Federal Reports

What We Looked AtWe contracted with the independent public accounting firm Leon Snead & Company, P.C., to audit the Surface Transportation Board’s (STB) financial statements as of and for the fiscal years ended September 30, 2020, and September 30, 2019, provide an opinion on those financial statements, and report on internal control over financial reporting, and report on compliance with laws and other matters. The contract requires the audit to be performed in accordance with U.S. generally accepted Government auditing standards, Office of Management and Budget audit guidance, and the Government Accountability Office’s and Council of the Inspectors General on Integrity and Efficiency’s Financial Audit Manual. We performed a quality control review of Leon Snead’s report dated November 6, 2020, and related documentation, and inquired of its representatives. What We FoundOur quality control review disclosed no instances in which Leon Snead did not comply, in all material respects, with U.S. generally accepted Government auditing standards. RecommendationsLeon Snead made no recommendations.

OBJECTIVE Our objective was to determine whether health centers in selected States used their Access Increases in Mental Health and Substance Abuse Services (AIMS) grant funding in accordance with Federal requirements and grant terms.BACKGROUNDThe Health Center Program The Health Center Program, authorized under section 330 of the Public Health Service Act (42 U.S.C. § 254b), provides primary health care services to medically underserved communities and vulnerable populations with limited access to health care through planning and operating grants to health centers. Health centers focus on integrating care for their patients across a full range of services, including medical, dental, mental health, substance use disorder (SUD) and vision services. Within the HHS, HRSA administers the Health Center Program. Access Increases in Mental Health and Substance Abuse Services GrantsIn September 2017, HRSA awarded $200.5 million in AIMS supplemental grant funding to 1,178 health centers nationwide. The grants were intended to expand access to mental health and SUD services focusing on the treatment, prevention, and awareness of opioid use disorder for health centers already funded under HRSA’s Health Center Program. Health centers were awarded the AIMS supplemental funds to increase personnel, strengthen health information technology (IT), and provide training to support the expansion of mental health and SUD services. Specifically, health centers received up to $85,200 in ongoing funds to support the expansion of services related to mental health and SUD services and up to $90,501 in one-time funds for health IT and training investments, for total awards up to $175,701. As a condition of receiving grant funding, health centers were required to claim reimbursement for allowable costs in accordance with grant terms and report progress toward achieving the expected outcomes in report submissions to HRSA.HOW WE CONDUCTED THIS AUDITOur audit covered AIMS grant funds totaling $112.9 million awarded during fiscal year (FY) 2017 to 665 health centers in the 30 States with the highest opioid overdose death rates in calendar year (CY) 2016. Depending on a health center’s budget period, these funds could be spent during the period September 1, 2017, through May 31, 2019. Of the 665 health centers in the 30 States, we reviewed a statistical sample of 100 health centers. For each selected health center, we reviewed documentation to determine whether the health center (1) met AIMS grant requirements for mental health and SUD service expansion and (2) claimed allowable costs.

The PRAC released the Toolkit as a resource to assist federal, state, and local oversight agencies and professionals in conducting timely reviews and oversight of federal funding. The Toolkit provides OIGs and other oversight offices a set of guidelines, best practices, and lessons learned to help prepare these types of reports for CARES Act oversight and beyond.