FAC Explorer

Audit 40914

FY End
2022-05-31
Total Expended
$10.77M
Findings
6
Programs
11
Organization: Betty Jean Kerr - People's Health Centers (MO)
Year: 2022 Accepted: 2023-04-18
Auditor: Cohnreznick LLP

Organization Exclusion Status:

Findings

ID Ref Severity Repeat Requirement
47917 2022-002 Significant Deficiency Yes N
47918 2022-002 Significant Deficiency Yes N
47919 2022-002 Significant Deficiency Yes N
624359 2022-002 Significant Deficiency Yes N
624360 2022-002 Significant Deficiency Yes N
624361 2022-002 Significant Deficiency Yes N

Programs

ALN Program Spent Major Findings
93.527 Affordable Care Act (aca) Grants for New and Expanded Services Under the Health Center Program $4.50M Yes 1
93.224 Consolidated Health Centers (community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care) $3.43M Yes 1
93.498 Provider Relief Fund and American Rescue Plan (arp) Rural Distribution $902,989 Yes 0
10.557 Special Supplemental Nutrition Program for Women, Infants, and Children $632,629 - 0
93.778 Medical Assistance Program $229,581 - 0
93.435 Innovative State and Local Public Health Strategies to Prevent and Manage Diabetes and Heart Disease and Stroke- $63,116 - 0
93.268 Immunization Cooperative Agreements $56,390 - 0
32.006 Covid-19 Telehealth Program $43,556 - 0
93.898 Cancer Prevention and Control Programs for State, Territorial and Tribal Organizations $35,291 - 0
93.526 Affordable Care Act (aca) Grants for Capital Development in Health Centers $22,646 - 0
93.436 Well-Integrated Screening and Evaluation for Women Across the Nation (wisewoman) $254 - 0

Contacts

Name Title Type
TMR8GAV35HH8 Rebecca Mankin Auditee
3143677848 James Lacroix Auditor
No contacts on file

Notes to SEFA

Title: Note 3 - COVID-19 Provider Relief Funding and American Rescue Plan (ARP) Accounting Policies: The accompanying Schedule of Expenditures of Federal Awards (the "Schedule") includes the federal award activity Betty Jean Kerr Peoples Health Centers (the "Center") under programs of the federal government for the year ended May 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 of the Center. 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. Pass-through entity identifying numbers are presented where available. De Minimis Rate Used: N Rate Explanation: The auditee did not use the de minimis cost rate. For the DHHS awards related to the Provider Relief Fund ("PRF") and American Rescue Plan ("ARP") Rural Distribution program, DHHS has indicated the amounts on the Schedule be reported corresponding to reporting requirements of the HRSA PRF Reporting Portal. Payments from DHHS for PRF are assigned to the 'Payment Received Periods' (each, a Period) based upon the date each payment from PRF was received. Each Period has a specified Period of Availability and timing of reporting requirements. Entities report into the HRSA PRF Reporting Portal after each Period's deadline to use the funds (i.e., after the end of the Period of Availability).The Schedule includes $282,797 received from DHHS between April 10, 2020 through June 30, 2020 and $620,192 received from DHHS between July 1, 2020 and December 31, 2020. In accordance with guidance from DHHS, these amounts represent Period 1 and Period 2, respectively. Grant revenue of $282,797 and $620,192 were recognized as revenue in the consolidated financial statements during the years ended May 31, 2022 and 2021, respectively.

Finding Details

Finding 2022-002
U.S. Department of Health and Human Services, COVID-19 - Health Center Program Cluster (Assistance Listing Number 93.224/93.527) Item 2022-002 ? Special Tests and Provisions Criteria In accordance with the Uniform Guidance, the Center must prepare and apply a sliding fee discount policy and schedule so that the amounts owed for health center services by eligible patients are adjusted (discounted) based on a patient's poverty level, which is determined by the patient's family size and income. Condition The Center did not always appropriately apply the sliding fee discount based on income levels and family size. Context A test of 40 discount transactions was performed and resulted in three instances of sliding fee discounts not being properly calculated based on the respective patient family size and income. Our sample was a statistically valid sample. Cause The Center did not have adequate internal controls in place to effectively ensure that patients receive the correct sliding fee discount. Effect The Center did not comply with the appropriate rules and regulations as per the Uniform Guidance. Questioned Costs None Identification of Repeat Finding Yes ? 2021-004 Recommendation The Center should ensure that internal controls are in place to effectively ensure that patients receive the correct sliding fee discount. View of Responsible Officials Management and the Board of Directors agree with the finding.
Finding 2022-002
U.S. Department of Health and Human Services, COVID-19 - Health Center Program Cluster (Assistance Listing Number 93.224/93.527) Item 2022-002 ? Special Tests and Provisions Criteria In accordance with the Uniform Guidance, the Center must prepare and apply a sliding fee discount policy and schedule so that the amounts owed for health center services by eligible patients are adjusted (discounted) based on a patient's poverty level, which is determined by the patient's family size and income. Condition The Center did not always appropriately apply the sliding fee discount based on income levels and family size. Context A test of 40 discount transactions was performed and resulted in three instances of sliding fee discounts not being properly calculated based on the respective patient family size and income. Our sample was a statistically valid sample. Cause The Center did not have adequate internal controls in place to effectively ensure that patients receive the correct sliding fee discount. Effect The Center did not comply with the appropriate rules and regulations as per the Uniform Guidance. Questioned Costs None Identification of Repeat Finding Yes ? 2021-004 Recommendation The Center should ensure that internal controls are in place to effectively ensure that patients receive the correct sliding fee discount. View of Responsible Officials Management and the Board of Directors agree with the finding.
Finding 2022-002
U.S. Department of Health and Human Services, COVID-19 - Health Center Program Cluster (Assistance Listing Number 93.224/93.527) Item 2022-002 ? Special Tests and Provisions Criteria In accordance with the Uniform Guidance, the Center must prepare and apply a sliding fee discount policy and schedule so that the amounts owed for health center services by eligible patients are adjusted (discounted) based on a patient's poverty level, which is determined by the patient's family size and income. Condition The Center did not always appropriately apply the sliding fee discount based on income levels and family size. Context A test of 40 discount transactions was performed and resulted in three instances of sliding fee discounts not being properly calculated based on the respective patient family size and income. Our sample was a statistically valid sample. Cause The Center did not have adequate internal controls in place to effectively ensure that patients receive the correct sliding fee discount. Effect The Center did not comply with the appropriate rules and regulations as per the Uniform Guidance. Questioned Costs None Identification of Repeat Finding Yes ? 2021-004 Recommendation The Center should ensure that internal controls are in place to effectively ensure that patients receive the correct sliding fee discount. View of Responsible Officials Management and the Board of Directors agree with the finding.
Finding 2022-002
U.S. Department of Health and Human Services, COVID-19 - Health Center Program Cluster (Assistance Listing Number 93.224/93.527) Item 2022-002 ? Special Tests and Provisions Criteria In accordance with the Uniform Guidance, the Center must prepare and apply a sliding fee discount policy and schedule so that the amounts owed for health center services by eligible patients are adjusted (discounted) based on a patient's poverty level, which is determined by the patient's family size and income. Condition The Center did not always appropriately apply the sliding fee discount based on income levels and family size. Context A test of 40 discount transactions was performed and resulted in three instances of sliding fee discounts not being properly calculated based on the respective patient family size and income. Our sample was a statistically valid sample. Cause The Center did not have adequate internal controls in place to effectively ensure that patients receive the correct sliding fee discount. Effect The Center did not comply with the appropriate rules and regulations as per the Uniform Guidance. Questioned Costs None Identification of Repeat Finding Yes ? 2021-004 Recommendation The Center should ensure that internal controls are in place to effectively ensure that patients receive the correct sliding fee discount. View of Responsible Officials Management and the Board of Directors agree with the finding.
Finding 2022-002
U.S. Department of Health and Human Services, COVID-19 - Health Center Program Cluster (Assistance Listing Number 93.224/93.527) Item 2022-002 ? Special Tests and Provisions Criteria In accordance with the Uniform Guidance, the Center must prepare and apply a sliding fee discount policy and schedule so that the amounts owed for health center services by eligible patients are adjusted (discounted) based on a patient's poverty level, which is determined by the patient's family size and income. Condition The Center did not always appropriately apply the sliding fee discount based on income levels and family size. Context A test of 40 discount transactions was performed and resulted in three instances of sliding fee discounts not being properly calculated based on the respective patient family size and income. Our sample was a statistically valid sample. Cause The Center did not have adequate internal controls in place to effectively ensure that patients receive the correct sliding fee discount. Effect The Center did not comply with the appropriate rules and regulations as per the Uniform Guidance. Questioned Costs None Identification of Repeat Finding Yes ? 2021-004 Recommendation The Center should ensure that internal controls are in place to effectively ensure that patients receive the correct sliding fee discount. View of Responsible Officials Management and the Board of Directors agree with the finding.
Finding 2022-002
U.S. Department of Health and Human Services, COVID-19 - Health Center Program Cluster (Assistance Listing Number 93.224/93.527) Item 2022-002 ? Special Tests and Provisions Criteria In accordance with the Uniform Guidance, the Center must prepare and apply a sliding fee discount policy and schedule so that the amounts owed for health center services by eligible patients are adjusted (discounted) based on a patient's poverty level, which is determined by the patient's family size and income. Condition The Center did not always appropriately apply the sliding fee discount based on income levels and family size. Context A test of 40 discount transactions was performed and resulted in three instances of sliding fee discounts not being properly calculated based on the respective patient family size and income. Our sample was a statistically valid sample. Cause The Center did not have adequate internal controls in place to effectively ensure that patients receive the correct sliding fee discount. Effect The Center did not comply with the appropriate rules and regulations as per the Uniform Guidance. Questioned Costs None Identification of Repeat Finding Yes ? 2021-004 Recommendation The Center should ensure that internal controls are in place to effectively ensure that patients receive the correct sliding fee discount. View of Responsible Officials Management and the Board of Directors agree with the finding.