Corrective Action Plans

In June of 2022, Rural Health Corporation of Northeastern Pennsylvania implemented a new Electronic Medical Records System. This implementation, combined with turnover in the billing department, and the hiring of an outsourced claims processor, led to billing delays and various other challenges rela...

In June of 2022, Rural Health Corporation of Northeastern Pennsylvania implemented a new Electronic Medical Records System. This implementation, combined with turnover in the billing department, and the hiring of an outsourced claims processor, led to billing delays and various other challenges related to accounts receivable. An internal biller was hired, and processes are in place to monitor and reconcile accounts receivable on at least a monthly basis. The CFO acknowledges and is responsible for this corrective action plan.

View Audit 299113

Finding 386807 (2023-002)

Significant Deficiency 2023

Dodgeland School District

WI

Internal Control / Segregation of Duties Reporting

This segregation of duties weakness is impratical to totally correct due to the limited resources and staff available to the district. The District will continue to use other controls, where practical, to compensate for this limitation.

View Audit 299093

Finding 386805 (2023-002)

Material Weakness 2023

Hamilton County, Tennessee

TN

Reporting Matching / Level of Effort / Earmarking

Person Responsible for Corrective Action Plan: Mary Ellen Heuton, Chief Financial Officer Hamilton County Schools Corrective Action Plan: The District (Hamilton County Schools) has implemented new procedures to ensure the quarterly reports are being loaded into the State's dashboard for compliance w...

Person Responsible for Corrective Action Plan: Mary Ellen Heuton, Chief Financial Officer Hamilton County Schools Corrective Action Plan: The District (Hamilton County Schools) has implemented new procedures to ensure the quarterly reports are being loaded into the State's dashboard for compliance with the requirement. Anticipated Completion Date: June 30, 2024.

View Audit 299091

Finding 386804 (2023-002)

Material Weakness 2023

Jardines De Aguada - Municipality of Aguada

PR

Subrecipient Monitoring Allowable Costs / Cost Principles Material Weakness

COMMONWEALTH OF PUERTO RICO AUTONOMOUS MUNICIPALITY OF AGUADA CORRECTIVE ACTION PLAN FOR THE FISCAL YEAR ENDED JUNE 30, 2023 Audit Report: Reports on Compliance and Internal Control in Accordance with Government Auditing Standards and OMB Super Circular Uniform Guidance Aud...

COMMONWEALTH OF PUERTO RICO AUTONOMOUS MUNICIPALITY OF AGUADA CORRECTIVE ACTION PLAN FOR THE FISCAL YEAR ENDED JUNE 30, 2023 Audit Report: Reports on Compliance and Internal Control in Accordance with Government Auditing Standards and OMB Super Circular Uniform Guidance Audit Period: July 1, 2022 – June 30, 2023 Principal Executive: Hon. Christian E. Cortés Feliciano Fiscal Year: 2022-2023 Contact Person: Mrs. Geavelis Pérez Ruiz, Finance Director Phone: (787)868-6400 Original Finding Number: 2023-002 Statement of Concurrence or Nonconcurrence: We concur partially with the finding. Corrective Action: The Municipality received strengthening funds, which require the filing of monthly reports, specifically on the 15th of each month. The Municipality acknowledges that it has not submitted certain reports specifically for the 15th of each month, however, they have been submitted monthly. The fact that the report was not submitted by a specific date is not synonymous with the municipality not adequately monitoring the program's activities. That is why we do not completely agree with what is stated in the cause of condition. To ensure that the report is submitted by the 15th of each month, since March 2023, a reminder with a notice was established in the calendar several days before the filing date. Implementation Date: Fiscal year 2023-2024 Responsible Person: CPA Marisol Rosa Acevedo Municipal Administrator

View Audit 299080

Finding 386777 (2023-005)

Significant Deficiency 2023

Regional School Unit No. 10

ME

Eligibility Reporting School Nutrition Programs

Management Response/Corrective Action Plan: Before the Nutrition Director submits the claim, the Business Manager will review the claim with the Nutrition Director.

View Audit 299071

Finding 386772 (2023-001)

None 2023

Big Brothers Big Sisters of Central Ohio, Inc. & Subsidiaries

OH

Subrecipient Monitoring Cash Management Reporting

Finding Number: 2023-001 Condition: The Organization failed to submit monthly reimbursement requests to the Franklin County Department of Job and Family Services by their due dates during the year ended June 30, 2023. Planned Corrective Action: The Organization will ensure that an appropriate staf...

Finding Number: 2023-001 Condition: The Organization failed to submit monthly reimbursement requests to the Franklin County Department of Job and Family Services by their due dates during the year ended June 30, 2023. Planned Corrective Action: The Organization will ensure that an appropriate staffing level and sufficient training will be achieved and maintained. The Organization will also implement system and process improvements to ensure timely submission. Contact Person Responsible for Corrective Action: Elizabeth Martinez, President and CEO Anticipated Completion Date: April 30, 2024

View Audit 299048

Finding 386724 (2023-001)

Significant Deficiency 2023

University System of New Hampshire

NH

Reporting Significant Deficiency Matching / Level of Effort / Earmarking § 200.303

Education Stabilization Fund – Assistance Listing Number 84.425F Granite State College (recently merged as part of a new college within the University of New Hampshire) will work to resolve the reporting finding for fiscal year 2023 reporting. The College will provide training to staff on reporting...

Education Stabilization Fund – Assistance Listing Number 84.425F Granite State College (recently merged as part of a new college within the University of New Hampshire) will work to resolve the reporting finding for fiscal year 2023 reporting. The College will provide training to staff on reporting policies and procedures to ensure that information is reported in a timely manner. Name(s) of the contact person(s) responsible for corrective action: Susan Zipkin, Director, Accounting and Financial Compliance, University of New Hampshire Planned completion date for corrective action plan: February 29, 2024

View Audit 299022

Finding 386713 (2023-008)

Material Weakness 2023

City of Peabody

MA

Subrecipient Monitoring Material Weakness Reporting

CORRECTIVE ACTION PLAN Oversight Agency for Audit: U.S. Department of Treasury The City of Peabody, Massachusetts respectfully submits the following corrective action plan for the year ended June 30, 2023. Name and address of independent public accounting firm: Powers & Sullivan, LLC 100 Qu...

CORRECTIVE ACTION PLAN Oversight Agency for Audit: U.S. Department of Treasury The City of Peabody, Massachusetts respectfully submits the following corrective action plan for the year ended June 30, 2023. Name and address of independent public accounting firm: Powers & Sullivan, LLC 100 Quannapowitt Parkway, Suite 101 Wakefield, MA 01880 Audit period: July 1, 2022 through June 30, 2023 The finding from the June 30, 2023, schedule of findings and questioned costs is discussed below. The finding is numbered consistently with the number assigned in the schedule. FINDINGS—FEDERAL AWARD PROGRAMS AUDITS U.S. DEPARTMENT OF EDUCATION Passed through Massachusetts Department of Elementary and Secondary Education Education Stabilization Fund Education Stabilization Fund Federal Assistance Listing No. 84.425D, 84.425U and 84.425W 2023-008: Reporting to the State Compliance Requirement: Reporting Type of Finding: Compliance and Material Weakness in Internal Control Over Compliance Criteria or Specific Requirement: Grantees must comply with reporting requirements established by the Massachusetts Department of Elementary and Secondary Education, the City’s Pass-Through Grantor (State). In order for the State to comply with federal reporting requirements, the City is required to submit complete and accurate “Recipient Data Collection Forms” to the State. Condition: The City was unable to provide copies of the Recipient Data Collection Forms submitted to the State. Context: The City did not maintain sufficient documentation to demonstrate compliance with grant reporting requirements. Effect: The City has not complied with the grant requirements. Cause: Management has not established guidelines and procedures to ensure and demonstrate that required reporting is completed, retained, and available upon request. Questioned Costs: None reported. Recommendation: The City should implement internal control procedures to ensure compliance with all grant requirements including the completion and retention of all required reports. The documentation should be filed in an organized manner and readily available upon request. Views of Responsible Officials and Planned Corrective Actions: The School District will implement internal control procedures to ensure that the required reporting is completed, retained and maintained in an organized manner. Management plans to implement these procedures in 2024. If the Oversight Agency has questions regarding this plan, please call Samuel Rippin, School Business Manager, at 978-536-6520. Sincerely yours, Samuel Rippin School Business Manager City of Peabody

View Audit 299007

Finding 386697 (2023-006)

Material Weakness 2023

City of Peabody

MA

Questioned Costs Allowable Costs / Cost Principles Subrecipient Monitoring

CORRECTIVE ACTION PLAN Oversight Agency for Audit: U.S. Department of Treasury The City of Peabody, Massachusetts respectfully submits the following corrective action plan for the year ended June 30, 2023. Name and address of independent public accounting firm: Powers & Sullivan, LLC 100 Qu...

CORRECTIVE ACTION PLAN Oversight Agency for Audit: U.S. Department of Treasury The City of Peabody, Massachusetts respectfully submits the following corrective action plan for the year ended June 30, 2023. Name and address of independent public accounting firm: Powers & Sullivan, LLC 100 Quannapowitt Parkway, Suite 101 Wakefield, MA 01880 Audit period: July 1, 2022 through June 30, 2023 The finding from the June 30, 2023, schedule of findings and questioned costs is discussed below. The finding is numbered consistently with the number assigned in the schedule. FINDINGS—FEDERAL AWARD PROGRAMS AUDITS U.S. DEPARTMENT OF EDUCATION Passed through Massachusetts Department of Elementary and Secondary Education Education Stabilization Fund Education Stabilization Fund Federal Assistance Listing No. 84.425D, 84.425U and 84.425W 2023-006: Controls for Monitoring Payroll Charged to the Grant Compliance Requirement: Allowable Costs/Cost Principles Type of Finding: Compliance and Material Weakness in Internal Control Over Compliance Criteria or Specific Requirement: Grantees must provide reasonable assurance that Federal Awards are expended only for allowable activities and that the costs of goods and services charged to Federal awards are allowable and in accordance with applicable cost principles. Condition: Payroll expenditures charged to the Education Stabilization Fund grant are required to be supported with documentation (i.e., semi-annual certifications and personnel activity reports) substantiating that the employees are eligible to be charged to the grant and that the payroll charged relates to time spent accomplishing grant objectives. The City utilizes semi-annual time and effort certification forms to document the eligibility of the employees paid out of the grant. These forms, however, were not completed for each employee charged out of the grant. Context: The City did not maintain sufficient documentation to demonstrate compliance with federal and state time and effort reporting requirements in accordance with the provisions of Title 2 U.S. Code of Federal Regulations Part 225 Cost Principals for State, Local, and Indian Tribal Governments. Effect: The City has not complied with the federal and state time and effort reporting requirements. Cause: Management has not established written guidelines and procedures outlining the time and effort reporting and documentation requirements that department heads must adhere with to ensure compliance with federal and state time and effort reporting requirements. Such guidelines and procedures should indicate under what circumstances semi-annual certifications and personnel activity reports (PARS) are required. Management also has not adopted and implemented standardized forms that include all data as required by federal and state guidelines to demonstrate compliance with these requirements. Questioned Costs: Total payroll costs charged to the grant in 2023 totaled $3,487,658, which was paid on a bi-weekly basis throughout the year. Three of the pay periods were selected for testing, which totaled $440,173 for 83 employees paid out of the grant during those pay periods. From the pay periods selected for testing, $440,173 of known questioned costs were identified. Repeat Finding: This matter was reported as a finding in the previous year as finding 2022-003. Recommendation: The City should establish written policies and procedures outlining the time and effort reporting and documentation requirements that must be adhered with to ensure compliance with federal and state time and effort reporting requirements. Management should adopt and implement standardized forms that include all data required by federal and state guidelines and provide training to ensure that program personnel understand the time and effort reporting requirements. Views of Responsible Officials and Planned Corrective Actions: The School District will immediately begin reissuing and recollecting the forms for the education stabilization grant for 2024, as well as into future periods. If the Oversight Agency has questions regarding this plan, please call Samuel Rippin, School Business Manager, at 978-536-6520. Sincerely yours, Samuel Rippin School Business Manager City of Peabody

View Audit 299007 Questioned Costs: $1

Finding 386685 (2023-003)

Material Weakness 2023

City of Peabody

MA

Questioned Costs Allowable Costs / Cost Principles Subrecipient Monitoring

CORRECTIVE ACTION PLAN Oversight Agency for Audit: U.S. Department of Treasury The City of Peabody, Massachusetts respectfully submits the following corrective action plan for the year ended June 30, 2023. Name and address of independent public accounting firm: Powers & Sullivan, LLC 100 Qu...

CORRECTIVE ACTION PLAN Oversight Agency for Audit: U.S. Department of Treasury The City of Peabody, Massachusetts respectfully submits the following corrective action plan for the year ended June 30, 2023. Name and address of independent public accounting firm: Powers & Sullivan, LLC 100 Quannapowitt Parkway, Suite 101 Wakefield, MA 01880 Audit period: July 1, 2022 through June 30, 2023 The finding from the June 30, 2023, schedule of findings and questioned costs is discussed below. The finding is numbered consistently with the number assigned in the schedule. FINDINGS—FEDERAL AWARD PROGRAMS AUDITS U.S. DEPARTMENT OF EDUCATION Passed through Massachusetts Department of Elementary and Secondary Education Title I Grants to Local Educational Agencies Title I Grants to Local Educational Agencies Federal Assistance Listing No. 84.010 2023-003: Controls for Monitoring Payroll Charged to the Grant Compliance Requirement: Allowable Costs/Cost Principles Type of Finding: Compliance and Material Weakness in Internal Control Over Compliance Criteria or Specific Requirement: Grantees must provide reasonable assurance that Federal Awards are expended only for allowable activities and that the costs of goods and services charged to Federal awards are allowable and in accordance with applicable cost principles. Condition: Payroll expenditures charged to the Title I grant are required to be supported with documentation (i.e., semi-annual certifications and personnel activity reports) substantiating that the employees are eligible to be charged to the grant and that the payroll charged relates to time spent accomplishing grant objectives. The City utilizes semi-annual time and effort certification forms to document the eligibility of the employees paid out of the grant. These forms, however, were not completed for each employee charged out of the grant. Context: The City did not maintain sufficient documentation to demonstrate compliance with federal and state time and effort reporting requirements in accordance with the provisions of Title 2 U.S. Code of Federal Regulations Part 225 Cost Principals for State, Local, and Indian Tribal Governments. Effect: The City has not complied with the federal and state time and effort reporting requirements. Cause: Management has not established written guidelines and procedures outlining the time and effort reporting and documentation requirements that department heads must adhere with to ensure compliance with federal and state time and effort reporting requirements. Such guidelines and procedures should indicate under what circumstances semi-annual certifications and personnel activity reports (PARS) are required. Management also has not adopted and implemented standardized forms that include all data as required by federal and state guidelines to demonstrate compliance with these requirements. Questioned Costs: Total payroll costs charged to the grant in 2023 totaled $919,109, which was paid on a bi-weekly basis throughout the year. Three of the pay periods were selected for testing, which totaled $110,714 for 28 employees paid out of the grant during those pay periods. From the pay periods selected for testing, $110,714 of known questioned costs were identified. Repeat Finding: This matter was reported as a finding in the previous year as finding 2022-002. Recommendation: The City should establish written policies and procedures outlining the time and effort reporting and documentation requirements that must be adhered with to ensure compliance with federal and state time and effort reporting requirements. Management should adopt and implement standardized forms that include all data required by federal and state guidelines, and provide training to ensure that program personnel understand the time and effort reporting requirements. Views of Responsible Officials and Planned Corrective Actions: The School District will immediately begin reissuing and recollecting the forms for the Title I grant for 2024, as well as into future periods. If the Oversight Agency has questions regarding this plan, please call Samuel Rippin, School Business Manager, at 978-536-6520. Sincerely yours, Samuel Rippin School Business Manager City of Peabody

View Audit 299007 Questioned Costs: $1

Finding 386679 (2023-002)

Material Weakness 2023

City of Peabody

MA

Questioned Costs Allowable Costs / Cost Principles Subrecipient Monitoring

CORRECTIVE ACTION PLAN Oversight Agency for Audit: U.S. Department of Treasury The City of Peabody, Massachusetts respectfully submits the following corrective action plan for the year ended June 30, 2023. Name and address of independent public accounting firm: Powers & Sullivan, LLC 100 Qu...

CORRECTIVE ACTION PLAN Oversight Agency for Audit: U.S. Department of Treasury The City of Peabody, Massachusetts respectfully submits the following corrective action plan for the year ended June 30, 2023. Name and address of independent public accounting firm: Powers & Sullivan, LLC 100 Quannapowitt Parkway, Suite 101 Wakefield, MA 01880 Audit period: July 1, 2022 through June 30, 2023 The finding from the June 30, 2023, schedule of findings and questioned costs is discussed below. The finding is numbered consistently with the number assigned in the schedule. FINDINGS—FEDERAL AWARD PROGRAMS AUDITS U.S. DEPARTMENT OF EDUCATION Passed through Massachusetts Department of Elementary and Secondary Education Special Education Cluster Special Education Grants to States Federal Assistance Listing No. 84.027 Special Education Preschool Grants Federal Assistance Listing No. 84.173 2023-002: Controls for Monitoring Payroll Charged to the Grant Compliance Requirement: Allowable Costs/Cost Principles Type of Finding: Compliance and Material Weakness in Internal Control Over Compliance Criteria or Specific Requirement: Grantees must provide reasonable assurance that Federal Awards are expended only for allowable activities and that the costs of goods and services charged to Federal awards are allowable and in accordance with applicable cost principles. Condition: Payroll expenditures charged to the Special Education Cluster grant are required to be supported with documentation (i.e., semi-annual certifications and personnel activity reports) substantiating that the employees are eligible to be charged to the grant and that the payroll charged relates to time spent accomplishing grant objectives. The City utilizes semi-annual time and effort certification forms to document the eligibility of the employees paid out of the grant. These forms, however, were not completed for each employee charged out of the grant. Context: The City did not maintain sufficient documentation to demonstrate compliance with federal and state time and effort reporting requirements in accordance with the provisions of Title 2 U.S. Code of Federal Regulations Part 225 Cost Principals for State, Local, and Indian Tribal Governments. Effect: The City has not complied with the federal and state time and effort reporting requirements. Cause: Management has not established written guidelines and procedures outlining the time and effort reporting and documentation requirements that department heads must adhere with to ensure compliance with federal and state time and effort reporting requirements. Such guidelines and procedures should indicate under what circumstances semi-annual certifications and personnel activity reports (PARS) are required. Management also has not adopted and implemented standardized forms that include all data as required by federal and state guidelines to demonstrate compliance with these requirements. Questioned Costs: Total payroll costs charged to the grant in 2023 totaled $1,794,406, which was paid on a bi-weekly basis throughout the year. Three of the pay periods were selected for testing, which totaled $156,211 for 65 employees paid out of the grant during those pay periods. From the pay periods selected for testing, $156,211 of known questioned costs were identified. Repeat Finding: This matter was reported as a finding in the previous year as finding 2022-001. Recommendation: The City should establish written policies and procedures outlining the time and effort reporting and documentation requirements that must be adhered with to ensure compliance with federal and state time and effort reporting requirements. Management should adopt and implement standardized forms that include all data required by federal and state guidelines and provide training to ensure that program personnel understand the time and effort reporting requirements. Views of Responsible Officials and Planned Corrective Actions: The School District will immediately begin reissuing and recollecting the forms for the special education grant for 2024, as well as into future periods. If the Oversight Agency has questions regarding this plan, please call Samuel Rippin, School Business Manager, at 978-536-6520. Sincerely yours, Samuel Rippin School Business Manager City of Peabody

View Audit 299007 Questioned Costs: $1

Finding 386677 (2023-004)

Significant Deficiency 2023

Community Health and Counseling Services

ME

HUD Housing Programs Reporting

Program Affected: 93.498 Provider Relief Fund and American Rescue Plan Rural Distribution, agreement period January 1, 2020 through June 30, 2023. Condition and Context:Of the one report haphazardly selected for testing, it was unable to be tested as it was not provided. Corrective Action Pla...

Program Affected: 93.498 Provider Relief Fund and American Rescue Plan Rural Distribution, agreement period January 1, 2020 through June 30, 2023. Condition and Context:Of the one report haphazardly selected for testing, it was unable to be tested as it was not provided. Corrective Action Plan:The new Finance Director will establish procedures to capture report submissions that are managed via a portal. The procedures will include parameters that can be used to verify timely submission. Responsible Official: Dale Hamilton, Executive Director & Kathie Norwood, Finance Director Implementation Date: April 1, 2024

View Audit 298999

Finding 386676 (2023-001)

Significant Deficiency 2023

City/county Association of Governments of San Mateo County

CA

Subrecipient Monitoring Reporting § 200.332 § 200.501

To improve the communication of the nature of the federal funding and associated requirements, C/CAG will ensure that future federal pass-through grant agreements include the following information and language: (1) The specific portion of funding that is federal funds, the Federal Awarding Agency, f...

To improve the communication of the nature of the federal funding and associated requirements, C/CAG will ensure that future federal pass-through grant agreements include the following information and language: (1) The specific portion of funding that is federal funds, the Federal Awarding Agency, full funding amount and applicable Federal Project Number, listing number and title. (2) A portion of the funds included are federal funds, and the recipient is responsible for compliance with all relevant Federal requirements, including, but not limited to § 200.501 Audit requirements and 2 CFR § 200.332 Requirements for pass-through entities.

View Audit 298992

Finding 386661 (2023-002)

Significant Deficiency 2023

Palmdale School District

CA

Subrecipient Monitoring Reporting Significant Deficiency

With the COVID-19 health pandemic came significant response and relief federal revenues in the General Fund. These funds included reporting requirements that had vague instructions and little subsequent clarifying information. The first GEER and ESSER Annual Report that was submitted on January 29, ...

With the COVID-19 health pandemic came significant response and relief federal revenues in the General Fund. These funds included reporting requirements that had vague instructions and little subsequent clarifying information. The first GEER and ESSER Annual Report that was submitted on January 29, 2021, requested Full-Time Equivalent (FTE) position data for four different historical dates (9/30/2018, 9/30/2019, 3/13/2020, and 9/30/2020). The District has documentation that agreed and supports three of the four figures reported to the California Department of Education (CDE); however, the supporting documentation for the 9/30/2019 FTE figure did not agree to the figure reported. The report contained the FTE of 1,714.00, but the supporting documentation maintained by the District had an FTE of 2,177.96. Unfortunately, the Fiscal Services Administrator who completed the calculation and submitted the report left employment with the District in June of 2021, so we are unable to determine why a different FTE figure was submitted than showed on the supporting backup documentation maintained by the District. Upon inquiry of the supporting documentation by the external auditors, the District recalculated the position FTE figures for the same period and the District has concluded that the 1,714.00 FTE figure submitted was incorrect.

View Audit 298972

Corrective Action Plans

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