SEA MAR COMMUNITY HEALTH CENTERS

Finding 2025-001 Eligibility – Significant Deficiency in Internal Control over Compliance and Immaterial Instances of Noncompliance Program: U.S. Department of Agriculture Rural Rental Assistance Program: ALN 10.427 Award Number: Various Award Year: 2024, 2025 Criteria: Pursuant to 7 CFR 3560.576, the Health Center must determine whether actual dollars earned from farm labor by a domestic farm laborer did not exceed 65 percent of the annual income limits. Condition/Cause: Sea Mar Farmworker and Community Housing Development Association did not consistently follow policies and procedures in place over the eligibility process. Income verification documents used in the eligibility determination process were not always obtained prior to the tenant’s movein date and/or were not retained. Effect: Elgibility upon move-in could not be verified for all tenants. Questioned Cost Not applicable. Con…

Corrective action: RE: Finding Reference Number: 2025-001 Corrective Action: Sea Mar will implement a compliance worksheet that will be used by staff to ensure they have collected all necessary documentation for each tenant. This tool will assist in tracking income verification documents and move-in/move-out dates and will be included as a cover sheet for each tenant file. Sea Mar will also provide staff with additional training on eligibility determination for qualifying applicants in alignment with applicable program guidelines. This will be completed by 3/31/2026. Name of Contact Person Responsible for Implementation: John Clerkin, Housing Director Sincerely, John Clerkin Housing Director P: (206) 788-3399 …

Finding 2024-001 Special Tests and Provisions – Significant Deficiency in Internal Control over Compliance Program: U.S. Department of Health and Human Services Health Center Program Cluster: ALN 93.224/93.527 Award Number: Various Award Year: 2023, 2024 U.S. Department of Treasury Coronavirus State and Local Fiscal Recovery Funds ALN 21.027 Award year: 2022, 2023 Criteria: In accordance with the Health Resources & Services Administration Health Center Program Compliance Manual, Chapter 9: Sliding Fee Discount Program, health centers must prepare and apply a sliding fee discount schedule so that amounts owed for health center services by eligible patients are adjusted based on the patients’ ability to pay. Condition/Cause: The Health Center had instances in which discounts were not applied accurately based on the underlying support that was provided by the patient. Effect: Certain patien…

Corrective action: Finding Reference Number: 2024-001. Corrective Action: Sea Mar will follow up with additional training on the sliding fee scale for all employees who issue the discount to patients. This training will be done via Relias, which is Sea Mar's web-based training platform. A score of 100% will be required to pass. Employees who do not score 100% will be retrained and will retake the test. Sea Mar has set a goal to achieve accuracy percentage of 95% and achieved its goal with 97% pass rate, but still had a finding on the audit because Sea Mar did not reach 100%. Sea Mar conducts monthly audits to monitor accuracy. Sea Mar will continue to use a process that will require supervisors to review and s…

Finding 2024-002 Preparation of the Schedule Expenditures of Federal Awards -Significant Deficiency in Internal Control over Compliance Program: U.S. Department of Treasury Coronavirus State and Local Fiscal Recovery Funds ALN 21.027 Award year: 2022, 2023 Criteria: The Uniform Guidance (2 CFR 200) Section 200.510 requires an auditee to “prepare a schedule of expenditures of Federal awards (SEFA) for the period covered by the auditee’s financial statements [that]….at a minimum shall…list individual Federal programs by Federal agency…[and] provide total Federal awards expended for each individual Federal program and the Assistance Listing Number (ALN) number or other identifying number when the ALN information is not available.” In accordance with Uniform Guidance, the Organization is required to maintain a structure of internal control to ensure compliance with applicable reporting requi…

Corrective action: Finding Reference Number: 2024-002. Corrective Action: Sea Mar will train its accounting and finance staff to recognize the difference between a state and local grant and a federal grant by learning how to read and interpret the provisions of the gran and determine whether this is a federal or state and local grant. The training will be conducted by the CFO and Controller of Sea Mar, and staff members will have to acknowledge they understand by signing acknowledgement forms stating they received the training and understand the differences. Staff will also be instructed not to rely on the name of grant because many times the name of the grant is not indicative of the agency that is funding th…

Finding 2024-003 Timely Reporting of Coronavirus State and Local Fiscal Recovery Funds – Significant Deficiency in Internal Controls over Compliance Program: U.S. Department of Treasury Coronavirus State and Local Fiscal Recovery Funds ALN 21.027 Award year: 2022, 2023 Criteria: Per the guidelines established by the U.S. Department of the Treasury and the Washington State Healthcare Authority (HCA), recipients of the Coronavirus State and Local Fiscal Recovery Funds are required to submit financial and programmatic reports within specified deadlines to ensure accountability and compliance with federal and state regulations. Condition/Cause: The Health Center did not submit the required annual report related to the Coronavirus State and Local Fiscal Recovery Funds to the Washington State Healthcare Authority within the mandated timeframe. Specifically, the Health Center submitted the repo…

Corrective action: Finding Reference Number: 2024-003 Corrective Action: Sea Mar will create a list of all report deadlines and due dates and have multiple staff review and monitor the list to ensure deadlines are met. This process will mitigate the chances that reports are submitted late. Name of Contact Person: Dustin Greer, CFO, DustinGreer@seamarchc.org Projected Completion Date: 3/31/2025

III. FEDERAL AWARD FINDINGS AND QUESTIONED COSTS Finding 2022-001 Special Tests and Provisions ? Material Weakness in Internal Control over Compliance Program: U.S Department of Health and Human Services Health Center Program Cluster: ALN 93.22/93.527. Award Number: Various. Award Year: 2022, 2023. Criteria: In accordance with the Health Resources & Services Administration Health Center Program Compliance Manual, Chapter 9: Sliding Fee Discount Program, health centers must prepare and apply a sliding fee discount schedule so that amounts owed for health center services by eligible patients are adjusted based on the patients? ability to pay. Condition/Cause: The Health Center did not retain underlying data in accordance with policy to support the sliding fee scale discount based on the patients? family size or income. Additionally, the Health Center had instances in which discounts were n…

Corrective action: Finding 2022-001 Sea Mar will retrain medical, dental and behavioral health department staff at all sites who conduct and/or oversee the patient registration and income verification process. This includes Health Center Administrators, Front Desk Supervisors, Dental Supervisors, Financial Specialists and Receptionists. This training will be conducted via Relias (web-based training and testing). This training will be required for all staff including new hires to ensure compliance and consistency. A competency test will be administered after the training, which requires a score of I 00% to pass. If an employee does not pass the competency test, they will be retrained and will retake the test. …

Criteria: In accordance with the Health Resources & Services Administration Health Center Program Compliance Manual, Chapter 9: Sliding Fee Discount Program, health centers must prepare and apply a sliding fee discount schedule so that amounts owed for health center services by eligible patients are adjusted based on the patients? ability to pay. Condition/Cause: The Health Center did not retain underlying data in accordance with policy to support the sliding fee scale discount based on the patients? family size or income. Additionally, the Health Center had instances in which discounts were not applied accurately based on the underlying support that was provided by the patient. The Health Center?s implementation of Epic during the current year impacted the design and im…

Corrective action: Sea Mar will retrain medical, dental and behavioral health department staff at all sites who conduct and/or oversee the patient registration and income verification process. This includes Health Center Administrators, Front Desk Supervisors, Dental Supervisors, Financial Specialists and Receptionists. This training will be conducted via live webinars. These webinars will be recorded so staff who did not attend the live webinar can view the recorded training and to use for refresher trainings and new staff trainings. A competency test will be administered after the training, which requires a 100% score to pass. If an employee does not pass the competency test, they will be retrained and retak…