Finding 1160329 (2024-003)

Material Weakness Repeat Finding

Requirement

Questioned Costs

Year

2024

Accepted

2025-10-11

Audit: 370709

Organization: Human Resource Development Institute (IL)

Auditor: Benford Brown & Associates LLC

AI Summary

Core Issue: FFHC failed to maintain adequate documentation for calculating discounted patient service fees, impacting compliance with federal requirements.
Impacted Requirements: Non-compliance with Special Tests and Provisions for Health Center Program and ACA, as outlined in Uniform Guidance.
Recommended Follow-Up: Enforce existing policies and internal controls to ensure proper documentation and compliance with federally determined poverty levels for discounted fees.

Finding Text

Finding 2024-003 Material Weakness in Internal Control Over Special Tests and Provisions Assistance Listing Numbers 93.224 Health Center Program 93.527 Affordable Care Act (ACA) for New and Expanded Services Under the Health Center Program Federal Agency U.S. Department of Health and Human Services, Health Resources and Services Administration Passthrough Agency N/A Award Number/Year 2024Criteria FFHC is responsible for keeping adequate supporting documentation of the calculation of patient service fees for those patients who qualify for discounted fees based on family size and household income. FFHC is also required to apply discounted fees accurately based on an approved sliding fee scale that meets federal compliance requirements. Condition For AL No. 93.224, Health Center Program and AL 93.527, Affordable Care Act (ACA) for New and Expanded Services Under the Health Center Program, we were not able to obtain supporting documentation of the household income for any of the forty (40) patients selected for testing, thus we were not able to recalculate discounted fees in order to determine whether they were in compliance with special tests and provisions for these programs. Cause During fiscal year 2024 sliding scale fees were not properly documented due to the allowance of telehealth visits and limited staff available to collect and maintain proper documentation. Effect FFHC was not in compliance with the Special Tests and Provisions requirements applicable to the Health Center Program and Affordable Care Act (ACA) for New and Expanded Services Under the Health Center Program as prescribed by Uniform Guidance. Questioned Costs None reported. Repeat Finding Yes. See Findings 2023-003, 2022-002 and 2021-003.Recommendation We recommend that FFHC enforce its current policy and related internal control procedures to ensure compliance with the requirement to provide discounted fees based on federally determined poverty levels for fiscal year 2024. Views of Responsible Officials and Planned Corrective Actions See corrective action plan.

Corrective Action Plan

Finding 2024-003 Material Weakness in Internal Control Over Special Tests and Provisions Assistance Listing Numbers 93.224 Health Center Program 93.527 Affordable Care Act (ACA) for New and Expanded Services Under the Health Center Program Federal Agency U.S. Department of Health and Human Services, Health Resources and Services Administration Passthrough Agency N/A Award Number/Year 2024 Criteria FFHC is responsible for keeping adequate supporting documentation of the calculation of patient service fees for those patients who qualify for discounted fees based on family size and household income. FFHC is also required to apply discounted fees accurately based on an approved sliding fee scale that meets federal compliance requirements.Views of Responsible Officials and Planned Corrective Actions Friend Family Health Center Inc. and Affiliates (Organization) will implement the following corrective actions for the fiscal year ending June 30, 2024 to remediate the finding and address the cause of the finding. The Organization will implement the following corrective actions for fiscal year 2024 to remediate the finding and address the cause of the finding. • The Chief Financial Officer (CFO) will be responsible for the implementation of the corrective action plan and will oversee all related finance activities. • FFHC will enforce its current policy and related internal control procedures to ensure that supporting documentation of family size and household income is maintained for all patients that receive discounted patient service fees in relation to the Health Centers Program and Affordable Care Act (ACA) for New and Expanded Services Under the Health Center Program. • FFHC will enforce its current policy and related internal control procedures to ensure that discounted patient service fees are properly calculated and charged based on the applicable approved sliding fee scale. The target date for full implementation of these corrective actions is December 30, 2025. The responsible party for the planned resources will be Wendy Thompson, Chief Executive Officer (312) 682-6110. Our address is 340 E. 51st St., Chicago, IL 60615.

Other Findings in this Audit

1160318 2024-001

Material Weakness Repeat
1160319 2024-002

Material Weakness Repeat
1160320 2024-003

Material Weakness Repeat
1160321 2024-001

Material Weakness Repeat
1160322 2024-002

Material Weakness Repeat
1160323 2024-003

Material Weakness Repeat
1160324 2024-001

Material Weakness Repeat
1160325 2024-002

Material Weakness Repeat
1160326 2024-003

Material Weakness Repeat
1160327 2024-001

Material Weakness Repeat
1160328 2024-002

Material Weakness Repeat

Programs in Audit

ALN	Program Name	Expenditures
93.224	Consolidated Health Centers (community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care)	$4.56M
93.516	Affordable Care Act (aca) Public Health Training Centers Program	$581,415
93.527	Affordable Care Act (aca) Grants for New and Expanded Services Under the Health Center Program	$300,000
21.027	Coronavirus State and Local Fiscal Recovery Funds	$94,065
93.323	Epidemiology and Laboratory Capacity for Infectious Diseases (elc)	$37,652