Health and Human Services Commission
A Review of Management Controls at the Texas Health and Human Services Commission
Overall Conclusion
Although the Commissioner has undertaken a major reorganization to accomplish the work as directed in the mandates of the 74th Legislature and achieved improvements in organizational management, control weaknesses exist in key functional areas of the Commission. During this time of transition, attention should be given to enhancing controls in operational areas of fiscal management, grant and contract management, information system coordination, performance measure management, and human resource management.
Key Facts and Findings
The Commission was established by H.B. 7, 72nd Legislature. The agency currently has an annual budget of over $5 million and 79 full-time equivalent employees. In addition to its other responsibilities, the Commission also serves as the State Medicaid Office and oversees $5.4 billion in federal Medicaid funds.
During the period of this review, the Commission has modified its organizational structure, accomplished a reduction in force, established an Operations Division, and prepared a work plan to guide its activities during the current fiscal year.
The Commission does not have adequate fiscal control over operations, grants, and contracts. Specific weaknesses exist in the forecasting and tracking of revenues, cost allocation methodology, monitoring and control of expenditures, and safeguarding and recording of fixed assets.
The Commission has not had a formal system to gather feedback from health and human services user agencies regarding the effectiveness of its coordinated projects in achieving service delivery goals. Further, the Integrated Data Base Network pilot project is not fully implemented, and plans have not been developed for a post-implementation review.
Controls have also been weak over policies and procedures, internal automation, compliance with Historically Underutilized Businesses guidelines, and the collection and utilization of performance measures. Also, improvements could be made in the management of the Commission's human resources.
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