Audit 367602

FY End
2024-12-31
Total Expended
$473.00M
Findings
6
Programs
86
Organization: Suffolk County, New York (NY)
Year: 2024 Accepted: 2025-09-25

Organization Exclusion Status:

Checking exclusion status...

Findings

ID Ref Severity Repeat Requirement
1155362 2024-002 Material Weakness Yes AB
1155363 2024-001 Material Weakness Yes E
1155364 2024-001 Material Weakness Yes E
1155365 2024-001 Material Weakness Yes E
1155366 2024-001 Material Weakness Yes E
1155367 2024-001 Material Weakness Yes E

Programs

ALN Program Spent Major Findings
93.558 Temporary Assistance for Needy Families $86.09M Yes 0
93.575 Child Care and Development Block Grant $73.22M Yes 0
21.027 Coronavirus State and Local Fiscal Recovery Funds $47.95M Yes 0
93.568 Low-Income Home Energy Assistance $20.99M Yes 0
93.778 Medical Assistance Program $20.95M Yes 1
97.039 Hazard Mitigation Grant $19.13M Yes 0
10.557 Wic Special Supplemental Nutrition Program for Women, Infants, and Children $18.46M Yes 0
10.561 State Administrative Matching Grants for the Supplemental Nutrition Assistance Program $15.30M Yes 0
93.667 Social Services Block Grant $11.77M Yes 0
93.658 Foster Care Title IV-E $11.06M Yes 0
93.563 Child Support Services $9.01M Yes 1
93.659 Adoption Assistance $6.42M Yes 0
11.307 Economic Adjustment Assistance $4.81M Yes 0
16.U01 Housing & Transportation of Federal Adult Prisoners $3.76M Yes 0
20.513 Enhanced Mobility of Seniors and Individuals with Disabilities $3.30M Yes 0
20.526 Buses and Bus Facilities Formula, Competitive, and Low Or No Emissions Programs $1.90M Yes 0
14.218 Community Development Block Grants/entitlement Grants $1.77M Yes 0
14.269 Hurricane Sandy Community Development Block Grant Disaster Recovery Grants (cdbg-Dr) $1.70M Yes 0
16.606 State Criminal Alien Assistance Program $1.29M Yes 0
93.767 Children's Health Insurance Program $1.24M Yes 0
93.044 Special Programs for the Aging, Title Iii, Part B, Grants for Supportive Services and Senior Centers $1.19M Yes 0
93.958 Block Grants for Community Mental Health Services $1.15M Yes 0
93.045 Special Programs for the Aging, Title Iii, Part C, Nutrition Services $1.12M Yes 0
97.067 Homeland Security Grant Program $865,163 Yes 0
93.052 National Family Caregiver Support, Title Iii, Part E $718,472 Yes 0
14.228 Community Development Block Grants/state's Program and Non-Entitlement Grants in Hawaii $703,527 Yes 0
14.239 Home Investment Partnerships Program $660,000 Yes 0
84.181 Special Education-Grants for Infants and Families $527,809 Yes 0
16.320 Services for Trafficking Victims $514,541 Yes 0
20.237 Motor Carrier Safety Assistance High Priority Activities Grants and Cooperative Agreements $514,488 Yes 0
21.016 Equitable Sharing $501,846 Yes 0
20.507 Federal Transit Formula Grants $440,544 Yes 0
93.069 Public Health Emergency Preparedness $432,183 Yes 0
16.590 Grants to Encourage Arrest Policies and Enforcement of Protection Orders Program $382,677 Yes 0
16.922 Equitable Sharing Program $376,851 Yes 0
93.053 Nutrition Services Incentive Program $352,827 Yes 0
17.259 Wioa Youth Activities $324,566 Yes 0
17.258 Wioa Adult Program $324,188 Yes 0
93.090 Guardianship Assistance $281,876 Yes 0
14.251 Economic Development Initiative, Community Project Funding, and Miscellaneous Grants $265,101 Yes 0
93.674 John H. Chafee Foster Care Program for Successful Transition to Adulthood $245,257 Yes 0
16.741 Dna Backlog Reduction Program $234,883 Yes 0
93.243 Substance Abuse and Mental Health Services Projects of Regional and National Significance $225,419 Yes 0
20.600 State and Community Highway Safety $211,493 Yes 0
97.042 Emergency Management Performance Grants $202,359 Yes 0
20.205 Highway Planning and Construction $166,108 Yes 0
93.268 Immunization Cooperative Agreements $140,385 Yes 0
20.106 Airport Improvement Program, Infrastructure Investment and Jobs Act Programs, and Covid-19 Airports Programs $128,312 Yes 0
17.278 Wioa Dislocated Worker Formula Grants $126,274 Yes 0
16.745 Criminal and Juvenile Justice and Mental Health Collaboration Program $111,155 Yes 0
16.752 Economic, High-Tech, and Cyber Crime Prevention $107,029 Yes 0
66.456 National Estuary Program $102,199 Yes 0
93.354 Public Health Emergency Response: Cooperative Agreement for Emergency Response: Public Health Crisis Response $91,933 Yes 0
16.609 Project Safe Neighborhoods $86,542 Yes 0
84.425 Education Stabilization Fund $86,540 Yes 0
93.914 Hiv Emergency Relief Project Grants $73,351 Yes 0
93.071 Medicare Enrollment Assistance Program $72,680 Yes 0
16.040 Matthew Shepard and James Byrd, Jr. Hate Crimes Education, Investigation and Prosecution Program $71,179 Yes 0
97.036 Disaster Grants - Public Assistance (presidentially Declared Disasters) $66,928 Yes 0
16.575 Crime Victim Assistance $66,295 Yes 0
93.967 Centers for Disease Control and Prevention Collaboration with Academia to Strengthen Public Health $66,074 Yes 0
93.323 Epidemiology and Laboratory Capacity for Infectious Diseases (elc) $64,353 Yes 0
93.779 Centers for Medicare and Medicaid Services (cms) Research, Demonstrations and Evaluations $56,683 Yes 0
16.742 Paul Coverdell Forensic Sciences Improvement Grant Program $53,555 Yes 0
96.006 Supplemental Security Income $44,400 Yes 0
16.710 Public Safety Partnership and Community Policing Grants $42,313 Yes 0
93.043 Special Programs for the Aging, Title Iii, Part D, Disease Prevention and Health Promotion Services $36,162 Yes 0
93.994 Maternal and Child Health Services Block Grant to the States $35,793 Yes 0
16.738 Edward Byrne Memorial Justice Assistance Grant Program $33,728 Yes 0
20.219 Recreational Trails Program $23,921 Yes 0
93.U02 Mammography Inspection $23,152 Yes 0
16.735 Prea Program: Strategic Support for Prea Implementation $22,943 Yes 0
16.585 Treatment Court Discretionary Grant Program $21,244 Yes 0
97.052 Emergency Operations Center $20,227 Yes 0
97.106 Securing the Cities Program $15,612 Yes 0
93.103 Food and Drug Administration Research $12,253 Yes 0
16.036 Comprehensive Forensic Dna Analysis Grant Program $7,700 Yes 0
66.472 Beach Monitoring and Notification Program Implementation Grants $7,280 Yes 0
93.698 Elder Justice Act – Adult Protective Services $6,998 Yes 0
97.056 Port Security Grant Program $5,078 Yes 0
15.616 Clean Vessel Act $4,838 Yes 0
93.008 Medical Reserve Corps Small Grant Program $4,097 Yes 0
93.747 Elder Abuse Prevention Interventions Program $3,558 Yes 0
66.605 Performance Partnership Grants $3,155 Yes 0
20.616 National Priority Safety Programs $2,144 Yes 0
93.959 Block Grants for Prevention and Treatment of Substance Abuse $-13,564 Yes 0

Contacts

Name Title Type
CAAAWFCH3T41 Frank Bayer Auditee
6318536040 Heather Briggs Auditor
No contacts on file

Notes to SEFA

Suffolk County is a charter form of government governed by an elected 18-member County Legislature and administered by an elected County Executive. The accompanying financial statements present the government and its component units, entities for which the government is considered to be financially accountable. The Governmental Accounting Standards Board (GASB) has set forth criteria to be considered in determining financial accountability. These criteria include the County appointing a voting majority of an organization's governing body and (1) the ability of the governing body to impose its will on that organization or (2) the potential for the organization to provide specific financial benefits to or impose specific financial burden on the County. Blended component units, although legally separate entities, are in substance, part of the government's operations. Discretely presented component units are reported in a separate column in the government-wide financial statements to emphasize that they are legally separate from the government. BASIS OF ACCOUNTING OF BASIC FINANCIAL STATEMENTS The government-wide financial statements are reported using the economic resources measurement focus and the accrual basis of accounting, as are the proprietary fund and fiduciary fund financial statements (except that agency funds have no measurement focus). Revenues are recorded when earned and expenses are recorded when a liability is incurred, regardless of the timing of related cash flows. Property taxes are recognized as revenues in the year for which they are levied. Grants and similar items are recognized as revenue as soon as all eligibility requirements imposed by the provider have been met. Governmental fund financial statements are reported using the current financial resources measurement focus and the modified accrual basis of accounting. Revenues are recognized as soon as they are both measurable and available. Revenues are considered to be available when they are collectible within the current period or soon enough thereafter to pay liabilities of the current period. For the County, available is defined as expected to be received within sixty days of fiscal year-end except for expenditure-driven grant revenues, which are considered available if collected within one year of the fiscal year-end. Expenditures generally are recorded when a liability is incurred, as under accrual accounting. However, debt service expenditures, as well as expenditures related to compensated absences and claims and judgments, are recorded only when payment is due. Property taxes, sales and use tax, franchise taxes, licenses, and interest associated with the current fiscal period are all considered to be susceptible to accrual and so have been recognized as revenues of the current fiscal period. Only the portion of special assessments receivable due within the current fiscal period is considered to be susceptible to accrual as revenue of the current period. All other revenue items are considered to be measurable and available only when cash is received by the government. BASIS OF PRESENTATION The accompanying Schedule of Expenditures of Federal Awards (the SEFA) presents the activity of federal financial assistance programs administered by the County of Suffolk, New York (the County), a financial reporting entity as defined in Note 1 to the County's general purpose financial statements. All federal financial assistance passed through other government agencies is included in the SEFA, except those federal expenditures of Suffolk County Community College (the College), a component unit, as the College engaged other auditors to perform an audit in accordance with 2 CFR Part 200. BASIS OF ACCOUNTING The accompanying SEFA of the County are presented on the accrual basis of accounting except for Disaster Grants - Public Assistance (Presidentially Declared Disasters) (Assistance Listing No. 97.036). In accordance with 2 CFR Part 200 Appendix XI, expenditures of federal Disaster Grants (Assistance Listing No. 97.036) are reported on the SEFA when (1) FEMA has approved the non-Federal entity's Project Worksheet (PW) and (2) the non-Federal entity has incurred the eligible expenditures.
The County has not elected to use the 10% de minimis indirect cost rate.
The County is in receipt of federal financial assistance programs that did not result in cash receipts or disbursements, termed "non-monetary programs". During the year ended December 31, 2024, the County distributed $18,458,340 worth of WIC Food Checks and WIC Special Formula Food Instruments to eligible participants in the Special Supplemental Food Program for Women, Infants and Children, WIC (Assistance Listing No. 10.557). Additionally, the HOME Investment Partnership Grant (Assistance Listing No. 14.239) contains an outstanding loan balance of $1,110,000. Included in this balance is a $660,000 loan made to Artspace in 2011 and a $450,000 loan to GGV Three Mile Harbor in 2024. These interest free loans, have a 30-year life, and continuing compliance requirements. Assistance Listing Number Program Name Beginning Balance at January 1, 2024 Interest Outstanding Balance at December 31, 2024 14.239 HOME Investment Partnership $660,000 $0 $660,000 14.239 HOME Investment Partnership $450,000 $0 $450,000
The regulations and guidelines governing the preparation of federal and state financial reports vary by state and federal agency and among programs administered by the same agency. Accordingly, the amounts reported in the federal and state financial reports do not necessarily agree with the amounts reported in the accompanying SEFA, which is prepared as explained above.
The Low-Income Home Energy Assistance Program (HEAP) total includes $20,992,166 in payments made by the NY Office of the State Comptroller on behalf of Suffolk DSS through the NYS Office of Temporary and Disability Assistance (Assistance Listing No. 93.568).
For the year ended December 31, 2024, amounts provided to subrecipients totaled $12,584,493 and are listed by program on the SEFA.
During the year ending December 31, 2024, the County maintained program income and recaptured funds as follows: In fiscal year 2024, the County generated and expended program income in the Federal Transit Formula Grant (Assistance Listing No. 20.507) totaling $440,544. Additionally, the Community Development Block and Entitlement Grant (Assistance Listing No. 14.218) maintained its program income balance of $23,800; however, this program did not generate nor expend any funds in 2024. Finally, the County maintained a balance of recaptured funds totaling $409,798, received additional recapture funds totaling $2,800, and expended recaptured funds totaling $355,198 for the HOME Investment Partnership Program (Assistance Listing No. 14.239). Recaptured fund expenditures include $14,000 to the Down Payment Assistance Program and $341,198 toward the 30-year loan to GGV Three Mile Harbor.
The following is a glossary of pass-through grantor acronyms which may be used in the SEFA: Acronym Agency HRI Health Research, Inc. NEHA National Environmental Health Association NYC POLICE New York City Police Department NYMTC New York Metropolitan Transit Council NYS DCJS New York State Division of Criminal Justice Services NYS DEC New York State Department of Environmental Conservation NYS DHSES New York State Division of Homeland Security & Emergency Services NYS DOH New York State Department of Health NYS DOH – OASAS New York State Department of Health – Office of Addiction Services & Supports NYS DOH – OMH New York State Department of Health – Office of Mental Health NYS DOL New York State Department of Labor NYS DOT New York State Department of Transportation NYS EFC New York State Environmental Facilities Corporation NYS GTSC New York State Governor’s Traffic Safety Committee NYS GTSC/DWI New York State Governor's Traffic Safety Committee / New York State STOP DWI Foundation NYS HCR NYS Homes & Community Renewal NYS HTFC New York State Housing Trust Fund Corporation (RHC Division) NYS OFA New York State Office for the Aging NYS OTDA New York State Office of Temporary and Disability Assistance NYS OVS New York State Office of Victim Services NYS PRHP NYS Office of Parks, Recreation and Historic Preservation NYS UCS New York State Unified Court System RGCC Rosamond and Gifford Charitable Corporation UWLI United Way of Long Island
The Schedule of Expenditures of Federal Awards includes prior period expenditures totaling $3,892,070. The prior period expenditures are as follows: Program Name Department Assistance Listing Number Amount Special Supplemental Nutrition (Food) Program for Women, Infants, and Children 2023 (WIC) HSV 10.557 $ 107 Community Development Block and Entitlement Grants CDV 14.218 115,644 COVID-19: Economic Development Initiative, Community Project Funding, and Miscellaneous Grants EDP 14.251 210,245 Grants to Encourage Arrest Policies and Enforcement of Protection Orders Program – Project DOVE PRO 16.590 91,809 Edward Byrne Memorial Justice Assistance Grant Program - Edward Byrne JAG 22 PRO 16.738 9,308 Paul Coverdell Forensic Sciences Improvement Grant Program MED 16.742 3,870 Equitable Sharing Program - Federal Forfeiture Funds POL 16.922 2,258 Equitable Sharing Program - Federal Forfeiture Funds DIS 16.922 25,000 WIOA Cluster LAB 17.258, 17.259, & 17.278 420,223 Recreational Trails Program EDP 20.219 3,736 Highway Planning and Construction DPW 20.205 230,667 National Priority Safety Programs – NYS Highway Safety Program 2023-2024 MED 20.616 8,972 Equitable Sharing - Federal Forfeiture Funds SHF 21.016 5,000 Equitable Sharing - Federal Forfeiture Funds DIS 21.016 38,580 COVID-19: Coronavirus State and Local Fiscal Recovery Funds (SLFRF) EXE 21.027 2,686,894 National Estuary Program FY 21 HSV 66.456 14 Maternal and Child Health Services Block Grant to the States - Childhood Lead Poisoning Prevention 23 HSV 93.994 2,185 Maternal and Child Health Services Block Grant to the States - Children with Special Health Care Needs 23 HSV 93.994 36,903 Homeland Security Grant Program - Urban Area Security Initiative 2020 (UASI) MED 97.067 230 Homeland Security Grant Program - Urban Area Security Initiative 2020 (UASI) FRE 97.067 62 Homeland Security Grant Program - Urban Area Security Initiative 2021 (UASI) MED 97.067 248 Homeland Security Grant Program - State Homeland Security Program 2021 (SHSP) FRE 97.067 9 Homeland Security Grant Program - State Homeland Security Program 2023 (SHSP) FRE 97.067 106

Finding Details

Reference Number: 2024-002 Prior Year Finding: No Federal Agency: U.S. Department of Health and Human Services Federal Program: Child Support Services Assistance Listing Number: 93.563 Pass-Through Entity: New York State Office of Temporary and Disability Assistance Identifying Number and Period: 18000 (2024) Compliance Requirement: Allowable Costs/Cost Principles – Time and Effort Reporting Type of Finding: Significant Deficiency in Internal Control Over Compliance, Other Matters Criteria or specific requirement: Compliance: 2 CFR Section 200.430 (8)(i) Standards for Documentation of Personnel Expenses states that: Charges to Federal awards for salaries and wages must be based on records that accurately reflect the work performed. These records must: (i) Be supported by a system of internal control that provides reasonable assurance that the charges are accurate, allowable, and properly allocated; (ii) Be incorporated into the official records of the recipient or subrecipient; (iii) Reasonably reflect the total activity for which the employee is compensated by the recipient or subrecipient, not exceeding 100 percent of compensated activities (for IHEs, this is the IBS); (iv) Encompass federally-assisted and all other activities compensated by the recipient or subrecipient on an integrated basis but may include the use of subsidiary records as defined in the recipient's or subrecipient's written policy; (v) Comply with the established accounting policies and procedures of the recipient or subrecipient (See paragraph (i)(1)(ii) of this section for treatment of incidental work for IHEs.); and (vi) Support the distribution of the employee's salary or wages among specific activities or cost objectives if the employee works on more than one Federal award; a Federal award and non-Federal award; an indirect cost activity and a direct cost activity; two or more indirect activities allocated using different allocation bases; or an unallowable activity and a direct or indirect cost activity. Control: Per 2 CFR section 200.303(a), a non-Federal entity must: Establish and maintain effective internal control over the Federal award that provides reasonable assurance that the non-Federal entity is managing the Federal award in compliance with Federal statutes, regulations, and the terms and conditions of the Federal award. These internal controls should comply with guidance in “Standards for Internal Control in the Federal Government” issued by the Comptroller General of the United States or the “Internal Control Integrated Framework”, issued by the Committee of Sponsoring Organizations of the Treadway Commission (COSO). Condition: Employee time and effort charged to the program did not agree with supporting documentation. Context: For two of thirty-three employee timesheets selected for testing, the amount claimed for employee time and effort did not agree with supporting documentation. Employee payroll data was entered incorrectly when the claim was compiled, resulting in an underclaim of the amount charged to the program. Cause: The County’s internal controls were not sufficient to ensure that employee time and effort charged to the program was accurate and tied to supporting documentation. Effect: The County underclaimed employee time and effort expended on the program. Questioned costs: None. The error resulted in an underclaim. Recommendation: The County should enhance its procedures and internal controls to ensure that employee time and effort charged to the program is accurate and agrees with supporting documentation. Views of Responsible Officials: There is no disagreement with the audit finding.
Reference Number: 2024-001 Prior Year Finding: No Federal Agency: U.S. Department of Health and Human Services Federal Program: Medicaid Cluster Assistance Listing Number: 93.778 Pass-Through Entity: New York State Department of Health Identifying Number and Period: DOH01-C37308GG-3450000 (7/1/2022 – 6/30/2027) Compliance Requirement: Eligibility Type of Finding: Significant Deficiency in Internal Control Over Compliance, Other Matters Criteria or specific requirement: Compliance: The financial and nonfinancial factors of eligibility must be verified per federal requirements at 42 CFR 435.948 through 435.956 and state requirements (as documented in the state plan, verification plan, and eligibility manual). The County must ensure that only eligible participants receive services under the program. Control: Per 2 CFR section 200.303(a), a non-Federal entity must: Establish and maintain effective internal control over the Federal award that provides reasonable assurance that the non-Federal entity is managing the Federal award in compliance with Federal statutes, regulations, and the terms and conditions of the Federal award. These internal controls should comply with guidance in “Standards for Internal Control in the Federal Government” issued by the Comptroller General of the United States or the “Internal Control Integrated Framework”, issued by the Committee of Sponsoring Organizations of the Treadway Commission (COSO). Condition: The County did not maintain adequate documentation of program participant eligibility, nor did it ensure that non-long-term care program participants were properly classified. Context: Sixty participants were selected for testing and the following exceptions were noted: • For five of sixty participants selected for testing, the County was unable to provide documentation that a program supervisor had approved the application. • For one of sixty participants selected for testing, the County was unable to provide a signed participant application. • For one of sixty participants selected for testing, upon reapplication and further documentation, a long-term care case was determined to be non-long-term care, but the County did not make this change and the participant was misclassified. Cause: The County’s procedures were not sufficient to ensure it properly classified program participants nor that eligibility documentation of program participant eligibility was maintained. Effect: Services may have been provided to an ineligible participant. Questioned costs: Undetermined. Recommendation: The County should enhance its procedures and internal controls to ensure it maintains documentation of participant eligibility. It should also enhance procedures and internal controls to ensure participants are correctly classified as long-term care versus non-long-term care. Views of Responsible Officials: There is no disagreement with the audit finding.
Reference Number: 2024-001 Prior Year Finding: No Federal Agency: U.S. Department of Health and Human Services Federal Program: Medicaid Cluster Assistance Listing Number: 93.778 Pass-Through Entity: New York State Department of Health Identifying Number and Period: DOH01-C37308GG-3450000 (7/1/2022 – 6/30/2027) Compliance Requirement: Eligibility Type of Finding: Significant Deficiency in Internal Control Over Compliance, Other Matters Criteria or specific requirement: Compliance: The financial and nonfinancial factors of eligibility must be verified per federal requirements at 42 CFR 435.948 through 435.956 and state requirements (as documented in the state plan, verification plan, and eligibility manual). The County must ensure that only eligible participants receive services under the program. Control: Per 2 CFR section 200.303(a), a non-Federal entity must: Establish and maintain effective internal control over the Federal award that provides reasonable assurance that the non-Federal entity is managing the Federal award in compliance with Federal statutes, regulations, and the terms and conditions of the Federal award. These internal controls should comply with guidance in “Standards for Internal Control in the Federal Government” issued by the Comptroller General of the United States or the “Internal Control Integrated Framework”, issued by the Committee of Sponsoring Organizations of the Treadway Commission (COSO). Condition: The County did not maintain adequate documentation of program participant eligibility, nor did it ensure that non-long-term care program participants were properly classified. Context: Sixty participants were selected for testing and the following exceptions were noted: • For five of sixty participants selected for testing, the County was unable to provide documentation that a program supervisor had approved the application. • For one of sixty participants selected for testing, the County was unable to provide a signed participant application. • For one of sixty participants selected for testing, upon reapplication and further documentation, a long-term care case was determined to be non-long-term care, but the County did not make this change and the participant was misclassified. Cause: The County’s procedures were not sufficient to ensure it properly classified program participants nor that eligibility documentation of program participant eligibility was maintained. Effect: Services may have been provided to an ineligible participant. Questioned costs: Undetermined. Recommendation: The County should enhance its procedures and internal controls to ensure it maintains documentation of participant eligibility. It should also enhance procedures and internal controls to ensure participants are correctly classified as long-term care versus non-long-term care. Views of Responsible Officials: There is no disagreement with the audit finding.
Reference Number: 2024-001 Prior Year Finding: No Federal Agency: U.S. Department of Health and Human Services Federal Program: Medicaid Cluster Assistance Listing Number: 93.778 Pass-Through Entity: New York State Department of Health Identifying Number and Period: DOH01-C37308GG-3450000 (7/1/2022 – 6/30/2027) Compliance Requirement: Eligibility Type of Finding: Significant Deficiency in Internal Control Over Compliance, Other Matters Criteria or specific requirement: Compliance: The financial and nonfinancial factors of eligibility must be verified per federal requirements at 42 CFR 435.948 through 435.956 and state requirements (as documented in the state plan, verification plan, and eligibility manual). The County must ensure that only eligible participants receive services under the program. Control: Per 2 CFR section 200.303(a), a non-Federal entity must: Establish and maintain effective internal control over the Federal award that provides reasonable assurance that the non-Federal entity is managing the Federal award in compliance with Federal statutes, regulations, and the terms and conditions of the Federal award. These internal controls should comply with guidance in “Standards for Internal Control in the Federal Government” issued by the Comptroller General of the United States or the “Internal Control Integrated Framework”, issued by the Committee of Sponsoring Organizations of the Treadway Commission (COSO). Condition: The County did not maintain adequate documentation of program participant eligibility, nor did it ensure that non-long-term care program participants were properly classified. Context: Sixty participants were selected for testing and the following exceptions were noted: • For five of sixty participants selected for testing, the County was unable to provide documentation that a program supervisor had approved the application. • For one of sixty participants selected for testing, the County was unable to provide a signed participant application. • For one of sixty participants selected for testing, upon reapplication and further documentation, a long-term care case was determined to be non-long-term care, but the County did not make this change and the participant was misclassified. Cause: The County’s procedures were not sufficient to ensure it properly classified program participants nor that eligibility documentation of program participant eligibility was maintained. Effect: Services may have been provided to an ineligible participant. Questioned costs: Undetermined. Recommendation: The County should enhance its procedures and internal controls to ensure it maintains documentation of participant eligibility. It should also enhance procedures and internal controls to ensure participants are correctly classified as long-term care versus non-long-term care. Views of Responsible Officials: There is no disagreement with the audit finding.
Reference Number: 2024-001 Prior Year Finding: No Federal Agency: U.S. Department of Health and Human Services Federal Program: Medicaid Cluster Assistance Listing Number: 93.778 Pass-Through Entity: New York State Department of Health Identifying Number and Period: DOH01-C37308GG-3450000 (7/1/2022 – 6/30/2027) Compliance Requirement: Eligibility Type of Finding: Significant Deficiency in Internal Control Over Compliance, Other Matters Criteria or specific requirement: Compliance: The financial and nonfinancial factors of eligibility must be verified per federal requirements at 42 CFR 435.948 through 435.956 and state requirements (as documented in the state plan, verification plan, and eligibility manual). The County must ensure that only eligible participants receive services under the program. Control: Per 2 CFR section 200.303(a), a non-Federal entity must: Establish and maintain effective internal control over the Federal award that provides reasonable assurance that the non-Federal entity is managing the Federal award in compliance with Federal statutes, regulations, and the terms and conditions of the Federal award. These internal controls should comply with guidance in “Standards for Internal Control in the Federal Government” issued by the Comptroller General of the United States or the “Internal Control Integrated Framework”, issued by the Committee of Sponsoring Organizations of the Treadway Commission (COSO). Condition: The County did not maintain adequate documentation of program participant eligibility, nor did it ensure that non-long-term care program participants were properly classified. Context: Sixty participants were selected for testing and the following exceptions were noted: • For five of sixty participants selected for testing, the County was unable to provide documentation that a program supervisor had approved the application. • For one of sixty participants selected for testing, the County was unable to provide a signed participant application. • For one of sixty participants selected for testing, upon reapplication and further documentation, a long-term care case was determined to be non-long-term care, but the County did not make this change and the participant was misclassified. Cause: The County’s procedures were not sufficient to ensure it properly classified program participants nor that eligibility documentation of program participant eligibility was maintained. Effect: Services may have been provided to an ineligible participant. Questioned costs: Undetermined. Recommendation: The County should enhance its procedures and internal controls to ensure it maintains documentation of participant eligibility. It should also enhance procedures and internal controls to ensure participants are correctly classified as long-term care versus non-long-term care. Views of Responsible Officials: There is no disagreement with the audit finding.
Reference Number: 2024-001 Prior Year Finding: No Federal Agency: U.S. Department of Health and Human Services Federal Program: Medicaid Cluster Assistance Listing Number: 93.778 Pass-Through Entity: New York State Department of Health Identifying Number and Period: DOH01-C37308GG-3450000 (7/1/2022 – 6/30/2027) Compliance Requirement: Eligibility Type of Finding: Significant Deficiency in Internal Control Over Compliance, Other Matters Criteria or specific requirement: Compliance: The financial and nonfinancial factors of eligibility must be verified per federal requirements at 42 CFR 435.948 through 435.956 and state requirements (as documented in the state plan, verification plan, and eligibility manual). The County must ensure that only eligible participants receive services under the program. Control: Per 2 CFR section 200.303(a), a non-Federal entity must: Establish and maintain effective internal control over the Federal award that provides reasonable assurance that the non-Federal entity is managing the Federal award in compliance with Federal statutes, regulations, and the terms and conditions of the Federal award. These internal controls should comply with guidance in “Standards for Internal Control in the Federal Government” issued by the Comptroller General of the United States or the “Internal Control Integrated Framework”, issued by the Committee of Sponsoring Organizations of the Treadway Commission (COSO). Condition: The County did not maintain adequate documentation of program participant eligibility, nor did it ensure that non-long-term care program participants were properly classified. Context: Sixty participants were selected for testing and the following exceptions were noted: • For five of sixty participants selected for testing, the County was unable to provide documentation that a program supervisor had approved the application. • For one of sixty participants selected for testing, the County was unable to provide a signed participant application. • For one of sixty participants selected for testing, upon reapplication and further documentation, a long-term care case was determined to be non-long-term care, but the County did not make this change and the participant was misclassified. Cause: The County’s procedures were not sufficient to ensure it properly classified program participants nor that eligibility documentation of program participant eligibility was maintained. Effect: Services may have been provided to an ineligible participant. Questioned costs: Undetermined. Recommendation: The County should enhance its procedures and internal controls to ensure it maintains documentation of participant eligibility. It should also enhance procedures and internal controls to ensure participants are correctly classified as long-term care versus non-long-term care. Views of Responsible Officials: There is no disagreement with the audit finding.