Audit 370709

Finding 2024-001 Noncompliance with Federal and State Reporting Requirements Assistance Listing Numbers 93.224 Health Centers Program 93.527 Affordable Care Act Grants (ACA) for New and Expanded Services Under the Health Center Program Federal Agency U.S. Department of Health and Human Services Passthrough Agency N/A Award Number/Year 2024 Criteria Uniform Guidance requires that entities required to complete a single audit submit a Data Collection Form, schedule of expenditures of federal awards (SEFA) and single audit reports to the Federal Audit Clearinghouse within the earlier of thirty (30) calendar days after receipt of the auditor’s report or nine (9) months after the end of the audit period. Condition FFHC did not submit its Data Collection Form and audited financial statements and SEFA to the Federal Audit Clearinghouse website within nine (9) months of June 30, 2024. Cause This condition was due to FFHC being understaffed within its accounting and finance department resulting in a significant delay in completing the recording of financial transactions, performing account reconciliations and preparing financial reports available for audit. Compliance Findings Finding 2024-001 Noncompliance with Federal and State Reporting Requirements (continued) Effect The effect is that controls over the financial reporting process were weakened thereby increasing the risk that material misstatements could be included in the financial statements without management being aware. Additionally, noncompliance with financial reporting deadlines could cause funding sources for FFHC to delay providing funding for the current fiscal year. Questioned Costs None noted. Repeat Finding Yes. See Finding 2023-003 in the summary schedule of prior audit findings. Recommendation We recommend that management 1) hire personnel within its accounting and finance department so that all defined tasks can be performed in a more timely manner and/or 2) evaluate its current processes to determine how to make them more efficient so that the current personnel within the accounting and finance department are able to complete their tasks in a more timely manner. Views of Responsible Officials and Planned Corrective Actions See corrective action plan.

Finding 2024-002 Material Weakness in Internal Control Over Reporting Assistance Listing Numbers 93.224 Health Center Program 93.527 Affordable Care Act (ACA) for New and Expanded Services Under the Health Center Program Federal Agency U.S. Department of Health and Human Services, Health Resources and Services Administration Passthrough Agency N/A Award Number/Year 2024 Criteria FFHC is responsible for preparing and submitting its annual Universal Report and Federal Financial Reports in a timely manner. Condition For AL No. 93.224, Health Center Program and AL 93.527, Affordable Care Act (ACA) for New and Expanded Services Under the Health Center Program, we noted that the required Universal Report was not submitted by the applicable deadline. Additionally, we noted that two (2) of the four (4) required annual Federal Financial Reports for the grants within these programs were not submitted by applicable deadlines. Cause During fiscal year 2024 FFHC was still in the process of getting its accounting records up to date, resulting in the late completion and submission of the Universal Data Report and Federal Financial Reports for the grants within these programs.Effect FFHC was not in compliance with the Reporting requirements for its federally funded programs as prescribed by Uniform Guidance. Questioned Costs None reported. Repeat Finding Yes. Recommendation We recommend that FFHC enforce its current specific internal control procedures to ensure compliance with applicable federal reporting requirements and ensure that all reports be filed timely in accordance with the federal reporting requirements. Views of Responsible Officials and Planned Corrective Actions See corrective action plan.

Finding 2024-003 Material Weakness in Internal Control Over Special Tests and Provisions Assistance Listing Numbers 93.224 Health Center Program 93.527 Affordable Care Act (ACA) for New and Expanded Services Under the Health Center Program Federal Agency U.S. Department of Health and Human Services, Health Resources and Services Administration Passthrough Agency N/A Award Number/Year 2024Criteria FFHC is responsible for keeping adequate supporting documentation of the calculation of patient service fees for those patients who qualify for discounted fees based on family size and household income. FFHC is also required to apply discounted fees accurately based on an approved sliding fee scale that meets federal compliance requirements. Condition For AL No. 93.224, Health Center Program and AL 93.527, Affordable Care Act (ACA) for New and Expanded Services Under the Health Center Program, we were not able to obtain supporting documentation of the household income for any of the forty (40) patients selected for testing, thus we were not able to recalculate discounted fees in order to determine whether they were in compliance with special tests and provisions for these programs. Cause During fiscal year 2024 sliding scale fees were not properly documented due to the allowance of telehealth visits and limited staff available to collect and maintain proper documentation. Effect FFHC was not in compliance with the Special Tests and Provisions requirements applicable to the Health Center Program and Affordable Care Act (ACA) for New and Expanded Services Under the Health Center Program as prescribed by Uniform Guidance. Questioned Costs None reported. Repeat Finding Yes. See Findings 2023-003, 2022-002 and 2021-003.Recommendation We recommend that FFHC enforce its current policy and related internal control procedures to ensure compliance with the requirement to provide discounted fees based on federally determined poverty levels for fiscal year 2024. Views of Responsible Officials and Planned Corrective Actions See corrective action plan.