Corrective Action Plans

Finding 24665 (2022-052)

Significant Deficiency 2022

State of Michigan

MI

Questioned Costs Special Tests & Provisions Equipment & Real Property Management

Finding 2022-052 Immunization Cooperative Agreements, ALN 93.268 - MCIR General Controls Management Views Although MDHHS and DTMB had not fully documented all database specific configuration standards until after the audit period, DTMB disagrees that during the audit period the system contained pot...

Finding 2022-052 Immunization Cooperative Agreements, ALN 93.268 - MCIR General Controls Management Views Although MDHHS and DTMB had not fully documented all database specific configuration standards until after the audit period, DTMB disagrees that during the audit period the system contained potentially vulnerable database configurations and disagrees that DTMB cannot ensure the security of the data. DTMB has been and continues to implement the manufacturer?s recommendations regarding security configurations. In addition, the databases reside in restricted trusted internal security zones, protected by firewalls, which are specific to each application and database, in conjunction with intrusion protection, antivirus software, and SOM standard security safeguards. Planned Corrective Action DTMB developed an organization-wide framework for database security configuration management. Anticipated Completion Date DTMB anticipates having compliance documentation by September 30, 2023. Responsible Individual(s) Nathan Buckwalter, DTMB

View Audit 20093

Finding 24637 (2022-002)

None 2022

The City of New York

NY

Equipment & Real Property Management Internal Control / Segregation of Duties § 200.313

Finding No. 2022-002 Department(s) New York City Police Department Program(s) Assistance Listing Number 97.056, Port Security Grant Program Corrective Action(s) Since the original finding in the FY2020 Single Audit, the NYPD has and continues to implement policies and procedures to ensure there are ...

Finding No. 2022-002 Department(s) New York City Police Department Program(s) Assistance Listing Number 97.056, Port Security Grant Program Corrective Action(s) Since the original finding in the FY2020 Single Audit, the NYPD has and continues to implement policies and procedures to ensure there are multiple levels of inventory asset verification and validation are completed in accordance with Federal requirements. The Grants Unit works closely with project managers to ensure they have continued access to the Grant Tracking System (GTS) and provide hands on training on the system. As previously mentioned, GTS has been updated, and access has been provided to at least two individuals within each command to ensure compliance and redundancy. The newer version of GTS will automatically email the project manager for each individual item that needs to be inspected and checked into the system at least 1 month prior to the expiration of the inventory due date. The Grant Units is also notified of this upcoming deadline and a follow up email is sent to the project manager again. In addition, on a regular basis, the Grants Unit manager will email the command points of contact reminding them of their Asset Inventory requirement as a follow up to the alerts automatically received from GTS. For the 3 items referenced above, an inventory verification was performed February 25, 2021. While the NYPD was unable to provide confirmation of a biannual inventory between the purchase date (April 2018 and May 2018) and a prior inventory date, we can confirm these assets were inventoried in November 2022. In addition, all assets currently listed in GTS are currently up to date and have been so since the FY2020 Single audit. Because all equipment entries are now being monitored regularly by the Grants Unit, in addition to the individual commands receiving automatic emails instructing them to update their inventory, we do not anticipate any further Inventory Verification issues as long as the period referenced is after February 2021. Anticipated Completion Date March 2023 Person(s) Responsible for Implementation Kristine Ryan Deputy Commissioner, Management and Budget (646) 610-6670

View Audit 22749

Finding 24635 (2022-004)

None 2022

The City of New York

NY

Subrecipient Monitoring Internal Control / Segregation of Duties

Finding No. 2022-004 Department(s) New York City Department of Health and Mental Hygiene Program(s) Assistance Listing Number 93.940, HIV Prevention Activities ? Health Department Based Corrective Action(s) We agree with the recommendation provided above and have been working on an internal control...

Finding No. 2022-004 Department(s) New York City Department of Health and Mental Hygiene Program(s) Assistance Listing Number 93.940, HIV Prevention Activities ? Health Department Based Corrective Action(s) We agree with the recommendation provided above and have been working on an internal control structure to address the compliance requirements. Subsequently, we will ensure that all FFATA reports are submitted within the required timeframe. Anticipated Completion Date September 2023 Person(s) Responsible for Implementation Jenny Fernandez Director of Administration, BHHS (347) 396-4258 Jenny Tejada Director of Programmatic Budgets, Budget Administration (347) 396-6247

View Audit 22749

Finding 24634 (2022-015)

Material Weakness 2022

The City of New York

NY

Matching / Level of Effort / Earmarking Internal Control / Segregation of Duties Questioned Costs § 200.303

Finding No. 2022-015 Department(s) New York City Administration for Children?s Services New York City Human Resources Administration Program(s) Assistance Listing Number 93.575, Child Care and Development Block Grant Corrective Action(s) HRA HRA will convene a small workgroup to meet bi-weekly to r...

Finding No. 2022-015 Department(s) New York City Administration for Children?s Services New York City Human Resources Administration Program(s) Assistance Listing Number 93.575, Child Care and Development Block Grant Corrective Action(s) HRA HRA will convene a small workgroup to meet bi-weekly to review the details and history of the cases identified to try to isolate the cause of the errors, and once we determine the cause, will work with the necessary parties/stakeholders to develop an approach to avoid the situation from repeating itself. First meeting will be 2nd week of April to identify the appropriate parties to include and come up with meeting goal and agenda. ACS Case No. 1 The audit reviewed a child care case relating to an older Fair Hearing which had not been closed timely per the original State Fair Hearing decision, which had been issued prior to FY22. ACS' Child and Family Well-Being (CFWB) division had previously instituted a new Quality Assurance review of pending Fair Hearing cases and through this QA review had already identified and closed the case. However, the auditors reviewed an earlier State FY22 claim prior to ACS' identification of the case. Per the new QA protocol, CFWB will be reviewing HRA/DSS systems reports on a monthly basis, identify any questioned cases and take appropriate follow-up action. CFWB is also preparing new written guidelines. Case No. 2 In one child care case, ACS was not able to provide eligibility documentation. Further ACS research determined a systems coding inconsistency. ACS procedure is to run reports to identify inconsistencies with programmatic codes and review any flagged cases prior to submission of claims to the State. However, in this instance, the case was not identified in the report. ACS will propose creation of a new exception report with a more refined level of detail to identify any case coding inconsistencies and allow follow up to ensure complete case eligibility support for any flagged cases. ACS will work with HRA/DSS on report development. Anticipated Completion Date HRA Beginning Q2 2023 ? Convene workgroup Beginning Q3 2023 ? Completion date ACS Initiated in FY 2022 ? New quality assurance (QA) review To be completed in FY 2023 ? New written guidelines and refined reporting Person(s) Responsible for Implementation HRA Ramon E. Flores Assistant Deputy Commissioner, Family Independence Administration (FIA) FloresRa@hra.nyc.gov ACS For new QA and guidelines Isabel Villegas Executive Director, Policy & Compliance Division of Child and Family Well-Being (212) 393-5325 For refined reporting Pauline Young Assistant Commissioner for Claiming and Revenue Division of Finance (212) 676-8803

View Audit 22749 Questioned Costs: $1

Finding 24633 (2022-006)

None 2022

The City of New York

NY

Matching / Level of Effort / Earmarking Internal Control / Segregation of Duties Questioned Costs § 200.514

Finding No. 2022-006 Department(s) New York City Department of Health and Mental Hygiene Program(s) Assistance Listing Number 93.069, Public Health Emergency Preparedness Corrective Action(s) DOHMH?s Office of Emergency Preparedness and Response (OEPR) and Division of Finance are in agreement with t...

Finding No. 2022-006 Department(s) New York City Department of Health and Mental Hygiene Program(s) Assistance Listing Number 93.069, Public Health Emergency Preparedness Corrective Action(s) DOHMH?s Office of Emergency Preparedness and Response (OEPR) and Division of Finance are in agreement with the recommendations. Non-compliance with the level of effort requirement occurred because the agency received additional federal funds as part of the American Rescue Plan and utilized those funds to cover city tax levy costs in FY22. This was a one-time offset. In addition to strengthening and maintaining internal controls, DOHMH plans to revisit how maintenance of effort is calculated for the PHEP award, as it is currently calculated using a 15-year-old formula that has not been tweaked to ensure it accurately captures health care preparedness and public health security spending. DOHMH will close out a 5-year project period on the PHEP award in 2024 and plans to revisit the current maintenance of effort formula in advance of applying for the new project period. Anticipated Completion Date June 2024 Person(s) Responsible for Implementation Monica Marquez Assistant Commissioner, OEPR (347) 396-2730 Wai ting Yu Assistant Commissioner, Central Finance (347) 396-6214

View Audit 22749

Finding 24622 (2022-010)

Significant Deficiency 2022

The City of New York

NY

Equipment & Real Property Management Internal Control / Segregation of Duties § 200.303 § 200.313

Finding No. 2022-010 Department(s) New York City Police Department Program(s) Assistance Listing Number 16.922, Equitable Sharing Program Corrective Action(s) The NYPD has, and continues to, implement policies and procedures to ensure that there are multiple levels of inventory asset verification a...

Finding No. 2022-010 Department(s) New York City Police Department Program(s) Assistance Listing Number 16.922, Equitable Sharing Program Corrective Action(s) The NYPD has, and continues to, implement policies and procedures to ensure that there are multiple levels of inventory asset verification and validation completed in accordance with Federal requirements. To that end, the NYPD is in the midst of discussions to utilize the NYPD?s Grants Unit?s Grants Tracking System (GTS) for equipment purchased with Asset Forfeiture funds. Currently, the GTS only tracks the inventory for a subset of equipment purchased with federal grant funding. While these discussions have not yet been finalized, the GTS has the ability to provide the type of robust inventory oversight necessary. This includes features such as an automatic email to the command points of contact (POC) for each item that needs to be inspected and checked into the system at least one month prior to the expiration of the inventory due date. If this solution is not deemed feasible, however, the NYPD will look to obtain a system exclusively for Asset Forfeiture item inventorying purposes. In addition, on a regular basis, the Management and Budget Analysis Unit will email the command POCs reminding them of their Asset Forfeiture Inventory responsibilities. For the four items referenced above, inventory verifications were indeed performed; however, the NYPD was unable to provide tangible date-specific documentation. As such, a standardized protocol is being developed for use by all commands with Asset Forfeiture equipment items to ensure that this documentation will exist going forward, and will be distributed upon any new Asset Forfeiture equipment purchases. In addition, this documentation will be the basis for updates/entries into the GTS or any other future system. Once the standardized protocol and systems are fully established, we do not anticipate any further Inventory Verification issues as long as the period referenced is after implementation. Anticipated Completion Date Spring/Summer 2023 Person(s) Responsible for Implementation Kristine Ryan Deputy Commissioner, Management and Budget (646) 610-6670

View Audit 22749

Finding 24621 (2022-009)

Significant Deficiency 2022

The City of New York

NY

Equipment & Real Property Management Internal Control / Segregation of Duties § 200.303 § 200.313

Finding No. 2022-009 Department(s) New York City Department of Investigation Program(s) Assistance Listing Number 16.922, Equitable Sharing Program Corrective Action(s) Based on the recommendations outlined in the audit report, we have developed the following corrective action plan to address the de...

Finding No. 2022-009 Department(s) New York City Department of Investigation Program(s) Assistance Listing Number 16.922, Equitable Sharing Program Corrective Action(s) Based on the recommendations outlined in the audit report, we have developed the following corrective action plan to address the deficiencies and improve our equipment and real property management compliance requirements. The following steps will be taken: ? Strengthen Controls over the Inventory Process: We will develop and implement additional controls over the inventory process to ensure that equipment dispositions are updated in the equipment records, inventories performed are reconciled back to equipment records, and biennial inventory counts are consistently performed over all equipment within the required timeframe. ? Develop and Implement a Standard Operating Procedure: We will develop and implement a standard operating procedure that outlines the process for conducting physical inventory counts, reconciling the inventory records with the equipment records, and documenting the review and approval of each inventory performed. ? Training for Personnel: We will provide training to all personnel involved in the equipment and real property management process, including property officers and program managers, to ensure they are aware of the new controls and standard operating procedure, and understand their roles and responsibilities related to compliance requirements. ? Continuous Monitoring: We will implement a continuous monitoring program to ensure that the new controls and procedures are being followed, and to identify any areas for improvement. The agency is actively pursuing a centralized inventory management system to improve the effectiveness of inventory management. These corrective actions will help to ensure that federally funded equipment is accurately recorded on inventory records, and that inventory is not misplaced, misappropriated, or otherwise disposed outside of the requirements of federal guidelines. We appreciate the opportunity to address the audit findings, and we are committed to implementing these corrective actions. Anticipated Completion Date September 2023 Person(s) Responsible for Implementation Caspar Barrow Director of Finance (212) 825-0666 Orane Gordon Internal Auditor (212) 825-0123

View Audit 22749

Finding 24620 (2022-014)

Significant Deficiency 2022

The City of New York

NY

Internal Control / Segregation of Duties Special Tests & Provisions Questioned Costs § 200.303

Finding No. 2022-014 Department(s) New York City Human Resources Administration Program(s) Assistance Listing Number 14.241, Housing Opportunities for Persons with AIDS Corrective Action(s) The auditors selected a non-statistical sample of nineteen (19) units that were subject to an initial inspect...

Finding No. 2022-014 Department(s) New York City Human Resources Administration Program(s) Assistance Listing Number 14.241, Housing Opportunities for Persons with AIDS Corrective Action(s) The auditors selected a non-statistical sample of nineteen (19) units that were subject to an initial inspection by HRA during fiscal 2022 and noted that for three (3) selections, HRA was unable to provide a copy of the inspection checklist that was completed by the QA Inspector prior to assistance being provided for the unit. Unfortunately, during the height of the COVID-19 pandemic, many housing vendor staff were working remotely, and a few documents may have been mislaid. To ensure continual compliance with federal HOPWA grant requirements, HRA will enhance its efforts to confirm that housing vendors properly maintain a copy of inspection checklists completed prior to initial move in. Monitoring visits conducted by HRA will include a review of the checklists. Anticipated Completion Date April 2023 and ongoing Person(s) Responsible for Implementation Pamela Xiomara Farquhar Assistant Deputy Commissioner FarquharX@hra.nyc.gov

View Audit 22749

Finding 24619 (2022-013)

Material Weakness 2022

The City of New York

NY

Internal Control / Segregation of Duties Questioned Costs Eligibility § 200.303

Finding No. 2022-013 Department(s) New York City Human Resources Administration Program(s) Assistance Listing Number 14.241, Housing Opportunities for Persons with AIDS Corrective Action(s) Rental assistance payments made on behalf of tenants residing in supportive housing are calculated by contract...

Finding No. 2022-013 Department(s) New York City Human Resources Administration Program(s) Assistance Listing Number 14.241, Housing Opportunities for Persons with AIDS Corrective Action(s) Rental assistance payments made on behalf of tenants residing in supportive housing are calculated by contracted supportive housing vendors, not directly by HRA. On December 20, 2022, agency staff received a formal notice informing them that the agency will cease issuing to clients a notification of their rent payment responsibility for agency-contracted supportive housing programs, as this is the responsibility of the supportive housing vendor. To ensure continual compliance with federal HOPWA grant requirements, HRA will enhance its monitoring of contract vendors during annual monitoring visits. This includes sampling of rent payments made to verify calculation of rent payment is appropriate, payments made are timely, and tenant income documentation is appropriately budgeted in rent payment calculation. Monitoring visits will also include a review of each client?s Notice of Rights, which describes rent information, including the client?s share, as per the Local Law that went into effect May 9, 2022. Anticipated Completion Date April 2023 Person(s) Responsible for Implementation Pamela Xiomara Farquhar Assistant Deputy Commissioner FarquharX@hra.nyc.gov

View Audit 22749 Questioned Costs: $1

Finding 24617 (2022-012)

Material Weakness 2022

The City of New York

NY

Matching / Level of Effort / Earmarking Internal Control / Segregation of Duties Questioned Costs § 200.303

Finding No. 2022-012 Department(s) New York City Human Resources Administration Program(s) Assistance Listing Number 14.239, HOME Investment Partnerships Program Corrective Action(s) Response: ? HRA agrees that the Agency had challenges in retaining some recertification documentation during the COVI...

Finding No. 2022-012 Department(s) New York City Human Resources Administration Program(s) Assistance Listing Number 14.239, HOME Investment Partnerships Program Corrective Action(s) Response: ? HRA agrees that the Agency had challenges in retaining some recertification documentation during the COVID Public Health crisis when staff were working from home and then ultimately leaving the Agency prior to the return to office. ? The identified HOME TBRA tenants had been originally found eligible over five years ago and have been recertified annually every year following. ? This FY22 audit was conducted on the heels of the FY21 audit where the finding was the same and the recommended Corrective Action was the development of a Quality Assurance Checklist due by November 2022 and ongoing. ? HRA agrees to strengthen internal controls and have created and implemented a Quality Assurance Tool that ensure eligibility is accurately assessed, allowable cost is correctly calculated and appropriate evidence (i.e. Recertification Information Form, Proof of Income, Rent Reasonableness Information, Passed Inspection, Landlord Packet, Client Packet, RAC, Tenant Breakdown) that support annual approval is maintained. Also, the payment system already fully requires supervisor approval before annual payments can be set up. Absolutely no payment can go out without supervisor approval. Corrective Actions: ? Strengthen internal governance and future compliance. ? Hire an Executive Director for the TBRA ? Create and implement a Quality Assurance tool that includes information that supports eligibility. ? Provide refresher training for staff involved with TBRA. Anticipated Completion Date May 2023 and ongoing Person(s) Responsible for Implementation Dori Hopkins-Figeroux Director, TBRA (929) 252-6089 Dwana Abraham Assistant Deputy Commissioner (929) 221-6726

View Audit 22749 Questioned Costs: $1

Finding 24616 (2022-011)

Material Weakness 2022

The City of New York

NY

Internal Control / Segregation of Duties Special Tests & Provisions Questioned Costs § 200.303

Finding No. 2022-011 Department(s) New York City Human Resources Administration Program(s) Assistance Listing Number 14.239, HOME Investment Partnerships Program Corrective Action(s) HRA is committed to better understand the Housing Quality Standards (HQS) inspection process and strengthen our monit...

Finding No. 2022-011 Department(s) New York City Human Resources Administration Program(s) Assistance Listing Number 14.239, HOME Investment Partnerships Program Corrective Action(s) HRA is committed to better understand the Housing Quality Standards (HQS) inspection process and strengthen our monitoring to ensure future compliance. Corrective Actions: ? Hire an Executive Director for the TBRA. ? Advance HRA understanding of the inspection process, deliverables and compliance including intentional notifications and requesting, collecting, and maintaining of documentation. ? Review and update, as determined, HRA procedures to strengthen monitoring of HQS inspections and ensure appropriate documentation is maintained. Anticipated Completion Date May 2023 and ongoing Person(s) Responsible for Implementation Dori Hopkins-Figeroux Director, TBRA (929) 252-6089 Dwana Abraham Assistant Deputy Commissioner (929) 221-6726

View Audit 22749

Finding 24614 (2022-003)

None 2022

The City of New York

NY

Internal Control / Segregation of Duties Special Tests & Provisions Questioned Costs

Finding No. 2022-003 Department(s) New York City Human Resources Administration Program(s) Assistance Listing Number 14.231, Emergency Shelter Grants Program Corrective Action(s) Because the ESG expense construct had to be vetted and approved before obligating the total grant amount, we were unable ...

Finding No. 2022-003 Department(s) New York City Human Resources Administration Program(s) Assistance Listing Number 14.231, Emergency Shelter Grants Program Corrective Action(s) Because the ESG expense construct had to be vetted and approved before obligating the total grant amount, we were unable to do so within the prescribed 180 days. We will ensure in the future that we strengthen our internal controls to ensure that 100% of the total ESG grant amount is obligated within 180 days of the signed grant agreement. This will include an added layer of review by the Associate Commissioner of Homeless Policy and Innovation, who oversees the unit that obligates the funds in IDIS. Anticipated Completion Date April 2023 and ongoing Person(s) Responsible for Implementation Kristen Mitchell Associate Commissioner, Homeless Policy & Innovation MitchellKr@dss.nyc.gov

View Audit 22749

Finding 24611 (2022-001)

Material Weakness 2022

Greene Acres Nursing Home Association, Inc.

AR

Questioned Costs Allowable Costs / Cost Principles Matching / Level of Effort / Earmarking § 200.303

Views of responsible officials and planned corrective actions: Management agrees with this finding and will ensure proper review is performed and evidenced.

View Audit 21261 Questioned Costs: $1

Finding 24576 (2022-051)

Significant Deficiency 2022

State of Michigan

MI

Questioned Costs Special Tests & Provisions Internal Control / Segregation of Duties

Finding 2022-051 Medicaid Cluster, ALN 93.775, 93.777, and 93.778 - MARIS General Controls Management Views Although MDHHS and DTMB had not fully documented all database specific configuration standards until after the audit period, DTMB disagrees that during the audit period the system contained p...

Finding 2022-051 Medicaid Cluster, ALN 93.775, 93.777, and 93.778 - MARIS General Controls Management Views Although MDHHS and DTMB had not fully documented all database specific configuration standards until after the audit period, DTMB disagrees that during the audit period the system contained potentially vulnerable database configurations and disagrees that DTMB cannot ensure the security of the data. DTMB has been and continues to implement the manufacturer?s recommendations regarding security configurations. In addition, the databases reside in restricted trusted internal security zones, protected by firewalls, which are specific to each application and database, in conjunction with intrusion protection, antivirus software, and SOM standard security safeguards. Planned Corrective Action DTMB developed an organization-wide framework for database security configuration management. Anticipated Completion Date DTMB anticipates having compliance documentation by September 30, 2023. Responsible Individual(s) Nathan Buckwalter, DTMB

View Audit 20093

Finding 24567 (2022-021)

Significant Deficiency 2022

State of Michigan

MI

Questioned Costs Eligibility Internal Control / Segregation of Duties

Finding 2022-021 Medicaid Cluster, ALN 93.775, 93.777, and 93.778 and Children's Health Insurance Program, ALN 93.767 - Eligibility Interface Errors Management Views MDHHS agrees with the finding. Planned Corrective Action Bridges is the system of record for eligibility and produces reports with p...

Finding 2022-021 Medicaid Cluster, ALN 93.775, 93.777, and 93.778 and Children's Health Insurance Program, ALN 93.767 - Eligibility Interface Errors Management Views MDHHS agrees with the finding. Planned Corrective Action Bridges is the system of record for eligibility and produces reports with potential duplicate records for local office staff to review. In addition, CHAMPS is currently designed to reject potential duplicate records to prevent duplicate payments for the same individuals that already exist in CHAMPS and places these records on a CHAMPS report for review. These two reports could potentially contain the same duplicate records identified by both CHAMPS and Bridges. MDHHS central office will develop a process to reconcile the rejected records identified on the CHAMPS and Bridges reports and ensure that MDHHS is appropriately reviewing those records and making any necessary corrections. Anticipated Completion Date December 2023 Responsible Individual(s) Jamy Hengesbach, MDHHS Mariah Schaefer, MDHHS

View Audit 20093

Finding 24562 (2022-009)

Significant Deficiency 2022

State of Michigan

MI

Questioned Costs Eligibility Internal Control / Segregation of Duties

Finding 2022-009 CHAMPS General Controls Management Views Although MDHHS and DTMB had not fully documented all database specific configuration standards until after the audit period, DTMB disagrees that during the audit period the system contained potentially vulnerable database configurations a...

Finding 2022-009 CHAMPS General Controls Management Views Although MDHHS and DTMB had not fully documented all database specific configuration standards until after the audit period, DTMB disagrees that during the audit period the system contained potentially vulnerable database configurations and disagrees that DTMB cannot ensure the security of the data. DTMB has been and continues to implement the manufacturer?s recommendations regarding security configurations. In addition, the databases reside in restricted trusted internal security zones, protected by firewalls, which are specific to each application and database, in conjunction with intrusion protection, antivirus software, and SOM standard security safeguards. Planned Corrective Action DTMB developed an organization-wide framework for database security configuration management. Anticipated Completion Date DTMB anticipates having compliance documentation by September 30, 2023. Responsible Individual(s) Nathan Buckwalter, DTMB

View Audit 20093

Finding 24541 (2022-002)

Significant Deficiency 2022

Okeechobee County, Fl

FL

Subrecipient Monitoring Reporting Internal Control / Segregation of Duties § 200.303

COVID-19 Coronavirus State and Local Fiscal Recovery Funds ? Assistance Listing No. 20.027 Recommendation: We recommend all reports submitted to grantors be reviewed by knowledgeable personnel before submittal. A copy of the review, approval, approval date, and submittal date should be maintained as...

COVID-19 Coronavirus State and Local Fiscal Recovery Funds ? Assistance Listing No. 20.027 Recommendation: We recommend all reports submitted to grantors be reviewed by knowledgeable personnel before submittal. A copy of the review, approval, approval date, and submittal date should be maintained as evidence. Explanation of disagreement with audit finding: There is no disagreement with the audit finding. Action planned in response to finding: Staff will ensure that all reports submitted to grantors be reviewed by knowledgeable personnel before submitting. A copy of the review, approval, approval date, and submittal date will be maintained as evidence. Name(s) of the contact person(s) responsible for corrective action: Budget and Grants Director Johnathan Blanco. Planned completion date for corrective action plan: September 30, 2023.

View Audit 21248

Finding 24539 (2022-003)

Significant Deficiency 2022

Okeechobee County, Fl

FL

Questioned Costs Subrecipient Monitoring Cash Management § 200.303

Airport Improvement Program ? Assistance Listing No. 20.106 Recommendation: We recommend all reports submitted to grantors be reviewed by knowledgeable personnel before submittal. A copy of the review, approval, approval date, and submittal date should be maintained as evidence. Explanation of disag...

Airport Improvement Program ? Assistance Listing No. 20.106 Recommendation: We recommend all reports submitted to grantors be reviewed by knowledgeable personnel before submittal. A copy of the review, approval, approval date, and submittal date should be maintained as evidence. Explanation of disagreement with audit finding: There is no disagreement with the audit finding. Action planned in response to finding: Staff will ensure that all reports submitted to grantors be reviewed by knowledgeable personnel before submitting. A copy of the review, approval, approval date, and submittal date will be maintained as evidence. Name(s) of the contact person(s) responsible for corrective action: Budget and Grants Director Johnathan Blanco. Planned completion date for corrective action plan: September 30, 2023.

View Audit 21248

Finding 24470 (2022-001)

Significant Deficiency 2022

Someplace Safe

MN

Internal Control / Segregation of Duties

FINDINGS ? FINANCIAL STATEMENTS AUDIT Significant Deficiency Item 2021-001. Inadequate Segregation of Duties Recommendation ? Although it may not be economically feasible for the Organization to attain an ideal segregation of duties environment, the Organization can periodically observe and evalu...

FINDINGS ? FINANCIAL STATEMENTS AUDIT Significant Deficiency Item 2021-001. Inadequate Segregation of Duties Recommendation ? Although it may not be economically feasible for the Organization to attain an ideal segregation of duties environment, the Organization can periodically observe and evaluate its current structure so as to make improvements when considered necessary. Action Planned ? The Organization has determined the benefit of adequately segregating duties is less than the cost. Based on the assessment, the Organization is accepting the risk posed by the deficiency while also evaluating mitigating controls that will help reduce the risk of material misstatement of the financial statements. Management attempts to mitigate the associated risks by doing the following: 1. Identifies areas where the lack of segregation of duties exists and where there are higher risks of errors or fraud occurring. 2. Implements limited segregation to the extent possible to reduce risks without impairing efficiency. 3. Uses the knowledge that management and the Board of Directors have of operations by having them review certain accounting records and reports. 4. Monitors the effectiveness of the above actions and makes changes as considered appropriate.

View Audit 22557

Finding 24429 (2022-012)

Significant Deficiency 2022

State of Michigan

MI

Questioned Costs Internal Control / Segregation of Duties § 200.303

Finding 2022-012 MATT 2.0 Change Management Process Management Views MSHDA agrees with the finding. Corrective Action MSHDA completed the improvement of the existing change management process for the MSHDA Activity Tracking Tool (MATT) 2.0 in November of 2021, which includes requiring electronical...

Finding 2022-012 MATT 2.0 Change Management Process Management Views MSHDA agrees with the finding. Corrective Action MSHDA completed the improvement of the existing change management process for the MSHDA Activity Tracking Tool (MATT) 2.0 in November of 2021, which includes requiring electronically documented approval before any production changes can be made. The remaining record that did not have documented support was a training issue that has already been addressed. Anticipated Completion Date Completed Responsible Individual(s) Mark Whitaker, MSHDA SaVille Hill, MSHDA

View Audit 20093

Finding 24428 (2022-011)

Significant Deficiency 2022

State of Michigan

MI

Questioned Costs Subrecipient Monitoring Internal Control / Segregation of Duties § 200.303

Finding 2022-011 MATT 2.0 Security Management and Access Controls Management Views The Michigan State Housing Development Authority (MSHDA) agrees with the finding. Planned Corrective Action For parts, a., b., and c., as of November 30, 2022, MSHDA implemented system security processes and procedu...

Finding 2022-011 MATT 2.0 Security Management and Access Controls Management Views The Michigan State Housing Development Authority (MSHDA) agrees with the finding. Planned Corrective Action For parts, a., b., and c., as of November 30, 2022, MSHDA implemented system security processes and procedures to review active generic and test accounts and to review and disable user accounts inactive for 60 days. In addition, MSHDA implemented a monitoring process that includes semiannual review of privileged accounts and annual review of all other accounts. For part d., MSHDA provided additional training to the user who did not properly approve and document a system access form. Anticipated Completion Date Completed Responsible Individual(s) Mark Whitaker, MSHDA SaVille Hill, MSHDA

View Audit 20093

Finding 24422 (2022-039)

Significant Deficiency 2022

State of Michigan

MI

Subrecipient Monitoring Allowable Costs / Cost Principles Equipment & Real Property Management § 200.303

Finding 2022-039 Formula Grants for Rural Areas and Tribal Transit Program, ALN 20.509 - PTMS Security Management and Access Controls Management Views MDOT agrees with the finding. Planned Corrective Action MDOT?s Office of Enterprise Information Management (EIM) and Office of Passenger Transporta...

Finding 2022-039 Formula Grants for Rural Areas and Tribal Transit Program, ALN 20.509 - PTMS Security Management and Access Controls Management Views MDOT agrees with the finding. Planned Corrective Action MDOT?s Office of Enterprise Information Management (EIM) and Office of Passenger Transportation (OPT) will collaborate and provide oversight to ensure there is properly approved access for Public Transportation Management System (PTMS) users and that PTMS user access is reviewed semiannually for privileged accounts and/or annually for all other accounts. MDOT EIM and OPT will do this by reviewing security management and access control procedures and making any necessary updates, providing training on the process and documentation requirements, and designating a PTMS system security administrator(s) and back-up(s) as needed. Anticipated Completion Date August 1, 2023 Responsible Individual(s) Kyle Nelson, MDOT Andy Esch, MDOT OPT Business area system administrator(s)

View Audit 20093

Finding 24397 (2022-002)

Material Weakness 2022

Ocala Housing Authority

FL

HUD Housing Programs Eligibility Material Weakness

2022-002 Tenant Files: Eligibility Program: U.S. Department of HUD: Section 8 Housing Choice Vouchers (CFDA 14.871) Type of Finding: Material Weakness in Internal Control and Material Noncompliance This is a repeat finding of 2021-001 from September 30, 2021 (Other Matter and Significant Deficiency ...

2022-002 Tenant Files: Eligibility Program: U.S. Department of HUD: Section 8 Housing Choice Vouchers (CFDA 14.871) Type of Finding: Material Weakness in Internal Control and Material Noncompliance This is a repeat finding of 2021-001 from September 30, 2021 (Other Matter and Significant Deficiency in Internal Control over Compliance). Originally reported as finding 2019-001 from September 30, 2019 (Material Weakness in Internal Control and Material Noncompliance) Statement of Condition: Out of a total tenant population of approximately 1,114 vouchers, 25 files were selected for testing. Exceptions were noted as follows: ? 1 tenant file had the following errors: o The tenant?s annual recertification application is missing. o The tenant?s signed 9886 form is missing. o The wrong utility allowance schedule was used to calculate the tenants? utility allowance. Correcting this error would cause the HAP rent to increase by $9. o The tenant?s signed HAP contract is missing. ? 1 tenant file had the following errors: o The name and social security number for one of the tenant?s dependents was reported incorrectly on the 50058 form. o The tenant?s utility allowance was calculated correctly but was reported incorrectly on the 50058 form. Correcting this error would cause the HAP rent to increase by $56. ? 1 tenant file had the following errors: o The lease agreement was not signed by the tenant. o The tenant?s assets was reported in error. Correcting this error would cause the rent to increase by $8. ? 2 tenant files where the tenants? income was miscalculated. Correcting the errors would cause the HAP rent for one of tenant files to decrease by $12 and the other to increase by $181. ? 2 tenant files where the wrong utility allowance schedule was used to calculate the tenants? utility allowance. Correcting these errors would cause the HAP rent for one of the tenant files to decrease by $13 and the other to increase by $14. ? 1 tenant file where the family?s assets was reported in error. Correcting the errors had no effect on the HAP rent. ? 1 tenant file where a member of the household moved but was reported on the 50058 form. ? 1 tenant file where the tenant?s signed HAP contract is missing. ? 1 tenant file where the EIV report was never generated or was misplaced. In addition to the above, we noted the following during our new admissions testing (out of a total of 118 new admission, 18 files were selected for testing.): ? 1 tenant file where the member of the household did not checkmark the checkbox on the 214-affidavit form indicating that they are a U.S. Citizen or permanent resident. However, the member?s birth certificate confirms that the member is a U.S. Citizen. ? 1 tenant file where the tenant?s signed 214-affidavit is missing. However, the member?s birth certificate confirms that the member is a U.S. Citizen. Recommendation: The Authority should correct the deficiencies noted in the tested files and utilize an ongoing quality control review process on the entire tenant population to ensure proper compliance with the requirements related to tenant eligibility. Ongoing staff training and timely management reviews should be utilized to ensure staff is aware of acceptable procedures. In addition, the Authority should review staffing levels, skill sets and case load. Action Taken: The Authority concurs with this finding. The Authority has an established review, oversight and training process and will continue to improve its review, oversight, and training process to ensure proper procedures are being followed. All audit findings of the files tested will have been corrected. The Authority has implemented a quality control system so that every file receives a quality review for appropriate third-party verification and upfront income and assistance is determined. The agency has created a Family Worksheet and an HCV Computation Worksheet to help staff identify errors in calculations and to check for accuracy prior to completing Annual Reexaminations and Interim Recertifications. The agency has changed its filing system to enable staff to thoroughly review all forms prior to admission and during regular recertification and interim adjustment processing. The agency created an Other Adult packet to ensure 214 forms and other pertinent are completed for all adult household members. The HCV Counselor caseloads have been distributed equitably amongst Counselors to promote efficiency and accuracy while working on each HCV participant?s file. The Counselor?s caseload is divided alphabetically and assigned by multifamily developments to track and monitor counselors? strength and weaknesses, and to determine if additional training and/or monitoring is needed. Internal file reviews are being completed and management will continue to conduct a 10% review for each Counselor?s processing of annual recertifications. This percentage may increase if work product indicates a need for more stringent review. To further ensure compliance and accuracy, the HCV Program Manager will review at least 1 out of every 5 intake files. The Authority has had a significant turnover in the HCV department over the past 24 months. All HCV staff will attend Voucher Specialist training and Nan McKay HCV Rental Calculation Certification training. Effective Date: June 20, 2023 Contact Information Gwendolyn B. Dawson, CEO Ocala Housing Authority 1629 NW 4th Street Ocala, Florida 34475 (352) 369-2636

View Audit 22927

Finding 24396 (2022-001)

Significant Deficiency 2022

The Reed Institute

OR

Reporting Matching / Level of Effort / Earmarking Internal Control / Segregation of Duties § 200.303

The following corrective measures have been implemented: The Director of Financial Aid requests the amounts and number of students who received HEERF funding from the Business Office at the end of each quarter and reviews, confirms, and documents the date of request and review. A log of the website ...

The following corrective measures have been implemented: The Director of Financial Aid requests the amounts and number of students who received HEERF funding from the Business Office at the end of each quarter and reviews, confirms, and documents the date of request and review. A log of the website updates is maintained to document timely submission of data. The website was revamped to include all necessary reporting requirements including the number of eligible students for CRSSA HEERF II and ARP HEERF III. This updated process was implemented upon identification of the prior year finding, which occurred after the first quarterly report for fiscal year 2022 was posted.

View Audit 22802

Finding 24392 (2022-001)

Significant Deficiency 2022

City of Sierra Vista, Arizona

AZ

Questioned Costs Allowable Costs / Cost Principles Reporting § 200.303

Program Name/Assistance Listing Title: COVID-19 Coronavirus State and Local Fiscal Recovery Funds Assistance Listing Number: 21.027 Contact Person: David Felix, Chief Financial Officer Anticipated Completion Date: May 18, 2023 Planned Corrective Action: When the City received notification of the awa...

Program Name/Assistance Listing Title: COVID-19 Coronavirus State and Local Fiscal Recovery Funds Assistance Listing Number: 21.027 Contact Person: David Felix, Chief Financial Officer Anticipated Completion Date: May 18, 2023 Planned Corrective Action: When the City received notification of the award of CSLFRF funds, the CFO and City Attorney reviewed the law and, based on how it was written, felt that we could apply it to the Fire Department?s salary expenses as over 80% of their calls are for emergency medical services, they are the first responders to a 911 EMS call, and they usually transport the patients to the hospital. Neither in the initial law documentation, nor in the initial application, was there an option to select a $10M de minimus revenue loss option. If this was available, the City would have chosen that up front. We completed the interim report based on data created by inquiries run in our General Ledger on the date we submitted the report. We believed the data was saved on our system, but we can not find the electronic copy of it. As adjustments have been made to the data since then, we are unable to recreate a report that matches the data on the interim report. We can get within $800, but not the exact amount. Going forward, we will ensure the data is saved and put in a place that it is easier to retrieve.

View Audit 19937

Corrective Action Plans

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