Corrective Action Plans

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The Department should review and enhance its procedures and internal controls to ensure that it charges expenditures to the program that are incurred within an award’s allowable period of performance. Response: The Department concurs with the finding and the need to enhance procedures and strengthen...
The Department should review and enhance its procedures and internal controls to ensure that it charges expenditures to the program that are incurred within an award’s allowable period of performance. Response: The Department concurs with the finding and the need to enhance procedures and strengthen controls over processing expenditures to ensure compliance with the awards’ period of performance. Corrective Action: The program will enhance procedures and strengthen controls to ensure expenditures presented for payment are allowable and within the awards’ period of performance. Program leadership will develop and document an internal expenditure review process to ensure a complete review of presented expenditures for payment is completed prior to submission to the agency’s Accounts Payable Department for processing. Name of contact person responsible for the corrective action: Jameshyia Ballard Anticipated date for completion of corrective action: September 30, 2026
The Department should reevaluate its current process, implement proper controls, and perform additional training over time and effort reporting. The Department of Health should not seek federal reimbursement unless it can substantiate that the time and effort was dedicated to the federal program. Do...
The Department should reevaluate its current process, implement proper controls, and perform additional training over time and effort reporting. The Department of Health should not seek federal reimbursement unless it can substantiate that the time and effort was dedicated to the federal program. Documentation should be readily available for audit. Response: The Department concurs with the finding and the need for an effective method of time recording for accurate time and effort reporting. Prior to the conclusion of the audit, the agency created an internal review group to assess the need for an efficient time keeping system to be utilized throughout the agency to allow for uniformity and accuracy. Corrective Action: The Department will continue to move forward with the implementation of the new time keeping system which allows for proper time and leave collection for documentation and allocation of employee time. In the system, the employee time will be recorded and approved by supervisory personnel for accuracy prior to submission payroll processing. The system will allow documentation to be assessed when needed. Name of contact person responsible for the corrective action: Lucreta Tribune
Finding No. 2024-002 Loan Originations Involving Fraudulent Documentation Federal Agency: U.S. Department of Commerce Economic Development Administration Program Titles and ALN Numbers: EDA Revolving Loan Fund Program Capital Allocation - New York Contractor Loans (a non major program) (11.307) Fede...
Finding No. 2024-002 Loan Originations Involving Fraudulent Documentation Federal Agency: U.S. Department of Commerce Economic Development Administration Program Titles and ALN Numbers: EDA Revolving Loan Fund Program Capital Allocation - New York Contractor Loans (a non major program) (11.307) Federal Grant Numbers: Award #01-79-15074 Compliance Requirements: Activities Allowed and Unallowed and Allowable Costs Contact Person: James H. Bason, President and Chief Executive Officer, TruFund Financial Services, Inc., 9 East 40th, NY 10016 Corrective Action: (1) Federal agency notification: Management has notified the U.S. Department of Commerce Economic Development Administration of this finding and the questioned cost, and will cooperate fully with any federal review or recovery process. (2) Federal corrective action plan: Management has provided EDA with a corrective action plan addressing the specific internal control deficiencies applicable to federally funded loan programs. (3) Enhanced internal controls over federally funded programs: All corrective actions implemented under Finding 2024-001 apply equally to all federally funded loan programs, including enhanced verification, segregation of duties, and suspicious activity monitoring. (4) Replenishment of EDA Revolving Loan Fund: Subsequent to year-end and prior to the issuance of this report, TruFund replenished $410,000 in non-federal, unencumbered funds to the EDA Revolving Loan Fund, in response to EDA's request to restore the fund balance. Anticipated Completion Date: April 30, 2026
The District uses an outside party to oversee grant management. District management will review work performed by outside parties to ensure completeness and accuracy.
The District uses an outside party to oversee grant management. District management will review work performed by outside parties to ensure completeness and accuracy.
Corrective Action Plan Management will prepare the schedule of expenditures of federal awards as part of the year end closing process each year to determine their audit requirements under the Uniform Guidance and provide the schedule to the audit firm during the financial audit process.
Corrective Action Plan Management will prepare the schedule of expenditures of federal awards as part of the year end closing process each year to determine their audit requirements under the Uniform Guidance and provide the schedule to the audit firm during the financial audit process.
See the University response section at the end of this report for the corrective action plan for finding 2024-118.
See the University response section at the end of this report for the corrective action plan for finding 2024-118.
Assistance listing numbers and program names 97.024 Emergency Management Performance Grants Agency: Department of Emergency and Military Affairs (DEMA) Name of contact person and title: Keith Tagaban, Audit Supervisor Anticipated completion date: September 18, 2026 Agency’s Response: Concur The Depa...
Assistance listing numbers and program names 97.024 Emergency Management Performance Grants Agency: Department of Emergency and Military Affairs (DEMA) Name of contact person and title: Keith Tagaban, Audit Supervisor Anticipated completion date: September 18, 2026 Agency’s Response: Concur The Department of Emergency and Military Affairs will maintain required documentation to support payroll costs charged to the federal program and ensure compliance with award requirements. Internal Audit will review FY2024 payroll charges for allowability and adequate support in coordination with the State Finance Office, the Emergency Management Grants Administration Office, and State Human Resources Office. Unallowable costs, if identified, will be resolved through reimbursement adjustments or repayment, as appropriate. Payroll documentation policies will be updated, and training will be provided to ensure required records are retained for the prescribed retention period.
Assistance listing numbers and program names: 93.575 Child Care and Development Block Grant 93.575 COVID-19 - Child Care and Development Block Grant 93.596 Child Care Mandatory and Matching Funds of the Child Care and Development Fund 93.596 COVID-19 - Child Care Mandatory and Matching Funds of the ...
Assistance listing numbers and program names: 93.575 Child Care and Development Block Grant 93.575 COVID-19 - Child Care and Development Block Grant 93.596 Child Care Mandatory and Matching Funds of the Child Care and Development Fund 93.596 COVID-19 - Child Care Mandatory and Matching Funds of the Child Care and Development Fund Agency: Department of Economic Security (DES) Name of contact person and titles Lacie Butler, Administrative Services Officer Anticipated completion date: May 30, 2026 Agency’s Response: Concur The Department of Economic Security will address the audit recommendations as follows: The Department is revising its procedures to ensure that it receives and retains documentation to support its provider’s expenditures, including Payment Disbursed Quickly (PDQ) submitted billings. Specifically, due to PDQ system limitations the Department is implementing additional validation procedures for these payments, and restricting the use of this system to limited providers to ensure future compliance. The Department is conducting an internal audit to validate that all required PDQ submissions are on file for Fiscal Year 2025; instances of non-compliance will be resolved in the same manner as an overpayment. The Department will continue to retain all records related to a federal award for a period of 3 years from the final expenditure report submission date.
Assistance listing numbers and program names: 21.023 COVID-19 Emergency Rental Assistance Program 21.027 COVID-19 Coronavirus State and Local Fiscal Recovery Funds Agency: Department of Economic Security (DES) Name of contact person and title: Molly Bright, Community Services Division Assistant Dire...
Assistance listing numbers and program names: 21.023 COVID-19 Emergency Rental Assistance Program 21.027 COVID-19 Coronavirus State and Local Fiscal Recovery Funds Agency: Department of Economic Security (DES) Name of contact person and title: Molly Bright, Community Services Division Assistant Director Anticipated completion date: June 30, 2026 Agency’s Response: Concur The Department of Economic Security will address the audit recommendations as follows: 1. Ensure benefit payments are for allowable costs paid to or on behalf of eligible program applicants. The Division will review and confirm that benefits payments paid to or on behalf of eligible program applicants are allowable expenditures of the federal funding being disbursed. 2. Update existing policies and procedures to include a post-review of the benefits subsystem’s automated review of eligibility requirements, such as verifying the income thresholds and geographic location aligned with the Division’s written policies and procedures, and supported by required documentation. The Division should correct any inaccurate eligibility determinations identified during the post-review. Emergency Rental Assistance Program policies and procedures require validation of eligibility based upon substantiating applicant documentation, including household income and geographic location. The Division will update Division policy to include a post-review process to identify and correct any errors or discrepancies. 3. Allocate sufficient staffing resources to perform a thorough evaluation of program benefits applications and provide training on eligibility requirements and allowable benefit payments. The Division will allocate sufficient staffing resources to evaluate program benefits applications and provide training on eligibility requirements and allowable benefit payments. 4. Work with the federal agencies to resolve the $64,131 in program funds that were spent in violation of federal regulations, policies and procedures, and may need to be returned to the federal agencies. The Department of Economic Security will address the audit recommendations as follows: 1. Ensure benefit payments are for allowable costs paid to or on behalf of eligible program applicants. The Division will review and confirm that benefits payments paid to or on behalf of eligible program applicants are allowable expenditures of the federal funding being disbursed. 2. Update existing policies and procedures to include a post-review of the benefits subsystem’s automated review of eligibility requirements, such as verifying the income thresholds and geographic location aligned with the Division’s written policies and procedures, and supported by required documentation. The Division should correct any inaccurate eligibility determinations identified during the post-review. Emergency Rental Assistance Program policies and procedures require validation of eligibility based upon substantiating applicant documentation, including household income and geographic location. The Division will update Division policy to include a post-review process to identify and correct any errors or discrepancies. 3. Allocate sufficient staffing resources to perform a thorough evaluation of program benefits applications and provide training on eligibility requirements and allowable benefit payments. The Division will allocate sufficient staffing resources to evaluate program benefits applications and provide training on eligibility requirements and allowable benefit payments. 4. Work with the federal agencies to resolve the $64,131 in program funds that were spent in violation of federal regulations, policies and procedures, and may need to be returned to the federal agencies. The Division will coordinate with applicable federal agencies to resolve these unallowable costs.
Assistance listing number and program name: 17.258 WIOA Adult Program 17.259 WIOA Youth Activities 17.278 WIOA Dislocated Worker Formula Grants Agency: Department of Economic Security (DES) Office of Economic Opportunity (OEO) Name of contact persons and titles: David Almaraz, DES DERS Business Admi...
Assistance listing number and program name: 17.258 WIOA Adult Program 17.259 WIOA Youth Activities 17.278 WIOA Dislocated Worker Formula Grants Agency: Department of Economic Security (DES) Office of Economic Opportunity (OEO) Name of contact persons and titles: David Almaraz, DES DERS Business Administrator Stephen Sifuentes, OEO Finance Administrator Senior Anticipated completion date: See below Agency’s Response: Concur DES Anticipated completion date: December 31, 2026 The Department will address the audit recommendations by amending its ISA subaward with the Arizona Office of Economic Opportunity. The Department will also adjust its subrecipient monitoring schedule, procedures and offer training and assistance on conference-related requirements to the Arizona Office of Economic Opportunity. OEO Anticipated completion date: June 30, 2027 The Office of Economic Opportunity (OEO) acknowledges the finding regarding the use of WIOA Dislocated Worker Formula Grant funds for conference meals and promotional items. To address these concerns, OEO has undertaken proactive measures to strengthen internal controls, enhance oversight, and improve compliance with federal cost principles. As such, OEO will utilize these findings to strengthen its existing system, address any identified deficiencies, and continue to enhance fiscal management. Through these corrective actions, the OEO is committed to full compliance and the effective stewardship of federal funds. 1. Ensure Summit costs charged to the WIOA federal program are appropriate, necessary, and managed to minimize charges to the federal award. The OEO acknowledges the auditors’ findings regarding the management of Summit costs charged to the Workforce Innovation and Opportunity Act (WIOA) federal program. OEO is committed to ensuring that all expenditures are appropriate, necessary, and managed with the highest level of fiscal responsibility to ensure charges are necessary and allowable to the federal award. To address this finding, OEO will collaborate closely with the Arizona Department of Economic Security (ADES) to develop and implement comprehensive formal policies and procedures governing the State Workforce Development Board and WIOA funded events including Summit expenditures. Our joint efforts will focus on implementing a documented review and approval process to ensure costs charged to the federal award are supported by documentation and evaluated in accordance with 2 CFR §§ 200.403. As part of this corrective action, the process will integrate cost-containment measures into the planning and approval of the events budget planning phase. This will include requiring staff to assess whether proposed costs are necessary, reasonable, allocable and limited to helping the workforce development system achieve the purpose of the Workforce Innovation and Opportunity Act (WIOA). OEO and ADES will conduct working sessions to develop, implement, and monitor these protocols, with the goal of finalizing a standardized procedure for all WIOA-funded event expenditures. This approach ensures consistency across agencies and establishes clear oversight to prevent recurrence. 2. Develop and implement written procedures, including a standardized review process, to ensure that costs charged to the WIOA federal program are allowable prior to requesting reimbursement from DES. The OEO recognizes the importance of verifying the allowability of expenditures prior to the reimbursement phase. We concur that a standardized documented review process is necessary to maintain fiscal integrity and compliance of WIOA federal program funding and federal regulations. OEO, in partnership with the ADES, will develop and formalize written internal control procedures designed to vet all costs before they are submitted to ADES for reimbursement. The proposed standardized review process will align with existing practices for monitoring and expending federal funds as described under WIOA for the State Workforce Development Board and will include: ● Pre-submission verification: Implementation of an internal review checklist based on 2 CFR 200 Subpart E Cost Principles and applicable State policy. This will ensure that every line item is: ○ Allowable under both WIOA statutory requirements and federal cost principles. ○ Allocable to the specific federal award in proportion to the benefits received. ○ Compliant with the State of Arizona Accounting Manual ○ Documented with sufficient supporting evidence (pictures, invoices, receipts, and justifications) to withstand audit scrutiny. ● Standardized approval workflow: Establishment of a clear designated approval framework. ● Policy Integration: These procedures will be codified into an OEO Fiscal Manual, providing staff with a clear roadmap for processing WIOA-related expenditures. OEO will coordinate with ADES technical assistance teams to ensure our internal review templates align with ADES’s appropriate reimbursement systems. This collaborative design phase will ensure that once a request reaches ADES, it has already undergone a vetting process, thereby reducing errors. 3. Work with federal grantor and/or DES to resolve the $90,015 of questioned costs associated with the 2024 Summit and any subsequently held Summits. OEO will collaborate with the ADES, the primary grant recipient, to establish the most appropriate course of action for resolving any unallowable expenditures. Initially, OEO will work with ADES to precisely define the actual allowable amount based on programmatic cost allowability, which may require consultation with the original federal grantor, for final clarification on disputed cost. Subsequent steps for resolution will be guided by ADES’s direction and the requirements of the federal grantor.
Finding Reference: 2024-007 Finding Title: Timecard Approval Controls – Payroll Charge to Federal Grant, Significant Deficiency CAP Contact Persons: • John Morris, Chief Financial Officer, Financial Affairs, (312) 322-6420 • Scott Dolude, Director of Payroll, Financial Affairs, (312) 322-6526 Planne...
Finding Reference: 2024-007 Finding Title: Timecard Approval Controls – Payroll Charge to Federal Grant, Significant Deficiency CAP Contact Persons: • John Morris, Chief Financial Officer, Financial Affairs, (312) 322-6420 • Scott Dolude, Director of Payroll, Financial Affairs, (312) 322-6526 Planned Corrective Actions: 1. Timecard Approval Requirements for Federal Grants: Management will reinforce payroll control procedures to require that all employee timecards charged to Federal grants are reviewed and approved by designated supervisors in a timely manner and in accordance with established payroll deadlines. Specifically, that all required approvals must be completed prior to payroll processing and fiscal period close to ensure the allowability, accuracy, and proper allocation of costs charged to Federal awards. By June 30, 2026, management will send an email to all impact supervisory and management personnel responsible for time review and approval processes. 2. Documentation Standards and Audit Trail: Management will establish formal documentation standards to ensure that evidence of supervisory review and approval, including approval dates, is consistently retained in a secure, centralized system. These standards will support a clear and retrievable audit trail demonstrating compliance with the payroll documentation and allowability requirements of 2 CFR §200.430(i). 3. Monitoring and Compliance Oversight: Management will implement periodic monitoring procedures to assess compliance with timecard review and approval requirements. These procedures will include exception reporting, timely follow-up on identified deficiencies, and management review of monitoring results. Corrective actions will be implemented, as necessary, to address recurring or systemic issues related to untimely, incomplete, or undocumented approvals. Based on the results of monitoring processes, Director of Payroll and Timekeeping will conduct organizational, departmental, or team-based follow-up to address non-compliance or other issues. Anticipated Completion Date: 06/30/2026
Finding Reference: 2024-006 Finding Title: Indirect Cost Rate Pool, Noncompliance and Significant Deficiency CAP Contact Persons: • John Morris, Chief Financial Officer, Financial Affairs, (312) 322-6420 • Alan Ochab, Senior Director, Budget Management & Analysis, (312) 322-1519 Planned Corrective A...
Finding Reference: 2024-006 Finding Title: Indirect Cost Rate Pool, Noncompliance and Significant Deficiency CAP Contact Persons: • John Morris, Chief Financial Officer, Financial Affairs, (312) 322-6420 • Alan Ochab, Senior Director, Budget Management & Analysis, (312) 322-1519 Planned Corrective Actions: 1. Correction Adjustment: Management has communicated to its consultant, Maximus, its expectation that the final 2026 indirect cost rate report will incorporate an adjustment to remove the disallowed expense related to the unallowable tax penalty for all affected 2026 rates. Metra will not authorize submission of the final report to the Federal Transit Administration (FTA) until the Finance team confirms that the adjustment has been appropriately reflected and its impact fully evaluated. The adjustment, including relevant background information and its general impact on the rates, will be disclosed in the transmittal letter submitted to the FTA with the final report. 2. Independent Review Controls: Management will strengthen internal review controls by implementing a secondary review of the indirect cost rate data, including consulting with Internal Audit to improve review procedures. This review will verify that costs included in the indirect cost pool are allowable, reasonable, and adequately supported in accordance with 2 CFR Part 200, prior to submission to the Federal Transit Administration (FTA). Anticipated Completion Date: 09/30/2026
The ROE will use time and effort documentation to distribute salary and benefit costs for all employees. The ROE will implement the necessary controls over payroll to ensure that payroll is being properly prepared and calculated.
The ROE will use time and effort documentation to distribute salary and benefit costs for all employees. The ROE will implement the necessary controls over payroll to ensure that payroll is being properly prepared and calculated.
Finding 2024-015 Material Weakness in Internal Control and Material Noncompliance – Reporting Condition: For the Education Stabilization Fund- Elementary and Secondary School Emergency Relief (84.425D), American Rescue Plan Elementary and Secondary School Emergency Relief (84.425U), the City provide...
Finding 2024-015 Material Weakness in Internal Control and Material Noncompliance – Reporting Condition: For the Education Stabilization Fund- Elementary and Secondary School Emergency Relief (84.425D), American Rescue Plan Elementary and Secondary School Emergency Relief (84.425U), the City provided supporting documentation that was unable to be agreed to the amounts that were submitted to the State in the annual performance report ESF - ESSER Recipient Data Collection Form OMB PRA Number: OMB No. 1810-0749 for the key line items: Line 3.b1 LEA expenditures by ESSER Subgrant fund, expenditure category, and object code, Line 3.b10 Number of specific positions supported with ESSER Funds, 3. Line 3.c Allocation of ESSER funds to schools and criteria used to allocate funds to schools, and Line 5.a Full Time Equivalent positions. Contact Person: Michael Weaver, CFO, Danbury Public Schools Corrective Actions Planned: We agree with the finding. The District acknowledges that a formal reconciliation process did not exist at the time of submission to verify that data entered into the annual ESF-ESSER Recipient Data Collection Form (OMB No. 1810-0749) was agreed to underlying financial records and supporting documentation prior to submission to the State. The District will proactively strengthen internal controls over federal reporting by implementing a formal reconciliation policy and establishing designated review prior to submission. Completion Date: 6/30/2025
Name of Contact Person: Willie Mack Carawan, Jr., Finance Director Corrective Action/Management's Response: This finding is primarily the result of turnover/ transition/ reporting access of key personnel. Management is working with staff member to establish contact with reporting agencies and to gai...
Name of Contact Person: Willie Mack Carawan, Jr., Finance Director Corrective Action/Management's Response: This finding is primarily the result of turnover/ transition/ reporting access of key personnel. Management is working with staff member to establish contact with reporting agencies and to gain the necessary access for reporting purposes, as well as reporting requirements. Proposed Completion Date: As soon as the discrepancy was identified by the auditor, management began working with staff to list their points of contact in the likelihood they are not available to meet reporting requirements for the year ending June 30, 2024.
Management will implement procedures to identify and properly allocate prepaid and multi-period expenses across the applicable benefit periods. Prepaid expenses will be recorded and amortized over the service period in accordance with GAAP and federal cost principles.
Management will implement procedures to identify and properly allocate prepaid and multi-period expenses across the applicable benefit periods. Prepaid expenses will be recorded and amortized over the service period in accordance with GAAP and federal cost principles.
Person Responsible for Corrective Action: Edward S. Churchill Jr., Chief Operating Officer Corrective Action Plan: College for Social Innovation’s inability to properly retain documentation relating to the noted selection was due in large part to rapid staff turnover at the senior level and an inabi...
Person Responsible for Corrective Action: Edward S. Churchill Jr., Chief Operating Officer Corrective Action Plan: College for Social Innovation’s inability to properly retain documentation relating to the noted selection was due in large part to rapid staff turnover at the senior level and an inability to access records from previous employees. Following the 2024 grant year, College for Social Innovation made updates to our accounting manual and segregation of duties protocols to ensure redundancy in the event of staff turnover. Additionally, College for Social Innovation has instituted new document storage and record keeping practices including the use of Google Drive and DropBox to securely store critical records and ensure access by relevant financial staff. At all times, at least two current staff members maintain access to record keeping digital drives and folders to ensure access redundancy. These policies and practices were first implemented in the beginning of the 2026 fiscal year and remain ongoing. Anticipated Completion Date: 7/1/2025
Person Responsible for Corrective Action: Edward S. Churchill Jr., Chief Operating Officer Corrective Action Plan: Following the 2024 grant year, College for Social Innovation made updates to our internal controls procedures to ensure greater oversight of financial calculation and appropriate segreg...
Person Responsible for Corrective Action: Edward S. Churchill Jr., Chief Operating Officer Corrective Action Plan: Following the 2024 grant year, College for Social Innovation made updates to our internal controls procedures to ensure greater oversight of financial calculation and appropriate segregation of duties. These updates include additional steps for review and approval of drawdown submissions, training for supervisory staff, and procedures for updating controls procedures as our staff grows and changes. These updates were completed as part of our Corrective Action Plan administered through AmeriCorps’ Office of Monitoring and confirmed as resolved in a notice dated 11/25/2025 [Re: Notification of Corrective Action Plan Closed – 23NDFMA002]. In considering the recommendations provided in this report, College for Social Innovation will further amend our internal controls procedures to include an additional layer of review, reconciliation, and approval of staff time and salary calculations related to AmeriCorps grant activities. In addition to the existing process of compilation by the Chief Operating Officer and review and approval by the Chief Executive Officer, staff time and salary calculations will now also be conducted by the Director of People Operations independently. This secondary calculation will be used for review and reconciliation by the Chief Operating Officer and Director of People Operations to ensure alignment and compliance to AmeriCorps and general accounting standards. Anticipated Completion Date: 2/23/26
Person Responsible for Corrective Action: Edward S. Churchill Jr., Chief Operating Officer Corrective Action Plan: College for Social Innovation’s corrective action plan to ensure timely preparedness for auditing is twofold. First, we are developing a new “Financial Command Center” tool to allow gre...
Person Responsible for Corrective Action: Edward S. Churchill Jr., Chief Operating Officer Corrective Action Plan: College for Social Innovation’s corrective action plan to ensure timely preparedness for auditing is twofold. First, we are developing a new “Financial Command Center” tool to allow greater speed, accuracy, and regularity in tracking account balances and transactions. This new tool better consolidates our tracking processes and allows for regular reconciliations across tracking platforms including Expensify, QuickBooks, Excel, and BambooHR. Second, College for Social Innovation is currently seeking the support services of a Certified Public Accountant. As of February 2, 2026, we have identified a list of potential candidates, are developing a formal request for proposals, and expect to enter a contracted agreement in early March of 2026. This new supporting role will assist in ensuring that our accounting practices fully align with accounting principles generally accepted in the United States. Anticipated Completion Date: 3/30/2026
Finding Number: 2024-048 Finding Name: Inadequate Review of Cash Draw Calculations Finding Condition(s): The Illinois Criminal Justice Information Authority (ICJIA) did not adequately document its review of cash draw calculations for the Crime Victim Assistance (CVA) program. Name of Contact Person(...
Finding Number: 2024-048 Finding Name: Inadequate Review of Cash Draw Calculations Finding Condition(s): The Illinois Criminal Justice Information Authority (ICJIA) did not adequately document its review of cash draw calculations for the Crime Victim Assistance (CVA) program. Name of Contact Person(s): • Hemant Modi, Chief Fiscal Officer – Illinois Criminal Justice Information Authority, Office of Fiscal Management • Precious Taylor, Accounting Supervisor – Illinois Criminal Justice Information Authority, Office of Fiscal Management Corrective Action(s): ICJIA re-implemented reviews and approvals of its cash draw calculations in fiscal year 2025. Proposed Completion Date: October 22, 2024 – Completed
Finding Number: 2024-023 Finding Name: Failure to Provide Supporting Documentation for Payroll and Related Costs Finding Condition(s): The Illinois Department of Child and Family Services (DCFS) could not provide adequate supporting documentation to substantiate payroll and related costs claimed for...
Finding Number: 2024-023 Finding Name: Failure to Provide Supporting Documentation for Payroll and Related Costs Finding Condition(s): The Illinois Department of Child and Family Services (DCFS) could not provide adequate supporting documentation to substantiate payroll and related costs claimed for federal reimbursement under the Foster Care – Title IV-E (Foster Care), Adoption Assistance, and Temporary Assistance for Needy Families (TANF) programs. Additionally, the auditors noted the controls to ensure required documentation is obtained to support payroll and related costs and maintained to evidence management approval of payroll information were not operating effectively. Finally, the auditors noted adequate internal controls have not been established to ensure the data included in the timekeeping system and used to allocate personal services expenditures to Foster Care, Adoption Assistance, TANF, and other programs operated by DCFS is consistent with the hours reported on manual timesheets prepared by the employees and approved by supervisor. Name of Contact Person(s): David Riley, Director – Illinois Department of Child and Family Services, Budget and Finance Division Corrective Action(s): The new quality controls introduced have helped to identify and correct errors, but system modernization is needed to fully implement. The DCFS is working with the Illinois Department of Innovation and Technology to implement the systems to shift to electronic timesheets. Proposed Completion Date: October 31, 2026
Finding Number: 2024-022 Finding Name: Inadequate Process for Foster Care Daycare Maintenance Assistance Payments Finding Condition(s): The Illinois Department of Child and Family Services (DCFS) does not have an adequate process in place to ensure Foster Care daycare maintenance assistance payments...
Finding Number: 2024-022 Finding Name: Inadequate Process for Foster Care Daycare Maintenance Assistance Payments Finding Condition(s): The Illinois Department of Child and Family Services (DCFS) does not have an adequate process in place to ensure Foster Care daycare maintenance assistance payments are accurately paid based on its approved rate schedule. Name of Contact Person(s): Stacy Mixon, Daycare Eligibility Administrator – Illinois Department of Child and Family Services, Office of Contract Administration Corrective Action(s): In July 2025, the daycare eligibility program discontinued the use of certification rate forms. As a result, all childcare providers now receive the state established reimbursement rate, regardless of the rate they charge private-paying families. This change ensures that all childcare providers receive the funding that they are entitled to. Proposed Completion Date: July 1, 2025 – Completed
Finding Number: 2024-020 Finding Name: Inadequate Procedures to Determine Provider Eligibility Finding Condition(s): The Illinois Department of Healthcare and Family Services (DHFS) did not adequately screen providers of the Children’s Health Insurance Program (CHIP) and the Medicaid Cluster program...
Finding Number: 2024-020 Finding Name: Inadequate Procedures to Determine Provider Eligibility Finding Condition(s): The Illinois Department of Healthcare and Family Services (DHFS) did not adequately screen providers of the Children’s Health Insurance Program (CHIP) and the Medicaid Cluster programs to ensure that Medicaid providers were not on the USDHHS Office of the Inspector General’s (OIG) List of Excluded Individuals/Entities (LEIE) at the time the vouchers for the related services performed were paid. Name of Contact Person(s): Susie Brown, Interim Bureau Chief - Illinois Department of Healthcare and Family Services, Provider Enrollment Services Corrective Action(s): The Illinois Medicaid Program Advanced Cloud Technology (IMPACT) system is used by the DHFS for the enrollment and screening of CHIP and Medicaid providers. On a monthly basis, IMPACT automatically checks providers enrolled within IMPACT to the LEIE to verify the provider is not on the LEIE. The IMPACT system is updated through quarterly system releases. As part of the 1.6 quarterly release, the DHFS’ Provider Enrollment Services (PES) updated the system to address the monthly screening check box defect causing the issue. In the Lexis Nexis monthly job, as part of license information, the DHFS receives files from the American Board of Medical Specialties (ABMS), the Clinical Laboratory Improvement Amendments (CLIA), the Drug Enforcement Administration (DEA), and the NCPDP (National Council for Prescription Drug Programs (NCPDP) and other states (out-of-state license/medical license files). Only the corresponding license check boxes are checked for the provider. As an example, for a provider with an ABMS license, the corresponding ABMS check box would be checked. Furthermore, as part of sanction information, the DHFS receives a discipline file, which has the information from the Excluded Parties List System (EPLS), the LEIE, the Medicaid Services Administration (MSA), and other federal and state databases to ensure all databases are checked for active providers in a monthly batch. Any sanctions identified from the sources during the monthly batch screenings will be marked based on the corresponding data source where the sanction was found. If a sanction is found, the system generates an email to the OIG that the provider has been identified as having a potential sanction through the Medicaid Management Information System (MMIS) automated validation process. The email contains the provider name, the National Provider Identifier (NPI), the IMPACT provider identifier, the provider’s address, and the sanction type. The email instructs the OIG to verify the sanction and proceed with the appropriate administrative action. The OIG will provide the necessary administrative action to provider enrollment staff to handle appropriately. Proposed Completion Date: June 30, 2024 - Completed
Finding Number: 2024-018 Finding Name: Improper Calculation of Qualified Incentive Payments Claimed under the Medicaid Cluster Finding Condition(s): The Illinois Department of Healthcare and Family Services (DHFS) incorrectly calculated qualified incentive payments charged to the Medicaid Cluster pr...
Finding Number: 2024-018 Finding Name: Improper Calculation of Qualified Incentive Payments Claimed under the Medicaid Cluster Finding Condition(s): The Illinois Department of Healthcare and Family Services (DHFS) incorrectly calculated qualified incentive payments charged to the Medicaid Cluster program using the enhanced federal medical assistance percentage (FMAP) rate applicable to payments under the Affordable Care Act (ACA) rather than its regular FMAP rate. Additionally, the auditors noted the supervisory review procedures related to the calculation of the qualified incentive payments were not designed to and did not operate at a level of precision to identify an error of this nature. Name of Contact Person(s): Rene Corso, Senior Public Service Administrator - Illinois Department of Healthcare and Family Services, Long Term Care (LTC) Rate Setting Unit Corrective Action(s): The LTC Rate Setting Unit has updated the spreadsheet for calculating the Quality Incentive Payment (QIP) to ensure the percentages for the ACA and the FMAP are distinguishable. Peer checking has also been implemented to ensure amounts are correct before processing Proposed Completion Date: April 16, 2025
Finding Number: 2024-017 Finding Name: Inadequate Procedures to Determine and Document Beneficiary Eligibility Finding Condition(s): The Illinois Department of Healthcare and Family Services (DHFS) does not have adequate procedures to determine and document eligibility for beneficiaries of the Child...
Finding Number: 2024-017 Finding Name: Inadequate Procedures to Determine and Document Beneficiary Eligibility Finding Condition(s): The Illinois Department of Healthcare and Family Services (DHFS) does not have adequate procedures to determine and document eligibility for beneficiaries of the Children’s Health Insurance Program (CHIP) and the Medicaid Cluster programs. Additionally, the auditors noted that the DHFS does not have adequate resources to perform and document eligibility determinations. Finally, the auditors noted that the DHFS has not established appropriate monitoring procedures to ensure eligibility determinations are properly documented in accordance with program requirements. Name of Contact Person(s): • Jacqueline Myers, Interim Deputy Administrator - Illinois Department of Healthcare and Family Services, Eligibility Data and Systems • Pam Winsel, Bureau Chief, Waiver Operations Management - Illinois Department of Healthcare and Family Services, Division of Medical Programs • Jeremy Thomas, Impact Technical Lead - Illinois Department of Healthcare and Family Services, Bureau of Technical Support Corrective Action(s): A report will be created to identify those enrolled in the waiver program, but not receiving full Medicaid that makes them ineligible for payment. This report will be run monthly and worked on manually until a system edit is implemented to reject claims when there is no match on full Medicaid coverage coding. Program staff at the waiver operating agencies will also be trained to assist them in identifying certain criteria that would exclude a waiver program enrollee from being eligible for payment. Rules have been modified (PIR #53483) to make sure eligibility in the RDB (Medicaid Management Information System (MMIS)) gets closed. In addition, a monthly report has been developed and is run monthly to identify any case with the eligibility closed in the IES, yet open in the Recipient Database (RDB). Cases shown on this report are worked to ensure both the Integrated Eligibility System (IES) and the RDB (MMIS) match. Proposed Completion Date: September 1, 2026
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