Performance audit, Board of Chiropractic Examiners

              DOUGLAS R. NORTON, CPA
AUDITOR GENERAL
STATE OF ARIZONA
OFFICE OF THE
AUDITOR GENERAL
August 27, 1991
Members of the Arizona Legislature
The Honorable F i f e Symington, Governor
Dr. James Badge, Chairman
State Board of Chiropractic Examiners
Transmitted herewith i s a report of the Auditor General, A Performance
Audit of the State Board of Chiropractic Examiners. This report i s in
response to a June 14, 1989, resolution of the Joint Legislative
Oversight Committee.
The report addresses the twelve Sunset Factors mandated in the Sunset
law. Our work included a review of the Board's two p r i n c i p l e statutory
functions: licensing and enforcement of standards of practice. We found
no s i g n i f i c a n t problems in the licensing area. Our abi l i t y to evaluate
the enforcement function was limited by the documentation available.
My s t a f f and I w i l l be pleased to discuss or c l a r i f y items in the report.
This report w i l l be released to the public on August 28, 1991.
DRN : l mn
Enc l osu re
Sincerely,
ADu i t ovr RG. ae nNeorarstlo n
2700 NORTH CENTRAL AVENUE " SUITE 700 ' PHOENIX, ARIZONA 85004 ' ( 602) 255- 4385 FAX ( 602) 255- 1251
TABLE OF CONTENTS
lNTRODUCTlON AND BACKGROUND. . . . . . . . . . . . . . . . .
SUNSETFACTORS. . . . . . . . . . . . . . . . . . . . . . .
LIST OF TABLES
TABLE 1 Board Of Chiropractic Examiners
Statement Of Revenues, Expenditures,
And Changes In Fund Balance
AFnids ca1l9 9Y0e- 9a1r sB u1d9g8e8t- 8e9d A( nudn au1d9 8i t9 e- 9d0) A. ct. ua. l . . . .
TABLE 2 Types Of Disciplinary Actions
Taken By The Board During Fiscal Years 1989, 1990, And 1991 . . .
INTRODUCTION AND BACKGROUND
The Office of the Auditor General has conducted a performance audit of
the Board of Chiropractic Examiners pursuant to a June 14, 1989,
resolution of the Joint Legislative Oversight Committee. This
performance audit was conducted as part of the Sunset Review set forth in
Arizona Revised Statutes ( A. R. S.) $ 541- 2351 through 41- 2379.
The Board of Chiropractic Examiners was established in 1921.
Chiropractic is defined as " a therapeutic system based upon the premise
that disease is caused by interference with nerve function, the method
being to restore normal condition by adjusting the segments of the spinal
column." The practice of chiropractic includes examination of the spine
and pelvis to determine malfunctions or abnormal body movements, the use
of diagnostic x- rays, and adjustment of the spine or joints. A. R. S.
$ 32- 925 prohibits a chiropractor from prescribing or administering
medicine or drugs, performing surgery, or practicing obstetrics.
Personnel And Budaet
The Board consists of five members: three licensed chiropractors and two
public members appointed by the Governor for a five- year term. The Board
is primarily responsible for licensing chiropractors and enforcing
standards of practice.
The Board has four full- time support s t a f f , including an Executive
Director, an investigator, and clerical s t a f f .
Monies for Board operat ions are appropriated from the Chi ropract ic
Examiners Fund. The fund receives revenues from fees col lected for
applications for examinations, licenses, and license renewals. The
Board retains 90 percent of the fees i t collects, while the remaining 10
percent is deposited in the State General Fund. Table 1 ( see page 2)
presents the Board's revenues, expenditures, and changes in fund balance
for fiscal years 1988- 89 through 1990- 91.
TABLE 1
BOARD OF CHIROPRACTIC EXAMINERS
STATEMENT OF REVENUES, EXPENDITURES,
AND CHANGES IN FUND BALANCE
FISCAL YEARS 1988- 89 AND 1989- 90 ACTUAL
AND 1990- 91 BUDGETED
( unaudited)
1988- 89 1989- 90 1990- 91
Actual Actual Budqe t ed
FTE Positions 4 4 4
Revenues $ 154.211 $ 155.233 $ 284.400
Expenditures
Personal services 65,480 77,568 107,800
Employee- related 15,494 15,184 26,700
Professional and outside
services 24,283 27,325 18,000
Travel, in- state 3,979 6,321 4,500
out- of- state 5,397 3,194 5,300
Equ i pmen t 4,350 3,788 5,300
Other operating 41.936 46,519 52.100
Total Expenditures 160,919 179,899 219,700
Excess of revenues over
( under ) expend i t u res ( 6,708) ( 24,666) 64,700
Beginning fund balance 188.000 181.292 89.100( a)
Ending fund balance
( a) The beginning balance f o r the f i s c a l year 1990- 91 budget was estimated p r i o r t o the
end of f i s c a l year 1989- 90. Therefore, the actual ending balance f o r f i s c a l year
1989- 90 does not agree with the beginning balance budget for f i s c a l year f o r 1990- 91.
Source: Arizona Financial Information Systems, Fiscal Years 1988- 89 and
1989- 90 Financial Reports; the State of Arizona, Appropriations
Report for the Fiscal Year Ending June 30, 1991.
Licensina Requirement$
A. R. S. 5532- 921 and 922 specifies the requirements an applicant must meet
in order to be licensed as a chiropractor. Applicants must successfully
pass a three- part examination conducted by the National Board of
Chiropractic Examiners. In addition, applicants must also pass
examinations on jurisprudence, x- ray interpretation, and c l i n i c a l
diagnosis administered by the Arizona Board. To specialize in
physiotherapy and acupuncture, chiropractors must complete a minimum
number of hours in those specialties from an accredited chiropractic
college and pass a specialty exam with a score of at least 75 percent.
The Board currently licenses approximately 1,100 chiropractors in- state
and 1,000 out- of- state. During the last two years the Board has issued
approximately 130 new licenses each year.
Scow And Methodology
This audit was conducted as a Sunset Review as defined by A. R. S.
$ 41- 2352. The purpose of the audit was to determine whether the Board of
Chiropractic Examiners is needed and the extent to which i t has
accomplished i t s statutory goals.
The Board is a relatively small agency and has two principle statutory
functions: to ensure applicants for licensure meet specified requirements
and to enforce the standards of practice. Our work included a review of
the Board's a c t i v i t i e s in these two areas. We found no significant
problems in the area of licensing ( see Sunset Factor 2, page 5).
However, in the area of enforcing standards of practice, our abi l i ty to
evaluate the Board's performance was limited ( see Sunset Factor 6, page
8). Based on the advice of a former Attorney General representative, the
Board maintains limited documentation in closed complaint f i l e s .
Complaint f i l e s typically contain the complaint, the doctor's response,
and the letter informing the complainant of the Board's action. Files in
which the complaint went to hearing also contain transcripts or any
documentation that was entered as evidence. Based on the documentation
available, we were frequently unable to determine the extent of the
Board's investigation or review, the reason for i t s decisions, and in
some cases when the Board began investigating the case. The l i m i ted
documentation generally precluded us from thoroughly assessing the
appropriateness of the Board's actions and i t s performance. Because of
the scope limitation, we were unable to develop audit findings and,
instead, we addressed areas of concern in the statutorily mandated Sunset
Factors, pages 5 - 11.
This audit was conducted in accordance with government auditing standards.
The Auditor General and staff express appreciation to the members and the
administrative staff of the Board of Chiropractic Examiners for their
cooperation and assistance during the audit.
SUNSET FACTORS
In accordance with A. R. S. 941- 2354, the Legislature should consider the
following twelve factors in determining whether the Board of Chiropractic
Examiners should be continued or terminated.
Substandard chiropractic care can directly impact public health;
hence, the profession is regulated to safeguard public health,
safety, and welfare. The mission of the Board of Chiropractic
Examiners is to assure the citizens of Arizona that only qualified
persons are allowed to practice chiropractic and to protect the
public from chiropractors whose conduct f a l l s below the standard of
the profession. The Board accomplishes i t s purpose by examining and
licensing qualified candidates, and enforcing relevant statutes and
rules governing practice.
2. The effectiveness with which the Board has met its objective and
pumose and the efficiencv with which it has o~ erated
The Board has been generally effective in regulating the practice of
chiropractic by licensing only those applicants that meet State
requirements and by taking action against practitioners who f a i l to
comply with statutes or rules when complaints are f i l e d against them.
Since our 1981 review of the Board, the following statutory changes
have been made to strengthen licensing requirements.
The 1981 audit report noted that the statutes required the Board
to license applicants in Arizona i f they were licensed to
practice in another state, regardless of the other state's
licensing requirements. For licensure through reciprocity, the
statutes now require that the licensing requirements in the
other state must be substantially equivalent to Arizona
chiropractic licensure requirements.
A t the time of the 1981 audit, the Board accepted examination
results from the National Board of Chiropractic Examiners or
results from the examination administered by the Arizona Board.
The Board now requires that applicants for licensure must have
received a c e r t i f i c a t e of attainment for parts I and I I of the
examination given by the National Board. In addition, Arizona
law also requires that applicants receive a score of 375 on part
Ill of the National exam, a score recommended by the National
Board.
Statutory revisions in 1990 expanded the requirements for
c e r t i f i c a t i o n of specialties in physiotherapy and acupuncture.
In addition to passing a specialty examination, the applicant
must also have successfully completed coursework with a minimum
number of hours in these specialties.
Our review of the Board's licensing a c t i v i t i e s suggests that the
Board is effectively and e f f i c i e n t l y meeting the objective of
licensing only qualified candidates. We reviewed records of a l l
applicants who were granted licenses from November 1, 1990 through
May 31, 1991, and found that the 34 recently licensed chiropractors
met the statutory requirements of licensure. Although minor
documentation was missing from a few f i l e s , we found no significant
problems in this area.
We also found that the Board generally handles complaints in an
e f f i c i e n t manner. Our review of a l l complaints received in the f i r s t
half of fiscal year 1991 indicates that the majority ( 63 percent) of
the complaints were resolved within four months. Ten cases in our
sample were not resolved as of June 1991. These cases range in age
f rom seven to e l even months . However, as noted under Sunset Factor
6, we were unable to evaluate the Board's effectiveness in handling
some complaints due to the lack of adequate documentation in Board
f i les.
The extent to which the Board has o~ erated within the public interest
The Board has operated in the public interest by ensuring that
chiropractors meet established professional standards of practice.
The Board's licensing requirements provide assurance that only
qualified applicants are permitted to practice chiropractic medicine
in Arizona.
Although our review of complaints found no evidence that the Board
has not acted in the public interest, the lack of adequate
documentation prevented us from determining the appropriateness of
the Board's handling of complaints or i t s actions. Once complaint
f i les are closed, the Board does not retain adequate documentation of
the information used in making their decisions. Most f i l e s contain
the original complaint, the doctor's response to the complaint, and
the letter stating the reason for dismissal. We reviewed several
cases in which we were unable to evaluate the Board's a c t i v i t y in
investigating the case and i t s decisions because evidence or
information was no longer included in the f i l e .
4. The extent to which rules and reaulations ~ romulaated bv the Board
are consistent with the leaislative mandate
The Board i s i n the process of amending i t s current rules to conform
with 1990 statutory revisions to the Chiropractic Act. The Board's
hearing procedures are also being amended to conform with the
Administrative Procedures Act.
In addition, the Board is drafting new rules pertaining to
chiropractic assistants as required by 1989 legislation. The Board
completed i t s f i r s t draft of these new rules in December 1989 and
revised the draft in early 1990. Public opposition to the proposed
training requirements and legal questions concerning c e r t i f i c a t i o n
delayed work on the rules. In June 1991, the Board submitted the
draft of the proposed rules to the Governor's Regulatory Review
Council. However, the Council declined to approve the draft stating
that the proposed rules were too specific given the legislation they
were based on. According to the Board's Executive Director, the
Council advised the Board to seek revisions to the statute before
attempting to rewrite the rules. Furthermore, the Board has
postponed any rule changes in this area u n t i l i t receives legal
advice from the Attorney General regarding the Physical Therapy
Board's argument that the provisions of the 1989 law w i l l result in
i l l e g a l practice of physical therapy by chiropractic assistants.
5. The extent to which the Board has encouraued input from the public
before ~ romulaatinq its rules and reaulations and the extent to which
it has informed the ~ u b l i c as to its actions and their exrsected impact
on the public
The Board i s currently in the process of revising i t s rules and
regulations and plans to encourage input from the professional
association and the public on revisions. The Board has scheduled
hearings on the new rules in August 1991. The professional
association w i l l be n o t i f i e d p r i o r to the hearings and asked to
comment on the draft of the new rules.
We also found that the Board has informed the public of i t s actions
by complying with the Open Meeting Law requirements regarding proper
notification of Board meetings during fiscal year 1990- 91. The
public may also learn about Board actions by reviewing i t s records.
6. The extent to which the Board has been able to investiaate and
resolve comrslaints that are within its iurisdiction
The Board has broad authority to investigate and act upon complaints
within i t s jurisdiction. The Board received an average of 103
complaints annually during fiscal years 1988- 89 through 1990- 91. On
average, 16 of those complaints went to an administrative hearing.
Table 2 presents the types of disciplinary actions taken by the Board
during fiscal years 1988- 89 through 1990- 91.
TABLE 2
TYPES OF DISCIPLINARY ACTIONS
TAKEN BY THE BOARD
DURING FISCAL YEARS 1989, 1990, AND 1991
Complaints Filed 79 119
Tvpe of Action
Decree of Censure Issued
Fine Levied
Placed on Probation
L i cense Summar i l y Suspended
L i cense Suspended
L i cense Revoked
Source: Executive Director, Board of Chiropractic Examiners.
result, i t cannot be determined from the f i l e whether or not the
Board made reasonable attempts to substantiate or disprove the
allegation in this case before dismissing i t .
Another patient alleged that treatment by one chiropractor
caused a pinched nerve and sought treatment by another
chiropractor to correct the condition. The patient reported
that the second practitioner believed that the previous
treatment caused the patient's problem. This complaint was
dismissed by the Board as a fee dispute over which i t has no
jurisdiction. Although the patient had requested reimbursement
for the costs of her subsequent treatment, the complaint also
raised additional questions about the appropriateness of care
received. The Board's complaint f i le does not indicate whether
the Board addressed these quest ions .
The Board needs to improve the documentation of i t s decisions on
complaints f i l e d against chiropractors. We spoke with the former
Attorney General representative regarding the Board's policy of
retaining few case records. He indicated that the Board should
maintain documentation in the case f i l e that explains the specific
basis for i t s decision. He also suggested that investigative reports
be retained. More complete documentation w i l l provide greater
assurance that the Board is operating in the public interest when i t
resolves complaints against chiropractors.
7. The extent to which the Attornev General or any other ap~ licable
aqencv of State uovernment has the authoritv to prosecute actions
under the enablinca leaislation
The Office of the Attorney General has the authority to prosecute
actions under the Board's statutes. The Assistant Attorney General
representative currently assigned to the Board considers the
authority adequate. According to the Executive Director, past
representatives have expressed similar opinions, with the exception
of concerns about the Board lacking specific authority to discipline
sexually inappropriate conduct. However, as part of the 1990
amendment to the Chiropractic Act, a specific c i t a t i o n was added
( A. R. S. $ 32- 924. A. 21) to grant that authority.
8. The extent to which the Board has addressed deficiencies in its
enablinu statutes which ~ revent it from fulfillina its statutorv mandate
The Board successfully sought legislation in 1990 to raise licensing
fees, require applicants for licensure to pass a l l three exams given
by the National Board of Chiropractic Examiners, and establish
coursework requirements for doctors seeking c e r t i f i c a t i o n i n
specialty areas. The new law also strengthened the Board's authority
to regulate chiropractors' conduct, particularly in advertising.
As part of the 1990 statutory revision, the Board also sought
authority to address other areas of concern; however, these were
deleted from the b i l l before passage. The Board did not succeed in
obtaining the authority to ( 1) require doctors to issue b i l l i n g
statements to patients ( 2) determine that a fee was clearly
excessive, and ( 3) requ i re cont i nu i ng educat ion for annual l i cense
renewal .
9. The extent to which chanaes are necessary in the laws of the Board
to adeauatelv complv with the factors listed in the subsection
Our limited audit work did not identify any changes needed in the
Board's enabling legislation.
10. The extent to which the termination of the Board would siqnificantlv
harm the ~ u b l i ch ealth, safety, or welfare
Termination of the Board could pose a threat to public health,
safety, or welfare because the unregulated practice of chiropractic
could result in substandard care. Patients could be a t r i s k because
improper diagnosis and chiropractic treatment can cause bodily harm.
According to the Executive Director, terminating the Board of
Chiropractic Examiners would also deny the public and the profession
a forum in which to review the standards of practice of chiropractic
in Arizona.
11. The extent to which the level of requlation exercised bv the Board is
a~ propriate and whether less or more strinaent levels of ~ reclulations
would be a~ pro~ riate
We found the current level of regulation to be appropriate. Although
Board members and individual practitioners identified certain areas,
such as b i l l i n g practices, in which they f e l t additional regulation
may be desirable, we did not perform audit work to determine the need
for such regulation.
The extent to which the Board has used ~ r i v a t e contractors in the
performance of its duties and how effective use of ~ r i v a t e contractors
could be accomplished
Current use of private contractors appears appropriate. The Board
contracts for court reporters and process servers outside of
metropolitan Phoenix. According to the Board, i t uses process
servers outside the Phoenix area because the cost of service and the
shipment of records from outlying areas is less expensive than the
travel costs that would be incurred i f the Board's investigator
served the papers. Contracted court reporters are used to transcribe
formal hearings because neither the Board nor the Assistant Attorney
General is satisfied with the quality of mechanically taped records
later transcribed by the Board's clerical s t a f f . According to the
Board, the service is contracted because the Board lacks sufficient
work to warrant hiring i t s own reporter.
STATE OF ARIZONA
BOARD OF CHIROPRACTIC EXAMINERS
5060 North 19th Avenue, Suite 416 Phoenix, Arizona 85015
I, Telephone ( 602) 255- 1 444 -.
ELAINE LETARTE
EXECUTIVE DIRECTOR
FIFE SYMINGTON
GOVERNOR
MEMBERS
JAMES J. BADGE. D. C.
CHAIRMAN
PHILIP L. PIERCE, D. C.
VICE- CHAIRMAN
DAVID J. BROTMAN, D. C.
CAROLYN GUNTER
BARBARA A. LUBIN
August 16, 1991
M r . Douglas R. Norton
Auditor General
2700 N. Central Avenue, Ste 700
Phoenix, Arizona 85004
HAND DELIVERED
Dear Mr. Norton:
The Board o f C h i r o p r a c t i c Examiners has reviewed the d r a f t r e p o r t o f
the performance audit your o f f i c e conducted as p a r t o f the Sunset review of
t h i s agency as s e t o u t i n A. R. S. 5541- 2351 through 2379.
The Board takes exception t o the presentation and conclusions drawn
from two o f the issues contained i n t h a t d r a f t . The f i r s t of these two
issues concerns the impact o f the Board's recordkeeping practices on the
appropriateness o f i t s decision making when reviewing complaints. The
second concerns the apparent c o n t r a d i c t i o n between the Board's and your
perspective on the need f o r changes i n enabling l e g i s l a t i o n .
I. Recordkeeping o f dismissed complaints
A. I n the r e p o r t ' s section on " Scope and Methodology," the Auditor General
states t h a t the team was kept from " thoroughly assessing the appropriate-ness
o f the Board's action and i t s performance" ( page 4 ) because o f the
Board's recordkeeping practices.
The Board contends t h a t the Auditor General had made a p r i o r and inde-pendent
decision t o l i m i t the thoroughness o f the audit. The audit process
was i n i t i a l l y presented t o the Board as being o f more l i m i t e d scope and
duration than was the norm. As an example, the r e p o r t states t h a t the
Auditor General was unable t o determine the dates or the extent o f i n v e s t i -
gations. The Board notes t h a t a review o f Minutes o f Board would y i e l d
a d d i t i o n a l documentation about the conduct and duration o f i n v e s t i g a t i o n s .
Douglas R: Norton
August 16, 1991
Page 2
Therefore, the Board requests t h a t the language o f the statement be
amended t o acknowledge t h a t the Board's p r a c t i c e o f not r e t a i n i n g c e r t a i n
records was n o t t h e s o l e determinant o f the thoroughness o f the assessment
made.
B. I n t h e s e c t i o n on " Scope and Methodology," and again i n the responses
t o three o f the sunset f a c t o r s ( see pages 3, 4, 6, 7 , 9 and l o ) , the
Auditor General c i t e s a p a r t i c u l a r one o f the Board's recordkeeping prac-t
i c e s as p r e c l u d i n g t h e A u d i t o r General's a b i l i t y t o evaluate and comment
on the appropriateness o f the Board's handling o f complaints. I n so doing,
the Auditor General has s u b s t i t u t e d the issue o f whether the appropriate
records were a v a i l a b l e a t the time the Board made it decisions w i t h the
issue o f whether those records were s t i l l a v a i l a b l e a t t h e t i m e t h e A u d i t o r
General conducted i t s review.
The Board contends that, through language and r e p e t i t i o n of t h i s
s u b s t i t u t i o n o f issues, the Auditor General sets f o r t h the unfounded
conclusion t h a t the Board has engaged i n e i t h e r negligent or d e l i b e r a t e
misconduct i n i n v e s t i g a t i n g , and making decisions on complaints.
1. The Board i s n o t r e q u i r e d by e i t h e r law or r u l e t o r e t a i n confiden-ti
a1 records gathered pursuant t o A. R. S. $ 32- 929. C. The Board Is s t a f f
looked t o t h e s t a t u a t o r y c o n f i d e n t i a l i t y o f those records and extrapolated
the advice given by the Board's A s s i s t a n t A t t o r n e y General on recordkeeping
o f hearing f i l e s i n e s t a b l i s h i n g the Board's p r a c t i c e o f not r e t a i n i n g con-f
i d e n t i a l records a f t e r the Board has made i t s decision and it seems
apparent t h a t there w i l l be no appeal o f t h a t decision. That p r a c t i c e i n
no way warrants the conclusion the Auditor General inferrences t h a t the
Board d i d not gather appropriate information, o r d i d not use i t i n making
decisions.
The Board argues t h a t the Minutes o f t h e i r meetings show evidence t h a t
the Board a p p r o p r i a t e l y conducted i n v e s t i g a t i o n s o f complaints. They
gathered and reviewed the appropriate records. That the records so
gathered a r e n o t kept does not diminish the appropriateness o f the Board's
i n v e s t i g a t i o n o f complaints.
The Board argues t h a t keeping a l l i n v e s t i g a t o r y records i s an unnec-cessary
a d m i n i s t r a t i v e burden on the agency. Since these records are not
a v a i l a b l e t o the public, t h e s o l e purpose for r e t a i n i n g them would be for
review b y the Auditor General. To t h a t end, the Board p o i n t s out the such
reviews are conducted once every ten years,
2. The Board f i n d s f a l l a c i o u s t h e A u d i t o r General's argument t h a t the
Board's decisions were i n a p p r o p r i a t e because those decisions were com-municated
c a t e g o r i c a l l y , and because t h e a u d i t team was unable t o reach the
same decisions as d i d the Board.
Douglas R. Norton
August 16, 1991
Page 3
The Board argues t h a t the manner i n which a decision i s communicated
does not c a l l i n t o question the appropriateness o f the decision. While
the Board acknowledges that more d e t a i l e d explanations o f decisions may be
more s a t i s f a c t o r y t o complainants, those explanations do not affect the
decisions themselves.
The Board f u r t h e r argues that the i n a b i l i t y o f the audit team t o reach
the same decision as does a professional regulatory board i s not s o l e l y a
function o f records. A fundamental tenet o f professional regulation i s
t h a t such may only be conducted meaningfully by members o f the profession,
or by those who, l i k e consumer members o f professional boards, acquire cer-t
a i n knowledge and i n s i g h t by association. Appropriate decisions depend as
much on t h e e x p e r t i s e o f the Board i n analyzing the complaint and applying
the law as on the records making up the complaint.
The Board requests t h a t the m u l t i p l e references t o the unretained
records be summarized i n t o a s i n g l e statement that acknowledges that the
Board has no s t a t u t o r y o b l i g a t i o n t o r e t a i n them, and t h a t the accompanying
inferences t h a t the Board erred i n i n v e s t i g a t i o n o r decision making be
deleted i n t h e i r e n t i r e t y .
11. Necesary L e g i s l a t i o n
I n the Board's response t o t h e e i g h t h o f the Sunset Factors ( page 11)
the Board noted t h a t some o f the changes i n the law they had sought i n the
past few years had not been successful i n the l e g i s l a t u r e . The Auditor
General noted those unsuccessful e f f o r t s i n t h e r e p o r t , but made no d i r e c t
comnent .
However, the Auditor General's response t o the n i n t h f a c t o r was t h a t
the audit ' Idid not i d e n t i f y any changes needed." That statement appears t o
d i r e c t l y c o n t r a d i c t the p o s i t i o n the Board has obviously taken by i t s
i n c l u s i o n o f the unsuccessful issues i n previous l e g i s l a t i v e b i l l s .
The Board requests that, i f t h i s c o n t r a d i c t i o n e x i s t s only i n the
language and j u x t a p o s i t i o n o f the two f a c t o r s , t h e A u d i t o r General c l a r i f y
the response i n n i n t h f a c t o r by d e l e t i n g the c o n t r a d i c t o r y language. If
the c o n t r a d i c t i o n i s i n t e n t i o n a l , the Board requests t h a t the Auditor
General d e t a i l the reasons f o r t h a t c o n t r a d i c t i o n so t h a t the Board may
respond specif i c i a l ly.
The Board appreciates your a t t e n t i o n t o t h e i r requests. Should you
wish t o discuss t h i s f u r t h e r , please contact me.
Executive Director