Audit 47661

2022-002 Information on the Federal Program CFDA 93.323- Pandemic Health Navigator sub-grant of Illinois Public Health Region 4 and Region 5 Compliance Requirements: Reporting Type of Finding: Noncompliance Criteria Shawnee Health Service and Development Corporation is required to submit monthly fiscal expenditure documentation and programmatic status reports to IPHCA?s PHN Regional Lead for each region that Shawnee Health Service and Development Corporation is responsible for by the close of business on the 10th of the month for the work done and expenses incurred in the previous month. Condition During the audit, we noted one instance of noncompliance with timely submission of monthly reports. Context There were 16 monthly reports submissions reviewed for timeliness, for the grant period March 2021 through June 2022. Cause The monthly report for May 2022 was submitted 1 day late as a result of oversight. Effect Oversight of the timely submission of monthly reports is a key control over compliance. Lack of oversight can result in issues with late submissions of monthly reporting requirements. Recommendation We recommend management review their internal control procedures and determine where modifications may be needed in the reporting and oversight process to ensure timely submission of reports. Responsible Official?s Response Management of Shawnee Health Service and Development Corporation concurs with the audit finding. Management has a financial reporting calendar in place and will improve the current process by adding a second staff person to monitor the reporting calendar. The primary monitor of the reporting calendar will issue electronic calendar invites with report due dates to appropriate staff who are charged with completing the report. Staff responsible for submitting reports will update a consolidated monthly calendar, viewable by all finance staff and monitors, with the actual dates that the reports are to be submitted. The monitors will routinely review the reporting calendar and follow up with appropriate staff for any reports with an upcoming due date that have not yet been submitted.

2022-001 CFDA 93.224 / 93.527- Health Center Program ? Cluster Health Center Program (Community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care) ? CFDA #93.224 Grants for New and Expanded Services Under the Health Center Program ? CFDA #93.527 Compliance Requirements: Special Tests and Provisions Type of Finding: Noncompliance Criteria Program requirements state that Health centers must prepare and apply a sliding fee discount schedule so that the amounts owed for health center services by eligible patients are adjusted (discounted) based on the patient?s ability to pay. Condition For the year ended June 30, 2022, we noted two instances of noncompliance with application of the sliding fee schedule. Cause Income was entered incorrectly by the person involved with the approval process and application of the sliding fee discount schedule resulting in the wrong discount being applied to the patient account. Additionally, a patient was granted a one-day extension when they should have been granted another temporary slide due to the length of time from the initial visit of 12/16/2020, in which a 30-day temporary slide was given, and the new visit date of 6/14/2022. Context During the audit there were 25 patients selected who received the sliding fee discount. Proper documentation and slide discounts applied were reviewed in accordance with Shawnee Health Service and Development Corporation?s sliding fee policy. Effect Oversight of the approval and application process is a key control over compliance. Lack of oversight can result in issues with the approval process and appropriately applying the sliding fee discount schedule. Recommendation We recommend management review their internal control procedures and determine where modifications may be needed in the proper training, education, approval, and application process. Responsible Official?s Response Management of Shawnee Health Service and Development Corporation concurs with the audit finding. Management will improve on their current processes while increasing the monthly internal audit sample from 20 applications per month to 30 applications per month. Additionally, management will implement a process to complete a 100% review of the sliding fee effective dates entered into the electronic patient management system. Also, prior to the anticipated completion date, management will require all staff who are involved in the sliding fee process to complete the established training module on data entry.

2022-002 Information on the Federal Program CFDA 93.323- Pandemic Health Navigator sub-grant of Illinois Public Health Region 4 and Region 5 Compliance Requirements: Reporting Type of Finding: Noncompliance Criteria Shawnee Health Service and Development Corporation is required to submit monthly fiscal expenditure documentation and programmatic status reports to IPHCA?s PHN Regional Lead for each region that Shawnee Health Service and Development Corporation is responsible for by the close of business on the 10th of the month for the work done and expenses incurred in the previous month. Condition During the audit, we noted one instance of noncompliance with timely submission of monthly reports. Context There were 16 monthly reports submissions reviewed for timeliness, for the grant period March 2021 through June 2022. Cause The monthly report for May 2022 was submitted 1 day late as a result of oversight. Effect Oversight of the timely submission of monthly reports is a key control over compliance. Lack of oversight can result in issues with late submissions of monthly reporting requirements. Recommendation We recommend management review their internal control procedures and determine where modifications may be needed in the reporting and oversight process to ensure timely submission of reports. Responsible Official?s Response Management of Shawnee Health Service and Development Corporation concurs with the audit finding. Management has a financial reporting calendar in place and will improve the current process by adding a second staff person to monitor the reporting calendar. The primary monitor of the reporting calendar will issue electronic calendar invites with report due dates to appropriate staff who are charged with completing the report. Staff responsible for submitting reports will update a consolidated monthly calendar, viewable by all finance staff and monitors, with the actual dates that the reports are to be submitted. The monitors will routinely review the reporting calendar and follow up with appropriate staff for any reports with an upcoming due date that have not yet been submitted.

2022-001 CFDA 93.224 / 93.527- Health Center Program ? Cluster Health Center Program (Community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care) ? CFDA #93.224 Grants for New and Expanded Services Under the Health Center Program ? CFDA #93.527 Compliance Requirements: Special Tests and Provisions Type of Finding: Noncompliance Criteria Program requirements state that Health centers must prepare and apply a sliding fee discount schedule so that the amounts owed for health center services by eligible patients are adjusted (discounted) based on the patient?s ability to pay. Condition For the year ended June 30, 2022, we noted two instances of noncompliance with application of the sliding fee schedule. Cause Income was entered incorrectly by the person involved with the approval process and application of the sliding fee discount schedule resulting in the wrong discount being applied to the patient account. Additionally, a patient was granted a one-day extension when they should have been granted another temporary slide due to the length of time from the initial visit of 12/16/2020, in which a 30-day temporary slide was given, and the new visit date of 6/14/2022. Context During the audit there were 25 patients selected who received the sliding fee discount. Proper documentation and slide discounts applied were reviewed in accordance with Shawnee Health Service and Development Corporation?s sliding fee policy. Effect Oversight of the approval and application process is a key control over compliance. Lack of oversight can result in issues with the approval process and appropriately applying the sliding fee discount schedule. Recommendation We recommend management review their internal control procedures and determine where modifications may be needed in the proper training, education, approval, and application process. Responsible Official?s Response Management of Shawnee Health Service and Development Corporation concurs with the audit finding. Management will improve on their current processes while increasing the monthly internal audit sample from 20 applications per month to 30 applications per month. Additionally, management will implement a process to complete a 100% review of the sliding fee effective dates entered into the electronic patient management system. Also, prior to the anticipated completion date, management will require all staff who are involved in the sliding fee process to complete the established training module on data entry.