Double-billing, conflicts of interest and misuse of taxpayer resources abounded under a now-discontinued grant program to give low-income veterans access to dental care, an audit revealed.
The 36-page internal audit, released Tuesday by a unanimous McHenry County Board vote, uncovered systemic problems with how the McHenry County Cooperative Dental Clinic administered the program, which was funded through a state grant and the county Veterans Assistance Commission.
While the state’s attorney’s office has concluded there is inadequate evidence to warrant criminal charges, and the dentists named in the audit resigned shortly after it was started, the audit contains numerous corrective actions that have been taken to prevent future occurrences.
Under the program, which existed from 2007 to 2012, veterans with dental issues were supposed to be diagnosed at the county dental clinic, then referred to local dentists for treatment. But almost all of that work went to two dentists who were under contract with the clinic, and not only paid for their hourly rates, but also for the work done, much of which took place not at their offices but at the taxpayer-owned clinic in Woodstock. What’s more, dentist Michael Koehne, who received more than $100,000 of the $150,000 paid out under the grant program, was married to Diane Metrick, the dentist who supervised the clinic.
Koehne and Metrick operate a clinic in Wheaton, while the third dentist, C. Eric Mayer, works in Richmond. All three of them resigned within weeks of the April 1, 2014, release of the preliminary audit to then-Public Health Administrator Patrick McNulty, who supervised the Department of Health in charge of the clinic. Metrick and Mayer were salaried employees of the county, while Koehne, Metrick’s husband, was contracted to do the dental work.
Of the $150,739 paid out to treat 41 veterans, all but $3,567 was paid to Koehne and Mayer. About $95,000 of that was covered by an Illinois Department of Veterans Affairs grant, while the county Veterans Affairs Commission, which is funded through a special property-tax levy, made up the difference. Koehne received $101,512, while Mayer received $45,659.
The audit supervised by County Auditor Pam Palmer concluded county staff, time, supplies and equipment were misused to treat the veterans at the county dental facility rather than at dentists’ practices – all but one of the 24 veterans Koehne treated were at the county facility. It also concluded more efforts should have been made to find other dentists besides Metrick’s husband, which the audit concluded “could be considered a conflict of interest,” especially given that she signed off on her husband’s contractual hours and expense reimbursements.
As for Metrick, the audit concluded she was not working the full 37.5 hours a week that she was being paid for, and alleged she also split her time working for the DuPage County veterans assistance commission and as a dental insurance claims adjuster – the audit estimated that her weekly work for the county actually averaged between 22 to 24 hours a week. Her salary at the time of her departure was $142,459, not including benefits.
But DuPage County VAC Board President Joseph Craig disputes the audit's description of its relationship with Metrick – he said Metrick was consulted only once, unpaid, for a grant request.
Also revealed in the audit were lax record keeping and misuse of the dental facility to treat inmates at the county jail, which was not provided for through agreements or documentation. The facility, the primary function of which is to provide dental care for the poor and disadvantaged, is funded through grants, Medicare and Medicaid reimbursement.
The County Board Finance and Audit Committee received the final report in closed session at its May 28 meeting, and the full board voted Tuesday to make it public, waiving the Illinois Freedom of Information Act exemption that allows governments to withhold internal audits from release. The only board member to comment before the vote was Charles Wheeler, R-McHenry, who called the findings “appalling” and called on the audit to be forwarded to the Internal Revenue Service to determine whether any tax laws were violated.
“The people of McHenry County deserve better, and if a contractor agrees to provide a service to the residents and to the county, they should follow through and follow the rules that are set and established,” Wheeler said.
Koehne and Metrick could not be reached for comment Tuesday. But Mayer said Tuesday afternoon that he believes that the audit “fully exonerates” him, and he said he was “very honored” to have the opportunity to help with the veterans’ program.
“I did it with my heart, and we did a great service for the community, and I believe it was done appropriately,” Mayer said.
The audit also reveals McNulty’s account of events differs from those of the dentists. The three dentists said in their interviews that McNulty knew about and approved allowing veterans to have their work done at the clinic, while McNulty told investigators he had no knowledge of it. It concluded that the dentist office under McNulty was essentially treated as a separate entity altogether – among other things, Metrick never was included on the list of health department staff who have to fill out a statement of economic interest, which as a department head she was required by state law to do.
McNulty retired in May 2014, and was replaced with new Administrator Michael Hill, who along with planning and personnel manager Joe Gugle has implemented a number of reforms creating much closer oversight and record keeping.
“The auditor’s report regarding our dental clinic resulted in implementation of significant changes in staff and office procedures to ensure that such issues cannot occur in the future. Monitoring and controls, including the addition of a Dental Clinic Advisory Committee, will help to ensure the success of this important community resource,” Hill said in a statement.
County Board Finance and Audit Committee Chairman Michael Skala, R-Huntley, and Public Health and Human Services Chairwoman Mary McCann, R-Woodstock, both said they are satisfied with the reforms Hill has spearheaded. But Skala said he is upset money that was double-billed could have been used to help other people.
“Money that could have been spent on veterans was going twofold to dentists, and that’s very frustrating,” Skala said.
Health departments enjoy a significant amount of autonomy under state law – the County Board’s power over it consists of approving its annual budget and appointing the members of the Board of Health that have the power to hire and fire.
The audit is not the first pall that has been cast on McNulty’s 13-year tenure as head of the county health department. Several County Board members called his management skills into question in the wake of 2005 accusations of rampant mismanagement at Animal Control, and questioned the health department’s investigation of the alleged McCullom Lake brain cancer cluster several years later after a Northwest Herald investigation concluded it was slipshod and biased in favor of the chemical manufacturers accused of causing it.
McNulty’s pension under the Illinois Municipal Retirement Fund is $100,396, the highest of any retired county employee, according to data released last month by a taxpayer watchdog group.
EDITOR'S NOTE: This story has since been changed to add a rebuttal from the DuPage County VAC's president alleging that the audit's portrayal of Metrick's work relationship with the agency is inaccurate.