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Texas Department of Health
William R. Archer, III, M.D.
Commissioner of Health 1100 West 49 Street TEXAS BOARD OF HEALTH
Patti J. Patterson, M.D., M.P.H. Austin, Texas 78756-3199 Walter D. Wilkerson, Jr., M.D., Chairman
Executive Deputy Commissioner (512) 458-7111
http:/www.tdh.state.tx.us Mary E. Ceverha, M.P.A., Vice-Chair
Mario R. Anzaldua, M.D.
J.C. Chambers
David L. Collins, P.E.
Ruth F. Stewart, M.S., R.N.C.
January 13, 1999
Lawrence F. Alwin, CPA, State Auditor
Office of the State Auditor
Two Commodore Plaza
206 East Ninth Street, Suite 1900
Austin, Texas 78701
Dear Mr. Alwin:
We are pleased that you have recognized the significant improvements we have made in the management
of the MCH Block Grant. While we agree that we can continue to improve in some areas, we believe our
cash management policy simply allowed the use of all funds appropriate for the purposes intended and that
federal dollars have been maximized over the long term. Our comments on the issues in your report follow.
Maximize Federal Funding
The Department consulted with staff members of the Senate Finance Committee, Speaker's Office,
Legislative Budget Board, Governor's Budget and Planning Office, and Health and Human Services
Commission on this issue during Conference Committee deliberations. In the future, the Department will
follow the same process to ensure adherence to legislative intent and the delivery of services to meet the
medical needs of mothers, infants, children with special health care needs, and others impacted by these
appropriation strategies.
Contract Administration, Performance Measurement, Human Resource Management
The Department has made significant improvements in all of these areas in recent years. Although the
conditions noted in your report are not material in terms of overall program management, we welcome the
opportunity to make appropriate improvements in internal controls aimed at reducing errors and
inconsistencies like those reported.
We appreciate the opportunity to respond to your report. If you have any question or if we can be of
as istance, please contact Frank E. Ditmore, Director, Internal Audit Division.
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ATTACHMENT
AN AUDIT REPORT ON THE MATERNAL AND CHILD HEALTH
JANUARY 1999 BLOCK GRANT AT THE TEXAS DEPARTMENT OF HEALTH PAGE 1