State Auditor Nicole Galloway said Monday that state government still isn't addressing concerns with Child Care Subsidy Program providers who are at a high risk of noncompliance.
The Statewide Single Audit also found the state continues to fail to account properly for federal dollars in several other state programs.
The Child Care Subsidy Program helps pay child care expenses for about 60,000 Missouri children, at 4,700 child care providers, with an annual cost of approximately $150 million, according to a news release from Galloway's office.
However, for the third year in a row, the report identified concerns with the state's procedures to ensure providers' compliance with regulations related to billing practices, attendance records, staffing ratios and fire safety.
"The state receives this federal funding to provide assistance to thousands of parents in Missouri, to help with the cost of child care," Galloway said in the news release. "The state is then responsible for holding providers accountable for following the rules. If the state does not ensure there is follow-up and consequences for breaking those rules, then there can be no expectation that these providers will change."
Galloway's report notes, when concerns are identified, the state can recommend training - or have the providers' contract terminated.
If required training is recommended but not completed, the providers' contract can be terminated. However, the auditor reported, the Department of Social Services did not have criteria or guidance for determining appropriate follow-up action.
Galloway said auditors reviewed specific cases and found - in the majority of those cases - action to address noncompliance was not taken timely or efficiently.
The audit has previously highlighted other concerns with child care subsidies.
For example, for the ninth year in a row, auditors questioned the department's ability to prevent or detect improper payments to child care providers and found some caregivers may have received inappropriate payments.
The Statewide Single Audit annually audits the state's financial reporting and reviews the management and spending of $12 billion federal dollars the state receives.
This year's report audited 15 major federal programs and reported 15 findings related to nine programs at four state agencies.
Other findings in the audit included:
As noted in the four previous audits of the Adoption Assistance program, the Social Services Department's controls over eligibility are not sufficient to prevent and/or detect payments made on behalf of ineligible children.
The Children's Division made payments on behalf of eight ineligible children, and could not provide documentation to demonstrate that another child met the various program eligibility requirements. The total of "known" questioned costs for these errors represents approximately 18 percent of the payments reviewed in the audit.
The Social Services Department's review of its foster care case management contract payments did not establishe adequate internal controls to ensure certain Foster Care assistance payments to contractors are allowable and supported adequately.
As noted in five prior audits of the Temporary Assistance for Needy Families program, Social Services' Family Support Division did not have adequate controls to ensure sanctions were imposed on TANF program recipients who failed to meet work participation requirements.
The department didn't perform monitoring reviews of the Crime Victims Assistance program, in accordance with its monitoring policy.
As noted in two previous audits, the Social Services Department didn't establish effective internal controls over - and did not fully implement federal revalidation requirements for - providers participating in the Medical Assistance Program (Medicaid) and the Children's Health Insurance Program (CHIPs).
As of June 30, 2018, the department had not performed the required revalidations for 48 percent of Medicaid and CHIP providers who required that revalidation.
As noted in three prior audits, the Mental Health Department's Division of Developmental Disabilities continued to pay historical per-diem rates to providers for residential habilitation services, provided to participants of the Home and Community Based Services, Developmental Disabilities Comprehensive Waiver program.
However, the audit found the division didn't retain documentation to support the per diem rates for eight of the 37 individualized supported living habilitation service payments tested, or for five of the 15 group home habilitation service payments tested.
The State Emergency Management Agency did not perform all of the required sub-recipient risk assessments, perform monitoring reviews in accordance with its monitoring policy, or monitor sub-recipient compliance with cash management requirements for the Public Assistance program.
The Missouri Department of Transportation's procedures related to preparation and review of Highway Planning and Construction program project closeouts, and for final vouchers, were not sufficient to ensure the proper reporting of total project costs, the auditor found.
As a result, MoDOT incorrectly reported the costs of two projects, causing a $19,432 overstatement of the federal share of costs for one project, and an incorrect allocation of local entity matching funds for another project.