FAC Explorer

Finding 584821 (2023-002)

Material Weakness Repeat Finding
Requirement
E
Questioned Costs
$1
Year
2023
Accepted
2024-01-12
Audit: 11283
Organization: Mecklenburg County (NC)
Auditor: Cherry Bekaert LLP

AI Summary

  • Core Issue: The County has repeated issues with eligibility documentation, leading to improper determinations and questioned costs of $59,534.
  • Impacted Requirements: Compliance failures include missing DMA-5097 forms, incomplete ex-parte reviews, and lack of documentation for forced eligibility decisions.
  • Recommended Follow-Up: The County should enhance internal controls and establish a formal policy for timely correction of identified documentation errors.

Finding Text

U.S. Department of Health and Human Services Pass-through Entity: North Carolina Department of Health and Human Services Program Name: Medical Assistance Federal Assistance Listing Number: 93.778 Material Weakness and Non-Material Non-Compliance – Eligibility Finding 2023-002 – Repeat Finding Criteria or specific requirement: 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 County should have adequate documentation for each participant that supports each eligibility determination and the information entered into NCFAST. We noted several errors related to the following compliance criteria: a) The caseworker should prepare and submit a DMA-5097 form in the case of noncooperation as described in the Eligibility Review Document. b) When the Social Security Administration (SSA) terminates social security income (“SSI”) eligibility, the county is required to make an ex-parte determination for eligibility. This determination is required to be made within 120 days after the termination of the SSI payment. c) An OVS inquiry must be completed and agreed to information reported in NC FAST. d) An AVS inquiry must be completed and agreed to information reported in NC FAST. e) When forcing eligibility, documentation explaining the reasoning for the forced eligibility is required to be maintained on file. Condition: The following are the results of non-material non-compliance noted for each criteria listed above out of the 122 program participants selected for testing: a) There were two instances where the non-cooperation with IV-D was identified but no DMA-5097 was sent. b) There were two instances where the County did not complete the ex-parte review for a participant whose SSI benefits were terminated during the year. The County should have forced eligibility, due to the COVID-19 exemption, but did not force eligibility for these instances. c) There was one instance where the County did force eligibility, but they forced it to the wrong program. d) There was one instance where the resources found through the register of deeds did not agree to the resources in NC FAST which affected the countable resource calculation. e) There were two instances where the OVS query was not run at the time of the determination. f) There were two instances where eligibility was forced but no documentation explaining the reasoning for was documented at the time of the determination. Lastly, there were 31 instances out of 60 program participants tested for control testing where the County did not remediate the errors identified within their internal review timely. Context: There were 9 out of 122 unique participants tested with the errors noted above, in which one was determined to have been improperly determined eligible. Questioned Costs: We noted a total of $59,534 in questioned costs related to improper eligibility determination related to item “b” above. Total claims tested totaled $6,913,895 and so the projected questioned costs were at a calculated 0.86% error rate. Effect: By not having the required documentation in the files or information being incorrectly documented, eligibility cannot be readily substantiated and there is a risk the County could provide funding to individuals who are not eligible. Cause: County oversight when performing reviews over applications. Additionally, the County does not have a formal process in place to ensure issues identified during the review process are appropriately corrected on a consistent and timely basis. Recommendation: Although these issues will occur from time to time considering the volume of case files, the County should review their processes to ensure proper supporting documentation of eligibility is maintained within each case file. Additionally, Mecklenburg County should consider implementing a formal policy for the requirements of having documentation corrected within a specific timeframe once identified. Views of Responsible Officials: Management agrees with the finding and is implementing procedures to correct this which is further discussed in the Corrective Action Plan. Corrective Action Plan: See Corrective Action Plan prepared by the County.

Categories

Questioned Costs Internal Control / Segregation of Duties Subrecipient Monitoring Eligibility Material Weakness Matching / Level of Effort / Earmarking

Other Findings in this Audit

  • 8376 2023-002
    Material Weakness Repeat
  • 8377 2023-002
    Material Weakness Repeat
  • 8378 2023-002
    Material Weakness Repeat
  • 8379 2023-002
    Material Weakness Repeat
  • 8380 2023-002
    Material Weakness Repeat
  • 8381 2023-003
    Significant Deficiency
  • 8382 2023-003
    Significant Deficiency
  • 8383 2023-004
    Material Weakness
  • 8384 2023-004
    Material Weakness
  • 8385 2023-004
    Material Weakness
  • 8386 2023-004
    Material Weakness
  • 8387 2023-004
    Material Weakness
  • 8388 2023-004
    Material Weakness
  • 8389 2023-004
    Material Weakness
  • 8390 2023-004
    Material Weakness
  • 8391 2023-004
    Material Weakness
  • 8392 2023-004
    Material Weakness
  • 8393 2023-005
    Significant Deficiency
  • 8394 2023-005
    Significant Deficiency
  • 8395 2023-005
    Significant Deficiency
  • 8396 2023-005
    Significant Deficiency
  • 8397 2023-005
    Significant Deficiency
  • 8398 2023-005
    Significant Deficiency
  • 8399 2023-005
    Significant Deficiency
  • 584818 2023-002
    Material Weakness Repeat
  • 584819 2023-002
    Material Weakness Repeat
  • 584820 2023-002
    Material Weakness Repeat
  • 584822 2023-002
    Material Weakness Repeat
  • 584823 2023-003
    Significant Deficiency
  • 584824 2023-003
    Significant Deficiency
  • 584825 2023-004
    Material Weakness
  • 584826 2023-004
    Material Weakness
  • 584827 2023-004
    Material Weakness
  • 584828 2023-004
    Material Weakness
  • 584829 2023-004
    Material Weakness
  • 584830 2023-004
    Material Weakness
  • 584831 2023-004
    Material Weakness
  • 584832 2023-004
    Material Weakness
  • 584833 2023-004
    Material Weakness
  • 584834 2023-004
    Material Weakness
  • 584835 2023-005
    Significant Deficiency
  • 584836 2023-005
    Significant Deficiency
  • 584837 2023-005
    Significant Deficiency
  • 584838 2023-005
    Significant Deficiency
  • 584839 2023-005
    Significant Deficiency
  • 584840 2023-005
    Significant Deficiency
  • 584841 2023-005
    Significant Deficiency

Programs in Audit

ALN Program Name Expenditures
93.323 Epidemiology and Laboratory Capacity for Infectious Diseases (elc) $12.85M
93.563 Child Support Enforcement $7.91M
10.557 Special Supplemental Nutrition Program for Women, Infants, and Children $5.15M
97.036 Disaster Grants - Public Assistance (presidentially Declared Disasters) $4.10M
93.659 Adoption Assistance $3.89M
21.023 Emergency Rental Assistance Program $2.99M
93.596 Child Care Mandatory and Matching Funds of the Child Care and Development Fund $2.78M
93.137 Community Programs to Improve Minority Health Grant Program $2.11M
20.507 Federal Transit_formula Grants $1.86M
93.940 Hiv Prevention Activities_health Department Based $1.48M
93.499 Low Income Household Water Assistance Program $1.42M
93.686 Ending the Hiv Epidemic: A Plan for America — Ryan White Hiv/aids Program Parts A and B (b) $1.39M
93.354 Public Health Emergency Response: Cooperative Agreement for Emergency Response: Public Health Crisis Response $865,611
93.767 Children's Health Insurance Program $799,638
14.218 Community Development Block Grants/entitlement Grants $782,578
93.268 Immunization Cooperative Agreements $759,934
93.994 Maternal and Child Health Services Block Grant to the States $705,791
93.667 Social Services Block Grant $657,165
66.001 Air Pollution Control Program Support $591,417
93.568 Low-Income Home Energy Assistance $586,746
84.181 Special Education-Grants for Infants and Families $557,953
93.914 Hiv Emergency Relief Project Grants $465,004
10.561 State Administrative Matching Grants for the Supplemental Nutrition Assistance Program $434,981
93.045 Special Programs for the Aging_title Iii, Part C_nutrition Services $349,627
93.217 Family Planning_services $332,612
93.053 Nutrition Services Incentive Program $295,980
93.967 Cdc's Collaboration with Academia to Strengthen Public Health $261,473
21.027 Coronavirus State and Local Fiscal Recovery Funds $252,004
66.034 Surveys, Studies, Research, Investigations, Demonstrations, and Special Purpose Activities Relating to the Clean Air Act $210,247
93.747 Elder Abuse Prevention Interventions Program $208,163
97.039 Hazard Mitigation Grant $202,772
16.021 Justice Systems Response to Families $202,496
93.136 Injury Prevention and Control Research and State and Community Based Programs $183,442
93.566 Refugee and Entrant Assistance_state Administered Programs $175,356
66.039 National Clean Diesel Emissions Reduction Program $145,143
20.205 Highway Planning and Construction $136,132
16.736 Transitional Housing Assistance for Victims of Domestic Violence, Dating Violence, Stalking, Or Sexual Assault $131,118
93.556 Promoting Safe and Stable Families $129,344
93.052 National Family Caregiver Support, Title Iii, Part E $117,633
93.977 Preventive Health Services_sexually Transmitted Diseases Control Grants $107,984
93.069 Public Health Emergency Preparedness $104,000
16.606 State Criminal Alien Assistance Program $103,563
93.671 Family Violence Prevention and Services/domestic Violence Shelter and Supportive Services $97,776
93.558 Temporary Assistance for Needy Families $95,325
17.289 Community Project Funding $84,707
16.745 Criminal and Juvenile Justice and Mental Health Collaboration Program $83,158
93.387 National and State Tobacco Control Program (b) $74,092
16.738 Edward Byrne Memorial Justice Assistance Grant Program $68,604
93.917 Hiv Care Formula Grants $64,231
14.267 Continuum of Care Program $61,007
93.898 Cancer Prevention and Control Programs for State, Territorial and Tribal Organizations $59,475
93.674 John H. Chafee Foster Care Program for Successful Transition to Adulthood $55,088
93.116 Project Grants and Cooperative Agreements for Tuberculosis Control Programs $47,101
16.710 Public Safety Partnership and Community Policing Grants $36,397
93.103 Food and Drug Administration_research $35,999
14.231 Emergency Solutions Grant Program $31,125
93.044 Special Programs for the Aging_title Iii, Part B_grants for Supportive Services and Senior Centers $30,773
93.991 Preventive Health and Health Services Block Grant $30,607
16.838 Comprehensive Opioid Abuse Site-Based Program $19,519
93.658 Foster Care_title IV-E $16,601
93.645 Stephanie Tubbs Jones Child Welfare Services Program $16,449
16.607 Bulletproof Vest Partnership Program $13,895
93.324 State Health Insurance Assistance Program $13,594
97.045 Cooperating Technical Partners $11,442
93.391 Activities to Support State, Tribal, Local and Territorial (stlt) Health Department Response to Public Health Or Healthcare Crises $7,719
93.071 Medicare Enrollment Assistance Program $7,584
14.241 Housing Opportunities for Persons with Aids $2,416
93.243 Substance Abuse and Mental Health Services_projects of Regional and National Significance $824
93.778 Medical Assistance Program $-25