FAC Explorer

Audit 407001

FY End
2025-12-31
Total Expended
$4.90M
Findings
2
Programs
6
Organization: Cowlitz Family Health Center (WA)
Year: 2025 Accepted: 2026-07-13
Auditor: APRIO LLP

Organization Exclusion Status:

Findings

ID Ref Severity Repeat Requirement
1223575 2025-001 Material Weakness Yes N
1223576 2025-001 Material Weakness Yes N

Programs

ALN Program Spent Major Findings
93.224 HEALTH CENTER PROGRAM $3.28M Yes 1
10.557 WIC SPECIAL SUPPLEMENTAL NUTRITION PROGRAM FOR WOMEN, INFANTS, AND CHILDREN $769,554 Yes 0
14.239 HOME INVESTMENT PARTNERSHIPS PROGRAM $764,880 Yes 0
93.527 GRANTS FOR NEW AND EXPANDED SERVICES UNDER THE HEALTH CENTER PROGRAM $39,727 Yes 1
93.800 ORGANIZED APPROACHES TO INCREASE COLORECTAL CANCER SCREENING $24,650 Yes 0
93.217 FAMILY PLANNING SERVICES $23,270 Yes 0

Contacts

Name Title Type
K2C9N2M49CP7 Jim Merrill Auditee
3607036701 Jennifer Perrier, CPA Auditor
No contacts on file

Notes to SEFA

The accompanying Schedule of Expenditures of Federal Awards (SEFA) includes all federal grant activity of Cowlitz Family Health Center (the Center) and is presented using the accrual basis of accounting in accordance with accounting principles generally accepted in the Unites States of America. The information in the SEFA 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 SEFA 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 of the Center. Therefore, some amounts presented in the SEFA may differ from amounts presented in, or used in the preparation of, the financial statements. Pass-through identifying numbers are presented when available.
Expenditures reported on the SEFA are recognized following cost principles in Uniform Guidance, wherein certain types of expenditures are not allowable or are limited as to reimbursement.
The Center has elected to not use the de minimis indirect cost rate under the Uniform Guidance.
Certain amounts reported in the accompanying SEFA include pass-through loan proceeds outstanding at December 31, 2025, as follows: Assistance Listing Number Federal Program or Cluster Outstanding Federal Loan Balance 14.239 Home Investment Partnerships Program $764,880

Finding Details

Finding 2025-001
Finding 2025-001 Special Tests and Provisions Significant Deficiency Health Center Program Cluster 93.224, 93.527 U.S. Department of Health and Human Services Federal Award Identification: H80CS00542, with multiple Notice of Awards issued during the year ended December 31, 2025 Federal program: Health Center Program Cluster Assistance listing number: 93.224, 93.527 Federal agency: U.S. Department of Health and Human Services Pass-through entity: Not applicable - direct award Award year: Year ended December 31, 2025 Criteria: Under Section 330 of the Public Health Service Act, health centers must prepare, approve, and consistently apply a sliding fee discount schedule (SFDS), supported by documented income verification, to ensure patient charges are adjusted based on the patient's ability to pay. Condition: During our audit, testing of 40 patient encounters identified 2 instances in which the SFDS was not applied in accordance with established requirements. These instances included the incorrect application of the sliding fee scale and the failure to apply the discount when required. As a result, certain patients were undercharged or overcharged for services received. Context: The control deficiency was identified during audit testing of patient encounters subject to sliding fee discount requirements for the Health Center Program Cluster. Cause: The Center did not consistently execute the internal control procedures designed to ensure proper application of the SFDS. Control activities relied on manual processes without sufficient system validation or supervisory review to detect and correct errors prior to billing. Effect: As a result, patient charges were not consistently calculated in accordance with sliding fee discount requirements. While the instances identified did not result in questioned costs, the deficiency increases the risk of noncompliance with the Special Tests and Provisions requirements, if not corrected timely. Known questioned costs: None. Repeat finding status: This is a new finding for the year ended December 31, 2025. Recommendation: The Center should strengthen controls over the sliding fee discount process by implementing system validations to support accurate SFDS application and performing periodic supervisory reviews to ensure consistent compliance with Section 330 requirements. Views of responsible officials: Management agrees with the finding. The Center has policies and procedures in place and has developed additional processes to ensure compliance.