Henry J. Austin Health Center, Inc.Non-Profit

Assistance Listing Number: 93.224 U.S. Department of Health and Human Services, Consolidated Health Centers Cluster: Community Health Centers; COVID-19 American Rescue Plan Act Funding for Health Centers Finding Type: Significant Deficiency Criteria: The 2 CFR Section 200.302 requires that nonfederal entities receiving federal awards present accurate, current, and complete disclosure of the financial results of each federal award or program. The entity is required to maintain records, supported by source documentation, that identify adequately the source of funds for federally funded programs. Condition/Context: For 1 of the Center’s 92 expense reimbursement request draw-downs for the year ended March 31, 2023, the reimbursement request included more expenses than the amount of respective expenses incurred. Cause: During the year, the Center experienced turnover within the finance department and expense reimbursement requests were inadvertently completed incorrectly using incorrect allocations percentages and information. Effect: As a result of the incorrect expense reimbursements, the Center received reimbursement payments in excess of related expenses incurred totaling $199,099 for the year ended March 31, 2023. Questioned Costs: $199,099 Recommendation: The Center should implement a more robust process and related internal controls surrounding the expense reimbursement requests to ensure that the submitted requests agree to the respective costs incurred and supported. Views of Responsible Officials: Due to extenuating circumstances, including turnover in the finance department, the reimbursement requests were not properly reviewed and agreed to supporting documentation. However, although the expense reimbursement requests exceeded the respective incurred expenses in the identified requests above, the Center consistently incurs allowable expenses that qualify to be reimbursed in excess of total grant payments received and is working to remediate the issue. Planned Implementation of Corrective Action: Additional preventative internal control procedures will be implemented, including and additional level of review of the reimbursement request prior to submission. These procedures and internal controls have been implemented as of the date of this report. Person responsible for Corrective Action: Chief Executive Officer.

Finding 2022-002 - Significant Deficiency in Internal Control, Reporting Assistance Listing Number: 93.498 COVID-19 Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution Federal Agency: U.S. Department of Health and Human Services Pass-through Agency: Not Applicable Award Number/Year: Not Applicable/2020 Criteria: Non-federal entities in receipt of federal funds must comply with the requirements of 2 CFR 200.303(a), which require an entity to establish and maintain effective internal control over the Federal award to ensure compliance with Federal statutes, regulations and the terms and conditions of the Federal award. Recipients of Provider Relief Funds (PRF) payments must comply with the reporting requirements described in the PRF terms and conditions and specified in directions issued by the U.S. Department of Health and Human Services (HHS). Condition/Context: For the reports tested, the Center used accounting data that was not adjusted for audit adjustments and other reclassifications when preparing the lost revenue calculation due to timing of when the audit was completed and with the reporting was due. As a result of these adjustments, the lost revenue decreased from $2,801,240 to $1,560,435. Additionally, the reports tested did not contain a documented review and approval of the reports prior to submission. Effect: The amounts reported to Health Resources and Services Administration (HRSA) were not in accordance with the established HHS Reporting Requirements. Questioned Costs: None reported. Cause: Timing of audit adjustments and reporting Recommendation: We recommend that management review and update, as needed, their procedure for completion of the reporting to ensure that a review and approval of such reporting is completed and documented prior to submission.

Finding 2021-003 - Reporting Assistance Listing Number: 93.224 (Covid and Non Covid) and 93.247 Federal Agency: US Department of Health and Human Services, Health Center Program Cluster and Advanced Nursing Education Workforce Grant Program Federal Award Number: H80CS00531/ H8DCS36406/ H8ECS38478 and 1T14HP33196 Federal Award Year: Various Pass-Through Entity: Not applicable Criteria: The Center is required to submit quarterly expenditure reports that are within allowed award limits and expenditures reconciled timely to the general ledger. Questioned Cost: None Condition: One of the grants was inadvertently overdrawn by $46,118 above the award amount. The funds were deferred and reduced by the next draw down in the next fiscal year. In addition, several grants had adjustments or reallocation of expenditures subsequent to the filing, therefore, expenditures did not reconcile between the general ledger and reported amounts. Context: Our population included all annual reports. Our sample included four federal financial reports. This was not a statistically valid sample. Effect: Overdrawn grant funds and inaccurate reporting Cause: Inadvertent error for the overdraw. Other reconciling differences were caused by subsequent analysis and adjustments. Recommendation: The Center should have procedures in place to ensure that reports are completed accurately in accordance with requirements. Views of Responsible Officials and Planned Corrective Actions: Management is in agreement with the recommendation. The Center is working to implement controls that will reduce the likelihood of similar errors in the future. Moving forward as part of the quarterly and annual close processes, the grant accountant will reconcile information submitted on the Federal Financial Reports to the general ledger to ensure that there are no discrepancies. The Center is also pursuing grants management education for all finance members. Contact Person Responsible for Corrective Action: The Director of Finance and Revenue Cycle, Dheera Lingamallu, will be responsible for this review. Anticipated Completion Date: The planned anticipated completion date for this review is June 30, 2022.

Finding 2020-003 - Reporting CFDA Number: 93.224 Federal Agency: US Department of Health and Human Services, Health Center Program Cluster Federal Award Number: H80CS00531/HCCS35089 Federal Award Year: April 1, 2019 - March 31, 2020 Pass-Through Entity: Not applicable Criteria: The Center is required to submit quarterly expenditure reports within 30 days of the end of the quarter and an annual universal report by July 31 after budget period ends. Questioned Cost: None Condition: A mathematical error was identified on the annual universal report. Context: Our population included four quarterly filings and the one annual report. Our sample included quarterly filings and the annual report. This was not a statistically valid sample. Effect: A mathematical error was identified on the annual universal report. Cause: Mathematical error Recommendation: The Center should have procedures in place to ensure that annual and quarterly reports are completed accurately on a timely basis in accordance with requirements. Views of Responsible Officials and Planned Corrective Actions: The report in question is the Annual FFR for H80CS00531. The variance amount is $25,019.65 under reported on the Annual FFR H80CS00531 to our actual PMS cash draws. We have attempted to correct the quarterly PMS reports, but found that they are `locked? and we cannot make the corrections ourselves. Steps taken to correct: ? Attempted to correct quarterly PMS reports, but locked out (see above). ? We have emailed and had conversations with our GMO, who cannot make the necessary revisions but referred us to the PMS help desk. ? Called PMS Help Desk who referred to our PMS Liaison. ? We escalated the matter to our PMS liaison who, we were told, is out of the office and unavailable. PMS advised that we need to correct the cash amount on quarterly cash report(s). ? Called PMS liaison he is out-of-office and unavailable now, but that we need to have liaison do a Journal Voucher to correct. Next steps to correct: ? Speak with PMS Liaison and request that he prepare and post the required Journal Voucher to correct. ? Verify that Journal Voucher has been posted and that difference has been eliminated. ? Develop internal Standard Operating Procedure (SOP) specifying necessary verifications between quarterly Cash reports and annual FFR by grant and requiring sign off by appropriate level of supervision. Contact person responsible for corrective action: Jim Foley, Chief Financial Officer Anticipated completion date: January 2021

Finding 2019-004, Reporting CFDA Number: 93.224 Federal Agency: US Department of Health and Human Services, Health Center Program Cluster Federal Award Number: Not applicable Federal Award Year: September 1, 2018 - March 31, 2019 Pass-Through Entity: Not applicable Criteria: The Center is required to submit quarterly expenditure reports within 30 days of the end of the quarter and an annual universal report by July 31 after budget period ends. Questioned Cost: None Condition: The Center failed to submit one quarterly reports within the specified timeline. Context: Our population included four quarterly filings and the one annual report. Our sample included quarterly filings and the annual report. This was not a statistically valid sample. Effect: One of the four quarterly reports were not submitted within the required reporting deadline. Cause: The Center did not meet its deadline for reporting due to turnover within the accounting department. Recommendation: The Center should have procedures in place to ensure that annual and quarterly reports are completed on a timely basis in accordance with requirements.

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