Finding 1174917 (2025-001)

Material Weakness Repeat Finding
Requirement
E
Questioned Costs
-
Year
2025
Accepted
2026-02-23

AI Summary

  • Core Issue: PATHS made errors in approving sliding scale benefits, leading to incorrect application statuses.
  • Impacted Requirements: Federal income eligibility guidelines were not properly followed, affecting applicants' benefit approvals.
  • Recommended Follow-Up: Strengthen controls to ensure accurate data entry in the online software; PATHS plans to address this by FY26.

Finding Text

Program: Health Center Program Cluster (Assistance Listing Number 93.224) Criteria: Applicants who meet the published federal income eligibility guidelines are eligible for sliding scale benefits. Condition: Fifteen applications were selected for testing. PATHS incorrectly approved an application for Slide A status, when it should have been approved for Slide B status. One application was approved for Slide D status, when it should have been approved for Slide C status. Cause: Household income and family size data were incorrectly calculated when determining sliding scale status. Effect: Applicants were not approved or denied appropriately. Recommendation: Controls should be strengthened to ensure that the amounts entered into the online software are accurate. Views of Responsible Officials: PATHS is considering corrective action for FY26.

Corrective Action Plan

Controls have been strengthened to ensure that the front desk accurately enters applicants’ income and family size into the ECW system when determining eligibility for the sliding fee schedule. A member of the Finance Department is reviewing all sliding fee applications. These policies and procedures have been implemented to improve accuracy and compliance. Policy 01-03-029 – Sliding Fee Audit Policy was implemented on June 1, 2025. This policy includes the following: The Compliance Officer conducts a monthly audit, with audit results submitted to the Risk Manager on a quarterly basis. The Front Desk Trainer provides additional training to any employee who receives a failing score on an audit. This training is documented and signed off by the employee, the Front Desk Trainer, and the employee’s supervisor. Disciplinary actions are as follows: 1. First occurrence – One-on-one training 2. Second occurrence – Verbal warning and additional training 3. Third occurrence – Written warning 4. Fourth occurrence – Up to and including termination Mandatory training was conducted on January 14th and 15th and included all site managers, operations managers, the CFO, and the COO. Additional Controls Implemented: Effective July 1, 2025, all sliding fee applications are reviewed by a member of the Finance Department. The front desk is required to make any corrections or changes identified during the finance review. In addition, a task force has been formed to ensure appropriate follow-up is completed and to identify new opportunities to improve accuracy and compliance for all sliding fee patients. The front desk has also been provided with an Excel-based tool to assist with accurately entering patient income.

Categories

Eligibility

Programs in Audit

ALN Program Name Expenditures
93.224 HEALTH CENTER PROGRAM (COMMUNITY HEALTH CENTERS, MIGRANT HEALTH CENTERS, HEALTH CARE FOR THE HOMELESS, AND PUBLIC HOUSING PRIMARY CARE) $4.44M
93.526 GRANTS FOR CAPITAL DEVELOPMENT IN HEALTH CENTERS $267,944
93.495 COMMUNITY HEALTH WORKERS FOR PUBLIC HEALTH RESPONSE AND RESILIENT $165,376
93.107 AREA HEALTH EDUCATION CENTERS $117,092