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Conservatively Speaking

State Senator Mary Lazich (R-New Berlin) represents parts of four counties: Milwaukee, Waukesha, Racine, and Walworth. Her Senate District 28 includes New Berlin, Franklin, Greendale, Hales Corners, Muskego, Waterford, Big Bend, the town of Vernon and parts of Greenfield, East Troy, and Mukwonago. Senator Lazich has been in the Legislature for more than a decade. She considers herself a tireless crusader for lower taxes, reduced spending and smaller government.

Audit: Medical Education, Research, and Public Health Grants

Audits


The Wisconsin Legislative Audit Bureau (LAB) has completed its review of public health programs and medical education and research initiatives created by the Medical College of Wisconsin and the University of Wisconsin (UW) School of Medicine and Public Health.

The results, for the most part, show good news. The two schools have followed requirements for awarding and monitoring their funding. Most of the grant recipients met goals outlined in their proposals. However, the LAB did find some exceptions.

Here is the background. The Wisconsin Office of the Commissioner of Insurance issued an order during March 2000 that converted Blue Cross Blue Shield United of Wisconsin from a not-for-profit hospital service insurance corporation to a for-profit, publicly held stock insurance corporation. The order provided $630.4 million to endowments held by the Medical College of Wisconsin and the University of Wisconsin (UW) School of Medicine and Public Health. Terms of the order designated that 65.0 percent of funds be used for medical education and research and 35.0 percent be spent for public health
initiatives.

The LAB conducted an analysis of the schools at the request of the Insurance Commissioner’s Office. The Bureau’s findings follow.

The Medical College spent $32.1 million and the UW School of Medicine and Public Health spent $44.1 million from the inception of the program through December 31, 2008. During the period of 2004 through 2008, 396 projects received grant funding. The LAB analyzed what it calls a “diverse sample” of 20 medical education and research projects and 20 public health projects funded by each School and discovered that most grant applicants supplied the appropriate materials. Of the 80 grants studied, 14 of the grant proposals had goals that were either unclear or overly ambitious. The LAB provided these examples:

One Medical College project that was awarded $242,600 had two broad goals—providing mental health educational services to providers and to consumers—
but the grant application did not cite more specific objectives for the services to be provided.

A UW project was awarded $450,000 to fund implementation of a home visitation program for low-income families, but the grant application did not detail the types of activities and services to be provided.”


The two schools require grant recipients to provide progress reports for the purpose of monitoring. In six cases, the reports failed to have adequate information to determine progress and in 18 cases, grant recipients altered project objectives of functions without the necessary approval of the schools.

Did the grant recipients achieve their stated goals? The LAB found 46 of the 80 grants met all or most of their goals or are likely to meet their goals by the end of the grant period. Five of the 80 projects studied met few of their goals or appear unlikely to meet goals. They include:

“A $450,000 Medical College public health project to address the prevention and reduction of obesity that did not develop a community action plan, conduct any of its proposed evaluations, or report on most of its objectives.

A $25,000 UW public health planning project that did not complete its primary goal of developing a strategic plan for an organization of family caregivers, nor did it apply for grants to continue support of the organization.”

While both schools according to the LAB have carefully monitored their endowment balances, the LAB expressed concern at the lack of requirements for the schools’ oversight and advisory committee members to abstain from voting on projects proposed by entities that either employed or had financial relationships with committee members.

The LAB, as is their practice, offers insightful and helpful recommendations. This audit’s offers counsel to the two schools:
  

 

  • Ensure that project proposals include clear objectives before funds are awarded.
  • Improve project monitoring, including clarifying when grant recipients must inform program staff of changes modifications to project objectives.
  • Ensure that grant applicants disclose all external funding on their supplanting forms and clarify conflict-of-interest policies.
  • The Commissioner of Insurance should work with both medical schools to ensure that funds are spent consistently with the intent of the 2000 order. 

Once again, the LAB has produced an outstanding, comprehensive audit. You can see the full audit here and the LAB’s review of selected projects here.

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