The audit covers the parts of the department that get federal money, and suggested general mismanagement largely across the board.
"We have not been very accountable for the money that we spent," said DHHS Secretary Dr. Aldona Wos in January after a scathing audit ripped parts of the state's Medicaid program.
Now, there's another tough review. An audit of federal money that goes through DHHS showed often costly mismanagement. It's riddled with sections where "costs exceed $10,000."
It frequently mentions overdraws and underdraws -- sometimes well into the hundreds of thousands of dollars. In one case, there was an overdraw of more than $8.5 million.
It looks at foster care in North Carolina and said it went unmonitored in nine counties for at least three years.
The audit includes responses from the agency. In most cases, it says Wos agrees with the findings and promises change.
Auditor Beth Wood said that is a break from the past.
"Most of the time, DHHS wanted to, you know, explain it away," said Wood. "Here's the reason why we couldn't do that, or didn't do that. And she's basically saying 'We agree with the findings and we're going to clean it up.'"
However, Wood said there could be another difference with this audit. It concerns the federal government and whether they are going to go after DHHS for money owed. Wood said that doesn't usually happen, but these aren't usual times.
"In years past, they've let them go," said Wood. "With budget cuts and economic downturn, it could be a whole different ballgame on taking back money and making states pay back money. This could be a game changer going forward."
Wood said what's really frustrating is that many of the problems have been pointed out before and keep happening.
ABC11 asked Wood if she's seeing a difference in how this administration is tackling some of the issues. She said she sees a difference in attitude, but it's too early to tell if that will translate to action.
DHHS released this statement, "This audit was conducted for the fiscal year ending June 30, 2012 and the department takes these findings very seriously. We thank the auditor and are actively working to improve oversight and accountability measures to be responsible stewards of taxpayer money."
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