Finding 561696 (2024-001)

Significant Deficiency Repeat Finding
Requirement
E
Questioned Costs
-
Year
2024
Accepted
2025-05-28
Audit: 357322
Organization: Seattle Indian Health Board (WA)
Auditor: Moss Adams LLP

AI Summary

  • Core Issue: The Health Board failed to maintain necessary Tribal enrollment documentation for 1 out of 60 patients, violating eligibility requirements for service provision.
  • Impacted Requirements: Compliance with Health Board’s grant regulations mandates verification of patient eligibility and proper documentation before services are rendered.
  • Recommended Follow-Up: Update policies to ensure regular reviews of patient files for required documentation, and provide staff training on identifying necessary eligibility records.

Finding Text

Eligibility (Significant Deficiency in Internal Control Over Compliance and an Instance of Non-Compliance) Criteria – In accordance with the Health Board’s grant award with the Portland Area Indian Health Service, Indian Health Service eligibility regulations require that grantees verify eligibility before providing services, and maintain records documenting such eligibility. Condition and Context – The Health Board is required to maintain eligibility records for patients who receive services under the Urban Indian Health Services program. These records include Tribal enrollment and insurance coverage, among other things. We randomly selected 60 patients who received services during the audit period and noted the Health Board did not maintain Tribal enrollment documentation for 1 of the 60 patients tested. Cause – The Health Board staff did not appear to be sufficiently trained to properly identify tribal enrollment documentation and ensure all required documents were obtained prior to providing services. Effect – Individuals that are not eligible may have received services. Questioned Costs – Questioned costs associated with this finding could not be determined. Repeat Finding – This is a repeat finding from the prior year. See prior year finding 2023-002. Recommendation – We recommend the Health Board update polices and controls to include regular review of patient files. This may include review of the patient file for any outstanding Tribal enrollment and insurance documentation prior to scheduling the patients’ appointment. Views of responsible officials – Management agrees with the auditors' findings and will implement the corrective action plan to address the issue identified.

Categories

Eligibility Significant Deficiency Internal Control / Segregation of Duties

Other Findings in this Audit

  • 561695 2024-001
    Significant Deficiency Repeat
  • 561697 2024-001
    Significant Deficiency Repeat
  • 561698 2024-001
    Significant Deficiency Repeat
  • 561699 2024-002
    Significant Deficiency
  • 561700 2024-002
    Significant Deficiency
  • 561701 2024-002
    Significant Deficiency
  • 561702 2024-002
    Significant Deficiency
  • 561703 2024-002
    Significant Deficiency
  • 561704 2024-002
    Significant Deficiency
  • 561705 2024-002
    Significant Deficiency
  • 561706 2024-002
    Significant Deficiency
  • 1138137 2024-001
    Significant Deficiency Repeat
  • 1138138 2024-001
    Significant Deficiency Repeat
  • 1138139 2024-001
    Significant Deficiency Repeat
  • 1138140 2024-001
    Significant Deficiency Repeat
  • 1138141 2024-002
    Significant Deficiency
  • 1138142 2024-002
    Significant Deficiency
  • 1138143 2024-002
    Significant Deficiency
  • 1138144 2024-002
    Significant Deficiency
  • 1138145 2024-002
    Significant Deficiency
  • 1138146 2024-002
    Significant Deficiency
  • 1138147 2024-002
    Significant Deficiency
  • 1138148 2024-002
    Significant Deficiency

Programs in Audit

ALN Program Name Expenditures
93.479 Good Health and Wellness in Indian Country $730,668
93.762 A Comprehensive Approach to Good Health and Wellness in Indian County – Financed Solely by Prevention and Public Health $697,506
93.391 Activities to Support State, Tribal, Local and Territorial (stlt) Health Department Response to Public Health Or Healthcare Crises $638,832
93.193 Urban Indian Health Services $582,198
93.527 Grants for New and Expanded Services Under the Health Center Program $447,594
93.323 Epidemiology and Laboratory Capacity for Infectious Diseases (elc) $432,895
93.237 Special Diabetes Program for Indians Diabetes Prevention and Treatment Projects $329,380
21.027 Coronavirus State and Local Fiscal Recovery Funds $296,827
93.224 Health Center Program (community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care) $284,952
93.933 Demonstration Projects for Indian Health $255,414
93.243 Substance Abuse and Mental Health Services Projects of Regional and National Significance $157,089
16.023 Sexual Assault Services Culturally Specific Program $89,604
10.557 Wic Special Supplemental Nutrition Program for Women, Infants, and Children $88,423
93.231 Epidemiology Program $52,545
93.788 Opioid Str $46,710
93.526 Grants for Capital Development in Health Centers $37,428
93.959 Block Grants for Prevention and Treatment of Substance Abuse $13,359
93.441 Indian Self-Determination $11,358
47.076 Stem Education (formerly Education and Human Resources) $6,450