Purpose

To determine whether the Office for People With Developmental Disabilities (OPWDD) is providing effective oversight of Family Support Service (FSS) contracts with entities within the Young Adult Institute Network (YAI Network) to ensure claimed expenses as reported on the Consolidated Fiscal Reports (CFRs) are program appropriate and consistent with contract requirements, including those in the Consolidated Fiscal Reporting and Claiming Manual (CFR Manual). There were three agencies within the YAI Network that had FSS contracts. Our audit covered seven contracts in total: five FSS contracts for the two fiscal years ended June 30, 2016, including three for Young Adult Institute, Inc. (YAI) and two for Premier Health Care, Inc.; and the final two contracts for Rockland County Association for People with Disabilities for the two fiscal years ended December 31, 2016.

Background

OPWDD is responsible for coordinating services for New Yorkers with developmental disabilities. OPWDD contracts with nonprofits to provide services, such as FSS, which are designed to help families care for a relative with a developmental disability at home. As of July 1, 2014, there were seven active FSS contracts covering 37 programs between OPWDD and YAI Network, totaling about $3 million per year. OPWDD reimburses providers, based on actual program expenses, up to the contracted amount. FSS providers report program expenses on their annual CFRs. The expenses reported on the CFR must fully comply with the CFR Manual regarding the eligibility of costs and documentation requirements. OPWDD reimburses the YAI Network’s FSS Programs quarterly, based on payment requests and Consolidated Quarterly Reports submitted to OPWDD’s Regional Offices.

Key Findings

• OPWDD needs to improve its fiscal oversight of the YAI Network to ensure that FSS expenses are program appropriate and consistent with contract requirements. OPWDD has not established controls necessary to ensure the expenses claimed by the YAI Network are reasonable, necessary, allowable, supported, and consistent with requirements. For example, OPWDD’s procedures for reviewing reimbursement claims do not provide guidance to the regional staff for when it is appropriate to request supporting documentation for expenses claimed and units of service provided.
• The YAI Network claimed $47,418 (13.7 percent of our sample) for personal service costs that were not properly supported, and inappropriately billed OPWDD for $15,042 in estimated related fringe benefit costs.
• The YAI Network claimed 2,362.5 FSS units of service (16.7 percent of our sample) were provided to 30 individuals, but did not maintain supporting documentation showing who received the services or when the services were provided. The YAI Network billed OPWDD $28,553 for these services.

Key Recommendations

• Establish additional monitoring controls to ensure that the YAI Network is claiming only reasonable, necessary, allowable, and supported expenses that are consistent with both the CFR Manual and OPWDD guidelines. Controls should include, but not be limited to:
  • Expanding desk reviews of supporting documentation for expenses and services on a sample basis; and
  • Ensuring regional offices are performing the required monitoring of program service providers.
• Establish and distribute formal policies and procedures to regional offices for reviewing CFRs and quarterly fiscal reports, and provide training to regional offices to ensure compliance.
• Follow up with the YAI Network to formally assess: the $47,418 in personal service expenses; the related estimated $15,042 in fringe benefit expenses; and the $28,553 for the units of service claimed that are not allowable. Take steps to ensure the organization does not re-claim these costs in the future.

Other Related Audits/Reports of Interest

Office for People With Developmental Disabilities/The Association of Neurologically Impaired Brain Injured Children, Inc.: Compliance With the Consolidated Fiscal Reporting and Claiming Manual (2013-S-60)
Office for People With Developmental Disabilities/Lifespire, Inc.: Compliance With the Consolidated Fiscal Reporting and Claiming Manual (2016-S-2)