Finding 375559 (2023-008)

Significant Deficiency
Requirement
E
Questioned Costs
-
Year
2023
Accepted
2024-03-12
Audit: 294603
Organization: Richmond County (NC)

AI Summary

  • Core Issue: There are significant deficiencies in record keeping and case review processes, leading to incomplete documentation and potential eligibility errors.
  • Impacted Requirements: Compliance with federal and state eligibility criteria, including effective internal controls as per Section 200.303 of the Uniform Grant Guidance.
  • Recommended Follow-Up: Retrain staff on documentation standards, implement thorough internal reviews, and ensure all eligibility files are complete and accurate.

Finding Text

Questioned Costs: Context: Effect: Identification of a repeat finding: Cause: Recommendation: Views of responsible officials and planned corrective actions: U.S. Department of Health and Human Services Passed through the NC Department of Health and Human Services Food and Nutrition Services (FNS) Cluster AL # 10.551 and 10.561 Finding: 2023-008 Inaccurate Information SIGNIFICANT DEFICENCY Eligibility Criteria: This is a repeat finding from the immediate previous audit, 2022-009. Ineffective record keeping and ineffective case review process, incomplete documentation, and incorrect application of rules for purposes of determining eligibility. Files should be reviewed internally to ensure proper documentation is in place for eligibility. Workers should be retrained on what files should contain and the importance of complete and accurate record keeping. We recommend that all files include online verifications, documented resources and income and those amounts agree to information in NC FAST. The results found or documentation made in case notes should clearly indicate what actions were performed and the results of those actions. The County agrees with the finding. See Corrective Action Plan in the following section. There was no known affect to eligibility and there were no known questioned costs. For those certifications/re-certifications there was a chance that information was not properly documented and reconciled to NC FAST and applicants could have been approved for benefits for which they were not eligible. Section III - Federal Award Findings and Questioned Costs (continued) 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 State has provided policies and procedures to ensure that the County is meeting the federal guidance, relevant policies are: Food and Nutrition Services Policy 305 describes the verification sources and requirements and the FNS units primary responsibility for providing documentary evidence to support statements on applications and recertifications and procedures required if the statements by applicant/beneficiary are questionable. Food and Nutrition Services Policy 300 describes the sources of income countable and not countable to the household for determining financial eligibility. Food and Nutrition Services Policy 310 describes the procedures related to verifying changes in income (i.e. termination, end of contract, temporary, etc.). We examined 60 cases from of a total of 754,993 Medicaid claims from the Medicaid beneficiary report provided by NC Department of Health and Human Services to re-determine eligibility. These findings are being reported with the financial statement audit as it relates to Medicaid administrative cost compliance audit. Condition: Questioned Costs: Context: Effect: Cause: Recommendation: Views of responsible officials and planned Program Name: Medical Assistance Program (Medicaid; Title XIX) AL #: 93.778 SIGNIFICANT DEFICENCY: Finding 2023-004, 2023-005, 2023-006, 2023-007 also apply to State requirements and State Awards. Section IV - State Award Findings and Questioned Costs internal review process is adequately completed to identify and correct errors in case reviews. The County agrees with the finding and is implementing actions to correct these issues, which are further discussed in the corrective action plan. There were a total of 8 errors found in our testing: 4 instances where verification of an expense used for a deduction of income was not included in the case file; 1 instance where verification check returned a record for employment but the case worker did not follow-up; 1 instance where a telephonic signature was not approapriately documented in NCFAST; 1 instance where the caseworked did not appropriately end date old evidence for an expense deduction in NCFAST; and 1 instance where child support income was not entered correctly in NCFAST. There was no known affect to eligibility and there were no known questioned costs. We examined 25 of 14,829 FNS recipients from the a report of all active FNS beneficiaries provided by Richmond County's Department of Human Services. The finding is being reported with the financial statement audit as it relates to FNS administrative cost compliance audit. For those certifications/re-certifications there was a chance that information was not properly documented and reconciled to NC FAST and a participant could have been approved for benefits for which they were not eligible. Due to the errors noted, eligibility cannot be sufficiently substantiated and there is a risk that the County could provide funding and/or benefits to individuals who are not program eligible. The County should provide training of management and staff on the program's eligibility requirements, proper case review process, and required verifications for eligibility. Also, the County should ensure that their formal

Corrective Action Plan

Finding 2023-008 Inaccurate Information Name of contact person: Corrective Action: Proposed Completion Date: Corrective Actions for Finding 2023-004, 2023-005, 2023-006, 2023-007 also apply to State State Award Findings. Section IV - State Award Findings and Questioned Costs Darcey Wiggins, Supervisor FNS Supervisor will conduct a training to inform and train all staff on how to read a DSS 2435 (FNS recertification), DSS 8107's ( FNS application), and DSS 8194 ( Transmittal form) correctly. All staff will be trained on how to verify evidences documented on these forms to ensure all evidence is verified and documented, and the DSS 8650 is used to request all information correctly. IMC supervisor will review policies for income and expenses with all staff. IMC supervisor will ensure that all staff are following policy to document all telephonic signatures and guided interviews correctly. January 19, 2024 and ongoing.

Categories

Eligibility Matching / Level of Effort / Earmarking Internal Control / Segregation of Duties

Other Findings in this Audit

  • 375555 2023-004
    Significant Deficiency Repeat
  • 375556 2023-005
    Significant Deficiency Repeat
  • 375557 2023-006
    Significant Deficiency Repeat
  • 375558 2023-007
    Significant Deficiency Repeat
  • 951997 2023-004
    Significant Deficiency Repeat
  • 951998 2023-005
    Significant Deficiency Repeat
  • 951999 2023-006
    Significant Deficiency Repeat
  • 952000 2023-007
    Significant Deficiency Repeat
  • 952001 2023-008
    Significant Deficiency

Programs in Audit

ALN Program Name Expenditures
21.027 Coronavirus State and Local Fiscal Recovery Funds $2.13M
93.778 Medical Assistance Program $1.43M
93.658 Foster Care_title IV-E $998,370
93.568 Low-Income Home Energy Assistance $973,950
93.563 Child Support Enforcement $760,841
93.558 Temporary Assistance for Needy Families $704,001
10.561 State Administrative Matching Grants for the Supplemental Nutrition Assistance Program $636,593
10.557 Special Supplemental Nutrition Program for Women, Infants, and Children $416,530
93.667 Social Services Block Grant $325,080
14.228 Community Development Block Grants/state's Program and Non-Entitlement Grants in Hawaii $307,825
93.323 Epidemiology and Laboratory Capacity for Infectious Diseases (elc) $192,521
93.045 Special Programs for the Aging_title Iii, Part C_nutrition Services $185,704
93.354 Public Health Emergency Response: Cooperative Agreement for Emergency Response: Public Health Crisis Response $123,833
93.268 Immunization Cooperative Agreements $115,616
93.994 Maternal and Child Health Services Block Grant to the States $105,501
93.596 Child Care Mandatory and Matching Funds of the Child Care and Development Fund $93,233
93.044 Special Programs for the Aging_title Iii, Part B_grants for Supportive Services and Senior Centers $66,507
97.042 Emergency Management Performance Grants $50,099
93.391 Activities to Support State, Tribal, Local and Territorial (stlt) Health Department Response to Public Health Or Healthcare Crises $44,660
93.217 Family Planning_services $40,196
93.069 Public Health Emergency Preparedness $33,216
16.738 Edward Byrne Memorial Justice Assistance Grant Program $30,799
93.991 Preventive Health and Health Services Block Grant $30,608
93.053 Nutrition Services Incentive Program $30,603
93.767 Children's Health Insurance Program $28,292
93.116 Project Grants and Cooperative Agreements for Tuberculosis Control Programs $20,860
16.607 Bulletproof Vest Partnership Program $14,410
93.674 John H. Chafee Foster Care Program for Successful Transition to Adulthood $14,307
93.645 Stephanie Tubbs Jones Child Welfare Services Program $12,246
93.898 Cancer Prevention and Control Programs for State, Territorial and Tribal Organizations $9,500
93.556 Promoting Safe and Stable Families $3,986
93.977 Preventive Health Services_sexually Transmitted Diseases Control Grants $100
93.566 Refugee and Entrant Assistance_state Administered Programs $98
93.560 Family Support Payments to States_assistance Payments $-129