Finding 530021 — 2024-045

Program: AL 93.575 and 93.596 – CCDF Cluster; AL 93.575 – COVID-19 Child Care and Development Block Grant – Allowability & Eligibility & Matching Grant Number & Year: 2301NETANF, FFY 2023; 2101NECDC6, FFY 2021; 2201NECCDD, FFY 2022; 2401NECCDF, FFY 2024; 2401NECCDM, FFY 2024; 2101NECCDF, FFY 2021 Federal Grantor Agency: U.S. Department of Health and Human Services Criteria: 45 CFR § 98.67 (October 1, 2023) states, in part, the following: (a) Lead Agencies shall expend and account for CCDF funds in accordance with their own laws and procedures for expending and accounting for their own funds. * * * * (c) Fiscal control and accounting procedures shall be sufficient to permit: * * * * (2) The tracing of funds to a level of expenditure adequate to establish that such funds have not been used in violation of the provisions of this part. 42 USC § 9858k(b) (1992) states, “With regard to services provided to students enrolled in grades 1 through 12, no financial assistance provided under this subchapter shall be expended for— (1) any services provided to such students during the regular school day[.]” 45 CFR § 98.55 (October 1, 2023) states the following: (a) Federal matching funds are available for expenditures in a State based upon the formula specified at § 98.63(a). (b) Expenditures in a State under paragraph (a) of this section will be matched at the Federal medical assistance rate for the applicable fiscal year for allowable activities, as described in the approved State Plan, that meet the goals and purposes of the Act. To be eligible for services, 45 CFR § 98.20 (October 1, 2023) requires a child to be under 13 years of age, a citizen, and reside with a family whose income does not exceed 85% of the State’s median income. Title 391 NAC 1-002 defines “infant” and “toddler” for child care subsidies, as follows: Ages of children: 1. Infant means a child age 6 weeks to 18 months; 2. Toddler means a child age 18 months to 3 years; 3. Preschool-age means a child age 3 or older who has not attended kindergarten; and 4. School-age means a child who attends kindergarten or above. Title 392 NAC 2-004, states, in part, the following: In order to receive Child Care Subsidy, the family must: * * * * (E) Have a child within the age limit. Child care is available for children age 12 or younger. Children who turn age 13 during their eligibility period remain eligible through the end of their eligibility period. Children age 18 or younger with special needs are eligible. The child’s age must be verified in order to qualify for assistance[.] Per Title 392 NAC 2-013.05, “If the individual is requesting child care for employment, the employment must have the potential to allow the individual to achieve or maintain economic self-sufficiency.” Title 392 NAC 3-001.02(D) requires the recipient and child care provider to ensure that the services are delivered as authorized. Title 392 NAC 3-004.01(A) states the following: The Department pays by attendance, not enrollment. Providers do not receive payment when the provider is on vacation, is ill, or is not providing care for some reason unrelated to the child or recipient. Title 392 NAC 3-004.01(A)(i) states the following: The provider may bill the full authorized amount for times that the child is absent on a scheduled day, up to five times per month. Title 392 NAC 4-002 states, in relevant part, the following: Before furnishing any service, each provider must sign an enrollment form agreeing: (A) No payments will be made for child care provided to a child before the service authorization date; (B) To provide service only as authorized, in accordance with the Department’s standards; * * * * (E) To accept a rate which is reasonable, necessary, and does not exceed the amount charged to private-paying persons; * * * * (G) To retain authorizations, billing documents, and attendance records for four years to support and document all claims; The Child Care Subsidy Provider Handbook (June 2023 revision), Section 5 (“Financial Matters”), states, in relevant part, the following: You must complete an attendance calendar to accurately reflect the dates on which child care services were provided, as well as the exact number of hours of service provided. You should mark “A” on the calendars for children who are absent. Up to five absent days can be billed per child per month. Nebraska Department of Health and Human Services’ Guidance Document for the Child Care Subsidy Program provides guidance for 392 NAC Chapter 3-004.01(A)(i) Payment for Absences as follows, “Absent days must be billed as 1 day unit per occurrence up to the maximum of 5 occurrences per month.” Nebraska Department of Health and Human Services’ Guidance Document for the Child Care Subsidy Program has the following guidance for Title 392 NAC Chapter 2-011, Categories of Eligibility Based on Income: The total amount of the sliding fee assessed will be based on 7% of the household’s gross income for all of their children enrolled in the subsidy program. It will not vary with the number of children in care, the amount of care they need, or the type of care they choose to use. The sliding fee must be paid each month to the provider before the provider bills the Department, it covers the first dollars of payment, regardless of when service begins or ends. The Child Care Subsidy Provider Handbook (June 2023 revision) requires that, for providers other than child care centers, “[P]arents/caregivers must sign the calendar at the end of the billing period.” EnterpriseOne is the official accounting system for the State of Nebraska, and all expenditures are generated from it. Good internal control requires procedures to ensure that payments are in accordance with Federal and State requirements. Condition: Child care payments did not comply with Federal and State requirements. A similar finding has been noted in our previous audit reports since 2007. Repeat Finding: 2023-043 Questioned Costs: $605,874 known See Schedule of Findings and Questioned Costs for chart/table. Statistical Sample: No Context: We noted claims that lacked support and/or did not agree to support, services billed more than authorized, and duplicate claims charged, as detailed below. Random Sample We tested 25 child care claims paid with Federal funds. We noted 12 claims with errors. Some payments had more than one type of error. • For two claims tested, there was a family fee co-pay required of $192 and $149 per month, respectively, but no such co-pay was deducted. • For four claims tested, the providers billed for more hours and/or days than what was recorded on the child’s attendance sheet: o One provider billed for 8 days and 2 partial days of child care, while the attendance sheet showed 5 days and 5 partial days of care. o One provider claimed 7 full days of care during the claim period; however, the attendance sheet provided did not detail the hours that the child was in the care of the provider. As such, the APA could not determine whether the claim was correct. o One provider billed 10 partial-days services; however, the attendance sheet showed only 4 partial-days and one full-day for this period. o One provider billed for 21 days, but the attendance sheet supported only 20 days. • For two claims tested, the providers billed for services over the authorized amount. o One provider was authorized to provide child care during the time that both the mother and father were working. The provider claimed numerous days for care provided overnight; however, no documentation was on file to support that both parents were working overnight. o One provider was authorized 20 hours of child care a week; however, per the attendance sheet, two weeks during the month had 23 service hours per week. • For six claims tested, the child care payment was incorrect because the rate was in excess of the private rates. Providers must accept a rate that is reasonable, necessary, and does not exceed the amount charged to private-paying persons. o One provider claimed $25/partial day but was only authorized to claim $18.33/partial day. o For two claims, the provider reported private rates of $75/week effective May 27, 2022, and $90/week effective May 2, 2024. Using an Agency-provided conversion table, this would result in a partial rate of $8.33-$10/partial day and $15-18/day. However, the provider was claiming $13.33/partial day and $24/day. o One provider reported a private rate of $40/day but was claiming $40.55/day, exceeding the private rate. o One provider reported its private weekly rate at $83. Using a DHHS-provided conversion table, this would result in $9.22/partial day. However, the provider was charging for $20.56/partial day. o One provider reported on its website a partial day private rate of $47 a week, which would result in a rate of $9.40/partial day. However, the provider was claiming $18 for a partial day. Federal payment errors noted for the sample tested were $1,356. The total Federal sample tested was $10,518, and total child care Federal assistance claims for the fiscal year were $83,226,143. Based on the sample tested, the case error rate was 48% (12/25). The dollar error rate for the sample was 12.89% ($1,356/10,518), which estimates the potential dollars at risk for fiscal year 2024 to be $10,727,850 (dollar error rate multiplied by the population). In addition to the $1,356 questioned costs noted on the sample items tested, we noted $2,027 of questioned costs on other line items of the claims reviewed, which resulted from missing and inaccurate documentation. Excessive Units The Nebraska Family Online Client User System (NFOCUS) application was used to automate benefit/service delivery and claim processing and payments for the Child Care program. Due to the volume of claims processed by the NFOCUS application, the Agency did not perform a review of each claim paid. Therefore, the Agency relied on edit checks within the system to review claims and deny or suspend claims that did not meet the criteria determined by the Agency. As noted in Finding 2024-015, during testing of significant edit checks within the NFOCUS application, it was noted that the “UN” edit check (“Units too high for service dates and frequency”) was incorrectly bypassed on claims submitted and interfaced through the Child and Family Services Provider online claims portal. Instead of applying a logical edit check to these claims, such as not exceeding the regular number days in one month (e.g., 31 days), the system only compared the claim to the service authorization to determine if adequate units were authorized. We identified 642 claim lines paid with Federal funds, totaling $286,079, where the number of days or partial days billed exceeded the number of days in the service period. We selected 24 claim lines, totaling $33,709, for review and noted 23 claim lines with errors as follows: • The claims charged to Federal funds were “Version 1” of the claim. Sometimes an error is detected and a “Version 2” of the claim is created with an underpayment or overpayment. We noted 11 of the claim lines tested had a Version 2 and 10 of those had overpayments received or recouped. However, the overpayments collected and recouped are credited to the State General Fund, not Federal funds. The 11 claim lines totaled $16,420 and are considered Federal questioned costs. Errors noted included a claim that had 199 days billed for the month of July 2022, the overpayment was collected in December 2022 and credited to the State General Fund. In February 2024 the Agency moved the Version 1 claim to Federal funds, resulting in the Federal grant being overcharged. We also noted a claim that billed 100 partial days for a 19-day period. The error was discovered, and a Version 2 was created in December 2023, but in April 2024, the Agency moved the Version 1 claim to Federal funds, resulting in the Federal grant being overcharged. • Twelve claim lines did not agree to the attendance records. One provider billed 25 to 64 partial days for 15-day service periods. Two providers billed 40 to 95 partial days for one month service periods. Per review of the attendance records, providers were overpaid $9,182 for these 12 claim lines, which are considered questioned costs. Duplicate Claims Child care claims are initially paid from State funds. Journal entries are then performed throughout the year to transfer costs to Federal funds. A detailed listing of claims accompanies these journal entries to show which claims are included in the amounts moved from State funds to Federal funds. We reviewed the detailed claim listings for each journal entry completed during the fiscal year and found that duplicate claims were included in two journal entries completed on September 28, 2023. Both entries included 594 identical claims, totaling $141,165. These claims were charged to Federal funds twice, and $141,165 is considered questioned costs. Additionally, we compared the detail claim listing to the claims charged to Federal funds in the prior fiscal year and found 1,144 claims that were used in both fiscal year 2023 and fiscal year 2024 journal entries, totaling $297,553, which are questioned costs. Attestation Examination The APA performed an attestation examination of the Nebraska Department of Health and Human Services Child Care NFOCUS Aid Payments for the period July 1, 2023, through March 31, 2024. All claims were initially paid with State General Funds. The APA reviewed the claims with findings to determine if the claims had been transferred and charged to Federal funds. We noted numerous issues with Federal questioned costs, totaling $138,171. We noted the following related to claims paid with Federal funds: Unusual Claims and Duplicate Billings We tested a family in-home care provider that billed a high number of hours for the month. The provider did not provide the requested attendance calendar for January 2024 services. The provider billed 260 hours at a rate of $12 per hour for a total of $3,120. Child care was authorized for the client’s self-employment, up to 60 hours per week. We were unable to determine if the payment was correct because no attendance calendar was provided; therefore, the entire claim was questioned. We also noted the 60 hours per week was authorized based on the client’s declaration of working 12 hours a day, seven days a week. The client’s reported income for this timeframe was $1,500 per month, which calculates to only $4.12 per hour, which is much less than the Nebraska minimum wage rate of $12 per hour. The client’s income does not appear to meet the self-sufficiency requirement. Federal questioned costs totaled $3,120. We noted overlapping of services as follows: Three children were authorized child care for a maximum of 50 hours per week while the parent was working at U-Stop and participating with Employment First. Child care was authorized with two providers. The attendance calendars for both providers showed no overlapping hours; however, the providers exceeded the authorized 50 hours per week for four weeks in September 2023. The secondary provider billed times from 8:30 a.m. to 3:00 p.m. or 4:00 p.m., and the primary provider billed evening and some overnight hours. A comparison of attendance calendars revealed that the total hours between the two providers exceeded the authorization by 6 to 23.5 hours each week. Federal questioned costs totaled $1,027. See the following chart: See Schedule of Findings and Questioned Costs for chart/table. We analyzed the NFOCUS claims paid during the period from July 1, 2023, through March 31, 2024. During this analysis, we identified several claims where the provider appeared to double bill child care services for the same child during the same time period. The providers were able to double bill when two service authorizations for the child were open at the same time and by changing the rate of the service. There were also multiple instances where the provider billed for duplicate services by changing the rate billed. For example, one provider, Tender Loving Tots, billed services three times for the same child for the same time period. A child was authorized for preschool care at the daily rate of $46.51. Tender Loving Tots billed four daily units at the authorized daily rate of $46.51 for service dates of July 11, 2023, through July 14, 2023, for this child on claim 32347682. The provider also billed four daily units at $46.50 per daily unit on claim 83255070, line 2. Tender Loving Tots billed a third time for this child for the same period on the same claim. On line 5 of claim 83255070, the provider billed four days at $45 per daily unit. As long as the billed rate was lower than the authorized rate, NFOCUS did not reject the claim for double billing. See Schedule of Findings and Questioned Costs for chart/table. The following chart shows the number of duplicate claims reviewed and Federal questioned costs by provider: See Schedule of Findings and Questioned Costs for chart/table. Incorrect Age Group We reviewed the claims for family home providers and child care centers for infant care services for children over the age of 18 months. We noted children over the age of 18 months with services paid at the infant rate. We also reviewed the claims for child care centers for toddler care services for children over the age of 36 months. We noted children over the age of 36 months with services paid at the toddler rate. As the rates for infants are higher than toddler rates, and toddler rates are higher than preschool rates, it is important that services be paid at the proper rate based on a child’s age. The following are a few examples that we noted: • A child who turned 19 months on September 18, 2023, continued to be paid at the infant rate for services through February 2024, resulting in questioned costs of $574. • A child who turned 36 months on March 8, 2023, was paid at the infant rate for services from August 16, 2023, through December 2, 2023, and should have been paid at the preschool rate, resulting in overpayments of $538. • A child over age five was paid at the toddler rate for services from June 16, 2023, through November 30, 2023, and should have been paid at the preschool rate, resulting in overpayments of $349. • A child who turned 36 months on October 5, 2023, was paid at the toddler rate for February 2024 services and should have been paid at the preschool rate, resulting in an overpayment of $105. Other Issues We selected six licensed family home providers and six child care centers and requested all attendance records for one month. We noted claims not agreeing with attendance records; attendance records not being provided; billings at an improper rate; services billed in excess of services authorized; overlapping services; and parents’ employment that did not appear to meet the requirement for self-sufficiency. 1. One family home provider billed full days for one child but should have billed partial days because the attendance record showed services from 4:00 p.m. to 6:00 p.m. (2 hours) each day, resulting in $66 questioned costs. 2. Next Generation Child Care and Preschool was paid $94,405 for February 2024 services. For one child, the attendance record showed service from 6:15 a.m. to 8:30 a.m. Per the parent, however, school began at 7:40 a.m., so it appears the time out of 8:30 a.m. is not accurate, resulting in $48 questioned costs. 3. Little Blazers Academy, located on North 61st Street in Omaha, Nebraska, and Little Blazers Academy II, located on West Dodge in Omaha, Nebraska, have the same owner. We question Federal costs of $2,703 for December 2023 services. • Services were billed for 18 children at both locations. For six of these children, the centers were billing partial days at each location when the total hours were less than five hours. For example, on multiple days, one child was claimed from 4:00 p.m. to 5:00 p.m. at one location and then from 5:30 p.m. to 6:30 p.m. at the second location. Each location billed for a partial day; however, only two hours of service were provided each day; therefore, it does not appear reasonable to bill for more than one partial day each day. • The attendance records for December, the month tested, were not provided for eight children, four of whom were paid with Federal funds. The attendance records provided were for September, not December, and were signed September 30, 2023. Also, the service authorization was exceeded for one child; for two children, the claim did not agree to the attendance records. 4. Sprouting Minds Childcare was paid $41,053 for November 2023 services, and we questioned costs of $14,133 – of which $4,309 was paid with Federal funds. We noted the following: • 19 children were billed and paid as an “absent” day on Thanksgiving and the Friday after Thanksgiving, even though the center was closed, and no children attended. • Attendance records were not provided for five children, and time records did not agree to the services billed for an additional five children. • Services claimed exceeded service authorizations for 13 children. • One child was billed both as a toddler and an infant for the same period and should have been billed only as a toddler. 5. International Day Care was paid $173,260 for November 2023 services – of which $132,328 was charged to Federal funds – and we question $111,609, an 84% dollar error rate. We noted the following: • 191 children were billed and paid as an “absent” day on Thanksgiving even though the center was closed, and no children attended. • One child billed was over age 13 and not eligible for services. • One child was billed as a toddler but was over the age of three at the time of service and should have been billed at the preschool rate. • One child was billed as an infant but was 35 months old at the time of service and should have been billed as a toddler. • Four families authorized for child care while a parent was working at the center billed for days after the parent was no longer working at the center. During our review of service authorizations, moreover, we noted that several children had a parent working at the daycare while the children attended. This is allowable if the parent is not working in the same room. However, of the 222 children paid for the month tested, 201 had a parent working at the daycare, and only 21 children did not. The 222 children were from 53 families, and 44 of those families had a parent working at the daycare. We asked the daycare to provide us with employment records for those parents. Most of the parents had income from International Day Care that was far less than the subsidies paid for child care services. For example, for one family, the parent earned $1,452 for the month, but child care payments totaled $6,353. Title 392 NAC 2-013.05 provides, “If the individual is requesting child care for employment, the employment must have the potential to allow the individual to achieve or maintain economic self-sufficiency.” Based on a comparison of wages to child care subsidies, however, the employment with the daycare does not appear to have that potential. For the families with a parent working at the daycare, there was a total of $154,326 in child care payments, but the parents’ gross salary from the daycare totaled only $64,163 – a discrepancy hardly reflective of employment arrangements conducive to economic autonomy. Many of these families had additional income from sources other than the daycare; however, child care subsidies still appeared unreasonable. In these cases, as illustrated by the examples below, parents working at the daycare in a capacity that failed to produce even the potential to “achieve or maintain economic self-sufficiency,” contrary to the explicit regulatory language cited above, actually resulted in far greater child care costs than would have occurred had those working parents stayed at home and cared for the children themselves. The following cases are representative of why subsidies are not available for jobs that prove ultimately counterproductive in terms of the relatively low wages received in comparison to the resultant child care expenses to the State: • One family with seven children had child care subsidies for the month of $5,945 plus paid a family fee of $465 per month, for total daycare costs of $6,410. This was a two-parent household, and one parent worked at the daycare and earned $1,386 for the month. The total gross income for the household was $6,647.97, which exceeds the cost of child care, but if the family was responsible for all daycare costs, it would leave less than $250 per month for rent, food, utilities, and other expenses. It would cost the family over $5,000 each month to have a parent working at the daycare; therefore, the employment does not appear to have the potential for self-sufficiency. • Another family had child care subsidies for the month of $5,610, and the parent who worked at the daycare earned $1,323. The family had total gross monthly income of $4,192.16, which is still $1,417.84 less than child care costs, and if the family was responsible for all child care costs, it would cost the family $4,287 each month to have the parent working at the daycare. Therefore, the employment does not appear to have the potential for self-sufficiency. It was also noted that seven families were receiving Temporary Assistance to Needy Families (TANF) and were required to work as a condition of that assistance. These seven families received child care subsidies of $24,850 for the month and were paid wages of $10,456 by the daycare. However, we did not question these costs because the individuals were required to work as a condition of receiving TANF. Excluding the TANF recipients, we questioned all other child care payments for families whose parents’ wages from the child care center were less than the child care payments. Market Rate Survey and Subsidy Rates The 2023 child care subsidy rates, which became effective July 1, 2023, were established following a Market Rate Survey issued in June 2022 by the Buffet Institute at the University of Nebraska (Institute). This market rate survey was commissioned by the Agency pursuant to Neb. Rev. Stat. § 43-536 (Cum. Supp. 2022). The results of the survey were based on a provider response rate of 32.9% (946 providers); however, in calculating the half-day and full-day rates, the Institute used rate information from only 21% of respondents who indicated that they had a part-time and full-time rate schedule similar to the guidelines set by the Agency (partial day for 0 to 4 hours and 59 minutes and full-time for 5 hours to 9 hours and 59 minutes). As such, the rates were established based on rate information provided by only 6.9% of Nebraska’s child care providers. The percentage of providers factored into the benefit calculation is so low because many providers responded that they did not have an equivalent half-day or full-day rate structure. Therefore, we question the reasonableness of the rates established pursuant to the market rate survey and whether it provides a clear picture of private market rates in the State. Additionally, Nebraska regulations require that providers have an established private rate prior to receiving any subsidy payments. This is because the subsidy payment is not allowed to exceed the provider’s private rate. However, as shown in the market survey results, many providers do not have such a rate structure and, therefore, do not have established half-day and full-day rates. In many cases, providers have a weekly rate. The Agency stated that it utilizes a weekly rate to daily/partial day rate conversion table, which was provided by the Institute. However, while this table is used to determine the equivalent rates, there is no written policy or guidance on when or how the table should be implemented, and no mention is made of these conversion tables in the market survey report. State Matching Claims States are required to match the Federal funds spent with the Federal Matching grant with State funded expenditures at the Federal Medical Assistance Percentage (FMAP) rate for the applicable fiscal year. Those State funding expenditures must be an eligible and allowable activity per the State Plan. The Agency periodically performs journal entries to move child care claims to the applicable business unit to identify and track the State matching expenditures. During the fiscal year, the Agency moved $10,737,243 of child care claims paid with State General funds to the business units for State matching expenditures. We tested 25 child care claims paid with State matching funds. We noted 10 claims with errors. Some payments had more than one type of error. • For one claim tested, there was a family fee co-pay required of $203, but no such co-pay was deducted. • For two claims tested, the attendance records were not provided. • For five claims tested, the providers billed for more hours and/or days than what was recorded on the child’s attendance sheet: o One provider billed for 4 full days and 25.25 hours of child care, while the attendance sheet showed 0 days and 18.75 hours of care. o One provider billed 13 partial days of service; however, the attendance sheet showed only 10 partial days. o Two providers billed an additional day compared to the attendance record. o One provider recorded full days of service from 6:00 a.m. to 9:00 a.m. and 4:00 p.m. to 6:00 p.m., for five hours of service. However, per the school calendar, classes began at 8:50 a.m. and ended at 4:05 p.m. The attendance sheet did not appear reasonable, as the child would still be at the child care provider when school started. If services were from 6:00 a.m. to 8:50 a.m. and 4:05 p.m. to 6:00 p.m., the provider would only be allowed partial days of service. • For one claim tested, the provider billed care over the authorized amount. The provider was authorized 39 hours of child care a week; however, per the attendance sheet, the child received 43 hours for one week tested. • For one claim tested, the attendance record was not signed by the parent, as required. Payment errors noted for the sample tested were $1,397. The total sample tested was $9,396, and total child care matching claims for the fiscal year were $10,737,243. Based on the sample tested, the case error rate was 40% (10/25). The dollar error rate for the sample was 14.87% ($1,397/9,396), which estimates the potential dollars at risk for fiscal year 2024 to be $1,596,628 (dollar error rate multiplied by the population). Cause: Ineffective review. The Agency does not have automated procedures to ensure attendance records agree to billing documents, service authorizations are not exceeded, and claims are in accordance with regulations. The edit check “Units too high for service dates and frequency” was incorrectly bypassed on claims submitted and interfaced through the Child and Family Services Provider online claims portal. Effect: Ineffective review of claims increases the risk for errors, fraud, and misuse of State and Federal funds. Recommendation: We recommend the Agency implement procedures to ensure payments are allowable, adequately supported, and in accordance with State and Federal regulations. We further recommend the Agency ensure billing documents agree with attendance sheets, and services are only authorized as needed and only if the parents’ employment has the potential for economic self-sufficiency. We also recommend the Agency implement procedures to ensure journal entries do not charge duplicate claims. Finally, we recommend the Agency take the necessary action to recover the overpayments. Management Response: Management agrees.

ALN	Program Name	Expenditures
10.551	Supplemental Nutrition Assistance Program	$310.78M
21.027	Coronavirus State and Local Fiscal Recovery Funds	$214.16M
97.036	Disaster Grants - Public Assistance (presidentially Declared Disasters)	$76.85M
84.010	Title I Grants to Local Educational Agencies	$57.45M
93.558	Temporary Assistance for Needy Families	$48.17M
93.575	Child Care and Development Block Grant	$48.05M
12.401	National Guard Military Operations and Maintenance (o&m) Projects	$36.95M
10.557	Wic Special Supplemental Nutrition Program for Women, Infants, and Children	$34.45M
66.468	Drinking Water State Revolving Fund	$33.99M
21.029	Coronavirus Capital Projects Fund	$29.75M
93.596	Child Care Mandatory and Matching Funds of the Child Care and Development Fund	$28.69M
10.558	Child and Adult Care Food Program	$28.62M
10.553	School Breakfast Program	$27.93M
64.015	Veterans State Nursing Home Care	$25.90M
93.778	Medical Assistance Program	$23.99M
93.563	Child Support Services	$23.93M
93.323	Epidemiology and Laboratory Capacity for Infectious Diseases (elc)	$23.75M
12.400	Military Construction, National Guard	$22.76M
10.542	Pandemic Ebt Food Benefits	$20.61M
10.555	National School Lunch Program	$18.26M
93.566	Refugee and Entrant Assistance State/replacement Designee Administered Programs	$17.19M
21.026	Homeowner Assistance Fund	$14.73M
66.458	Clean Water State Revolving Fund	$14.24M
21.023	Emergency Rental Assistance Program	$14.17M
96.001	Social Security Disability Insurance	$14.01M
15.611	Wildlife Restoration and Basic Hunter Education and Safety	$13.38M
93.667	Social Services Block Grant	$12.32M
20.106	Airport Improvement Program, Infrastructure Investment and Jobs Act Programs, and Covid-19 Airports Programs	$11.94M
10.569	Emergency Food Assistance Program (food Commodities)	$10.69M
16.575	Crime Victim Assistance	$10.43M
93.917	Hiv Care Formula Grants	$9.64M
93.268	Immunization Cooperative Agreements	$9.02M
10.646	Summer Electronic Benefit Transfer Program for Children	$8.95M
84.048	Career and Technical Education -- Basic Grants to States	$8.82M
15.018	Energy Community Revitalization Program (ecrp)	$8.58M
84.369	Grants for State Assessments and Related Activities	$8.05M
84.367	Supporting Effective Instruction State Grants (formerly Improving Teacher Quality State Grants)	$7.62M
93.391	Activities to Support State, Tribal, Local and Territorial (stlt) Health Department Response to Public Health Or Healthcare Crises	$7.18M
84.011	Migrant Education State Grant Program	$7.16M
93.434	Every Student Succeeds Act/preschool Development Grants	$7.14M
15.605	Sport Fish Restoration	$7.02M
21.U01	State Small Business Credit Initiative (ssbci)	$6.17M
20.205	Highway Planning and Construction	$6.10M
84.287	Twenty-First Century Community Learning Centers	$5.79M
93.569	Community Services Block Grant	$5.59M
93.069	Public Health Emergency Preparedness	$5.33M
17.207	Employment Service/wagner-Peyser Funded Activities	$5.28M
20.933	National Infrastructure Investments	$5.28M
97.067	Homeland Security Grant Program	$4.75M
84.027	Special Education Grants to States	$4.64M
84.126	Rehabilitation Services Vocational Rehabilitation Grants to States	$4.53M
14.239	Home Investment Partnerships Program	$4.38M
20.218	Motor Carrier Safety Assistance	$4.24M
14.275	Housing Trust Fund	$4.19M
93.994	Maternal and Child Health Services Block Grant to the States	$3.86M
20.600	State and Community Highway Safety	$3.82M
93.354	Public Health Emergency Response: Cooperative Agreement for Emergency Response: Public Health Crisis Response	$3.76M
17.259	Wioa Youth Activities	$3.73M
16.554	National Criminal History Improvement Program (nchip)	$3.63M
93.568	Low-Income Home Energy Assistance	$3.61M
93.136	Injury Prevention and Control Research and State and Community Based Programs	$3.59M
84.002	Adult Education - Basic Grants to States	$3.55M
81.042	Weatherization Assistance for Low-Income Persons	$3.17M
10.559	Summer Food Service Program for Children	$3.13M
20.616	National Priority Safety Programs	$3.11M
14.228	Community Development Block Grants/state's Program and Non-Entitlement Grants in Hawaii	$3.10M
64.005	Grants to States for Construction of State Home Facilities	$2.96M
84.365	English Language Acquisition State Grants	$2.87M
93.788	Opioid Str	$2.85M
10.582	Fresh Fruit and Vegetable Program	$2.57M
66.460	Nonpoint Source Implementation Grants	$2.45M
17.258	Wioa Adult Program	$2.41M
15.916	Outdoor Recreation Acquisition, Development and Planning	$2.31M
93.243	Substance Abuse and Mental Health Services Projects of Regional and National Significance	$2.26M
93.991	Preventive Health and Health Services Block Grant	$2.24M
20.237	Motor Carrier Safety Assistance High Priority Activities Grants and Cooperative Agreements	$2.02M
97.045	Cooperating Technical Partners	$1.99M
93.898	Cancer Prevention and Control Programs for State, Territorial and Tribal Organizations	$1.98M
10.565	Commodity Supplemental Food Program	$1.89M
17.278	Wioa Dislocated Worker Formula Grants	$1.85M
93.556	Marylee Allen Promoting Safe and Stable Families Program	$1.85M
11.035	Broadband Equity, Access, and Deployment Program	$1.84M
45.310	Grants to States	$1.84M
93.767	Children's Health Insurance Program	$1.81M
93.645	Stephanie Tubbs Jones Child Welfare Services Program	$1.78M
11.307	Economic Adjustment Assistance	$1.77M
64.014	Veterans State Domiciliary Care	$1.67M
20.200	Highway Research and Development Program	$1.64M
84.421	Disability Innovation Fund (dif)	$1.55M
93.674	John H. Chafee Foster Care Program for Successful Transition to Adulthood	$1.43M
94.006	Americorps State and National 94.006	$1.41M
64.203	Veterans Cemetery Grants Program	$1.34M
16.606	State Criminal Alien Assistance Program	$1.26M
17.225	Unemployment Insurance	$1.24M
10.561	State Administrative Matching Grants for the Supplemental Nutrition Assistance Program	$1.23M
45.025	Promotion of the Arts Partnership Agreements	$1.20M
15.634	State Wildlife Grants	$1.16M
16.813	Nics Act Record Improvement Program	$1.14M
95.001	High Intensity Drug Trafficking Areas Program	$1.13M
93.044	Special Programs for the Aging, Title Iii, Part B, Grants for Supportive Services and Senior Centers	$1.11M
93.241	State Rural Hospital Flexibility Program	$1.10M
10.025	Plant and Animal Disease, Pest Control, and Animal Care	$1.09M
93.045	Special Programs for the Aging, Title Iii, Part C, Nutrition Services	$1.08M
84.368	Competitive Grants for State Assessments	$1.08M
66.805	Leaking Underground Storage Tank Trust Fund Corrective Action Program	$1.04M
93.775	State Medicaid Fraud Control Units	$1.04M
93.747	Elder Abuse Prevention Interventions Program	$1.02M
16.588	Violence Against Women Formula Grants	$1.02M
93.671	Family Violence Prevention and Services/domestic Violence Shelter and Supportive Services	$1.01M
10.170	Specialty Crop Block Grant Program - Farm Bill	$1.01M
93.387	National and State Tobacco Control Program	$1.01M
93.967	Centers for Disease Control and Prevention Collaboration with Academia to Strengthen Public Health	$985,409
14.241	Housing Opportunities for Persons with Aids	$983,410
97.008	Non-Profit Security Program	$979,226
15.904	Historic Preservation Fund Grants-in-Aid	$946,365
93.053	Nutrition Services Incentive Program	$932,713
17.801	Jobs for Veterans State Grants	$922,465
93.977	Sexually Transmitted Diseases (std) Prevention and Control Grants	$907,184
93.110	Maternal and Child Health Federal Consolidated Programs	$894,122
20.509	Formula Grants for Rural Areas and Tribal Transit Program	$864,166
93.940	Hiv Prevention Activities Health Department Based	$859,152
93.301	Small Rural Hospital Improvement Grant Program	$841,836
20.505	Metropolitan Transportation Planning and State and Non-Metropolitan Planning and Research	$818,850
66.442	Water Infrastructure Improvements for the Nation Small and Underserved Communities Emerging Contaminants Grant Program	$790,946
16.741	Dna Backlog Reduction Program	$774,154
66.817	State and Tribal Response Program Grants	$757,677
17.002	Labor Force Statistics	$749,357
93.165	Grants to States for Loan Repayment	$718,744
17.235	Senior Community Service Employment Program	$715,845
93.959	Block Grants for Prevention and Treatment of Substance Abuse	$709,005
93.464	Acl Assistive Technology	$698,265
93.103	Food and Drug Administration Research	$673,594
93.336	Behavioral Risk Factor Surveillance System	$671,465
97.012	Boating Safety Financial Assistance	$671,428
97.039	Hazard Mitigation Grant	$664,076
81.041	State Energy Program	$653,712
15.608	Fish and Aquatic Conservation - Aquatic Invasive Species	$651,598
93.436	Well-Integrated Screening and Evaluation for Women Across the Nation (wisewoman)	$631,891
17.504	Consultation Agreements	$628,409
20.219	Recreational Trails Program	$604,987
66.040	Diesel Emissions Reduction Act (dera) State Grants	$598,470
84.323	Special Education - State Personnel Development	$579,905
10.560	State Administrative Expenses for Child Nutrition	$576,032
30.001	Employment Discrimination Title Vii of the Civil Rights Act of 1964	$575,820
84.184	School Safely National Activities	$536,088
84.181	Special Education-Grants for Infants and Families	$528,612
15.524	Recreation Resources Management	$508,452
66.034	Surveys, Studies, Research, Investigations, Demonstrations, and Special Purpose Activities Relating to the Clean Air Act	$505,499
93.659	Adoption Assistance	$502,097
17.245	Trade Adjustment Assistance	$500,140
93.472	Title IV-E Prevention Program	$491,005
97.041	National Dam Safety Program	$489,894
93.800	Organized Approaches to Increase Colorectal Cancer Screening	$487,606
97.042	Emergency Management Performance Grants	$479,246
93.070	Environmental Public Health and Emergency Response	$477,377
14.231	Emergency Solutions Grant Program	$468,523
84.425	Education Stabilization Fund	$465,758
16.017	Sexual Assault Services Formula Program	$464,134
90.404	Hava Election Security Grants	$463,691
39.003	Donation of Federal Surplus Personal Property	$462,019
93.958	Block Grants for Community Mental Health Services	$457,125
93.324	State Health Insurance Assistance Program	$447,433
66.447	Sewer Overflow and Stormwater Reuse Municipal Grant Program	$441,000
97.023	Community Assistance Program State Support Services Element (cap-Ssse)	$440,333
66.802	Superfund State, Political Subdivision, and Indian Tribe Site-Specific Cooperative Agreements	$438,810
20.700	Pipeline Safety Program State Base Grant	$436,143
10.649	Pandemic Ebt Administrative Costs	$431,980
93.586	State Court Improvement Program	$430,726
97.137	State and Local Cybersecurity Grant Program Tribal Cybersecurity Grant Program	$428,150
84.196	Education for Homeless Children and Youth	$426,540
66.804	Underground Storage Tank (ust) Prevention, Detection, and Compliance Program	$422,626
93.497	Family Violence Prevention and Services/ Sexual Assault/rape Crisis Services and Supports	$409,737
93.116	Project Grants and Cooperative Agreements for Tuberculosis Control Programs	$408,583
66.046	Climate Pollution Reduction Grants	$407,891
93.197	Childhood Lead Poisoning Prevention Projects, State and Local Childhood Lead Poisoning Prevention and Surveillance of Blood Lead Levels in Children	$396,844
84.173	Special Education Preschool Grants	$389,371
16.320	Services for Trafficking Victims	$387,580
16.543	Missing Children's Assistance	$383,300
93.603	Adoption and Legal Guardianship Incentive Payments Program	$371,219
93.946	Cooperative Agreements to Support State-Based Safe Motherhood and Infant Health Initiative Programs	$367,220
94.003	Americorps State Commissions Support Grant	$366,646
93.426	The National Cardiovascular Health Program	$362,380
11.032	State Digital Equity Planning and Capacity Grant	$361,089
93.599	Chafee Education and Training Vouchers Program (etv)	$352,014
84.372	Statewide Longitudinal Data Systems	$348,665
10.568	Emergency Food Assistance Program (administrative Costs)	$338,912
93.988	Cooperative Agreements for Diabetes Control Programs	$331,267
93.092	Affordable Care Act (aca) Personal Responsibility Education Program	$305,281
93.236	Grants to States to Support Oral Health Workforce Activities	$296,454
97.047	Bric: Building Resilient Infrastructure and Communities	$289,175
14.401	Fair Housing Assistance Program	$288,560
59.061	State Trade Expansion	$286,911
16.738	Edward Byrne Memorial Justice Assistance Grant Program	$286,681
93.150	Projects for Assistance in Transition From Homelessness (path)	$285,627
66.605	Performance Partnership Grants	$277,132
84.187	Supported Employment Services for Individuals with the Most Significant Disabilities	$270,000
16.750	Support for Adam Walsh Act Implementation Grant Program	$266,548
93.048	Special Programs for the Aging, Title Iv, and Title Ii, Discretionary Projects	$263,927
66.419	Water Pollution Control State, Interstate, and Tribal Program Support	$263,861
12.112	Payments to States in Lieu of Real Estate Taxes	$259,512
96.006	Supplemental Security Income	$258,965
16.922	Equitable Sharing Program	$258,564
93.235	Title V State Sexual Risk Avoidance Education (title V State Srae) Program	$256,134
93.052	National Family Caregiver Support, Title Iii, Part E	$246,346
93.071	Medicare Enrollment Assistance Program	$234,022
10.579	Child Nutrition Discretionary Grants Limited Availability	$225,899
17.271	Work Opportunity Tax Credit Program (wotc)	$220,035
93.658	Foster Care Title IV-E	$218,958
10.093	Voluntary Public Access and Habitat Incentive Program	$213,757
16.754	Harold Rogers Prescription Drug Monitoring Program	$208,550
16.742	Paul Coverdell Forensic Sciences Improvement Grant Program	$207,810
93.251	Early Hearing Detection and Intervention	$207,653
93.079	Cooperative Agreements to Promote Adolescent Health Through School-Based Hiv/std Prevention and School-Based Surveillance	$205,949
10.185	Local Food for Schools Cooperative Agreement Program	$195,203
10.574	Team Nutrition Grants	$190,829
10.576	Senior Farmers Market Nutrition Program	$189,630
17.273	Temporary Labor Certification for Foreign Workers	$188,942
93.262	Occupational Safety and Health Program	$184,782
93.913	Grants to States for Operation of State Offices of Rural Health	$183,226
16.827	Justice Reinvestment Initiative	$183,059
16.839	Stop School Violence	$180,156
10.666	Schools and Roads - Grants to Counties	$177,159
93.817	Hospital Preparedness Program (hpp) Ebola Preparedness and Response Activities	$175,347
93.413	The State Flexibility to Stabilize the Market Grant Program	$174,507
64.U01	Cooperative Agreement for Veteran Training Program	$168,369
84.161	Rehabilitation Services Client Assistance Program	$167,696
66.032	State and Tribal Indoor Radon Grants	$164,697
93.279	Drug Use and Addiction Research Programs	$163,584
84.013	Title I State Agency Program for Neglected and Delinquent Children and Youth	$155,085
16.812	Second Chance Act Reentry Initiative	$150,873
10.U01	Nebraska Rural Rehabilitation Program	$148,019
93.270	Viral Hepatitis Prevention and Control	$134,993
94.009	Training and Technical Assistance	$134,328
20.611	Incentive Grant Program to Prohibit Racial Profiling	$130,163
84.325	Special Education - Personnel Development to Improve Services and Results for Children with Disabilities	$129,880
93.314	Early Hearing Detection and Intervention Information System (ehdi-Is) Surveillance Program	$129,574
66.454	Water Quality Management Planning	$129,102
16.576	Crime Victim Compensation	$127,483
10.578	Wic Grants to States (wgs)	$127,309
93.435	The Innovative Cardiovascular Health Program	$127,027
93.600	Head Start	$126,610
84.358	Rural Education	$122,557
93.643	Children's Justice Grants to States	$121,882
10.575	Farm to School Grant Program	$120,179
93.870	Maternal, Infant and Early Childhood Home Visiting Grant	$115,679
93.547	National Health Service Corps	$113,833
15.669	Cooperative Landscape Conservation	$112,427
10.435	State Mediation Grants	$111,515
93.127	Emergency Medical Services for Children	$110,328
20.232	Commercial Driver's License Program Implementation Grant	$103,335
66.608	Environmental Information Exchange Network Grant Program and Related Assistance	$103,032
84.177	Rehabilitation Services Independent Living Services for Older Individuals Who Are Blind	$102,461
93.597	Grants to States for Access and Visitation Programs	$99,628
93.734	Empowering Older Adults and Adults with Disabilities Through Chronic Disease Self-Management Education Programs Financed by Prevention and Public Health Funds (pphf)	$98,762
12.113	State Memorandum of Agreement Program for the Reimbursement of Technical Services	$92,590
10.182	Pandemic Relief Activities: Local Food Purchase Agreements with States, Tribes, and Local Governments	$84,836
16.540	Juvenile Justice and Delinquency Prevention	$80,660
93.043	Special Programs for the Aging, Title Iii, Part D, Disease Prevention and Health Promotion Services	$79,248
20.614	National Highway Traffic Safety Administration (nhtsa) Discretionary Safety Grants and Cooperative Agreements	$78,000
32.U01	Fcc - Certification	$76,287
16.710	Public Safety Partnership and Community Policing Grants	$74,748
20.703	Interagency Hazardous Materials Public Sector Training and Planning Grants	$72,708
93.U01	Medicated Feed Inspection Contract	$71,046
20.224	Federal Lands Access Program	$70,418
10.603	Emerging Markets Program	$68,860
84.424	Student Support and Academic Enrichment Program	$67,049
15.626	Enhanced Hunter Education and Safety	$66,175
93.630	Developmental Disabilities Basic Support and Advocacy Grants	$56,216
66.444	Voluntary School and Child Care Lead Testing and Reduction Grant Program (sdwa 1464(d))	$55,105
93.042	Special Programs for the Aging, Title Vii, Chapter 2, Long Term Care Ombudsman Services for Older Individuals	$50,435
10.190	Resilient Food System Infrastructure Program	$48,877
16.582	Crime Victim Assistance/discretionary Grants	$47,065
84.144	Migrant Education Coordination Program	$46,330
93.234	Traumatic Brain Injury State Demonstration Grant Program	$45,588
66.433	State Underground Water Source Protection	$42,912
93.421	Strengthening Public Health Systems and Services Through National Partnerships to Improve and Protect the Nations Health	$41,060
15.615	Cooperative Endangered Species Conservation Fund	$38,151
93.669	Child Abuse and Neglect State Grants	$37,116
17.005	Compensation and Working Conditions	$36,599
20.513	Enhanced Mobility of Seniors and Individuals with Disabilities	$36,251
10.556	Special Milk Program for Children	$36,026
10.932	Regional Conservation Partnership Program	$35,997
15.946	Cultural Resources Management	$35,571
97.029	Flood Mitigation Assistance	$32,250
10.U02	Hazardous Waste Management	$30,945
97.043	State Fire Training Systems Grants	$28,384
45.312	National Leadership Grants	$28,183
10.645	Farm to School State Formula Grant	$23,199
89.003	National Historical Publications and Records Grants	$20,746
16.550	State Justice Statistics Program for Statistical Analysis Centers	$19,923
93.041	Special Programs for the Aging, Title Vii, Chapter 3, Programs for Prevention of Elder Abuse, Neglect, and Exploitation	$19,146
84.326	Special Education Technical Assistance and Dissemination to Improve Services and Results for Children with Disabilities	$15,857
66.432	State Public Water System Supervision	$15,529
10.931	Agricultural Conservation Easement Program	$14,155
66.920	Solid Waste Infrastructure for Recycling Infrastructure Grants	$13,597
81.128	Energy Efficiency and Conservation Block Grant Program (eecbg)	$12,915
81.254	Grid Infrastructure Deployment and Resilience	$12,629
10.477	Meat, Poultry, and Egg Products Inspection	$11,795
15.511	Cultural Resources Management	$10,650
66.820	State Programs for Control of Coal Combustion Residuals	$9,134
93.090	Guardianship Assistance	$8,112
15.637	Migratory Bird Joint Ventures	$7,078
93.130	Cooperative Agreements to States/territories for the Coordination and Development of Primary Care Offices	$5,495
81.138	State Heating Oil and Propane Program	$4,959
93.U03	Food Inspection Contract	$4,189
16.U01	Dea Grants	$3,586
15.517	Fish and Wildlife Coordination Act	$2,875
84.310	Statewide Family Engagement Centers	$1,736
16.593	Residential Substance Abuse Treatment for State Prisoners	$399
10.072	Wetlands Reserve Program	$178
93.777	State Survey and Certification of Health Care Providers and Suppliers (title Xviii) Medicare	$160
15.631	Partners for Fish and Wildlife	$12
93.981	Improving Student Health and Academic Achievement Through Nutrition, Physical Activity and the Management of Chronic Conditions in Schools	$-12
97.044	Assistance to Firefighters Grant	$-255
93.889	National Bioterrorism Hospital Preparedness Program	$-9,275

Finding 530021 (2024-045)

AI Summary

Finding Text

Categories

Other Findings in this Audit

Programs in Audit