Finding No.: 2021-003
Federal Agency: U.S. Department of Labor
AL Program: 17.225 Unemployment Insurance
Federal Award No.: UI-34839-20-55-A-70
Area: Activities Allowed or Unallowed
Questioned Costs: $11,820
Criteria:
1. In accordance with 2 CFR Part 200 – Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Award Section 200.303, grant recipient must establish, document, and maintain effective internal control over the Federal award that provides reasonable assurance that the recipient or subrecipient is managing the Federal award in compliance with Federal statutes, regulations, and the terms and conditions of the Federal award.
2. In accordance with applicable program requirements, funds may be used only for the payment of Pandemic Unemployment Assistance (PUA) benefits and for PUA-related state administrative costs.
Condition: During the audit, the following matters were noted:
1. Internal control over the administration of activities allowed or unallowed requirements are not implemented. The Republic’s internal controls are unlikely to operate effectively, as we cannot verify the controls implemented in the program. This is due to the unavailability of the individuals responsible for performing these controls during the audit fieldwork.
2. For 9 (or 4%) of 60 transactions tested, aggregating $43,674 of $16.2 million in total program expenditures, deductions of $11,820 were deducted from PUA and FPUC benefits as follows:
No. Claim
ID Date PUA FPUC Total Benefits Withholding SS HCF ROP Cross Act Total Deductions Net Amount Disbursed Amount
1 43381 10/02/2020 $3,176 $4,800 7,976 $883 $559 $199 $200 $1,841 $6,135 $6,135
2 43562 10/16/2020 3,573 5,400 8,973 823 628 224 800 2,475 6,498 6,498
3 43825 11/13/2020 3,573 – 3,573 346 250 89 – 685 2,888 2,888
4 43701 11/13/2020 5,161 – 5,161 499 362 129 – 990 4,171 4,171
5 43882 11/17/2020 4,367 – 4,367 423 305 109 – 837 3,530 3,530
6 43967 11/20/2020 5,161 – 5,161 499 362 129 – 990 4,171 4,171
7 44077 12/02/2020 5,161 – 5,161 499 362 129 – 990 4,171 4,171
8 44127 12/11/2020 5,161 4,800 9,961 1,075 698 249 – 2,022 7,939 7,939
9 44268 12/23/2020 5,161 – 5,161 499 362 129 – 990 4,171 4,171
Total: $40,494 $15,000 $55,494 $5,546 $3,888 $1,386 $1,000 $11,820 $43,674 $43,674
Cause: The Republic did not maintain effective internal controls over management of the program or monitor compliance with applicable activities allowed or unallowed requirements.
Effect: Condition 1: The Republic is not in compliance with applicable internal control requirements. This represents a material weakness, and the Compliance reports is modified accordingly.
Condition 2: The Republic is in noncompliance with applicable activities allowed or unallowed requirements. The reportable questioned cost is $11,820.
Recommendation: The Republic should establish and maintain internal controls over the administration of the program and effectively monitor program costs for compliance with allowable costs requirements. The Republic should establish and maintain internal controls and document roles and processes to address potential future personnel turnover.
Views of Responsible Officials: The Republic’s Corrective Action Plan does not indicate disagreement and provides planned corrective action. The identified questioned costs were subsequently refunded in FY2022 and FY2023.
Finding No.: 2021-004
Federal Agency: U.S. Department of Labor
AL Program: 17.225 Unemployment Insurance
Federal Award No.: UI-34839-20-55-A-70
Area: Eligibility
Questioned Costs: $1,726
Criteria: In accordance with applicable eligibility requirements, a claimant must be unemployed, partially unemployed, or unable or unavailable to work due to one of the COVID-19 related reasons identified Attachment I to Unemployment Insurance Program Letter (UIPL) No. 16-20, Change 5. Additionally, the claimant must self-certify availability to work.
Condition: For 3 (or 5%) of 60 case files tested, case file documentation is not sufficient to support claimant’s eligibility to receive benefits.
Description No. of case file Benefit Amount
(1) Checked "No" on Able and Available to work and no response to “Did you perform any work or telework?” Section 1 $ 697
(2) Incomplete COVID-19 reasons Section 1 385
(3) Insufficient documentation 1 644
Total: 3 $1,726
(1) For 1 (or 2%) of 60 case files tested, the claimant certified “not” able and available to work and no response to “Did you perform any work or telework?”.
(2) For 1 (or 2%) of 60 case files tested, no COVID-19 related reasons identified as a basis of unemployment status.
(3) For 1 (or 2%) of 60 case files tested, case file documentation is incomplete.
Cause: The Republic did not effectively monitor compliance with applicable eligibility requirements.
Effect: The Republic is in noncompliance with applicable eligibility requirements. Reportable questioned cost is $1,726.
Recommendation: The Republic should strengthen monitoring and administrative controls over recordkeeping and processing to substantiate compliance with applicable eligibility requirements. Qualified personnel should be assigned to support proper review of eligibility determination, period of eligibility, level of assistance, and other PUA eligibility requirements.
Views of Responsible Officials: The Republic’s Corrective Action Plan does not indicate disagreement and provides planned corrective action.
Finding No.: 2021-005
Federal Agency: U.S. Department of Labor
AL Program: 17.225 Unemployment Insurance
Federal Award No.: UI-34839-20-55-A-70
Area: Reporting
Questioned Costs: $0
Criteria: In accordance with applicable reporting requirements, the expenditures reported in the quarterly reports should be supported by underlying accounting records.
Condition: For all quarterly ETA 9130 reports tested, no underlying accounting records are available to support the expenditures reported in the reports.
No. Report Period Document Number Program Category Cumulative Expenditures
1 Quarterly Report - Q1 10/01/2020-12/31/2020 UI34839Z40 FPUC Benefits - FY20 $7,151,000
2 Quarterly Report - Q2 01/01/2021-3/31/2021 UI34839CA0 FPUC Administration - FY21 25,814
3 Quarterly Report - Q2 01/01/2021-3/31/2021 UI34839Z20 PUA Benefits - FY20 7,626,000
4 Quarterly Report - Q2 01/01/2021-3/31/2021 UI34839Z30 PUA Administration - FY20 181,415
5 Quarterly Report - Q2 01/01/2021-3/31/2021 UI34839C70 PUA Benefits - FY21 5,057,474
6 Quarterly Report - Q2 01/01/2021-3/31/2021 UI34839C90 FPUC Benefits - FY21 1,845,000
7 Quarterly Report - Q3 04/01/2021-6/30/2021 UI34839CA0 FPUC Administration - FY21 58,114
8 Quarterly Report - Q4 07/01/2021-9/30/2021 UI34839C70 PUA Benefits - FY21 5,758,576
Total: $27,703,393
Cause: The Republic did not effectively monitor compliance with applicable reporting requirements.
Effect: The Republic is in noncompliance with applicable reporting requirements. No question cost is presented; however, we are unable to verify the accuracy and completeness of the reports due to lack of the underlying accounting records supporting the expenditures reported in the ETA 9130 reports. This constitutes a scope limitation, and the compliance opinion is modified accordingly.
Recommendation: The Republic should strengthen monitoring controls over applicable reporting requirements. Responsible personnel should maintain underlying accounting records to substantiate reported amounts.
Views of Responsible Officials: The Republic’s Corrective Action Plan does not indicate disagreement and provides planned corrective action.
Finding No.: 2021-006
Federal Agency: U.S. Department of Labor
AL Program: 17.225 Unemployment Insurance
Federal Award No.: UI-34839-20-55-A-70
Area: Special Tests and Provisions – UI Program Integrity Overpayments
Questioned Costs: $0
Criteria: In accordance with applicable special tests and provisions requirements relative to overpayments, the state should have written procedure for identifying overpayments and classifying them in a manner that allows the state to take appropriate follow-up action.
Condition: The Republic has no written procedure for identifying overpayments and classifying them in a manner that allows the state to take appropriate follow-up action.
Cause: The Republic did not effectively monitor compliance with applicable special tests and provisions relative to overpayments written procedure requirements.
Effect: The Republic is in noncompliance with applicable special tests and provisions relative to overpayments written procedure requirements.
Recommendation: The Republic should strengthen monitoring controls over applicable special tests and provisions relative to overpayments written procedure requirements. The Republic should develop and implement written policies and procedures for identifying, classifying, and addressing overpayments, including appropriate follow-up action plan.
Views of Responsible Officials: The Republic’s Corrective Action Plan does not indicate disagreement and provides planned corrective action.
Finding No.: 2021-007
Federal Agency: U.S. Department of Health and Human Services
AL Program: 93.224 Health Center Program
Federal Award No.: 3 H80CS02467-34-02, 6 H80CS02467-34-03, 3 H80CS02467-34-04,
2 H80CS02467-34-00, 1 H8DCS36516-01-00, 1 H8ECS37981-01-00,
6 H80CS02467-35-02, 6 H80CS02467-35-03, 1 H8CCS34824-01-00
1 H8FCS41190-01-00, 6 H80CS02467-36-08, 5 H80CS02467-36-00
Area: Special Tests and Provisions – Sliding Fee Discounts
Questioned Costs: $1,209
Criteria: In accordance with applicable special tests and provisions requirements for sliding fee discounts, health centers must prepare and apply a sliding fee discount schedule (SFDS) so that the amounts owed for health center services by eligible patients are adjusted (discounted) based on the patient’s ability to pay.
Condition: For 57 (or 95%) of 60 invoices tested, aggregating $1,569 of $973,460 in total billed amount, patients were not properly billed based on the SFDS. Family income and size are not determining factors when patient services are provided. The discounts were applied and determined based on whether the patient is a resident or a nonresident, tourist or non-tourist, with insurance or none, senior citizen, and behavioral health patient.
No. Hospital
No. Invoice
Number Bill Charge Audit Calculation Overbilled / (Underbilled)
1 30639 674345 $18 $5 $13
2 17749 650946 18 5 13
3 51658 679220 9 – 9
4 87762 653008 21 5 16
5 20033 649309 68 15 53
6 100337 634472 44 10 34
7 39547 643820 17 – 17
8 2603 642508 2 – 2
9 25719 650848 19 10 9
10 23159 665988 2 – 2
11 192 645642 5 – 5
12 104165 668724 20 – 20
13 4785 641898 45 56 (11)
14 14760 658001 $42 $5 $37
15 117589 673704 34 – 34
16 11149 662247 23 10 13
17 57317 666221 5 – 5
18 3139 670270 2 – 2
19 102258 648154 49 15 34
20 95374 662894 55 5 50
21 13731 633477 123 6 117
22 68287 678980 31 5 26
23 45549 649513 5 – 5
24 114000 683812 16 5 11
25 68281 686013 128 – 128
26 42808 695258 44 10 34
27 84611 689021 47 6 41
28 3492 641733 6 5 1
29 42764 675271 13 - 13
30 23943 664656 8 5 3
31 31580 692356 44 31 13
32 42028 655072 9 – 9
33 48835 685960 7 5 2
34 4467 685896 49 18 31
35 14833 678083 8 – 8
36 24584 664517 9 – 9
37 119191 630403 31 – 31
38 31215 645644 51 6 45
39 50445 677256 14 5 9
40 100140 632085 67 10 57
41 5571 673304 3 – 3
42 114601 647495 $24 $15 $9
43 24388 660339 10 5 5
44 3561 690511 4 – 4
45 112788 668194 5 – 5
46 91850 690014 58 – 58
47 65395 630750 8 5 3
48 15720 670735 21 – 21
49 10658 694876 22 16 6
50 7384 638162 15 10 5
51 58429 678081 34 12 22
52 83643 666947 20 – 20
53 11259 685649 66 – 66
54 27698 655658 14 – 14
55 11867 675837 11 10 1
56 17370 676270 14 5 9
57 4906 666942 32 24 8
Total: $1,569 $360 $1,209
Cause: Republic of Palau Public Law (RPPL) 7-13 Section 19, which amends RPPL 5-7, requires Palauan citizens and their spouses to be charged hospital fees at a subsidized rate compared to non-Palauans. Accordingly, the Ministry of Health implemented its sliding fee schedule policy in 2006 in accordance with RPPL 7-13.
The community health centers program adopted its fee schedule policy based on income and family size. However, this policy cannot be implemented without the support of the Olbiil era Kelulau (National Congress).
Effect: The Republic is in noncompliance with applicable special tests and provisions requirements for sliding fee discounts. The reportable questioned cost is $1,209.
Identification as a Repeat Finding: Finding 2020-005 issued by the predecessor auditor.
Recommendation: We recommend that the Republic implement policies related to the sliding fee discount based on family income and size, in accordance with the aforementioned criteria.
Views of Responsible Officials: The Republic’s Corrective Action Plan does not indicate disagreement and provides planned corrective action.
Finding No.: 2021-008
Federal Agency: U.S. Department of Health and Human Services
AL Program: 93.268 Immunization Cooperative Agreements
Federal Award No.: 6 NH23IP922576-01-02, 5 NH23IP922576-02-00,
6 NH23IP922576-02-01, 6 NH23IP922576-02-03
6 NH23IP922576-02-05, 5 NH23IP922576-03-00
Area: Other Information
Questioned Costs: $0
Criteria: In accordance with applicable information requirements, the Centers for Disease Control and Prevention (CDC) advises each grantee of the value of all federally funded vaccines distributed, in lieu of cash, directly to the grantee and/or on behalf of the grantee to vaccinating providers located in the grantee’s geographical area. The annual dollar value of federally funded vaccines should be treated by the grantee as expenditures under a federal award for the purposes of determining audit coverage and reporting on the Schedule of Expenditures of Federal Awards.
Condition: The Republic failed to report the annual dollar value of the vaccines received from the CDC, amounting to $251,270, in its Schedule of Expenditures of Federal Awards for Fiscal Year 2021.
Cause: The Republic did not effectively monitor compliance with the applicable other information requirements.
Effect: The Republic is in noncompliance with the applicable other information requirements. A potential misstatement of federal expenditures within the Schedule of Expenditures of Federal Awards, basic financial statements, or related disclosures could exist undetected and uncorrected. No questioned cost is presented, as such potential misstatements were mitigated through the proposed audit adjustment.
Recommendation: The Republic should strengthen its monitoring controls over applicable other information requirements. Responsible personnel should obtain an understanding of the agency program requirements in the OMB Compliance Supplement.
Views of Responsible Officials: The Republic’s Corrective Action Plan does not indicate disagreement and provides planned corrective action.
Finding No.: 2021-003
Federal Agency: U.S. Department of Labor
AL Program: 17.225 Unemployment Insurance
Federal Award No.: UI-34839-20-55-A-70
Area: Activities Allowed or Unallowed
Questioned Costs: $11,820
Criteria:
1. In accordance with 2 CFR Part 200 – Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Award Section 200.303, grant recipient must establish, document, and maintain effective internal control over the Federal award that provides reasonable assurance that the recipient or subrecipient is managing the Federal award in compliance with Federal statutes, regulations, and the terms and conditions of the Federal award.
2. In accordance with applicable program requirements, funds may be used only for the payment of Pandemic Unemployment Assistance (PUA) benefits and for PUA-related state administrative costs.
Condition: During the audit, the following matters were noted:
1. Internal control over the administration of activities allowed or unallowed requirements are not implemented. The Republic’s internal controls are unlikely to operate effectively, as we cannot verify the controls implemented in the program. This is due to the unavailability of the individuals responsible for performing these controls during the audit fieldwork.
2. For 9 (or 4%) of 60 transactions tested, aggregating $43,674 of $16.2 million in total program expenditures, deductions of $11,820 were deducted from PUA and FPUC benefits as follows:
No. Claim
ID Date PUA FPUC Total Benefits Withholding SS HCF ROP Cross Act Total Deductions Net Amount Disbursed Amount
1 43381 10/02/2020 $3,176 $4,800 7,976 $883 $559 $199 $200 $1,841 $6,135 $6,135
2 43562 10/16/2020 3,573 5,400 8,973 823 628 224 800 2,475 6,498 6,498
3 43825 11/13/2020 3,573 – 3,573 346 250 89 – 685 2,888 2,888
4 43701 11/13/2020 5,161 – 5,161 499 362 129 – 990 4,171 4,171
5 43882 11/17/2020 4,367 – 4,367 423 305 109 – 837 3,530 3,530
6 43967 11/20/2020 5,161 – 5,161 499 362 129 – 990 4,171 4,171
7 44077 12/02/2020 5,161 – 5,161 499 362 129 – 990 4,171 4,171
8 44127 12/11/2020 5,161 4,800 9,961 1,075 698 249 – 2,022 7,939 7,939
9 44268 12/23/2020 5,161 – 5,161 499 362 129 – 990 4,171 4,171
Total: $40,494 $15,000 $55,494 $5,546 $3,888 $1,386 $1,000 $11,820 $43,674 $43,674
Cause: The Republic did not maintain effective internal controls over management of the program or monitor compliance with applicable activities allowed or unallowed requirements.
Effect: Condition 1: The Republic is not in compliance with applicable internal control requirements. This represents a material weakness, and the Compliance reports is modified accordingly.
Condition 2: The Republic is in noncompliance with applicable activities allowed or unallowed requirements. The reportable questioned cost is $11,820.
Recommendation: The Republic should establish and maintain internal controls over the administration of the program and effectively monitor program costs for compliance with allowable costs requirements. The Republic should establish and maintain internal controls and document roles and processes to address potential future personnel turnover.
Views of Responsible Officials: The Republic’s Corrective Action Plan does not indicate disagreement and provides planned corrective action. The identified questioned costs were subsequently refunded in FY2022 and FY2023.
Finding No.: 2021-004
Federal Agency: U.S. Department of Labor
AL Program: 17.225 Unemployment Insurance
Federal Award No.: UI-34839-20-55-A-70
Area: Eligibility
Questioned Costs: $1,726
Criteria: In accordance with applicable eligibility requirements, a claimant must be unemployed, partially unemployed, or unable or unavailable to work due to one of the COVID-19 related reasons identified Attachment I to Unemployment Insurance Program Letter (UIPL) No. 16-20, Change 5. Additionally, the claimant must self-certify availability to work.
Condition: For 3 (or 5%) of 60 case files tested, case file documentation is not sufficient to support claimant’s eligibility to receive benefits.
Description No. of case file Benefit Amount
(1) Checked "No" on Able and Available to work and no response to “Did you perform any work or telework?” Section 1 $ 697
(2) Incomplete COVID-19 reasons Section 1 385
(3) Insufficient documentation 1 644
Total: 3 $1,726
(1) For 1 (or 2%) of 60 case files tested, the claimant certified “not” able and available to work and no response to “Did you perform any work or telework?”.
(2) For 1 (or 2%) of 60 case files tested, no COVID-19 related reasons identified as a basis of unemployment status.
(3) For 1 (or 2%) of 60 case files tested, case file documentation is incomplete.
Cause: The Republic did not effectively monitor compliance with applicable eligibility requirements.
Effect: The Republic is in noncompliance with applicable eligibility requirements. Reportable questioned cost is $1,726.
Recommendation: The Republic should strengthen monitoring and administrative controls over recordkeeping and processing to substantiate compliance with applicable eligibility requirements. Qualified personnel should be assigned to support proper review of eligibility determination, period of eligibility, level of assistance, and other PUA eligibility requirements.
Views of Responsible Officials: The Republic’s Corrective Action Plan does not indicate disagreement and provides planned corrective action.
Finding No.: 2021-005
Federal Agency: U.S. Department of Labor
AL Program: 17.225 Unemployment Insurance
Federal Award No.: UI-34839-20-55-A-70
Area: Reporting
Questioned Costs: $0
Criteria: In accordance with applicable reporting requirements, the expenditures reported in the quarterly reports should be supported by underlying accounting records.
Condition: For all quarterly ETA 9130 reports tested, no underlying accounting records are available to support the expenditures reported in the reports.
No. Report Period Document Number Program Category Cumulative Expenditures
1 Quarterly Report - Q1 10/01/2020-12/31/2020 UI34839Z40 FPUC Benefits - FY20 $7,151,000
2 Quarterly Report - Q2 01/01/2021-3/31/2021 UI34839CA0 FPUC Administration - FY21 25,814
3 Quarterly Report - Q2 01/01/2021-3/31/2021 UI34839Z20 PUA Benefits - FY20 7,626,000
4 Quarterly Report - Q2 01/01/2021-3/31/2021 UI34839Z30 PUA Administration - FY20 181,415
5 Quarterly Report - Q2 01/01/2021-3/31/2021 UI34839C70 PUA Benefits - FY21 5,057,474
6 Quarterly Report - Q2 01/01/2021-3/31/2021 UI34839C90 FPUC Benefits - FY21 1,845,000
7 Quarterly Report - Q3 04/01/2021-6/30/2021 UI34839CA0 FPUC Administration - FY21 58,114
8 Quarterly Report - Q4 07/01/2021-9/30/2021 UI34839C70 PUA Benefits - FY21 5,758,576
Total: $27,703,393
Cause: The Republic did not effectively monitor compliance with applicable reporting requirements.
Effect: The Republic is in noncompliance with applicable reporting requirements. No question cost is presented; however, we are unable to verify the accuracy and completeness of the reports due to lack of the underlying accounting records supporting the expenditures reported in the ETA 9130 reports. This constitutes a scope limitation, and the compliance opinion is modified accordingly.
Recommendation: The Republic should strengthen monitoring controls over applicable reporting requirements. Responsible personnel should maintain underlying accounting records to substantiate reported amounts.
Views of Responsible Officials: The Republic’s Corrective Action Plan does not indicate disagreement and provides planned corrective action.
Finding No.: 2021-006
Federal Agency: U.S. Department of Labor
AL Program: 17.225 Unemployment Insurance
Federal Award No.: UI-34839-20-55-A-70
Area: Special Tests and Provisions – UI Program Integrity Overpayments
Questioned Costs: $0
Criteria: In accordance with applicable special tests and provisions requirements relative to overpayments, the state should have written procedure for identifying overpayments and classifying them in a manner that allows the state to take appropriate follow-up action.
Condition: The Republic has no written procedure for identifying overpayments and classifying them in a manner that allows the state to take appropriate follow-up action.
Cause: The Republic did not effectively monitor compliance with applicable special tests and provisions relative to overpayments written procedure requirements.
Effect: The Republic is in noncompliance with applicable special tests and provisions relative to overpayments written procedure requirements.
Recommendation: The Republic should strengthen monitoring controls over applicable special tests and provisions relative to overpayments written procedure requirements. The Republic should develop and implement written policies and procedures for identifying, classifying, and addressing overpayments, including appropriate follow-up action plan.
Views of Responsible Officials: The Republic’s Corrective Action Plan does not indicate disagreement and provides planned corrective action.
Finding No.: 2021-007
Federal Agency: U.S. Department of Health and Human Services
AL Program: 93.224 Health Center Program
Federal Award No.: 3 H80CS02467-34-02, 6 H80CS02467-34-03, 3 H80CS02467-34-04,
2 H80CS02467-34-00, 1 H8DCS36516-01-00, 1 H8ECS37981-01-00,
6 H80CS02467-35-02, 6 H80CS02467-35-03, 1 H8CCS34824-01-00
1 H8FCS41190-01-00, 6 H80CS02467-36-08, 5 H80CS02467-36-00
Area: Special Tests and Provisions – Sliding Fee Discounts
Questioned Costs: $1,209
Criteria: In accordance with applicable special tests and provisions requirements for sliding fee discounts, health centers must prepare and apply a sliding fee discount schedule (SFDS) so that the amounts owed for health center services by eligible patients are adjusted (discounted) based on the patient’s ability to pay.
Condition: For 57 (or 95%) of 60 invoices tested, aggregating $1,569 of $973,460 in total billed amount, patients were not properly billed based on the SFDS. Family income and size are not determining factors when patient services are provided. The discounts were applied and determined based on whether the patient is a resident or a nonresident, tourist or non-tourist, with insurance or none, senior citizen, and behavioral health patient.
No. Hospital
No. Invoice
Number Bill Charge Audit Calculation Overbilled / (Underbilled)
1 30639 674345 $18 $5 $13
2 17749 650946 18 5 13
3 51658 679220 9 – 9
4 87762 653008 21 5 16
5 20033 649309 68 15 53
6 100337 634472 44 10 34
7 39547 643820 17 – 17
8 2603 642508 2 – 2
9 25719 650848 19 10 9
10 23159 665988 2 – 2
11 192 645642 5 – 5
12 104165 668724 20 – 20
13 4785 641898 45 56 (11)
14 14760 658001 $42 $5 $37
15 117589 673704 34 – 34
16 11149 662247 23 10 13
17 57317 666221 5 – 5
18 3139 670270 2 – 2
19 102258 648154 49 15 34
20 95374 662894 55 5 50
21 13731 633477 123 6 117
22 68287 678980 31 5 26
23 45549 649513 5 – 5
24 114000 683812 16 5 11
25 68281 686013 128 – 128
26 42808 695258 44 10 34
27 84611 689021 47 6 41
28 3492 641733 6 5 1
29 42764 675271 13 - 13
30 23943 664656 8 5 3
31 31580 692356 44 31 13
32 42028 655072 9 – 9
33 48835 685960 7 5 2
34 4467 685896 49 18 31
35 14833 678083 8 – 8
36 24584 664517 9 – 9
37 119191 630403 31 – 31
38 31215 645644 51 6 45
39 50445 677256 14 5 9
40 100140 632085 67 10 57
41 5571 673304 3 – 3
42 114601 647495 $24 $15 $9
43 24388 660339 10 5 5
44 3561 690511 4 – 4
45 112788 668194 5 – 5
46 91850 690014 58 – 58
47 65395 630750 8 5 3
48 15720 670735 21 – 21
49 10658 694876 22 16 6
50 7384 638162 15 10 5
51 58429 678081 34 12 22
52 83643 666947 20 – 20
53 11259 685649 66 – 66
54 27698 655658 14 – 14
55 11867 675837 11 10 1
56 17370 676270 14 5 9
57 4906 666942 32 24 8
Total: $1,569 $360 $1,209
Cause: Republic of Palau Public Law (RPPL) 7-13 Section 19, which amends RPPL 5-7, requires Palauan citizens and their spouses to be charged hospital fees at a subsidized rate compared to non-Palauans. Accordingly, the Ministry of Health implemented its sliding fee schedule policy in 2006 in accordance with RPPL 7-13.
The community health centers program adopted its fee schedule policy based on income and family size. However, this policy cannot be implemented without the support of the Olbiil era Kelulau (National Congress).
Effect: The Republic is in noncompliance with applicable special tests and provisions requirements for sliding fee discounts. The reportable questioned cost is $1,209.
Identification as a Repeat Finding: Finding 2020-005 issued by the predecessor auditor.
Recommendation: We recommend that the Republic implement policies related to the sliding fee discount based on family income and size, in accordance with the aforementioned criteria.
Views of Responsible Officials: The Republic’s Corrective Action Plan does not indicate disagreement and provides planned corrective action.
Finding No.: 2021-008
Federal Agency: U.S. Department of Health and Human Services
AL Program: 93.268 Immunization Cooperative Agreements
Federal Award No.: 6 NH23IP922576-01-02, 5 NH23IP922576-02-00,
6 NH23IP922576-02-01, 6 NH23IP922576-02-03
6 NH23IP922576-02-05, 5 NH23IP922576-03-00
Area: Other Information
Questioned Costs: $0
Criteria: In accordance with applicable information requirements, the Centers for Disease Control and Prevention (CDC) advises each grantee of the value of all federally funded vaccines distributed, in lieu of cash, directly to the grantee and/or on behalf of the grantee to vaccinating providers located in the grantee’s geographical area. The annual dollar value of federally funded vaccines should be treated by the grantee as expenditures under a federal award for the purposes of determining audit coverage and reporting on the Schedule of Expenditures of Federal Awards.
Condition: The Republic failed to report the annual dollar value of the vaccines received from the CDC, amounting to $251,270, in its Schedule of Expenditures of Federal Awards for Fiscal Year 2021.
Cause: The Republic did not effectively monitor compliance with the applicable other information requirements.
Effect: The Republic is in noncompliance with the applicable other information requirements. A potential misstatement of federal expenditures within the Schedule of Expenditures of Federal Awards, basic financial statements, or related disclosures could exist undetected and uncorrected. No questioned cost is presented, as such potential misstatements were mitigated through the proposed audit adjustment.
Recommendation: The Republic should strengthen its monitoring controls over applicable other information requirements. Responsible personnel should obtain an understanding of the agency program requirements in the OMB Compliance Supplement.
Views of Responsible Officials: The Republic’s Corrective Action Plan does not indicate disagreement and provides planned corrective action.