Finding 1092186 (2024-001)

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 Significant Deficiency and Non-Material Noncompliance – Eligibility Finding 2024-001 Criteria: In accordance with Section 200.303 of the Uniform 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 non-federal entity is also required to confirm that the Register of Deeds was checked for aged, blind, or disabled cases or MQB programs to determine if the individual owns property and is documented in the case file and agrees to information in the NC FAST system. Condition: The County did not follow up with individuals after reviews were completed and issues were noted in the review in accordance with its policies on a consistent basis. The County did not perform a Register of Deeds check during the recertification period. Context: There were 11 instances out of 60 reviews tested in which the County did not remediate the errors identified timely. There was 1 instance out of 60 eligibility samples tested that did not have a Register of Deeds check performed during the recertification period. Questioned Costs: No questioned costs reported. Effect: The caseworkers that had errors identified in their eligibility determinations were not notified timely of the issues which could result in potential future issues. The required procedures and verification checks were not fully followed during the period of recertification. Cause: The County has a policy in place but does not have a way to ensure the policy is being enforced. The County missed the step to run the Register of Deeds check at the time of recertification. Recommendation: We recommend the County assign individuals to ensure all reviews are taking place timely in accordance with its policy including timely follow up with case workers once the review is complete. We also recommend all required steps are performed during eligibility check and the recertification period. 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.