Finding 384932 (2023-002)

Material Weakness
Requirement
L
Questioned Costs
-
Year
2023
Accepted
2024-03-26

AI Summary

  • Core Issue: The Organization's report to the PRF Portal had inconsistencies with its accounting records.
  • Impacted Requirements: Compliance with mandatory reporting requirements under the CARES Act and ARP Act.
  • Recommended Follow-Up: Strengthen internal controls to ensure all submissions align with regulatory requirements and supporting records.

Finding Text

Item 2023-002 - Accuracy of Reporting to the PRF Portal: U.S. Department of Health and Human Services, COVID-19: Provider Relief Fund and American Rescue Plan ("ARP") Rural Distribution: Assistance Listing Number 93.498 - Reporting (Material Weakness) Criteria: The Coronavirus Aid, Relief, and Economic Security ("CARES") Act and American Rescue Plan ("ARP") Act of 2021 appropriated funds to reimburse eligible healthcare providers for health care related expenses or lost revenues attributable to COVID-19. These funds were distributed by Health Resources and Services Administration ("HRSA"). HRSA developed the Provider Relief Fund ("PRF") Reporting Portal to enable PRF and ARP Rural recipients to comply with mandatory reporting requirements. Statement of Condition: During our audit of the year ended June 30, 2023, we noted that the Organization's submission to the PRF Portal included inconsistencies with the underlying supporting accounting records. Cause: Due to the timing of the completion of the audit and the portal report submission deadline, certain audit-related adjustments were not included in the report submitted to the PRF portal. Effect: The Organization's report in the PRF portal does not agree to the underlying supporting accounting records. Questioned costs: None Context: Although there were inconsistencies between the actual revenue amounts reported in the PRF portal and the underlying supporting accounting records, the Organization had an adequate amount of lost revenue to earn the PRF funding received. Identification as a repeat finding: This is not a repeat finding. Recommendation: We recommend that the Organization strengthen its system of internal controls to ensure that all reporting that is done and submitted is consistent with requirements and instructions as provided by regulatory agencies. Management response: Management is in agreement with the audit finding that the PRF portal submission was not consistent with the underlying supporting accounting records. Measures will be taken to implement controls that will ensure that reports are reviewed and agreed to supporting underlying accounting records before they are submitted.

Corrective Action Plan

March 15, 2024 Health Resources and Services Administration Patrick McGovern, Community Health Project, Inc.’s (d/b/a Michael Callen-Audre Lorde Community Health Center’s) CEO respectfully submits the following corrective action plan for the year ended June 30, 2023: CohnReznick LLP 1301 Avenue of the Americas New York, NY 10019 Audit Period: June 30, 2023 The findings from the June 30, 2023 schedule of findings and questioned costs are discussed below. The findings are numbered consistently with the numbers assigned in the schedule. FINDINGS FEDERAL AWARD PROGRAM AUDITS Material Weakness 2023-002 - Accuracy of Reporting to the PRF Portal: U.S. Department of Health and Human Services, COVID-19: Provider Relief Fund and American Rescue Plan ("ARP") Rural Distribution: Assistance Listing Number 93.498 – Reporting Recommendation We recommend that the Organization strengthen its system of internal controls to ensure that all reporting that is done and submitted is consistent with requirements and instructions as provided by regulatory agencies. Action Taken The Organization has implemented policies and procedure to ensure controls are implemented to review against underlying documentation prior to submission to ensure compliance with regulatory agencies. Significant Deficiency 2023-001 - Implementation of Sliding Fee Scale Policy: U.S. Department of Health and Human Services, Health Center Program Cluster: Assistance Listing Number 93.224/93.527 - Special Tests and Provisions Chelsea 356 West 18th Street New York, NY 10011 212.271.7200 Thea Spyer Center 230 West 17th St New York, NY 10011 212.271.7200 Bronx 3144 3rd Ave Bronx, NY 10451 718.215.1800 Recommendation We recommend that management implement their policy that requires board review of the sliding fee scale in a consistent manner. The approval of the sliding fee scale should be added to the agenda items as a recurring annual matter to help ensure that it is completed. We recommend further that the employee/s in charge of inputting the sliding fee scale into the electronic medical record (EMR) system obtain evidence of board approval of the sliding fee scale before it is coded into the EMR. Action Taken The organization has implemented an annual approval process for the sliding fee scale to be added as an agenda item for our board approval within the first quarter of every calendar year. For the 2023 sliding fee scale, the board subsequently performed its review and did not find any errors with it thus they retroactively approved and authorized its application We have implemented a procedure whereby the billing department in charge shall seek to obtain this approval annually. Sincerely yours, Signature: Name: Patrick McGovern Title: Chief Executive Officer Organization’s Name: Callen-Lorde Community Health Center Date: 3/15/2024

Categories

Material Weakness Reporting Internal Control / Segregation of Duties

Other Findings in this Audit

  • 384925 2023-001
    Significant Deficiency
  • 384926 2023-001
    Significant Deficiency
  • 384927 2023-001
    Significant Deficiency
  • 384928 2023-001
    Significant Deficiency
  • 384929 2023-001
    Significant Deficiency
  • 384930 2023-001
    Significant Deficiency
  • 384931 2023-001
    Significant Deficiency
  • 961367 2023-001
    Significant Deficiency
  • 961368 2023-001
    Significant Deficiency
  • 961369 2023-001
    Significant Deficiency
  • 961370 2023-001
    Significant Deficiency
  • 961371 2023-001
    Significant Deficiency
  • 961372 2023-001
    Significant Deficiency
  • 961373 2023-001
    Significant Deficiency
  • 961374 2023-002
    Material Weakness

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) $1.42M
93.243 Substance Abuse and Mental Health Services_projects of Regional and National Significance $971,070
93.498 Provider Relief Fund and American Rescue Plan (arp) Rural Distribution $925,530
93.696 Certified Community Behavioral Health Clinic Expansion Grants $664,276
93.918 Grants to Provide Outpatient Early Intervention Services with Respect to Hiv Disease $639,949
93.944 Human Immunodeficiency Virus (hiv)/acquired Immunodeficiency Virus Syndrome (aids) Surveillance $520,108
93.914 Hiv Emergency Relief Project Grants $498,985
93.686 Ending the Hiv Epidemic: A Plan for America — Ryan White Hiv/aids Program Parts A and B (b) $471,494
93.153 Coordinated Services and Access to Research for Women, Infants, Children, and Youth $334,061
93.917 Hiv Care Formula Grants $304,290
93.958 Block Grants for Community Mental Health Services $250,826
93.307 Minority Health and Health Disparities Research $161,144
93.527 Affordable Care Act (aca) Grants for New and Expanded Services Under the Health Center Program $121,176
93.941 Hiv Demonstration, Research, Public and Professional Education Projects $64,434
93.855 Allergy, Immunology and Transplantation Research $60,535
93.829 Section 223 Demonstration Programs to Improve Community Mental Health Services $58,493
93.242 Mental Health Research Grants $44,397
93.865 Child Health and Human Development Extramural Research $14,146