The state Department of Health and Mental Hygiene is not properly securing birth, death and marriage certificates, leaving the vital records vulnerable to criminals, according to a new legislative audit.
State and local health departments issued more than 600,000 copies of the records last year, for $7 million in fees. The case of one employee, who is suspected by auditors of misappropriating some fees, is being referred to the attorney general's office.
Copies of birth certificates issued at the state and local levels were of particular concern to the auditors because they could aid illegal immigration and flights from justice. Specifically, the documents could be used to obtain driver's licenses and passports, as well as Social Security benefits and other government assistance.
"Our audit disclosed that adequate procedures and controls were not established over vital records and related collections at the [health department] headquarters location, as well as local health departments," said Bruce Myers, the state's auditor, in a letter to the state General Assembly's audit committee. "Accordingly, there was a lack of assurance that birth information recorded on the vital records system was accurate, that certificates were only issued to authorized recipients."
Specifically, at the Division of Vital Records, the audit of records from 2006 to 2009 found that officials didn't check live birth information with hospitals to ensure accuracy of the information. Officials in the office also didn't verify changes made to existing certificates for spelling errors or changes in paternity.
There was no system to keep employees from printing fake birth certificates, and there was no accounting of blank certificates — a problem recorded by auditors in reviews going back to 1999. Officials also didn't routinely reconcile the number of certificates made and fees collected, and indeed, when auditors asked for an accounting of several thousand certificates, more than $20,000 was unaccounted for.
The office also wasn't ensuring the information from local health departments was accurate.
The audit also looked at other offices in the state health department, including the Division of Cost Accounting and Reimbursements. The auditors found there weren't sufficient efforts to collect payment from patients in state facilities or to go after delinquent accounts. On pharmacy accounts, the state didn't take corrective action when errors were found.
There also were insufficient controls and record-keeping problems in the areas of network information systems, payroll and state credit cards.
In vital records, the audit noted that the state bought a new computer system for $3.9 million but it was not delivered in a timely manner and wasn't performing up to standards. The state has since sought to cancel the rest of the contract, but the matter is still in dispute.
In a written response and an interview, officials at the Department of Health and Mental Hygiene didn't dispute the findings of the report and said many of the deficiencies are being addressed. For example, officials said, an employee was hired to check birth certificates with hospital information, and an audit will be conducted of changes to existing certificates.
"While the auditors noted systems concerns at the Division of Vital Records that could lead to problems, including money that wasn't collected, fortunately there were no instances where certificates were found to be inaccurate," said Wendy Kronmiller, the department's chief of staff. "The department agrees that the integrity of these systems is extremely important and has already taken active measures to address the auditors' concerns."
A spokesman for the Maryland attorney general's office said there have been no cases of falsified or stolen birth certificates related to the vital records office reported in recent times.