Audit 321655

2023-002 Eligibility Prior Year Finding Number: N/A Year of Finding Origination: 2023 Type of Finding: Internal Control Over Compliance and Compliance Severity of Deficiency: Material Weakness and Modified Opinion Federal Agency: U.S. Department of Health and Human Services Program: 93.778 Medical Assistance Program Award Number and Year: 2305MN5ADM; 2023 Pass-Through Agency: Minnesota Department of Human Services Criteria: Title 2 U.S. Code of Federal Regulations § 200.303 states that the auditee must establish and maintain effective internal control over the federal award that provides reasonable assurance that the auditee is managing the federal award in compliance with federal statutes, regulations, and the terms and conditions of the federal award. Condition: The Minnesota Department of Human Services maintains the computer system, MAXIS, which is used by Clay County to support the eligibility determination process. In the case files reviewed for eligibility, not all documentation to support participant eligibility was available or input into MAXIS. The following exceptions were noted in the sample of 40 case files tested: • Two case files had no application on file with the County, and one case file was missing the signature page of the application. • In four case files, the documented method used to verify citizenship in MAXIS was different than documented in the case file. • Four case files had an asset listed in MAXIS that did not match the documentation in the case file. Questioned Costs: Not applicable. The County administers the program, but the State of Minnesota pays benefits to program participants. Context: The State of Minnesota and the County split the eligibility determination process. Pursuant to Minnesota statutes, Clay County performs the “intake function” needed for this program, while the state maintains the MAXIS system, which supports the eligibility determination process. Participants receive benefit payments from the state. The sample size was based on the guidance from chapter 11 of the AICPA Audit Guide, Government Auditing Standards and Single Audits. Effect: The lack of updated information in MAXIS to document verification of key eligibility-determining factors increases the risk that program participants will receive benefits when they are not eligible. Cause: Program personnel entering case data into MAXIS did not obtain and/or update the information in the system. Recommendation: We recommend Clay County implement additional procedures to provide reasonable assurance that all documentation is obtained and properly input or updated in MAXIS. View of Responsible Official: Concur

2023-002 Eligibility Prior Year Finding Number: N/A Year of Finding Origination: 2023 Type of Finding: Internal Control Over Compliance and Compliance Severity of Deficiency: Material Weakness and Modified Opinion Federal Agency: U.S. Department of Health and Human Services Program: 93.778 Medical Assistance Program Award Number and Year: 2305MN5ADM; 2023 Pass-Through Agency: Minnesota Department of Human Services Criteria: Title 2 U.S. Code of Federal Regulations § 200.303 states that the auditee must establish and maintain effective internal control over the federal award that provides reasonable assurance that the auditee is managing the federal award in compliance with federal statutes, regulations, and the terms and conditions of the federal award. Condition: The Minnesota Department of Human Services maintains the computer system, MAXIS, which is used by Clay County to support the eligibility determination process. In the case files reviewed for eligibility, not all documentation to support participant eligibility was available or input into MAXIS. The following exceptions were noted in the sample of 40 case files tested: • Two case files had no application on file with the County, and one case file was missing the signature page of the application. • In four case files, the documented method used to verify citizenship in MAXIS was different than documented in the case file. • Four case files had an asset listed in MAXIS that did not match the documentation in the case file. Questioned Costs: Not applicable. The County administers the program, but the State of Minnesota pays benefits to program participants. Context: The State of Minnesota and the County split the eligibility determination process. Pursuant to Minnesota statutes, Clay County performs the “intake function” needed for this program, while the state maintains the MAXIS system, which supports the eligibility determination process. Participants receive benefit payments from the state. The sample size was based on the guidance from chapter 11 of the AICPA Audit Guide, Government Auditing Standards and Single Audits. Effect: The lack of updated information in MAXIS to document verification of key eligibility-determining factors increases the risk that program participants will receive benefits when they are not eligible. Cause: Program personnel entering case data into MAXIS did not obtain and/or update the information in the system. Recommendation: We recommend Clay County implement additional procedures to provide reasonable assurance that all documentation is obtained and properly input or updated in MAXIS. View of Responsible Official: Concur