FAC Explorer

Finding 516064 (2024-004)

Significant Deficiency Repeat Finding
Requirement
E
Questioned Costs
-
Year
2024
Accepted
2024-12-19
Audit: 333850
Organization: Edgecombe County (NC)
Auditor: Thompson Price Scott Adams & CO

AI Summary

  • Core Issue: Errors in referrals between the County's Department of Social Services and Child Support Agencies were identified, along with inaccuracies in income or household size calculations.
  • Impacted Requirements: Compliance with 42 CFR 435 and 2 CFR 200 regarding proper documentation and internal controls for eligibility determinations was not met.
  • Recommended Follow-Up: Conduct internal reviews of case files to ensure accurate information and proper procedures are followed for eligibility determinations.

Finding Text

Condition: There were 2 errors discovered during our procedures that referrals between the County's Department of Social Services and Child Support Agencies were not properly made. Questioned Costs: There was no known affect to eligibility and there were no known questioned costs. Context: We examined 60 cases from of a total of 1,005,637 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. Section III. Federal Award Findings (continued) Views of responsible officials and planned corrective actions: The county agrees with the finding. Please refer to the corrective action plan for details. Recommendation: Files should be reviewed internally to ensure proper information is in place and necessary procedures are taken when determine eligibility. The results found or documentation made in case notes should clearly indicate what actions were performed and the results of those actions. Criteria: In accordance with 42 CFR 435, documentation must be obtained as needed to determine if a recipient meets specific standards, and documentation must be maintained to support eligibility determinations. In accordance with 2 CFR 200, management should have an adequate system of internal controls procedures in place to ensure an applicant is properly determined or redetermined for benefits. Condition: There were 9 errors discovered during our procedures where income or household size was incorrectly calculated or inaccurate information was entered into the case file. Questioned Costs: There was no known affect to eligibility and there were

Corrective Action Plan

Finding: 2024-004 Inaccurate Information Entry Finding: 2024-005 Inaccurate Resource Calculation Finding: 2024-006 Inadequate Request for Information Corrective Action: Application checklist updated to include a list of persons in the household, a line item also added to ask if changes have been applied in NCFAST. A line item was also added to list the children in the home and request for IV-D referral if applicable. Medicaid Supervisors and Quality Control workers will review files internally prior to approval or denial of a case to ensure that verifications match the evidence in NCFAST and changes have been applied to the cases. This will serve as a second check to catch things prior to the case being completed. MA-3300 Income training will be conducted with all workers. Corrective Action: Application checklist updated to include a line item to check to see if the bank account information in evidence matches what shows in determinations. Caseworkers will be trained to enddate old evidence and start a new evidence for a new period to show when the information has been updated. Medicaid Supervisors and Quality Control workers will review files internally to ensure verifications received and put into evidence matches information in determinations once an eligibility check has been ran. They will also ensure that changes have been applied. Proposed Completion Date: Training and implementation of additional reviews and procedures will be implemented by January 15, 2025.

Categories

Eligibility Internal Control / Segregation of Duties

Other Findings in this Audit

  • 516063 2024-003
    Significant Deficiency Repeat
  • 516065 2024-005
    Significant Deficiency Repeat
  • 516066 2024-006
    Significant Deficiency Repeat
  • 516067 2024-007
    Significant Deficiency Repeat
  • 1092505 2024-003
    Significant Deficiency Repeat
  • 1092506 2024-004
    Significant Deficiency Repeat
  • 1092507 2024-005
    Significant Deficiency Repeat
  • 1092508 2024-006
    Significant Deficiency Repeat
  • 1092509 2024-007
    Significant Deficiency Repeat

Programs in Audit

ALN Program Name Expenditures
10.760 Water and Waste Disposal Systems for Rural Communities $6.73M
93.778 Medical Assistance Program $2.14M
93.563 Child Support Services $1.12M
93.558 Temporary Assistance for Needy Families $953,270
10.561 State Administrative Matching Grants for the Supplemental Nutrition Assistance Program $890,693
93.667 Social Services Block Grant $456,861
93.658 Foster Care Title IV-E $405,585
21.027 Coronavirus State and Local Fiscal Recovery Funds $227,381
10.557 Wic Special Supplemental Nutrition Program for Women, Infants, and Children $218,798
93.994 Maternal and Child Health Services Block Grant to the States $200,103
93.045 Special Programs for the Aging, Title Iii, Part C, Nutrition Services $185,005
93.596 Child Care Mandatory and Matching Funds of the Child Care and Development Fund $155,560
93.323 Epidemiology and Laboratory Capacity for Infectious Diseases (elc) $144,892
93.767 Children's Health Insurance Program $96,928
93.967 Centers for Disease Control and Prevention Collaboration with Academia to Strengthen Public Health $95,528
93.568 Low-Income Home Energy Assistance $88,095
93.917 Hiv Care Formula Grants $65,613
93.217 Family Planning Services $56,864
97.067 Homeland Security Grant Program $54,000
93.268 Immunization Cooperative Agreements $49,668
93.044 Special Programs for the Aging, Title Iii, Part B, Grants for Supportive Services and Senior Centers $45,793
16.001 Law Enforcement Assistance Narcotics and Dangerous Drugs Laboratory Analysis $42,330
97.042 Emergency Management Performance Grants $39,698
93.069 Public Health Emergency Preparedness $34,935
93.053 Nutrition Services Incentive Program $30,703
93.991 Preventive Health and Health Services Block Grant $29,265
20.600 State and Community Highway Safety $28,249
16.738 Edward Byrne Memorial Justice Assistance Grant Program $24,856
93.116 Project Grants and Cooperative Agreements for Tuberculosis Control Programs $21,327
16.607 Bulletproof Vest Partnership Program $21,060
93.674 John H. Chafee Foster Care Program for Successful Transition to Adulthood $11,948
93.659 Adoption Assistance $6,874
93.645 Stephanie Tubbs Jones Child Welfare Services Program $5,546
93.556 Marylee Allen Promoting Safe and Stable Families Program $3,842
93.898 Cancer Prevention and Control Programs for State, Territorial and Tribal Organizations $380
93.977 Sexually Transmitted Diseases (std) Prevention and Control Grants $58