Programmatic and Fiscal Audits
Posted by: CQL on 12/29/2006
Filed under: Tennessee
Tennessee Department of Finance and Administration
The Situation
A settlement agreement between People First of Tennessee and the State of Tennessee in 1996 required that audits be conducted in those places where members of the class reside. The state recognized that anyone conducting these audits must be knowledgeable in both financial and programmatic areas.
The state issued a request for proposal for external expertise to support its efforts and selected CQL to complete the required work.
What CQL Did
Annually over a period of three years, CQL conducted programmatic and fiscal audits of a sample of individuals receiving support services from both public and private providers across the state. Procedures included:
- Determine if plans of correction resulting from ICF/MR certification surveys are in place and what progress has been made to address recommendations;
- Determine that providers have policies and procedures governing the care of individuals – including client rights and protections, client finance, health care, behavioral problems, staff training, etc.;
- Review Individual Service Plans – including time frames, participation by clients and families in planning process, delivery of actual services as identified in the plan, transition plans, explanation of rights to clients and families, procedures for reporting (and occurrences of) abuse and neglect, procedures regarding use of restraints/drugs for behavioral control, client privacy and access to telephones and contact with families or guardians, etc.;
- Evaluate the providers’ internal control structure for client funds;
- Review incident reports concerning client funds and determine what actions were taken to correct deficiencies; and,
- Select a random sample of clients and test system for funds transactions.
A report of findings was completed for each facility audited and presented to the Department of Finance and Administration.