HSA promises ‘clean accounts’ by 2018

The Cayman Islands Health Services Authority has pledged to report “clean” financial statements by 2018, after receiving a tongue-lashing from Public Accounts Committee Chairman Ezzard Miller this week.

The public health agency, which has never received an “unqualified” audit opinion since government changed its accounting system in 2004, said Wednesday that a few issues are preventing it from reaching that goal.

For every audit of the agency’s finances up to June 30, 2010, the HSA received what is known as a “disclaimer of opinion” – meaning not enough information was provided for auditors to provide an opinion on the validity of the report. Each audit since mid-2010 has received a “qualified” opinion, meaning there were significant issues in the reporting of the financial statements.

In the HSA’s case, those issues include tens of millions of dollars in uncollected bills and confusion over what it will owe for retired workers’ healthcare coverage.

Health Services Authority Chief Executive Officer Lizzette Yearwood and HSA board Chairman Jonathan Tibbetts said Wednesday that 2018 was set as the date for when those items would come off the books.

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“The Public Accounts Committee is beyond this idea that the auditor general keeps reporting the same thing, year after year after year after year and we keep getting promises [that are] under-delivered,” Mr. Miller said.

The chairman added that uncollected hospital debts – which totaled about $90 million as of June 2016 – were “far more important to us [the committee members]” than the hospital accreditation process being pursued now by the HSA.

“Most of this accreditation is, you pay for it, you get it,” Mr. Miller said.

Mr. Tibbetts told the committee that Cabinet and the HSA board were working on plans to write off a significant portion of the hospital system’s unpaid debts within the next 18 months. He said it had generally been agreed so far that any amounts due for more than six years would not be able to be collected.

Mr. Tibbetts also said a key component of addressing the auditor general’s concerns would be deciding how to deal with post-retirement health insurance for HSA employees. He said discussions were under way with the Cayman Islands National Insurance Company to create a coverage plan for hospital system employees.

“Our number one priority has been to get a clean [audit] opinion,” Mr. Tibbetts said.

Ongoing problems with poor financial information have plagued the Cayman Islands government and related entities for the better part of the past decade. In recent years, government agencies have improved reporting significantly, receiving – in most cases – unqualified or qualified audit opinions.

The entire government sector has never achieved a clean audit opinion since the Cayman Islands changed its public accounting system in 2004.

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