ALPENA — District Health Department No. 4’s finances appear to be in good health, despite accusations of financial mismanagement from former employees.

The Health Department’s leadership team has come under fire publicly in recent months from former employees. Lauren Krueger, the department’s former nurse practitioner, told the department’s board in August the leadership team is “incompetant.”A day later, Brenda Hanson came forward with her own accounts of harassment, bullying, and retaliation, and told The News funds were mismanaged, but wouldn’t discuss the allegations further.

Hanson had worked as the support services supervisor on the Health Department’s leadership team, but was fired in July. Hanson refused to comment earlier this week, saying her attorney advised her not to.

Health Officer Denise Bryan, the chief executive at the department serving Alpena, Presque Isle, Montmorency, and Chebeygan counties, did not return messages seeking comment for this story. Bryan has never publicly addressed the allegations. Board members have repeatedly discussed the issue in closed session and at least one board member told The News recently things are moving in a positive direction.

A review by The News of the Health Department’s finances reveals there have been issues.

An audit of the department’s Women, Infants, and Children programs from the fiscal year ending Sept. 30, 2017 shows the department was required to repay $997 in unallowable expenditures to the Michigan Department of Health and Human Services. A corrective action was also issued to the department’s WIC Program in January 2017, for the fiscal year ending Sept. 30, 2015, because the department did not allocate salaries and wages based on actual costs of individual employees.

District Health Department No. 2, also managed by Bryan, had to repay $8,009 from its family planning program because auditors identified indirect cost allocation innacuracies. DHD No. 2 serves Alcona, Iosco, Oscoda, and Ogemaw counties.

Data from the Municipal Employees Retirement System of Michigan’s actuarial report from 2017 shows the department has nearly $20.8 million in unfunded pension debt, meaning it could only cover about 63% of benefits for current and future retirees.

Health Department officials were notified last November they would need to submit a corrective action plan to the Michigan Treasury based upon those figures. Significant numbers of governments across the state were required to submit corrective action plans. But DHD No. 4 officials failed to submit the corrective action plan on time, and, on Aug. 19, the department was notified its status had changed to “underfunded with deficiencies.”

The Aug.19 letter from the Treasury noted the data provided by the department was inconsistent with its most recent audited financial statements, and some paperwork required to accompany the audit was not provided.

But, overall, the department’s finances appear to be in good shape.

Similar to other governments in Northeast Michigan, the Health Department’s revenues are generated through a mix of government funding, grants, and fees for services, its biggest expenditures going toward employee salaries and benefits. The department has a cash reserve that waxes and wanes to cover expenses, as needed.

The department ended the 2017 fiscal year with $656,550 in cash reserves, enough to cover 15% of its annual expenses, according to the department’s annual reports posted online. The fund balance decreased slightly to 14%, or $605,432, at the end of the 2018 fiscal year, when the department spent $51,118 more than it took in. Its annual spending exceeds $4 million.

The department started the 2019 fiscal year with enough cash to cover about 14% of its expenses, according to documents provided by the department through a Freedom of Information Act request. A proposed budget of $4.4 million was adopted for 2019.

The department’s services geared toward the general public increased in recent years, while specialized services to women and children decreased, according to the annual reports.

Patient volumes for hearing screenings increased by 20% from 2012 to 2018, and vision screenings increased by 16% from 2012 to 2018.

Communicable disease investigations have increased more than 400% since 2012, when the Health Department conducted 195 investigations. The department conducted 1,008 such investigations in 2018.

The department also saw the number of patients receiving immunizations increase to 1,664 in 2018 since the figure dipped to 1,172 in 2014. The 2018 number still falls short of the 2,099 patients who received immunizations in 2012.

Some of the largest decreases were to womens and childrens health services. Health department staff saw 19 women for cancer screenings in 2018, down from 535 screenings conducted in 2012. The number of women receiving maternal health visits in their home decreased to 738 patients in 2018, from 1,281 in 2012. The number of infants receiving home visits also decreased, with 970 fewer infants receiving services in 2018 than in 2012.

Additionally, patient volumes for public health services, such as jail health, adult day care services, and volunteer physicals are also trending downward.

The reasons for the changes to patient volumes wasn’t immediately clear.

Crystal Nelson can be reached at 989-358-5687 or cnelson@thealpenanews.com.