Audit 392189

FY End
2024-12-31
Total Expended
$7.66M
Findings
1
Programs
9
Year: 2024 Accepted: 2026-03-16

Organization Exclusion Status:

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Contacts

Name Title Type
K38VK6M92M21 Ken Kosowicz Auditee
9032340776 Adrienne Deason Auditor
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Notes to SEFA

The accompanying schedule of expenditures of federal awards (Schedule) includes the federal award activity of Special Health Resources for Texas, Inc. under programs of the federal government for the year ended December 31, 2024. The Organization’s reporting entity is defined in Note 1 to the Organization’s basic financial statements. Federal awards received directly from federal agencies as well as federal awards passed through other government agencies are included on the Schedule.
The accompanying schedule of expenditures of federal awards is presented using the accrual basis of accounting. The information in this Schedule is presented in accordance with the requirements of Title 2 U.S. Code of Federal Regulations (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 Special Health Resources for Texas, Inc., it is not intended to and does not present the financial position, changes in net assets, or cash flows of Special Health Resources for Texas, Inc.
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.
For indirect costs, the amounts expended are claimed as an indirect cost recovery using an approved cost allocation plan. The Organization has not elected to use the 10-percent de minimis indirect cost rate allowed under the Uniform Guidance.
Subsequent to the financial statements being issued, the Organization identified an error in the reporting of certain federal and state awards. The schedule of expenditures of federal and state awards has been adjusted to restate the Block Grant for HIV Prevention (AL# 93.940) which was passed through from the Texas Department of State Health Services. Of the originally reported federal expenditure of $390,870, only $24,524 was attributed to federal funding. The remaining expenditures were reclassified as state expenditures directly from the Texas Department of State Health Services. It was further discovered that the Organization mistakenly reported, as state expenditures, a private grant from the Episcopal Health Foundation on the schedule of expenditures of federal and state awards in the amount of $518,441. As a result, total federal and state awards decreased $518,417.

Finding Details

Grantee health centers must prepare and apply a sliding fee discount schedule so that the amounts owed for health center services by eligible patients are adjusted (discounted) based on the patient's ability to pay. The Organization adopted a Sliding Fee Discount Schedule based on current Federal poverty guidelines; however, they failed to consistently document the patient's assessment for the discount and retain thepatient's application. 9 out of 25 patients tested (36%) did not have documentation of the sliding fee discount assessment. We were unable to determine whether the sliding fee discount was properly applied to these patients. The effect is reportable non-compliance with the Special Tests compliance requirement for this grant. Further, the Organization has a significant deficiency in internal controls over compliance. The Organization's internal control over compliance was properly designed to ensure patients were assessed for ability to pay; however, it was not operating effectively during the period under audit.