Corrective Action Plans

Finding 498579 (2023-001)

Significant Deficiency 2023

City of Chisholm

MN

Internal Control / Segregation of Duties Questioned Costs Reporting

Lack of segregation of duties - significan deficiency Name of contact person responsible for corrective acttion - Devin Ceglar, City Clerk-Treasurer Corrective action planned - The City Clerk-Tre...

Lack of segregation of duties - significan deficiency Name of contact person responsible for corrective acttion - Devin Ceglar, City Clerk-Treasurer Corrective action planned - The City Clerk-Treasurer will attempt to monitor transactions and structure the duties of the office personnel to ensure as much segregation of duties as possible within the City's staffing limitations and funding contraints. Anticipated completion date - ongoing

View Audit 321321

Finding 498576 (2023-001)

Material Weakness 2023

Wishek Hospital Clinic Association D/b/a South Central Health

ND

Reporting § 200.512

Contact Person Megan Rath 2023-001 Corrective Action Plan The Association’s audited financial statements are now up to date. Proper checks and balances have been put into place to ensure ongoing complete and accurate financial data to avoid delinquent audits and data collection forms. Completion D...

Contact Person Megan Rath 2023-001 Corrective Action Plan The Association’s audited financial statements are now up to date. Proper checks and balances have been put into place to ensure ongoing complete and accurate financial data to avoid delinquent audits and data collection forms. Completion Date The data collection form will be submitted to the Federal Audit Clearinghouse by September 30, 2024.

View Audit 321320

Finding 498563 (2023-001)

None 2023

Franciscan Alliance, Inc.

IN

Reporting Questioned Costs Subrecipient Monitoring § 200.328

The Management of Franciscan Alliance, Inc. and Affiliates (“Franciscan”) considers the implementation and monitoring of effective internal controls to be one of its most important responsibilities, especially as they relate to the funds received from the Federal government. Management has continued...

The Management of Franciscan Alliance, Inc. and Affiliates (“Franciscan”) considers the implementation and monitoring of effective internal controls to be one of its most important responsibilities, especially as they relate to the funds received from the Federal government. Management has continued to promote sound business practices and effective internal controls across the organization through communication, training, and consistent enforcement of the Franciscan’s policies. The following are the Views and Corrective Action Plans of Management regarding the Schedule of Findings and Questioned Costs for the year ended December 31, 2023 for Franciscan Alliance, Inc. and Affiliates. AUDIT FINDING 2023-001 – Compliance with Reporting Requirements MANAGEMENT’S RESPONSE: Management concurs that the Programmatic Report due December 28, 2023 was not submitted until July 25, 2024. CORRECTIVE ACTION PLAN: Franciscan submitted the report on July 25, 2024. Franciscan created an additional tracking system to document reporting requirements for all grants, provide reminders, and document the submitted date. The tracker is prepared and reviewed monthly, with appropriate segregation of duties, to ensure all reports are being submitted accurately and timely. Franciscan now verifies the appropriate individuals have access to reporting systems in advance of reporting due dates. RESPONSIBLE PERSONS: Gregory Pantale, Director Grant Administration, Franciscan Alliance, Inc. COMPLETION DATE: September 2024

View Audit 321315

Finding 498554 (2023-002)

None 2023

County of Cumberland, Pennsylvania

PA

Special Tests & Provisions Questioned Costs Reporting

To: Boyer & Ritter From: Lisa A. Reider, Financial Manager RE: Corrective Action Plan for 2023-002 Date: September 20, 2024 Finding 2023-002: Internal Control over Compliance Finding/Compliance Finding Finding Title: Special Tests and Provisions Anticipated Completion Date: Already Im...

To: Boyer & Ritter From: Lisa A. Reider, Financial Manager RE: Corrective Action Plan for 2023-002 Date: September 20, 2024 Finding 2023-002: Internal Control over Compliance Finding/Compliance Finding Finding Title: Special Tests and Provisions Anticipated Completion Date: Already Implemented Name of Agency Responsible for carrying out the corrective action plan: Children and Youth Person in the agency (name & title): Lisa A. Reider, Financial Manager The Agency has a case management system (CAPS) that provides alerts to the caseworker when regulatory requirements are due. All cases are logged into the system and once the accepted for service date is entered it triggers the system to give the caseworker alerts for the Family Service Plan (FSP) due date. When each worker logs into the CAPS system they have certain alerts on their home page and FSP due dates is one of the default alerts. The FSP due date is also reviewed during the caseworker’s supervision time with their supervisor. Management has reminded caseworkers to regularly monitor the status of the FSP due dates. Further, when workforce turnover occurs the supervisors have been reminded to review caseload details, such as upcoming regulatory due dates, as part of the case reassignments.

View Audit 321313

Finding 498553 (2023-001)

Significant Deficiency 2023

County of Cumberland, Pennsylvania

PA

Reporting

To: Boyer & Ritter From: Lisa A. Reider, Financial Manager RE: Corrective Action Plan for 2023-001 Date: September 20, 2024 Finding 2023-001: Internal Control over Compliance Finding/Compliance Finding Finding Title: Reporting Anticipated Completion Date: Already Implemented Name of Agen...

To: Boyer & Ritter From: Lisa A. Reider, Financial Manager RE: Corrective Action Plan for 2023-001 Date: September 20, 2024 Finding 2023-001: Internal Control over Compliance Finding/Compliance Finding Finding Title: Reporting Anticipated Completion Date: Already Implemented Name of Agency Responsible for carrying out the corrective action plan: Children and Youth Person in the agency (name & title): Lisa A. Reider, Financial Manager The Children and Youth Agency submits complete and accurate Act 148 reports; however, there are circumstances which cause untimely report submissions. There can be various reasons for untimely Act 148 report submission such as late or inaccurate provider invoices. The Children and Youth Agency will continue to work with our providers for more timely and accurate invoice submissions. Further the Administrative Technician will continue to request any outstanding provider invoices monthly, in an effort to obtain information timelier, as part of the monthly expense accrual for the monthly County Close process. Untimely or incomplete information needed in determining a child’s eligibility for Title IV-E funding can impact the submission process. The agency has prioritized ensuring all aspects of the administrative and eligibility requirements are met to avoid errors and accurate invoicing to the Federal Government. The Administrative Technician also works with the caseworkers and supervisors in gathering the information needed from parents as part of the Title IV-E eligibility process. Caseworkers and supervisors have been reminded of the importance of obtaining such eligibility information on a timely basis. Untimely Act 148 reporting is a Statewide issue. While timeliness is important for meeting deadlines and compliance, in most instances the reporting schedule requires more than 45 days to work through all the administrative and eligibility requirements. Management continuously evaluates internal processes to identify potential process improvements that could lead to timelier filings. The agency will continue to strive to file complete and accurate Act 148 reports as timely as possible once all required information has been received..

View Audit 321313

Finding 498543 (2023-003)

Material Weakness 2023

Town of Arcadia

IN

Internal Control / Segregation of Duties Allowable Costs / Cost Principles Material Weakness § 200.1 § 200.303

FINDING 2023-003 Finding Subject: COVID-19 – Coronavirus State and Local Fiscal Recovery Funds – Reporting Summary of Finding: The Project and Expenditure (P&E) report covering April 1, 2022, to March 31, 2023, was submitted without a review or oversight process in place to prevent or detect and cor...

FINDING 2023-003 Finding Subject: COVID-19 – Coronavirus State and Local Fiscal Recovery Funds – Reporting Summary of Finding: The Project and Expenditure (P&E) report covering April 1, 2022, to March 31, 2023, was submitted without a review or oversight process in place to prevent or detect and correct errors. As a result, errors in reporting were identified. Contact Person Responsible for Corrective Action: Jennifer Pickett Contact Person Phone Number: 317-984-3512 jennifer.pickett@arcadia.in.gov Views of Responsible Officials: We concur with the finding. Description of Corrective Action Plan: When the Clerk-Treasurer goes to do the Project and Expenditure report next, she will have the Grant Administrator set with her to complete the form. After the form is completed and has no errors the Clerk Treasurer will print the report off and allow her Deputy Clerk Treasurer to review it. Anticipated Completion Date: This will be corrected in 2025 when the report must be submitted again.

View Audit 321300

Finding 498542 (2023-006)

Significant Deficiency 2023

St Landry Parish Government

LA

Reporting

State and Local Fiscal Recovery Funds Reporting Response: Turnover in key financial management positions led to an oversight in the reporting process for State and Local Fiscal Recovery Act Funding. Failure to report was isolated to one quarter and has been corrected for all subsequent reporting per...

State and Local Fiscal Recovery Funds Reporting Response: Turnover in key financial management positions led to an oversight in the reporting process for State and Local Fiscal Recovery Act Funding. Failure to report was isolated to one quarter and has been corrected for all subsequent reporting periods. Controls will be implemented to ensure accurate and timely reporting.

View Audit 321298

Finding 498541 (2023-001)

Significant Deficiency 2023

Journalism Development Network, Inc.

DC

Subrecipient Monitoring Reporting

Views of Responsible Officials: We acknowledge this lapse. We have already updated procedures to ensure that we are registering subgrants correctly. Name and Title of Responsible Officials: Oliver Rivers, Chief Operating Officer and Deniz Sarkinovic, Senior Director of Compliance Anticipated Complet...

Views of Responsible Officials: We acknowledge this lapse. We have already updated procedures to ensure that we are registering subgrants correctly. Name and Title of Responsible Officials: Oliver Rivers, Chief Operating Officer and Deniz Sarkinovic, Senior Director of Compliance Anticipated Completion Date: September 1, 2024

View Audit 321281

Finding 498531 (2023-001)

Material Weakness 2023

Howard County

IN

Allowable Costs / Cost Principles Material Weakness Period of Performance § 200.1 § 200.303

FINDING 2023-001 Finding Subject: COVID-19 - Coronavirus State and Local Fiscal Recovery Funds - Reporting Summary of Finding: The Deputy Auditor prepared the quarterly reports and the Auditor reviewed the reports; however, the control was not effective and did not detect and allow correction of mat...

FINDING 2023-001 Finding Subject: COVID-19 - Coronavirus State and Local Fiscal Recovery Funds - Reporting Summary of Finding: The Deputy Auditor prepared the quarterly reports and the Auditor reviewed the reports; however, the control was not effective and did not detect and allow correction of material misstatements prior to submission. Two of the four quarterly reports submitted during the audit period were selected for testing. For the two reports tested, all activity for the reporting period was not included, information submitted was not supported by the County's records, and the reports were not fairly presented Contact Person Responsible for Corrective Action: Jessica Secrease Contact Phone Number and Email Address: 765-456-2804 Jessica.secrease@howardcountyin.gov Views of Responsible Officials: We concur with the finding. Description of Corrective Action Plan: The County will follow the internal controls established, including policies and procedures to ensure that the County provides the Treasury with complete and accurate information for the P&E Report in compliance with Federal statutes, regulations, and the terms and conditions of the Federal award. The Chief Deputy will continue to work with the Projects Manager to ensure the reporting is accurate and all obligations and expenditures are reported correctly before sending the information to a third-party vendor. The Auditor will review and approve any reporting prior to submission. Initialed reports will be kept within the grant file. Anticipated Completion Date: September 2024

View Audit 321268

Finding 498527 (2023-001)

Significant Deficiency 2023

Boys & Girls Clubs of South Puget Sound

WA

Reporting Internal Control / Segregation of Duties

Preparation of Schedule of Expenditures of Federal Awards ("SEFA") Condition Schedule for Expenditures of Federal Awards was overstated by $303,678 due to several errors. CORRECTIVE ACTION: Beginning September 2024, Cindy Nguyen, Director of Finance will work with the Director of Data to keep and ma...

Preparation of Schedule of Expenditures of Federal Awards ("SEFA") Condition Schedule for Expenditures of Federal Awards was overstated by $303,678 due to several errors. CORRECTIVE ACTION: Beginning September 2024, Cindy Nguyen, Director of Finance will work with the Director of Data to keep and maintain a rolling SEFA schedule for the year. The total expenditures will be updated monthly by the Director of Data, who also creates and submits all of our grant billings. After which, the Director of Finance will go into the SEFA schedule to confirm the expenditure totals by comparing them to the GL. If any variances exist, the Director of Finance will reach out to the Director of Data to investigate the variances and document why potential variances would exist. They will also meet on a quarterly basis to review the SEFA to make sure nothing was missed or needs correcting.

View Audit 321263

Finding 498518 (2023-004)

Significant Deficiency 2023

Marquette County

WI

Questioned Costs Reporting Matching / Level of Effort / Earmarking

Finding 2023-004 Program Federal Assistance Listing and Title: 93.778 Medicaid Cluster State ID Numbers and Titles: 435.283 IMAA State Share 395.168 Elderly and Handicapped County Aids Award Numbers: Unknown Federal Agency: U.S. Department of Health and Human Services Pass-Throu...

Finding 2023-004 Program Federal Assistance Listing and Title: 93.778 Medicaid Cluster State ID Numbers and Titles: 435.283 IMAA State Share 395.168 Elderly and Handicapped County Aids Award Numbers: Unknown Federal Agency: U.S. Department of Health and Human Services Pass-Through Agency: Wisconsin Department of Health Services State Agencies: Wisconsin Department of Health Services Wisconsin Department of Transportation Criteria: 2 CRF 200.303 Internal Controls requires that non-federal entities receiving federal awards establish and maintain internal control designed to reasonably ensure compliance with federal laws, regulations and program compliance requirements. The State Single Audit Guidelines (SSAG) require that local entities receiving State awards establish and maintain internal control designed to reasonably ensure compliance with laws, regulations and program compliance requirements. To minimize the risk of errors, internal controls should be in place for all program compliance requirements, including appropriate review and approval of expenditures. Condition/Context: During our testing, we were unable to view approval for the following number of expenditures in each program: • 93.778: 4 out of 7 of the expenditures tested. • 395.168: 15 out of 40 of the expenditures tested. • 435.283: 3 out of 6 of the expenditures tested. These samples were not statistically valid. Corrective Action Plan Corrective Action Planned: In response to Finding 2023-004 regarding Internal Control Over Financial Reporting, note that the County is aware that there is a lack of controls over its year-end financial reporting process. The County will endeavor to evaluate the need to increase additional staff to meet the deficiencies noted in the finding. However, because of its size, the County does not feel it is cost-effective to hire the number of employees needed to complete these tasks in-house at this point in time and will rely on an outside audit firm to review financial statements, disclosures and schedules. County administration and financial staff review the adjustments and reports prepared by the auditors to ensure the accuracy of the information. Name(s) of Contact Person(s) Responsible for Corrective Action: Ron Barger, Marquette County Administrator. Anticipated Completion Date: Administration will examine the lack of internal financial reporting on an ongoing basis and consider adding additional accounting staff as resources become available.

View Audit 321245

Finding 498512 (2023-007)

Significant Deficiency 2023

Traverse County

MN

Questioned Costs Cash Management Reporting § 200.303

Finding Number: 2023-007 Finding Title: Local Collaborative Time Study (LCTS) Reporting (Cost Schedules DHS-3220.1 and DHS-3220.2) Program: 93.778 Medical Assistance Program Name of Contact Person Responsible for Corrective Action: Melanie Lupkes/Shelly Staebler Corrective Action Planned: Social Ser...

Finding Number: 2023-007 Finding Title: Local Collaborative Time Study (LCTS) Reporting (Cost Schedules DHS-3220.1 and DHS-3220.2) Program: 93.778 Medical Assistance Program Name of Contact Person Responsible for Corrective Action: Melanie Lupkes/Shelly Staebler Corrective Action Planned: Social Services and Probation staff met as a group to go over the most recent bulletin that includes the instructions for completing the forms and for the allowable expenses. Consulted with OSA staff for interpretation of some of the items and all quarterly reports have been resubmitted, reviewed by Traverse County Social Services Fiscal and accepted by the State. Anticipated Completion Date: Completed, September 7, 2024

View Audit 321238

Finding 498511 (2023-006)

Significant Deficiency 2023

Traverse County

MN

Internal Control / Segregation of Duties Questioned Costs Reporting § 200.303

Finding Number: 2023-006 Finding Title: Local Collaborative Time Study (LCTS) Reporting (Cost Schedules DHS-3220.2) Program: 93.778 Medical Assistance Program Name of Contact Person Responsible for Corrective Action: Melanie Lupkes/Shelly Staebler Corrective Action Planned: Social Services and Prob...

Finding Number: 2023-006 Finding Title: Local Collaborative Time Study (LCTS) Reporting (Cost Schedules DHS-3220.2) Program: 93.778 Medical Assistance Program Name of Contact Person Responsible for Corrective Action: Melanie Lupkes/Shelly Staebler Corrective Action Planned: Social Services and Probation staff met as a group to go over the most recent bulletin that includes the instructions for completing the forms and for the allowable expenses. Consulted with OSA staff for interpretation of some of the items and all quarterly reports have been resubmitted, reviewed by Traverse County Social Services Fiscal and accepted by the State. Anticipated Completion Date: Completed, September 7, 2024

View Audit 321238

Finding 498510 (2023-005)

Material Weakness 2023

Traverse County

MN

Internal Control / Segregation of Duties Questioned Costs Cash Management § 200.303

Finding Number: 2023-005 Finding Title: Reporting (DHS 2550 and 2556) Program: 93.778 Medical Assistance Program Name of Contact Person Responsible for Corrective Action: Shelly Staebler Corrective Action Planned: Traverse County Social Services fiscal staff will review the new detailed instructions...

Finding Number: 2023-005 Finding Title: Reporting (DHS 2550 and 2556) Program: 93.778 Medical Assistance Program Name of Contact Person Responsible for Corrective Action: Shelly Staebler Corrective Action Planned: Traverse County Social Services fiscal staff will review the new detailed instructions on how to complete the referenced quarterly reports that include recent changes. Staff will correct an resubmit quarterly reports as requested. Anticipated Completion Date: January 20, 2025

View Audit 321238

Finding 498499 (2023-003)

Material Weakness 2023

American Academy of Child and Adolescent Psychiatry

DC

Questioned Costs Material Weakness Reporting

Identifying Number: 2023-003 Finding: Timely Submission of the Data Collection Form Corrective Actions Taken or Planned: Management’s Response to Audit Finding on Timely Submission of the Data Collection Form During the 2023 calendar year, AACAP (The Academy) did not submit the 2022 data collect...

Identifying Number: 2023-003 Finding: Timely Submission of the Data Collection Form Corrective Actions Taken or Planned: Management’s Response to Audit Finding on Timely Submission of the Data Collection Form During the 2023 calendar year, AACAP (The Academy) did not submit the 2022 data collection form within nine months after the end of the audit period. Management takes this deficiency seriously and is committed to improving the timeliness of accounting functions. The following procedures are being implemented: 1. An outsourced accounting and consulting firm provided 2023 financial services to the Academy and worked in conjunction with a federal grant consultant bring federal reports current. Additionally, the Academy hired in-house financial staff with experience in federal grant reporting to oversee the process. We expect that 2023 and future federal reports will be filed on a timely basis. Name of Responsible Person: Heidi Fordi, Executive Director/CEO Projected Date of Completion: September 23, 2024

View Audit 321217

Finding 498472 (2023-002)

Significant Deficiency 2023

City of Union City

IN

Internal Control / Segregation of Duties Special Tests & Provisions Reporting § 200.303

The City will review the wage-rate testing prepared by the consultant and formally document their review

View Audit 321171

Finding 498471 (2023-001)

Significant Deficiency 2023

City of Union City

IN

Internal Control / Segregation of Duties Cash Management Reporting § 200.303

The City will review the reports prepared by the consultant and formally document their review

View Audit 321171

Finding 498468 (2023-002)

None 2023

Medical Debt Resolution, Inc.

NY

Questioned Costs Subrecipient Monitoring Reporting

Finding Number: 2023-002 Compliance Requirement: Reporting Programs: United States Department of the Treasury ALN Number: 21.019 ALN Name: Coronavirus Relief Fund Contract Periods: June 16, 2023 – June 16, 2024 (City of New Orleans, Louisiana) Planned Corrective Action: The Organization is committed...

Finding Number: 2023-002 Compliance Requirement: Reporting Programs: United States Department of the Treasury ALN Number: 21.019 ALN Name: Coronavirus Relief Fund Contract Periods: June 16, 2023 – June 16, 2024 (City of New Orleans, Louisiana) Planned Corrective Action: The Organization is committed to improving its timeliness of reporting, and is developing a plan to align and adhere to all grantor’s reporting requirements. The Organization is also hiring several new staff to ensure adequate internal capacity to deliver in a timely manner. Person Responsible: Chief Operating Officer (performance reporting) and Vice President, Finance & Administration (fiscal reporting) Expected Completion Date: October 31, 2024

View Audit 321164

Finding 498459 (2023-008)

Material Weakness 2023

City of Baton Rouge - Parish of East Baton Rouge

LA

Subrecipient Monitoring Special Tests & Provisions Reporting

Management’s response and corrective action is as follows: The responsibility to monitor projects in the affordability period recently transferred to the City-Parish. However, our office has had insufficient capacity thus far to inspect all projects within their 20-year affordability period. We ha...

Management’s response and corrective action is as follows: The responsibility to monitor projects in the affordability period recently transferred to the City-Parish. However, our office has had insufficient capacity thus far to inspect all projects within their 20-year affordability period. We have prioritized inspection of projects currently under construction to ensure that our office can continues to meet our community’s affordable housing needs. Our team has worked diligently with the Finance Department, the Human Resources Department, and the Mayor-President’s Office to create an expanded organizational chart and capacity plan. That plan was approved by the EBR Metro Council earlier this year and hiring activities are ongoing. Simultaneously, we have procured additional consultant support to provide technical expertise throughout this monitoring. Expected Implementation Date: December 2024 Contact person: Marlee Pittman Miller, Director, Mayor-President’s Office of Community Development

View Audit 321162

Finding 498452 (2023-003)

Material Weakness 2023

Box Butte General Hospital

NE

Questioned Costs Material Weakness Reporting

FINDING 2023-003 COMPLETION AND TIMELY FILING OF SINGLE AUDIT REPORTS Effect and recommendation The Hospital implemented a new accounting and electronic health record (EHR) system in May of 2023 and incurred significant issues with the implementation resulting in both the financial statement and co...

FINDING 2023-003 COMPLETION AND TIMELY FILING OF SINGLE AUDIT REPORTS Effect and recommendation The Hospital implemented a new accounting and electronic health record (EHR) system in May of 2023 and incurred significant issues with the implementation resulting in both the financial statement and compliance audits being significantly delayed. This resulted in the Hospital’s financial statements and compliance audits for June 30, 2023 reporting period not being filed within the required timeline. Views of responsible officials and planned corrective actions The financial statement and compliance audit will be filed with the Federal Audit Clearinghouse shortly after issuance. Anticipated completion date Ongoing

View Audit 321161

Finding 498427 (2023-004)

Material Weakness 2023

State of Missouri

MO

Internal Control / Segregation of Duties Cash Management Reporting

State of Missouri Single Audit Corrective Action Plan Year Ended June 30, 2023 State Agency: Department of Social Services (DSS) – MO HealthNet Division (MHD) Audit Finding Number: 2023-004 – Medicaid and CHIP Receipt Controls Name of the contact person responsible for corrective acti...

State of Missouri Single Audit Corrective Action Plan Year Ended June 30, 2023 State Agency: Department of Social Services (DSS) – MO HealthNet Division (MHD) Audit Finding Number: 2023-004 – Medicaid and CHIP Receipt Controls Name of the contact person responsible for corrective action: Ashley Logan Anticipated completion date for corrective action: June 30, 2024 Recommendation: The DSS through the MHD review, strengthen, and enforce internal controls over Medicaid and CHIP receipts. The MHD should restrict user access within the MMIS for FORU accounting personnel and adequately segregate asset custody and receipt recording duties from accounts receivable duties, or perform documented supervisory reviews of MMIS entries and changes made by employees whose duties are not segregated. In addition, the MHD should establish procedures to account for all cash control numbers to ensure all receipts are deposited or returned to senders. DSS Response: DSS agrees with the auditor's finding. Our Corrective Action Plan includes the department’s planned actions to address the finding. Corrective action planned is as follows: MHD has implemented a process to document supervisory reviews of the Finance Manual Checks Quarterly report to ensure segregation of duties in HeathTrack/AHS. MHD will continue to perform the audit of clerk ID adhoc reports to review any segregation of duties within the MMIS. To ensure all cash control numbers are accounted for, MHD is implementing a new cash control number sequence, exclusive to manual checks logged within the FORU. This will resolve the issue of cash control numbers occurring out of sequence due to AHS running files in the background at the same time checks are being logged.

View Audit 321142

Finding 498425 (2023-002)

Material Weakness 2023

State of Missouri

MO

Reporting Matching / Level of Effort / Earmarking Internal Control / Segregation of Duties

State of Missouri Single Audit Corrective Action Plan Year Ended June 30, 2023 State Agency: Department of Social Services (DSS) – MO HealthNet Division (MHD) Audit Finding Number: 2023-002 - Medicaid Management Information System Access Name of the contact person responsible for cor...

State of Missouri Single Audit Corrective Action Plan Year Ended June 30, 2023 State Agency: Department of Social Services (DSS) – MO HealthNet Division (MHD) Audit Finding Number: 2023-002 - Medicaid Management Information System Access Name of the contact person responsible for corrective action: Christopher Boyle Anticipated completion date for corrective action: March 10, 2024 Recommendation: The DSS through the MHD review user access to the MMIS annually and ensure inappropriate access, including that of terminated users, is removed in a timely manner. DSS Response: DSS agrees with the auditor’s recommendation. The Corrective Action Plan includes the department’s planned actions to address the finding. Corrective action planned is as follows: MHD will continue to perform the annual review, but to ensure that the annual review is completed timely, monthly calendar meetings have been created. The FY24 annual review is in progress. In addition to the annual review, instead of relying on supervisors to inform MHD of terminations, MHD staff have updated the off-boarding process to identify additional eMOMED and eMMIS users who no longer require access. MHD staff are comparing the MMIS active user lists with lists of terminated users. When an active user is located on a termination list, a request to disable the MMIS account is submitted.

View Audit 321142

Finding 498414 (2023-016)

Significant Deficiency 2023

State of Missouri

MO

Questioned Costs Allowable Costs / Cost Principles Eligibility

State of Missouri Single Audit Corrective Action Plan Year Ended June 30, 2023 State Agency: Department of Elementary and Secondary Education (DESE) Audit Finding Number: 2023-016 Child Care Payments Name of the contact person responsible for corrective action: Shelley Woods Anti...

State of Missouri Single Audit Corrective Action Plan Year Ended June 30, 2023 State Agency: Department of Elementary and Secondary Education (DESE) Audit Finding Number: 2023-016 Child Care Payments Name of the contact person responsible for corrective action: Shelley Woods Anticipated completion date for corrective action: 12/31/2024 Corrective action planned is as follows: DESE agrees with the auditor’s finding. It has been challenging to have adequate internal controls over the child care program with two separate state agencies trying to administer different aspects of the program. The Department of Social Services (DSS) has been implementing eligibility and authorizations for families, while DESE has been administering rates, rules, licensure, and provider agreements. Effective July 1, 2024, eligibility and authorizations for families transfers under DESE’s authority to ensure all facets of program implementation are within one state agency for better internal controls. In addition, DESE transitioned to a new Child Care Data System (CCDS) for provider payments in the beginning of January 2024. Access, interfaces, and updates within the older systems has created multiple barriers and payments issues for the program. This single system, CCDS, allows parents to have a streamlined process for eligibility determinations, report changes in address or income, find or change providers, while also giving providers one place to apply for a contract, view authorizations, update contact information, view payment remittances, and make payment adjustments. By December 31, 2024, the CCDS will have combined all functions of FAMIS, FACES, and CCBIS attendance system into CCDS. DESE users can easily and efficiently make family and rate changes as necessary and view all information in the system, which will also strengthen internal controls. DESE also continues to revise and clarify internal procedures to ensure consistent and accurate eligibility determinations and claims processing. CCDF regulations specifically state pursuant to 45 CFR 98.21(a)(1) that because a child meeting eligibility requirements at the most recent eligibility determination or redetermination is considered eligible between redeterminations, any payment for such a child shall not be considered an error or improper payment due to a change in the family's circumstances. Based on this regulation, DESE will work with the Administration for Children and Families to repay any claims considered questioned costs.

View Audit 321142 Questioned Costs: $1

Finding 498411 (2023-010)

Material Weakness 2023

State of Missouri

MO

Subrecipient Monitoring Procurement, Suspension & Debarment Reporting § 200.303 § 200.331 § 200.332

State of Missouri Single Audit Corrective Action Plan Year Ended June 30, 2023 State Agency: Office of Administration Audit Finding Number: 2023-010, SLFRF Program Subrecipient Monitoring Name of the contact person responsible for corrective action: Stacy Neal Anticipated completion d...

State of Missouri Single Audit Corrective Action Plan Year Ended June 30, 2023 State Agency: Office of Administration Audit Finding Number: 2023-010, SLFRF Program Subrecipient Monitoring Name of the contact person responsible for corrective action: Stacy Neal Anticipated completion date for corrective action: September 2024 Recommendation A.: Develop policies and procedures to determine whether recipients of SLFRF program funds are subrecipients or contractors. Work with the state agencies to ensure accurate and documented determinations are prepared for all recipients and modify subrecipient records as needed. OA partially agrees with the auditor’s finding. Corrective action planned is as follows: OA believes there are opportunities to improve the classification of subrecipient vs. contractor to ensure compliance with federal regulations. We concur that OA, as the responsible party, should modify a department determination of subrecipient when there is a conflict with the regulation. Finally, we agree that clear communication on roles and responsibilities of OA vs. departments related to compliance is essential and can be improved. Given this position, we disagree that OA needs to issue procedures that restate the rules the uniform guidance and SLFRF regulations already state. We will continue to have discussions with agencies and ensure compliance with federal regulations. Recommendation B.: Develop a subrecipient monitoring program in accordance with the Uniform Guidance, that including performing risk assessments for each subrecipient for the purposes of determining the appropriate subrecipient monitoring procedures; monitoring for compliance with federal requirements and subaward terms and conditions and ensuring subaward performance goals are achieved; and reviewing subrecipient single audit reports. Ensure tasks delegated to state agencies are adequately communicated and establish procedures to ensure those tasks are appropriately completed. OA agrees with the auditor’s finding. Corrective action planned is as follows: OA approached the SLFRF money to consider all spending (whether to subrecipients or any other payment) as high risk due to the large dollar amount of one-time funding that is subject to rules that have changed over time. We have continued to treat this unique and highly publicized funding as high risk for fraud and exercise due diligence to mitigate that risk. OA agrees however, that our universal determination related to the SLFRF does not meet the specific uniform guidance rules. OA agrees to provide additional communications to departments to ensure agencies understand their responsibilities for sub-recipient monitoring including sub-recipient specific risk assessments and monitoring. Finally, OA will implement random reviews of the sub-recipient monitoring compliance.

View Audit 321142

Finding 498408 (2023-011)

Significant Deficiency 2023

State of Missouri

MO

Reporting Matching / Level of Effort / Earmarking § 200.303 § 200.510 § 200.512

State of Missouri Single Audit Corrective Action Plan Year Ended June 30, 2023 State Agency: Office of Administration Audit Finding Number: 2023-011 OA Statewide SEFA Name of the contact person responsible for corrective action: Stacy Neal Anticipated completion date for corrective ac...

State of Missouri Single Audit Corrective Action Plan Year Ended June 30, 2023 State Agency: Office of Administration Audit Finding Number: 2023-011 OA Statewide SEFA Name of the contact person responsible for corrective action: Stacy Neal Anticipated completion date for corrective action: September 30, 2024 Corrective action planned is as follows: We agree. DOA completed a materially correct SEFA within historically consistent timeframes including providing the document 3 weeks earlier than last year. However, after recent discussions with SAO, DOA does acknowledge a materially correct draft is needed by October to support an efficient single audit and we will provide the document on that timeframe next audit. DOA further recognizes that there are always opportunities for improved training, reduced turnover, and efficient communications.

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Corrective Action Plans

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