1 Virginia Department for the Aging 2006 Financial Management Training Presentation (FY 2005/06 Program/Financial Compliance Review) Raymond L. Williams, Jr. External Financial Auditor

2 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; Title III-E National Family Caregiver Support Program, Title III Home Services; Partnerships and Outreach Programs specific to Kinship Care and LEP ; Transportation Services; Public Information and Education;

3 Program / Financial Compliance Review Objective  Cost Allocation Process Follow-up Review; Bank Reconciliation Process/Procedures; AIM Reporting; Small, Women-Owned & Minority Businesses (SWAM) Reporting; Cost Sharing Policies; Socialization Recreation Support Expenses; Virginia Respite Care Grant Program; Alzheimer’s Grants and Guardianship Program and records review.

4 Program / Financial Compliance Review Objective-Current  Bank Reconciliation Completion; AIM Reporting; Budget Maintenance; Credit Card & Charge Card Maintenance; Financial Management Continuity; Advisory Council; Guardianship Client Bill Paying; Title V Client Placement Verification; Corrective Action Follow-up Virginia Respite Care Grant Program; Alzheimer’s Grants and Guardianship Program and records review.

5 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.

6 Faye Cates, Transportation & Public Information Education Pat Cummins, Title V Elaine S. Smith, MS, RD, Nutrition Services Ellen Nau, Title III-E, Title III, Kinship, LEP Janet Dingle Brown, Guardianship Janet Schaefer, Alzheimer’s Grants Raymond L. Williams, Jr., Financial / AIM Review Staff

7 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.

8 04 Review Activities Total of 50 individual reviews were completed. (FY 04/05) 25 Area Agencies on Aging. 8 Guardianship Programs. 13 General Program Contracts. 3 Title V Programs.

9 05 Review Activities Total of 51 individual reviews will be completed. (FY 05/06) 25 Area Agencies on Aging. 9 Guardianship Programs. 13 General Program Contracts. 3 Title V Programs.

10 Financial Review Findings / Observations (AAA) Review Highlights – AIM Reporting 04 & 05  AIM and AIM Reporting has become consistent, few exceptions noted.  VA 01 Annual NAPIS Summary for All Title III Services some issues were noted in collecting the required poverty information from clients, perhaps more staff training on how to request this information.  VA 08 Clients Receiving Service without a Recent Nutritional Screening n o nutritional screenings completed.  VA 11 Clients Receiving Service without a Recent Nutritional Screening some issues with completing reassessments.

11 Review Highlights – AIM Reporting 04 & 05  VA 26 NAPIS Group - Individuals Under 60 and Units Detail noted some issues at the AAA reviewed, did not review at all agencies, will complete during the next cycle.  VA 36 III-E Program Group Listing / 35 Program Group - Detail Persons Without Caregiver Linked some issues not many. Financial Review Findings / Observations (AAA)

12 Financial Review Findings / Observations (AAA/Contractor) Review Highlights – Annual Audit  Noted two finding where the audit was not completed as required, three observations where a corrective actions was required to be completed.

13 Financial Review Findings / Observations (AAA/Contractor) Review Highlights – Bank Reconciliation Procedures  One finding identifying that reconciliations were four months behind.  Observations requiring procedures to be updated.  Observation requiring that the date completed is documented, along with the reviewer’s initials and date.

14 Financial Review Findings / Observations (AAA/Contractor) Review Highlights–Corrective Action Follow-up  One finding which addressed the need for completing the audit process timely.

15 Financial Review Findings / Observations (AAA/Contractor) Review Highlights – Cost Sharing / Fee For Service  Four observations requiring that procedures are documented.

16 Financial Review Findings / Observations (AAA/Contractor) Review Highlights – Cost Allocation Process Follow-up  Recommend that in the absence of completing timesheets, some form of supporting documentations is developed to support staff time being offered as match to the grant.

17 Financial Review Findings / Observations (AAA/Contractor) 05 Review Highlights – Advisory Council Meeting as Required  Council not meeting as required – at least Quarterly  Need to identify the areas of representations (older individuals including minority, health care providers; supportive service providers, local elected officials, and the general public) on the membership roster.

18 Financial Review Findings / Observations (AAA/Contractor) Review Highlights – Credit Cards and Charge Accounts Maintenance  There is a need to document policies and procedures.

19 Financial Review Findings / Observations (AAA/Contractor) Review Highlights – Other Reviews Completed  Reviews were completed by the Department of Rail and Transportation; RSVP; Virginia Employment Commission Payroll review and WIA Compliance Unit; Workers Compensation Board; Department of Social Service Adult Day Care License Review; County/City Internal Audit Department; Department of Housing and Urban Development; Federal Transportation Administration; Department of Housing and Community Development; Veterans Administration; Virginia Department of Health; Legal Services Corporation Of Virginia; Virginia Department of Criminal Justice Services

20 Financial Review Findings / Observations (AAA/Contractor) Review Highlights – Small and Women and Minority Owned Business (SWAM)  Documenting the procedures used to collect information.  Implementing a process where service providers verify its business classification.

21 Financial Review Findings / Observations (AAA/Contractor) Review Highlights – Socialization and Recreation Support Expense  Identifying expense in the Area Plan/budget.  Documenting the agency’s responsibilities as it relates to activity accounts.  Communicating to clients at field sites the need to establish financial controls over activity accounts.

22 Financial Review Findings / Observations (AAA/Contractor) Review Highlights – Legal Litigations  Three were noted related to accidents with agency vehicles.  One issue within a guardianship program.

23 Review Highlights  Ensure that the facilities are properly licensed.  Ensure that client files are in compliance with VDA Service Standards. Adult Day Care Facility Review Finding / Observation (AAA-Contractor)

24 Review Highlights  Care Plans could be more complete.  Post-it notes in client files.  Documents should be secure in client files.  Case summary not complete.  Complete the UAI as required. Care Coordination Program Review Finding / Observation (AAA-Contractor)

25 Review Highlights  Consistently document the temperature of potentially hazardous cold food items.  Update Area Plan as needed to list new congregate meal sites.  Review procedures for handling the accounting of, and safeguarding client contributions. Congregate and Home Delivered Nutrition Finding / Observation (AAA-Contractor)

26 Review Highlights  Note critical errors in client files for a contractor, i.e.: court documents, etc. Guardianship Program Finding / Observation (AAA-Contractor)

27 Review Highlights  Client files were incomplete.  The AAA employs personal care aides, however the agency is not a DMAS provider licensed as a home care agency or accredited by one of the organizations named in the VDA personal care service standard. Homemaker Services Review Finding / Observation (AAA-Contractor)

28 Review Highlights  Post-it notes were used in files.  Information documented on the UAI was confusing and incomplete. In-House Respite Care File Review Finding / Observation (AAA-Contractor)

29 Review Highlights  UAIs were incomplete or unclear.  White out used on the UAI.  Develop an agency policy and procedures manual for all services. Title III Home Services Program Review Finding / Observation (AAA-Contractor)

30 Review Highlights  Agency utilized AoA funds for ineligible clients.  Three clients are not eligible due to neither of the clients or the caregiver being 60 or older.  Post-It notes were used in the client files.  UAIs were incomplete or unclear.  Reassessments were not completed. Title III-E National Family Caregiver Support Program Records Review Finding / Observation (AAA-Contractor)

31 Review Highlights  Develop a system for tracking preventive maintenance and documenting procedures.  Establishing a behind the wheel driving test and documenting requirements in the drivers manual.  Policy verifying drivers records.  Keeping the drivers manual current. Transportation Review Finding / Observation (AAA-Contractor)

32 Review Highlights  Documenting procedures for collecting client contributions.  Establishing procedures for the use of safety equipment.  Documenting procedures for pre- employment drug and alcohol testing. Transportation Review Finding / Observation (AAA-Contractor)

33 Review Highlights  UAIs were incomplete.  Post-It notes were used in client files.  Respite Personal Care needs to be marked on the service sheets in front of the client’s file. Respite Care Initiative Program Review Finding / Observation (AAA-Contractor)

34 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.

35 Beginning December 1, 2006 (AAA/ contractors) Financial – ?????? SCC Filings; Filing with the Dept of Agriculture and Consumer Affairs AIM Reporting; Corrective Action Follow- up review. Suggestions??? me Programs – selected AAAs and contractors: corrective action follow-up review. Review Activities – Future (AAA-Contractor)

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