FAC Explorer

Audit 316037

FY End
2023-06-30
Total Expended
$8.66M
Findings
6
Programs
13
Organization: Christian Community Health Center (IL)
Year: 2023 Accepted: 2024-07-26
Auditor: Capincrouse LLP

Organization Exclusion Status:

Findings

ID Ref Severity Repeat Requirement
479513 2023-003 Material Weakness Yes N
479514 2023-004 - Yes L
479515 2023-004 - Yes L
1055955 2023-003 Material Weakness Yes N
1055956 2023-004 - Yes L
1055957 2023-004 - Yes L

Programs

ALN Program Spent Major Findings
93.224 Consolidated Health Centers (community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care) $3.00M Yes 2
93.224 Covid-19 Consolidated Health Centers (community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care) $1.01M Yes 1
93.526 Covid-19 Affordable Care Act (aca) Grants for Capital Development in Health Centers $384,215 - 0
93.918 Grants to Provide Outpatient Early Intervention Services with Respect to Hiv Disease $302,459 - 0
14.241 Housing Opportunities for Persons with Aids $149,480 - 0
93.323 Epidemiology and Laboratory Capacity for Infectious Diseases (elc) $104,410 - 0
93.243 Substance Abuse and Mental Health Services_projects of Regional and National Significance $100,278 - 0
93.917 Hiv Care Formula Grants $99,455 - 0
14.267 Continuum of Care Program $66,715 Yes 0
14.218 Community Development Block Grants/entitlement Grants $51,724 - 0
14.231 Covid-19 Emergency Solutions Grant Program $40,888 - 0
93.914 Hiv Emergency Relief Project Grants $11,680 - 0
93.493 Community Project Funding/congressional Directives- Construction $9,345 - 0

Contacts

Name Title Type
UUVSU7NZ18E5 L. Renee Wallace, CPA Auditee
7732334100 Julie Adams, CPA Auditor
No contacts on file

Notes to SEFA

Title: RELATIONSHIP TO FINANCIAL STATEMENTS Accounting Policies: The accompanying schedule of expenditures of federal awards (the schedule) includes the federal grant activity of Christian Community Health Center under programs of the federal government for the year ended June 30, 2023. The information in the schedule is presented in accordance with the requirements of the Title 2 U.S. Code of Federal Regulations Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (Uniform Guidance). Therefore, some amounts presented in the schedule may differ from amounts presented in, or used in the preparation of, the basic financial statements. Expenditures in 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. If Christian Community Health Center is required to match certain federal assistance, as defined by the grant agreements, no such matching has been included as expenditures in the schedule. De Minimis Rate Used: N Rate Explanation: The auditee did not use the de minimis cost rate. See the Notes to the SEFA for chart/table.
Title: SUBRECIPIENTS, NON-CASH ASSISTANCE, FEDERAL INSURANCE, LOANS, AND LOAN GUARANTEES Accounting Policies: The accompanying schedule of expenditures of federal awards (the schedule) includes the federal grant activity of Christian Community Health Center under programs of the federal government for the year ended June 30, 2023. The information in the schedule is presented in accordance with the requirements of the Title 2 U.S. Code of Federal Regulations Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (Uniform Guidance). Therefore, some amounts presented in the schedule may differ from amounts presented in, or used in the preparation of, the basic financial statements. Expenditures in 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. If Christian Community Health Center is required to match certain federal assistance, as defined by the grant agreements, no such matching has been included as expenditures in the schedule. De Minimis Rate Used: N Rate Explanation: The auditee did not use the de minimis cost rate. Christian Community Health Center did not provide any federal funds to subrecipients nor did they receive any federal non-cash assistance, insurance, loans, or loan guarantees.

Finding Details

Finding 2023-003
Sliding Scale Assessment Material Weakness U.S. Department of Health and Human Services ALN #: 93.224 Federal Award Identification #: H80CS00594 Condition: The sliding scale assessment and approval based on the patient’s ability to pay was not always accurately performed or applied. Criteria: 42 CFR Part 51c.303 (f) Questioned Costs: $0 Context: For 5 out of 25 patients tested, Christian Community Health Center incorrectly calculated and applied the sliding scale fee discount based on the published HHS poverty guidelines. Additionally, 2 of those patients did not have documented approval of the sliding fee discount. For another patient, the assessment was correctly made but they did not charge the patient the correct sliding scale fee. Cause: Management oversight, challenges in the system with pulling from the correct poverty guidelines. It appears that vendor for the electronic record system has not updated the poverty tables appropriately. Effect: Non-compliance with federal regulations. Identification as repeat finding, if applicable: 2022-005 Recommendation: We recommend that management review the system to ensure it is pulling the correct poverty guidelines. We also recommend a periodic secondary review be completed to ensure accuracy of sliding scale assessment and that supervisory approval is documented. Views of Responsible Officials and Planned Corrective Action: Management agrees with the finding. See corrective action plan.
Finding 2023-004
SF-425 Federal Financial Report (FFR) Reporting U.S. Department of Health and Human Services ALN #: 93.224 Federal Award Identification #: H80CS00594, H8FCS40676 Condition: Support for annual SF-425 Federal Financial Report (FFR) submitted for the grant periods ending 2/28/23 and 3/31/23 were not submitted timely. Additionally, for grant H80CS00594, Christian Community Health Center also did not indicate their intention of carrying the funds forward to the next budget period in the remarks section of the report. Criteria: 45 CFR Part 75.302(b), 45 CFR Part 75.308 (d) Questioned Costs: $0 Context: The cumulative authorized amounts and H80CS00594 grant funds drawn reported $1,989,278 in unobligated funds for the budget period ending February 28, 2023. Additionally, both reports were submitted past the 90 day deadline. Cause: Turnover in staffing. Effect: Noncompliance with federal requirements. Potential loss of unobligated funds for the next budget period. Identification as repeat finding, if applicable: 2022-006 Recommendation: We recommend Christian Community Health Center put procedures in place to submit reports timely and always include their intention in the annual FFR to carry forward unused funds from one budget period to the next when formal approval is not required. Views of Responsible Officials and Planned Corrective Action: Management agrees with the finding. See corrective action plan.
Finding 2023-004
SF-425 Federal Financial Report (FFR) Reporting U.S. Department of Health and Human Services ALN #: 93.224 Federal Award Identification #: H80CS00594, H8FCS40676 Condition: Support for annual SF-425 Federal Financial Report (FFR) submitted for the grant periods ending 2/28/23 and 3/31/23 were not submitted timely. Additionally, for grant H80CS00594, Christian Community Health Center also did not indicate their intention of carrying the funds forward to the next budget period in the remarks section of the report. Criteria: 45 CFR Part 75.302(b), 45 CFR Part 75.308 (d) Questioned Costs: $0 Context: The cumulative authorized amounts and H80CS00594 grant funds drawn reported $1,989,278 in unobligated funds for the budget period ending February 28, 2023. Additionally, both reports were submitted past the 90 day deadline. Cause: Turnover in staffing. Effect: Noncompliance with federal requirements. Potential loss of unobligated funds for the next budget period. Identification as repeat finding, if applicable: 2022-006 Recommendation: We recommend Christian Community Health Center put procedures in place to submit reports timely and always include their intention in the annual FFR to carry forward unused funds from one budget period to the next when formal approval is not required. Views of Responsible Officials and Planned Corrective Action: Management agrees with the finding. See corrective action plan.
Finding 2023-003
Sliding Scale Assessment Material Weakness U.S. Department of Health and Human Services ALN #: 93.224 Federal Award Identification #: H80CS00594 Condition: The sliding scale assessment and approval based on the patient’s ability to pay was not always accurately performed or applied. Criteria: 42 CFR Part 51c.303 (f) Questioned Costs: $0 Context: For 5 out of 25 patients tested, Christian Community Health Center incorrectly calculated and applied the sliding scale fee discount based on the published HHS poverty guidelines. Additionally, 2 of those patients did not have documented approval of the sliding fee discount. For another patient, the assessment was correctly made but they did not charge the patient the correct sliding scale fee. Cause: Management oversight, challenges in the system with pulling from the correct poverty guidelines. It appears that vendor for the electronic record system has not updated the poverty tables appropriately. Effect: Non-compliance with federal regulations. Identification as repeat finding, if applicable: 2022-005 Recommendation: We recommend that management review the system to ensure it is pulling the correct poverty guidelines. We also recommend a periodic secondary review be completed to ensure accuracy of sliding scale assessment and that supervisory approval is documented. Views of Responsible Officials and Planned Corrective Action: Management agrees with the finding. See corrective action plan.
Finding 2023-004
SF-425 Federal Financial Report (FFR) Reporting U.S. Department of Health and Human Services ALN #: 93.224 Federal Award Identification #: H80CS00594, H8FCS40676 Condition: Support for annual SF-425 Federal Financial Report (FFR) submitted for the grant periods ending 2/28/23 and 3/31/23 were not submitted timely. Additionally, for grant H80CS00594, Christian Community Health Center also did not indicate their intention of carrying the funds forward to the next budget period in the remarks section of the report. Criteria: 45 CFR Part 75.302(b), 45 CFR Part 75.308 (d) Questioned Costs: $0 Context: The cumulative authorized amounts and H80CS00594 grant funds drawn reported $1,989,278 in unobligated funds for the budget period ending February 28, 2023. Additionally, both reports were submitted past the 90 day deadline. Cause: Turnover in staffing. Effect: Noncompliance with federal requirements. Potential loss of unobligated funds for the next budget period. Identification as repeat finding, if applicable: 2022-006 Recommendation: We recommend Christian Community Health Center put procedures in place to submit reports timely and always include their intention in the annual FFR to carry forward unused funds from one budget period to the next when formal approval is not required. Views of Responsible Officials and Planned Corrective Action: Management agrees with the finding. See corrective action plan.
Finding 2023-004
SF-425 Federal Financial Report (FFR) Reporting U.S. Department of Health and Human Services ALN #: 93.224 Federal Award Identification #: H80CS00594, H8FCS40676 Condition: Support for annual SF-425 Federal Financial Report (FFR) submitted for the grant periods ending 2/28/23 and 3/31/23 were not submitted timely. Additionally, for grant H80CS00594, Christian Community Health Center also did not indicate their intention of carrying the funds forward to the next budget period in the remarks section of the report. Criteria: 45 CFR Part 75.302(b), 45 CFR Part 75.308 (d) Questioned Costs: $0 Context: The cumulative authorized amounts and H80CS00594 grant funds drawn reported $1,989,278 in unobligated funds for the budget period ending February 28, 2023. Additionally, both reports were submitted past the 90 day deadline. Cause: Turnover in staffing. Effect: Noncompliance with federal requirements. Potential loss of unobligated funds for the next budget period. Identification as repeat finding, if applicable: 2022-006 Recommendation: We recommend Christian Community Health Center put procedures in place to submit reports timely and always include their intention in the annual FFR to carry forward unused funds from one budget period to the next when formal approval is not required. Views of Responsible Officials and Planned Corrective Action: Management agrees with the finding. See corrective action plan.