Audit 26879

Finding No. 2022-001 ? Alternative to Abortion Program ? CFDA No. 93.558; Grant No. 1701MOTA Criteria and Condition: The Alternatives to Abortion program requires eligibility criteria including the client to be at or below 185 percent of federal poverty level based on the client or family income and the woman must be carrying an unborn child or children and chooses to carry the unborn child(ren) to term instead of having an abortion. Context: A test of 36 files revealed inadequate documentation surrounding verification of income. 2 of the 36 case files reviewed did not have documentation to support income eligibility. In June 2022, the Agency was audited by the Missouri Department of Social Services (oversight agency) and their report indicated documentation issues surrounding eligibility related to income verification. In July 2022, the Agency had responded with corrective action plans that included a revised eligibility form to address income verification. Cause: The case workers are required to re-verify income; however, they did not always maintain adequate documentation in the file. The Agency communicated in its corrective action plan with the oversight agency. Questioned Cost: $-0- Effect: The lack of documentation could lead to ineligible participants entering into the program. Recommendation: We recommend management ensures all documentation is received and retained through strict following of the tracking checklist for newly eligible participants that documents the proof of pregnancy, income, residency, and lack of involvement with other Alternative to Abortions providers. Classification: Compliance finding and control deficiency in internal controls View of Responsible Officials and Planned Corrective Actions: Management agrees with the finding and the recommended procedures have been implemented. Supervisors will ensure that all client files have proof of eligibility during quarterly file reviews.

Finding No. 2022-002 ? Alternative to Abortion Program ? CFDA No. 93.558; Grant No. 1701MOTA Criteria and Condition: The Alternatives to Abortion program requires eligibility criteria including the client to be at or below 185 percent of federal poverty level based on the client or family income and the woman must be carrying an unborn child or children and chooses to carry the unborn child(ren) to term instead of having an abortion. Context: A test of 36 files revealed inadequate documentation surrounding the re-verification of income at the time of birth. The clients program eligibility must be determined upon entry into the program and again upon the birth of the child(ren). 2 of the 36 case files reviewed did not have documentation to support the re-confirmation of income eligibility upon the birth of the child(ren). Cause: The case workers are required to re-verify income; however, they did not always maintain adequate documentation in the file. The Agency communicated in its corrective action plan with the oversight agency. Questioned Cost: $-0- Effect: The lack of documentation could lead to ineligible participants continuing in the program after becoming ineligible. Recommendation: We recommend management ensures all documentation is received and retained through strict following of the tracking checklist for newly eligible participants that documents the proof of pregnancy, income, residency, and lack of involvement with other Alternatives to Abortion providers and then re-confirmed and documented upon the birth of the child(ren). Classification: Compliance finding and control deficiency in internal controls View of Responsible Officials and Planned Corrective Actions: Management agrees with the finding and the recommended procedures have been implemented. Supervisors will ensure that necessary proofs are obtained and documented.

Finding No. 2022-001 ? Alternative to Abortion Program ? CFDA No. 93.558; Grant No. 1701MOTA Criteria and Condition: The Alternatives to Abortion program requires eligibility criteria including the client to be at or below 185 percent of federal poverty level based on the client or family income and the woman must be carrying an unborn child or children and chooses to carry the unborn child(ren) to term instead of having an abortion. Context: A test of 36 files revealed inadequate documentation surrounding verification of income. 2 of the 36 case files reviewed did not have documentation to support income eligibility. In June 2022, the Agency was audited by the Missouri Department of Social Services (oversight agency) and their report indicated documentation issues surrounding eligibility related to income verification. In July 2022, the Agency had responded with corrective action plans that included a revised eligibility form to address income verification. Cause: The case workers are required to re-verify income; however, they did not always maintain adequate documentation in the file. The Agency communicated in its corrective action plan with the oversight agency. Questioned Cost: $-0- Effect: The lack of documentation could lead to ineligible participants entering into the program. Recommendation: We recommend management ensures all documentation is received and retained through strict following of the tracking checklist for newly eligible participants that documents the proof of pregnancy, income, residency, and lack of involvement with other Alternative to Abortions providers. Classification: Compliance finding and control deficiency in internal controls View of Responsible Officials and Planned Corrective Actions: Management agrees with the finding and the recommended procedures have been implemented. Supervisors will ensure that all client files have proof of eligibility during quarterly file reviews.

Finding No. 2022-002 ? Alternative to Abortion Program ? CFDA No. 93.558; Grant No. 1701MOTA Criteria and Condition: The Alternatives to Abortion program requires eligibility criteria including the client to be at or below 185 percent of federal poverty level based on the client or family income and the woman must be carrying an unborn child or children and chooses to carry the unborn child(ren) to term instead of having an abortion. Context: A test of 36 files revealed inadequate documentation surrounding the re-verification of income at the time of birth. The clients program eligibility must be determined upon entry into the program and again upon the birth of the child(ren). 2 of the 36 case files reviewed did not have documentation to support the re-confirmation of income eligibility upon the birth of the child(ren). Cause: The case workers are required to re-verify income; however, they did not always maintain adequate documentation in the file. The Agency communicated in its corrective action plan with the oversight agency. Questioned Cost: $-0- Effect: The lack of documentation could lead to ineligible participants continuing in the program after becoming ineligible. Recommendation: We recommend management ensures all documentation is received and retained through strict following of the tracking checklist for newly eligible participants that documents the proof of pregnancy, income, residency, and lack of involvement with other Alternatives to Abortion providers and then re-confirmed and documented upon the birth of the child(ren). Classification: Compliance finding and control deficiency in internal controls View of Responsible Officials and Planned Corrective Actions: Management agrees with the finding and the recommended procedures have been implemented. Supervisors will ensure that necessary proofs are obtained and documented.