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YELLOW SHEET Office of the State Auditor of Missouri |
Report No. 2005-82
November 2005
The following was discovered as a result of an audit conducted by our office of the Department of Mental Health, Central Missouri Regional Center (CMRC).
CMRC service coordinators provide Targeted Case Management (TCM) services for many of its clients. These clients must be eligible for the state's Medicaid program and must also meet the eligibility requirements for services from the Division of Mental Retardation and Developmental Disabilities. Most of what service coordinators do as routine activity qualifies as TCM and is billable. Each time a service coordinator provides TCM services they are required to log the duration and description of the services into the computer system. The Department of Mental Health has established a standard that provides that service coordinators are to log 106 direct service hours to the TCM system monthly, or 1,272 hours each year. Of 16 full-time service coordinators reviewed, 5 did not meet the 106 direct hour standard. We estimate the CMRC lost over $29,000 in potential reimbursements during fiscal year 2005 due to these service coordinators not providing and logging direct service hours equal to the established standard.
Various problems were noted related to placement facilities' management of client funds. During our review, we visited four placement facilities and reviewed the records related to 27 client fund accounts. Problems noted included client ledgers not being reconciled to checking account balances, inadequate documentation to support some disbursements, client fund balances exceeding maximum limits, inaccurate recording of transactions, accounts with negative balances, and untimely deposits.
The audit report also includes some other matters related to the use of state vehicles, billing of Medicaid Waiver match, and payroll documentation upon which the CMRC should consider and take appropriate corrective action.
