DES MOINES VALLEY HEALTH & HUMAN SERVICES

Condition: During our audit, adjustments were needed to correct the financial statements, including the following material entries: To adjust classification of state and federal aid revenues Criteria: The financial statements are the responsibility of the Agency’s management; therefore, the Agency must be able to prevent or detect a material misstatement in the financial statements including footnote disclosures. Cause: Agency staff has not prepared a year-end trial balance reflecting all necessary accounting entries. Effect: This indicates that it would be likely that a misstatement may occur and not be detected by the Agency’s system of internal control. The audit firm cannot serve as a compensating control over this deficiency. Recommendation: We recommend that management review each journal entry, obtain an understanding of why the entry was necessary and modify procedures to ensure that future corrections are not needed. Management Response: Management will continue to review and gain an understanding of the audit adjustments in order to reduce the number of entries necessary for future audits. The Agency Fiscal Manager plans to remedy this finding in future years.

2022-001 Material Audit Adjustment Condition: During our audit, adjustments were needed to correct the financial statements, including the following material entries: ? To adjust state and federal aid revenues and receivables Criteria: The financial statements are the responsibility of the Agency?s management; therefore, the Agency must be able to prevent or detect a material misstatement in the financial statements including footnote disclosures. Cause: Agency staff has not prepared a year-end trial balance reflecting all necessary accounting entries. Effect: This indicates that it would be likely that a misstatement may occur and not be detected by the Agency?s system of internal control. The audit firm cannot serve as a compensating control over this deficiency. Recommendation: We recommend that management review each journal entry, obtain an understanding of why the entry was necessary and modify procedures to ensure that future corrections are not needed. Management Response: Management will continue to review and gain an understanding of the audit adjustments in order to reduce the number of entries necessary for future audits. The Agency Fiscal Manager plans to remedy this finding in future years

2020-003 Material Audit Adjustments Condition: During our audit, adjustments were needed to record a number of audit adjustments, including the following material entries: ? To adjust grant revenues and receivables ? To reclassify receipts to proper accounts ? To record additional accounts payable Criteria: The financial statements are the responsibility of the Agency?s management; therefore, the Agency must be able to prevent or detect a material misstatement in the financial statements including footnote disclosures. Cause: Agency staff has not prepared a year-end trial balance reflecting all necessary accounting entries. Effect: This indicates that it would be likely that a misstatement may occur and not be detected by the Agency?s system of internal control. The audit firm cannot serve as a compensating control over this deficiency. Recommendation: We recommend that management review each journal entry, obtain an understanding of why the entry was necessary and modify current procedures to ensure that future corrections are not needed. Management Response: Management will continue to review and gain an understanding of the audit adjustments in order to reduce the number of entries necessary for future audits.

TIME STUDY TRACKING 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: 05-1905MN5ADM, 05-1905MN5MAP Compliance Requirement Affected: Allowable Activities and Allowable Costs Award Period: Year Ended December 31, 2019 Type of Finding: Significant Deficiency in Internal Control over Compliance and Compliance Criteria: The County is required to send a list to DHS each quarter of county employees that should be subjected to time studies in order to receive federal reimbursement for staff time. Context: During our statistically valid sample of allowable activities, it was noted that 1 of the 14 employees was having their time coded to the Income Maintenance payroll code, however they were not on the IMRMS listing as having their time allocated to Income Maintenance. Questioned Costs: Not able to be determined. Cause: Employee was not added to the random moments database when the employee was promoted to Eligibility Worker. Possible Effect: The amount of federal reimbursement the county received could be incorrect as the wages reported on the quarterly report did not match the listing of time study employees that DHS was performing time studies on. Repeat Finding: Not applicable Recommendation: We recommend the County ensure that all individuals that are having their payroll coded to the Income Maintenance payroll code be on the IMRMS listing. Views of Responsible Officials and Planned Corrective Action: There is no disagreement with the audit finding. The Agency will review all time studies to make sure they are accurate.

REIMBURSEMENT CLAIMS 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: 05-1905MN5ADM, 05-1905MN5MAP Compliance Requirement Affected: Reporting Award Period: Year Ended December 31, 2019 Type of Finding: Significant Deficiency in Internal Control over Compliance Criteria: Reimbursement for claims are to be submitted only after the expenditures have been incurred and paid. Context: During our testing, Child and Teen Checkup reimbursement claims were being submitted as 1/12 of the annual budget, not as expenditures were incurred and paid. Questioned Costs: Not able to be determined. Cause: Agency staff were unware of the requirement. Possible Effect: A reimbursement might be made for an activity that is not allowable per MA criteria. Repeat Finding: Finding was a repeat finding from the prior year identified as Finding 2018-007. Recommendation: We recommend the Agency claim reimbursement for only expenditures that have been incurred and paid. Views of Responsible Officials and Planned Corrective Action: There is no disagreement with the audit finding. The Agency will claim reimbursement for only expenditures that have been incurred.

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