GLOUCESTER COUNTY LIBRARY COMMISSIONLocal Government

Information on the Federal Program U.S. Department of Health and Human Services, passed through New Jersey Department of Human Services, Division of Family Development and Division of Medical Assistance and Health Services – Medicaid Cluster, Medical Assistance Program (Medicaid; Title XIX), Assistance Listing No. 93.778 1/1/2024 – 12/31/2024 Criteria or Specific Requirement Per 42 CFR § 435.945(a) and § 435.948, state Medicaid agencies are required to verify income using electronic data sources to the extent available, and must ensure that eligibility determinations are based on accurate and verified information. Condition The GCDSS did not consistently verify income reported on the Medical Assistance applications prior to granting program eligibility to individuals. Questioned Costs Unknown. Context During our testing of eligibility determinations under the Medical Assistance program, we noted that for 3 out of 40 sampled cases, the income reported on the application was not verified prior to granting program eligibility. The documentation lacked evidence of income verification through acceptable sources such as pay stubs, employer statements, or data matches with state wage databases. Effect or Potential Effect Improper eligibility determinations may result in ineligible individuals receiving benefits, leading to questioned costs and potential disallowance by the federal agency. Cause The failure to verify income was attributed to a lapse in internal controls and staff oversight. In some cases, eligibility workers relied solely on self-attested income without initiating verification procedures. Identification as a Repeat Finding Not applicable. Recommendation We recommend that GCDSS strengthen its internal controls over eligibility determinations by consistently documenting income verification procedures prior to approval. View of Responsible Officials and Planned Corrective Action The responsible officials agree with the finding and will address the matter as part of their corrective action plan.

Information on the Federal Program U.S. Department of Health and Human Services, passed through New Jersey Department of Human Services, Division of Family Development and Division of Medical Assistance and Health Services – Medicaid Cluster, Medical Assistance Program (Medicaid; Title XIX), Assistance Listing No. 93.778 1/1/2024 – 12/31/2024 Criteria or Specific Requirement Per 42 CFR § 435.945(a) and § 435.948, state Medicaid agencies are required to verify income using electronic data sources to the extent available, and must ensure that eligibility determinations are based on accurate and verified information. Condition The GCDSS did not consistently verify income reported on the Medical Assistance applications prior to granting program eligibility to individuals. Questioned Costs Unknown. Context During our testing of eligibility determinations under the Medical Assistance program, we noted that for 3 out of 40 sampled cases, the income reported on the application was not verified prior to granting program eligibility. The documentation lacked evidence of income verification through acceptable sources such as pay stubs, employer statements, or data matches with state wage databases. Effect or Potential Effect Improper eligibility determinations may result in ineligible individuals receiving benefits, leading to questioned costs and potential disallowance by the federal agency. Cause The failure to verify income was attributed to a lapse in internal controls and staff oversight. In some cases, eligibility workers relied solely on self-attested income without initiating verification procedures. Identification as a Repeat Finding Not applicable. Recommendation We recommend that GCDSS strengthen its internal controls over eligibility determinations by consistently documenting income verification procedures prior to approval. View of Responsible Officials and Planned Corrective Action The responsible officials agree with the finding and will address the matter as part of their corrective action plan.

Information on the Federal Program U.S. Department of Health and Human Services, passed through New Jersey Department of Human Services, Division of Family Development, Temporary Assistance to Needy Families (TANF) Assistance Listing No. 93.558 1/1/2023 – 12/31/2023 Criteria or Specific Requirement N.J.A.C. 10:90-3.22 – Case redetermination is a review of the factors affecting WFNJ TANF eligibility and payment amount. At the time of redetermination, the recipient shall execute a formal application for continuation for assistance. WFNJ/TANF cases shall be redetermined at least every 12 months. When there is a substantial question of continuing WFNJ eligibility to be resolved, the monthly assistance benefit may be suspended, subject to timely and adequate notice provisions. N.J.A.C. 10:90-2.3 – Eligibility for cash assistance benefits shall be limited to a lifetime total of 60 cumulative months (lifetime limit) for an adult individual recipient, except as exempted in accordance with N.J.A.C. 10:90-2.4 or extended in accordance with N.J.A.C. 10:90-2.5. Condition Ineligible recipients were being paid monthly cash assistance. The GCDSS did not maintain an effective control environment over eligibility requirements of the TANF program. Questioned Costs $7,564 – Known total amount of benefits received by ineligible recipients during the year: • Failure to timely close out terminated case: $2,768 • Failure to properly exempt participant from lifetime limit: $4,796 Context 53 TANF cases were selected for testing, the following exceptions were noted: 1) 1 case continued to receive monthly benefits during 2023 when the records indicated that the case should have closed in 2022. 2) 1 case was incorrectly coded as being exempted from lifetime limit. 3) 1 case was coded as being exempted from lifetime limit; however, the GCDSS cannot locate supporting documentation. Each new case determined eligible to receive cash assistance receives an initial prorated grant amount, and continues to receive their monthly allotment on the first day of the following month. The sample was not intended to be, and was not, a statistically valid sample. Effect or Potential Effect Improper cash assistance payments to ineligible recipients. Cause Procedures not consistently followed to timely close out terminated cases; procedures not consistently followed to ensure all required exemption documentations are in the recipients’ case folder. Identification as a Repeat Finding Not applicable. Recommendation The GCDSS should ensure internal control procedures are consistently followed to timely closeout terminated cases, and that all required documentation are in the recipients’ case folder to support eligibility to receive cash assistance benefits. View of Responsible Officials and Planned Corrective Action The responsible officials agree with the finding and will address the matter as part of their corrective action plan.

Information on the Federal Program U.S. Department of Health and Human Services, passed through New Jersey Department of Human Services, Division of Family Development, Temporary Assistance to Needy Families (TANF) Assistance Listing No. 93.558 1/1/2023 – 12/31/2023 Criteria or Specific Requirement N.J.A.C. 10:90-3.22 – Case redetermination is a review of the factors affecting WFNJ TANF eligibility and payment amount. At the time of redetermination, the recipient shall execute a formal application for continuation for assistance. WFNJ/TANF cases shall be redetermined at least every 12 months. When there is a substantial question of continuing WFNJ eligibility to be resolved, the monthly assistance benefit may be suspended, subject to timely and adequate notice provisions. N.J.A.C. 10:90-2.3 – Eligibility for cash assistance benefits shall be limited to a lifetime total of 60 cumulative months (lifetime limit) for an adult individual recipient, except as exempted in accordance with N.J.A.C. 10:90-2.4 or extended in accordance with N.J.A.C. 10:90-2.5. Condition Ineligible recipients were being paid monthly cash assistance. The GCDSS did not maintain an effective control environment over eligibility requirements of the TANF program. Questioned Costs $7,564 – Known total amount of benefits received by ineligible recipients during the year: • Failure to timely close out terminated case: $2,768 • Failure to properly exempt participant from lifetime limit: $4,796 Context 53 TANF cases were selected for testing, the following exceptions were noted: 1) 1 case continued to receive monthly benefits during 2023 when the records indicated that the case should have closed in 2022. 2) 1 case was incorrectly coded as being exempted from lifetime limit. 3) 1 case was coded as being exempted from lifetime limit; however, the GCDSS cannot locate supporting documentation. Each new case determined eligible to receive cash assistance receives an initial prorated grant amount, and continues to receive their monthly allotment on the first day of the following month. The sample was not intended to be, and was not, a statistically valid sample. Effect or Potential Effect Improper cash assistance payments to ineligible recipients. Cause Procedures not consistently followed to timely close out terminated cases; procedures not consistently followed to ensure all required exemption documentations are in the recipients’ case folder. Identification as a Repeat Finding Not applicable. Recommendation The GCDSS should ensure internal control procedures are consistently followed to timely closeout terminated cases, and that all required documentation are in the recipients’ case folder to support eligibility to receive cash assistance benefits. View of Responsible Officials and Planned Corrective Action The responsible officials agree with the finding and will address the matter as part of their corrective action plan.