Corrective Action Plans

Finding 402359 (2021-005)

Material Weakness 2021

CA

Questioned Costs Internal Control / Segregation of Duties Allowable Costs / Cost Principles § 200.303

Given the unprecedented volume of unemployment insurance claims during the federal disaster -approximately 20 million claims compared to 3.8 million during the Great Recession - EDD took action to speed payments to eligible claimants whenever possible. For example, EDD launched in July 2021 a Condit...

Given the unprecedented volume of unemployment insurance claims during the federal disaster -approximately 20 million claims compared to 3.8 million during the Great Recession - EDD took action to speed payments to eligible claimants whenever possible. For example, EDD launched in July 2021 a Conditional Payment Program to speed payments to claimants who certified for benefits and already received at least one week of benefits in the past but whose payments were later pending for more than two weeks. EDD also boosted its capacity to process workloads, prioritized timely payments, and employed automation among other measures. As reported in Reference Number 2020-006 in fiscal year 2019-2020, EDD began automatically cross-matching EDD wage records and Franchise Tax Board (FTB) records in November 2020 to assist in verifying the income of PUA claimants. Claimants who could not be automatically verified through the FTB wage record match were required to submit additional documentation to EDD for a manual review. Regarding the manual processing of the income documents to substantiate the PUA weekly benefit amounts that have been increased above the minimum California weekly benefit amount (WBA) of $167, in June 2022, the EDD submitted a blanket waiver application to the U.S. Department of Labor (DOL), pursuant to the DOL Unemployment Insurance Program Letter 20-21, Change 1. EDD’s application is pending the DOL’s determination. If approved, our blanket waiver application would cover any overpayments for claimants who, through no fault of their own, failed to provide proof of income substantiation to support the increase or whose WBA will be decreased because the proof they provided was insufficient. Regarding the verification of employment or self-employment substantiation (known in California as “Self-employment/Employment Substantiation” or “SEES”), this verification process is being implemented in two phases. Phase 1 of the SEES effort was implemented on November 10, 2021, and involved notifying claimants registered in California’s UI Online (UIO) system by email and text of their requirement to provide SEES documentation. Phase 2 will involve notifying claimants who did not respond to the UIO request for SEES documentation, and those who are not registered in UIO, via a paper notice mailed through the United States Postal Service (USPS). EDD submitted a blanket overpayment waiver application in June 2022 to DOL regarding this issue. EDD will assess further implementation based on the DOL’s decision. If approved, our blanket waiver application would cover any overpayments for claimants who, through no fault of their own, provided insufficient documentation or did not provide any documentation. Estimated Implementation Date: To be determined once the DOL provides a decision on the waiver application. Contact: Diane Underwood, Division Chief Unemployment Insurance Branch California Employment Development Department

View Audit 309913 Questioned Costs: $1

Finding 402357 (2021-004)

Material Weakness 2021

State of California

CA

Questioned Costs Eligibility Matching / Level of Effort / Earmarking § 200.303

Since fiscal year 2020-21, EDD has implemented dozens of strict anti-fraud measures to continue to evaluate and enhance its fraud detection. These measures, described in last year’s response to finding Reference Number 2020-005, included, but were not limited to, cross matching claimant information ...

Since fiscal year 2020-21, EDD has implemented dozens of strict anti-fraud measures to continue to evaluate and enhance its fraud detection. These measures, described in last year’s response to finding Reference Number 2020-005, included, but were not limited to, cross matching claimant information against law enforcement and government databases and implementing rigorous new identity verification procedures. As a result, EDD caught and stopped multiple fraud attempts starting in September 2020. As previously described, EDD implemented the following measures to address the nationwide fraud attempts perpetrated against the new emergency federal benefit programs in 2020-21: • Implemented additional cross-matches in September 2020 to detect multiple claims per address. • Ceased automatically backdating Pandemic Unemployment Assistance (PUA) claims under federal rules in September 2020. • Strengthened identity verification procedures in October 2020 by implementing ID.me. • Implemented additional cross-matches in November 2020 against state inmate information. • Vetted applications against law enforcement databases and other tools provided by Thomson Reuters in December 2020 to further curb identity and non-identity fraud. • Established a 1099-G call center to help victims of identity theft deal with any tax-related questions. • Ceased printing Social Security numbers on mailed documents to reduce identity theft risk. • Enhanced benefit card security with Bank of America. • Partnered with state, local and federal law enforcement agencies to support thousands of criminal investigations, arrests, prosecutions and convictions. The EDD will continue to evaluate and enhance the fraud detection/prevention tools that have been put in place. Estimated Implementation Date: September 2020 Contact: Diane Underwood, Division Chief Unemployment Insurance Branch California Employment Development Department

View Audit 309913 Questioned Costs: $1

Finding 402355 (2021-003)

Material Weakness 2021

State of California

CA

Eligibility Allowable Costs / Cost Principles HUD Housing Programs § 200.303

The Women, Infants, and Children Division (WIC) of the California Department of Public Health (Public Health) agrees that the WIC WISE system does not currently store eligibility history that should be included in the “Cert History Report.” Currently, the initial eligibility data is overwritten when...

The Women, Infants, and Children Division (WIC) of the California Department of Public Health (Public Health) agrees that the WIC WISE system does not currently store eligibility history that should be included in the “Cert History Report.” Currently, the initial eligibility data is overwritten when subsequent eligibility information is keyed into WIC WISE. WIC WISE does include preventative internal stops or check points that do not allow ineligible individuals to be certified and issued benefits (e.g., over income, not a CA resident, no nutrition risk factor, etc.). User acceptance testing vetted these items prior to system implementation. The certification history condition will be remediated via a system Defect Correction to WIC WISE. WIC has entered Defect Correction #6972 in Team Foundation Services (TFS), the tracking system used to capture system changes and defects. This correction is included in a release that is currently being tested and is targeted for release into production by May 2023. The defect supports a system change to ensure initial eligibility information is retained when subsequent eligibility information is entered into WIC WISE. Estimated Implementation Date: May 2023 Contact: William Welch, Assistant Division Chief, Operations Women, Infants, and Children Division California Department of Public Health

View Audit 309913

Finding 402354 (2021-002)

Material Weakness 2021

State of California

CA

Reporting Matching / Level of Effort / Earmarking Subrecipient Monitoring § 200.303 § 200.502 § 200.510

Public Health’s Accounting Office will generate the FI$Cal Year End Close report (KK_12 expenditure) and collaborate with the ELC program to ensure that all expenditures captured are complete and accurate, ensuring timely reporting of the SEFA data for FY 2023-24 and beyond. Additionally, we will up...

Public Health’s Accounting Office will generate the FI$Cal Year End Close report (KK_12 expenditure) and collaborate with the ELC program to ensure that all expenditures captured are complete and accurate, ensuring timely reporting of the SEFA data for FY 2023-24 and beyond. Additionally, we will update the procedures to document the SEFA reporting for the ELC program.

View Audit 309913

Finding 400962 (2021-003)

Material Weakness 2021

Gloversville Housing Authority

RI

HUD Housing Programs Subrecipient Monitoring Eligibility

Auditee’s Response and Planned Corrective Action The Authority hired a new Executive Director in November 2023. Under new management, the Authority provided training to necessary staff and will discuss with the third party management company to ensure compliance with 24 CFP 982.516 in the future. Pl...

Auditee’s Response and Planned Corrective Action The Authority hired a new Executive Director in November 2023. Under new management, the Authority provided training to necessary staff and will discuss with the third party management company to ensure compliance with 24 CFP 982.516 in the future. Planned Implementation Date of Corrective Action: Immediately Person Responsible for Corrective Action: Kayla Potter, Executive Director

View Audit 309030

Finding 397059 (2021-006)

Material Weakness 2021

Open Cities Health Center, Inc. and Affiliate

MN

Eligibility Special Tests & Provisions Subrecipient Monitoring

Finding 2021-006 Compliance Requirement: Special Tests and Provisions – Sliding Fee Discounts Material Weakness Assistance Living Number 93.224 Health Center Programs Grant Award Number H80CS00112 U.S. Department of Human Services Condition: Supporting documents could not be located for four of...

Finding 2021-006 Compliance Requirement: Special Tests and Provisions – Sliding Fee Discounts Material Weakness Assistance Living Number 93.224 Health Center Programs Grant Award Number H80CS00112 U.S. Department of Human Services Condition: Supporting documents could not be located for four of the thirty patients selected for testing. As such, we were unable to determine eligibility. Action Planned in Response to the Finding: Effective immediately, the revenue cycle team will implement and monitor procedures to ensure that all supporting documents are kept for determining sliding fee discounts and patient eligibility. Official Responsible for Ensuring the CAP: Becky Howard Planned Completion Date: June 30th, 2024

View Audit 306434

Finding 397056 (2021-005)

Material Weakness 2021

Open Cities Health Center, Inc. and Affiliate

MN

Questioned Costs Allowable Costs / Cost Principles Eligibility

Finding 2021-005 Compliance Requirement: Allowable Cost/Cost Principles Material Weakness Assistance Living Number 93.224 Health Center Programs Grant Award Number H80CS00112 U.S. Department of Human Services Condition: A walkthrough of fourteen individuals was performed to agree personnel files a...

Finding 2021-005 Compliance Requirement: Allowable Cost/Cost Principles Material Weakness Assistance Living Number 93.224 Health Center Programs Grant Award Number H80CS00112 U.S. Department of Human Services Condition: A walkthrough of fourteen individuals was performed to agree personnel files and to payroll. Of the fourteen files reviewed, seven had no approved current pay rate documented, and the salary or hourly rate paid was not the rate contained in the file. Action Planned in Response to the Finding: Effective immediately, the human resources team will begin using of a checklist within each file as an additional procedure to ensure that each file contains all necessary documents and that the file has been updated for current rates of pay. Official Responsible for Ensuring the CAP: Becky Howard Planned Completion Date: June 30th, 2024

View Audit 306434 Questioned Costs: $1

Finding 396189 (2021-004)

Significant Deficiency 2021

City of Manteca

CA

Questioned Costs Subrecipient Monitoring Allowable Costs / Cost Principles

Finding #SA2021-004: Allowable Subrecipient and Contract Costs Assistance Listing Number: 14.218 Assistance Listing Title: COVID-19 - Community Development Block Grants/Entitlement Grants Name of Federal Agency: Department of Housing and Urban Development Pass Through Entity: San Joaquin County Comm...

Finding #SA2021-004: Allowable Subrecipient and Contract Costs Assistance Listing Number: 14.218 Assistance Listing Title: COVID-19 - Community Development Block Grants/Entitlement Grants Name of Federal Agency: Department of Housing and Urban Development Pass Through Entity: San Joaquin County Community Development Department Federal Award Identification Number: A-93-916 • Name(s) of the contact person: Shay Narayan, Director of Finance; Carmen Gusman, Deputy Director of Finance • Corrective Action Plan: The City will develop procedures for grant management, accounting and reporting to ensure that only allowable subrecipient costs are claimed and are supported by contract. • Anticipated Completion Date: 06/30/24

View Audit 305817 Questioned Costs: $1

Finding 396188 (2021-003)

Material Weakness 2021

City of Manteca

CA

Questioned Costs Allowable Costs / Cost Principles Eligibility § 200.430

Finding Reference Number #SA2021-003: Pro-Rating Annual Payroll Costs Charged to Grant Assistance Listing Number: 21.019 Assistance Listing Title: COVID-19 - Coronavirus Relief Fund Name of Federal Agency: Department of Treasury Pass Through Entity: California Department of Finance Federal Award Ide...

Finding Reference Number #SA2021-003: Pro-Rating Annual Payroll Costs Charged to Grant Assistance Listing Number: 21.019 Assistance Listing Title: COVID-19 - Coronavirus Relief Fund Name of Federal Agency: Department of Treasury Pass Through Entity: California Department of Finance Federal Award Identification Number: 390 • Name(s) of the contact person: Shay Narayan, Director of Finance; Carmen Gusman, Deputy Director of Finance • Corrective Action Plan: Now that payroll services and the budget unit are both fully staffed, the City will be able to develop procedures that will ensure personnel budgets and costs are accurately pro-rated to the appropriate funding source. Additionally, the City expects to have sufficient staffing to work more closely with grantors make certain the all eligible costs are accounted for. • Anticipated Completion Date: 06/30/24

View Audit 305817 Questioned Costs: $1

Finding 396132 (2021-001)

Significant Deficiency 2021

Catholic Charities of Yolo-Solano

CA

Questioned Costs Eligibility

Views of Responsible Officials and Planned Corrective Actions: Catholic Charities of Yolo-Solano, Inc. concurs that our internal control system, in some instances, did not fully connect our program documentation of eligibility criteria and necessary documentation to our accounting department’s docum...

Views of Responsible Officials and Planned Corrective Actions: Catholic Charities of Yolo-Solano, Inc. concurs that our internal control system, in some instances, did not fully connect our program documentation of eligibility criteria and necessary documentation to our accounting department’s documentation. Further, we concur that our external bookkeeper did not have proper review controls in place, nor were our systems properly designed to identify this lack of internal controls over expenditures. Catholic Charities of Yolo-Solano, Inc. have already initiated several corrective actions. • Catholic Charities of Yolo-Solano, Inc. engaged an external accounting firm that specializes in nonprofit accounting, internal controls and grant compliance to assist us in ensuring that each awarded grant includes the necessary eligibility details and supporting documentation. This firm utilizes a team-based approach, ensuring all monthly accounting is reviewed by the assigned Chief Financial Officer assigned to manage and oversee the accounting as well as design and implement strong internal controls.

View Audit 305711 Questioned Costs: $1

Finding 395081 (2021-002)

Material Weakness 2021

Houston Housing Authority

TX

HUD Housing Programs Eligibility Material Weakness

The Houston Housing Authority agrees with this finding. The Houston Housing Authority has undertaken a program to review all voucher files for the purpose of getting all delinquent recertifications completed. During this process, if other required documents are identified, steps are taken to complet...

The Houston Housing Authority agrees with this finding. The Houston Housing Authority has undertaken a program to review all voucher files for the purpose of getting all delinquent recertifications completed. During this process, if other required documents are identified, steps are taken to complete the missing documentation and make sure that the files are complete. This review is still ongoing with expected completion in the first half of 2024. Where needed staff will be provided the necessary training to make sure that all HCVP staff have the skills needed to successfully complete their job tasks. To facilitate this training, the Houston Housing Authority has created a training center that is made available to not only Houston Housing Authority staff but also others to provide a wide variety of training classes. Current leadership at the Houston Housing Authority is committed to having competent, well-trained staff working in the HCVP as well as other departments within the agency.

View Audit 305009

Finding 395062 (2021-006)

Significant Deficiency 2021

Housing Authority of Cass County

ND

Eligibility Significant Deficiency

Contact Person Derek Johnson, Executive Director Corrective Action Plan The Authority will review its policies and procedures over program compliance requirements and continue to provide occupancy training to staff to prevent future exceptions. Planned Completion Date for CAP December 31, 2022.

View Audit 304992

Finding 393845 (2023-003)

Significant Deficiency 2021

Hospital Comunitario Buen Samaritano, Inc.

PR

Questioned Costs Eligibility Subrecipient Monitoring

As discussed during the past couple of weeks we are lacking some detailed information that could have helped us clarify some of, or all of the questions and/ or doubts that you have raised, but unfortunately key people that generated the list are no longer employees (Finance Director, Human Resource...

As discussed during the past couple of weeks we are lacking some detailed information that could have helped us clarify some of, or all of the questions and/ or doubts that you have raised, but unfortunately key people that generated the list are no longer employees (Finance Director, Human Resource Director, and Payroll Manager). In regards to whom was eligible, this is a more difficult question to answer primarily due to the same reasons expressed above. But asking the team members that are still employed, they indicated that most of areas during this stage of the pandemic had direct or indirect contact with the patients visiting us, reason being that a significant percentage of our employees at the time were diagnosticated with COVID-19. In order to significantly improve future Federal funds receipts management processes, we will take the following steps: 1. Discuss, document and safe guard documentations regarding meetings that take place with all responsible parties on Federal requirements that must be followed to ensure compliance (Signatures required of all participants) 2. Depending on the nature of the funds and its intended utilization, the responsible parties will designate whom (Position/Department) will be the custodian of all the documentation 3. Ensure that each step of the implementation processes is well documented, with clear instructional details that are required to comply with the Federal requirements 4. Before submitting the required information, the responsible parties must meet to ensure that all requirements have been met, and that all required documentation is safe guarded for future reference (Signatures required of all participants) The plan will be approved by the Board and implemented no later than April 26th, 2024.

View Audit 304036 Questioned Costs: $1

Finding 393842 (2023-001)

Significant Deficiency 2021

Hospital Comunitario Buen Samaritano, Inc.

PR

Questioned Costs Eligibility Subrecipient Monitoring

As discussed during the past couple of weeks we are lacking some detailed information that could have helped us clarify some of, or all of the questions and/ or doubts that you have raised, but unfortunately key people that generated the list are no longer employees (Finance Director, Human Resource...

As discussed during the past couple of weeks we are lacking some detailed information that could have helped us clarify some of, or all of the questions and/ or doubts that you have raised, but unfortunately key people that generated the list are no longer employees (Finance Director, Human Resource Director, and Payroll Manager). In regards to whom was eligible, this is a more difficult question to answer primarily due to the same reasons expressed above. But asking the team members that are still employed, they indicated that most of areas during this stage of the pandemic had direct or indirect contact with the patients visiting us, reason being that a significant percentage of our employees at the time were diagnosticated with COVID-19. In order to significantly improve future Federal funds receipts management processes, we will take the following steps: 1. Discuss, document and safe guard documentations regarding meetings that take place with all responsible parties on Federal requirements that must be followed to ensure compliance (Signatures required of all participants) 2. Depending on the nature of the funds and its intended utilization, the responsible parties will designate whom (Position/Department) will be the custodian of all the documentation 3. Ensure that each step of the implementation processes is well documented, with clear instructional details that are required to comply with the Federal requirements 4. Before submitting the required information, the responsible parties must meet to ensure that all requirements have been met, and that all required documentation is safe guarded for future reference (Signatures required of all participants) The plan will be approved by the Board and implemented no later than April 26th, 2024.

View Audit 304036 Questioned Costs: $1

Finding 393787 (2021-004)

Material Weakness 2021

Housing Authority of the City of Pueblo

CO

Eligibility Material Weakness Internal Control / Segregation of Duties

U.S. Department of Housing and Urban Development – CFDA #14.850 Public and Indian Housing – 2021 Eligibility Material Weakness in Internal Control over Compliance Finding Summary: Testing indicated that there was an error in a tenant’s rent calculation that was not detected by the Authority’s intern...

U.S. Department of Housing and Urban Development – CFDA #14.850 Public and Indian Housing – 2021 Eligibility Material Weakness in Internal Control over Compliance Finding Summary: Testing indicated that there was an error in a tenant’s rent calculation that was not detected by the Authority’s internal controls. In addition, there was no review of the rent calculation by another individual. Responsible Individual: Steven Trujillo, Executive Director Corrective Action Plan: We have implemented a process to ensure eligibility requirements are being followed and that another person reviews the rent calculations once they are determined. Anticipated Completion Date: January 2023

View Audit 303983

Finding 393783 (2021-011)

Significant Deficiency 2021

Housing Authority of the City of Pueblo

CO

HUD Housing Programs Eligibility Significant Deficiency

U.S. Department of Housing and Urban Development – CFDA #14.182/14.856 Section 8 Project-based Cluster– 2021 Eligibility Significant Deficiency in Internal Control over Compliance Finding Summary: The Authority could not find a tenant file from 2021. In addition, there was 1 participant file that di...

U.S. Department of Housing and Urban Development – CFDA #14.182/14.856 Section 8 Project-based Cluster– 2021 Eligibility Significant Deficiency in Internal Control over Compliance Finding Summary: The Authority could not find a tenant file from 2021. In addition, there was 1 participant file that did not have a signed HUD-50059 form that was signed by the participant or the Authority. Responsible Individual: Steven Trujillo, Executive Director Corrective Action Plan: We have established procedures to ensure that all files are maintained and that all forms are signed by both the tenant and the Authority. Anticipated Completion Date: January 2023

View Audit 303983

Finding 393711 (2021-005)

None 2021

Community Development Partnership

MA

Subrecipient Monitoring Eligibility

Upon the completion of the annual audits for FY21, FY22 and FY23 management will file Form SF-SAC with the Federal Audit Clearing House (FAC). Thereafter the annual audit will be completed on a timely basis which will allow for the timely filing of the Form SF-SAC with the FAC.Anticipated Completio...

Upon the completion of the annual audits for FY21, FY22 and FY23 management will file Form SF-SAC with the Federal Audit Clearing House (FAC). Thereafter the annual audit will be completed on a timely basis which will allow for the timely filing of the Form SF-SAC with the FAC.Anticipated Completion Date October 15, 2024.Responsible Contact Person-Kathleen Boyce, CFAO

View Audit 303856

Finding 393335 (2021-009)

Significant Deficiency 2021

Village of North Syracuse Housing Authority

NY

HUD Housing Programs Eligibility

Finding # 2021-009 HCV Waiting List Tenant Selection Corrective Action Plan: With the newly hired staff as of October 2022, the process of selecting eligible tenants from the list has been accomplished by identifying the preference and verifying in writing the reason for such preference to move for...

Finding # 2021-009 HCV Waiting List Tenant Selection Corrective Action Plan: With the newly hired staff as of October 2022, the process of selecting eligible tenants from the list has been accomplished by identifying the preference and verifying in writing the reason for such preference to move forward with the housing the applicant. All verification is kept in the eligible tenant file. The existing staff has had 10-15 years' experience maintaining Federal program waiting list.

View Audit 303605

Finding 392607 (2021-007)

Material Weakness 2021

Fairbanks Rescue Mission, Inc.

AK

Questioned Costs HUD Housing Programs Subrecipient Monitoring

Federal Award Finding: 2021-007 Material Weakness in Internal Control over Compliance and Noncompliance - Eligibility Requirement. Name and Contact Person: Pete Kelly, Chief Executive Officer. Corrective Action: The Fairbanks Rescue Mission's Board of Directors created a Finance Committee with exte...

Federal Award Finding: 2021-007 Material Weakness in Internal Control over Compliance and Noncompliance - Eligibility Requirement. Name and Contact Person: Pete Kelly, Chief Executive Officer. Corrective Action: The Fairbanks Rescue Mission's Board of Directors created a Finance Committee with extensive banking and accounting experience to create a higher level of scrutiny and oversite of the Missions finances. We contracted a professional accounting/bookkeeping firm {Midnight Sun Bookkeeping Services) and empowered them to establish procedures and practices consistent with GAAP {Generally Accepted Accounting Principles) as well as track and participate in day to day activities of Accounting; thereby, assuring accuracy of financial data and assuring compliance. We have formalized check writing, money handling, and credit card control procedures. Switched to an online time tracking system for employees and digitized all employee documents. Created an online filing system for all grant expenses Proposed Completion Date: January 01, 2024

View Audit 302911 Questioned Costs: $1

Finding 392595 (2021-001)

Significant Deficiency 2021

Self Regional Healthcare and Affiliates

SC

Questioned Costs Internal Control / Segregation of Duties Eligibility

Contact Person: Timothy Evans Managements Response: Management had claimed pharmacy costs for drugs that were reimbursed by insurance plans. We incorrectly made an assumption that all drug related expenditures for treating the coronavirus virus were allowable expenditures. We have changed o...

Contact Person: Timothy Evans Managements Response: Management had claimed pharmacy costs for drugs that were reimbursed by insurance plans. We incorrectly made an assumption that all drug related expenditures for treating the coronavirus virus were allowable expenditures. We have changed our processes for inclusion of only expenditures that have not been reimbursed. Similarly we included costs of COVID testing expenditures however, some of those costs were either billed to patients or reimbursed from other sources. We have corrected that process also. Completion Date: January 2024.

View Audit 302889 Questioned Costs: $1

Finding 392586 (2021-004)

Material Weakness 2021

The Jackson County Health Care Authority

AL

Questioned Costs Allowable Costs / Cost Principles Eligibility

Finding 2021-004- Material Weakness and Material Noncompliance over Allowable Cost and Reporting Contact Person: Andrew Wenning Managements Response: During a review of expenses related to the COVID pandemic, the audit identified payroll and non-payroll expenses that management first thought eligibl...

Finding 2021-004- Material Weakness and Material Noncompliance over Allowable Cost and Reporting Contact Person: Andrew Wenning Managements Response: During a review of expenses related to the COVID pandemic, the audit identified payroll and non-payroll expenses that management first thought eligible but on further review, (and subsequent to the submission to the portal) determined were unallowable per the Coronavirus Relief Fund grant terms and conditions. Management has put into place a policy for an individual in the accounting department to review all COVID expenses on a monthly basis going forward. In addition, management will further investigate the total likely questioned cost in order to determine the complete known questioned cost in the period 1 payroll and non-payroll expenditure population by June 30, 2024. For payroll expenses, the policy includes that a review and approval of the expenditures will be performed by an individual in accounting to ensure that the hours and wages calculated meet the terms and conditions of the CRF. If any non-eligible payroll expenses are identified during the review process, they will be removed. For all other expenses, we will obtain and retain approved copies of all invoices or other documentation to support expenses and review for eligibility. If any non-eligible expenses are identified during the review process, they will be removed. Completion Date: April 5, 2024

View Audit 302859 Questioned Costs: $1

Finding 392585 (2021-003)

Material Weakness 2021

The Jackson County Health Care Authority

AL

Questioned Costs Allowable Costs / Cost Principles Eligibility

Finding 2021-003- Material Weakness and Material Noncompliance over Allowable Cost and Reporting Contact Person: Andrew Wenning Managements Response: During a review of expenses related to the COVID pandemic, the audit identified payroll and non-payroll expenses that management first thought eligibl...

Finding 2021-003- Material Weakness and Material Noncompliance over Allowable Cost and Reporting Contact Person: Andrew Wenning Managements Response: During a review of expenses related to the COVID pandemic, the audit identified payroll and non-payroll expenses that management first thought eligible but on further review, (and subsequent to the submission to the portal) determined were unallowable per the Provider Relief Fund grant and Coronavirus Relief Fund grant terms and conditions. Management has put into place a policy for an individual in the accounting department to review all COVID expenses on a monthly basis going forward. In addition, management will further investigate the total likely questioned cost in order to determine the complete known questioned cost in the period 1 payroll and non-payroll expenditure population by June 30, 2024. For payroll expenses, the policy includes that a review and approval of the expenditures will be performed by an individual in accounting to ensure that the hours and wages calculated meet the terms and conditions of the PRF. If any non-eligible payroll expenses are identified during the review process, they will be removed. For all other expenses, we will obtain and retain approved copies of all invoices or other documentation to support expenses and review for eligibility. If any non-eligible expenses are identified during the review process, they will be removed. Completion Date: April 5, 2024

View Audit 302859 Questioned Costs: $1

Finding 392156 (2021-003)

Significant Deficiency 2021

Housing Authority of the City of Renton

WA

HUD Housing Programs Allowable Costs / Cost Principles Eligibility

Finding 2021-003 a. Comments on the Finding and Each Recommendation: Management agrees with both the finding and recommendations. b. Action(s) Taken or Planned on the Finding The management overseeing the process has been completely replaced to ensure a fresh perspective and unwavering dedication to...

Finding 2021-003 a. Comments on the Finding and Each Recommendation: Management agrees with both the finding and recommendations. b. Action(s) Taken or Planned on the Finding The management overseeing the process has been completely replaced to ensure a fresh perspective and unwavering dedication to implementing robust internal controls. To address the shortcomings identified in Finding 2021-003, the Authority commits to a targeted action plan aimed at ensuring timely compliance with reporting requirements. Central to our approach is the engagement of a fee accountant, recognized for expertise in HUD reporting and public housing financial management. This specialist will be tasked with overseeing and streamlining our reporting processes. By leveraging this expertise, we aim to quickly rectify past reporting lapses and ensure future submissions are timely and compliant with HUD requirements. The new fee accountant will conduct a comprehensive review of our current reporting mechanisms, identify bottlenecks, and implement best practices tailored to our operations. This decisive action, centered around the expertise of the newly appointed fee accountant, demonstrates our commitment to enhancing our financial management practices and aligning with HUD's reporting expectations. Through these measures, we anticipate not only meeting HUD's deadlines but also setting a new standard for operational excellence within our Authority.

View Audit 302365

Finding 392079 (2021-004)

Material Weakness 2021

Lss Housing Jamestown, Inc.

ND

Allowable Costs / Cost Principles Eligibility Special Tests & Provisions § 200.334

US Department of Housing and Urban Development Federal Financial Assistance Listing #14.157 Supportive Housing for the Elderly (Section 202) Finding Summary: As a result of management transition, supporting documentation for expense transactions and tenant eligibility were destroyed and were unable ...

US Department of Housing and Urban Development Federal Financial Assistance Listing #14.157 Supportive Housing for the Elderly (Section 202) Finding Summary: As a result of management transition, supporting documentation for expense transactions and tenant eligibility were destroyed and were unable to be recreated. The organization was lacking appropriate internal controls to ensure records were retained for the required period of time. Responsible Individual: Dawn Helmowski, Finance Director Corrective Action Plan: Subsequent to the audit period under review, the affiliated entity of Luther Social Services of North Dakota has been replaced with Beyond Shelter, Inc. Upon this change, the new LSS Jamestown Housing, Inc. Board of Directors, implemented a Document Retention and Destruction Policy that includes retention or required documents for the required time periods that will ensure documents are retained. This policy was put into place on April 19, 2023. Anticipated Completion Date: April 2023

View Audit 302211

Finding 382704 (2021-002)

Material Weakness 2021

University of Kansas Hospital Authority

KS

Questioned Costs Cash Management Eligibility

The Authority has performed a review of all patients who have had indications of additional health insurance on an account with a HRSA payment, and made appropriate refunds. A sample of HRSA paid claims were reviewed for ineligible diagnosis codes and appropriate refunds were made.

View Audit 296290 Questioned Costs: $1

Corrective Action Plans

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