Identifying Number: 2025-001 - Eligibility Finding: Under the Health Center Program (Community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care) and Grants for New and Expanded Services Under the Health Center Program, eligible individuals receive...
Identifying Number: 2025-001 - Eligibility Finding: Under the Health Center Program (Community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care) and Grants for New and Expanded Services Under the Health Center Program, eligible individuals receive a sliding fee discount on amounts owed for health center services based on family size and income levels in comparison to the federal poverty guidelines. The Organization should maintain records providing evidence that the patients included under this program are eligible. However, during the compliance testing of 43 sample items, there were two instances where the patients had properly submitted their forms, but the Organization applied the incorrect sliding fee category. There is no known monetary impact, improper expenditure of funds or questioned costs identified. However, if the Organization does not strengthen the internal controls in regard to the eligibility determination process, there is a possible effect on the ability of the Organization to obtain additional funding under this program if ineligible patients are being treated with grant funding. Corrective Action Plan: The Operations and Social Work leadership met to determine a corrective action plan to address the audit findings for sliding fee scale eligibility. The leadership, under the direction of Alice Sliwka, Chief Operating and Quality Officer, will re-educate all appropriate staff who complete all eligibility ensuring standardization of naming convention for all documents received. The leadership will also review and edit the policy as the frequency of review has changed from every six months to annually. Monthly audits will continue to be completed to address any individual issue of non-compliance. Monthly follow-up and review of all findings will be shared with the Quality Excellence Committee until full compliance is maintained. Chase Brexton anticipates completion of this by March 31, 2026.