AMPLA HEALTH

Finding 2023-002 Program Name: WIC Special Supplemental Nutrition Program for Women,Infants, and Children and Grants for Capital Development in Health Centers Federal Assistance Listing Number: 10.557 and 93.526 Federal Agencies: United States Department of Agriculture (USDA) and and U.S. Department of Health and Human Services Finding Type: Material Weakness Compliance Requirement: Procurement Condition: Ampla Health did not have adequate procurement policies in place that meet the minimum federal requirements for procurement standards. We examined the procurement records for nine vendors where Ampla Health expended federal funds. For all four sole source procurement records reviewed, Ampla Health did not retain documentation of the sole source determination or have an approved sole source vendor list. For two of three vendors selected in the small acquisition threshold, Amp…

Corrective action: Finding # 2023-001 Condition: Ampla Health did not have adequate procurement policies in place that meet the minimum federal requirements for procurement standards. We examined the procurement records for nine vendors where Ampla Health expended federal funds. For all four sole source procurement records reviewed, Ampla Health did not retain documentation of the sole source determination or have an approved sole source vendor list. For two of three vendors selected in the small acquisition threshold, Ampla Health could not provide competing quotes or sufficient evidence to demonstrate procurement was performed. For one of three vendors selected in the small acquisition threshold, Ampla H…

2021-001 ? REPORTING Federal Program: Provider Relief Fund Federal Agency: U.S. Department of Health and Human Services Assistance Listing Number: 93.498 Grant Award Number and Year: DS-84221582664, 1/1/20 ? 6/30/21 Criteria: The Provider Relief Fund (PRF) grant requires health centers to prepare and submit a report on their use of funds, in addition to other information about the Organization that is relevant to administration of the award. Title 2 CFR part 200.302 Financial Management states that non-federal entities that receive federal awards must provide for separate identification in the accounting records of all federal awards received and expended, and must retain records that adequately identify the source and application of funds for federally funded activities and include source-documentation and appropriate authorizations. Additionally, an effective internal control system …

Corrective action: Finding # 2021-001 Reporting Ampla Health recognizes the importance of being up to date and sufficiently knowledgeable with federal grant requirements prior to submitting for new funding opportunities. While the finance department did research and attempt to gather adequate information on the COVID-19 Relief funding program, we recognize there were challenges due to the resource shortages created by the pandemic as well as minimal timelines to submit for funds coupled with changing/limited guidance and requirements. To ensure compliance moving forward with federal grant opportunities, Ampla is committed to forming a committee to review all program requirements prior to applying for new fundi…

2021-002 ? ACTIVITIES ALLOWED OR UNALLOWED Federal Program: Provider Relief Fund Federal Agency: U.S. Department of Health and Human Services Assistance Listing Number: 93.498 Grant Award Number and Year: DS-84221582664, 1/1/20 ? 6/30/21 Criteria: The Provider Relief Fund (PRF) award documents do not contain significant information or guidance related to compliance with the award. However, there is information available on the Health Resources & Services Administration Website. The PRF FAQs found there state that no matter what method of lost revenue calculation is chosen (actual to actual, or budget to actual), the revenue to use is net patient care revenue. In August 2021 the HRSA released a "Lost Revenue Guide" which made it explicit that lost revenue must be calculated with revenue from "all patient care services." There is no indication that isolating a single patient care departmen…

Corrective action: Finding # 2021-002 ? Activities Allowed or Unallowed Ampla Health recognizes the importance of being up to date and sufficiently knowledgeable with federal grant requirements prior to submitting for new funding opportunities. While the finance department did research and attempt to gather adequate information on the COVID-19 Relief funding program, we recognize there were challenges due to the resource shortages created by the pandemic as well as minimal timelines to submit for funds coupled with changing/limited guidance and requirements. To ensure compliance moving forward with federal grant opportunities, Ampla is committed to forming a committee to review all program requirements prior t…

Federal Program: Consolidated Health Centers and Affordable Care Act (ACA) Grants for New and Expanded Services under the Health Center Prog. (Health Center Cluster) Federal Agency: U.S. Department of Health and Human Services CFDA Number: 93.224 Grant Award Number and Year: H80CSS00765-17-01, 6/1/18 ? 5/31/19; H80CSS00765-18-03, 6/1/19 ? 5/31/20 Criteria: The Consolidated Health Centers and Affordable Care Act (ACA) Grants for New and Expanded Services under the Health Center Programs (Health Center Cluster) requires health centers prepare and apply a sliding fee discount schedule so that the amounts owed for health care center services by eligible patients are adjusted (discounted) based on the patient?s ability to pay. An effective internal control system over compliance with this requirement provides reasonable assurance for the safeguarding of assets, the reliability of financial in…

Corrective action: Independent Audit FY 7/1/2018-6/30/2019 Corrective Action Plan Finding # 1 Federal Award and Questioned Costs Eligibility for sliding fee discounts. 40 patients were selected and 1 of the patients was appropriately approved for the sliding fee discount based on the applicable criteria, however was charged at an incorrect rate for services provided. Recommendation It was recommended that the Organization review its policies and procedures to ensure compliance with internal policies and granting requirements related to appropriately applying approved sliding discount fees to services for eligible patients. Committed Ampla Health has and will continue to do a significant amount of staff educati…