Cayman Islands Health Services Authority officials appeared at the Legislative Assembly’s Public Accounts Committee meeting for the second time this month on Tuesday to answer questions about their efforts to collect millions of dollars of debt, and to be grilled about the qualifications of its top officials.

According to HSA Chairman Jonathan Tibbetts, the amount of “bad debt” – bills that are unlikely to be paid but which remain on the government’s books – accrued by the Authority decreased from about $15 million at the end of August 2016 fiscal year to $7 million a year later.

The Authority’s CEO Lizzette Yearwood added that it had stepped up its collection efforts. The HSA typically collects about $6 million per month, but had collected $14 million to date in October, with about a week left to go in the month, she said.

The health authority has also written off some $9.2 million of its roughly $94.5 million in bad debt. Public Accounts Committee Chairman Ezzard Miller asked why the HSA board only voted to write off that amount when Ms. Yearwood had requested that $27.6 million be written off, and Mr. Tibbetts replied that the board chose to write off debt that was more than six years old.

Those factors have helped the Authority decrease its total accounts receivable from $122 million to $108 million, according to Mr. Tibbetts.

“And it will continue to decrease,” he told Mr. Miller.

Ms. Yearwood and Mr. Tibbetts also updated the committee about the Health Services Authority’s efforts to update its accounting practices and collection procedures.

Where the Authority used to pursue collections after treating a patient, customers are now asked to provide their means of payment beforehand unless it is an emergency, she said, attributing this policy change to the uptick in collections.

The HSA is also creating an internal compliance office to make sure the department is following its own rules, she said. The Authority is also outsourcing its internal audits to government’s Internal Audit Unit – the HSA internal auditor is being transferred there, and will be assisted by the Unit in carrying out future internal audits, she explained.

Mr. Tibbetts added that the board has recommend that the HSA add a chief operations officer, which will focus more on the Authority’s daily operations while allowing Ms. Yearwood to focus on larger strategic goals.  Along with discussing accounting and internal procedures, independent legislator Chris Saunders also questioned the HSA officials about hiring decisions that in some cases were made more than a decade ago.

Mr. Saunders mostly focused on HSA Chief Financial Officer Heather Boothe, who he said was underqualified to serve in her position. Other than a two-year stint as an accountant at a shipping services company from 2001-2003, Ms. Boothe did not have any accounting experience before being hired, he said.

“You hired a person with a degree in economics who had two years of accounting experience in a shipping services company, and you hand them a $100 million hospital to run,” he said, suggesting that Ms. Boothe was hired because her husband was a doctor with the HSA. “I’m sorry, I can’t accept this.”

Later in the session, Mr. Tibbetts corrected Mr. Saunders, pointing out that Ms. Boothe has been an Association of Chartered Certified Accountants-certified accountant for the past 18 years, having achieved that designation in 1999.

“Just for the record, based on what [Mr. Saunders] read, as far as the CV, I think there may have been a page missing,” Ms. Yearwood said. “So I will undertake to resend the entire document so you have it on record.”

Mr. Tibbetts also released a statement on Wednesday afternoon, giving Ms. Boothe a vote of confidence.

“Her extensive experience in a range of diverse industries provided her the breadth of skills and knowledge, and experience to benefit the HSA, reflected in the fact that the auditor general has been able to highlight the positive impact of her work on the organization’s financial reports since her tenure,” he stated. “This is significant from the years when the Audit reports reflect unflattering comments about the finances of the HSA.”

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  1. It is hard to determine (from this article) and missing pages on Ms. Boothe CV, what exactly her education, certification, licensure and experience was prior to being hired as HSA Chief Financial Officer.

    Also, don’t get blinded by collection numbers yet, something is fishy here. Going from $6 million per mont to “$14 million to date in October” is practically impossible. Someone has to take a very close look at where the numbers are coming from.

    For clarification:

    CPA Certificate-work experience is often NOT required.
    No CPA CPE (continuous professional education) hours required.
    Cannot normally hold yourself out as a CPA.

    CPA License- Typically require 1-2 years of working experience, supervised and/or verified by a CPA licensee.
    CPE hours required every reporting years (typically 80 hours every 2 years)
    Can use CPA title in business cards and own CPA firm/sign audit report.

    Because certificate is easier to get, one can consider certificate as the “first level”. The license, or permit to practice, is the “second level”. In fact, many international students aim for certificates only because the CPA qualification is used mainly for the enhancement of their credentials.

    If you want to be a CPA, you ought to be licensed.

    To maintain a CPA license=> 80 hours of CPE every 2 years is REQUIRED.

    International Topics: Frequently Asked Questions.
    3. I hold a license or designation from the Association of Chartered Certified Accountants (ACCA). How can I become a U.S. CPA?
    A. Unfortunately, the designation from the ACCA is not generally recognized by the states in the U.S., so you are required to complete all of the regular requirements to become a U.S. Certified Public Accountant (CPA).