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Corrective Action Plans

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Finding 567969 (2022-002)
Material Weakness 2022
Community Action Partnership of Providence County
RI
Eligibility
Policies for all programs are being developed by each department and will include random, periodic file audits to ensure eligibility documentation and other mandatory paperwork is maintained for all programs.
Policies for all programs are being developed by each department and will include random, periodic file audits to ensure eligibility documentation and other mandatory paperwork is maintained for all programs.
View Audit 360314
Finding 565761 (2022-007)
Material Weakness 2022
Detroit Central City Cmh, Inc.
MI
Eligibility
To address this finding, the Finance Department along with the Revenue Cycle department will take the following actions: * An Executive Director of Revenue Cycle has been hired to manage all aspects of revenue cycle (including the Sliding Fee Discount Program). * The Director will implement a target...
To address this finding, the Finance Department along with the Revenue Cycle department will take the following actions: * An Executive Director of Revenue Cycle has been hired to manage all aspects of revenue cycle (including the Sliding Fee Discount Program). * The Director will implement a targeted training program for staff involved in administering the program, focusing on a sliding fee approach. This traning will include identifying patients who are eligible for the sliding fee discount. * The Director has created a Standard Operating Procedure (SOP) for each EHR system to ensure that all staff administering sliding fees understand the Sliding Fee process. This will also include monitoring the program for compliance and the appropriate application of any sliding fee discount transactions. * Update the sliding fee scale annually using the Federal Poverty Guidelines.
View Audit 359454
Finding 565179 (2022-012)
Material Weakness 2022
City of Paterson
NJ
Questioned Costs Procurement, Suspension & Debarment Cash Management
City was delayed due to staff shrotages. City is catching up and has controls set
City was delayed due to staff shrotages. City is catching up and has controls set
View Audit 359090 Questioned Costs: $1
Finding 565178 (2022-007)
Material Weakness 2022
City of Paterson
NJ
Questioned Costs Procurement, Suspension & Debarment Cash Management
City was delayed due to staff shrotages. City is catching up and has controls set
City was delayed due to staff shrotages. City is catching up and has controls set
View Audit 359090 Questioned Costs: $1
Finding 565177 (2022-009)
Material Weakness 2022
City of Paterson
NJ
Questioned Costs Procurement, Suspension & Debarment Eligibility
City was delayed due to staff shrotages. City is catching up and has controls set
City was delayed due to staff shrotages. City is catching up and has controls set
View Audit 359090 Questioned Costs: $1
Finding 565176 (2022-008)
Material Weakness 2022
City of Paterson
NJ
Questioned Costs Procurement, Suspension & Debarment Cash Management
City was delayed due to staff shrotages. City is catching up and has controls set
City was delayed due to staff shrotages. City is catching up and has controls set
View Audit 359090 Questioned Costs: $1
Finding 565174 (2022-010)
Material Weakness 2022
City of Paterson
NJ
Questioned Costs Procurement, Suspension & Debarment Cash Management
City was delayed due to staff shrotages. City is catching up and has controls set
City was delayed due to staff shrotages. City is catching up and has controls set
View Audit 359090 Questioned Costs: $1
Finding 565074 (2022-002)
Material Weakness 2022
United Way of Marion County, Inc.
FL
Cash Management Eligibility Material Weakness
United of Marion County, Inc. experienced staff turnover during the ERA 1 & ERA2 which may have contributed to data not being regularly reconciled to the third-party grant tracking system. The United Way of Marion County, Inc has hired a full-time accounting professional to improve internal controls...
United of Marion County, Inc. experienced staff turnover during the ERA 1 & ERA2 which may have contributed to data not being regularly reconciled to the third-party grant tracking system. The United Way of Marion County, Inc has hired a full-time accounting professional to improve internal controls. Management as the time utilized the resources available to ensure residents received timely housing assistance.
View Audit 359012
Finding 564774 (2022-004)
Significant Deficiency 2022
American Society for Engineering Education
DC
Eligibility
ASEE is working with the Program directors to ensure that proper and sufficient documentation is stored and retained for all federal awards. In addition, the organization is providing the proper tools to assist the Program Directors store and retain all documents safely for a long time.
ASEE is working with the Program directors to ensure that proper and sufficient documentation is stored and retained for all federal awards. In addition, the organization is providing the proper tools to assist the Program Directors store and retain all documents safely for a long time.
View Audit 358839
Finding 561489 (2022-007)
Material Weakness 2022
Sayre Health Center
PA
Questioned Costs Subrecipient Monitoring Allowable Costs / Cost Principles
Finding No. 2022-007: Inadequate Documentation and Records for Application of Sliding Fee Discounts We have incorporated a policy that establishes the basis for the sliding fee policy to assure affordable access to care for uninsured and underinsured patients of the organization. The policy will rec...
Finding No. 2022-007: Inadequate Documentation and Records for Application of Sliding Fee Discounts We have incorporated a policy that establishes the basis for the sliding fee policy to assure affordable access to care for uninsured and underinsured patients of the organization. The policy will recognize a “full discount” for individuals and families with annual incomes at or below 100% Federal poverty level (FPL) with only nominal fees charged, three levels of discount between 100% and 200%, and no discounts for copays for individuals and families earning over 200% FPL. This policy will be in accordance with Section 330(k)(3)(G) of the PHS Act and 42 CFR Part 51c.303(f) and 42 CFR Part 51c.303(u) which are incorporated herewith. We will charge a nominal fee to individuals and families with annual incomes at or below 100% of the FPL. Patients whose incomes are above 100% or below 200% of the FPL will be charged according to our sliding fee scale based on income and family size. Discounts will be provided to patients with incomes up to 200% of the FPL for medical visits. Discounts will be provided to patients with incomes up to 250% of the FPL for family planning visits. Staff will assess patients’ incomes based upon a sliding fee scale and no patient will be denied care based upon their inability to pay. The organization also has a policy of nondiscrimination in the delivery of health care as stated in its Patient Bill of Rights. Also, the Board of Directors define the income and family size, and has defined the family size to be all parents, minors or guardians that are financially responsible for the household. The tracking and documentation of sliding fees is now maintained with the deposit record of each fee received in the shared file for immediate availability and reference.
View Audit 357068 Questioned Costs: $1
Finding 560504 (2022-010)
Material Weakness 2022
Orutsararmiut Native Council
AK
Allowable Costs / Cost Principles Eligibility Material Weakness
Name of Contact: Brian Henry, Executive Director Corrective Action Plan: Vacant positions within the accounting and program departments have been filled to ensure that the Council follows internal control policies over grant reporting. Proposed Completion Date: Complete as of June 30, 2024
Name of Contact: Brian Henry, Executive Director Corrective Action Plan: Vacant positions within the accounting and program departments have been filled to ensure that the Council follows internal control policies over grant reporting. Proposed Completion Date: Complete as of June 30, 2024
View Audit 356419
Finding 560149 (2022-016)
Material Weakness 2022
Oregon Coast Community Action
AL
Cash Management Subrecipient Monitoring Allowable Costs / Cost Principles
The Energy program has been current on the required reporting since the referenced audit period. The program is aware of the grants' requirements now. Additionally, ORCCA plans to utilize grant tracker system with the ability to send reminders for important dates to avoid future delinquent reporting...
The Energy program has been current on the required reporting since the referenced audit period. The program is aware of the grants' requirements now. Additionally, ORCCA plans to utilize grant tracker system with the ability to send reminders for important dates to avoid future delinquent reporting that was experienced during the audit period. The system will be utilized by the program directors as well as finance team (Finance Director, Accounting Manager, Program Fiscal Compliance Coordinator) working with grants/directors. ORCCA's current process at the Energy program level has already improved to ensure proper documentation of eligibility. The Energy program director and staff are implementing this internal control at the program level to review the supporting documents and information and proper coding to the correct period. Responsible party: Bonnie Foroudi, Finance Director Estimated completion date: December 31, 2025
View Audit 356132
Finding 560144 (2022-015)
Material Weakness 2022
Oregon Coast Community Action
AL
Questioned Costs Matching / Level of Effort / Earmarking Subrecipient Monitoring
ORCCA's current process at the Energy program level has already improved to ensure proper documentation of eligibility. The Energy program director and staff are currently implementing this internal control at the program level to document the information and proper coding to the correct period. Re...
ORCCA's current process at the Energy program level has already improved to ensure proper documentation of eligibility. The Energy program director and staff are currently implementing this internal control at the program level to document the information and proper coding to the correct period. Responsible party: Bonnie Foroudi, Finance Director Estimated completion date: December 31, 2025
View Audit 356132 Questioned Costs: $1
Finding 560138 (2022-013)
Material Weakness 2022
Oregon Coast Community Action
AL
Allowable Costs / Cost Principles Eligibility Period of Performance § 200.303
ORCCA's current process at the program level has improved to ensure proper documentation of eligibility. The Housing director and staff have implemented this internal control at the program level. The finance department's internal control (as noted earlier) is in place to ensure the payment requests...
ORCCA's current process at the program level has improved to ensure proper documentation of eligibility. The Housing director and staff have implemented this internal control at the program level. The finance department's internal control (as noted earlier) is in place to ensure the payment requests have sufficient supporting documentation. As for record retention, ORCCA hired additional temp workers to ensure completed transactions are filed timely with the goal of going paperless in the near future. Responsible party: Bonnie Foroudi, Finance Director Estimated completion date: December 31, 2025
View Audit 356132
Finding 559160 (2022-014)
Significant Deficiency 2022
Caswell County
NC
Eligibility Significant Deficiency
CASWELL COUNTY 144 Court Square, Yanceyville, NC 27379 www.caswellcountync.gov 336/694-4193 Corrective Action Plan For the Year Ended June 30, 2022 Finding: 2022-014 Inadequate Request for Information Name of contact person: Corrective Action: Proposed Completion Date: Corrective Action for Findings...
CASWELL COUNTY 144 Court Square, Yanceyville, NC 27379 www.caswellcountync.gov 336/694-4193 Corrective Action Plan For the Year Ended June 30, 2022 Finding: 2022-014 Inadequate Request for Information Name of contact person: Corrective Action: Proposed Completion Date: Corrective Action for Findings 2022-012, 2022-013, 2022-014 also apply to the State Award findings. Section IV - State Award Findings and Question Costs April 11, 2024 Heather Starr Thomas, Medicaid Supervisor Cases will be reviewed internally to ensure proper documentation is in place for eligibility. Workers will be retrained on what cases should contain and the importance of complete and accurate record keeping. All cases will include online verifications ran timely, documented resources, income and make certain those amounts agree to information input into NC FAST. The results found or documentation made in case notes should clearly indicate what actions were performed by the caseworker and the results of those actions. Information must be updated at every application/recertification and change in circumstance adhering to Medicaid Policy. Templates have been updated to address request for information, income verifications, reasonable compatibility and to include electronic resources are ran with verification of date ran. Help Desk tickets should be submitted timely if information or functionality is not working properly. All avenues available to caseworker must be exhausted before requesting information from client, unless information provided and information obtained is questionable. We will continue to train on this issue, and it will also be addressed in new worker Trainings. Training in the learning gateway is also available. Section III - Federal Award Findings and Question Costs (continued) 137
View Audit 355386
Finding 559159 (2022-013)
Significant Deficiency 2022
Caswell County
NC
Eligibility Significant Deficiency Internal Control / Segregation of Duties
Proposed Completion Date: Finding: 2022-013 Inaccurate Information Entry Name of contact person: Corrective Action: Proposed Completion Date: Heather Starr Thomas, Medicaid Supervisor A refresher training will be held to review errors. Files will be reviewed internally to ensure proper documentation...
Proposed Completion Date: Finding: 2022-013 Inaccurate Information Entry Name of contact person: Corrective Action: Proposed Completion Date: Heather Starr Thomas, Medicaid Supervisor A refresher training will be held to review errors. Files will be reviewed internally to ensure proper documentation is in place for eligibility. Workers will be retrained on what files should contain and the importance of complete and accurate record keeping. All files include accurate household members, online verifications, documented sources and verifications of income and those amounts agree to information in NC FAST. The results found or documentation made in case notes should clearly indicate what actions were performed and the results of those actions. An updated template has been put in place for applications and recertification to address household members, tax filing status, electronic checks/verifications and documentation that is needed to accurately approve/deny/continue or terminate benefits. Caseworkers will need to review Determinations to ensure all eligibility is calculated accurately. All active cases regardless of program in NCFAST are to be reviewed to ensure we have the correct information. Weekly Communications and Changes will be reviewed weekly at Unit Meeting to address any changes and NCFAST issues that may require a Help Desk Ticket. We will continue to train on this issue, and it will also be addressed in new worker Trainings. Training in the learning gateway is also available. April 11, 2024 Section III - Federal Award Findings and Question Costs (continued) N/A - Caseworkers will adhere to the policy in Administrative Letter 13-23.
View Audit 355386
Finding 559158 (2022-012)
Significant Deficiency 2022
Caswell County
NC
Eligibility Significant Deficiency
Finding: 2022-012 IV-D Non-Cooperation Name of contact person: Corrective Action: Section II - Financial Statement Findings (continued) As noted in Findings 2022-001 and 2022-006, the county finance staff is diligently working to improve the timeliness of transaction processing and anticipates timel...
Finding: 2022-012 IV-D Non-Cooperation Name of contact person: Corrective Action: Section II - Financial Statement Findings (continued) As noted in Findings 2022-001 and 2022-006, the county finance staff is diligently working to improve the timeliness of transaction processing and anticipates timely completion of the FY24 audit which will resolve this finding. Melissa Miller, Interim Finance Officer Heather Starr Thomas, Medicaid Supervisor At the time the determinations under audit were completed this was a requirement. However, under current policy referrals are not being enforced for cooperation with the Child Support Enforcement Agency (IV-D). This became effective August 18, 2023. Please see Administrative Letter 13-23.Proposed Completion Date: Finding: 2022-013 Inaccurate Information Entry Name of contact person: Corrective Action: Proposed Completion Date: Heather Starr Thomas, Medicaid Supervisor A refresher training will be held to review errors. Files will be reviewed internally to ensure proper documentation is in place for eligibility. Workers will be retrained on what files should contain and the importance of complete and accurate record keeping. All files include accurate household members, online verifications, documented sources and verifications of income and those amounts agree to information in NC FAST. The results found or documentation made in case notes should clearly indicate what actions were performed and the results of those actions. An updated template has been put in place for applications and recertification to address household members, tax filing status, electronic checks/verifications and documentation that is needed to accurately approve/deny/continue or terminate benefits. Caseworkers will need to review Determinations to ensure all eligibility is calculated accurately. All active cases regardless of program in NCFAST are to be reviewed to ensure we have the correct information. Weekly Communications and Changes will be reviewed weekly at Unit Meeting to address any changes and NCFAST issues that may require a Help Desk Ticket. We will continue to train on this issue, and it will also be addressed in new worker Trainings. Training in the learning gateway is also available. April 11, 2024 Section III - Federal Award Findings and Question Costs (continued) N/A - Caseworkers will adhere to the policy in Administrative Letter 13-23.
View Audit 355386
Finding 556195 (2022-003)
Material Weakness 2022
Benton County
WA
Subrecipient Monitoring Allowable Costs / Cost Principles Internal Control / Segregation of Duties
Thank you for bringing this to our attention. There were several factors that contributed to the difficulties we encountered submitting the required quarterly reports and have since remedied those issues. The Human Services Department has worked with Treasury on the challenges we encountered uploa...
Thank you for bringing this to our attention. There were several factors that contributed to the difficulties we encountered submitting the required quarterly reports and have since remedied those issues. The Human Services Department has worked with Treasury on the challenges we encountered uploading the required reporting templates and we now has multiple people with access to the reporting portal and in the event of staff turnover we can continue to submit required reports. The Human Services Manager and the Budget and Finance Analyst have created reminders on their calendars to ensure reporting is completed on time and with accurate data.
View Audit 354873
Finding 555649 (2022-008)
Significant Deficiency 2022
Town of Coventry, Rhode Island
RI
Procurement, Suspension & Debarment Subrecipient Monitoring Eligibility § 200.213 § 200.303
Significant Deficiency in Internal Control over Compliance, Other Matters Description of Finding The Town does not have policies and procedures in place to ensure that they do not contract with or make subawards to parties that are suspended or debarred. Statement of Concurrence or Nonconcurrence ...
Significant Deficiency in Internal Control over Compliance, Other Matters Description of Finding The Town does not have policies and procedures in place to ensure that they do not contract with or make subawards to parties that are suspended or debarred. Statement of Concurrence or Nonconcurrence Management concurs with the finding. Corrective Action The Town will review the district’s suspension and debarment policy and make sure that it is following the criteria as set out in the 2 CFR sections 200.213. The policy will then be updated and communicated to all personnel involved in the procurement process. Name of Contact Person Robert J. Civetti, CPA, Finance Director Projected Completion Date June 30, 2025
View Audit 354246
Finding 554717 (2022-003)
Material Weakness 2022
Passaic County Board of Social Services
NJ
Eligibility
Temporary Assistance for Needy Families (TANF), CFDA #93.558, Grant Period 1/1/22-12/31/22. There were multiple instances where eligibility files selected for review were either incomplete, or unable to be presented for audit review. Recommendation: As per Federal OMB Uniform Guidance Circular Compl...
Temporary Assistance for Needy Families (TANF), CFDA #93.558, Grant Period 1/1/22-12/31/22. There were multiple instances where eligibility files selected for review were either incomplete, or unable to be presented for audit review. Recommendation: As per Federal OMB Uniform Guidance Circular Compliance Supplement, each individual who receives benefits under the TANF Program, should have a completed eligibility determination on file which is available for audit review. Corrective Action: PCBSS have created a DIMS unit, where files are scanned and stored in DIMS. Implementation Date: Commenced 2022 and ongoing.
View Audit 353335
Finding 554716 (2022-002)
Material Weakness 2022
Passaic County Board of Social Services
NJ
Eligibility
Medical Assistance Program (Medicaid, Title IXI), CFDA #93.778, Grant Period 1/1/22-12/31/22. There were multiple instances where eligibility files selected for review were either incomplete, or unable to be presented for audit review. Recommendation: As per Federal OMB Uniform Guidance Circular Com...
Medical Assistance Program (Medicaid, Title IXI), CFDA #93.778, Grant Period 1/1/22-12/31/22. There were multiple instances where eligibility files selected for review were either incomplete, or unable to be presented for audit review. Recommendation: As per Federal OMB Uniform Guidance Circular Compliance Supplement, each individual who receives benefits under the Medicaid Program, should have a completed eligibility determination on file which is available for audit review. Corrective Action: PCBSS have created a DIMS unit, where files are scanned and stored in DIMS. Implementation Date: Commenced 2022 and ongoing.
View Audit 353335
Finding 554569 (2022-011)
Material Weakness 2022
Bristlecone Family Resources
CA
Questioned Costs Allowable Costs / Cost Principles Eligibility
Recommendation: Strengthen controls over compliance, reporting, and cost allocation. Action Plan: - Immediate Actions (Q2 2024): - Review and document grant compliance requirements. - Implement a structured approval process for financial reports. - Long-Term Actions: - Conduct quarterly compliance t...
Recommendation: Strengthen controls over compliance, reporting, and cost allocation. Action Plan: - Immediate Actions (Q2 2024): - Review and document grant compliance requirements. - Implement a structured approval process for financial reports. - Long-Term Actions: - Conduct quarterly compliance training for grant managers (Q3 2024). - Engage an external consultant for a mid-year compliance review (Q4 2024). Responsible: John Opalinski Completion Date: Within 3 months of CAP issuance.
View Audit 353270 Questioned Costs: $1
Finding 554472 (2022-009)
Significant Deficiency 2022
East End Neighborhood House Association
OH
Eligibility Significant Deficiency Matching / Level of Effort / Earmarking
Views of Responsible Officials and Planned Corrective Action: To address the issue, the management will develop and document a clear policy for obtaining and retaining eligibility documentation. This policy should outline the specific types of documentation required and the procedures for collectin...
Views of Responsible Officials and Planned Corrective Action: To address the issue, the management will develop and document a clear policy for obtaining and retaining eligibility documentation. This policy should outline the specific types of documentation required and the procedures for collecting and storing them. Set up a monitoring and reporting system to track the status of eligibility documentation. Regularly review reports to ensure that all required documentation is up-to-date and complete. Anticipated Date of Completion: Ongoing analysis; expected to be completed by December 1, 2025.
View Audit 353100
Finding 547561 (2022-002)
Material Weakness 2022
Housing Authority of the County of Monterey
CA
Questioned Costs HUD Housing Programs Eligibility
Views of responsible officials and planned corrective action: The Authority accepts the recommendation of the auditor. The affected files relate to clients that have been on the program for decades and as files get large, archiving takes place. To correct this finding, a directive will be issued to ...
Views of responsible officials and planned corrective action: The Authority accepts the recommendation of the auditor. The affected files relate to clients that have been on the program for decades and as files get large, archiving takes place. To correct this finding, a directive will be issued to staff that will ensure that when files are archived the original application must be placed in the current working file going forward. Diana Ruiz, Interim Director of Housing Programs, will be responsible to implement this corrective action by June 30, 2023.
View Audit 351745 Questioned Costs: $1
Finding 544472 (2022-009)
Material Weakness 2022
Marian High School
IN
Eligibility Reporting School Nutrition Programs
Management agrees with the finding and has developed a set of policies and documented them. The Business Manager has implemented the changes as of June 2023.
Management agrees with the finding and has developed a set of policies and documented them. The Business Manager has implemented the changes as of June 2023.
View Audit 351152
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