Finding 1146477 (2024-003)

Material Weakness
Requirement
E
Questioned Costs
-
Year
2024
Accepted
2025-07-02
Audit: 361326
Organization: Passage Home (NC)

AI Summary

  • Core Issue: The corporation lacks adequate documentation for eligibility determinations, leading to a material weakness in internal controls.
  • Impacted Requirements: Compliance with federal requirements for maintaining proper intake forms and documentation reviews is not being met.
  • Recommended Follow-Up: Implement standardized processes, provide staff training, and conduct periodic internal audits to ensure compliance and identify improvement areas.

Finding Text

Federal Agency: U.S. Department of Veterans Affairs Federal Program Name: Supportive Services for Veteran Families Assistance Listing Number: 64.033 Federal Award Identification Number and Year: 12-NC-050 Award Period: September 30, 2022 through September 30, 2024 - Type of Finding: Material Weakness in Internal Control over Compliance Criteria or specific requirement: The Corporation is required to maintain adequate documentation to support the required eligibility determinations and redeterminations were performed for individuals receiving benefits. Properly completed intake forms and appropriately reviewed documentation are essential to ensure compliance requirements of the program. Condition: The corporation failed to maintain adequate documentation to substantiate the eligibility determinations for individuals receiving benefits. Specifically, intake forms were not properly completed, documentation was not appropriately reviewed, and in certain instances, documentation was available for review. Questioned costs: None Context: During our testing of 16 samples related to eligibility determinations for individuals receiving benefits, we identified the following issues: 4 instances where the intake form was not properly completed, 10 instances where the documentation was not appropriately reviewed, and 1 instance where there was no documentation on the individual receiving benefits. Management has asserted that these may not be the only instances of such issues. Cause: The corporation did not have sufficient controls in place to ensure that all eligibility determination documentation was properly completed, reviewed, and maintained. Effect: Noncompliance with the federal requirements around the determination of an eligible individual. Recommendation: We recommend that the Corporation establish and enforce a standardized process for completing and reviewing intake forms, provide training to staff on the importance of maintaining proper documentation and the procedures for completing and reviewing eligibility determinations, and implement periodic internal audits to ensure compliance with documentation requirements and to identify any areas needing improvement. Views of responsible officials: Management agrees with the above finding. In fiscal year 2025, Passage Home implemented new programmatic policies and procedures ensuring that a Program Manager or the Program Director reviews and approves (by signature) all new client enrollments prior to case manager assignment. The Program Director will conduct related training for all program staff and will administer quarterly client record audits (peer or supervisor review) to verify ongoing compliance.

Categories

Eligibility Material Weakness Internal Control / Segregation of Duties

Other Findings in this Audit

  • 570034 2024-002
    Material Weakness
  • 570035 2024-003
    Material Weakness
  • 570036 2024-004
    Material Weakness
  • 570037 2024-005
    Material Weakness
  • 570038 2024-006
    Significant Deficiency
  • 1146476 2024-002
    Material Weakness
  • 1146478 2024-004
    Material Weakness
  • 1146479 2024-005
    Material Weakness
  • 1146480 2024-006
    Significant Deficiency

Programs in Audit

ALN Program Name Expenditures
93.569 Community Services Block Grant $1.37M
64.033 Va Supportive Services for Veteran Families Program $837,696
14.235 Supportive Housing Program $250,538
14.239 Home Investment Partnerships Program $200,000
14.218 Community Development Block Grants/entitlement Grants $64,684
21.027 Coronavirus State and Local Fiscal Recovery Funds $50,782
14.231 Emergency Solutions Grant Program $39,285