Public Health Integrated Audit

Published December 17, 2024

This report was updated on November 4, 2025. The previous version relied on employee evaluation data from the Human Resources data system which was missing records. The revised analysis supports the same conclusion that Public Health employee evaluation completion rates contributed to low rates at the County overall. For more information, see the errata memo.

The survey-level assessment of administrative practices at Public Health highlighted a mix of strengths and areas requiring improvement. While Public Health demonstrated effective grant management, procurement processes, and planned upgrades to enhance accessibility, persistent challenges—such as delays in employee evaluations, fragmented performance measures, incomplete fiscal documentation, and high-risk concerns around gift card oversight—hampered operational efficiency. Furthermore, data inconsistencies in the County enterprise information system exposed the division to avoidable risks. Addressing these issues will be critical to aligning administrative
practices with the division’s broader objectives and ensuring sustained effectiveness in delivering public health services to the County.

What was found:

Key areas for improvement included:

• Employee evaluations: Scheduled evaluations were not completed, limiting formal feedback on performance and employee growth.
• Performance reporting: Metrics were spread across multiple platforms, hindering public accessibility and reducing the effectiveness of performance reporting for stakeholders.
• Fiscal controls: Cash handling procedures were incomplete and did not reflect practice, while gift card accountability was reduced when confirmed solely by the custodian.
• Data integrity: Errors within the County’s information system elevated fraud risks and did not reflect an accurate organizational structure.

What was recommended:

We recommended that Public Health:

• Complete performance evaluations and set expectations for timely completion.
• Create a single source of performance reporting information.
• Strengthen fiscal controls and incorporate cash collection practices, workflows, and responsibilities.
• Monitor and report information system data errors.

Recommendation Update:

Nine months later, the Department emphasized the importance of annual employee evaluations with supervisors but were still working to update cash control procedures and performance reporting. Staff committed to reporting Human Resources data errors that impacted operations but not to tracking and reporting data about errors.

Audit Report

Public Health Integrated Audit

Follow-Up Reports

Follow-Up report published November 4, 2025

Recommendation Status

Of the six recommendations

RESOLVED: 1
Recommendations have been fully implemented. Auditor will no longer monitor.

IN PROCESS: 4
Recommendations are in progress. Auditor will continue to monitor.

ACCEPT RISK: 1
Management accepted the risk of not implementing the recommendation.