Audit 415398

Material Weakness Finding: 2026-001 Sliding Fee Discounts Federal Programs: Department of Health and Human Services Health Center Program Cluster Assistance Listing No. - 93.224 and 93.527 Criteria: Uniform Guidance, Special Tests & Provisions, Sliding Fee Discounts, 42 CFR, 56.303 Condition: Health Centers receiving funding under the Health Center Program Cluster must prepare and apply a sliding fee discount so that the amounts owed for health center services by eligible patients are discounted based on the patient’s ability to pay. During compliance testing, it was determined that the Organization did not properly apply the sliding fee discount for six sliding fee patients tested. In addition, ten patients received discounts without completed applications. Cause: There were deficiencies in the internal controls related to the application of the sliding fee discounts in accordance with the Organization’s sliding fee policy and sliding fee scale. Effect: Discounts were not properly applied to certain patient accounts. Questioned Costs: None reported. Context/Sampling: For 6 of 48 sliding fee patients selected for testing, the account had an incorrect discount applied. For 10 of 48 sliding fee patients selected for testing, applications were not completed. This sample was not, and was not intended to be, a statistically valid sample. The finding appears to be a systemic issue. Repeat Finding from Prior Year: No Recommendation: It is recommended that proper training be given to employees and that the sliding fee discounts be reviewed by a supervisor on a periodic basis to ensure compliance with the Organization’s sliding fee scale and policy. Views of Responsible Officials: Management concurs. Efforts will be made to implement corrective actions as recommended above. Contact Person: Dr. Aretha Powers, CEO Anticipated Date of Completion: October 31, 2026

Material Weakness Finding: 2026-002 Monthly Time/Activity Reports not Maintained for Salaried Employees Federal Program Identification: U.S. Department of Health and Human Services Health Center Cluster Assistance Listing No. - 93.224 and 93.527 Criteria: Uniform Guidance Compliance Supplement, Grant Policy Statements, 45 CFR, 75.430 Condition: Time/activity reports (time sheets) and /or wage authorization approvals are not maintained for certain employees as required by federal cost principles. Cause: The Organization failed to follow its policy to maintain time and effort reports that coincide with the Organization’s payroll cycle (at least on a monthly basis) and failed to maintain wage authorization approvals for all employees. Effect: Failure to comply with federal requirements regarding personnel cost and time and effort could result in a reduction of grant funds. Questioned Costs: None Context/Sampling: A test of payroll disbursements revealed that time and effort certifications for 2 employees were not maintained, and 2 employees wage authorizations were not approved. The finding appears to be a systemic issue. Repeat Finding from Prior Year: No Recommendation: The Organization should evaluate and revise its processes and procedures to ensure that it maintains documentation of personnel time and efforts in accordance with federal cost principles and that approved wage authorizations are maintained for all employees. It is recommended that time and effort certifications be prepared no less than monthly and coincide with the Organization’s payroll cycle. Views of Responsible Officials: Policies and procedures will be established to ensure that wage authorizations are approved for all employees and that salaried employees maintain time and effort reports that coincide with the Organization’s payroll cycle. Contact Person: Dr. Aretha Powers, CEO Anticipated Date of Completion: October 31, 2026