2022-003 Department of Health and Human Services Iowa Department of Public Health CFDA #93.268 Immunization Cooperative Agreements Applicable Federal Award Number and Year ? 5881I429E, 5885BT431 #7, and 5885BT431 #8 for 2022 Cash Management Material Weakness in Internal Control Over Compliance Criteria: 2 CFR 200.303(a) establishes that the auditee must establish and maintain effective internal control over the federal award that provides assurance that the entity is managing the federal award in compliance with federal statutes, regulations, and conditions of the federal award. The Cash Management Improvement Act of 1990-31 CFR 205.33 requires that when grant funds are advanced, recipients must follow procedures to minimize the time elapsing between the transfer of funds and disbursement. Condition: The County?s requests for reimbursement submitted to the Iowa Department of Public Health were not reviewed and approved by a separate individual outside of the preparer. In addition, on two occasions the County held grant funds in excess of seven weeks. Cause: The County did not have an internal control process in place to ensure a secondary review and approval of the requests for reimbursement. Effect: Without a secondary review and approval, there is a possibility that the requests for reimbursement contain errors, which could lead to ineligible expenditures being claimed under the program and noncompliance with federal requirements regarding the Cash Management Improvement Act. Questioned Costs: None reported. Context: A nonstatistical sample of 6 requests for reimbursement out of 21 were tested. Repeat Finding from Prior Years: No Recommendation: We recommend the County implement a control process which includes a secondary review and approval of all requests for reimbursements. Views of Responsible Officials: The VNA will submit the claim to the Health Department for approval before submitting going forward.
2022-004 Department of Health and Human Services Iowa Department of Public Health CFDA #93.268 Immunization Cooperative Agreements Applicable Federal Award Number and Year ? 5881I429E, 5885BT431 #7, and 5885BT431 #8 for 2022 Subrecipient Monitoring and Special Tests and Provisions Material Weakness in Internal Control Over Compliance and Material Noncompliance Criteria: 2 CFR 200.303(a) establishes that the auditee must establish and maintain effective internal control over the federal award that provides assurance that the entity is managing the federal award in compliance with federal statutes, regulations, and conditions of the federal award. Subrecipient monitoring requirements are contained in 2 CFR 200.331 through 2 CFR 200.333 and include requirements to identify the award and applicable requirements to the subrecipient and monitor the activities of the subrecipient. Condition: The County did not formally communicate the required information to the subrecipient. No subrecipient agreement was executed. In addition, no monitoring activities were documented, including monitoring of the program?s special tests and provisions. Cause: The County did not have an internal control process in place to ensure subrecipient monitoring requirements were met. Effect: Without the proper communication of applicable requirements and monitoring of the subrecipient, there is a possibility that federal statutes, regulations, and the terms and conditions of the federal award, including the program?s special tests and provisions, were not complied with. Questioned Costs: None reported. Context: $112,801 was passed through to one subrecipient during the year ended June 30, 2022. Repeat Finding from Prior Years: No Recommendation: We recommend the County implement a control process which includes the applicable subrecipient monitoring requirements. Views of Responsible Officials: Dubuque County is working with the Dubuque Visiting Nurse Association on implementing a subrecipient agreement and will put a control process in place to monitor.
2022-003 Department of Health and Human Services Iowa Department of Public Health CFDA #93.268 Immunization Cooperative Agreements Applicable Federal Award Number and Year ? 5881I429E, 5885BT431 #7, and 5885BT431 #8 for 2022 Cash Management Material Weakness in Internal Control Over Compliance Criteria: 2 CFR 200.303(a) establishes that the auditee must establish and maintain effective internal control over the federal award that provides assurance that the entity is managing the federal award in compliance with federal statutes, regulations, and conditions of the federal award. The Cash Management Improvement Act of 1990-31 CFR 205.33 requires that when grant funds are advanced, recipients must follow procedures to minimize the time elapsing between the transfer of funds and disbursement. Condition: The County?s requests for reimbursement submitted to the Iowa Department of Public Health were not reviewed and approved by a separate individual outside of the preparer. In addition, on two occasions the County held grant funds in excess of seven weeks. Cause: The County did not have an internal control process in place to ensure a secondary review and approval of the requests for reimbursement. Effect: Without a secondary review and approval, there is a possibility that the requests for reimbursement contain errors, which could lead to ineligible expenditures being claimed under the program and noncompliance with federal requirements regarding the Cash Management Improvement Act. Questioned Costs: None reported. Context: A nonstatistical sample of 6 requests for reimbursement out of 21 were tested. Repeat Finding from Prior Years: No Recommendation: We recommend the County implement a control process which includes a secondary review and approval of all requests for reimbursements. Views of Responsible Officials: The VNA will submit the claim to the Health Department for approval before submitting going forward.
2022-004 Department of Health and Human Services Iowa Department of Public Health CFDA #93.268 Immunization Cooperative Agreements Applicable Federal Award Number and Year ? 5881I429E, 5885BT431 #7, and 5885BT431 #8 for 2022 Subrecipient Monitoring and Special Tests and Provisions Material Weakness in Internal Control Over Compliance and Material Noncompliance Criteria: 2 CFR 200.303(a) establishes that the auditee must establish and maintain effective internal control over the federal award that provides assurance that the entity is managing the federal award in compliance with federal statutes, regulations, and conditions of the federal award. Subrecipient monitoring requirements are contained in 2 CFR 200.331 through 2 CFR 200.333 and include requirements to identify the award and applicable requirements to the subrecipient and monitor the activities of the subrecipient. Condition: The County did not formally communicate the required information to the subrecipient. No subrecipient agreement was executed. In addition, no monitoring activities were documented, including monitoring of the program?s special tests and provisions. Cause: The County did not have an internal control process in place to ensure subrecipient monitoring requirements were met. Effect: Without the proper communication of applicable requirements and monitoring of the subrecipient, there is a possibility that federal statutes, regulations, and the terms and conditions of the federal award, including the program?s special tests and provisions, were not complied with. Questioned Costs: None reported. Context: $112,801 was passed through to one subrecipient during the year ended June 30, 2022. Repeat Finding from Prior Years: No Recommendation: We recommend the County implement a control process which includes the applicable subrecipient monitoring requirements. Views of Responsible Officials: Dubuque County is working with the Dubuque Visiting Nurse Association on implementing a subrecipient agreement and will put a control process in place to monitor.
2022-003 Department of Health and Human Services Iowa Department of Public Health CFDA #93.268 Immunization Cooperative Agreements Applicable Federal Award Number and Year ? 5881I429E, 5885BT431 #7, and 5885BT431 #8 for 2022 Cash Management Material Weakness in Internal Control Over Compliance Criteria: 2 CFR 200.303(a) establishes that the auditee must establish and maintain effective internal control over the federal award that provides assurance that the entity is managing the federal award in compliance with federal statutes, regulations, and conditions of the federal award. The Cash Management Improvement Act of 1990-31 CFR 205.33 requires that when grant funds are advanced, recipients must follow procedures to minimize the time elapsing between the transfer of funds and disbursement. Condition: The County?s requests for reimbursement submitted to the Iowa Department of Public Health were not reviewed and approved by a separate individual outside of the preparer. In addition, on two occasions the County held grant funds in excess of seven weeks. Cause: The County did not have an internal control process in place to ensure a secondary review and approval of the requests for reimbursement. Effect: Without a secondary review and approval, there is a possibility that the requests for reimbursement contain errors, which could lead to ineligible expenditures being claimed under the program and noncompliance with federal requirements regarding the Cash Management Improvement Act. Questioned Costs: None reported. Context: A nonstatistical sample of 6 requests for reimbursement out of 21 were tested. Repeat Finding from Prior Years: No Recommendation: We recommend the County implement a control process which includes a secondary review and approval of all requests for reimbursements. Views of Responsible Officials: The VNA will submit the claim to the Health Department for approval before submitting going forward.
2022-004 Department of Health and Human Services Iowa Department of Public Health CFDA #93.268 Immunization Cooperative Agreements Applicable Federal Award Number and Year ? 5881I429E, 5885BT431 #7, and 5885BT431 #8 for 2022 Subrecipient Monitoring and Special Tests and Provisions Material Weakness in Internal Control Over Compliance and Material Noncompliance Criteria: 2 CFR 200.303(a) establishes that the auditee must establish and maintain effective internal control over the federal award that provides assurance that the entity is managing the federal award in compliance with federal statutes, regulations, and conditions of the federal award. Subrecipient monitoring requirements are contained in 2 CFR 200.331 through 2 CFR 200.333 and include requirements to identify the award and applicable requirements to the subrecipient and monitor the activities of the subrecipient. Condition: The County did not formally communicate the required information to the subrecipient. No subrecipient agreement was executed. In addition, no monitoring activities were documented, including monitoring of the program?s special tests and provisions. Cause: The County did not have an internal control process in place to ensure subrecipient monitoring requirements were met. Effect: Without the proper communication of applicable requirements and monitoring of the subrecipient, there is a possibility that federal statutes, regulations, and the terms and conditions of the federal award, including the program?s special tests and provisions, were not complied with. Questioned Costs: None reported. Context: $112,801 was passed through to one subrecipient during the year ended June 30, 2022. Repeat Finding from Prior Years: No Recommendation: We recommend the County implement a control process which includes the applicable subrecipient monitoring requirements. Views of Responsible Officials: Dubuque County is working with the Dubuque Visiting Nurse Association on implementing a subrecipient agreement and will put a control process in place to monitor.
2022-002 Department of Health and Human Services CFDA #93.498 COVID-19 Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution Applicable Federal Award Number and Year ? Periods 2 and 3 TIN #426004597 Activities Allowed or Unallowed and Allowable Costs/Cost Principles and Reporting Material Weakness in Internal Control Over Compliance Criteria: 2 CFR 200.303(a) establishes that the auditee must establish and maintain effective internal control over the federal award that provides assurance that the entity is managing the federal award in compliance with federal statutes, regulations, and conditions of the federal award. Condition: The Center?s final expenditure listing identified as eligible and claimed under the Provider Relief Fund program was not reviewed and approved by a separate individual outside of the preparer. In addition, the County?s special reports submitted to the Department of Health and Human Services for Periods 2 and 3 TIN #426004597 were not reviewed and approved by a separate individual outside of the preparer. Cause: The County did not have an internal control process in place to ensure a secondary review and approval of eligible expenditures that were summarized from the underlying support to the final expenditure listing was documented. The summary spreadsheet was used to claim allowable costs under the federal program. In addition, the review and approval of the reports submitted to the Department of Health and Human Services for Periods 2 and 3 were not performed by someone other than the preparer of the report. Effect: Without a secondary review and approval, there is a possibility that ineligible expenditures may be claimed under the program and the report may not be accurately completed. Questioned Costs: None reported. Context: Testing was performed over general and administrative expenses and healthcare related expenses, including personnel costs and certain supplies for activities allowed and unallowed and allowable costs/cost principles. A nonstatistical sample of 17 transactions totaling $129,627 out of $213,848 were tested. In addition, key line items were tested on the Period 2 and Period 3 Department of Health and Human Services special reports. Repeat Finding from Prior Years: No Recommendation: We recommend the County implement a control process which includes a secondary review and approval of the summarized final expenditure listing used to claim the allowable costs under the federal program and secondary review and approval of required reports to be submitted to the federal agency. Views of Responsible Officials: Moving forward, the Finance Director and/or Administrator will review and approve the expenditures and reports prior to being submitted.
2022-003 Department of Health and Human Services Iowa Department of Public Health CFDA #93.268 Immunization Cooperative Agreements Applicable Federal Award Number and Year ? 5881I429E, 5885BT431 #7, and 5885BT431 #8 for 2022 Cash Management Material Weakness in Internal Control Over Compliance Criteria: 2 CFR 200.303(a) establishes that the auditee must establish and maintain effective internal control over the federal award that provides assurance that the entity is managing the federal award in compliance with federal statutes, regulations, and conditions of the federal award. The Cash Management Improvement Act of 1990-31 CFR 205.33 requires that when grant funds are advanced, recipients must follow procedures to minimize the time elapsing between the transfer of funds and disbursement. Condition: The County?s requests for reimbursement submitted to the Iowa Department of Public Health were not reviewed and approved by a separate individual outside of the preparer. In addition, on two occasions the County held grant funds in excess of seven weeks. Cause: The County did not have an internal control process in place to ensure a secondary review and approval of the requests for reimbursement. Effect: Without a secondary review and approval, there is a possibility that the requests for reimbursement contain errors, which could lead to ineligible expenditures being claimed under the program and noncompliance with federal requirements regarding the Cash Management Improvement Act. Questioned Costs: None reported. Context: A nonstatistical sample of 6 requests for reimbursement out of 21 were tested. Repeat Finding from Prior Years: No Recommendation: We recommend the County implement a control process which includes a secondary review and approval of all requests for reimbursements. Views of Responsible Officials: The VNA will submit the claim to the Health Department for approval before submitting going forward.
2022-004 Department of Health and Human Services Iowa Department of Public Health CFDA #93.268 Immunization Cooperative Agreements Applicable Federal Award Number and Year ? 5881I429E, 5885BT431 #7, and 5885BT431 #8 for 2022 Subrecipient Monitoring and Special Tests and Provisions Material Weakness in Internal Control Over Compliance and Material Noncompliance Criteria: 2 CFR 200.303(a) establishes that the auditee must establish and maintain effective internal control over the federal award that provides assurance that the entity is managing the federal award in compliance with federal statutes, regulations, and conditions of the federal award. Subrecipient monitoring requirements are contained in 2 CFR 200.331 through 2 CFR 200.333 and include requirements to identify the award and applicable requirements to the subrecipient and monitor the activities of the subrecipient. Condition: The County did not formally communicate the required information to the subrecipient. No subrecipient agreement was executed. In addition, no monitoring activities were documented, including monitoring of the program?s special tests and provisions. Cause: The County did not have an internal control process in place to ensure subrecipient monitoring requirements were met. Effect: Without the proper communication of applicable requirements and monitoring of the subrecipient, there is a possibility that federal statutes, regulations, and the terms and conditions of the federal award, including the program?s special tests and provisions, were not complied with. Questioned Costs: None reported. Context: $112,801 was passed through to one subrecipient during the year ended June 30, 2022. Repeat Finding from Prior Years: No Recommendation: We recommend the County implement a control process which includes the applicable subrecipient monitoring requirements. Views of Responsible Officials: Dubuque County is working with the Dubuque Visiting Nurse Association on implementing a subrecipient agreement and will put a control process in place to monitor.
2022-003 Department of Health and Human Services Iowa Department of Public Health CFDA #93.268 Immunization Cooperative Agreements Applicable Federal Award Number and Year ? 5881I429E, 5885BT431 #7, and 5885BT431 #8 for 2022 Cash Management Material Weakness in Internal Control Over Compliance Criteria: 2 CFR 200.303(a) establishes that the auditee must establish and maintain effective internal control over the federal award that provides assurance that the entity is managing the federal award in compliance with federal statutes, regulations, and conditions of the federal award. The Cash Management Improvement Act of 1990-31 CFR 205.33 requires that when grant funds are advanced, recipients must follow procedures to minimize the time elapsing between the transfer of funds and disbursement. Condition: The County?s requests for reimbursement submitted to the Iowa Department of Public Health were not reviewed and approved by a separate individual outside of the preparer. In addition, on two occasions the County held grant funds in excess of seven weeks. Cause: The County did not have an internal control process in place to ensure a secondary review and approval of the requests for reimbursement. Effect: Without a secondary review and approval, there is a possibility that the requests for reimbursement contain errors, which could lead to ineligible expenditures being claimed under the program and noncompliance with federal requirements regarding the Cash Management Improvement Act. Questioned Costs: None reported. Context: A nonstatistical sample of 6 requests for reimbursement out of 21 were tested. Repeat Finding from Prior Years: No Recommendation: We recommend the County implement a control process which includes a secondary review and approval of all requests for reimbursements. Views of Responsible Officials: The VNA will submit the claim to the Health Department for approval before submitting going forward.
2022-004 Department of Health and Human Services Iowa Department of Public Health CFDA #93.268 Immunization Cooperative Agreements Applicable Federal Award Number and Year ? 5881I429E, 5885BT431 #7, and 5885BT431 #8 for 2022 Subrecipient Monitoring and Special Tests and Provisions Material Weakness in Internal Control Over Compliance and Material Noncompliance Criteria: 2 CFR 200.303(a) establishes that the auditee must establish and maintain effective internal control over the federal award that provides assurance that the entity is managing the federal award in compliance with federal statutes, regulations, and conditions of the federal award. Subrecipient monitoring requirements are contained in 2 CFR 200.331 through 2 CFR 200.333 and include requirements to identify the award and applicable requirements to the subrecipient and monitor the activities of the subrecipient. Condition: The County did not formally communicate the required information to the subrecipient. No subrecipient agreement was executed. In addition, no monitoring activities were documented, including monitoring of the program?s special tests and provisions. Cause: The County did not have an internal control process in place to ensure subrecipient monitoring requirements were met. Effect: Without the proper communication of applicable requirements and monitoring of the subrecipient, there is a possibility that federal statutes, regulations, and the terms and conditions of the federal award, including the program?s special tests and provisions, were not complied with. Questioned Costs: None reported. Context: $112,801 was passed through to one subrecipient during the year ended June 30, 2022. Repeat Finding from Prior Years: No Recommendation: We recommend the County implement a control process which includes the applicable subrecipient monitoring requirements. Views of Responsible Officials: Dubuque County is working with the Dubuque Visiting Nurse Association on implementing a subrecipient agreement and will put a control process in place to monitor.
2022-003 Department of Health and Human Services Iowa Department of Public Health CFDA #93.268 Immunization Cooperative Agreements Applicable Federal Award Number and Year ? 5881I429E, 5885BT431 #7, and 5885BT431 #8 for 2022 Cash Management Material Weakness in Internal Control Over Compliance Criteria: 2 CFR 200.303(a) establishes that the auditee must establish and maintain effective internal control over the federal award that provides assurance that the entity is managing the federal award in compliance with federal statutes, regulations, and conditions of the federal award. The Cash Management Improvement Act of 1990-31 CFR 205.33 requires that when grant funds are advanced, recipients must follow procedures to minimize the time elapsing between the transfer of funds and disbursement. Condition: The County?s requests for reimbursement submitted to the Iowa Department of Public Health were not reviewed and approved by a separate individual outside of the preparer. In addition, on two occasions the County held grant funds in excess of seven weeks. Cause: The County did not have an internal control process in place to ensure a secondary review and approval of the requests for reimbursement. Effect: Without a secondary review and approval, there is a possibility that the requests for reimbursement contain errors, which could lead to ineligible expenditures being claimed under the program and noncompliance with federal requirements regarding the Cash Management Improvement Act. Questioned Costs: None reported. Context: A nonstatistical sample of 6 requests for reimbursement out of 21 were tested. Repeat Finding from Prior Years: No Recommendation: We recommend the County implement a control process which includes a secondary review and approval of all requests for reimbursements. Views of Responsible Officials: The VNA will submit the claim to the Health Department for approval before submitting going forward.
2022-004 Department of Health and Human Services Iowa Department of Public Health CFDA #93.268 Immunization Cooperative Agreements Applicable Federal Award Number and Year ? 5881I429E, 5885BT431 #7, and 5885BT431 #8 for 2022 Subrecipient Monitoring and Special Tests and Provisions Material Weakness in Internal Control Over Compliance and Material Noncompliance Criteria: 2 CFR 200.303(a) establishes that the auditee must establish and maintain effective internal control over the federal award that provides assurance that the entity is managing the federal award in compliance with federal statutes, regulations, and conditions of the federal award. Subrecipient monitoring requirements are contained in 2 CFR 200.331 through 2 CFR 200.333 and include requirements to identify the award and applicable requirements to the subrecipient and monitor the activities of the subrecipient. Condition: The County did not formally communicate the required information to the subrecipient. No subrecipient agreement was executed. In addition, no monitoring activities were documented, including monitoring of the program?s special tests and provisions. Cause: The County did not have an internal control process in place to ensure subrecipient monitoring requirements were met. Effect: Without the proper communication of applicable requirements and monitoring of the subrecipient, there is a possibility that federal statutes, regulations, and the terms and conditions of the federal award, including the program?s special tests and provisions, were not complied with. Questioned Costs: None reported. Context: $112,801 was passed through to one subrecipient during the year ended June 30, 2022. Repeat Finding from Prior Years: No Recommendation: We recommend the County implement a control process which includes the applicable subrecipient monitoring requirements. Views of Responsible Officials: Dubuque County is working with the Dubuque Visiting Nurse Association on implementing a subrecipient agreement and will put a control process in place to monitor.
2022-002 Department of Health and Human Services CFDA #93.498 COVID-19 Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution Applicable Federal Award Number and Year ? Periods 2 and 3 TIN #426004597 Activities Allowed or Unallowed and Allowable Costs/Cost Principles and Reporting Material Weakness in Internal Control Over Compliance Criteria: 2 CFR 200.303(a) establishes that the auditee must establish and maintain effective internal control over the federal award that provides assurance that the entity is managing the federal award in compliance with federal statutes, regulations, and conditions of the federal award. Condition: The Center?s final expenditure listing identified as eligible and claimed under the Provider Relief Fund program was not reviewed and approved by a separate individual outside of the preparer. In addition, the County?s special reports submitted to the Department of Health and Human Services for Periods 2 and 3 TIN #426004597 were not reviewed and approved by a separate individual outside of the preparer. Cause: The County did not have an internal control process in place to ensure a secondary review and approval of eligible expenditures that were summarized from the underlying support to the final expenditure listing was documented. The summary spreadsheet was used to claim allowable costs under the federal program. In addition, the review and approval of the reports submitted to the Department of Health and Human Services for Periods 2 and 3 were not performed by someone other than the preparer of the report. Effect: Without a secondary review and approval, there is a possibility that ineligible expenditures may be claimed under the program and the report may not be accurately completed. Questioned Costs: None reported. Context: Testing was performed over general and administrative expenses and healthcare related expenses, including personnel costs and certain supplies for activities allowed and unallowed and allowable costs/cost principles. A nonstatistical sample of 17 transactions totaling $129,627 out of $213,848 were tested. In addition, key line items were tested on the Period 2 and Period 3 Department of Health and Human Services special reports. Repeat Finding from Prior Years: No Recommendation: We recommend the County implement a control process which includes a secondary review and approval of the summarized final expenditure listing used to claim the allowable costs under the federal program and secondary review and approval of required reports to be submitted to the federal agency. Views of Responsible Officials: Moving forward, the Finance Director and/or Administrator will review and approve the expenditures and reports prior to being submitted.