Reasonable Rent Review Material Weakness U.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT ALN #: 14.267 - Continuum of Care Program Federal Award Identification #: IL0099L5T102215, IL0096L5T102215, IL0178L5T102215, IL0180L5T102215, IL0179L5T102215, IL0216L5T102215, IL0097L5T102215, IL0393L5T102214, IL0374L5T102212, IL0269L5T112215, IL0667L5T102206, IL0667L5T102206 Condition: HAH did not have evidence of performing reasonable rent review for the 22 tenants tested as required by the Department of Housing and Urban Development (HUD). Criteria: 24 CFR 578.49(b)(2), 24 CFR 578.51 (g) Questioned Costs: $0 Context: For all 22 tenants selected as part of the audit testing, HAH did not perform procedures to assess rent reasonableness compared to unassisted units in the same property. While the rents paid did not exceed HUD’s published fair market rents (FMR), this assessment is required to be performed in accordance with program guidelines. Cause: Turnover at HAH. HAH has since transferred their Continuum of Care programs to another HAH and was unable to locate tenant files. Effect: Noncompliance with program requirements. Identification as repeat finding, if applicable: Not applicable. Recommendation: We recommend that HAH make sure that the organization who took over the program maintains the program files for the required record retention period. Views of Responsible Officials and Planned Corrective Action: Management agrees with the finding. See corrective action plan.
Compliance with Cash Management Requirements Material Weakness U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES ALN #: 93.224 - Health Centers Program Federal Award Identification #: 24H80CS00111 Condition: HAH did not minimize the time elapsing between drawdown of funds and expenditure of funds. Criteria: 45 CFR 75.305 Questioned Costs: $0 Context: Beginning in May 2024, HAH drew down approximately $830,000 of advanced funds from HHS, which were not completely expended until September 2024. Cause: Turnover at HAH, who separated from the parent entity in FY24 resulting in changes in procedures. Effect: Excess cash on hand. Identification as repeat finding, if applicable: Not applicable. Recommendation: We recommend HAH review Cash Management compliance requirements and update their policies and procedures to minimize the time between drawdown and expenditures of federal awards. Views of Responsible Officials and Planned Corrective Action: Management agrees with the finding. See corrective action plan.
Inaccurate and Late Reporting Material Weakness U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES ALN #: 93.224 - Health Centers Program and 93.527 - Grants for New and Expanded Services under the Health Center Program Federal Award Identification #: 20H80CS00111, 21H8FCS40976 Condition: During the audit of the Health Centers Program, the SF-425 reporting tested. Reported amounts and totals could not be tied to underlying support. Additionally, two of the SF-425 reports were submitted late. Criteria: 45 CFR Part 75.302(b) Questioned Costs: $0 Context: During the audit, the SF-425 reporting was tested for three grant agreements. Reported amounts could not be tied to underlying support for federal expenditures during the period reported on based on the definitions provided in 45 CFR 75.2 for agreement 20H80CS00111. Additionally, two of the SF-425 reports (agreement 20H80CS00111 and 21H8FCS40976) , between 3-15 days late. Cause: Turnover at HAH, who separated from the parent entity in FY24 resulting in changes in procedures. Effect: Lack of internal control to ensure program requirements Identification as repeat finding, if applicable: Not applicable. Recommendation: We recommend that HAH maintain underlying accounting records for each report. We also recommend that reviews of these reports be implemented to ensure timely submission. Views of Responsible Officials and Planned Corrective Action: Management agrees with the finding. See corrective action plan.
Compliance with Allowable Activities Significant Deficiency U.S DEPARTMENT OF HEALTH AND HUMAN SERVICES ALN #: 93.224 - Health Centers Program and 93.527 - Grants for New and Expanded Services under the Health Center Program Federal Award Identification #: 20H80CS00111, 24H80CS00111, 21H8FCS40976, 23H8GCS47647 Condition: HAH did not retain documentation in support of services provided as part of the Health Centers Program. Criteria: 42 USC 254B Questioned Costs: $0 Context: During the audit, 3 out of 40 patients tested for allowable activities did not have the required documentation for medical services provided. 1 patient did not have a medical service code documented. 2 patients did not have the provider sign off that services were provided and allowable under the grant provisions. Cause: Turnover at HAH, who separated from the parent entity in FY24 resulting in changes in procedures. Effect: Lack of internal control to ensure program requirements are met. Identification as repeat finding, if applicable: Not applicable. Recommendation: We recommend that all required information be documented in patient file. Views of Responsible Officials and Planned Corrective Action: Management agrees with the finding. See corrective action plan.
Federal Procurement Regulations Significant Deficiency U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES ALN #: 93.224 - Health Centers Program and 93.527 - Grants for New and Expanded Services under the Health Center Program Federal Award Identification #: 20H80CS00111, 24H80CS00111, 21H8FCS40976, 23H8GCS47647 Condition: During the Health Centers Program audit, it was noted that HAH did not follow their procurement policies as required by the Uniform Guidance 2 CFR 200.318. Criteria: 2 CFR 200.318 Questioned Costs: $0 Context: During the audit, it was noted that while the majority of program expenditures are salary and benefits, HAH did not follow their policies for procurement for other goods and services, and did not obtain multiple bids or sole source justification for any purchases that exceeded the micro-purchases threshold. Cause: Turnover at HAH, who separated from the parent entity in FY24 resulting in changes in procedures. Effect: Lack of internal control to ensure program requirements Identification as repeat finding, if applicable: Not applicable. Recommendation: We recommend that HAH establish an updated procurement policy and designate an individual to review all purchases over the micro-purchases threshold and review procurement documentation to ensure it is sufficient before expenses are approved for payment. Views of Responsible Officials and Planned Corrective Action: Management agrees with the finding. See corrective action plan.