Finding Text
2024-001 – ALN 93.958 – Block Grant for Community Mental Health Services – Activities Allowed/Allowable Costs: Completion of Comprehensive Assessment (Repeat Comment)
Criteria: The Block Grant for Community Mental Health Services provides for a set of documentation requirements for clients in the covered programs, including the completion of a Financial Assessment Form (FAF) to document financial eligibility over allowable costs. Based on the client’s income and number of dependents, this form is used to determine a “discount class”, and calculate a sliding scale discount percentage and/or dollar amount of SMA’s fees that the client
would be responsible for paying. This form is required to be completed when clients are discharged after being provided mental health services. FAF are to be updated yearly for patients with active billable services, noting all service dates with a billed service should fall within one year of the FAF completion date.
Condition: 7 of the 60 clients tested did not have the discount fee that was used shown on their Financial Assessment Form. Additionally, 8 of the 60 clients tested had service dates that did not fall within one year of the FAF completion date.
Cause: The requirement to perform these control elements were not followed by the case managers.
Effect: The Financial Assessment Forms that were not properly completed or not completed within the required timeframe could result in noncompliance with the grant agreement or noncompliance with established controls.
Recommendation: We recommend that the process be changed so that all Financial Assessment Forms required be completed fully and accurately for all patients within one year of service, and that additional controls be put in place to ensure the discount rate applied is documented and proper.