Finding 1207033 (2024-021)

Material Weakness Repeat Finding
Requirement
N
Questioned Costs
-
Year
2024
Accepted
2026-04-16
Audit: 398893
Organization: State of Illinois (IL)
Auditor: KPMG LLP

AI Summary

  • Core Issue: DHFS did not conduct required reviews for five Home and Community Based Waiver Services (HCBS) due to a lapsed vendor contract, leading to unmonitored Medicaid claims.
  • Impacted Requirements: Compliance with 42 CFR 456, which mandates utilization reviews to ensure quality care in Medicaid services, was not met.
  • Recommended Follow-Up: DHFS should secure a new contractor for fiscal year 2025 or develop an internal plan for conducting reviews if no contractors are available.

Finding Text

State Agency: Illinois Department of Healthcare and Family Services (DHFS) Federal Agency: U.S. Department of Health and Human Services (USDHHS) Program Name: Medicaid Cluster ALN and Program Expenditures: 93.775/93.777/93.778 ($20,707,079,599) Award Numbers: Various – see schedule of award numbers Federal Award Year: Various – see schedule of award numbers Questioned Costs: Cannot be determined Compliance Requirement: Special Tests and Provisions – Utilization Control Finding 2024-021: Failure to Perform Reviews over Home and Community Based Waiver Services (HCBS) Condition Found: DHFS failed to conduct utilization reviews over HCBS services for five of the nine waivers contracted out to their vendor during fiscal year 2024. DHFS is required to follow the state plan’s methods and procedures to safeguard against unnecessary utilization of care and services. HCBS services are furnished to beneficiaries who would otherwise need inpatient care that is furnished in a hospital, nursing facility or other institutional setting which are reimbursable for Medicaid claims under the state plan. One of these requirements is to perform reviews over HCBS waiver services. There are nine total HCBS waivers and five of them are contracted out through a vendor. These five waivers are: Persons with Disabilities, People with HIV or AIDS, Persons with Brain Injury, Adults with Developmental Disabilities, and Persons who are Elderly. During our audit procedures and based on inquiries with DHFS officials, the vendor contract came to an end on February 28, 2023, and a new contract was not in place to cover July 1, 2023 through June 30, 2024 (fiscal year 2024). As a result, we identified no reviews performed during fiscal year 2024. The agency continued to provide reviews and monitoring over the other four HCBS waivers: Residential Waiver for Children and Young Adults with Developmental Disabilities, the Support Waiver for Children and Young Adults with Developmental Disabilities, the Medically Fragile/Technology Dependent Children waiver, and the Supportive Living Facility waiver. The failure to perform reviews from July 1, 2023 through June 30, 2024 resulted in $2,754,254,430 in Medicaid claims that were not subject to contractor reviews during fiscal year 2024. Payments made on behalf of beneficiaries of the Medicaid Cluster program totaled $19,742,854,768 during the year ended June 30, 2024. Criteria or Requirement: 42 CFR 456 discusses the entire utilization control program to help ensure appropriate care is being provided for Medicaid services. Specifically, 42 CFR 456.22 requires the State Medicaid agency to have a sampling plan in place to perform reviews over the quality of Medicaid services. Additionally, 42 CFR 456.4 discusses the responsibilities of the state Medicaid agency to monitor these requirements even if they are outsourced to a third-party to perform these reviews. Cause: In discussing these conditions with DHFS management, they stated the contract with the third-party servicer expired as of February 28, 2023. The intention was to have the contract extended to continue working on the HCBS waiver reviews, but there were issues extending the contract. DHFS posted a request for quote in attempt to hire another contractor but did not receive any responses. As a result, there were no reviews performed after the expiration of the contract. Possible Asserted Effect: Failure to properly review and monitor Medicaid services could result in inadequate services being provided and poor quality of care at the facilities. Repeat Finding: A similar finding was reported in the prior year audit as finding number 2023-025 (Finding Code 2024-021, 2023-025). Statistical Sampling: The sample was not intended to be, and was not, a statistically valid sample. Recommendation: We recommend DHFS obtain a contractor for fiscal year 2025 or have a plan in place to perform reviews themselves if there are no contractors willing and able to perform these reviews. Views of DHFS Officials: DHFS agrees with the finding. An Invitation for Bid has been posted to procure a contractor to resume record reviews. The opening of bids occurred in January 2026. Contract execution is anticipated prior to June 30, 2026.

Corrective Action Plan

Finding Number: 2024-021 Finding Name: Failure to Perform Reviews over Home and Community Based Waiver Services (HCBS) Finding Condition(s): The Illinois Department of Healthcare and Family Services (DHFS) failed to conduct utilization reviews over home and community-based services for five of the nine waivers contracted out to its vendor during fiscal year 2024. Name of Contact Person(s): • Pamela Winsel, Bureau Chief, Waiver Operations Management - Illinois Department of Healthcare and Family Services, Division of Medical Programs • Tracy Anderson, Public Service Administrator, Waiver Operations Management - Illinois Department of Healthcare and Family Services, Division of Medical Programs • Sarah Myerschough-Mueller, Deputy Administrator - Illinois Department of Healthcare and Family Services, Division of Medical Programs Corrective Action(s): The DHFS will procure a new vendor to complete record reviews. An Invitation for Bid was been posted to procure a contractor to resume record reviews. The opening of bids occurred in January 2026. The new vendor will begin record reviews in fiscal year 2027. Proposed Completion Date: July 1, 2026

Categories

Special Tests & Provisions Procurement, Suspension & Debarment Subrecipient Monitoring

Other Findings in this Audit

  • 1206885 2024-002
    Material Weakness Repeat
  • 1206886 2024-002
    Material Weakness Repeat
  • 1206887 2024-002
    Material Weakness Repeat
  • 1206888 2024-002
    Material Weakness Repeat
  • 1206889 2024-002
    Material Weakness Repeat
  • 1206890 2024-002
    Material Weakness Repeat
  • 1206891 2024-002
    Material Weakness Repeat
  • 1206892 2024-002
    Material Weakness Repeat
  • 1206893 2024-002
    Material Weakness Repeat
  • 1206894 2024-002
    Material Weakness Repeat
  • 1206895 2024-002
    Material Weakness Repeat
  • 1206896 2024-002
    Material Weakness Repeat
  • 1206897 2024-002
    Material Weakness Repeat
  • 1206898 2024-002
    Material Weakness Repeat
  • 1206899 2024-002
    Material Weakness Repeat
  • 1206900 2024-002
    Material Weakness Repeat
  • 1206901 2024-002
    Material Weakness Repeat
  • 1206902 2024-002
    Material Weakness Repeat
  • 1206903 2024-002
    Material Weakness Repeat
  • 1206904 2024-002
    Material Weakness Repeat
  • 1206905 2024-002
    Material Weakness Repeat
  • 1206906 2024-002
    Material Weakness Repeat
  • 1206907 2024-002
    Material Weakness Repeat
  • 1206908 2024-002
    Material Weakness Repeat
  • 1206909 2024-002
    Material Weakness Repeat
  • 1206910 2024-002
    Material Weakness Repeat
  • 1206911 2024-002
    Material Weakness Repeat
  • 1206912 2024-002
    Material Weakness Repeat
  • 1206913 2024-002
    Material Weakness Repeat
  • 1206914 2024-002
    Material Weakness Repeat
  • 1206915 2024-002
    Material Weakness Repeat
  • 1206916 2024-002
    Material Weakness Repeat
  • 1206917 2024-002
    Material Weakness Repeat
  • 1206918 2024-002
    Material Weakness Repeat
  • 1206919 2024-002
    Material Weakness Repeat
  • 1206920 2024-002
    Material Weakness Repeat
  • 1206921 2024-002
    Material Weakness Repeat
  • 1206922 2024-002
    Material Weakness Repeat
  • 1206923 2024-002
    Material Weakness Repeat
  • 1206924 2024-002
    Material Weakness Repeat
  • 1206925 2024-002
    Material Weakness Repeat
  • 1206926 2024-002
    Material Weakness Repeat
  • 1206927 2024-003
    Material Weakness Repeat
  • 1206928 2024-003
    Material Weakness Repeat
  • 1206929 2024-004
    Material Weakness Repeat
  • 1206930 2024-004
    Material Weakness Repeat
  • 1206931 2024-005
    Material Weakness Repeat
  • 1206932 2024-005
    Material Weakness Repeat
  • 1206933 2024-005
    Material Weakness Repeat
  • 1206934 2024-005
    Material Weakness Repeat
  • 1206935 2024-006
    Material Weakness Repeat
  • 1206936 2024-006
    Material Weakness Repeat
  • 1206937 2024-006
    Material Weakness Repeat
  • 1206938 2024-006
    Material Weakness Repeat
  • 1206939 2024-006
    Material Weakness Repeat
  • 1206940 2024-007
    Material Weakness Repeat
  • 1206941 2024-007
    Material Weakness Repeat
  • 1206942 2024-007
    Material Weakness Repeat
  • 1206943 2024-007
    Material Weakness Repeat
  • 1206944 2024-007
    Material Weakness Repeat
  • 1206945 2024-007
    Material Weakness Repeat
  • 1206946 2024-007
    Material Weakness Repeat
  • 1206947 2024-007
    Material Weakness Repeat
  • 1206948 2024-008
    Material Weakness Repeat
  • 1206949 2024-009
    Material Weakness Repeat
  • 1206950 2024-009
    Material Weakness Repeat
  • 1206951 2024-009
    Material Weakness Repeat
  • 1206952 2024-009
    Material Weakness Repeat
  • 1206953 2024-009
    Material Weakness Repeat
  • 1206954 2024-009
    Material Weakness Repeat
  • 1206955 2024-009
    Material Weakness Repeat
  • 1206956 2024-009
    Material Weakness Repeat
  • 1206957 2024-009
    Material Weakness Repeat
  • 1206958 2024-009
    Material Weakness Repeat
  • 1206959 2024-009
    Material Weakness Repeat
  • 1206960 2024-009
    Material Weakness Repeat
  • 1206961 2024-010
    Material Weakness Repeat
  • 1206962 2024-010
    Material Weakness Repeat
  • 1206963 2024-011
    Material Weakness Repeat
  • 1206964 2024-011
    Material Weakness Repeat
  • 1206965 2024-011
    Material Weakness Repeat
  • 1206966 2024-011
    Material Weakness Repeat
  • 1206967 2024-011
    Material Weakness Repeat
  • 1206968 2024-012
    Material Weakness Repeat
  • 1206969 2024-012
    Material Weakness Repeat
  • 1206970 2024-013
    Material Weakness Repeat
  • 1206971 2024-013
    Material Weakness Repeat
  • 1206972 2024-013
    Material Weakness Repeat
  • 1206973 2024-013
    Material Weakness Repeat
  • 1206974 2024-013
    Material Weakness Repeat
  • 1206975 2024-013
    Material Weakness Repeat
  • 1206976 2024-013
    Material Weakness Repeat
  • 1206977 2024-013
    Material Weakness Repeat
  • 1206978 2024-014
    Material Weakness Repeat
  • 1206979 2024-014
    Material Weakness Repeat
  • 1206980 2024-014
    Material Weakness Repeat
  • 1206981 2024-014
    Material Weakness Repeat
  • 1206982 2024-014
    Material Weakness Repeat
  • 1206983 2024-014
    Material Weakness Repeat
  • 1206984 2024-014
    Material Weakness Repeat
  • 1206985 2024-014
    Material Weakness Repeat
  • 1206986 2024-014
    Material Weakness Repeat
  • 1206987 2024-014
    Material Weakness Repeat
  • 1206988 2024-014
    Material Weakness Repeat
  • 1206989 2024-014
    Material Weakness Repeat
  • 1206990 2024-014
    Material Weakness Repeat
  • 1206991 2024-014
    Material Weakness Repeat
  • 1206992 2024-014
    Material Weakness Repeat
  • 1206993 2024-014
    Material Weakness Repeat
  • 1206994 2024-014
    Material Weakness Repeat
  • 1206995 2024-014
    Material Weakness Repeat
  • 1206996 2024-015
    Material Weakness Repeat
  • 1206997 2024-015
    Material Weakness Repeat
  • 1206998 2024-015
    Material Weakness Repeat
  • 1206999 2024-015
    Material Weakness Repeat
  • 1207000 2024-015
    Material Weakness Repeat
  • 1207001 2024-016
    Material Weakness Repeat
  • 1207002 2024-016
    Material Weakness Repeat
  • 1207003 2024-017
    Material Weakness Repeat
  • 1207004 2024-017
    Material Weakness Repeat
  • 1207005 2024-017
    Material Weakness Repeat
  • 1207006 2024-017
    Material Weakness Repeat
  • 1207007 2024-017
    Material Weakness Repeat
  • 1207008 2024-017
    Material Weakness Repeat
  • 1207009 2024-017
    Material Weakness Repeat
  • 1207010 2024-018
    Material Weakness Repeat
  • 1207011 2024-018
    Material Weakness Repeat
  • 1207012 2024-018
    Material Weakness Repeat
  • 1207013 2024-018
    Material Weakness Repeat
  • 1207014 2024-018
    Material Weakness Repeat
  • 1207015 2024-019
    Material Weakness Repeat
  • 1207016 2024-019
    Material Weakness Repeat
  • 1207017 2024-019
    Material Weakness Repeat
  • 1207018 2024-019
    Material Weakness Repeat
  • 1207019 2024-019
    Material Weakness Repeat
  • 1207020 2024-019
    Material Weakness Repeat
  • 1207021 2024-019
    Material Weakness Repeat
  • 1207022 2024-020
    Material Weakness Repeat
  • 1207023 2024-020
    Material Weakness Repeat
  • 1207024 2024-020
    Material Weakness Repeat
  • 1207025 2024-020
    Material Weakness Repeat
  • 1207026 2024-020
    Material Weakness Repeat
  • 1207027 2024-020
    Material Weakness Repeat
  • 1207028 2024-020
    Material Weakness Repeat
  • 1207029 2024-021
    Material Weakness Repeat
  • 1207030 2024-021
    Material Weakness Repeat
  • 1207031 2024-021
    Material Weakness Repeat
  • 1207032 2024-021
    Material Weakness Repeat
  • 1207034 2024-022
    Material Weakness Repeat
  • 1207035 2024-023
    Material Weakness Repeat
  • 1207036 2024-023
    Material Weakness Repeat
  • 1207037 2024-023
    Material Weakness Repeat
  • 1207038 2024-023
    Material Weakness Repeat
  • 1207039 2024-024
    Material Weakness Repeat
  • 1207040 2024-024
    Material Weakness Repeat
  • 1207041 2024-024
    Material Weakness Repeat
  • 1207042 2024-024
    Material Weakness Repeat
  • 1207043 2024-024
    Material Weakness Repeat
  • 1207044 2024-025
    Material Weakness Repeat
  • 1207045 2024-026
    Material Weakness Repeat
  • 1207046 2024-026
    Material Weakness Repeat
  • 1207047 2024-026
    Material Weakness Repeat
  • 1207048 2024-026
    Material Weakness Repeat
  • 1207049 2024-026
    Material Weakness Repeat
  • 1207050 2024-026
    Material Weakness Repeat
  • 1207051 2024-026
    Material Weakness Repeat
  • 1207052 2024-027
    Material Weakness Repeat
  • 1207053 2024-027
    Material Weakness Repeat
  • 1207054 2024-027
    Material Weakness Repeat
  • 1207055 2024-027
    Material Weakness Repeat
  • 1207056 2024-027
    Material Weakness Repeat
  • 1207057 2024-027
    Material Weakness Repeat
  • 1207058 2024-027
    Material Weakness Repeat
  • 1207059 2024-028
    Material Weakness Repeat
  • 1207060 2024-028
    Material Weakness Repeat
  • 1207061 2024-028
    Material Weakness Repeat
  • 1207062 2024-029
    Material Weakness Repeat
  • 1207063 2024-029
    Material Weakness Repeat
  • 1207064 2024-029
    Material Weakness Repeat
  • 1207065 2024-030
    Material Weakness Repeat
  • 1207066 2024-030
    Material Weakness Repeat
  • 1207067 2024-031
    Material Weakness Repeat
  • 1207068 2024-031
    Material Weakness Repeat
  • 1207069 2024-032
    Material Weakness Repeat
  • 1207070 2024-032
    Material Weakness Repeat
  • 1207071 2024-033
    Material Weakness Repeat
  • 1207072 2024-033
    Material Weakness Repeat
  • 1207073 2024-034
    Material Weakness Repeat
  • 1207074 2024-035
    Material Weakness Repeat
  • 1207075 2024-036
    Material Weakness Repeat
  • 1207076 2024-036
    Material Weakness Repeat
  • 1207077 2024-036
    Material Weakness Repeat
  • 1207078 2024-036
    Material Weakness Repeat
  • 1207079 2024-037
    Material Weakness Repeat
  • 1207080 2024-038
    Material Weakness Repeat
  • 1207081 2024-038
    Material Weakness Repeat
  • 1207082 2024-039
    Material Weakness Repeat
  • 1207083 2024-039
    Material Weakness Repeat
  • 1207084 2024-040
    Material Weakness Repeat
  • 1207085 2024-040
    Material Weakness Repeat
  • 1207086 2024-041
    Material Weakness Repeat
  • 1207087 2024-041
    Material Weakness Repeat
  • 1207088 2024-042
    Material Weakness Repeat
  • 1207089 2024-043
    Material Weakness Repeat
  • 1207090 2024-044
    Material Weakness Repeat
  • 1207091 2024-045
    Material Weakness Repeat
  • 1207092 2024-046
    Material Weakness Repeat
  • 1207093 2024-047
    Material Weakness Repeat
  • 1207094 2024-048
    Material Weakness Repeat
  • 1207095 2024-049
    Material Weakness Repeat
  • 1207096 2024-049
    Material Weakness Repeat
  • 1207097 2024-049
    Material Weakness Repeat
  • 1207098 2024-049
    Material Weakness Repeat
  • 1207099 2024-049
    Material Weakness Repeat
  • 1207100 2024-050
    Material Weakness Repeat
  • 1207101 2024-050
    Material Weakness Repeat
  • 1207102 2024-050
    Material Weakness Repeat
  • 1207103 2024-050
    Material Weakness Repeat
  • 1207104 2024-050
    Material Weakness Repeat
  • 1207105 2024-051
    Material Weakness Repeat
  • 1207106 2024-051
    Material Weakness Repeat
  • 1207107 2024-051
    Material Weakness Repeat
  • 1207108 2024-051
    Material Weakness Repeat
  • 1207109 2024-051
    Material Weakness Repeat

Programs in Audit

ALN Program Name Expenditures
93.778 Medical Assistance Program $20.28B
10.551 Non-Cash - Supplemental Nutrition Assistance Program (SNAP) $4.50B
17.225 Unemployment Insurance $2.32B
20.205 Highway Planning and Construction $2.09B
84.010 Title I Grants to Local Educational Agencies $696.90M
97.036 Disaster Grants - Public Assistance (Presidentially Declared Disasters) $626.47M
10.555 National School Lunch Program $597.85M
84.027 Special Education Grants to States $565.19M
93.558 Temporary Assistance for Needy Families (TANF) $554.65M
93.767 Children's Health Insurance Program $509.73M
93.778 COVID-19 - Medical Assistance Program $384.07M
93.575 Child Care and Development Block Grant $318.95M
93.575 COVID-19 - Child Care and Development Block Grant $299.26M
10.542 Non-Cash - Pandemic EBT Food Benefits $216.56M
93.568 Low-Income Home Energy Assistance $205.17M
10.557 WIC Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) $181.53M
10.553 School Breakfast Program $180.49M
66.458 Clean Water State Revolving Fund $174.97M
10.561 State Administrative Matching Grants for the SNAP $172.00M
10.558 Child and Adult Care Food Program $170.35M
93.658 Foster Care Title IV-E $157.28M
66.468 Drinking Water State Revolving Fund $142.40M
84.126 Rehabilitation Services Vocational Rehabilitation Grants to States $138.99M
93.563 Child Support Services $135.03M
93.596 Child Care Mandatory and Matching Funds of the Child Care and Development Fund $129.41M
93.268 Non-Cash - Immunization Cooperative Agreements $121.34M
20.205 COVID-19 - Highway Planning and Construction $106.68M
93.659 Adoption Assistance $103.67M
93.323 COVID-19 - Epidemiology and Laboratory Capacity for Infectious Diseases (ELC) $91.24M
20.106 Airport Improvement Program, COVID-19 Airports Programs, and Infrastructure Investment and Jobs Act Programs $82.55M
84.367 Supporting Effective Instruction State Grants (formerly Improving Teacher Quality State Grants) $79.84M
97.067 Homeland Security Grant Program $78.89M
96.001 Social Security Disability Insurance $75.26M
93.959 Block Grants for Prevention and Treatment of Substance Abuse $63.46M
84.287 Twenty-First Century Community Learning Centers $61.13M
10.555 Non-Cash - National School Lunch Program $60.68M
17.278 WIOA Dislocated Worker Formula Grants $58.59M
93.667 Social Services Block Grant $55.63M
10.569 Non-Cash - Emergency Food Assistance Program (Food Commodities) $55.41M
16.575 Crime Victim Assistance $53.10M
84.027 COVID-19 - Special Education Grants to States $52.60M
93.959 COVID-19 - Block Grants for Prevention and Treatment of Substance Abuse $51.44M
84.048 Career and Technical Education -- Basic Grants to States $50.12M
84.424 Student Support and Academic Enrichment Program $46.47M
64.015 Veterans State Nursing Home Care $45.42M
17.259 WIOA Youth Activities $43.05M
93.958 Block Grants for Community Mental Health Services $42.72M
93.917 HIV Care Formula Grants $42.23M
93.788 Opioid STR $40.84M
17.258 Workforce Innovation and Opportunity Act (WIOA) Adult Program $40.67M
97.036 COVID-19 - Disaster Grants - Public Assistance (Presidentially Declared Disasters) $39.87M
93.472 Title IV-E Prevention Program $37.38M
93.967 Centers for Disease Control and Prevention Collaboration with Academia to Strengthen Public Health $37.11M
93.777 State Survey and Certification of Health Care Providers and Suppliers (Title XVIII) Medicare $36.75M
93.569 Community Services Block Grant $35.92M
81.042 Weatherization Assistance for Low-Income Persons $33.82M
84.365 English Language Acquisition State Grants $33.12M
21.029 COVID-19 - Coronavirus Capital Projects Fund $31.26M
84.002 Adult Education - Basic Grants to States $30.00M
93.558 Non-Cash - Temporary Assistance for Needy Families (TANF) $28.48M
84.181 Special Education-Grants for Infants and Families $27.49M
12.401 National Guard Military Operations and Maintenance (O&M) Projects $27.48M
93.045 Special Programs for the Aging, Title III, Part C, Nutrition Services $26.83M
93.268 COVID-19 - Immunization Cooperative Agreements $26.58M
12.400 Military Construction, National Guard $26.53M
66.605 Performance Partnership Grants $26.17M
93.994 Maternal and Child Health Services Block Grant to the States $20.63M
93.556 MaryLee Allen Promoting Safe and Stable Families Program $20.10M
15.611 Wildlife Restoration and Basic Hunter Education and Safety $19.35M
10.561 COVID-19 - State Administrative Matching Grants for the SNAP $18.29M
93.354 COVID-19 - Public Health Emergency Response: Cooperative Agreement for Emergency Response: Public Health Crisis Response $17.81M
84.173 Special Education Preschool Grants $17.60M
20.509 Formula Grants for Rural Areas and Tribal Transit Program $16.81M
14.228 Community Development Block Grants/State's program and Non-Entitlement Grants in Hawaii $16.64M
81.041 State Energy Program $16.34M
93.566 Refugee and Entrant Assistance State/Replacement Designee Administered Programs $15.92M
93.069 Public Health Emergency Preparedness $15.52M
93.044 Special Programs for the Aging, Title III, Part B, Grants for Supportive Services and Senior Centers $15.09M
15.252 Abandoned Mine Land Reclamation (AMLR) $14.41M
10.559 Summer Food Service Program for Children $14.20M
93.268 Immunization Cooperative Agreements $14.20M
20.600 State and Community Highway Safety $13.60M
20.218 Motor Carrier Safety Assistance $12.90M
20.933 National Infrastructure Investments $12.37M
93.674 John H. Chafee Foster Care Program for Successful Transition to Adulthood $12.31M
84.425 COVID-19 - Education Stabilization Fund $12.24M
84.369 Grants for State Assessments and Related Activities $11.91M
97.042 Emergency Management Performance Grants $11.81M
93.045 COVID-19 - Special Programs for the Aging, Title III, Part C, Nutrition Services $11.75M
93.391 COVID-19 - Activities to Support State, Tribal, Local and Territorial (STLT) Health Department Response to Public Health or Healthcare Crises $11.34M
14.231 Emergency Solutions Grant Program $10.84M
10.560 State Administrative Expenses for Child Nutrition $10.27M
17.225 COVID-19 - Unemployment Insurance $9.72M
93.870 Maternal, Infant and Early Childhood Home Visiting Grant Program $9.62M
93.645 Stephanie Tubbs Jones Child Welfare Services Program $9.51M
17.277 WIOA National Dislocated Worker Grants / WIA National Emergency Grants $9.06M
15.018 Energy Community Revitalization Program (ECRP) $8.83M
93.090 Guardianship Assistance $8.69M
20.505 Metropolitan Transportation Planning and State and Non-Metropolitan Planning and Research $8.66M
15.605 Sport Fish Restoration $8.39M
15.662 Great Lakes Restoration $8.35M
93.898 Cancer Prevention and Control Programs for State, Territorial, and Tribal Organizations $8.02M
12.404 National Guard ChalleNGe Program $7.93M
10.475 Cooperative Agreements with States for Intrastate Meat and Poultry Inspection $7.93M
93.243 Substance Abuse and Mental Health Services Projects of Regional and National Significance $7.87M
93.889 National Bioterrorism Hospital Preparedness Program $7.54M
93.053 Nutrition Services Incentive Program $7.53M
20.616 National Priority Safety Programs $7.47M
93.499 COVID-19 - Low Income Household Water Assistance Program $7.12M
93.044 COVID-19 - Special Programs for the Aging, Title III, Part B, Grants for Supportive Services and Senior Centers $7.01M
10.568 Emergency Food Assistance Program (Administrative Costs) $6.97M
20.509 COVID-19 - Formula Grants for Rural Areas and Tribal Transit Program $6.97M
94.006 AmeriCorps State and National 94.006 $6.89M
11.307 Economic Adjustment Assistance $6.43M
93.671 Family Violence Prevention and Services/Domestic Violence Shelter and Supportive Services $6.40M
17.245 Trade Adjustment Assistance $6.36M
93.052 National Family Caregiver Support, Title III, Part E $6.27M
10.582 Fresh Fruit and Vegetable Program $6.11M
66.460 Nonpoint Source Implementation Grants $5.93M
59.037 Small Business Development Centers $5.58M
93.136 Injury Prevention and Control Research and State and Community Based Programs $5.46M
16.588 Violence Against Women Formula Grants $5.45M
45.310 Grants to States $5.36M
17.801 Jobs for Veterans State Grants $5.28M
10.649 COVID-19 - Pandemic EBT Administrative Costs $5.27M
16.738 Edward Byrne Memorial Justice Assistance Grant Program $5.05M
97.039 Hazard Mitigation Grant $5.01M
97.047 BRIC: Building Resilient Infrastructure and Communities $4.95M
97.008 Non-Profit Security Program $4.69M
93.775 State Medicaid Fraud Control Units $4.64M
10.565 Non-Cash - Commodity Supplemental Food Program $4.56M
84.173 COVID-19 - Special Education Preschool Grants $4.56M
39.003 Non-Cash - Donation of Federal Surplus Personal Property $4.55M
93.217 Family Planning Services $4.54M
93.977 COVID-19 - Sexually Transmitted Diseases (STD) Prevention and Control Grants $4.22M
90.404 HAVA Election Security Grants $4.11M
93.600 Head Start $4.04M
93.747 COVID-19 - Elder Abuse Prevention Interventions Program $4.01M
20.106 COVID-19 - Airport Improvement Program, COVID-19 Airports Programs, and Infrastructure Investment and Jobs Act Programs $3.98M
20.319 High-Speed Rail Corridors and Intercity Passenger Rail Service – Capital Assistance Grants $3.97M
97.137 State and Local Cybersecurity Grant Program Tribal Cybersecurity Grant Program $3.95M
93.940 HIV Prevention Activities Health Department Based $3.70M
93.991 Preventive Health and Health Services Block Grant $3.60M
84.196 Education for Homeless Children and Youth $3.60M
10.902 Soil and Water Conservation $3.47M
16.741 DNA Backlog Reduction Program $3.38M
93.630 Developmental Disabilities Basic Support and Advocacy Grants $3.28M
15.250 Regulation of Surface Coal Mining and Surface Effects of Underground Coal Mining $3.22M
93.669 Child Abuse and Neglect State Grants $3.21M
11.419 Coastal Zone Management Administration Awards $3.21M
66.805 Leaking Underground Storage Tank Trust Fund Corrective Action Program $3.15M
93.323 Epidemiology and Laboratory Capacity for Infectious Diseases (ELC) $3.03M
84.334 Gaining Early Awareness and Readiness for Undergraduate Programs $2.97M
97.012 Boating Safety Financial Assistance $2.77M
10.182 COVID-19 - Pandemic Relief Activities: Local Food Purchase Agreements with States, Tribes, and Local Governments $2.75M
66.802 Superfund State, Political Subdivision, and Indian Tribe Site-Specific Cooperative Agreements $2.71M
11.035 Broadband Equity, Access, and Deployment Program $2.68M
17.285 Registered Apprenticeship $2.66M
84.425 Education Stabilization Fund $2.62M
17.002 Labor Force Statistics $2.62M
17.235 Senior Community Service Employment Program $2.61M
93.434 Every Student Succeeds Act/Preschool Development Grants $2.55M
93.150 Projects for Assistance in Transition from Homelessness (PATH) $2.53M
14.241 Housing Opportunities for Persons with AIDS $2.48M
93.977 Sexually Transmitted Diseases (STD) Prevention and Control Grants $2.43M
93.116 Project Grants and Cooperative Agreements for Tuberculosis Control Programs $2.43M
66.817 State and Tribal Response Program Grants $2.31M
15.608 Fish and Aquatic Conservation - Aquatic Invasive Species $2.25M
20.219 Recreational Trails Program $2.11M
84.421 Disability Innovation Fund (DIF) $2.10M
15.634 State Wildlife Grants $2.09M
20.700 Pipeline Safety Program State Base Grant $2.04M
10.579 Child Nutrition Discretionary Grants Limited Availability $1.99M
93.052 COVID-19 - National Family Caregiver Support, Title III, Part E $1.98M
66.034 Surveys, Studies, Research, Investigations, Demonstrations, and Special Purpose Activities Relating to the Clean Air Act $1.95M
16.754 Harold Rogers Prescription Drug Monitoring Program $1.93M
93.599 Chafee Education and Training Vouchers Program (ETV) $1.88M
93.497 Family Violence Prevention and Services/ Sexual Assault/Rape Crisis Services and Supports $1.87M
84.011 Migrant Education State Grant Program $1.83M
93.387 National and State Tobacco Control Program $1.78M
17.504 Consultation Agreements $1.77M
93.590 Community-Based Child Abuse Prevention Grants $1.77M
84.323 Special Education - State Personnel Development $1.70M
93.092 Affordable Care Act (ACA) Personal Responsibility Education Program $1.64M
93.590 COVID-19 - Community-Based Child Abuse Prevention Grants $1.62M
64.124 All-Volunteer Force Educational Assistance $1.61M
93.071 Medicare Enrollment Assistance Program $1.51M
84.184 School Safely National Activities $1.45M
10.556 Special Milk Program for Children $1.42M
20.528 Rail Fixed Guideway Public Transportation System State Safety Oversight Formula Grant Program $1.33M
12.002 Procurement Technical Assistance For Business Firms $1.32M
20.200 Highway Research and Development Program $1.26M
93.324 State Health Insurance Assistance Program $1.25M
20.703 Interagency Hazardous Materials Public Sector Training and Planning Grants $1.21M
10.576 Senior Farmers Market Nutrition Program $1.20M
10.675 Urban and Community Forestry Program $1.20M
45.025 Promotion of the Arts Partnership Agreements $1.16M
10.187 The Emergency Food Assistance Program (TEFAP) Commodity Credit Corporation Eligible Recipient Funds $1.15M
93.426 The National Cardiovascular Health Program $1.11M
93.110 Maternal and Child Health Federal Consolidated Programs $1.08M
97.091 Homeland Security Biowatch Program $1.06M
17.503 Occupational Safety and Health State Program $1.04M
16.540 Juvenile Justice and Delinquency Prevention $1.02M
93.336 Behavioral Risk Factor Surveillance System $1.02M
84.358 Rural Education $1.00M
84.177 Rehabilitation Services Independent Living Services for Older Individuals Who are Blind $961,213
10.565 Commodity Supplemental Food Program $931,641
10.678 Forest Stewardship Program $919,868
93.042 Special Programs for the Aging, Title VII, Chapter 2, Long Term Care Ombudsman Services for Older Individuals $911,125
10.170 Specialty Crop Block Grant Program - Farm Bill $894,193
66.485 Support for the Gulf Hypoxia Action Plan $885,010
16.017 Sexual Assault Services Formula Program $880,181
17.271 Work Opportunity Tax Credit Program (WOTC) $865,498
93.165 Grants to States for Loan Repayment $850,380
93.369 ACL Independent Living State Grants $848,514
11.032 State Digital Equity Planning and Capacity Grant $846,053
16.576 Crime Victim Compensation $822,095
17.268 H-1B Job Training Grants $800,075
10.093 Voluntary Public Access and Habitat Incentive Program $773,598
10.665 Schools and Roads - Grants to States $769,435
59.061 State Trade Expansion $763,944
93.043 Special Programs for the Aging, Title III, Part D, Disease Prevention and Health Promotion Services $762,256
93.301 Small Rural Hospital Improvement Grant Program $758,784
93.643 Children's Justice Grants to States $736,275
16.543 Missing Children's Assistance $721,595
84.187 Supported Employment Services for Individuals with the Most Significant Disabilities $699,900
93.767 COVID-19 - Children's Health Insurance Program $681,160
93.478 Preventing Maternal Deaths: Supporting Maternal Mortality Review Committees $681,074
17.273 Temporary Labor Certification for Foreign Workers $678,914
12.113 State Memorandum of Agreement Program for the Reimbursement of Technical Services $678,679
93.634 Support for Ombudsman and Beneficiary Counseling Programs for States Participating in Financial Alignment Model Demonstrations for Dually Eligible Individuals $641,865
93.791 Money Follows the Person Rebalancing Demonstration $640,788
93.464 ACL Assistive Technology $635,424
93.197 Childhood Lead Poisoning Prevention Projects, State and Local Childhood Lead Poisoning Prevention and Surveillance of Blood Lead Levels in Children $628,777
93.586 State Court Improvement Program $616,750
93.070 Environmental Public Health and Emergency Response $606,585
93.073 Birth Defects and Developmental Disabilities - Prevention and Surveillance $584,817
10.912 Environmental Quality Incentives Program $578,671
12.401 Non-Cash - National Guard Military Operations and Maintenance (O&M) Projects $544,451
66.804 Underground Storage Tank (UST) Prevention, Detection, and Compliance Program $538,231
93.988 Cooperative Agreements for Diabetes Control Programs $531,795
16.922 Equitable Sharing Program $530,900
64.014 Veterans State Domiciliary Care $503,377
16.593 Residential Substance Abuse Treatment for State Prisoners $499,904
10.185 Local Food for Schools Cooperative Agreement Program $493,791
93.436 Well-Integrated Screening and Evaluation for Women Across The Nation (Wisewoman) $480,012
10.698 State & Private Forestry Cooperative Fire Assistance $477,911
93.043 COVID-19 - Special Programs for the Aging, Title III, Part D, Disease Prevention and Health Promotion Services $464,488
14.900 Lead Hazard Reduction Grant Program $455,224
84.326 Special Education Technical Assistance and Dissemination to Improve Services and Results for Children with Disabilities $451,235
94.003 AmeriCorps State Commissions Support Grant $430,923
93.240 State Capacity Building $425,688
20.215 Highway Training and Education $411,756
30.002 Employment Discrimination State and Local Fair Employment Practices Agency Contracts $394,249
93.600 COVID-19 - Head Start $393,748
97.029 Flood Mitigation Assistance $388,797
93.944 Human Immunodeficiency Virus (HIV)/Acquired Immunodeficiency Virus Syndrome (AIDS) Surveillance $386,807
66.433 State Underground Water Source Protection $380,305
93.236 Grants to States to Support Oral Health Workforce Activities $377,975
84.013 Title I State Agency Program for Neglected and Delinquent Children and Youth $375,460
66.032 State and Tribal Indoor Radon Grants $372,208
20.706 Pipeline Emergency Response Grant (PERG) $368,726
20.725 PHMSA Pipeline Safety Underground Natural Gas Storage Grant $365,536
20.237 Motor Carrier Safety Assistance High Priority Activities Grants and Cooperative Agreements $365,500
17.005 Compensation and Working Conditions $336,626
10.680 Forest Health Protection $332,872
93.597 Grants to States for Access and Visitation Programs $322,674
10.664 Cooperative Forestry Assistance $320,108
10.069 Conservation Reserve Program $313,405
93.103 Food and Drug Administration Research $312,451
93.270 Viral Hepatitis Prevention and Control $310,493
16.827 Justice Reinvestment Initiative $305,935
93.603 Adoption and Legal Guardianship Incentive Payments Program $301,000
15.916 Outdoor Recreation Acquisition, Development and Planning $285,987
10.572 WIC Farmers' Market Nutrition Program (FMNP) $282,142
93.130 Cooperative Agreements to States/Territories for the Coordination and Development of Primary Care Offices $263,235
93.072 Lifespan Respite Care Program $260,229
66.454 Water Quality Management Planning $257,231
97.023 Community Assistance Program State Support Services Element (CAP-SSSE) $254,889
14.401 Fair Housing Assistance Program $252,449
17.270 Reentry Employment Opportunities $246,824
93.946 Cooperative Agreements to Support State-Based Safe Motherhood and Infant Health Initiative Programs $236,699
16.839 STOP School Violence $232,974
16.742 COVID-19 - Paul Coverdell Forensic Sciences Improvement Grant Program $225,326
16.812 Second Chance Act Reentry Initiative $219,749
16.745 Criminal and Juvenile Justice and Mental Health Collaboration Program $209,595
66.469 Geographic Programs - Great Lakes Restoration Initiative $198,445
93.314 Early Hearing Detection and Intervention Information System (EHDI-IS) Surveillance Program $196,735
20.611 Incentive Grant Program to Prohibit Racial Profiling $190,269
93.912 Rural Health Care Services Outreach, Rural Health Network Development and Small Health Care Provider Quality Improvement $187,648
93.041 Special Programs for the Aging, Title VII, Chapter 3, Programs for Prevention of Elder Abuse, Neglect, and Exploitation $186,703
89.003 National Historical Publications and Records Grants $184,595
66.472 Beach Monitoring and Notification Program Implementation Grants $183,893
93.913 Grants to States for Operation of Offices of Rural Health $181,625
16.742 Paul Coverdell Forensic Sciences Improvement Grant Program $178,734
16.548 Delinquency Prevention Program $178,051
16.560 National Institute of Justice Research, Evaluation, and Development Project Grants $176,765
93.251 Universal Newborn Hearing and Screening $162,495
16.550 State Justice Statistics Program for Statistical Analysis Centers $158,264
66.046 Climate Pollution Reduction Grants $156,514
66.204 Multipurpose Grants to States and Tribes $155,892
94.008 AmeriCorps Commission Investment Fund 94.008 $154,440
93.982 Mental Health Disaster Assistance and Emergency Mental Health $147,199
66.809 Superfund State and Indian Tribe Core Program Cooperative Agreements $143,677
93.777 COVID-19 - State Survey and Certification of Health Care Providers and Suppliers (Title XVIII) Medicare $137,249
10.025 Plant and Animal Disease, Pest Control, and Animal Care $131,281
66.820 State Programs for Control of Coal Combustion Residuals $127,848
94.021 AmeriCorps Volunteer Generation Fund 94.021 $126,086
97.041 National Dam Safety Program $120,624
17.700 Women's Bureau $119,037
16.609 Project Safe Neighborhoods $114,161
16.582 Crime Victim Assistance/Discretionary Grants $114,037
93.297 Teenage Pregnancy Prevention Program $112,355
21.027 COVID-19 - Coronavirus State and Local Fiscal Recovery Funds $110,823
15.615 Cooperative Endangered Species Conservation Fund $108,805
15.657 COVID-19 - Endangered Species Recovery Implementation $105,000
66.444 Voluntary School and Child Care Lead Testing and Reduction Grant Program (SDWA 1464(d)) $104,314
20.614 National Highway Traffic Safety Administration (NHTSA) Discretionary Safety Grants and Cooperative Agreements $103,592
93.127 Emergency Medical Services for Children $102,098
20.720 State Damage Prevention Program Grants $97,001
16.585 Treatment Court Discretionary Grant Program $96,541
93.354 Public Health Emergency Response: Cooperative Agreement for Emergency Response: Public Health Crisis Response $91,654
90.401 Help America Vote Act (HAVA) Requirements Payments $82,279
20.314 Railroad Development $81,139
10.163 Market Protection and Promotion $80,000
45.161 Promotion of the Humanities Research $77,532
17.207 Employment Service/Wagner-Peyser Funded Activities $74,940
93.079 Cooperative Agreements to Promote Adolescent Health through School-Based HIV/STD Prevention and School-Based Surveillance $72,661
16.590 Grants to Encourage Arrest Policies and Enforcement of Protection Orders Program $70,754
14.267 Continuum of Care Program $66,954
66.419 Water Pollution Control State, Interstate, and Tribal Program Support $64,357
66.818 Brownfields Multipurpose, Assessment, Revolving Loan Fund, and Cleanup Cooperative Agreements $63,087
93.042 COVID-19 - Special Programs for the Aging, Title VII, Chapter 2, Long Term Care Ombudsman Services for Older Individuals $61,165
16.589 Rural Domestic Violence, Dating Violence, Sexual Assault, and Stalking Assistance Program $57,512
66.701 Toxic Substances Compliance Monitoring Cooperative Agreements $56,952
20.513 Enhanced Mobility of Seniors and Individuals with Disabilities $56,256
16.820 Postconviction Testing of DNA Evidence $54,256
16.529 Education, Training, and Enhanced Services to End Violence Against and Abuse of Women with Disabilities $50,094
97.045 Cooperating Technical Partners $50,000
10.190 Resilient Food System Infrastructure Program $49,033
20.721 PHMSA Pipeline Safety Program One Call Grant $48,126
97.052 Emergency Operations Center $46,586
16.320 Services for Trafficking Victims $46,043
10.574 Team Nutrition Grants $44,568
32.011 Affordable Connectivity Outreach Grant Program $40,080
14.218 Community Development Block Grants (CDBG)/Entitlement Grants $38,963
84.144 Migrant Education Coordination Program $38,000
10.535 Supplemental Nutrition Assistance Program (SNAP) Fraud Framework Implementation Grant $36,849
93.699 COVID-19 - Child Abuse and Neglect State Grants $33,180
66.608 Environmental Information Exchange Network Grant Program and Related Assistance $32,377
84.368 Competitive Grants for State Assessments $30,449
11.407 Interjurisdictional Fisheries Act of 1986 $29,379
20.224 Federal Lands Access Program $27,645
64.101 Burial Expenses Allowance for Veterans $27,010
17.261 Workforce Data Quality Initiative (WDQI) $24,026
97.082 Earthquake State Assistance $23,752
15.684 White-nose Syndrome National Response Implementation $22,968
10.646 Summer Electronic Benefit Transfer Program for Children $19,495
20.526 Buses and Bus Facilities Formula, Competitive, and Low or No Emissions Programs $19,490
38.006 State Appraiser Agency Support Grants $18,028
93.334 The Healthy Brain Initiative: Technical Assistance to Implement Public Health Actions related to Cognitive Health, Cognitive Impairment, and Caregiving at the State and Local Levels $13,951
15.616 Clean Vessel Act $13,421
93.048 Special Programs for the Aging, Title IV, and Title II, Discretionary Projects $12,878
16.750 Support for Adam Walsh Act Implementation Grant Program $12,828
20.301 Railroad Safety $12,403
93.367 Flexible Funding Model - Infrastructure Development and Maintenance for State Manufactured Food Regulatory Programs $12,106
93.336 COVID-19 - Behavioral Risk Factor Surveillance System $11,479
10.645 Farm to School State Formula Grant $11,474
10.525 Farm and Ranch Stress Assistance Network Competitive Grants Program $10,986
10.153 Market News $10,000
16.040 Matthew Shepard and James Byrd, Jr. Hate Crimes Education, Investigation and Prosecution Program $9,484
93.279 Drug Use and Addiction Research Programs $8,940
16.607 Bulletproof Vest Partnership Program $8,760
10.537 Supplemental Nutrition Assistance Program (SNAP) Employment and Training (E&T) Data and Technical Assistance Grants $8,434
84.372 Statewide Longitudinal Data Systems $6,541
16.710 Public Safety Partnership and Community Policing Grants $5,000
66.436 Surveys, Studies, Investigations, Demonstrations, and Training Grants and Cooperative Agreements - Section 104(b)(3) of the Clean Water Act $3,486
15.904 Historic Preservation Fund Grants-In-Aid $1,419
16.034 COVID-19 - Coronavirus Emergency Supplemental Funding Program $-7,983
21.019 COVID-19 - Coronavirus Relief Fund $-19,814
93.665 COVID-19 - Emergency Grants to Address Mental and Substance Use Disorders During COVID-19 $-47,501
93.241 State Rural Health Flexibility Program $-48,958