Wayne County audit finds control gaps at federally qualified health centers; commission receives report

The Wayne County Committee on Audit on Jan. 15 received and filed a performance audit of the Department of Health, Human and Veterans Services’ (HHVS) Federally Qualified Health Center (FQHC) processes, which identified five issues and 13 recommendations to strengthen controls.

The audit, presented by Marci Koro, Auditor General, covered Oct. 1, 2021, through Sept. 30, 2024, and concluded the county’s FQHC operations and payment controls need improvement to ensure federal grant compliance and accurate county budgeting. "We identified 5 issues and 13 recommendations to strengthen the internal control environment within the FQHC processes," Koro said during the committee meeting.

The report found the county did not provide a salaries-and-positions listing before contract execution for the SEMHA (Southeastern Michigan Health Association) contract that supports the FQHCs. According to the audit, SEMHA’s budget narrative listed 21.8 full-time-equivalent (FTE) positions while its employee roster showed 26.8 FTEs, a variance of five positions. The auditors also reported roughly $1,600,000 in salaries expended in fiscal 2023—about $155,000 more than budgeted—and noted instances where position salaries exceeded budgeted amounts without documentation of county approval. The auditors recommended the county require documented approval of initial staffing lists and any subsequent changes; HHVS management disagreed with that recommendation.

Kamal Kepuru, finance director for HHVS, told the…