Audit 29462

FY End
2022-12-31
Total Expended
$3.52M
Findings
16
Programs
18
Year: 2022 Accepted: 2023-07-06

Organization Exclusion Status:

Checking exclusion status...

Findings

ID Ref Severity Repeat Requirement
32933 2022-001 Significant Deficiency - I
32934 2022-002 Significant Deficiency - N
32935 2022-001 Significant Deficiency - I
32936 2022-002 Significant Deficiency - N
32937 2022-001 Significant Deficiency - I
32938 2022-002 Significant Deficiency - N
32939 2022-001 Significant Deficiency - I
32940 2022-002 Significant Deficiency - N
609375 2022-001 Significant Deficiency - I
609376 2022-002 Significant Deficiency - N
609377 2022-001 Significant Deficiency - I
609378 2022-002 Significant Deficiency - N
609379 2022-001 Significant Deficiency - I
609380 2022-002 Significant Deficiency - N
609381 2022-001 Significant Deficiency - I
609382 2022-002 Significant Deficiency - N

Programs

ALN Program Spent Major Findings
93.224 Consolidated Health Center, Affordable Care Act for New and Expanded Services $1.50M Yes 2
93.224 Covid-19: American Rescue Plan Act Funding for Health Centers $1.18M Yes 2
93.959 Block Grants for Prevention and Treatment of Substance Abuse $210,684 - 0
93.217 Title X Family Planning Services $189,629 - 0
32.006 Covid-19: Telehealth Program $127,856 - 0
93.526 Covid-19: Grants for Capital Development in Health Centers $84,620 - 0
93.498 Covid-19: Provider Relief Fund and American Rescue Plan (arp) Rural Distribution $74,198 - 0
93.898 Cancer Prevention and Control Programs for State, Territorial and Tribal Organizations $73,185 - 0
93.436 Well-Integrated Screening and Evaluation for Women Across the Nation (wisewoman) $24,603 - 0
93.800 Organized Approaches to Increase Colorectal Cancer Screening $15,826 - 0
93.461 Covid-19: Hrsa Covid-19 Claims Reimbursement for the Uninsured Program and the Covid-19 Coverage Assistance Fund $13,211 - 0
21.027 Covid-19: Coronavirus State and Local Fiscal Recovery Funds $11,029 - 0
93.224 Covid-19: Fy 2020 Expanding Capacity for Coronavirus Testing (ect) $9,302 Yes 2
93.991 Preventive Health and Health Services Block Grant $3,515 - 0
93.426 Improving the Health of Americans Through Prevention and Management of Diabetes and Heart Disease and Stroke $2,962 - 0
93.366 State Actions to Improve Oral Health Outcomes and Partner Actions to Improve Oral Health Outcomes $500 - 0
93.439 State Physical Activity and Nutrition (span) $264 - 0
93.527 Consolidated Health Center, Affordable Care Act for New and Expanded Services $0 Yes 2

Contacts

Name Title Type
NVNNU6LE4M78 Daniel Becker Auditee
9706684040 James Mann Auditor
No contacts on file

Notes to SEFA

Title: NOTE 1 BASIS OF PRESENTATION Accounting Policies: Expenditures reported on the Schedule are reported on the accrual basis of accounting. Such expenditures are recognized following the cost principles contained in the Uniform Guidance, wherein certain types of expenditures are not allowable or are limited as to reimbursement. Negative amounts shown on the Schedule represent adjustments or credits made in the normal course of business to amounts reported as expenditures in prior years. De Minimis Rate Used: N Rate Explanation: The auditee did not use the de minimis cost rate. The accompanying schedule of expenditures of federal awards (the Schedule) includes the federal award activity of Summit Community Care Clinic, Inc. under programs of the federal government for the year ended December 31, 2022. The information in this Schedule is presented in accordance with the requirements of 2 CFR Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (Uniform Guidance). Because the Schedule presents only a selected portion of the operations of Summit Community Care Clinic, Inc., it is not intended to and does not present the financial position, changes in net assets, or cash flows of Summit Community Care Clinic, Inc. For the year ended December 31, 2022, the federal expenditures included $84,620 of capital grants. The financial statements reflect revenue recognized from the Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution of $74,198 and $1,630,415 for the years ended December 31, 2022 and 2021, respectively. The Schedule includes Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution amounts of $74,198 that were received during Period 4 in accordance with the requirements of the compliance supplement for assistance listing number 93.498. The Organization did not receive any Provider Relief Funds for Period 3.

Finding Details

Federal Agency: U.S. Department of Health and Human Services Federal Program: Consolidated Health Centers Grant AL Number: 93.224 & 93.527 Award Period: 1/1/22 - 12/31/22 Type of Finding: Significant deficiency in Internal Control over Compliance and Compliance Criteria or Specific Requirement 2 CFR Part 200 Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards requires compliance with the provisions of procurement and suspension and debarment. The Organization should have internal controls designed to ensure compliance with these provisions. Condition and Context During our testing over suspension and debarment, we noted the two instances in which the Organization did not perform the suspension and debarment check prior to entering into a transaction with a vendor. Effect The auditor noted instances of noncompliance. Noncompliance could result in possible federal funds being provided to ineligible vendors. Questioned Costs None identified. Cause The Organization lacks established internal controls and procedures over financial grant management. The Organization did not perform the suspension and debarment check prior to entering into the transactions. Recommendation We recommend the Organization implement a process to ensure suspension and debarment checks are performed and documentation to show that the checks are occurring prior to entering into transactions with vendors. Views of Responsible Officials The Organization will retrain staff to follow the current Procurement Policy. The current policy does state: ?Federal exclusions list: the SCCC staff initiating the purchase or department which is seeking purchase from a particular vendor shall screen the vendor name against the Office of Inspector General?s (OIG) List of Excluded Individuals and Entities http://oig.hhs.gov/exclusions/exclusions_list.asp and the General Service Administration?s (GSA) Excluded Parties List System https://www.sam.gov/portal/SAM/#1 (together referred to as the Excluded Lists).
Federal Agency: U.S. Department of Health and Human Services Federal Program: Consolidated Health Centers Grant AL Number: 93.224 & 93.527 Award Period: 1/1/22 - 12/31/22 Type of Finding: Significant deficiency in Internal Control over Compliance and Compliance Criteria or Specific Requirement Per Title 42 Chapter 1 Subchapter D Section 51c303(f), ?Health centers must have a schedule of fees or payments for the provision of their health services consistent with locally prevailing rates or charges designed to cover their reasonable costs of operation. They are also required to have a corresponding schedule of discounts applied and adjusted on the basis of the patient?s ability to pay.? Condition and Context During our testing of forty sliding fee discounts for health center patients qualifying for reduced charge visits, we identified one visit that received the incorrect sliding fee discount. Effect Potential that a patient would not receive the appropriate sliding fee discount. Questioned Costs None identified. Cause Clerical error in which the incorrect discount was applied due to lack of an oversight process in place. Recommendation We recommend the Organization to review internal controls in regards to the determination, recording, and monitoring of the sliding fee process to ensure that appropriate sliding fee rates/categories are utilized for each sliding fee encounter. Views of Responsible Officials The Organization will implement a procedure to randomly test ten Sliding Fee Discounts per service line monthly to ensure we are applying the correct discounts and the patient is paying the correct discounted amount. The Organization will train staff to test Sliding Fee Discounted visits going forward starting July 1, 2023.
Federal Agency: U.S. Department of Health and Human Services Federal Program: Consolidated Health Centers Grant AL Number: 93.224 & 93.527 Award Period: 1/1/22 - 12/31/22 Type of Finding: Significant deficiency in Internal Control over Compliance and Compliance Criteria or Specific Requirement 2 CFR Part 200 Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards requires compliance with the provisions of procurement and suspension and debarment. The Organization should have internal controls designed to ensure compliance with these provisions. Condition and Context During our testing over suspension and debarment, we noted the two instances in which the Organization did not perform the suspension and debarment check prior to entering into a transaction with a vendor. Effect The auditor noted instances of noncompliance. Noncompliance could result in possible federal funds being provided to ineligible vendors. Questioned Costs None identified. Cause The Organization lacks established internal controls and procedures over financial grant management. The Organization did not perform the suspension and debarment check prior to entering into the transactions. Recommendation We recommend the Organization implement a process to ensure suspension and debarment checks are performed and documentation to show that the checks are occurring prior to entering into transactions with vendors. Views of Responsible Officials The Organization will retrain staff to follow the current Procurement Policy. The current policy does state: ?Federal exclusions list: the SCCC staff initiating the purchase or department which is seeking purchase from a particular vendor shall screen the vendor name against the Office of Inspector General?s (OIG) List of Excluded Individuals and Entities http://oig.hhs.gov/exclusions/exclusions_list.asp and the General Service Administration?s (GSA) Excluded Parties List System https://www.sam.gov/portal/SAM/#1 (together referred to as the Excluded Lists).
Federal Agency: U.S. Department of Health and Human Services Federal Program: Consolidated Health Centers Grant AL Number: 93.224 & 93.527 Award Period: 1/1/22 - 12/31/22 Type of Finding: Significant deficiency in Internal Control over Compliance and Compliance Criteria or Specific Requirement Per Title 42 Chapter 1 Subchapter D Section 51c303(f), ?Health centers must have a schedule of fees or payments for the provision of their health services consistent with locally prevailing rates or charges designed to cover their reasonable costs of operation. They are also required to have a corresponding schedule of discounts applied and adjusted on the basis of the patient?s ability to pay.? Condition and Context During our testing of forty sliding fee discounts for health center patients qualifying for reduced charge visits, we identified one visit that received the incorrect sliding fee discount. Effect Potential that a patient would not receive the appropriate sliding fee discount. Questioned Costs None identified. Cause Clerical error in which the incorrect discount was applied due to lack of an oversight process in place. Recommendation We recommend the Organization to review internal controls in regards to the determination, recording, and monitoring of the sliding fee process to ensure that appropriate sliding fee rates/categories are utilized for each sliding fee encounter. Views of Responsible Officials The Organization will implement a procedure to randomly test ten Sliding Fee Discounts per service line monthly to ensure we are applying the correct discounts and the patient is paying the correct discounted amount. The Organization will train staff to test Sliding Fee Discounted visits going forward starting July 1, 2023.
Federal Agency: U.S. Department of Health and Human Services Federal Program: Consolidated Health Centers Grant AL Number: 93.224 & 93.527 Award Period: 1/1/22 - 12/31/22 Type of Finding: Significant deficiency in Internal Control over Compliance and Compliance Criteria or Specific Requirement 2 CFR Part 200 Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards requires compliance with the provisions of procurement and suspension and debarment. The Organization should have internal controls designed to ensure compliance with these provisions. Condition and Context During our testing over suspension and debarment, we noted the two instances in which the Organization did not perform the suspension and debarment check prior to entering into a transaction with a vendor. Effect The auditor noted instances of noncompliance. Noncompliance could result in possible federal funds being provided to ineligible vendors. Questioned Costs None identified. Cause The Organization lacks established internal controls and procedures over financial grant management. The Organization did not perform the suspension and debarment check prior to entering into the transactions. Recommendation We recommend the Organization implement a process to ensure suspension and debarment checks are performed and documentation to show that the checks are occurring prior to entering into transactions with vendors. Views of Responsible Officials The Organization will retrain staff to follow the current Procurement Policy. The current policy does state: ?Federal exclusions list: the SCCC staff initiating the purchase or department which is seeking purchase from a particular vendor shall screen the vendor name against the Office of Inspector General?s (OIG) List of Excluded Individuals and Entities http://oig.hhs.gov/exclusions/exclusions_list.asp and the General Service Administration?s (GSA) Excluded Parties List System https://www.sam.gov/portal/SAM/#1 (together referred to as the Excluded Lists).
Federal Agency: U.S. Department of Health and Human Services Federal Program: Consolidated Health Centers Grant AL Number: 93.224 & 93.527 Award Period: 1/1/22 - 12/31/22 Type of Finding: Significant deficiency in Internal Control over Compliance and Compliance Criteria or Specific Requirement Per Title 42 Chapter 1 Subchapter D Section 51c303(f), ?Health centers must have a schedule of fees or payments for the provision of their health services consistent with locally prevailing rates or charges designed to cover their reasonable costs of operation. They are also required to have a corresponding schedule of discounts applied and adjusted on the basis of the patient?s ability to pay.? Condition and Context During our testing of forty sliding fee discounts for health center patients qualifying for reduced charge visits, we identified one visit that received the incorrect sliding fee discount. Effect Potential that a patient would not receive the appropriate sliding fee discount. Questioned Costs None identified. Cause Clerical error in which the incorrect discount was applied due to lack of an oversight process in place. Recommendation We recommend the Organization to review internal controls in regards to the determination, recording, and monitoring of the sliding fee process to ensure that appropriate sliding fee rates/categories are utilized for each sliding fee encounter. Views of Responsible Officials The Organization will implement a procedure to randomly test ten Sliding Fee Discounts per service line monthly to ensure we are applying the correct discounts and the patient is paying the correct discounted amount. The Organization will train staff to test Sliding Fee Discounted visits going forward starting July 1, 2023.
Federal Agency: U.S. Department of Health and Human Services Federal Program: Consolidated Health Centers Grant AL Number: 93.224 & 93.527 Award Period: 1/1/22 - 12/31/22 Type of Finding: Significant deficiency in Internal Control over Compliance and Compliance Criteria or Specific Requirement 2 CFR Part 200 Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards requires compliance with the provisions of procurement and suspension and debarment. The Organization should have internal controls designed to ensure compliance with these provisions. Condition and Context During our testing over suspension and debarment, we noted the two instances in which the Organization did not perform the suspension and debarment check prior to entering into a transaction with a vendor. Effect The auditor noted instances of noncompliance. Noncompliance could result in possible federal funds being provided to ineligible vendors. Questioned Costs None identified. Cause The Organization lacks established internal controls and procedures over financial grant management. The Organization did not perform the suspension and debarment check prior to entering into the transactions. Recommendation We recommend the Organization implement a process to ensure suspension and debarment checks are performed and documentation to show that the checks are occurring prior to entering into transactions with vendors. Views of Responsible Officials The Organization will retrain staff to follow the current Procurement Policy. The current policy does state: ?Federal exclusions list: the SCCC staff initiating the purchase or department which is seeking purchase from a particular vendor shall screen the vendor name against the Office of Inspector General?s (OIG) List of Excluded Individuals and Entities http://oig.hhs.gov/exclusions/exclusions_list.asp and the General Service Administration?s (GSA) Excluded Parties List System https://www.sam.gov/portal/SAM/#1 (together referred to as the Excluded Lists).
Federal Agency: U.S. Department of Health and Human Services Federal Program: Consolidated Health Centers Grant AL Number: 93.224 & 93.527 Award Period: 1/1/22 - 12/31/22 Type of Finding: Significant deficiency in Internal Control over Compliance and Compliance Criteria or Specific Requirement Per Title 42 Chapter 1 Subchapter D Section 51c303(f), ?Health centers must have a schedule of fees or payments for the provision of their health services consistent with locally prevailing rates or charges designed to cover their reasonable costs of operation. They are also required to have a corresponding schedule of discounts applied and adjusted on the basis of the patient?s ability to pay.? Condition and Context During our testing of forty sliding fee discounts for health center patients qualifying for reduced charge visits, we identified one visit that received the incorrect sliding fee discount. Effect Potential that a patient would not receive the appropriate sliding fee discount. Questioned Costs None identified. Cause Clerical error in which the incorrect discount was applied due to lack of an oversight process in place. Recommendation We recommend the Organization to review internal controls in regards to the determination, recording, and monitoring of the sliding fee process to ensure that appropriate sliding fee rates/categories are utilized for each sliding fee encounter. Views of Responsible Officials The Organization will implement a procedure to randomly test ten Sliding Fee Discounts per service line monthly to ensure we are applying the correct discounts and the patient is paying the correct discounted amount. The Organization will train staff to test Sliding Fee Discounted visits going forward starting July 1, 2023.
Federal Agency: U.S. Department of Health and Human Services Federal Program: Consolidated Health Centers Grant AL Number: 93.224 & 93.527 Award Period: 1/1/22 - 12/31/22 Type of Finding: Significant deficiency in Internal Control over Compliance and Compliance Criteria or Specific Requirement 2 CFR Part 200 Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards requires compliance with the provisions of procurement and suspension and debarment. The Organization should have internal controls designed to ensure compliance with these provisions. Condition and Context During our testing over suspension and debarment, we noted the two instances in which the Organization did not perform the suspension and debarment check prior to entering into a transaction with a vendor. Effect The auditor noted instances of noncompliance. Noncompliance could result in possible federal funds being provided to ineligible vendors. Questioned Costs None identified. Cause The Organization lacks established internal controls and procedures over financial grant management. The Organization did not perform the suspension and debarment check prior to entering into the transactions. Recommendation We recommend the Organization implement a process to ensure suspension and debarment checks are performed and documentation to show that the checks are occurring prior to entering into transactions with vendors. Views of Responsible Officials The Organization will retrain staff to follow the current Procurement Policy. The current policy does state: ?Federal exclusions list: the SCCC staff initiating the purchase or department which is seeking purchase from a particular vendor shall screen the vendor name against the Office of Inspector General?s (OIG) List of Excluded Individuals and Entities http://oig.hhs.gov/exclusions/exclusions_list.asp and the General Service Administration?s (GSA) Excluded Parties List System https://www.sam.gov/portal/SAM/#1 (together referred to as the Excluded Lists).
Federal Agency: U.S. Department of Health and Human Services Federal Program: Consolidated Health Centers Grant AL Number: 93.224 & 93.527 Award Period: 1/1/22 - 12/31/22 Type of Finding: Significant deficiency in Internal Control over Compliance and Compliance Criteria or Specific Requirement Per Title 42 Chapter 1 Subchapter D Section 51c303(f), ?Health centers must have a schedule of fees or payments for the provision of their health services consistent with locally prevailing rates or charges designed to cover their reasonable costs of operation. They are also required to have a corresponding schedule of discounts applied and adjusted on the basis of the patient?s ability to pay.? Condition and Context During our testing of forty sliding fee discounts for health center patients qualifying for reduced charge visits, we identified one visit that received the incorrect sliding fee discount. Effect Potential that a patient would not receive the appropriate sliding fee discount. Questioned Costs None identified. Cause Clerical error in which the incorrect discount was applied due to lack of an oversight process in place. Recommendation We recommend the Organization to review internal controls in regards to the determination, recording, and monitoring of the sliding fee process to ensure that appropriate sliding fee rates/categories are utilized for each sliding fee encounter. Views of Responsible Officials The Organization will implement a procedure to randomly test ten Sliding Fee Discounts per service line monthly to ensure we are applying the correct discounts and the patient is paying the correct discounted amount. The Organization will train staff to test Sliding Fee Discounted visits going forward starting July 1, 2023.
Federal Agency: U.S. Department of Health and Human Services Federal Program: Consolidated Health Centers Grant AL Number: 93.224 & 93.527 Award Period: 1/1/22 - 12/31/22 Type of Finding: Significant deficiency in Internal Control over Compliance and Compliance Criteria or Specific Requirement 2 CFR Part 200 Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards requires compliance with the provisions of procurement and suspension and debarment. The Organization should have internal controls designed to ensure compliance with these provisions. Condition and Context During our testing over suspension and debarment, we noted the two instances in which the Organization did not perform the suspension and debarment check prior to entering into a transaction with a vendor. Effect The auditor noted instances of noncompliance. Noncompliance could result in possible federal funds being provided to ineligible vendors. Questioned Costs None identified. Cause The Organization lacks established internal controls and procedures over financial grant management. The Organization did not perform the suspension and debarment check prior to entering into the transactions. Recommendation We recommend the Organization implement a process to ensure suspension and debarment checks are performed and documentation to show that the checks are occurring prior to entering into transactions with vendors. Views of Responsible Officials The Organization will retrain staff to follow the current Procurement Policy. The current policy does state: ?Federal exclusions list: the SCCC staff initiating the purchase or department which is seeking purchase from a particular vendor shall screen the vendor name against the Office of Inspector General?s (OIG) List of Excluded Individuals and Entities http://oig.hhs.gov/exclusions/exclusions_list.asp and the General Service Administration?s (GSA) Excluded Parties List System https://www.sam.gov/portal/SAM/#1 (together referred to as the Excluded Lists).
Federal Agency: U.S. Department of Health and Human Services Federal Program: Consolidated Health Centers Grant AL Number: 93.224 & 93.527 Award Period: 1/1/22 - 12/31/22 Type of Finding: Significant deficiency in Internal Control over Compliance and Compliance Criteria or Specific Requirement Per Title 42 Chapter 1 Subchapter D Section 51c303(f), ?Health centers must have a schedule of fees or payments for the provision of their health services consistent with locally prevailing rates or charges designed to cover their reasonable costs of operation. They are also required to have a corresponding schedule of discounts applied and adjusted on the basis of the patient?s ability to pay.? Condition and Context During our testing of forty sliding fee discounts for health center patients qualifying for reduced charge visits, we identified one visit that received the incorrect sliding fee discount. Effect Potential that a patient would not receive the appropriate sliding fee discount. Questioned Costs None identified. Cause Clerical error in which the incorrect discount was applied due to lack of an oversight process in place. Recommendation We recommend the Organization to review internal controls in regards to the determination, recording, and monitoring of the sliding fee process to ensure that appropriate sliding fee rates/categories are utilized for each sliding fee encounter. Views of Responsible Officials The Organization will implement a procedure to randomly test ten Sliding Fee Discounts per service line monthly to ensure we are applying the correct discounts and the patient is paying the correct discounted amount. The Organization will train staff to test Sliding Fee Discounted visits going forward starting July 1, 2023.
Federal Agency: U.S. Department of Health and Human Services Federal Program: Consolidated Health Centers Grant AL Number: 93.224 & 93.527 Award Period: 1/1/22 - 12/31/22 Type of Finding: Significant deficiency in Internal Control over Compliance and Compliance Criteria or Specific Requirement 2 CFR Part 200 Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards requires compliance with the provisions of procurement and suspension and debarment. The Organization should have internal controls designed to ensure compliance with these provisions. Condition and Context During our testing over suspension and debarment, we noted the two instances in which the Organization did not perform the suspension and debarment check prior to entering into a transaction with a vendor. Effect The auditor noted instances of noncompliance. Noncompliance could result in possible federal funds being provided to ineligible vendors. Questioned Costs None identified. Cause The Organization lacks established internal controls and procedures over financial grant management. The Organization did not perform the suspension and debarment check prior to entering into the transactions. Recommendation We recommend the Organization implement a process to ensure suspension and debarment checks are performed and documentation to show that the checks are occurring prior to entering into transactions with vendors. Views of Responsible Officials The Organization will retrain staff to follow the current Procurement Policy. The current policy does state: ?Federal exclusions list: the SCCC staff initiating the purchase or department which is seeking purchase from a particular vendor shall screen the vendor name against the Office of Inspector General?s (OIG) List of Excluded Individuals and Entities http://oig.hhs.gov/exclusions/exclusions_list.asp and the General Service Administration?s (GSA) Excluded Parties List System https://www.sam.gov/portal/SAM/#1 (together referred to as the Excluded Lists).
Federal Agency: U.S. Department of Health and Human Services Federal Program: Consolidated Health Centers Grant AL Number: 93.224 & 93.527 Award Period: 1/1/22 - 12/31/22 Type of Finding: Significant deficiency in Internal Control over Compliance and Compliance Criteria or Specific Requirement Per Title 42 Chapter 1 Subchapter D Section 51c303(f), ?Health centers must have a schedule of fees or payments for the provision of their health services consistent with locally prevailing rates or charges designed to cover their reasonable costs of operation. They are also required to have a corresponding schedule of discounts applied and adjusted on the basis of the patient?s ability to pay.? Condition and Context During our testing of forty sliding fee discounts for health center patients qualifying for reduced charge visits, we identified one visit that received the incorrect sliding fee discount. Effect Potential that a patient would not receive the appropriate sliding fee discount. Questioned Costs None identified. Cause Clerical error in which the incorrect discount was applied due to lack of an oversight process in place. Recommendation We recommend the Organization to review internal controls in regards to the determination, recording, and monitoring of the sliding fee process to ensure that appropriate sliding fee rates/categories are utilized for each sliding fee encounter. Views of Responsible Officials The Organization will implement a procedure to randomly test ten Sliding Fee Discounts per service line monthly to ensure we are applying the correct discounts and the patient is paying the correct discounted amount. The Organization will train staff to test Sliding Fee Discounted visits going forward starting July 1, 2023.
Federal Agency: U.S. Department of Health and Human Services Federal Program: Consolidated Health Centers Grant AL Number: 93.224 & 93.527 Award Period: 1/1/22 - 12/31/22 Type of Finding: Significant deficiency in Internal Control over Compliance and Compliance Criteria or Specific Requirement 2 CFR Part 200 Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards requires compliance with the provisions of procurement and suspension and debarment. The Organization should have internal controls designed to ensure compliance with these provisions. Condition and Context During our testing over suspension and debarment, we noted the two instances in which the Organization did not perform the suspension and debarment check prior to entering into a transaction with a vendor. Effect The auditor noted instances of noncompliance. Noncompliance could result in possible federal funds being provided to ineligible vendors. Questioned Costs None identified. Cause The Organization lacks established internal controls and procedures over financial grant management. The Organization did not perform the suspension and debarment check prior to entering into the transactions. Recommendation We recommend the Organization implement a process to ensure suspension and debarment checks are performed and documentation to show that the checks are occurring prior to entering into transactions with vendors. Views of Responsible Officials The Organization will retrain staff to follow the current Procurement Policy. The current policy does state: ?Federal exclusions list: the SCCC staff initiating the purchase or department which is seeking purchase from a particular vendor shall screen the vendor name against the Office of Inspector General?s (OIG) List of Excluded Individuals and Entities http://oig.hhs.gov/exclusions/exclusions_list.asp and the General Service Administration?s (GSA) Excluded Parties List System https://www.sam.gov/portal/SAM/#1 (together referred to as the Excluded Lists).
Federal Agency: U.S. Department of Health and Human Services Federal Program: Consolidated Health Centers Grant AL Number: 93.224 & 93.527 Award Period: 1/1/22 - 12/31/22 Type of Finding: Significant deficiency in Internal Control over Compliance and Compliance Criteria or Specific Requirement Per Title 42 Chapter 1 Subchapter D Section 51c303(f), ?Health centers must have a schedule of fees or payments for the provision of their health services consistent with locally prevailing rates or charges designed to cover their reasonable costs of operation. They are also required to have a corresponding schedule of discounts applied and adjusted on the basis of the patient?s ability to pay.? Condition and Context During our testing of forty sliding fee discounts for health center patients qualifying for reduced charge visits, we identified one visit that received the incorrect sliding fee discount. Effect Potential that a patient would not receive the appropriate sliding fee discount. Questioned Costs None identified. Cause Clerical error in which the incorrect discount was applied due to lack of an oversight process in place. Recommendation We recommend the Organization to review internal controls in regards to the determination, recording, and monitoring of the sliding fee process to ensure that appropriate sliding fee rates/categories are utilized for each sliding fee encounter. Views of Responsible Officials The Organization will implement a procedure to randomly test ten Sliding Fee Discounts per service line monthly to ensure we are applying the correct discounts and the patient is paying the correct discounted amount. The Organization will train staff to test Sliding Fee Discounted visits going forward starting July 1, 2023.