Recurring Findings
| Federal Program | Issue | First Year Reported |
|---|---|---|
| Department's Assertion | Page Number | |
| HIV Care Formula Grants | Eligibility. Out of 60 beneficiaries reviewed, 7 beneficiaries did not submit all required documentation, including income documentation and medical reports, to prove that they have a positive HIV/AIDS diagnosis or their annual Modified Adjusted Gross Income did not exceed 500 percent of the Federal Poverty Level based on household size and income. These individuals were placed on a 30- day temporary access period but continued to receive full benefits from the program after the temporary access period ended. In December 2018, the HIV Care Formula Grants unit updated the Aids Drug Assistance Program (ADAP) guidelines to include a secondary review of ADAP applications that requiresa review of specified eligibility criteria. The ADAP Branch should continue to monitor compliance with its policies to ensure enrollment workers follow the established guidelines and retain acceptable documentation to support eligibility determinations. | 2017-18 |
| Partially Corrected – repeat finding – refer to finding 2019-006. Secondary review was implemented in the ADAP Enrollment System for ADAP Advisors. Secondary review is the process in which an ADAP Advisor reviews an application to ensure that the client provided all necessary documents to substantiate eligibility for ADAP (i.e., proof of identification, proof of California residency, proof of income, clinical information, third party pay or information). ADAP Advisors review 100 percent of ADAP applications which includes initial ADAP applications and re-enrollment applications that have not been granted an eligibility exception (i.e., Temporary Access Period, Medi-Cal Eligibility Exception Request, or Eligibility Exception Request) on a daily basis. As part of the secondary review process, ADAP Advisors complete their review of the application and are required to document the outcome. ADAP Advisors must select whether the application passed review, the client was placed on temporary access period, or whether the client was disenrolled. | 37 |