Finding 514613 (2024-002)

Significant Deficiency Repeat Finding
Requirement
AB
Questioned Costs
-
Year
2024
Accepted
2024-12-17
Audit: 332958
Organization: Sma Healthcare, Inc. (FL)

AI Summary

  • Core Issue: One client lacked a properly signed Financial Assessment Form, and two clients had service dates outside the required one-year timeframe.
  • Impacted Requirements: Compliance with documentation standards for the Block Grant for Prevention and Treatment of Substance Abuse is at risk due to incomplete forms.
  • Recommended Follow-Up: Review processes and provide regular training to staff to ensure all Financial Assessment Forms are completed correctly and timely.

Finding Text

2024-002 – ALN 93.959 – Block Grant for Prevention and Treatment of Substance Abuse – Activities Allowed/Allowable Costs: Completion of Financial Assessment Form (Repeat Comment) Criteria: The Block Grant for Prevention and Treatment of Substance Abuse provides for a set of documentation requirements for clients in the covered programs, including the completion of a Financial Assessment Form (FAF) to document financial eligibility over allowable costs. Based on the client's income and number of dependents, this form is used to determine a "discount class", and calculate a sliding scale discount percentage and/or dollar amount of SMA's fees that the client would be responsible for paying. This form is required to be completed when clients are discharged after being provided mental health services. FAF are to be updated yearly for patients with active billable services, noting all service dates with a billed service should fall within one year of the FAF completion date. Condition: 1 of the 60 clients tested did not have the Financial Assessment Form properly signed by the client. Additionally, 2 of the 60 clients tested had service dates that did not fall within one year of the FAF completion date. Cause: The requirements to perform these control elements were not followed by the case managers. Effect: The Financial Assessment Forms that were not properly completed or not completed within the required timeframe could result in noncompliance with the grant agreement or noncompliance with established controls. Recommendation: We recommend that the process be reviewed and staff be trained and have regular training updates to ensure that the required Financial Assessment Forms are completed fully and signed for all clients, and that additional controls be put in place to ensure the discount rate applied is documented and proper.

Corrective Action Plan

For ALN 93.959, a Financial Assessment Form was not properly signed for 1 of the 60 clients tested. Additionally, 2 of the 60 clients tested had service dates that did not fall within one year of the Financial Assessment Form completion date. Obtaining a client's signature on the form has been challenging, particularly during recent years as use of telehealth services has expanded. As a corrective action, team members will be trained in how to properly document receipt of verbal approval. Our internal tracking of completion of the Financial Assessment Form at admission indicates that compliance with this requirement occurs about 89% of the time. As a corrective action plan, SMA will include the completion of the Financial Assessment Form both at admission and annually to be reviewed monthly by the programs. In addition, an action plan will be required to be present at the quarterly Quality Assurance Committee meeting if not at 100%.

Categories

Allowable Costs / Cost Principles Eligibility

Other Findings in this Audit

  • 514612 2024-001
    Significant Deficiency Repeat
  • 514614 2024-004
    Significant Deficiency
  • 1091054 2024-001
    Significant Deficiency Repeat
  • 1091055 2024-002
    Significant Deficiency Repeat
  • 1091056 2024-004
    Significant Deficiency

Programs in Audit

ALN Program Name Expenditures
93.959 Block Grants for Prevention and Treatment of Substance Abuse $8.19M
93.958 Block Grants for Community Mental Health Services $4.93M
93.788 Opioid Str $2.83M
93.243 Substance Abuse and Mental Health Services Projects of Regional and National Significance $861,748
93.558 Temporary Assistance for Needy Families $811,362
93.912 Rural Health Care Services Outreach, Rural Health Network Development and Small Health Care Provider Quality Improvement $559,407
93.767 Children's Health Insurance Program $286,128
93.354 Public Health Emergency Response: Cooperative Agreement for Emergency Response: Public Health Crisis Response $184,523
16.738 Edward Byrne Memorial Justice Assistance Grant Program $81,092
14.231 Emergency Solutions Grant Program $54,915
14.235 Supportive Housing Program $46,667
93.421 Strengthening Public Health Systems and Services Through National Partnerships to Improve and Protect the Nation�s Health $35,433
93.136 Injury Prevention and Control Research and State and Community Based Programs $27,000
93.778 Medical Assistance Program $26,363