Human Services of Faribault and Martin CountiesLocal Government

Federal Agency: U.S. Department of Health and Human Services Federal Program Name: Medical Assistance Program (Medicaid Cluster) Assistance Listing Number: 93.778 Federal Award Identification Number and Year: 2405MN5MAP, 2405MN5ADM – 2024 Pass-Through Agency: Minnesota Department of Human Services Pass-Through Numbers: 2405MN5MAP, 2405MN5ADM Compliance Requirement Affected: Allowable Costs/Allowable Activities Award Period: Year-Ended December 31, 2024 Type of Finding: Significant Deficiency in Internal Control over Compliance and Other Matters Criteria or Specific Requirement: Standard internal control and compliance procedures require that the quarterly random moment study listings reported to the MN Department of Human Services be accurate for reimbursement of allowable costs and activities relating to the 2550 Income Maintenance and 2556 Social Services quarterly reports. Condition: During testing of allowable activities requirements, it was noted the Agency did not have adequate procedures designed to ensure the quarterly Income Maintenance Random Moment Study (IMRMS) and Social Services Time Study (SSTS) listings were submitted accurately. Questioned Costs: Unknown. Context: During testing, it was noted that 2 of 2 quarters tested in IMRMS listings and 1 of 2 quarters tested in SSTS listings had employees that were not accurately being reported. Cause: Lack of oversight by management. Effect: The Agency could receive incorrect federal funding for the program if employees are not properly being reported on the IMRMS and SSTS listings. Repeat Finding: No. Recommendation: It is recommended the Agency implement procedures to ensure the IMRMS and SSTS listings are reviewed prior to submitting the listings to the state. Views of Responsible Officials: There is no disagreement with the audit finding.

Timely Reporting Federal Agency: U.S. Department of Health and Human Services Federal Program Name: Medical Assistance Program (Medicaid Cluster) Assistance Listing Number: 93.778 Federal Award Identification Number and Year: 2305MN5MAP, 2305MN5ADM – 2023 Pass-Through Agency: Minnesota Department of Human Services Pass-Through Numbers: 2305MN5MAP, 2305MN5ADM Compliance Requirement Affected: Reporting Award Period: Year-Ended December 31, 2023 Type of Finding: Significant Deficiency in Internal Control over Compliance and Other Matters Criteria or Specific Requirement: Standard internal control and compliance procedures require reports to be formally reviewed and submitted to the State of Minnesota by a specified deadline for each particular report. Condition: During testing of reporting requirements, it was noted the Agency did not have adequate procedures designed to ensure the Annual Collaborative report for LCTS was formally reviewed and submitted timely. Questioned Costs: Not applicable. Context: During testing of reporting, it was noted that the Annual Collaborative report for LCTS was not reviewed and was reported to the State of Minnesota after the deadline requirement. Cause: Turnover within the financial department. Effect: The Agency could receive incorrect federal funding for the program if expenditures are not reviewed and are not being reported timely. Repeat Finding: Yes – finding 2022-004. Recommendation: We recommend the Agency implement procedures to ensure all reports are formally reviewed and all reporting deadlines are met. Views of Responsible Officials: There is no disagreement with the audit finding

2022-004 ? Timely Reporting Federal Agency: U.S. Department of Health and Human Services Federal Program Name: Medical Assistance Program (Medicaid Cluster) Assistance Listing Number: 93.778 Federal Award Identification Number and Year: 2205MN5MAP, 2205MN5ADM ? 2022 Pass-Through Agency: Minnesota Department of Human Services Pass-Through Numbers: 2205MN5MAP, 2205MN5ADM Compliance Requirement Affected: Reporting Award Period: Year-Ended December 31, 2022 Type of Finding: Significant Deficiency in Internal Control over Compliance and Other Matters Criteria or Specific Requirement: Standard internal control and compliance procedures require expenditures reported on quarterly reports to be submitted to the State of Minnesota by a specified deadline for each particular report. Condition: During testing of reporting requirements, it was noted the Agency did not have adequate internal controls designed to ensure quarterly reports are submitted timely. Questioned Costs: Not applicable. Context: During testing of reporting, it was noted that one of two quarterly Social Services 2556 reports tested were reported to the State of Minnesota after the deadline requirement, it was noted that one of two quarterly Income Maintenance 2550 reports tested were reported to the State of Minnesota after the deadline requirement, and it was noted that two of two quarterly Child and Teen Checkup reports tested were reported to the State of Minnesota after the deadline requirement. Cause: Turnover within the financial department. Effect: The Agency could receive an incorrect federal funding for the program if expenditures are not being timely reported. Repeat Finding: Not applicable. Recommendation: We recommend the Agency implement procedures to ensure all reporting deadlines are met. Views of Responsible Officials: There is no disagreement with the audit finding.

2021-003 ? Inaccurate ReportingFederal Agency: U.S. Department of Health and Human ServicesFederal Program Title: Medical Assistance Program (Medicaid Cluster)Assistance Listing Number: 93.778Pass-Through Agency: Minnesota Department of Human ServicesPass-Through Numbers: 2105MN5MAP and 2105MN5ADMCompliance Requirement Affected: ReportingAward Period: Year-Ended December 31, 2021Type of Finding: Significant Deficiency in Internal Control over Compliance and Other MattersCriteria: Standard internal control and compliance procedures require expenditures reported on quarterly reports to be accurate and in accordance with the State of Minnesota guidance for each particular report.Condition and Context: During statically valid sample testing of reporting, it was noted that one of two quarterly Local Collaborative Time Study (LCTS) reports tested were reported inaccurately per the State of Minnesota?s instructions for the report, resulting in eligible expenditures not being reported. The sample size was based on guidance from chapter 11 of the AICPA Audit Guide, Government Auditing Standards and Single Audits and was a statistically valid sample.Questioned Costs: Not applicable.Cause: Lack of oversight by management.Possible Effect: The Agency could receive an incorrect federal funding for the program if expenditures are not being properly reported.Repeat Finding: Not applicable.Recommendation: We recommend the Agency implement procedures to review all quarterly reports in detail to ensure accurate reporting each quarter.Views of Responsible Officials: There is no disagreement with the audit finding.

2021-004 ?Inaccurate Listing of Employees for Random Moment StudiesFederal Agency: U.S. Department of Health and Human ServicesFederal Program Title: Medical Assistance Program (Medicaid Cluster)Assistance Listing Number: 93.778Pass-Through Agency: Minnesota Department of Human ServicesPass-Through Numbers: 2105MN5MAP and 2105MN5ADMCompliance Requirement Affected: Activities Allowed or Unallowed/Allowable Cost/Cost PrinciplesAward Period: Year-Ended December 31, 2021Type of Finding: Significant Deficiency in Internal Control over Compliance and Other MattersCriteria: The County maintains a list of all employees subject to random moment studies, which the State uses as a basis for determining salary reimbursement under federal programs.Condition and Context: During our statistically valid sample of the first and fourth quarter random moment study listings, it was noted that one individual was not included on the 4th quarter Local Collaborative Time Study (LCTS) listing that should have been included. The sample size was based on guidance from chapter 11 of the AICPA Audit Guide, Government Auditing Standards and Single Audits and was a statistically valid sample.Questioned Costs: Not applicable.Cause: Lack of oversight by management.Possible Effect: The Agency could receive an incorrect federal funding allocation on incorrect employee information provided to the state for reimbursement.Repeat Finding: Not applicable.Recommendation: We recommend the Agency implement procedures to ensure the quarterly listing provided to the state is an accurate listing of employees working on the program and coded to the random moments line on the quarterly report.Views of Responsible Officials: There is no disagreement with the audit finding.

2020-003 ELIGIBILITY- ASSETS Federal Agency: U.S. Department of Health and Human Services Federal Program Title: Medical Assistance Program (Medicaid Cluster) CFDA Number: 93.778 Pass-Through Agency: Minnesota Department of Human Services Pass-Through Numbers: 2005MN5MAP and 2005MN5AMD Compliance Requirement Affected: Eligibility Award Period: Year-Ended December 31, 2020 Type of Finding: Significant Deficiency in Internal Control over Compliance and Compliance Criteria: According to Uniform Guidance 2 CFR Part 200, Appendix XI Compliance Supplement for CFDA 93.778 and 42 CFR section 431.10, the federal eligibility compliance requirements for Medical Assistance require verification of specific assets owned by the applicants. In order for benefit amounts to be calculated correctly, it is necessary for the information to be entered into the state eligibility system, MAXIS, accurately. Condition and Context: During statically valid sample testing of eligibility, it was noted that three out of sixty transactions did not have the updated information entered into the state system, MAXIS, at the time of the renewal. The sample size was based on guidance from chapter 11 of the AICPA Audit Guide, Government Auditing Standards and Single Audits and was a statistically valid sample. Questioned Costs: Not applicable. The Agency administers the program, but benefits to participants in this program are paid by the state of Minnesota. Cause: Lack of oversight by management. Possible Effect: The Agency could be providing benefits to ineligible clients. Repeat Finding: Not applicable. Recommendation: We recommend the Agency implement procedures to provide reasonable assurance that all necessary documentation to support eligibility determinations exists and are properly input or updated in MAXIS. Views of Responsible Officials: There is no disagreement with the audit finding.

Federal Agency: U.S. Department of Health and Human Services Federal Program Title: Foster Care IV-E CFDA Number: 93.658 Pass-Through Agency: Minnesota Department of Human Services Pass-Through Numbers: 1901MNFOST Compliance Requirement Affected: Eligibility Award Period: Year-Ended December 31, 2019 Type of Finding: Material Weakness in Internal Control over Compliance Criteria: Standard internal control procedures recommend internal reviews over case file eligibility determinations to ascertain case workers are complying with state and federal requirements. Condition and Context: The Agency does not have documented procedures in place to perform internal reviews of case files for eligibility determinations. The sample size was based on guidance from chapter 11 of the AICPA Audit Guide, Government Auditing Standards and Single Audits and was a statistically valid sample. Cause: Past practice. Possible Effect: Errors made in determining eligibility may not be discovered and benefits may be issued to clients who are not eligible. Repeat Finding: Not applicable. Questioned Costs: None. Recommendation: We recommend the Agency implement procedures to perform regular internal reviews on case files to determine that proper policies and procedures are being followed in determining eligibility. Views of Responsible Officials: There is no disagreement with the audit finding.

Federal Agency: U.S. Department of Health and Human Services Federal Program Title: Medical Assistance Program (Medicaid Cluster); Foster Care Title IV-E CFDA Number: 93.778; 93.658 Pass-Through Agency: Minnesota Department of Human Services Pass-Through Numbers: 1905MN5MAP, 1905MN5ADM; 1901MNFOST Compliance Requirement Affected: Activities Allowed or Unallowed and Allowable Costs/Cost Principles Award Period: Year-Ended December 31, 2019 Type of Finding: Significant Deficiency in Internal Control over Compliance and Other Matters Criteria: The Agency maintains a list of all employees subject to random moment studies, which the State uses as a basis for determining salary reimbursement under federal programs. Condition and Context: During our testing of 2 out of 4 quarters of the Random Moment Studies reports for Social Services, we noted that 1 out of 41 employees was included on the listing in the first quarter, however, they were no longer an employee of the Agency. The sample size was based on guidance from chapter 11 of the AICPA Audit Guide, Government Auditing Standards and Single Audits and was a statistically valid sample. Cause: Staff turnover and lack of time. Possible Effect: The Agency could receive incorrect federal funding allocation based on incorrect employee information provided to the state for reimbursement. Repeat Finding: Yes ? Finding 2018-003. Questioned Costs: None. Recommendation: We recommend the Agency implement procedures to ensure the quarterly listings provided to the state is an accurate listing of employees working on social services programs. Views of Responsible Officials: There is no disagreement with the audit finding.

Federal Agency: U.S. Department of Health and Human Services Federal Program Title: Medical Assistance Program (Medicaid Cluster); Foster Care Title IV-E CFDA Number: 93.778; 93.658 Pass-Through Agency: Minnesota Department of Human Services Pass-Through Numbers: 1905MN5MAP, 1905MN5ADM; 1901MNFOST Compliance Requirement Affected: Reporting Award Period: Year-Ended December 31, 2019 Type of Finding: Significant Deficiency in Internal Control over Compliance Criteria: Standard internal control procedures suggest that reports should be reviewed by someone other than the preparer and this review process should be formally documented. Condition and Context: During our testing of 2 out of 4 quarters of the Child and Teen Checkup and Foster Care IV-E reports, along with the LCTS Annual Spending report, we noted that the reports were not being reviewed by someone other than the preparer prior to submission. The sample sizes was based on guidance from chapter 11 of the AICPA Audit Guide, Government Auditing Standards and Single Audits, and was a statistically valid sample. Cause: Past practice. Possible Effect: The Agency could submit inaccurate reports and receive incorrect federal funding based on the information provided to the state for reimbursement. Repeat Finding: Not applicable. Questioned Costs: None. Recommendation: We recommend the Agency implement procedures to ensure the quarterly and annual reports are being reviewed by someone other than the preparer prior to submission. Views of Responsible Officials: There is no disagreement with the audit finding.

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