Audit 357322

FY End
2024-09-30
Total Expended
$32.26M
Findings
24
Programs
19
Organization: Seattle Indian Health Board (WA)
Year: 2024 Accepted: 2025-05-28
Auditor: Moss Adams LLP

Organization Exclusion Status:

Checking exclusion status...

Findings

ID Ref Severity Repeat Requirement
561695 2024-001 Significant Deficiency Yes E
561696 2024-001 Significant Deficiency Yes E
561697 2024-001 Significant Deficiency Yes E
561698 2024-001 Significant Deficiency Yes E
561699 2024-002 Significant Deficiency - I
561700 2024-002 Significant Deficiency - I
561701 2024-002 Significant Deficiency - I
561702 2024-002 Significant Deficiency - I
561703 2024-002 Significant Deficiency - I
561704 2024-002 Significant Deficiency - I
561705 2024-002 Significant Deficiency - I
561706 2024-002 Significant Deficiency - I
1138137 2024-001 Significant Deficiency Yes E
1138138 2024-001 Significant Deficiency Yes E
1138139 2024-001 Significant Deficiency Yes E
1138140 2024-001 Significant Deficiency Yes E
1138141 2024-002 Significant Deficiency - I
1138142 2024-002 Significant Deficiency - I
1138143 2024-002 Significant Deficiency - I
1138144 2024-002 Significant Deficiency - I
1138145 2024-002 Significant Deficiency - I
1138146 2024-002 Significant Deficiency - I
1138147 2024-002 Significant Deficiency - I
1138148 2024-002 Significant Deficiency - I

Programs

ALN Program Spent Major Findings
93.479 Good Health and Wellness in Indian Country $730,668 Yes 0
93.762 A Comprehensive Approach to Good Health and Wellness in Indian County – Financed Solely by Prevention and Public Health $697,506 - 0
93.391 Activities to Support State, Tribal, Local and Territorial (stlt) Health Department Response to Public Health Or Healthcare Crises $638,832 - 0
93.193 Urban Indian Health Services $582,198 Yes 2
93.527 Grants for New and Expanded Services Under the Health Center Program $447,594 - 0
93.323 Epidemiology and Laboratory Capacity for Infectious Diseases (elc) $432,895 - 0
93.237 Special Diabetes Program for Indians Diabetes Prevention and Treatment Projects $329,380 - 0
21.027 Coronavirus State and Local Fiscal Recovery Funds $296,827 - 0
93.224 Health Center Program (community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care) $284,952 - 0
93.933 Demonstration Projects for Indian Health $255,414 - 0
93.243 Substance Abuse and Mental Health Services Projects of Regional and National Significance $157,089 - 0
16.023 Sexual Assault Services Culturally Specific Program $89,604 - 0
10.557 Wic Special Supplemental Nutrition Program for Women, Infants, and Children $88,423 - 0
93.231 Epidemiology Program $52,545 Yes 1
93.788 Opioid Str $46,710 - 0
93.526 Grants for Capital Development in Health Centers $37,428 - 0
93.959 Block Grants for Prevention and Treatment of Substance Abuse $13,359 - 0
93.441 Indian Self-Determination $11,358 - 0
47.076 Stem Education (formerly Education and Human Resources) $6,450 - 0

Contacts

Name Title Type
T4PQLK8JNHL1 Ray Oen Auditee
2063249360 Mary Wright Auditor
No contacts on file

Notes to SEFA

Title: Pass-Through to Subrecipients Accounting Policies: The accompanying schedule of expenditures of federal awards (the Schedule) includes the federal grant activity of Seattle Indian Health Board under programs of the federal government for the year ended September 30, 2024. The information in this schedule is presented in accordance with the requirements of Title 2 U.S. Code of Federal Regulations (CFR) Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (Uniform Guidance). Because the Schedule presents only a selected portion of the operations of Seattle Indian Health Board, it is not intended to and does not present the financial position, changes in net assets, functional expenses, or cash flows of Seattle Indian Health Board. Expenditures reported on the Schedule are reported on the accrual basis of accounting. Such expenditures are recognized following the cost principles contained in the Uniform Guidance wherein certain types of expenditures are not allowable or are limited as to reimbursement. De Minimis Rate Used: N Rate Explanation: Seattle Indian Health Board has elected not to use the 10 percent de minimis indirect cost rate as allowed under the Uniform Guidance The Health Board also provided federal awards to subrecipients, of which the amounts are presented in the schedule of expenditures of federal awards.

Finding Details

Eligibility (Significant Deficiency in Internal Control Over Compliance and an Instance of Non-Compliance) Criteria – In accordance with the Health Board’s grant award with the Portland Area Indian Health Service, Indian Health Service eligibility regulations require that grantees verify eligibility before providing services, and maintain records documenting such eligibility. Condition and Context – The Health Board is required to maintain eligibility records for patients who receive services under the Urban Indian Health Services program. These records include Tribal enrollment and insurance coverage, among other things. We randomly selected 60 patients who received services during the audit period and noted the Health Board did not maintain Tribal enrollment documentation for 1 of the 60 patients tested. Cause – The Health Board staff did not appear to be sufficiently trained to properly identify tribal enrollment documentation and ensure all required documents were obtained prior to providing services. Effect – Individuals that are not eligible may have received services. Questioned Costs – Questioned costs associated with this finding could not be determined. Repeat Finding – This is a repeat finding from the prior year. See prior year finding 2023-002. Recommendation – We recommend the Health Board update polices and controls to include regular review of patient files. This may include review of the patient file for any outstanding Tribal enrollment and insurance documentation prior to scheduling the patients’ appointment. Views of responsible officials – Management agrees with the auditors' findings and will implement the corrective action plan to address the issue identified.
Eligibility (Significant Deficiency in Internal Control Over Compliance and an Instance of Non-Compliance) Criteria – In accordance with the Health Board’s grant award with the Portland Area Indian Health Service, Indian Health Service eligibility regulations require that grantees verify eligibility before providing services, and maintain records documenting such eligibility. Condition and Context – The Health Board is required to maintain eligibility records for patients who receive services under the Urban Indian Health Services program. These records include Tribal enrollment and insurance coverage, among other things. We randomly selected 60 patients who received services during the audit period and noted the Health Board did not maintain Tribal enrollment documentation for 1 of the 60 patients tested. Cause – The Health Board staff did not appear to be sufficiently trained to properly identify tribal enrollment documentation and ensure all required documents were obtained prior to providing services. Effect – Individuals that are not eligible may have received services. Questioned Costs – Questioned costs associated with this finding could not be determined. Repeat Finding – This is a repeat finding from the prior year. See prior year finding 2023-002. Recommendation – We recommend the Health Board update polices and controls to include regular review of patient files. This may include review of the patient file for any outstanding Tribal enrollment and insurance documentation prior to scheduling the patients’ appointment. Views of responsible officials – Management agrees with the auditors' findings and will implement the corrective action plan to address the issue identified.
Eligibility (Significant Deficiency in Internal Control Over Compliance and an Instance of Non-Compliance) Criteria – In accordance with the Health Board’s grant award with the Portland Area Indian Health Service, Indian Health Service eligibility regulations require that grantees verify eligibility before providing services, and maintain records documenting such eligibility. Condition and Context – The Health Board is required to maintain eligibility records for patients who receive services under the Urban Indian Health Services program. These records include Tribal enrollment and insurance coverage, among other things. We randomly selected 60 patients who received services during the audit period and noted the Health Board did not maintain Tribal enrollment documentation for 1 of the 60 patients tested. Cause – The Health Board staff did not appear to be sufficiently trained to properly identify tribal enrollment documentation and ensure all required documents were obtained prior to providing services. Effect – Individuals that are not eligible may have received services. Questioned Costs – Questioned costs associated with this finding could not be determined. Repeat Finding – This is a repeat finding from the prior year. See prior year finding 2023-002. Recommendation – We recommend the Health Board update polices and controls to include regular review of patient files. This may include review of the patient file for any outstanding Tribal enrollment and insurance documentation prior to scheduling the patients’ appointment. Views of responsible officials – Management agrees with the auditors' findings and will implement the corrective action plan to address the issue identified.
Eligibility (Significant Deficiency in Internal Control Over Compliance and an Instance of Non-Compliance) Criteria – In accordance with the Health Board’s grant award with the Portland Area Indian Health Service, Indian Health Service eligibility regulations require that grantees verify eligibility before providing services, and maintain records documenting such eligibility. Condition and Context – The Health Board is required to maintain eligibility records for patients who receive services under the Urban Indian Health Services program. These records include Tribal enrollment and insurance coverage, among other things. We randomly selected 60 patients who received services during the audit period and noted the Health Board did not maintain Tribal enrollment documentation for 1 of the 60 patients tested. Cause – The Health Board staff did not appear to be sufficiently trained to properly identify tribal enrollment documentation and ensure all required documents were obtained prior to providing services. Effect – Individuals that are not eligible may have received services. Questioned Costs – Questioned costs associated with this finding could not be determined. Repeat Finding – This is a repeat finding from the prior year. See prior year finding 2023-002. Recommendation – We recommend the Health Board update polices and controls to include regular review of patient files. This may include review of the patient file for any outstanding Tribal enrollment and insurance documentation prior to scheduling the patients’ appointment. Views of responsible officials – Management agrees with the auditors' findings and will implement the corrective action plan to address the issue identified.
Suspension and Debarment (Material Weakness in Internal Control Over Compliance) Criteria – The Uniform Guidance prohibits non-federal entities from contracting with parties through covered transactions that are suspended or debarred. “Covered transactions” include those procurement contracts for good and services awarded under a non-procurement transaction (e.g., grant or cooperative agreement) that are expected to be equal to or exceed $25,000 or meet certain other specified criteria (2 CFR 200.213 and 2 CFR part 180). Condition and Context – We reviewed covered transactions in excess of $25,000 that were subject to suspension and debarment requirements, as noted below, for evidence of review of the Federal Excluded Parties List System or other controls to ensure that the vendors were not suspended or debarred before the Heath Board entered into contracts with those vendors. Control deficiencies were identified in the suspension and debarment process, include the following for these programs: • Assistance Listing Number 93.193 – The program had 24 covered transactions over $25,000. From this full population, we randomly selected a sample of nine (9) covered transactions subject to suspension and debarment requirements. For three (3) of the items tested the Health Board could not provide the required evidence that the Health Board performed its own suspension and debarment search. • Assistance Listing Number 93.231 – The program had four covered transactions over $25,000. We tested all four covered transactions subject to suspension and debarment requirements. For one (1) of the items tested the Health Board could not provide the required evidence that the Health Board performed its own suspension and debarment search. However, based on our testing, we noted none of the vendors were suspended or debarred. Cause – The programs did not follow the Health Board’s established policies to maintain documentation to support requirements under Uniform Guidance. Effect – The Health Board could be at risk of contracting with vendors that have been suspended or debarred from governmental contracts. Questioned Costs – There were no questioned costs associated with this finding. Repeat Finding – This is not a repeat finding. Recommendation – The Health Board has adequate policies in place, so we recommend that all programs and department overseeing all programs receive updated training on the Health Board’s procurement requirements. Views of responsible officials – Management agrees with the auditors' findings and will implement the corrective action plan to address the issue identified.
Suspension and Debarment (Material Weakness in Internal Control Over Compliance) Criteria – The Uniform Guidance prohibits non-federal entities from contracting with parties through covered transactions that are suspended or debarred. “Covered transactions” include those procurement contracts for good and services awarded under a non-procurement transaction (e.g., grant or cooperative agreement) that are expected to be equal to or exceed $25,000 or meet certain other specified criteria (2 CFR 200.213 and 2 CFR part 180). Condition and Context – We reviewed covered transactions in excess of $25,000 that were subject to suspension and debarment requirements, as noted below, for evidence of review of the Federal Excluded Parties List System or other controls to ensure that the vendors were not suspended or debarred before the Heath Board entered into contracts with those vendors. Control deficiencies were identified in the suspension and debarment process, include the following for these programs: • Assistance Listing Number 93.193 – The program had 24 covered transactions over $25,000. From this full population, we randomly selected a sample of nine (9) covered transactions subject to suspension and debarment requirements. For three (3) of the items tested the Health Board could not provide the required evidence that the Health Board performed its own suspension and debarment search. • Assistance Listing Number 93.231 – The program had four covered transactions over $25,000. We tested all four covered transactions subject to suspension and debarment requirements. For one (1) of the items tested the Health Board could not provide the required evidence that the Health Board performed its own suspension and debarment search. However, based on our testing, we noted none of the vendors were suspended or debarred. Cause – The programs did not follow the Health Board’s established policies to maintain documentation to support requirements under Uniform Guidance. Effect – The Health Board could be at risk of contracting with vendors that have been suspended or debarred from governmental contracts. Questioned Costs – There were no questioned costs associated with this finding. Repeat Finding – This is not a repeat finding. Recommendation – The Health Board has adequate policies in place, so we recommend that all programs and department overseeing all programs receive updated training on the Health Board’s procurement requirements. Views of responsible officials – Management agrees with the auditors' findings and will implement the corrective action plan to address the issue identified.
Suspension and Debarment (Material Weakness in Internal Control Over Compliance) Criteria – The Uniform Guidance prohibits non-federal entities from contracting with parties through covered transactions that are suspended or debarred. “Covered transactions” include those procurement contracts for good and services awarded under a non-procurement transaction (e.g., grant or cooperative agreement) that are expected to be equal to or exceed $25,000 or meet certain other specified criteria (2 CFR 200.213 and 2 CFR part 180). Condition and Context – We reviewed covered transactions in excess of $25,000 that were subject to suspension and debarment requirements, as noted below, for evidence of review of the Federal Excluded Parties List System or other controls to ensure that the vendors were not suspended or debarred before the Heath Board entered into contracts with those vendors. Control deficiencies were identified in the suspension and debarment process, include the following for these programs: • Assistance Listing Number 93.193 – The program had 24 covered transactions over $25,000. From this full population, we randomly selected a sample of nine (9) covered transactions subject to suspension and debarment requirements. For three (3) of the items tested the Health Board could not provide the required evidence that the Health Board performed its own suspension and debarment search. • Assistance Listing Number 93.231 – The program had four covered transactions over $25,000. We tested all four covered transactions subject to suspension and debarment requirements. For one (1) of the items tested the Health Board could not provide the required evidence that the Health Board performed its own suspension and debarment search. However, based on our testing, we noted none of the vendors were suspended or debarred. Cause – The programs did not follow the Health Board’s established policies to maintain documentation to support requirements under Uniform Guidance. Effect – The Health Board could be at risk of contracting with vendors that have been suspended or debarred from governmental contracts. Questioned Costs – There were no questioned costs associated with this finding. Repeat Finding – This is not a repeat finding. Recommendation – The Health Board has adequate policies in place, so we recommend that all programs and department overseeing all programs receive updated training on the Health Board’s procurement requirements. Views of responsible officials – Management agrees with the auditors' findings and will implement the corrective action plan to address the issue identified.
Suspension and Debarment (Material Weakness in Internal Control Over Compliance) Criteria – The Uniform Guidance prohibits non-federal entities from contracting with parties through covered transactions that are suspended or debarred. “Covered transactions” include those procurement contracts for good and services awarded under a non-procurement transaction (e.g., grant or cooperative agreement) that are expected to be equal to or exceed $25,000 or meet certain other specified criteria (2 CFR 200.213 and 2 CFR part 180). Condition and Context – We reviewed covered transactions in excess of $25,000 that were subject to suspension and debarment requirements, as noted below, for evidence of review of the Federal Excluded Parties List System or other controls to ensure that the vendors were not suspended or debarred before the Heath Board entered into contracts with those vendors. Control deficiencies were identified in the suspension and debarment process, include the following for these programs: • Assistance Listing Number 93.193 – The program had 24 covered transactions over $25,000. From this full population, we randomly selected a sample of nine (9) covered transactions subject to suspension and debarment requirements. For three (3) of the items tested the Health Board could not provide the required evidence that the Health Board performed its own suspension and debarment search. • Assistance Listing Number 93.231 – The program had four covered transactions over $25,000. We tested all four covered transactions subject to suspension and debarment requirements. For one (1) of the items tested the Health Board could not provide the required evidence that the Health Board performed its own suspension and debarment search. However, based on our testing, we noted none of the vendors were suspended or debarred. Cause – The programs did not follow the Health Board’s established policies to maintain documentation to support requirements under Uniform Guidance. Effect – The Health Board could be at risk of contracting with vendors that have been suspended or debarred from governmental contracts. Questioned Costs – There were no questioned costs associated with this finding. Repeat Finding – This is not a repeat finding. Recommendation – The Health Board has adequate policies in place, so we recommend that all programs and department overseeing all programs receive updated training on the Health Board’s procurement requirements. Views of responsible officials – Management agrees with the auditors' findings and will implement the corrective action plan to address the issue identified.
Suspension and Debarment (Material Weakness in Internal Control Over Compliance) Criteria – The Uniform Guidance prohibits non-federal entities from contracting with parties through covered transactions that are suspended or debarred. “Covered transactions” include those procurement contracts for good and services awarded under a non-procurement transaction (e.g., grant or cooperative agreement) that are expected to be equal to or exceed $25,000 or meet certain other specified criteria (2 CFR 200.213 and 2 CFR part 180). Condition and Context – We reviewed covered transactions in excess of $25,000 that were subject to suspension and debarment requirements, as noted below, for evidence of review of the Federal Excluded Parties List System or other controls to ensure that the vendors were not suspended or debarred before the Heath Board entered into contracts with those vendors. Control deficiencies were identified in the suspension and debarment process, include the following for these programs: • Assistance Listing Number 93.193 – The program had 24 covered transactions over $25,000. From this full population, we randomly selected a sample of nine (9) covered transactions subject to suspension and debarment requirements. For three (3) of the items tested the Health Board could not provide the required evidence that the Health Board performed its own suspension and debarment search. • Assistance Listing Number 93.231 – The program had four covered transactions over $25,000. We tested all four covered transactions subject to suspension and debarment requirements. For one (1) of the items tested the Health Board could not provide the required evidence that the Health Board performed its own suspension and debarment search. However, based on our testing, we noted none of the vendors were suspended or debarred. Cause – The programs did not follow the Health Board’s established policies to maintain documentation to support requirements under Uniform Guidance. Effect – The Health Board could be at risk of contracting with vendors that have been suspended or debarred from governmental contracts. Questioned Costs – There were no questioned costs associated with this finding. Repeat Finding – This is not a repeat finding. Recommendation – The Health Board has adequate policies in place, so we recommend that all programs and department overseeing all programs receive updated training on the Health Board’s procurement requirements. Views of responsible officials – Management agrees with the auditors' findings and will implement the corrective action plan to address the issue identified.
Suspension and Debarment (Material Weakness in Internal Control Over Compliance) Criteria – The Uniform Guidance prohibits non-federal entities from contracting with parties through covered transactions that are suspended or debarred. “Covered transactions” include those procurement contracts for good and services awarded under a non-procurement transaction (e.g., grant or cooperative agreement) that are expected to be equal to or exceed $25,000 or meet certain other specified criteria (2 CFR 200.213 and 2 CFR part 180). Condition and Context – We reviewed covered transactions in excess of $25,000 that were subject to suspension and debarment requirements, as noted below, for evidence of review of the Federal Excluded Parties List System or other controls to ensure that the vendors were not suspended or debarred before the Heath Board entered into contracts with those vendors. Control deficiencies were identified in the suspension and debarment process, include the following for these programs: • Assistance Listing Number 93.193 – The program had 24 covered transactions over $25,000. From this full population, we randomly selected a sample of nine (9) covered transactions subject to suspension and debarment requirements. For three (3) of the items tested the Health Board could not provide the required evidence that the Health Board performed its own suspension and debarment search. • Assistance Listing Number 93.231 – The program had four covered transactions over $25,000. We tested all four covered transactions subject to suspension and debarment requirements. For one (1) of the items tested the Health Board could not provide the required evidence that the Health Board performed its own suspension and debarment search. However, based on our testing, we noted none of the vendors were suspended or debarred. Cause – The programs did not follow the Health Board’s established policies to maintain documentation to support requirements under Uniform Guidance. Effect – The Health Board could be at risk of contracting with vendors that have been suspended or debarred from governmental contracts. Questioned Costs – There were no questioned costs associated with this finding. Repeat Finding – This is not a repeat finding. Recommendation – The Health Board has adequate policies in place, so we recommend that all programs and department overseeing all programs receive updated training on the Health Board’s procurement requirements. Views of responsible officials – Management agrees with the auditors' findings and will implement the corrective action plan to address the issue identified.
Suspension and Debarment (Material Weakness in Internal Control Over Compliance) Criteria – The Uniform Guidance prohibits non-federal entities from contracting with parties through covered transactions that are suspended or debarred. “Covered transactions” include those procurement contracts for good and services awarded under a non-procurement transaction (e.g., grant or cooperative agreement) that are expected to be equal to or exceed $25,000 or meet certain other specified criteria (2 CFR 200.213 and 2 CFR part 180). Condition and Context – We reviewed covered transactions in excess of $25,000 that were subject to suspension and debarment requirements, as noted below, for evidence of review of the Federal Excluded Parties List System or other controls to ensure that the vendors were not suspended or debarred before the Heath Board entered into contracts with those vendors. Control deficiencies were identified in the suspension and debarment process, include the following for these programs: • Assistance Listing Number 93.193 – The program had 24 covered transactions over $25,000. From this full population, we randomly selected a sample of nine (9) covered transactions subject to suspension and debarment requirements. For three (3) of the items tested the Health Board could not provide the required evidence that the Health Board performed its own suspension and debarment search. • Assistance Listing Number 93.231 – The program had four covered transactions over $25,000. We tested all four covered transactions subject to suspension and debarment requirements. For one (1) of the items tested the Health Board could not provide the required evidence that the Health Board performed its own suspension and debarment search. However, based on our testing, we noted none of the vendors were suspended or debarred. Cause – The programs did not follow the Health Board’s established policies to maintain documentation to support requirements under Uniform Guidance. Effect – The Health Board could be at risk of contracting with vendors that have been suspended or debarred from governmental contracts. Questioned Costs – There were no questioned costs associated with this finding. Repeat Finding – This is not a repeat finding. Recommendation – The Health Board has adequate policies in place, so we recommend that all programs and department overseeing all programs receive updated training on the Health Board’s procurement requirements. Views of responsible officials – Management agrees with the auditors' findings and will implement the corrective action plan to address the issue identified.
Suspension and Debarment (Material Weakness in Internal Control Over Compliance) Criteria – The Uniform Guidance prohibits non-federal entities from contracting with parties through covered transactions that are suspended or debarred. “Covered transactions” include those procurement contracts for good and services awarded under a non-procurement transaction (e.g., grant or cooperative agreement) that are expected to be equal to or exceed $25,000 or meet certain other specified criteria (2 CFR 200.213 and 2 CFR part 180). Condition and Context – We reviewed covered transactions in excess of $25,000 that were subject to suspension and debarment requirements, as noted below, for evidence of review of the Federal Excluded Parties List System or other controls to ensure that the vendors were not suspended or debarred before the Heath Board entered into contracts with those vendors. Control deficiencies were identified in the suspension and debarment process, include the following for these programs: • Assistance Listing Number 93.193 – The program had 24 covered transactions over $25,000. From this full population, we randomly selected a sample of nine (9) covered transactions subject to suspension and debarment requirements. For three (3) of the items tested the Health Board could not provide the required evidence that the Health Board performed its own suspension and debarment search. • Assistance Listing Number 93.231 – The program had four covered transactions over $25,000. We tested all four covered transactions subject to suspension and debarment requirements. For one (1) of the items tested the Health Board could not provide the required evidence that the Health Board performed its own suspension and debarment search. However, based on our testing, we noted none of the vendors were suspended or debarred. Cause – The programs did not follow the Health Board’s established policies to maintain documentation to support requirements under Uniform Guidance. Effect – The Health Board could be at risk of contracting with vendors that have been suspended or debarred from governmental contracts. Questioned Costs – There were no questioned costs associated with this finding. Repeat Finding – This is not a repeat finding. Recommendation – The Health Board has adequate policies in place, so we recommend that all programs and department overseeing all programs receive updated training on the Health Board’s procurement requirements. Views of responsible officials – Management agrees with the auditors' findings and will implement the corrective action plan to address the issue identified.
Eligibility (Significant Deficiency in Internal Control Over Compliance and an Instance of Non-Compliance) Criteria – In accordance with the Health Board’s grant award with the Portland Area Indian Health Service, Indian Health Service eligibility regulations require that grantees verify eligibility before providing services, and maintain records documenting such eligibility. Condition and Context – The Health Board is required to maintain eligibility records for patients who receive services under the Urban Indian Health Services program. These records include Tribal enrollment and insurance coverage, among other things. We randomly selected 60 patients who received services during the audit period and noted the Health Board did not maintain Tribal enrollment documentation for 1 of the 60 patients tested. Cause – The Health Board staff did not appear to be sufficiently trained to properly identify tribal enrollment documentation and ensure all required documents were obtained prior to providing services. Effect – Individuals that are not eligible may have received services. Questioned Costs – Questioned costs associated with this finding could not be determined. Repeat Finding – This is a repeat finding from the prior year. See prior year finding 2023-002. Recommendation – We recommend the Health Board update polices and controls to include regular review of patient files. This may include review of the patient file for any outstanding Tribal enrollment and insurance documentation prior to scheduling the patients’ appointment. Views of responsible officials – Management agrees with the auditors' findings and will implement the corrective action plan to address the issue identified.
Eligibility (Significant Deficiency in Internal Control Over Compliance and an Instance of Non-Compliance) Criteria – In accordance with the Health Board’s grant award with the Portland Area Indian Health Service, Indian Health Service eligibility regulations require that grantees verify eligibility before providing services, and maintain records documenting such eligibility. Condition and Context – The Health Board is required to maintain eligibility records for patients who receive services under the Urban Indian Health Services program. These records include Tribal enrollment and insurance coverage, among other things. We randomly selected 60 patients who received services during the audit period and noted the Health Board did not maintain Tribal enrollment documentation for 1 of the 60 patients tested. Cause – The Health Board staff did not appear to be sufficiently trained to properly identify tribal enrollment documentation and ensure all required documents were obtained prior to providing services. Effect – Individuals that are not eligible may have received services. Questioned Costs – Questioned costs associated with this finding could not be determined. Repeat Finding – This is a repeat finding from the prior year. See prior year finding 2023-002. Recommendation – We recommend the Health Board update polices and controls to include regular review of patient files. This may include review of the patient file for any outstanding Tribal enrollment and insurance documentation prior to scheduling the patients’ appointment. Views of responsible officials – Management agrees with the auditors' findings and will implement the corrective action plan to address the issue identified.
Eligibility (Significant Deficiency in Internal Control Over Compliance and an Instance of Non-Compliance) Criteria – In accordance with the Health Board’s grant award with the Portland Area Indian Health Service, Indian Health Service eligibility regulations require that grantees verify eligibility before providing services, and maintain records documenting such eligibility. Condition and Context – The Health Board is required to maintain eligibility records for patients who receive services under the Urban Indian Health Services program. These records include Tribal enrollment and insurance coverage, among other things. We randomly selected 60 patients who received services during the audit period and noted the Health Board did not maintain Tribal enrollment documentation for 1 of the 60 patients tested. Cause – The Health Board staff did not appear to be sufficiently trained to properly identify tribal enrollment documentation and ensure all required documents were obtained prior to providing services. Effect – Individuals that are not eligible may have received services. Questioned Costs – Questioned costs associated with this finding could not be determined. Repeat Finding – This is a repeat finding from the prior year. See prior year finding 2023-002. Recommendation – We recommend the Health Board update polices and controls to include regular review of patient files. This may include review of the patient file for any outstanding Tribal enrollment and insurance documentation prior to scheduling the patients’ appointment. Views of responsible officials – Management agrees with the auditors' findings and will implement the corrective action plan to address the issue identified.
Eligibility (Significant Deficiency in Internal Control Over Compliance and an Instance of Non-Compliance) Criteria – In accordance with the Health Board’s grant award with the Portland Area Indian Health Service, Indian Health Service eligibility regulations require that grantees verify eligibility before providing services, and maintain records documenting such eligibility. Condition and Context – The Health Board is required to maintain eligibility records for patients who receive services under the Urban Indian Health Services program. These records include Tribal enrollment and insurance coverage, among other things. We randomly selected 60 patients who received services during the audit period and noted the Health Board did not maintain Tribal enrollment documentation for 1 of the 60 patients tested. Cause – The Health Board staff did not appear to be sufficiently trained to properly identify tribal enrollment documentation and ensure all required documents were obtained prior to providing services. Effect – Individuals that are not eligible may have received services. Questioned Costs – Questioned costs associated with this finding could not be determined. Repeat Finding – This is a repeat finding from the prior year. See prior year finding 2023-002. Recommendation – We recommend the Health Board update polices and controls to include regular review of patient files. This may include review of the patient file for any outstanding Tribal enrollment and insurance documentation prior to scheduling the patients’ appointment. Views of responsible officials – Management agrees with the auditors' findings and will implement the corrective action plan to address the issue identified.
Suspension and Debarment (Material Weakness in Internal Control Over Compliance) Criteria – The Uniform Guidance prohibits non-federal entities from contracting with parties through covered transactions that are suspended or debarred. “Covered transactions” include those procurement contracts for good and services awarded under a non-procurement transaction (e.g., grant or cooperative agreement) that are expected to be equal to or exceed $25,000 or meet certain other specified criteria (2 CFR 200.213 and 2 CFR part 180). Condition and Context – We reviewed covered transactions in excess of $25,000 that were subject to suspension and debarment requirements, as noted below, for evidence of review of the Federal Excluded Parties List System or other controls to ensure that the vendors were not suspended or debarred before the Heath Board entered into contracts with those vendors. Control deficiencies were identified in the suspension and debarment process, include the following for these programs: • Assistance Listing Number 93.193 – The program had 24 covered transactions over $25,000. From this full population, we randomly selected a sample of nine (9) covered transactions subject to suspension and debarment requirements. For three (3) of the items tested the Health Board could not provide the required evidence that the Health Board performed its own suspension and debarment search. • Assistance Listing Number 93.231 – The program had four covered transactions over $25,000. We tested all four covered transactions subject to suspension and debarment requirements. For one (1) of the items tested the Health Board could not provide the required evidence that the Health Board performed its own suspension and debarment search. However, based on our testing, we noted none of the vendors were suspended or debarred. Cause – The programs did not follow the Health Board’s established policies to maintain documentation to support requirements under Uniform Guidance. Effect – The Health Board could be at risk of contracting with vendors that have been suspended or debarred from governmental contracts. Questioned Costs – There were no questioned costs associated with this finding. Repeat Finding – This is not a repeat finding. Recommendation – The Health Board has adequate policies in place, so we recommend that all programs and department overseeing all programs receive updated training on the Health Board’s procurement requirements. Views of responsible officials – Management agrees with the auditors' findings and will implement the corrective action plan to address the issue identified.
Suspension and Debarment (Material Weakness in Internal Control Over Compliance) Criteria – The Uniform Guidance prohibits non-federal entities from contracting with parties through covered transactions that are suspended or debarred. “Covered transactions” include those procurement contracts for good and services awarded under a non-procurement transaction (e.g., grant or cooperative agreement) that are expected to be equal to or exceed $25,000 or meet certain other specified criteria (2 CFR 200.213 and 2 CFR part 180). Condition and Context – We reviewed covered transactions in excess of $25,000 that were subject to suspension and debarment requirements, as noted below, for evidence of review of the Federal Excluded Parties List System or other controls to ensure that the vendors were not suspended or debarred before the Heath Board entered into contracts with those vendors. Control deficiencies were identified in the suspension and debarment process, include the following for these programs: • Assistance Listing Number 93.193 – The program had 24 covered transactions over $25,000. From this full population, we randomly selected a sample of nine (9) covered transactions subject to suspension and debarment requirements. For three (3) of the items tested the Health Board could not provide the required evidence that the Health Board performed its own suspension and debarment search. • Assistance Listing Number 93.231 – The program had four covered transactions over $25,000. We tested all four covered transactions subject to suspension and debarment requirements. For one (1) of the items tested the Health Board could not provide the required evidence that the Health Board performed its own suspension and debarment search. However, based on our testing, we noted none of the vendors were suspended or debarred. Cause – The programs did not follow the Health Board’s established policies to maintain documentation to support requirements under Uniform Guidance. Effect – The Health Board could be at risk of contracting with vendors that have been suspended or debarred from governmental contracts. Questioned Costs – There were no questioned costs associated with this finding. Repeat Finding – This is not a repeat finding. Recommendation – The Health Board has adequate policies in place, so we recommend that all programs and department overseeing all programs receive updated training on the Health Board’s procurement requirements. Views of responsible officials – Management agrees with the auditors' findings and will implement the corrective action plan to address the issue identified.
Suspension and Debarment (Material Weakness in Internal Control Over Compliance) Criteria – The Uniform Guidance prohibits non-federal entities from contracting with parties through covered transactions that are suspended or debarred. “Covered transactions” include those procurement contracts for good and services awarded under a non-procurement transaction (e.g., grant or cooperative agreement) that are expected to be equal to or exceed $25,000 or meet certain other specified criteria (2 CFR 200.213 and 2 CFR part 180). Condition and Context – We reviewed covered transactions in excess of $25,000 that were subject to suspension and debarment requirements, as noted below, for evidence of review of the Federal Excluded Parties List System or other controls to ensure that the vendors were not suspended or debarred before the Heath Board entered into contracts with those vendors. Control deficiencies were identified in the suspension and debarment process, include the following for these programs: • Assistance Listing Number 93.193 – The program had 24 covered transactions over $25,000. From this full population, we randomly selected a sample of nine (9) covered transactions subject to suspension and debarment requirements. For three (3) of the items tested the Health Board could not provide the required evidence that the Health Board performed its own suspension and debarment search. • Assistance Listing Number 93.231 – The program had four covered transactions over $25,000. We tested all four covered transactions subject to suspension and debarment requirements. For one (1) of the items tested the Health Board could not provide the required evidence that the Health Board performed its own suspension and debarment search. However, based on our testing, we noted none of the vendors were suspended or debarred. Cause – The programs did not follow the Health Board’s established policies to maintain documentation to support requirements under Uniform Guidance. Effect – The Health Board could be at risk of contracting with vendors that have been suspended or debarred from governmental contracts. Questioned Costs – There were no questioned costs associated with this finding. Repeat Finding – This is not a repeat finding. Recommendation – The Health Board has adequate policies in place, so we recommend that all programs and department overseeing all programs receive updated training on the Health Board’s procurement requirements. Views of responsible officials – Management agrees with the auditors' findings and will implement the corrective action plan to address the issue identified.
Suspension and Debarment (Material Weakness in Internal Control Over Compliance) Criteria – The Uniform Guidance prohibits non-federal entities from contracting with parties through covered transactions that are suspended or debarred. “Covered transactions” include those procurement contracts for good and services awarded under a non-procurement transaction (e.g., grant or cooperative agreement) that are expected to be equal to or exceed $25,000 or meet certain other specified criteria (2 CFR 200.213 and 2 CFR part 180). Condition and Context – We reviewed covered transactions in excess of $25,000 that were subject to suspension and debarment requirements, as noted below, for evidence of review of the Federal Excluded Parties List System or other controls to ensure that the vendors were not suspended or debarred before the Heath Board entered into contracts with those vendors. Control deficiencies were identified in the suspension and debarment process, include the following for these programs: • Assistance Listing Number 93.193 – The program had 24 covered transactions over $25,000. From this full population, we randomly selected a sample of nine (9) covered transactions subject to suspension and debarment requirements. For three (3) of the items tested the Health Board could not provide the required evidence that the Health Board performed its own suspension and debarment search. • Assistance Listing Number 93.231 – The program had four covered transactions over $25,000. We tested all four covered transactions subject to suspension and debarment requirements. For one (1) of the items tested the Health Board could not provide the required evidence that the Health Board performed its own suspension and debarment search. However, based on our testing, we noted none of the vendors were suspended or debarred. Cause – The programs did not follow the Health Board’s established policies to maintain documentation to support requirements under Uniform Guidance. Effect – The Health Board could be at risk of contracting with vendors that have been suspended or debarred from governmental contracts. Questioned Costs – There were no questioned costs associated with this finding. Repeat Finding – This is not a repeat finding. Recommendation – The Health Board has adequate policies in place, so we recommend that all programs and department overseeing all programs receive updated training on the Health Board’s procurement requirements. Views of responsible officials – Management agrees with the auditors' findings and will implement the corrective action plan to address the issue identified.
Suspension and Debarment (Material Weakness in Internal Control Over Compliance) Criteria – The Uniform Guidance prohibits non-federal entities from contracting with parties through covered transactions that are suspended or debarred. “Covered transactions” include those procurement contracts for good and services awarded under a non-procurement transaction (e.g., grant or cooperative agreement) that are expected to be equal to or exceed $25,000 or meet certain other specified criteria (2 CFR 200.213 and 2 CFR part 180). Condition and Context – We reviewed covered transactions in excess of $25,000 that were subject to suspension and debarment requirements, as noted below, for evidence of review of the Federal Excluded Parties List System or other controls to ensure that the vendors were not suspended or debarred before the Heath Board entered into contracts with those vendors. Control deficiencies were identified in the suspension and debarment process, include the following for these programs: • Assistance Listing Number 93.193 – The program had 24 covered transactions over $25,000. From this full population, we randomly selected a sample of nine (9) covered transactions subject to suspension and debarment requirements. For three (3) of the items tested the Health Board could not provide the required evidence that the Health Board performed its own suspension and debarment search. • Assistance Listing Number 93.231 – The program had four covered transactions over $25,000. We tested all four covered transactions subject to suspension and debarment requirements. For one (1) of the items tested the Health Board could not provide the required evidence that the Health Board performed its own suspension and debarment search. However, based on our testing, we noted none of the vendors were suspended or debarred. Cause – The programs did not follow the Health Board’s established policies to maintain documentation to support requirements under Uniform Guidance. Effect – The Health Board could be at risk of contracting with vendors that have been suspended or debarred from governmental contracts. Questioned Costs – There were no questioned costs associated with this finding. Repeat Finding – This is not a repeat finding. Recommendation – The Health Board has adequate policies in place, so we recommend that all programs and department overseeing all programs receive updated training on the Health Board’s procurement requirements. Views of responsible officials – Management agrees with the auditors' findings and will implement the corrective action plan to address the issue identified.
Suspension and Debarment (Material Weakness in Internal Control Over Compliance) Criteria – The Uniform Guidance prohibits non-federal entities from contracting with parties through covered transactions that are suspended or debarred. “Covered transactions” include those procurement contracts for good and services awarded under a non-procurement transaction (e.g., grant or cooperative agreement) that are expected to be equal to or exceed $25,000 or meet certain other specified criteria (2 CFR 200.213 and 2 CFR part 180). Condition and Context – We reviewed covered transactions in excess of $25,000 that were subject to suspension and debarment requirements, as noted below, for evidence of review of the Federal Excluded Parties List System or other controls to ensure that the vendors were not suspended or debarred before the Heath Board entered into contracts with those vendors. Control deficiencies were identified in the suspension and debarment process, include the following for these programs: • Assistance Listing Number 93.193 – The program had 24 covered transactions over $25,000. From this full population, we randomly selected a sample of nine (9) covered transactions subject to suspension and debarment requirements. For three (3) of the items tested the Health Board could not provide the required evidence that the Health Board performed its own suspension and debarment search. • Assistance Listing Number 93.231 – The program had four covered transactions over $25,000. We tested all four covered transactions subject to suspension and debarment requirements. For one (1) of the items tested the Health Board could not provide the required evidence that the Health Board performed its own suspension and debarment search. However, based on our testing, we noted none of the vendors were suspended or debarred. Cause – The programs did not follow the Health Board’s established policies to maintain documentation to support requirements under Uniform Guidance. Effect – The Health Board could be at risk of contracting with vendors that have been suspended or debarred from governmental contracts. Questioned Costs – There were no questioned costs associated with this finding. Repeat Finding – This is not a repeat finding. Recommendation – The Health Board has adequate policies in place, so we recommend that all programs and department overseeing all programs receive updated training on the Health Board’s procurement requirements. Views of responsible officials – Management agrees with the auditors' findings and will implement the corrective action plan to address the issue identified.
Suspension and Debarment (Material Weakness in Internal Control Over Compliance) Criteria – The Uniform Guidance prohibits non-federal entities from contracting with parties through covered transactions that are suspended or debarred. “Covered transactions” include those procurement contracts for good and services awarded under a non-procurement transaction (e.g., grant or cooperative agreement) that are expected to be equal to or exceed $25,000 or meet certain other specified criteria (2 CFR 200.213 and 2 CFR part 180). Condition and Context – We reviewed covered transactions in excess of $25,000 that were subject to suspension and debarment requirements, as noted below, for evidence of review of the Federal Excluded Parties List System or other controls to ensure that the vendors were not suspended or debarred before the Heath Board entered into contracts with those vendors. Control deficiencies were identified in the suspension and debarment process, include the following for these programs: • Assistance Listing Number 93.193 – The program had 24 covered transactions over $25,000. From this full population, we randomly selected a sample of nine (9) covered transactions subject to suspension and debarment requirements. For three (3) of the items tested the Health Board could not provide the required evidence that the Health Board performed its own suspension and debarment search. • Assistance Listing Number 93.231 – The program had four covered transactions over $25,000. We tested all four covered transactions subject to suspension and debarment requirements. For one (1) of the items tested the Health Board could not provide the required evidence that the Health Board performed its own suspension and debarment search. However, based on our testing, we noted none of the vendors were suspended or debarred. Cause – The programs did not follow the Health Board’s established policies to maintain documentation to support requirements under Uniform Guidance. Effect – The Health Board could be at risk of contracting with vendors that have been suspended or debarred from governmental contracts. Questioned Costs – There were no questioned costs associated with this finding. Repeat Finding – This is not a repeat finding. Recommendation – The Health Board has adequate policies in place, so we recommend that all programs and department overseeing all programs receive updated training on the Health Board’s procurement requirements. Views of responsible officials – Management agrees with the auditors' findings and will implement the corrective action plan to address the issue identified.
Suspension and Debarment (Material Weakness in Internal Control Over Compliance) Criteria – The Uniform Guidance prohibits non-federal entities from contracting with parties through covered transactions that are suspended or debarred. “Covered transactions” include those procurement contracts for good and services awarded under a non-procurement transaction (e.g., grant or cooperative agreement) that are expected to be equal to or exceed $25,000 or meet certain other specified criteria (2 CFR 200.213 and 2 CFR part 180). Condition and Context – We reviewed covered transactions in excess of $25,000 that were subject to suspension and debarment requirements, as noted below, for evidence of review of the Federal Excluded Parties List System or other controls to ensure that the vendors were not suspended or debarred before the Heath Board entered into contracts with those vendors. Control deficiencies were identified in the suspension and debarment process, include the following for these programs: • Assistance Listing Number 93.193 – The program had 24 covered transactions over $25,000. From this full population, we randomly selected a sample of nine (9) covered transactions subject to suspension and debarment requirements. For three (3) of the items tested the Health Board could not provide the required evidence that the Health Board performed its own suspension and debarment search. • Assistance Listing Number 93.231 – The program had four covered transactions over $25,000. We tested all four covered transactions subject to suspension and debarment requirements. For one (1) of the items tested the Health Board could not provide the required evidence that the Health Board performed its own suspension and debarment search. However, based on our testing, we noted none of the vendors were suspended or debarred. Cause – The programs did not follow the Health Board’s established policies to maintain documentation to support requirements under Uniform Guidance. Effect – The Health Board could be at risk of contracting with vendors that have been suspended or debarred from governmental contracts. Questioned Costs – There were no questioned costs associated with this finding. Repeat Finding – This is not a repeat finding. Recommendation – The Health Board has adequate policies in place, so we recommend that all programs and department overseeing all programs receive updated training on the Health Board’s procurement requirements. Views of responsible officials – Management agrees with the auditors' findings and will implement the corrective action plan to address the issue identified.