Finding 517644 (2024-001)

Significant Deficiency Repeat Finding
Requirement
N
Questioned Costs
-
Year
2024
Accepted
2025-01-03

AI Summary

  • Core Issue: The Center failed to calculate sliding fee discounts correctly and lacked proper documentation.
  • Impacted Requirements: Non-compliance with federal guidelines for sliding fee discounts as outlined by the U.S. Department of Health and Human Services.
  • Recommended Follow-up: Implement stronger internal controls to ensure accurate calculations and documentation of sliding fee discounts.

Finding Text

Finding 2024.001: Special test and provisions – Sliding Fee Discounts – Significant Deficiency Grantor: U.S. Department of Health and Human Services Federal Program Names: Health Center Program Cluster Community Health Centers Affordable Care Act (ACA) Grants for New and Expanded Services Under the Health Center Program COVID-19 Affordable Care Act (ACA) Grants for New and Expanded Services Under the Health Center Program Federal Assistance Listing Numbers: 93.224 and 93.527 Federal Award Identification Number and Year: H8000133 – 2024 and 2023, C14CS39925 - 2021, H8G48629 – 2023, H8L50678 – 2024, H8H46190 - 2023 Criteria Health centers are required to have a corresponding schedule of discounts applied and adjusted on the basis of patients' ability to pay and their eligibility. A patient's eligibility to pay is determined on the basis of the official poverty guideline, as revised by DHHS (42 CFR Sections 51c, 107(b)(5),56.108(b)(5) and 56.303(f)). The Center should be implementing and monitoring procedures to properly determine, calculate and review slide fee discounts issued to patients in accordance with the Center's sliding fee scale. Condition The Center did not always calculate the proper slide fee discount based on approved policies or have adequate documentation on file. Cause The Center did not have adequate internal controls in place to effectively ensure that patients received the correct sliding fee discount and have adequate documentation on file. Effect The Center did not comply with the appropriate Special Tests and Provisions rules and regulations as per the Uniform Guidance in 2024. Questioned costs None. Context A test of 40 slide fee discount transactions was performed and resulted in seven instances of a sliding fee discount not being properly calculated based on the respective patient family size and income or inadequate documentation being on file. Our sample was a statistically valid sample. Identification of Repeat Finding Yes Recommendation The Center should establish a system of internal controls to ensure that all slide fee discounts are properly calculated and supported based on family size and income. Views of Responsible Officials Management agrees with the audit finding and will strengthen internal controls and accountability to correct the deficiency.

Corrective Action Plan

12/16/2024 United States Department of Health and Human Services Betty Jean Kerr – People’s Health Centers respectfully submits the following corrective action plan for the year ended May 31, 2024. CohnReznick LLP 350 Church Street Hartford, CT 06103 Audit Period: May 31, 2024 The findings from the May 31, 2024 schedule of findings and questioned costs are discussed below. The findings are numbered consistently with the numbers assigned in the schedule. FEDERAL AWARDS FINDINGS AND QUESTIONED COSTS Section III‐ Federal Award Findings and Questioned Costs Community Health Centers, Affordable Care Act (ACA) Grants for New and Expanded Services Under the Health Center Program, COVID-19 Affordable Care Act (ACA) Grants for New and Expanded Services Under the Health Center Program Federal Assistance Listing Numbers: 93.224 and 93.527 Item 2024‐001 – Special Tests Recommendation The Center should establish a system of internal controls to ensure that all slide fee discounts are properly calculated based on family size and income. Repeat Finding Yes Action Taken 1. Upon notification of findings, new reporting structures and training were developed for the FOA staff. Direct governance was moved from finance to operations, and the scheduling supervisor was promoted to a newly created role entitled the Director of Patient Access. This role is directly responsible for training and the scheduling of FOA staff as well as data integrity of registration information. 2. Once developed, we provided targeted training sessions for all staff involved with the calculation of sliding fees on the policies and procedures to ensure:  The sliding fee guidelines document is known.  Understanding of the methodology for calculating fees, including how family size and income are considered.  Documentation required to support income and family size information provided by clients. This may include tax returns, pay stubs, or other relevant documents.  To use the standardized form (checklist) to ensure all necessary information is collected and verified. 3. We also have implemented a monthly audit process that randomly selects a sample of sliding fee patients. Selected patients’ files are reviewed to identify any potential discrepancies. If discrepancies are noted, prior to remediation, errors are documented so that thematic analysis can be conducted, and root causes can be identified. To ensure traction of the initiative, audit findings are presented monthly to the quality assurance and performance improvement committee. 4. We make every effort we can to effectively communicate the sliding fee scale to clients. In addition to face-to-face communication, it is presented openly in several locations throughout the agency and is also available on our website. We are aware that ensuring the continued compliance of the SFS scale determinations, as well as the financial accuracy of our books requires consistent and continuous commitment to quality and improvement. We are confident that the changes made to our internal controls will significantly strengthen our processes. We believe these measures will mitigate the risk of errors and inaccuracies in the future, providing greater assurance over the reliability of our financial reporting. If the Cognizant or Oversight Agency for Audit has questions regarding this plan, please call: Javier Vallejo, CFO at 314-482-0915. Sincerely yours, Javier Vallejo Chief Financial Officer

Categories

Special Tests & Provisions Subrecipient Monitoring Allowable Costs / Cost Principles Eligibility Significant Deficiency Internal Control / Segregation of Duties

Other Findings in this Audit

  • 517645 2024-001
    Significant Deficiency Repeat
  • 517646 2024-001
    Significant Deficiency Repeat
  • 1094086 2024-001
    Significant Deficiency Repeat
  • 1094087 2024-001
    Significant Deficiency Repeat
  • 1094088 2024-001
    Significant Deficiency Repeat

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) $3.74M
93.493 Congressional Directives $826,632
10.557 Special Supplemental Nutrition Program for Women, Infants, and Children $657,566
93.829 Section 223 Demonstration Programs to Improve Community Mental Health Services $492,210
21.027 Coronavirus State and Local Fiscal Recovery Funds $393,205
93.778 Medical Assistance Program $299,168
93.527 Affordable Care Act (aca) Grants for New and Expanded Services Under the Health Center Program $268,830
93.323 Epidemiology and Laboratory Capacity for Infectious Diseases (elc) $83,383
32.006 Covid-19 Telehealth Program $76,666
93.332 Cooperative Agreement to Support Navigators in Federally-Facilitated and State Partnership Marketplaces $75,329
93.526 Fip Verification $46,040
93.435 The Innovative Cardiovascular Health Program $16,944
93.898 Cancer Prevention and Control Programs for State, Territorial and Tribal Organizations $15,931