a g e n d a - kane county, illinois pkt - 13... · • organizational chart • documented policies...

AGENDA COMMITTEE OF THE WHOLE

COUNTY OF KANE

Tuesday, March 26, 2013 5:00 p.m.

County Board Room

Bldg. A

A. CALL TO ORDER B. ROLL CALL C. APPROVAL OF MINUTES: January 29, 2013 & February 26, 2013 D. PRESENTATIONS/DISCUSSION: (*ATTACHMENT)

• *Public Health in Kane County (Carmella Moran, PhD & David Stone, PhD) • Office Overviews

o *Auditor (T. Hunt) o Treasurer (D. Rickert) o *Circuit Clerk (T. Hartwell)

E. ADJOURNMENT

K A N E C O U N T Y P U B L I C H E A L T H C O M M I T T E E J A N U A R Y 2 2 , 2 0 1 3

Public Health in Kane County

Kane County Board of Health charged with protecting and improving public health

Enforce and observe all State laws pertaining to the preservation of health, and all county and municipal ordinances

Investigate the existence of any contagious or infectious disease and adopt measures to arrest the progress of the same

Make all necessary sanitary and health investigations and inspections

Initiate and carry out programs and activities of all kinds, not inconsistent with law, that may be deemed necessary or desirable in the promotion and protection of health and in the control of disease

Recommend to the county board or boards the adoption of such ordinances and of such rules and regulations as may be deemed necessary or desirable for the promotion and protection of health and control of disease

Health Advisory Committee

Board of Health comprised of all members of Kane County Board

Since created by resolution, state legislation stipulates a Health Advisory Committee made up of health professionals be created to advise Board of Health

Health Advisory Committee provides expert knowledge and advice to the Board of Health regarding public health policies and issues

Health Advisory Committee provides expert knowledge and advice to Kane County Health Department regarding strategic initiatives and public health issues

Public Health is Population Health

Public health has made its greatest contribution when focusing on those conditions that ensure health for the population: the environment, sanitation, safe food, safe water, and communicable disease control

While the health of individuals is the ultimate goal, the focus of public health is on the health of populations.

When we talk about populations, we mean either the community as a whole OR subgroups in the community that are at greater risk of disease or injury.

Public Health is not Medical Care

The primary strategy of medical care is treatment of disease in individuals.

The primary strategy of public health is prevention through policy, system and environmental changes that reduce chronic disease, injuries and premature death.

Investment in Public Health

Americans spend $8,2331 per person on healthcare each year, that’s about $22.00/day.

Kane County residents pay about $0.01 per day in taxes2 for county public health services.

Investment in public health can result in medical cost savings as well as gains in worker productivity, reduced absenteeism at work and school, and enhanced quality of life. 1Organization for Economic Co-operation & Development Health Data 2012. Retrieved from: http://www.oecd.org/els/healthpoliciesanddata/OECDHealthData2012FrequentlyRequestedData_Updated_October.xls 2Kane County Health Department Budget FY13

http://www.oecd.org/els/healthpoliciesanddata/OECDHealthData2012FrequentlyRequestedData_Updated_October.xls

How Public Heath Matters

In the last 100 years, average life expectancy has increased by 30 years:

Advances in Medicine account for 4.5 of those additional

years;

Advances in public health account for the other 25.5 years of life by ensuring safe environments, sanitation, safe food, safe water, and communicable disease control*

*Turnock, BJ. Public Health: What it is and How it Works, 3rd Edition. Sudbury, MA: Jones and Bartlett Publishers, 2004.

Airborne, Foodborne & Waterborne Health Threats to Kane County Residents

Hepatitis Pneumonia Human papillomavirus (HPV) E. coli Legionella HIV/AIDS Salmonella Staphylococcus aureus (MRSA) Influenza Clostridium difficile Radon Mumps Rhinoviruses (common cold) Lead Cryptosprodiosis

Growing Threats to Public Health Tuberculosis West Nile Virus Lyme Disease Hantavirus Pertussis

0

20

40

60

80

100

120

140

2008 2009 2010 2011 2012

Kane County Salmonellosis Cases

Public Health Matters Now in Kane County Obesity, Chronic Disease Premature Death

69% of Kane County residents are overweight or obese. This increases the risk for health

problems including heart disease, type 2 diabetes, high blood pressure, cancer, and stroke.

Chronic diseases cause 81%

of deaths in Kane County. They are costly to individuals,

health care providers, taxpayers and strains the entire health system. In 2010, the cost of heart disease and stroke in the U.S. was about $444 billion.

Chronic diseases are the most common and costly of all health problems, but they are also the most preventable

40 percent of cancer, as well as 80 percent of heart disease, stroke, and type 2 diabetes, could be prevented if Americans exercised more, stopped smoking, and ate healthier

Four common, health-damaging, but modifiable behaviors are responsible for much of the illness, disability, and premature death related to chronic diseases. 1. Tobacco use 2. Insufficient physical activity 3. Poor eating habits 4. Excessive alcohol use

Kane County residents are the 8th healthiest in Illinois out of 102 counties

Medical Care: Screening, diagnostics & treatments for individuals

Personal Behaviors: Exercise, healthy eating, & medication

Public Health (KCHD): Developing effective health policies, partnerships, & environmental systems Access to fruit & vegetables for all through

community gardens Access to safe walkways, parks and open space

in all communities Coordination of public health & medical efforts

to make healthy choices the easy choice for communities

Public Health

(KCHD)

Kane County Medical

Providers

Healthier individuals

& communities

Personal Choices

6 top health threats identified by the Kane County Community

1. Obesity 2. Chronic Disease 3. Infant Mortality 4. Childhood Lead 5. Communicable Disease 6. Poor Social & Emotional Wellness

*From the 2012-2016 Kane County Community Health Improvement Plan http://kanehealth.com/chip.htm

http://kanehealth.com/chip.htm

Kane County Health Advisory Committee

Lulu Blacksmith, MA - Waubonsee Community College, Director of Governmental and Multicultural Affairs

Richard Chroust, D.D.S. - Private Dental Practice Diane Homan, M.D. - Rush-Copley Medical Center, Vice President,

Quality Carmella Moran, Ph.D., MSN, RN - Aurora University, Director

School of Nursing & Associate Professor of Nursing Karin Podolski, MSN, MPH, RN - Cadence Health, Director,

Community Health and Outreach David Stone, Ph.D. - Northern Illinois University, Associate Vice

President & Associate Professor of Public Health Bob Tanner – Greater Elgin Family Care Center, President/CEO Linnea Windell, MSN, RN – VNA Healthcare, President/CEO

Next Steps

Relationship Building

Presentation at Committee of the Whole

The role of the

presented to the Committee of the Whole

March 26, 2013

Kane County Organizational Chart

County Board Chairman

Other Elected Officials Auditor Regional Office Circuit Clerk of Education County Clerk Sheriff Coroner State’s Attorney Recorder Treasurer

Circuit Judges Chief Judge 16th Circuit

Citizens Elect

Standing Committees Administration Agriculture County & Development Energy & Environmental

Finance & Budget Human Services Jobs Judicial & Public Safety

Executive*

Legislative Public Health Public Service Transportation

County Board Members (24)

Vice Chairman

Kane County Reporting Structure Every operating department within Kane County government reports to one of the standing committees. All elected officials, including the County Auditor, operate their office in accordance with state statutes and resolutions established by the County Board. However, there are some notable distinctions relative to the responsibility and authority of an elected official as compared to that of an appointed director. Elected officials are accountable to the citizens, and are statutorily granted internal controls to manage their office within the budget approved by the County Board. As part of the Kane County government structure, elected officials do file regular periodic reports to committees and the County Board. The County Auditor prepares reports for the Executive Committee as well as the entire County Board.

Kane County Auditor Authority & Duties

The Kane County Auditor is authorized and mandated by the statutes of the state of Illinois and by the combination of resolutions and the code adopted by the Kane County Board. A partial compilation of the sources of authority and responsibility for the office of County Auditor are described on the following slides.

Kane County Auditor Duties

Audit all claims against Kane County, and recommend payment or rejection of bills presented. (55 ILCS 5/3 – 1005)


Maintain a file of all contracts entered into by the Kane County Board and all authorized county officers, for or on behalf of the county. (55 ILCS 5/3 – 1005)


Report quarterly to the Kane County Board, the entire financial operations of the county including forecast and actual revenues and expenditures, obligations unpaid, and the condition of all funds and appropriations. (55 ILCS 5/3 – 1005)


Audit the receipts of all Kane County officers and departments presented for deposit with the county treasurer. (55 ILCS 5/3 – 1005)


Audit the inventory of all real and personal property owned by Kane County under the control and management of the various officers and departments of the county. (55 ILCS 5/3 – 1005)


The Kane County Auditor shall be responsible for auditing the internal controls covering the credit card program. (Kane County Resolution #11-32 Sect. 12a)


Collect, analyze and preserve statistical and financial information with respect to the cost of operation of the various institutions and facilities, maintained, operated, or owned by Kane County. (55 ILCS 5/3 – 1005)


Maintain a continuous internal audit of the operations and financial records of the officers, agents or divisions of Kane County. The county auditor shall have access to all records, documents and resources necessary for the discharge of this responsibility. (55 ILCS 5/3 – 1005)


A report…by the Auditor of all claims paid each two week period…available to all members of the County Board…[which] shall identify the creditor, the department or official which purchased the product or service, the fund from which the payment was made, the amount…and date the check was issued. (Kane County Resolution #11-32 Sect. 8b)


It shall be the intent of the County…to establish a formal set of best practice internal controls…the County Auditor shall ensure that all departments comply with those controls. (Kane County Resolution #11-32 Sect. 8b)


Upon the completion of each internal audit, the county auditor shall issue an internal audit report…[which] will address actual or potential weaknesses with the internal control…and recommend procedures which will improve or eliminate the problem areas. (Kane County Code Sec. 2-192)


Subsequent to the issuance of the internal audit report, the county auditor shall review the operations and financial reporting…Upon completion of the review, a report…will be prepared and delivered to the county board. (Kane County Code Sec. 2-192)

Internal Audit Report XYZ Department

July 1, 2013

During the course of our internal audit we discovered the following internal control concerns. • Organizational Chart • Documented Policies • Segregation of duties

Internal Audit Review XYZ Department October 1, 2013

During the course of our review 90 after the internal audit report was issued, the following internal control concern(s) remain.

• Organizational Chart • Segregation of duties

Report to Board on Internal Audit Review

XYZ Department December 1, 2013

The department was in the process of updating the organizational chart, however due to budget limitations complete segregation of duties remains an outstanding issue for management.


The Kane County auditor shall obtain at least 20 hours of continuing professional education related to the operation of the auditor’s office each year. Reasonable expenses incurred by the auditor in obtaining that education shall be reimbursed by the county. (55 ILCS 5/3 – 1008)

Kane County Auditor Mission Statement Our mission is to provide high quality, cost efficient financial information which accurately represents the operations of Kane County government in accordance with professional standards.”

“The Kane County Auditor and the staff of the Auditor's Office work for, and on behalf of, the citizens of Kane County.

To achieve that goal, the Office will focus its efforts on the enhancement of the continuous audit program, and the development and implementation of a program of better practice policies and procedures designed to promote improved accountability and transparency.

Kane County Auditor Objectives

OVERSIGHT

INSIGHT

FORESIGHT

Oversight Continuous Audits Certain county functions are subject to continuous audit. For example, the review and approval of all claims to be paid is an ongoing process throughout the year. Every week the department reviews either accounts payable or payroll and related liabilities.

Oversight Cyclical Audits Other functions are audit subjects every year – such as General and Special Fund receipts, economic interest statements, cash accounts, credit card compliance, and fixed asset verifications.

Oversight Internal Audits The schedule and rotation of internal audits of the various offices and departments of the county is determined by a variety of factors – limited auditing resources in terms of time, budget and personnel being one. The selections are also largely prioritized by risk assessment.

Oversight Transition Audit

In Kane County there will be four such audits conducted during the fiscal year ended November 30, 2013.

1. County Chairman 2. County Auditor 3. Circuit Clerk 4. County Coroner

The scope of a transition audit typically is limited to activities of the last fiscal year reporting period prior to the beginning of the newly elected official’s term in office.

Best practice policies recommend that a transition audit be conducted after there is a change of officeholder in an elected position.

Insight Internal Control Questionnaire Risk assessment is one of the first steps in creating the annual audit plan. To provide perspective on both the inherent and net risk of the County operations, we developed a broadly scoped Internal Control Questionnaire.

The ICQ contains about 60 questions covering a variety of areas of potential risk such as systems security, cash and procurement, payroll, and generic fraud indicators. Some of those questions are illustrated on the following slides.

Does your department have a documented set of established

policies and procedures? If so, is it current,

comprehensive, and in practice?

Insight Internal Control Questionnaire

Insight Policy & Procedure Documentation

Do records, documented procedures and other internal controls exist to properly guide operations?

START

EXISTING? YES

NO

COMPREHENSIVE?

DOCUMENT PROCEDURES

YES IN PRACTICE?

UPDATE & COMPLETE

NO NO

IMPLEMENT PROGRAM

YES

CURRENT STATUS OF

DOCUMENTED PROCEDURES

Does your department have a current organizational chart that clearly defines authority and responsibility?


Does your staff understand password security and the need to change passwords regularly?


Does your department fully comply with the

Kane County Procurement Ordinance?



Does your department employ competitive bidding practices when not using the County Purchasing Department?

Does your department payroll

administrator review and

authorize time records?


Kane County Treasurer Five thousand two hundred fifty

John Q. Citizen

5,250.00

RE Tax 12-345-6789

June 1, 13

Are all checks made payable to

the department or office and

restrictively endorsed

immediately?


Does your department maintain all cash receipts in secure storage until deposited at the bank?


Does your department segregate and rotate

cash handling functions to the extent possible?


Does more than one person have access to every software application in your department?


Does your department review and document

employee performance on a regular basis?


The Auditor’s office has conducted a series of

interviews with all departments to review

the ICQ responses with elected officials,

department heads and key staff.

Insight Risk Assessment Interviews

Through a combination of effective interview

techniques, the auditors are able to extract the

information necessary to perform risk analysis.

Thanks to everyone for your cooperation.

Insight Risk Assessment Interviews

Foresight Risk Assessment Analysis The horizontal axis represents the IMPACT of departmental operational or procedural risks…ranging from left to right in overall terms of low to high inherent risk.

A high level of potential operational risk DOES NOT indicate poor management practices…only that there is a relatively high impact value of the risks involved with the department and/or process.

IMPACT of RISK

Foresight Risk Assessment Analysis

The vertical axis represents the PROBABILITY of occurrence of a risk related event…ranging from low to high in terms of likelihood.

A high level of inherent possibility DOES NOT indicate poor management practices…only that the relatively high potential requires that internal and other compensating controls be more intensely focused and applied.

IMPACT of RISK

PRO

BABI

LITY

of O

CCU

REN

CE

Foresight Risk Assessment Analysis

IMPACT of RISK

PRO

BABI

LITY

of O

CCU

REN

CE MEDIUM-

LEVEL RISK

HIGH-LEVEL RISK

LOW-LEVEL RISK

MEDIUM-LEVEL RISK

The risk assessment analysis matrix creates four distinct quadrants which clearly identify extreme high or low risk. The matrix fails to objectively classify many situations which appear in the upper and/or lower levels of each quadrant, requiring additional subjective consideration.

Foresight Better Practice Policies Theory vs. Reality

A countywide commitment to progress towards enhanced public accountability through an evolving series of better practice policies is a more realistic expectation.

Terms such as “Best Practice Policies” and “Transparency” are descriptions of objectives and conditions which exist in text book theory more often than in reality.

Kane County Auditor Special Projects In addition to the continuous audit functions and reporting requirements, the overall plan includes ten to twelve internal audit projects, four transitional audits, physical asset verification, audits of special funds receipts, etc. as well as some special projects we are evaluating.

For a number of reasons, the exact nature of our special projects cannot be divulged at this time.

Please stay tuned for further developments.

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Questions? More Information?

New Case Information Sheet Is

Filed

Documents Are Filed & Entered

Data Entry Is Made To Reflect All Parties

Into Case Management

System

Document Receives Court Case Number

Documents Are Sent For Imaging/Scanning For

Viewing By All Judicial Partners

Physical File Is Created For The

Shelf

Court call Is Generated File Is Pulled For Court

Files Check In For Court Call

Court Call Is Delivered To Court

Locations

Order From Court Is Filed/Entered

Unless An Electronic Process Is Used Via

ECO

Order Is Sent For Imaging/Scanning Unless Order Was

An Electronic Order

Case Is Placed On Shelf For Next Date

A File Can Be Pulled For Viewing At Any Time For Customer

requests

Other Documents Not Filed In Court

Are Scanned & Entered Into The Case Mangement

For Viewing

If Court Order Closes The Case

Once The File Is Closed An Appeal or Expungment Process

Can Still Proceed

Per The Illinois Record Keeping

Manual We Have Retention

Guidelines Set To Determine When A

Case Can Be Destroyed

Life Of A New Civil File

Judgments Are Entered & Checked

For Accuracy

Officer/SAO Files The Complaint

Via Paper, Email, Bond Call or E

Ticket

Documents Are Filed & Entered

Data Entry Is Made To Reflect All

Parties Into Case Management

System

Document Receives Court Case Number

Documents Are Sent For Imaging/

Scanning For Viewing By All

Judicial Partners

Physical File Is Created For The

Shelf

Court call Is Generated File Is Pulled For Court

Files Check In For Court Call

Court Call Is Delivered To Court

Locations

Order From Court Is Filed/Entered

Unless An Electronic Process Is Used Via ECO

Order Is Sent For Imaging/Scanning Unless Order Was

An Electronic Order

Case Is Placed On Shelf For Next

Date

A File Can Be Pulled For Viewing At Any Time For

Customer requests

Other Documents Not Filed In Court

Are Scanned & Entered Into The Case Mangement

For Viewing

If Court Order Closes The Case

Information Is Reported To The

AOIC

From The AOIC Disposition Is

Reported To ISP & SOS

Once The File Is Closed An Appeal or Expungment Process Can Still

Proceed

Per The Illinois Record Keeping Manual We Have

Retention Guidelines Set To

Determine When A Case Can Be Destroyed

Life Of A New Criminal/Traffic File

Bond Is Determined By Statute Or By

Judge In Bond Call

Bond Is Posted Court Dates Are

Given Documents Are Filed With Our

Office

Bond DL/ Money Is Deposited Or

Transferred To Our Office For Processing

2013 Case Filings

New Case Filings

Criminal Family Civil Total Month

Jan 7051 391 1623 9065

Feb 6751 331 1257 8339

Mar

Apr

May

Jun

Jul

Aug

Sept

Oct

Nov

Dec

Total 13802 722 2880 17404

At The Front Counters Customers Are Being Served By 8-10 Clerks Daily.

Our Clerks Are Assisting In:

• Filing Documents and New Cases • Payments On Criminal, Traffic, Child Support • Inquiries • Copies • Incoming Bonds

31 Staffed Court Rooms

• Across Kane County • We Send 2-3 Clerks On Large Calls • Cashiers In KBC & ABC During Court Calls • Clerks Are Responsible For All Filings That Are

Handled In Court

2 Satellite Offices To Assist The Public

• Room 160 Located At The Old Court House Is Covered By 2 Clerk’s To Help With Filings

• Room 003 Located At The Judicial Center

Covered By 2 Clerk’s To Help With Filings & Wedding Certificates For Court Room 005

The Office

• Handling Daily Duties Of Pulling Files, Checking In Court Calls, Entering Court Calls, Research, Phones, Filing Cases, Answering public Emails, Mail, Payments, Corrections, Scanning And Any Other Administrative Duties That Are Required By My Staff.