Raymond L. Williams, Jr. External Financial Auditor Virginia Department for the Aging 2004 Financial Management Training Presentation (FY 2003/04 Program/Financial Compliance Review ) Raymond L. Williams, Jr. External Financial Auditor

Program / Financial Compliance Review Objective Perform a follow-up review of completed corrective-action; Evaluate compliance with applicable state and federal laws, regulations, for care coordination; Respite, Title III Home Services, Information & Referral, Nutrition & Disease Prevention/Health Promotion, Title V, Cost Allocation procedures, Client Confidentiality procedures, AIM Reporting, Alzheimer’s Grants and Guardianship Program and records review.

Program / Financial Compliance Review Objective Verify AAA and other contractor’s adherence with the program and reporting requirements specified in our contracts; Identify potential problems and possible resolutions; Ensure effective services are delivered to citizen clients; and Provide technical assistance in meeting regulatory requirements.

Review Staff Faye Cates, Information & Assistance\Referral Pat Cummins, Title V Carol Driskill, Nutrition Services Ellen Nau, Home Services, Care Coord. Terry Raney, Guardianship Janet Honeycutt, Alzheimer’s Grants Raymond L. Williams, Jr., Financial / AIM

Findings & Observations Definition Findings are deficiencies identified during the review which are determined to be non-compliant with federal or state requirements. Observation are potential deficiencies, however there is no specific regulatory requirement, but staff experience indicates that some evaluation should occur by the program to consider incorporating recommendations to assist with improving program outcome. Positive observations are those applications which appear to work exceptionally well.

Review Activities Total of 47 individual reviews will be completed. 25 Area Agencies on Aging. 7 Guardianship Programs. 12 General Program Contracts. 3 Title V Programs.

Financial Review Findings / Observation (AAA) Review Highlights –AIM Reporting AIM and AIM Reporting has become consistent, only few exceptions noted. VA 11 reassessment improving some problems still exist.

Financial Review Findings / Observation (AAA) Review Highlights-AIM Reporting VA 01 some issues were noted in collecting the required poverty information from clients, perhaps more staff training on how to request this information. VA 26 noted some issues at the AAA reviewed, did not review at all agencies, will complete during the next cycle.

Financial Review Findings / Observation (AAA/Contractor) Review Highlights- Client Confidentiality Noted two observations where procedures have not been documented, others have developed policies and procedures that reference the HIPPA regulations or taken aspects from the policy.

Financial Review Findings / Observation (AAA/Contractor) Review Highlights – Cost Allocation Noted two observations where procedures have not been documented, one instance requires some type of diagram because of the complexity of the process. Most have developed statements/procedures to define the process.

Financial Review Findings / Observation (AAA/Contractor) Review Highlights–Corrective Action Follow-up One finding which addressed the need for completing the audit process timely. All agencies completed some form of corrective action or were in the process of completing.

Financial Review Findings / Observation (AAA/Contractor) Review Highlights – Audit Two issues where audits were not completed. One was a small contractor, new contract requirements, no matter the dollar amount an audit/accounting review must be completed. The other was not completed within the contract closing period, due to personnel changes.

Client information not documented on the UAI. Information and Assistance\Referral Record Review Finding / Observation (AAA-Contractor) Review Highlights Client information not documented on the UAI. Various required data elements not documented in the client file. Staff not signing off on documents in client files. Staff not documenting work complete for a client. Improvements have been made overall, however improvements in collection and maintenance of client files should continue.

In-Home and Respite Services Programs Finding / Observation (AAA-Contractor) Review Highlights Client information not documented on the UAI. Required documentation not in client files.

Case notes missing for a period of time in client file. Care Coordination Program Records Review Finding / Observation (AAA-Contractor) Review Highlights Information missing from UAI. Noticeable improvement from prior review. Case notes missing for a period of time in client file. Documents missing from client files.

Congregate and Home Delivered Nutrition Finding / Observation (AAA-Contractor) Review Highlights Not meeting meal temperature requirements, majority have improved or/are improving on this process. Instance of congregate site not meeting the 33 1/3percent of daily RDA/AI requirement. Nutrition contractor not being monitored.

Corrective Action Plans Plans are due to the Department 60 days from the receipt of the report. Should include responses as to how recommendations to findings and observations will be addressed. Development of a corrective action plan may begin during the review process.

Review Activities – Future (AAA-Contractor) Beginning July 1, 2004 (contractors) October 1, 2004 (AAA) Financial – cost allocation follow-up; bank reconciliations process; Aim Reporting; Corrective action follow-up review. Programs – selected AAAs and contractors: corrective action follow-up review.

Review Activities – Future (AAA-Contractor) Future Program & Financial Compliance Reviews FY 04 October 1, 2004 – September 30, 2005 FY 05 October 1, 2005 – September 30, 2006

Program / Financial Compliance Review 2004 Financial Management Training PFCR Presentation Questions & Answers Thank You!!!!!!!!!!!!!!!!!!!!!!!!!!