The board is located in Monroe. It operates and/or contracts for inpatient, outpatient, partial day, residential, case management, respite, prevention, crisis, and gerontology services for the mentally ill and developmentally disabled.

For fiscal year 1992-93, the board expended approximately $14.8 million. The board's operations are generally funded by 90% State and 10% local funds. As of September 30, 1994, the board had 151 full-time employees and served approximately 2,000 clients through board-operated and contracted programs.

Conclusion: The board was effective and efficient in its delivery and oversight of mental health services. However, we noted four reportable conditions related to vendor payment documentation, contract management, pharmaceutical purchasing, and goal attainment reporting (Findings 1 through 4).

Noteworthy Accomplishment: The board received accreditation, effective January 31, 1992, from the Joint Commission on Accreditation of Healthcare Organizations for its substantial compliance with national health care standards. The board was the first community mental health board in the State to receive such accreditation for its group home operations.

Audit Objective: To evaluate the effectiveness of the board's reimbursement system related to rate setting, billing, and collecting for mental health services.

Conclusion: The board's reimbursement system related to rate setting was not effective, while its system related to billing and collecting for mental health services was generally effective. We noted that the board did not periodically update many of its rates, lacked documentation to support some of its rate calculation methodologies, and utilized rate calculation methodologies that did not result in accurate reimbursement rates (Finding 5). In addition, we noted seven reportable conditions related to the internal control structure over the board's billing system and billing errors and omissions (Findings 6 through 12).

Audit Objective: To assess the board's compliance with contracts, laws, rules, policies, directives, and procedures governing community mental health services board operations. Conclusion: The board generally complied with contracts, laws, rules, policies, directives, and procedures. However, we noted that the board did not maintain documentation to support waiting list data reported to the Department of Mental Health (Finding 13).

To accomplish our objectives, we reviewed applicable statutes, rules, policies, and procedures; interviewed board and contract agency staff; assessed the effectiveness of applicable areas of the internal control structure; reviewed applicable program, financial, and clinical records; reviewed board costs to provide mental health services; and reviewed the board's monitoring of its performance relative to established goals and objectives.