REPORT DIGEST

DEPARTMENT ON AGING

COMPLIANCE EXAMINATION
FOR THE TWO YEARS ENDED: JUNE 30, 2016

Release Date:  May 25, 2017

FINDINGS THIS AUDIT:  14

CATEGORY:  NEW -- REPEAT -- TOTAL
Category 1:  0 -- 1 -- 1
Category 2:  9 -- 4 -- 13
Category 3:  0 -- 0 -- 0
TOTAL:  9 -- 5 -- 14

FINDINGS LAST AUDIT: 9

Category 1:	Findings that are material
weaknesses in internal control and/or a
qualification on compliance with State
laws and regulations (material
noncompliance).
Category 2:	Findings that are
significant deficiencies in internal
control and noncompliance with State laws
and regulations.
Category 3:	Findings that have no
internal control issues but are in
noncompliance with State laws and
regulations.

State of Illinois, Office of the Auditor
General
FRANK J. MAUTINO, AUDITOR GENERAL

To obtain a copy of the Report contact:
Office of the Auditor General, Iles Park
Plaza, 740 E. Ash Street, Springfield, IL
62703
(217) 782-6046 or TTY (888) 261-2887

This Report Digest and Full Report are
also available on the worldwide web at
www.auditor.illinois.gov

SYNOPSIS

• (16-1) The Department lacked adequate
controls and monitoring over eligibility
determinations and payments made to
service provider agencies that applied for
and received a special hourly rate under
the Community Care Program.
• (16-6) The Department failed to
implement the Adult Protective Service
Registry for caregivers involved in deaths
caused by abuse or neglect.
• (16-9) The Department did not prepare
and submit accurate accounting reports
(Generally Accepted Accounting Principles
(GAAP) reporting form) to the Office of
the Comptroller (Comptroller) for Fiscal
Year 2016. In addition, the information
reported on the GAAP reporting forms did
not agree with the information reported on
the Department prepared Schedule of
Expenditures of Federal Awards (SEFA).

FINDINGS, CONCLUSIONS, AND RECOMMENDATIONS

INADEQUATE CONTROLS AND MONITORING OVER
ENHANCED RATE PAYMENTS MADE TO COMMUNITY
CARE PROGRAM SERVICE PROVIDERS

The Department lacked adequate controls
and monitoring over eligibility
determinations and payments made to
service provider agencies (providers) that
applied for and received a special hourly
rate under the Community Care Program.

Public Act 095-0713, effective July 1,
2008, authorized the Department to pay
vendors providing homemaker, chore and
housekeeping services an additional $1.61
per hour (enhanced rate) for the purpose
of providing health insurance coverage to
their employees and to those employees’
dependents. For the two fiscal years under
examination, the Department has paid
providers approximately $90 million for
the enhanced rate payments.

During testing, the following was noted:

• Six of fourteen (43%) providers tested
did not submit required annual eligibility
documentation or financial reports to the
Department during the examination period
even though they continued to receive the
enhanced rate payments from the
Department.

• One of fourteen (7%) providers tested
submitted a Direct Service Worker Health
Insurance Certification (DSWHIC) form to
the Department that did not satisfy the
requirement of at least one quarter of
total direct service workers accepting the
health insurance offered. (Finding 1,
pages 9-10) This finding has been repeated
since 2010.

We recommended the Department strengthen
controls to ensure that initial and
ongoing reviews of eligibility and annual
reporting for the enhanced reimbursement
rate are conducted properly, in a timely
manner, and in accordance with the
Illinois Administrative Code. We also
recommended the Department ensure required
information is obtained from providers and
maintained to support agency
determinations.

The Department concurred with the
recommendation and stated discussions
within the Department regarding controls
that are currently in place for monitoring
of the enhanced rate need to be reviewed
for improved efficiency. The Department
also responded they have strengthened
their efforts to ensure compliance by the
providers to submit the necessary
verification documents. Additionally, the
Department responded they will continue
their efforts to obtain documentation even
after termination of the provider contract
to close out the final allowable
expenditures payable to the providers.
(For the previous Department response, see
Digest Footnote #1)

FAILURE TO IMPLEMENT REGISTRY

The Department failed to implement the
Adult Protective Service Registry
(Registry) for caregivers involved in
deaths caused by abuse or neglect.

The Adult Protective Services Act (Act)
(320 ILCS 20/3(c-5)) states if the law
enforcement agency, coroner, or medical
examiner determines the reported death was
caused by abuse or neglect by a caregiver,
the law enforcement agency, coroner, or
medical examiner shall inform the
Department, and the Department shall
report the caregiver’s identity on the
Registry as described in Section 7.5 of
the Act.

The Act (320 ILCS 20/7.5(a)) requires the
Department, in order to protect
individuals receiving in-home and
community-based services, establish a
Registry that will be hosted by the
Department of Public Health on its website
effective January 1, 2015, and if
practicable, shall propose rules for the
Registry by January 1, 2015.

The Act (320 ILCS 20/7.5(c)) states access
to and use of the Registry shall be
limited to the Department, the Department
of Healthcare and Family Services, the
Department of Human Services, and the
Department of Public Health and providers
of direct care as described in subsection
(a-10) of this Section.  These State
agencies and providers shall not hire,
compensate either directly or on behalf of
a participant, or utilize the service of
any person seeking to provide direct care
without first conducting an online check
of whether the person has been place on
the Registry.  (Finding 6, pages 15 -16)

We recommended the Department develop and
implement the Registry.

The Department concurred with the
recommendation and stated they plan to
implement and properly develop the
registry.

INADEQUATE CONTROLS OVER GAAP REPORTING

The Department did not prepare and submit
accurate accounting reports (Generally
Accepted Accounting Principles (GAAP)
reporting forms) to the Office of the
Comptroller (Comptroller) for Fiscal Year
2016. In addition, the information
reported on the GAAP reporting forms did
not agree with the information reported on
the Department prepared Schedule of
Expenditures of Federal Awards (SEFA).

During testing, the following was noted:

• The Department did not accurately report
receipt amounts on the SCO-563 for Fund
0396. The receipts were overstated by
$115,030 compared to the Department’s
receipt records.

• The Department did not accurately report
expenditure amounts on the SCO-563 for
Fund 0618. The expenditures were
understated by $245,166 compared to the
Department’s expenditure records.

• The Department reported two programs on
the Department prepared SEFA 10.555
National School Lunch Program for
$1,728,000 and 10.560 State Administrative
Expenses for Child Nutrition for $76,000.
However, on the SCO-563 for Fund 0618
these were combined and reported as 10.555
National School Lunch Program for
$1,804,000. (Finding 9, pages 19-20)

We recommended the Department implement
procedures to ensure complete and accurate
information is reported to the Comptroller
on the accounting reports.

The Department concurred with the
recommendation and stated they will
implement additional procedures in its
Fiscal Procedure Manual to have work
completed and reviewed for accuracy. This
will enhance the accuracy of the reporting
of federal expenditures.

OTHER FINDINGS

The remaining findings are reportedly
being given attention by the Department.
We will review the Department’s progress
towards the implementation of our
recommendations in our next compliance
examination.

ACCOUNTANT’S OPINION

The accountants conducted a compliance
examination of the Department for the two
years ended June 30, 2016, as required by
the Illinois State Auditing Act.  The
accountants qualified their report on
State compliance for Finding 2016-001.
Except for the noncompliance described in
this finding, the accountants stated the
Department complied, in all material
respects, with the requirements described
in the report.

This compliance examination was conducted
by Winkel, Parker & Foster, CPA PC.

JANE CLARK
Division Director

This report is transmitted in accordance
with Section 3-14 of the Illinois State
Auditing Act.

FRANK J. MAUTINO
Auditor General

FJM:cgc

DIGEST FOOTNOTES

#1 – Inadequate Controls and Monitoring
Over Enhanced Rate Payments Made to
Community Care Program Service Providers –
Previous Department Response

2014:  Agree. The Department has discussed
the controls that were in place during the
review period for monitoring the enhanced
reimbursement rate. Based on those
discussions, and additional support from
the CCP monitoring staff, the Department
has strengthened the efforts to ensure
compliance by the providers to submit the
necessary verification documents. Contract
sanctions will be imposed for non-
compliance. The Department will continue
its efforts to obtain documentation even
after termination of the contract to
close-out the final allowable expenditures
payable to the provider.