Finding 481318 (2023-008)

Material Weakness
Requirement
E
Questioned Costs
-
Year
2023
Accepted
2024-08-16
Audit: 317385
Organization: Mesa County, Colorado (CO)
Auditor: Eide Bailly LLP

AI Summary

  • Core Issue: The County failed to complete eligibility determinations within the required 45-day timeframe for nine cases.
  • Impacted Requirements: This non-compliance violates federal regulations and state processing standards regarding timely notice of eligibility decisions.
  • Recommended Follow-up: The County should use COGNOS reports to monitor cases approaching deadlines to ensure timely processing.

Finding Text

Criteria: The Federal requirement related to processing of an application requires the State to provide notice of its decision concerning eligibility and provide timely and adequate notice of the basis for denial or termination of assistance (42 USC 1320c-7(d)). According to the Colorado Department of Health Care Policy and Financing (HCPF), processing standards 8.100.3.D, the County is required to process an initial application for any program not requiring a disability determination no later than 45 days following receipt of application. Condition: We tested eligibility determination and controls over this process for sixty case files. We noted the following in our testing: •Nine instances of non-compliance in which the County did not complete the eligibilitydetermination and approve/deny the case within 45 days and no notice of action wassent to the client within the required timeframe. Cause: Due to the County’s ineffective monitoring, eligibility determinations were not completed in a timely manner and within the 45-day deadline. Effect: Failure to process applications timely could result in participants that are delayed approval of Medicaid services. Questioned Costs: None to report. Context/Sampling: A nonstatistical sample of 60 participants were selected for eligibility testing. Repeat Finding from Prior Years: No. Recommendation: We recommend the County utilize available COGNOS reports to determine which cases are nearing the exceeding processing guidelines. Views of Responsible Officials: Agree

Corrective Action Plan

The County concurs with this finding and will be working to improve the timeliness of Medicaid eligibility determinations by using the COGNOS reports to determine which cases are approaching the due date.

Categories

Subrecipient Monitoring Eligibility

Other Findings in this Audit

  • 481313 2023-004
    Material Weakness
  • 481314 2023-005
    Material Weakness
  • 481315 2023-003
    Material Weakness
  • 481316 2023-006
    Material Weakness
  • 481317 2023-007
    Material Weakness
  • 1057755 2023-004
    Material Weakness
  • 1057756 2023-005
    Material Weakness
  • 1057757 2023-003
    Material Weakness
  • 1057758 2023-006
    Material Weakness
  • 1057759 2023-007
    Material Weakness
  • 1057760 2023-008
    Material Weakness

Programs in Audit

ALN Program Name Expenditures
93.558 Temporary Assistance for Needy Families $4.91M
93.658 Foster Care_title IV-E $3.25M
93.575 Child Care and Development Block Grant $2.69M
21.027 Coronavirus State and Local Fiscal Recovery Funds $2.57M
93.659 Adoption Assistance $2.22M
10.561 State Administrative Matching Grants for the Supplemental Nutrition Assistance Program $2.00M
93.563 Child Support Enforcement $1.69M
20.526 Buses and Bus Facilities Formula, Competitive, and Low Or No Emissions Programs $1.05M
17.258 Wia Adult Program $1.01M
93.596 Child Care Mandatory and Matching Funds of the Child Care and Development Fund $805,838
17.259 Wia Youth Activities $745,683
93.323 Epidemiology and Laboratory Capacity for Infectious Diseases (elc) $708,825
93.667 Social Services Block Grant $642,269
20.507 Federal Transit_formula Grants $459,898
10.665 Schools and Roads - Grants to States $443,373
95.001 High Intensity Drug Trafficking Areas Program $396,478
17.207 Employment Service/wagner-Peyser Funded Activities $340,369
16.710 Public Safety Partnership and Community Policing Grants $218,171
93.243 Substance Abuse and Mental Health Services_projects of Regional and National Significance $201,953
14.228 Community Development Block Grants/state's Program and Non-Entitlement Grants in Hawaii $200,904
93.045 Special Programs for the Aging_title Iii, Part C_nutrition Services $188,215
93.645 Stephanie Tubbs Jones Child Welfare Services Program $182,956
16.922 Equitable Sharing Program $181,165
93.569 Community Services Block Grant $168,095
16.738 Edward Byrne Memorial Justice Assistance Grant Program $162,032
10.558 Child and Adult Care Food Program $155,575
17.278 Wia Dislocated Worker Formula Grants $150,543
93.217 Family Planning_services $146,234
17.285 Apprenticeship USA Grants $136,748
93.434 Every Student Succeeds Act/preschool Development Grants $129,965
93.053 Nutrition Services Incentive Program $107,563
93.354 Public Health Emergency Response: Cooperative Agreement for Emergency Response: Public Health Crisis Response $91,223
93.090 Guardianship Assistance $89,242
93.994 Maternal and Child Health Services Block Grant to the States $89,150
93.778 Medical Assistance Program $87,656
97.042 Emergency Management Performance Grants $80,161
93.044 Special Programs for the Aging_title Iii, Part B_grants for Supportive Services and Senior Centers $76,944
93.069 Public Health Emergency Preparedness $76,702
16.575 Crime Victim Assistance $69,604
20.513 Enhanced Mobility of Seniors and Individuals with Disabilities $62,532
93.674 John H. Chafee Foster Care Program for Successful Transition to Adulthood $59,668
93.268 Immunization Cooperative Agreements $56,359
93.052 National Family Caregiver Support, Title Iii, Part E $50,476
15.228 Blm Fuels Management and Community Fire Assistance Program Activities $45,112
16.606 State Criminal Alien Assistance Program $43,216
93.747 Elder Abuse Prevention Interventions Program $40,111
10.557 Special Supplemental Nutrition Program for Women, Infants, and Children $38,902
93.791 Money Follows the Person Rebalancing Demonstration $36,737
10.551 Supplemental Nutrition Assistance Program $36,028
93.568 Low-Income Home Energy Assistance $35,231
17.225 Unemployment Insurance $33,421
93.043 Special Programs for the Aging_title Iii, Part D_disease Prevention and Health Promotion Services $31,713
17.277 Workforce Investment Act (wia) National Emergency Grants $31,490
20.939 Safe Streets and Roads for All $22,584
93.136 Injury Prevention and Control Research and State and Community Based Programs $19,392
93.324 State Health Insurance Assistance Program $18,614
20.205 Highway Planning and Construction $14,711
93.042 Special Programs for the Aging_title Vii, Chapter 2_long Term Care Ombudsman Services for Older Individuals $8,572
93.556 Promoting Safe and Stable Families $7,677
17.273 Temporary Labor Certification for Foreign Workers $7,529
17.801 Jobs for Veterans State Grants $7,000
15.225 Recreation Resource Management $5,390
20.616 National Priority Safety Programs $4,237
93.041 Special Programs for the Aging_title Vii, Chapter 3_programs for Prevention of Elder Abuse, Neglect, and Exploitation $3,208
93.967 Cdc's Collaboration with Academia to Strengthen Public Health $2,648
17.245 Trade Adjustment Assistance $2,045
93.472 Title IV-E Prevention and Family Services and Programs (a) $269