Audit 407278

2026-101 Special Tests and Provisions - Sliding Fee Scale Discounts Federal program: Health Center Program Cluster / FAL 93.224 Health Center Program U.S. Department of Health and Human Services Federal grant number H80CS00416 Questioned costs: not applicable Criteria: Patients applying for sliding fee scale (SFS) discounts should have their income levels adequately documented and accurately calculated, and patients should be given the proper discount based upon their income level in accordance with 42 CFR Section 51c.303(f). Condition: The Center requires patients that apply for the SFS discount to complete attestation forms that includes their household sizes and income levels, and these forms are then used to determine patients' SFS discounts. One patient attestation form out of forty SFS patient encounters that we tested reflected an incorrect SFS discount. Cause: Unknown Effect: Due to incorrect attestation forms, we could not determine whether the Center consistently provided patients with the proper discount based upon their income levels. Recommendation: To help ensure that SFS discounts are properly calculated and documented, the Center should perform random reviews of its SFS applications in order to detect and correct errors or incomplete applications on a timely basis.

2026-102: Allowability of Costs / Internal Controls over Payroll Federal program:Health Center Program Cluster / FAL 93.224 Health Center Program U.S. Department of Health and Human Services Federal grant number H80CS00416 Questioned costs: Unknown Criteria: In accordance with 2 CFR, §200.430(g)(1)(i), charges to Federal awards for salaries and wages must be based on records that accurately reflect the work performed. These records must: (i) Be supported by a system of internal control which provides reasonable assurance that the charges are accurate, allowable, and properly allocated. Condition: For 3 out of 40 payroll transactions tested, we noted that the employees were compensated at rates that did not agree to their approved payroll contract or other management-approved documentation. Cause: Unknown Effect: Employees' compensation costs charged to the Federal program may not have represented an accurate allocation of grant funds, which could result in unallowed costs being charged to the program. It was not practical to extend our auditing procedures sufficiently to determine questioned costs, if any, that may have resulted from this finding. Recommendation: The Center should develop policies and procedures to help ensure pay rates are consistent with supporting employee agreements or other management-approved documentation.