Audit 412000

Federal Agency: U.S. Department of Health and Human Services Federal Program Name: Medical Assistance (Medicaid Cluster) Assistance Listing Number: 93.778 Pass-Through Agency: Minnesota Department of Human Services, Minnesota Department of Health Federal Award Identification and Pass-Through Numbers: 2505MN5ADM, 2505MN5MAP Award Period: January 1, 2025 – December 31, 2025 Compliance Requirement: Eligibility Type of Finding: Significant Deficiency in Internal Control over Compliance and Other Matter Criteria or Specific Requirements: Uniform Guidance requires the County to ensure compliance over eligibility by having the proper documentation of income, citizenship, redeterminations, and social security numbers. Condition and Context: During our testing of compliance over eligibility, we noted two of 60 case files tested did not have proper documentation in the casefile. The sample sizes were based on guidance from chapter 11 of the AICPA Audit Guide, Government Auditing Standards and Single Audits. Questioned Costs: None noted Cause: Lack of oversight by management. 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 the County implement procedures to ensure proper documentation is maintained in the casefiles and that it matches the information input into the eligibility system. Views of Responsible Officials: There is no disagreement with the audit finding.

Federal Agency: U.S. Department of Health and Human Services Federal Program Name: Medical Assistance (Medicaid Cluster) Assistance Listing Number: 93.778 Pass-Through Agency: Minnesota Department of Human Services, Minnesota Department of Health Federal Award Identification and Pass-Through Numbers: 2505MN5ADM, 2505MN5MAP Award Period: January 1, 2025 – December 31, 2025 Compliance Requirement: Allowable Costs, Allowable Activities Type of Finding: Significant Deficiency in Internal Control over Compliance and Other Matter Criteria or Specific Requirements: Uniform Guidance requires the County to charge salaries and wages based on records that accurately reflect the work performed by participating workers related to income maintenance, social services, and local collaborative public health activities on the RMS listings. Condition and Context: During our testing of compliance of the social services time study listings, two of two quarterly reports had an individual who was not included on the listing but had wages allocated to the account codes used on the listings. The sample sizes were based on guidance from chapter 11 of the AICPA Audit Guide, Government Auditing Standards and Single Audits. Questioned Costs: None noted Cause: Lack of oversight by management. Effect: There is minimal effect on the programs. Due to the funding structure, the random moment studies are only used to determine the allocation percentages to the various federal programs and not to determine the total amount of the reimbursement. Repeat Finding: No. Recommendation: We recommend the County implement procedures to ensure appropriate individuals are included in the account codes used for reporting and on the random moment study listings. Views of Responsible Officials: There is no disagreement with the audit finding.