FINANCIAL AUDIT OF THE DEPARTMENT OF HUMAN SERVICES STATE OF HAWAII Fiscal Year Ended June 30, 2009_part9 potx
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End
Date:
DHS
budget
request
to
the
2010
Legislature.
However,
the
MOD
intends
to
submit
a
request
to
hire
for
this
position.
Also
impacting
the
resources
required
to
address
these
recommendations
are
similar
vacant
positions
frozen
and
offered
for
abolishment
in
the
MOD
Systems
Office
(SO).
These
SO
positions
are
required
to
assist
with
developing
HPMMIS
reports
for
SURS
analysis.
In
spite
of
all
the
shortcomings,
the
MOD
is
currently
in
the
testing
stage
of
using
a
Data
Storage
Warehouse.
Once
testing
is
completed
and
training
is
done,
the
MOD
will
be
able
to
produce
its
own
reports
and
not
have
to
rely
on
other
resources
for
those
reports.
The
MOD
is
a part
of
an
RFP
released
by
the
state
of
Arizona's
Medicaid
program
(AHCCCS)
to
obtain
a
SURS
subsystem
for
use
with
the
Data
Storage
Warehouse.
This
subsystem
will
enable
the
MOD
to
use
pre-set
algorithms
to
obtain
reports.
It
is
not
known
when
human
resources
will
be
restored
to
the
full
and
necessary
MOD
staffing to
allow
the
program
to
meet
the
compliance
requirements
in
this
important
area,
and
we
understand
that
this
is
due
to
the
unprecedented
statewide
budget
shortfall.
Ongoing
Responding
Person:
Ann
Kinningham,
MOD
Finance
Officer
Phone:
(808)
692-7956
Ref.
No.
2009-06
Auditor's
Recommendation:
Corrective Action
Taken
or
Planned:
Complete Eligibility Applications and Annual Eligibility
Re-
verifications
in
a Timely Manner
The
DHS
should
assess
the
staffing
requirements
at
the
MOD
Eligibility
Branch
and
make
every
effort
to
eliminate
the
backlog
of
applications
pending
eligibility
determinations
and
perform
timely
annual
Je-verifications
as
required
by
federal
regulations
in
order
to
reduce
the
risk
that
ineligible
recipients
are
receiving
Medicaid
benefits.
The
MOD
is
keenly
aware
of
the
staffing
shortages
in
the
Eligibility
Branch
as
a result
of
the
hiring
freeze,
Reduction
in
Force
(RIF),
and
budget
requests
to
abolish
the
RIF
and
vacant
positions.
These
staffing shortfalls
have
affected
the
Branch's
ability
to
perform
timely eligibility
application
determinations
and
annual
re-determinations
as
reqUired
by
federal
regulations.
Prior
to
these
events,
with
implementation
of
new
workflow
processes,
the backlog
was
decreased
by
more
than
50%
while
at
the
same
time
new
enrollment
increased
by
a
record
13%.
An
eligibility calculator
is
under
development
that
will
improve
the
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accuracy
and
efficiency
of
eligibility
determinations,
and
a
reorganization
to
develop
a
new
eligibility
division
with
substantial
efficiencies
has
been
proposed.
Ongoing
Responding
Person:
Ann
H.
Kinningham,
MOD
Finance
Officer
Phone:
(808)
692-7956
Ref. No. 2009-07
Auditor's
Recommendation:
Corrective
Action
Taken
or
Planned:
End
Date:
Monitor
the
Medicaid Drug Rebate Program
The
DHS
should
establish
formal
procedures
to
monitor
its
subcontractor
to.
ensure
the
drug
rebate
program
operates
in
compliance
with
CMS
guidelines
and
help
identify
issues
timely.
In
addition,
the
DHS
should
resolve
outstanding
issues
on
a
timely
basis.
The
MOD
acknowledges
the
problems
resulting
from
its
previous
contractor
implementing
the
initial
drug
rebate
program
during
the
period
1991
;
2001.
Significant
efforts
have
been
made
to
seek
drug
manufacturers
input
and
corrections
to
the
questionable
accounts
receivable
ledgers
in
the
past
six
months.
A
fin.al
report
has
been
submitted
to
the
CMS
and
is
currently
under
review.
Procedures
have
been
developed
and
issued
to
the
current
fiscal
agent.
With
the
implementation
of
QUEST
Expanded
Access,
the
volume
of
prescription
drug
claims
has
decreased
substantially.
Ongoing
Responding
Person:
Ann
Kinningham,
MOD
Finance
Officer
Phone:
(808)
692-7956
Ref. No. 2009·08
Auditor's
Recommendation:
Corrective
Actions
Taken
or
Planned:
Maintain
All
Required
Documentation
In
Child Care Case
Flies
The
DHS
should
ensure
that
required
documents
are
maintained
in
each
case
file
to
support
the
allowability
and
eligibility
of
the
child
care
payments
claimed
for
federal
reimbursement.
The
DHS
should
perform
secondary
reviews
on
a
sample
basis
in
order
to
assess
case
manager
performance.
We
have
discussed
this
issue
with
our
Staff
Development
Office
which
is
responsible
to
provide
training
to
all
staff
who
issue
child
care
payments.
They
will
continue
to
emphasize
the
need
to
maintain
appropriate
documentation
in
the
case
record.
Random
cases
are
now
reviewed
monthly
to
determine
that
payments
issued
were
properly
authorized.
DHS
will
continue
this
practice
as
it
has
been
helpful
in
determining
on-going
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training needs
as
well
as
worker performance.
Ongoing
Responding
Person:
Julie Morita,
BESSO
CCP
Administrator
Phone
(808)
586-7187
Ref. No. 2009-09
Auditor's
Recommendation:
Corrective Action
Taken or Planned:
End
Date:
Improve the Accuracy
of
Child Care Reimbursement
The
OHS
should
ensure
that
reimbursements
to
child
care
program
participants
are
calculated
properly.
The
OHS
should
perform
post
payment
reviews
of a
sample
of
child
care
payments
to
ensure
accuracy
and
assess
case
worker
performance.
Random
cases
are
now reviewed
monthly
to determine that
correct payments were issued.
OHS
will
continue
this practice
as
it
has
been
helpful
in
determining
on-going
training needs
as
well
as
worker performance.
Ongoing
Responding Person: Julie
Morita,
BESSO
CCP
Administrator
Phone
(808)
586-7187
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