Audit 47801

FY End
2022-06-30
Total Expended
$59.54M
Findings
24
Programs
34
Organization: Durham County (NC)
Year: 2022 Accepted: 2022-12-21

Organization Exclusion Status:

Checking exclusion status...

Findings

ID Ref Severity Repeat Requirement
51385 2022-002 Significant Deficiency - E
51386 2022-003 Significant Deficiency - E
51387 2022-003 Significant Deficiency - E
51388 2022-003 Significant Deficiency - E
51389 2022-003 Significant Deficiency - E
51390 2022-003 Significant Deficiency - E
51391 2022-001 Significant Deficiency Yes E
51392 2022-001 Significant Deficiency Yes E
51393 2022-001 Significant Deficiency Yes E
51394 2022-001 Significant Deficiency Yes E
51395 2022-001 Significant Deficiency Yes E
51396 2022-002 Significant Deficiency - E
627827 2022-002 Significant Deficiency - E
627828 2022-003 Significant Deficiency - E
627829 2022-003 Significant Deficiency - E
627830 2022-003 Significant Deficiency - E
627831 2022-003 Significant Deficiency - E
627832 2022-003 Significant Deficiency - E
627833 2022-001 Significant Deficiency Yes E
627834 2022-001 Significant Deficiency Yes E
627835 2022-001 Significant Deficiency Yes E
627836 2022-001 Significant Deficiency Yes E
627837 2022-001 Significant Deficiency Yes E
627838 2022-002 Significant Deficiency - E

Programs

ALN Program Spent Major Findings
21.023 Emergency Rental Assistance Program $20.71M Yes 0
93.563 Child Support Enforcement $4.20M - 0
10.561 State Administrative Matching Grants for the Supplemental Nutrition Assistance Program $3.62M Yes 1
93.323 Epidemiology and Laboratory Capacity for Infectious Diseases (elc) $2.40M - 0
93.658 Foster Care_title IV-E $1.66M Yes 1
93.045 Special Programs for the Aging_title Iii, Part C_nutrition Services $963,014 - 0
14.228 Community Development Block Grants/state's Program and Non-Entitlement Grants in Hawaii $870,331 - 0
93.596 Child Care Mandatory and Matching Funds of the Child Care and Development Fund $814,487 - 0
10.551 Supplemental Nutrition Assistance Program $788,029 Yes 1
93.568 Low-Income Home Energy Assistance $594,005 Yes 0
93.778 Medical Assistance Program $478,748 Yes 1
93.940 Hiv Prevention Activities_health Department Based $441,242 - 0
93.674 John H. Chafee Foster Care Program for Successful Transition to Adulthood $430,429 - 0
93.137 Community Programs to Improve Minority Health Grant Program $292,091 - 0
93.767 Children's Health Insurance Program $265,575 - 0
93.217 Family Planning_services $215,027 Yes 0
93.566 Refugee and Entrant Assistance_state Administered Programs $123,719 - 0
93.116 Project Grants and Cooperative Agreements for Tuberculosis Control Programs $110,052 - 0
93.556 Promoting Safe and Stable Families $108,436 - 0
93.136 Injury Prevention and Control Research and State and Community Based Programs $107,233 - 0
14.241 Housing Opportunities for Persons with Aids $93,632 - 0
93.305 National State Based Tobacco Control Programs $88,274 - 0
16.738 Edward Byrne Memorial Justice Assistance Grant Program $82,187 - 0
93.069 Public Health Emergency Preparedness $80,000 - 0
93.645 Stephanie Tubbs Jones Child Welfare Services Program $79,710 - 0
93.268 Immunization Cooperative Agreements $64,230 - 0
93.558 Temporary Assistance for Needy Families $38,010 Yes 0
93.667 Social Services Block Grant $32,051 - 0
16.922 Equitable Sharing Program $27,964 - 0
93.576 Refugee and Entrant Assistance_discretionary Grants $27,312 - 0
93.994 Maternal and Child Health Services Block Grant to the States $25,270 - 0
93.919 Cooperative Agreements for State-Based Comprehensive Breast and Cervical Cancer Early Detection Programs $17,550 - 0
20.600 State and Community Highway Safety $15,304 - 0
93.659 Adoption Assistance $3,560 Yes 1

Contacts

Name Title Type
LJ5BA6U2HLM7 Crystally Wright Auditee
9195600049 Scott Duda Auditor
No contacts on file

Notes to SEFA

Title: Note 1-Basis of presentation Accounting Policies: Basis of Accounting - Expenditures reported on the Schedule are presented using the modified accrual basis of accounting method. This method is consistent with the method used to prepare the County's basic financial statements. Cost Principles - The cost principles applicable to the expenditures on the Schedule include Title 2 U.S. Code of Federal Regulations Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards. These principles identify certain types of expenditures that are not allowable or are limited as to reimbursement. De Minimis Rate Used: N Rate Explanation: Indirect Cost Rate - The County has not elected to use the 10% de minimis indirect cost rate as allowed under the Uniform Guidance. The schedule of expenditures and federal and state awards (the "schedule") presents the activities of all federal and state financial award programs of Durham County, North Carolina (i.e., primary government only) for the year ended June 30, 2022. The Durham County, North Carolina (the "County") reporting entity is defined in Note 1 to the County's basic financial statements. All federal and state awards received directly from federal and state agencies as well as federal and state financial awards passed through other government agencies are included in the Schedule. The information in the 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 ("Uniform Guidance") for Federal Awards and the State Single Audit Implementation Act. Because the schedule presents only a selected portion of the operations of Durham County, it is not intended to present the financial position, changes in net assets or cash flows of Durham County.
Title: Note 3-Cluster of programs Accounting Policies: Basis of Accounting - Expenditures reported on the Schedule are presented using the modified accrual basis of accounting method. This method is consistent with the method used to prepare the County's basic financial statements. Cost Principles - The cost principles applicable to the expenditures on the Schedule include Title 2 U.S. Code of Federal Regulations Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards. These principles identify certain types of expenditures that are not allowable or are limited as to reimbursement. De Minimis Rate Used: N Rate Explanation: Indirect Cost Rate - The County has not elected to use the 10% de minimis indirect cost rate as allowed under the Uniform Guidance. The following are clustered by the N.C. Department of Health and Human Services and are treated separately for state audit requirement purposes: See Notes to the SEFA for Chart/Table. Special Children Adoption Fund Cluster 93.558 and 93.556 Refugee and Entrant Assistance Cluster 93.566 and 93.576 CCDF/Subsidized Child Care Cluster 93.575, 93.596, 93.658, and 93.558 Foster Care and Adoption Programs Cluster 93.658 and 93.659 HIV Cluster 93.940 and 93.944
Title: Note 4-Non-cash awards Accounting Policies: Basis of Accounting - Expenditures reported on the Schedule are presented using the modified accrual basis of accounting method. This method is consistent with the method used to prepare the County's basic financial statements. Cost Principles - The cost principles applicable to the expenditures on the Schedule include Title 2 U.S. Code of Federal Regulations Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards. These principles identify certain types of expenditures that are not allowable or are limited as to reimbursement. De Minimis Rate Used: N Rate Explanation: Indirect Cost Rate - The County has not elected to use the 10% de minimis indirect cost rate as allowed under the Uniform Guidance. The County did not receive non-cash federal or non-cash state awards during the year ended June 30, 2022.
Title: Note 5-Contingencies Accounting Policies: Basis of Accounting - Expenditures reported on the Schedule are presented using the modified accrual basis of accounting method. This method is consistent with the method used to prepare the County's basic financial statements. Cost Principles - The cost principles applicable to the expenditures on the Schedule include Title 2 U.S. Code of Federal Regulations Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards. These principles identify certain types of expenditures that are not allowable or are limited as to reimbursement. De Minimis Rate Used: N Rate Explanation: Indirect Cost Rate - The County has not elected to use the 10% de minimis indirect cost rate as allowed under the Uniform Guidance. These programs are subject to financial and compliance audits by grantor agencies. The amount, if any, of expenditures that may be disallowed by the grantor agencies cannot be determined at this time, although the County expects such amounts, if any, to be immaterial.
Title: Note 6-Schedule of revenues, expenditures, and changes in fund balance Accounting Policies: Basis of Accounting - Expenditures reported on the Schedule are presented using the modified accrual basis of accounting method. This method is consistent with the method used to prepare the County's basic financial statements. Cost Principles - The cost principles applicable to the expenditures on the Schedule include Title 2 U.S. Code of Federal Regulations Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards. These principles identify certain types of expenditures that are not allowable or are limited as to reimbursement. De Minimis Rate Used: N Rate Explanation: Indirect Cost Rate - The County has not elected to use the 10% de minimis indirect cost rate as allowed under the Uniform Guidance. for the CDBG Program: See Notes to the SEFSA for Chart/Table.

Finding Details

Finding 2022-002 Federal Agency: U.S. Department of Agriculture Federal Program: Supplemental Nutrition Assistance Program (SNAP) Cluster ALN: #10.551 and #10.561 Compliance Requirement: Eligibility Type of Finding: Significant Deficiency in Internal Controls over Compliance, Nonmaterial Noncompliance Repeat Finding: No CRITERIA: Title 2 U.S. Code of Federal Regulations Section 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 County has established a Quality Assurance and Training ("QAT") unit that reviews all cases prepared by probationary employees during the mentoring and 100% QC phase of Family Economic Independence new-hire training. The unit also conducts random reviews of actions prepared by case workers (two per worker/month). The QAT unit completes quality assurance reviews using an automated QC tool that immediately sends review results to the worker and their supervisor. It is the County's policy that corrections be made by case workers within 10 days of the QAT unit's review and that the supervisors review the corrections within 30 days. During our testing of controls over eligibility, we sampled 40 case files that were reviewed by the Quality Assurance and Training unit during FY22 and noted the following: - 16 instances in which the County?s QAT unit found no corrective action necessary. - 6 instances in which the County?s QAT noted corrective actions were required and remediated within the time period specified by County policy. - 8 instances in which the County?s QAT unit noted corrective actions were required and not remediated within the time period specified by County policy ? case worker corrections not made within 10 days and not reviewed by supervisor within 30 days. CONTEXT: Out of 82 reviews performed by the Quality Assurance and Training (QAT) unit during FY22, we tested the timeliness of the corrections made to 40 files. The deficiencies above were noted in 8 of the 40 files tested. QUESTIONED COSTS: None noted. CAUSE: The County did not follow its policy on when remediation must occur. EFFECTS: Incomplete case files or case files that do not adhere to the County's policies or procedures increases the risk that the County could provide services to individuals not eligible to receive such services or that eligible individuals could be denied benefits. RECOMMENDATIONS: We recommend the County adhere to its policy to ensure cases selected for quality review are remediated in a timely manner. Best practices in this regard are within 30 days. VIEWS of RESPONSIBLE OFFICIALS: Management agrees with the finding.
Finding 2022-003 Federal Agency: U.S. Department of Health and Human Services Federal Program: Foster Care - Title IV-E; Adoption Assistance ALNs: #93.658 and #93.659 Compliance Requirement: Eligibility Type of Finding: Significant Deficiency in Internal Controls over Compliance, Nonmaterial Noncompliance Repeat Finding: No CRITERIA: Title 2 U.S. Code of Federal Regulations Section 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 has established a policy that all social workers are responsible for ensuring all requirements are met and that appropriate documentation is maintained. Supervisors are required to perform reviews to ensure case workers are following guidelines and are required to review and approve files prior to enrollment. During our testing of controls over eligibility, we sampled 25 case files for FY22 and noted the following: - 1 instance in which the case file contained no support documents, child aged out of system in FY22. - 1 instance in which the case file did not contain evidence to support that the NC Child Abuse and Neglect registry check was complete, nor the Responsible Individual?s List check. - 1 instance in which the Supervisor?s approval was not evident and the child?s residency as a U.S. Citizen or qualified alien could not be supported. CONTEXT: Out of 25 case files reviewed, we tested completeness of the support documents associated with the files. The deficiencies above were noted in 3 of the 25 files tested. QUESTIONED COSTS: None noted. CAUSE: The County did not follow its policy to ensure appropriate documentation is maintained. EFFECTS: Incomplete case files or case files that do not adhere to the County's policies or procedures increases the risk that the County could provide services to individuals not eligible to receive such services or that eligible individuals could be denied benefits. RECOMMENDATIONS: We recommend the County adhere to its policy to review cases and ensure appropriate documentation is maintained for all cases. VIEWS of RESPONSIBLE OFFICIALS: Management agrees with the finding.
Finding 2022-003 Federal Agency: U.S. Department of Health and Human Services Federal Program: Foster Care - Title IV-E; Adoption Assistance ALNs: #93.658 and #93.659 Compliance Requirement: Eligibility Type of Finding: Significant Deficiency in Internal Controls over Compliance, Nonmaterial Noncompliance Repeat Finding: No CRITERIA: Title 2 U.S. Code of Federal Regulations Section 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 has established a policy that all social workers are responsible for ensuring all requirements are met and that appropriate documentation is maintained. Supervisors are required to perform reviews to ensure case workers are following guidelines and are required to review and approve files prior to enrollment. During our testing of controls over eligibility, we sampled 25 case files for FY22 and noted the following: - 1 instance in which the case file contained no support documents, child aged out of system in FY22. - 1 instance in which the case file did not contain evidence to support that the NC Child Abuse and Neglect registry check was complete, nor the Responsible Individual?s List check. - 1 instance in which the Supervisor?s approval was not evident and the child?s residency as a U.S. Citizen or qualified alien could not be supported. CONTEXT: Out of 25 case files reviewed, we tested completeness of the support documents associated with the files. The deficiencies above were noted in 3 of the 25 files tested. QUESTIONED COSTS: None noted. CAUSE: The County did not follow its policy to ensure appropriate documentation is maintained. EFFECTS: Incomplete case files or case files that do not adhere to the County's policies or procedures increases the risk that the County could provide services to individuals not eligible to receive such services or that eligible individuals could be denied benefits. RECOMMENDATIONS: We recommend the County adhere to its policy to review cases and ensure appropriate documentation is maintained for all cases. VIEWS of RESPONSIBLE OFFICIALS: Management agrees with the finding.
Finding 2022-003 Federal Agency: U.S. Department of Health and Human Services Federal Program: Foster Care - Title IV-E; Adoption Assistance ALNs: #93.658 and #93.659 Compliance Requirement: Eligibility Type of Finding: Significant Deficiency in Internal Controls over Compliance, Nonmaterial Noncompliance Repeat Finding: No CRITERIA: Title 2 U.S. Code of Federal Regulations Section 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 has established a policy that all social workers are responsible for ensuring all requirements are met and that appropriate documentation is maintained. Supervisors are required to perform reviews to ensure case workers are following guidelines and are required to review and approve files prior to enrollment. During our testing of controls over eligibility, we sampled 25 case files for FY22 and noted the following: - 1 instance in which the case file contained no support documents, child aged out of system in FY22. - 1 instance in which the case file did not contain evidence to support that the NC Child Abuse and Neglect registry check was complete, nor the Responsible Individual?s List check. - 1 instance in which the Supervisor?s approval was not evident and the child?s residency as a U.S. Citizen or qualified alien could not be supported. CONTEXT: Out of 25 case files reviewed, we tested completeness of the support documents associated with the files. The deficiencies above were noted in 3 of the 25 files tested. QUESTIONED COSTS: None noted. CAUSE: The County did not follow its policy to ensure appropriate documentation is maintained. EFFECTS: Incomplete case files or case files that do not adhere to the County's policies or procedures increases the risk that the County could provide services to individuals not eligible to receive such services or that eligible individuals could be denied benefits. RECOMMENDATIONS: We recommend the County adhere to its policy to review cases and ensure appropriate documentation is maintained for all cases. VIEWS of RESPONSIBLE OFFICIALS: Management agrees with the finding.
Finding 2022-003 Federal Agency: U.S. Department of Health and Human Services Federal Program: Foster Care - Title IV-E; Adoption Assistance ALNs: #93.658 and #93.659 Compliance Requirement: Eligibility Type of Finding: Significant Deficiency in Internal Controls over Compliance, Nonmaterial Noncompliance Repeat Finding: No CRITERIA: Title 2 U.S. Code of Federal Regulations Section 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 has established a policy that all social workers are responsible for ensuring all requirements are met and that appropriate documentation is maintained. Supervisors are required to perform reviews to ensure case workers are following guidelines and are required to review and approve files prior to enrollment. During our testing of controls over eligibility, we sampled 25 case files for FY22 and noted the following: - 1 instance in which the case file contained no support documents, child aged out of system in FY22. - 1 instance in which the case file did not contain evidence to support that the NC Child Abuse and Neglect registry check was complete, nor the Responsible Individual?s List check. - 1 instance in which the Supervisor?s approval was not evident and the child?s residency as a U.S. Citizen or qualified alien could not be supported. CONTEXT: Out of 25 case files reviewed, we tested completeness of the support documents associated with the files. The deficiencies above were noted in 3 of the 25 files tested. QUESTIONED COSTS: None noted. CAUSE: The County did not follow its policy to ensure appropriate documentation is maintained. EFFECTS: Incomplete case files or case files that do not adhere to the County's policies or procedures increases the risk that the County could provide services to individuals not eligible to receive such services or that eligible individuals could be denied benefits. RECOMMENDATIONS: We recommend the County adhere to its policy to review cases and ensure appropriate documentation is maintained for all cases. VIEWS of RESPONSIBLE OFFICIALS: Management agrees with the finding.
Finding 2022-003 Federal Agency: U.S. Department of Health and Human Services Federal Program: Foster Care - Title IV-E; Adoption Assistance ALNs: #93.658 and #93.659 Compliance Requirement: Eligibility Type of Finding: Significant Deficiency in Internal Controls over Compliance, Nonmaterial Noncompliance Repeat Finding: No CRITERIA: Title 2 U.S. Code of Federal Regulations Section 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 has established a policy that all social workers are responsible for ensuring all requirements are met and that appropriate documentation is maintained. Supervisors are required to perform reviews to ensure case workers are following guidelines and are required to review and approve files prior to enrollment. During our testing of controls over eligibility, we sampled 25 case files for FY22 and noted the following: - 1 instance in which the case file contained no support documents, child aged out of system in FY22. - 1 instance in which the case file did not contain evidence to support that the NC Child Abuse and Neglect registry check was complete, nor the Responsible Individual?s List check. - 1 instance in which the Supervisor?s approval was not evident and the child?s residency as a U.S. Citizen or qualified alien could not be supported. CONTEXT: Out of 25 case files reviewed, we tested completeness of the support documents associated with the files. The deficiencies above were noted in 3 of the 25 files tested. QUESTIONED COSTS: None noted. CAUSE: The County did not follow its policy to ensure appropriate documentation is maintained. EFFECTS: Incomplete case files or case files that do not adhere to the County's policies or procedures increases the risk that the County could provide services to individuals not eligible to receive such services or that eligible individuals could be denied benefits. RECOMMENDATIONS: We recommend the County adhere to its policy to review cases and ensure appropriate documentation is maintained for all cases. VIEWS of RESPONSIBLE OFFICIALS: Management agrees with the finding.
Finding 2022-001 Federal Agency: U.S. Department of Health and Human Services Federal Program: Medical Assistance Program (Medicaid; Title XIX) ALN: #93.778 Compliance Requirement: Eligibility Type of Finding: Significant Deficiency in Internal Controls over Compliance, Nonmaterial Noncompliance Repeat Finding: Yes - 2021-001, 2020-001 CRITERIA: Title 2 U.S. Code of Federal Regulations Section 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 County maintains the computer system which is used to support the eligibility determination process. The Quality Assurance and Training ("QAT") unit reviews three randomly generated cases for each social worker per month. The selected cases are reviewed by the QAT team and notes are made in the quality control system to document any necessary corrections. The system requires the QAT team to enter a review date and a due date. The social worker and manager are notified of the selected case files that require correction. Once the social workers make their corrections, the supervisors review the corrections. It is the County's policy that the social workers make the corrections within 10 days of the QAT unit's review, and the supervisors confirm the corrections within 30 days of the QAT review. During our testing of controls over Eligibility, we sampled 60 case file reviews that were reviewed by the QAT unit during FY 2022 and noted the following: - 20 instances in which the QAT unit found no corrective action necessary. - 28 instances in which the QAT unit noted corrective actions were required and these were remediated within the time period specified by County policy. - 8 instances in which the County?s QAT unit noted corrective actions were required and these were remediated, but not within the time period specified by County policy ? corrections were made and reviewed more than 30 days after the QAT unit?s review ? specifically 33, 33, 35, 36, 42, 56, 61, and 147 days later. - 4 instances in which the County?s QAT unit noted corrective actions were required and had not been remediated at of the time of the audit. CONTEXT: Out of 1,197 reviews performed by the Quality Assurance and Training (QAT) unit during FY22, we tested the timeliness of the corrections made to 60 files. The deficiencies above were noted in 12 of the 60 files tested. QUESTION COSTS: None noted. CAUSE: The County did not follow its policy on when corrective action must occur. EFFECTS: Incomplete case files or case files which do not adhere to the County's policies or procedures increases the risk that the County could provide services to individuals not eligible to receive such services or that individuals could be denied benefits for which they are eligible. RECOMMENDATIONS: We recommend the County adhere to the policies to ensure cases selected for quality review are remediated in a timely manner. Best practices in this regard are within 30 days. VIEWS of RESPONSIBLE OFFICIALS: Management agrees with the finding.
Finding 2022-001 Federal Agency: U.S. Department of Health and Human Services Federal Program: Medical Assistance Program (Medicaid; Title XIX) ALN: #93.778 Compliance Requirement: Eligibility Type of Finding: Significant Deficiency in Internal Controls over Compliance, Nonmaterial Noncompliance Repeat Finding: Yes - 2021-001, 2020-001 CRITERIA: Title 2 U.S. Code of Federal Regulations Section 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 County maintains the computer system which is used to support the eligibility determination process. The Quality Assurance and Training ("QAT") unit reviews three randomly generated cases for each social worker per month. The selected cases are reviewed by the QAT team and notes are made in the quality control system to document any necessary corrections. The system requires the QAT team to enter a review date and a due date. The social worker and manager are notified of the selected case files that require correction. Once the social workers make their corrections, the supervisors review the corrections. It is the County's policy that the social workers make the corrections within 10 days of the QAT unit's review, and the supervisors confirm the corrections within 30 days of the QAT review. During our testing of controls over Eligibility, we sampled 60 case file reviews that were reviewed by the QAT unit during FY 2022 and noted the following: - 20 instances in which the QAT unit found no corrective action necessary. - 28 instances in which the QAT unit noted corrective actions were required and these were remediated within the time period specified by County policy. - 8 instances in which the County?s QAT unit noted corrective actions were required and these were remediated, but not within the time period specified by County policy ? corrections were made and reviewed more than 30 days after the QAT unit?s review ? specifically 33, 33, 35, 36, 42, 56, 61, and 147 days later. - 4 instances in which the County?s QAT unit noted corrective actions were required and had not been remediated at of the time of the audit. CONTEXT: Out of 1,197 reviews performed by the Quality Assurance and Training (QAT) unit during FY22, we tested the timeliness of the corrections made to 60 files. The deficiencies above were noted in 12 of the 60 files tested. QUESTION COSTS: None noted. CAUSE: The County did not follow its policy on when corrective action must occur. EFFECTS: Incomplete case files or case files which do not adhere to the County's policies or procedures increases the risk that the County could provide services to individuals not eligible to receive such services or that individuals could be denied benefits for which they are eligible. RECOMMENDATIONS: We recommend the County adhere to the policies to ensure cases selected for quality review are remediated in a timely manner. Best practices in this regard are within 30 days. VIEWS of RESPONSIBLE OFFICIALS: Management agrees with the finding.
Finding 2022-001 Federal Agency: U.S. Department of Health and Human Services Federal Program: Medical Assistance Program (Medicaid; Title XIX) ALN: #93.778 Compliance Requirement: Eligibility Type of Finding: Significant Deficiency in Internal Controls over Compliance, Nonmaterial Noncompliance Repeat Finding: Yes - 2021-001, 2020-001 CRITERIA: Title 2 U.S. Code of Federal Regulations Section 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 County maintains the computer system which is used to support the eligibility determination process. The Quality Assurance and Training ("QAT") unit reviews three randomly generated cases for each social worker per month. The selected cases are reviewed by the QAT team and notes are made in the quality control system to document any necessary corrections. The system requires the QAT team to enter a review date and a due date. The social worker and manager are notified of the selected case files that require correction. Once the social workers make their corrections, the supervisors review the corrections. It is the County's policy that the social workers make the corrections within 10 days of the QAT unit's review, and the supervisors confirm the corrections within 30 days of the QAT review. During our testing of controls over Eligibility, we sampled 60 case file reviews that were reviewed by the QAT unit during FY 2022 and noted the following: - 20 instances in which the QAT unit found no corrective action necessary. - 28 instances in which the QAT unit noted corrective actions were required and these were remediated within the time period specified by County policy. - 8 instances in which the County?s QAT unit noted corrective actions were required and these were remediated, but not within the time period specified by County policy ? corrections were made and reviewed more than 30 days after the QAT unit?s review ? specifically 33, 33, 35, 36, 42, 56, 61, and 147 days later. - 4 instances in which the County?s QAT unit noted corrective actions were required and had not been remediated at of the time of the audit. CONTEXT: Out of 1,197 reviews performed by the Quality Assurance and Training (QAT) unit during FY22, we tested the timeliness of the corrections made to 60 files. The deficiencies above were noted in 12 of the 60 files tested. QUESTION COSTS: None noted. CAUSE: The County did not follow its policy on when corrective action must occur. EFFECTS: Incomplete case files or case files which do not adhere to the County's policies or procedures increases the risk that the County could provide services to individuals not eligible to receive such services or that individuals could be denied benefits for which they are eligible. RECOMMENDATIONS: We recommend the County adhere to the policies to ensure cases selected for quality review are remediated in a timely manner. Best practices in this regard are within 30 days. VIEWS of RESPONSIBLE OFFICIALS: Management agrees with the finding.
Finding 2022-001 Federal Agency: U.S. Department of Health and Human Services Federal Program: Medical Assistance Program (Medicaid; Title XIX) ALN: #93.778 Compliance Requirement: Eligibility Type of Finding: Significant Deficiency in Internal Controls over Compliance, Nonmaterial Noncompliance Repeat Finding: Yes - 2021-001, 2020-001 CRITERIA: Title 2 U.S. Code of Federal Regulations Section 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 County maintains the computer system which is used to support the eligibility determination process. The Quality Assurance and Training ("QAT") unit reviews three randomly generated cases for each social worker per month. The selected cases are reviewed by the QAT team and notes are made in the quality control system to document any necessary corrections. The system requires the QAT team to enter a review date and a due date. The social worker and manager are notified of the selected case files that require correction. Once the social workers make their corrections, the supervisors review the corrections. It is the County's policy that the social workers make the corrections within 10 days of the QAT unit's review, and the supervisors confirm the corrections within 30 days of the QAT review. During our testing of controls over Eligibility, we sampled 60 case file reviews that were reviewed by the QAT unit during FY 2022 and noted the following: - 20 instances in which the QAT unit found no corrective action necessary. - 28 instances in which the QAT unit noted corrective actions were required and these were remediated within the time period specified by County policy. - 8 instances in which the County?s QAT unit noted corrective actions were required and these were remediated, but not within the time period specified by County policy ? corrections were made and reviewed more than 30 days after the QAT unit?s review ? specifically 33, 33, 35, 36, 42, 56, 61, and 147 days later. - 4 instances in which the County?s QAT unit noted corrective actions were required and had not been remediated at of the time of the audit. CONTEXT: Out of 1,197 reviews performed by the Quality Assurance and Training (QAT) unit during FY22, we tested the timeliness of the corrections made to 60 files. The deficiencies above were noted in 12 of the 60 files tested. QUESTION COSTS: None noted. CAUSE: The County did not follow its policy on when corrective action must occur. EFFECTS: Incomplete case files or case files which do not adhere to the County's policies or procedures increases the risk that the County could provide services to individuals not eligible to receive such services or that individuals could be denied benefits for which they are eligible. RECOMMENDATIONS: We recommend the County adhere to the policies to ensure cases selected for quality review are remediated in a timely manner. Best practices in this regard are within 30 days. VIEWS of RESPONSIBLE OFFICIALS: Management agrees with the finding.
Finding 2022-001 Federal Agency: U.S. Department of Health and Human Services Federal Program: Medical Assistance Program (Medicaid; Title XIX) ALN: #93.778 Compliance Requirement: Eligibility Type of Finding: Significant Deficiency in Internal Controls over Compliance, Nonmaterial Noncompliance Repeat Finding: Yes - 2021-001, 2020-001 CRITERIA: Title 2 U.S. Code of Federal Regulations Section 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 County maintains the computer system which is used to support the eligibility determination process. The Quality Assurance and Training ("QAT") unit reviews three randomly generated cases for each social worker per month. The selected cases are reviewed by the QAT team and notes are made in the quality control system to document any necessary corrections. The system requires the QAT team to enter a review date and a due date. The social worker and manager are notified of the selected case files that require correction. Once the social workers make their corrections, the supervisors review the corrections. It is the County's policy that the social workers make the corrections within 10 days of the QAT unit's review, and the supervisors confirm the corrections within 30 days of the QAT review. During our testing of controls over Eligibility, we sampled 60 case file reviews that were reviewed by the QAT unit during FY 2022 and noted the following: - 20 instances in which the QAT unit found no corrective action necessary. - 28 instances in which the QAT unit noted corrective actions were required and these were remediated within the time period specified by County policy. - 8 instances in which the County?s QAT unit noted corrective actions were required and these were remediated, but not within the time period specified by County policy ? corrections were made and reviewed more than 30 days after the QAT unit?s review ? specifically 33, 33, 35, 36, 42, 56, 61, and 147 days later. - 4 instances in which the County?s QAT unit noted corrective actions were required and had not been remediated at of the time of the audit. CONTEXT: Out of 1,197 reviews performed by the Quality Assurance and Training (QAT) unit during FY22, we tested the timeliness of the corrections made to 60 files. The deficiencies above were noted in 12 of the 60 files tested. QUESTION COSTS: None noted. CAUSE: The County did not follow its policy on when corrective action must occur. EFFECTS: Incomplete case files or case files which do not adhere to the County's policies or procedures increases the risk that the County could provide services to individuals not eligible to receive such services or that individuals could be denied benefits for which they are eligible. RECOMMENDATIONS: We recommend the County adhere to the policies to ensure cases selected for quality review are remediated in a timely manner. Best practices in this regard are within 30 days. VIEWS of RESPONSIBLE OFFICIALS: Management agrees with the finding.
Finding 2022-002 Federal Agency: U.S. Department of Agriculture Federal Program: Supplemental Nutrition Assistance Program (SNAP) Cluster ALN: #10.551 and #10.561 Compliance Requirement: Eligibility Type of Finding: Significant Deficiency in Internal Controls over Compliance, Nonmaterial Noncompliance Repeat Finding: No CRITERIA: Title 2 U.S. Code of Federal Regulations Section 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 County has established a Quality Assurance and Training ("QAT") unit that reviews all cases prepared by probationary employees during the mentoring and 100% QC phase of Family Economic Independence new-hire training. The unit also conducts random reviews of actions prepared by case workers (two per worker/month). The QAT unit completes quality assurance reviews using an automated QC tool that immediately sends review results to the worker and their supervisor. It is the County's policy that corrections be made by case workers within 10 days of the QAT unit's review and that the supervisors review the corrections within 30 days. During our testing of controls over eligibility, we sampled 40 case files that were reviewed by the Quality Assurance and Training unit during FY22 and noted the following: - 16 instances in which the County?s QAT unit found no corrective action necessary. - 6 instances in which the County?s QAT noted corrective actions were required and remediated within the time period specified by County policy. - 8 instances in which the County?s QAT unit noted corrective actions were required and not remediated within the time period specified by County policy ? case worker corrections not made within 10 days and not reviewed by supervisor within 30 days. CONTEXT: Out of 82 reviews performed by the Quality Assurance and Training (QAT) unit during FY22, we tested the timeliness of the corrections made to 40 files. The deficiencies above were noted in 8 of the 40 files tested. QUESTIONED COSTS: None noted. CAUSE: The County did not follow its policy on when remediation must occur. EFFECTS: Incomplete case files or case files that do not adhere to the County's policies or procedures increases the risk that the County could provide services to individuals not eligible to receive such services or that eligible individuals could be denied benefits. RECOMMENDATIONS: We recommend the County adhere to its policy to ensure cases selected for quality review are remediated in a timely manner. Best practices in this regard are within 30 days. VIEWS of RESPONSIBLE OFFICIALS: Management agrees with the finding.
Finding 2022-002 Federal Agency: U.S. Department of Agriculture Federal Program: Supplemental Nutrition Assistance Program (SNAP) Cluster ALN: #10.551 and #10.561 Compliance Requirement: Eligibility Type of Finding: Significant Deficiency in Internal Controls over Compliance, Nonmaterial Noncompliance Repeat Finding: No CRITERIA: Title 2 U.S. Code of Federal Regulations Section 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 County has established a Quality Assurance and Training ("QAT") unit that reviews all cases prepared by probationary employees during the mentoring and 100% QC phase of Family Economic Independence new-hire training. The unit also conducts random reviews of actions prepared by case workers (two per worker/month). The QAT unit completes quality assurance reviews using an automated QC tool that immediately sends review results to the worker and their supervisor. It is the County's policy that corrections be made by case workers within 10 days of the QAT unit's review and that the supervisors review the corrections within 30 days. During our testing of controls over eligibility, we sampled 40 case files that were reviewed by the Quality Assurance and Training unit during FY22 and noted the following: - 16 instances in which the County?s QAT unit found no corrective action necessary. - 6 instances in which the County?s QAT noted corrective actions were required and remediated within the time period specified by County policy. - 8 instances in which the County?s QAT unit noted corrective actions were required and not remediated within the time period specified by County policy ? case worker corrections not made within 10 days and not reviewed by supervisor within 30 days. CONTEXT: Out of 82 reviews performed by the Quality Assurance and Training (QAT) unit during FY22, we tested the timeliness of the corrections made to 40 files. The deficiencies above were noted in 8 of the 40 files tested. QUESTIONED COSTS: None noted. CAUSE: The County did not follow its policy on when remediation must occur. EFFECTS: Incomplete case files or case files that do not adhere to the County's policies or procedures increases the risk that the County could provide services to individuals not eligible to receive such services or that eligible individuals could be denied benefits. RECOMMENDATIONS: We recommend the County adhere to its policy to ensure cases selected for quality review are remediated in a timely manner. Best practices in this regard are within 30 days. VIEWS of RESPONSIBLE OFFICIALS: Management agrees with the finding.
Finding 2022-003 Federal Agency: U.S. Department of Health and Human Services Federal Program: Foster Care - Title IV-E; Adoption Assistance ALNs: #93.658 and #93.659 Compliance Requirement: Eligibility Type of Finding: Significant Deficiency in Internal Controls over Compliance, Nonmaterial Noncompliance Repeat Finding: No CRITERIA: Title 2 U.S. Code of Federal Regulations Section 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 has established a policy that all social workers are responsible for ensuring all requirements are met and that appropriate documentation is maintained. Supervisors are required to perform reviews to ensure case workers are following guidelines and are required to review and approve files prior to enrollment. During our testing of controls over eligibility, we sampled 25 case files for FY22 and noted the following: - 1 instance in which the case file contained no support documents, child aged out of system in FY22. - 1 instance in which the case file did not contain evidence to support that the NC Child Abuse and Neglect registry check was complete, nor the Responsible Individual?s List check. - 1 instance in which the Supervisor?s approval was not evident and the child?s residency as a U.S. Citizen or qualified alien could not be supported. CONTEXT: Out of 25 case files reviewed, we tested completeness of the support documents associated with the files. The deficiencies above were noted in 3 of the 25 files tested. QUESTIONED COSTS: None noted. CAUSE: The County did not follow its policy to ensure appropriate documentation is maintained. EFFECTS: Incomplete case files or case files that do not adhere to the County's policies or procedures increases the risk that the County could provide services to individuals not eligible to receive such services or that eligible individuals could be denied benefits. RECOMMENDATIONS: We recommend the County adhere to its policy to review cases and ensure appropriate documentation is maintained for all cases. VIEWS of RESPONSIBLE OFFICIALS: Management agrees with the finding.
Finding 2022-003 Federal Agency: U.S. Department of Health and Human Services Federal Program: Foster Care - Title IV-E; Adoption Assistance ALNs: #93.658 and #93.659 Compliance Requirement: Eligibility Type of Finding: Significant Deficiency in Internal Controls over Compliance, Nonmaterial Noncompliance Repeat Finding: No CRITERIA: Title 2 U.S. Code of Federal Regulations Section 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 has established a policy that all social workers are responsible for ensuring all requirements are met and that appropriate documentation is maintained. Supervisors are required to perform reviews to ensure case workers are following guidelines and are required to review and approve files prior to enrollment. During our testing of controls over eligibility, we sampled 25 case files for FY22 and noted the following: - 1 instance in which the case file contained no support documents, child aged out of system in FY22. - 1 instance in which the case file did not contain evidence to support that the NC Child Abuse and Neglect registry check was complete, nor the Responsible Individual?s List check. - 1 instance in which the Supervisor?s approval was not evident and the child?s residency as a U.S. Citizen or qualified alien could not be supported. CONTEXT: Out of 25 case files reviewed, we tested completeness of the support documents associated with the files. The deficiencies above were noted in 3 of the 25 files tested. QUESTIONED COSTS: None noted. CAUSE: The County did not follow its policy to ensure appropriate documentation is maintained. EFFECTS: Incomplete case files or case files that do not adhere to the County's policies or procedures increases the risk that the County could provide services to individuals not eligible to receive such services or that eligible individuals could be denied benefits. RECOMMENDATIONS: We recommend the County adhere to its policy to review cases and ensure appropriate documentation is maintained for all cases. VIEWS of RESPONSIBLE OFFICIALS: Management agrees with the finding.
Finding 2022-003 Federal Agency: U.S. Department of Health and Human Services Federal Program: Foster Care - Title IV-E; Adoption Assistance ALNs: #93.658 and #93.659 Compliance Requirement: Eligibility Type of Finding: Significant Deficiency in Internal Controls over Compliance, Nonmaterial Noncompliance Repeat Finding: No CRITERIA: Title 2 U.S. Code of Federal Regulations Section 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 has established a policy that all social workers are responsible for ensuring all requirements are met and that appropriate documentation is maintained. Supervisors are required to perform reviews to ensure case workers are following guidelines and are required to review and approve files prior to enrollment. During our testing of controls over eligibility, we sampled 25 case files for FY22 and noted the following: - 1 instance in which the case file contained no support documents, child aged out of system in FY22. - 1 instance in which the case file did not contain evidence to support that the NC Child Abuse and Neglect registry check was complete, nor the Responsible Individual?s List check. - 1 instance in which the Supervisor?s approval was not evident and the child?s residency as a U.S. Citizen or qualified alien could not be supported. CONTEXT: Out of 25 case files reviewed, we tested completeness of the support documents associated with the files. The deficiencies above were noted in 3 of the 25 files tested. QUESTIONED COSTS: None noted. CAUSE: The County did not follow its policy to ensure appropriate documentation is maintained. EFFECTS: Incomplete case files or case files that do not adhere to the County's policies or procedures increases the risk that the County could provide services to individuals not eligible to receive such services or that eligible individuals could be denied benefits. RECOMMENDATIONS: We recommend the County adhere to its policy to review cases and ensure appropriate documentation is maintained for all cases. VIEWS of RESPONSIBLE OFFICIALS: Management agrees with the finding.
Finding 2022-003 Federal Agency: U.S. Department of Health and Human Services Federal Program: Foster Care - Title IV-E; Adoption Assistance ALNs: #93.658 and #93.659 Compliance Requirement: Eligibility Type of Finding: Significant Deficiency in Internal Controls over Compliance, Nonmaterial Noncompliance Repeat Finding: No CRITERIA: Title 2 U.S. Code of Federal Regulations Section 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 has established a policy that all social workers are responsible for ensuring all requirements are met and that appropriate documentation is maintained. Supervisors are required to perform reviews to ensure case workers are following guidelines and are required to review and approve files prior to enrollment. During our testing of controls over eligibility, we sampled 25 case files for FY22 and noted the following: - 1 instance in which the case file contained no support documents, child aged out of system in FY22. - 1 instance in which the case file did not contain evidence to support that the NC Child Abuse and Neglect registry check was complete, nor the Responsible Individual?s List check. - 1 instance in which the Supervisor?s approval was not evident and the child?s residency as a U.S. Citizen or qualified alien could not be supported. CONTEXT: Out of 25 case files reviewed, we tested completeness of the support documents associated with the files. The deficiencies above were noted in 3 of the 25 files tested. QUESTIONED COSTS: None noted. CAUSE: The County did not follow its policy to ensure appropriate documentation is maintained. EFFECTS: Incomplete case files or case files that do not adhere to the County's policies or procedures increases the risk that the County could provide services to individuals not eligible to receive such services or that eligible individuals could be denied benefits. RECOMMENDATIONS: We recommend the County adhere to its policy to review cases and ensure appropriate documentation is maintained for all cases. VIEWS of RESPONSIBLE OFFICIALS: Management agrees with the finding.
Finding 2022-003 Federal Agency: U.S. Department of Health and Human Services Federal Program: Foster Care - Title IV-E; Adoption Assistance ALNs: #93.658 and #93.659 Compliance Requirement: Eligibility Type of Finding: Significant Deficiency in Internal Controls over Compliance, Nonmaterial Noncompliance Repeat Finding: No CRITERIA: Title 2 U.S. Code of Federal Regulations Section 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 has established a policy that all social workers are responsible for ensuring all requirements are met and that appropriate documentation is maintained. Supervisors are required to perform reviews to ensure case workers are following guidelines and are required to review and approve files prior to enrollment. During our testing of controls over eligibility, we sampled 25 case files for FY22 and noted the following: - 1 instance in which the case file contained no support documents, child aged out of system in FY22. - 1 instance in which the case file did not contain evidence to support that the NC Child Abuse and Neglect registry check was complete, nor the Responsible Individual?s List check. - 1 instance in which the Supervisor?s approval was not evident and the child?s residency as a U.S. Citizen or qualified alien could not be supported. CONTEXT: Out of 25 case files reviewed, we tested completeness of the support documents associated with the files. The deficiencies above were noted in 3 of the 25 files tested. QUESTIONED COSTS: None noted. CAUSE: The County did not follow its policy to ensure appropriate documentation is maintained. EFFECTS: Incomplete case files or case files that do not adhere to the County's policies or procedures increases the risk that the County could provide services to individuals not eligible to receive such services or that eligible individuals could be denied benefits. RECOMMENDATIONS: We recommend the County adhere to its policy to review cases and ensure appropriate documentation is maintained for all cases. VIEWS of RESPONSIBLE OFFICIALS: Management agrees with the finding.
Finding 2022-001 Federal Agency: U.S. Department of Health and Human Services Federal Program: Medical Assistance Program (Medicaid; Title XIX) ALN: #93.778 Compliance Requirement: Eligibility Type of Finding: Significant Deficiency in Internal Controls over Compliance, Nonmaterial Noncompliance Repeat Finding: Yes - 2021-001, 2020-001 CRITERIA: Title 2 U.S. Code of Federal Regulations Section 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 County maintains the computer system which is used to support the eligibility determination process. The Quality Assurance and Training ("QAT") unit reviews three randomly generated cases for each social worker per month. The selected cases are reviewed by the QAT team and notes are made in the quality control system to document any necessary corrections. The system requires the QAT team to enter a review date and a due date. The social worker and manager are notified of the selected case files that require correction. Once the social workers make their corrections, the supervisors review the corrections. It is the County's policy that the social workers make the corrections within 10 days of the QAT unit's review, and the supervisors confirm the corrections within 30 days of the QAT review. During our testing of controls over Eligibility, we sampled 60 case file reviews that were reviewed by the QAT unit during FY 2022 and noted the following: - 20 instances in which the QAT unit found no corrective action necessary. - 28 instances in which the QAT unit noted corrective actions were required and these were remediated within the time period specified by County policy. - 8 instances in which the County?s QAT unit noted corrective actions were required and these were remediated, but not within the time period specified by County policy ? corrections were made and reviewed more than 30 days after the QAT unit?s review ? specifically 33, 33, 35, 36, 42, 56, 61, and 147 days later. - 4 instances in which the County?s QAT unit noted corrective actions were required and had not been remediated at of the time of the audit. CONTEXT: Out of 1,197 reviews performed by the Quality Assurance and Training (QAT) unit during FY22, we tested the timeliness of the corrections made to 60 files. The deficiencies above were noted in 12 of the 60 files tested. QUESTION COSTS: None noted. CAUSE: The County did not follow its policy on when corrective action must occur. EFFECTS: Incomplete case files or case files which do not adhere to the County's policies or procedures increases the risk that the County could provide services to individuals not eligible to receive such services or that individuals could be denied benefits for which they are eligible. RECOMMENDATIONS: We recommend the County adhere to the policies to ensure cases selected for quality review are remediated in a timely manner. Best practices in this regard are within 30 days. VIEWS of RESPONSIBLE OFFICIALS: Management agrees with the finding.
Finding 2022-001 Federal Agency: U.S. Department of Health and Human Services Federal Program: Medical Assistance Program (Medicaid; Title XIX) ALN: #93.778 Compliance Requirement: Eligibility Type of Finding: Significant Deficiency in Internal Controls over Compliance, Nonmaterial Noncompliance Repeat Finding: Yes - 2021-001, 2020-001 CRITERIA: Title 2 U.S. Code of Federal Regulations Section 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 County maintains the computer system which is used to support the eligibility determination process. The Quality Assurance and Training ("QAT") unit reviews three randomly generated cases for each social worker per month. The selected cases are reviewed by the QAT team and notes are made in the quality control system to document any necessary corrections. The system requires the QAT team to enter a review date and a due date. The social worker and manager are notified of the selected case files that require correction. Once the social workers make their corrections, the supervisors review the corrections. It is the County's policy that the social workers make the corrections within 10 days of the QAT unit's review, and the supervisors confirm the corrections within 30 days of the QAT review. During our testing of controls over Eligibility, we sampled 60 case file reviews that were reviewed by the QAT unit during FY 2022 and noted the following: - 20 instances in which the QAT unit found no corrective action necessary. - 28 instances in which the QAT unit noted corrective actions were required and these were remediated within the time period specified by County policy. - 8 instances in which the County?s QAT unit noted corrective actions were required and these were remediated, but not within the time period specified by County policy ? corrections were made and reviewed more than 30 days after the QAT unit?s review ? specifically 33, 33, 35, 36, 42, 56, 61, and 147 days later. - 4 instances in which the County?s QAT unit noted corrective actions were required and had not been remediated at of the time of the audit. CONTEXT: Out of 1,197 reviews performed by the Quality Assurance and Training (QAT) unit during FY22, we tested the timeliness of the corrections made to 60 files. The deficiencies above were noted in 12 of the 60 files tested. QUESTION COSTS: None noted. CAUSE: The County did not follow its policy on when corrective action must occur. EFFECTS: Incomplete case files or case files which do not adhere to the County's policies or procedures increases the risk that the County could provide services to individuals not eligible to receive such services or that individuals could be denied benefits for which they are eligible. RECOMMENDATIONS: We recommend the County adhere to the policies to ensure cases selected for quality review are remediated in a timely manner. Best practices in this regard are within 30 days. VIEWS of RESPONSIBLE OFFICIALS: Management agrees with the finding.
Finding 2022-001 Federal Agency: U.S. Department of Health and Human Services Federal Program: Medical Assistance Program (Medicaid; Title XIX) ALN: #93.778 Compliance Requirement: Eligibility Type of Finding: Significant Deficiency in Internal Controls over Compliance, Nonmaterial Noncompliance Repeat Finding: Yes - 2021-001, 2020-001 CRITERIA: Title 2 U.S. Code of Federal Regulations Section 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 County maintains the computer system which is used to support the eligibility determination process. The Quality Assurance and Training ("QAT") unit reviews three randomly generated cases for each social worker per month. The selected cases are reviewed by the QAT team and notes are made in the quality control system to document any necessary corrections. The system requires the QAT team to enter a review date and a due date. The social worker and manager are notified of the selected case files that require correction. Once the social workers make their corrections, the supervisors review the corrections. It is the County's policy that the social workers make the corrections within 10 days of the QAT unit's review, and the supervisors confirm the corrections within 30 days of the QAT review. During our testing of controls over Eligibility, we sampled 60 case file reviews that were reviewed by the QAT unit during FY 2022 and noted the following: - 20 instances in which the QAT unit found no corrective action necessary. - 28 instances in which the QAT unit noted corrective actions were required and these were remediated within the time period specified by County policy. - 8 instances in which the County?s QAT unit noted corrective actions were required and these were remediated, but not within the time period specified by County policy ? corrections were made and reviewed more than 30 days after the QAT unit?s review ? specifically 33, 33, 35, 36, 42, 56, 61, and 147 days later. - 4 instances in which the County?s QAT unit noted corrective actions were required and had not been remediated at of the time of the audit. CONTEXT: Out of 1,197 reviews performed by the Quality Assurance and Training (QAT) unit during FY22, we tested the timeliness of the corrections made to 60 files. The deficiencies above were noted in 12 of the 60 files tested. QUESTION COSTS: None noted. CAUSE: The County did not follow its policy on when corrective action must occur. EFFECTS: Incomplete case files or case files which do not adhere to the County's policies or procedures increases the risk that the County could provide services to individuals not eligible to receive such services or that individuals could be denied benefits for which they are eligible. RECOMMENDATIONS: We recommend the County adhere to the policies to ensure cases selected for quality review are remediated in a timely manner. Best practices in this regard are within 30 days. VIEWS of RESPONSIBLE OFFICIALS: Management agrees with the finding.
Finding 2022-001 Federal Agency: U.S. Department of Health and Human Services Federal Program: Medical Assistance Program (Medicaid; Title XIX) ALN: #93.778 Compliance Requirement: Eligibility Type of Finding: Significant Deficiency in Internal Controls over Compliance, Nonmaterial Noncompliance Repeat Finding: Yes - 2021-001, 2020-001 CRITERIA: Title 2 U.S. Code of Federal Regulations Section 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 County maintains the computer system which is used to support the eligibility determination process. The Quality Assurance and Training ("QAT") unit reviews three randomly generated cases for each social worker per month. The selected cases are reviewed by the QAT team and notes are made in the quality control system to document any necessary corrections. The system requires the QAT team to enter a review date and a due date. The social worker and manager are notified of the selected case files that require correction. Once the social workers make their corrections, the supervisors review the corrections. It is the County's policy that the social workers make the corrections within 10 days of the QAT unit's review, and the supervisors confirm the corrections within 30 days of the QAT review. During our testing of controls over Eligibility, we sampled 60 case file reviews that were reviewed by the QAT unit during FY 2022 and noted the following: - 20 instances in which the QAT unit found no corrective action necessary. - 28 instances in which the QAT unit noted corrective actions were required and these were remediated within the time period specified by County policy. - 8 instances in which the County?s QAT unit noted corrective actions were required and these were remediated, but not within the time period specified by County policy ? corrections were made and reviewed more than 30 days after the QAT unit?s review ? specifically 33, 33, 35, 36, 42, 56, 61, and 147 days later. - 4 instances in which the County?s QAT unit noted corrective actions were required and had not been remediated at of the time of the audit. CONTEXT: Out of 1,197 reviews performed by the Quality Assurance and Training (QAT) unit during FY22, we tested the timeliness of the corrections made to 60 files. The deficiencies above were noted in 12 of the 60 files tested. QUESTION COSTS: None noted. CAUSE: The County did not follow its policy on when corrective action must occur. EFFECTS: Incomplete case files or case files which do not adhere to the County's policies or procedures increases the risk that the County could provide services to individuals not eligible to receive such services or that individuals could be denied benefits for which they are eligible. RECOMMENDATIONS: We recommend the County adhere to the policies to ensure cases selected for quality review are remediated in a timely manner. Best practices in this regard are within 30 days. VIEWS of RESPONSIBLE OFFICIALS: Management agrees with the finding.
Finding 2022-001 Federal Agency: U.S. Department of Health and Human Services Federal Program: Medical Assistance Program (Medicaid; Title XIX) ALN: #93.778 Compliance Requirement: Eligibility Type of Finding: Significant Deficiency in Internal Controls over Compliance, Nonmaterial Noncompliance Repeat Finding: Yes - 2021-001, 2020-001 CRITERIA: Title 2 U.S. Code of Federal Regulations Section 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 County maintains the computer system which is used to support the eligibility determination process. The Quality Assurance and Training ("QAT") unit reviews three randomly generated cases for each social worker per month. The selected cases are reviewed by the QAT team and notes are made in the quality control system to document any necessary corrections. The system requires the QAT team to enter a review date and a due date. The social worker and manager are notified of the selected case files that require correction. Once the social workers make their corrections, the supervisors review the corrections. It is the County's policy that the social workers make the corrections within 10 days of the QAT unit's review, and the supervisors confirm the corrections within 30 days of the QAT review. During our testing of controls over Eligibility, we sampled 60 case file reviews that were reviewed by the QAT unit during FY 2022 and noted the following: - 20 instances in which the QAT unit found no corrective action necessary. - 28 instances in which the QAT unit noted corrective actions were required and these were remediated within the time period specified by County policy. - 8 instances in which the County?s QAT unit noted corrective actions were required and these were remediated, but not within the time period specified by County policy ? corrections were made and reviewed more than 30 days after the QAT unit?s review ? specifically 33, 33, 35, 36, 42, 56, 61, and 147 days later. - 4 instances in which the County?s QAT unit noted corrective actions were required and had not been remediated at of the time of the audit. CONTEXT: Out of 1,197 reviews performed by the Quality Assurance and Training (QAT) unit during FY22, we tested the timeliness of the corrections made to 60 files. The deficiencies above were noted in 12 of the 60 files tested. QUESTION COSTS: None noted. CAUSE: The County did not follow its policy on when corrective action must occur. EFFECTS: Incomplete case files or case files which do not adhere to the County's policies or procedures increases the risk that the County could provide services to individuals not eligible to receive such services or that individuals could be denied benefits for which they are eligible. RECOMMENDATIONS: We recommend the County adhere to the policies to ensure cases selected for quality review are remediated in a timely manner. Best practices in this regard are within 30 days. VIEWS of RESPONSIBLE OFFICIALS: Management agrees with the finding.
Finding 2022-002 Federal Agency: U.S. Department of Agriculture Federal Program: Supplemental Nutrition Assistance Program (SNAP) Cluster ALN: #10.551 and #10.561 Compliance Requirement: Eligibility Type of Finding: Significant Deficiency in Internal Controls over Compliance, Nonmaterial Noncompliance Repeat Finding: No CRITERIA: Title 2 U.S. Code of Federal Regulations Section 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 County has established a Quality Assurance and Training ("QAT") unit that reviews all cases prepared by probationary employees during the mentoring and 100% QC phase of Family Economic Independence new-hire training. The unit also conducts random reviews of actions prepared by case workers (two per worker/month). The QAT unit completes quality assurance reviews using an automated QC tool that immediately sends review results to the worker and their supervisor. It is the County's policy that corrections be made by case workers within 10 days of the QAT unit's review and that the supervisors review the corrections within 30 days. During our testing of controls over eligibility, we sampled 40 case files that were reviewed by the Quality Assurance and Training unit during FY22 and noted the following: - 16 instances in which the County?s QAT unit found no corrective action necessary. - 6 instances in which the County?s QAT noted corrective actions were required and remediated within the time period specified by County policy. - 8 instances in which the County?s QAT unit noted corrective actions were required and not remediated within the time period specified by County policy ? case worker corrections not made within 10 days and not reviewed by supervisor within 30 days. CONTEXT: Out of 82 reviews performed by the Quality Assurance and Training (QAT) unit during FY22, we tested the timeliness of the corrections made to 40 files. The deficiencies above were noted in 8 of the 40 files tested. QUESTIONED COSTS: None noted. CAUSE: The County did not follow its policy on when remediation must occur. EFFECTS: Incomplete case files or case files that do not adhere to the County's policies or procedures increases the risk that the County could provide services to individuals not eligible to receive such services or that eligible individuals could be denied benefits. RECOMMENDATIONS: We recommend the County adhere to its policy to ensure cases selected for quality review are remediated in a timely manner. Best practices in this regard are within 30 days. VIEWS of RESPONSIBLE OFFICIALS: Management agrees with the finding.