Federal Agency: U.S. Department of Health and Human Services
Federal Program Name: Opioid Response Grants
Assistance Listing Number: 93.788
Federal Award
Identification Number: H79TI083278
Pass-Through Entity: Illinois Department of Human Services
Pass-Through Number: 43CBC03525
Award Periods: July 1, 2022 – June 30, 2023
Criteria:
A non-federal entity may charge only allowable costs incurred during the approved budget period of a federal award's period of performance and any costs incurred before the federal awarding agency or pass-through entity made the federal award that were authorized by the federal awarding agency or pass-through entity (2 CFR sections 200.308 200.309 and 200.403(h)). A period of performance may contain one or more budget periods.
Condition:
Costs incurred outside of the period of performance were charged to the grant.
Questioned Costs:
$26,230
Context:
Six of eighteen transactions selected for testing.
Cause:
Unknown.
Effect:
The Organization may allocate unallowable costs to the grant.
Repeat Finding:
No.
Recommendation:
We recommend that only costs incurred during the period of performance be charged to the grant. For payroll in which periods extend over multiple budget periods, we recommend prorating the amount charged to the grant by days worked within the grant period.
Views of Responsible Officials:
There is no disagreement with the audit finding.
Federal Agency: U.S. Department of Health and Human Services
Federal Program Name: Health Center Cluster
Assistance Listing Number: 93.224 & 93.527
Federal Award
Identification Number: H80CS00725-21 and H80CS00725-22
Award Periods: June 1, 2022 – May 31, 2023 and June 1, 2023 – May 31, 2024
Criteria:
Health centers must prepare and apply a sliding fee discount schedule so that the amounts owed for health center services by eligible patients are adjusted (discounted) based on the patient’s ability to pay. (42 USC 254(k)(3)(E), (F), and (G); 42 CFR sections 51c.303(e), (f), and (g); and 42 CFR sections 56.303(e), (f), and (g)).
Condition:
The Organization incorrectly assessed and/or applied the sliding fee discount to a patient encounter during the year.
Questioned Costs:
None.
Context:
One of forty transactions selected for testing.
Cause:
Unknown.
Effect:
Patients are not charged according to the Organization's sliding fee scale and their ability to pay.
Repeat Finding:
No.
Recommendation:
Management should consider increasing the frequency of its self-reviews of patient encounters or expanding its sample sizes in addition to providing additional training for front desk staff regarding the collection and verification of patient information for each patient.
Views of Responsible Officials:
There is no disagreement with the audit finding.
Federal Agency: U.S. Department of Health and Human Services
Federal Program Name: Health Center Cluster
Assistance Listing Number: 93.224 & 93.527
Federal Award
Identification Number: H80CS00725-21 and H80CS00725-22
Award Periods: June 1, 2022 – May 31, 2023 and June 1, 2023 – May 31, 2024
Criteria:
Recipients of grants from the Bureau of Primary Health Care Health Center Program are required to prepare and file the Uniform Data System (UDS) report on an annual basis. The UDS report contains various information which has been identified as key line items with the compliance supplement for the health center program cluster.
Condition:
The amounts reported for Table 8A, line 1, column c and Table 8A, line 3, column c within the UDS report did not agree to the supporting documentation provided by the organization.
Questioned Costs:
None.
Context:
One of the key line items within the UDS report contained an amount which did not agree to the supporting documentation provided by the Organization. Total costs were in agreement however a change made to an allocation did not get updated within the final UDS report.
Cause:
During the UDS preparation process, the Organization was addressing various diagnostic checks which are built into the UDS report. As part of this process, a change was made to Table 5 and the Organization was unaware that this change also resulted in a change being made to Table 8.
Effect:
Reporting of incorrect amounts within the UDS report.
Repeat Finding:
No.
Recommendation:
We recommend the Organization performed a final review of amounts entered within the UDS report, as compared to the supporting schedules, prior to submission.
Views of Responsible Officials:
There is no disagreement with the audit finding.
Federal Agency: U.S. Department of Health and Human Services
Federal Program Name: Health Center Infrastructure Support
Assistance Listing Number: 93.526
Federal Award
Identification Number: C8ECS43959-01
Award Periods: September 15, 2021 – September 14, 2024
Criteria:
2 CFR section 200.320 outlines the acceptable methods of procurement. Purchases below the simplified acquisition threshold, but above the micro-purchase threshold, require that price or rate quotations be obtained from an adequate number of qualified sources as determined appropriate by the non-Federal entity. Furthermore, the Organization's procurement policies require the maintaining of records sufficient to detail the history of procurement including the rationale for the method of procurement, selection of contract type, contractor selection or rejection, and the basis for the contract price
Condition:
The organization did not maintain appropriate documentation to support the procurement method utilized for contracts selected for testing.
Questioned Costs:
None.
Context:
Three of three transactions selected for testing.
Cause:
The Center did not create and maintain appropriate documentation to support the method of procurement utilized.
Effect:
Potential noncompliance with 2 CFR section 200.320(c)(1) - (3).
Repeat Finding:
No.
Recommendation:
We recommend the Organization consistently follow its established policies and procedures related to the maintaining of necessary documentation to support the method of procurement utilized. The Organization may also consider qualifying multiple vendors for particular goods/service and then utilizing an approved vendors list.
Views of Responsible Officials:
There is no disagreement with the audit finding.
Federal Agency: U.S. Department of Health and Human Services
Federal Program Name: Provider Relief Fund (PRF)
Assistance Listing Number: 93.498
Federal Award
Identification Number: n/a
Award Periods: PRF period 4
Criteria:
§200.303(a) indicates non-federal entities must establish and maintain effective internal control over the Federal award that provides reasonable assurance that the non-Federal entity is managing the Federal award in compliance with Federal statutes, regulations, and the terms and conditions of the Federal award. These internal controls should be in compliance with guidance in “Standards for Internal Control in the Federal Government” issued by the Comptroller General of the United States or the “Internal Control Integrated Framework”, issued by the Committee of Sponsoring Organizations of the Treadway Commission (COSO).
Condition:
The Organization did not maintain sufficient documentation to demonstrate effective internal controls over selected transactions.
Questioned Costs:
$3,554.
Context:
Of the sixty transactions selected for testing, the Organization was unable to provide sufficient documentation for thirteen transactions.
Cause:
Turnover within the accounts payable department and transition to new accounting software.
Effect:
Potential for unallowable costs could be charged to the grant.
Repeat Finding:
No.
Recommendation:
We recommend the Organization maintain supporting documentation for all expenses (i.e. invoices, etc.) and use electronic means, such as accounts payable spend management software, when possible.
Views of Responsible Officials:
There is no disagreement with the audit finding.
Federal Agency: U.S. Department of Health and Human Services
Federal Program Name: Provider Relief Fund (PRF)
Assistance Listing Number: 93.498
Federal Award
Identification Number: n/a
Award Periods: PRF period 4
Criteria:
§200.303(a) indicates non-federal entities must establish and maintain effective internal control over the Federal award that provides reasonable assurance that the non-Federal entity is managing the Federal award in compliance with Federal statutes, regulations, and the terms and conditions of the Federal award. These internal controls should be in compliance with guidance in “Standards for Internal Control in the Federal Government” issued by the Comptroller General of the United States or the “Internal Control Integrated Framework”, issued by the Committee of Sponsoring Organizations of the Treadway Commission (COSO).
Condition:
The Organization did not maintain sufficient documentation to demonstrate effective internal controls over selected transactions.
Questioned Costs:
$3,554.
Context:
Of the sixty transactions selected for testing, the Organization was unable to provide sufficient documentation for thirteen transactions.
Cause:
Turnover within the accounts payable department and transition to new accounting software.
Effect:
Potential for unallowable costs could be charged to the grant.
Repeat Finding:
No.
Recommendation:
We recommend the Organization maintain supporting documentation for all expenses (i.e. invoices, etc.) and use electronic means, such as accounts payable spend management software, when possible.
Views of Responsible Officials:
There is no disagreement with the audit finding.
Federal Agency: U.S. Department of Health and Human Services
Federal Program Name: Opioid Response Grants
Assistance Listing Number: 93.788
Federal Award
Identification Number: H79TI083278
Pass-Through Entity: Illinois Department of Human Services
Pass-Through Number: 43CBC03525
Award Periods: July 1, 2022 – June 30, 2023
Criteria:
A non-federal entity may charge only allowable costs incurred during the approved budget period of a federal award's period of performance and any costs incurred before the federal awarding agency or pass-through entity made the federal award that were authorized by the federal awarding agency or pass-through entity (2 CFR sections 200.308 200.309 and 200.403(h)). A period of performance may contain one or more budget periods.
Condition:
Costs incurred outside of the period of performance were charged to the grant.
Questioned Costs:
$26,230
Context:
Six of eighteen transactions selected for testing.
Cause:
Unknown.
Effect:
The Organization may allocate unallowable costs to the grant.
Repeat Finding:
No.
Recommendation:
We recommend that only costs incurred during the period of performance be charged to the grant. For payroll in which periods extend over multiple budget periods, we recommend prorating the amount charged to the grant by days worked within the grant period.
Views of Responsible Officials:
There is no disagreement with the audit finding.
Federal Agency: U.S. Department of Health and Human Services
Federal Program Name: Health Center Cluster
Assistance Listing Number: 93.224 & 93.527
Federal Award
Identification Number: H80CS00725-21 and H80CS00725-22
Award Periods: June 1, 2022 – May 31, 2023 and June 1, 2023 – May 31, 2024
Criteria:
Health centers must prepare and apply a sliding fee discount schedule so that the amounts owed for health center services by eligible patients are adjusted (discounted) based on the patient’s ability to pay. (42 USC 254(k)(3)(E), (F), and (G); 42 CFR sections 51c.303(e), (f), and (g); and 42 CFR sections 56.303(e), (f), and (g)).
Condition:
The Organization incorrectly assessed and/or applied the sliding fee discount to a patient encounter during the year.
Questioned Costs:
None.
Context:
One of forty transactions selected for testing.
Cause:
Unknown.
Effect:
Patients are not charged according to the Organization's sliding fee scale and their ability to pay.
Repeat Finding:
No.
Recommendation:
Management should consider increasing the frequency of its self-reviews of patient encounters or expanding its sample sizes in addition to providing additional training for front desk staff regarding the collection and verification of patient information for each patient.
Views of Responsible Officials:
There is no disagreement with the audit finding.
Federal Agency: U.S. Department of Health and Human Services
Federal Program Name: Health Center Cluster
Assistance Listing Number: 93.224 & 93.527
Federal Award
Identification Number: H80CS00725-21 and H80CS00725-22
Award Periods: June 1, 2022 – May 31, 2023 and June 1, 2023 – May 31, 2024
Criteria:
Recipients of grants from the Bureau of Primary Health Care Health Center Program are required to prepare and file the Uniform Data System (UDS) report on an annual basis. The UDS report contains various information which has been identified as key line items with the compliance supplement for the health center program cluster.
Condition:
The amounts reported for Table 8A, line 1, column c and Table 8A, line 3, column c within the UDS report did not agree to the supporting documentation provided by the organization.
Questioned Costs:
None.
Context:
One of the key line items within the UDS report contained an amount which did not agree to the supporting documentation provided by the Organization. Total costs were in agreement however a change made to an allocation did not get updated within the final UDS report.
Cause:
During the UDS preparation process, the Organization was addressing various diagnostic checks which are built into the UDS report. As part of this process, a change was made to Table 5 and the Organization was unaware that this change also resulted in a change being made to Table 8.
Effect:
Reporting of incorrect amounts within the UDS report.
Repeat Finding:
No.
Recommendation:
We recommend the Organization performed a final review of amounts entered within the UDS report, as compared to the supporting schedules, prior to submission.
Views of Responsible Officials:
There is no disagreement with the audit finding.
Federal Agency: U.S. Department of Health and Human Services
Federal Program Name: Health Center Infrastructure Support
Assistance Listing Number: 93.526
Federal Award
Identification Number: C8ECS43959-01
Award Periods: September 15, 2021 – September 14, 2024
Criteria:
2 CFR section 200.320 outlines the acceptable methods of procurement. Purchases below the simplified acquisition threshold, but above the micro-purchase threshold, require that price or rate quotations be obtained from an adequate number of qualified sources as determined appropriate by the non-Federal entity. Furthermore, the Organization's procurement policies require the maintaining of records sufficient to detail the history of procurement including the rationale for the method of procurement, selection of contract type, contractor selection or rejection, and the basis for the contract price
Condition:
The organization did not maintain appropriate documentation to support the procurement method utilized for contracts selected for testing.
Questioned Costs:
None.
Context:
Three of three transactions selected for testing.
Cause:
The Center did not create and maintain appropriate documentation to support the method of procurement utilized.
Effect:
Potential noncompliance with 2 CFR section 200.320(c)(1) - (3).
Repeat Finding:
No.
Recommendation:
We recommend the Organization consistently follow its established policies and procedures related to the maintaining of necessary documentation to support the method of procurement utilized. The Organization may also consider qualifying multiple vendors for particular goods/service and then utilizing an approved vendors list.
Views of Responsible Officials:
There is no disagreement with the audit finding.
Federal Agency: U.S. Department of Health and Human Services
Federal Program Name: Provider Relief Fund (PRF)
Assistance Listing Number: 93.498
Federal Award
Identification Number: n/a
Award Periods: PRF period 4
Criteria:
§200.303(a) indicates non-federal entities must establish and maintain effective internal control over the Federal award that provides reasonable assurance that the non-Federal entity is managing the Federal award in compliance with Federal statutes, regulations, and the terms and conditions of the Federal award. These internal controls should be in compliance with guidance in “Standards for Internal Control in the Federal Government” issued by the Comptroller General of the United States or the “Internal Control Integrated Framework”, issued by the Committee of Sponsoring Organizations of the Treadway Commission (COSO).
Condition:
The Organization did not maintain sufficient documentation to demonstrate effective internal controls over selected transactions.
Questioned Costs:
$3,554.
Context:
Of the sixty transactions selected for testing, the Organization was unable to provide sufficient documentation for thirteen transactions.
Cause:
Turnover within the accounts payable department and transition to new accounting software.
Effect:
Potential for unallowable costs could be charged to the grant.
Repeat Finding:
No.
Recommendation:
We recommend the Organization maintain supporting documentation for all expenses (i.e. invoices, etc.) and use electronic means, such as accounts payable spend management software, when possible.
Views of Responsible Officials:
There is no disagreement with the audit finding.
Federal Agency: U.S. Department of Health and Human Services
Federal Program Name: Provider Relief Fund (PRF)
Assistance Listing Number: 93.498
Federal Award
Identification Number: n/a
Award Periods: PRF period 4
Criteria:
§200.303(a) indicates non-federal entities must establish and maintain effective internal control over the Federal award that provides reasonable assurance that the non-Federal entity is managing the Federal award in compliance with Federal statutes, regulations, and the terms and conditions of the Federal award. These internal controls should be in compliance with guidance in “Standards for Internal Control in the Federal Government” issued by the Comptroller General of the United States or the “Internal Control Integrated Framework”, issued by the Committee of Sponsoring Organizations of the Treadway Commission (COSO).
Condition:
The Organization did not maintain sufficient documentation to demonstrate effective internal controls over selected transactions.
Questioned Costs:
$3,554.
Context:
Of the sixty transactions selected for testing, the Organization was unable to provide sufficient documentation for thirteen transactions.
Cause:
Turnover within the accounts payable department and transition to new accounting software.
Effect:
Potential for unallowable costs could be charged to the grant.
Repeat Finding:
No.
Recommendation:
We recommend the Organization maintain supporting documentation for all expenses (i.e. invoices, etc.) and use electronic means, such as accounts payable spend management software, when possible.
Views of Responsible Officials:
There is no disagreement with the audit finding.