Finding Text
2023-003 U.S. Department of Health and Human Services
Federal Financial Assistance Listing 93.217
Family Planning Services Project Grant – FPHPA006544
Program Income
Significant Deficiency in Internal Control over Compliance
Criteria: 2 CFR 200.303(a) establishes that the auditee must establish and maintain effective internal control over the federal award that provides assurance that the Organization is managing the federal award in compliance with federal statutes, regulations, and conditions of the federal award, including with respect to the calculation of program income.
Condition: In connection with the audit performed, it was noted that there was an instance where a patient received more federal assistance and another patient received less federal assistance than allowed based on federal poverty guidelines.
Cause: Organization’s internal controls did not ensure that the proper amount of assistance was provided to the patient.
Effect: There is an increased risk of noncompliance when internal controls are not adequately established, followed, and documented relating to program income requirements.
Questioned Costs: None reported.
Context/Sampling: Nonstatistical sampling was used for this compliance requirement. Sample size was 60 patients out of 53,365 total program patient visits, and included $7,201 out of $2,250,000 federal awards. There were two errors noted during our testing. For the first error, it was noted that $88 of costs charged to the program were in excess of the amount allowed to be used for the participant under federal poverty guidelines. For the second error, it was noted that a patient should have received an additional $57 of assistance under federal poverty guidelines.
Repeat Finding from Prior Year(s): No
Recommendation: The Organization should improve its processes and controls for identifying the total amount of federal assistance that should be given to patients based on their income levels.
Views of Responsible Officials: Management agrees with this finding.