The State Auditor’s Office has found that for the sixth straight year the Department of Human Services (DHS) is not adhering to their own policy of checking on children from reported abusive situations in the allowed timeframes. When children are reported in extreme abusive situations such as sexual abuse, grossly inappropriate discipline, and risk of death, DHS policy mandates a response time of 24 hours. The Auditor’s Office found DHS is averaging 13 days.
This was one of four areas identified in the last audit of DHS that have not been addressed. If this situation would have been addressed when first identified, 577 cases of severe child abuse for extended amounts of time may have been avoided.
The audit identified eight total areas of concern including the following:
Failure to Timely Contact Suspected Victims of Child Abuse and Neglect
*PRIOR AUDIT IDENTIFIED, DHS STILL HAS NOT ADDRESSED*
DHS is not following their own policy and guidelines to check on children who are suspected victims of abuse and neglect. Face-to-face contact with children who are suspected victims of abuse is required by DHS policy to occur between 24 hours and 14 days depending on the severity of abuse. The most severe category — which includes substantial risk of death, burns, and sexual abuse to children — is required to have contact within 24 hours. DHS averaged 13 days. This is the third consecutive audit that our team has found this issue and recommended DHS address this concern.
Childcare Providers Operating Without Implementing Corrective Orders
*PRIOR AUDIT IDENTIFIED, DHS STILL HAS NOT ADDRESSED*
Childcare providers are operating without proper re-inspection of corrective orders, jeopardizing the health and safety of children. Correction orders are issued when childcare facilities are not in compliance with state law. The Auditor’s Office found that of the 537 orders reviewed, 170 facilities were not re-inspected within the required time frames allowed.
Not Verifying Income
DHS administers a Substance Use Disorder (SUD) Voucher Program. The Auditor’s Office found they are not verifying income for people who apply for that voucher program. An individual who receives benefits from the voucher when they are not eligible is taking away that opportunity for another person who actually is eligible for the program.
Substance Use Disorder Vouchers Incorrectly Paid
Over a million dollars was incorrectly paid for by the SUD Voucher Program, rather than Medicaid. If the treatment services paid for by the Voucher would have been correctly allocated from Medicaid, up to 293 people could have benefited from the substance use disorder treatment services. Because the SUD Voucher Program ran out of funds, people were denied into the program for an entire year (July 1, 2020, until July 1, 2021). If treatment is billed and paid correctly, more people will have access to the treatment services they require.
Employees Underpaid by $132,000
Employees at the Life Skills and Transition Center and the State Hospital who worked both nights and weekends were underpaid by $132,000 because of a misstated 2021 shift differential policy.
Bonuses Paid to Ineligible Employees
DHS paid $157,000 of bonuses to 130 employees who were not eligible.
$629 Million in Financial Statement Errors
*PRIOR AUDIT IDENTIFIED, DHS STILL HAS NOT ADDRESSED*
DHS had a total of $629 million in errors in financial statement amounts reported to the State’s Annual Comprehensive Financial Report.
Unsupported Controls Over Medicaid Drug Rebate Program, Likely Error Rate of $6,297,706
*PRIOR AUDIT IDENTIFIED, DHS STILL HAS NOT ADDRESSED*
Internal controls surrounding the Drug Rebate and Analysis Management System (DRAMS) are inadequate. The DRAMS system is used to calculate drug rebates and interest due from drug manufacturers for the Medicaid drug rebate program. DHS was not able to provide a detailed list of accounts that made up the receivables balances provided for the statewide Annual Comprehensive Financial Report. As a result, the Auditor’s Office was not able to check the account balances. Also identified was a known overstatement of interest calculated on conversion balances on DRAMS of $287,619, with a projected likely error of $6,297,706.
“This is the third consecutive audit that our team has identified that children are in extreme abusive situations for longer than they should be. These are children who are experiencing sexual abuse, physical abuse, drug use, and are at risk of death.” Stated State Auditor Joshua Gallion. “I urge DHS to work with the legislative assembly to gain resources to be responsive and better staffed so these unacceptable conditions improve for the most vulnerable voices.”
The complete audit report can be found here: https://ndsao.link/DHS