Audit 293199

FY End
2021-09-30
Total Expended
$8.14M
Findings
6
Programs
18
Year: 2021 Accepted: 2024-03-01
Auditor: Sjt Group LLC

Organization Exclusion Status:

Checking exclusion status...

Findings

ID Ref Severity Repeat Requirement
371930 2021-007 Significant Deficiency - B
371931 2021-008 Significant Deficiency - L
371932 2021-008 Significant Deficiency - L
948372 2021-007 Significant Deficiency - B
948373 2021-008 Significant Deficiency - L
948374 2021-008 Significant Deficiency - L

Programs

ALN Program Spent Major Findings
93.527 Affordable Care Act (aca) Grants for New and Expanded Services Under the Health Center Program $3.51M - 0
93.498 Provider Relief Fund $1.12M Yes 0
93.228 Indian Health Service_health Management Development Program $750,432 - 0
93.224 Consolidated Health Centers (community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care) $712,534 - 0
93.665 Emergency Grants to Address Mental and Substance Use Disorders During Covid-19 $407,191 Yes 1
93.193 Urban Indian Health Services $366,593 Yes 2
93.237 Special Diabetes Program for Indians_diabetes Prevention and Treatment Projects $264,318 - 0
93.243 Substance Abuse and Mental Health Services_projects of Regional and National Significance $220,697 - 0
93.933 Demonstration Projects for Indian Health $204,193 - 0
93.762 A Comprehensive Approach to Good Health and Wellness in Indian County Ð Financed Solely by Prevention and Public Health $139,265 - 0
93.912 Rural Health Care Services Outreach, Rural Health Network Development and Small Health Care Provider Quality Improvement $120,365 - 0
16.841 Voca Tribal Victim Services Set-Aside Program $102,848 - 0
93.242 Mental Health Research Grants $57,570 - 0
93.421 Strengthening Public Health Systems and Services Through National Partnerships to Improve and Protect the Nation’s Health $47,312 - 0
93.650 Accountable Health Communities $40,072 - 0
16.320 Services for Trafficking Victims $31,612 - 0
93.978 Preventive Health Services_sexually Transmitted Diseases Research, Demonstrations, and Public Information and Education Grants $30,340 - 0
16.575 Crime Victim Assistance $18,502 - 0

Contacts

Name Title Type
P3Q7YN23QCK4 Linda Son-Stone Auditee
5052626546 Joshua Trujillo Auditor
No contacts on file

Notes to SEFA

Title: Other Direct Reimbursements Accounting Policies: Expenditures reported on the Schedule are reported on the modified accrual basis of accounting. Such expenditures are recognized following the cost principles contained in Title 2 U.S. Code of Federal Regulations Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (Uniform Guidance), wherein certain types of expenditures are not allowable or are limited as to reimbursement. Pass-through entity identifying numbers are presented where available. De Minimis Rate Used: N Rate Explanation: The auditee has elected not to use the 10 percent de minimis indirect cost rate allowed under the Uniform Guidance. FNCH receives certain direct reimbursement revenue from federal agencies under the Medicare and Medicaid programs, which are not subject to the requirements of the Uniform Guidance and are not presented in the Schedule.
Title: COVID-19 Provider Relief Funds Accounting Policies: Expenditures reported on the Schedule are reported on the modified accrual basis of accounting. Such expenditures are recognized following the cost principles contained in Title 2 U.S. Code of Federal Regulations Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (Uniform Guidance), wherein certain types of expenditures are not allowable or are limited as to reimbursement. Pass-through entity identifying numbers are presented where available. De Minimis Rate Used: N Rate Explanation: The auditee has elected not to use the 10 percent de minimis indirect cost rate allowed under the Uniform Guidance. The Provider Relief Fund (PRF) is administered by the Health Resources and Services Administration (HRSA) and provides relief funds to hospitals and other healthcare providers, including those on the front lines of the coronavirus response. The funding supports healthcare-related expenses or lost revenue attributable to COVID-19 and ensures that uninsured Americans can get treatment for COVID-19. During fiscal year 2020, FNCH received funding under the PRF of approximately $1.1 million. In accordance with guidance included in the 2021 OMB Compliance Supplement, amounts for this program in the Schedule are based upon the PRF report that is required to be submitted to the HRSA reporting portal. FNCH reported the entire $1.1 million received from the PRF in its period 1 PRF report and therefore reported this entire amount in the Schedule for the year ending September 30, 2021.
Title: Reconciliation of the Schedule to the Consolidated Financial Statements Accounting Policies: Expenditures reported on the Schedule are reported on the modified accrual basis of accounting. Such expenditures are recognized following the cost principles contained in Title 2 U.S. Code of Federal Regulations Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (Uniform Guidance), wherein certain types of expenditures are not allowable or are limited as to reimbursement. Pass-through entity identifying numbers are presented where available. De Minimis Rate Used: N Rate Explanation: The auditee has elected not to use the 10 percent de minimis indirect cost rate allowed under the Uniform Guidance. The following is a reconciliation of the expenditures reported on the schedule of expenditures of federal awards to the consolidated financial statements: Contracts and grants revenue reported in the statement of activities $ 10,468,807 Add: COVID-19 Provider Relief Fund revenue reported in fiscal year 2020 1,116,971 Less: Nonfederal contract and grant revenue (3,442,714) Total expenditures of federal awards $ 8,143,064

Finding Details

2021-007—Allowable Costs/Cost Principles Federal program information: Funding agency: U.S. Department of Health and Human Services Title: COVID-19 Urban Indian Health Services ALN: 93.193 Award number: 75H70720C00006 Award period: March 27, 2020 – September 30, 2021 Criteria: According to 2 CFR Part 225, to be allowable under federal awards, costs must be adequately documented, be necessary and reasonable for the performance of the federal award and be allocable thereto under the principles in 2 CFR Part 200, Subpart E. According to the grant agreement for this award, this funding is to prevent, prepare for, and respond to COVID- 19, including COVID-19 related public health support, telehealth, other information technology upgrades, and other activities to protect the safety of patients and staff. Additionally, non-Federal entities receiving federal awards should establish and maintain internal control designed to reasonably ensure compliance with Federal laws, regulations and program compliance requirements. Condition: Three of 28 nonpayroll transactions tested were for utility costs, which are not an allowable cost of this federal award. For two additional nonpayroll transactions, we noted that the transactions were not approved by the Program Manager, Grants Manager, CFO, or CEO as required under the Finance policies and procedures. Questioned Costs: Utility expenses totaling $731. Context: Three of 28 nonpayroll disbursements tested represented utility costs, and two of 28 nonpayroll disbursements tested were not approved. Cause: FNCH is not following its approved Finance policies and procedures related to purchasing and accounts payable. Effect: FNCH may not be able to demonstrate that the costs charged to federal programs are allowable. Auditor’s Recommendations: FNCH should implement its approved Finance policies and procedures to ensure that amounts charged to federal programs are allowable and properly approved. Management’s Response: FNCH management agrees with the auditor’s recommendations. The Finance Department faced significant staffing challenges due to the COVID-19 pandemic. These challenges resulted in an 80% staff turnover, including the CFO. Additionally, the pandemic made it difficult for the Finance Department to hire new staff in a timely manner. The COVID- 19 outbreak also impacted attendance, resulting in employees being absent from work for one to two weeks. To address this issue, FNCH will initiate the following corrective actions. The CFO will implement internal measures, including creating a schedule of activities with due dates, progress reports, and staff meetings, to monitor and ensure that the amounts charged to federal programs are allowable and properly approved. Corrective action steps will be identified and implemented as needed. The grant/contract staff will review the grant budgets, including line-item allocations, to determine allowable expenses. The CFO will verify the monthly expenses are allowable and approve the drawdown budgets of the grants accordingly.
2021-008—Reporting Federal program information: Funding agency: U.S. Department of Health and Human Services Title: Urban Indian Health Services; COVID-19 Emergency Grants to Address Mental and Substance Use Disorders During COVID-19 ALN: 93.193; 93.665 Award number: 75H70720C00006; H722IHS0133; H79FG000227; H79FG000667 Award period: Various Criteria: Quarterly Federal Financial Reports (SF-425) are required to be submitted to the granting agency according to the Notice of Awards for these programs. Condition: Three of four quarterly SF-425 reports were submitted past the 30-day deadline after the end of each quarter. Questioned Costs: N/A Context: Three of four quarterly SF-425 reports for the Urban Indian Health Services grant awards and three of four quarterly SF-425 reports for the Emergency Grants to Address Mental and Substance Use Disorders During COVID-19 grant awards. Cause: Program personnel did not review and approve the reports for submission in a timely manner. Effect: FNCH is not in compliance with reporting requirements for these programs. Auditor’s Recommendations: FNCH should develop internal controls to ensure all program reports are properly completed and submitted by the required due dates. Management’s Response: FNCH management agrees with the auditor’s recommendations. The Finance Department faced significant staffing challenges due to the COVID-19 pandemic. These challenges resulted in an 80% staff turnover, including the CFO. Additionally, the pandemic made it difficult for the Finance Department to hire new staff in a timely manner. The COVID- 19 outbreak also impacted attendance, resulting in employees being absent from work for one to two weeks. As a result, the Finance Department could not submit the quarterly SF-425 reports due to the lack of staff. The CFO will implement internal measures, including creating a schedule of activities with due dates, progress reports, and staff meetings, to monitor and ensure the financial close and reporting process has been completed within the required timeframes and are accurate. Corrective action steps will be identified and implemented as needed. The grant/contract staff will maintain a log of when financial and other grant reports are due. The CFO will review the log and track report submissions to ensure timely completion and submission. To ensure timely completion, the staff will initiate activities to complete required reports and financial close at least 60 days before the deadline. The CFO will be responsible for ensuring the reporting deadlines have been met.
2021-008—Reporting Federal program information: Funding agency: U.S. Department of Health and Human Services Title: Urban Indian Health Services; COVID-19 Emergency Grants to Address Mental and Substance Use Disorders During COVID-19 ALN: 93.193; 93.665 Award number: 75H70720C00006; H722IHS0133; H79FG000227; H79FG000667 Award period: Various Criteria: Quarterly Federal Financial Reports (SF-425) are required to be submitted to the granting agency according to the Notice of Awards for these programs. Condition: Three of four quarterly SF-425 reports were submitted past the 30-day deadline after the end of each quarter. Questioned Costs: N/A Context: Three of four quarterly SF-425 reports for the Urban Indian Health Services grant awards and three of four quarterly SF-425 reports for the Emergency Grants to Address Mental and Substance Use Disorders During COVID-19 grant awards. Cause: Program personnel did not review and approve the reports for submission in a timely manner. Effect: FNCH is not in compliance with reporting requirements for these programs. Auditor’s Recommendations: FNCH should develop internal controls to ensure all program reports are properly completed and submitted by the required due dates. Management’s Response: FNCH management agrees with the auditor’s recommendations. The Finance Department faced significant staffing challenges due to the COVID-19 pandemic. These challenges resulted in an 80% staff turnover, including the CFO. Additionally, the pandemic made it difficult for the Finance Department to hire new staff in a timely manner. The COVID- 19 outbreak also impacted attendance, resulting in employees being absent from work for one to two weeks. As a result, the Finance Department could not submit the quarterly SF-425 reports due to the lack of staff. The CFO will implement internal measures, including creating a schedule of activities with due dates, progress reports, and staff meetings, to monitor and ensure the financial close and reporting process has been completed within the required timeframes and are accurate. Corrective action steps will be identified and implemented as needed. The grant/contract staff will maintain a log of when financial and other grant reports are due. The CFO will review the log and track report submissions to ensure timely completion and submission. To ensure timely completion, the staff will initiate activities to complete required reports and financial close at least 60 days before the deadline. The CFO will be responsible for ensuring the reporting deadlines have been met.
2021-007—Allowable Costs/Cost Principles Federal program information: Funding agency: U.S. Department of Health and Human Services Title: COVID-19 Urban Indian Health Services ALN: 93.193 Award number: 75H70720C00006 Award period: March 27, 2020 – September 30, 2021 Criteria: According to 2 CFR Part 225, to be allowable under federal awards, costs must be adequately documented, be necessary and reasonable for the performance of the federal award and be allocable thereto under the principles in 2 CFR Part 200, Subpart E. According to the grant agreement for this award, this funding is to prevent, prepare for, and respond to COVID- 19, including COVID-19 related public health support, telehealth, other information technology upgrades, and other activities to protect the safety of patients and staff. Additionally, non-Federal entities receiving federal awards should establish and maintain internal control designed to reasonably ensure compliance with Federal laws, regulations and program compliance requirements. Condition: Three of 28 nonpayroll transactions tested were for utility costs, which are not an allowable cost of this federal award. For two additional nonpayroll transactions, we noted that the transactions were not approved by the Program Manager, Grants Manager, CFO, or CEO as required under the Finance policies and procedures. Questioned Costs: Utility expenses totaling $731. Context: Three of 28 nonpayroll disbursements tested represented utility costs, and two of 28 nonpayroll disbursements tested were not approved. Cause: FNCH is not following its approved Finance policies and procedures related to purchasing and accounts payable. Effect: FNCH may not be able to demonstrate that the costs charged to federal programs are allowable. Auditor’s Recommendations: FNCH should implement its approved Finance policies and procedures to ensure that amounts charged to federal programs are allowable and properly approved. Management’s Response: FNCH management agrees with the auditor’s recommendations. The Finance Department faced significant staffing challenges due to the COVID-19 pandemic. These challenges resulted in an 80% staff turnover, including the CFO. Additionally, the pandemic made it difficult for the Finance Department to hire new staff in a timely manner. The COVID- 19 outbreak also impacted attendance, resulting in employees being absent from work for one to two weeks. To address this issue, FNCH will initiate the following corrective actions. The CFO will implement internal measures, including creating a schedule of activities with due dates, progress reports, and staff meetings, to monitor and ensure that the amounts charged to federal programs are allowable and properly approved. Corrective action steps will be identified and implemented as needed. The grant/contract staff will review the grant budgets, including line-item allocations, to determine allowable expenses. The CFO will verify the monthly expenses are allowable and approve the drawdown budgets of the grants accordingly.
2021-008—Reporting Federal program information: Funding agency: U.S. Department of Health and Human Services Title: Urban Indian Health Services; COVID-19 Emergency Grants to Address Mental and Substance Use Disorders During COVID-19 ALN: 93.193; 93.665 Award number: 75H70720C00006; H722IHS0133; H79FG000227; H79FG000667 Award period: Various Criteria: Quarterly Federal Financial Reports (SF-425) are required to be submitted to the granting agency according to the Notice of Awards for these programs. Condition: Three of four quarterly SF-425 reports were submitted past the 30-day deadline after the end of each quarter. Questioned Costs: N/A Context: Three of four quarterly SF-425 reports for the Urban Indian Health Services grant awards and three of four quarterly SF-425 reports for the Emergency Grants to Address Mental and Substance Use Disorders During COVID-19 grant awards. Cause: Program personnel did not review and approve the reports for submission in a timely manner. Effect: FNCH is not in compliance with reporting requirements for these programs. Auditor’s Recommendations: FNCH should develop internal controls to ensure all program reports are properly completed and submitted by the required due dates. Management’s Response: FNCH management agrees with the auditor’s recommendations. The Finance Department faced significant staffing challenges due to the COVID-19 pandemic. These challenges resulted in an 80% staff turnover, including the CFO. Additionally, the pandemic made it difficult for the Finance Department to hire new staff in a timely manner. The COVID- 19 outbreak also impacted attendance, resulting in employees being absent from work for one to two weeks. As a result, the Finance Department could not submit the quarterly SF-425 reports due to the lack of staff. The CFO will implement internal measures, including creating a schedule of activities with due dates, progress reports, and staff meetings, to monitor and ensure the financial close and reporting process has been completed within the required timeframes and are accurate. Corrective action steps will be identified and implemented as needed. The grant/contract staff will maintain a log of when financial and other grant reports are due. The CFO will review the log and track report submissions to ensure timely completion and submission. To ensure timely completion, the staff will initiate activities to complete required reports and financial close at least 60 days before the deadline. The CFO will be responsible for ensuring the reporting deadlines have been met.
2021-008—Reporting Federal program information: Funding agency: U.S. Department of Health and Human Services Title: Urban Indian Health Services; COVID-19 Emergency Grants to Address Mental and Substance Use Disorders During COVID-19 ALN: 93.193; 93.665 Award number: 75H70720C00006; H722IHS0133; H79FG000227; H79FG000667 Award period: Various Criteria: Quarterly Federal Financial Reports (SF-425) are required to be submitted to the granting agency according to the Notice of Awards for these programs. Condition: Three of four quarterly SF-425 reports were submitted past the 30-day deadline after the end of each quarter. Questioned Costs: N/A Context: Three of four quarterly SF-425 reports for the Urban Indian Health Services grant awards and three of four quarterly SF-425 reports for the Emergency Grants to Address Mental and Substance Use Disorders During COVID-19 grant awards. Cause: Program personnel did not review and approve the reports for submission in a timely manner. Effect: FNCH is not in compliance with reporting requirements for these programs. Auditor’s Recommendations: FNCH should develop internal controls to ensure all program reports are properly completed and submitted by the required due dates. Management’s Response: FNCH management agrees with the auditor’s recommendations. The Finance Department faced significant staffing challenges due to the COVID-19 pandemic. These challenges resulted in an 80% staff turnover, including the CFO. Additionally, the pandemic made it difficult for the Finance Department to hire new staff in a timely manner. The COVID- 19 outbreak also impacted attendance, resulting in employees being absent from work for one to two weeks. As a result, the Finance Department could not submit the quarterly SF-425 reports due to the lack of staff. The CFO will implement internal measures, including creating a schedule of activities with due dates, progress reports, and staff meetings, to monitor and ensure the financial close and reporting process has been completed within the required timeframes and are accurate. Corrective action steps will be identified and implemented as needed. The grant/contract staff will maintain a log of when financial and other grant reports are due. The CFO will review the log and track report submissions to ensure timely completion and submission. To ensure timely completion, the staff will initiate activities to complete required reports and financial close at least 60 days before the deadline. The CFO will be responsible for ensuring the reporting deadlines have been met.