Finding 29005 (2022-004)

Material Weakness
Requirement
E
Questioned Costs
-
Year
2022
Accepted
2023-02-01

AI Summary

  • Core Issue: Inconsistent documentation in casefiles could lead to ineligible individuals receiving benefits.
  • Impacted Requirements: Management must ensure adequate internal controls for documentation as per 2 CFR 200.
  • Recommended Follow-up: Caseworkers should verify and update eligibility documentation to ensure accuracy.

Finding Text

U.S. Department of Health and Human Services Passed-through the N.C. Department of Health and Human Services Program Name: Medical Assistance Program AL # 93.778 Grant Number: 071-420, 071-375, 071-128, 071-480, 071-434 Finding: 2022-004 Material Weakness Criteria: In accordance with 2 CFR 200, management should have an adequate system of internal control procedures in place to ensure that casefiles include all required documentation. Condition: The County Department of Social Services maintained inconsistent documentation for household membership and countable resources. Context: Of the 430,010 benefit payments valued at $139,895,964, we examined 60 and determined that three (5%) had inconsistent documentation supporting the eligibility determination in the case file. Upon further review, the recipients were deemed eligible. Effect: Casefile maintained inconsistent documentation, which could allow benefits to be provided to individuals who are not eligible. Cause: The caseworker did not verify updated documentation to the NCFAST system. Questioned Costs: None. The finding represents an internal control issue; therefore, no questioned costs are applicable. The County was able to substantiate that the recipients were eligible to receive benefits. Recommendation: Caseworkers should review their eligibility determinations and ensure the correct information is included for proper documentation for eligibility. Views of Responsible Officials and Planned Corrective Actions: The County agrees with this finding. Please refer to the Corrective Action Plan section of this report.

Corrective Action Plan

Finding: 2022-004 Name of Contact Person: Carolyn Moser, Health & Human Services Director Corrective Action/Management?s Response: Audit Finding Review Training is held with Family and Children's Medicaid to review Audit results and errors found. Verification sheet for F&C Medicaid are reviewed. This form is to be used for every application and recertification. Additional trainings/unit meetings are also held throughout the year. Areas covered are review of: Child Support referrals, income, verification of Social Security Number, tax household, household relationship, reacting to changes, addresses, and OVS. Ongoing trainings continue. Individual conferences are held with each worker with an error. During the conference, the case record is reviewed along with policy, error explanations and steps to take to prevent error from reoccurring. Each quarter Pender County is required to submit to the State a Quarterly Report of cases 2nd party reviewed along with verification of trainings held, agendas and attendance sheets. Pender is required to review over 120 cases per quarter. There are 4 Medicaid Supervisors. Each month supervisors pull cases from each worker to 2nd party review. Supervisors meet with each worker that they have an error or internal control issue. Errors and internal control issues are discussed monthly at Unit meetings. Policy, manual changes, Admin letters, job aids and other information are also discussed and reviewed monthly during Unit meetings. Proposed Completion Date: Immediately and ongoing. Finding: 2022-005 Name of Contact Person: Carolyn Moser, Health & Human Services Director Corrective Action/Management?s Response: The County has corrected and resubmitted the impacted report and continues to pay close attention to detail when compiling all of the data for payroll calculations. Once resubmitted, there were no monies owed, just minor adjustments in allocations between programming. Additionally, the Business Officer has worked with the Internal Audit Compliance Officer in the Finance Department to strengthen the excel formulas and lessen the inherent opportunity for errors. Finance also implemented additional checks during the 1571 monthly review process to ensure elimination of any such errors prior to submission. Proposed Completion Date: Immediately and ongoing. Finding: 2022-006 Name of Contact Person: Carolyn Moser, Health & Human Services Director Corrective Action/Management?s Response: The County, much like other local governments around the State and Country, has experienced turnover from employee resignation and longterm employee retirements. The County met requirements for 2nd party reviews when program supervisor positions were filled, and in the future will ensure that there is a back up or at least a look back period for 2nd party reviews for periods of SNAP program supervisor vacancies. Proposed Completion Date: Immediately and ongoing. Finding: 2022-007 Name of Contact Person: Carolyn Moser, Health & Human Services Director Corrective Action/Management?s Response: The County, much like other local governments around the State and Country, has experienced turnover from employee resignation and long-term employee retirements. The County met requirements for 2nd party reviews when program supervisor positions were filled, and in the future will ensure that there is a back up or at least a look back period for 2nd party reviews for periods of LIHEAP program supervisor vacancies. Proposed Completion Date: Immediately and ongoing.

Categories

Eligibility Material Weakness Internal Control / Segregation of Duties

Other Findings in this Audit

  • 28994 2022-006
    Material Weakness
  • 28995 2022-006
    Material Weakness
  • 28996 2022-006
    Material Weakness
  • 28997 2022-006
    Material Weakness
  • 28998 2022-007
    Material Weakness
  • 28999 2022-007
    Material Weakness
  • 29000 2022-007
    Material Weakness
  • 29001 2022-007
    Material Weakness
  • 29002 2022-007
    Material Weakness
  • 29003 2022-007
    Material Weakness
  • 29004 2022-007
    Material Weakness
  • 29006 2022-005
    Material Weakness
  • 29007 2022-004
    Material Weakness
  • 29008 2022-005
    Material Weakness
  • 29009 2022-004
    Material Weakness
  • 29010 2022-005
    Material Weakness
  • 29011 2022-004
    Material Weakness
  • 29012 2022-005
    Material Weakness
  • 29013 2022-004
    Material Weakness
  • 29014 2022-005
    Significant Deficiency
  • 605436 2022-006
    Material Weakness
  • 605437 2022-006
    Material Weakness
  • 605438 2022-006
    Material Weakness
  • 605439 2022-006
    Material Weakness
  • 605440 2022-007
    Material Weakness
  • 605441 2022-007
    Material Weakness
  • 605442 2022-007
    Material Weakness
  • 605443 2022-007
    Material Weakness
  • 605444 2022-007
    Material Weakness
  • 605445 2022-007
    Material Weakness
  • 605446 2022-007
    Material Weakness
  • 605447 2022-004
    Material Weakness
  • 605448 2022-005
    Material Weakness
  • 605449 2022-004
    Material Weakness
  • 605450 2022-005
    Material Weakness
  • 605451 2022-004
    Material Weakness
  • 605452 2022-005
    Material Weakness
  • 605453 2022-004
    Material Weakness
  • 605454 2022-005
    Material Weakness
  • 605455 2022-004
    Material Weakness
  • 605456 2022-005
    Significant Deficiency

Programs in Audit

ALN Program Name Expenditures
10.557 Special Supplemental Nutrition Program for Women, Infants, and Children $294,224
93.323 Epidemiology and Laboratory Capacity for Infectious Diseases (elc) $290,316
21.027 Coronavirus State and Local Fiscal Recovery Funds $222,250
93.558 Temporary Assistance for Needy Families $215,020
20.600 State and Community Highway Safety $134,882
93.659 Adoption Assistance $123,613
10.927 Emergency Watershed Protection Program - Disaster Relief Appropriations Act $120,258
14.871 Section 8 Housing Choice Vouchers $119,324
93.045 Special Programs for the Aging_title Iii, Part C_nutrition Services $110,812
97.039 Hazard Mitigation Grant $92,100
93.596 Child Care Mandatory and Matching Funds of the Child Care and Development Fund $75,733
93.778 Medical Assistance Program $72,870
93.044 Special Programs for the Aging_title Iii, Part B_grants for Supportive Services and Senior Centers $56,634
93.052 National Family Caregiver Support, Title Iii, Part E $42,924
93.667 Social Services Block Grant $42,592
93.767 Children's Health Insurance Program $42,467
93.217 Family Planning_services $42,259
93.994 Maternal and Child Health Services Block Grant to the States $40,340
93.069 Public Health Emergency Preparedness $36,466
93.991 Preventive Health and Health Services Block Grant $30,607
97.067 Homeland Security Grant Program $30,391
93.116 Project Grants and Cooperative Agreements for Tuberculosis Control Programs $21,561
93.645 Stephanie Tubbs Jones Child Welfare Services Program $18,763
93.053 Nutrition Services Incentive Program $18,216
93.268 Immunization Cooperative Agreements $15,386
10.561 State Administrative Matching Grants for the Supplemental Nutrition Assistance Program $15,199
93.658 Foster Care_title IV-E $14,715
93.568 Low-Income Home Energy Assistance $13,908
97.042 Emergency Management Performance Grants $11,068
93.556 Promoting Safe and Stable Families $10,664
93.043 Special Programs for the Aging_title Iii, Part D_disease Prevention and Health Promotion Services $5,783
93.898 Cancer Prevention and Control Programs for State, Territorial and Tribal Organizations $5,525
93.674 John H. Chafee Foster Care Program for Successful Transition to Adulthood $4,622
93.563 Child Support Enforcement $2,134
93.566 Refugee and Entrant Assistance_state Administered Programs $1,645
16.738 Edward Byrne Memorial Justice Assistance Grant Program $285
93.977 Preventive Health Services_sexually Transmitted Diseases Control Grants $100