June 15, Internal Audit Report Child Care Assistance Program Department of Health and Human Services

Similar documents
May 1, Internal Audit Report Child Care Assistance Program Health and Human Services

Alaska Child Care Grant Program. Policies and Procedures Manual

Paramedic (Entry Level) CAREERS Application & Public Safety Entry Registration System (PERS) Frequently Asked Questions (FAQs)

February 19, Internal Audit Report Child Care Licensing Department of Health and Human Services

Audit of Indigent Care Agreement with Shands - #804 Executive Summary

How to Read a Medicare Summary Notice (MSN)

Legacy General Operating Grant Guidelines for Operators without Service Agreement for Fee Subsidy: Operator Guide

Nursing facility-based level of care assessment and determination process for children.

Eligibility and the Definition of a Site

Complete instructions are located online at and within the online application system.

LTC User Guide for Nursing Facility Forms 3618/3619 and Minimum Data Set/ Long Term Care Medicaid Information (MDS/LTCMI)

NEW YORK CITY DEPARTMENT OF BUILDINGS ELEVATOR INSPECTIONS AND TESTS. Report 2007-N-9 OFFICE OF THE NEW YORK STATE COMPTROLLER

Nursing facility-based level of care assessment and determination process for adults.

Emory University Research Administration Services (RAS) Standard Operating Procedure (SOP)

DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION. Office of Inspector General. Audit Report A-1415BPR-020

EARLY LEARNING COALITION OF OSCEOLA COUNTY

The Joint Legislative Audit Committee requested that we

42 CFR 438 MMC Service Authorization and Appeals MMC/HIV SNP/HARP/MLTC/Medicaid Advantage/Medicaid Advantage Plus

Medical Assistance Provider Incentive Repository. User Guide. For Eligible Hospitals

Elderly Simplified Application Project Guidance

STATE OF NEVADA DEPARTMENT OF HEALTH AND HUMAN SERVICES DIVISION OF MENTAL HEALTH AND DEVELOPMENTAL SERVICES

STATE OF NORTH CAROLINA OFFICE OF THE STATE AUDITOR BETH A. WOOD, CPA

MDS Default Funding Update - List of ChartField errors. Contents

REMOVE II Public Transportation Subsidy and Park-and-Ride Lot Component GUIDELINES, POLICIES, AND PROCEDURES GUIDELINES, POLICIES, AND PROCEDURES

TEXAS LOTTERY COMMISSION INTERNAL AUDIT DIVISION. An Internal Audit of CHARITABLE BINGO LICENSING

PUBLIC TRANSPORTATION & COMMUTER VANPOOL PASSENGER SUBSIDY COMPONENT REMOVE II PROGRAM GUIDELINES, POLICIES, AND PROCEDURES

FINAL AUDIT REPORT DEPARTMENT OF COMMUNITY AFFAIRS WEATHERIZATION ASSISTANCE PROGRAM ARRA IMPLEMENTATION FEBRUARY 14, 2009 THROUGH JANUARY 31, 2010

STATE OF NORTH CAROLINA OFFICE OF THE STATE AUDITOR BETH A. WOOD, CPA

Medical Assistance Provider Incentive Repository. User Guide. For Eligible Hospitals

LOS ANGELES COUNTY SHERIFF S DEPARTMENT

TAA Ad Hoc Reports. Revised 9/09/2013 Page 1

Presentation Overview

STATE OF NORTH CAROLINA OFFICE OF THE STATE AUDITOR BETH A. WOOD, CPA

LA14-22 STATE OF NEVADA. Performance Audit. Department of Education. Legislative Auditor Carson City, Nevada

Objectives for Financial Control over Grant Programs

BEFORE THE ALASKA OFFICE OF ADMINISTRATIVE HEARINGS ON REFERRAL FROM THE COMMISSIONER OF HEALTH AND SOCIAL SERVICES

Southface LEED for Homes 2017 Quality Assurance Plan

Nursing and Personal Care: Funding Increase Survey

Family Service Practice Audit

An Exercise in Effort

Georgia Institute of Technology/Georgia Tech Research Corporation A-133 Coordinated Audit Research and Development Cluster Summary Schedule of Prior

The purpose of this survey

STATE OF NORTH CAROLINA OFFICE OF THE STATE AUDITOR BETH A. WOOD, CPA DEPARTMENT OF PUBLIC SAFETY

Income Maintenance Random Moment Time Study (IMRMS) Operational Procedures

Roles & Responsibilities

Transitions. Dear Colleagues,

Any potential fiscal action will be calculated once the corrective action responses have been received and approved.

INDEPENDENT VERIFICATION AND CODING VALIDATION (IV & V) FOR APR-DRG. Effective September 1, 2014

INTERNAL AUDIT DIVISION REPORT 2017/087. Audit of education grant disbursement at the United Nations Office at Vienna

NASC AS-C Recertification Application

Verification Process Guide

Precertification Frequently Asked Questions

Charter School Application Technical Assistance

LOW INCOME SUBSIDY (LIS) DEEMING UPDATES STANDARD OPERATING PROCEDURE

Home Health Care CAHPS Survey Vendor Update Webinar Training Session. February 2018

Industry Fellowships 1. Overview

California Department of Developmental Services DDS Rate Study

Sponsored Project Personnel Effort Reporting Policy No. GSU: University Research Services and Administration

Psychiatric Consultant Guide CMTS. Care Management Tracking System. University of Washington aims.uw.edu

PAYMENT ERROR RATE MEASUREMENT

INTERNAL AUDIT DIVISION REPORT 2017/086. Audit of education grant disbursement at the United Nations Office at Geneva

Community Mental Health Centers PROVIDER TRAINING

Uniform Data System for Medical Rehabilitation

February 13, 2018 Lubbock, Texas REV 1/18/2018 1

OFFICE OF AUDIT REGION 9 f LOS ANGELES, CA. Office of Native American Programs, Washington, DC

PAC Waiver. eqhealth Solutions PAC Waiver Authorization Process

Department of Human Services Baltimore City Department of Social Services

CONSUMER GAME OF CHANCE COMPETITION SCHEDULE TO CONDITIONS OF ENTRY

New Jersey State Legislature Office of Legislative Services Office of the State Auditor. July 1, 2011 to September 7, 2016

AUDITOR GENERAL S REPORT

STATE OF NORTH CAROLINA

Complaint Performance Customers & Neighbourhoods: Quarter 3 17/18

Department of Human Services Division of Medical Assistance and Health Services Transportation Broker Services Contract Capitation Rates


STANDARD ADMINISTRATIVE PROCEDURE

TABLE OF CONTENTS OBJECTIVES, SCOPE, AND METHODOLOGY... 1 BACKGROUND... 2 FINDINGS AND RECOMMENDATIONS Security Report Distribution...

Seminar on Financial Management. VOCA s National Conference

Family Service Practice Audit

LOS ANGELES COUNTY SHERIFF S DEPARTMENT

ISP Manual Lesson 4: Service Implementation, Utilization, and Monitoring. Welcome to the fourth lesson in the ISP Manual 2012 Update course.

KanCare Implementation Meeting: January 4, 2013 Questions & Answers. 9:00am-12pm

2014 Interpretive Guidelines for 2013 Review Nutrition programs (C1, C2 & NSIP meals)

Recovery Audit Contractors: AHA Perspective. Elizabeth Baskett, Policy, AHA February 23, 2012

ATLANTA AREA COUNCIL MERIT BADGE COUNSELOR APPLICATION PROCEDURE

Audits, Administrative Reviews, & Serious Deficiencies

INTERNAL AUDIT DIVISION REPORT 2017/109

Graduate Student Organization Funding

UNIVERSITY OF UTAH RULES FOR THE PERSONAL ACTIVITY REPORT SYSTEM (PAR)

INDIVIDUAL TRAINING ACCOUNT POLICY AND PROCEDURES

SUBJECT: EPIC, PACS/RIS Image Processing Errors Effective: 12/2003 Reviewed: 10/2013 APPROVED BY: Director of Radiology Page 1 of 5

Introduction to the Home Health Care CAHPS Survey Webinar Training Session. Session II. January 2018

Testimony Before the United States Senate Committee on Homeland Security and Governmental Affairs

July 1, June 30, 2019

Navy Officials Did Not Consistently Comply With Requirements for Assessing Contractor Performance

University of Mississippi Medical Center University of Mississippi Health Care. Pharmacy and Therapeutics Committee Medication Use Evaluation

Mental Health Rehabilitation Authorization Resource Kit

NOTICE OF PRIVACY PRACTICES

Office of Inspector General Annual Report

GVHBA OVATION AWARDS 2018

MANAGING AND CERTIFYING EFFORT ON SPONSORED PROJECTS

Transcription:

Internal Audit Report 2009-07 Introduction. The (HHS) received $1,278,081 from the State of Alaska Division of Public Assistance (State) to administer the Child Care Assistance Program (CCAP) for fiscal year 2008 and $1,396,440 for fiscal year 2009. This program subsidizes child care costs for low income families if each parent in the family is working, seeking work, or attending school with the intent of improving employability. Fourteen positions are currently funded at HHS to administer the program. CCAP staff determines parent eligibility and the level of assistance. The State pays the subsidized child care costs on behalf of participating parents to the licensed or approved child care providers. As of February 2009, CCAP had about 1,673 active clients. Objective and Scope. The objective of this audit was to determine whether CCAP staff complied with grant requirements, including determining client eligibility and maintaining required documentation in client files. Our audit included a random sample of 75 active client files and 37 closed client files from the current grant period. Specifically, we reviewed the files and electronic documents in the Integrated Child Care Information System (ICCIS) to determine if applications for child care assistance were processed timely. We also reviewed each sampled file to determine if a family s contribution amount was calculated correctly based on the supporting documents. The audit was conducted in accordance with generally accepted government auditing standards, except for the requirement of an external quality control review, and accordingly, included tests of accounting records and such other auditing procedures as we considered necessary in the circumstances. The audit was performed during the period of February 2009 through April 2009. The audit was requested by the Administration.

Overall Evaluation. The Department has made improvements in administering CCAP since our previous audit in May 2008. The Department implemented two of the five findings and partially implemented three findings from our 2008 audit report. However, there are still areas that need to be improved. Specifically, this audit disclosed that CCAP staff did not always calculate income correctly. In addition, the specified application process was not always followed, including continuing problems with timely action on submitted applications and incomplete in-home care documentation. FINDINGS AND RECOMMENDATIONS 1. Client Files had Incorrect Income Calculations. a. Finding. CCAP staff did not always calculate income correctly and in accordance with the Child Care Assistance Policy and Procedure Manual (Policy and Procedure Manual), for clients seeking child care assistance. Specifically, 40 of 75 (53%) sampled client files contained incorrect income calculations with 27 of the 40 (68%) files basing the calculations on information that did not match the documentation provided by the clients. Calculating income correctly is important because the amount of child care assistance to be provided by the State and the contribution amount to be paid by the client is based on the client income. When the income was recalculated for these forty clients, the monthly amount contributed increased for 12 clients, decreased for 17 clients, and remained unchanged for 7 clients. The remaining four clients had insufficient information to calculate their income. Some common mistakes in calculating monthly income included mathematical errors, using an incorrect factor rate, not including all of the income received by the clients, or the use of the wrong method to calculate income. For example, one client paid an extra $272 per month because CCAP staff used the wrong method to calculate income. In another case, a client underpaid $18 per month because tips and commissions were incorrectly excluded from the income calculation. - 2 of 5 -

b. Recommendation. The Program Manager should ensure CCAP staff calculates families income accurately and in accordance with the Child Care Assistance Policy and Procedure Manual. c. Management Comments. Management concurred and stated, Management is in the process of hiring new staff to assist with the quality control. A new internal process of checking every income determination before release to the participants was implemented in late 2008. Individual employee performance plans have been implemented based on the issues found in file reviews and on-going training has been conducted. The error rate reflected by the audit could be reduced to 28% if a method supported by the State is used. The State Policy and Procedure Manual outlines one practice, however, the State Child Care Program Office provided instructions that allow the additional method we used of supporting income. d. Evaluation of Management Comments. Management comments were responsive to the audit finding and recommendation. 2. Application Process Not Always Followed. a. Finding. Applications for child care assistance were not always processed properly. Our review and testing of 75 randomly selected files revealed that actions were not taken timely on submitted applications, the Parent Responsibilities Form was not always signed, and CCAP staff issued authorizations for in-home care even though incomplete applications were submitted by clients. In addition, our review and testing of 37 closed files revealed that files with expired authorizations were not closed timely. Our audit revealed the following problems: 1) Action Not Taken Timely On Submitted Applications Nine of 75 (12%) files had no action taken within 30 calendar days from the application submittal date. Three of the nine files had no action taken for over 45 days. - 3 of 5 -

The Policy and Procedure Manual, Section 305, Application and Responsibilities, states that The designee must take action (approve, deny, or pend) the application within 30 calendar days from the application submittal. 2) Required Document Not In File Three of 75 client files did not contain the required Parent Responsibilities Form. Also, one of the 75 client files was missing a copy of the applicant=s photo ID. 3) In-Home Care Authorization Issued Without Completed Form All 10 in-home care family files had an incomplete Parent/In-Home Provider Agreement. This form is important because it is used to verify that the inhome care provider is currently employed by the family. For example, the forms were missing the contract date, length of employment, rate of pay, the employee=s responsibilities, or the employer s tax ID number. 4) Files Not Closed Timely In ICCIS - Ten of 37 client files were not closed in ICCIS within 10 days. The Policy and Procedure Manual, Section 305 states that The ICCIS cases files may remain open for no longer than 10 days after a family s case closes. For example, two case files had their eligibility periods end on February 28, 2009 and December 31, 2008. However, their ICCIS case files were never closed and the cases were still open as of March 25, 2009. b. Recommendation. Although the application process has improved since our 2008 audit, additional steps need to be taken to ensure the application process in the Child Care Assistance Policy and Procedure Manual is followed by CCAP staff. Adherence to the application process is important to help prevent fraud and miscalculation of benefits. The Program Manager should ensure the child care application process specified in the Child Care Assistance Policy and Procedure Manual is followed by CCAP staff. - 4 of 5 -

c. Management Comments. Management concurred and stated: 1) Action Not Taken Timely On Submitted Applications: Individual caseloads were implemented in February, 2009, prior to this audit, to streamline the timely required action. Regular monitoring is being conducted by the Assistant Program Manager on the volume of applications and the timeframe needed for completion. We had one eligibility vacancy during this time. 2) Required Document Not in File: The hiring of a new staff to assist with the quality control should insure all required documents are on file. 3) In-Home Care Authorization Issued without Completed Form: Monitoring of the Parent/In-Home Provider Agreement form will be conducted to insure the necessary information is completed. Although the form has a space for the employer s tax ID number, the State does not require it to be entered for the form to be considered complete. 4) Files Not Closed Timely in ICCIS: The implementation of individual caseloads makes completing this case management function easier. Timely reminders are issued to complete this process, and follow-up by the Quality Control position should insure stronger internal controls. d. Evaluation of Management Comments. Management comments were responsive to the audit finding and recommendation. Discussion with Responsible Officials. The results of this audit were discussed with appropriate Municipal officials on May 4, 2009. Audit Staff: Scott Lee - 5 of 5 -