Finding 1171849 (2025-002)

Material Weakness Repeat Finding
Requirement
E
Questioned Costs
-
Year
2025
Accepted
2026-01-31

AI Summary

  • Core Issue: Program benefits were given to individuals without proper eligibility documentation due to issues with the new practice management system.
  • Impacted Requirements: Noncompliance with federal and state eligibility criteria for the HIV Services Grant Programs, leading to potential questioned costs of $779.
  • Recommended Follow-Up: Review and improve eligibility policies and procedures, enhance training for staff, and maintain ongoing internal audits to ensure compliance.

Finding Text

HIV Care Formula Grants - Assistance Listing No. 93.917 U.S. Department of Health and Human Services Houston Regional HIV/AIDS Resource Group, Inc. April 1, 2024 - March 31, 2025 and April 1, 2025 - March 31, 2026 State HIV Services Grant Programs Texas Department of State Health Services Houston Regional HIV/AIDS Resource Group, Inc. September 1, 2023 – August 31, 2024, and September 1, 2024 – August 31, 2025 Criteria or specific requirement – Eligibility Condition – Program benefits were extended to individuals for whom eligibility supporting documentation was not available. Cause – The Organization relies on its practice management systems to conduct a portion of the eligibility screening required for these programs. During the prior fiscal year, a new practice management system was implemented. During this time, the Organization provided training and support in an effort to minimize disruption following this change. However, some new processes appear to have not been followed as the Organization transitioned to the new system and some documentation was noted to be missing or not obtained for transactions occurring during the fiscal year. Effect or potential effect – Weaknesses in internal control over compliance present the potential for noncompliance with federal and state eligibility requirements. As a result, program benefits were provided to an individual that did not meet the eligibility requirements of the State HIV Services Grant Programs. Questioned costs – State HIV Services Grant Programs - $779; Questioned costs were quantified using the value of benefits provided to program participants that were not eligible to receive benefits from the program. Context – The Organization's controls to ensure compliance with eligibility requirements are not consistently operating as designed for the impacted programs. In addition, a sample of 25 transactions were tested from a population of approximately 5,075 State HIV Services Grant Programs transactions, with 1 instance of benefits being received by an individual that did not qualify to receive such benefits. The sampling methodology is not and is not intended to be statistically valid. Identification as a repeat finding, if applicable – Yes, see 2024-003 Recommendation – The Organization should review the eligibility policy and procedures to ensure compliance with the ALN 93.917 HIV Care Formula Grants and Texas Department of State Health Services State HIV Services Manuals and other authoritative guidance while considering improvements that can be made for both potential program beneficiaries and personnel. Continued education efforts and internal audit processes should continue as well.

Corrective Action Plan

The Organization acknowledges the identified gap and concurs with the finding. The issue occurred due to a lack of verification of whether the patient had active eligibility or not. Steps have been implemented to remedy the issue in FY 2026. The Director of Financial Services-IAT reporting team is enhancing training and communication to improve understanding of eligibility and documentation requirements. Furthermore, procedures will be implemented to systematically monitor all medications billed to Ryan White and State HIV Services Programs, as well as verify participants' current eligibility status on a biweekly basis. The organization expects these processes to run efficiently by April 30th, 2026.

Categories

Eligibility Internal Control / Segregation of Duties

Other Findings in this Audit

  • 1171826 2025-001
    Material Weakness Repeat
  • 1171827 2025-001
    Material Weakness Repeat
  • 1171828 2025-001
    Material Weakness Repeat
  • 1171829 2025-001
    Material Weakness Repeat
  • 1171830 2025-001
    Material Weakness Repeat
  • 1171831 2025-001
    Material Weakness Repeat
  • 1171832 2025-001
    Material Weakness Repeat
  • 1171833 2025-001
    Material Weakness Repeat
  • 1171834 2025-001
    Material Weakness Repeat
  • 1171835 2025-001
    Material Weakness Repeat
  • 1171836 2025-001
    Material Weakness Repeat
  • 1171837 2025-001
    Material Weakness Repeat
  • 1171838 2025-001
    Material Weakness Repeat
  • 1171839 2025-001
    Material Weakness Repeat
  • 1171840 2025-001
    Material Weakness Repeat
  • 1171841 2025-001
    Material Weakness Repeat
  • 1171842 2025-001
    Material Weakness Repeat
  • 1171843 2025-001
    Material Weakness Repeat
  • 1171844 2025-001
    Material Weakness Repeat
  • 1171845 2025-001
    Material Weakness Repeat
  • 1171846 2025-001
    Material Weakness Repeat
  • 1171847 2025-002
    Material Weakness Repeat
  • 1171848 2025-002
    Material Weakness Repeat

Programs in Audit

ALN Program Name Expenditures
94.006 AMERICORPS STATE AND NATIONAL 94.006 $1.41M
93.917 HIV CARE FORMULA GRANTS $902,397
93.914 HIV EMERGENCY RELIEF PROJECT GRANTS $758,764
93.939 HIV PREVENTION ACTIVITIES NON-GOVERNMENTAL ORGANIZATION BASED $395,877
93.940 HIV PREVENTION ACTIVITIES HEALTH DEPARTMENT BASED $184,293
93.224 HEALTH CENTER PROGRAM (COMMUNITY HEALTH CENTERS, MIGRANT HEALTH CENTERS, HEALTH CARE FOR THE HOMELESS, AND PUBLIC HOUSING PRIMARY CARE) $166,683
93.217 FAMILY PLANNING SERVICES $148,131
93.527 GRANTS FOR NEW AND EXPANDED SERVICES UNDER THE HEALTH CENTER PROGRAM $94,600
93.493 CONGRESSIONAL DIRECTIVES $71,878
93.918 GRANTS TO PROVIDE OUTPATIENT EARLY INTERVENTION SERVICES WITH RESPECT TO HIV DISEASE $13,235