Finding 520596 (2024-001)

U.S. Department of Health and Human Services Pass-through Programs from: Nebraska Department of Health and Human Services and the Iowa Department of Health and Human Services HIV Care Formula Grants AL #93.917 Award No. 24X07HA00042, 24X07HA00041, 5884HC14 Award Periods: April 1, 2023 to March 31, 2024 and April 1, 2024 to March 31, 2025 Criteria: Per the terms and conditions of the pass-through entity agreement between the Nebraska Department of Health and Human Services, “client must be HIV positive and documentation (e.g., viral load laboratory results, physician’s verification of HIV status in form of signed letter) substantiating their HIV status must be on file with the contracting/subrecipient organization providing Ryan White Part B funded services.” Additionally, per the terms and conditions of the pass-through entity agreement between the Iowa Department of Health and Human Services, “Client eligibility must be determined within 60 days of initial intake and annually thereafter. Eligibility documentation must include proof of HIV diagnosis, proof of residency, and proof of income.” Condition: For 1 of 25 program participants selected for testing from the State of Nebraska, the participant file was missing documentation of HIV status. For 1 of 13 program participants selected for testing from the State of Iowa, the participant file was missing documentation for the annual recertification. Cause: Adequate internal controls were not in place to ensure compliance with eligibility requirements. Effect: Documentation was not maintained or obtained related to client eligibility which could cause the participant to not be considered eligible and be discharged from the program Questioned Costs: None Context/Sampling: During our audit, we selected a sample of 25 program participants for testing from Nebraska and 13 program participants for testing from Iowa. Repeat Finding from Prior Year: No Recommendation: Management should implement procedures to verify documentation for eligibility is maintained in the files. Additionally, management should implement procedures to ensure completion of the recertification within the timeframe. Views of Responsible Officials: Management agrees with this finding.