FAC Explorer

Finding 21287 (2022-002)

Material Weakness Repeat Finding
Requirement
E
Questioned Costs
$1
Year
2022
Accepted
2023-01-29
Audit: 21439
Organization: Mecklenburg County (NC)
Auditor: Cherry Bekaert LLP

AI Summary

  • Core Issue: The County failed to maintain proper documentation and internal controls for eligibility determinations, risking improper funding to ineligible individuals.
  • Impacted Requirements: Key compliance criteria from Section 200.303 of the Uniform Grant Guidance were not met, including timely eligibility reviews and accurate documentation in NCFAST.
  • Recommended Follow-Up: The County should enhance processes for maintaining eligibility documentation and implement a formal policy for timely corrections of identified issues.

Finding Text

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 Material Weakness and Non-Material Non-Compliance ? Eligibility Finding 2022-002 Criteria or specific requirement: Per Section 200.303 of the Uniform Grant 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 County should have adequate documentation for each participant that supports each eligibility determination and the information entered into NCFAST. We noted several errors related to the following compliance criteria: a) When the Social Security Administration (SSA) terminates social security income (SSI) eligibility, the county is required to make an exparte (on the record) determination for eligibility under any other coverage group in the State Plan. This determination is required to be made within 120 days after the termination of the SSI payment. b) The caseworker should prepare and submit a DMA-5097 form in the case of incompatible income verification and self-attestation as described in the Eligibility Review Document. The case should be terminated by date of termination cited in notice if applicant did not respond to DMA-5097. c) If the County received any notifications of non-cooperation with IV-D related to this participant and confirm that the case was terminated on the effective date identified in the termination notice. d) Documentation must exist in the case file/NC FAST of medical expenses verified by the caseworker or case notes indicating that the caseworker verified medical bills were incurred for an allowable service. e) The self-attest wages entered into NC FAST should agree to the supporting documentation submitted by the applicant. f) The AVS inquiry has to be completed and agrees to information reported in NC FAST. Condition: The following are the results of non-material non-compliance noted for each criteria listed above out of the 93 program participants selected for testing: a) There was one instance where the County did not complete the exparte review for a participant whose SSI benefits were terminated. b) There was one instance where the evidence of the participant?s income and employment status did not agree to the self-attestation and the case was not properly terminated. c) There was one instance where the non-cooperation with IV-D was identified during the application process and not properly documented. d) There was one instance where the medical expenses were not properly verified and included within NC FAST. e) There were six instances where the client?s self-attest wages did not agree with the supporting documentation in NC FAST. f) There were two instances where the AVS query was not ran timely. Lastly, there were 37 instances out of 60 program participants tested for control testing where the County did not remediate the errors identified within their internal review timely. Context: There were 11 out of 93 unique participants tested with the errors noted above, in which two were determined to have been improperly determined eligible. Questioned Costs: We noted a total of $52,293 in questioned costs related to improper eligibility determination related to items "a" and "b" noted above. Total claims tested totaled $3,234,101 and so the projected questioned costs were a calculated 1.62% error rate. Effect: By not having the required documentation in the files or information being incorrectly documented, eligibility cannot be readily substantiated and there is a risk that the County could provide funding to individuals who are not eligible. Cause: County oversight when performing reviews over applications. Additionally, the County does not have a formal process in place to ensure issues identified during the review process are appropriately corrected on a consistent and timely basis. Recommendation: Although these issues will occur from time to time considering the volume of case files, the County should review their processes to ensure proper supporting documentation of eligibility is maintained within each case file. Additionally, Mecklenburg County should consider implementing a formal policy for the requirements of having documentation corrected within a specific timeframe once identified. 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.

Categories

Questioned Costs Internal Control / Segregation of Duties Subrecipient Monitoring Eligibility Material Weakness Matching / Level of Effort / Earmarking

Other Findings in this Audit

  • 21281 2022-003
    Significant Deficiency
  • 21282 2022-003
    Significant Deficiency
  • 21283 2022-003
    Significant Deficiency
  • 21284 2022-003
    Significant Deficiency
  • 21285 2022-002
    Material Weakness Repeat
  • 21286 2022-002
    Material Weakness Repeat
  • 21288 2022-002
    Material Weakness Repeat
  • 21289 2022-003
    Significant Deficiency
  • 21290 2022-004
    -
  • 21291 2022-004
    -
  • 21292 2022-004
    -
  • 21293 2022-005
    -
  • 21294 2022-005
    -
  • 21295 2022-005
    -
  • 21296 2022-005
    -
  • 597723 2022-003
    Significant Deficiency
  • 597724 2022-003
    Significant Deficiency
  • 597725 2022-003
    Significant Deficiency
  • 597726 2022-003
    Significant Deficiency
  • 597727 2022-002
    Material Weakness Repeat
  • 597728 2022-002
    Material Weakness Repeat
  • 597729 2022-002
    Material Weakness Repeat
  • 597730 2022-002
    Material Weakness Repeat
  • 597731 2022-003
    Significant Deficiency
  • 597732 2022-004
    -
  • 597733 2022-004
    -
  • 597734 2022-004
    -
  • 597735 2022-005
    -
  • 597736 2022-005
    -
  • 597737 2022-005
    -
  • 597738 2022-005
    -

Programs in Audit

ALN Program Name Expenditures
21.023 Emergency Rental Assistance Program $21.76M
21.027 Coronavirus State and Local Fiscal Recovery Funds $9.63M
93.323 Epidemiology and Laboratory Capacity for Infectious Diseases (elc) $9.34M
93.563 Child Support Enforcement $9.18M
10.557 Special Supplemental Nutrition Program for Women, Infants, and Children $4.32M
93.659 Adoption Assistance $3.99M
93.568 Low-Income Home Energy Assistance $3.04M
93.596 Child Care Mandatory and Matching Funds of the Child Care and Development Fund $1.99M
93.268 Immunization Cooperative Agreements $1.97M
20.507 Federal Transit_formula Grants $1.80M
93.499 Low Income Household Water Assistance Program $1.59M
93.940 Hiv Prevention Activities_health Department Based $1.34M
21.019 Coronavirus Relief Fund $1.27M
93.686 Ending the Hiv Epidemic: A Plan for America Ryan White Hiv/aids Program Parts A and B (b) $820,345
66.001 Air Pollution Control Program Support $742,703
93.391 Activities to Support State, Tribal, Local and Territorial (stlt) Health Department Response to Public Health Or Healthcare Crises $727,717
93.137 Community Programs to Improve Minority Health Grant Program $697,745
97.036 Disaster Grants - Public Assistance (presidentially Declared Disasters) $662,270
93.994 Maternal and Child Health Services Block Grant to the States $654,526
93.767 Children's Health Insurance Program $640,131
10.561 State Administrative Matching Grants for the Supplemental Nutrition Assistance Program $613,168
84.181 Special Education-Grants for Infants and Families $557,953
14.218 Community Development Block Grants/entitlement Grants $532,474
93.778 Medical Assistance Program $518,680
20.205 Highway Planning and Construction $497,053
93.044 Special Programs for the Aging_title Iii, Part B_grants for Supportive Services and Senior Centers $398,658
66.039 National Clean Diesel Emissions Reduction Program $319,584
93.556 Promoting Safe and Stable Families $299,497
93.053 Nutrition Services Incentive Program $256,155
14.231 Emergency Solutions Grant Program $250,358
93.217 Family Planning_services $249,434
93.667 Social Services Block Grant $225,531
93.136 Injury Prevention and Control Research and State and Community Based Programs $218,533
16.021 Justice Systems Response to Families $187,184
93.045 Special Programs for the Aging_title Iii, Part C_nutrition Services $183,893
16.736 Transitional Housing Assistance for Victims of Domestic Violence, Dating Violence, Stalking, Or Sexual Assault $182,735
66.034 Surveys, Studies, Research, Investigations, Demonstrations, and Special Purpose Activities Relating to the Clean Air Act $175,397
93.914 Hiv Emergency Relief Project Grants $154,572
93.558 Temporary Assistance for Needy Families $113,405
93.069 Public Health Emergency Preparedness $104,000
93.898 Cancer Prevention and Control Programs for State, Territorial and Tribal Organizations $102,900
93.387 National and State Tobacco Control Program (b) $81,656
93.243 Substance Abuse and Mental Health Services_projects of Regional and National Significance $79,448
93.671 Family Violence Prevention and Services/domestic Violence Shelter and Supportive Services $76,424
93.566 Refugee and Entrant Assistance_state Administered Programs $76,358
93.917 Hiv Care Formula Grants $52,397
93.116 Project Grants and Cooperative Agreements for Tuberculosis Control Programs $36,240
93.991 Preventive Health and Health Services Block Grant $30,607
93.674 John H. Chafee Foster Care Program for Successful Transition to Adulthood $28,901
93.658 Foster Care_title IV-E $24,626
93.052 National Family Caregiver Support, Title Iii, Part E $14,161
14.241 Housing Opportunities for Persons with Aids $13,712
16.745 Criminal and Juvenile Justice and Mental Health Collaboration Program $10,991
16.609 Project Safe Neighborhoods $10,735
97.045 Cooperating Technical Partners $10,358
16.838 Comprehensive Opioid Abuse Site-Based Program $9,081
93.645 Stephanie Tubbs Jones Child Welfare Services Program $8,684
93.747 Elder Abuse Prevention Interventions Program $7,811
14.267 Continuum of Care Program $4,012
93.071 Medicare Enrollment Assistance Program $3,689
93.103 Food and Drug Administration_research $3,000
16.738 Edward Byrne Memorial Justice Assistance Grant Program $2,237
93.043 Special Programs for the Aging_title Iii, Part D_disease Prevention and Health Promotion Services $1,700
93.324 State Health Insurance Assistance Program $220