FAC Explorer

Finding 559003 (2024-001)

Significant Deficiency
Requirement
E
Questioned Costs
-
Year
2024
Accepted
2025-05-01
Audit: 355246
Organization: Indiana Health Centers, Inc. (IN)
Auditor: Cohnreznick LLP

AI Summary

  • Core Issue: There is a significant deficiency in eligibility documentation for the WIC program, leading to potential compliance risks.
  • Impacted Requirements: Internal controls as per 2CFR 200.303(a) were not effectively maintained, resulting in insufficient support for verifying recipient eligibility.
  • Recommended Follow-up: Management should provide training for staff on eligibility verification to ensure proper documentation and adherence to internal controls.

Finding Text

Finding 2024.001: Eligibility - Significant Deficiency Grantor: U.S. Department of Agriculture Federal Program Names: WIC Special Supplemental Nutrition Program for Women, Infants and Children Federal Assistance Listing Numbers: 10.557 Federal Award Identification Number and Year: 79194 - 2023, 76709 - 2023 and 88458 - 2024 Name of Pass-through Entity: Indiana State Department of Health Criteria In accordance with 2CFR 200.303(a), Internal Controls, a nonfederal entity must establish and maintain effective internal control over the federal award that provides reasonable assurance that the nonfederal entity is managing the federal award in compliance with federal statutes, regulations, and the terms and conditions of the federal award. The specific eligibility requirements are unique to each federal program, in accordance with the terms and conditions of the Federal award pertaining to the program. Condition During our testing over eligibility requirements, we were unable to review sufficient documentation to support that benefit recipients were eligible for benefits. Cause The Center's internal controls over eligibility were not consistently followed to ensure the presence of documentation to support that all benefit recipients were eligible for benefits. Effect Lack of sufficient support over eligibility could result in ineligible individuals receiving benefits. Questioned Costs None. Context We selected 40 beneficiaries charged to the federal program to test compliance and controls over eligibility. Out of 40 individuals tested, we noted 4 instances where there was no documentation to support that the benefit recipients were eligible for benefits and the internal controls over eligibility were followed. Identification of Repeat Finding None. Recommendation We recommend that management provide training to those responsible for verifying eligibility to ensure that documentation and internal control over eligibility is maintained. Views of Responsible Officials Management agrees with the audit finding and will strengthen internal controls and accountability to correct the deficiency.

Corrective Action Plan

SIGNIFICANT DEFICIENCIES WIC Special Supplemental Nutrition Program for Women, Infants and Children Federal Assistance Listing Numbers: 10.557 2024.001 Recommendation We recommend that management provide training for those responsible for verifying eligibility to ensure that documentation and internal control over eligibility is maintained. Action Taken The agency Coordinator will have a training session with each clerk in the agency on the importance of documentation and completion of assessing WIC eligibility. This re-training will include step-by-step instructions. Clerks will be instructed to add notes when needed to explain a client's eligibility, (ex. immigrants and eligibility). Demonstration will be required by each clerk to their supervisor. The re-education will be completed by the end of June 2025 and reported on a log with attendees. Ongoing monitoring will be performed by agency supervisors. They will audit five charts twice a month for each clerk/certifier. In the event, there are deficiencies identified, the supervisor will re-train the clerk/certifier at that time. 1. A folder for each clerk will be kept in a locked cabinet by the agency supervisor. It will contain a log that will consist of the clerk's name, household audited and an analysis of the eligibility that was completed at the certification. 2. Ongoing corrections if needed will be addressed by the agency supervisor or coordinator. Retraining may be requested by clerical staff at any time. If the Cognizant or Oversight Agency for Audit has questions regarding this plan, please call: Mr. Tracy Nagel, CFO at (317) 576-1335 or email to tnagel@ihcinc.org.

Categories

Eligibility Subrecipient Monitoring Significant Deficiency Matching / Level of Effort / Earmarking

Other Findings in this Audit

  • 1135445 2024-001
    Significant Deficiency

Programs in Audit

ALN Program Name Expenditures
93.224 Health Center Program (community Health Centers, Migrant Health Centers, Health Care for the Homeless and Publi Housing Primary Care $5.09M
10.557 Wic Special Supplemental Nutrition Program for Women, Infants, and Children $2.72M
93.268 Immunization Cooperative Agreements $1.49M
93.530 Affordable Care Act - Teaching Health Center Graduate Medical Education Payments Program $244,360
93.224 Health Center Program (community Health Centers, Migrant Health Centers, Health Care for the Homeless and Public Housing Primary Care $95,259
93.994 Maternal and Child Health Services Block Grant to the States $70,316
93.527 Affordable Care Act (aca) Grants for New and Expanded Services Under the Health Center Program $30,089
93.778 Medical Assistance Program $20,887
93.217 Family Planning_services $782