Corrective Action Plans

Finding 496965 (2023-004)

Significant Deficiency 2023

AS

Special Tests & Provisions Subrecipient Monitoring Significant Deficiency

Special Tests and Provisions * Significant Deficiencies in Internal Controls over Compliance; Non-Compliance Federal Program - CFDA 20.205 - Highway Planning & Construction The Department of Public Works (DPW) awaits approval of its Implementation and Stewardship agreement from Federal Highway. ...

Special Tests and Provisions * Significant Deficiencies in Internal Controls over Compliance; Non-Compliance Federal Program - CFDA 20.205 - Highway Planning & Construction The Department of Public Works (DPW) awaits approval of its Implementation and Stewardship agreement from Federal Highway. The finding will remain open until the agreement is approved. POC  DPW Deputy Director Laupule Tilei  Civil Engineer Uaealesi Doris Faumuina-Sipelii

View Audit 319698

Finding 496948 (2023-004)

Significant Deficiency 2023

Regional School Unit #54 - Msad #54

ME

Eligibility School Nutrition Programs Internal Control / Segregation of Duties

Management response/corrective action: The Nutrition Director will update student eligibility when verification requests are not returned. The Director will participate in Department of Education professional development to stay abreast of all requirements of School Nutrition.

View Audit 319690

Finding 496947 (2023-003)

Significant Deficiency 2023

Regional School Unit #54 - Msad #54

ME

Cash Management Reporting Internal Control / Segregation of Duties

Management response/corrective action: The Nutrition Director will involve the Support Services Administrative Assistant in the claims process to review and check for accuracy.

View Audit 319690

Finding 496946 (2023-005)

Material Weakness 2023

Village of Luck

WI

Subrecipient Monitoring Internal Control / Segregation of Duties Cash Management

Pre-Disaster Mitigation PDM Program – Assistance Listing No. 97.047 Recommendation: The Village should monitor the various reporting requirements and have the proper reporting documentation on file from the subrecipient. Explanation of disagreement with audit finding: There is no disagreement with...

Pre-Disaster Mitigation PDM Program – Assistance Listing No. 97.047 Recommendation: The Village should monitor the various reporting requirements and have the proper reporting documentation on file from the subrecipient. Explanation of disagreement with audit finding: There is no disagreement with the audit finding. Action taken in response to finding: The Village will revise their control process to ensure that they are monitoring the various reporting requirements and have the proper reporting documentation on file from the subrecipient. Name(s) of the contact person(s) responsible for corrective action: Laurie Cook, Village Treasurer. Planned completion date for corrective action plan: December 31, 2024

View Audit 319689

Finding 496945 (2023-004)

Material Weakness 2023

Village of Luck

WI

Material Weakness Reporting Internal Control / Segregation of Duties

Pre-Disaster Mitigation PDM Program – Assistance Listing No. 97.047 Recommendation: The Village should submit the quarterly status reports within 15 days of the end of the quarter. Explanation of disagreement with audit finding: There is no disagreement with the audit finding. Action taken in respo...

Pre-Disaster Mitigation PDM Program – Assistance Listing No. 97.047 Recommendation: The Village should submit the quarterly status reports within 15 days of the end of the quarter. Explanation of disagreement with audit finding: There is no disagreement with the audit finding. Action taken in response to finding: The Village will revise their control process to ensure that the quarterly status reports are submitted within 15 days of the end of the quarter. Name(s) of the contact person(s) responsible for corrective action: Laurie Cook, Village Treasurer. Planned completion date for corrective action plan: December 31, 2024

View Audit 319689

Finding 496944 (2023-006)

Material Weakness 2023

City of Michigan City

IN

Subrecipient Monitoring Internal Control / Segregation of Duties Material Weakness § 200.303 § 200.329

FINDING 2023-006 Finding Subject: COVID - 19: Coronavirus State and Local Fiscal Recovery Funds – US 12 Stormwater Drainage Improvement Project – Reporting Summary of Finding: The Michigan City Sanitary District did not design or implement a system of internal controls that would have prevented the ...

FINDING 2023-006 Finding Subject: COVID - 19: Coronavirus State and Local Fiscal Recovery Funds – US 12 Stormwater Drainage Improvement Project – Reporting Summary of Finding: The Michigan City Sanitary District did not design or implement a system of internal controls that would have prevented the omission of required progress reports, and lack of oversight process. Contact Person Responsible for Corrective Action: Mary Lynn Wall 219-873-1404 Ext 2006 Contact Phone Number and Email Address: 219-873-1404 Ext 2006 mlwall@emichigancity.com Views of Responsible Officials: We concur with the finding Description of Corrective Action Plan: The Sanitary District will review the federal grant requirements in order to ensure required reports are submitted in a timely manner. Reports will also be reviewed and documented by another employee prior to submission. Anticipated Completion Date: 08/26/2024

View Audit 319688

Finding 496942 (2023-004)

Material Weakness 2023

City of Michigan City

IN

Subrecipient Monitoring Internal Control / Segregation of Duties Material Weakness § 200.303 § 200.329

FINDING 2023-004 Finding Subject: COVID - 19: Coronavirus State and Local Fiscal Recovery Funds – Body Camera - Reporting Summary of Finding: The City did not design or implement a system of internal controls that would have prevented the omission of required progress reports, and lack of oversight ...

FINDING 2023-004 Finding Subject: COVID - 19: Coronavirus State and Local Fiscal Recovery Funds – Body Camera - Reporting Summary of Finding: The City did not design or implement a system of internal controls that would have prevented the omission of required progress reports, and lack of oversight process. Contact Person Responsible for Corrective Action: Mary Lynn Wall Contact Phone Number and Email Address: 219-873-1404 Ext. 2006 mlwall@emichigancity.com Views of Responsible Officials: We concur with the finding Description of Corrective Action Plan: The City department responsible for federal grant reporting will review the grant requirements in order to ensure required reports are submitted in a timely manner. Reports will also be reviewed and documented by another employee prior to submission. Anticipated Completion Date: 08/26/2024

View Audit 319688

Finding 496940 (2023-002)

Material Weakness 2023

City of Michigan City

IN

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

FINDING 2023-002 Finding Subject: COVID - 19: Coronavirus State and Local Fiscal Recovery Funds – Reporting – Internal Controls Summary of Finding: The City of Michigan City was not in compliance with effective internal controls related to submitting the P&E reports Contact Person Responsible for Co...

FINDING 2023-002 Finding Subject: COVID - 19: Coronavirus State and Local Fiscal Recovery Funds – Reporting – Internal Controls Summary of Finding: The City of Michigan City was not in compliance with effective internal controls related to submitting the P&E reports Contact Person Responsible for Corrective Action: Mary Lynn Wall Contact Phone Number and Email Address: 219-873-1404 mlwall@emichigancity.com Views of Responsible Officials: We concur with the finding Description of Corrective Action Plan: To bring the City into compliance with effective internal controls to ensure requirements related to the grant agreement and the reporting compliance requirements are satisfied, the City Controller will download from the Treasury website the project detail listing for the Deputy Controller to review and verify prior to submitting the report. Anticipated Completion Date: 08/26/2024

View Audit 319688

Finding 496937 (2023-002)

Significant Deficiency 2023

Plymouth Housing Authority

NC

Eligibility HUD Housing Programs Reporting

Section III - Federal Award Findings and Questioned Costs Finding 2023-002 Name of Contact Person: Anette Ange Executive Director Corrective Action: Management will review the recertification process and plan to monitor recertifications. Proposed Compeltion Date: Immediately.

View Audit 319683

Finding 496936 (2023-004)

Significant Deficiency 2023

Iowa Valley Resource Conservation & Development

IA

Reporting Significant Deficiency Internal Control / Segregation of Duties

View of Responsible Officials and Planned Corrective Actions: We will begin providing written documentation of authorizations and reviews as outlined in the Accounting Policies and Procedures Manual.

View Audit 319681

Finding 496927 (2023-001)

Significant Deficiency 2023

Maine School Administrative District No. 35

ME

Eligibility School Nutrition Programs Internal Control / Segregation of Duties

Management’s Response/Corrective Action Plan: We agree with RKO's recommendation that there are no provisions in the regulations that provide for large scale reclassifications through administrative override. There was some confusion on the part of Maine School Administrative District No. 35 when a...

Management’s Response/Corrective Action Plan: We agree with RKO's recommendation that there are no provisions in the regulations that provide for large scale reclassifications through administrative override. There was some confusion on the part of Maine School Administrative District No. 35 when a communication from the State of Maine was received in November of 2022, that the rate of Free and Reduced children identified at Maine School Administrative District No. 35 had dropped dramatically from the prior year (due to the meals being free to all) and that it may negatively impact our subsidy. At that point, Maine School Administrative District No. 35 asked its building administrators to identify needy families based on conversations they had previously had with parents, from speaking with their guidance counselors, from knowledge they had working with outside community agencies (68 Hours of Hunger) to help identify families potentially in need. From there the lists provided by the building administrators were compared with the families who had already submitted applications, and the directly certified students, and any students who were not identified in either of those cohorts were added to the free and reduced list per administrative override. When RKO arrived in May 2023 to perform interim testing, they let us know that this was not appropriate. At that time, we removed those students from the free and reduced list, and adjusted all of our previously submitted claim forms to account for the change. Maine School Administrative District No. 35 is now clear on the rules with regards to the use of administrative override, and will not use it again in the future.

View Audit 319663

Finding 496898 (2023-001)

Material Weakness 2023

Shelton School District No. 309

WA

Subrecipient Monitoring Internal Control / Segregation of Duties Special Tests & Provisions

Finding ref number: 2023-001 Finding caption: The District did not have adequate internal controls for ensuring compliance with federal wage rate requirements. Name, address, and telephone of District contact person: Brenda Trogstad, Assistant Superintendent of Finance and Operations 700 S 1st Str...

Finding ref number: 2023-001 Finding caption: The District did not have adequate internal controls for ensuring compliance with federal wage rate requirements. Name, address, and telephone of District contact person: Brenda Trogstad, Assistant Superintendent of Finance and Operations 700 S 1st Street Shelton, WA 98584 360-426-8232 Corrective action the auditee plans to take in response to the finding: If federal funds are used for future construction projects, the Shelton School District will refer to the Davis-Bason Act for specific guidance. The district used the small work roster procedures based on Washington State law because we were not aware of the Davis-Bacon Act. The Director of Facilities and Construction has been given a copy of the Davis-Bacon Act for future reference. This is the first time the Shelton School District has used federal funds for construction in my 34 years in the district. Anticipated date to complete corrective action: Immediately.

View Audit 319645

Finding 496892 (2023-002)

Significant Deficiency 2023

Cumberland County Housing Authority

PA

Reporting Internal Control / Segregation of Duties

Criteria: Financial Data Schedule (FDS) submission for unaudited financials are due within 2 months after the fiscal year end; FDS audited submissions are due 9 months after fiscal year end; and the Federal Audit Clearing House reporting package is due 30 days after receipt of the auditors reports o...

Criteria: Financial Data Schedule (FDS) submission for unaudited financials are due within 2 months after the fiscal year end; FDS audited submissions are due 9 months after fiscal year end; and the Federal Audit Clearing House reporting package is due 30 days after receipt of the auditors reports or 9 months after the end of the fiscal year (24 CFR section 5.801). Condition: Management missed deadlines for the audited submissions and missed the deadline for completing the Federal Audit Clearing House reporting package. Context: Significant delay in the audit process resulted from these journal entries identified in finding 2023-001. Cause: Management was late in submitting its financial information to the auditor. This in part was caused by personnel changes that limited its ability to produce timely and reliable financial data. Effect: The Authority will receive a lower SEMAP score and will be classified as a troubled housing authority which could impact its subsidies. Recommendations: The Authority needs to improve its internal controls over financial reporting by submitting its financial data on a timelier basis. Views of responsible officials and planned corrective action: : The Authority agrees with this finding and has outlined a plan of action to address Audit Finding 2023-002. The Authority has implemented several activities that are designed to fully address the finding and prevent any reoccurrence in the future. These actions include: An Assistant Finance Director and a new Staff Accountant have been hired to ensure timely preparation of financial statements. New financial software has been implemented along with a new chart of accounts that provides for more consistent reporting and year end close. The process of internal reporting will be monitored to ensure timely submission of financial reports.

View Audit 319635

Finding 496867 (2023-001)

Material Weakness 2023

City of Lancaster

WI

Internal Control / Segregation of Duties HUD Housing Programs

Finding #2023-001- Segregation of Duties Condition: The available office staff precludes a proper segregation of duties in the control areas reviewed. Criteria: Segregation of duties is an aspect of internal control intended to prevent or decrease opportunities of intentional and unintentional e...

Finding #2023-001- Segregation of Duties Condition: The available office staff precludes a proper segregation of duties in the control areas reviewed. Criteria: Segregation of duties is an aspect of internal control intended to prevent or decrease opportunities of intentional and unintentional errors and fraud. Duties and responsibilities are properly segregated if no single individual either has control over all phases of a transaction or can both make and conceal an error, whether such error is intentional or unintentional. Cause: Limited number of personnel. Effect: Errors or intentional fraud could occur and not be detected timely by other employees in the normal course of their responsibilities because of the lack of segregation of duties. Recommendation: We recommend that the City consider the benefits of implementing additional policies and procedures to address key controls related to its significant transaction cycles as noted. Response: We agree with the finding but do not believe it is cost-effective to increase the office staff in an attempt to bring about a more effective segregation of duties. Contact Person: David Kurihara, Clerk/Treasurer Anticipated Completion: Not Applicable

View Audit 319622

Finding 496865 (2023-001)

Significant Deficiency 2023

Self Initiated Living Options, Inc.

NY

Reporting Significant Deficiency Internal Control / Segregation of Duties

SILO will make sure the financial statement and Uniform Guidance audits are started earlier to ensure enough time to file timely in the future.

View Audit 319609

Finding 496854 (2023-001)

Significant Deficiency 2023

South Mississippi Housing Authority

MS

Internal Control / Segregation of Duties Eligibility HUD Housing Programs

2023-001 ALN 14.871 – Housing Voucher Cluster – Eligibility Management acknowledges the finding and will follow the Auditor's recommendations as listed in the Schedule of Findings and Questioned Costs. The agency has begun implementing the Yardi software system that will include a landlord portal th...

2023-001 ALN 14.871 – Housing Voucher Cluster – Eligibility Management acknowledges the finding and will follow the Auditor's recommendations as listed in the Schedule of Findings and Questioned Costs. The agency has begun implementing the Yardi software system that will include a landlord portal that will streamline W-9 and direct deposit documentation, while also creating a digital, cloud-based file for each landlord. This will enable the agency to better serve the needs of our landlords while also improving our records retention and filing systems. This function will also improve redundancy for continuity of operations and disaster planning. The new management team also created two (2) Fraud Specialist positions within the Housing Choice Voucher – Assisted Housing department that will audit landlord documentation to mitigate fraud risk. Person Responsible for Correction of Finding: Mr. Justin Brooks, Executive Director Projected Completion Date: December 31, 2024

View Audit 319579

Finding 496821 (2023-003)

Significant Deficiency 2023

Mark Twain Association for Mental Health Inc.

MO

Subrecipient Monitoring Reporting Significant Deficiency

September 9, 2024 Re: MTBH 2023 Single Audit To Whom it May Concern: In response to our recent MTBH 2023 Single Audit findings related to reimbursement request "KV-4", MTBH will implement a review process for future grant reimbursement requests, effective immediately. I, Jenny Haught, will complete ...

September 9, 2024 Re: MTBH 2023 Single Audit To Whom it May Concern: In response to our recent MTBH 2023 Single Audit findings related to reimbursement request "KV-4", MTBH will implement a review process for future grant reimbursement requests, effective immediately. I, Jenny Haught, will complete and send the reimbursement requests to Michael Cantrell, President and CEO for review. Upon his review and approval, I will send the reimbursement requests to the appropriate person per the grant agreement for official reimbursement. In response to our recent MTBH 2023 Single Audit findings related to quarterly progress reports, MTBH will implement a review process for future grant reporting, adhering to the grant agreement, effective immediately. Sincerely, Jenny Haught, Vice President of Finance

View Audit 319554

Finding 496771 (2023-005)

Material Weakness 2023

Overdose Lifeline, Inc.

IN

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

Finding 2022-05 Misallocation of Grant Funds Condition: The Organization claimed purchases under a reimbursement-based federal grant but then used these supplies for a different grant. This improper use of grant-funded supplies is a violation of the grant’s terms and conditions. Corrective Actions...

Finding 2022-05 Misallocation of Grant Funds Condition: The Organization claimed purchases under a reimbursement-based federal grant but then used these supplies for a different grant. This improper use of grant-funded supplies is a violation of the grant’s terms and conditions. Corrective Actions Taken or Planned: The Organizations’ Board and Executive Team consisting of the Chief Executive Officer (CEO) and the Chief Operating Officer (COO) and key Overdose Lifeline (ODL) Staff to include the independent bookkeeper and Grant and Finance Manager recognize the need to further significantly improve on the oversight and reconciliation of supply ordering and inventory. This is already underway with the QB inventory process described previously and an improved process for backup documentation. Additionally key staff will complete of a formal course that covers performing a single audit and engage in consultation with the Independent Public Accounting Firm (Pile CPAs)

View Audit 319539 Questioned Costs: $1

Finding 496765 (2023-002)

Material Weakness 2023

Fairview Health Services

MN

Matching / Level of Effort / Earmarking Internal Control / Segregation of Duties

Finding 2023-002 Federal Grantor: United States Department of the Homeland Security Planned Corrective Actions: Responsible Official – Dawn Ksepka, VP of Finance and System Controller Anticipated completion date – August 31, 2024 Management agrees with the finding. In May 2023, the COVID-19 emer...

Finding 2023-002 Federal Grantor: United States Department of the Homeland Security Planned Corrective Actions: Responsible Official – Dawn Ksepka, VP of Finance and System Controller Anticipated completion date – August 31, 2024 Management agrees with the finding. In May 2023, the COVID-19 emergency was ended and therefore remediation of internal controls specific to allowability of costs for the FEMA program are no longer applicable. However, remediation steps were taken to improve documentation of review of internal controls over all federal expenditures, not limited to the FEMA program. Remediation: Fairview revised its internal control processes to improve the retention and documentation of the review and approval of inputs to the calculation of federal expenditures, as well as ensure that the review is precise enough to challenge the appropriateness of the methodology utilized.

View Audit 319532

Finding 496764 (2023-001)

Material Weakness 2023

Fairview Health Services

MN

Matching / Level of Effort / Earmarking Internal Control / Segregation of Duties

Finding 2023-001 Federal Grantor: United States Department of the Homeland Security Planned Corrective Actions: Responsible Official – Dawn Ksepka, VP of Finance and System Controller Anticipated completion date – August 31, 2024 Management agrees with the finding. In May 2023, the COVID-19 emer...

Finding 2023-001 Federal Grantor: United States Department of the Homeland Security Planned Corrective Actions: Responsible Official – Dawn Ksepka, VP of Finance and System Controller Anticipated completion date – August 31, 2024 Management agrees with the finding. In May 2023, the COVID-19 emergency was ended and therefore remediation of internal controls specific to allowability of costs for the FEMA program are no longer applicable. However, remediation steps were taken to improve documentation of review of internal controls over all federal expenditures, not limited to the FEMA program. Remediation: Fairview revised its internal control processes to improve the retention and documentation of the review and approval of inputs to the calculation of federal expenditures.

View Audit 319532

Finding 496759 (2023-001)

Significant Deficiency 2023

Isles, INC and Subsidiaries

NJ

Internal Control / Segregation of Duties

Finding: Organization erroneously identified certain federal grants as state funded grants on the schedules. Contact person responsible for corrective action plan: Sean Jackson, Chief Executive Officer. Corrective Action Planned: Isles operation, service delivery and finance staff are dedicated to e...

Finding: Organization erroneously identified certain federal grants as state funded grants on the schedules. Contact person responsible for corrective action plan: Sean Jackson, Chief Executive Officer. Corrective Action Planned: Isles operation, service delivery and finance staff are dedicated to ensuring that funding is used appropriately and in accordance with any restrictions set forth by the funder. The following procedures have been refined to ensure all funding sources are reflected accurately going forward. 1) when grant funding is received, the staff person who receives the award will request a new revenue code specific to the new grant award from the finance department. In order for dinance department to generate that code, staff person must provide the followin: a. funder (either federal, state, county, city, or private entity), b. grant number, c. amount, d. grant period, e. department, f. initiative code - internal code for specific areas of work, g. revenue code, h. revenue GL code (4017 - Federal// 4016 - State // 4015 - City etc.), i. reporting requirements - monthly, quarterly, progress reports, etc., j. include attachment of actual grant. 2) Appropriate finance staff reviews provide contract along with the information outlined in item 1, confirms accuracy of the information, and then creates the apporpriate codes in accounting software. 3) Appropriate finance staff creates and reviews the schedules and director of finance reviews report before the schedules are prepared annually.

View Audit 319529

Finding 496758 (2023-003)

None 2023

Near West Side Multi-Service Corporation

OH

Questioned Costs Eligibility Internal Control / Segregation of Duties

We will implement stricter verification processes and comprehensive staff training to ensure proper documetnation of eligibility. We will also conduct regular audits to prevent such issues in the future and review the questioned costs of to rectify any discrepancies.

View Audit 319526 Questioned Costs: $1

Finding 496757 (2023-002)

None 2023

Near West Side Multi-Service Corporation

OH

Internal Control / Segregation of Duties

We will implement a comprehensive review process to ensure all required documentation is included. This will involve regular audits of case files, enhanced training for staff on documentation requirements, and the development of a standardized checklist to ensure completeness.

View Audit 319526

Finding 496756 (2023-001)

None 2023

Near West Side Multi-Service Corporation

OH

Reporting Internal Control / Segregation of Duties

We will implement stricter adherence to deadlines and ensure that all reports are filed on time. Measures will include setting up reminder systems and providing additional training to staff on the importance of meeting these deadlines.

View Audit 319526

Finding 496754 (2023-002)

Material Weakness 2023

City of Gadsden, Alabama

AL

Cash Management HUD Housing Programs Internal Control / Segregation of Duties § 200.303

2023-002 – ALN #14.218 Community Development Block Grant/Entitlements Grant; Recommendation: We recommend that the City return the duplicate drawn funds to HUD. We recommend all drawdown requests are completed by appropriately trained employees and that all drawdowns are reviewed and approved by a...

2023-002 – ALN #14.218 Community Development Block Grant/Entitlements Grant; Recommendation: We recommend that the City return the duplicate drawn funds to HUD. We recommend all drawdown requests are completed by appropriately trained employees and that all drawdowns are reviewed and approved by an appropriately personnel prior to submission to HUD. Corrective Action Planned: The City agrees with this finding. The City will work with HUD to repay the duplicated funds and implement additional review and approval procedures for drawdown requests. Person responsible for corrective action: Brandon Phillips, Finance Director Telephone: (256) 549-4715 Anticipated Completion Date: Corrective action will be implemented for the fiscal year ended September 30, 2024.

View Audit 319516

Corrective Action Plans

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