Editor’s Note: The following is full investigative report by the Auditor General Of Belize into allegations of “misuse” of public funds at the Central Health Region in the Ministry of Health.

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CEO, Ministry of Health (MOH)

Dated:                        16th October 2013

Background

1)      The Chief Executive Officer (CEO), Ministry of Health informed the Auditor General of Belize via memorandum referenced GEN/63/05/13 (14) Vol. 7, dated 26th August 2013, that he has received credible allegations of misuse of public funds at the Central Health Region (CHR) in Belize City.  As a result, he requested an urgent audit of the accounts at CHR for the past year.

2)      Based upon this initial predication, the Auditor General requested that an immediate investigation be conducted which included the review of relevant records and interviews of appropriate personnel and vendors.

Executive Summary

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Central Health Regional Manager, Melinda Guerra

3)      The audit investigation commenced on 30th August 2013, after the Office of the Auditor General received an official audit request on 26th August 2013, from the CEO in the Ministry of Health.  The request informed that the Ministry had received credible allegations of misuse of public funds at the CHR, in Belize City, and required an urgent audit of the accounts.

4)      We initially focused the examination on transactions which formed the basis of the audit request and allegations. However, other payments which came to the attention of the team during the investigation were also reviewed and reported on.

5)      The CHR is managed by the Central Health Regional Manager (CHRM), Melinda Guerra.  The accounts unit is currently headed by the Finance Officer (FO), Ena Codrington, previously by FO, Judith Swift.

6)      We interviewed key officials and CHR employees who we believed may have information regarding the allegations.  We also reviewed purchasing guidelines, general and personnel files of staff and various financial documents relating to the CHR and the related bank accounts.

7)      Based on the documents reviewed, information collected and interviews conducted during the course of the investigation, we can reasonably conclude that the CHRM, Melinda Guerra, as the Head of Department, appeared to have knowingly:

i.      Submitted, approved and received the proceeds of four (4) reimbursement claims which totaled $3,407.50 for costs she claimed to have incurred in an official capacity.  However, we did not see, nor were we provided with sufficient evidence to satisfy ourselves, that such claims were genuine or appropriate.  FO #370, 371, 373 and 384 refers.

ii.      Authorized the preparation and approval of twelve (12) payments that totaled $16,997.99, which misrepresented the service or item ordered, received and paid for by the CHR, contrary to FO #370 and #371 (b), (d), (f) and (g).

iii.      Authorized four (4) prepayments which totaled $14,682.00, for goods and services that were not received as of the time of the investigation, contrary to FO #373 and 371 (b) and (g).

iv.      Requested and approved some twelve (12) withdrawals which totaled $50,096.00, from the NHI bank account, managed by the Matron Roberts Polyclinic.  These payments appeared inconsistent with the governing policies and guidelines for the Polyclinic and also FO# 358 and 359.  In two (2) instances, payments were made without the requisite approvals from the competent authority, which is the Ministry of Finance.  Stores Order (SO) #13 and FO #366 (b) and 371 (d) also refers.

8)      We were particularly concerned about the apparent intentional disguising and misrepresentation of key information on official payment documents and records for it creates an environment that is susceptible to fraud, waste and abuse.  It is suggested that this matter be referred to the proper and competent authorities as outlined at FO#601 to 605 for it to be appropriately resolved.

Scope

9)      The objective of the investigation was to determine:

  • Whether there existed irregularities and or misuse of public funds.  The examination was predicated upon the official request which alleged possible misuse of public funds at the CHR. This initial investigation was limited to the selected transactions which formed the basis of the audit request. However, other transactions which came to the attention of the team during the investigation were also reviewed and reported in the “other matters” section.  It is envisage that an audit investigation and/or a general audit that covers the one year period as requested by the CEO, Ministry of Health, should follow.
  • This initial investigation commenced on 30th August 2013 and was completed on 1st October, 2013.

Approach

The members of the Investigative Team were:

    • Randolph I. Young, Supervisor of Audit, MBA, CFE
    • Maria A. Rodriguez Examiner of Accounts 111, BA, CFE
    • Pierre Escalante, Audit Clerk 1, BA
    • Supportive research was also provided by Merli Lopez, Audit Clerk 1

Investigative Procedures

 

10)  As a part of the examination of this matter, we took the following actions:

  • Obtained, reviewed, and analyzed memoranda which outlined the allegations previously described.
  • Obtained, reviewed, and analyzed CHR purchasing and accounts payable transactions including departmental requisitions, SmartStream generated purchase orders, invoices, cancelled cheques, inventory ledger, Central Information Technology Office’s (CITO) Report Manager Transaction listing and minutes of meetings.
  • Obtained, reviewed, and analyzed San Pedro Polyclinic’s (SPP) financial records which included record of donations received, receipts, returned cheques and stubs, bank statements, minutes of meetings and assets file.
  • Obtained, reviewed and analyzed Matron Robert’s Polyclinic’s financial records which included NHI returned cheques, payment memoranda, and bank statements.

11)  We conducted our audit investigation in accordance with best practices and guidelines prescribed by the Association of Certified Fraud Examiners (ACFE), and the International Standards for Supreme Audit Institutions (ISSAI).

 

Individuals Interviewed:

 

12)  The  following individuals were interviewed in person by members of the Investigative Team:

  • Dr. Peter Allen (CEO, Ministry  of  Health)
  • Melinda Guerra (Regional Manager, CHR)
  • Lizette Bell (Acting CHR Regional Manager, CHR)
  • Ramon Figueroa (Director, Planning and Policy Unit, MOH)
  • Melissa Diaz, (Medical Coordinator, Matron Roberts Polyclinic)
  • Idalia Machuca (Medical Coordinator, Cleopatra White Polyclinic)
  • Judith Swift (Finance Officer, Treasury Department)
  • Ena Codrington (Ag. Finance Officer, CHR)
  • Mark Bernard (Former Public Health Officer, CHR)
  • Douglas Westby (Director, National Engineering and Maintenance Unit, CHR)
  • Shamir Polanco (Technician, CHR)
  • Owen Vellos (Administrator, Dr. Otto Rodriguez Polyclinic/ San Pedro Polyclinic, SPP)
  • Anthony Flowers (Water Analyst, Environmental Health Unit, CHR)
  • Rachel Richards (Staff Nurse, Port Loyola Polyclinic)
  • Sharon Espinosa (Nursing Supervisor I, CHR)
  • Annette Usher (Nurse Specialist II, CHR)
  • Corette Flores (Senior Pharmacist, Pharmacy, CHR)
  • Dorothy Wade (Administrator, Cleopatra White Polyclinic)
  • Christina Sanchez (Health Educator, CHR)
  • Floridalia Quiroz (Administrative Assistant, CHR)
  • Pauline Rhamdas (Senior Secretary, CHR)
  • Emir Castaneda (Health Educator, CHR)
  • Ingrid Clare (Nurse Specialist II, CHR)
  • Bernadette Smith Flowers (Rural Health Nurse, Double Head Cabbage Village)
  • Ana Quiroz (Rural Health Nurse, Burrell Boom Village)
  • Antonette Tillet (Rural Health Nurse, Crooked Tree Village)
  • Leonia Duncan (First Class Clerk, CHR)
  • Merissa Gillett (Second Class Clerk, CHR)
  • Andrea Ayala (Second Class Clerk, CHR)

 

 

Findings

13)  Based on the documents reviewed, information collected and interviews conducted during the course of the investigation, we found as follows:

  • Did the investigation determine the existence of any irregularities and or possible misuse of funds at the CHR?

14)  Yes.  The documents and information we reviewed and interviews conducted during the course of the examination indicated that the CHRM, Melinda Guerra, as the Head of Department, appeared to have knowingly:

i.      Submitted, approved and received the proceeds of four (4) reimbursement claims which totaled $3,407.50 for costs she claimed to have incurred in an official capacity.  However, we did not see, nor were we provided with sufficient evidence to satisfy ourselves, that such claims were genuine or appropriate.  FO #370, 371, 373 and 384 refers.

ii.      Authorized the preparation and approval of twelve (12) payments that totaled $16,997.99, which misrepresented the service or item ordered, received and paid for by the CHR, contrary to FO #370 and #371 (b), (d), (f) and (g).

iii.      Authorized four (4) prepayments which totaled $14,682.00, for goods and services that were not received as of the time of the investigation, contrary to FO #373 and 371 (b) and (g).

iv.      Requested and approved some twelve (12) withdrawals which totaled $50,096.00, from the NHI bank account, managed by the Matron Roberts Polyclinic.  These payments appeared inconsistent with the governing policies and guidelines for the Polyclinic and also FO# 358 and 359.  In two (2) instances, payments were made without the requisite approvals from the competent authority, which is the Ministry of Finance.  Stores Order (SO) #13 and FO #366 (b) and 371 (d) also refers.

15)  The Finance and Administrative Officers at CHR were the second approvers to these transactions and should have ensured that the applicable financial regulations and government accounting practices were adhered to.  A proper review of the involvement of all parties to these transactions should be undertaken to establish culpability if any.

Unresolved Reimbursements

16)  The following are the detailed report, evidence and information supporting our findings in relation to the reimbursement claims to the CHRM, Melinda Guerra, which have not been resolved:

Reimbursement of $500.00 paid to the CHRM, Melinda Guerra, for purchase of food for CORE team meeting at SPP on 2nd May 2013, when food was already provided and paid for from the Vote.

17)  Financial Order #386 states that in cases where officers present claims for reimbursement of small payments made by them, actual receipts shall be produced where practicable.  When these cannot be obtained the officer shall certify the fact that he or she has actually incurred the expenditure.

18)  We noted SmartStream voucher #019398 dated 7th May 2013, for five hundred dollars ($500.00) made payable to the CHRM, Melinda Guerra.  This payment was in respect of reimbursement for food provided by Melinda Guerra at a senior management (CORE) team meeting held in San Pedro on 2nd May 2013.  The Smartstream Invoice was first approved by the CHRM, Melinda Guerra and second approved by the then FO, Judith Swift.  We noted that SmartStream voucher #019398 in respect of this reimbursement for food was charged to the salaries line item (23001), a contravention of FO #358 and 359. Please see Exhibit 1-A.

19)  We visited the SPP and confirmed that there was a staff meeting on 2nd May 2013, and no other CORE team meeting was held except for this one.  Thirteen (13) officers attended the meeting as per minutes dated 2nd May 2013.  Exhibit 1-B refers. In addition, requisition #10125 showed that SPP ordered for food for said staff meeting from Elvis Kitchen/Staines Enterprise Ltd.  Exhibit 1-C refers.

20)  We reviewed SmartStream payments to confirm whether Elvis Kitchen/Staines Enterprises Ltd was paid for the food provided for the staff meeting held on 2nd May 2013.  We were able to verify that payment was made via SmartStream voucher #019379 dated 3rd May 2013, for food and drinks totaling three hundred dollars ($300.00). The SmartStream Invoice was first approved by Melinda Guerra and second approved by Finance Officer, Judith Swift.  The value of the Invoice was charged to the SPP’s recurrent expenditure vote. Exhibit 1-D refers.

21)  On 13th September 2013, we interviewed Ms. Guerra to clarify why she requested a reimbursement for meals and drinks “Buffet Style” for staff meeting held at SPP on 2nd May 2013, for five hundred dollars ($500.00) when food was paid for from the vote. In addition, the receipt attached as source document stated that she paid for twenty-five (25) plates of food when the minutes of meeting showed that only thirteen (13) persons attended the meeting.

22)  Ms. Guerra stated that she will have to research the payment and get back to us but that all reimbursements she has claimed and received were based on invoices she has provided.  Ms. Guerra also made mentioned that this request may have been for another event.

23)  We noted that Ms. Pauline Rhamdas, Senior Secretary, made the request on behalf of Ms. Guerra which specifically stated that it was for the same event. Exhibit 1-E refers.

24)  On 6th September 2013, we interviewed Ms. Swift to determine why she had approved the payment for the reimbursement of out of pocket expenses to Ms. Guerra when she had already approved a payment for food for the same occasion.  In addition, the invoice attached to the request showed that it was for twenty-five (25) plates when only thirteen (13) officers had attended the meeting.

25)  Ms. Swift responded that she would approve any reimbursement requested by her Regional Manager and trusted that the invoices attached were genuine.

26)  This reimbursement claim that was paid to the CHRM, Melinda Guerra, has not been resolved.

Reimbursement for out of pocket expenses incurred in pre-paying for a Glow Box, Gel and Powder Materials not received – $1,907.00.

27)  We noted SmartStream voucher #019506 dated 13th May 2013 with description which read “reimbursement for out of pocket expenses incurred in paying for a glow box, gel and powder materials for hospital in San Pedro” for the amount of one thousand nine hundred and seven dollars ($1,907.00).  The Smart Stream Invoice was first approved by the CHRM, Melinda Guerra and second approved by FO, Judith Swift.

28)  Further scrutiny also revealed that SmartStream voucher #019506 was paid from the Personal Emoluments line item, 23001, contrary to FO #358 and 359.   Exhibit 2-A refers.  Most noteworthy, was that the supplier’s invoice #2435 dated 7th March 2013, for SmartStream voucher #019506 was for one thousand six hundred sixty-seven dollars and ten cents ($1,667.10).  A difference of $239.90 from the amount claimed as reimbursement.  The purported signature of the CHRM, Manager, Melinda Guerra was also seen on this invoice.  Her signature was dated 18th March 2013.

29)   On 5th September 2013, we visited the SPP to confirm whether a glow box and materials had been received. The SPP Administrator informed us that the glow box, gel and powder have not been delivered to date.

30)  We visited the supplier in the City of Belmopan to confirm the cost of the items and whether the supplier’s invoice attached to the Smart Stream payment was for the actual cost of the items.  The supplier provided us with a copy of an invoice #4235 dated 5th September 2013 for one thousand nine hundred and seven dollars ($1,907.00) which matched the value of the reimbursement claimed.  Exhibit 2-B refers.  However, differed from the supporting invoice affixed to SmartStream voucher #019506 which was for $1,667.10.

31)  The supplier’s staff indicated to us that the invoice had been placed in the paid file since the items had been delivered and paid for. We were informed that the business owner was out of country and would return 20 September 2013.

32)  The official reimbursement request submitted by Ms. Pauline Rhamdas on behalf of Ms. Guerra indicated that the reimbursement was for out of pocket expenses incurred for paying Mr. Orlando McKenzie from PROCARE for supplying glow box, gel and powder materials for the SPP as seen at Exhibit 2-C.  It had attached a receipt signed by the one Orlando McKenzie as the receiver of cash for the paid items.

33)  On 13th September 2013, Ms. Guerra informed us that she paid for the glow box by depositing the funds to the vendor’s local bank account and confirmed that the glow box, gel and powder materials have not arrived as at the time of the investigation.

34)  We informed Ms. Guerra that the request for payment and Smart Stream invoice payment was a misrepresentation of the facts in that it stated that the reimbursement was requested and paid for items already supplied.  Also, this was a prepayment, a practice that is not supported by the Government of Belize’s financial regulations, particularly due to the financial risk involved.

35)  Ms. Guerra stated that government does do prepayments and that this is a trustworthy person and that she was certain that the items will be delivered on September 20, 2013.  Ms. Guerra also stated that she believed that the Finance Officer should not process a payment if it was not proper in the first place.

36)  Ms. Swift was not questioned about this payment since when we attempted to do so she stated that all claims submitted by the Regional Manager would have to be clarified by her.

37)  This reimbursement and prepayment was unresolved at the time of the investigation.  In addition, we question why a signed receipt was provided as source document when the payment was done via a bank deposit.  This source document was misleading since it misrepresented what had actually occurred: it showed that cash was paid for the items when a bank deposit was done instead.

Reimbursement made to Melinda Guerra for out of pocket expenses incurred in paying for four boxes of x-ray films not yet received – $600.00.

38)  We perused Smart Stream voucher #020767 dated 5th August 2013, made payable to Melinda Guerra for out of pocket expenses incurred in paying for four boxes of x-ray films for the SPP at a cost of six hundred dollars ($600.00).  The Smart Stream Invoice was first approved by the CHRM, Melinda Guerra and second approved by the FO, Ena Codrington.  We also noted that there was no supplier’s invoice attached to the SmartStream payment. See Exhibit 3-A.

39)  We visited the SPP to confirm whether the boxes of x-ray films had been delivered.  The Administrator informed us that the x-ray films had not been delivered as at the time of our investigation.

40)  We reviewed the “letter of request” for payment of the reimbursement claim signed by the Secretary, Ms. Pauline Rhamdas on behalf of Ms. Guerra.  The latter stated that the claim was for out of pocket expenses incurred in paying PROCARE for the balance of (four boxes) x-ray films for San Pedro and receipt was attached to the request.   The receipt appeared to be signed by Mr. Orlando McKenzie.  Exhibit 3-B refers.

41)  We also visited the supplier to obtain evidence that the items were delivered and the amount paid for.  The entity provided us with invoice #4887 dated July 31, 2013.  Exhibit 3-C refers.  The supplier’s staff indicated to us that the invoice had been placed in the paid file since the items had been delivered and paid for. We were informed that the business owner was out of the country and would return on the 20th  September 2013

42)  On 13th September 2013, Ms. Guerra informed us that as in the case of the glow box, she had paid for it in advance and that the items have not arrived in Belize as yet.

43)  We informed Ms. Guerra that the request for reimbursement and the Smart Stream invoice payment appeared to be a misrepresentation of what occurred, given that it stated the items were already supplied. Also, that this was another case of prepayment.   Ms. Guerra stated that the items will be delivered on 20th  September 2013.  She admitted that the payment was another “prepayment”.

44)  On 30th September 2013, Ms. Codrington informed us that based on the request sent from the CHRM’s office, she assumed that the items had been received hence she proceeded to make the payment.   We asked Ms. Codrington whether she was aware that this was a prepayment.  Ms. Codrington stated that she was not aware that the transaction was a prepayment since the request indicated that it was for a reimbursement for items already received.

45)  While the focus of the investigation was on the appropriateness of the reimbursement and whether or not the items were received, we would like know why were these items purportedly ordered in this fashion when items of this nature are normally provided to public health facilities through the Central Medical Stores system?

46)  This reimbursement was unresolved at the time of our investigation.

Payment of $400.50 to CHRM, Melinda Guerra, being reimbursement for cost of food provided by her when records show that food was already paid from the CHR vote.

47)  SmartStream voucher #019225 dated 24th April 2013 for four hundred dollars and fifty cents ($400.50) was made payable to the CHRM, Melinda Guerra.  This payment was in respect of a reimbursement claimed by her for out of pocket expenses incurred for food at CORE team meeting held in San Pedro on April 19 and 20, 2013.  The SmartStream Invoice was first approved by Melinda Guerra and second approved by Judith Swift.  Exhibit 4-A refers.

48)  Scrutiny of the letter of request made by Ms. Pauline Rhamdas on behalf of Ms. Melinda Guerra claiming the reimbursement was worded the same as SmartStream voucher #019225. Exhibit 4-B refers.

49)  We visited the SPP to confirm whether the event for which the reimbursement was being requested occurred and whether food was provided by Ms. Guerra.  The Administrator informed us that there was an ACLS training that was held on the 20-21/4/2013 and that food was paid for to the owner of El Fogon Restaurant from the vote for both days and was requested via requisition #10115 attached at Exhibit 4-C. The Administrator confirmed that there was no CORE meeting held on these dates.

50)  We reviewed SmartStream payments to verify whether payment for food was made to one Maria Susana Eiley owner of El Fogon for April 20 – 21, 2013.  We noted that payment was made via SmartStream voucher #019432 dated May 7, 2013 for breakfast and lunches for six hundred and sixteen dollars ($616.00). Payment was first approved by Melinda Guerra and second approved by Judith Swift.  Exhibit 4-D refers.

51)  On 13th September 2013, we interviewed Ms. Guerra to clarify why she had requested a reimbursement for food in respect of April 19 and 20, 2013 when food was provided for by the vote for April 20, 2013. In addition, to clarify why she needed a reimbursement for April 19, 2013 when no record of any meeting was found for that specific date.    Ms. Guerra stated that she would not ask for a reimbursement for what did not occur and that she wondered whether the dates were wrong.

52)  On 6th September 2013, Judith Swift informed us that she would approve any reimbursement requested by her Regional Manager and trusted that the invoices attached were genuine.

53)  This reimbursement was not resolved at the time of our investigation.

Reimbursement paid to Melinda Guerra for out of pocket expenses incurred for paying the transportation cost for fifty-five (55) portfolio pad zippers and hemoglobin kit for a workshop not held by the CHR – $657.54.

54)  We perused SmartStream voucher number #019406 dated 6th May 2013 for reimbursement of out of pocket expenses incurred in paying for portfolio pad zipper and hemoglobin kit gift for six hundred and fifty-seven dollars and fifty-four cents ($657.54). The Invoice also showed that the reimbursement was paid from the Personal Emolument (23001) vote which contravened FO #358 and 359. The SmartStream Invoice was first approved by the CHRM, Melinda Guerra and second approved by FO, Judith Swift. There was no supplier’s receipt attached to payment. Exhibit 5-A refers.

55)  The reimbursed expenses included cost incurred for paying for gift for 55 portfolio pad zipper and for storage and delivery from Orange Walk for Workshop at Radisson on February 26, 2013 and for paying for the delivery of hemoglobin kit.  Exhibit 5-B refers. We  reviewed the Workshop General File kept at the CHR and saw no evidence of a workshop for the CHR held on that specific date.

56)  We interviewed Ms. Guerra On 13th September 2013.  She informed us that this payment was not for CHR but in regards to a workshop held by Dr. Largaespada-beer from Maternal Health in Belmopan. Ms Guerra agreed that this was not a CHR expense, but expenditure related to the national level.

57)  On 6th September 2013, we interviewed Ms. Swift who stated that she would approve any reimbursement requested by her Regional Manager and trusted that the invoices attached were genuine.

58)  We further reviewed estimates for the year 2013/2014 and found that Maternal Health in Belmopan has an approved vote and any such reimbursements should have been appropriately charged against that account.  Exhibit 5-C refers.  Ms. Guerra’s response was that she chose to help in this case.

59)  Kindly inform us how this transaction which was wrongly charged to the personal emoluments line item (23001), and was unrelated to the CHR operations, will be treated?

Apparent Misrepresentations

60)  This section of the report covers some twelve (12) payments (10 to Captain Shark’s Marine Centre and 2 to Fultec Systems) made by the CHR which appeared to us to be a misrepresentation of what actually transpired.  .

The CHRM authorized irregular payments of $14,000.00, misrepresented as Golf Cart repairs

61)  It was alleged that the CHRM utilized funds from the recurrent budget to purchase a new golf cart under the disguise of repairs to an existing non-operational golf cart.  This was in addition to the $2,000.00 drawn from the SPCC Donation Account reported at paragraph “115”.  As a result, we attempted to establish whether:

i.       The payments for repairs to the Golf Cart were proper and justified and

ii.      Whether the repairs were completed to the satisfaction of the CHR or

iii.      If the payments were for a new cart, that such existed and was registered in the name of the SPP

62)  Financial Orders #370 and #371 (b), (d),  (f) and (g) states that public officials that approve payments are responsible to ensure that:

i.            The services specified on payment documents have been duly performed,

ii.            Authority has been obtained as quoted from the competent authorities,

iii.            The persons named on such payments are those entitled to receive payment and

iv.            That the stores purchased have been received and accounted for.

63)  We observed that for the period 4th of March to the 12th of June 2013, the CHR made ten (10) SmartStream payments which totaled $14,000.00, payable to Captain Shark’s Marine Centre.  Exhibit 6–A refers.  All payments were described as being payment for repairs done on a Golf Cart attached to the SPP as illustrated in Table 1 below:

Table 1

Payments made to Captain Shark’s Marine Centre for repairs done on Golf Cart attached to the SPP

SMARTSTREAM
NO VENDOR INVOICE # INVOICE DATE VOUCHER # AMOUNT PAID FIRST APPROVER SECOND APPROVER RECURRENT EXPENDITURE ACCOUNT
1 CAPTAIN SHARK’S MARINE CENTER BDHS-GOLF CART REPAIRS 04/03/2013 018617 $1,440.00 Melinda Guerra Judith Swift 19291/34204/610/131
2 CAPTAIN SHARK’S MARINE CENTER BDHS-REPAIRS         05/03/2013 018618 $1,750.00 Melinda Guerra Judith Swift 19291/34204/610/131
3 CAPTAIN SHARK’S MARINE CENTER BDHS-REPAIRS         06/03/2013 018619 $1,900.00 Melinda Guerra Judith Swift 19291/34204/610/131
4 CAPTAIN SHARK’S MARINE CENTER BDHS-REPAIR           06/03/2013 018782 $1,800.00 Melinda Guerra Judith Swift 19291/34210/610/131
5 CAPTAIN SHARK’S MARINE CENTER BDHS-REPAIR/G.CART   06/03/2013 018783 $1,750.00 Melinda Guerra Judith Swift 19291/34210/610/131
6 CAPTAIN SHARK’S MARINE CENTER BDHS-REP/G.CART       06/03/2013 018784 $1,550.00 Melinda Guerra Judith Swift 19291/34210/610/131
7 CAPTAIN SHARK’S MARINE CENTER BDHS-REP./G.CART     06/03/2013 018785 $900.00 Melinda Guerra Judith Swift 19291/34210/610/131
8 CAPTAIN SHARK’S MARINE CENTER BDHS-REPAIRS         07/03/2013 018620 $1,650.00 Melinda Guerra Judith Swift 19291/34204/610/131
9 CAPTAIN SHARK’S MARINE CENTER BDHS-REPAIRS          18/03/2013 *018931 $900.00 Melinda Guerra Floridalia Quiroz 19291/34204/610/131
10 CAPTAIN SHARK’S MARINE CENTER BDHS-0000052537       12/06/2013 019956 $360.00 Melinda Guerra Ena Codrington 19031/34204/610/808
Total Paid From CHR’s Recurrent Votes $14,000.00
Cash Paid From Donation Bank Account $2,000.00
Total Paid for New Golf Cart   16,000.00

*Original payment document was not seen in file

 

Source: Payment documents and SmartStream Financial System

 

64)  Contrary to FO #366 and the Government of Belize’s purchasing and accounts payable practices, the 10 payments did not have any requisition, invoice or bill which should have detailed the repairs that were requested, ordered and completed by the vendor.  The 10 transactions were “direct invoice payments”, a blatant disregard of FO #366 and the Government of Belize’s accounting practices.

65)  As illustrated in Table 1 above, the 10 payments were first approved by the CHRM, Melinda Guerra, and second approved by the Finance Officers, Judith Swift and Ena Codrington and Administrative Officer, Floridalia Quiroz.  On 5th September 2013, we visited the SPP to verify the works undertaken on the Golf Cart.  We were met by the Administrator at the SPP, Owen Vellos, who informed us of the following:-

i.            There were no repairs conducted on the Golf Cart,

ii.            The proceeds from the “payments for repairs” were instead for a new Golf Cart purchased from Captain Shark’s Marine Center,

iii.            The CHRM, Melinda Guerra, directed that the sum of $2,000.00 from the SPP donation account be deposited in the bank account of Captain Shark’s Marine Center towards the cost of the new Golf Cart and,

iv.            That the total cost of the new Golf Cart was $16,000.00.

66)  We also approached the vendor, Captain Shark’s Marine Center.  We were able to match the exact payments reported at Table1 to the amounts included on the SPP account for the new Golf Cart.  A copy of the Captain Shark’s Marine Center statement is attached at exhibit 7-A for ease of reference.

67)  We were able to verify that indeed a new 2006 Golf Cart with VIN# AGO613613054 was received by the SPP and was registered with the San Pedro Transport Department on 24th April 2013.  Exhibit 8-A refers.  Mr. Vellos informed us that the cart was attached to the SPP for official purposes.

68)  On 6th September 2013, we discussed these findings with the Finance Officer, Judith Swift, who approved SmartStream payments 1 through to 8 at Table 1 which totaled $12,740.00.  Ms Swift admitted that she knew and consented for the payments to be created and described as “payments for repairs” knowing that the intent was to purchase a new Golf Cart in parts.

69)  Ms Guerra was the first approver for all 10 SmartStream payments which totaled $14,000.00 as per Table 1.   She admitted that she knew and agreed for the payments to be created and described as “payments for repairs” knowing that the intention was to purchase a new Golf Cart.

70)  The Finance Officer, Ena Codrington was the second approver for SmartStream voucher #019956 dated 12th June 2013 which totaled $360.00.  She informed us that her approval was based on the official request by the CHRM, Melinda Guerra.  Ms. Codrington informed us that based on the information provided by the CHRM, Melinda Guerra, she was of the belief that indeed repairs were carried out on the old Golf Cart.

71)  On the issue of direct payments, Ms. Codrington acknowledged that it was an improper payment practice she inherited; but that she currently ensures that payments have a matching purchase order.

72)  The Administrative Officer, Ms Floridalia Quiroz, second approved voucher #018931 dated 18th March 2013.  She informed us that her approval was based on a letter of request from CHRM, Melinda Guerra.  Ms. Quiroz explained that:

i.      On 18th March 2013, the CHRM informed her that the SmartStream system was closing for the fiscal year 2012/2013 on that said day and she (Guerra) needed Ms. Quiroz to urgently approve the payment.

ii.      No supplier’s invoice was provided and that the CHRM, Melinda Guerra was to provide such the following day.

iii.      Payment was made based on an outstanding bill from Captain Sharks in San Pedro.

iv.      She wasn’t aware that there were prior payments for repairs

73)  The Invoice Clerk, Andrea Ayala, created payments 1 to 8 included at Table 1.  Ms Ayala informed us that all 8 payments were direct payments and were so created based on directive from the Finance Officer, Judith Swift.  Ms. Ayala stated that at the time of preparing the payments she was of the belief that the payments were for the repairs of the Golf Cart.

74)  The other 2 payments were created by Invoice Clerk, L. Duncan.  However, Ms. Duncan was not available for an interview.

75)  The apparent intentional falsification of the description of the 10 payments detailed at Table 1 was evident.  The CHRM, Ms. Melinda Guerra and the FO, Judith Swift, both admitted that they knowingly crafted these payments in this manner in order to pay for a new Golf Cart.  This apparent misrepresentation is a breach of the FO #370 and 371.

76)  In addition, we were not provided with any approval from the Ministry of Finance for the purchase of a new Golf Cart for the CHR as required by Stores Order #13.

77)  This case has revealed the need for enhanced oversight and guidance by the Ministry of Health to the various health regions.  There is a need for enhanced internal controls and checks as outlined at Financial order #558 which states:-

 

“Even where a good system of internal control has been devised, it is essential that the Accounting Officer or Finance Officer shall regularly have it under review to ensure its continued efficiency. He shall need to exercise continuous vigilance in this regard. It is no good e.g. for an Accounting Officer to turn

around and say “I told so and so to do it and he did not do it, what do you expect me to do?” for it is up to the Accounting Officer to make sure that his instructions for internal check and internal control are being carried out.”

Payments of $2,997.99 for two (2) Apple Ipad Mini Wi-Fi 32 GB (Black) & 2 External Storage Devices misrepresented as payment for 2 Hard Drives  

78)  It was alleged that the CHRM had purchased (2) two Ipads from recurrent budget under the guise of “payments for 2 hard drives” and that the Ipads could not be accounted for at the institution.   As a result, we attempted to establish whether:

i.      There were approvals, requisitions, purchase orders and payments for the purchase of 2 Ipad and or “payments for 2 hard drives” and that the payments were proper and justified,

ii.      That the items were received and accounted for on inventory ledger in accordance with Stores Order #28.

79)  Financial Orders #370 and #371 (b), (d),  (f) and (g) states that public officials that approve payments are responsible to ensure that:

i.             The services specified on payment documents have been duly performed,

ii.            Authority has been obtained as quoted from the competent authorities,

iii.            That the stores purchased have been received and accounted for.

80)  Stores Order #28 also states that all stores whether purchased or received as a gift should be taken on charge in a ledger.  Also, Stores Order #13 states that the approval of the Ministry of Finance should be obtained for individual purchase orders exceeding $1,000.00

81)  We observed that the CHR made two (2) purchase orders and payments for $1,499.00 each payable to Fultec Systems for “providing a hard drive to the Manager’s Office” as illustrated in Table 2 below.  Exhibit 9-A refers.

Table 2

Payments made to Fultec Systems for 1/2 PAYMENTs FOR HARD DRIVE.

SMARTSTREAM
NO VENDOR INVOICE # INVOICE DATE VOUCHER # AMOUNT PAID First Approver 2nd Approver
1 FULTEC SYSTEMS BDHS-INV38310         06/05/2013 019430 $1,499.00  Melinda Guerra  Judith Swift
2 FULTEC SYSTEMS BDHS-INV38310         05/05/2013 019431 $1,499.00  Melinda Guerra  Judith Swift
$2,998.00

Source: Payment documents and SmartStream Financial System

82)  The following supporting documents were provided for both payments:

i.            Requisition.   Perusal of the attached requisition dated 6th May 2013, revealed that three (3) quarts of round up was requisitioned by the Manager’s office for use at the Ladyville Health Center.  Exhibit 9-B refers.  The CHRM’s secretary signed the requisition for the items and it was approved by the CHRM. Interestingly, an insert was placed on requisition #6999 for 2 hard drives from Fultec just above the line drawn by the secretary after she had signed off the requisition. We discussed this with the secretary who stated that she had no knowledge of the requisition for the hard drive.

ii.            Purchase Order.  Both payments were supported by purchase orders #BDH14-000153 and #BDH14-000154 both dated 7th May 2013.  Both purchase orders described the items ordered as “1/2 payment for hard drive” at $1,499.00 each.  The purchase orders were created by Second Class Clerk, Merissa Gillette and approved by the Finance Officer, Judith Swift.

iii.            We perused the purchase order book which included the signature of the officer that actually received the purchase order from the CHR accounts department and apparently took it to the vendor.  In both cases, the signature of the FO, Judith Swift was evident in the register to acknowledge receipt of the approved purchase orders.  Exhibit 9-C refers.  Ms. Swift also confirmed in the meeting with us on 6th September 2013, that she took purchase orders #BDH14-000153 and #BDH14-000154 to the vendor in the accompaniment of the CHRM, Melinda Guerra.

iv.            Suppliers Invoice.  Attached to SmartStream voucher #019430, was a duplicate Fultec System’s tax invoice #38310, dated 7th May 2013, for an Intel CPU i7 2600 3.4GHz LGA1155 8MB and associated items which cost $2,997.99.  The signature of the FO, Judith Swift, was seen on the tax invoice #38310 from Fultec acknowledging that she had received such item.  Attached to voucher #019431 was a photocopy of the duplicate Fultec System’s tax invoice #38310.  Exhibit 22-A refers.

83)  Although Ms. Swift purportedly received the items from Fultec and indicated such by her signature on tax invoice #38310, verification on SmartStream financial system revealed that the purchasing clerk, Merissa Gillette, electronically received the items ordered as per Fultec System’s tax invoice #38310.  This was to enable the SmartStream matching and payment process.

84)  We determined that the 2 hard drives that were requested via requisition #6999 ordered on purchase orders #BDH14-000153 and #BDH14-000154 and represented as received via Fultec System’s tax invoice #38310 was a fiction and were not received. The accounts section was provided with the tax invoice #38310 which was also a misrepresentation of what the transaction was about.

85)  In separate interviews we conducted with the CHRM, Melinda Guerra and the FO, Judith Swift, they both confirmed that they knew that what was ordered and quoted in the Purchase Orders was not what was received by them.

86)  We also discussed this case with the FO, Ena Codrington, who informed us that Fultec Systems was querying outstanding accounts receivable with the CHR.  Fultec, in proving evidence, shared with her a copy of Invoice #38307 dated 7th May 2013, which also made reference to purchase orders #BDH14-000153 and #BDH14-000154.  This Invoice reflected that the FO, Judith Swift, had also received and signed for the following items in Table 3 instead of the hard drives which were ordered and paid for but not received.  Exhibit 9-D refers.

Table 3

Items which were not requisitioned or ordered by CHR but were signed for and received by the FO Judith Swift.

 

ELECTRONIC ITEMS RECIEVED FROM FULTEC BY THE CHR’S FO WHICH WERE NOT REQUISITIONED, ORDERED OR PAID FOR SERIAL # PRICE
WD Passport Essential SE USB3.0 1 TB Blue (External Storage Device) WX71AA224775 1 $222.22
WD Passport Essential SE USB3.0 1 TB Blue (External Storage Device) WX81AA216144 1 $222.22
Apple IPod Mini Wife 32Gb Black SF4KK7BAFF194 1 $1,110.22
Apple Ipad Mini Wi-Fi 32Gb Black SF4KK7GTMF194 1 $1,110.22
GST $333.11
Source:  Suppliers Invoice Total $2,997.99

87)  No one other than the CHRM, Melinda Guerra and the FO, Judith Swift, knew of the Ipads and external storage devices. On the date we interviewed her, the FO Judith Swift, informed us that the items in question were in the CHRM’s room.

88)  Based on the information from the FO, Judith Swift, the CHRM’s Secretary found and showed us both Apple Ipad Minis stored in a cabinet in the CHRM’s Melinda Guerra’s room.  The CHRM, Melinda Guerra also showed us the two (2) WD Passport Essential SE USB3.0 on the 13th September 2013, when we interviewed her.  She had one on her person and the other was stored in her Secretary’s office.

89)  Contrary to Stores Orders #28, we confirmed that none of these items were accounted for on the CHRM’s inventory list as at the date of the investigation.  Exhibit 9-E refers.  This was in spite of the CHRM’s inventory list being signed off by the FO, Judith Swift on 7th, May 2013.  This was the same date that Ms. Swift signed the Fultec Invoice #38307 indicating that she received the four items.

90)  Once again, the apparent intentional misrepresentation of the two (2) payments detailed at Table 3 was evident.  The CHRM, Ms. Melinda Guerra and the FO, Judith Swift, both admitted that they were aware of the fact, that what was ordered and paid for was not received. Again, this was another transaction approved knowingly by the CHRM and the FO to be an apparent misrepresentation of what occurred.  Both transactions were also a breach of Financial Orders 370 and #371 (b), (d), (f) and (g).

Outstanding prepayments

91)       The following are details in regards to 4 additional prepayments made to vendors for goods and services that were not received as of the time of the investigation.

Lachman Tekchandani was paid $800.00 for providing phone cards to rural health nurses that were never received.

92)       We perused Smart Stream voucher #020060, dated 20th June 2013, for eight hundred dollars ($800.00) made payable to Lachman Tekchandani.  The payment description read that the sum was for providing phone cards to the CHRM, to be used by the rural health nurses at the health centers.  The Smart Stream Invoice was first approved by Melinda Guerra and second approved by Ena Codrington.  Exhibit 10-A refers.

93)       We reviewed the letter of request for payment made by Ms. Guerra and it had the same description as what was quoted in the comments field of SmartStream voucher #020060.  The phone cards were for the health centers in Burrell Boom, Double Head Cabbage, Crooked Tree and Maskall for the period January to April, 2013. Exhibit 10-B refers. Both the letter of request and supplier’s invoice were attached to the Smart Stream invoice payment.

94)       We interviewed the rural health nurses for the villages of Burrell Boom, Double Head Cabbage, Crooked Tree and Maskall to confirm whether or not they had received phone cards of the said amount for the period of January to April 2013.  All the rural health nurses stated that they have not received any phone card of any amount from the CHRM.  In addition, the village of Maskall has an open land line, so they were not required to receive any phone cards.  The villages of Double Head Cabbage and Crooked Tree both have a smart phone that was provided with credit and have since not received any.  The village of Burrell Boom would get reimbursement of phone cards purchased through the subsistence claim form process.

95)       On 13th September 2013, Ms. Guerra informed us that she had made an error in her request and that the payment should have been for phone cards to be provided for the months of September 2013 to April 2014 to rural health nurses and not phone cards provided for the period of January to April 2013.  In addition, that she had intentions of fixing the request upon her return from vacation leave.

96)       We informed Ms. Guerra that the letter of request for payment and Smart Stream invoice payment misrepresented what actually transpired as no phone credit was received.  Ms. Guerra agreed that this was also a prepayment and that the credits have not been received from Mr. Lachman. Ms. Guerra told us that the cash derived from the payment was with Lachman Tekchandani in an account for the CHR.

97)       On 30th September 2013, Ena Codrington informed us that once again, she assumed that the items had been received given the official request sent by the CHRM’s office.  Ms Codrington claimed that she proceeded to make the payment based on the request.  We asked Ms. Codrington whether she was aware that this was a prepayment.  Ms. Codrington stated that she was not aware the payment was a prepayment since the request appeared to be asking for a reimbursement for the payment for items purchased and already received.

98)       This matter is unresolved.

 

 

Lachman Tekchandani paid $975.00 for providing phone cards to the Emergency Operation Centre Team that was not received.

99)       We perused SmartStream voucher #020333, dated 4th July 2013, for nine hundred and seventy five dollars ($975.00) for providing phone cards to twenty-two (22) staff members of the Emergency Operation Centre (EOC) Team as part of the hurricane preparedness for CHR.  The Smart Stream Invoice was first approved by the CHRM, Melinda Guerra and second approved by the FO, Ena Codrington.  No supplier’s invoice was attached to the SmartStream invoice.  Exhibit 11-A refers.

100)   The letter of request for the payment made by Ms. Guerra stated that Mr. Lachman Tekchandani should be paid nine hundred and seventy-five dollars ($975.00) for providing prepaid phone cards to 22 staff members of the Emergency Operation Centre Team as part of the hurricane preparedness for CHR. A list of the officers who apparently received the phone cards was also attached to the request.  Appendix 11-B refers.

101)   We attempted to interview the 22 staff members listed as having received the prepaid phone cards. We were able to interview seventeen (17) of the persons on the list since one (1) of the officers was the CHRM, one (1) officer’s name was recorded twice, one (1) officer was on vacation leave, one (1) officer was on sick leave and another transferred to the Caye Caulker Health Center.

102)   All the persons interviewed stated that they have not received any phone cards of any amount from anyone.    One of the staff member stated that he was informed by the Regional Manager that he would receive phone credit in case of an emergency.  Two of the staff members stated that they were not part of the Emergency Operation Centre Team.

103)   On 13 September 2013, Ms. Guerra informed us that indeed no one had received any phone card since she paid for them in the event of an emergency.  That is, in the event a hurricane threat.

104)   We informed Ms. Guerra that the request for payment and Smart Stream invoice misrepresented the facts in that it stated that the payment was requested and paid due to the items being already supplied. Also, that this was clearly another prepayment since the items paid for have not been received.

105)   Ms. Guerra agreed that this was also a prepayment and that everything that was paid for and not received from Mr. Lachman is there in an account for the CHR.  She added that she can obtain a statement from Mr. Lachman that should show all the funds lodged at his business in the name of the CHR.  A statement was e-mailed to us on 19th September 2013. Exhibit 11-C refers.  An attempt was made to confirm the statement with Mr. Lachman however he was not present at his business at that time.

106)   On 30th September 2013, we interviewed Ms. Codrington to clarify why she had approved a payment to a vendor when items had not been received. Ms. Codrington stated that in this case she was aware that this was a prepayment, since her name was on the list for receiving an item which she knew she did not receive. Ms. Codrington questioned this prepayment once she observed that after a while the items paid for were not forthcoming.  She also explained that the payment was approved by her based on the official request from the CHRM’s office.

107)   This matter remains unresolved.

$7,000.00 withdrawn from the SPP’s Bank Account of Donations and $5,000.00 was deposited with a Vendor as prepayments for 2014.  

108)   It was alleged that funds amounting to $7,000.00 was withdrawn from the SPP’s Bank Account of Donations and were not properly accounted for by the CHRM.   As a result, we attempted to establish whether the sum withdrawn was proper and that the SPP had:

i.            Received some value or good and

ii.            That such was accounted for by the entity.

109)   Financial Order #371 (b), (f) and (g) also states that public officials that approve payments are responsible to ensure that:

i.            The services specified have been duly performed,

ii.            The persons named on such payments are those entitled to receive payment and

iii.            The stores purchased have been received and accounted for.

110)   We found that the San Pedro Polyclinic (SPPC) operated Belize Bank Account #670-1-1-24210 to deposit daily collections of donations received from patients and the general public.  However, there existed no documented policy to show how this bank account was to operate.

111)   Discussion with the Director of SPPC, Owen Vellos, revealed that the funds were to be used to purchase miscellaneous petty purchases for staff and social activities.  On the other hand, the CHRM, Ms. Melinda Guerra, informed us that the account was to be used for expenditures for the SPP and the entire region.

112)   Financial Order #301 states “No official bank account may be opened unless authorized by the Accountant General to whom all applications shall be made. Each approved account shall be in the name of the Government of Belize…” We were not provided with any evidence to show whether a request was sent or approval was granted by the Accountant General for the opening of the bank account for the SPPC.

113)   We observed that on 18th March 2013, cheque#000104 for $7,000.00 was drawn from the Bank Account and made payable to the Administrator, Owen Vellos.  Exhibit 12-A refers.  We were informed by Mr. Vellos that the cheque was approved by himself and Jerry Lanza. According to Mr. Vellos, The CHRM verbally instructed him to dispose of the cash proceeds of the $7,000.00 as follows:

Table 4: Breakdown of how the $7,000.00 withdrawal from SPP bank account was distributed

AMOUNT RECIPIENT PURPOSE
$5,000.00 Lachman Tekchandani to cover cost of uniforms for CHR staff in unnamed month  in 2014 (12-B)
$2,000.00 Captain Shark Part payment towards purchase of a new Golf Cart for the SPCC (12-C).

Source: SPP’s Bank deposit slip

114)   We were unable to verify whether both payments were aligned with the intentions and objectives of the Donations Account given that no policy governing its use existed.

115)   However, we were able to satisfy ourselves that the $2,000.00 was received by Captain Sharks as referenced by receipt #172804, dated 19th March, 2004 (12-C).  Captain Sharks also provided us with a detailed statement which reflected that the $2,000.00 was included towards the cost of a new Golf Cart (7-A).

116)   We were able to verify by way of a copy of the bank deposit slip dated 20th March 2013 that the sum of $5,000.00 was deposited into Mr. Technandani’s bank account.  The deposit slip had a note that the $5,000.00 was for uniforms for 2014.  See exhibit 12-B.

117)   The CHRM, Melinda Guerra sent us an email on 16th September 2013, with a statement from Mr. Tekchandani signed 9th September 2013.  Exhibit 11-C refers. In the statement, Mr. Tekchandani acknowledged that he was holding the sum of $5,000.00 on behalf of the CHR in his bank account.  According to the statement, the funds will go towards uniform for 2014 for the administrative staff at CHR.

118)   We considered the advance payment of $5,000.00 to Mr. Tekchandani to be inappropriate given that:

                                            i.            This was a prepayment from public funds made in March 2013, for items to be provided by the vendor “sometime in 2014”; a direct contravention of Financial Order #371 (b), (f) and (g).

ii.            There was incomplete and improper information to support the alleged uniforms which were to be provided by the vendor.  Ms. Guerra had informed us that the uniforms will be for the male administrative staff however, no agreement or pro-forma invoice was available.

119)   At all times, expenditures by Ministries and Departments should be in strict accord with the annual budget approved by the National Assembly and the financial regulations.

$6,000.00 withdrawn from the NHI’s bank account managed by Matron Roberts Polyclinic, paid as prepayment for CHR’s annual Christmas party scheduled for December 14, 2013.

120)   We noted three (3) cheque payments made to the Radisson Hotel on 12TH March and 1st July 2013, which totaled six thousand dollars ($6,000.00).  (13-A, 13-B, 13-C) refers.

Table 5

Payments made as prepayment for CHR’s 2013 Christmas party

VENDOR CHEQUE# DATE AMOUNT PURPOSE
Radisson #79888217 /13 $2,000.00 Venue for annual Christmas party on December 14th, 2013.
Radisson #8215 7/1/13 $2,000.00 Venue for annual Christmas party on December 14th, 2013
Radisson #8216 7/1/13 $2,000.00 Venue for annual Christmas party on December 14th, 2013

Source: Payment information

121)   These three (3) payments were for CHR’s annual Christmas party scheduled for 14th December 2013.  All three (3) payments were approved by Ms. Alexy Rosado and Ms. Melinda Guerra.

122)   While we were unable to clarify this transaction we believe it represents the series of prepayments which contravenes the principles and practices outlined in the Government of Belize’s financial regulations.

123)   Please explain

 

OTHER MATTERS

124)   While the scope of the audit focused on specific allegations, we observed several transactions paid from the bank account of NHI funds controlled by the Matron Roberts Polyclinic for which we had queries and required further clarification.  We queried these transactions as they appeared as either:

  • Unrelated to the operations and functions of the Matron Roberts Polyclinic,
  • Inconsistent to the documented policies and guidelines of the program/checking account or,
  • Contravened the requirements of the Government of Belize’s financial regulations.

125)   Given the time element, we were unable to fully examine and discuss all these transactions.  However, we believe that it was important to report them to management for clarification and resolution.  It is hoped that explicit documented decisions may be made as to what management considers appropriate withdrawals from this bank account factoring the documented guidelines and the Government of Belize’s financial regulations.  In the end, these are public funds and should be subjected to strict controls and oversight.

Transactions which appeared inconsistent with the policies and guidelines of the Belize Bank Checking Account managed by the Matron Roberts Polyclinic

126)   The following were transactions; evidence and information which we believe were paid and appeared inconsistent with the policies and guidelines of the Belize Bank Checking Account No. 695-5057954, managed by the Matron Roberts Polyclinic.  Also, these expenses appeared unrelated to the Matron Robert’s Polyclinic

$12,957.25 used from the NHI Bank Account for the payment of the 2012 CHR’s Christmas Party.

127)   We saw six cheque payments made to three vendors for expenses related to the 2012 CHR annual Christmas party which totaled twelve thousand nine hundred and fifty-seven dollars and twenty-five cents ($12,957.25) as illustrated below.

Table 6 – Payments made towards CHR’s 2012 Christmas Party.

VENDOR CHEQUE # DATE AMOUNT DESCRIPTION
Princess Hotel & Casino 7843 21/12/2012 BZ$     1,985.75 3rd payment – Rental of Prince Hall, waitress, bartender and unlimited drinks for CHR’s Christmas party held on 14/12/12.
Princess Hotel & Casino 7842 21/12/2012 BZ$     1,985.75 2nd payment – Rental of Prince Hall, waitress, bartender and unlimited drinks for CHR’s Christmas party held on 14/12/12.
Princess Hotel & Casino 7838 20/12/2012 BZ$     1,985.75 1st payment – Rental of Prince Hall, waitress, bartender and unlimited drinks for CHR’s Christmas party held on 14/12/12.
Tereza Maria Waite 7814 13/12/2012 BZ$     1,850.00 Catering of Christmas dinner for CHR’s Christmas Party 14/12/12. – 280 plate @ $20.00 per plate = $5,600.00 – increase in 30 plates and per plate cost COPY OF CHEQUE NOT SEEN
Tereza Maria Waite 7712 22/11/2012 BZ$     3,750.00 Catering of Christmas dinner for CHR’s Christmas Party 14/12/12. 250 plates @ $15.00 per plate = $3,750.00
Anthony Flowers 7809 13/12/2012 BZ$  1,400.00 Purchase of drinks for CHR’s Christmas party – 14/12/12
  BZ$ 12,957.25  

Source: Payment information

128)   Three (3) of the payments were approved by both Ms. Judith Swift and Ms. Melinda Guerra.  The other (3) three were approved by both Ms. Alexy Rosado and Ms. Melinda Guerra.  Photocopies of such payment details are appended at Exhibits 14-A, 14-B, 14-C, 14-D, 14-E, and 14-F.  We also noted that the signature of the authorizing officer was omitted from the payment voucher seen at exhibit 14-E.

129)   We reviewed the chart of accounts for the NHI funds which is in the Financial Guideline and it showed that no expenditure line item for expenses was to be incurred for the CHR. We also noted that the performance bonus regulations of PCP’s stated that it was geared towards the rewarding of good service by the clinic’s staff.

130)   On September 13, 2013 Ms. Guerra informed us that the NHI funds used for the Christmas party were amounts of bonus that the CHR received since they were the best operating region. We informed Ms. Guerra that based on the guidelines; the performance bonus is geared towards the rewarding of good service by the staff of a clinic and not a region.  Thus, the CHR office was not eligible to receive a bonus.  Ms. Guerra reiterated that the bonus is not just for the staff in the clinic.

131)   On September 6, 2013 we conducted an interview with Ms. Judith Swift to clarify why she had approved payments for the 2012 CHR annual Christmas party from the NHI funds.  Ms. Swift informed us that in the absence of the Administrator, she is authorized to sign on cheques for the Matron Roberts Polyclinics and that in this specific case the Administrator was absent hence she had to approve the cheques.

132)   The Administrator, Ms. Alexy Rosado, informed us that the CHRM, Melinda Guerra, informed her that $10,000.00 should be used from the NHI account for the CHR’s Christmas party and that this year the amount was to be increased.  According to her, she only complied with the official request that came from the CHRM who is her direct supervisor.

133)   Please clarify.

$1,400.00 paid from the NHI Bank Account for the CHRM’s personal medical expenses

134)   We noted cheque #007472 dated 3rd August 2012, made payable to the Belize Gastroenterology and Endoscopy Center for one thousand four hundred dollars ($1,400.00).  The details of the payment read that it was for a colonoscopy test in respect of the CHRM, Melinda Guerra.  The cheque payment was authorized by Ms. Guerra and approved by both Ms. Alexy Rosado and Ms. Melinda Guerra.  Exhibit 15-A refers.

135)   We reviewed the financial guidelines for the Primary Care Provider (PCP) under the National Health Insurance (NHI) program, of which Matron Roberts Polyclinic is a part of.  The guidelines stated that in no circumstances shall any officer use PCP funds for any private purposes, however temporary. Exhibit 15-B refers.

136)   On 13th September 2013, we conducted an interview with Ms. Guerra to establish why she authorized a payment for a personal medical expense using the NHI funds.  Ms. Guerra informed us that she had made a request for assistance to the Administrator of the Matron Roberts Polyclinic to assist her with such medical expense and that the Administrator made the payment directly to the medical centre.

137)   We informed Ms. Guerra that the financial guidelines for NHI funds specifically stated that in no circumstances shall any officer use PCP funds for any private purposes, however temporary.  Ms. Guerra stated that the payment of the medical expense was an incentive to her.

138)   On 30th September 2013, we interviewed the Administrator, Ms. Alexy Rosado, to determine her involvement in the approval of the payment of personal medical expenses for the CHRM.  Ms. Rosado informed us that this was an official request from the CHRM and that the request came from Melinda Guerra who was her supervisor hence she did not question the request.

139)   The CEO, Ministry of Health, informed us that there is a system in place for medical assistance for members of staff.   Hence, there was no need for her to use the NHI funds for her personal medical expense.

140)   Kindly inform us how this transaction will be treated given that it appears to be contrary to criteria in the PCP financial guidelines?

The sum of $1,000.00 paid from the NHI bank account to purchase personal gift items for the CHRM, Melinda Guerra as part of 2012 NHI bonus.

141)   Cheque payment details shows that Cheque #8299 dated 6th August 2013 for one thousand dollars ($1,000.00) was made payable to Lachman Tekchandani for a gift (one Nikon SLR Digital Camera), on behalf of the CHRM Melinda Guerra for the 2012 NHI Bonus.  The cheque payment was approved by Ms. Alexy Rosado and the CHRM, Ms. Melinda Guerra.  Exhibit 16-A refers.  The actual cheque was not found on hand however we found the cheque stub showing that this payment was made. Exhibit 16-B refers.

142)   We reviewed the performance bonus regulations and noted that the bonuses were geared towards the reward of good service by the staff of a clinic and thereby geared towards the staff of the clinic.  Once again, we were of the opinion that the staff of the CHR may not have met the eligibility criteria to receive a bonus.

143)   The Administrator, Ms. Alexy Rosado stated that Ms. Guerra included her own name on the list of officers to receive a bonus and specified that she did not wanted cash but preferred that a digital camera to be purchased from Mr. Lachman Tekchandani.

144)   Ms Rosado explained that Ms. Guerra brought with her a copy of the supplier’s invoice which was attached to the payment voucher.  Ms. Rosado explained that she later learnt of a refund of one thousand dollars ($1,000.00) apparently repaid to the bank account by Lachman Tekchandani.

145)   On 13th September 2013, the CHRM, Melinda Guerra informed us that she did not receive a cash bonus but that the Administrator of the Matron Roberts Polyclinic decided to give her a token of appreciation.  However, the vendor was not able to provide the electronic device and therefore deposited the funds back to the NHI bank account.  Ms. Guerra also stated that the Administrator would know of the reimbursement of funds.

146)   The Administrator, Ms. Alexy Rosado subsequently informed us that she did not offer any gift or token of appreciation to the CHRM, Melinda Guerra.

147)   Further inquiry revealed that the clerk at the Matron Roberts Polyclinic came across a deposit of one thousand dollars $1,000.00 made to their Belize Bank account on September 9th 2013.  Ms. Rosado informed us that her clerk told her that she received a phone call from Ms. Guerra informing her that Mr. Lachman had refunded the one thousand dollars ($1,000.00) which he was originally paid to purchase the digital camera. Exhibit 16-C refers.

148)   Although the funds may have been recovered, this case illustrates the need for urgent enhancement of fiscal control over this NHI bank account to minimize opportunities for fraud and abuse.

The sum of $2,000.00 was paid from the NHI bank account as a bonus to FO, Judith Swift and a retired staff member.

149)   We perused cheque #8239 dated 5th July 2013, for one thousand dollars ($1,000.00) made payable to Joan Flowers for a NHI 2012 bonus.  Exhibit 17-A refers.  The cheque was approved by Administrator, Ms. Alexy Rosado and CHRM, Ms. Melinda Guerra.

150)   Further inquiries by us revealed that Ms. Joan Flowers was the Deputy Regional Manager of the CHR and she retired on February 23, 2013.

151)   We noted cheque #008240 dated 7th October 2013, for one thousand dollars ($1,000.00) was made payable to Scotia Bank on behalf of the FO, Judith Swift.   Exhibit 17-B refers.  Management informed us that it was payment of bonus to Ms. Swift. We were unable to locate the related payment voucher for cheque #008240.

152)   We reviewed the performance bonus regulations and noted that the bonuses were geared towards the rewarding of good service by the staff of the clinic and thereby geared towards the staff of the Matron Roberts Polyclinic.  It was therefore apparent that the staff of the CHR may not have been eligible to receive such bonus.

153)   On 13th September 2013, Ms. Guerra informed us that the payment of bonus to Ms. Swift was an incentive to her since Ms. Swift was leaving the region and there was no farewell party for her.  She also stated that the bonus for Ms. Joan Flowers was authorized by her since it was a bonus for the last year while Ms. Flowers was still Deputy Regional Manager.  Ms. Guerra informed us that she believes the bonus is for both NHI and GOB officers in the CHR.

154)   On 6th September 2013, the FO, Ms. Judith Swift informed us she was not sure whether she had received the bonus since she was told it would go directly to her bank account.  She stated that she does not check her bank account to see what is deposited or not, that she tends to just withdraw.  We asked her about her eligibility for receiving the said bonus and she responded that if her manager wanted to give her a bonus she would not question it.

155)   The Administrator of the Matron Roberts Polyclinic, Ms. Alexy Rosado informed us that she had submitted proposals for the payment of bonuses.  On the list were names of eligible persons to receive the bonus.  The list was submitted to the CHRM who in turn submitted it to the CEO, Ministry of Health for approval.

156)   According to Ms. Rosado, the CEO, Ministry of Health, had approved one of the proposals and a list of names.  Subsequently, the CHRM, Melinda Guerra, included additional names to the list already approved by the CEO, Ministry of Health.   The names allegedly added by the CHRM, Melinda Guerra were:

  • the drivers from CHR,
  • Judith Swift,
  • Melinda Guerra and
  • Ms. Joan Flowers.

157)    Ms. Rosado expressed that she was uncomfortable with the additional names added to the list which the CEO, Ministry of Health had already approved.   She also claimed that she did not feel at ease to pay a bonus to a retired officer.  However, it was done based on the approval of the CHRM, Melinda Guerra.

158)   In the case of the drivers, Ms. Rosado claimed that it was justified given that they assisted in picking up doctors at night when needed therefore she ultimately agreed to the payment of bonus to the drivers.

159)   This was a matter that remains unresolved.

$16,100.00 in interest free loans paid from the NHI bank account to employees and non- employees of Matron Roberts Polyclinic

160)   We perused the following four cheques drawn from the Matron Roberts Polyclinic’s NHI bank account 695-5057954.  The four cheques were for personal loans made to employees and non- employees of Matron Roberts Polyclinic which totaled sixteen thousand and one hundred dollars ($16,100.00) as detailed below:

Table 7:        Persons employed and not employed at Matron Roberts Polyclinic who received personal loans from the NHI bank account managed by the Matron Roberts Polyclinic

OFFICER EMPLOYMENT AMOUNT OF LOAN CHEQUE# & DATE
Dr. Egbert Grinage KHMH $5,000.00 #7844 dated 21/12/12
Errol Barnett CHR $4,500.00 #7701 dated 16/11/12
Natalia Largaespada Beer Maternal & Child Health Unit $6,000.00 7229 dated 22/5/12
Alexy Rosado Matron Roberts Polyclinic $600.00 #7730 dated 26/11/12
Total $16,100.00

Source: Payment documents

161)   All four (4) payments were authorized by Melinda Guerra.  Three of the payments were approved by both Ms. Alexy Rosado and Ms. Melinda Guerra.  One of the payments was approved by both Ms. Melinda Guerra and Ms. Judith Swift. Photocopies of the payment voucher are appended at Exhibits 18-A, 18-B, 18-C, and 18-D.

162)   Ms. Alexy Rosado, Administrator of the Matron Roberts Polyclinic also received a loan of six hundred dollars ($600.00) from the NHI funds.  Exhibit 18-A refers.  This loan was authorized by Ms. Melinda Guerra.  The payment was approved by both Ms. Guerra and Ms. Swift.

163)   We reviewed the financial guidelines and noted that the document makes reference to circumstances whereby any officer may not use PCP funds for any private purposes, however temporary.

164)   On 13th September 2013, we conducted an interview with Melinda Guerra to clarify why loans were granted to employees and non employees of Matron Roberts Polyclinic.  Ms. Guerra stated that the CEO informed her that loans can be granted.  She stated that the persons committed to repay by signing and paying into the bank account and that a record of loans and payments should be at the clinic.  In the case of the $5,000.00 loan to Dr. Grinage, Ms. Guerra claimed that it was a direct approval and request from the CEO, Ministry of Health.

165)   The FO, Judith Swift, informed us that she felt uncomfortable with the payment made to Dr. Grinage; however, she went ahead and processed it because the request came from the CHRM, Melinda Guerra and the Administrator, Alexy Rosado.

166)   We questioned Ms. Rosado whether she was aware of the financial guideline for PCP’s.  Ms. Rosado informed us that she didn’t know of any financial guideline and that she has been asking for a policy particularly for payments not directly linked to the clinic.  Ms. Rosado explained that payment requests for loans would come from the CHR or the CEO, Ministry of Heath.  She stated that the loans for the doctors were a request from the CEO, Ministry of Health.

167)   On October 1, 2013, we confirmed that the CEO, Ministry of Health, Dr. Peter Allen, directed that loans from the NHI funds be issued to Dr. Grinage and Dr. Largaespada-beer.  He stated that upon a case by case basis loans would be granted.  He was however, not aware of the other two loans paid from the bank account but stated he did not have a problem with the granting of loans.

168)   Of note is that of the four loans issued, one is not being repaid.  That is the $5,000.00 paid to Dr. Egbert Grinage.  Attached at Exhibit 18-B is memorandum referenced GEN/30/11/13(37) dated 21st June 2013, from the CEO, Ministry Health in which he was requesting that the repayments be delayed for one calendar year.

169)   Kindly inform us whether the granting of interest free loans has been sanctioned by the Ministry of Finance? If so, kindly provide us with the authority.

Matron Roberts Polyclinic’s NHI bank account used to pay $5,626.77 in salaries/wages for persons not employed with the health facility.

 

170)   We perused six (6) payments of salaries or wages paid to officers not employed by the Matron Roberts Polyclinic which totaled five thousand six hundred and twenty-six dollars and seventy-seven cents ($5,626.77) as illustrated at Table 8 below.  Five (5) of the payments were approved by both Ms. Alexy Rosado and Ms. Melinda Guerra.  One (1) of the payment was approved by Ms. Judith Swift and Ms. Joan Flowers.

Table 8: List of payments of salaries/wages to staff not employed at the Matron Roberts Polyclinic

OFFICER EMPLOYMENT TOTAL SALARY/WAGE RECEIVED CHEQUE #/ EXHIBIT REFERENCE
Michelle Hemsley Domestic Auxiliary at CHR $441.64 #7988/Exhibit 19-A
Francis Symms Central Medical Store $254.68 #7055/Exhibit 19-B
Idalia Machuca Cleopatra White Polyclinic II $3,341.66 #7170/Exhibit 19-C
Josephine Tesecum Hattieville Health Center $721.45 #7077/Exhibit 19-D
Michelle Hemsley Domestic Auxiliary at CHR $330.90 #8001/Exhibit 19-E
Sharon Astheimer San Pedro Polyclinic $536.44 #6501/Exhibit 19-F
TOTAL $5,626.77

Source:  Payment vouchers

171)   On 30th September 2013, we discussed these payments with Ms. Alexy Rosado to clarify her involvement with the approval of payments for salaries of officers not working at the Matron Roberts Polyclinic.

172)   Ms. Rosado explained that this was a practice she inherited.  That is doctors not working at the Matron Roberts Polyclinic being paid from the NHI funds.  She stated that this practice continues to date and that it impacts on her ability to employ another doctor due to the resources of the Matron Roberts Polyclinic being used to pay a doctor not working there.   She stated that whenever the CHR funds were low, the NHI funds would be utilized.

173)   What is the position of the Ministry of Health in this regard?

NHI funds used to pay for materials to be used by the CHR and not for Matron Roberts Polyclinic – $2,636.00.

174)   We noted the following two cheque payments:

Table 9 – Payments for materials to be used by the CHR

CHEQUE # DATE  AMOUNT DESCRIPTION
7609 10/08/2012  $1,620.00 80 tons of 1 – ½” all-in material to CHR compound
7617 10/09/2012  $1,016.00 hauling and spreading of 4 loads of all-in sand to CHR compound
 $2,636.00

Source:  Payment information

175)    Cheque #7609 for 80 tons of 1 – ½” all-in material as seen at Exhibit 20-A and cheque #7617 for haulage and spreading of 4 loads all-in sand to the CHR compound, Exhibit 20-B refers.  A total amount of two thousand six hundred and thirty-six dollars ($2,636.00) was therefore spent on materials for the CHR’s Compound.  The payment was authorized by Ms. Melinda Guerra and approved by both Ms. Alexy Rosado and Ms. Melinda Guerra.

176)    We reviewed the chart of accounts for the NHI funds found in the Financial Guideline and did not see an expenditure line item for expenses to be incurred for the CHR.

177)   On 13th September 2013, we interviewed Ms. Guerra to clarify why she had authorized two payments for materials to be used at the CHR compound.  We informed Ms. Guerra that the NHI funds and accounts did not stipulate the use of such monies for expenses related to the CHR.  Ms. Guerra informed us that the NHI funds can be used for the entire region and therefore she authorized payments for materials to be used in the CHR compound.

178)   The Administrator, Ms. Alexy Rosado, informed us that all payments for any purchase of a service or good that was not for the Matron Roberts Polyclinic would be requested either by the CHRM or directly from the CEO, Ministry of Health depending on where the items would be used.  In this case, the request came from the CHRM who was her direct supervisor.

179)   Please clarify.

$1,500.00 in NHI funds used to pay for repairs to SPP’s Generator and wages for an officer who is being paid from the Smart Stream Payables Module.

180)   Cheque #7836 was made payable to Ms. Sheina Wade for $1,500.00 dated 19th December 2012.  Exhibit 21-A refers.  The payment description detailed that it was for overseeing the repairs to generator radiator from SPP by Mr. Allen Stuart, NEMC mechanic. The payment was approved by both Ms. Judith Swift and Ms. Melinda Guerra.

181)   We reviewed the chart of accounts for the NHI funds found in the Financial Guideline where it showed no expenditure line item for expenses to be incurred for the CHR or the SPP.

182)   Further inquiry revealed that nine hundred dollars ($900.00) was used towards the repairs of a generator that was kept in the SPP, three hundred and thirty dollars and ninety cents ($330.90) was used to pay wages of one Ms. Angela Usher and the balance of two hundred and sixty-nine dollars and ten cents ($269.10) was claimed to have been deposited back to the NHI funds.

183)   The Administrator at the SPP confirmed that they do have a generator; however, they have one person designated as the repair person for such generator.  We questioned whether any repairs had been done by anyone other than this designated repair man and Mr. Vellos, stated that no other repairs had been done at least not to his knowledge.

184)   On September 13, 2013 we conducted an interview with Ms. Guerra to clarify why NHI funds were used to pay for repairs of generator kept in the San Pedro Polyclinic when the San Pedro Polyclinic had a designated repair man for this type of jobs.  In addition, we queried why an officer working at the CHR was paid wages for the period 16 – 31/12/2012 using the NHI funds.  Ms. Guerra informed us that she recalls the repairs being done and that the person to explain this payment would have to be the Administrator of the Matron Roberts Polyclinic.  She explained that the repairs had to be done and that the Administrator at the SPP “at times does not remember things”.

185)   In the case of the wages being paid, Ms. Guerra stated that there were times when the funds in the recurrent vote run low.  She informed us that in this case, because it was around the Christmas season, she approved the cash payment of wages for Ms. Angela Usher using the remaining cash to Ms. Sheina Wade for the repairs of the said radiator.

186)   The FO, Ms. Judith Swift, explained that Mr. Allen Stuart had taken the radiator to Melchor and that Ms. Wade had given him the cash to do so.  We informed Ms. Swift that the business was located in Chetumal and not Melchor.

187)   Ms. Swift also stated that Ms. Usher was not paid from the payroll for some reason therefore the extra cash on hand was used to pay her salary.  She stated that the monies used from the NHI funds were repaid to the NHI funds.

188)   On 30th September 2013, Administrator, Ms Sheina Wade, informed us that she was instructed by Ms. Swift to create a cheque in her own name for one thousand five hundred dollars ($1,500.00) for repairs that would be done in Chetumal.

189)   Ms. Wade also stated that she cashed the cheque and handed over the proceeds to Ms. Swift who then returned to her cash which totaled six hundred dollars ($600.00).  Ms. Wade clarified that she paid the wages to the officer from her petty cash and that upon receipt of the six hundred dollars ($600.00), Ms. Swift instructed her to repay funds used from her petty cash and that the balance be deposited into the NHI funds.  Ms. Wade claimed to have done the deposit and repaid her petty cash with the funds.

190)   Audit reviewed bank statements for the period December 2012 to July 2013 and was not able to identify the repayment made to the bank account.

191)   We did not get to meet Mr. Allan Stuart since he has retired from the CHR.

192)   This matter remains unresolved.  Please clarify.

NHI funds used for payment of personal medical expenses for staff of the CHR – $400.00.

193)   Cheque #7839 dated 20th December 2012 for four hundred dollars ($400.00) made payable to Emir Castaneda for reimbursement for part of expenses incurred in undergoing a laparoscope surgery, Exhibit 22-A refers, was approved by both Ms. Judith Swift and Ms. Melinda Guerra.

194)   Further inquiry revealed that Emir Castaneda was employed under cost centre 19031, Belize District Health Services.  We reviewed the chart of accounts for the NHI funds and found in the Financial Guideline where it showed no expenditure line item for expenses to be incurred for the staff of the CHR.

195)   On September 13, 2013 Ms. Guerra informed us that she indeed approved this payment as an “incentive to him”.  She also stated that the CEO, Ministry of Health had informed her that she can make small incentive payments to staff so she went ahead approved that one.  The FO Judith Swift stated that in the absence of Ms. Rosado, she is to assist with all payments authorized by the Regional Manager.

196)   On 30th September 2013, Ms. Rosado, explained that she was absent from work when this transaction occurred and that she was not consulted.  Upon her return from her holiday she found out that Ms. Swift and Ms. Guerra had approved the medical assistance to Mr. Castaneda from the NHI funds.

197)   This payment is another payment unrelated to the operations and functions of Matron Roberts Polyclinic.  Please clarify.

$2,245.00 paid to Lachman Tekchandani from the NHI bank account for uniforms for CHR staff

198)   Cheque #7846 dated December 31, 2012 for two thousand two hundred and forty-five dollars ($2,245.00) was paid to Lachman Tekchandani.  The payment details read that it was for 21 pants and 18 shirts for CHR.  The payment was approved by the FO, Judith Swift and CHRM, Melinda Guerra. Exhibit 23-A refers.

199)   We reviewed the chart of accounts for the NHI funds found in the Financial Guideline and we did not see any approved expenditure line item for expenses to be incurred for the staff of the CHR.  We also reviewed the approved recurrent estimates for Cost Centre 19031, which showed that there was an approved line item specifically for uniforms, 34004.

200)   On 13th September 2013, we interviewed Ms. Guerra to get clarity on why she had authorized payment to Mr. Tekchandani for uniforms for staff at the CHR utilizing the NHI funds.  Ms. Guerra informed us that as with previous cases, she used the NHI funds for the entire central region and not just for Matron Roberts Polyclinic.  It was on that basis she claimed to have authorized payments for uniforms to be used by staff of the CHR.

201)   On 6 September 2013 the FO, Ms. Judith Swift, informed us that she authorized the payment to Mr. Tekchandani for uniforms for staff at the CHR using the NHI funds. She claimed that she did so given that she was authorized to approve payments in the absence of the Administrator, Ms. Rosado.

NHI funds used to pay monthly Body 2000 Gym membership for staff of Matron Roberts Polyclinic and CHR – $440.00.

202)   Cheque payments for cheque# 8086 and 8027 dated 15th May 2013 and 10th April 2013 for $220.00 each was made payable to Body 2000.  Exhibits 24-A and 25-B refer.  The payments were for monthly membership for staff for the Exercise Program.  Payment was approved by both Ms. Alexy Rosado and Ms. Melinda Guerra.

203)   Even though the details of the payment states that the membership fee is for the staff of the Matron Roberts Polyclinic we note that three of the officers for whom the membership fee is being paid for are employees of the CHR.  These include the CHRM, Melinda Guerra, FO, Judith Swift, and Senior Secretary Ms. Pauline Rhamdas.

204)   On September 13, 2013 Ms. Guerra stated that payment for the Gym membership was considered as health incentives for all staff including those at the CHR and on that basis she approved the payments.

$3,791.00 from Matron Roberts Polyclinic’s NHI funds used to pay for materials to construct a building at the Ladyville Health Centre.

205)   Cheques #7695 and #7718 both for $1,895.50 each and dated 15th and 23rd November, 2013 respectively were made payable to the Springfield Community Fund.   See Exhibit 25-A and 25-B.  The payment details for both cheques revealed that the payments were for materials purchased for the construction of new building at the Ladyville Health Centre which totaled three thousand seven hundred ninety-one dollars ($3,791.00).  Both cheques were approved by Ms. Alexy Rosado and Ms. Melinda Guerra.

206)   In reviewing the chart of accounts for the NHI funds as stipulated in the Financial Guideline, it can be seen that there exists no expenditure line item for expenses to be incurred for the CHR.  This also raises the questions as to whether said payments should have been made from the NHI bank account given that the construction of a Health Center is a capital project which would be budgeted for and appropriated by the National Assembly.   The contractual process would have also been activated dependent on the estimated cost involved.

207)   On 13th September 2013, Ms. Guerra informed us that all expenses incurred from the NHI funds not directly for the Matron Roberts Polyclinic were approved by her since she believed that the NHI funds were for the entire region.

208)   The Administrator, Ms. Alexy Rosado, informed us that the request for this payment came from the CHRM Melinda Guerra who was her direct supervisor.

209)   We did not get to perform field verification to determine whether the works were completed.  This should form a part of the detailed audit.

210)   Due to findings already detailed in this report, we decided to expand the search for more payments that appeared to have been done regardless of them deviating from the financial orders and other relevant regulations.  In some instances, we were able to obtain clarification from the Regional Manager, in others we were not able to due to time constraints.

 

Other Apparent Irregular Transactions Charged Against Recurrent Expenditure Accounts Managed by the CHRM

211)   We also questioned the following payments during the investigation for which satisfactory information was not provided.  We therefore decided to include them in this report in order that management may seek to have them resolved:

Reimbursement of $175.00, paid to the FO, Judith Swift, for purchasing food and drinks for CORE team when no evidence was provided to show that CORE team meeting was held.

 

212)   Scrutiny of SmartStream voucher #019221 dated 24th April 2013, for one hundred and seventy-five dollars ($175.00) was made payable to the FO, Judith Swift for reimbursement for purchasing food and drinks for CORE Team meeting on a visit to SPP staff meeting on April 20, 2013.  The Smart Stream Invoice was first approved by Melinda Guerra and second approved by Judith Swift.  The invoice had no supplier’s invoice attached. Exhibit 26-A refers.

213)   Audit reviewed the request made by Ms. Melinda Guerra which requested that a reimbursement be made in the sum of one hundred and seventy five dollars ($175.00) to Ms. Judith Swift for out of pocket expenses incurred in paying for food and drinks for CORE Team visits to Dr. Otto Rodriguez Polyclinic a staff meeting on April 20, 2013.  Exhibit 26-B refers.

214)   We visited the San Pedro Polyclinic to confirm whether the event for which the reimbursement was being requested occurred and whether food was provided by Ms. Swift.  The Administrator informed us that there was an ACLS training that was held on the 20-21/4/2013 and that food was paid for to the owner of El Fogon restaurant from the vote for both days and was requested via requisition #10115.  See Exhibit 26-C. The Administrator confirmed that there was no CORE meeting held on these dates.

215)   We reviewed SmartStream payments to confirm whether payment of food was done to one Maria Susana Eiley owner of El Fogon for April 20 – 21, 2013.  Payment was done via SmartStream voucher #019432 dated May 7, 2013 for breakfast and lunches for six hundred and sixteen dollars ($616.00). Payment was first approved by Melinda Guerra and second approved by Judith Swift. Exhibit 26-D refers

216)   On 6th September 2013 Ms. Swift informed us that she would approve a reimbursement for herself if the manager had already certified it.  She stated that she wouldn’t have requested a reimbursement if she had not made the expenditure.  We informed Ms. Swift that the records show that on said date only ACLS training seemed to have occurred and there was no record of a CORE Team meeting.  Ms. Swift stated that it may not have been a CORE team meeting with the San Pedro officers but with other members.

217)   We observed that the CHRM, Melinda Guerra and the FO at CHR, Judith Swift submitted reimbursement claims for same dates and same event even though records did not indicate that a CORE team meeting was held.  In fact it shows that food was provided and paid for from the recurrent budget.

218)   At the time of investigation this reimbursement claim had not been resolved.

Double payment of $419.32 made by CHR to Majil’s Mexican Products for a fax machine

 

219)   We noted SmartStream voucher #019982 dated 14th June, 2013 paid to Majil’s Mexican Products for providing the SPP with a Fax machine as per invoice #317440 dated March 14, 2013 for Four hundred and nineteen dollars and thirty-two cents ($419.32). Exhibit 27-A refers.  The payment was first approved by Ms. Melinda Guerra and second approved by Ms. Ena Codrington.

220)   Further scrutiny of the payment revealed that invoice #317440 was for a supplier named Majil’s Mexican Products/Caye Supplies.  We therefore proceeded to identify whether this supplier was already paid for the said fax machine.

221)   Review of SmartStream payments revealed that the vendor Majil’s Mexican Products/Caye Supplies was paid for providing a fax machine to the SPP via SmartStream Voucher #019392, dated 6th May 2013, for four hundred and nineteen dollars and thirty-five cents ($419.35). Exhibit 27-B refers.  The supplier’s invoice used to pay for this item was invoice #317440 dated March 14, 2013, apparently the same invoice used for making the payment to Majil’s Mexican Products.  This payment was also approved by Ms. Melinda Guerra and Ms. Judith Swift.

222)   It appears to us that the difference between both vendor names was that one was located in Corozal and the other in San Pedro.  In addition, one of them has the words “Caye Supplies” added to its vendor name.

223)   We visited the SPP to clarify how many fax machines were received.  The Administrator informed us that only one (1) fax machine was received.  It is therefore reasonable to conclude that the vendor was paid twice for providing one Fax Machine causing an overpayment of $419.35.

224)   The FO, Ena Codrington told us that she had received a statement from the vendor and asked her clerk to confirm whether the item had been paid.   If not, for the clerk to proceed with the payment.  She stated that it appeared that the clerk searched for the wrong vendor and was unaware that the item had already been paid.  The invoice was therefore paid twice creating a double payment.  Ms Codrington said that she will take necessary action to recover the overpayment.

225)   Kindly indicate whether these funds have since been recovered?

Approval of Transfer allowance by Regional Manager to an officer employed at the Matron Roberts Polyclinic – $1,200.00.

226)   The Ministry of the Public Service is the proper authority to approve and authorize allowances such as transport and transfer allowances.

227)   We noted a Smart Stream voucher #019018 dated 9th April 2013, for one thousand two hundred dollars ($1,200.00) in respect of “transfer allowance” paid to Jerry Lanza for his transfer to SPP.  The payment was first approved by Melinda Guerra and second approved by Judith Swift.  Exhibit 28-A refers.

228)   Scrutiny of the SmartStream payroll module revealed that Dr. Jerry Lanza was not being paid salaries from the Government of Belize’s consolidated fund.  Further verification revealed that he was employed by the NHI system and was stationed at the Matron Roberts Polyclinic.  The decision to transfer him to the SPP was made by the CHRM, Melinda Guerra.

229)   We conducted an interview with Dr. Figueroa, who helped develop the financial guidelines for the NHI program.  In that meeting, we learnt that staff employed under the NHI program was intended to serve at the specific polyclinic where they were employed.  In addition, these employees should not be transferred to any other medical facility.  In this case, Dr. Lanza was employed to work at the Matron Roberts Polyclinic.

230)   On September 13, 2013 Ms. Guerra informed us that the CEO, Ministry of Health told her that all NHI employees are public officers and that the CEO was aware that Dr. Lanza would be transferred.  In this regard, she thought that all benefits would be paid to Dr. Lanza and that requesting a transfer allowance from the Ministry of the Public Service would not be possible since Dr. Lanza was not employed under the Government of Belize’s umbrella.  Hence, she opted to pay him the transfer allowance from the recurrent expenditure vote.

231)   We questioned the Administrative Officer at CHR, Floridalia Quiroz, who stated that she was not aware of the payment.  Ms. Quiroz also claimed that she would not be informed of this since Dr. Lanza was not employed under the Public Service Regulations but on contractual basis to work at the Matron Roberts Polyclinic.

232)   We attempted to conduct a second interview with Ms. Swift to clarify why she had approved a payment of transfer allowance to Dr. Lanza who was not employed in accordance with the Public Service Regulations; however, Ms. Swift had proceeded on vacation leave.

233)   It appears to us that the CHRM, Melinda Guerra acted without authority when she approved and paid this transfer allowance.

234)   Please explain.

235)   At Appendix A, we have briefly described some fourteen (14) sets of transactions which also required clarification.  These payments were not resolved at the time of our investigation and should be reviewed by management and/or a follow-up audit

Overall Summary

236)   This report revealed that the CHRM, Melinda Guerra and the FO, Judith Swift, in selected cases authorized and approved transactions which appeared to us to be a misrepresentation of the service or good ordered, received and paid for by the CHR.

237)   We also showed cases whereby public funds appeared to have been misused and misapplied (recurrent budget and bank account) for purposes inconsistent with the financial guidelines for the Primary Care Provider (PCP) under the National Health Insurance (NHI) program and the appropriations approved by the National Assembly. There were also instances whereby public funds were used to pre-pay for items and services not received as of the time of the investigation.

Impact to CHR

238)   The decision to use the NHI commercial bank account which is managed by the Matron Roberts Polyclinic to incur expenditure related to the CHR may lead to excess spending by this entity for which funds were not appropriated.  These excesses may also be omitted from the national accounts of the country prepared by the Accountant General given that the NHI bank accounts were not reported to the Treasury Department as required by FO #301.  From our preliminary work, it can be reasonably concluded that the NHI bank account managed by Matron Roberts Polyclinic was being used by the CHR as a supplement to the annual recurrent budget provisions.

239)   The CHR, as all government ministries and departments, received budget appropriations for annual recurrent and capital expenditures.    Financial Order #358 states that expenditures chargeable against votes shall be classified strictly in accordance with the estimates.  The exhaustion of a subhead and the availability of funds under another do not justify the misallocation to the latter of a charge properly falling on the former subhead.  In this instance, reimbursements were being paid from the salaries subhead.

240)   We noted that in most cases the Finance Officer at CHR should have provided better advice and guidance to the CHRM in regards to these financial matters.  FO #10 (a) states ….”Finance Officers are appointed with duties such as to be financial advisers to their Accounting Officers.”  In this case, the Finance Officer(s) appeared to have failed to advise the Regional Manager on the cases of misallocations, use of NHI funds, instances of uneconomical spending, prepayments and misrepresentation of financial information.

241)   Lastly, while accounting officers and managers may want to be expedient in implementing policies, due care should be exercised at all times to ensure financial regulations and policies are not disregarded for it can create an atmosphere that is susceptible to wrongdoing.

Recommendations

242)   As a result of the above findings, the Office of the Auditor General recommends the following:

The CEO of the Ministry of Health should:

i.            Initiate action in accordance with Financial Orders #601 to 605 given the

a)      Irregular nature of  selected transactions;

b)      Misrepresented payment descriptions and supporting documents and

c)      Questionable reimbursement claims that remain unresolved.

ii.            Institute action to recover those public monies which were improperly prepaid to the vendor for services and items not received to date

iii.            Ensure that any monies due to the NHI bank account that were used for the CHR or any other entity other than the Matron Roberts Polyclinic be refunded.

iv.            Ensure that a proper system of internal checks are conducted on the financial operations of  the wider CHR operations and other entities under the Ministry of Health as required by FO #558 to enhance compliance to relevant financial regulations and the policies governing the use of the bank accounts.

v.            Strengthen the internal controls in place to reduce the degree of arbitrary and discretionary spending at the regional level.

vi.            Conduct a detailed review of material transactions processed by the CHR to determine whether there may be similar irregular transactions of this nature and if so, that they are resolved.

vii.            Organize relevant training in relation to the Government of Belize’s financial and accountability process for key technical officials within the Ministry of Health which may enhance their awareness and compliance to the financial regulations, systems and practices.

                         viii.            Take action against the officers if found culpable as directed by FO #373 which states “in the event of any payment being made in consequence of an incorrect certificate on a voucher, the officer authorizing the voucher for payment shall be held responsible for the same, and the amount may be surcharged against him.”

ix.            Devise a policy/system to ensure that the CHRM is restrained from utilizing public funds for social events, in particular, when no such funds were appropriated by the National Assembly.

x.            Consider implementing a fraud and wrong doing notification system, which would allow officers at these entities, an opportunity to disclose allegations they may be knowledgeable of in order that they may be resolved in a timely manner.

xi.            As it relates to the SPP Donation Bank Account:

a)      Recoup the sum of $5,000.00 from the vendor and that a decision is made as to whether the “alleged uniform purchase for administrative staff” falls within the policy of the Ministry of Health and the Government of Belize.

b)      Seek approval from the Accountant General for the operation of the bank account as required by Financial Order #301.

c)      Create and formalize a policy governing the collection and use of donations collected by the SPCC and/or other entities under the portfolio of the Ministry of Health.

d)      Enhance the system of accounting for the collection and payment of funds in respect of the donation account.

e)      Adhere to Financial Orders # 370 and 371 when approving payments.

243)   We express our gratitude to the management and staff of the Ministry of Health and the Central Health Regional Office for the administrative support provided to the Investigative Audit Team during the examination.

244)   I shall be grateful for your comments.

Mrs. Dorothy Bradley

Auditor General

Cc        Financial Secretary, Min of Finance

CEO, Min of the Public Service

Accountant General

Central Health Regional Manager

Enc.

Appendiix A

Payments which required clarification, however, these were not resolved given the time constraint and should be reviewed by management and/or a follow-up audit.

 

Reference paragraph 235 of Audit Report referenced AUD/13/08 (04)

Deduction payments made to the Bank of Nova Scotia on behalf of employee working at the Cleopatra White Polyclinic – $1,400.00.

  1. We noted two payments seen at Exhibits 29-A and 29-B made to the Bank of Nova Scotia on behalf of Dr. Idalia Machuca, medical officer at the Cleopatra White Polyclinic as payment of deduction due to the bank for amount totaling one thousand four hundred dollars ($1,400.00).  Both payments were approved by Ms. Alexy Rosado and Ms. Melinda Guerra.
  2. Please Clarify.

Payment of items for the Laboratory at the Central Health Region and not for Matron Roberts Polyclinic – $5,000.00.

  1. Audit noted a payment to one Enrique Romero dated March 8, 2012 for a centrifuge machine for the laboratory at the CHR for the amount of five thousand dollars ($5,000.00).  Payment was approved by both Ms. Alexy Rosado and Ms. Melinda Guerra. Exhibit 30-A refers
  2. Please Clarify.

$725.00 in reimbursements paid to the CHRM, Melinda Guerra, for out of pocket expenses unrelated to the Matron Roberts Polyclinic.

  1. We noted a reimbursement made payable to Ms. Melinda Guerra, Central Regional Manager for expenses incurred for fuel in regards to Heads of Sections meeting held in Stann Creek on March 30 ad 31, 2012 for the amount of three hundred and seventy five dollars ($375.00).  Payment was approved both by Ms. Alexy Rosado and Ms. Joan Flowers. See Exhibit 31-A.
  2. We also perused a reimbursement made to the Central Regional Manager for expenses incurred for purchasing of 1 tire in Belmopan for the CHR van BZB-0137 on March 30, 2012 for the amount of three hundred and fifty dollars ($350.00). Payment was approved by both Ms. Alexy Rosado and Ms. Joan Flowers. Exhibit 31-B refers.
  1.                    Please clarify.

Overtime being paid to an officer performing the duties of driver at the CHR – $115.20

  1. Audit noted a payment for overtime as seen at Exhibit 32-A dated October 6, 2013 for the amount of one hundred and fifteen dollars and twenty cents ($115.20).  The payment was approved by both Ms. Alexy Rosado and Ms. Melinda Guerra.
  2. Further scrutiny revealed that the CHR has two drivers under their payroll.
  3. Please explain why the above payment was charged to NHI funds?

Payment made to Sagicor for Insurance of Dr. Idalia Machuca, Medical Officer at the Cleopatra White Polyclinic – $1,048.66.

  1. Audit noted 2 payments as seen at Exhibits 33-A and 33-B made to Sagicor totaling one thousand forty-eight dollars and sixty-six cents ($1,048.66) for insurance for Dr. Idalia Machuca, Medical Officer at the Cleopatra White Polyclinic.  Payment was approved by Ms. Alexy Rosado and Ms. Melinda Guerra.
  2. Please Clarify.

Payment made to Maya Island Air for transportation services provided to staff of the CHR – $161.00.

  1. Audit noted one (1) payment as seen at Exhibit 34-A made to Maya Island Air totaling one hundred sixty-one dollars ($161.00) for providing transportation services to Mr. Shamir Polanco for a round trip flight from Belize to San Pedro and back.
  2. Further scrutiny revealed that the CHR has a line item for other travel expenses – 23105, that can be used for this type of expenses.
  3. Please clarify.

Payment of motor vehicle parts and maintenance for vehicles not belonging to Matron Roberts Polyclinic – $3,772.85

  1. We noted seven (7) cheque payments as detailed in Table 10 below, for vehicle parts and maintenance for vehicles which do not belong to the Matron Roberts Polyclinic.

Table 10

List of payments for vehicle maintenance and parts for vehicles not belonging to the Matron Roberts Polyclinic.

DATE VENDOR PARTICULARS AMOUNT REFERENCE
18/5/2012 Bravo Investment Ltd. 1 battery for vehicle #BZB-1844 belonging to CHR $408.99 Exhibit 35-A
13/3/2013 Clifford Butler Repairing of wires and starter motor to vehicle BZ1758 belonging to CHR $337.00 Exhibit 35-B
13/6/2012 Bravo Investment Ltd. Items to vehicle B1844. $554.41 Exhibit 35-C
2/4/2012 Westrac Ltd. Items for vehicle for Ministry of Health $78.53 Exhibit 35-D
26/3/2012 Belize Diesel Equipment Items for vehicle BZB-1344 belonging to the Ministry of Health $200.82 Exhibit 35-E
27/3/2012 Bravo Investment Ltd. Vehicle parts to BZB-1844 belonging to the Regional Manager $1,135.26 Exhibit 35-F
17/9/2012 Caribbean Motors Repairing of shocks & fuel servicing of vehicle belonging CHR. B-1722. $1,057.84 Exhibit 35-G
TOTAL $3,772.85

Source:      Payment vouchers

  1. These (7) seven payments totaled three thousand seven hundred seventy-two dollars and eighty-five ($3,772.85).  Five (5) payments were approved by Ms. Alexy Rosado and Ms. Melinda Guerra.  One (1) payment was approved by Ms. Alexy Rosado and Ms. Joan Flowers.  One (1) payment was approved by Ms. Judith Swift and Ms. Melinda Guerra
  2. Please clarify.

Payment for items to be used at the CHR and not Matron Roberts Polyclinic- $2,698.12.

  1. We noted two (2) payments as seen below for items to be used by the CHR totaling two thousand six hundred ninety-eight dollars and twelve cents ($2,698.12).  Both payments were approved by Ms. Alexy Rosado and Ms. Melinda Guerra.

Table 11:         List of payments for items to be used by the CHR

DATE VENDOR PARTICULARS AMOUNT REFERENCE
27/3/2012 Orlando Quan 11 – 40 x 54 white slider windows with screen for the CHR. $2,293.12 Exhibit 36-A
29/5/2012 Neon Plastic Installation of 2 aluminum signs at the Central Medical Laboratory for the CHR $405.00 Exhibit 36-B
TOTAL $2,698.12

Source:            voucher payments

  1. Please clarify

Payment of transport allowance to officer working for the CHR – $400.00.

  1. We observed payment as seen at Exhibit 37-A dated December 20, 2012 paid to one Corette Elijio, for transport allowance for the month of September and October 2012 for the amount of four hundred dollars ($400.00).  Payment was approved by Ms. Judith Swift and Ms. Melinda Guerra.
  2. Further scrutiny revealed that Corette Elijio is employed by the CHR.
  3. We also noted that the approval for payment of transport allowance for officers working for the Government of Belize should be done by the Ministry of the Public Service.
  4. Please clarify.

Payment of $700.00 for dwelling quarters for nurse working at SPP.

  1. We perused a payment as seen at Exhibit 38-A made to one Idelita Arnott dated May 22, 2012 for one dwelling quarters for nurse working at Dr. Otto Rodriguez Polyclinic in San Pedro for the amount of seven hundred dollars ($700.00).  Payment was approved by Alexy Rosado and Melinda Guerra.
  2. In the case of rental of residential quarters, the Ministry of the Public Service is the proper authority to approve and authorize same.  In this instance, the Regional Manager acted without authority in approving the rental of residential quarters.  The approval for rental of premises should be submitted to the Ministry of the Public Service who may decide whether or not to approve and make payment of same.
  3. Please clarify and inform us how this case will be treated?

Payment of Stipend for new Cuban comers for CHR – $3,800.00.

  1. We noted two (2) payments, Exhibit 39-A and 39-B refer, made to Sheina Wade for the payment of two hundred dollars ($200.00), for stipend to nine (9) new Cuban comers who worked for the CHR.  Both payments were approved by Ms. Alexy Rosado and Ms. Melinda Guerra.
  2. We also noted a payment, Exhibit 39-C refers, made to Sheina Wade dated July 20, 2012 for payment of stipend for new Cuban comers for the CHR totaling two thousand dollars ($2,000.00).  A list of fourteen (14) names of Cuban comers was attached to the payment where it reflected that each signed and received two hundred dollars ($200.00).   This therefore meant that two thousand eight hundred dollars ($2,800.00) was disbursed to the new Cuban comers although the payment voucher was made for two thousand dollars ($2,000.00) only.
  3. On 30th September 2013, Sheina Wade stated that there was a mistake in the request and that two payments added to the two thousand eight hundred dollars ($2,800.00) since she had already crated the voucher for the two thousand dollars ($2,000.00) and that a request came again for additional five Cuban doctors.  We asked Ms. Wade whether it was a practice to make cheques in her name and then she would cash it and issue the cash to third parties.  Ms. Wade stated that indeed this was the practice.
  1. Please clarify.

Payment for food provided to HECOPAB – $297.50.

  1. We perused a payment made to Royal Catering Service for supplying 35 plates of food to HECOPAB on April 2, 2012 for the amount of two hundred ninety-seven dollars and fifty cents ($297.50). Exhibit 40-A refers.  Payment approved by Ms. Alexy Rosado and Ms. Joan Flowers.
  2. We noted that HECOPAB has its own vote to cover its own expenses.
  3. Please clarify.

Payment made to American Airlines for airline tickets from Belize to Chicago for the Minister and CEO Ministry of Health – $2,765.53.

  1. We noted cheque payment made to American Airlines for the cost of airline tickets for the Minister of Health, Honorable Pablo Marin and the CEO, Dr. Peter Allen from Belize to Chicago departing on 4th August 2012.  There was no supporting documentation or authority for the payment of airfare.  The cheque was approved by Ms. Alexy Rosado and Ms. Melinda Guerra. Exhibit 41-A refers.
  2. We are aware that foreign travel is to be approved by the Ministry of Finance and the payment of airfare should be centralized through that Ministry.  Financial Order #439 (b) also states that where expenses are anticipated in excess of five hundred dollars $500.00, they become chargeable to the conference expenses subhead and shall have the prior approval of the Ministry of Finance before any arrangement involving their incurrence is made
  1. Ms. Rosado explained that this was a request from the CEO, Ministry of Health.  The CEO had informed her that they were going to Chicago to deal with the receipt of a donated ambulance.  Ms. Rosado stated that the ambulance would not be for the Matron Roberts Polyclinic.
  1. On 1st October 2013, the CEO indicated that he had requested assistance from the CHRM to obtain the airline tickets.  He explained that the purpose of the trip was to receive a possible donation of ambulances.

Payment of $64,432.77 for purchasing a 2012 Hyundai Tucson for the Health Economist in the Policy and Planning Unit, Ministry of Health

  1. We perused a payment made to JMA Motors, Exhibit 42-A refers, dated 28th March 2012, for the purchase of a motor vehicle, a 2012 Hyundai Tucson, black diesel engine for the Ministry of Health in care of the  Policy and Planning unit for the total amount of sixty four thousand four hundred and thirty-two dollars and seventy-seven cents ($64,432.77).  There was no supporting documentation or authority for the purchase of the vehicle. Payment was approved by Ms. Alexy Rosado and Ms. Melinda Guerra.
  1. We are aware that the purchase and approval for the purchase of vehicles is centralized through the Ministry of Finance.
  1. On 30th September 2013, we conducted an interview with Ms. Alexy Rosado to clarify her involvement in the approval of payment for a vehicle for the Ministry of Health.   Ms. Rosado informed the auditors that this was a request from the CEO.  In addition, she explained that the vehicle was to be assigned to the Policy and Planning unit of the Ministry of Health.
  1. On 1st October 2013, the CEO, Ministry of Health confirmed that he submitted a request to the Ministry of Finance for the purchase of the vehicle. According to him, there is documentation for the approval of this purchase from the Ministry of Finance.   However at the time of the investigation such was not available at CHR.