Audit 317783

U.S. Department of Veterans Affairs Staff Sergeant Parker Gordon Fox Suicide Prevention Grant Program Assistance Listing # 64.055 Finding 2023-002 Significant Deficiency – Allowable Costs/Activities and Cash Management Criteria – The A-102 Common Rule requires that non-Federal entities receiving Federal awards establish and maintain internal control designed to reasonably ensure compliance with federal laws, regulations, and program compliance requirements. Adequate segregation of duties provided between performance, review, and recordkeeping of a task is a control activity which will reasonably ensure compliance with Federal laws, regulations, and program requirements. Condition – Documentation of preparer and reviewer could not be readily substantiated for two reimbursement requests selected for testing which is part of the Organization’s controls over allowable costs/activities and cash management. Questioned Costs – None. Context – Review of reimbursement requests are not performed in a consistent manner or consistently documented. Various methods, including emails, Teams chats, and informal verbal communications are used by the Organization. Evidence was provided for other reimbursement requests being reviewed and approved through various methods. However, for the reimbursement requests selected for testing, documentation of review and approval could not be readily substantiated. Effect – By not maintaining adequate and consistent documentation of review, the Organization may not be able to readily prevent, detect, and correct potential errors in allowable costs/activities and cash management requirements. Therefore, the Organization may be incorrectly reimbursed for expenditures under the program requirements. Cause – Current processes do not include a consistent method of performing, documenting, and maintaining adequate documentation of the review of reimbursement requests. Recommendation – The Organization should improve procedures to consistently perform and document review of reimbursement requests, including maintaining adequate documentation of its occurrence. Management’s Response – Management agrees with the finding.

U.S. Department of Veterans Affairs Staff Sergeant Parker Gordon Fox Suicide Prevention Grant Program Assistance Listing # 64.055 Finding 2023-003 Nonmaterial Noncompliance – Special Tests Criteria – The Staff Sergeant Parker Gordon Fox Suicide Prevention Grant Program, Program Guide Version 2, requires grantees to maintain certain information in each participant case file. Included in the requirements is an exit checklist to ensure appropriate exit steps have been carried out once it is determined that a participant is going to be exited. Condition – Exit checklists were not completed nor filed in each participant case file. Questioned Costs – None. Context – The Organization has an informal checklist that is used when participants are exiting. This checklist is not completed and maintained in each participant’s case file. Effect – By not completing and filing an exit checklist for each participant that is exiting, the Organization may not have completed all appropriate exit steps. Additionally, participant case files do not contain the documentation required by the program. Cause – Current processes do not include completing and filing in the participant’s case file a checklist for each participant exiting the program. Recommendation – The Organization should improve procedures to formally complete and include in participant case files a checklist for each participant who exiting the program. Management’s Response – Management agrees with the finding.

U.S. Department of Veterans Affairs Staff Sergeant Parker Gordon Fox Suicide Prevention Grant Program Assistance Listing # 64.055 Finding 2023-002 Significant Deficiency – Allowable Costs/Activities and Cash Management Criteria – The A-102 Common Rule requires that non-Federal entities receiving Federal awards establish and maintain internal control designed to reasonably ensure compliance with federal laws, regulations, and program compliance requirements. Adequate segregation of duties provided between performance, review, and recordkeeping of a task is a control activity which will reasonably ensure compliance with Federal laws, regulations, and program requirements. Condition – Documentation of preparer and reviewer could not be readily substantiated for two reimbursement requests selected for testing which is part of the Organization’s controls over allowable costs/activities and cash management. Questioned Costs – None. Context – Review of reimbursement requests are not performed in a consistent manner or consistently documented. Various methods, including emails, Teams chats, and informal verbal communications are used by the Organization. Evidence was provided for other reimbursement requests being reviewed and approved through various methods. However, for the reimbursement requests selected for testing, documentation of review and approval could not be readily substantiated. Effect – By not maintaining adequate and consistent documentation of review, the Organization may not be able to readily prevent, detect, and correct potential errors in allowable costs/activities and cash management requirements. Therefore, the Organization may be incorrectly reimbursed for expenditures under the program requirements. Cause – Current processes do not include a consistent method of performing, documenting, and maintaining adequate documentation of the review of reimbursement requests. Recommendation – The Organization should improve procedures to consistently perform and document review of reimbursement requests, including maintaining adequate documentation of its occurrence. Management’s Response – Management agrees with the finding.

U.S. Department of Veterans Affairs Staff Sergeant Parker Gordon Fox Suicide Prevention Grant Program Assistance Listing # 64.055 Finding 2023-003 Nonmaterial Noncompliance – Special Tests Criteria – The Staff Sergeant Parker Gordon Fox Suicide Prevention Grant Program, Program Guide Version 2, requires grantees to maintain certain information in each participant case file. Included in the requirements is an exit checklist to ensure appropriate exit steps have been carried out once it is determined that a participant is going to be exited. Condition – Exit checklists were not completed nor filed in each participant case file. Questioned Costs – None. Context – The Organization has an informal checklist that is used when participants are exiting. This checklist is not completed and maintained in each participant’s case file. Effect – By not completing and filing an exit checklist for each participant that is exiting, the Organization may not have completed all appropriate exit steps. Additionally, participant case files do not contain the documentation required by the program. Cause – Current processes do not include completing and filing in the participant’s case file a checklist for each participant exiting the program. Recommendation – The Organization should improve procedures to formally complete and include in participant case files a checklist for each participant who exiting the program. Management’s Response – Management agrees with the finding.