HomeMy WebLinkAboutF0115 PH Follow Up Report (PUBLISHED 11-4-25)To request this information in an alternate format, please call (541) 330-
4674 or send email to internal.audit@Deschutes.org
Public Health Integrated Audit Follow-up: Strong
commitment to employee performance reporting,
exploring department reporting improvements
November 2025 Our 2024 audit of Public Health found compliance with
procurement policies, grant requirements, and safety meeting
standards. However, several areas presented risks to operational
efficiency, transparency, and accountability. 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.
Deschutes County Office of the Internal Auditor Page 1 of 4
Audit Follow-up Report: November 2025
Public Health Integrated Audit
Recommendation Status Key:
Initial finding: Employee evaluations serve as an important tool to enhance
employee engagement, satisfaction, and retention. County
personnel rules and most union agreements require employee
evaluations in a timely manner. Though the County as a whole
faced persistent delays in completing employee evaluations, the
Public Health completion rate was lower.
Recommendation: Public Health management should lead by example by
completing annual performance evaluations for all direct reports
promptly and setting a division-wide expectation for timely
completion of evaluations.
Update: The Public Health Director shared the audit results and set clear
expectations for evaluation completion at a January 2025
management meeting. A goal related to annual performance
evaluation completion has been added to each supervisor’s own
evaluation.
Initial finding: Performance measures help guide decisions, drive
improvements, and enhance understanding. Outcomes often
trigger evaluations to identify root causes and solutions. The
1
Resolved
4
In Process
1
Accept Risk
Management addressed risk.
Auditors will no longer monitor.
progress. Auditors will continue
to monitor.
not implementing the
recommendation.
Clear expectations for completing employee
performance evaluations in place.
performance reporting.
Deschutes County Office of the Internal Auditor Page 2 of 4
Audit Follow-up Report: November 2025
Public Health Integrated Audit
Public Health division had numerous performance measures, but
they were scattered across various reporting platforms, hindering
a clear understanding of the department's overall objectives.
Recommendation: The Public Health division should improve performance reporting
by developing a unified, public-facing report that aligns measures
with the updated strategic plan goals.
Update: Public Health is continuing to explore the best approach to
implement this recommendation, including the possibility of
creating a consolidated public-facing dashboard as recommended
within the constraints of available, curated data and capacity to
respond to numerous reporting requirements.
Initial finding: Cash controls practices were in place to prevent theft, but
incomplete procedures weakened these controls by relying solely
on staff experience and training rather than documented
expectations. There were some inconsistencies among Public
Health sections when documenting cash received by mail, and
staff used a generic receipt book as a backup when the receipting
system was down.
Recommendation: Public Health should strengthen controls over mailed payments
and accounts receivable oversight and get receipt books that
meet county policy.
Update: Staff stated that all Public Health sections were using Health
Services receipt books that meet county policy. The department
will update its cash control procedure, including receiving by mail,
by February 2026.
Plans to update cash control procedures.
Deschutes County Office of the Internal Auditor Page 3 of 4
Audit Follow-up Report: November 2025
Public Health Integrated Audit
Initial finding: Health Services policies guided revenue collection procedures,
but they lacked detailed steps for funds security, accounts
receivable write-offs, and did not fully address segregation of
duties. Fraud risk assessments are the first step in designing
effective controls, as they identify, evaluate, and address
vulnerabilities where fraud could occur. Health Services
completed an annual comprehensive risk assessment but
overlooked the role of written procedures as a key tool to
mitigate fraud risk, minimizing their importance.
Recommendation: Public Health should revise current procedures to incorporate
cash collection practices, workflows, and defined responsibilities,
and ensure these procedures are reflected in the annual risk
assessment.
Update: Staff said they planned to update revenue collection procedures
by February 2026.
Initial finding: Health Services considers gift cards to be a cash-equivalent asset.
Cash assets require strict controls to avoid fraud, waste, and
abuse. However, Health Services gift card logs showed several
inconsistencies when compared to physical count audit records.
Recommendation: Public Health should reinforce accountability expectations and
practices for prepaid gift cards either through training,
monitoring, or revising procedures.
Update: Staff said that they audited gift cards in January and June of 2025.
Staff reported that the department was undergoing an evaluation
of practices against procedures, with planned updates to
procedures expected by June 2026.
Deschutes County Office of the Internal Auditor Page 4 of 4
Audit Follow-up Report: November 2025
Public Health Integrated Audit
Initial finding: Data inconsistencies in the enterprise information system
exposed the Public Health division to risks. One staff member's
financial system access was not revoked after their role changed,
and the system inaccurately reflected which managers were
responsible for employee supervision. Allowing staff more
privileges than required weakens authorization controls and
increases fraud risks. Inaccurate organizational structures in the
information system may have also contributed to the low
completion rate of employee evaluations.
Recommendation: Public Health should establish a tracking system to monitor the
extent and frequency of data errors in the enterprise information
system. If significant errors are identified, they should be
reported to the Human Resources Director for resolution.
Update: Public Health agreed with reporting data errors to Human
Resources and said that they did so on a regular basis. However,
they declined to implement a recommendation to track and
monitor data entry errors occurring in another department.
Next Steps: We will continue to report on the status of in-process
audit recommendations in our Global Follow-up Report at the end
of each calendar year.
Will report but not track or monitor Human
Resources data errors.
Deschutes County Office of the Internal Auditor
Audit Follow-up Report: Public Health Integrated Audit
The mission of the Office of Internal Audit is to improve the performance of Deschutes
County government and to provide accountability to residents. We examine and
evaluate the effectiveness, efficiency, and equity of operations through an objective,
disciplined, and systematic approach.
The Office of Internal Audit: Audit committee:
Jodi Burch – Public member
Email: internal.audit@deschutes.org Joe Healy – Public member
Steve Dennison, County Clerk
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