Audit Report on Cash Accountability and Controls at the Department of Health and Mental Hygiene Office of Vital Records

Audit Report In Brief

This audit determined whether the Department of Health and Mental Hygiene (DOHMH) had adequate cash control practices in its Office of Vital Records (OVR).  DOHMH’s programs and activities include: health information and laboratory services; inspecting, permitting, licensing, and monitoring a wide range of enterprises related to public health; and maintaining the City’s health-related vital statistics.  OVR registers and issues birth and death certificates.

OVR is composed of five units: the Public Service Office (PSO), the Corrections unit, the Registration unit, the Records Management unit, and the Customer Relations unit.  PSO is responsible for issuing birth certificates on the spot as well as for processing, in the Cash Management System (CMS) system, fees collected by other OVR units (Corrections and Registration).  PSO has five subunits: the Cashiering unit, the Mail Reading unit, the Credit Card unit, the Search unit, and the Customer Service unit.  PSO prints short-form birth certificates, Records Management copies long-form birth and death certificates, and Registration issues original death certificates.

In Fiscal Year 2005, according to the transactions recorded in the CMS system, OVR collected about $12 million in revenue from the issuance of birth and death certificates.

OVR had adequate controls over the registration and issuance of certified copies of death certificates and burial permits at the Registration unit.  In addition, moneys collected by OVR units were deposited in the bank in a timely manner.

However, OVR cash controls had several weaknesses.  OVR needs to improve its internal controls over transactions processed through its Cashiering, Mail Reading, Credit Card, Corrections, and Records Management units.  The weaknesses included weak recordkeeping practices, inadequate controls over blank certificates used for short-form birth certificates, inadequate tracking of long-form copies of vital records, inadequate controls over the handling of fee waivers during in-person transactions, and weak cash management practices.  As a result, OVR has limited assurance that it has collected all the money that it is due for the issuance of certificates.

To address these issues, the audit recommends, among other things, that DOHMH:

• Ensure that applications processed in the CMS system are properly maintained to account for all the certificates issued and revenue collected.
• Ensure that supervisors reconcile daily the number of blank short-form certificates used according to the Computer Terminal Daily Worksheets (CTDW) forms completed by OVR operators and the number of certificates issued according to the CMS system.
• Establish a procedure for reconciling the long-form copies of certificates issued by the Records Management unit to the applications processed by the CMS system to ensure that copies are only issued for certificates processed by the Cashiering, Mail Reading, and Credit Card units.
• Revise the fee-waiver approval form to specifically ask for information on the reason for the fee waiver and on the evidence that was provided to justify the waiver.
• Ensure that the supervisor who prepares deposits and does the final reconciliation does not process any applications in CMS during the same day.

DOHMH agreed with six of the 11 recommendations, partially agreed with two recommendations, and disagreed with three recommendations.