Press Release  Audit Calls on Administration to Reduce Delays to Providing Financial Relief for Families of Children with Catastrophic Medical Conditions

Boston — Auditor Suzanne M. Bump today released an audit of the Catastrophic Illness in Children Relief Fund (CICRF), which provides financial assistance to families of children with a catastrophic illness to pay for medical expenses that aren’t covered by their health insurance. The audit found that delays in processing applications for assistance slowed the disbursement of funds to families of children with catastrophic medical conditions, potentially causing financial hardship. The audit is the first in a series of audits to be conducted by Bump’s office identifying and making recommendations to eliminate barriers to access that the Commonwealth’s residents face when seeking public assistance.

The audit found that on average, applicant families waited 289 days from the date of the initial application for assistance to approval. During the majority of this time, applications sat idle, waiting to be assigned to staff members for review and processing. Under the current procedure, applicants are not notified of necessary documents to verify income and financial need until their cases are assigned to staff, which takes an average of 208 days. An analysis of states with similar programs found that CICRF had among the longest application processing timelines.

“Families of children with catastrophic illness face immense financial and emotional hardship. Our audit found that long delays in application processing is unnecessarily extending this financial and emotional burden,” Bump said of the audit findings. “I encourage the Catastrophic Illness in Children Relief Fund to seek ways to reduce this barrier to access and the time the families must wait to get assistance for their needs.”

The audit encourages CICRF to consider requiring all documentation of income and need at the time of initial application to speed up processing. Furthermore, the audit calls on CICRF to perform an analysis of staffing and work processes to reduce delays.

Additionally, the audit recommends CICRF implement a sliding fee scale for reimbursements as required, pursue federal matching funds when available, ensure it receives all required information from beneficiaries, file required annual reports, and process reimbursements according to its established policies.

Last year, Bump announced that her office would expand its work to strengthen the social safety net. In addition to identifying fraud in public benefits programs, the Office of the State Auditor (OSA) would also seek to identify barriers to accessing these safety net programs, and provide recommendations to reduce these barriers.

CICRF reimburses families for medical expenses related to their child’s catastrophic illness when those expenses are not covered by health insurance. The program is managed by the Department of Public Health’s Division of Children and Youth with Special Health Needs. The audit examined activities of CICRF from July 1, 2012 through June 30, 2015. During the audit period, CICRF reimbursed 500 families a total of $5,409,693 for medical expenses.

Read the audit of the Catastrophic Illness in Children Relief Fund here.

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