Cabarrus County

Information on the federal program: Medicaid Cluster (Medicaid), CFDA 93.778, U.S. Department of Health andHuman Services, passed through the N.C Department of Health and Human Services, Division of MedicalAssistance.Criteria or specific requirement: Per the North Carolina Medicaid Assistance Program (Medicaid; Title XIX)Compliance Supplement and the DSS manuals (Aged, Blind and Disabled manual, Family and ChildrenMedicaid manual and the Integrated Policy manual), case files for individuals or families receivingassistance are required to retain documentation to evidence appropriate eligibility determination,including:? verifications of date of birth? verifications of United States citizenship? accurate record of household members and relationships? verification of social security number? verification of real property ownership? accurate computation of countable income? verification of earned income? verification of unearned income? social security statusConditions: We noted that in two instances the case file did not contain evidence to verify the individual'sdate of birth. In two instances, the casefile did not contain evidence that SOLIQ was completed or manualdocumentation obtained to verify the individuals citizenship/ alien status. In one instance, the case recorddid not contain evidence that the household and relationship information to verify household composition.In two instances, the Employment Security Commission (ESC) OVS was not completed to verify theindividual?s earned income. In two instances, SOLQ OVS/ OLV, Bendex OVS/OLV, SDX OVS, ESC OVS, andACTS OVS were not completed to verify the individual?s unearned income. In two instances, the case recorddid not contain evidence that the State Online Query OVS (SOLQ) was completed to verify the individual?sSocial Security Number (SSN). In one instance, the case record did not contain an appropriate incomeconversion and computation in accordance with policy manuals. In two instances, the total countableincome was not recorded accurately into NC FAST based upon documentation in the case record. In oneinstance, the case record did not contain eligibility reviews for an individual who no longer receives SSI.Context: We sampled 93 payments from a total population of 2,026,496 payments made to the participantsduring the fiscal year. We noted the above condition in 5 of the 93 case files inspected for applicablepayments.Effect: Case files not containing all required documentation results in a risk that the County could provideservices to individuals not eligible to receive such services or that such services could be denied to eligibleindividuals. Subsequent to being notified that required documentation had not been retained in case files,the County was able obtain documentation to substantiate that the applicants tested were eligible toreceive benefits.Cause: The County did not retain required documentation in case files at the time eligibility wasdetermined.Recommendation: We recommend that the County train and monitor employees on the eligibilitydetermination process. We also recommend the County review and amend current policy and proceduresin place to ensure that all eligibility determination documentation is completed and retained by the County.

Information on the federal program: Temporary Assistance for Needy Families (TANF), CFDA 93.558, U.S.Department of Health and Human Services, passed through the N.C Department of Health and HumanServices, Division of Social Services.Criteria or specific requirement: Per the North Carolina TANF Program (Work First Program) ComplianceSupplement and the DSS manuals, case files for individuals receiving assistance are required to retaindocumentation to evidence appropriate eligibility determination, including:? verification of law enforcement searchCondition: We noted that in one instance the case file did not contain evidence to verify the individual's lawenforcement search.Context: We sampled 93 payments from a total population of 5,355 payments made to the participantsduring the fiscal year. We noted the above condition in 1 of the 93 case files inspected for applicablepayments.Effect: Case files not containing all required documentation results in a risk that the County could provideservices to individuals not eligible to receive such services or that such services could be denied to eligibleindividuals. Subsequent to being notified that required documentation had not been retained in case files,the County was able obtain documentation to substantiate that the applicants tested were eligible toreceive benefits.Cause: The County did not retain required documentation in case files at the time eligibility wasdetermined.Recommendation: We recommend that the County train and monitor employees on the eligibilitydetermination process. We also recommend the County review and amend current policy and proceduresin place to ensure that all eligibility determination documentation is completed and retained by the County.

Information on the federal program: Temporary Assistance for Needy Families (TANF), CFDA 93.558, U.S.Department of Health and Human Services, passed through the N.C Department of Health and HumanServices, Division of Social Services.Criteria or specific requirement: Per the North Carolina TANF Program (Work First Program) ComplianceSupplement and the DSS manuals, the family?s net earned and unearned income are deducted from theNeed Standard for the number of assistance unit members. The payment is one-half the difference.Conditions: We noted that in two instances a families monthly benefit check was larger than the calculatedstandard payment amount they should have received.Questioned cost: The known questioned cost was $100.Context: We sampled 93 payments from a total population of 5,355 payments made to the participantsduring the fiscal year. We noted the above condition in 2 of the 93 case files inspected for applicablepayments. The families received benefits that where considered ineligible for a one to six month period.Effect: Individuals received larger monthly benefit payments than allowed. The known questioned cost was$100.Cause: Countable income was incorrectly recorded in NCFAST resulting in an inaccurate needs calculation.Recommendation: We recommend that the County train and monitor employees on the eligibilitydetermination process. We also recommend that caseworkers understand how the benefits are calculatedand determined and that the appropriate amounts are used to calculate benefits.

Information on the state program: DSS Crosscutting, U.S. Department of Health and Human Services, ChildSupport Enforcement, CFDA 93.563, Temporary Assistance for Needy Families, CFDA 93.558, MedicaidCluster, 93.778..Criteria or specific requirement: Per the North Carolina DSS Crosscutting Supplement and the DSS ServicesInformation System Policy, all employees who provide direct client services during the month mustmaintain day sheets and report 100% of the employee's time.Conditions: We noted one instance where a County Human Services employee, who provides direct clientservices, did not report 100% of their time for the month.Context: We inspected the day sheets of 46 employees supporting the time recorded on Part I of the DSS-1571 for the months of July 2018, October 2018, and May 2019 and noted the condition above in oneinstance.Effect: Day sheets not containing all required employee time results in a risk that the County could requestreimbursement for wages that are not allowable for reimbursement. Subsequent to being notified thatrequired documentation had not been retained, the County was able to provide documentation tosubstantiate that the employee had worked the appropriate amount of hours for reimbursement.Cause: The County did not have adequate internal controls in place related to the submission and approvalof employee's time to ensure its completeness.Recommendation: We recommend that the County implement or revise policies and procedures in placeover DSS 1571 - Part I to ensure that 100% of all employee time is recorded on Day Sheets prior to theapproval reimbursement.

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