Finding 8196 (2023-001)

Significant Deficiency
Requirement
L
Questioned Costs
-
Year
2023
Accepted
2024-01-10

AI Summary

  • Core Issue: The Center failed to submit required performance measure outcomes to the Carisk portal and submitted one invoice late.
  • Impacted Requirements: Monthly data reporting and invoicing deadlines were not met, violating contract terms with the Broward Behavioral Health Coalition.
  • Recommended Follow-Up: Enhance internal controls to ensure timely compliance with all reporting requirements moving forward.

Finding Text

Section III - Federal Award Findings and Questioned Costs U.S. Department of Health and Human Services, Opioid STR (Assistance Listing Number 93.788) Item 2023-001 - Reporting Criteria In accordance with the contract agreement with the Broward Behavioral Health Coalition, monthly service data, inclusive of performance measures, is to be submitted to the Carisk portal, the data reporting system designated by the Broward Behavioral Health Coalition, and is due on the seventh calendar day of the following month for which services were rendered. In addition, invoices and supporting documentation are to be submitted and are due on the tenth calendar day of the following month for which services were provided. Statement of Condition The Center did not submit performance measure outcomes to the Carisk portal. In addition, for one out of three months tested, the invoice and supporting documentation was not submitted on a timely basis. Cause The Center had data upload issues that resulted in performance outcome measures being rejected as errors. The monthly invoice was submitted late due to data invoice processing issues. Effect The Center did not comply with the rules and regulations per the award. Questioned Costs None Context The Center did not submit the monthly performance measure outcomes to the Carisk portal for majority of the fiscal year. During the audit, we were only able to evidence the submission for the month of June 2023. In addition, the monthly invoice and supporting documentation for the month of May 2023 was submitted one day late. Identification as a Repeat Finding Condition is not a repeat finding. Recommendation We recommend that the Center strengthen their system of internal controls to ensure that all reporting requirements are monitored and met on a timely basis. Views of Responsible Official Management agrees with the audit finding and will strengthen internal controls and accountability to correct the deficiency.

Corrective Action Plan

CORRECTIVE ACTION PLAN October 23, 2023 Health Resources and Services Administration Care Resource Community Health Centers, Inc. respectfully submits the following corrective action plan for the year ended June 30, 2023. ____________________________________________________________________________________ CohnReznick LLP 1301 Avenue of the Americas New York, NY 10019 Audit Period: June 30, 2023 The findings from the June 30, 2023 schedule of findings and questioned costs are discussed below. The findings are numbered consistently with the number assigned in the schedule. FINDINGS – FEDERAL AWARDS PROGRAM AUDIT U.S. Department of Health and Human Services, Opioid STR (Assistance Listing Number 93.788) Finding 2023-001 – Reporting SIGNIFICANT DEFICIENCY We recommend that the Center strengthen their system of internal controls to ensure that all reporting requirements are monitored and met on a timely basis. Action Taken Management agrees with the audit finding and will strengthen internal controls and accountability to correct the deficiency. This deficiency has been corrected as of the current date. During the fiscal year, there was a data element change in the Carisk portal that required an “evaluation score” to be added to the performance outcome measures. This was not previously required. Although data was uploaded on a monthly basis to the Carisk portal, the change caused the data to be rejected as an “error” resulting in measures not being uploaded. This was discovered in the BBHC February 2023 desk review of July - December 2022 data. A corrective action plan was recommended, prepared, and accepted by BBHC. The “evaluation score” was not part of the template in the electronic medical record (NextGen) therefore data could not be uploaded and was rejected. Once discovered, the data element was added to the template within the electronic medical record and data uploads of performance outcome measures were able to be extracted and successfully uploaded to the Carisk portal. The screening tool to produce the “evaluation score” is being added to the electronic health record and will be included in the workflow of the Behavioral Health Providers so that it may be captured for performance outcomes and discharges. This process requires the Care Resource Data Analytics team and external data consultants and service providers to create the templates. During the fiscal year, invoices are due on the 10th of the month unless the tenth falls on a weekend or a holiday in which case the invoices are due the following business day. There are times where extensions are necessary due to portal uploads or data corrections. Approval is given by the contract manager of BBHC. Approvals have been granted verbally and in writing (email). In the case of the invoice for the month of May 2023, verbal approval was provided, however not documented. In the future, all requests if approved verbally, will be confirmed in writing (email) to ensure proper supporting documentation of the approval. If the Health Resources and Services Administration has questions regarding this plan, please call Keenan Karwan, Chief Financial Officer at 305 - 576-1234 x203. Sincerely yours, Keenan Karwan

Categories

Reporting Matching / Level of Effort / Earmarking Internal Control / Segregation of Duties

Other Findings in this Audit

  • 8197 2023-001
    Significant Deficiency
  • 584638 2023-001
    Significant Deficiency
  • 584639 2023-001
    Significant Deficiency

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) $4.02M
93.914 Hiv Emergency Relief Project Grants $1.95M
32.006 Covid-19 Telehealth Program $958,500
93.939 Hiv Prevention Activities_non-Governmental Organization Based $895,382
93.940 Hiv Prevention Activities_health Department Based $412,829
14.241 Housing Opportunities for Persons with Aids $358,079
93.917 Hiv Care Formula Grants $290,927
93.944 Human Immunodeficiency Virus (hiv)/acquired Immunodeficiency Virus Syndrome (aids) Surveillance $277,010
97.024 Emergency Food and Shelter National Board Program $220,959
93.958 Block Grants for Community Mental Health Services $210,149
93.526 Affordable Care Act (aca) Grants for Capital Development in Health Centers $126,097
93.924 Ryan White Hiv/aids Dental Reimbursement and Community Based Dental Partnership Grants $119,499
93.527 Affordable Care Act (aca) Grants for New and Expanded Services Under the Health Center Program $104,985
93.686 Ending the Hiv Epidemic: A Plan for America — Ryan White Hiv/aids Program Parts A and B (b) $99,458
93.788 Opioid Str $86,940
93.307 Minority Health and Health Disparities Research $45,911
93.279 Drug Abuse and Addiction Research Programs $45,383
93.959 Block Grants for Prevention and Treatment of Substance Abuse $43,709
84.126 Rehabilitation Services_vocational Rehabilitation Grants to States $36,400
93.498 Provider Relief Fund $8,881
97.032 Crisis Counseling $6,958