Finding 1190743 (2025-001)

Finding 2025-001: Material Weakness in Internal Control Over Compliance and Non-Material Noncompliance Federal Awarding Agency: Department of Health and Human Services (HHS) Responsible Person: Deidra Bolden, Acting Director, Department of Family Services Estimated Completion: June 30, 2026 Corrected Action: 1. The Department of Family Services has implemented a Medicaid-focused caseworker structure and a specialized intake-and-ongoing case management model. This model reduces task switching and allows staff to develop proficiency more quickly by focusing on Medicaid and progressing from simpler to more complex case types. It also improves consistency in case processing and allows supervisors to provide more targeted oversight. The Department has also completed a Medicaid Overdue Resolution Project, significantly reducing backlog and stabilizing renewal processing. These structural changes, combined with reduced caseloads and increased supervisory capacity, allow for more focused case management, improved oversight, and more consistent application of eligibility policy. 2. The Department has expanded training capacity and structure to address prior limitations. A second trainer position has been added, doubling internal training capacity and enabling more frequent onboarding, refresher training, and targeted instruction. This allows the Department to better support both new and tenured staff and respond more quickly to identified training needs. In addition, the Department is implementing a competency-based training model that establishes structured learning pathways for new staff, experienced workers, and supervisors. This model incorporates modular curriculum, scenario-based application, and targeted refreshers tied to error trends, supporting more consistent policy application and stronger staff development over time. 3. The Department is strengthening monitoring and case review practices to improve early detection of issues and reinforce consistent oversight. As supervisory capacity has increased and caseloads have begun to stabilize, supervisors are better positioned to conduct more frequent and targeted case reviews, particularly for high-risk and time-sensitive work. The Department is also strengthening case review capacity and moving toward a higher percentage of routine case review to improve early detection of errors and reinforce policy compliance. Trend analysis is being expanded to identify patterns across workers, supervisors, and case types, allowing for more targeted and timely corrective action. These enhancements, supported by improved staffing levels and more manageable caseloads, strengthen the Department’s ability to identify issues earlier, reinforce expectations consistently, and reduce the likelihood of overdue or noncompliant cases. 4. The Department is strengthening how it evaluates the effectiveness of corrective actions by conducting on going case reviews, monthly performance monitoring to track timeliness and accuracy trends, performing trend analysis over time to measure improvement and identify recurring issues, and conducting executive-level reporting to monitor progress and ensure accountability. These evaluation methods provide a structured approach to verifying that corrective actions are implemented effectively and produce sustained improvement. 5. The Department has onboarded additional staff, including supervisors, case managers, a case reviewer, and a trainer, improving both workload distribution and monitoring capacity. Continued investment in staffing, combined with ongoing efforts to right-size caseloads, is expected to further strengthen supervisory oversight, expand case review capacity, and sustain improvements in timeliness and compliance.