BURKE COUNTY

Burke County, North Carolina Schedule of Findings and Questioned Costs For the Year Ended June 30, 2025 State Awards Internal control over major State programs: • Material Weakness(es) identified? yes X no • Significant Deficiency(s) identified X yes none reported Unmodified Identification of major State programs: Program Name Medical Assistance Program NC Public School Building Capital-Lottery Proceeds Courthouse repairs and renovations Dollar threshold used to determine a State major program $ 500,000 Auditee qualified as State low-risk auditee? X yes no None reported U.S. Department of Health and Human Services Passed through the NC Department of Health and Human Services Program Name: Medical Assistance Program (Medicaid) AL #: 93.778Burke County, North Carolina Schedule of Findings and Questioned Costs For the Year Ended June 30, 2025 Condition: Questioned Costs: Context: Effect: Identification of a repeat finding: Cause: Due to the nature of the populations provided from which the samples were chosen, we are unable to calculate questioned costs for the above mentioned potential eligibility and noncompliance errors. We examined 60 cases from of a total of 555,247 Medicaid claims from the Medicaid beneficiary report provided by NC Department of Health and Human Services to redetermine eligibility. These findings are being reported with the financial statement audit as it relates to Medicaid administrative cost compliance audit. These control deficiencies and noncompliance increase the risk of improper Medicaid payments, potentially resulting in overpayments to ineligible beneficiaries or underpayments to those who qualify. Section III. Federal Award Findings and Questioned Costs (continued) This is a repeat finding from the immediate previous audit, 2024-001, 2024-002, and 2024-003. Note in FY 2025 Medicaid findings were combined into a single finding. The deficiencies and noncompliance reported above are caused from ineffective record keeping and case review processes due to insufficient training of staff, lack of oversight from management, and/or inadequate communication between departments resulting in inconsistencies in data sharing and delayed information exchanges. There were a total of 20 errors found during our testing procedures: - There were 2 errors where income or household size was incorrectly calculated or inaccurate information was entered into the case file. In 1 instance, a failure resulted in a recipient being deemed eligible for Medicaid benefits when they were not, due to income exceeding the eligibility threshold. - There was 8 error where resources were incorrectly calculated or were not properly documented in the case file. - There were 9 errors where required information needed for eligibility determinations were not requested or not requested timely at applications or redeterminations. In 1 instance, a failure resulted in a recipient being deemed eligible for Medicaid benefits when they were not, due to income exceeding the eligibility threshold. - There were 1 errors where a redetermination of eligibility was not performed in accordance with program requirements. 137Burke County, North Carolina Schedule of Findings and Questioned Costs For the Year Ended June 30, 2025 Recommendation: Views of responsible officials and planned corrective actions: Program Name: Medical Assistance Program (Medicaid) AL #: 93.778 Section III. Federal Award Findings and Questioned Costs (continued) SIGNIFICANT DEFICENCY/NONCOMPLIANCE (NOT MATERIAL): Findings 2025-001 also apply to State requirements and State Awards. Section IV. State Award Findings and Questioned Costs The County agrees with the finding and is implementing actions to correct these issues, which are further discussed in the corrective action plan. We recommend that management enhance internal controls by: (1) Providing comprehensive training to staff on the program's eligibility requirements and procedures outlined in the State's Medicaid manuals; (2) Ensuring that there is a formal internal review process and that it is adequately completed to identify and correct errors and monitor compliance; and (3) Communicating all program or policy changes clearly and timely across all departments who oversee eligibility determinations for federal funded programs. 138 Finding: 2025-001 SIGNIFICANT DEFICENCY; NONCOMPLIANCE Eligibility Criteria: Section I. Summary of Auditors' Results (continued) Section II. Financial Statement Findings Type of auditors' report issued on compliance for major State programs: Federal regulations under 42 CFR § 435.956 require states to verify eligibility factors using electronic data sources where available, and to obtain documentation for unverifiable information. Additionally, the state's Medicaid manual (Aged, Blind and Disabled manual, Family and Children Medicaid manual and the Integrated Policy manual) mandates that all eligibility determinations include cross-verification of applicant-provided data against reliable external sources to ensure accuracy and prevent improper payments. Section III. Federal Award Findings and Questioned Costs 136

None reported Finding 2025-001 Name of contact person: Corrective Action: Proposed Completion Date: Corrective Actions for Findings 2025-001 also apply to State requirements and State Awards. Margaret Pierce - Burke County Finance Director, Korey Fisher-Wellman - Department of Social Services Director, Amanda Grady - Assistant Department of Social Services Director, and Tammy Wright - Medicaid Program Manager For all findings identified, Medicaid staff are required to attend training sessions to address the issues, and sign-in sheets will be required. During training, appropriate policies will be reviewed. The root causes of the errors were determined to be staff oversight and procedural lapses, compounded by policy changes, staff turnover, and the inexperience of some workers. Medicaid Supervisors will continue conducting 2nd Party Reviews. As cases are reviewed, supervisors will provide additional training as needed, either individually or in group settings. Training materials will be kept current and shared with the lead worker to ensure proper delivery. Workers will be required to complete refresher training when errors are found and collaborate with lead workers or supervisors for more detailed instruction or training. Group training will be scheduled if multiple workers demonstrate similar issues based on 2nd Party Review results. Supervisors conducting 2nd Party Reviews will examine two random cases per worker each month for timeliness and accuracy. In addition, two extra cases per worker will be spot-checked monthly to verify accurate resource entry. The Program Manager and Supervisors will monitor reports to ensure timeliness and require staff to document any cases that have gone overdue. These processes will help determine whether improvements have been made in resource accuracy. New employees will have notices and other correspondence reviewed before they are sent out to ensure accuracy. All new employees will continue to have 100% of their cases reviewed until supervisors determine they can process cases independently and correctly. Results from 2nd Party Reviews will be shared with the Program Manager, Assistant Director, and DSS Director. Corrections have been made to cases in error, and supporting documentation has been updated in NCFAST. Section IV - State Award Findings and Question Costs Supervisors will conduct training in response to the identified errors, with completion targeted by the end of January. Success will be measured through the results of ongoing 2nd Party Reviews. The agency will continue to monitor outcomes, provide group or individual training as needed, and address persistent issues through the disciplinary process when necessary. Additional training requirements and expanded, targeted spot-checks of cases will be implemented on an ongoing basis, based on continued findings, to further strengthen accuracy and compliance. Burke County, North Carolina Section III - Federal Award Findings and Question Costs Corrective Action Plan For the Year Ended June 30, 2025 Section II - Financial Statement Findings 139

2024-001

U.S. Department of Health and Human Services Passed through the NC Department of Health and Human Services Program Name: Medical Assistance Program (Medicaid; Title XIX) AL #: 93.778 Finding: 2024-001 Inaccurate Information Entry SIGNIFICANT DEFICENCY ELIGIBILITY Criteria: Section I. Summary of Auditors' Results (continued) Section II. Financial Statement Findings Type of auditors' report issued on compliance for major State programs: In accordance with 42 CFR 435, documentation must be obtained as needed to determine if a recipient meets specific standards, and documentation must be maintained to support eligibility determinations. In accordance with 2 CFR 200, management should have an adequate system of internal controls procedures in place to ensure an applicant is properly determined or redetermined for benefits. Section III. Federal Award Findings and Questioned Costs 130Burke County, North Carolina Schedule of Findings and Questioned Costs For the Year Ended June 30, 2024 Condition: Questioned Costs: Context: Effect: Cause: Recommendation: Views of responsible officials and planned corrective actions: U.S. Department of Health and Human Services Passed through the NC Department of Health and Human Services Program Name: Medical Assistance Program (Medicaid; Title XIX) AL #: 93.778 Finding: 2024-002 Inaccurate Resource Entry SIGNIFICANT DEFICENCY ELIGIBILITY Criteria: There was 1 error discovered during our procedures where income or household size was incorrectly calculated or inaccurate information was entered into the case file. There was no known affect to eligibility and there were no known questioned costs. We examined 60 cases from of a total of 1,076,004 Medicaid claims from the Medicaid beneficiary report provided by NC Department of Health and Human Services to re-determine eligibility. These findings are being reported with the financial statement audit as it relates to Medicaid administrative cost compliance audit. For those certifications/re-certifications there was a chance that information was not properly documented and reconciled to NC FAST and a participant could have been approved for benefits for which they were not eligible. Ineffective record keeping and ineffective case review process, incomplete documentation, and incorrect application of rules for purposes of determining eligibility. Files should be reviewed internally to ensure proper documentation is in place for eligibility. Workers should be retrained on what files should contain and the importance of complete and accurate record keeping. We recommend that all files include online verifications, documented resources of income and those amounts agree to information in NC FAST. The results found or documentation made in case notes should clearly indicate what actions were performed and the results of those actions. The County agrees with the finding. See Corrective Action Plan in the following section. In accordance with Medicaid Manual MA-2230, Medicaid for Aged, Blind and Disabled case records should contain documentation that verifications were done in preparation of the application and these items will agree to reports in the NC FAST system. In this process, the countable resources should be calculated correctly and agree back to the amounts in the NC FAST system. Any items discovered in the verification process should be considered countable or noncountable resources and explained within the documentation. Section III. Federal Award Findings and Questioned Costs (continued) 131

None reported Finding 2024-001 INACCURATE INFORMATION ENTRY Name of contact person: Corrective Action: Proposed Completion Date: Finding 2024-002 INACCURATE RESOURCE ENTRY Name of contact person: Corrective Action: Proposed Completion Date: Burke County, North Carolina Section III - Federal Award Findings and Question Costs Corrective Action Plan For the Year Ended June 30, 2024 Section II - Financial Statement Findings Korey Fisher-Wellman, Department of Social Services Director and Amanda Grady, Assistant Department of Social Services Director Medicaid staff will be required to attend training sessions to address the negative findings found. The following MA policy will be discussed during training to address the areas that need improvement: MA 3306, and the importance of ensuring that the tax filer is correct and documented in NCFAST. Medicaid Supervisors will continue to conduct 2nd Party Reviews. As cases are reviewed, supervisors will provide any additional training as needed, either on an individual or group basis. The results from these 2nd party reviews will be shared with the Assistant Director and DSS Director. Corrections will be made to the cases in error, and documentation to support the corrections will be updated in NCFAST. Korey Fisher-Wellman, Department of Social Services Director and Amanda Grady, Assistant Department of Social Services Director For all findings listed, Medicaid staff will be required to attend training sessions to address the negative findings found. The following MA policy will be discussed during training to address the areas that need improvement: MA-2230 Financial Resources and importance to update the evidence in NCFAST to ensure the case is accurate. Medicaid Supervisors will continue to conduct 2nd Party Reviews. As cases are reviewed, supervisors will provide any additional training as needed, either on an individual or group basis. The results from these 2nd party reviews will be shared with the Assistant Director and DSS Director. Corrections will be made to the cases in error, and documentation to support the corrections will be updated in NCFAST. The initial training will be completed by 12/06/2024. Our success will be measured by the results of the 2nd party reviews. We will continue to review the results of all 2nd party reviews, conduct group or individual training, and address issues through the disciplinary process if necessary. The initial training will be completed by 12/06/2024. Our success will be measured by the results of the 2nd party reviews. We will continue to review the results of all 2nd party reviews, conduct group or individual training, and address issues through the disciplinary process if necessary. JEFFREY C. BRITTAIN, CHAIR SCOTT MULWEE, VICE CHAIR RANDY BURNS, COMMISSIONER JOHNNIE W. CARSWELL, COMMISSIONER PHIL SMITH, COMMISSIONER BRIAN EPLEY, COUNTY MANAGER KAY H. DRAUGHN, CLERK TO THE BOARD J. R. SIMPSON, II, COUNTY ATTORNEY KANIA LAW FIRM, P.A., TAX ATTORNEY 136

Burke County, North Carolina Schedule of Findings and Questioned Costs For the Year Ended June 30, 2024 Condition: Questioned Costs: Context: Effect: Cause: Recommendation: Views of responsible officials and planned corrective actions: U.S. Department of Health and Human Services Passed through the NC Department of Health and Human Services Program Name: Medical Assistance Program (Medicaid; Title XIX) AL #: 93.778 Finding: 2024-002 Inaccurate Resource Entry SIGNIFICANT DEFICENCY ELIGIBILITY Criteria: There was 1 error discovered during our procedures where income or household size was incorrectly calculated or inaccurate information was entered into the case file. There was no known affect to eligibility and there were no known questioned costs. We examined 60 cases from of a total of 1,076,004 Medicaid claims from the Medicaid beneficiary report provided by NC Department of Health and Human Services to re-determine eligibility. These findings are being reported with the financial statement audit as it relates to Medicaid administrative cost compliance audit. For those certifications/re-certifications there was a chance that information was not properly documented and reconciled to NC FAST and a participant could have been approved for benefits for which they were not eligible. Ineffective record keeping and ineffective case review process, incomplete documentation, and incorrect application of rules for purposes of determining eligibility. Files should be reviewed internally to ensure proper documentation is in place for eligibility. Workers should be retrained on what files should contain and the importance of complete and accurate record keeping. We recommend that all files include online verifications, documented resources of income and those amounts agree to information in NC FAST. The results found or documentation made in case notes should clearly indicate what actions were performed and the results of those actions. The County agrees with the finding. See Corrective Action Plan in the following section. In accordance with Medicaid Manual MA-2230, Medicaid for Aged, Blind and Disabled case records should contain documentation that verifications were done in preparation of the application and these items will agree to reports in the NC FAST system. In this process, the countable resources should be calculated correctly and agree back to the amounts in the NC FAST system. Any items discovered in the verification process should be considered countable or noncountable resources and explained within the documentation. Section III. Federal Award Findings and Questioned Costs (continued) 131Burke County, North Carolina Schedule of Findings and Questioned Costs For the Year Ended June 30, 2024 Condition: Questioned Costs: Context: Effect: Cause: Recommendation: Views of responsible officials and planned corrective actions: U.S. Department of Health and Human Services Passed through the NC Department of Health and Human Services Program Name: Medical Assistance Program (Medicaid; Title XIX) AL #: 93.778 Finding: 2024-003 Inadequate Request For Information SIGNIFICANT DEFICENCY ELIGIBILITY Criteria: Condition: The County agrees with the finding. See Corrective Action Plan in the following section. In accordance with 42 CFR 435, documentation must be obtained as needed to determine if a recipient meets specific standards, and documentation must be maintained to support eligibility determinations. Electronic matches are required at applications and redeterminations. There were 2 errors discovered during our procedures where required information needed for eligibility determinations were not requested or not requested timely at applications or redeterminations. Section III. Federal Award Findings and Questioned Costs (continued) There was no known affect to eligibility and there were no known questioned costs. We examined 60 cases from of a total of 1,076,004 Medicaid claims from the Medicaid beneficiary report provided by NC Department of Health and Human Services to re-determine eligibility. These findings are being reported with the financial statement audit as it relates to Medicaid administrative cost compliance audit. For those certifications/re-certifications there was a chance that information was not properly documented and reconciled to NC FAST and a participant could have been approved for benefits for which they were not eligible. Ineffective record keeping and ineffective case review process, incomplete documentation, and incorrect application of rules for purposes of determining eligibility. Case files should be reviewed internally to ensure correct calculations of resources are made, proper information is included in the case file, and necessary procedures are taken when determining eligibility. The results found or documentation made in case notes should clearly indicate what actions were performed and the results of those actions. There were 5 errors discovered during our procedures where resources were imcorrectly calculated or were not properly documented in the case file. 132

None reported Finding 2024-001 INACCURATE INFORMATION ENTRY Name of contact person: Corrective Action: Proposed Completion Date: Finding 2024-002 INACCURATE RESOURCE ENTRY Name of contact person: Corrective Action: Proposed Completion Date: Burke County, North Carolina Section III - Federal Award Findings and Question Costs Corrective Action Plan For the Year Ended June 30, 2024 Section II - Financial Statement Findings Korey Fisher-Wellman, Department of Social Services Director and Amanda Grady, Assistant Department of Social Services Director Medicaid staff will be required to attend training sessions to address the negative findings found. The following MA policy will be discussed during training to address the areas that need improvement: MA 3306, and the importance of ensuring that the tax filer is correct and documented in NCFAST. Medicaid Supervisors will continue to conduct 2nd Party Reviews. As cases are reviewed, supervisors will provide any additional training as needed, either on an individual or group basis. The results from these 2nd party reviews will be shared with the Assistant Director and DSS Director. Corrections will be made to the cases in error, and documentation to support the corrections will be updated in NCFAST. Korey Fisher-Wellman, Department of Social Services Director and Amanda Grady, Assistant Department of Social Services Director For all findings listed, Medicaid staff will be required to attend training sessions to address the negative findings found. The following MA policy will be discussed during training to address the areas that need improvement: MA-2230 Financial Resources and importance to update the evidence in NCFAST to ensure the case is accurate. Medicaid Supervisors will continue to conduct 2nd Party Reviews. As cases are reviewed, supervisors will provide any additional training as needed, either on an individual or group basis. The results from these 2nd party reviews will be shared with the Assistant Director and DSS Director. Corrections will be made to the cases in error, and documentation to support the corrections will be updated in NCFAST. The initial training will be completed by 12/06/2024. Our success will be measured by the results of the 2nd party reviews. We will continue to review the results of all 2nd party reviews, conduct group or individual training, and address issues through the disciplinary process if necessary. The initial training will be completed by 12/06/2024. Our success will be measured by the results of the 2nd party reviews. We will continue to review the results of all 2nd party reviews, conduct group or individual training, and address issues through the disciplinary process if necessary. JEFFREY C. BRITTAIN, CHAIR SCOTT MULWEE, VICE CHAIR RANDY BURNS, COMMISSIONER JOHNNIE W. CARSWELL, COMMISSIONER PHIL SMITH, COMMISSIONER BRIAN EPLEY, COUNTY MANAGER KAY H. DRAUGHN, CLERK TO THE BOARD J. R. SIMPSON, II, COUNTY ATTORNEY KANIA LAW FIRM, P.A., TAX ATTORNEY 136

Burke County, North Carolina Schedule of Findings and Questioned Costs For the Year Ended June 30, 2024 Condition: Questioned Costs: Context: Effect: Cause: Recommendation: Views of responsible officials and planned corrective actions: U.S. Department of Health and Human Services Passed through the NC Department of Health and Human Services Program Name: Medical Assistance Program (Medicaid; Title XIX) AL #: 93.778 Finding: 2024-003 Inadequate Request For Information SIGNIFICANT DEFICENCY ELIGIBILITY Criteria: Condition: The County agrees with the finding. See Corrective Action Plan in the following section. In accordance with 42 CFR 435, documentation must be obtained as needed to determine if a recipient meets specific standards, and documentation must be maintained to support eligibility determinations. Electronic matches are required at applications and redeterminations. There were 2 errors discovered during our procedures where required information needed for eligibility determinations were not requested or not requested timely at applications or redeterminations. Section III. Federal Award Findings and Questioned Costs (continued) There was no known affect to eligibility and there were no known questioned costs. We examined 60 cases from of a total of 1,076,004 Medicaid claims from the Medicaid beneficiary report provided by NC Department of Health and Human Services to re-determine eligibility. These findings are being reported with the financial statement audit as it relates to Medicaid administrative cost compliance audit. For those certifications/re-certifications there was a chance that information was not properly documented and reconciled to NC FAST and a participant could have been approved for benefits for which they were not eligible. Ineffective record keeping and ineffective case review process, incomplete documentation, and incorrect application of rules for purposes of determining eligibility. Case files should be reviewed internally to ensure correct calculations of resources are made, proper information is included in the case file, and necessary procedures are taken when determining eligibility. The results found or documentation made in case notes should clearly indicate what actions were performed and the results of those actions. There were 5 errors discovered during our procedures where resources were imcorrectly calculated or were not properly documented in the case file. 132Burke County, North Carolina Schedule of Findings and Questioned Costs For the Year Ended June 30, 2024 Questioned Costs: Context: Effect: Cause: Recommendation: Views of responsible officials and planned corrective actions: There was no known affect to eligibility and there were no known questioned costs. We examined 60 cases from of a total of 1,076,004 Medicaid claims from the Medicaid beneficiary report provided by NC Department of Health and Human Services to re-determine eligibility. These findings are being reported with the financial statement audit as it relates to Medicaid administrative cost compliance audit. For those certifications/re-certifications there was a chance that information was not properly documented and reconciled to NC FAST and applicants could have been approved for benefits for which they were not eligible. Ineffective record keeping and ineffective case review process, incomplete documentation, and incorrect application of rules for purposes of determining eligibility. Files should be reviewed internally to ensure all required verifications have been completed and information requested from the applicant/beneficiary or through various systems have been included and necessary procedures are taken when determining eligibility. The results found or documentation made in case notes should clearly indicate what actions were performed and the results of those actions. The County agrees with the finding. See Corrective Action Plan in the following section. Section III. Federal Award Findings and Questioned Costs (continued) 133

Finding 2024-003 INADEQUATE REQUEST FOR INFORMATION Name of contact person: Corrective Action: Proposed Completion Date: Finding 2024-004 INTERNAL CONTROLS RELATED TO FNS ELIGIBILITY DETERMINATIONS Name of contact person: Corrective Action: Proposed Completion Date: Corrective Actions for Findings 2024-001, 2024-002, and 2024-003 also apply to State requirements and State Awards. Korey Fisher-Wellman, Department of Social Services Director and Amanda Grady, Assistant Department of Social Services Director Medicaid staff will be required to attend training sessions to address the negative findings found. The following MA policies will be discussed during training to address the areas that need improvement: MA-3200 APPLICATION XII. Requesting Information and MA-3421 MAGI RECERTIFICATION VIII. Recertification Procedures. Medicaid Supervisors will continue to conduct 2nd Party Reviews. As cases are reviewed, supervisors will provide any additional training as needed, either on an individual or group basis. The results from these 2nd party reviews will be shared with the Assistant Director and DSS Director. Corrections will be made to the cases in error, and documentation to support the corrections will be updated in NCFAST. Section IV - State Award Findings and Question Costs The initial training will be completed by 12/06/2024. Our success will be measured by the results of the 2nd party reviews. We will continue to review the results of all 2nd party reviews, conduct group or individual training, and address issues through the disciplinary process if necessary. Korey Fisher-Wellman, Department of Social Services Director and Amanda Grady, Assistant Department of Social Services Director All FNS staff will be required to attend training sessions to address the negative findings found. The following FNS policies will be discussed during training to address the areas that need improvement: Food and Nutrition Services Policy 300 Sources of Income; Food and Nutrition Services Policy 305 Rules for Budgeting Income; Food and Nutrition Services Policy 310 Budgeting New, Changed, and Terminated Income FNS Supervisors will continue to conduct 2nd Party Reviews. As cases are reviewed, supervisors will provide any additional training as needed, either on an individual or group basis. The results from these 2nd party reviews will be shared with the Assistant Director and DSS Director. Corrections will be made to the cases in error, and documentation to support the corrections will be updated in NCFAST. The initial training will be completed by 11/30/2024. Our success will be measured by the results of the 2nd party reviews. We will continue to review the results of all 2nd party reviews, conduct group or individual training, and address issues through the disciplinary process if necessary. Section III - Federal Award Findings and Question Costs (continued) BRIAN EPLEY, COUNTY MANAGER KAY H. DRAUGHN, CLERK TO THE BOARD J. R. SIMPSON, II, COUNTY ATTORNEY KANIA LAW FIRM, P.A., TAX ATTORNEY JEFFREY C. BRITTAIN, CHAIR SCOTT MULWEE, VICE CHAIR RANDY BURNS, COMMISSIONER JOHNNIE W. CARSWELL, COMMISSIONER PHIL SMITH, COMMISSIONER 137

Burke County, North Carolina Schedule of Findings and Questioned Costs For the Year Ended June 30, 2024 U.S. Department of Health and Human Services Passed through the NC Department of Health and Human Services Program Name: Food and Nutrition Services (FNS) Cluster AL #: 10.551 and 10.561 Finding: 2024-004 Internal Controls Related to Food and Nutrition Services Eligibility SIGNIFICANT DEFICENCY ELIGIBILITY Criteria: Condition: Questioned Costs: Context: Effect: Section III. Federal Award Findings and Questioned Costs (continued) 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 State has provided policies and procedures to ensure that the County is meeting the federal guidance, relevant policies are: Food and Nutrition Services Policy 305 describes the verification sources and requirements and the FNS units primary responsibility for providing documentary evidence to support statements on applications and recertifications and procedures required if the statements by applicant/beneficiary are questionable. Food and Nutrition Services Policy 300 describes the sources of income countable and not countable to the household for determining financial eligibility. Food and Nutrition Services Policy 310 describes the procedures related to verifying changes in income (i.e. termination, end of contract, temporary, etc.). There were a total of 2 errors found in our testing, both instances where earned income was incorrectly caclculated and entered in NCFAST. Of these 2 errors, 1 of these could potentially be an eligibility error. Due to the nature of the populations provided from which the samples were chosen, we are unable to calculate questioned costs for the above mentioned potential eligibility issue. We examined 25 of 96,362 FNS cases from a report of all active FNS beneficiaries provided by the County's Department of Social Services. The finding is being reported with the financial statement audit as it relates to FNS administrative cost compliance audit. For those certifications/re-certifications there was a chance that information was not properly documented and reconciled to NC FAST and a participant could have been approved for benefits for which they were not eligible. 134

Finding 2024-003 INADEQUATE REQUEST FOR INFORMATION Name of contact person: Corrective Action: Proposed Completion Date: Finding 2024-004 INTERNAL CONTROLS RELATED TO FNS ELIGIBILITY DETERMINATIONS Name of contact person: Corrective Action: Proposed Completion Date: Corrective Actions for Findings 2024-001, 2024-002, and 2024-003 also apply to State requirements and State Awards. Korey Fisher-Wellman, Department of Social Services Director and Amanda Grady, Assistant Department of Social Services Director Medicaid staff will be required to attend training sessions to address the negative findings found. The following MA policies will be discussed during training to address the areas that need improvement: MA-3200 APPLICATION XII. Requesting Information and MA-3421 MAGI RECERTIFICATION VIII. Recertification Procedures. Medicaid Supervisors will continue to conduct 2nd Party Reviews. As cases are reviewed, supervisors will provide any additional training as needed, either on an individual or group basis. The results from these 2nd party reviews will be shared with the Assistant Director and DSS Director. Corrections will be made to the cases in error, and documentation to support the corrections will be updated in NCFAST. Section IV - State Award Findings and Question Costs The initial training will be completed by 12/06/2024. Our success will be measured by the results of the 2nd party reviews. We will continue to review the results of all 2nd party reviews, conduct group or individual training, and address issues through the disciplinary process if necessary. Korey Fisher-Wellman, Department of Social Services Director and Amanda Grady, Assistant Department of Social Services Director All FNS staff will be required to attend training sessions to address the negative findings found. The following FNS policies will be discussed during training to address the areas that need improvement: Food and Nutrition Services Policy 300 Sources of Income; Food and Nutrition Services Policy 305 Rules for Budgeting Income; Food and Nutrition Services Policy 310 Budgeting New, Changed, and Terminated Income FNS Supervisors will continue to conduct 2nd Party Reviews. As cases are reviewed, supervisors will provide any additional training as needed, either on an individual or group basis. The results from these 2nd party reviews will be shared with the Assistant Director and DSS Director. Corrections will be made to the cases in error, and documentation to support the corrections will be updated in NCFAST. The initial training will be completed by 11/30/2024. Our success will be measured by the results of the 2nd party reviews. We will continue to review the results of all 2nd party reviews, conduct group or individual training, and address issues through the disciplinary process if necessary. Section III - Federal Award Findings and Question Costs (continued) BRIAN EPLEY, COUNTY MANAGER KAY H. DRAUGHN, CLERK TO THE BOARD J. R. SIMPSON, II, COUNTY ATTORNEY KANIA LAW FIRM, P.A., TAX ATTORNEY JEFFREY C. BRITTAIN, CHAIR SCOTT MULWEE, VICE CHAIR RANDY BURNS, COMMISSIONER JOHNNIE W. CARSWELL, COMMISSIONER PHIL SMITH, COMMISSIONER 137

"US Department of Health and Human Services Passed Through the NC Department of Health and Human Services Program Name: Title IV-E Adoption Assistance - Direct Benefit Payment CFDA # 93.659 Grant Number: 2001NCFOST Significant Deficiency/Non-compliance Criteria: In accordance with 45 CFR 1355-1356 and in the State law NCGS 180-A-49, the requirement applicable in this case, applicant files should contain certain eligibility forms. Condition: Three cases did not include all of the required forms. Questioned Costs: $20,916. This amount was determined by totaling all the aid received by the cases. Context: Of the 322 case files, we examined 32 and determined three case files did not contain all of the required documentation. Effect: Three applicants received assistance for which they may not have been eligible. Cause: Adoption assistance agreements are currently scanned into a paperless system. Accordingly, the County's system of review did not detect these errors in a timely manner. Identification of a repeat finding: This is a repeat finding from the immediate previous audit - 2019-002. Recommendation: Procedures should continue to ensure all required forms are completed and are included in the scanning process prior to being discarded Name of Contact Person: Korey Wellman-Fisher, DSS Director Views of responsible officials and planned corrective actions: The County agrees with the finding and will implement adequate checks and balances to ensure this problem does not recur. "

"Name of Contact Person: Korey Fisher- Wellman, Burke County Department of Social Services Director Matthew Hillman, Social Service Program Administrator Corrective Action: The DSS Director will review the case file with error with the Service Program Administrator to ensure clear understanding of finding. The Service Program Administrator will conduct periodic reviews on a selection of case files to ensure all required procedures are followed in a timely basis. Proposed Completion Date: November 1, 2020"

2019-002

US Department of Health and Human Services Passed Through the NC Department of Health and Human Services Program Name: Title IV-E Adoption Asisstance - Direct Benefit Payment CFDA # 93.659 Grant Number: 1901NCFOST Significant Deficiency/Non-compliance Criteria: In accordance with 45 CFR 1355-1356 and in the State law NCGS 180-A-49, the requirement applicable in this case, applicant files should contain certain eligibility forms. Condition: One case did not include all of the required forms. Questioned Costs: $6,972. This amount was determined by totaling all the aid received by the case. Context: Of the 240 case files, we examined 24 and determined one case file did not contain a signed adoption assistance agreement. Effect: One applicant received assistance for which they may not have been eligible. Cause: Adoption assistance agreements are currently scanned into a paperless system. Accordingly, the County's system of review did not detect these errors in a timely manner. Identification of a repeat finding: This is a repeat finding from the immediate previous audit - 2018-001. Recommendation: Procedures should continue to ensure all required forms are completed and are included in the scanning Name of Contact Person: Korey Wellman-Fisher, DSS Director Views of responsible officials and planned corrective actions: The County agrees with the finding and will implement adequate checks and balances to ensure this problem does not recur.

Name of Contact Person: Korey Fisher- Wellman, Burke County Department of Social Services Director Kathy Craig, Service Program Administrator Corrective Action: The DSS Director will review the case file with error with the Service Program Administrator to ensure clear understanding of finding. The Service Program Administrator will conduct periodic reviews on a selection of case files to ensure all required procedures are followed in a timely basis. Proposed Completion Date: January 23, 2020

2018-001

GSA_MIGRATION

GSA_MIGRATION