FAC Explorer

Audit 3268

FY End
2022-12-31
Total Expended
$13.55M
Findings
20
Programs
33
Organization: Itasca County (MN)
Year: 2022 Accepted: 2023-11-15
Auditor: Cliftonlarsonallen LLP

Organization Exclusion Status:

Findings

ID Ref Severity Repeat Requirement
1868 2022-006 Material Weakness Yes L
1869 2022-006 Material Weakness Yes L
1870 2022-007 Material Weakness - E
1871 2022-007 Material Weakness - E
1872 2022-009 Significant Deficiency - AB
1873 2022-009 Significant Deficiency - AB
1874 2022-008 Material Weakness - E
1875 2022-008 Material Weakness - E
1876 2022-009 Significant Deficiency - AB
1877 2022-009 Significant Deficiency - AB
578310 2022-006 Material Weakness Yes L
578311 2022-006 Material Weakness Yes L
578312 2022-007 Material Weakness - E
578313 2022-007 Material Weakness - E
578314 2022-009 Significant Deficiency - AB
578315 2022-009 Significant Deficiency - AB
578316 2022-008 Material Weakness - E
578317 2022-008 Material Weakness - E
578318 2022-009 Significant Deficiency - AB
578319 2022-009 Significant Deficiency - AB

Programs

ALN Program Spent Major Findings
21.027 Coronavirus State and Local Fiscal Recovery Funds $3.15M Yes 0
20.205 Highway Planning and Construction $2.92M Yes 0
93.563 Child Support Enforcement $1.00M - 0
10.561 State Administrative Matching Grants for the Supplemental Nutrition Assistance Program $629,973 - 0
15.226 Payments in Lieu of Taxes $621,968 - 0
93.558 Temporary Assistance for Needy Families $518,871 Yes 2
16.838 Comprehensive Opioid Abuse Site-Based Program $397,247 - 0
93.667 Social Services Block Grant $314,869 - 0
93.658 Foster Care_title IV-E $304,726 - 0
10.557 Special Supplemental Nutrition Program for Women, Infants, and Children $274,050 - 0
10.665 Schools and Roads - Grants to States $188,070 - 0
93.323 Epidemiology and Laboratory Capacity for Infectious Diseases (elc) $144,578 - 0
93.994 Maternal and Child Health Services Block Grant to the States $126,374 - 0
93.268 Immunization Cooperative Agreements $121,217 - 0
20.219 Recreational Trails Program $120,000 - 0
16.575 Crime Victim Assistance $88,163 - 0
97.036 Disaster Grants - Public Assistance (presidentially Declared Disasters) $76,971 - 0
93.674 John H. Chafee Foster Care Program for Successful Transition to Adulthood $74,653 - 0
93.069 Public Health Emergency Preparedness $66,264 - 0
16.034 Coronavirus Emergency Supplemental Funding Program $36,289 - 0
90.404 2018 Hava Election Security Grants $34,476 - 0
93.556 Promoting Safe and Stable Families $22,322 - 0
97.042 Emergency Management Performance Grants $21,146 - 0
97.012 Boating Safety Financial Assistance $16,827 - 0
93.778 Medical Assistance Program $16,723 Yes 3
93.354 Public Health Emergency Response: Cooperative Agreement for Emergency Response: Public Health Crisis Response $12,442 - 0
20.600 State and Community Highway Safety $10,398 - 0
93.669 Child Abuse and Neglect State Grants $9,694 - 0
93.575 Child Care and Development Block Grant $7,442 - 0
93.645 Stephanie Tubbs Jones Child Welfare Services Program $6,972 - 0
93.767 Children's Health Insurance Program $1,829 - 0
93.590 Community-Based Child Abuse Prevention Grants $1,636 - 0
93.566 Refugee and Entrant Assistance_state Administered Programs $1,051 - 0

Contacts

Name Title Type
NHLFNZ9GKFA8 Gail Guck Auditee
2183277481 Douglas P. Host Auditor
No contacts on file

Notes to SEFA

Accounting Policies: REPORTING ENTITY The Schedule of Expenditures of Federal Awards presents the activities of federal award programs expended by Itasca County. The County’s reporting entity is defined in Note 1 to the financial statements. Itasca County's financial statements include the operations of the Itasca Nursing Home, an enterprise fund, which expended $642,630 in federal awards for the year ended September 30, 2022 which are not included in the County's schedule of expenditures of federal awards for the year ended December 31, 2022, because they engaged to have a separate audit. BASIS OF PRESENTATION The accompanying Schedule of Expenditures of Federal Awards includes the federal grant activity of Itasca County under programs of the federal government for the year ended December 31, 2022. The information in this schedule is presented in accordance with the requirements of Title 2 U.S. Code of Federal Regulations Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (Uniform Guidance) from the Office of Management and Budget (OMB). Because the schedule presents only a selected portion of the operations of Itasca County, it is not intended to and does not present the financial position, changes in net position, or cash flows of Itasca County. RECONCILIATION TO THE SCHEDULE OF INTERGOVERNMENTAL REVENUE Federal Grant Revenue per Schedule of Intergovernmental Revenue $13,439,684 Expenditures Included on the Schedule of Expenditures of Federal Awards that are Not Considered Intergovernmental Revenues 241,216 Revenues Included on the Schedule of Intergovernmental Revenue that are Not Considered Federal Grant Expenditures (127,590) Expenditures per Schedule of Expenditures of Federal Awards $13,553,310 De Minimis Rate Used: N Rate Explanation: SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES Expenditures reported on the schedule are reported on the modified accrual basis of accounting. Such expenditures are recognized following the cost principles contained in Title 2 U.S. Code of Federal Regulations Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards, for all awards. Under these principles, certain types of expenditures are not allowable or are limited as to reimbursement. Itasca County has elected not to use the 10 percent de minimis indirect cost rate allowed under the Uniform Guidance.

Finding Details

Finding 2022-006
CONTROLS OVER REPORTING (2022 – 006) Federal Agency: U.S. Department of Health and Human Services Federal Program Name: Medical Assistance Program (Medicaid Cluster) Assistance Listing Number: 93.778 Pass-Through Agency: Minnesota Department of Human Services and the Aitkin-Itasca-Koochiching Community Health Board Pass-Through Numbers: 2205MN5ADM, 2205MN5MAP Federal Award Identification Number and Year: 2205MN5ADM, 2205MN5MAP, 2022 Compliance Requirement Affected: Reporting Award Period: Year Ended December 31, 2022 Type of Finding: Material Weakness in Internal Control over Compliance Criteria or Specific Requirement: Standard internal control procedures recommend that reports should have a review documented by someone other than the preparer. Condition: The quarterly CTC reports filed were missing documentation of review by someone other than the preparer. Questioned Costs: None Context: During our testing of the four CTC quarterly reports, it was noted that two quarterly reports were missing documentation of review by someone other than the preparer. Cause: The Minnesota Department of Human Services is not requiring a reviewer and lack of management oversight. Effect: Reports could be prepared with errors that are not corrected prior to report submission. Repeat Finding: Yes, Finding 2021-006 Recommendation: We recommend that the County ensures each report is reviewed by someone other than the preparer. Views of responsible officials: There is no disagreement with the audit finding.
Finding 2022-006
CONTROLS OVER REPORTING (2022 – 006) Federal Agency: U.S. Department of Health and Human Services Federal Program Name: Medical Assistance Program (Medicaid Cluster) Assistance Listing Number: 93.778 Pass-Through Agency: Minnesota Department of Human Services and the Aitkin-Itasca-Koochiching Community Health Board Pass-Through Numbers: 2205MN5ADM, 2205MN5MAP Federal Award Identification Number and Year: 2205MN5ADM, 2205MN5MAP, 2022 Compliance Requirement Affected: Reporting Award Period: Year Ended December 31, 2022 Type of Finding: Material Weakness in Internal Control over Compliance Criteria or Specific Requirement: Standard internal control procedures recommend that reports should have a review documented by someone other than the preparer. Condition: The quarterly CTC reports filed were missing documentation of review by someone other than the preparer. Questioned Costs: None Context: During our testing of the four CTC quarterly reports, it was noted that two quarterly reports were missing documentation of review by someone other than the preparer. Cause: The Minnesota Department of Human Services is not requiring a reviewer and lack of management oversight. Effect: Reports could be prepared with errors that are not corrected prior to report submission. Repeat Finding: Yes, Finding 2021-006 Recommendation: We recommend that the County ensures each report is reviewed by someone other than the preparer. Views of responsible officials: There is no disagreement with the audit finding.
Finding 2022-007
CASEFILE REVIEW (2022 – 007) Federal Agency: U.S. Department of Health and Human Services Federal Program Name: Medical Assistance Program (Medicaid Cluster) Assistance Listing Number: 93.778 Pass-Through Agency: Minnesota Department of Human Services and the Aitkin-Itasca-Koochiching Community Health Board Pass-Through Numbers: 2205MN5ADM, 2205MN5MAP Federal Award Identification Number and Year: 2205MN5ADM, 2205MN5MAP, 2022 Compliance Requirement Affected: Eligibility Award Period: Year Ended December 31, 2022 Type of Finding: Material Weakness in Internal Control over Compliance, Other Matters Criteria or Specific Requirement: Standard internal control procedures recommend internal reviews over case file eligibility determinations to ascertain case workers are complying with state and federal requirements and correctly determining program eligibility. Condition: There was no formal review documented over internal case files worked by program eligibility specialists. Questioned Costs: None Context: During our testing of eligibility and testing of case file reviews completed during 2022 for Medical Assistance, it was noted that there were no documented case file reviews performed. Cause: The Minnesota Department of Human Services is not requiring a review and lack of management oversight. Effect: Errors made in determining eligibility may not be discovered and benefits may be issued to clients who are not eligible. Repeat Finding: No Recommendation: We recommend that the County review case files on a periodic basis throughout the year and document the review. Views of responsible officials: There is no disagreement with the audit finding.
Finding 2022-007
CASEFILE REVIEW (2022 – 007) Federal Agency: U.S. Department of Health and Human Services Federal Program Name: Medical Assistance Program (Medicaid Cluster) Assistance Listing Number: 93.778 Pass-Through Agency: Minnesota Department of Human Services and the Aitkin-Itasca-Koochiching Community Health Board Pass-Through Numbers: 2205MN5ADM, 2205MN5MAP Federal Award Identification Number and Year: 2205MN5ADM, 2205MN5MAP, 2022 Compliance Requirement Affected: Eligibility Award Period: Year Ended December 31, 2022 Type of Finding: Material Weakness in Internal Control over Compliance, Other Matters Criteria or Specific Requirement: Standard internal control procedures recommend internal reviews over case file eligibility determinations to ascertain case workers are complying with state and federal requirements and correctly determining program eligibility. Condition: There was no formal review documented over internal case files worked by program eligibility specialists. Questioned Costs: None Context: During our testing of eligibility and testing of case file reviews completed during 2022 for Medical Assistance, it was noted that there were no documented case file reviews performed. Cause: The Minnesota Department of Human Services is not requiring a review and lack of management oversight. Effect: Errors made in determining eligibility may not be discovered and benefits may be issued to clients who are not eligible. Repeat Finding: No Recommendation: We recommend that the County review case files on a periodic basis throughout the year and document the review. Views of responsible officials: There is no disagreement with the audit finding.
Finding 2022-009
INACCURATE LISTING OF EMPLOYEES FOR RANDOM MOMENT STUDIES (2022 – 009) Federal Agency: U.S. Department of Health and Human Services Federal Program Name: Medical Assistance Program (Medicaid Cluster) & Temporary Assistance for Needy Families (TANF) Assistance Listing Number: 93.778 & 93.558 Pass-Through Agency: Minnesota Department of Human Services and the Aitkin-Itasca-Koochiching Community Health Board Pass-Through Numbers: 2205MN5ADM, 2205MN5MAP, 2201MNTANF Federal Award Identification Number and Year: 2205MN5ADM, 2205MN5MAP, 2201MNTANF, 2022 Compliance Requirement Affected: Activities Allowed or Unallowed/Allowable Cost/Cost Principles Award Period: Year Ended December 31, 2022 Type of Finding: Significant Deficiency in Internal Control over Compliance, Other Matters Criteria or Specific Requirement: The County maintains a list of all employees subject to random moment studies, which the State uses as a basis for determining salary reimbursement under federal programs. Condition: The County did not properly report employees working on the Medical Assistance and Temporary Assistance for Needy Families programs to the state of Minnesota during a time study conducted by the Minnesota Department of Human Services. Questioned Costs: None Context: During our testing of eligibility and testing of the second and fourth quarter random moment study listing completed during 2022 for the Medical Assistance and Temporary Assistance for Needy Families programs, it was noted that one individual was included on the second quarter Income Maintenance listing that should not have been included. Cause: The Minnesota Department of Human Services is not requiring a review of and lack of management oversight. Effect: The County could receive an incorrect federal funding allocation on incorrect employee information provided to the state for reimbursement. Repeat Finding: No Recommendation: We recommend that the County review the listing of employees working on certain programs on a periodic basis throughout the year and document the review. Views of responsible officials: There is no disagreement with the audit finding.
Finding 2022-009
INACCURATE LISTING OF EMPLOYEES FOR RANDOM MOMENT STUDIES (2022 – 009) Federal Agency: U.S. Department of Health and Human Services Federal Program Name: Medical Assistance Program (Medicaid Cluster) & Temporary Assistance for Needy Families (TANF) Assistance Listing Number: 93.778 & 93.558 Pass-Through Agency: Minnesota Department of Human Services and the Aitkin-Itasca-Koochiching Community Health Board Pass-Through Numbers: 2205MN5ADM, 2205MN5MAP, 2201MNTANF Federal Award Identification Number and Year: 2205MN5ADM, 2205MN5MAP, 2201MNTANF, 2022 Compliance Requirement Affected: Activities Allowed or Unallowed/Allowable Cost/Cost Principles Award Period: Year Ended December 31, 2022 Type of Finding: Significant Deficiency in Internal Control over Compliance, Other Matters Criteria or Specific Requirement: The County maintains a list of all employees subject to random moment studies, which the State uses as a basis for determining salary reimbursement under federal programs. Condition: The County did not properly report employees working on the Medical Assistance and Temporary Assistance for Needy Families programs to the state of Minnesota during a time study conducted by the Minnesota Department of Human Services. Questioned Costs: None Context: During our testing of eligibility and testing of the second and fourth quarter random moment study listing completed during 2022 for the Medical Assistance and Temporary Assistance for Needy Families programs, it was noted that one individual was included on the second quarter Income Maintenance listing that should not have been included. Cause: The Minnesota Department of Human Services is not requiring a review of and lack of management oversight. Effect: The County could receive an incorrect federal funding allocation on incorrect employee information provided to the state for reimbursement. Repeat Finding: No Recommendation: We recommend that the County review the listing of employees working on certain programs on a periodic basis throughout the year and document the review. Views of responsible officials: There is no disagreement with the audit finding.
Finding 2022-008
ELIGIBILITY (2022 – 008) Federal Agency: U.S. Department of Health and Human Services Federal Program Name: Temporary Assistance for Needy Families (TANF) Assistance Listing Number: 93.558 Pass-Through Agency: Minnesota Department of Human Services and the Aitkin-Itasca-Koochiching Community Health Board Pass-Through Numbers: 2201MNTANF Federal Award Identification Number and Year: 2201MNTANF, 2022 Compliance Requirement Affected: Eligibility Award Period: Year Ended December 31, 2022 Type of Finding: Material Weakness in Internal Control over Compliance, Other Matters Criteria or Specific Requirement: Standard internal control procedures recommend internal reviews over case file eligibility determinations to ascertain case workers are complying with state and federal requirements. Condition: There was no formal review documented over internal case files worked by program eligibility specialists. There was also missing documentation of the County’s screening of eligibility. Questioned Costs: None Context: During our testing of case file reviews during 2022, it was noted that there were no documented case file reviews performed for the public health or human services component of Temporary Assistance for Needy Families. It was also noted that during our testing of case files that 3 of 13 public health cases and 0 of 60 human services case files tested did not have documentation on file showing the case file worker’s screening of eligibility. Cause: The Minnesota Department of Human Services is not requiring a review of case files and lack of management oversight. Effect: Errors made in determining eligibility may not be discovered and benefits may be issued to clients who are not eligible. Repeat Finding: No Recommendation: We recommend that the County review case files on a periodic basis throughout the year. Views of responsible officials: There is no disagreement with the audit finding.
Finding 2022-008
ELIGIBILITY (2022 – 008) Federal Agency: U.S. Department of Health and Human Services Federal Program Name: Temporary Assistance for Needy Families (TANF) Assistance Listing Number: 93.558 Pass-Through Agency: Minnesota Department of Human Services and the Aitkin-Itasca-Koochiching Community Health Board Pass-Through Numbers: 2201MNTANF Federal Award Identification Number and Year: 2201MNTANF, 2022 Compliance Requirement Affected: Eligibility Award Period: Year Ended December 31, 2022 Type of Finding: Material Weakness in Internal Control over Compliance, Other Matters Criteria or Specific Requirement: Standard internal control procedures recommend internal reviews over case file eligibility determinations to ascertain case workers are complying with state and federal requirements. Condition: There was no formal review documented over internal case files worked by program eligibility specialists. There was also missing documentation of the County’s screening of eligibility. Questioned Costs: None Context: During our testing of case file reviews during 2022, it was noted that there were no documented case file reviews performed for the public health or human services component of Temporary Assistance for Needy Families. It was also noted that during our testing of case files that 3 of 13 public health cases and 0 of 60 human services case files tested did not have documentation on file showing the case file worker’s screening of eligibility. Cause: The Minnesota Department of Human Services is not requiring a review of case files and lack of management oversight. Effect: Errors made in determining eligibility may not be discovered and benefits may be issued to clients who are not eligible. Repeat Finding: No Recommendation: We recommend that the County review case files on a periodic basis throughout the year. Views of responsible officials: There is no disagreement with the audit finding.
Finding 2022-009
INACCURATE LISTING OF EMPLOYEES FOR RANDOM MOMENT STUDIES (2022 – 009) Federal Agency: U.S. Department of Health and Human Services Federal Program Name: Medical Assistance Program (Medicaid Cluster) & Temporary Assistance for Needy Families (TANF) Assistance Listing Number: 93.778 & 93.558 Pass-Through Agency: Minnesota Department of Human Services and the Aitkin-Itasca-Koochiching Community Health Board Pass-Through Numbers: 2205MN5ADM, 2205MN5MAP, 2201MNTANF Federal Award Identification Number and Year: 2205MN5ADM, 2205MN5MAP, 2201MNTANF, 2022 Compliance Requirement Affected: Activities Allowed or Unallowed/Allowable Cost/Cost Principles Award Period: Year Ended December 31, 2022 Type of Finding: Significant Deficiency in Internal Control over Compliance, Other Matters Criteria or Specific Requirement: The County maintains a list of all employees subject to random moment studies, which the State uses as a basis for determining salary reimbursement under federal programs. Condition: The County did not properly report employees working on the Medical Assistance and Temporary Assistance for Needy Families programs to the state of Minnesota during a time study conducted by the Minnesota Department of Human Services. Questioned Costs: None Context: During our testing of eligibility and testing of the second and fourth quarter random moment study listing completed during 2022 for the Medical Assistance and Temporary Assistance for Needy Families programs, it was noted that one individual was included on the second quarter Income Maintenance listing that should not have been included. Cause: The Minnesota Department of Human Services is not requiring a review of and lack of management oversight. Effect: The County could receive an incorrect federal funding allocation on incorrect employee information provided to the state for reimbursement. Repeat Finding: No Recommendation: We recommend that the County review the listing of employees working on certain programs on a periodic basis throughout the year and document the review. Views of responsible officials: There is no disagreement with the audit finding.
Finding 2022-009
INACCURATE LISTING OF EMPLOYEES FOR RANDOM MOMENT STUDIES (2022 – 009) Federal Agency: U.S. Department of Health and Human Services Federal Program Name: Medical Assistance Program (Medicaid Cluster) & Temporary Assistance for Needy Families (TANF) Assistance Listing Number: 93.778 & 93.558 Pass-Through Agency: Minnesota Department of Human Services and the Aitkin-Itasca-Koochiching Community Health Board Pass-Through Numbers: 2205MN5ADM, 2205MN5MAP, 2201MNTANF Federal Award Identification Number and Year: 2205MN5ADM, 2205MN5MAP, 2201MNTANF, 2022 Compliance Requirement Affected: Activities Allowed or Unallowed/Allowable Cost/Cost Principles Award Period: Year Ended December 31, 2022 Type of Finding: Significant Deficiency in Internal Control over Compliance, Other Matters Criteria or Specific Requirement: The County maintains a list of all employees subject to random moment studies, which the State uses as a basis for determining salary reimbursement under federal programs. Condition: The County did not properly report employees working on the Medical Assistance and Temporary Assistance for Needy Families programs to the state of Minnesota during a time study conducted by the Minnesota Department of Human Services. Questioned Costs: None Context: During our testing of eligibility and testing of the second and fourth quarter random moment study listing completed during 2022 for the Medical Assistance and Temporary Assistance for Needy Families programs, it was noted that one individual was included on the second quarter Income Maintenance listing that should not have been included. Cause: The Minnesota Department of Human Services is not requiring a review of and lack of management oversight. Effect: The County could receive an incorrect federal funding allocation on incorrect employee information provided to the state for reimbursement. Repeat Finding: No Recommendation: We recommend that the County review the listing of employees working on certain programs on a periodic basis throughout the year and document the review. Views of responsible officials: There is no disagreement with the audit finding.
Finding 2022-006
CONTROLS OVER REPORTING (2022 – 006) Federal Agency: U.S. Department of Health and Human Services Federal Program Name: Medical Assistance Program (Medicaid Cluster) Assistance Listing Number: 93.778 Pass-Through Agency: Minnesota Department of Human Services and the Aitkin-Itasca-Koochiching Community Health Board Pass-Through Numbers: 2205MN5ADM, 2205MN5MAP Federal Award Identification Number and Year: 2205MN5ADM, 2205MN5MAP, 2022 Compliance Requirement Affected: Reporting Award Period: Year Ended December 31, 2022 Type of Finding: Material Weakness in Internal Control over Compliance Criteria or Specific Requirement: Standard internal control procedures recommend that reports should have a review documented by someone other than the preparer. Condition: The quarterly CTC reports filed were missing documentation of review by someone other than the preparer. Questioned Costs: None Context: During our testing of the four CTC quarterly reports, it was noted that two quarterly reports were missing documentation of review by someone other than the preparer. Cause: The Minnesota Department of Human Services is not requiring a reviewer and lack of management oversight. Effect: Reports could be prepared with errors that are not corrected prior to report submission. Repeat Finding: Yes, Finding 2021-006 Recommendation: We recommend that the County ensures each report is reviewed by someone other than the preparer. Views of responsible officials: There is no disagreement with the audit finding.
Finding 2022-006
CONTROLS OVER REPORTING (2022 – 006) Federal Agency: U.S. Department of Health and Human Services Federal Program Name: Medical Assistance Program (Medicaid Cluster) Assistance Listing Number: 93.778 Pass-Through Agency: Minnesota Department of Human Services and the Aitkin-Itasca-Koochiching Community Health Board Pass-Through Numbers: 2205MN5ADM, 2205MN5MAP Federal Award Identification Number and Year: 2205MN5ADM, 2205MN5MAP, 2022 Compliance Requirement Affected: Reporting Award Period: Year Ended December 31, 2022 Type of Finding: Material Weakness in Internal Control over Compliance Criteria or Specific Requirement: Standard internal control procedures recommend that reports should have a review documented by someone other than the preparer. Condition: The quarterly CTC reports filed were missing documentation of review by someone other than the preparer. Questioned Costs: None Context: During our testing of the four CTC quarterly reports, it was noted that two quarterly reports were missing documentation of review by someone other than the preparer. Cause: The Minnesota Department of Human Services is not requiring a reviewer and lack of management oversight. Effect: Reports could be prepared with errors that are not corrected prior to report submission. Repeat Finding: Yes, Finding 2021-006 Recommendation: We recommend that the County ensures each report is reviewed by someone other than the preparer. Views of responsible officials: There is no disagreement with the audit finding.
Finding 2022-007
CASEFILE REVIEW (2022 – 007) Federal Agency: U.S. Department of Health and Human Services Federal Program Name: Medical Assistance Program (Medicaid Cluster) Assistance Listing Number: 93.778 Pass-Through Agency: Minnesota Department of Human Services and the Aitkin-Itasca-Koochiching Community Health Board Pass-Through Numbers: 2205MN5ADM, 2205MN5MAP Federal Award Identification Number and Year: 2205MN5ADM, 2205MN5MAP, 2022 Compliance Requirement Affected: Eligibility Award Period: Year Ended December 31, 2022 Type of Finding: Material Weakness in Internal Control over Compliance, Other Matters Criteria or Specific Requirement: Standard internal control procedures recommend internal reviews over case file eligibility determinations to ascertain case workers are complying with state and federal requirements and correctly determining program eligibility. Condition: There was no formal review documented over internal case files worked by program eligibility specialists. Questioned Costs: None Context: During our testing of eligibility and testing of case file reviews completed during 2022 for Medical Assistance, it was noted that there were no documented case file reviews performed. Cause: The Minnesota Department of Human Services is not requiring a review and lack of management oversight. Effect: Errors made in determining eligibility may not be discovered and benefits may be issued to clients who are not eligible. Repeat Finding: No Recommendation: We recommend that the County review case files on a periodic basis throughout the year and document the review. Views of responsible officials: There is no disagreement with the audit finding.
Finding 2022-007
CASEFILE REVIEW (2022 – 007) Federal Agency: U.S. Department of Health and Human Services Federal Program Name: Medical Assistance Program (Medicaid Cluster) Assistance Listing Number: 93.778 Pass-Through Agency: Minnesota Department of Human Services and the Aitkin-Itasca-Koochiching Community Health Board Pass-Through Numbers: 2205MN5ADM, 2205MN5MAP Federal Award Identification Number and Year: 2205MN5ADM, 2205MN5MAP, 2022 Compliance Requirement Affected: Eligibility Award Period: Year Ended December 31, 2022 Type of Finding: Material Weakness in Internal Control over Compliance, Other Matters Criteria or Specific Requirement: Standard internal control procedures recommend internal reviews over case file eligibility determinations to ascertain case workers are complying with state and federal requirements and correctly determining program eligibility. Condition: There was no formal review documented over internal case files worked by program eligibility specialists. Questioned Costs: None Context: During our testing of eligibility and testing of case file reviews completed during 2022 for Medical Assistance, it was noted that there were no documented case file reviews performed. Cause: The Minnesota Department of Human Services is not requiring a review and lack of management oversight. Effect: Errors made in determining eligibility may not be discovered and benefits may be issued to clients who are not eligible. Repeat Finding: No Recommendation: We recommend that the County review case files on a periodic basis throughout the year and document the review. Views of responsible officials: There is no disagreement with the audit finding.
Finding 2022-009
INACCURATE LISTING OF EMPLOYEES FOR RANDOM MOMENT STUDIES (2022 – 009) Federal Agency: U.S. Department of Health and Human Services Federal Program Name: Medical Assistance Program (Medicaid Cluster) & Temporary Assistance for Needy Families (TANF) Assistance Listing Number: 93.778 & 93.558 Pass-Through Agency: Minnesota Department of Human Services and the Aitkin-Itasca-Koochiching Community Health Board Pass-Through Numbers: 2205MN5ADM, 2205MN5MAP, 2201MNTANF Federal Award Identification Number and Year: 2205MN5ADM, 2205MN5MAP, 2201MNTANF, 2022 Compliance Requirement Affected: Activities Allowed or Unallowed/Allowable Cost/Cost Principles Award Period: Year Ended December 31, 2022 Type of Finding: Significant Deficiency in Internal Control over Compliance, Other Matters Criteria or Specific Requirement: The County maintains a list of all employees subject to random moment studies, which the State uses as a basis for determining salary reimbursement under federal programs. Condition: The County did not properly report employees working on the Medical Assistance and Temporary Assistance for Needy Families programs to the state of Minnesota during a time study conducted by the Minnesota Department of Human Services. Questioned Costs: None Context: During our testing of eligibility and testing of the second and fourth quarter random moment study listing completed during 2022 for the Medical Assistance and Temporary Assistance for Needy Families programs, it was noted that one individual was included on the second quarter Income Maintenance listing that should not have been included. Cause: The Minnesota Department of Human Services is not requiring a review of and lack of management oversight. Effect: The County could receive an incorrect federal funding allocation on incorrect employee information provided to the state for reimbursement. Repeat Finding: No Recommendation: We recommend that the County review the listing of employees working on certain programs on a periodic basis throughout the year and document the review. Views of responsible officials: There is no disagreement with the audit finding.
Finding 2022-009
INACCURATE LISTING OF EMPLOYEES FOR RANDOM MOMENT STUDIES (2022 – 009) Federal Agency: U.S. Department of Health and Human Services Federal Program Name: Medical Assistance Program (Medicaid Cluster) & Temporary Assistance for Needy Families (TANF) Assistance Listing Number: 93.778 & 93.558 Pass-Through Agency: Minnesota Department of Human Services and the Aitkin-Itasca-Koochiching Community Health Board Pass-Through Numbers: 2205MN5ADM, 2205MN5MAP, 2201MNTANF Federal Award Identification Number and Year: 2205MN5ADM, 2205MN5MAP, 2201MNTANF, 2022 Compliance Requirement Affected: Activities Allowed or Unallowed/Allowable Cost/Cost Principles Award Period: Year Ended December 31, 2022 Type of Finding: Significant Deficiency in Internal Control over Compliance, Other Matters Criteria or Specific Requirement: The County maintains a list of all employees subject to random moment studies, which the State uses as a basis for determining salary reimbursement under federal programs. Condition: The County did not properly report employees working on the Medical Assistance and Temporary Assistance for Needy Families programs to the state of Minnesota during a time study conducted by the Minnesota Department of Human Services. Questioned Costs: None Context: During our testing of eligibility and testing of the second and fourth quarter random moment study listing completed during 2022 for the Medical Assistance and Temporary Assistance for Needy Families programs, it was noted that one individual was included on the second quarter Income Maintenance listing that should not have been included. Cause: The Minnesota Department of Human Services is not requiring a review of and lack of management oversight. Effect: The County could receive an incorrect federal funding allocation on incorrect employee information provided to the state for reimbursement. Repeat Finding: No Recommendation: We recommend that the County review the listing of employees working on certain programs on a periodic basis throughout the year and document the review. Views of responsible officials: There is no disagreement with the audit finding.
Finding 2022-008
ELIGIBILITY (2022 – 008) Federal Agency: U.S. Department of Health and Human Services Federal Program Name: Temporary Assistance for Needy Families (TANF) Assistance Listing Number: 93.558 Pass-Through Agency: Minnesota Department of Human Services and the Aitkin-Itasca-Koochiching Community Health Board Pass-Through Numbers: 2201MNTANF Federal Award Identification Number and Year: 2201MNTANF, 2022 Compliance Requirement Affected: Eligibility Award Period: Year Ended December 31, 2022 Type of Finding: Material Weakness in Internal Control over Compliance, Other Matters Criteria or Specific Requirement: Standard internal control procedures recommend internal reviews over case file eligibility determinations to ascertain case workers are complying with state and federal requirements. Condition: There was no formal review documented over internal case files worked by program eligibility specialists. There was also missing documentation of the County’s screening of eligibility. Questioned Costs: None Context: During our testing of case file reviews during 2022, it was noted that there were no documented case file reviews performed for the public health or human services component of Temporary Assistance for Needy Families. It was also noted that during our testing of case files that 3 of 13 public health cases and 0 of 60 human services case files tested did not have documentation on file showing the case file worker’s screening of eligibility. Cause: The Minnesota Department of Human Services is not requiring a review of case files and lack of management oversight. Effect: Errors made in determining eligibility may not be discovered and benefits may be issued to clients who are not eligible. Repeat Finding: No Recommendation: We recommend that the County review case files on a periodic basis throughout the year. Views of responsible officials: There is no disagreement with the audit finding.
Finding 2022-008
ELIGIBILITY (2022 – 008) Federal Agency: U.S. Department of Health and Human Services Federal Program Name: Temporary Assistance for Needy Families (TANF) Assistance Listing Number: 93.558 Pass-Through Agency: Minnesota Department of Human Services and the Aitkin-Itasca-Koochiching Community Health Board Pass-Through Numbers: 2201MNTANF Federal Award Identification Number and Year: 2201MNTANF, 2022 Compliance Requirement Affected: Eligibility Award Period: Year Ended December 31, 2022 Type of Finding: Material Weakness in Internal Control over Compliance, Other Matters Criteria or Specific Requirement: Standard internal control procedures recommend internal reviews over case file eligibility determinations to ascertain case workers are complying with state and federal requirements. Condition: There was no formal review documented over internal case files worked by program eligibility specialists. There was also missing documentation of the County’s screening of eligibility. Questioned Costs: None Context: During our testing of case file reviews during 2022, it was noted that there were no documented case file reviews performed for the public health or human services component of Temporary Assistance for Needy Families. It was also noted that during our testing of case files that 3 of 13 public health cases and 0 of 60 human services case files tested did not have documentation on file showing the case file worker’s screening of eligibility. Cause: The Minnesota Department of Human Services is not requiring a review of case files and lack of management oversight. Effect: Errors made in determining eligibility may not be discovered and benefits may be issued to clients who are not eligible. Repeat Finding: No Recommendation: We recommend that the County review case files on a periodic basis throughout the year. Views of responsible officials: There is no disagreement with the audit finding.
Finding 2022-009
INACCURATE LISTING OF EMPLOYEES FOR RANDOM MOMENT STUDIES (2022 – 009) Federal Agency: U.S. Department of Health and Human Services Federal Program Name: Medical Assistance Program (Medicaid Cluster) & Temporary Assistance for Needy Families (TANF) Assistance Listing Number: 93.778 & 93.558 Pass-Through Agency: Minnesota Department of Human Services and the Aitkin-Itasca-Koochiching Community Health Board Pass-Through Numbers: 2205MN5ADM, 2205MN5MAP, 2201MNTANF Federal Award Identification Number and Year: 2205MN5ADM, 2205MN5MAP, 2201MNTANF, 2022 Compliance Requirement Affected: Activities Allowed or Unallowed/Allowable Cost/Cost Principles Award Period: Year Ended December 31, 2022 Type of Finding: Significant Deficiency in Internal Control over Compliance, Other Matters Criteria or Specific Requirement: The County maintains a list of all employees subject to random moment studies, which the State uses as a basis for determining salary reimbursement under federal programs. Condition: The County did not properly report employees working on the Medical Assistance and Temporary Assistance for Needy Families programs to the state of Minnesota during a time study conducted by the Minnesota Department of Human Services. Questioned Costs: None Context: During our testing of eligibility and testing of the second and fourth quarter random moment study listing completed during 2022 for the Medical Assistance and Temporary Assistance for Needy Families programs, it was noted that one individual was included on the second quarter Income Maintenance listing that should not have been included. Cause: The Minnesota Department of Human Services is not requiring a review of and lack of management oversight. Effect: The County could receive an incorrect federal funding allocation on incorrect employee information provided to the state for reimbursement. Repeat Finding: No Recommendation: We recommend that the County review the listing of employees working on certain programs on a periodic basis throughout the year and document the review. Views of responsible officials: There is no disagreement with the audit finding.
Finding 2022-009
INACCURATE LISTING OF EMPLOYEES FOR RANDOM MOMENT STUDIES (2022 – 009) Federal Agency: U.S. Department of Health and Human Services Federal Program Name: Medical Assistance Program (Medicaid Cluster) & Temporary Assistance for Needy Families (TANF) Assistance Listing Number: 93.778 & 93.558 Pass-Through Agency: Minnesota Department of Human Services and the Aitkin-Itasca-Koochiching Community Health Board Pass-Through Numbers: 2205MN5ADM, 2205MN5MAP, 2201MNTANF Federal Award Identification Number and Year: 2205MN5ADM, 2205MN5MAP, 2201MNTANF, 2022 Compliance Requirement Affected: Activities Allowed or Unallowed/Allowable Cost/Cost Principles Award Period: Year Ended December 31, 2022 Type of Finding: Significant Deficiency in Internal Control over Compliance, Other Matters Criteria or Specific Requirement: The County maintains a list of all employees subject to random moment studies, which the State uses as a basis for determining salary reimbursement under federal programs. Condition: The County did not properly report employees working on the Medical Assistance and Temporary Assistance for Needy Families programs to the state of Minnesota during a time study conducted by the Minnesota Department of Human Services. Questioned Costs: None Context: During our testing of eligibility and testing of the second and fourth quarter random moment study listing completed during 2022 for the Medical Assistance and Temporary Assistance for Needy Families programs, it was noted that one individual was included on the second quarter Income Maintenance listing that should not have been included. Cause: The Minnesota Department of Human Services is not requiring a review of and lack of management oversight. Effect: The County could receive an incorrect federal funding allocation on incorrect employee information provided to the state for reimbursement. Repeat Finding: No Recommendation: We recommend that the County review the listing of employees working on certain programs on a periodic basis throughout the year and document the review. Views of responsible officials: There is no disagreement with the audit finding.