Eager for guidance, this CBO recognized that internal issues could endanger $800k in federal funding

Challenge:

Located in a large Eastern city, this 501(c)(3) non-profit CBO was providing quality HIV health care services. It did not provide the services directly – it operated as an administrative and fiscal agency by contracting with 7 providers, then monitoring and managing those providers. The program’s design was good. However, the organization’s fiscal and administrative practices were weak.

This organization had received $800,000 in federal funding through HRSA (the agency that hired Joseph Boyd to conduct the review). This non-profit agency needed to shore up its effectiveness and compliance. Good news: They knew they faced multiple issues and were eager to receive insight and guidance.

Solution:

In conducting the review, Joseph identified 15 findings. A key compliance issue was failure to fully and accurately track the 7 contracted providers. Tracking deficiencies involved:

• Income reporting
• Sliding fee discounts
• Annual cap on charges
• Time and effort of clinicians delivering services
• Overall performance quality of each provider

Joseph’s on-site review included interviewing the leadership team, board of directors, and all staff members. Plus, he conducted a fine-tooth-comb review of the accounting books and financial practices. He then prepared a set of specific recommendations. A few highlights are:

• Implement stronger internal reporting, since this function was so disconnected. (Joseph provided an HRSA template and recommended making one person responsible for faithfully tracking and reporting all data related to compliance.)
• Conduct desk audits of each provider every 6 months to follow compliance guidelines. (Joseph provided detailed advice along with a tool.)
• Conduct an annual review of all providers to confirm they are performing quality services, then team with them to identify and implement improvements.
• Ensure the internal policies and actual procedures align with legislative and programmatic compliance.

Result:

To its credit, the organization made all required changes and is continuing to offer a successful program that delivers quality HIV health care. The program recipients are men, women, infants, children, and youth in that community – people who would have lost access to critical health care if that organization did not survive.