Cash Management - Lack of Management Oversight over Drawdown
Requests – Material Weakness in Internal Control over Financial Reporting
Criteria
Drawdowns for Federal awards should be properly supported with relevant forms and reports to
substantiate the costs incurred and evidence management review and approval.
Condition and Context
In connection with our cash management testing, the Health Center’s management was able to
provide cost center reports generated from the accounting system which supported the $2,344,620
charged to the health center grants during the year. However, the Health Center was unable to
provide documentation to support individual draws made during the year. Thus, we were unable
to determine that individual draw requests were based on actual costs incurred on an interim basis
throughout the year.
Cause
Significant turnover in the Finance department and the records to support grant drawdowns were
not maintained.
Effect
While we were able to determine that the draws in total for the year were based on actual costs
incurred, the lack of retention of supporting documentation resulted in our inability to specifically
determine that individual draws were properly determined throughout the year. Noncompliance
with laws, rules and regulations could impact the Health Center’s ability to monitor grant
information timely.
Questioned Cost
None.
We recommend that management establish procedures to ensure that documents supporting all
drawdown requests are properly retained. Such requests should also be reviewed and approved
prior to the request being made, with this approval documented and retained.
Views of Responsible Officials and Planned Corrective Action
See corrective action plan.
Reporting - Inadequate System to Ensure Timely Filing and Review of
Required Reports – Material Weakness in Internal Control Over Compliance
Criteria
In accordance with the Uniform Guidance, the audit package and Data Collection Form must be
submitted within 30 days after receipt of the auditors’ report or nine months after the end of the
fiscal year, whichever comes first.
Additionally, in accordance with the grant agreement, the Health Center must submit a final
detailed SF-424A and line-item narrative of both Federal and non-Federal costs incurred for the
completed activities supported with QIA funding within 90 days of the Budget End Date.
Condition and Context
The Data Collection Form for the year ended June 30, 2022, was not submitted to the Federal
Audit Clearinghouse by the due date of March 31, 2023, which is a finding for all federal awards.
The Health Center was unable to locate Form SF-424A and the submission of this report.
Cause
Staff turnover in the Finance Department coupled with inadequate controls to ensure that general
ledger accounts were reconciled properly and in a timely manner throughout the year.
Effect
The Health Center was not in compliance with the requirements of the Uniform Guidance and the
federal awards, which can hamper management’s ability to monitor the federal awards on a timely
basis, fulfilling its responsibilities.
Questioned Costs
None.
Repeat Finding
No.
Recommendation
We recommend that management implement procedures to ensure that all federal reports are filed
by the required due dates. We also recommend that management implement a process of formally
documenting the review and approval of reports prior to submission.
Views of Responsible Officials and Planned Corrective Action
See corrective action plan.
Special Provisions - Inadequate Documentation and Records for
Application of Sliding Fee Discounts – Material Weakness in Internal Control Over Compliance
Criteria
The Health Center is required to apply a sliding fee discount for health services provided to eligible
patients. This sliding fee discount is based on the patient’s ability to pay.
Condition and Context
The Health Center was unable to provide documentation to support the income requirements of
patients and the proper application of the sliding fee discount to patients seen during the year.
Cause
Staff turnover in the Finance Department coupled with inadequate controls to ensure that the
sliding fee discount was properly applied to patient’s based on their eligibility.
Effect
Discounts to patient service fees may have been improperly provided and inaccurate information
may have been used in making management decisions during the year.
Questioned Costs
Amount, if any, could not be determined due to lack of supporting documentation.
Repeat Finding
No.
Recommendation
We recommend that management implement procedures to ensure that the sliding fee discount is
properly applied to patients based on their eligibility. We also recommend that management
implement a process of formal documenting the review and approval of sliding fee discount
eligibility forms. Such forms should also be retained in case needed for future reference purposes.
Views of Responsible Officials and Planned Corrective Action
See corrective action plan.
Allowable Costs - Lack of Management Oversight to Ensure Retention
of Timesheets – Material Weakness in Internal Control Over Compliance
Criteria
In accordance with the Uniform Guidance, the costs charged to federal funds must comply with
the cost principles of 45 CFR Part 75, Subpart E, and any other requirements or restrictions on the
use of federal funding.
Condition and Context
The Health Center was unable to locate timesheets for 5 out of 40 selections for payroll control
testing.
Cause
Staff turnover in the Finance Department coupled with inadequate controls to ensure that the
historical payroll records are maintained.
Effect
Time charges to the federal award may have been improper leading to inaccurate information being
charged through the awards.
Questioned Costs
$21,317.
Repeat Finding
No.
Recommendation
We recommend that management implement procedures to ensure that timesheets and related
approvals are adequately maintained and supported.
Views of Responsible Officials and Planned Corrective Action
See corrective action plan.
Cash Management - Lack of Management Oversight over Drawdown
Requests – Material Weakness in Internal Control over Financial Reporting
Criteria
Drawdowns for Federal awards should be properly supported with relevant forms and reports to
substantiate the costs incurred and evidence management review and approval.
Condition and Context
In connection with our cash management testing, the Health Center’s management was able to
provide cost center reports generated from the accounting system which supported the $2,344,620
charged to the health center grants during the year. However, the Health Center was unable to
provide documentation to support individual draws made during the year. Thus, we were unable
to determine that individual draw requests were based on actual costs incurred on an interim basis
throughout the year.
Cause
Significant turnover in the Finance department and the records to support grant drawdowns were
not maintained.
Effect
While we were able to determine that the draws in total for the year were based on actual costs
incurred, the lack of retention of supporting documentation resulted in our inability to specifically
determine that individual draws were properly determined throughout the year. Noncompliance
with laws, rules and regulations could impact the Health Center’s ability to monitor grant
information timely.
Questioned Cost
None.
We recommend that management establish procedures to ensure that documents supporting all
drawdown requests are properly retained. Such requests should also be reviewed and approved
prior to the request being made, with this approval documented and retained.
Views of Responsible Officials and Planned Corrective Action
See corrective action plan.
Reporting - Inadequate System to Ensure Timely Filing and Review of
Required Reports – Material Weakness in Internal Control Over Compliance
Criteria
In accordance with the Uniform Guidance, the audit package and Data Collection Form must be
submitted within 30 days after receipt of the auditors’ report or nine months after the end of the
fiscal year, whichever comes first.
Additionally, in accordance with the grant agreement, the Health Center must submit a final
detailed SF-424A and line-item narrative of both Federal and non-Federal costs incurred for the
completed activities supported with QIA funding within 90 days of the Budget End Date.
Condition and Context
The Data Collection Form for the year ended June 30, 2022, was not submitted to the Federal
Audit Clearinghouse by the due date of March 31, 2023, which is a finding for all federal awards.
The Health Center was unable to locate Form SF-424A and the submission of this report.
Cause
Staff turnover in the Finance Department coupled with inadequate controls to ensure that general
ledger accounts were reconciled properly and in a timely manner throughout the year.
Effect
The Health Center was not in compliance with the requirements of the Uniform Guidance and the
federal awards, which can hamper management’s ability to monitor the federal awards on a timely
basis, fulfilling its responsibilities.
Questioned Costs
None.
Repeat Finding
No.
Recommendation
We recommend that management implement procedures to ensure that all federal reports are filed
by the required due dates. We also recommend that management implement a process of formally
documenting the review and approval of reports prior to submission.
Views of Responsible Officials and Planned Corrective Action
See corrective action plan.
Special Provisions - Inadequate Documentation and Records for
Application of Sliding Fee Discounts – Material Weakness in Internal Control Over Compliance
Criteria
The Health Center is required to apply a sliding fee discount for health services provided to eligible
patients. This sliding fee discount is based on the patient’s ability to pay.
Condition and Context
The Health Center was unable to provide documentation to support the income requirements of
patients and the proper application of the sliding fee discount to patients seen during the year.
Cause
Staff turnover in the Finance Department coupled with inadequate controls to ensure that the
sliding fee discount was properly applied to patient’s based on their eligibility.
Effect
Discounts to patient service fees may have been improperly provided and inaccurate information
may have been used in making management decisions during the year.
Questioned Costs
Amount, if any, could not be determined due to lack of supporting documentation.
Repeat Finding
No.
Recommendation
We recommend that management implement procedures to ensure that the sliding fee discount is
properly applied to patients based on their eligibility. We also recommend that management
implement a process of formal documenting the review and approval of sliding fee discount
eligibility forms. Such forms should also be retained in case needed for future reference purposes.
Views of Responsible Officials and Planned Corrective Action
See corrective action plan.
Allowable Costs - Lack of Management Oversight to Ensure Retention
of Timesheets – Material Weakness in Internal Control Over Compliance
Criteria
In accordance with the Uniform Guidance, the costs charged to federal funds must comply with
the cost principles of 45 CFR Part 75, Subpart E, and any other requirements or restrictions on the
use of federal funding.
Condition and Context
The Health Center was unable to locate timesheets for 5 out of 40 selections for payroll control
testing.
Cause
Staff turnover in the Finance Department coupled with inadequate controls to ensure that the
historical payroll records are maintained.
Effect
Time charges to the federal award may have been improper leading to inaccurate information being
charged through the awards.
Questioned Costs
$21,317.
Repeat Finding
No.
Recommendation
We recommend that management implement procedures to ensure that timesheets and related
approvals are adequately maintained and supported.
Views of Responsible Officials and Planned Corrective Action
See corrective action plan.
Cash Management - Lack of Management Oversight over Drawdown
Requests – Material Weakness in Internal Control over Financial Reporting
Criteria
Drawdowns for Federal awards should be properly supported with relevant forms and reports to
substantiate the costs incurred and evidence management review and approval.
Condition and Context
In connection with our cash management testing, the Health Center’s management was able to
provide cost center reports generated from the accounting system which supported the $2,344,620
charged to the health center grants during the year. However, the Health Center was unable to
provide documentation to support individual draws made during the year. Thus, we were unable
to determine that individual draw requests were based on actual costs incurred on an interim basis
throughout the year.
Cause
Significant turnover in the Finance department and the records to support grant drawdowns were
not maintained.
Effect
While we were able to determine that the draws in total for the year were based on actual costs
incurred, the lack of retention of supporting documentation resulted in our inability to specifically
determine that individual draws were properly determined throughout the year. Noncompliance
with laws, rules and regulations could impact the Health Center’s ability to monitor grant
information timely.
Questioned Cost
None.
We recommend that management establish procedures to ensure that documents supporting all
drawdown requests are properly retained. Such requests should also be reviewed and approved
prior to the request being made, with this approval documented and retained.
Views of Responsible Officials and Planned Corrective Action
See corrective action plan.
Reporting - Inadequate System to Ensure Timely Filing and Review of
Required Reports – Material Weakness in Internal Control Over Compliance
Criteria
In accordance with the Uniform Guidance, the audit package and Data Collection Form must be
submitted within 30 days after receipt of the auditors’ report or nine months after the end of the
fiscal year, whichever comes first.
Additionally, in accordance with the grant agreement, the Health Center must submit a final
detailed SF-424A and line-item narrative of both Federal and non-Federal costs incurred for the
completed activities supported with QIA funding within 90 days of the Budget End Date.
Condition and Context
The Data Collection Form for the year ended June 30, 2022, was not submitted to the Federal
Audit Clearinghouse by the due date of March 31, 2023, which is a finding for all federal awards.
The Health Center was unable to locate Form SF-424A and the submission of this report.
Cause
Staff turnover in the Finance Department coupled with inadequate controls to ensure that general
ledger accounts were reconciled properly and in a timely manner throughout the year.
Effect
The Health Center was not in compliance with the requirements of the Uniform Guidance and the
federal awards, which can hamper management’s ability to monitor the federal awards on a timely
basis, fulfilling its responsibilities.
Questioned Costs
None.
Repeat Finding
No.
Recommendation
We recommend that management implement procedures to ensure that all federal reports are filed
by the required due dates. We also recommend that management implement a process of formally
documenting the review and approval of reports prior to submission.
Views of Responsible Officials and Planned Corrective Action
See corrective action plan.
Special Provisions - Inadequate Documentation and Records for
Application of Sliding Fee Discounts – Material Weakness in Internal Control Over Compliance
Criteria
The Health Center is required to apply a sliding fee discount for health services provided to eligible
patients. This sliding fee discount is based on the patient’s ability to pay.
Condition and Context
The Health Center was unable to provide documentation to support the income requirements of
patients and the proper application of the sliding fee discount to patients seen during the year.
Cause
Staff turnover in the Finance Department coupled with inadequate controls to ensure that the
sliding fee discount was properly applied to patient’s based on their eligibility.
Effect
Discounts to patient service fees may have been improperly provided and inaccurate information
may have been used in making management decisions during the year.
Questioned Costs
Amount, if any, could not be determined due to lack of supporting documentation.
Repeat Finding
No.
Recommendation
We recommend that management implement procedures to ensure that the sliding fee discount is
properly applied to patients based on their eligibility. We also recommend that management
implement a process of formal documenting the review and approval of sliding fee discount
eligibility forms. Such forms should also be retained in case needed for future reference purposes.
Views of Responsible Officials and Planned Corrective Action
See corrective action plan.
Allowable Costs - Lack of Management Oversight to Ensure Retention
of Timesheets – Material Weakness in Internal Control Over Compliance
Criteria
In accordance with the Uniform Guidance, the costs charged to federal funds must comply with
the cost principles of 45 CFR Part 75, Subpart E, and any other requirements or restrictions on the
use of federal funding.
Condition and Context
The Health Center was unable to locate timesheets for 5 out of 40 selections for payroll control
testing.
Cause
Staff turnover in the Finance Department coupled with inadequate controls to ensure that the
historical payroll records are maintained.
Effect
Time charges to the federal award may have been improper leading to inaccurate information being
charged through the awards.
Questioned Costs
$21,317.
Repeat Finding
No.
Recommendation
We recommend that management implement procedures to ensure that timesheets and related
approvals are adequately maintained and supported.
Views of Responsible Officials and Planned Corrective Action
See corrective action plan.
Cash Management - Lack of Management Oversight over Drawdown
Requests – Material Weakness in Internal Control over Financial Reporting
Criteria
Drawdowns for Federal awards should be properly supported with relevant forms and reports to
substantiate the costs incurred and evidence management review and approval.
Condition and Context
In connection with our cash management testing, the Health Center’s management was able to
provide cost center reports generated from the accounting system which supported the $2,344,620
charged to the health center grants during the year. However, the Health Center was unable to
provide documentation to support individual draws made during the year. Thus, we were unable
to determine that individual draw requests were based on actual costs incurred on an interim basis
throughout the year.
Cause
Significant turnover in the Finance department and the records to support grant drawdowns were
not maintained.
Effect
While we were able to determine that the draws in total for the year were based on actual costs
incurred, the lack of retention of supporting documentation resulted in our inability to specifically
determine that individual draws were properly determined throughout the year. Noncompliance
with laws, rules and regulations could impact the Health Center’s ability to monitor grant
information timely.
Questioned Cost
None.
We recommend that management establish procedures to ensure that documents supporting all
drawdown requests are properly retained. Such requests should also be reviewed and approved
prior to the request being made, with this approval documented and retained.
Views of Responsible Officials and Planned Corrective Action
See corrective action plan.
Reporting - Inadequate System to Ensure Timely Filing and Review of
Required Reports – Material Weakness in Internal Control Over Compliance
Criteria
In accordance with the Uniform Guidance, the audit package and Data Collection Form must be
submitted within 30 days after receipt of the auditors’ report or nine months after the end of the
fiscal year, whichever comes first.
Additionally, in accordance with the grant agreement, the Health Center must submit a final
detailed SF-424A and line-item narrative of both Federal and non-Federal costs incurred for the
completed activities supported with QIA funding within 90 days of the Budget End Date.
Condition and Context
The Data Collection Form for the year ended June 30, 2022, was not submitted to the Federal
Audit Clearinghouse by the due date of March 31, 2023, which is a finding for all federal awards.
The Health Center was unable to locate Form SF-424A and the submission of this report.
Cause
Staff turnover in the Finance Department coupled with inadequate controls to ensure that general
ledger accounts were reconciled properly and in a timely manner throughout the year.
Effect
The Health Center was not in compliance with the requirements of the Uniform Guidance and the
federal awards, which can hamper management’s ability to monitor the federal awards on a timely
basis, fulfilling its responsibilities.
Questioned Costs
None.
Repeat Finding
No.
Recommendation
We recommend that management implement procedures to ensure that all federal reports are filed
by the required due dates. We also recommend that management implement a process of formally
documenting the review and approval of reports prior to submission.
Views of Responsible Officials and Planned Corrective Action
See corrective action plan.
Special Provisions - Inadequate Documentation and Records for
Application of Sliding Fee Discounts – Material Weakness in Internal Control Over Compliance
Criteria
The Health Center is required to apply a sliding fee discount for health services provided to eligible
patients. This sliding fee discount is based on the patient’s ability to pay.
Condition and Context
The Health Center was unable to provide documentation to support the income requirements of
patients and the proper application of the sliding fee discount to patients seen during the year.
Cause
Staff turnover in the Finance Department coupled with inadequate controls to ensure that the
sliding fee discount was properly applied to patient’s based on their eligibility.
Effect
Discounts to patient service fees may have been improperly provided and inaccurate information
may have been used in making management decisions during the year.
Questioned Costs
Amount, if any, could not be determined due to lack of supporting documentation.
Repeat Finding
No.
Recommendation
We recommend that management implement procedures to ensure that the sliding fee discount is
properly applied to patients based on their eligibility. We also recommend that management
implement a process of formal documenting the review and approval of sliding fee discount
eligibility forms. Such forms should also be retained in case needed for future reference purposes.
Views of Responsible Officials and Planned Corrective Action
See corrective action plan.
Allowable Costs - Lack of Management Oversight to Ensure Retention
of Timesheets – Material Weakness in Internal Control Over Compliance
Criteria
In accordance with the Uniform Guidance, the costs charged to federal funds must comply with
the cost principles of 45 CFR Part 75, Subpart E, and any other requirements or restrictions on the
use of federal funding.
Condition and Context
The Health Center was unable to locate timesheets for 5 out of 40 selections for payroll control
testing.
Cause
Staff turnover in the Finance Department coupled with inadequate controls to ensure that the
historical payroll records are maintained.
Effect
Time charges to the federal award may have been improper leading to inaccurate information being
charged through the awards.
Questioned Costs
$21,317.
Repeat Finding
No.
Recommendation
We recommend that management implement procedures to ensure that timesheets and related
approvals are adequately maintained and supported.
Views of Responsible Officials and Planned Corrective Action
See corrective action plan.
Cash Management - Lack of Management Oversight over Drawdown
Requests – Material Weakness in Internal Control over Financial Reporting
Criteria
Drawdowns for Federal awards should be properly supported with relevant forms and reports to
substantiate the costs incurred and evidence management review and approval.
Condition and Context
In connection with our cash management testing, the Health Center’s management was able to
provide cost center reports generated from the accounting system which supported the $2,344,620
charged to the health center grants during the year. However, the Health Center was unable to
provide documentation to support individual draws made during the year. Thus, we were unable
to determine that individual draw requests were based on actual costs incurred on an interim basis
throughout the year.
Cause
Significant turnover in the Finance department and the records to support grant drawdowns were
not maintained.
Effect
While we were able to determine that the draws in total for the year were based on actual costs
incurred, the lack of retention of supporting documentation resulted in our inability to specifically
determine that individual draws were properly determined throughout the year. Noncompliance
with laws, rules and regulations could impact the Health Center’s ability to monitor grant
information timely.
Questioned Cost
None.
We recommend that management establish procedures to ensure that documents supporting all
drawdown requests are properly retained. Such requests should also be reviewed and approved
prior to the request being made, with this approval documented and retained.
Views of Responsible Officials and Planned Corrective Action
See corrective action plan.
Reporting - Inadequate System to Ensure Timely Filing and Review of
Required Reports – Material Weakness in Internal Control Over Compliance
Criteria
In accordance with the Uniform Guidance, the audit package and Data Collection Form must be
submitted within 30 days after receipt of the auditors’ report or nine months after the end of the
fiscal year, whichever comes first.
Additionally, in accordance with the grant agreement, the Health Center must submit a final
detailed SF-424A and line-item narrative of both Federal and non-Federal costs incurred for the
completed activities supported with QIA funding within 90 days of the Budget End Date.
Condition and Context
The Data Collection Form for the year ended June 30, 2022, was not submitted to the Federal
Audit Clearinghouse by the due date of March 31, 2023, which is a finding for all federal awards.
The Health Center was unable to locate Form SF-424A and the submission of this report.
Cause
Staff turnover in the Finance Department coupled with inadequate controls to ensure that general
ledger accounts were reconciled properly and in a timely manner throughout the year.
Effect
The Health Center was not in compliance with the requirements of the Uniform Guidance and the
federal awards, which can hamper management’s ability to monitor the federal awards on a timely
basis, fulfilling its responsibilities.
Questioned Costs
None.
Repeat Finding
No.
Recommendation
We recommend that management implement procedures to ensure that all federal reports are filed
by the required due dates. We also recommend that management implement a process of formally
documenting the review and approval of reports prior to submission.
Views of Responsible Officials and Planned Corrective Action
See corrective action plan.
Special Provisions - Inadequate Documentation and Records for
Application of Sliding Fee Discounts – Material Weakness in Internal Control Over Compliance
Criteria
The Health Center is required to apply a sliding fee discount for health services provided to eligible
patients. This sliding fee discount is based on the patient’s ability to pay.
Condition and Context
The Health Center was unable to provide documentation to support the income requirements of
patients and the proper application of the sliding fee discount to patients seen during the year.
Cause
Staff turnover in the Finance Department coupled with inadequate controls to ensure that the
sliding fee discount was properly applied to patient’s based on their eligibility.
Effect
Discounts to patient service fees may have been improperly provided and inaccurate information
may have been used in making management decisions during the year.
Questioned Costs
Amount, if any, could not be determined due to lack of supporting documentation.
Repeat Finding
No.
Recommendation
We recommend that management implement procedures to ensure that the sliding fee discount is
properly applied to patients based on their eligibility. We also recommend that management
implement a process of formal documenting the review and approval of sliding fee discount
eligibility forms. Such forms should also be retained in case needed for future reference purposes.
Views of Responsible Officials and Planned Corrective Action
See corrective action plan.
Allowable Costs - Lack of Management Oversight to Ensure Retention
of Timesheets – Material Weakness in Internal Control Over Compliance
Criteria
In accordance with the Uniform Guidance, the costs charged to federal funds must comply with
the cost principles of 45 CFR Part 75, Subpart E, and any other requirements or restrictions on the
use of federal funding.
Condition and Context
The Health Center was unable to locate timesheets for 5 out of 40 selections for payroll control
testing.
Cause
Staff turnover in the Finance Department coupled with inadequate controls to ensure that the
historical payroll records are maintained.
Effect
Time charges to the federal award may have been improper leading to inaccurate information being
charged through the awards.
Questioned Costs
$21,317.
Repeat Finding
No.
Recommendation
We recommend that management implement procedures to ensure that timesheets and related
approvals are adequately maintained and supported.
Views of Responsible Officials and Planned Corrective Action
See corrective action plan.
Cash Management - Lack of Management Oversight over Drawdown
Requests – Material Weakness in Internal Control over Financial Reporting
Criteria
Drawdowns for Federal awards should be properly supported with relevant forms and reports to
substantiate the costs incurred and evidence management review and approval.
Condition and Context
In connection with our cash management testing, the Health Center’s management was able to
provide cost center reports generated from the accounting system which supported the $2,344,620
charged to the health center grants during the year. However, the Health Center was unable to
provide documentation to support individual draws made during the year. Thus, we were unable
to determine that individual draw requests were based on actual costs incurred on an interim basis
throughout the year.
Cause
Significant turnover in the Finance department and the records to support grant drawdowns were
not maintained.
Effect
While we were able to determine that the draws in total for the year were based on actual costs
incurred, the lack of retention of supporting documentation resulted in our inability to specifically
determine that individual draws were properly determined throughout the year. Noncompliance
with laws, rules and regulations could impact the Health Center’s ability to monitor grant
information timely.
Questioned Cost
None.
We recommend that management establish procedures to ensure that documents supporting all
drawdown requests are properly retained. Such requests should also be reviewed and approved
prior to the request being made, with this approval documented and retained.
Views of Responsible Officials and Planned Corrective Action
See corrective action plan.
Reporting - Inadequate System to Ensure Timely Filing and Review of
Required Reports – Material Weakness in Internal Control Over Compliance
Criteria
In accordance with the Uniform Guidance, the audit package and Data Collection Form must be
submitted within 30 days after receipt of the auditors’ report or nine months after the end of the
fiscal year, whichever comes first.
Additionally, in accordance with the grant agreement, the Health Center must submit a final
detailed SF-424A and line-item narrative of both Federal and non-Federal costs incurred for the
completed activities supported with QIA funding within 90 days of the Budget End Date.
Condition and Context
The Data Collection Form for the year ended June 30, 2022, was not submitted to the Federal
Audit Clearinghouse by the due date of March 31, 2023, which is a finding for all federal awards.
The Health Center was unable to locate Form SF-424A and the submission of this report.
Cause
Staff turnover in the Finance Department coupled with inadequate controls to ensure that general
ledger accounts were reconciled properly and in a timely manner throughout the year.
Effect
The Health Center was not in compliance with the requirements of the Uniform Guidance and the
federal awards, which can hamper management’s ability to monitor the federal awards on a timely
basis, fulfilling its responsibilities.
Questioned Costs
None.
Repeat Finding
No.
Recommendation
We recommend that management implement procedures to ensure that all federal reports are filed
by the required due dates. We also recommend that management implement a process of formally
documenting the review and approval of reports prior to submission.
Views of Responsible Officials and Planned Corrective Action
See corrective action plan.
Special Provisions - Inadequate Documentation and Records for
Application of Sliding Fee Discounts – Material Weakness in Internal Control Over Compliance
Criteria
The Health Center is required to apply a sliding fee discount for health services provided to eligible
patients. This sliding fee discount is based on the patient’s ability to pay.
Condition and Context
The Health Center was unable to provide documentation to support the income requirements of
patients and the proper application of the sliding fee discount to patients seen during the year.
Cause
Staff turnover in the Finance Department coupled with inadequate controls to ensure that the
sliding fee discount was properly applied to patient’s based on their eligibility.
Effect
Discounts to patient service fees may have been improperly provided and inaccurate information
may have been used in making management decisions during the year.
Questioned Costs
Amount, if any, could not be determined due to lack of supporting documentation.
Repeat Finding
No.
Recommendation
We recommend that management implement procedures to ensure that the sliding fee discount is
properly applied to patients based on their eligibility. We also recommend that management
implement a process of formal documenting the review and approval of sliding fee discount
eligibility forms. Such forms should also be retained in case needed for future reference purposes.
Views of Responsible Officials and Planned Corrective Action
See corrective action plan.
Allowable Costs - Lack of Management Oversight to Ensure Retention
of Timesheets – Material Weakness in Internal Control Over Compliance
Criteria
In accordance with the Uniform Guidance, the costs charged to federal funds must comply with
the cost principles of 45 CFR Part 75, Subpart E, and any other requirements or restrictions on the
use of federal funding.
Condition and Context
The Health Center was unable to locate timesheets for 5 out of 40 selections for payroll control
testing.
Cause
Staff turnover in the Finance Department coupled with inadequate controls to ensure that the
historical payroll records are maintained.
Effect
Time charges to the federal award may have been improper leading to inaccurate information being
charged through the awards.
Questioned Costs
$21,317.
Repeat Finding
No.
Recommendation
We recommend that management implement procedures to ensure that timesheets and related
approvals are adequately maintained and supported.
Views of Responsible Officials and Planned Corrective Action
See corrective action plan.