FAC Explorer

Finding 371329 (2023-001)

Significant Deficiency
Requirement
E
Questioned Costs
-
Year
2023
Accepted
2024-02-29
Audit: 292998
Organization: Aleutian Pribilof Islands Association, Inc. (AK)
Auditor: Porter & Allison INC

AI Summary

  • Core Issue: Four out of forty individuals tested for IHS benefits lacked proof of eligibility, indicating a significant deficiency in internal controls.
  • Impacted Requirements: This finding violates Uniform Guidance 42 C.F.R section 136.12(a)(1)(2), which mandates eligibility criteria for receiving benefits.
  • Recommended Follow-Up: Enhance the patient intake process to include additional eligibility checks before benefits are provided, as agreed upon in the management's corrective action plan.

Finding Text

2023-001 Significant Deficiency in Internal Control over Compliance and non-compliance – Eligibility Identification of federal program: 93.210 Tribal Self-Governance Program: IHS Compact/Funding Agreement Criteria or specific requirement: Uniform Guidance 42 C.F.R section 136.12(a)(1)(2) 136.12(a)(1)(2) Subject to the requirements of this subpart, the Indian Health Service will provide direct services at its facilities, and contract health services, as medically indicated, and to the extent that funds and resources allocated to the particular Health Service Delivery Area Permit, to persons of Indian or Alaska Native decent who: (1) Are members of a federally recognized Indian tribe; and (2) Reside within a Health Service Delivery Area designated under section 36a.15 Condition: It was noted during the audit that four of the forty samples tested did not have proof that individuals that received IHS benefits were eligible for these benefits based on Uniform Guidance 42 C.F.R section 136.12(a)(1)(2) Cause: The controls in place were not operating effectively to ensure eligibility requirements were met. Effect or potential effect: The Association is out of compliance with Uniform Guidance eligibility requirements. Questioned Costs: None Context: For this program, a sample of forty individuals that received IHS benefits were tested for eligibility requirements. Of the forty individuals tested, four did not have documentation supporting the eligibility requirements were met. Identification of Repeat Finding: Not applicable. Recommendations: We recommend that as a part of the Association’s internal control structure over compliance with Uniform Guidance, additional criteria be added to the patient’s intake form and reviewed to ensure eligibility requirements are met prior to the patient receiving benefits. Views of Responsible Officials: Management agrees with the finding and has set up a corrective action plan. Refer to Corrective Action Plan.

Categories

Eligibility Significant Deficiency Internal Control / Segregation of Duties

Other Findings in this Audit

  • 371328 2023-001
    Significant Deficiency
  • 371330 2023-001
    Significant Deficiency
  • 371331 2023-001
    Significant Deficiency
  • 371332 2023-001
    Significant Deficiency
  • 371333 2023-001
    Significant Deficiency
  • 371334 2023-001
    Significant Deficiency
  • 371335 2023-001
    Significant Deficiency
  • 371336 2023-001
    Significant Deficiency
  • 371337 2023-001
    Significant Deficiency
  • 371338 2023-001
    Significant Deficiency
  • 371339 2023-001
    Significant Deficiency
  • 371340 2023-001
    Significant Deficiency
  • 947770 2023-001
    Significant Deficiency
  • 947771 2023-001
    Significant Deficiency
  • 947772 2023-001
    Significant Deficiency
  • 947773 2023-001
    Significant Deficiency
  • 947774 2023-001
    Significant Deficiency
  • 947775 2023-001
    Significant Deficiency
  • 947776 2023-001
    Significant Deficiency
  • 947777 2023-001
    Significant Deficiency
  • 947778 2023-001
    Significant Deficiency
  • 947779 2023-001
    Significant Deficiency
  • 947780 2023-001
    Significant Deficiency
  • 947781 2023-001
    Significant Deficiency
  • 947782 2023-001
    Significant Deficiency

Programs in Audit

ALN Program Name Expenditures
15.022 Tribal Self-Governance $4.22M
93.600 Head Start $2.73M
16.841 Voca Tribal Victim Services Set-Aside Program $1.44M
84.250 American Indian Vocational Rehabilitation Services $760,086
15.U01 477 Cluster $611,263
93.587 Promote the Survival and Continuing Vitality of Native American Languages $531,471
64.055 Staff Sergeant Parker Gordon Fox Suicide Prevention Grant Program $514,114
93.224 Consolidated Health Centers (community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care) $447,481
93.568 Low-Income Home Energy Assistance $308,637
93.563 Child Support Enforcement $287,201
16.587 Violence Against Women Discretionary Grants for Indian Tribal Governments $281,505
93.243 Substance Abuse and Mental Health Services_projects of Regional and National Significance $237,347
93.498 Provider Relief Fund $236,354
93.788 Opioid Str $229,442
93.470 Alzheimer's Disease Program Initiative (adpi) $226,159
66.926 Indian Environmental General Assistance Program (gap) $200,374
93.762 A Comprehensive Approach to Good Health and Wellness in Indian County Ð Financed Solely by Prevention and Public Health $168,721
21.027 Coronavirus State and Local Fiscal Recovery Funds $158,693
93.107 Area Health Education Centers Point of Service Maintenance and Enhancement Awards $138,164
15.156 Cooperative Landscape Conservation $101,306
93.738 Pphf: Racial and Ethnic Approaches to Community Health Program Financed Solely by Public Prevention and Health Funds $94,485
94.002 Retired and Senior Volunteer Program $92,092
45.311 Native American and Native Hawaiian Library Services $89,079
93.603 Adoption Incentive Payments $73,851
93.527 Affordable Care Act (aca) Grants for New and Expanded Services Under the Health Center Program $69,571
10.177 Regional Food System Partnerships (b) $61,699
93.671 Family Violence Prevention and Services/domestic Violence Shelter and Supportive Services $61,237
93.653 Indian Health Service Domestic Violence Prevention Programs $48,510
66.034 Surveys, Studies, Research, Investigations, Demonstrations, and Special Purpose Activities Relating to the Clean Air Act $45,972
93.327 Demonstration Grants for Domestic Victims of Severe Forms of Human Trafficking $44,393
93.391 Activities to Support State, Tribal, Local and Territorial (stlt) Health Department Response to Public Health Or Healthcare Crises $40,999
93.054 National Family Caregiver Support, Title Vi, Part C, Grants to Indian Tribes and Native Hawaiians $39,195
93.479 Good Health and Wellness in Indian Country (a) $34,510
45.164 Promotion of the Humanities_public Programs $32,107
93.658 Foster Care_title IV-E $26,358
93.237 Special Diabetes Program for Indians_diabetes Prevention and Treatment Projects $25,244
45.308 Native American/native Hawaiian Museum Services Program $24,409
93.043 Special Programs for the Aging_title Iii, Part D_disease Prevention and Health Promotion Services $21,298
10.558 Child and Adult Care Food Program $21,112
90.100 Denali Commission Program $18,172
93.053 Nutrition Services Incentive Program $10,045
93.071 Medicare Enrollment Assistance Program $7,483
93.556 Promoting Safe and Stable Families $5,905
93.092 Affordable Care Act (aca) Personal Responsibility Education Program $5,335
15.643 Alaska Migratory Bird CO-Management Council $4,731
16.582 Crime Victim Assistance/discretionary Grants $4,579
93.499 Low Income Household Water Assistance Program $4,144
93.665 Emergency Grants to Address Mental and Substance Use Disorders During Covid-19 $3,846
93.645 Stephanie Tubbs Jones Child Welfare Services Program $2,214
11.307 Economic Adjustment Assistance $1,452
93.210 Tribal Self-Governance Program: Ihs Compacts/funding Agreements $474
93.047 Special Programs for the Aging_title Vi, Part A, Grants to Indian Tribes_part B, Grants to Native Hawaiians $74