Audit 380315

2025-001 – ALN 93.958 – Block Grant for Community Mental Health Services; ALN 93.959 – Block Grant for Prevention and Treatment of Substance Abuse; ALN 93.788 Opioid STR Program: Activities Allowed/Allowable Costs - Completion of Financial Assessment Form – (Repeat Comment) Criteria: The Block Grant for Community Mental Health Services and the Block Grant for Prevention and Treatment of Substance Abuse provide for a set of documentation requirements for clients in the covered programs, including the completion of a Financial Assessment Form (FAF) to document financial eligibility over allowable costs. Based on the client’s income and number of dependents, this form is used to determine a “discount class”, and calculate a sliding scale discount percentage and/or dollar amount of SMA’s fees that the client would be responsible for paying. This form is required to be completed when clients are discharged after being provided mental health services. FAF are to be updated yearly for patients with active billable services, noting all service dates with a billed service should fall within one year of the FAF completion date. Condition: 3 of the 60 clients tested on the Block Grant for Community Mental Health Services did not have the discount fee that was used properly calculated and documented on their Financial Assessment Form. Additionally, 4 of the 60 clients tested on the Block Grant for Community Mental Health Services had service dates that did not fall within one year after the FAF completion date. 1 of the 60 clients tested on the Block Grant for Prevention and Treatment of Substance Abuse and 1 of 40 clients tested on the Opioid STR Program did not have a completed FAF. 1 of the 60 clients tested on the Block Grant for Prevention and Treatment of Substance Abuse had a FAF missing the client signature. Cause: The requirement to perform these control elements were not followed by the case managers. Effect: The Financial Assessment Forms that were not properly completed or not completed within the required timeframe could result in noncompliance with the grant agreement or noncompliance with established controls. Recommendation: We recommend that the process be updated to ensure all Financial Assessment Forms required be completed fully and accurately for all patients within one year of service, and that additional controls be put in place to ensure the discount rate applied is documented and proper.