Audit 9504

2022 – 001 Federal agency: U.S. Department of Health and Human Services Other Programs Federal program title: Rural Communities Opioid Response Program-Implementation Assistance Listing Number: 93.912 Pass-Through Agency: N/A Pass-Through Number(s): N/A Award Period: Fiscal Year 2022 Type of Finding: Significant Deficiency in Internal Control in and over Compliance Compliance Requirement: Subrecipient Monitoring Criteria or specific requirement: Surrounding monitoring activities, the Hospital’s internal controls should be designed to assure all subrecipients are monitored throughout the award period. Condition: During our testing, we identified the Hospital did not have internal controls in place to ensure subrecipients were monitored during the award period. Questioned costs: None Context: During our testing, it was identified that no contracts or agreements exist between the Hospital and the four subrecipient organizations who received Opioid Implementation Program funds passed through from the Hospital. Cause: Guidance for the Opioid Implementation Program funding is unclear beyond the objective within the program narrative. Effect: The lack of controls in place over the monitoring functions increases the risk of misstatements, fraud, or errors occurring and not being detected and corrected. Repeat Finding: N/A Recommendation: We recommend the Hospital implements agreements between the Hospital and any entities in which federal funding are awarded (passed through) to in order to make the respective program requirements understood. Views of responsible officials: There is no disagreement with the audit finding. Processes have been corrected over the course of the single audit and agreements with subrecipients have been executed.

2022 – 001 Federal agency: U.S. Department of Health and Human Services Other Programs Federal program title: Rural Communities Opioid Response Program-Implementation Assistance Listing Number: 93.912 Pass-Through Agency: N/A Pass-Through Number(s): N/A Award Period: Fiscal Year 2022 Type of Finding: Significant Deficiency in Internal Control in and over Compliance Compliance Requirement: Subrecipient Monitoring Criteria or specific requirement: Surrounding monitoring activities, the Hospital’s internal controls should be designed to assure all subrecipients are monitored throughout the award period. Condition: During our testing, we identified the Hospital did not have internal controls in place to ensure subrecipients were monitored during the award period. Questioned costs: None Context: During our testing, it was identified that no contracts or agreements exist between the Hospital and the four subrecipient organizations who received Opioid Implementation Program funds passed through from the Hospital. Cause: Guidance for the Opioid Implementation Program funding is unclear beyond the objective within the program narrative. Effect: The lack of controls in place over the monitoring functions increases the risk of misstatements, fraud, or errors occurring and not being detected and corrected. Repeat Finding: N/A Recommendation: We recommend the Hospital implements agreements between the Hospital and any entities in which federal funding are awarded (passed through) to in order to make the respective program requirements understood. Views of responsible officials: There is no disagreement with the audit finding. Processes have been corrected over the course of the single audit and agreements with subrecipients have been executed.