Audit 392296

Finding 2021-002 Program Name/CFDA Title: Provider Relief Fund Federal Assistance Listing Number: 93.498 Federal Agency: U.S. Department of Health and Human Services Type of Finding: Noncompliance, Significant Deficiency Questioned Cost: None Compliance Requirement: Reporting Condition: The federal reporting deadline for the Single Audit reporting package was September 30, 2022; however, the District did not submit its Single Audit Reporting Package by that date. Criteria: The District is required to file the Data Collection Form (SFSAC) within 30 calendar days after receipt of the auditor’s report, or nine months after year end, whichever is first as referenced in 2 CFR 200.512. Cause: As a result of the COVID-19 pandemic, financial constraints and corresponding staffing challenges, the accounting and finance team at the District was unable to complete the required single audit reporting package on a timely basis. At the same time, the accounting and finance team were faced with other administrative and operational matters requiring immediate attention to help ensure the District remained operational. The financial and staffing constraints resulted in the late submissions of the Single Audit reporting package. Effect: The District was not in compliance with federal reporting requirements and regulations. Recommendation: We recommend audit preparations are completed on a timely basis to ensure that the reporting deadline is met. View of Responsible Management agrees with the finding above. Officials:

Finding 2021-003 Program Name/CFDA Title: Provider Relief Fund Federal Assistance Listing Number: 93.498 Federal Agency: U.S. Department of Health and Human Services Type of Finding: Noncompliance, Significant Deficiency Questioned Cost: None Compliance Requirement: Reporting Condition: During the audit, it was determined the Provider Relief Funds portal submission for period 1 was filed late. The District’s internal controls related to the reporting of the Provider Relief Fund payments were not effective and therefore was out of compliance with reporting requirements. Criteria: The Provider Relief Fund Portal Reporting due date for Period 1 was September 30, 2021. Cause: As a result of the COVID-19 pandemic, financial constraints and corresponding staffing challenges, the accounting and finance team at the District was unable to complete the required PRF portal submission on a timely basis. At the same time, the accounting and finance team were faced with other administrative and operational matters requiring immediate attention to help ensure the District remained operational. The financial and staffing constraints resulted in the late submissions of the PRF portal submission. Effect: Provider Relief Fund recipients that do not report funds received within the respective time periods are out of compliance with payment Terms and Conditions and may be subject to recoupment. Recommendation: We recommend that management meet future reporting deadlines and include all PRF funds received to ensure that they are in compliance with the Provider Relief Fund Terms and Conditions. View of Responsible Management agrees with the finding above. Officials:

Finding 2021-004 Program Name/CFDA Title: Provider Relief Fund Federal Assistance Listing Number: 93.498 Federal Agency: U.S. Department of Health and Human Services Type of Finding: Noncompliance, Significant Deficiency Questioned Cost: None Compliance Requirement: Allowable Costs/ Cost Principle Condition: During the audit, it was determined the District did not initially report expending all of its Provider Relief Funds within the period of availability. Based on its initial Provider Relief Fund report submitted, the District received more Provider Relief Funds than it expended using lost revenues but did not return the excess funds when the District filed its Period 1 portal submission. However, HRSA allowed the District to re-file its report at a later date with additional identified allowable expenses, and HRSA provided confirmation that the District is not required to return any of the grant funds. Criteria: The Provider Relief Funds were provided under the Coronavirus Aid, Relief, and Economic Security Act (Pub. L. No. 116-136, 134 Stat. 563) and are to be used to prevent, prepare for, and respond to coronavirus and that the funds shall reimburse the recipient only for healthcare related expenses or lost revenues that are attributable to coronavirus and costs not reimbursed by another source. The funds were required to be spent by June 30, 2021. Cause: As a result of the COVID-19 pandemic, the finance team were faced with administrative and operational matters requiring immediate attention to help ensure the District remained operational. The constraints resulted in management’s oversight of spending the Provider Relief Funds on allowable expenses by the deadline to use the funds. Effect: The District received more Provider Relief Funds than it reported as eligible expenses for reimbursement and the District did not return the excess funds when filing its Period 1 portal submission. As described above, it was later confirmed by HRSA that the District is not required to return any of the grant funds. Recommendation: We recommend that management comply with all the terms and conditions of the Provider Relief Funds. We also recommend management review expenditures before the end of grant deadlines to verify all eligible expenses have been accounted for and reported properly. View of Responsible Management agrees with the finding above. Officials: