Finding 499837 (2023-005)

Material Weakness Repeat Finding
Requirement
E
Questioned Costs
-
Year
2023
Accepted
2024-09-30
Audit: 322695
Organization: Itasca County (MN)

AI Summary

  • Core Issue: Lack of documented reviews for eligibility case files by program specialists, leading to potential errors in determining client eligibility.
  • Impacted Requirements: Internal control procedures for eligibility determinations are not being followed, risking compliance with state and federal guidelines.
  • Recommended Follow-Up: Implement regular case file reviews and ensure documentation is maintained to enhance oversight and compliance.

Finding Text

Federal Agency: U.S. Department of Health and Human Services Federal Program Name: Medical Assistance Program (Medicaid Cluster) Assistance Listing Number: 93.778 Pass-Through Agency: Minnesota Department of Human Services and the Aitkin-Itasca-Koochiching Community Health Board Pass-Through Numbers: 2305MN5ADM, 2305MN5MAP Federal Award Identification Number and Year: 2305MN5ADM, 2305MN5MAP, 2023 Compliance Requirement Affected: Eligibility Award Period: Year Ended December 31, 2023 Type of Finding: Material Weakness in Internal Control Over Compliance Criteria or Specific Requirement: Standard internal control procedures recommend internal reviews over case file eligibility determinations to ascertain case workers are complying with state and federal requirements and correctly determining program eligibility. Condition: There was no formal review documented over internal case files worked by program eligibility specialists. Questioned Costs: None Context: During our testing of eligibility and testing of case file reviews completed during 2023 for Medical Assistance, it was noted that there were no documented case file reviews performed. Cause: The Minnesota Department of Human Services is not requiring a review and lack of management oversight. Effect: Errors made in determining eligibility may not be discovered and benefits may be issued to clients who are not eligible. Repeat Finding: Yes, 2022-007. Recommendation: We recommend that the County review case files on a periodic basis throughout the year and document the review. Views of Responsible Officials: There is no disagreement with the audit finding.

Corrective Action Plan

Federal Agency: U.S. Department of Health and Human Services Federal Program Name: Medical Assistance Program (Medicaid Cluster) – Assistance Listing Number: 93.778 Pass-Through Agency: Minnesota Department of Human Services and the Aitkin-Itasca-Koochiching Community Health Board Federal Award Identification Number and Pass-Through Number: 2305MN5ADM, 2305MN5MAP Compliance Requirement Affected: Eligibility Award Period: Year Ended December 31, 2023 Type of Finding: Material Weakness in Internal Control over Compliance Recommendation: We recommend the County review case files on a periodic basis throughout the year and document the review. Explanation of disagreement with audit finding: There is no disagreement with the audit finding. Action taken in response to finding: The County will begin reviewing case files and documenting their review. Name(s) of the contact person(s) responsible for corrective action: Eric Villeneuve, Health and Human Services Director Planned completion date for corrective action plan: December 31, 2024

Categories

Internal Control / Segregation of Duties Eligibility Material Weakness

Other Findings in this Audit

  • 499838 2023-005
    Material Weakness Repeat
  • 499839 2023-005
    Material Weakness Repeat
  • 499840 2023-007
    Significant Deficiency
  • 499841 2023-007
    Significant Deficiency
  • 499842 2023-007
    Significant Deficiency
  • 499843 2023-006
    Material Weakness Repeat
  • 499844 2023-006
    Material Weakness Repeat
  • 1076279 2023-005
    Material Weakness Repeat
  • 1076280 2023-005
    Material Weakness Repeat
  • 1076281 2023-005
    Material Weakness Repeat
  • 1076282 2023-007
    Significant Deficiency
  • 1076283 2023-007
    Significant Deficiency
  • 1076284 2023-007
    Significant Deficiency
  • 1076285 2023-006
    Material Weakness Repeat
  • 1076286 2023-006
    Material Weakness Repeat

Programs in Audit

ALN Program Name Expenditures
20.205 Highway Planning and Construction $2.84M
21.027 Coronavirus State and Local Fiscal Recovery Funds $1.39M
93.563 Child Support Enforcement $1.28M
10.561 State Administrative Matching Grants for the Supplemental Nutrition Assistance Program $703,970
15.226 Payments in Lieu of Taxes $616,141
93.558 Temporary Assistance for Needy Families $572,496
10.665 Schools and Roads - Grants to States $384,997
93.658 Foster Care_title IV-E $343,017
93.667 Social Services Block Grant $312,907
93.994 Maternal and Child Health Services Block Grant to the States $206,952
20.219 Recreational Trails Program $165,000
10.557 Special Supplemental Nutrition Program for Women, Infants, and Children $162,665
16.838 Comprehensive Opioid Abuse Site-Based Program $131,106
93.069 Public Health Emergency Preparedness $104,763
93.958 Block Grants for Community Mental Health Services $60,389
97.042 Emergency Management Performance Grants $59,712
16.575 Crime Victim Assistance $39,518
10.698 State & Private Forestry Cooperative Fire Assistance $31,946
93.778 Medical Assistance Program $18,562
93.674 John H. Chafee Foster Care Program for Successful Transition to Adulthood $16,498
20.600 State and Community Highway Safety $10,558
93.575 Child Care and Development Block Grant $8,280
93.645 Stephanie Tubbs Jones Child Welfare Services Program $8,181
97.012 Boating Safety Financial Assistance $8,000
93.556 Promoting Safe and Stable Families $5,160
93.590 Community-Based Child Abuse Prevention Grants $4,415
93.747 Elder Abuse Prevention Interventions Program $3,997
93.767 Children's Health Insurance Program $2,837
93.566 Refugee and Entrant Assistance_state Administered Programs $2,366
93.323 Epidemiology and Laboratory Capacity for Infectious Diseases (elc) $1,924
93.268 Immunization Cooperative Agreements $1,776
97.036 Disaster Grants - Public Assistance (presidentially Declared Disasters) $1,411