Finding 1150893 (2024-001)

- Repeat Finding
Requirement
E
Questioned Costs
-
Year
2024
Accepted
2025-08-22

AI Summary

  • Core Issue: Indiana University Health's paperless system limits our ability to verify compliance with WIC eligibility requirements.
  • Impacted Requirements: Eligibility documentation retention is not enforced, leading to a qualified opinion on compliance for Assistance Listing No. 10.557.
  • Recommended Follow-up: No corrective action is planned, as the current system aligns with state and federal guidance.

Finding Text

2024-001 – Scope Limitation – E. Eligibility Identification of the federal program: Federal Agency: U.S. Department of Agriculture Assistance Listing No.: 10.557 – Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) Pass-through Entity and Award Periods: Indiana Department of Health – October 1, 2023 through September 30, 2024, and October 1, 2024 through September 30, 2025 Criteria or specific requirement (including statutory, regulatory, or other citation): Applicants for WIC program benefits are screened at WIC clinic sites to determine their WIC eligibility. To be certified as eligible, they must meet various eligibility criteria as outlined in 7 CFR sections 246.7(c), (d), (e), (g), and (l). When an applicant meets all eligibility criteria, he/she is determined by WIC clinic staff to be eligible for program benefits. Certification periods are assigned to each participant based on categorical status for women, infants, and children (7 CFR section 246.7(g)). A WIC local agency assigns each eligible person a priority classification according to the classification system described in 7 CFR section 246.7(e)(4). A person’s priority assignment reflects the severity of his/her nutritional risk. If the local agency cannot immediately place the person on the program for lack of an available caseload slot, the person is placed on a waiting list. Caseload vacancies are filled from the waiting list in priority classification order. State agencies are expected to target program outreach and caseload management efforts toward persons at greatest nutritional risk (i.e., those in the highest priority classifications). Condition: Indiana University Health, Inc. and Subsidiaries screen applicants for eligibility by following the State of Indiana guidelines as provided through the INWIC system used to enter, track, and store information about applicants. Based on guidance from the Department of Agriculture, states were encouraged to move to a paperless system. The State of Indiana has followed that guidance and does not require participating entities to retain copies of an applicant’s proof of residence, income, etc. regarding eligibility. Therefore, we were not able to test internal controls over compliance or compliance over the eligibility compliance requirement and have issued a qualified opinion based on the scope limitation. Cause: Indiana University Health, Inc. and Subsidiaries follow a paperless system as supported by the State of Indiana and the U.S. Department of Agriculture. Effect or potential effect: A scope limitation qualified opinion was issued for Assistance Listing No. 10.557, as we were unable to obtain sufficient documentation supporting the compliance of Indiana University Health, Inc. and Subsidiaries regarding eligibility. Questioned costs: None. Context: Federal expenditures reported in the schedule of expenditures of federal awards for Assistance Listing No. 10.557 totaled $1,699,733 for the year ended December 31, 2024. Identification as a repeat finding, if applicable: This is a repeat of finding 2023-001. Recommendation: Not practical. Views of responsible officials: As Indiana University Health, Inc. and Subsidiaries follow the State of Indiana’s paperless system, as described above, which is also supported by 7 CFR 246, no further corrective action will be taken.

Categories

Subrecipient Monitoring Eligibility Reporting Matching / Level of Effort / Earmarking Internal Control / Segregation of Duties

Other Findings in this Audit

  • 574451 2024-001
    - Repeat
  • 574452 2024-002
    Significant Deficiency
  • 1150894 2024-002
    Significant Deficiency

Programs in Audit

ALN Program Name Expenditures
93.917 Hiv Care Formula Grants $2.46M
10.557 Wic Special Supplemental Nutrition Program for Women, Infants, and Children $1.70M
93.243 Substance Abuse and Mental Health Services_projects of Regional and National Significance $801,039
93.767 Children's Health Insurance Program $503,250
10.855 Distance Learning and Telemedicine Loans and Grants $406,435
14.241 Housing Opportunities for Persons with Aids $377,869
93.253 Poison Center Support and Enhancement Grant $311,338
14.267 Continuum of Care Program $303,557
93.912 Rural Health Care Services Outreach, Rural Health Network Development and Small Health Care Provider Quality Improvement $296,069
93.211 Telehealth Programs $256,732
16.560 National Institute of Justice Research, Evaluation, and Development Project Grants $253,755
93.391 Activities to Support State, Tribal, Local and Territorial (stlt) Health Department Response to Public Health Or Healthcare Crises $248,850
93.493 Congressional Directives $243,024
93.914 Hiv Emergency Relief Project Grants $203,739
93.853 Extramural Research Programs in the Neurosciences and Neurological Disorders $183,908
93.110 Maternal and Child Health Federal Consolidated Programs $126,524
93.889 National Bioterrorism Hospital Preparedness Program $118,569
93.866 Aging Research $116,162
16.575 Crime Victim Assistance $108,856
93.247 Advanced Nursing Education Workforce Grant Program $90,941
93.940 Hiv Prevention Activities_health Department Based $76,134
93.354 Public Health Emergency Response: Cooperative Agreement for Emergency Response: Public Health Crisis Response $67,500
93.959 Block Grants for Prevention and Treatment of Substance Abuse $62,300
93.847 Diabetes, Digestive, and Kidney Diseases Extramural Research $53,730
93.969 Pphf Geriatric Education Centers $32,950
93.838 Lung Diseases Research $16,357
93.941 Hiv Demonstration, Research, Public and Professional Education Projects $2,797
93.994 Maternal and Child Health Services Block Grant to the States $1,345
93.837 Cardiovascular Diseases Research $1,034