Audit 339776

FY End
2024-09-30
Total Expended
$25.56M
Findings
4
Programs
33
Year: 2024 Accepted: 2025-01-24
Auditor: Ernst & Young

Organization Exclusion Status:

Checking exclusion status...

Findings

ID Ref Severity Repeat Requirement
520219 2024-001 Material Weakness - P
520220 2024-001 Material Weakness - P
1096661 2024-001 Material Weakness - P
1096662 2024-001 Material Weakness - P

Programs

ALN Program Spent Major Findings
97.036 Covid-19 Disaster Grants - Public Assistance (presidentially Declared Disasters) $9.81M Yes 1
93.498 Covid-19 Provider Relief Fund and American Rescue Plan (arp) Rural Distribution $2.39M - 0
93.918 Grants to Provide Outpatient Early Intervention Services with Respect to Hiv Disease $323,192 - 0
93.912 Rural Health Care Services Outreach, Rural Health Network Development and Small Health Care Provider Quality Improvement $198,440 - 0
93.870 Maternal, Infant and Early Childhood Homevisiting Grant Program $163,989 - 0
93.251 Universal Newborn Hearing and Screening $153,533 - 0
93.940 Hiv Prevention Activities Health Department Based $130,646 - 0
93.994 Maternal and Child Health Services Block Grant to the States $118,978 - 0
90.601 Northern Border Regional Development $100,224 - 0
93.314 Early Hearing Detection and Intervention Information System (ehdi-Is) Surveillance Program $90,410 - 0
93.778 Medical Assistance Program $78,383 - 0
93.917 Hiv Care Formula Grants $77,967 - 0
93.253 Poison Control Stabilization and Enhancement Grants $56,603 - 0
93.044 Special Programs for the Aging, Title Iii, Part B, Grants for Supportive Services and Senior Centers $55,107 - 0
84.268 Federal Direct Student Loans $52,061 - 0
84.063 Federal Pell Grant Program $45,478 - 0
93.145 Aids Education and Training Centers $43,043 - 0
93.889 National Bioterrorism Hospital Preparedness Program $42,500 - 0
93.421 Strengthening Public Health Systems and Services Through National Partnerships to Improve and Protect the Nations Health $35,443 - 0
93.352 Construction Support $31,578 - 0
10.558 Child and Adult Care Food Program $21,850 - 0
21.027 Covid-19 Coronavirus State and Local Fiscal Recovery Funds $21,618 - 0
93.080 Blood Disorder Program: Prevention, Surveillance, and Research $20,000 - 0
93.977 Sexually Transmitted Diseases (std) Prevention and Control Grants $17,639 - 0
93.354 Public Health Emergency Response: Cooperative Agreement for Emergency Response: Public Health Crisis Response $13,819 - 0
93.334 The Healthy Brain Initiative: Technical Assistance to Implement Public Health Actions Related to Cognitive Health, Cognitive Impairment, and Caregiving at the State and Local Levels $13,695 - 0
93.110 Maternal and Child Health Federal Consolidated Programs $11,619 - 0
93.070 Environmental Public Health and Emergency Response $11,369 - 0
93.959 Block Grants for Prevention and Treatment of Substance Abuse $10,144 - 0
93.391 Activities to Support State, Tribal, Local and Territorial (stlt) Health Department Response to Public Health Or Healthcare Crises $8,982 - 0
93.301 Small Rural Hospital Improvement Grant Program $7,837 - 0
93.945 Assistance Programs for Chronic Disease Prevention and Control $3,575 - 0
93.865 Child Health and Human Development Extramural Research $2,144 - 0

Contacts

Name Title Type
CEX7F74WQ8B5 Rick Vincent Auditee
8028472089 Jessica Liconti Auditor
No contacts on file

Notes to SEFA

Title: COVID-19 – Provider Relief Fund Accounting Policies: The accompanying Schedule of Expenditures of Federal Awards (the Schedule) presents the federal grant expenditures of The University of Vermont Health Network Inc. and its subsidiaries (the Network) for the year ended September 30, 2024. Federal program expenditures included in the accompanying Schedule are presented on the accrual basis of accounting. The information in this Schedule is presented in accordance with the requirements of Title 2 U.S. Code of Federal Regulations Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (Uniform Guidance). In accordance with applicable requirements, certain programs may be presented in a fiscal period based on the program-specific guidance (see Notes 2 and 3). Therefore, some amounts presented in the accompanying Schedule may differ from amounts presented in or used in the preparation of the Network’s consolidated financial statements. For purposes of the Schedule, federal awards include any assistance provided by a federal agency directly or indirectly in the form of grants, contracts, cooperative agreements, loan and loan guarantees, or other non-cash assistance. Direct and indirect costs are charged to awards in accordance with cost principles contained in the United States Department of Health and Human Services Cost Principles for Hospitals at 45 CFR Part 75 Appendix IX for awards subject to the Uniform Guidance. Under these cost principles, certain types of expenditures are not allowable or are limited as to reimbursement. De Minimis Rate Used: Both Rate Explanation: The Network has elected to use the 10% de minimis indirect cost rate allowed under the Uniform Guidance. Effective May 1, 2024, the Network has negotiated an indirect rate of 26% on grants applied for after that date. The accompanying Schedule includes grant activity related to the Department of Health and Human Services (HHS) COVID-19 Provider Relief Fund (PRF) and American Rescue Plan (ARP) Distribution under Assistance Listing Number 93.498. In accordance with the guidance in the 2024 U.S. Office of Management and Budget Compliance Supplement, the Schedule includes all Period 6 and Period 7 funds received between July 1, 2022 and June 30, 2023 and expended by June 30, 2024, as reported to the Health Resources and Services Administration (HRSA) via the PRF Reporting Portal. The amounts reported in the accompanying Schedule reconcile to the PRF information previously reported to the HRSA for PRF Reporting Periods 6 and 7 as follows: Reporting Period 6: Activity from the period January 1, 2020 through December 31, 2023. [See the Notes to the SEFA for chart/table] Reporting Period 7: Activity from the period January 1, 2020 through June 30, 2024 No applicable PRF receipts during this Reporting Period. The expenses attributable to Coronavirus Disease 2019 (COVID-19) and lost revenues incurred by the Network during the period of availability for PRF Reporting Periods 6 and 7 are in excess of the general, targeted and infection control distributions received in PRF Reporting Periods 1 through 5 (which addressed payments received during April 10, 2020 to June 30, 2022, and previously reported on the Schedule of Expenditures of Federal Awards for the years ended September 30, 2023, 2022 and 2021) and distributions received from July 1, 2021 through June 30, 2023 and, therefore, the amounts presented in the table above and on the accompanying Schedule are limited to the amount of such distributions.
Title: Federal Emergency Management Agency: Disaster Grants Accounting Policies: The accompanying Schedule of Expenditures of Federal Awards (the Schedule) presents the federal grant expenditures of The University of Vermont Health Network Inc. and its subsidiaries (the Network) for the year ended September 30, 2024. Federal program expenditures included in the accompanying Schedule are presented on the accrual basis of accounting. The information in this Schedule is presented in accordance with the requirements of Title 2 U.S. Code of Federal Regulations Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (Uniform Guidance). In accordance with applicable requirements, certain programs may be presented in a fiscal period based on the program-specific guidance (see Notes 2 and 3). Therefore, some amounts presented in the accompanying Schedule may differ from amounts presented in or used in the preparation of the Network’s consolidated financial statements. For purposes of the Schedule, federal awards include any assistance provided by a federal agency directly or indirectly in the form of grants, contracts, cooperative agreements, loan and loan guarantees, or other non-cash assistance. Direct and indirect costs are charged to awards in accordance with cost principles contained in the United States Department of Health and Human Services Cost Principles for Hospitals at 45 CFR Part 75 Appendix IX for awards subject to the Uniform Guidance. Under these cost principles, certain types of expenditures are not allowable or are limited as to reimbursement. De Minimis Rate Used: Both Rate Explanation: The Network has elected to use the 10% de minimis indirect cost rate allowed under the Uniform Guidance. Effective May 1, 2024, the Network has negotiated an indirect rate of 26% on grants applied for after that date. The Network incurred certain expenditures related to the COVID-19 pandemic which are eligible for reimbursement from the Federal Emergency Management Agency (FEMA) Disaster Grants – Public Assistance (Presidentially Declared Disasters) program (Assistance Listing Number 97.036). The Network has applied for and received approval from FEMA in fiscal year 2024 for reimbursement of qualifying expenses totaling approximately $19,300,000, all of which are expenditures that were incurred in previous periods. The total amount approved in fiscal year 2024 has been included in the accompanying Schedule in accordance with the guidance specific to Assistance Listing Number 97.036.

Finding Details

Finding 2024-001 – Material weakness over amounts reported on the Schedule of Expenditures of Federal Awards (SEFA) Identification of the federal program: Federal Granting Agency: U.S. Department of Homeland Security, Federal Emergency Management Agency (FEMA) Award Name: COVID-19 – Disaster Grants – Public Assistance (Presidentially Declared Disasters) Assistance Listing Number: 97.036 Pass-through entity: Vermont Department of Public Safety and New York State Division of Homeland Security and Emergency Services Criteria or specific requirement: 2 CFR Section 200.303 of the Uniform Guidance states the following regarding internal control: “The non-Federal entity must: (a) 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 preliminary fiscal year 2024 expenditures reported on the schedule of expenditures of federal awards (SEFA) for the COVID-19 Disaster Grants – Public Assistance (Presidentially Declared Disasters) program (Disaster Grants program) incorrectly excluded Disaster Grants program funding that was obligated by FEMA during fiscal year 2024. Cause: Management did not have effective internal controls in place to ensure accurate reporting of the obligated funds for the Disaster Grants program. Effect or potential effect: Certain obligated amounts were incorrectly reported in the preliminary SEFA for the year ended September 30, 2024. Questioned costs: None. The updated SEFA, as presented in this report, was adjusted for the item noted in the Context section below. Context: Certain obligated amounts were incorrectly reported in the preliminary SEFA for the year ended September 30, 2024. After commencement of the Uniform Guidance audit procedures, adjustments of $18,199,589 were made to correctly report the SEFA amounts related to the Disaster Grants program. Identification as a repeat finding, if applicable: No. Recommendation: Management should reassess its internal controls over the review and approval process of the SEFA preparation. Views of responsible officials: Management has updated internal controls for the review and approval of the SEFA. Outlier projects (unique grant projects that aren’t recorded in the grant recording system) are reviewed for Uniform Guidance reporting based on program-specific guidance. Once complete, another member of management reviews the SEFA and general ledger details for accuracy. When questions arise, discussion will occur to ensure accuracy in the amounts reported on the SEFA.
Finding 2024-001 – Material weakness over amounts reported on the Schedule of Expenditures of Federal Awards (SEFA) Identification of the federal program: Federal Granting Agency: U.S. Department of Homeland Security, Federal Emergency Management Agency (FEMA) Award Name: COVID-19 – Disaster Grants – Public Assistance (Presidentially Declared Disasters) Assistance Listing Number: 97.036 Pass-through entity: Vermont Department of Public Safety and New York State Division of Homeland Security and Emergency Services Criteria or specific requirement: 2 CFR Section 200.303 of the Uniform Guidance states the following regarding internal control: “The non-Federal entity must: (a) 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 preliminary fiscal year 2024 expenditures reported on the schedule of expenditures of federal awards (SEFA) for the COVID-19 Disaster Grants – Public Assistance (Presidentially Declared Disasters) program (Disaster Grants program) incorrectly excluded Disaster Grants program funding that was obligated by FEMA during fiscal year 2024. Cause: Management did not have effective internal controls in place to ensure accurate reporting of the obligated funds for the Disaster Grants program. Effect or potential effect: Certain obligated amounts were incorrectly reported in the preliminary SEFA for the year ended September 30, 2024. Questioned costs: None. The updated SEFA, as presented in this report, was adjusted for the item noted in the Context section below. Context: Certain obligated amounts were incorrectly reported in the preliminary SEFA for the year ended September 30, 2024. After commencement of the Uniform Guidance audit procedures, adjustments of $18,199,589 were made to correctly report the SEFA amounts related to the Disaster Grants program. Identification as a repeat finding, if applicable: No. Recommendation: Management should reassess its internal controls over the review and approval process of the SEFA preparation. Views of responsible officials: Management has updated internal controls for the review and approval of the SEFA. Outlier projects (unique grant projects that aren’t recorded in the grant recording system) are reviewed for Uniform Guidance reporting based on program-specific guidance. Once complete, another member of management reviews the SEFA and general ledger details for accuracy. When questions arise, discussion will occur to ensure accuracy in the amounts reported on the SEFA.
Finding 2024-001 – Material weakness over amounts reported on the Schedule of Expenditures of Federal Awards (SEFA) Identification of the federal program: Federal Granting Agency: U.S. Department of Homeland Security, Federal Emergency Management Agency (FEMA) Award Name: COVID-19 – Disaster Grants – Public Assistance (Presidentially Declared Disasters) Assistance Listing Number: 97.036 Pass-through entity: Vermont Department of Public Safety and New York State Division of Homeland Security and Emergency Services Criteria or specific requirement: 2 CFR Section 200.303 of the Uniform Guidance states the following regarding internal control: “The non-Federal entity must: (a) 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 preliminary fiscal year 2024 expenditures reported on the schedule of expenditures of federal awards (SEFA) for the COVID-19 Disaster Grants – Public Assistance (Presidentially Declared Disasters) program (Disaster Grants program) incorrectly excluded Disaster Grants program funding that was obligated by FEMA during fiscal year 2024. Cause: Management did not have effective internal controls in place to ensure accurate reporting of the obligated funds for the Disaster Grants program. Effect or potential effect: Certain obligated amounts were incorrectly reported in the preliminary SEFA for the year ended September 30, 2024. Questioned costs: None. The updated SEFA, as presented in this report, was adjusted for the item noted in the Context section below. Context: Certain obligated amounts were incorrectly reported in the preliminary SEFA for the year ended September 30, 2024. After commencement of the Uniform Guidance audit procedures, adjustments of $18,199,589 were made to correctly report the SEFA amounts related to the Disaster Grants program. Identification as a repeat finding, if applicable: No. Recommendation: Management should reassess its internal controls over the review and approval process of the SEFA preparation. Views of responsible officials: Management has updated internal controls for the review and approval of the SEFA. Outlier projects (unique grant projects that aren’t recorded in the grant recording system) are reviewed for Uniform Guidance reporting based on program-specific guidance. Once complete, another member of management reviews the SEFA and general ledger details for accuracy. When questions arise, discussion will occur to ensure accuracy in the amounts reported on the SEFA.
Finding 2024-001 – Material weakness over amounts reported on the Schedule of Expenditures of Federal Awards (SEFA) Identification of the federal program: Federal Granting Agency: U.S. Department of Homeland Security, Federal Emergency Management Agency (FEMA) Award Name: COVID-19 – Disaster Grants – Public Assistance (Presidentially Declared Disasters) Assistance Listing Number: 97.036 Pass-through entity: Vermont Department of Public Safety and New York State Division of Homeland Security and Emergency Services Criteria or specific requirement: 2 CFR Section 200.303 of the Uniform Guidance states the following regarding internal control: “The non-Federal entity must: (a) 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 preliminary fiscal year 2024 expenditures reported on the schedule of expenditures of federal awards (SEFA) for the COVID-19 Disaster Grants – Public Assistance (Presidentially Declared Disasters) program (Disaster Grants program) incorrectly excluded Disaster Grants program funding that was obligated by FEMA during fiscal year 2024. Cause: Management did not have effective internal controls in place to ensure accurate reporting of the obligated funds for the Disaster Grants program. Effect or potential effect: Certain obligated amounts were incorrectly reported in the preliminary SEFA for the year ended September 30, 2024. Questioned costs: None. The updated SEFA, as presented in this report, was adjusted for the item noted in the Context section below. Context: Certain obligated amounts were incorrectly reported in the preliminary SEFA for the year ended September 30, 2024. After commencement of the Uniform Guidance audit procedures, adjustments of $18,199,589 were made to correctly report the SEFA amounts related to the Disaster Grants program. Identification as a repeat finding, if applicable: No. Recommendation: Management should reassess its internal controls over the review and approval process of the SEFA preparation. Views of responsible officials: Management has updated internal controls for the review and approval of the SEFA. Outlier projects (unique grant projects that aren’t recorded in the grant recording system) are reviewed for Uniform Guidance reporting based on program-specific guidance. Once complete, another member of management reviews the SEFA and general ledger details for accuracy. When questions arise, discussion will occur to ensure accuracy in the amounts reported on the SEFA.