Syringe Access and Sharps Disposal Programs Follow-up

Images of hazardous waste disposal boxes, needles, sharp disposal boxes and crews working out of vans to provide syringe access and sharp disposal services.

The Denver Department of Public Health and Environment fully implemented three recommendations we made in the original audit report, but five others have yet to be fully implemented or acted upon.

The department developed an evaluation plan to ensure it collects standardized and meaningful data to assess program operations and further program progress. The department also reviewed the city ordinance that restricted service providers, and it began advocating for changes to the ordinance.

However, risks remain from the five recommendations that were not fully implemented or acted upon. For example, the department did not provide policies and procedures that clarify oversight responsibilities and the critical activities of the multiple divisions involved in the programs’ operations. In addition, the department conducted a staffing analysis, but the risk of insufficient staffing remains unmitigated with the transfer of the programs.

While the department developed an assessment plan to determine community needs for program services, it has yet to conduct the assessment because of a lack of funding. And lastly, the communication protocols the department developed involved only service providers, not external partners or other city agencies — both within Public Health and Environment and across city government — as we recommended.

Furthermore, during our follow-up, we learned Public Health and Environment transferred the syringe access and sharps disposal programs from its Community and Behavioral Health Division to its HIV Resources Section in November 2021. However, HIV Resources officials have yet to adopt Community and Behavioral Health’s revised processes.

Therefore, the risks Community and Behavioral Health mitigated by implementing our recommendations may reoccur.

 Recommendation chart: 3 fully implemented, 4 partially implemented, 1 not implemented

Auditor's Letter

March 3, 2022

In keeping with generally accepted government auditing standards and Auditor’s Office policy, as authorized by city ordinance, the Audit Services Division has a responsibility to monitor and follow-up on audit recommendations to ensure city agencies address audit findings through appropriate corrective action and to aid us in planning future audits.

In our follow-up effort for the “Syringe Access and Sharps Disposal Programs” audit report issued in August 2020, we determined the Denver Department of Public Health and Environment fully or partially implemented seven of the eight recommendations in the original audit report. Despite the department’s efforts, auditors determined the risks associated with the audit team’s initial findings — such as documenting critical program activities and oversight responsibilities — have not been fully mitigated.

Additionally, we learned the department moved the programs we audited to a different part of the department, which may reintroduce some of the risks we noted in our initial findings. As a result, the Audit Services Division may revisit these risk areas in future audits to ensure the city takes appropriate corrective action.

The Highlights page in this report provides background and summary information about the original audit and the completed follow-up effort. Following the Highlights page is a detailed implementation status update for each recommendation.

I would like to express our sincere appreciation to the personnel in the Department of Public Health and Environment who assisted us throughout the audit and the follow-up process. For any questions, please feel free to contact me at 720-913-5000.

Denver Auditor,

Auditor's Signature
Timothy O'Brien, CPA

Timothy O'Brien Official Headshot

Denver Auditor

Denver Auditor's Office

201 W. Colfax Ave. #705 Denver, CO 80202
Call: 720-913-5000
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