Finding Text
Program Title: Ryan White HIV Services Part AALN: 93.914Contract Grant Number: 2101501 220007, and 210147Federal Award Years: March 1, 2021 ? February 28, 2023Federal Agency: U.S. Department of Health and Human ServicesPass-through Entity: Bexar County Hospital DistrictType of Finding: Significant DeficiencyProgram Title: Ryan White HIV Services Part BALN: 93.917Contract Grant Number: HHS000084600001 and HHS001122200001Federal Award Years: April 1, 2021 ? March 31, 2023Federal Agency: U.S. Department of Health and Human ServicesPass-through Entity: Bexar County Hospital DistrictType of Finding: Significant DeficiencyEligibilityCriteria: 2 CFR Section 200.303 of the Uniform Guidance requires the non-Federal entity to establish and maintain effective internal control over the Federal award that provides reasonable assurance that the non-Federal entity is managing the Federal award in compliance with Federal statutes, regulations and the terms and conditions of the Federal award.Per the Ryan White HIV Services Part A program subcontract with Bexar County Hospital District, all clients must be recertified on an annual basis, or as client circumstances change, to confirm they are still eligible to participate in the program. The recertification consists of obtaining proof of residency, income, and insurance.Per the Ryan White HIV Services Part B program subcontract with Bexar County Hospital District, all clients must be recertified every six months to confirm they are still eligible to participate in the program. The recertification must occur in the client?s birth month and half birth month or as client circumstances change. This consists of obtaining proof of residency, income, and insurance.Condition: During testing of eligibility of clients for the Part A program, we noted one client was not certified within year prior to visit. Also, we noted a referred client never responded to attempts to enroll but was billed to the grant when they were not eligible. During testing of eligibility of clients for the Part B programs, we noted four clients were not recertified within six months as required by the grant.Cause: Lack of controls over monitoring the eligibility and participation of clients by program staff.Effect or potential effect: The Organization?s lack of controls over monitoring the continuous eligibility of clients may cause the Organization to be in noncompliance with the grant agreement, which could lead to loss or return of funding.Questioned Costs: NoneRepeat Finding: NoRecommendation: We recommend the Organization implement a policy and procedure for supervisory review and maintenance of client files to ensure the recertification of clients occurs as required in the grant agreements. Management should prevent any clients from being seen by a nurse practitioner if recertification has not been completed.Views of Responsible Officials and Planned Corrective Actions: Management agrees with the finding. See Corrective Action Plan.