Results in Brief

The Bureau has not complied with state and federal laws significant to the administration of programs for the prevention and treatment of alcohol and drug abuse. For instance, the Bureau has not adequately planned for the development and distribution of prevention and treatment services. In addition, liquor tax funds have not been awarded according to statutory priorities. As a result, the State has little assurance funding is directed to areas of the State with the greatest need or that individuals in high-risk groups receive the services required.

The Bureau also lacks adequate information to monitor the availability of services and determine compliance with spending requirements for high-risk groups. For example, the Bureau lacks information regarding the referral of pregnant women and intravenous (IV) drug users to available treatment providers. In addition, information was not available to show that required amounts were spent on women’s services, and tuberculosis (TB) and HIV programs. Furthermore, we could not substantiate the amounts reported by the Bureau as spent on drug and alcohol abuse prevention and treatment.

Finally, the Bureau has not complied with laws and regulations related to the proper administration of state agencies. For example, the Bureau has not provided adequate control over revenues, oversight of employee performance, and proper access to public meetings.Furthermore, the Bureau has failed to establish a system of financial and administrative controls as required by state law.

Principal Finding

· The Bureau has not prepared a comprehensive state plan for the development and distribution of services as required by state law. In addition, the Bureau’s assessment of the State’s needs fails to meet all federal requirements. Furthermore, liquor tax funds were not awarded according to statutory priorities. (page 9)

· The Bureau has not complied with federal regulations for its Substance Abuse Prevention and Treatment block grant regarding high-risk, targeted groups. Specifically, the Bureau has not developed procedures for treatment programs for TB, HIV, and pregnant women’s services. In addition, the Bureau did not adequately monitor providers to ensure appropriate services were provided. Furthermore, the Bureau did not publicize the availability of services to pregnant women or ensure IV drug user outreach programs were instituted by treatment providers. (page 12)

· The group home revolving loan fund has been poorly managed. For example, the Bureau lacked adequate documentation for approved loans. In addition, the Bureau did not ensure the fund manager tracked borrowers’ repayment of loans or contacted borrowers when payments were missed. Finally, the fund manager failed to remit quarterly bank statements when required. Since 1990, only 3 of 14 loans have been repaid in full; the other 11 loans are in default. (page 16)

· The Bureau did not ensure the state’s peer review program complied with federal regulations. For example, the Bureau has not developed procedures for peer reviews or ensured reviews were conducted in compliance with federal regulations. (page 17)

· Unallowable audit costs for 3 of 10 providers tested were charged to the providers’ grants. The audit costs were paid using federal block grant funds, which is not allowed by federal guidelines if the provider spends less than $300,000 in federal funding during the year. (page 17)

· The Bureau’s information system does not provide the information necessary to monitor the availability of services to high-risk groups. For example, the Bureau lacks information to ensure pregnant women and IV drug users are admitted for treatment within appropriate time frames or to refer these clients to other available programs. (page 18)

· The Bureau cannot demonstrate that it spent the required amounts for women’s services, and TB and HIV programs because of incomplete data. In addition, the Bureau uses an inappropriate method for determining and reporting amounts spent for drug and alcohol prevention and treatment. (page 19)

· The Bureau did not always seek reimbursement for personal long distance telephone calls made by employees as required by state law. We found over 75 personal long distance calls made by one employee during fiscal year 1999 that were not reimbursed. Although the cost of the calls was minimal, making personal long distance calls at state expense is a misuse of state funds. (page 24)

· The Bureau has not established current work performance standards or completed annual employee performance evaluations for all employees as required by state laws and regulations. We found work performance standards were outdated for six of eight classified employees we tested. (page 25)

· The Bureau did not comply with the Open Meeting Law for the Advisory Board on Certification. We found portions of Board meetings were closed to the public for discussion and decision-making for items that are not confidential by law. In addition, the Bureau did not post an agenda or prepare minutes of one Board subcommittee meeting. Finally, the agendas for Board meetings did not provide for public comment. (page 25)

·
A comprehensive system of administrative and financial controls has not been established, as required by NRS 353A.020. The Bureau was not able to provide us with current, complete, and approved copies of policies and procedures related to most of the compliance problems noted in this report. In addition, management turnover, staff vacancies, and recent reorganization at the Bureau have contributed to the lack of adequate financial and administrative controls. (page 26)

Department of Human Resources

Health Division

Bureau of Alcohol and Drug Abuse

Agency Response

to Audit Recommendations

Recommendation Number		Accepted	Rejected
1	Develop procedures to ensure state and federal require-ments related to planning and needs assessment are met	X
2	Develop and implement procedures to ensure liquor tax funds are awarded according to the priorities outlined in statute	X
3	Develop procedures related to TB, HIV, and pregnant women’s services, as required by federal regulations	X
4	Develop and implement procedures to monitor providers, and follow-up with providers found not in compliance with TB, pregnant women, and IV drug user requirements	X
5	Publicize the availability of services and treatment preference for pregnant women and ensure treatment providers conduct activities to encourage IV drug users to seek treatment	X
6	Require providers of HIV, TB, and women’s services to seek payment from sources other than federal grant funds and monitor the providers’ efforts	X
7	Monitor the revolving loan fund and develop procedures to ensure compliance with regulations related to the fund	X
8	Develop procedures for conducting peer reviews and monitor the conduct of the reviews	X

Recommendation Number		Accepted	Rejected
9	Develop and implement procedures to ensure unallowable audit costs are not paid with federal grant money	X
10	Develop and implement a system to track available treatment capacity for pregnant women and IV drug users	X
11	Develop and implement procedures designed to ensure providers comply with requirements related to services to pregnant women and IV drug users seeking treatment	X
12	Develop and implement a system to track funding of and expenditures on HIV, TB, women’s services, and alcohol and drug prevention and treatment to ensure compliance with federal requirements	X
13	Develop and implement policies and procedures to ensure receipts are deposited into the correct revenue accounts in the time frame required by state law	X
14	Develop and implement policies and procedures to ensure prenumbered receipts from the State Printing Division are written for all money received; all receipts are accounted for; and voided receipts are properly explained, reviewed, and approved	X
15	Develop and implement policies and procedures to ensure the cash receipts log is adequately protected and controlled and is reconciled to deposit by a person independent of the receipt and deposit process	X
16	Develop and implement policies and procedures to ensure telephone billings are reviewed to detect personal long distance telephone calls made at state expense, and the State is reimbursed for these calls	X
17	Review, revise, and obtain approval for classified employee work performance standards, and perform annual employee performance evaluations	X
18	Post proper notices of all public meetings, close potions of meetings only when allowed by statute, and include all required elements in meeting minutes	X
19	Develop written procedures to carry out a system of administrative and financial controls as required by NRS 353A.020	X
Totals		19	0

Results in Brief

Agency Response

Number

Accepted

Rejected

Number

Accepted

Rejected