FAC Explorer

Audit 40020

FY End
2022-12-31
Total Expended
$24.06M
Findings
2
Programs
9
Organization: North County Health Project, Inc. D/b/a Truecare (CA)
Year: 2022 Accepted: 2023-05-23
Auditor: Chw LLP

Organization Exclusion Status:

Findings

ID Ref Severity Repeat Requirement
42529 2022-001 Significant Deficiency - N
618971 2022-001 Significant Deficiency - N

Programs

ALN Program Spent Major Findings
93.498 Provider Relief Fund $2.80M Yes 0
14.218 Community Development Block Grants/entitlement Grants $712,105 - 0
93.526 Affordable Care Act (aca) Grants for Capital Development in Health Centers $691,887 - 0
93.224 Consolidated Health Centers (community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care) $88,127 Yes 0
93.767 Children's Health Insurance Program $79,216 - 0
93.243 Substance Abuse and Mental Health Services_projects of Regional and National Significance $71,152 - 0
10.561 State Administrative Matching Grants for the Supplemental Nutrition Assistance Program $41,122 - 0
10.557 Special Supplemental Nutrition Program for Women, Infants, and Children $37,123 - 0
93.527 Affordable Care Act (aca) Grants for New and Expanded Services Under the Health Center Program $13,907 Yes 0

Contacts

Name Title Type
MW2CMZYLRSZ1 Kathy Martinez Auditee
7607366761 Robert Church Auditor
No contacts on file

Notes to SEFA

Title: Loan/loan guarantee outstanding balances Accounting Policies: Note B: Summary of Significant Accounting PoliciesExpenditures reported on the Schedule are reported on the accrual basis of accounting. For ALN 93.498, the amount included on the Schedule is based on the Period 3 and Period 4 PRF report. 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. The Center elected not to use the de minimis cost rate because it has a negotiated indirect cost rate in place. De Minimis Rate Used: N Rate Explanation: The auditee did not use the de minimis cost rate. COMMUNITY DEVELOPMENT BLOCK GRANTS/ENTITLEMENT GRANTS (14.218) - Balances outstanding at the end of the audit period were 656967. The Center entered into a loan agreement with the City of Carlsbad on February 15, 2012 in the amount of $1,130,000. These funds were allocated from a Community Block Development Grant (CDBG) as a no interest, deferred, and forgivable loan to be used for the acquisition of property for a health center to serve low income households. The loan has a term of 20 years and is forgivable upon the expiration of the term of the loan if the property has been maintained and operated as a health center consistent with the conditions of the loan. The balance as of December 31, 2022 was $656,967.
Title: Basis of Presentation Accounting Policies: Note B: Summary of Significant Accounting PoliciesExpenditures reported on the Schedule are reported on the accrual basis of accounting. For ALN 93.498, the amount included on the Schedule is based on the Period 3 and Period 4 PRF report. 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. The Center elected not to use the de minimis cost rate because it has a negotiated indirect cost rate in place. De Minimis Rate Used: N Rate Explanation: The auditee did not use the de minimis cost rate. The accompanying Schedule of Expenditures of Federal Awards (the Schedule) summarizes the expenditures of North County Health Project, Inc., d/b/a TrueCare (the Center) under programs of the federal government for the year ended December 31, 2022. The information in this Schedule is presented in accordance with the requirements of Title 2 U.S. Code of Federal Regulations 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 the Center, it is not intended to, and does not, present the financial position, changes in net assets, or cash flows for the Center.

Finding Details

Finding 2022-001
2022-001 Sliding Fee Discount Determination ALN: 93.224 Program: Health Center Program Cluster Agency: US Department of Health and Human Services Compliance Requirement: N- Special Tests and Provisions Repeat Finding: No Criteria: Federal grant compliance provisions require that the Center correctly identify a patient's ability to pay and that the rates for services be adjusted accordingly based on the sliding fee schedule. The Center is required to follow its sliding fee policy when providing discounts to eligible patients. Finding/ Condition: In the sample of 40 tested items, patient information was inadequate to determine the proper sliding fee discount or the patient was given an innapropriate discount based on information provided. Questioned Cost: None. Effect: Lack of strict enforcement of the policy of sliding fee eligibility determination and compliance may have resulted in the Center providing incorrect discounts for services provided. Cause: There was inadequate understanding and inconsistent handling of the documentation requirements of the sliding fee discount program policies and procedures by certain employees who were involved in sliding fee discount determination. Recommendation: Training should be provided to employees on the sliding fee program requirements. The Center should perform regular audits of sliding fee transactions to identify weaknesses in compliance. Views of Responsible Officials and Corrective Action Plan: The Center agrees with the finding and will implement additional controls to ensure that this does not recur. Please refer to the corrective action plan on page 34.
Finding 2022-001
2022-001 Sliding Fee Discount Determination ALN: 93.224 Program: Health Center Program Cluster Agency: US Department of Health and Human Services Compliance Requirement: N- Special Tests and Provisions Repeat Finding: No Criteria: Federal grant compliance provisions require that the Center correctly identify a patient's ability to pay and that the rates for services be adjusted accordingly based on the sliding fee schedule. The Center is required to follow its sliding fee policy when providing discounts to eligible patients. Finding/ Condition: In the sample of 40 tested items, patient information was inadequate to determine the proper sliding fee discount or the patient was given an innapropriate discount based on information provided. Questioned Cost: None. Effect: Lack of strict enforcement of the policy of sliding fee eligibility determination and compliance may have resulted in the Center providing incorrect discounts for services provided. Cause: There was inadequate understanding and inconsistent handling of the documentation requirements of the sliding fee discount program policies and procedures by certain employees who were involved in sliding fee discount determination. Recommendation: Training should be provided to employees on the sliding fee program requirements. The Center should perform regular audits of sliding fee transactions to identify weaknesses in compliance. Views of Responsible Officials and Corrective Action Plan: The Center agrees with the finding and will implement additional controls to ensure that this does not recur. Please refer to the corrective action plan on page 34.