type: other

text:
Kommunstyrelsen 2002-08-14
 Budgetuppföljning för kommunstyrelsens verksamhetsområde för perioden den 1 januari till den 30 juni 2002
 Delbetänkandet "Miljöbalken under utveckling – ett principbetänkande" (SOU 2002:50)
 Remiss över utredning av Bohusbanan, delen Uddevalla-Strömstad
 Om- och tillbyggnad av räddningstjänstens lokaler i Tanumshede
 Projekt "Förstudie Utbyggnad av E6 – en regionalekonomisk analys"
 Projekt "Förstudie Utbyggnad av E6 – en regionalekonomisk analys", upphandling
 Projekt "Identitetsskapande design", mål 3
 Detaljplan för fastigheten Ertseröd 2:12 m fl
 Detaljplan för fastigheten Kuseröd 1:13 m fl
 Ändring av detaljplan för del av fastigheten Tanums-Rörvik 1:91
 Tanums Bostäder AB – Förvärv av fastigheter i Grebbestad och Fjällbacka
 Demokratirådslaget 2003
 Delegation tillkommunstyrelsens ordförande att besluta i brådskande ärenden
 BOSAM – Utredning om vindkraft i Bohuslän
 Konstkusten – Inbjudan att medverka i projektets ledningsgrupp
 SKAF sektion Tanum – Anmälan av arbetsplatsombud
 Ansökan från Hamburgö Gamla Skola AB om tillstånd för servering av starköl, vin och spritdrycker till allmänheten året runt på Hamburgö Gamla Skola med tillhörande uteservering
 Ansökan från LJ Scandinavia AB om tillstånd för servering av starköl, vin och spritdrycker till allmänheten året runt på Terassen med tillhörande uteservering
 Ks § 208 2002.471-978 Ks
 att lägga årsredovisning och revisionsberättelse 2001 för Tanums Bostäder AB
 Ks § 209 2002.008-200 Ks
 Byggstart skedde i februari 2000. Entreprenaden godkändes vid slutbesiktning den 22 december 2000.
 Ks § 210 2002.008-200 Ks
 Totalt slutligt utbetalt bidrag från Räddningsverket är 410 000 kronor. Bidraget som utbetalades från Räddningsverket ökade från 300 000 kronor till
 410 000 kronor på grund av tillkommande kostnader.
 Ks § 211 2002.017-923 Ks
 Ks § 212 2002.018-923 Ks
 Budgetuppföljningsrapport har upprättats för kommunstyrelsens verksamhetsområde för perioden den 1 januari till den 30 juni 2002.
 Ks § 213 2002.449-809 Ks
 Miljödepartementet har den 19 juli 2002 inkommit med delbetänkandet "Miljöbalken under utveckling – ett principbetänkande" (SOU 2002:50) för yttrande.
 Regeringen har den 22 december 1999 beslutat att tillkalla en parlamentarisk kommitté med uppdrag att utvärdera tillämpningen av miljöbalken och lämna förslag till nödvändiga reformer.
 Föreliggande delbetänkande redovisar principiella förslag och slutsatser gällande
 bestämmelserna om användning av mark- och vattenområden i 3 och 4 kap miljöbalken,
 ordningen för tillståndsprövning,
 bestämmelserna om omprövning av vattendomar mot bakgrund av översvämningar,
 förhållandet mellan tillsyn och standardiserade miljöledningssystem, och
 att uppdra åt miljö- och byggnadsnämnden att avge kommunens yttrande över delbetänkandet.
 Ks § 214 2002.176-700 Ks
 Kommunstyrelsen beslutade den 3 april 2002, § 105,
 Omsorgsnämndens bedömning
 Omsorgsnämnden har behandlat ärendet vid sammanträde den 4 april, § 51. Av omsorgsnämndens protokoll kan utläsas att finansieringen av FoU-enheten beräknas till totalt 20,2 mkr, varav 8,6 mkr utgör basfinansiering. Kommunerna i Fyrbodalsområdet belastas efter antalet invånare. Kostnaden för Tanums kommun
 blir totalt 93 050 kronor, varav 37 270 kronor utgör basfinansiering.
 Föreliggande förslag lyfter inte tydligt fram äldreomsorg och äldresjukvård som prioriterade områden i verksamheten. Omsorgsnämnden vill göra kommunstyrelsen uppmärksam på att förslaget bör kompletteras med förtydligande i detta avseende.
 Omsorgsnämnden beslutade
 att till kommunstyrelsen framföra att förslaget bör kompletteras med tydlig prioritering av forskning och utbildning inom äldreomsorg och äldresjukvård,
 att i övrigt ställa sig bakom föreslagen organisation för FoU-center i Fyrbodal under förutsättning att kommunstyrelsen finansierar verksamheten.
 Arbetsutskottet beslutade den 24 april 2002, § 40,
 att framföra att förslaget bör kompletteras med tydlig prioritering av forskning och utbildning inom äldreomsorg och äldresjukvård, och
 att i övrigt ställa sig bakom föreslagen organisation för FoU-center i Fyrbodal.
 Efter remissbehandlingen har de regionala parternas företrädare justerat och enats om det dokument som skall utgöra grunden för bildandet av Fyrbodalsinstitutet.
 I dokumentet presenteras ett institut för forskning och utveckling (FoU) i samverkan mellan sjukvård, socialtjänst, försäkringskassa och högskola.
 Den föreslagna konstruktionen skall dels genom samverkan ge goda möjligheter att bedriva FoU inom gemensamma arbetsfält samt dels genom samlokalisering och gemensamma stödresurser ge goda möjligheter till FoU inom de enskilda verksamheternas arbetsfält. Institutets inriktning fokuseras på patient-, klient- och kundnära problem i den praktiska verksamheten.
 Frågan om driftsform för institutet är ännu inte klarlagd.
 Finansiering för åren 2003 t o m 2006 med 2 års förlängning beräknas ske enligt följande räknat i miljoner kronor per år:
 Tidsresurs
 Kommunerna i Fyrbodal
 För den enskilda kommunen är den kontanta insatsen 3,50 kronor per invånare och år för 2003-2006 med möjlighet till två års förlängning. Denna summa utgör basen för den gemensamma verksamheten.
 Härutöver skall varje kommun avsätta tid där medarbetare lägger ner tid på aktiviteter och arrangemang som är initierade av institutet.
 Dessutom skall varje kommun avsätta 0,50 kronor per invånare och år till en särskild forsknings- och utvecklingsfond (FoU).
 Tanums andel av den årliga finansieringen för perioden 2003-2006 med möjlighet till två års förlängning.
 Tidresurs
 Frågan i vilken form institutet skall drivas är ännu inte bestämd. En interimsstyrelse behöver bildas för att påbörja det praktiska arbetet.
 Varje huvudman (kommun) är avtalsbeslutande part gentemot institutet.
 att godkänna inrättandet av en interimsstyrelse enligt upprättat förslag,
 att kommunernas representant i interimsstyrelsen och kommande styrelse utses av kommunförbundet Fyrbodal,
 att interimsstyrelsen får i uppdrag att
 utreda och föreslå driftsform
 rekrytera chef till Fyrbodalsinstitutet
 tillsammans med chef vidta övriga nödvändiga åtgärder för att det skall bli möjligt att i början av 2003 starta institutet, och
 att avsätta medel till institutet under perioden 2003-2006.
 Ks § 215 2002.407-442 Ks
 En utredning har gjorts över Bohusbanan, Sträckningen Uddevalla – Strömstad.
 Utredningen har gjorts på uppdrag av Västtrafik, Banverket, Vägverket, Västra Götalandsregionen och kommunerna/BOSAM.
 Utredningen syftar till att ge ett underlag för diskussion och samråd med Regionen om den framtida trafiken på Bohusbanan.
 Kommunen har fått utredningen på remiss från BOSAM och har möjlighet att lämna synpunkter på utredningen senast den 26 september 2002.
 Siv Bergström (V) yrkar att Bohusbanan skall utvecklas i enlighet med alternativen 1 eller 4 och att andra att-satsen i beredningsförslaget stryks.
 att tågtrafiken på Bohusbanan, delen Uddevalla-Strömstad, i en första etapp skall bibehållas och utvecklas i enlighet med utredningsalternativ 0 och på längre sikt utvecklas i enlighet med alternativ 1, och
 att upprustningen av Bohusbanan ej får innebära ökade kollektivtrafikkostnader för kommunen.
 Siv Bergström (V) anmäler reservation mot kommunstyrelsens beslut till förmån för eget yrkande.
 Ks § 216 2002.414-265 Ks
 Arbetsmiljöverket har i inspektionsmeddelande den 19 april 2001 ålagt att åtgärda ett antal brister i räddningstjänsten lokaler i Tanumshede.
 Fastighetschefen meddelar i skrivelse inkommen den 27 juni 2002 att det föreslagna åtgärdsalternativet (alternativ 2) är kostnadsberäknat till 2 370 000 kronor.
 Projektering samt upphandling av projektör beräknas ske under innevarande år. De om- och tillbyggda lokalerna beräknas färdiga för inflyttning innan utgången av år 2003.
 att ingå till budgetberedningen med begäran om anslag i budget 2003 för ombyggnad av räddningstjänstens lokaler i Tanumshede.
 Ks § 217 2002.438-994 Ks
 En förstudie för utbyggnad av väg E6 föreslås genomföras. Syftet med förstudien är att genomföra en regionalekonomisk analys av de effekter man kan förvänta sig av en förbättrad tillgänglighet till Norra Bohuslän genom framförallt E6:ans utbyggnad till motorväg. Frågeställningar som berörs är villkor för boende, arbete, pendling, konsumtion av kommersiell service, näringslivsutveckling, turism samt "Norgeeffekten".
 I samband med analysen kommer ett antal seminarier genomföras för att belysa ett antal aktuella frågeställningar samt kommunicera analysresultaten och starta nya processer på lokal och regional nivå.
 I varje kommun kommer dessutom en fördjupad analys av ett speciellt område att genomföras. För Tanums del kommer den del som avser området för kommande etableringar och som ingår i arbetet med en fördjupad översiktsplan för Tanumshede att ingå i projektet
 Förstudien omfattar kommunerna i norra Bohuslän.
 Tanums kommun är projektägare.
 294 tkr
 Finansiering in natura
 Strömstad, Munkedal och Sotenäs
 99 tkr
 Privat finansiering likvida medel
 Lokal handel, hotell och restaurang
 Privat finansiering in natura
 att medverka i projekt "Förstudie Utbyggnad av E6 – En regionalekonomisk analys",
 att vara projektägare för projektet,
 att under förutsättning av medverkan från övriga finansiärer anslå 75 000 kronor i kontanta medel för år 2002 och 70 000 kronor för år 2003 kronor samt medfinansiering i form av arbetsinsats till ett värde av 55 000 för hela projektperioden,
 att 50 000 kronor för år 2002 finansieras ur konto Kommunstyrelsens oförutsedda till projekt under näringslivsåtgärder,
 att 25 000 kronor för år 2002 finansieras ur avsatta medel för fördjupad översiktsplan för Tanumshede,
 att 50 000 kronor för år 2003 finansieras från näringslivsåtgärder EU-projekt,
 att 20 000 kronor för år 2003 finansieras ur avsatta medel för fördjupad översiktsplan för Tanumshede, och
 Ks § 218 2002.438-994 Ks
 Under sommaren har upphandling av förstudiens genomförande skett.
 Anbudstiden utgick den 12 juli 2002 och totalt har tre anbud inkommit.
 Utvärdering av anbuden pågår och väntas vara klar i mitten av augusti varför ännu inget underlag för beslut föreligger.
 att uppdra åt arbetsutskottet att fatta beslut om antagande av konsult för genomförande av förstudien.
 Ks § 219 2002.440-998 Ks
 Fjällbacka samhällsförening har inkommit med en förfrågan om kommunen kan vara projektägare för projekt "Identitetsskapande design", mål 3.
 att skapa kunskap hos kommuner och samhällsföreningar om den verksamhet som bedrivs inom KDH och Alnarp,
 att skapa ett nätverk mellan de ingående samhällsföreningarna Fjällbacka, Krokstrand och Berfendahl,
 att lyfta fram och öka kompetensen om den kultur och tradition som finns kring sten i norra Bohuslän och att använda den som en ledstjärna i projektet, samt
 att skapa nya arbetstillfällen kopplade till sten och turism.
 Projektet pågår under tiden 2002-06-18--2002-10-15. Arbetet utförs av ett antal studenter från högskolan.
 Budgeten uppgår till 100 tkr och är helt finansierad av Mål 3.
 att medverka i projekt "Identitetsskapande design" som projektägare.
 Ks § 220 2002.388-130 Ks
 Kommunalförbundet Bosam har kommit med begäran om anslag på 5 000 kr till nya Företagsakutens verksamhet för 2002.
 Företagsakuten är en organisation som erbjuder akut hjälp till mindre företag som fått ekonomiska problem och hotas av konkurs inom BOSAM:s verksamhetsområde samt i Trollhättan och Vänersborgs kommuner.
 Företagsakuten erbjuder specialisthjälp i form av kostnadsfri rådgivning av erfarna konsulter i upp till fem timmar.
 Företagsakuten drivs av svensk Handel, Företagarnas Riksorganisation, kommunerna Lysekil, Munkedal, Sotenäs, Strömstad, Tanum, Trollhättan, Uddevalla och Vänersborg.
 Verksamheten administreras av Kommunalförbundet BOSAM.
 att anslå 5 000 kronor för Företagsakutens verksamhet under 2002, och
 att anslagna medel finansieras ur konto Näringslivsåtgärder - EU-projekt.
 Ks § 221 2002.162-314 Ks
 Miljö- och byggnadsnämnden meddelar i skrivelse inkommen den 3 juli 2002 att nämnden avser att upprätta en detaljplan för del av fastigheten Sannäs 3:1.
 Som ett steg i arbetet har ett planprogram tagits fram av Plan- och byggavdelningen.
 Kommunstyrelsen beslutade den 3 april 2002, § 94,
 Räddningstjänstens bedömning
 Räddningstjänsten meddelar i yttrande inkommet den 3 juli 2002 att på grund av den ökande tätheten av antalet byggnader och områden vid kusten kommer högre krav att ställas på räddningstjänsten.
 I de planförslag som sänds till räddningstjänsten skall det redovisas hur släckvatten för räddningstjänsten tillgodoses. Räddningstjänstens tankbilar skall kunna återfyllas inom en rimlig tid.
 Framkomligheten för räddningstjänstens tunga fordon skall redovisas. Tunga fordon med högt axeltryck kan medföra problem på mindre vägar.
 Ks § 222 2001.513-314 Ks
 Miljö- och byggnadsnämnden meddelar i skrivelse inkommen den 25 juni 2002 att nämnden avser att upprätta en detaljplan för fastigheten Ertseröd 2:12.
 Det aktuella området är beläget ca 2 km söder om centrala Grebbestad och ca 1 km söder om gränsen för tätortsbebyggelsen.
 Som ett steg i arbetet har ett planprogram tagits fram av Gränsland Arkitektkontor.
 Kommunstyrelsen beslutade den 4 april 2002, § 93,
 Ks § 223 2000.136-314 Ks
 Miljö- och byggnadsnämnden meddelar i skrivelse inkommen den 13 juni 2002 att nämnden avser att upprätta en detaljplan för fastigheten Kuseröd 1:13 m fl.
 Planområdet är central beläget i Grönemad ca 2,5 km nordväst om Grebbestad.
 Syftet med planen är att följa upp kommunens målsättning och ge möjlighet till helårsbosättning för gamla och nya kommuninvånare i ett attraktivt och havsnära bostadsläge i vackra omgivningar. I detaljplanen föreslås en liten realtivt tät grupp av friliggande bostadshus inom ett begränsat område av Grönemad.
 Som ett steg i arbetet har ett planförslag tagits fram av Rådhuset Arkitekter AB i Uddevalla.
 Räddningstjänsten meddelar i yttrande inkommet den 24 juni 2002 att på grund av den ökande tätheten av antalet byggnader och områden vid kusten kommer högre krav att ställas på räddningstjänsten.
 Bengt Mattsson (Fp) yrkar
 att fastigheten Kuseröd 1:13 del av försäljes till Tanums Bostäder AB så snart detaljplanen vunnit laga kraft för att säkerställa helårsboende på fastigheten, och
 att planområdet skall ingå i kommunens verksamhetsområde och att skrivningen vad gäller urinhantering skall följa kommunens VA-policy.
 Ordföranden ställer fråga på framlagt yrkande och förklarar att han finner att kommunstyrelsen bifaller detsamma.
 att fastigheten Kuseröd 1:13 del av försäljes till Tanums Bostäder AB så snart detaljplanen vunnit laga kraft för att säkerställa helårsboende på fastigheten,
 att planområdet skall ingå i kommunens verksamhetsområde och att skrivningen vad gäller urinhantering skall följa kommunens VA-policy,
 Lennart Larson (M) och Kristina Frigert (M) meddelar att de ej deltar i beslut avseende försäljning till Tanums Bostäder AB.
 Ks § 224 2001.557-215 Ks
 Ändring av del av detaljplan för del av fastigheten Tanums-Rörvik 1:91
 Miljö- och byggnadsnämnden meddelar i skrivelse inkommen den 25 juni 2002 att nämnden avser att ändra del av detaljplan för del av fastigheten Tanums-Rörvik 1:91.
 Kommunstyrelsen beslutade den 3 april 2002, § 96,
 Räddningstjänsten meddelar i yttrande inkommet den 3 juli 2002 att man inget har att erinra.
 Ks § 225 2002.479-212 Ks
 Tanums Bostäder AB - Förvärv av fastigheter i Grebbestad och Fjällbacka
 Tanums Bostäder AB har den 31 juli 2002 inkommit med skrivelse om förvärv av fastigheter i Grebbestad och Fjällbacka.
 Efterfrågan på bostäder har blivit allt större. Flera av företagen i Tanums kommun har idag svårigheter att rekrytera personal beroende på att personalen inte hittar det boende de vill ha. Tanums Bostäder har en viktig roll i att det byggs nya bostäder i Tanums kommun. Under förutsättning att det går att få rimlig ekonomi på projekten kommer Tanums Bostäder att bygga nya bostäder de kommande åren för att möta den ökade efterfrågan och att se till att Tanums Bostäder är en konkurrenskraftig och viktig aktör på bostadsmarknaden.
 Tanums Bostäder AB:s styrelse beslutade den 10 juni bland annat
 att tillskriva Tanums kommun med en begäran att få förvärva följande fastigheter
 Härlidsområdet i Grebbestad (Grebbestad 2:297 och del av Grebbestad 2:1),
 Annebergsområdet i Grebbestad,
 Håkebackens f d skola i Fjällbacka,
 Fjällbacka Brisens förskola,
 att uppdra till VD Ulf Ericsson och ordförande Kurt Svedberg att föra diskussioner om med Tanums kommun om en eventuell förvärv för byggande av bostäder i Havstensund,
 att tillskriva Tanums kommun och förklara att Tanums Bostäder är intresserad att förvärva fastigheten Kuseröd 1:13 under förutsättning att Tanums kommun tar fram en detaljplan som medger byggande av bostäder,
 att tillskriva Tanums kommun att man som ägare till Tanums Bostäder informerar Tanums Bostäder fortlöpande om exploateringsplaner för bostäder.
 Lennart Larson (M) yrkar i tillägg till beredningsförslaget att ägaren till Tanums Bostäder AB genom kommunstyrelsens arbetsutskott skall föra en strategi-diskussion med bolaget.
 Ordföranden ställer fråga på Lennart Larson yrkande och förklarar att han finner att kommunstyrelsen bifaller yrkandet.
 att inhämta "Boendegruppens" synpunkter,
 att ärendet därefter bereds av kommunstyrelsens arbetsutskott, och
 att ägaren till Tanums Bostäder AB genom kommunstyrelsens arbetsutskott skall föra en strategidiskussion med bolaget.
 Ks § 226 2002.001-111 Ks
 Demokratiforum har den 10 juni 2002 inkommit med inbjudan till medverkan i Demokratirådslaget 2003.
 Vid innevarande års rådslag medverkade ett 50-tal skolor inom Västra Götaland. Detta skedde genom egna arrangemang samt genom deltagande i Demokratiforums seminarier och workshops.
 Demokratiforum vill nu fortsätta med ett långsiktigt arbete för att öka kunskap, engagemang och inflytande hos ungdomar.
 Under hösten 2002 kommer ett pilotprojekt starta med utbildning för lärare och elever. Demokratirådslaget 2003 genomförs vecka 12.
 Demokratiforum önskar nu att kommunstyrelser och regionstyrelsen fattar beslut om medverkan i rådslaget. Medverkan innebär att förtroendevalda under rådslagsveckan besöker gymnasieskolan och de aktiviteter som arrangeras i olika delar av regionen.
 Demokratiforum föreslår kommunstyrelsen besluta
 att medverka i Demokratirådslaget,
 att senast i augusti 2002 utse en kontaktperson för rådslagets planering, och
 att arvodera förtroendevalda som vill besöka skolor och medverka vid andra aktiviteter under veckan.
 att ställa sig bakom medverkan i Demokratirådslaget 2003, och
 att uppdra åt barn- och utbildningsnämnden att handlägga ärendet fortsättningsvis.
 Ks § 227 2002.366-215 Ks
 Motionen avslutas med att Folkpartiet-Liberalerna anhåller om att Tanums kommunfullmäktige uppdrar åt kultur- och fritidsnämnden
 Kommunfullmäktige beslutade den 24 juni 2002, § 79,
 att överlämna motionen till kultur- och fritidsnämnden för i samråd med övriga berörda nämnder göra en översyn av gällande sjöbodspolicy samt avge förslag till förändringar av policyn utifrån nu gällande förutsättningar, och
 att uppmana kultur- och fritidsnämnden att definiera begreppen "sjöbod", "sjöbodsförråd", "sjöbodsliknande byggnad" m fl.
 Ks § 228 2002.428-900 Ks
 Delegation till kommunstyrelsens ordförande att besluta i brådskande ärenden
 6 kapitlet 36 § kommunallagen ger kommunstyrelsen möjlighet att i brådskande ärenden, där nämndens avgörande inte kan avvaktas, uppdra åt ordföranden eller annan ledamot som styrelsen utser att besluta på nämndens vägnar. Beslut som är fattade med stöd av denna delegation skall anmälas vid nämndens nästa sammanträde.
 Denna bestämmelse motiveras med att det i vissa lägen kan vara viktigt med snabba beslut. Den har emellertid getts ett restriktivt innehåll. Det är endast ordföranden eller annan ledamot som nämnden utsett som kan få i uppdrag att besluta på nämndens vägnar. Genom att det antages att dessa beslut fattas på nämndens vägnar klargörs att besluten med stöd av denna paragraf kan överklagas.
 Någon begränsning av möjligheterna att delegera brådskande ärenden enligt denna paragraf med hänsyn till ärendenas art finns inte. Däremot kan nämnden precisera och begränsa uppdraget till vissa typer av ärenden, om nämnden så vill. Alternativet till att utnyttja möjligheten till delegering i brådskande ärenden är att påkalla extra sammanträde med nämnden.
 att enligt 6 kap 36 § KL uppdra åt kommunstyrelsens ordförande att i brådskande ärenden fatta beslut på nämndens vägnar, och
 att delegationen omfattar vice ordföranden då denne tjänstgör i ordförandens ställe.
 Ks § 229 2002.001-111 Ks
 Med anledning av regeringens energipolitiska proposition har kommunerna i BOSAM samt Tjörn och Orust beslutat att låta utreda förutsättningarna för etablering av vindkraft i Bohuslän.
 Utredningsarbetet syftar dels till att klargöra möjligheterna till att lokalisera vindkraft i Bohuslän och dels att skapa en produktionsgrupp för tillverkning och montering av vindkraft.
 En ledningsgrupp skall utses med ansvar för främst det förstnämnda arbetsområdet.
 BOSAM hemställer nu om att kommunen utser en ledamot att ingå i lednings-gruppen.
 Bengt Mattsson (Fp) yrkar att avslag till deltagande i en kommunövergripande utredning om lokalisering av vindkraftparker till havs eller i kustbandet då sådana parker skadar kommunens viktigaste resurs vad gäller attraktionskraft och livskvalitet.
 Rolf Hermansson (C), Lennart Larson (M), Ronny Larsson (S) och
 Siv Bergström (V) yrkar bifall till beredningsförslaget.
 Ja-röst för bifall till beredningsförslaget.
 Nej-röst för bifall till Bengt Mattssons yrkande.
 Voteringen verkställs genom namnupprop och utfaller så att 9 ledamöter röstar Ja och 2 ledamöter röstar Nej.
 Kommunstyrelsen beslutar således i enlighet med beredningsförslaget.
 att utse kommunstyrelsens ordförande som ledamot i ledningsgruppen för utredning om vindkraft i Bohuslän, med Lennart Larson som ersättare.
 Bengt Mattsson (Fp) och Nils Olsson (Fp) anmäler skriftlig reservation, bilaga.
 Ks § 230 2002.207-994 Ks
 Projektledningen för Konstkusten har den 10 juli 2002 inkommit med inbjudan till att medverka i projektets ledningsgrupp med en ledamot.
 Projektet har till syfte att skapa ett kluster av konstnärer och kulturarbetare i norra Bohuslän. Genom nätverksbyggande mellan konstnärer, kulturarbetare, institutioner och företagare inom kulturnäringen skall kulturnäringens roll stärkas och marknaden vidgas.
 Kommunstyrelsen beslutade den 7 maj 2002, § 119, bland annat
 att medverka i projekt Konstkusten i norra Bohuslän,
 att anslå 30 000 kronor i kontanta medel för vardera åren 2002 och 2003, och
 att medfinansiera projektet med finansiering in natura i form av arbetsinsatser, lokaler och utrustning till ett värde av 50 000 kronor.
 att uppmana kultur- och fritidsnämnden ur nämnden/förvaltningen utse en ledamot att ingå i Konstkustens ledningsgrupp.
 Ks § 231 2002.404-968 Ks
 SKAF sektion Tanum har den 20 juni 2002 inkommit med anmälan av arbetsplatsombud.
 Ks § 232 2002.287-745 Ks
 att jml 7 kap 5 § Alkohollagen bevilja Hamburgö Gamla Skola AB
 tillstånd för servering av starköl, vin och spritdrycker till allmänheten året runt på Hamburgö Gamla Skola med tillhörande uteservering,
 att jml 7 kap 5 § 3 st Alkohollagen infoga villkoret att högsta tillåtna antalet besökare i serveringslokalen skall motsvara de högsta antal som räddningstjänsten godkänt i sitt senaste brand- och tillsynsprotokoll, och
 Ks § 233 2002.266-745 Ks
 att jml 7 kap 5 § Alkohollagen bevilja LJ Scandinavia AB tillstånd för servering av starköl, vin och spritdrycker till allmänheten året runt på Terassen i Grebbestad med tillhörande uteservering,
 att jml 7 kap 5 § 3 st Alkohollagen infoga villkoret att högsta tillåtna antalet besökare i serveringslokalen skall motsvara de högsta antal som räddningstjänsten angivit som högsta antal besökare i sitt senaste brand- och tillsynsprotokoll, och
 nr 123 -164
 2002-07-01—2002-08-23,
 2002-07-02—2002-08-23
 kl 11.00-01.00
 2002.287-745 Ks
 Terassen i Grebbestad
 2002-07-01—2002-08-23
 2002.266-745 Ks
 Pub Hörnet, Grebbestad
 Område på torget i Grebbestad
 2002-07-12—2002-07-14
 varierande serveringstider för de olika dagarna
 Hamnens dag 2002-07-13 samt pubaftnar
 2002.211-745 Ks
 Tillfälligt utökade serveringstillstånd
 2002-06-19—2003-06-18
 2002.363-745 Ks
 Röde Orm, Grebbestad
 2002-06-21—2003-06-20
 2002.221-745 Ks
 020621, 020712, 020713, 021231, 030419
 kl 11.00-03.00
 020621, 020712, 020713
 2002-07-04—2002-07-06
 till kl 03.00
 2002-07-04—2002-07-06 utökat serveringsområde
 kl 12.00-01.00
 2002-07-12—2002-07-13 till kl 03.00
 2002.308-745
 Inskränkt serveringstillstånd
 Inget tillstånd för Konserven årligen under perioden 020601-020831
 2001.372-745 Ks
 Överföring av serveringstillstånd
 Urrob AB överförs till
 Urrob AB, på Gästis i Grebbestad
 2002.278-488 Ks
 Skrivelse från XX om Tingvalls Ekos försäljning. Att kommunen diskuterar med Hushållningssällskapet om vikten av att miljöprofilen kvarstår efter försäljning.
 Protokollsutdrag från KHR med information om vikten av att samråd sker kontinuerligt i frågor som rör handikapporganisationerna.
 Verksamhetsplan för Västtrafik åren 2003-2005
 Kommunal musiksatsning i Tanums kommun. Rapport från Tanums ungdomsgrupp – TUG. Musikutveckling i ungdomsperspektiv
 2002.203-175 Ks
 Räddningsverkets beslut om ansökan av förlängd sotningsfrist – medger ej förlängning av sotningsfrist.
 2001.448-994 Ks
 Kalvö båt- och intresseförenings tack för kommunens medverkan till utmärkning av Tärneskärssundet samt utbyte av hamnkran.
 Skrivelse från personalen på Hedeskolan om inomhusmiljön.
 1999.553-211 Ks
 Länsstyrelsen har genom beslut den 20 juni 2002 avslagit överklagandet över kommunfullmäktiges beslut den 4 mars 2002, § 22, att anta detaljplan för Vetteberget, del av Fjällbacka 176:124. Något överklagande av Länsstyrelsens beslut har ej inkommit.
 Kommunhuset, Tanumshede, klockan 09.00-13.00.
 Ulf Ericsson, ekonomichef/vd TBAB, §§ 208, 211, 212
 Inge Berndtsson, samhällsbyggnadschef, §§ 209, 210, 216, 221-224
 Lars Löfberg, fastighetschef, §§ 209, 210, 216
 Ulf Björkman, kanslichef, §§ 211, 212, 214, 228
 Birgitta Jonsson, miljöchef, § 213
 Kerstin Danielsson, näringslivssekreterare, 217-220
 Elin Andersson, fysisk planerare, §§ 221-224
 Torbjörn Ericsson, alkoholhandläggare, §§ 232-233
 Sekreterare........................................................................ §§ 208-235
 ........................................../Kerstin Berius/........................................................................................
 Senast ändrad: 2002-09-02 Dokumentinfo


type: wikipedia

text:
Oheislaite eli lisälaite () on tietokoneen yksikkö, joka erään määritelmän mukaan on "apulaite tiedon syöttämiseen ja saamiseen tietokoneelta". Oheislaitteita ovat esimerkiksi syöttö-, tulostus- ja tallennusvälineet. Ne mahdollistavat ihmisen ja tietokoneen välisen kommunikoinnin ja tietojen varastoinnin.
 Oheislaite on tyypillisesti ulkoinen laite eikä tietokonelaitteiston komponentti, joka ei suoraan kuulu keskusyksikköön. Oheislaitteet ovat myös valinnaisia, esimerkiksi palvelintietokone voi olla ilman näyttöä ja näppäimistöä.
 Tietokoneiden oheislaitteiden historia
 Syöttölaitteet
 3D-skanneri
 hiiri
 kaukokirjoitin
 kosketusnäyttö
 kuvanlukija
 mikrofoni
 näppäimistö
 piirtopöytä (piirustuslauta)
 pääte
 reikäkorttikone (reikäkortinlävistyslaite)
 valokynä
 valopistooli
 verkkokamera
 videopeliohjain
 Näyttölaitteet
 kuvaputkinäyttö (CRT)
 nestekidenäyttö (LCD)
 pistenäyttö
 projektori
 teletype (paperipääte)
 vektorinäyttö (ks. Imlac PDS-1, Tektronix 4010)
 virtuaalitodellisuuslasit
 Äänentoisto ja -tallennus
 Kaiutin
 MIDI-yhteensopivat laitteet (esim. syntetisaattori)
 Samplerit
 Tulostimet
 Piirturi
 kiekkokirjoittimet
 rivikirjoittimet
 matriisitulostimet
 lämpökirjoittimet
 lasertulostimet kaupallisesti saatavilla 1970-luvun lopusta lähtien
 mustesuihkutulostimet
 sublimaatiotulostimet
 3D-tulostin
 Muut
 Telakka (tietokone)
 Katso myös
 Oheislaiteliitännät
 Tietokonetekniikan historia
 Lähteet
 Aiheesta muualla
 Seulonnan keskeiset artikkelit


jurisdiction: US

text: b'Office of the Inspector General\nSkip to content\nSocial Security Online\nOffice of the Inspector General\nwww.socialsecurity.gov\nHome\xc2\xa0\xc2\xa0|\xc2\xa0\xc2\xa0Questions?\xc2\xa0\xc2\xa0|\xc2\xa0\xc2\xa0Contact\nUs\nSearch\nAbout\nHotline\nOffices\nResources\nEspa\xc3\xb1ol\nOIG Home\nAudit\nReport - A-04-96-54001\nOffice\nof Audit\nAudit of the Tennessee`s Disability Determination\nServices Administrative Costs for Fiscal Years 1993 Through 1995\n(A-04-96-54001) \xc2\xa0 3/24/98\nTABLE OF CONTENTS\nEXECUTIVE SUMMARY\nINTRODUCTION\nSCOPE AND METHODOLOGY\nRESULTS OF REVIEW\nTNDDS\xc2\x92 ACCOUNTING\nFOR DISBURSEMENTS\nMedical Service Costs\nALL OTHER NONPERSONNEL\nCOSTS\nOverpayment\nof Contract to Install Computer Equipment\nControls\nover Computer Equipment Inventory\nTNDDS\nDifference In Audited vs. Claimed Indirect Costs\nTNDDS\xc2\x92 ACCOUNTING\nFOR UNLIQUIDATED OBLIGATIONS\nINTERNAL\nCONTROL ISSUES AT TNDDS\nControls\nover Time and Attendance Records and Sign-in Logs\nControls\nover the Earning of Employee Overtime\nOTHER MATTERS\nCONCLUSIONS\nAND RECOMMENDATIONS\nAPPENDICES\nAppendix A - Obligations Reported/Allowed\nTNDDS for Fiscal Year 1993 as of June 30, 1996\nAppendix B - Obligations Reported/Allowed\nTNDDS for Fiscal Year 1994 as of June 30, 1996\nAppendix C - Obligations Reported/Allowed\nTNDDS for Fiscal Year 1995 as of June 30, 1996\nAppendix D - Consultative\nExam Overpayment Calculation Methodology\nAppendix F - Major Report\nContributors\nEXECUTIVE\nSUMMARY\nWe conducted an audit of the administrative costs claimed\nby the Tennessee State Department of Human Services (TNDHS) for\nits Disability Determination Services (TNDDS) for the 3-year period\nending September 30, 1995.\nBACKGROUND\nThe Social Security Administration (SSA) pays State agencies\n(SA) for 100 percent of allowable expenditures. Each year, SSA\ndetermines the amount of funding authorization. Once approved,\neach SA is allowed to withdraw Federal funds through the Payment\nManagement System (PMS) within the U.S. Department of Health and\nHuman Services (HHS) to meet immediate program expenses. At the\nend of each quarter of the Federal Fiscal Year (FY), each SA submits\nto SSA a "State Agency Report of Obligations for SSA Disability\nPrograms" (Form SSA-4513).\nThe Disability Insurance (DI) program, established in 1954\nunder title II of the Social Security Act (the Act), is\ndesigned to provide benefits to disabled wage earners and their\nfamilies in the event the family wage earner becomes disabled.\nIn 1972, the Congress enacted title XVI, the Supplemental Security\nIncome (SSI) program (Public Law (P.L.) 92-603). Title XVI of the\nAct provides a nationally uniform program of income and disability\ncoverage to financially needy individuals who are aged, blind,\nor disabled.\nSSA is primarily responsible for implementing the general\npolicies governing the development of disability claims under the\nDI and SSI programs. Disability determinations under both DI and\nSSI are performed by an agency in each State in accordance with\nFederal regulations. In carrying out its obligation, each SA is\nresponsible for determining the claimants` disabilities and\nensuring that adequate evidence is available to support its determinations.\nTo assist in making proper disability determinations, each SA is\nauthorized to purchase medical examinations, x-ray, and laboratory\ntests on a consultative basis to supplement evidence obtained from\nthe claimants` physicians or other treating sources.\nThe objectives of our audit were to determine whether:\nexpenditures and obligations for the period October 1,\n1992 through September 30, 1995, were properly authorized, approved,\nand disbursed;\nthe unliquidated obligation balance is correct;\nthe Federal funds drawn down agree with total expenditures\nfor FYs\xc2\xa01993 through 1995; and\ninternal controls over the accounting and reporting of\nadministrative costs claimed for TNDDS were adequate.\nOur methodology included a review of Federal laws, regulations,\nand instructions pertaining to administrative costs incurred by\nTNDDS and to the draw down of Federal funds. We held discussions\nwith TNDHS\xc2\x92 internal auditors, State of Tennessee auditors,\nand SSA`s Atlanta regional office staff. We also reviewed TNDDS\xc2\x92 general\noperating policies and procedures, and maintenance of computer\nequipment inventory.\nWe reviewed internal controls regarding the administration\nof disability determination activities and performed an examination\nof administrative expenditures (personnel, medical service, and\nindirect costs) incurred and claimed by TNDDS for the period October\n1, 1992 through September 30, 1995. We reviewed the reconciliation\nof official accounting records to administrative costs reported\nby TNDDS to SSA on the Form SSA-4513 report for the period October\xc2\xa01,\n1992 through September 30, 1995, and compared the amount of Federal\nfunds drawn for support of program operations to allowable expenditures.\nThe work was performed at the site of the TNDDS located in\nNashville, Tennessee; at the Office of Audit field office in Birmingham,\nAlabama; and SSA Headquarters in Baltimore, Maryland. The field\nwork was conducted from October 1996 to August 1997.\nRESULTS OF REVIEW\nTNDDS claimed administrative costs of $79,911,653 for SSA\ndisability determinations as of June 30, 1996, for the years ended\nSeptember 30, 1993, 1994, and 1995. Obligations reported to SSA\nshould be reduced by $2,012,196 to adjust for overstated disbursements\nand unliquidated obligations for 1993, 1994, and 1995. (See Appendices\nA, B, and C.) Specifically, we determined that:\nMEDICAL SERVICE COSTS OF $425,024 CLAIMED ON FORM SSA-4513\nFOR FYs 1993 TO 1995 WERE OVERSTATED\nA CONTRACT TO INSTALL COMPUTER EQUIPMENT WAS OVERPAID\nBY $18,750\nCLAIMED INDIRECT COSTS EXCEEDED AUDITED INDIRECT COSTS\nBY $6,372\nCOMPUTER EQUIPMENT COSTING $17,839 WAS NOT BEING USED\nBY TNDDS PERSONNEL\nUNLIQUIDATED OBLIGATIONS WERE OVERSTATED BY $1,544,211\nINTERNAL CONTROL WEAKNESSES WERE IDENTIFIED IN MEDICAL\nSERVICE COSTS, THE MAINTENANCE OF EQUIPMENT INVENTORIES, AND\nTHE RECORDING AND REPORTING OF TIME AND ATTENDANCE (T & A)\nAND OVERTIME (OT)\nCONCLUSIONS AND RECOMMENDATIONS\nBased on the tests performed and information obtained from\nSSA, TNDDS, TNDHS and the State of Tennessee, we recommend that\nSSA require TNDDS to:\nrefund $425,024 with applicable interest for costs claimed\non consultative examination (CE) reimbursements in excess of\nthe highest Federal or State rates for FYs 1993, 1994, and 1995;\nrefund $18,750 with applicable interest for costs claimed\nin excess of a contract price for FY 1995;\nrefund $6,372 with applicable interest for unsupported\nindirect costs claimed for FY 1993 and periodically review these\nobligations to assure that proper balances are reported on Form\nSSA-4513;\nreimburse SSA $17,839 with applicable interest for the\ncost of computer equipment used by TNDHS; and\ndecrease unliquidated obligations by $1,544,211 for computer\nsystem upgrades not supported by outstanding purchase orders\nfor FYs 1994 and 1995.\nIn addition, we have the following internal control recommendations\nfor TNDDS:\nmaintain a crosswalk of TNDDS\xc2\x92 CE codes to the American\nMedical Association\xc2\x92s (AMA) Physicians\xc2\x92 Current Procedural\nTerminology (CPT) manual codes used by Federal and State agencies\nthat provide similar services. Provide a costing methodology\nto enable SSA to determine that TNDDS\xc2\x92 services do not exceed\nthe highest rate paid by Federal or other agencies in the State\nfor the same or similar services;\nstrengthen internal controls over payroll T&A records\nto prevent duplicate certifications and the potential for submission\nof erroneous T&A records; and\nimprove internal controls to assure that OT logs and OT\nworkload reports contain prior approval and certification of\nemployee OT, evidenced by signatures of supervisory personnel\nresponsible for the OT.\nWe also have the following recommendations to SSA:\nreview the various components of the Statewide Indirect\nCost Allocation Plan (Cost Allocation Plan) to assure that services\nare planned and will be rendered to TNDDS for all categories\nof indirect costs and notify HHS of any exceptions prior to final\napproval; and\ncontrols over desktop computers, printers, and other equipment\nshould be monitored as part of its oversight procedures.\nAGENCY COMMENTS AND THE OFFICE OF THE INSPECTOR GENERAL (OIG) RESPONSE\nAn exit conference was held with TNDDS and SSA on November\n25, 1997. Subsequently, TNDDS responded with written comments to\nour draft findings. Overall, TNDDS did not concur with our findings.\nThe findings and recommendations as presented consider the comments\nand additional information provided by TNDDS. We believe our recommendations\nare valid and should be implemented. SSA advised us that it had\nno further comments. For a full explanation, see page 15 of this\nreport. The full text of TNDDS\xc2\x92 comments is shown in Appendix\nE.\nBack to top\nINTRODUCTION\nThe DI program was established in 1954 under title\nII of the Act. The program is designed to provide benefits\nto wage earners and their families in the event the wage earner\nbecomes disabled. In 1972, the Congress enacted the SSI program\n(P.L. 92-603). Title XVI of the Act provides a nationally\nuniform program of income to financially needy individuals who\nare aged, blind, or disabled.\nSSA is primarily responsible for implementing the general\npolicies governing the development of disability claims under the\nDI and SSI programs. Disability determinations under both DI and\nSSI are performed by an agency in each State in accordance with\nFederal regulations. In carrying out its obligation, each SA is\nresponsible for determining claimants\xc2\x92 disabilities and ensuring\nthat adequate evidence is available to support its determinations.\nTo assist in making proper disability determinations, each SA is\nauthorized to purchase medical examinations, x-rays, and laboratory\ntests on a consultative basis to supplement evidence obtained from\nclaimants\xc2\x92 physicians or other treating sources. SSA pays\nthe SA for 100 percent of allowable expenditures. Each year, SSA\ndetermines the amount of funding authorization. Once approved,\neach SA is allowed to withdraw Federal funds through HHS\xc2\x92 PMS\nto meet immediate program expenses. HHS` Division of Payment\nManagement is responsible for operating this centralized payment\nsystem.\nCash drawn from the Department of the Treasury (Treasury)\nto pay for program expenditures is to be drawn in accordance with\n31 Code of Federal Regulation (CFR), Part 205 and, since July\xc2\xa01,\xc2\xa01994,\na Treasury/State agreement under the Cash Management Improvement\nAct (CMIA). At the end of each quarter of the Federal FY, each\nSA submits to SSA a "State Agency Report of Obligations for\nSSA Disability Programs" (Form SSA-4513) to account for program\ndisbursements and unliquidated obligations. An advance or reimbursement\nfor costs under the program is subject to the requirements set\nforth in the Office of Management and Budget\xc2\x92s (OMB) Circular\nA-87, "Cost Principles for State and Local Governments."\nTNDDS is a component within the Division of Rehabilitation\nServices (DRS) under TNDHS, the parent agency. TNDDS employed approximately\n375 people, and for the 3 years audited, had an average annual\nbudget of $26.7\xc2\xa0million. SSA authorized a budget of $79,983,108\nfor FYs\xc2\x92 1993 through 1995 disability determinations, the\nonly Federal program for which TNDDS conducted operations. TNDHS\xc2\x92 Fiscal\nServices group performs TNDDS\xc2\x92 primary accounting functions.\nAllocation of indirect costs is done according to TNDHS\xc2\x92 indirect\ncost agreement approved by HHS.\nBack to top\nSCOPE\nAND METHODOLOGY\nWe audited the costs reported by TNDDS in its Report of Obligations\nfor SSA Disability Programs (Form SSA-4513) for the period October\n1, 1992 through September 30, 1995, as reported to SSA through\nJune 30, 1996. The purpose of the audit was to determine whether\nTNDDS complied with the laws, rules and regulations, and established\npolicies governing SSA\xc2\x92s DDS program. The audit included a\nreview of allowed expenditures and the proper balances of unliquidated\nobligations. We also reconciled the Federal payments to the allowed\nexpenditures to determine the final amounts due to or from TNDDS.\nTNDDS costs are reported in four categories: personnel, medical,\nindirect, and all other costs. We developed sampling plans to test\npersonnel. Medical expenditures were randomly selected from the\nuniverse. (See Appendix D.) TNDDS\xc2\x92 records were not sufficient\nfor us to test all maximum allowable charges for CEs claimed as\nmedical expenditures. However, we were able to test x-ray and lab\nfees, and other medical costs. We determined that indirect costs\nwere claimed in accordance with the Cost Allocation Plan. We judgmentally\nselected two cost items reported in the "all other" category\nfor review. For unliquidated obligations, we reviewed the balances\nof all amounts reported.\nWe obtained sufficient evidence and conducted such tests,\nas necessary, to assess TNDDS\xc2\x92 compliance with applicable\nlaws and regulations relating to the draw down of funds pursuant\nto HHS\xc2\x92 PMS regulations, and its accounting for disbursements\nand unliquidated obligations pursuant to Treasury regulation 31\xc2\xa0CFR\nPart 205, the CMIA agreement effective July 1, 1994, OMB Circular\xc2\xa0A-87,\nand SSA\xc2\x92s Program Operations Manual System (POMS). Except\nas noted under "RESULTS OF REVIEW," the results of our\ntests indicated that, with respect to the items tested, TNDDS complied\nin all material respects with Federal cost principles and regulations.\nFor those items not tested, nothing came to our attention to indicate\nthat the untested items were not in compliance with applicable\nlaws and regulations.\nOur audit of TNDDS\xc2\x92 administrative costs for FYs 1993\nthrough 1995 was performed in accordance with generally accepted\ngovernment auditing standards. The objectives of our audit were\nto determine whether:\nexpenditures and obligations for the period October 1,\n1992 through September 30, 1995, were properly authorized, approved,\nand disbursed;\nunliquidated obligation balances were correct;\nFederal funds drawn down agree with total expenditures\nfor FYs 1993 through 1995; and\ninternal controls over the accounting and reporting of\nadministrative costs claimed for TNDDS were adequate.\nTo accomplish our objectives, we performed the following:\nReviewed Title 20 CFR sections, POMS, and other instructions\npertaining to administrative costs incurred by TNDDS and the\ndraw down of Federal funds covered by the CMIA agreement.\nInterviewed internal auditors for the State of Tennessee\nand SSA`s regional office (RO) staff on the reporting of\ncosts and RO oversight.\nReviewed SSA and TNDDS\xc2\x92 policies and procedures on\nthe recording and reporting of expenditures and obligations.\nReviewed the Federal funds drawn down by TNDDS.\nPerformed an examination of administrative expenditures\n(personnel, medical service, indirect, and all other nonpersonnel\ncosts) incurred and claimed by TNDDS for the period October 1,\n1992 through September 30, 1995.\nReviewed the reconciliation of official accounting records\nto administrative costs reported by TNDDS to SSA on Form SSA-4513\nreports for the period October 1, 1992 through September 30,\n1995.\nCompared the amount of Federal funds drawn for support\nof program operations to the allowable expenditures.\nWe reviewed the internal controls applicable to the recording\nand reporting of funds authorized, expensed, and obligated. We\nalso reviewed internal controls related to the disbursement of\nfunds and personnel costs. We found the internal controls were\nlogical in design except for the weaknesses identified in this\nreport. Our review of controls included tests of each line item\non Form SSA-4513, including personnel, medical, and indirect costs,\nand a limited review of all other costs.\nOur work was performed at the site of TNDDS located in Nashville,\nTennessee; the Office of Audit field office in Birmingham, Alabama;\nand SSA Headquarters in Baltimore, Maryland. Field work was conducted\nfrom October 1996 through August 1997. (See Appendix G for SSA\xc2\x92s\nOrganizational Chart.)\nBack to top\nRESULTS\nOF REVIEW\nOur review of the reconciliation of accounting records to\nadministrative costs claimed by TNDDS showed that disbursements\nand unliquidated obligations were overstated. During FYs 1993 through\n1995, TNDDS overstated disbursements by $467,985 and unliquidated\nobligations by $1,544,211. As a result, total obligations reported\nto SSA by TNDDS for the periods under audit should be reduced by\na total of $2,012,196. (See Appendices A, B, and C.)\nWe reviewed personnel costs by selecting a sample and reviewing\ntransactions in accordance with that sample. We also reviewed draw\ndowns to determine whether the draw downs agreed with the costs\nthat were claimed. We did not find any questioned costs in either\nof these areas.\nTNDDS\xc2\x92 accounting\nfor disbursements\nTNDDS\xc2\x92 costs claimed on Form SSA-4513 should be reduced\nby $467,985 for the 3-year audit period, FYs 1993 through 1995.\nCost adjustments occurred in the medical services, indirect costs,\nand all other nonpersonnel cost categories. We compared the line\nitem costs reported on Form SSA-4513 to the audited cost accounting\nrecords for TNDDS.\nThe audit adjustments between Form SSA-4513 and the audited\ncost accounting records are shown below.\nDISBURSEMENTS\nFOR FYs 1993 \xc2\x96 1995\nFORM SSA-4513 LINE ITEMS\nFORM SSA-4513\nCOSTS CLAIMED\nAUDITED\nCOST ACCOUNTING RECORDS\nAUDIT ADJUSTMENTS\nPERSONNEL COSTS\n$40,699,215\n$40,699,215\n$0\nMEDICAL SERVICE\nCOSTS\n22,036,696\n21,611,672\n425,024\nINDIRECT COSTS\n5,759,691\n5,753,319\n6,372\nALL OTHER NONPERSONNEL\nCOSTS\n11,416,051\n11,379,462\n36,589\nTOTAL\nDISBURSEMENTS\n$79,911,653\n$79,443,668\n$467,985\nMedical Service Costs\nIn reviewing medical service costs, we selected a sample\nof CE fees claimed by TNDDS during our audit period. CEs are ordered\nby TNDDS as part of its eligibility determination process. We tested\nexpenditures for medical examinations, X-rays, and laboratory tests\nto confirm that TNDDS\xc2\x92 rates of payment complied with SSA\nrequirements for the reimbursement of medical and other services.\nAccording to TNDDS personnel, the CE fee schedule was historically\nbased, in part, on the Medicaid Maximum Price Listing, and, in\npart, on a psychological services price list provided by TNDHS\xc2\x92 DRS\nwhich uses usual and customary charges. TNDDS did not use the AMA\nCPT codes when requesting CE services. TNDDS created an internal\ncoding system to expedite purchases of medical services by its\npersonnel. TNDDS did not crosswalk its CE codes or otherwise maintain\nits records in a manner that would enable us to test CE fees for\ncompliance with SSA regulations. We made several requests for TNDDS\xc2\x92 criteria\nfor maximum allowable charges. TNDDS used Medicaid as its criteria\nfor maximum allowable charges for FY 1993. However, TNDDS was unable\nto demonstrate the use of maximum allowable charges in its payment\nof medical services. For FYs 1994 through-95, TNDDS did not have\ncriteria for maximum allowable charges. TNDDS personnel stated\nthey were unable to obtain fee schedules from Medicare, TennCare,\nor other organizations that provide medical services. Therefore,\nwe performed alternative tests.\nTitle 20 CFR, sections 404.1624 and 416.1024, set forth SSA\xc2\x92s\nrequirements for the purchase of medical and other services, as\nfollows:\nThe State will determine the rates of payment to be\nused for purchasing medical or other services necessary to\nmake determinations of disability. The rates may not exceed\nthe highest rate paid by Federal or other agencies in the State\nfor the same or similar type of service. The State will maintain\ndocumentation to support the rates of payment it uses.\nSSA\xc2\x92s POMS, section DI 39545.210, states the DDS will\nconsider its fee schedules as a maximum payment schedule. Authorized\npayments will represent the lower of either the provider\xc2\x92s\nusual and customary charge or, the maximum allowable charge under\nthe fee schedule. (Emphasis added.) The rates must be reasonable\nand necessary for the administration of the program. POMS, section\xc2\xa039545.410,\nstates that where possible, the AMA coding system should be used\nto identify each procedure in the schedule. In addition, the DDS\nshould maintain a well-documented methodology for establishing\nand updating rates of payment.\nSince TNDDS was unable to provide copies of its Medicaid\nand Medicare fee schedules, we obtained Medicare fee schedules\nfor 1993 through1996 and AMA CPT reference books for 1994, 1995,\nand 1997 from the Medicare intermediary for the State of Tennessee.\nIn testing CE fees, we used established Medicaid and/or Medicare\nfee schedules and TNDDS\xc2\x92 fee schedules. For FY 1993 and the\nfirst quarter of FY 1994 (ending December 31, 1993), we applied\nthe greater of 1990 through 1993 Medicaid rates used by TNDDS as\nits maximum allowable charges or the Medicare rates to determine\nthe highest allowable rates of payment. For the remainder of FY\n1994 and all of 1995, we used Medicare rates because they represented\nthe highest rates of reimbursement available after TNDDS terminated\nits Medicaid program.\nEffective January 1, 1994, Tennessee adopted a statewide\nmanaged care program known as TennCare. All medical fees under\nthe new program were negotiated on a provider-by-provider basis.\nThese changes eliminated TNDDS\xc2\x92 use of the Medicaid price\nlist as its maximum allowable charge for rates of payment to be\nused in purchasing medical or other services. The Tennessee Bureau\nof Medicaid confirmed the State of Tennessee terminated its Medicaid\nprogram on December\xc2\xa031, 1993.\nWe requested the assistance of TNDDS personnel in matching\nits CE codes to established AMA CPT codes to assure the comparison\nof similar medical services in our testing. After consultation\nwith TennCare personnel, most of the remaining coding discrepancies\nwere resolved. We also contacted CIGNA Medicare of Tennessee and\nthe Health Care Financing Administration to resolve other questioned\ncodes.\nWe selected a simple random sample of 200 CEs purchased by\nTNDDS for each year under audit. (See Appendix D.) We matched TNDDS\xc2\x92 CE\ncodes to AMA CPT codes. After determining the equivalent AMA CPT\ncodes, we calculated the differences between established Medicaid/Medicare\nfee schedules and TNDDS\xc2\x92 fee schedules. The resulting variances\nwere applied to the actual number of procedures paid by TNDDS for\neach year under audit. We determined TNDDS was not in compliance\nwith 20 CFR 404 and 416 due to its failure to apply maximum allowable\ncharges in FY 1993 and its lack thereof for FYs 1994 and 1995.\nTNDDS\xc2\x92 psychological fees were based on the usual and\ncustomary charges of TNDHS\xc2\x92 DRS whereas AMA CPT codes were\nbased on an hourly rate. We accepted the conversion of customary\ncharges to hourly rates based on information provided by TNDDS\nand other professionals. Based on our review, we concluded that\nthe amounts paid for psychological fees did not exceed the highest\nrates paid by Federal or other agencies in the State for the same\nor similar services.\nAs an additional comment, a third-party medical professional\ncontacted by us observed, after reviewing TNDDS\xc2\x92 psychological\ndescriptions and codes, that, in the absence of any reporting of\ntime spent by the CE providers, the extent of testing and quality\nof services provided to patients was a serious concern. SSA may\nwish to study the impact of this on disability determinations.\nWe also tested TNDDS\xc2\x92 laboratory, x-ray, and other medical\ncosts. In testing x-rays, we selected CPT codes that represented\nthe types of x-rays performed and number of views taken. X-rays\nlisted in the Medicare fee schedules contained three codes: an\noverall code, a technical component modifier, and a professional\ncomponent (\xc2\x9626) modifier. The Medicaid Maximum Price Listing\nprovided by TNDDS did not use the same modifiers. The modifiers\nallow for separate billing of the two x-ray components: the technical\n(filmtaking) component and the professional (interpretation) component.\nThe maximum allowable charge on the Medicare schedules for the\n5-digit overall code includes filmtaking and interpretation\nbut also allows for separate billing of the components using the\nmodifiers. In all instances, we used the overall code (inclusive\nof the two components) as the maximum fee allowed.\nWe also used Deficit Reduction Act of 1984 (DEFRA) legislation\nin applying maximum price caps of 80 percent and 62 percent to\nx-ray and blood test codes. Applying the maximum allowable charges\nfor labs, x-rays, and other medical costs for each FY resulted\nin total overpayments of $425,024, as shown below:\nLabs\nX-rays\nOther\nMedical Costs\nTotal\nFY 1993\n$1,516\n$ 83,872\n$ 8,857\n$ 94,245\nFY 1994\n$3,516\n$158,136\n$ 28,828\n$ 190,480\nFY 1995\n$2,172\n$104,880\n$ 33,247\n$ 140,299\nTotals\n$ 7,204\n$ 346,888\n$ 70,932\n$ 425,024\nResults of our analyses for the 3-year audit period show\nthat TNDDS\xc2\x92 CE costs exceeded the highest allowable rates\nby a total of $425,024 and should be refunded to SSA with applicable\ninterest. TNDDS\xc2\x92 practice of using an internal procedural\ncoding system that does not readily translate to the AMA CPT coding\nsystem and its lack of and/or failure to apply maximum allowable\ncharges were the primary reasons for the CE overcharges. TNDDS\nshould be required to maintain a crosswalk of its CE codes to AMA\nCPT codes used by Federal and State agencies that provide similar\nservices. TNDDS should also provide a costing methodology to enable\nSSA to determine that TNDDS\xc2\x92 services do not exceed the highest\nrate paid by Federal or other agencies in the State for the same\nor similar services.\nBack to top\nALL\nOTHER NONPERSONNEL COSTS\nOverpayment\nof Contract to Install Computer Equipment\nOn March 31, 1994, TNDDS was funded by SSA to upgrade its\nAS/400 minicomputer, undertake software conversion, site preparation,\nand training. On May 16, 1994, TNDDS entered into a sole source,\nproprietary contract with VERSA, with headquarters in Toronto,\nCanada, in the amount of $300,000, for the purpose of converting\npresent software in preparation for examiner workstations.\nWe reviewed five invoices and disbursement records totaling\n$318,750 in payment to VERSA under contract number FA-4-11091-4-00.\nContract sections B.2., B.3., and B.7. provide:\nSection B.2.: The Compensation set forth in Section B.1.\nshall constitute the entire compensation due the Contractor for\nthe Service and all the Contractor\xc2\x92s obligations hereunder\nregardless of the difficulty, materials or equipment required.\nSection B.3.: The Compensation set forth in Section B.1.\nis firm for the duration of the Contract and is not subject to\nescalation for any reason, unless amended.\nSection B.7.: In no event shall the maximum liability to\nthe STATE under this contract exceed Three Hundred Thousand Dollars\n($300,000).\nThe only contract amendment, signed by TNDHS on April 26,\n1995, extended the contract period for deliverables through December\n29, 1995. The amendment stipulated the State would have no obligation\nfor services not performed in accordance with the accompanying\nschedule. No other amendments were provided by TNDDS or acknowledged\nby the vendor. VERSA confirmed the $18,750 payment related to the\nreferenced contract. In the absence of an amendment modifying the\ncontract price, TNDDS violated the contract provisions and the\nexcess payment of $18,750 should be refunded to SSA with applicable\ninterest.\nControls\nover Computer Equipment Inventory\nWe reviewed TNDDS\xc2\x92 controls over computer equipment\nby selecting three locations in which to trace inventory logs to\nthe physical equipment. The review disclosed several instances\nin which equipment was assigned outside TNDDS or to the wrong person,\nunassigned, or not listed on the inventory.\nTNDHS Office Services staff, not TNDDS personnel, were using\nfour desktop computers and two laser printers purchased by SSA\nfor $17,839. Costs associated with TNDHS\xc2\x92 Office Services\nare allocated based on TNDDS\xc2\x92 average filled positions. Cost\ncenters allocated to TNDDS are as follows: Office Services Administration\n(cc125), Printing (cc126), Procurement (cc127), Central Supply\n(cc128), and Lease Management (cc133). During the audit period,\nthese cost centers allocated costs to TNDDS. Therefore, we consider\nthe use of TNDDS equipment duplicative of costs claimed through\nthe Cost Allocation Plan.\nIn addition, we tested inventory controls and visually inspected\n5 of 12 IBM ThinkPad notebook computers. The remaining seven notebook\ncomputers could not be verified. The notebooks were stored in a\nlocked cabinet, but the key could not be found. We were told that\nall the notebooks had been signed out, but no log was produced,\nand no internal control procedures were provided. TNDDS later produced\na sign-out sheet for the 12 notebooks that we tested for accuracy.\nComputer assignments could not be determined. For example, one\nperson had possession of a notebook still assigned to another employee.\nThe person with the notebook had not signed the inventory control\nsheet. Another employee had a notebook at his home since November\n1996. TNDDS\xc2\x92 record was inadequate and poorly maintained.\nTNDDS remedied the situation by establishing a formal inventory\nlog book for the notebook computers which contains the employee\xc2\x92s\nname, date the equipment is signed out, and expected and actual\nreturn dates. A second inventory check verified or accounted for\nall 12 notebooks. We did not test any changes TNDDS made to inventory\ncontrols over the desktop computers, printers, and other equipment.\nThese controls should be monitored by SSA as part of its oversight\nprocedures.\nTNDDS\nDifference In Audited vs. Claimed Indirect Costs\nWe have also determined there is a difference of $6,372 between\nthe audited and claimed indirect costs under the Cost Allocation\nPlan in accounts 345.01, and 345.17, statewide parent and departmental\nallocations, and space allocations, respectively. Total indirect\ncosts billed by the State of Tennessee to TNDDS were $1,916,628.\nTotal costs claimed on Form SSA-4513 for FY 1993 were $1,923,000.\nSince no unliquidated obligations exist, TNDDS should reimburse\nSSA the difference of $6,372 and adjust the account balances to\ntheir proper amounts. SSA should periodically review the Cost Allocation\nPlan with TNDDS to assure that indirect costs reflect the proper\ncharges and types of services rendered to TNDDS.\nBack to top\nTNDDS\xc2\x92 accounting\nfor unliquidated obligations\nUnliquidated obligations are cost commitments for orders\nplaced, contracts awarded, and services received that have not\nbeen paid. Our review showed that TNDDS costs reported on Form\nSSA-4513 as of June 30, 1996, were overstated by $1,544,211 for\nunliquidated obligations that were no longer needed. We found controls\nwere inadequate to detect the overstatement. TNDDS did not follow\nprocedures for the approval and monitoring of unliquidated obligations.\nThe errors occurred in the line item category as follows:\nUNLIQUIDATED\nOBLIGATIONS FOR FYs 1994 \xc2\x96 1995\nFORM SSA-4513 LINE ITEMS\nFORM SSA-4513\nCOST CLAIMED\nAUDITED COST\nACCOUNTING RECORDS\nAUDIT ADJUSTMENT\nALL OTHER NONPERSONNEL\nCOST\n$11,416,051\n$9,871,840\n$1,544,211\nTOTAL\nUNLIQUIDATED OBLIGATIONS\n$11,416,051\n$9,871,840\n$1,544,211\nWe reviewed the unliquidated obligation line item - All Other\nNonpersonnel Costs for FYs 1994-1995. TNDDS obligated $527,476\nand $1,016,735 in FY 1994 and 1995, respectively, to buy electronic\ndata processing equipment (EDP) for the intelligent work station/local\narea network (IWS/LAN) approved by SSA. We obtained copies of purchase\norders and interviewed TNDDS systems personnel and TNDHS purchasing\npersonnel. We determined that no EDP equipment purchases remained\noutstanding.\nTNDDS and TNDHS are responsible for ensuring obligations\nare proper. POMS,\xc2\xa0section DI 39506.809, states that obligations\nshould be supported by a valid purchase order or other binding\nagreement for the purchase of supplies, equipment, and other contractual\nservices.\nPOMS, section DI 39506.812, states that valid unliquidated\nobligations should be supported by documents and records describing\nthe nature of obligations and supporting amounts recorded. POMS\nfurther provides that SAs should review unliquidated obligations\nat least once each month and cancel those no longer valid. However,\nwe found that neither TNDHS nor TNDDS reviews unliquidated obligations\nas a monthly routine. Controls over the monitoring of unliquidated\nobligations should be improved so that funds obligated but no longer\nneeded can be reduced.\nInternal control issues\nat TNDDS\nOMB Circular A-123 defines management controls as the organization,\npolicies, and procedures used to reasonably ensure that: (i) programs\nachieve their intended results, (ii) resources are used consistent\nwith agency mission; (iii)\xc2\xa0programs and resources are protected\nfrom waste, fraud, and mismanagement; (iv) laws and regulations\nare followed; and (v) reliable and timely information is obtained,\nmaintained, reported and used for decision-making.\nThe American Institute of Certified Public Accountants\xc2\x92 Statements\non Auditing Standards, No. 1, section 110, states management is\nresponsible for adopting sound accounting policies and establishing\nand maintaining an internal control structure that will, among\nother things, record, process, summarize, and report financial\ndata that is consistent with management\xc2\x92s assertions embodied\nin the financial statements.\nControls\nover Time and Attendance Records and Sign-in Logs\nTNDDS had personnel service costs of $40.7 million, during\nthe 3-year audit period. We reviewed T&A records for 37 of\n45 employees in our sample (8\xc2\xa0records could not be found).\nWe verified the missing employee records by other means. T&A\nrecords require certification of accuracy by three different signatories:\nthe timekeeper, employee, and his/her supervisor. For 15 of the\n37\xc2\xa0employee records reviewed, 2 of the 3 signatures were the\nsame. In some instances, the employee was also his/her own timekeeper,\nand in others, the supervisor was also the timekeeper or had signed\nfor the employee. These duplications occurred on 41 percent of\nT&A records reviewed.\nOMB Circular A-123 states key duties such as authorizing,\napproving, recording transactions, . . . shall be assigned to separate\nindividuals to minimize the risk of loss to the Government. TNDDS\ndid not follow procedures for the separation of payroll recordkeeping\nfunctions to ensure the accuracy and reliability of payroll records.\nTNDDS should strengthen internal controls over payroll T&A\nrecords to prevent duplicate certifications and the potential for\nsubmission of erroneous T&A records.\nControls\nover the Earning of Employee Overtime\nWe selected employee OT for review because TNDDS\xc2\x92 OT\nusage, though not extreme, totaled more than 75,000 hours, or the\nequivalent of 38 staff positions, over the 3-year audit period.\nTNDDS\xc2\x92 OT expense totaled $1.1 million for the audit period.\nA comparison of personnel service costs among the eight states\nin the southeastern region disclosed that TNDDS had the second\nhighest costs in FYs\xc2\xa01993 and 1994, behind Georgia. TNDDS\nhad the highest costs for FY 1995, as Georgia dropped to second\nplace. TNDDS\xc2\x92 FY 1995 obligations per case (i.e., total obligations \xc2\xb8 total\nclaims processed) were highest at $311, followed by Georgia with\n$301. The average for the remaining six states was $254. TNDDS\xc2\x92 obligations\nper case were 22 percent higher than the average. In contrast,\nTNDDS\xc2\x92 production ranked fourth and fifth in the region during\nthe audit period.\nSSA\xc2\x92s POMS DI 39518.015 states DDS management has a\nresponsibility to establish payment procedures for OT worked by\nemployees of the disability unit such as disability examiners,\nclerical personnel, and medical consultants. For all direct and\nindirect personnel services and related employee costs, DDSs are\nrequired to maintain records that support payroll expenditures\nand related services rendered by officers or employees of the agency,\nreflect that OT expense was necessary and properly approved, and\ndemonstrate applicable personnel rules and regulations were observed.\nPOMS also states while OT may be necessary to provide the productive\ncapacity to cope with variations and peaks in workload levels,\nOT should be used only where it would be consistent with efficient\neconomical administration and that necessary controls applicable\nto OT work must be maintained in State agencies.\nWe analyzed OT from the statistical sample of employees drawn\nfor the purpose of testing payroll costs. We determined that 93.5\nhours of OT were recorded during the sampled pay periods, with\none employee accounting for the majority of OT hours. OT was recorded\nfor this employee every month during the 3-year audit period, except\nOctober 1993 when OT could not be earned due to budget constraints.\nAnalysis of this clerical supervisor\xc2\x92s use of OT disclosed\nthat the employee routinely worked 11 to 14 hour days and was among\nthe last TNDDS employees to leave the building. OT for this and\nseveral other clerical supervisors was 37 percent to 56 percent\nabove the normal 1,950 hour work year. TNDDS did not require these\nsupervisors to use a sign-in/sign-out log for OT.\nTNDDS provided excerpts of departmental OT procedures for\n1993 through 1994. Copies of signature logs received at the conclusion\nof field work were generally outside the audit period. OT hours\nfor selected employees with high OT were independently verified\nthrough inspection of sign-in logs maintained by building security.\nTwo clerical supervisors routinely left 4 to 5 hours after the\nsupervisor who certified their time cards. OT logs and workload\nreports contained insufficient evidence of supervisory signatures\nand approval. While these examples appeared to be aberrant situations\ncompared to all other employees, TNDDS should improve internal\ncontrols to assure that OT logs and workload reports contain prior\napproval and certification of all employee OT, evidenced by signatures\nof supervisory personnel responsible for the OT.\nBack to top\nOTHER\nMATTERS\nTNDDS\xc2\x92 Indirect Costs for Internal Audit Are Not\nAllocable\nSingle Audits conducted by the Division of State Audit for\nState FYs 1994 and 1995 contained findings that TNDHS\xc2\x92 internal\naudit function was ineffective and understaffed. State Audit Reports\ndisclosed that, in both periods, TNDHS\xc2\x92 internal audit section\ndid not have sufficient personnel to meet the needs of the department.\nThe FY 1994 report noted that TNDHS\xc2\x92 internal audit section\nhad no more than four auditors, two of whom performed audits solely\nof Child and Adult Care Food Program recipients. The FY 1995 report\nnoted TNDHS\xc2\x92 internal audit function was understaffed and\ndue to the lack of personnel, planned audits and reviews were not\ncompleted.\nTNDHS internal auditors attending the October 1996 entrance\nconference stated they had not performed any internal reviews for\nTNDDS during our 3-year audit period. TNDDS incurred internal audit\ncharges of $21,769 for FYs 1993 through 1995 under indirect cost\nallotment code 345.01, cost center 104. TNDDS was reimbursed by\nSSA for 100 percent of the quarterly charges, as shown below.\nQuarter Ended:\nIndirect cost charged:\nDecember 31, 1992\n$1,040\nMarch 31, 1993\n1,749\nJune 30, 1993\n1,948\nSeptember 30, 1993\n1,837\n$ 6,574\n(FY 1993)\nDecember 31, 1993\n$1,733\nMarch 31, 1994\n2,047\nJune 30, 1994\n2,126\nSeptember 30, 1994\n2,080\n$ 7,986\n(FY 1994)\nDecember 31, 1994\n$1,984\nMarch 31, 1995\n1,195\nJune 30, 1995\n1,719\nSeptember 30, 1995\n2,311\n$ 7,209\n(FY 1995)\nTotal Indirect Cost\n$21,769\nBased on the Single Audit Reports of the State Audit Division\nand statements of the TNDHS auditors, TNDDS incurred costs for\nwhich no services or benefits were received.\nSince indirect costs were reviewed on a selective basis,\nwe were unable to determine the extent of SSA reimbursements to\nTNDDS for services not rendered by the State of Tennessee. SSA\nneeds to take a more active role in the development and acceptance\nof the Cost Allocation Plan. SSA should review the various components\nof the Cost Allocation Plan to assure that services are planned\nand will be rendered to TNDDS for all categories of indirect costs.\nSSA should notify HHS of any exceptions prior to final approval.\nBack to top\nCONCLUSIONS\nAND RECOMMENDATIONS\nBased on information obtained from SSA, TNDDS, TNDHS, and\nthe State of Tennessee, and the tests performed, we recommend that\nSSA require TNDDS to:\n1.\xc2\xa0\xc2\xa0 Refund $425,024 with applicable interest\nfor the costs claimed on CE reimbursements in excess of the highest\nFederal or State rates for FYs 1993, 1994, and 1995.\n2.\xc2\xa0\xc2\xa0 Refund $18,750 with applicable interest\nfor costs claimed in excess of a contract price for FY 1995.\n3.\xc2\xa0\xc2\xa0 Refund $6,372 with applicable interest for\nunsupported indirect costs claimed for FY 1993 and to periodically\nreview these obligations to assure that proper balances are reported\non\xc2\xa0\xc2\xa0 Form SSA-4513.\n4.\xc2\xa0\xc2\xa0 Reimburse SSA $17,839 with applicable interest\nfor cost of computer equipment used by TNDHS.\n5.\xc2\xa0\xc2\xa0 Decrease unliquidated obligations by $1,544,211\nfor computer system upgrades not supported by outstanding purchase\norders for FYs 1994 and 1995.\nIn addition, we have the following internal control recommendations\nfor TNDDS:\n6.\xc2\xa0\xc2\xa0 Maintain a crosswalk of TNDDS\xc2\x92 CE codes\nto AMA CPT codes used by Federal and State agencies that provide\nsimilar services. Provide a costing methodology to enable SSA\nto determine that TNDDS\xc2\x92 services do not exceed the highest\nrate paid by Federal or other agencies in the State for the same\nor similar services.\n7.\xc2\xa0\xc2\xa0 Strengthen internal controls over payroll\nT&A records to prevent duplicate certifications and the potential\nfor submission of erroneous T&A records.\n8.\xc2\xa0\xc2\xa0 Improve internal controls to assure that\nOT logs and OT workload reports contain written approval and\ncertification of employee OT, evidenced by signatures of supervisory\npersonnel responsible for the OT.\nWe also have the following recommendations to SSA:\n9.\xc2\xa0\xc2\xa0 Review the various components of the Cost\nAllocation Plan to assure that services are planned and will\nbe rendered to TNDDS for all categories of indirect costs and\nnotify HHS of any exceptions prior to final approval.\n10. Controls over desktop computers, printers, and other\nequipment should be monitored as part of its oversight procedures.\nAGENCY COMMENTS AND\nOIG RESPONSE\nAn exit conference was held with TNDDS and SSA on November\n25, 1997. Subsequently, TNDDS responded with written comments to\nour draft findings. Overall, TNDDS did not concur with our findings.\nThe findings and recommendations as presented consider the comments\nand additional information provided by TNDDS. We believe our recommendations\nare valid and should be implemented. SSA advised us that it had\nno further comments. See below for a full explanation. The full\ntext of TNDDS\xc2\x92 comments is shown in Appendix E.\nFINDING 1 \xc2\x96 MEDICAL SERVICE COSTS\nTNDDS\xc2\x92 COMMENTS\nTNDDS did not concur that the costs for laboratory, x-ray\nservices, and other medical costs exceeded the highest rate paid\nby Federal or other agencies in the State for the same or similar\ntype of service. TNDDS responded that the OIG had failed to include\nthe fee for interpretation as part of the necessary costs in most\nof the laboratory, x-ray, and other medical cost rates cited in\nthe fee schedules. TNDDS also stated it has an adequate crosswalk\nsystem to AMA CPT manual codes but will undertake further efforts\nto clarify this as an aid for an audit trail.\nOIG RESPONSE\nWhile TNDDS is correct in stating that certain fees are separated\ninto a technical (filmtaking) component and a professional (interpretation)\ncomponent by code, there is also a 5-digit overall code that includes\nfilmtaking and interpretation. In all instances,\nwe used the overall code as the maximum fee allowed. TNDDS also\ncontended type of service (TOS) codes 3 and 5 on the Medicaid Maximum\nPrice Listing represented the filmtaking and interpretation fees.\nHowever, TOS codes represent the location of the service or type\nof service provider. Code 3 indicates medical services and code\n5 indicates a hospital-based provider.\nInformation obtained from the Tennessee Bureau of Medicaid\nconcerning x-ray and blood test codes revealed maximum price caps\nof 80 percent and 62 percent, due to DEFRA legislation. The Tennessee\nBureau of Medicaid also advised us that TNDDS\xc2\x92 use of an interpretation\nfee equal to 33\xc2\xa0percent of filmtaking charges was unique to\nthe DDS and not a customary billing methodology under Medicaid.\nWe used the DEFRA price caps to determine total CE overcharges\nfor FY 1993 and the first quarter of 1994. Similar changes were\nmade to exam codes and the hearing evaluation code based on information\nobtained from TNDDS and other third parties.\nFINDING 2 \xc2\x96 UNLIQUIDATED OBLIGATIONS\nTNDDS\xc2\x92 COMMENTS\nTNDDS did not concur. TNDDS responded that the original correspondence\nfrom SSA\xc2\x92s regional office in Atlanta on this issue could\nnot be retrieved. In telephone conversations between TNDDS and\nthe Atlanta SSA regional office, an agreement was made to obligate\nfunds to the Tennessee Department of Finance and Administration\nto complete the reconfiguration of TNDDS\xc2\x92 occupied space.\nTNDDS also stated that during the post-audit quarter ending\nSeptember 30, 1996, the FY 1994 unliquidated obligation of $527,476\nwas liquidated in the amount of $140,760 and the remaining unexpended\nfunds of $386,716 would be closed out on a final Form SSA-4513.\nThe FY 1995 unliquidated obligation of $1,016,735 has been partially\nliquidated in the amount of $58,308, leaving a balance of $958,427,\nwith invoices for upgrades continuing to be received.\nOIG RESPONSE\nOur audit disclosed that TNDDS reported outstanding obligations\nof $527,476 and $1,016,735 in FYs 1994 and 1995, respectively,\nto buy EDP equipment for the IWS/LAN approved by SSA.\nCopies of purchase orders and interviews with TNDDS systems\npersonnel and TNDHS purchasing personnel confirmed that no EDP\nequipment purchases remained outstanding. TNDDS did not provide\nevidence that the $140,760 and $58,308, subsequently liquidated,\nwere obligated by valid purchase orders or binding agreements prior\nto the end of its respective FY. Therefore, TNDDS has not provided\nany documentary evidence indicating that the reported $1,544,211\nunliquidated balance was for valid obligations recorded prior to\nthe close of the FY. We affirm our recommendation that unliquidated\nobligations be decreased in the amount unsupported by purchase\norders outstanding.\nFINDING 3 \xc2\x96 ALL OTHER NONPERSONNEL COSTS\nTNDDS\xc2\x92 COMMENTS\nTNDDS did not concur with three issues relating to all other\npersonnel costs.\nFirst, TNDDS believed that the $18,750 paid to VERSA Management\nSystems Incorporated (VERSA) was not part of its $300,000 contract\nbut was contracted for separately.\nSecond, TNDDS believed that equipment used by TNDHS personnel,\nvalued at $17,839, was used to provide services to TNDDS. TNDDS\nbelieved that these costs were not duplicative of costs contained\nin its Cost Allocation Plan.\nFinally, TNDDS stated that its records supported costs amounting\nto $6,372, because the amounts reported on Form SSA-4513 match\nits schedule of indirect costs. The schedule agrees with the billings\nfrom Fiscal Services staff who calculate the indirect costs.\nOIG RESPONSE\nWe examined invoices and disbursement records to VERSA totaling\n$318,750 in payment under contract number FA-4-11091-4-00 for the\nconversion of software in preparation for examiner workstations.\nContrary to TNDDS\xc2\x92 comments, VERSA confirmed that the FY 1995\npayment of $18,750 related to the referenced contract. In the absence\nof an amendment modifying the $300,000 contract price, TNDDS violated\ncontract provisions prohibiting escalation and should be required\nto refund the excess payment to SSA with applicable interest.\nWith respect to the second issue, TNDHS Office Services staff\nnot TNDDS personnel were using four desktop computers and two laser\nprinters purchased by SSA for $17,839. During the 3-year audit\nperiod, these office services were also allocated to the TNDDS\nthrough the TNDHS Cost Allocation Plan. No evidence was presented\nto show that TNDHS\xc2\x92 Office Service costs dedicated to TNDDS\nwere more than the costs included in the Cost Allocation Plan.\nSince office services are included in the Cost Allocation Plan,\nwe recommend that TNDDS reimburse SSA for the cost of the computers\nplus applicable interest.\nFinally, our review disclosed that claimed indirect costs\nunder the Cost Allocation Plan exceeded audited costs by $6,372.\nTotal indirect costs billed by the State of Tennessee to TNDDS\nin FY 1993 were $1,916,628. Total costs claimed by TNDDS on the\nForm SSA-4513 were $1,923,000. Information provided by TNDDS Fiscal\nServices staff at the close of our field work contained no evidence\nor explanation for the unlocated variance, and TNDDS has not provided\nany evidence since that time. Since no unliquidated obligations\nexist, TNDDS should reimburse SSA the difference of $6,372 and\nadjust the account balances to their proper amounts.\nFINDING 4 \xc2\x96 INTERNAL CONTROL ISSUES AT TNDDS\nTNDDS\xc2\x92 COMMENTS\nTNDDS partially concurred with this finding. TNDDS responded\nthat for the audit period, some leave and attendance records could\nnot be retrieved due to several moves resulting from space reconfiguration\nand employee transfers. Other records may have been purged in keeping\nwith State government time frames for retention of files. TNDDS\nnoted efforts have been initiated to improve internal controls\nover attendance records.\nOIG RESPONSE\nWe reviewed T&A records for 37 of 45 employees in our\nsample. Although the TNDDS provided a general explanation for the\nloss of records POMS governs record retention in TNDDS\xc2\x92 operations.\nPOMS, sections DI 39509.001 and DI 39509.005, require all financial\nrecords and supporting documents to be retained for a period of\n3 years with the qualification that financial records and supporting\ndocuments will be retained until resolution of Federal audit findings.\nWe recommend TNDDS strengthen internal controls to ensure proper\ncertification and prior approval of employee payroll and OT records.\nBack to top\nAPPENDICES\nAPPENDIX\nA\nOBLIGATIONS REPORTED/ALLOWED\nTENNESSEE DISABILITY DETERMINATION SERVICES FOR FISCAL YEAR 1993\nAS OF JUNE 30, 1996\nTOTAL\nOBLIGATIONS\nUNLIQUIDATED\nOBLIGATIONS\nDISBURSEMENTS\nCOSTS\nREPORTED\nNET RECOMMENDED\nADJUSTMENTS\nALLOWABLE\nREPORTED\nNET RECOMMENDED\nADJUSTMENTS\nALLOWABLE\nREPORTED\nADJUSTMENTS\nALLOWABLE\nPERSONNEL\n$12,581,127\n$0\n$12,581,127\n$0\n$0\n$0\n$12,581,127\n$0\n$12,581,127\nMEDICAL\n7,294,802\n(94,245)\n7,200,557\n0\n0\n0\n7,294,802\n(94,245)\n7,200,557\nINDIRECT\n1,923,000\n(6,372)\n1,916,628\n0\n0\n0\n1,923,000\n(6,372)\n1,916,628\nALL OTHER\n1,976,981\n0\n1,976,981\n0\n0\n0\n1,976,981\n0\n1,976,981\nTOTAL\n($100,617)\n$0\n$0\n$0\n($100,617)\nAPPENDIX B\nOBLIGATIONS REPORTED/ALLOWED\nTENNESSEE DISABILITY DETERMINATION SERVICES FOR FISCAL YEAR 1994\nAS OF JUNE 30, 1996\nTOTAL\nOBLIGATIONS\nUNLIQUIDATED\nOBLIGATIONS\nDISBURSEMENTS\nCOSTS\nREPORTED\nNET RECOMMENDED\nADJUSTMENTS\nALLOWABLE\nREPORTED\nNET RECOMMENDED\nADJUSTMENTS\nALLOWABLE\nREPORTED\nADJUSTMENTS\nALLOWABLE\nPERSONNEL\n$13,474,673\n$0\n$13,474,673\n$0\n$0\n$0\n$13,474,673\n$0\n$13,474,673\nMEDICAL\n7,542,866\n(190,480)\n7,352,386\n0\n0\n0\n7,542,866\n(190,480)\n7,352,386\nINDIRECT\n1,962,839\n0\n1,962,839\n0\n0\n0\n1,962,839\n0\n1,962,839\nALL OTHER\n4,355,927\n(527,476)\n3,828,451\n527,476\n(527,476)\n0\n3,828,451\n0\n3,828,451\nTOTAL\n$527,476\n($527,476)\n$0\n($190,480)\nAPPENDIX\nC\nOBLIGATIONS REPORTED/ALLOWED\nTENNESSEE DISABILITY DETERMINATION SERVICES FOR FISCAL YEAR 1995\nAS OF JUNE 30, 1996\nTOTAL\nOBLIGATIONS\nUNLIQUIDATED\nOBLIGATIONS\nDISBURSEMENTS\nCOST\nREPORTED\nNET RECOMMENDED\nADJUSTMENTS\nALLOWABLE\nREPORTED\nNET RECOMMENDED\nADJUSTMENTS\nALLOWABLE\nREPORTED\nADJUSTMENTS\nALLOWABLE\nPERSONNEL\n$14,643,415\n$0\n$14,643,415\n$0\n$0\n$0\n$14,643,415\n$0\n$14,643,415\nMEDICAL\n7,199,028\n(140,299)\n7,058,729\n0\n0\n0\n7,199,028\n(140,299)\n7,058,729\nINDIRECT\n1,873,852\n0\n1,873,852\n0\n0\n0\n1,873,852\n0\n1,873,852\nALL OTHER\n5,083,143\n(1,053,324)\n4,029,819\n1,016,735\n(1,016,735)\n0\n4,066,408\n(36,589)\n4,029,819\nTOTAL\n$1,016,735\n($1,016,735)\n$0\nBack to top\nAPPENDIX\nD\nCONSULTATIVE\nEXAM CALCULATION METHODOLOGY\nPopulation: The total number of consultative exams (CE) encumbered\nand paid during any Federal fiscal year (FY) by the Tennessee Disability\nDetermination Services (TNDDS) and submitted for reimbursement to\nthe Social Security Administration (SSA). Our population consisted\nof 117,317\xc2\xa0CE transactions paid and reimbursed by SSA for the\naudit period (52,031 for FY 1993, 64,841 for FY 1994, and 60,445\nfor FY 1995).\nSample Size: A sample size of 600 was used because of an\nexpected high error rate. The 600\xc2\xa0sample size consists of 200\nitems for each FY under review (1993 through 1995).\nSample Selection: A simple random sample was used.\nCharacteristics: An error would be a CE claim with a fee\ncharge that is in excess of Medicaid/Medicare maximum charges for\nreimbursement.\nCalculation Methodology: From the sample of CE claims, we\ndeveloped a crosswalk to the American Medical Association\xc2\x92s\nPhysician\xc2\x92s Current Procedural Terminology (CPT) codes. The\ncrosswalk codes were determined in conjunction with TNDDS personnel\nand other medical service providers. For x-rays, we selected CPT\ncodes that represented the types of x-rays performed and the number\nof views taken. We then matched the identified CPT codes with the\nMedicaid/Medicare fee schedules. Certain procedures, like x-rays,\nare a combination of a professional component (interpretation) and\na technical component (filmtaking). When the professional component\nis reported separately, the service may be identified by adding the\nmodifier \xc2\x91\xc2\x9626\xc2\x92 to the usual 5-digit procedure number.\nThe technical component (TC)\xc2\x92 modifier used in the Medicare\nfee schedules denotes the technical component. The Medicare fee schedules\nlist three codes: a 5-digit procedure code; a 5-digit procedure code\nwith \xc2\x91TC\xc2\x92 modifier; and a 5-digit code with \xc2\x91\xc2\x9626\xc2\x92 modifier.\nThe maximum allowable charge on the Medicare schedules for the 5-digit\nprocedure code are inclusive of interpretation and filmtaking but\nallow for separate billing of the two components. For our audit,\nwe used the overall 5-digit procedure code (inclusive of both filmtaking\nand interpretation), without modifiers, as the maximum fee allowed.\nWe applied our crosswalk to the files obtained from TNDDS representing\nCE reimbursements for the years under audit. We calculated the variance\nbetween established Medicaid/Medicare fee schedules and TNDDS\xc2\x92 fee\nschedules. The variances calculated were multiplied by the actual\nnumber of procedures paid by TNDDS for each year under audit and\ntotaled to arrive at the overcharges. TNDDS codes that could not\nbe crosswalked to CPT codes were excluded from our calculations.\nResults: Calculated CE overpayments amounted to: $94,244.76\nfor FY 1993; $190,479.88 for FY\xc2\xa01994; and $140,299.45 for FY\n1995. Total overpayments amount to $425,024.09, as follows:\nOther\nLabs\nX-rays\nMedical Services\nTotals\n1993\n$ 1,515.86\n$ 83,871.60\n$ 8,857.30\n$ 94,244.76\n1994\n$ 3,515.85\n$ 158,136.20\n$ 28,827.83\n$ 190,479.88\n1995\n$ 2,172.32\n$ 104,879.96\n$ 33,247.17\n$ 140,299.45\n$ 7,204.03\n$ 346,887.76\n$ 70,932.30\n$ 425,024.09\nAPPENDIX E\nAPPENDIX\nF\nMAJOR REPORT\nCONTRIBUTORS\nThis audit report was prepared by the Office of Audit,\nEastern Program Audit Group in Baltimore,\nunder the direction of Gary Kramer, Director. Audit staff included:\nAlbert Darago, Acting Director\nBetty Alexander, Deputy Director\nLance Chilcoat, Acting Team Leader\nRobert Daniels, Jr., Auditor-in-Charge\nGlenn Lee, Auditor\nReginald Palmore, Auditor\nFor additional copies of this report, please contact the\nOffice of the Inspector General\xc2\x92s Public Affairs Specialist\nat (410) 966-9135.\nRefer to Common Identification Number A-04-96-54001.\nPrivacy Policy | Website\nPolicies & Other Important Information\xc2\xa0| Site\nMap\nNeed Larger Text?\nLast reviewed or modified'