Current through Register Vol. 54, No. 44, November 2, 2024
(a)
The
audit review of public assistance cases. The auditors will provide the
county office with a list of the case records to be included in the audit. The
county will provide these records within 24 hours. Requests for the return of
certain cases needed for County Office business may be worked out amicably with
the auditors. Audits will be conducted on a planned, scheduled basis by
auditors of the Bureau of Public Assistance Audits, Department of the Auditor
General. The audit of the Public Assistance file will be made from a sampling
of Aid to Dependent Children, General Assistance, Food Stamp, Medical
Assistance and State Blind Pension case records. The audit will be conducted in
three progressive phases.
(1)
Record
information, Phase I. The record information phase is an audit of each
case record of the sample for accuracy and propriety of cash grants being paid,
food stamps being issued and Medical Assistance being granted. The attention of
the auditor will be focused on the case record material as it relates to the
proper interpretation and application of the rules and regulations of the
Department pertaining to the recipient's eligibility for Public Assistance,
Food Stamps or Medical Assistance.
(2)
Field visit, Phase II.
The field visit phase is that period of the audit during which the auditors
visit a selected number of the recipients whose case record was audited in the
record information phase. The field visit auditor may contact collateral
resources as they pertain to the particular recipient whose case record is
being audited. The purpose of the field visit audit is to substantiate the
particular case record information and to obtain any other information
pertaining to the eligibility of the particular recipient, for public
assistance. The field visit audit will be conducted in a confidential, tactful,
and respectful manner.
(3)
Corrective action, Phase III. The corrective action phase is
that period of the audit during which the county staff takes action on the
exceptions which the auditors indicated. The auditors will take exceptions
based upon misapplication by the county office of the rules and regulations of
the Department. The auditor will also take exceptions when the auditor
discovers information affecting eligibility which is not known to the county
office. Exceptions will be based on the following:
(i) The data in the case records as of the
date it is reviewed.
(ii) Data
affecting eligibility that is not in the case record at the time the case is
requested.
(iii) The information
obtained at the interview.
(iv) The
information obtained from documents examined.
(v) Information from sources other than the
client.
(4)
Determination made during the review. The determination made
during the review will be based on the following:
(i) The accuracy and propriety of the cash
grants, food stamps or medical assistance being provided. This includes
substantiating that the case record supports the amount being paid.
(ii) Whether regulations and procedures
regarding overpayment, restitution and reimbursement have been
followed.
(iii) Whether required
record documentation is complete, including signed applications, reimbursement
agreements and other appropriate documents.
(b)
General method of conducting the
review. The general method of conducting the review will be as
follows:
(1) The Chief Administrative
Officer, Office of Income Maintenance, will provide the Director, Bureau of
Public Assistance Audits, Department of the Auditor General, with a schedule of
the location of the Division of Eligibility Examination teams so that an
overlapping of auditing activities or unreasonable working assignment will not
be imposed upon any one County Board of Assistance.
(2) The Director, Bureau of Public Assistance
Audits, Department of the Auditor General, will notify the Chief Administrative
Officer, Office of Income Maintenance, Department of Human Services, that an
audit will be conducted in a particular County or District beginning on a
specified date.
(3) The Chief
Administrative Officer will notify the proper Regional Deputy Secretary that
the Bureau of Public Assistance Audits will conduct an audit in a particular
county under his jurisdiction beginning on a specified date.
(4) The Chief Administrative Officer will
notify the Executive Director of the county in which an audit is to be
conducted that an audit will take place beginning on a specified date. The
Executive Director will be responsible for providing adequate working space for
the auditors.
(c)
Action by the Bureau of Policy. The Bureau of Policy will be
responsible for resolving controversial exceptions. The controversy will be
resolved by review with the county office or the Department of the Auditor
General or both. When the Bureau of Policy makes a decision about each
controversial exception, the Bureau returns a copy of the Form PA 157 (Report
of Exception-County Reply) through the Chief Administrative Officer to the
County Office showing the disposition of the exception on the Form PA 157, III
(Report of Exception-County Reply). The county office will take whatever action
may be required, if any.
