Finding 39604 (2022-001)

Significant Deficiency
Requirement
E
Questioned Costs
-
Year
2022
Accepted
2023-02-19

AI Summary

  • Core Issue: Three out of twenty-five program participants lacked recent income documentation, raising concerns about their eligibility for services.
  • Impacted Requirements: Program rules mandate that participants meet specific eligibility criteria, including income thresholds, to be counted in Unduplicated Client totals.
  • Recommended Follow-Up: Establish a control process to verify participant eligibility at least every six months to ensure compliance with program requirements.

Finding Text

Finding 2022-001 CFDA: 93.914 Program Title: Emergency Relief Project Grants Federal Agency: U.S. Department of Health and Human Services Pass-Through Agency: City and County of San Francisco Pass-Through Award No.: 1000002517; 1000006123; 1000024465 Criteria Program requirements state that program participants must meet certain eligibility requirements including residency, HIV status, and income thresholds in order to receive services. Eligible participants are used to calculate Unduplicated Client (?UDC?) totals required by the program. Condition Testing selected twenty-five program participants. Of the twenty-five, three did not have documentation of recent income sufficient to determine income eligibility under the program. All twenty-five had documentation of HIV status. Cause The Organization does not have a control in place to verify participants in a program met continuing eligibility requirements in a timely manner. Context Program participants may receive services from several organizations and agencies, and eligibility is tracked by all organizations and agencies through a single database managed by the City and County of San Francisco. All errors occurred with participants that had been determined to be eligible in a previous period. The physical condition of the typical participant makes it unlikely their income status would change from earlier periods? certification. Effect It is possible that certain participants in the program are not eligible for services and should not have been counted toward the required total UDC reported by the program to the granting agency. Questioned Costs The finding did not result in any questioned costs. Prior Audit Finding No. Recommendation The Organization should implement a procedure and control to determine program participant eligibility on at least an annual or six-month schedule as required by the program. Views of Responsible Officials The Organization agrees with the finding, and will implement procedures to implement the recommendation.

Corrective Action Plan

CORRECTIVE ACTION PLAN YEAR ENDED JUNE 30, 2022 COGNIZANT OR OVERSIGHT AGENCY U.S. Department of Health and Human Services INDEPENDENT PUBLIC ACCOUNTING FIRM Karlsson & Lane, An Accountancy Corporation 4725 First Street, Suite 226 Pleasanton, California 94566 AUDIT PERIOD - For the year ended June 30, 2022 The findings from the June 30, 2022 Schedule of Findings and Questioned Costs are discussed below. FINDINGS - FEDERAL AWARD PROGRAMS AUDIT 2022-001 The Organization should implement a procedure and control to determine program participant eligibility on at least an annual or six month schedule as required by the program. Action: The Organization agrees with the finding, and will implement procedures to implement the recommendation. Conclusion: If the U.S. Department of Health and Human Services has questions regarding this plan, please contact Charlie Meade at: 3170 23rd Street San Francisco, CA 94110 (415) 625 5220 cmeade@shanti.org CORRECTIVE ACTION: Following this audit finding, Shanti?s HIV Programs performed an internal review of all clients served during FY 2021-present to identify active clients out of compliance with Ryan White eligibility. Shanti?s HIV Programs will rectify the auditor?s findings in the following ways: All clients with outstanding eligibility documents will be reached out to regarding their compliance status and HIV Programs staff will attempt to obtain proper documentation. If a client is unable to provide Ryan White eligibility documents, they may sign an attestation stating that they are a San Francisco resident and their income is at or below 500% of the Federal Poverty Level. When eligibility documentation is received, HIV Programs will update the ARIES database, the client?s chart and Shanti?s internal tracking document. Shanti will communicate status updates regarding client eligibility and will inform the appropriate parties if any clients served during the FY 22-23 contract period were not able to prove Ryan White eligibility. Previously reported UOS and UDC that remain undocumented will be restated with February 2023 reporting. POLICY & PROCEDURE CHANGES: HIV Programs? Policies and Procedures will be updated to reflect that clients who are not in compliance with Ryan White eligibility should not receive services or be billed for until documentation is provided. o The Director of HIV Programs will review a listing of all clients out of compliance monthly. o HIV Care Navigators and/or the HIV Program Coordinator will follow-up with clients out of compliance to obtain documentation. o The Director of HIV Programs will review the clients reported monthly into ARIES and sign off that all clients are eligible and documented to have received services during the month. o The Director of HIV Programs will sign off on all UOS and UDC reported monthly to finance for inclusion on the monthly invoices to the City. PROJECTED COMPLETION DATE: Shanti?s HIV Programs Department is working diligently to update Ryan White eligibility documents for all clients served during the FY 21-22 and FY 22-23 contract periods. The corrective action plan is anticipated to take until the end of the FY 22-23 contract period (2/28/23).

Categories

Eligibility

Other Findings in this Audit

  • 39605 2022-001
    Significant Deficiency
  • 39606 2022-001
    Significant Deficiency
  • 616046 2022-001
    Significant Deficiency
  • 616047 2022-001
    Significant Deficiency
  • 616048 2022-001
    Significant Deficiency

Programs in Audit

ALN Program Name Expenditures
93.914 Hiv Emergency Relief Project Grants $358,539
93.940 Hiv Prevention Activities_health Department Based $11,226