The departments of Social Services (DSS), Mental Health (DMH), and Health and Senior Services (DHSS) have responsibility to protect clients who receive department services. Our audit found DSS policy and state law have not automatically precluded individuals with child abuse charges or criminal convictions from being employed at residential facilities. In addition, four DMH state-run facilities reviewed did not perform periodic criminal history and Central Registry checks of employees because DMH did not require it. Auditors found employers are not always required to conduct FCSR screenings for individuals required to register and DHSS data disclosed delays in processing initial Family Care Safety Registry (FCSR) registrations.

The Department of Social Services, through its Family Support Division, oversees the collection of child support owed to custodial parents, and tracks the amount of unpaid child support. As of June 30, 2006, the division's computerized system showed approximately 240,000 child support cases had arrears totaling approximately $2.2 billion. Incorrect arrears balances existed on approximately 27 percent of child support cases with arrears over $1,000, as of June 30, 2006. In addition, incorrect arrears balances existed on 22 of 35 cases reviewed that had arrears greater than $100,000 on that date.

Missouri State Auditor Susan Montee released an audit of the Missouri Higher Education Loan Authority (MOHELA) that found millions of dollars spent on executive employee salaries and perks. At June 30, 2006, the MOHELA's net assets totaled about $234 million, with operating revenues exceeding operating expenses by over $25 million in fiscal year 2006. During 2007, a law was enacted that will require the MOHELA to distribute $350 million to the state over the next six years, primarily for various capital improvement projects at the state's public colleges and universities. The MOHELA has paid or will pay almost $2.3 million in severance benefits to four former executives who either resigned or whose employment was terminated in recent years. Approximately $2 million of this amount represented severance pay to these individuals and included: health insurance payments, pension benefits, and other lump sum payments. In addition, from fiscal year 2001 through fiscal year 2004, five MOHELA executives received annual performance bonuses totaling almost $1.5 million. Other findings include, a lack of competitive bidding for construction of the MOHELA new $11 million headquarters, no formal procurement policy, imprudent use of funds for retreats and parties, fixed assets and closed meetings.

An audit of the Department of Elementary and Secondary Education Educator Certification Background Checks found that Missouri laws regarding background checks for educators are not adequate to ensure students’ safety. The Department of Elementary and Secondary Education (DESE) is responsible for ensuring background checks are conducted on applicants for educator certificates and for reviewing background check results. State law requires applicants for most school district positions to submit to both a criminal history background check and a Family Care Safety Registry (FCSR) background check prior to having contact with a student. However, due to the imprecise language in the law, DESE officials have not been requiring, and not all school districts are performing, FCSR background checks prior to employing educators and other school district personnel. State law does not require FCSR background checks for educators before they can obtain a certificate to teach. While state law intended the Child Abuse/Neglect Central Registry to be checked as part of the FCSR background checks, state law does not specifically require Central Registry background checks for educators. Our review found instances of certified educators who had a criminal background and/or a history of committing other offenses, such as child abuse or neglect.

As of December 31, 2005, 98 TDDs had been established in Missouri, including 29 established in 2005. An additional 22 were established in 2006. Officials or representatives of 97 of the TDDs reported total estimated transportation project costs of over $923 million, while 87 of those TDDs reported total estimated revenues of over $1 billion would be collected over the lives of the TDDs.

TDDs are established for the construction of transportation-related projects, and governed by a board of directors with the authority to impose sales taxes within that district to pay those costs. In 95 percent of the districts the property owner/developer petitioned for its creation. All of the districts have additional sales tax on retail items sold within the districts' boundaries imposed by the property owner/developer. This results in higher sales tax than the retail establishments outside the district's boundaries. The TDDs are created without public input and sales tax is increased without a public vote.

The audit found issues in the areas of construction contracts and project management, professional services, budgetary matters, and financial reporting.

Missouri State Auditor Susan Montee's audit of the Department of Labor and Industrial Relations (DOLIR), Second Injury Fund (fund), states the fund will run out of money in 2008.

Montee's audit found expenditures are estimated to outpace revenues by approximately $19.2 million per year from 2007 through 2009. A 2005 legislative change capping the fund surcharge rate restricts DOLIR's ability to generate adequate revenues to cover the fund's expenditures. Worker's benefits will be endangered when the fund becomes insolvent, as state law only guarantees their payment through the Second Injury Fund. The DOLIR paid approximately $68 million during 2006 on fund claims by injured employees and for administrative costs.

The Riverview Gardens School District's financial condition has declined significantly in the past year and based on the amended fiscal year 2007 budget, is expected to further deteriorate. The district is considered "financially stressed" per state law and has been classified as "Provisionally Accredited" by the Missouri Department of Elementary and Secondary Education.

During the four year, six month period ended December 31, 2006, the superintendent was apparently overpaid by approximately $158,400, received 12 unauthorized salary advances and the district paid interest totaling approximately $39,000 on the superintendent's personal loans against his insurance policies. In addition, the superintendent carried forward more vacation days than allowed by his contract and was paid $27,551 for 45 vacation days in June 2005 and $26,122 for 40 vacation days in February 2006.

Original budgets approved by the board were not accurate and complete, reasons for budget amendments were not clearly documented, and the district’s final actual operating funds disbursements exceeded budgeted amounts by $5.7 million for the year ended June 30, 2006. Also, there were concerns regarding bidding and contracts. Several purchases were not competitively bid or competitive requests for proposals were not obtained, including: alternative education services, $2,020,188; custodial equipment and supplies, $410,743; classroom learning materials, $364,034; and educational software, $250,000 to name a few.

Included in the report are recommendations related to personnel policies, payroll records, district credit card use, cellular phones and capital improvements.

First Steps is Missouri's early intervention system for infants and toddlers with special needs. Nationally, Missouri's First Steps Program ranks 45th in percentage of children served to age three. Missouri is one of three states requiring a developmental delay of 50 percent or more for early intervention eligibility. Such restrictive criteria results in children with known delays waiting too long before they can receive services, and as a result, some children have not received needed services.

Our audit found that some children eligible for the program did not receive all needed services or received reduced services as a result of shortage of providers due to low pay rates, lack of mileage reimbursement, and insufficient local funding to supplement provider pay. Workload issues and low pay caused provider turnover.

The Department of Health and Senior Services' compliance with its statutory responsibilities has declined significantly from previous audits. We noted that 58 facilities received neither a full nor an interim inspection in fiscal year 2005, and in fact, some of these facilities have been cited repeatedly for the same deficiencies. Also, state surveyors tend to cite fewer deficiencies when federal inspectors are absent from the process, with only 15 to 20 percent of the deficiencies cited by the federal inspectors also cited by state surveyors.

Only 28% of recommendations from previous audits have been implemented. Conditions sited in prior audits that continue include:

• Certification and/or inspection packets not always submitted to  Central Office timely.

• Performance evaluations of employees not prepared as required by state law.

• On-site complaint investigation visits not always initiated in a timely manner.

• No minimum staffing standard in place for nursing home facilities or tracking staff hours.

• Quality Assurance Unit not performing quality control reviews of completed inspections.

Missouri's $5,829 average annualized tuition for 4-year public institutions was above the national average of $5,491 for fiscal year 2005-2006 and continues to increase at rates above inflation and personal income. Missouri received a D+ grade on its affordability of higher education from the national Center for Public Policy and Higher Education in 2000 and 2002. This affordability grade fell to F in 2004. At the same time, funding for state tuition assistance grants has decreased during the period 2002-2005.

In 2002, most 4-year institutions experienced state budget withholdings totaling approximately 18 percent of the original appropriations and in fiscal year 2003, 10 percent of state funding to higher education was cut from the state's budget. This lack of state funding has universities passing on these increased costs to students and their families. For the first time, students are paying a higher percentage than the state for the costs of public higher education.

The Department of Revenue (DOR) incurred closing costs that could have been avoided, when it decided to close the St. Louis area Deer Creek Office Building in 2005, and was liable for the lease expenditures until it was subleased.

The DOR was granted authority by the state to auction state-owned equipment at the 11 former branch offices. Bids accepted for the equipment ranged from $151 to $3,100 for a total of $16,477 at all 11 offices. While notification of the sealed bid auction was sent to all 182 contract agents operating at that time, only the 11 contract agents operating the former branch offices were allowed to inspect the equipment. In addition, most of these agents used the state-owned equipment for several months. This does not appear to provide a fair, open, and competitive environment for all potential bidders.

Furthermore, the DOR could not account for the disposition of approximately 250 state-owned assets. These 250 items included a laser printer, a fax machine, computers, software, and other miscellaneous items.

Missouri has lagged behind neighboring states in establishing an intelligence fusion center and progress has been slow toward achieving the goal of communications interoperability. In 2005, a report of Missouri's 28 Homeland Security Response Teams (HSRTs) found communication interoperability problems existed with 46 percent of teams. Issues included a lack of radios, cellular telephones and towers, and equipment age. During this time period, the state's expenditures had exceed $2 million, which is approximately 26 percent of the amount budgeted to address communications interoperability.

The state distributed almost 19,000 individual Personal Protective Equipment (PPE) suits to emergency medical services and law enforcement agencies statewide. Auditors visited 43 agencies and noted several different levels of effective use of PPE. At the police departments for the cities of St. Louis and Kansas City, PPE remained unopened and stored in their original boxes. Furthermore, the distribution of the PPE was not adequately monitored and accurate records of the various agencies that received equipment are not kept.

Transportation development districts (TDDs) are established for the construction of transportation-related projects, and governed by a board of directors with the authority to impose sales taxes to pay those costs. All of the districts established as of December 31, 2004, have imposed a sales tax on retail items sold within the districts' boundaries, resulting in a higher sales tax than the retail establishments outside the district's boundaries. In many instances, it appears only a single property owner/developer petitioned for the creation of a district and approved the additional tax.

Our audit disclosed issues regarding the TDDs including: no requirement for the public to be notified when a property owner(s)/developer files a petition with the circuit court to form a TDD, neither registered voters nor their elected representatives are involved in the decision to levy taxes for most TDDs, no requirement the petitions filed with the circuit court include any information regarding estimated transportation project costs or the anticipated revenues that will be collected over the life of the TDD, and in many cases, significant project costs were initially paid by the private developer(s), who were then subsequently reimbursed by the TDD after bonds or other debt had been issued.

In a survey of the 69 districts, officials of 68 of the TDDs reported total estimated transportation project costs of over $578 million. In addition, 62 of the 69 TDDs reported total estimated revenues of over $787 million would be collected during the lives of the respective TDDs.

Our audit regarding the State Adoption Program found that the number of adoptions has been decreasing in the last three fiscal years and the Department of Social Services is still not petitioning to Terminate Parental Rights (TPR) and / or achieving child permanency in a timely fashion.

Auditors reviewed 60 of the 288 cases of children who had been in state custody for over 15 of the last 22 consecutive months in fiscal years 2003 and 2004, focusing on children whose goal was adoption and who had no action or incomplete action on TPR. Auditors chose test items in Greene, Jasper, and Jackson counties and St. Louis City because they had almost half of the cases meeting these specifications. Issues leading to delays in TPR included: untimely court hearings; child mental and behavior issues; unsuccessful attempts at placement with other relatives; continued involvement of biological parents in their children's lives; and some courts' unwillingness to TPR until an adoptive placement is found. In addition, a children's division report dated June 30, 2004 showed 250 children had no case goal of adoption. Our review of the 104 who had been in care more than 15 of the past 22 months found that 96 percent did have an adoption goal, but it was not entered in the system.

Our audit reviewed the cost-effectiveness and efficiency of these state programs. Both programs cost the state about $100 million during the audit period examined. During that time, the state worked with nearly 1,300 providers to distribute medical equipment and one contractor to transport recipients to appointments. Our audit found that Missouri pays more for medical equipment than other states and by bidding equipment contracts the Durable Medical Equipment program could save millions. In addition, auditors found the state paid the sole Medicaid transportation contractor $44.1 million over a period of 15 months, with the company realizing at least $19 million in gross profit.

This audit reviewed how well the Department of Mental Health tracks, investigates and handles incidents and investigations of individuals committing abuse or neglect against DMH's 140,000 clients. From July 2003 through August 2004, 5,689 incidents were reported. Notable finding include, background check procedures were not always followed; employees who previously abused clients were still working between April 2003 and April 2005; and abuse investigations lack independence and consistency.

Since 2002 Medicaid drug costs have doubled to $1.2 billion. Our audit found division policy allows a recipient to use four or more pharmacists and five or more physicians to obtain prescriptions before they are targeted as a potential system abuse. Auditors found division staff did not review a quarterly list of potential abuses until the data was 6 to 12 months old. Additionally, auditors found division officials do not restrict recipients who obtain drugs from multiple prescribers, but just one pharmacy.
Oversight Controls in the State's Medicaid Prescription Drug Program

A follow-up audit report finds most previously cited problems still occurring with commercial breeders and other licensed facilities. Auditors found the majority of findings noted in the first audit of the animal care inspection program, released in February 2001, were still occurring four years later.

State auditors found   Missouri Department of Agriculture, Division of Animal Health inspectors did not always cite obvious violations and criticisms relating to not checking medications, verifying dog counts or identification were called "nitpicking". Three years ago our audit found state inspectors had not fined, revoked or suspended licenses of any commercial breeders or licensed facilities during 1999 and 2000, the period of our first review. Since then, only two administrative hearings have been held regarding problem facilities.
Commercial dog breeders have no incentive to comply with Missouri laws, leaving canines at risk for substandard care.

As of June 30, 2003, eligibility had not been redetermined for a year or more for 383,004 of 934,453 recipients (41 percent). In July 2002, caseworkers were notified they could stop doing routine eligibility redeterminations.

Federal regulations require a Medicaid recipient furnish a valid social security number to receive benefits, but auditors found caseworkers were not obtaining valid numbers on all recipients. as of June 30, 2003, auditors identified nearly 45,000 active Medicaid recipients without a social security number or an invalid number in department computer systems. Obtaining valid social security numbers for all recipients is an important step in ensuring only eligible individuals received Medicaid services.
Medicaid Follow-Up: Prior Unimplemented Medicaid Recommendations Found To Becosting State An Estimated $50 Million Of State General Revenue.

The audit finds initial contact with children reported abused is still not timely. Face to face visits are supposed to occur within 24 hours of a call warranting investigation and within 72 hours for purposes of assessment, however, auditors found that in 16 percent of cases tested caseworkers did not see the child within required time frames. Also, auditors found caseworkers only about half the time adequately follow-up on cases involving family services, placing children at risk.

Audit Finds Missouri Children Risk Repeat Abuse

This audit is the second of two reports on the effectiveness of Missouri's foster care system and focuses on core program support functions within the Children's Division of the Department of Social Services, including appropriate care for the children served, correct payments to placement providers, and retention of experienced foster parents.

Foster care caseloads were unable to be determined because division databases are not current. The foster care case management system listed 923 more social workers than were on the payroll and had numerous errors that would affect the number of cases listed. Background checks conducted by the division on prospective social workers do not include the Family Care Registry, which identifies those individuals excluded from working for the Department of Health and Senior Services or Mental Health because of their previous history.

Providing higher education at an affordable price has become increasingly difficult with recent state budget pressures and large decreases in state funding. Average tuition for Missouri's 4-year public colleges and universities is the highest among the Big 12 states and second highest among the contiguous states. In addition, a national report ranked Missouri's recent tuition increases among the highest. This audit reviewed in-state undergraduate tuition levels at the state's thirteen 4-year public colleges and universities and analyzed trends in annual tuition, state support, enrollment and operations between 1998 to 2003.

This report is the third in a series of audits showing how well public bodies comply with the Sunshine Law. Auditors sent the public records request on official State Auditor's Office letterhead to 319 public bodies and the response times ranged from 1 to 171 days. Fifty-seven of the responding public bodies did not answer the request until after receiving either a follow-up letter and/or a phone call. On average, public bodies took 31 days to respond to Sunshine Law requests by auditors regarding closed meetings held as opposed to the 3 business days allowed by law.

Auditors reviewed practices of 152 public bodies which held closed meetings/sessions in 2001 and found open meeting minutes of 75 percent of those public bodies reviewed identified the planned discussion topics for the closed meetings and recorded the members' votes. Our audit found 50 percent of the public bodies that submitted meeting notices to us did not include the date and time of posting on the notices. While a posting date and time is not required, a date/time stamp would prove the public body posted the notice at least 24 before the meeting. In addition, auditors found at least 25 percent of the public bodies reviewed did not keep closed meeting minutes.
Inadequate Sunshine Law Policies Exist For More Than Half The State Agencies, Boards and Commissions, Which Can Lead To Non-compliance.

Missouri collected no more than 20 percent of the child support owed to 538,000 custodial parents and their children from fiscal years 1996 to 2001, leaving over $1 billion uncollected.

The Child Support Enforcement Division identified 176,279 cases with no address or employer information for the delinquent, non-custodial parents. Additionally, data showed only 29 percent of computerized enforcement actions helped collect more child support.

With a high percentage of education graduates and/or teachers receiving their initial certification never entering the public teaching workforce coupled with a high turnover rate, the experience level of the state's public school educators is declining and the school districts are continually faced with recruiting new teachers and battling to address teacher shortages in certain areas. Due to the high turnover rates for beginning teachers, the percentage of the teaching work force with experience of 0 to 5 years has actually increased from 21 percent in 1992 to 31 percent in 2001.

An audit released by State Auditor Claire McCaskill finds state officials do not actively seek out unlicensed child care providers throughout Missouri and state penalties do not deter unlawful daycare operations.

Unlicensed providers can only be charged with an infraction, which carries a maximum $200 fine when first issued. The fine has not deterred providers from operating illegally. More disturbing is the lack of knowledge by Bureau of Child Care officials as to how many unlicensed providers operate in Missouri.

Missouri's Medicaid outpatient prescription drug costs have more than doubled in the last five years and totaled $770 million in fiscal year 2001. The audit focuses on the Division of Medical Services' effort to reduce prescription drug costs. Auditors found Missouri has not been as proactive as other states with certain cost containment programs.

In a detailed review of registration lists, auditors found 36 percent of the offenders listed had not met their most recent registration requirement. Missouri legislators first established the registration law in 1994 and have since revised the law several times. Some revisions to the laws and court decisions have affected the degree of compliance.

Jefferson County Prosecutor Bob Wilkins tells reporters in St. Louis the importance of placing sex offender registrants on the internet. St. Louis County Prosecutor Bob McCulloch and St. Louis Circuit Attorney Jennifer Joyce stood by Wilkins and the State Auditor's report. Under current law, all convicted sex offenders have to register within 10 days of coming into a county and verify their information yearly or every 90 days, in most cases. The public can then obtain a listing of sexual offenders living in their area.

Missouri's roads and bridges are deteriorating and generally in worse condition than those in neighboring states, partly because Missouri is responsible for a larger highway system than neighboring states with the sixth largest in the nation. Missouri is receiving less revenues for highway purposes and expending less money (on a per mile basis) than its neighbors. Missouri is well below the national average of $110,255 per mile.

Missouri roads are rated as poor or very poor. Missouri ranked first compared to its neighboring states for highest percentage of total substandard bridges and ranks seventh in the nation in the percentage of substandard bridges.

At the current rate of grade crossing upgrades, it will take the state approximately four years to upgrade the grade crossings it has currently identified as most needing upgrades. The division does not publicly release a ranking of grade crossings by the exposure index. The index is the main basis for selecting which grade crossings are being considered for upgrade. Releasing the index information, along with accident and complaint information, may also serve as a public awareness measure, warning individuals of the need to be more cautious and alert at certain crossings.

Missouri has been listed among the nation's top ten states with outstanding criminal warrants. This audit reviewed how well various state law enforcement agencies manage the state's approximately 728,000 outstanding warrants and determined system improvements to arrest more felons.

Audit staff ran persons with warrants in the Highway Patrol system against at least 10 different state databases, including childcare vendors, school teachers and public assistance recipients. Auditors found 15,761 felony warrants that matched with important location data already listed with the state.

This audit reviewed Missouri’s growing instant loan industry and the Division of Finance charged with regulating it.  Current statutes do not limit the interest rates lenders charge a consumer.  As a result, in Missouri, lenders commonly charge up to 300 percent interest on a $500 title loan or 391 percent interest on a $300 payday loan.

Missouri law allows lenders to renew loans up to a year, set unlimited interest rates and concurrently loan money from various instant loan operators.  Although, Missouri law does not give the Division of Finance explicit authority to suspend or revoke the license of a lender who violates state law.

The State Auditor's Office released two separate audits which show individual victims are being shorted when receiving court ordered restitution, as well as overlooked in general due to lax oversight of the Crime Victims Compensation Program.

At least $37 million in restitution is owed to crime victims, but the money may never reach them because Missouri laws are not victim friendly. One of the two audits examined how well Missouri restores the financial loss to crime victims through collecting court-ordered restitution. In 1999, more than half of the cases requiring restitution received no payment at all. When offenders make their court-ordered payments, the victim ranks 36th among 38 which draw from these funds.
Crime Victims Compensation Program
Collection and Distribution of Restitution for Crime Victims

More than 5,000 women and children were turned away from Missouri domestic violence shelters, even though millions of dollars in additional funding could have been available to help these victims.  State laws do not maximize the state’s ability to protect victims.  One city held more than $300,000 even though local shelters reported turning away at least 1,300 victims.  The most critical change needed in state law is to establish a centralized collection and distribution system for all domestic violence fees required by state statute.