Finding 574641 (2024-001)

Significant Deficiency
Requirement
N
Questioned Costs
-
Year
2024
Accepted
2025-08-25
Audit: 364910
Organization: Friends of Family Health Center (CA)
Auditor: Wipfli LLP

AI Summary

  • Core Issue: Friends of Family Health Center lacks effective controls over its sliding fee discount program, leading to incorrect discount applications.
  • Impacted Requirements: Compliance with the sliding fee schedule policy is essential to ensure discounts align with patients' ability to pay.
  • Recommended Follow-Up: Conduct regular reviews of discounts applied and provide staff training to improve accuracy in discount calculations.

Finding Text

Finding 2024-001 - Sliding Fee Discount Determination Federal Agency: U.S. Department of Health and Human Services Program Name: Health Center Program Federal Assistance Listing Number: 93.224/93.527 Questioned Costs: N/A Repeat Finding: No Type of Finding: Noncompliance, significant deficiency Compliance Requirement: Special Tests and Provisions - Sliding fee Schedule ("SFS") Condition: Friends of Family Health Center lacked adequate controls over its sliding fee discount program to ensure patients received the correct discount. Criteria: Health Centers must maintain a sliding fee discount policy and apply a sliding fee discount based on patient's ability to pay (42 USC 254(k((3)(E), (F), (G); 42 CFR sections 53c.303(e), (f), and (g); and 42 CFR sections 56.303(e), (f), and (g)). Context: In testing patients receiving discounts under Friends of Family Health Center's sliding fee schedule, we noted that for 1 of 40 patients selected for testing Friends of Family Health Center incorrectly applied the discount or were put in the incorrect category based on income and family size. Cause: Friends of Family Health Center's review process was not effective in verifying the sliding fee discount was correctly calculated and applied in accordance to the Friends of Family Health Center's policy. Effect: There is an increased risk that discounts may be given to patients not eligible to receive a discount, or incorrect discounts may be provided for patients eligible to receive a discount. Recommendation: We recommend Friends of Family Health Center periodically review patients receiving discounts under the sliding fee program to ensure that the correct discounts are being applied based on the current sliding fee schedule. View of Responsible Officials: Friends of Family Health Center will implement procedures for reviewing sliding fee discounts and provide additional training to staff for calculating those discounts.

Corrective Action Plan

Condition Friends of Family Health Center lacked adequate controls over its sliding fee discount program to ensure patients received the correct discount. In testing patients receiving discounts under Friends of Family Health Center's sliding fee schedule, we noted that for 1 of 40 patients selected for testing Friends of Family Health Center incorrectly applied the discount or were put in the incorrect category based on income and family size. Response One error in calculating a patient’s income with 40 others is a minor 2.5% error margin. FOFHC will have a quarterly training course on how to properly use the various income level tables provided to the front office staff. Responsible Party Dawn Ta, CFO Estimated Completion Date December 31, 2025

Categories

Special Tests & Provisions Significant Deficiency

Other Findings in this Audit

  • 574642 2024-002
    Significant Deficiency
  • 1151083 2024-001
    Significant Deficiency
  • 1151084 2024-002
    Significant Deficiency

Programs in Audit

ALN Program Name Expenditures
93.526 Grants for Capital Development in Health Centers $448,338
93.527 Grants for New and Expanded Services Under the Health Center Program $402,843
93.224 Health Center Program (community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care) $200,000