Overview
The Suffolk County Sheriff’s Department (SCSD) did not always ensure that it received an annual statistical summary from its healthcare vendor. During the audit period, SCSD did not receive the calendar year 2021 annual statistical summary from the healthcare vendor. If SCSD does not receive the annual statistical summary, SCSD might not identify, assess, and treat healthcare concerns, and it may not develop improvement plans.
Authoritative Guidance
Section 932.01(3) of Title 103 of the Code of Massachusetts Regulations (CMR) states, “The county correctional facility shall require that the health authority . . . submit annual statistical summaries.”
Reasons for Noncompliance
SCSD does not have policies and procedures in place to ensure that it obtains the annual statistical summaries from the healthcare vendor. SCSD management told us that they were still working with the healthcare vendor to obtain the annual statistical summary for calendar year 2021.
Recommendation
SCSD should establish policies and procedures to ensure that it obtains the annual statistical summaries.
Auditee’s Response
Although the Department provided the auditors with all of the statistical reports from the healthcare vendor that provided services to inmates between July 1, 2019 and February 28, 2021, it could not provide reports for the remainder of the audit period because Wellpath, its medical vendor for that period, failed to supply the Department with the information necessary to do so.
The Department’s contract with Wellpath covered March 1, 2021 through February 28, 2023, and required Wellpath to provide all information the Department needed to comply with its state and federal reporting requirements. After successfully bidding for the Department’s medical contract, Wellpath struggled to staff our facilities and failed to meet the contract’s reporting requirements. As a result of these and other breaches, and before the Department was notified about this Audit, the Department notified Wellpath of its breach, took steps to replace Wellpath at one facility location only 11 months into the contract and later terminated the entire contract. Wellpath is no longer providing inmate medical services to the Department.
The Department accepts the finding of non-compliance because it couldn’t produce the statistical reports requested, but it disputes that this was a result of not having sufficient policies and procedures in place to ensure we received them. We have annual statistical reports from every other healthcare vendor that contracted with the Department before and after Wellpath. Unfortunately, Wellpath was unable to live up to the terms of the contract, and the Department acted promptly and diligently to terminate the contract. The Department regularly sought these reports from Wellpath, and these requests continue even after the contracted was terminated. The failings of Wellpath should not be shifted to the Department given the appropriate actions taken before and during the onset of the Audit to address this issue and given the historical documentation detailing the Department’s regular receipt of the statistical information from other vendors.
Auditor’s Reply
The Office of the State Auditor (OSA) acknowledges that SCSD had issues with its former healthcare vendor, including difficulty in obtaining the required statistical summary. As noted above, under 103 CMR 932.01(3), SCSD is required to have its healthcare vendor submit annual statistical summaries to SCSD. Although SCSD contractually required its healthcare vendor to submit these summaries, it did not establish proper internal controls (i.e., policies and procedures) to ensure that its healthcare vendor complied with this contractual requirement. It is the responsibility of SCSD management to ensure that adequate and effective internal controls exist over all agency activities, including those related to contract compliance.
| Date published: | December 7, 2022 |
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