FAC Explorer

Finding 1090421 (2024-001)

Material Weakness Repeat Finding
Requirement
E
Questioned Costs
-
Year
2024
Accepted
2024-12-12
Audit: 332196
Organization: Mecklenburg County (NC)
Auditor: Cherry Bekaert LLP

AI Summary

  • Core Issue: The County lacks adequate documentation and controls for eligibility determinations in the Medical Assistance program, leading to repeated findings of noncompliance.
  • Impacted Requirements: Key compliance criteria from Section 200.303 of the Uniform Grant Guidance were not met, including proper verification of wages, resources, and timely reviews.
  • Recommended Follow-Up: The County should enhance documentation processes and establish a formal policy to ensure timely correction of identified issues to maintain compliance.

Finding Text

U.S. Department of Health and Human Services Pass-through Entity: North Carolina Department of Health and Human Services Program Name: Medical Assistance Federal Assistance Listing Number: 93.778 Material Weakness and Nonmaterial Noncompliance – Eligibility Finding 2024-001 – Repeat Finding Criteria or Specific Requirement: Per Section 200.303 of the Uniform Grant Guidance, a non-federal entity must establish and maintain effective internal control over the federal award that provides reasonable assurance that the non-federal entity is managing the federal award in compliance with federal statutes, regulations, and the terms and conditions of the federal award. The County should have adequate documentation for each participant that supports each eligibility determination and the information entered into NCFAST. We noted several errors related to the following compliance criteria: a) Self-attestation wages should be compared to information in NC FAST. b) All countable resources should be confirmed and recalculated and ensure they are computed accurately in NC FAST. c) An OVS inquiry must be completed and agreed to information reported in NC FAST. d) An ex parte review is required every six (6) to twelve (12) months. e) Forced eligibility cases should maintain the proper documentation within NC FAST to support the determination for the required forced eligibility. f) For Aged, Blind, or Disabled cases or MQB programs the Register of Deeds is required to be verified and documented in the case file. g) The caseworker should prepare and submit a DMA-5097 form in the case of incompatible income verification and self-attestation income as described in the Eligibility Review Document. h) For countable earned and unearned income, income conversion and computation was done in accordance with policy manuals and have to agree to amounts in NC FAST. Condition: The following are the results of nonmaterial noncompliance noted for each criteria listed above out of the 124 program participants selected for testing: a) There were four instances where the participants self-attest wages did not agree to the wages entered into NC FAST. b) There were three instances where the countable resources were inaccurate within NC FAST. c) There was one instance where the OVS query was not run at the time of the determination. d) There were two instances where the ex parte review was not completed timely. e) There were two instances where the support for the forced eligibility was not properly maintained in NC FAST. f) There was one instance where the Register of Deeds support was not maintained in NC FAST. g) There were five instances where the income was incompatible between the income verification and selfattestation income but no DMA-5097 was sent. h) There were two instances where countable income was not properly included in NC FAST. Lastly, there were 6 instances out of 60 program participants tested for control testing where the County did not remediate the errors identified within their internal review timely. Context: There were 14 out of 124 unique participants tested with the errors noted above. Questioned Costs: None noted. Effect: By not having the required documentation in the files or information being incorrectly documented, eligibility cannot be readily substantiated and there is a risk the County could provide funding to individuals who are not eligible. Cause: County oversight when performing reviews over applications. Additionally, the County does not have a formal process in place to ensure issues identified during the review process are appropriately corrected on a consistent and timely basis. Recommendation: Although these issues will occur from time to time considering the volume of case files, the County should review their processes to ensure proper supporting documentation of eligibility is maintained within each case file. Additionally, Mecklenburg County should consider implementing a formal policy for the requirements of having documentation corrected within a specific timeframe once identified. Views of Responsible Officials: Management agrees with the finding and is implementing procedures to correct this which is further discussed in the Corrective Action Plan. Corrective Action Plan: See Corrective Action Plan prepared by the County.

Categories

Internal Control / Segregation of Duties Subrecipient Monitoring Eligibility Material Weakness Matching / Level of Effort / Earmarking

Other Findings in this Audit

  • 513979 2024-001
    Material Weakness Repeat
  • 513980 2024-001
    Material Weakness Repeat
  • 513981 2024-001
    Material Weakness Repeat
  • 513982 2024-001
    Material Weakness Repeat
  • 513983 2024-001
    Material Weakness Repeat
  • 513984 2024-001
    Material Weakness Repeat
  • 513985 2024-002
    Significant Deficiency
  • 513986 2024-002
    Significant Deficiency
  • 513987 2024-002
    Significant Deficiency
  • 513988 2024-002
    Significant Deficiency
  • 513989 2024-002
    Significant Deficiency
  • 513990 2024-002
    Significant Deficiency
  • 513991 2024-002
    Significant Deficiency
  • 513992 2024-002
    Significant Deficiency
  • 513993 2024-002
    Significant Deficiency
  • 513994 2024-002
    Significant Deficiency
  • 513995 2024-002
    Significant Deficiency
  • 513996 2024-003
    Material Weakness
  • 513997 2024-005
    Significant Deficiency Repeat
  • 513998 2024-005
    Significant Deficiency Repeat
  • 513999 2024-005
    Significant Deficiency Repeat
  • 514000 2024-006
    Significant Deficiency
  • 1090422 2024-001
    Material Weakness Repeat
  • 1090423 2024-001
    Material Weakness Repeat
  • 1090424 2024-001
    Material Weakness Repeat
  • 1090425 2024-001
    Material Weakness Repeat
  • 1090426 2024-001
    Material Weakness Repeat
  • 1090427 2024-002
    Significant Deficiency
  • 1090428 2024-002
    Significant Deficiency
  • 1090429 2024-002
    Significant Deficiency
  • 1090430 2024-002
    Significant Deficiency
  • 1090431 2024-002
    Significant Deficiency
  • 1090432 2024-002
    Significant Deficiency
  • 1090433 2024-002
    Significant Deficiency
  • 1090434 2024-002
    Significant Deficiency
  • 1090435 2024-002
    Significant Deficiency
  • 1090436 2024-002
    Significant Deficiency
  • 1090437 2024-002
    Significant Deficiency
  • 1090438 2024-003
    Material Weakness
  • 1090439 2024-005
    Significant Deficiency Repeat
  • 1090440 2024-005
    Significant Deficiency Repeat
  • 1090441 2024-005
    Significant Deficiency Repeat
  • 1090442 2024-006
    Significant Deficiency

Programs in Audit

ALN Program Name Expenditures
93.563 Child Support Services $8.58M
10.557 Wic Special Supplemental Nutrition Program for Women, Infants, and Children $5.35M
93.659 Adoption Assistance $3.86M
93.596 Child Care Mandatory and Matching Funds of the Child Care and Development Fund $2.40M
93.967 Centers for Disease Control and Prevention Collaboration with Academia to Strengthen Public Health $2.26M
93.940 Hiv Prevention Activities Health Department Based $2.15M
93.767 Children's Health Insurance Program $2.07M
93.323 Epidemiology and Laboratory Capacity for Infectious Diseases (elc) $1.83M
14.218 Community Development Block Grants/entitlement Grants $1.57M
93.686 Ending the Hiv Epidemic: A Plan for America � Ryan White Hiv/aids Program Parts A and B $1.18M
93.914 Hiv Emergency Relief Project Grants $1.15M
93.994 Maternal and Child Health Services Block Grant to the States $773,133
93.568 Low-Income Home Energy Assistance $723,074
93.137 Community Programs to Improve Minority Health Grant Program $633,652
10.561 State Administrative Matching Grants for the Supplemental Nutrition Assistance Program $618,657
84.181 Special Education-Grants for Infants and Families $591,677
93.667 Social Services Block Grant $562,157
17.289 Community Project Funding/congressionally Directed Spending $507,890
66.001 Air Pollution Control Program Support $469,032
20.205 Highway Planning and Construction $451,031
97.039 Hazard Mitigation Grant $441,300
93.217 Family Planning Services $356,839
93.045 Special Programs for the Aging, Title Iii, Part C, Nutrition Services $342,354
93.053 Nutrition Services Incentive Program $259,195
93.917 Hiv Care Formula Grants $242,507
93.566 Refugee and Entrant Assistance State/replacement Designee Administered Programs $215,021
93.268 Immunization Cooperative Agreements $205,040
16.745 Criminal and Juvenile Justice and Mental Health Collaboration Program $194,168
66.034 Surveys, Studies, Research, Investigations, Demonstrations, and Special Purpose Activities Relating to the Clean Air Act $193,664
93.674 John H. Chafee Foster Care Program for Successful Transition to Adulthood $172,768
93.243 Substance Abuse and Mental Health Services Projects of Regional and National Significance $161,553
66.039 Diesel Emission Reduction Act (dera) National Grants $151,742
16.606 State Criminal Alien Assistance Program $145,986
93.044 Special Programs for the Aging, Title Iii, Part B, Grants for Supportive Services and Senior Centers $138,413
93.052 National Family Caregiver Support, Title Iii, Part E $124,497
16.738 Edward Byrne Memorial Justice Assistance Grant Program $117,766
93.671 Family Violence Prevention and Services/domestic Violence Shelter and Supportive Services $106,088
93.069 Public Health Emergency Preparedness $105,660
10.935 Urban Agriculture and Innovative Production $103,366
93.977 Sexually Transmitted Diseases (std) Prevention and Control Grants $102,060
93.898 Cancer Prevention and Control Programs for State, Territorial and Tribal Organizations $101,650
93.556 Marylee Allen Promoting Safe and Stable Families Program $96,045
20.507 Federal Transit Formula Grants $94,838
93.387 National and State Tobacco Control Program $88,746
16.021 Justice Systems Response to Families $88,741
21.027 Coronavirus State and Local Fiscal Recovery Funds $85,051
93.499 Low Income Household Water Assistance Program $84,968
93.747 Elder Abuse Prevention Interventions Program $71,453
93.391 Activities to Support State, Tribal, Local and Territorial (stlt) Health Department Response to Public Health Or Healthcare Crises $58,815
93.136 Injury Prevention and Control Research and State and Community Based Programs $56,000
93.116 Project Grants and Cooperative Agreements for Tuberculosis Control Programs $44,218
14.267 Continuum of Care Program $39,683
16.710 Public Safety Partnership and Community Policing Grants $39,494
93.354 Public Health Emergency Response: Cooperative Agreement for Emergency Response: Public Health Crisis Response $37,116
93.978 Sexually Transmitted Diseases (std) Provider Education Grants $32,486
93.421 Strengthening Public Health Systems and Services Through National Partnerships to Improve and Protect the Nation�s Health $31,938
93.991 Preventive Health and Health Services Block Grant $30,431
16.736 Transitional Housing Assistance for Victims of Domestic Violence, Dating Violence, Stalking, Or Sexual Assault $29,147
93.558 Temporary Assistance for Needy Families $28,911
16.838 Comprehensive Opioid, Stimulant, and Other Substances Use Program $26,317
16.922 Equitable Sharing Program $23,000
93.645 Stephanie Tubbs Jones Child Welfare Services Program $20,420
93.658 Foster Care Title IV-E $17,647
16.607 Bulletproof Vest Partnership Program $17,551
93.318 Protecting and Improving Health Globally: Building and Strengthening Public Health Impact, Systems, Capacity and Security $13,550
93.304 Racial and Ethnic Approaches to Community Health $13,363
97.045 Cooperating Technical Partners $10,662
93.431 Networking2save�: Cdc�s National Network Approach to Preventing and Controlling Tobacco-Related Cancers in Special Populations $6,015
93.103 Food and Drug Administration Research $2,817
14.241 Housing Opportunities for Persons with Aids $1,193
93.778 Medical Assistance Program $-500
21.023 Emergency Rental Assistance Program $-107,226