An Audit Report on

John Keel, CPA
State Auditor

Correctional Managed Health Care at
The Texas Tech University Health Sciences Center

February 10, 2011
Members of the Legislative Audit Committee:
The Texas Tech University Health Sciences Center (TTUHSC)
reported that it will experience a $6.0 million deficit in providing
correctional managed health care services to offenders in fiscal years
2010 and 2011. In fiscal year 2009, TTUHSC experienced a $38,496
surplus after receiving $1.6 million in supplemental appropriations.
In fiscal year 2010, TTUHSC management reported that offsite
hospital, ambulance, and specialty care costs had a significant effect
on TTUHSC’s reported deficit (see Table 1 in the attachment to this
letter for additional details).
The State Auditor’s Office’s audit of TTUHSC identified issues that
were similar to the issues identified at the University of Texas
Medical Branch at Galveston (see An Audit Report on Correctional
Managed Health Care at the University of Texas Medical Branch at
Galveston, State Auditor’s Office Report No. 11-017, February
2011). Those issues may have a direct effect on the deficit that
TTUHSC reported and are summarized below.

Background Information
The Department of Criminal Justice
contracts with the Correctional Managed
Health Care Committee to provide
offender health care.
The Correctional Managed Health Care
Committee serves as the oversight and
coordination authority for the delivery of
health care to offenders. Texas
Government Code, Chapter 501,
established the primary mission and
related authority of the Correctional
Managed Health Care Committee.
The Correctional Managed Health Care
Committee then contracts with the
University of Texas Medical Branch at
Galveston and the Texas Tech University
Health Sciences Center to provide health
care services to offenders.
The State Auditor’s Office has issued a
separate report on the University of Texas
Medical Branch at Galveston (see An
Audit Report on Correctional Managed
Health Care at the University of Texas
Medical Branch at Galveston, State
Auditor’s Office Report No. 11-017,
February 2011).

Indirect Costs. In fiscal years 2009 and 2010, TTUHSC charged its
contract with the Correctional Managed Health Care Committee for
indirect costs totaling $11.8 million. TTUHSC calculates those Source: Correctional Managed Health Care
indirect costs at an estimated 6 percent of total revenues. However, Committee.
TTUHSC did not provide support showing that the administrative
costs associated with providing offender health care were equivalent to 6 percent of total revenues. The
manner in which TTUHSC calculates indirect costs could have a significant effect on whether TTUHSC
experiences a surplus or a deficit.
Salaries. According to information TTUHSC provided, while projecting a deficit of $2.0 million in fiscal
year 2010, TTUHSC also awarded $1.1 million in salary increases in the form of merits, equity adjustments,
and pay plan adjustments to its correctional managed health care staff. The annual salary increases per
individual ranged from $374 to $11,630. Of the $1.1 million in salary increases, $112,503 (approximately
10 percent) was awarded to staff who provide administrative support under the managed health care
contract.
SAO Report No. 11-019

~

r

Robert E. Johnson Building
1501 North Congress Avenue
Austin, Texas 78701

r

P.O. Box 12067
Austin, Texas 78711 -20 67

Phone: (512) 936 -950 0
Fax: (512) 93 6-9400
Internet: www.sao.state.tx.u s

Members of the Legislative Audit Committee
February 10, 2011
Page 2
Allowable Costs. TTUHSC had support for almost all expenditures auditors tested related to the reported
deficits. However, in fiscal year 2010, TTUHSC’s correctional managed health care unit (TTUHSC-CMC
Division) spent at least $52,465 for employee benefits not authorized by the contract. (See Section 4 of the
attachment to this letter for auditors’ methodology for auditing employee benefits.) Due to a lack of clear
guidance in the contract between TTUHSC and the Correctional Managed Health Care Committee, auditors
were unable to determine whether $159,082 in fiscal year 2010 expenditures were reasonable and necessary
to providing offender health care.
Reimbursement Amounts. The majority of TTUHSC’s expenditures related to offender health care are
associated with TTUHSC’s contracts with medical facilities or medical professionals. The contracts specify
agreed-upon reimbursement amounts for providing services. For example:


TTUHSC has 213 offsite professional services contracts through which providers offer offender health
care. TTUHSC reimburses approximately 67 percent of those 213 providers based on the Medicare fee
schedule.



TTUHSC reimburses most offsite hospitals or facilities with which it contracts to provide offender
health care at rates based on the Medicare fee schedule.



TTUHSC reimburses nine local community hospitals with which it contracts to provide onsite health
care to offenders at capitated rates that range from $1.86 to $3.57 per patient per day.

Organizational Structure. TTUHSC has established TTUHSC-CMC Division as a department within
TTUHSC. That department operates under the direction of an executive director of administration and an
executive medical director. The Correctional Managed Health Care Committee does not participate in the
day-to-day operations of providing offender health care at TTUHSC. (See Section 2 of the attachment to
this letter for an organizational chart.)
In a 2007 report1, the State Auditor’s Office recommended that TTUHSC continue its efforts to replace its
existing financial management system with a new system. TTUHSC implemented a new financial
accounting system in September 2008.
The information systems TTUHSC uses to report information and generate financial reports on correctional
managed health care are generally secure and provide complete and accurate information. However,
TTUHSC does not maintain documentation to support the test results for the procedures it performed on
certain information systems prior to implementation and upgrade.

1

See An Audit Report on Correctional Managed Health Care Funding Requirements, State Auditor’s Office Report No. 07-017, March 2007.

Members of the Legislative Audit Committee
February 10, 2011
Page 3
Recommendations
TTUHSC should:


Maintain documentation to support indirect costs for offender health care and ensure that it charges only
reasonable and authorized direct and indirect expenditures to its contract with the Correctional Managed
Health Care Committee.



Obtain approval from the Legislative Budget Board before charging any indirect costs to TTUHSCCMC Division and using funds appropriated for the purpose of providing offender health care to cover
those costs.



Seek prior approval from the Correctional Managed Health Care Committee and/or the Legislative
Budget Board before TTUHSC-CMC Division awards salary increases to its employees using funds
appropriated for offender health care.



Ensure transparency in its process for determining reimbursement amounts for professional services,
local community hospitals, and other contracted hospital services by annually providing proposed
reimbursement amounts, the methodology applied, and related supporting documentation to:





The executive director of the Correctional Managed Health Care Committee for review and written
approval.



The Health and Human Services Commission’s rate-setting division for its review and comment.



The Legislative Budget Board for its review and written approval prior to expending any
appropriated funds for the purpose of providing offender health care.

Maintain documentation for the test results of procedures performed for certain information systems
prior to implementation and upgrade.

The Legislature may consider requiring TTUHSC to:


Annually obtain a review of reimbursement amounts from the Health and Human Services
Commission’s rate-setting division and from the Legislative Budget Board.



Annually obtain written approval from the Legislative Budget Board before implementing TTUHSCCMC Division reimbursement amounts.



Publish proposed TTUHSC-CMC Division reimbursement amounts, rates, and the associated
methodology in the Texas Register.

The Legislature also may wish to consider determining the extent to which or whether TTUHSC-CMC
Division’s funds appropriated for offender health care should be used to pay indirect costs.

Members of the Legislative Audit Committee
February 10, 2011
Page 4
TTUHSC management did not agree with the recommendations in this report, and its detailed response is
presented in Section 3 of the attachment to this letter. The information in TTUHSC’s management’s
response did not cause the State Auditor’s Office to modify the issues or recommendations in this report. If
you have any questions, please contact Nicole Guerrero, Audit Manager, or me at (512) 936-9500.
Sincerely,

John Keel, CPA
State Auditor
Attachment
cc:

Members of the Texas Tech University System Board of Regents
Mr. Larry K. Anders, Chair
Mr. Jerry E. Turner, Vice Chair
Mr. L. Frederick Francis
Mr. Jeff Harris
Mr. John Huffaker
Mr. Mickey L. Long
Ms. Debbie Montford
Ms. Nancy Neal
Mr. John F. Scovell
Mr. Daniel T. Serna
Mr. Kent Hance, Chancellor, Texas Tech University System
Dr. Tedd Mitchell, President, Texas Tech University Health Sciences Center
Members of the Correctional Managed Health Care Committee
Dr. James D. Griffin, Chair
Mr. Elmo Cavin
Mr. Bryan Collier
Mr. William Elger
Mr. Gerald Evenwel, Jr.
Dr. Cynthia Jumper
Dr. Lannette Linthicum
Dr. Ben G. Raimer
Dr. Desmar Walkes
Mr. Allen Hightower, Executive Director, Correctional Managed Health Care Committee

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In compliance with the Americans with Disabilities Act, this document may also be requested in
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programs, or activities.
To report waste, fraud, or abuse in state government call the SAO Hotline: 1-800-TX-AUDIT.

Attachment
Section 1

TTUHSC Correctional Managed Health Care Expenditures for Fiscal
Years 2009 and 2010
Table 1 shows Texas Tech University Health Sciences Center’s (TTUHSC)
correctional managed health care expenditures for fiscal years 2009 and 2010.
Table 1

TTUHSC Correctional Managed Health Care Expenditures
Fiscal Years 2009 and 2010
Fiscal Year 2009

Expenditure Category

Expenditures

Fiscal Year 2010

Percent of
Total
Expenditures

Expenditures

Percent of
Total
Expenditures

Totals for
Fiscal Years
2009 and
2010

Salaries

$ 29,862,758

29.57%

$ 32,662,091

29.76%

$ 62,524,849

Benefits

7,210,003

7.14%

7,708,921

7.02%

14,918,924

Operating Expenditures
(Maintenance and
Operations)

3,438,278

3.40%

2,766,681

2.52%

6,204,959

Professional Services

6,707,716

6.64%

7,058,522

6.43%

13,766,238

23,660,936

23.43%

24,551,003

22.37%

48,211,939

Travel

179,349

0.18%

188,504

0.17%

367,853

Electronic Medicine
(Telemedicine/EMR)

315,274

0.31%

371,697

0.34%

686,971

Capital Equipment
Exceeding $5,000

411,675

0.41%

370,010

0.34%

781,685

0

0.00%

0

0.00%

$0

Indirect Expenses

5,701,280

5.65%

6,133,412

5.59%

11,834,692

Pharmaceutical Purchases
(Drug Costs)

6,859,760

6.79%

7,605,150

6.93%

14,464,910

962,023

0.95%

1,122,476

1.02%

2,084,499

15,421,674

15.27%

18,904,415

17.22%

34,326,089

250,000

0.25%

325,000

0.30%

575,000

$109,767,882

100.00%

$210,748,608

Contracted Units/Services

Depreciation

University Professional
Services
Freeworld Provider
Services
Estimated Incurred But
Not Reported (IBNR)
Expenditures
Totals

$100,980,726

100.00%

a

Source: Information provided by TTUHSC.

Attachment
An Audit Report on Correctional Managed Health Care at the Texas Tech University Health Sciences Center
SAO Report No. 11-019
February 2011
Page 1

Section 2

Organizational Chart for TTUHSC Correctional Managed Health Care
Figure 1 shows the flow of funds from the Department of Criminal Justice to the Texas Tech
University Health Sciences Center (TTUHSC) and identifies the TTUHSC departments that
are involved in providing offender health care services. As of August 2010, the correctional
managed health care program at TTUHSC had approximately 685 filled, full-time positions.
Figure 1

Organizational Chart for TTUHSC Correctional Managed Health Care
Fiscal Year 2010
Department of Criminal
Justice
$466.4 million

Correctional Managed Health
Care Committee
Retains $0.7 million
(See Note 1)

Texas Tech University Health
Sciences Center
$99.6 million

Texas Tech University Health
Sciences Center
Dean of the School of
Medicine

Texas Tech University Health
Sciences Center
Associate Dean
Health Services Management

CMHC Executive Medical
Director

CMHC Executive Director

CMHC Medical
(includes Dental, Regional
Medical Directors and staff,
Nursing Services, Utilization
Management, and
Credentials Coordinator)

CMHC Administration
(Includes Field Operations,
CMHC Recruitment, CMHC
Mental Health System,
Regional Medical Facility,
Information Systems,
Finance and Administration,
and Human Resources)

(See Note 2)

(See Note 2)

Note 1: Of the $466.4 million it receives from the Department of Criminal Justice, the Correctional Managed Health Care Committee
retains $0.7 million for its operations, passes $99.6 million through to TTUHSC, and passes $366.1 million to the University of Texas
Medical Branch at Galveston.
Note 2: TTUHSC estimated its fiscal year 2010 salary costs would be approximately $23 million for CMHC Medical and approximately $8
million for CMHC Administration.
Source: Developed by auditors based on information provided by TTUHSC.
Attachment
An Audit Report on Correctional Managed Health Care at the Texas Tech University Health Sciences Center
SAO Report No. 11-019
February 2011
Page 2

Section 3

Management’s Responses

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HEALTH SCIENCES CENTER
Office of the Pre..denr

.
Fehruary 7. 201 I
: tall' uduor"s Officc
I I 'Courtney \mhres- \Vade
P,O. B l, Ul67
uSlin. 1 78711-2067
Dear Ms,

mbres- Wade:

rhank you for the opportunily 10 re\ic\\ and re p nd 10 the draft repor! for the 'laIC uditor's
Omce (: 0) audit of orreclillnal Managed Ilealth arc til Ie, a. Iech LInivcrsil) 1Ic,Ilth
,dences enter (TIUII l, The respon es of our leadership ll:am arc II1cluded hclo\1
IndirecI ('osUi
In the ) loher 200(} audit related I
rrc lional managed health care, the. laIC udilor', fliel'
Issued thIS stah:ment encompas ing Tr II '. mcth dol g' for charging indlrecI ellst,. "The
inslillllioos' methodologies for calculating the indirect co 'IS aSSOCiated \1 uh prm idll1g health
care to tate pri on inmate' arc reaonahle .. We bdic\ e thUI the 6°" indirect Cl :1 rale i. fair and
reasonable. (The lillli (' federal government indirect cosl rate I. 41l.S" ) Included 111 the 6° 0
rate arc all the direci adminl.lrative ost of this contract. Hfecti\e wilh Ihe renewal oflhis
conlraCI on • eplember 1. _0 II, IT II 'V\ ill charge Ihesl: dIrect udmilllslrati\ e CIlSt. to the
contract. thereb) I wering the IIlt!lrecl COSI ratl: to t5° o. n llll: i 'urr>ntl) preparing Ih'
IIldlrect co't 'Iud)' Ii r lis al year _010 in nrder 10 supporl our rail' n.:newal wilh the federal
government. The results oflhis . Iud) will he :.l\ailahk tn documenllhe fact that an mdin,:cI CUI
rale ofl.S% for this contra 't i \\cll-juslllied.
\:'e reo re Ifully di agree with th' 'late uditor's recommendation lhat rr H.T gain appro\'al
from the Legi IUli\c Budgct Board (T RRl tor the indin: t co I ralc. a no su h requirement
currently cxi IS.

Salancs
Wc respcctfully disagrce \\ith the ,'lalC udilOr's ree 11lll1lCndattnn 10 :cd. pnur appro\,,1 from
the Correcli nol onoged Ilcalth arc ommillee ( tv 11 I C) and or Ihe I.HB bdim.: u\\arding
salar) incrca'e 10 our empll )ecs. (\ rre lional I\dUlgcd lIealth 'arc (C \111 ') al I Il II. C is a
di\'ision of the hool of tvlcdicine. and all it employec' arc cmplo)cc )1' I I LJII' . rhe
, hool of Medicine and 'Mlle arc go\'erned by all instilulil nal policie and guidelines of
n Llil. ',and \\C 10110\\ Instillltion:ll policic for salar) increa'e' I'llI' lIJ' • 111 'empltlyees

36014th treel STOP 6258

I Lubbock. Texa.

79430·6258

I T 806.7432900 II' 806.743.2910

An I::.EO, Altlnn.IU\lt.· Acuon Immullon

Attachment
An Audit Report on Correctional Managed Health Care at the Texas Tech University Health Sciences Center
SAO Report No. 11-019
February 2011
Page 3

Page Iwo

lIowuble osts
e r pe tfull) di agree \\ iUl the tate uditor' s implications that 159,082 in Iiscal ) car 20 I0
e penditures ma) ha e been unreasonable or unnece 'ar) We believe all fthe expen e are
appropriate. allowable. and nece ar) 10 conduct day -to-day bU'ine 'rclated to pri 'on health
can: operations. Th' questioned expenditure include 0 t of recruitll1g h alth care candidate
and 0 t 0 cellular phone u ed dail. by ur empl yee in fulfilling the agreement vvith the
H '. The'e co 't. art: rt:3' nabk and required to conduct busincs and compete in the
recruitment of health care pr)\ idcrs out ide the correctional. y.-tern. dditionall). contract
langua 'e in rticle III 'cction L pro ides guidelin" on "Restri 'tions f r:xpenditures" for ur
correctional agrccment, and expenditures arc audited monthl b the 111
10 ensure
compliance \\ith the e requirement, \. uch. we di agr.:e that con ract c1anlic!lti n I: needed
TIle 52.46 in 'mplo ee b 'nelit the. tate \uditor a crt' arc n I auth riLed by the e I1traet
repre 'CIllS rctirernelll fringe benefit expen'e ' that arc not omplctcl relmbur. ed b fringe
rev nue credits, therefor re, ulting in a net expl:n, e un ler thl greem nl. I It .en r. I
ppr priation
t tate' that no IT II" higher cdueati n fund' 'hall be 'pent on the
correcti nal agreement. as rclcreneed in enate Bill I, 1'1 Legi lature. Jeneral ppropriation
ct. rticle III, page 192 #4 ppropriation of o. t for Ilealth ar' to Inmate', which ·tate '. "It
i the intent of the Legislature that all st f r providing health care to inmate of the TD J
in luding co t of operating
J h pital fa ilitie in ah eton • unt) and Lubbol:k 'ount
shalt be paid from appropriations made to the TD 'J," Durin I contract neg llati n. r the ne
bienniwlL rUll"
ill seek I, rifi ati n in ule 'Mlle' I II JJ J' agreement and
recommend appropriate changes to the section addres 'ing fringes to clarify this i sue and to be
con i tent with legislative intenl.

Reimbur. ement mounts
We re pectfult) disagree with the tate uditor' re ommendations lor TTUH
toeek
appro al from lIealth and lIuman 'r ice ommi ion and the Of) of th rates w' pay to 'ubsu h requirement urrentl e ists and implementing thi
ntra t health car providers.
re ommendati n w uld add to the admini 'trative co t thi' ntra I. I he
J I' appro\e
the e costs when the appro e lhe bienmal contract with I lUll: 'to deliver health care t the
II1mat p pulati n.
fhe current rate structure for offsite care (onsite 'pecialty ph) 'i ·ian. hospitali/tllion. and
ambulan e rvi c ) ha. igniti, ntly dis oUllled ntra t nd payment mechanism in pia e.
The 'Mil
urrcntl} m nit r' thee type' or e penditurc m nthl}. dditi n It)', the ,., c. I
hospital nsite contracts" refer to our contracts with local communit ho. pital' t operate 'ome
of our onsile pri on medical clinic. TIle e co t con i t mainly of alar)' and fringe. and
increase are gi en under the ame ir umstan e a raLe. for Trlll!.T cmplo ee..

Attachment
An Audit Report on Correctional Managed Health Care at the Texas Tech University Health Sciences Center
SAO Report No. 11-019
February 2011
Page 4

Pa 'c rhrcc

Organwllion I tru tun:
We re 'pectfull) di agree \\ ilh!he tate udllor' . recommendation to ma1l1La1l1 d cumentatlon f
the test reult f pr cedure· perf, rmed pri r ( implementation and upgrade of information
stems. , preadshcets that wcre u ·cd during the "mo 1,." c. erci 'C 'pri r t implemcntati n and
prior t th upgrad were pr( \ Ided to the
(during the audit. Thc . pread heet utlined the
t . t pro cdurc. thaI were perf, mled pri r t implementati nand pn r to the upgrade.• u ceo .Iul
complcti n fall cnarios \~a<; enfied bcfore impl'menlati)l1, In our pll1l n. r~tall1lng le·t
r ult aft r implcm ntallon i unn 'ccssar)

If ou havc questi )I1S about our resp n c , plea.. ' fi 'I In: 'to '(Intact Ir. I Iml
\111. 1
·xecutivc Ice I rc Ident for I'manec and dmml. tratl n, r Ir. larr) U1,.1I1., I Il H,'
xccutivc Dircct r f, r orrcctl nal Managed Ilcal!h 'arc.

II

in erel) ,

I dd L

fitch ,11. \II D

Pr' Id III

T xas Ie h nive lIy lIealth 'cicnces 'cntcr

Attachment
An Audit Report on Correctional Managed Health Care at the Texas Tech University Health Sciences Center
SAO Report No. 11-019
February 2011
Page 5

Section 4

Objectives, Scope, and Methodology
Objectives
The objectives of this audit were to:


Examine the shortfall reported by the Correctional Managed Health Care
Committee for fiscal year 2009, the projected shortfall reported by the
Correctional Managed Health Care Committee for the 2010-2011
biennium, and any projected shortfall reported in the Correctional
Managed Health Care Committee’s legislative appropriation request for
fiscal years 2012 and 2013.



Follow up on selected recommendations in State Auditor’s Office Report
No. 07-017 (March 2007), An Audit Report on Correctional Managed
Health Care Funding Requirements.

Scope
The scope of this audit covered Texas Tech University Health Sciences
Center’s (TTUHSC) projected and actual deficit calculations for fiscal years
2009 through 2011. Auditors also reviewed the Correctional Managed Health
Care Committee’s oversight and its projected deficits for fiscal years 2012 and
2013. (According to the Correctional Managed Health Care Committee, the
higher education institution health care providers cannot project expected
deficits for fiscal years 2012 and 2013 until they know how much the
Legislature will appropriate for their services.) In addition, auditors followed
up on a previous state auditor recommendation at TTUHSC.
Methodology
The audit methodology consisted of collecting information and
documentation, performing selected tests and other procedures, analyzing and
evaluating the results of the tests, and conducting interviews with
management and staff at TTUHSC, the Correctional Managed Health Care
Committee, and the Department of Criminal Justice.
According to the Society for Human Resource Management, fringe benefits
are benefits granted to employees in addition to their current base salary or
wages (for example, cash, merchandise, services, health insurance, pension
plans, holidays, and paid vacations).
For this audit, the State Auditor’s Office considered the following to be fringe
benefits:


Optional retirement program expenditures.

Attachment
An Audit Report on Correctional Managed Health Care at the Texas Tech University Health Sciences Center
SAO Report No. 11-019
February 2011
Page 6



Old-age, survivors, and disability insurance expenditures.



Old age, survivors, disability, and health insurance expenditures.



Premium sharing expenditures for accidental death and dismemberment,
health, life, and vision.

The State Auditor’s Office did not include benefits such as paid leave in its
interpretation of fringe benefits.
Information collected and reviewed included the following:


Contract between the Correctional Managed Health Care Committee and
the Department of Criminal Justice, and contract between the Correctional
Managed Health Care Committee and TTUHSC.



Correctional Managed Health Care Committee and TTUHSC policies and
procedures.



Revenue TTUHSC received from the Correctional Managed Health Care
Committee.



TTUHSC’s correctional managed care expenditures related to salaries and
benefits, hospital costs, professional services, regional medical facility
contracts, and pharmacy costs.



Budgeting process documentation.



Financial reports that TTUHSC submitted to the Correctional Managed
Health Care Committee.



TTUHSC financial systems.

Procedures and tests conducted included:


Tests of expenditure data, including verification of invoices, purchase
orders, reasonableness of expenditures in the deficit calculation, and
appropriateness of amounts billed for offender health care for fiscal years
2009 and 2010.



Verification of amounts paid by the Correctional Managed Health Care
Committee and received by TTUHSC.



Review of deficit calculations for fiscal years 2009 and 2010.



Review of TTUHSC financial systems used to provide information to the
Correctional Managed Health Care Committee and to generate related
financial reports.

Attachment
An Audit Report on Correctional Managed Health Care at the Texas Tech University Health Sciences Center
SAO Report No. 11-019
February 2011
Page 7



Interviews with management and staff at TTUHSC, the Correctional
Managed Health Care Committee, and the Department of Criminal Justice.



Analysis of employee salary actions data.

Criteria used included the following:


Texas Government Code, Chapter 501.



Title 1, Texas Administrative Code, Chapter 202.



Riders 41 and 42, page V-22, the General Appropriations Act (81st
Legislature).



Rider 61, page V-24, the General Appropriations Act (81st Legislature).



Riders 82 and 83, page V-28, the General Appropriations Act (81st
Legislature).



TTUHSC and Correctional Managed Health Care Committee policies and
procedures.



Contract between the Correctional Managed Health Care Committee and
TTUHSC.

Project Information
Audit fieldwork was conducted from May 2010 through January 2011. We
conducted this performance audit in accordance with generally accepted
government auditing standards. Those standards require that we plan and
perform the audit to obtain sufficient, appropriate evidence to provide a
reasonable basis for our findings and conclusions based on our audit
objectives. We believe that the evidence obtained provides a reasonable basis
for our findings and conclusions based on our audit objectives.
The following members of the State Auditor’s staff performed the audit:


Courtney Ambres-Wade, CGAP (Project Manager)



Ileana Barboza, MBA, CGAP, CICA (Assistant Project Manager)



Michelle Ann Feller, CIA (Assistant Project Manager)



Shahpar M. Ali, CPA, M/SBT



Jennifer D. Brantley, CPA



Ann E. Karnes, CPA



Seorin Kim, CPA

Attachment
An Audit Report on Correctional Managed Health Care at the Texas Tech University Health Sciences Center
SAO Report No. 11-019
February 2011
Page 8



Jennifer Wiederhold, CGAP



Michael Yokie, CISA



Brian York



Charles P. Dunlap, Jr., CPA (Quality Control Reviewer)



Nicole M. Guerrero, MBA, CIA, CGAP, CICA (Audit Manager)

Attachment
An Audit Report on Correctional Managed Health Care at the Texas Tech University Health Sciences Center
SAO Report No. 11-019
February 2011
Page 9