Audit 410692

2025-001 — Single Audit Report Submission – Significant Deficiency in Internal Controls Over Compliance and Noncompliance (Repeat Finding 2024-002) Federal program information: Funding agency: All Major Programs Title: All Major programs ALN number: All Major Programs Award years and number: All Major Programs Criteria: The Uniform Guidance 2 CFR 200.512(a) requires the audit package and data collection form be submitted 30 days after receipt of the auditor’s report or 9 months after the end of the fiscal year, whichever comes first. Condition: The Center’s fiscal year 2025 single audit reporting package was not submitted within nine months after the end of the audit period. Questioned Costs: None. Cause: The Center did not have appropriate internal control policies and procedures in place to ensure accounting records and financial statements were reconciled timely and the audit conducted to meet compliance requirements. Effect: As a result of not timely reconciling accounting records and financial statements, the single audit reporting package was submitted after the required reporting time period. Auditor’s Recommendations: To ensure compliance with the Uniform Guidance, the Center should prepare accurate, complete and timely financial statements and ensure an audit is performed to ensure the timely submission of the Single Audit reporting package. Management Response: All Nations Health Center concurs with this finding and will work with its accounting firm to identify appropriate resources and implement procedures, including beginning to prepare for the past fiscal year’s audit in January to ensure the timely submission of the Single Audit report in future years.

2025-002 — Procurement, Suspension, and Debarment – Significant Deficiency in Internal Controls Over Compliance and Noncompliance Federal program information: Funding agency: U.S. Department of Health and Human Services Title: Urban Indian Health Services ALN number: 93.193 Award years and number: 75H70921C00004 Criteria: In accordance with 2 CFR 200.319(a), it is required that “all procurement transactions under the federal award must be conducted in a manner that provides full and open competition and is consistent with the standards of this section and § 200.320.” Condition: Auditor reviewed one procurement sample. During our review, no documentation was provided to demonstrate that full and open competition was maintained in the procurement process, such as advertisement for bids, quotes obtained, evaluation of price, or basis for selecting the contractor. In addition, no documentation was provided indicating proper verification that the contractor was not debarred, suspended, or otherwise excluded. A subsequent check was conducted, indicating the contractor was not debarred, suspended or excluded. Questioned Costs: None. Cause: Although the Center maintains sufficient procurement policy, program personnel did not adequately follow the procurement policy. The inconsistency in the adherence to the procurement policy is attributed to the lack of monitoring. Effect: The failure to adhere to established procurement policy increases the risk of noncompliance with federal regulations. Auditor’s Recommendations: We recommend providing comprehensive training to all personnel involved in review and approval over procurement on the procurement process. Ensure all employees understand the importance of adhering to procurement policies and the benefits of a streamlined, centralized approach. Regular communication and updates on any changes in procurement procedures should be maintained. Management Response: All Nations will regularly review its purchasing policies with Finance and Leadership staff and members of its Board of Directors’ Audit and Finance Committee to ensure that proper procedures and documentation are followed and to update purchasing policies when changes are required.