Health Opportunities for the People of East Texas, Inc.

Item 2023-001: Compliance with Client Placement on the Sliding Fee Scale for the Health Center Cluster Program Major Program: Health Center Cluster - Health Center Program (Community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care) - ALN/CFDA 93.224 and Grants for New and Expanded Services under the Health Center Program -ALN/CFDA 93.527 Criteria: The Health Center Cluster requires the Organization to perform a financial assessment on consumers in order to place them on a sliding fee scale. The sliding fee scale must be based on the cun-ent Federal Poverty Guidelines at the time of assessment. Condition: Consumers are not always placed correctly on the sliding fee scale based on their household size and income level. Questioned Costs: None Context: We tested 40 consumer files for proper placement on the sliding fee scale. During this test we found one (1) consumer file which placement on the sliding scale B was determined by using an out of date income supporting documentation to verify income in accordance with Center policy. The sliding fee discount schedule is used to determine eligibility for patient discounts adjusted on the basis of the patient's ability to pay. This schedule is based on the most recent Federal Poverty Guidelines. Effect: Consumer was not appropriately placed on the sliding fee scale. Cause: The Organization's controls over placement of consumers on the sliding fee scale necessary for financial assessment of consumers are not operating effectively. Recommendation: The Organization should review procedures and training regarding the sliding fee scale calculation and placement. Views of Responsible Officials: See management's corrective action plan.