliation of annual physical inventory

            The recommendation is  not feasible and reflects a  lack of
            understanding of  the SAM System by the auditors.   The SAM
            System (Statewide Accounting for Missouri) is an
            accounting system that accumulates expenditures for  each
            fiscal year by fund.   Fixed asset purchases are recorded
            as expenditures of their respective fund.  Any fixed
            asset acquired is set  up on the property control record
            with all the appropriate identification noted in the
            auditor's recommendation.  The annual physical inventory
            is reconciled to  the property control records and  any
            discrepancies investigated.

         3. No close-out submission of equipment listing

            We concur; and February 7, 1987, issued a letter listing
            equipment costing over $1,000 for cooperative agreement
            No. U61-CCU700563.
                                        Sincerely,
                                        Robert G. Harmon, M.D.,  M.P.H,
                                        Director
    RGH:AT:jar
                        AN EQUAL OPPORTUNITY/AFFIRMATIVE ACTION EMPLOYER
                           MIVIOM poviitad on a nondBcnrrinnoiy tt&m

-------
       DEPARTMENT OF HEALTH & HUMAN SERVICES
                                                      /<
                                                      c •
                         Office of Inspector General
                         ,    Office of Audit
                                                            REGION IV
                                                           P. O. BOX 1704
                                                       ATLANTA, GEORGIA 30301
      MAY  2 138T
Common Identification No.  A-04-88-04068
       Dr. Robert G.  Harmon, Director
       Missouri  Department of Health
       P.O.  Box  570
       Jefferson City,  Missouri  65102

       Dear  Dr.  Harmon:

       Enclosed  for your information and use is a report on  the  Results
       of the  Audit of  Environmental Protection Agency Superfund Awards
       to the  Missouri  Department of Health (MDH).

       The audit was conducted of Cooperative Agreements U61/CCU700563
       and U61/CCU700735,  which were awarded by the Centers  for  Disease
       Control (CDC)  on behalf of the Agency for Toxic Substances  and
       Disease Registry (ATSDR).   The periods reviewed were  July 12,
       1983  through March 31, 1987 and May 13, 1985 through  September
       29, 1987,  respectively.  The audit was performed by the CPA firm
       of Carmichael, Ingle, White, & Company, P.C., which is under
       contract  with the Department of Health and Human Services,  Office
       of Inspector General, Office of Audit.

       The audit disclosed untimely reporting of equipment dispositions
       to property control personnel.  Recommendations are that  the MDH
       implement stricter accounting procedures within the existing
       equipment control system to ensure current information regarding
       equipment transfers and dispositions.

       Another finding  disclosed that the MDH was not submitting a
       listing of equipment costing over $1,000 to the ATSDR as  required
       by the  Assistance Award Close-out Requirements.  Recommendations
       are that  the MDH compile and submit the necessary list.

       The auditor also found that there was no reconciliation of  annual
       physical  inventory to the State-wide Accounting for Missouri
       (SAM) reports.   Recommendations are that the MDH not  only
       reconcile the annual inventory counts to the SAM reports  and
       accounting records, but also account for any discrepancies  to
       ensure  adequate  safeguarding of Federal assets.

       MDH concurred with the auditor concerning the first two
       recommendations  and plans to implement appropriate changes.  MDH
       did not,  however,  agree with the auditor's findings on inventory
       reconciliation.   The MDH believes that it already has adequate
       procedures in place.
P O. 00X 1T747
                    Box 20
                    51 SWFi>MAv*nu«
                    Miami Fiona* 33131
         Room 2091
         227 N. Bwwuon suwt
            w*. Floridi 323O1
P O. 8o> 27443
RUwgfl. Men*Carolina 27«n

-------
Page 2 - Dr. Robert G. Harmon
The complete text of MDH's written response is included as
Appendix A in the auditor's report.

Final determinations as to actions to be taken on all matters
reported will be made by the HHS official named below.  We
request that you respond to each of the recommendations in this
report within 30 days from the date of this letter to the HHS
official named, presenting any comments or additional information
that you believe may have a bearing on his final determination.

In accordance with the principles of the Freedom of Information
Act (Public Law 90-23), HHS/OIG Office of Audit reports issued to
the Department's grantees and contractors are made available, if
requested, to members of the press and general public to the
extent information contained therein is not subject to exemptions
in the Act, which the Department chooses to exercise.  (See
Section 5.71 of the Department's Public Information Regulation,
dated August 1974, as revised.)

To facilitate identification, please refer to Common
Identification Number A-04-88-04068 in all correspondence
relating to this report.
                              Si'ncerely yours
                              Emil A. Trefzge^
                              Regional Inspectof General
                                for Audit, Region IV
Enclosure

Direct Reolv to;

Associate Director for Policy Coordination
Room 2419 - Mail Stop D-14
Centers for Disease Control
1600 Clifton Road, N.E.
Atlanta, Georgia  30333

-------
                      Distribution Schedule
Auditee                                             No. of Copies

    Dr. Robert G. Harmon, Director                         2
    Missouri Department of Health
    P.O. Box 570
    Jefferson City, Missouri  65102

Environmental Protection Aaencv

    Assistant Inspector General for Audit                  1
    Office of Inspector General
    Environmental Protection Agency
    4th and M Streets, SW
    Washington, D.C.  20460

Action Official - ATSDR

    Associate Director for Policy Coordination            2
    Room 2419 - Mail stop D-14
    Centers of Disease Control
    1600 Clifton Road, N.E.
    Atlanta, Georgia  30333

Audit Liaison

    Chief, Cost and Audit Management Branch, PHS           1
    Room 17A-50, Parklawn Building
    5600 Fisher's Lane
    Rockville, Maryland  20857

Office of Audit

    Deputy Assistant Inspector General for Audit           1
    Public Health Service Audit Division

    Management, Operations and Evaluation Division         1

    Regional Inspector General for Audit, Region VII       l

    Regional Office                                        2

Other Parties

    Associate Administrator, ATSDR - CDC                   1
    Mail Stop  F-38
    1600 Clifton Road, N.E.
    Atlanta, Georgia  30333
Total

-------
        DEPARTMENT OF HEALTH AND HUMAN SERVICES/
             ENVIRONMENTAL PROTECTION AGENCY
                     SUPERFUND AUDIT
              MISSOURI DEPARTMENT OF HEALTH
{FORMERLY PART OF MISSOURI DEPARTMENT OF SOCIAL SERVICES)
                JEFFERSON CITY, MISSOURI

                 COOPERATIVE AGREEMENTS
                      U61/CCU700563
                      U61/CCU700735
                     FOR THE PERIODS
          JULY 12,  V983 THROUGH MARCH 31,  1987
         MAY 13,  1985 THROUGH SEPTEMBER 29,  1987

-------
                              TABLE OF CONTENTS
ACRONYMS

EXECUTIVE  SUMMARY

BACKGROUND

SCOPE OF AUDIT

AUDITORS'  REPORT

SCHEDULES:

  A - SUMMARY OF COSTS  - COOPERATIVE AGREEMENT U61/CCU700563

  A-t - SCHEDULE OF COSTS  -  7/12/83 - 9/30/84

  A-1a - FINANCIAL STATUS  REPORT  - 7/12/83 - 9/30/84

  A-2 - SCHEDULE OF COSTS  -  10/1/84 - 3/31/86

  A-2a - FINANCIAL STATUS  REPORT  10/1/84 - 3/31/86

  A-3 - SCHEDULE OF COSTS  -  4/1/86 - 3/31/87

  A-3a - FINANCIAL STATUS  REPORT  4/1/86 - 3/31/87

  B - SCHEDULE OF COSTS -  COOPERATIVE AGREEMENT U61/CCU700735

  B-1 - FINANCIAL STATUS REPORT - 5/13/85 - 9/29/87

AUDITORS'  REPORT ON COMPLIANCE

AUDITORS'  REPORT ON INTERNAL CONTROL

FINDINGS AND RECOMMENDATIONS

  1.  Equipment Control System Deficiencies
  2.  No Reconciliation of Annual Physical Inventory

  3.  No Close-out Submission of Equipment Listing

APPENDIX A:  GRANTEE'S RESPONSE
Page

  1

  2

  4

  6

  7



  9

 10

 11

 13

 14

 16

 17

 18

 19

 20

 22



 25
 27

 29

 30

-------
                                 ACRONYMS



DHHS or HHS - Department of Health and Human Services

ATSDR - Agency for Toxic Substances and Disease Registry

CDC - Center for Disease Control

EPA - Environmental Protection Agency

NIEHS - National Institute of Environmental Health Sciences

DIG - Office of Inspector General

U.S. - United States

PHS - Public Health Service

OMB * Office of Management and Budget

FSR - Financial Status Report

CFR - Code of Federal Regulations

CERCLA - Comprehensive Environment Response Compensation
         and Liability Act of 1980

SARA - Superfund Amendments and Reauthorization Act of
       1986

SUPERFUND - Hazardous Substance Response Trust Fund

P.L. - Public Law

FSR - Financial Status Report

-------
                                 EXECUTIVE SUMMARY








This audit  of  costs claimed under Superfund awards was performed under contract with




the U.  S. Department of Health and Human Services, Office of  Inspector General.




The specific objectives of the audit were:




        - To determine if costs claimed by each grantee were reconciled to  the




         accounting records for expenditures.




        - To evaluate the methodology and adequacy of  monitoring  activities.




        - To determine,  for grantee transactions tested,  the degree of




         compliance with applicable Environmental Protection  Agency  (EPA)




         laws  and regulations,  cost principles,  and generally accepted



         accounting principles.




        - To determine if operations adhered to the principles of economy




         and efficiency in the administration  of the  grants.




        - TO evaluate internal  controls for  each of the grantee operations,



         as appropriate.
Our audit disclosed  the  following findings:



       - Missouri Department of  Health does not insure timely reporting



         of equipment dispositions to property control personnel.



         We recommend the Agency implement accounting procedures to assure



         that dispositions of equipment are reported on a timely basis to property



         control personnel.  MDH concurs with our finding, and has implemented



         controls to ensure dispositions are reported timely.

-------
The Agency  does  not  reconcile  the  annual physical  inventory  to  the




Stats-wide  Accounting  for Missouri (SAM) reports.  We recommend the Agency




implement accounting procedures  to insure  that equipment per the SAM




reports  is  reconciled  to the detail physical inventory equipment list.




MDH believes  they have adequate  controls to reconcile the physical inven-




tory with the property control records.  We believe  the recommendation




should be implemented  unless the cost would be prohibitive.








The Agency  did not submit to ATSDR an equipment listing detailing




items that  cost  over $1,000 for  the Cooperative Agreement U61/CCU700563




as required per  the  Assistance Award Close-out Requirements.  How-




ever, the Agency did submit a letter to ATSDR stating that no equip-




ment costing  over $1,000 was purchased during the period 4/1/86 -




3/31/87.  We  recommend the Agency  submit to ATSDR an equipment listing




detailing items  that cost over $1,000 for all periods of Cooperative




Agreement U61/CCU700563.  Also,  we recommend that the same is done




when Cooperative Agreement U61/CCU700735 is closed-out.   The Agency concurs




with our finding, and  intends to submit detail equipment listings for the




close-out of  each cooperative agreement.

-------
                                     BACKGROUND
The Comprehensive Environmental  Response,  Compensation and Liability  Act of  1980




(CERCLA)  established the Hazardous Substance Response Trust Fund (Superfund) to




provide monies for the identification,  prioritization,  and remediation of the




nation's  uncontrolled hazardous  waste sites.   The Superfund is  administered by the



Environmental  Protection Agency  (EPA).   The Department of Health and  Human Services




(HHS) receives an annual allocation from this Superfund trust fund.   HHS uses the




funds to  perform studies of  health related issues attributable  to hazardous waste.




Within HHS,  the Superfund program  is administered by  the Agency for Toxic Substances




and Disease  Registry (ATSDR)  and the National Institute of Environmental Health



Sciences  (NIEHS).








ATSDR and NIEHS are authorized to  award grants,  cooperative agreements or contracts




to states or private contractors to perform health related studies.   The Department's




Office of Inspector (OIG)  is required to attest  to the reasonableness of costs




claimed by the grantees and  contractors.   These  requirements are stated in  section




111 (JO of the Comprehensive Environmental Response Compensation and  Liability Act




(P.L. 96-510 CERCLA}.   CERCLA, as  amended by the Superfund Amendments and




Reauthorization Act of 1986  {P.L.  99-499 SARA),  provides for the recovery from




responsible  parties of response  costs  incurred by the Federal Government.  Response




costs generally include expenses for health studies,  investigatory clean-up,




enforcement  and administrative activities.

-------
ATSDR awarded two cooperative  agreements  listed below,  which were  in  effect  for




the period July  12,  1983  through September 29,  1987  to  the Missouri Department




of Social Services,  Jefferson  City,  Missouri:




   Cooperative Agreement         Cooperative Agreement         Federal  Funds




          Number                       Period                  Authorized
     061/CCU700563




     U61/CCU700735
7/12/83 to 3/31/87




5/13/85 to 9/29/87
$943,091




$568,880
Chemical wastes containing 2,3,7,8-tetrachlorodibenzo-p'-dioxin  (dioxin)




originating from the NEPACCQ/SYNTEX  plant at Verona, Missouri  in 1971 were




widely distributed over a several month period  throughout  southwestern and




eastern Missouri.  During 1971, numerous domestic and wild animals died in the




vicinity of these areas sprayed with the contaminated waste oil.  The Missouri




Department of Health and the Center  for Disease Control  (CDC)  investigated the




toxic illness in 1971, but it was not until 1974 that CDC  identified the toxic




agent as dioxin.  The presence of dioxin in the soil had been  confirmed in 36




sites in Missouri, and there are approximately  100 additional  sites that were




under investigation by the U. S. Environmental  Protection  Agency and the




Missouri Department of Natural Resources.  The  major objective of this project




was to determine whether, and to what extent, health effects have occurred among




persons exposed to these dioxin contaminated areas.

-------
ARMICHAEL.	
 INGLE. WHITE Sc
 HOMPANY ":
2970 CUirmont Rd., N.E.
          Suite 780
  Atlanta. Georgia 30329
                               AUDITORS'  REPORT
 Mr. Emil A. Trefzger, Jr., C.P.A.
 Regional Inspector General for  Audit
 U. S. Department of Health and  Human  Services
 Office of Inspector General  - Region  IV
 101 Marietta Tower  Suite 1401
 Atlanta, Georgia 30323
 We have performed a financial and  compliance  audit  of  the  accompanying

 Schedules A and B, Summary of Costs  -  Cooperative Agreements  U61/CCU700563  and

 U61/CCU700735, presenting the Federal  share of  outlays submitted by Missouri

 Department of Health for the periods July  12,  1983  through March 31,  1987

 and May 13, 1985 through September 29,  1987,  respectively.  Our examination was

 made in accordance with generally  accepted auditing standards and the standards

 for financial and compliance audits  contained in the Standards for Audit of

 Governmental Organizations, Programs,  Activities, and  Functions 1981  Revision,

 issued by the U. S. General Accounting Office and accordingly,  included such

 tests of accounting records and  such other auditing procedures as we considered

 necessary in the circumstances.  We  did not examine the Federal share of outlays

 for the period July 12, 1983 through September  30,  1984 which constitutes 37%  of

 the total Federal share of outlays-Schedule A Cooperative  Agreement

 U61/CCU700563.  These Federal share  of outlays  were examined  by other auditors

 whose report thereon has been furnished to us,  and  our opinion expressed herein,

 insofar as it relates to the amounts included for the  Federal share of outlays

 for the period July 12, 1983 through September  30,  1984, is based solely upon

 the report of the other auditors.

-------
In our opinion, based upon our examination and the report of other auditors,

Schedules A & B present fairly the Federal share of outlays for the periods

July 12, 1983 through March 31,  1987 and May 13, 1985 through September 29,

1987, respectively.

This report is intended solely for the use of management, the U. 5. Department

of Health & Human Services, and  the U.S. Environmental Protection Agency.  This

restriction is not intended to limit the distribution of this report which, upon

acceptance by the U. S. Department of Health & Human Services, is a matter of

public record.
September 15, 1988
Atlanta, Georgia

-------
                                                                   Schedule A
                      DEPARTMENT OF HEALTH AND HUMAN SERVICES/
                           ENVIRONMENTAL PROTECTION AGENCY
                                   SUPERFUND AUDIT
                            MISSOURI DEPARTMENT OF HEALTH
                      SUMMARY OF COSTS - COOPERATIVE AGREEMENT
                                    U61/CCU700563
                 AUDIT PERIOD:  JULY 12,  1983 THROUGH MARCH 31,  1987
Personal  Service

Fringe Benefits

Contractual

Travel

Equipment

Supplies

Other  -

        Total Direct Costs

Indirect Cost

        Total
Budget
$116,006
29,228
613,131
33,698
38,456
4,204
51,497
$886,220
56,871
$943,091
Actual
$ 97,148
21,921
465,576
22,287
38,454
1,667
60,905
$707,958
46,557
$754,515
Variance
$ 18,853
7,307
147,555
11,411
2
2,537
(9,4C8)
$178,262
10,314
$188,576
Note:  The Cooperative Agreement approved by ATSDR allowed for line item differences
       in the budget.

-------
                                                                  Schedule A-1
                      DEPARTMENT OF HEALTH AND HUMAN SERVICES/
                           ENVIRONMENTAL  PROTECTION AGENCY
                                   SUPERFUND AUDIT
                            MISSOURI DEPARTMENT OF HEALTH
                      SCHEDULE OF COSTS - COOPERATIVE AGREEMENT
                                  U61/CCU700563-01
               AUDIT  PERIOD:  JULY 12,  1983 THROUGH SEPTEMBER 30, 1984
Personal Service

Fringe Benefits

Contractual

Travel

Equipment

Supplies

Other

        Total Direct Costs

Indirect Cost

        Total
Budget
S 75,372
19,597
208,562
7,960
38,456
1,990
8,555
$360,492
38,213
$398,705
Actual
$ 51,247
12,024
142,248
11,342
38,454
490
675
$256,480
25,610
$282,090
Variance
$ 24,125
7,573
66,314
(3,382)
2
1,500
7,880
$104,012
12,603
$116,615
Note:  The Cooperative Agreement approved by ATSDR allowed for line item differences
       in the budget.
                                        10

-------
              MISSOURI DEPARTMENT OF HEALTH
•  v»
I  S

II
iM

!!
i!
 W5

III
    i
    !
    C


    I



    is

I « O
III
«s£

Me
 £1
FINANCIAL STATU

>~*ll>w tMlnKlMM P«
    D

    = s
    g^
       4?

       15
    h
    i'g

    {^

    IN
    I £ 3 >'
    ! 1=0 r
     •-. C x C
     u c o

          2
            Sl

           ^
                f:
                !
                !
                  !
                     S

                         \
»s

Ii
I'-
ll

1!
i!
il
                                  »

                                  I
                                    >

                                    5:
           s
                                      g
                                          £3 "
                                          H
                •-J
                i  ,
               !?
                                           i
                                             *?
                                             if Ji
                                             »» ^

                                             1*
                                             =u
                                            Hi
                                          •iii!
                                           |Ifa
                                           Ills
ivn or un

tflf** '*"
                                              i.
                                                 Si
                        11

-------
MISSOURI DEPARTMENT OF HEALTH

















C
X
O
•*•»
~
t














N
M
i
s ri

*.
11
D .
i

E
«r 2
£ *?
1
1 E
! c

'i 5
: "
i
j
s
>
i
5 S
H
2 5
s v.
3 g-
a|l
hi
ii
iv|
i ^
j u b
{ - -
b ^



DC

3
£1
FINANCIAL STATUS 1
(FfUtui iiulnulw** •» If" 1

§
J
D
i
!°

cD

>•
|G
4
1
j
1
f
I
i
3
S
s
Ig
!
IT



i
!
^
i?
ii
s s
i;
-



a
s


i
0
c




•i


I
4
1
1
I
I



4



M
o





Is
12
.• *
1 5
!
|


in
ice
i*
Js
S


-
4s
3^
7
Is

1
» uk
" 8

•} •«
' O
llCinlirt OMMIIUIIOM l*««« .-4 (••>»!<«• *«•—
I'issiiuri Mcp.inncnt of Social S
l>) vision of Health
r.o. j;ox S7n
Jefferson fity, fUssouri f:5in2
-

















s
b
IS
s
I
ft













e
•
a«
|5






5





7


s




2




S

t>

•<•

•*
ji
PNOGftAMS/rUNCTlONS/XCTIVniCS f




J





«»





»


~




«*




<•



c


•*
t
1
A

ft
i
ri
c:



























t

1


1
i
t
1
4



c



























1
c
1


j
•1

r-.

-------
                                   SCOPE  OF AUDIT




The audit procedures referred  to  herein  were performed under contract with  the U. S.




Department of Health and Human Services,  Office of  Inspector General, to determine if




the Missouri Department of Health properly:




    - disbursed Federal funds  awarded  in accordance with EPA laws and



      regulations;




    - reported costs claimed on the  Financial  Status Report;




    - administered the cooperative agreement in accordance with the




      principles of economy and efficiency; and




    - adequately monitored program activities.




To accomplish the audit objectives:




    - reviewed Single Audit Act audit  reports  and the applicable workpapers,



      and held discussions with the  auditor-in-charge;




    - examined the Financial Status  Reports;



    - reviewed Federal legislation pertaining  to the Superfund (Hazardous




      Substance Response Trust Fund);  and




    - applied detailed audit procedures  at the Missouri Department of Health.




Two subrecipients, St. Louis University  Medical School and Allied Health Consultants,



were judgementally chosen to be audited.  These subrecipients represent approximately




43% and 42% of all cooperative agreement  costs incurred by the Missouri Department of




Health during the audit periods July 12,  1983  through March 31, 1987 and May 13,  1985




through September 29, 1987, respectively.  We performed the audit procedures in




accordance with generally accepted auditing standards, and in accordance with audit




standards and requirements for financial  and compliance audits set forth in the



Standards for Audit of Governmental  Organizations, Programs, Activities and Functions




1981  Revision, issued by the U. S. General Accounting Office.  In selecting sample




items for testing, we used non-statistical sampling techniques.

-------
                                                                  Schedule A-2
                     DEPARTMENT OF HEALTH AND HUMAN SERVICES/
                          ENVIRONMENTAL PROTECTION AGENCY
                                  SUPERFUND AUDIT
                           MISSOURI DEPARTMENT OF HEALTH
                     SCHEDULE OF COSTS - COOPERATIVE AGREEMENT
                                 U61/CCU700563-02
               AUDIT PERIOD: OCTOBER 1, 1984 THROUGH MARCH 31, 1986
Personal Service

Fringe Benefits

Contractual

Travel

Equipment

Supplies

Other

        Total Direct Costs

Indirect Cost

        Total
Budget
$ 37,134
8,854
347,433
22,138
2,214
39,942
$457,715
17,083
$474,798
Actual
$ 42,477
9,154
267,773
8,375
1,177
56,847
$385,803
19,406
$405,209
Variance
$ (5,343)
(300)
79,660
13,763
1,037
(16,905)
$ 71,912
(2,323)
$ 69,589
Note:  The Cooperative Agreement approved by ATSDR allowed for line item differences
       in the budget.
                                        13

-------
   I


   M
i:
 3

 o
   ft

   

          I*
       '

              31
 s


j
              o
              I
                   4
       o
        I
                      in
                      in
                      o\
o
 I
                         4
                             in
                             in
                            8
                                o
                                in
                                in
                                m
                                an
                                   o
                                   o
                              4
o
J
                                      (*>


                                      in
                                      m
                                      3
                                      an
o
                                    4
                          4
                                         4
                                            o
                                             t
                             4
o
 I
                      4
                      4
                                          4
                                               4
                                                  o
                                                  in
                                                  
-------
   M
t

D
li
i   1
I   3
i
S
n
\
*
      id

       2
          i
          •
        c

       1

        S
        vc

i

ii
i
           * a

           J3
            4r!i

            15


                   s
                           M
                           C*
                           8
                                  a
                                  2
                                  ID
                                  O

                                      Ut4JAKi.JrUnNTi' ur
                           (N
                           CM

                           S
                           M


                           8
                                      TT
                                       01
                                      4
M
IN
 %
in
o
                                  •J-'. 5

                                  rrw
                                                 UQ
                                                  4
                                          4
fM
fN

S
U1
O
§
                                                                     OS
       '9
      if
      si
                       s

TELEPHONE (Art*
                                                                             S
                                                                         D

                                                                        !ti
                                                                         [I
                                             15

-------
                                                                  Schedule A-3
                     DEPARTMENT OF HEALTH AND HUMAN SERVICES/
                          ENVIRONMENTAL PROTECTION AGENCY
                                  SUPERFUND AUDIT
                           MISSOURI DEPARTMENT OF HEALTH
                     SCHEDULE OF COSTS - COOPERATIVE AGREEMENT
                                 U61/CCU700563-03
                AUDIT PERIOD: APRIL 1, 1986 THROUGH MARCH 31, 1987
Personal Service

Fringe Benefits

Contractual

Travel

Equipment

Supplies

Other

        Total Direct Costs

Indirect Cost

        Total
Budget
$ 3,500
777
57,136
3,600
Actual
$ 3,424
743
55,555
2,570
Variance
$ 76
34
1,581
1,030
3,000
$68,013
1,575
3,383
$65,675
1,541
(383)
$2,338
34
$69,588
$67,216
$2,372
Note:  The Cooperative Agreement approved by ATSDR allowed for line item differences
       in the budget.
                                        16

-------
MISSOURI DEPARTMENT OF HEALTH
S
If
1_
»
II
*
S
i









i
s?
S S
£
1

3s
li
"i
S5
si










»
sf
ii

.2

*—


^


I
> _
I £
2 3
• rf1
3 =
I f
s S •*
* * —
:!"


M
i
i
P*
** *«
§ t
5 i
is*-
Ili
1* J
™*5 <
iz *
9 ii
a" i
•A t
1 3 !



^B %
5 s
I!
& i
* s
CA $
§1
1^ »
FINANCIAL S
f *WJ» ftfviMl 99 (Mff 1
i

l
3
a
* 1
sQ
*•


3
1°
3 S
S rQ
«
^••••••H
£
1
S
s
2
|i
• **
MCMMI UCMMI 1
P.C. Ho. 04
..




•
i 2
S l
S 2

s S
s 3
I i



!
N
I
i
j

1*8
ii iMiwMiaii (\<» ««•».
xiri department of
E. Cl« St.
§22
a-2C
Ml





i
j

«
3
»
e


—


1
f
!
^


i
t



.










a
3
•
o



^
\ ^
J *
1 5
I C
a
i,

3 ^
1 °


i
J 00
OB
1 i
1 ^
9
*™




1
J| f*^
J?
i S









3
•••
X
v«
i
MM
MM

;









a
s







i
s
M
3
<
M














Sl



!
•c
>
*


MMl nUCMII MCOUI 40*.





S





3




5


B
u
j
O
2


4
I
5
i
I
i
*









Mt
i
|

^



t
«•





M




w



i
a
i


¥•



I
!



,
«
I
j

3
!
i
i
a




.,
5













r*

•o





I
1
l
i
1
i
i






i

j
2
a
jl
ii
i





o














?






5
^









^
a




p*
CH













r*

*O





i_
Ij
i!
si








i
ii
i!
S3
il
i




s
n
4













•*
?
•A





11
i-









s
4
i
i
i





i
e
i














4






i
1
]
£





jf
|
5 3
ll
2*
n
I

s


rs
m
r%













*»
VI
i£





|
1.



•




|
32
li
3;
il
§" i
I

^



i
e














^











§
2

S

afi
IM PHOGMU lUCOUi MUU
|.
a M
*«* ^
*


i
e














i






ii
ji
-1





">
1

1^
1
I
a
!l
a ):
3 •
*


4














4






I
*
i














.»
•M
CM
*













^
r*






1
L
It
H
S~ j
*














s
CD
S







•





s
09

t«i













•»
9*






\
I
9
}
1














i
!
i
t
1 1
S f
tt »
If

m
a

a
a
i
i
i
S
8
1
a




a
s
w .1
a v
J









i




!i
|5
il
t 4
I
i*3
• i *
ill

s-
1*
3 S
ii

^ ,
1 °
i 5
*



^
^
22
s
I
s
i














j
i |
sis

!• S

a| i


S§
4rf <*4
ss
w "
M U
s««
5^»
. d
til
n**
* -
Is*

l!i
w




i
i



-------
                                                                  Schedule B
                     DEPARTMENT OF  HEALTH AND HUMAN SERVICES/
                          ENVIRONMENTAL PROTECTION AGENCY
                                  SUPERFUND AUDIT
                           MISSOURI DEPARTMENT OF HEALTH
                     SUMMARY OF COSTS  - COOPERATIVE AGREEMENT
                                    U61/CCU700735
               AUDIT PERIOD: MAY  13,  1985 THROUGH SEPTEMBER 29, 1987
Personal Service

Fringe Benefits

Contractual

Travel

Equipment

Supplies

Other

        Total Direct Costs

Indirect Cost

        Total
Budget
$ 80,736
18,654
360,704
29,900
12,404
6,500
23,650
$532,548
36,332
$568,880
Actual
$ 91,704
19,903
260,130
15,517
9,013
1,050
97,309
$494,626
38,758
$533,384
Variance
$(10,968)
(1,249)
100,574
14,383
3,391
5,450
(73,659)
$ 37,922
(2,426)
$ 35,496
=5====S5
Note:  The Cooperative Agreement approved by ATSDR allowed for line item differences
       in the budget.
                                        18

-------
MIM M *IMI HMIIf
M*
I/CCU70071J-HI-S
if
M I
1


]i

a -
la
•I


1
! 7



U
 > •
 b* 
IAL S
•• UM
* C
il

| ^
3 "
     i?

     1?
•»
 •    f»
 i    ®
 II  2
     o
  S

pi  i
I" •*
i«l •   •
ix •*  >•
I-SoS
S°5SU
 J3«§
 o.«* o <•
.Jt "" S
*  • • »M
f • > O 
-------
lARMICHAEL.
  INGLE. WHITE &.
   iOMP.ANY lv
2970 Clairmont Rd., N.E.
          Suite 780
  Atlanta. Georgia 30329
                             AUDITORS'  REPORT ON COMPLIANCE

  We have examined Schedules A & B,  Summary of Costs - Cooperative Agreements

  U61/CCU700563 and U61/CCU700735 presenting the Federal  share of  outlays submitted by

  Missouri Department of  Health for  the period July 12,  1983  through March 31,  1987,

  and May 13, 1985 through  September 29,  1987,  respectively,  and have issued our report

  thereon, dated September  15,  1988.    Our examination was made in accordance with

  generally accepted auditing standards and the standards for financial  and compliance

  audits contained in the Standards  for Audit of Governmental Organizations,  Programs,

  Activities,and Functions 1981  Revision,  issued by the  U. S.  General Accounting

  Office and, accordingly,  included  such tests of the accounting records and such other

  auditing procedures as  we considered necessary in the circumstances.




  The management of the Missouri Department of Health is  responsible for their

  compliance with laws and  regulations.   In connection with the examination referred to

  above, we selected and  tested transactions and records  pertinent to Schedules  A & B,

  Summary of Costs - Cooperative Agreement U61/CCU700563  and  U61/CCU700735,  presenting

  the Federal share of outlays  submitted by Missouri Department of Health for the

  period July 12, 1983 through  March 31,  1987 and May 13,  1985  through September 29,

  1987,  respectively.  The  purpose of  our testing of transactions  and records from the

  program detailed above  was to obtain reasonable assurance that the Missouri

  Department of Health had,  in  all material respects,  administered the programs  and

  executed the tested program transactions,  in compliance with  laws and  regulations,

  including those pertaining to financial reports and claims  for advances and

  reimbursements, noncompliance with which we believe could have a material effect on

  the allowability of program expenditures.
                                          20

-------
 Our testing of transactions and records selected from the program detailed above




 disclosed instances of noncompliance with those laws and regulations.  All instances




 of noncompliance that we found are identified in the Findings and Recommendations




 section of this report, (page 25).








 In our opinion, subject to the effect of the ultimate resolution of those instances




'of noncompliance referred to in the preceding paragraph,  for the period of July 12,




 1983 through September 29, 1987 for the items tested, the Missouri Department of




 Health administered the above programs in compliance, in all material respects, with




 laws and regulations, including those pertaining to financial reports and claims for




 advances and reimbursements,  noncompliance with which we believe could have a




 material effect on the allowability of program expenditures.  With respect to the




 transactions and records that were not tested by us, nothing came to our attention to




 indicate that the Missouri Department of Health had not complied with laws and



 regulations other than those laws and regulations for which we noted violations in




 our testing referred to above.








 This report is intended solely for the use of management,  the U. S.  Department of




 Health & Human Services, and the U.S. Environmental Protection Agency.  This




 restriction is not intended to limit the distribution of  this report which,  upon




 acceptance by the U. S. Department of Health & Human Services,  is a matter of public




 record.
 September 15,  1988



 Atlanta,  Georgia
                                         21

-------
                                                                       297°
ARMiCHAEL.
 INGLE. WHITE &.                                                                     ivute 
-------
Our study included all of  the applicable  control categories  listed above.   The




management of the Missouri Department  of  Health is responsible  for  establishing  and




maintaining internal control systems used in administering federal financial




assistance programs.  In fulfilling that  responsibility, estimates and  judgments  by




management are required to assess the  expected benefits and  related costs of control




procedures.  The objectives of  internal control systems used in administering federal




financial assistance programs are to provide management with reasonable, but not




absolute, assurance that, with  respect to  federal financial  assistance  programs,




resource use is consistent with laws,  regulations, and policies; resources are




safeguarded against waste, loss, and misuse; and reliable data is  obtained,




maintained, and fairly disclosed in reports.








Because of inherent limitations in any system of internal accounting and




administrative controls used in administering federal financial assistance programs,



errors or irregularities may nevertheless  occur and not be detected.  Also,




projection of any evaluation of the systems to future periods is subject to the risk




that procedures may become inadequate  because of changes in  conditions or that the




degree of compliance with the procedures may deteriorate.








Our study and evaluation of the internal control systems was limited to a review of




the audit work performed by other auditors whose report thereon has been furnished to




us, and a review of the systems to obtain  an understanding of the  control environment




and the flow of transactions through the accounting system.  Internal control




weaknesses identified in the review of audit work performed by other auditors were




considered in determining the nature,  timing, and extent of  the audit tests
                                        23

-------
to be applied  in our examination of Schedules A & B,  Summary of Costs -  Cooperative
Agreements  U61/CCU700563  and U61/CCU700735 presenting the Federal  share  of  outlays
submitted by the Missouri Department of Health for the period July 12,  1983 through
March 31, 1987 and May 13,  1985  through September 29,  1987,  respectively.   In
addition, these above mentioned  weaknesses were considered during  our examination and
review of the  Missouri Department of Health's compliance  with laws and regulations,
noncompliance  with which  we believe could have a material effect on the  allowability
of program  expenditures.   This report on internal control does  not affect our reports
on Schedules A & B,  Summary of Costs - Cooperative Agreements U61/CCU700563 and
U61/CCU700735  and on the  Missouri Department  of Health's  compliance with laws and
regulations dated September 15,  1988.   Accordingly, we do not express an opinion on
the system  of  internal accounting control.  However, our  study  and evaluation and our
examination disclosed no  condition that we believe to  be  a material weakness in
relation to the above programs of the Missouri Department of  Health.
                                                         *

This report is intended solely for the use of management,  the U. S. Department    of
Health & Human Services,  and the U.S.  Environmental Protection  Agency.   This
restriction is not intended to limit the distribution  of  this report which,  upon
acceptance  by  the U.  5. Department of  Health  & Human Services,  is  a matter of public
record.
September 15, 1988
Atlanta, Georgia
                                                         ~
                                        24

-------
                           FINDINGS AND RECOMMENDATIONS




1.  EQUIPMENT CONTROL SYSTEM DEFICIENCIES




The Agency is required by both federal and state regulations to maintain a system for




managing equipment until transfer, replacement, or disposition takes place.  During




the audit of property/equipment, inadequacies were discovered with regard to the




timely reporting of dispositions to property control personnel.  Controls have not



been implemented within the equipment control system to insure that dispositions are




properly recorded and that existing equipment is safeguarded against theft, loss, or




unauthorized transfer.








45 CFR Part 74.140(c), states: "A control system shall be in effect to insure




adequate safeguards to prevent loss, damage, or theft of the equipment."








It is possible that equipment can be disposed of or transferred without proper




accounting in the existing equipment control system.




Recommendation



The Agency should incorporate stricter controls within the existing equipment control




system to insure that the property control personnel receive timely information




regarding equipment transfers and dispositions.




Auditee's Comments



On March 1, 1989, the Missouri Department of Health provided written comments to our




preliminary findings and recommendations. (See Appendix A for the complete text of




MDH's comments.)  MDH agreed with the recommendation to incorporate stricter controls




to ensure dispositions of property are reported timely and physical, inventory and




reconciliation are performed annually.  MDH stated it would require completion of



Form DH-60, Non-Expendable Property Transfer, to be forwarded to the property control




officer.
                                        25

-------
Auditors' Response








These actions by the Missouri Department of Health, in our opinion, are positive




measures which will enhance the financial management of the Department's resources,




and will contribute to better ensure the integrity of assets.
                                        26

-------
2. NO RECONCILIATION OF ANNUAL PHYSICAL INVENTORY




During  the  course of the audit of property/equipment,  inadequacies  were noted  with




regard  to the implementation of the Agency's equipment management system.   The




Agency  does not  reconcile the annual physical inventory to  the  State-Wide




Accounting  for Missouri (SAM) reports.   The SAM reports do  not  have accounts




set up  that distinguish equipment purchases over $1,000.  Therefore, other  means




were used to account for all equipment.
Per  "Accounting  for Nonexpendable Property in Missouri  State Agencies", issued by the




Office of  the  State Auditor of  Missouri,  each state  agency shall perform an annual




physical inventory, accounting  for all  acquisitions  and dispositions in the interim.








Recommendat i on




We recommend that  the  Agency reconcile  annual inventory counts to the SAM reports




and  accounting records and  account for  any discrepancies  to insure adequate safe-




guarding of Federal assets.   These accounting records should, at a minimum,




include a  description  of  the equipment, an identification number, identification




of the grant under which  the recipient  acquired the  equipment, the information




needed to  calculate the Federal share of  the  equipment, acquisition date and



unit acquisition cost,  location,, use and  condition of the equipment, and all




pertinent  information  on  the ultimate transfer,  replacement, or disposition of




the  equipment.




Auditee's  Comments




In commenting  on our draft  report,  the  Missouri  Department of Health believes they




are performing adequate procedures to reconcile  the  physical inventory with the



property control records.   (See Appendix  A for the complete text of MDH's comments}.

-------
Auditors' Response




In our opinion, our recommendation should be enacted unless the cost of implementing




our recommendation would exceed  its benefits.
                                        28

-------
3. NO CLOSE-OUT SUBMISSION OF EQUIPMENT LISTING




As required per the Assistance Award Close-out Requirements an equipment listing




detailing items that cost over $1,000 must be submitted to ATSDR  for Cooperative




Agreement U61/CCU70Q563  .  The Agency misinterpreted the requirement and submitted a




letter to ATSDR stating  that no equipment costing over $1,000 was purchased during




one of the three FSR periods, April 1, 1986 through March 31, 1987.  Since ATSDR




accepted this letter and did not request any further information, the Agency thought




it had fulfilled its close-out responsibilities for equipment.








Recommendation




We recommend the Agency  submit to ATSDR an equipment listing detailing items that




cost over $1,000 for all periods of Cooperative Agreement U61/CCU700562.   Also,  we




recommend that the same  is done when Cooperative Agreement U61/CCU700735 is




closed-out.








Auditee's Comments




In commenting on our draft report, the Missouri Department of Health agreed with our




recommendation.  (See Appendix A for complete text of MDH's comments).  The




Department had, originally, misinterpreted the requirement.








Auditors' Iteponse




In our opinion, Missouri Department of Health's intention to prepare a detail




equipment listing for each cooperative agreement will meet the Assistance Award




Close-Out Requirements.
                                        29

-------
    !;•*•   Missouri Department of
                             n_
    APPENDIX A
   John Ashcroft
    Governor

Robert Harmon, M.D.
     Director
P.O. Bon 570, Jefferson City, MO 65102 • 314/751-6400
                                                           March 1,  1989
    Mr.  Emil A. Trefzger, Jr.
    Regional Inspector General
    For  Audit Region IV
    Department of Health and Human Services
    Region IV
    P.O. Box 1704
    Atlanta, Georgia 30301

    Dear Mr. Trefzger:

    RE:  A-04-88-04068

         I have received and reviewed your draft audit report
    regarding the above audit of the cooperative agreements U61-
    CCU700563 and U61-CCU700735 for the  period July 12, 1983 through
    March 31, 1987 and May 13, 1985 through  September 29, 1987. The
    following are my responses to the findings and recommendations
    contained in the report:

         1. EQUIPMENT CONTROL SYSTEM DEFICIENCIES

            We concur.  We have since improved the controls to ensure
            dispositions are reported timely and physical inventory
            and reconciliation are performed annually.

            Department policy requires the transferring unit to
            complete a Nonexpendable Property Transfer form, DH-60,
            and forward it to the property control officer for
            equipment they plan to transfer  or dispose of.  The
            reconciliation of the physical inventory to the property
            control records would highlight  this item and resolve the
            matter.  The division director and bureau chief are held
            accountable and have to explain  what happened to the
            items not located.

         2. NO RECONCILIATION OF ANNUAL  PHYSICAL INVENTORY

            On September 28, 1985, the Division of Health became the
            Department of Health.  The Department of Health (DOH)
            began retagging all items in October, 1985 and into 1986.
            We feel this actually constituted an inventory.  All
            items that were listed on the Department of Social
            Services inventory were given DOH numbers and loaded onto
            our system.  Another physical inventory was conducted in
            early 1988 and reconciled to the property control
            records.                                      ;          •.•
                                                        MAR  -• 1989
                                                                      i I
                       AN EQUAL OPPORTUNITY/AFFIRMATIVE ACTION EMPLOYER

-------
                                 2  -
                                                         APPENDIX A
        Per 15CSR 40-2.031 Control of Nonexpendable Property, we
        are required to reconcile the physical inventory with the
        property control records.  We are  not required to
        reconcile to the SAM reports.  Equipment purchases are
        expensed in the SAM reports when purchased.  SAM reports
        accumulate expenses incurred during the fiscal year.  It
        would be impossible to  reconcile the physical inventory
        to the SAM reports for  the number  of years involved.

        The inventory control records indicate the identification
        number, description of  the item, acquisition date, unit
        requisition cost, location and federal program code.

        We recently implemented the federal program code
        identification to know  from what federal program the
        property was purchased.  Prior to  this time, the property
        was identified as being purchased  with state or federal
        funds .

     3. NO CLOSE-OUT SUBMISSION OF EQUIPMENT LISTING

        We concur.  This was due to a misinterpretation of the
        requirement.
                              Sincerely
 J
£cn~-
/
                              Robert G.
                              Director
,  M.D.,  M.P.H.
RGH:AWT:jar
P.S. Since these findings are not material, we do not feel the
     need for an exit conference.
                                 31

-------