Corrective Action Plans

Finding 548002 (2024-002)

Material Weakness 2024

MA

Questioned Costs

Views of Responsible Officials and Planned Corrective Action: While Quincy Asian Resources, Inc. concurs with the ultimate outcome identified in the finding regarding timesheet the identified documentation issues stemmed from procedural gaps in our timekeeping processes rather than any misuse of fun...

Views of Responsible Officials and Planned Corrective Action: While Quincy Asian Resources, Inc. concurs with the ultimate outcome identified in the finding regarding timesheet the identified documentation issues stemmed from procedural gaps in our timekeeping processes rather than any misuse of funds. Our internal review confirms employees dedicated appropriate time to grant activities, but our timecard reporting system did not adequately capture this effort due to: 1. Staff’s incomplete understanding of federal documentation requirements 2. Need for enhanced timesheet review protocols 3. Limitations of our current time tracking system To strengthen our processes, we are: 1. Implementing a new time tracking system better aligned with federal requirements 2. Providing comprehensive training to all employees on proper time reporting 3. Training supervisors on thorough timesheet review procedures 4. Enhancing our internal controls around time documentation These improvements will ensure our documentation fully supports the valuable grant-funded services we provide to the community

View Audit 351904 Questioned Costs: $1

Finding 548001 (2024-001)

Significant Deficiency 2024

Quincy Asian Resources, Inc.

MA

HUD Housing Programs Reporting Internal Control / Segregation of Duties

Views of Responsible Officials and Planned Corrective Action: While Quincy Asian Resources, Inc. concurs with the ultimate outcome identified in the finding, we want to emphasize our review indicates all transactions were handled with appropriate intent. The identified adjustments were primarily due...

Views of Responsible Officials and Planned Corrective Action: While Quincy Asian Resources, Inc. concurs with the ultimate outcome identified in the finding, we want to emphasize our review indicates all transactions were handled with appropriate intent. The identified adjustments were primarily due to timing of personnel transitions on our accounting department. To further strengthen our financial reporting processes, we have subsequently hired a new controller with extensive nonprofit accounting experience. This addition to our team will help ensure continued accuracy in financial reporting while maintaining strong internal controls.

View Audit 351904

Finding 547993 (2024-004)

Material Weakness 2024

Umpqua Public Transportation District

OR

Procurement, Suspension & Debarment Material Weakness Internal Control / Segregation of Duties § 200.318

Finding 2024-004 - Procurement (Material Weakness) CFDA Title and Number: 20.526 Grants for Buses and Bus Facilities Formula Program Name of Federal Agency: Department of Transportation Internal Control over Compliance: Procurement CFDA Title and Number: 20.513 (5310) Enhanced Mobility of Seniors ...

Finding 2024-004 - Procurement (Material Weakness) CFDA Title and Number: 20.526 Grants for Buses and Bus Facilities Formula Program Name of Federal Agency: Department of Transportation Internal Control over Compliance: Procurement CFDA Title and Number: 20.513 (5310) Enhanced Mobility of Seniors & Individuals with Disabilities. Name of Federal Agency: Department of Transportation Internal Control over Compliance: Procurement CFDA Title and Number: 20.509 (5311) Operating Assistance. Formula Grants for Rural. Name of Federal Agency: Department of Transportation Internal Control over Compliance: Procurement Criteria: 2 CFR Part 200.318(a-k) Numerous procurement regulations exist requiring federal grant awardees to develop and implement internal control policies and procedures related to procurement activities. Condition: The District made expenditures and engaged in contracts without following relevant procurement requirements. Cause: Management lacked awareness of relevant procurement regulations. Consequently, no internal control policies or procedures related to procurement existed, or policies and procedures existed but were not implemented. Effect or Potential Effect: The lack of effective internal controls over procurement activities allowed for widespread deficiencies and noncompliant activities, which resulted in the District’s revocation of one award. Questioned Cost: No Context: Without proper procurement policies and procedures, the risk of compliance requirement violations is significant. The District failed to meet numerous procurement requirements throughout the year, and ultimately lost a significant award for bus acquisitions. Repeat of a Prior-Year Finding: No Recommendation: The District should design and implement internal controls related to procurement regulations that will reduce the risk that the District’s procurement activities are not in compliance with federal regulations. District's Response: The District acknowledges the weaknesses and its intention of correcting weaknesses. Corrective Action Plan: The District’s shall design and implement, or revise, policies and procedures for meeting procurement compliance requirements. The District will work with ODOT to ensure compliance. The new procurement policy must include not only policies for procurements, but also for documentation of solicitations, contracts activities. Planned Implementation Date: October 31, 2024 Responsible Persons: District Board, Umpqua Public Transit District

View Audit 351895

Finding 547987 (2024-003)

Material Weakness 2024

Umpqua Public Transportation District

OR

Cash Management Subrecipient Monitoring Material Weakness § 200.302 § 200.328 § 200.329

Finding 2024-003 – Fiscal Management (Material Weakness) CFDA Title and Number: 20.513 (5310) Enhanced Mobility of Seniors and Individuals with Disabilities. Name of Federal Agency: Department of Transportation Internal Control over Compliance: Cash Management CFDA Title and Number: 20.509 (53...

Finding 2024-003 – Fiscal Management (Material Weakness) CFDA Title and Number: 20.513 (5310) Enhanced Mobility of Seniors and Individuals with Disabilities. Name of Federal Agency: Department of Transportation Internal Control over Compliance: Cash Management CFDA Title and Number: 20.509 (5311) Operating Assistance. Formula Grants for Rural. Name of Federal Agency: Department of Transportation Internal Control over Compliance: Cash Management Criteria: 2 CFR Part 200.302(b)(1) The financial management system of each non-federal entity must provide for the following: Identification, in its accounts, of all Federal awards received and expended and the Federal programs under which they were received. 200.302(b)(2) Accurate, current, and complete disclosure of the financial results of each Federal award or program in accordance with the reporting requirements set forth in 200.328 and 200.329. Condition: During portions of the fiscal year, the District prepared reimbursement calculations relying on an internally developed spreadsheet tool, rather than using amounts solely obtained from the general ledger and supporting documentation. The reimbursement reports were prepared by management with limited review. Conflicts over review and other monitoring procedures occurred, and were not always resolved. Complete supporting documentation for the claimed costs were not always available. Claims and other financial reports due to ODOT were regularly submitted after the due dates. The late and/or unsubstantiated filings have resulted in lost claims for the District, and potential refunding of reimbursements received. Cause: Internal control procedures assuring timely and accurate preparation of reports and filing of the reimbursement requests were not designed or implemented adequately. Maintaining sufficient and accurate supporting documentation for each report was not possible because original data was not relied upon by management, to complete the reports and reimbursement requests. Effect or Potential Effect: The lack of effective internal control activities over cash management, including financial reporting, allowed for reporting and claims errors, from simple calculation errors to requests for reimbursements of unauthorized purposes. Improper financial reporting to the ODOT occurred regularly. Lack of timely filing of reimbursement requests for amounts claimed, resulted in lost revenues and claims that may be required to be returned. Questioned Cost: No Context: Delays in filing reimbursement claims, delays in filing financial reports to ODOT, and internal disputes regarding completion of grant reimbursement request procedures were evident. Weak or nonexistent controls over cash management, including fiscal management, may result in lost revenues and risks of creating unnecessary liabilities in the form of refunds due to ODOT. Repeat of a Prior-Year Finding: Yes Recommendation: The District should design and implement internal control policies and procedures for cash management, including fiscal management and financial reporting. Monitoring, information and communication control activities should also be designed and implemented as part of the effort the reduce the risk of continued matters of noncompliance related to cash management. District's Response: The District acknowledges the weaknesses and its intention of correcting weaknesses. Corrective Action Plan: The District’s General Manager resigned effective September 13, 2024. The Board has adopted a plan to procure qualified professional assistance to evaluate and restructure the organization and assist in daily management activities until a new General Manager can be hired and trained. Additional assistance for resolving these deficiencies has been offered by ODOT and accepted by the Board. Planned Implementation Date: October 31, 2024 Responsible Persons: District Board, Umpqua Public Transit District

View Audit 351895

Finding 547985 (2024-101)

Material Weakness 2024

Maricopa County

AZ

Subrecipient Monitoring Procurement, Suspension & Debarment Reporting § 200.303

Concur: The Maricopa County Human Services Department will update its procedures involving subaward actions as required by FFATA and Federal Uniform Guidance. These internal procedures will include reporting subaward actions equaling or exceeding more than $30,000 no later than month-end following t...

Concur: The Maricopa County Human Services Department will update its procedures involving subaward actions as required by FFATA and Federal Uniform Guidance. These internal procedures will include reporting subaward actions equaling or exceeding more than $30,000 no later than month-end following the subaward action. Additionally, the Department has updated all tracking listings and will ensure all grants contracted through other departments and amendments are included. On February 27, 2025, the Department completed and submitted the required FFATA form to USAspending.gov.

View Audit 351894

Finding 547981 (2024-003)

Significant Deficiency 2024

Nuestra Escuela

PR

Reporting Internal Control / Segregation of Duties

Management response: • Nuestra Escuela’s Program Director will adopt automated data collection software to ensure the timely availability of participants information, thereby preventing delays in report submission. • Nuestra Escuela will enhance its internal controls to ensure adherence to all req...

Management response: • Nuestra Escuela’s Program Director will adopt automated data collection software to ensure the timely availability of participants information, thereby preventing delays in report submission. • Nuestra Escuela will enhance its internal controls to ensure adherence to all required reporting deadlines, promoting timely and accurate submissions under the TANF program strengthen internal controls to ensure the compliance with the reporting. • Nuestra Escuela will conduct regular audits to verify data accuracy, maintaining open and consistent communication with all relevant parties to address potential reporting bottlenecks. • Nuestra Escuela Management staff will receive specialized training on participant qualification and proper requirements and efficient time management practices to improve reporting compliance. • The Executive President will develop and implement a contingency plan to address unforeseen circumstances that could otherwise hinder timely submission of reports. Corrective action plan: Action Date of Compliance Involved areas Adopt automated data collection software Jun 25 - 2025 Executive President Program Director Schedule of internal monitoring for compliance with Special Conditions Monthly Program Director Specialized training on participant qualification and proper requirements May 22 - 2025 External Consultant Program Director Directors in charge of Programs Develop a contingency plan to address unforeseen circumstances Apr 10 - 2025 Executive President External Consultant Actions to complete monthly: ● Internal monitoring by the Program Director with the automated data collection software. ● Meeting between the Program Director and the Directors of each of the Programs to validate the correct status of the reports. Actions to complete quarterly: ● Meeting between the Program Director and the Executive President for a physical review of the files. Contact Person: Ana Yris Guzmán – Executive President|

View Audit 351891

Finding 547968 (2024-002)

Significant Deficiency 2024

Nuestra Escuela

PR

Reporting Significant Deficiency Internal Control / Segregation of Duties

Management response: • Nuestra Escuela will design and implement internal controls specifically addressing the accounting of conditional advances. These controls will include developing a clear rubric to assess whether grants and contracts meet the criteria for conditional contributions under ASU 2...

Management response: • Nuestra Escuela will design and implement internal controls specifically addressing the accounting of conditional advances. These controls will include developing a clear rubric to assess whether grants and contracts meet the criteria for conditional contributions under ASU 2018-08. • The accounting staff will undergo specialized training on the proper recognition of conditional advances. Regular reviews will be conducted to ensure ongoing compliance with ASU 2018-08 and to maintain accurate financial reporting. • Recognizing the need to meet both agency (cash basis) and GAAP (accrual basis), Nuestra Escuela will prepare management reports on both bases. This approach will facilitate accurate grant reporting while ensuring compliance with generally accepted accounting principles. Corrective action plan: Action Date of Compliance Involved areas Developing a clear rubric to assess whether grants and contracts meet the criteria for conditional contributions under ASU 2018-08. Apr 21 - 2025 External Consultant Executive President Administrative Director Directors in charge of Programs Create a “Model reports” on both bases, to use monthly. Monthly Executive President Administrative Director Specialized training on the proper recognition of conditional advances. Jun 10 - 2025 External Consultant Executive President Administrative Director Directors in charge of Programs Actions to complete monthly: • To prepare management reports on both bases Actions to complete quarterly: • Use the rubric to assess whether grants and contracts meet the criteria for conditional contributions under ASU 2018-08. Contact Person: Ana Yris Guzmán – Executive President

View Audit 351891

Finding 547967 (2024-001)

Significant Deficiency 2024

Nuestra Escuela

PR

Reporting Significant Deficiency Internal Control / Segregation of Duties

Management response: • Nuestra Escuela will strengthen its processes to ensure that all grants and accrued expenses are recorded promptly and that services rendered are accounted for in the correct period accurately. • The Administrative Director will perform regular reconciliations of accounts to...

Management response: • Nuestra Escuela will strengthen its processes to ensure that all grants and accrued expenses are recorded promptly and that services rendered are accounted for in the correct period accurately. • The Administrative Director will perform regular reconciliations of accounts to detect, identify, and correct, any discrepancies that may indicate cut-off errors. • The administrative staff and accounting team will receive additional training on the best practices and proper cut-off procedures, emphasizing the importance of timely and accurate recognition of liabilities and receivables and the impact of errors on financial reporting. • Nuestra Escuela will reinforce its internal audit processes to periodically review compliance with cut-off procedures. This practice will involve analyzing the impact of contractual clauses on the period of receipt and use of funds. • Nuestra Escuela will Create documentation of its cut-off policies and procedures to ensure consistent application and understanding among all relevant staff and ensure that they are strictly enforced. • Nuestra Escuela is committed to preventing cut-off errors through a proactive approach from accountants. This involves a combination of robust procedures, leveraging technology, and fostering a culture of accuracy and compliance within the accounting department. By following these best practices, accountants can help ensure the integrity of the financial reporting process. Corrective action plan: Action Date of Compliance Involved areas Reconciliations of each account to identify any discrepancies that may indicate cut-off errors. Monthly Executive President Administrative Director Analyze the impact of contractual clauses on the period of receipt and use of funds. Apr 15 – 2025 Jul 15 -2025 Oct 15 – 2025 Ene 15 - 2026 Executive President Administrative Director Training on the best practices and proper cut-off procedures May 8 - 2025 External Consultant Executive President Administrative Director Directors in charge of Programs Complete file with cut-off policies and procedures Jun 20 - 2025 Administrative Director Directors in charge of Programs Actions to complete monthly: • Reconciliations of each account to identify any discrepancies that may indicate cut-off errors. Actions to complete quarterly: • Analyze the impact of contractual clauses on the period of receipt and use of funds. • Training on the best practices and proper cut-off procedures • Complete file with cut-off policies and procedures Contact Person: Ana Yris Guzmán – Executive President

View Audit 351891

Finding 547966 (2024-003)

Material Weakness 2024

Community Action Partnership of Mercer County

PA

Questioned Costs Cash Management Reporting

Condition: During audit procedures, we noted expenditures were charged to the program via adjusting journal entry for which adequate supporting documentation could not be provided. Corrective Actions: Going forward, the Organization will implement procedures requiring supporting documentation for a...

Condition: During audit procedures, we noted expenditures were charged to the program via adjusting journal entry for which adequate supporting documentation could not be provided. Corrective Actions: Going forward, the Organization will implement procedures requiring supporting documentation for all journal entries made to the program to ensure that amount charged to the program are actual expenses/expenditure of the program. Employee Responsible for Corrective Action: Michelle Clarke Completion Date: March 31, 2025

View Audit 351890 Questioned Costs: $1

Finding 547965 (2024-002)

Material Weakness 2024

Community Action Partnership of Mercer County

PA

Allowable Costs / Cost Principles Material Weakness

Condition: During the audit several adjusting journal entries were proposed. These entries would have a material effect on the financial statements if not proposed and recorded. Corrective Actions: Going forward, the Organization will implement procedures to perform a more comprehensive monthly clo...

Condition: During the audit several adjusting journal entries were proposed. These entries would have a material effect on the financial statements if not proposed and recorded. Corrective Actions: Going forward, the Organization will implement procedures to perform a more comprehensive monthly closing, especially at year end, to ensure that all general ledger accounts are reviewed and reconciled to arrive at a complete and accurate set of books and records to be audited. Employee Responsible for Corrective Action: Michelle Clarke Completion Date: March 31, 2025

View Audit 351890

Finding 547964 (2024-001)

Material Weakness 2024

Community Action Partnership of Mercer County

PA

Questioned Costs Allowable Costs / Cost Principles Cash Management § 200.403

Condition: During audit procedures, it was noted total reimbursements received exceeded expenditures. The Organization has charged costs to the program and received reimbursement; however, the products cost charged to the program had not been received prior to June 30, 2024. Corrective Actions: Goi...

Condition: During audit procedures, it was noted total reimbursements received exceeded expenditures. The Organization has charged costs to the program and received reimbursement; however, the products cost charged to the program had not been received prior to June 30, 2024. Corrective Actions: Going forward, the Organization will review all vouchers being charged to the program to make sure costs have been incurred before being charged to the program. Employee Responsible for Corrective Action: Michelle Clarke Completion Date: March 31, 2025

View Audit 351890 Questioned Costs: $1

Finding 547954 (2024-001)

Material Weakness 2024

County of El Dorado

CA

Eligibility Material Weakness Matching / Level of Effort / Earmarking

Reference Number: 2024-001 Name of Contact Person: Kelly Nakamura Phone: 530-642-7167 Email: Kelly.nakamura@edcgov.us Corrective Action: • Increasing Staffing Levels: o By April 1, 2025, the County will have 11 newly trained Eligibility Specialists who are fully trained to proces...

Reference Number: 2024-001 Name of Contact Person: Kelly Nakamura Phone: 530-642-7167 Email: Kelly.nakamura@edcgov.us Corrective Action: • Increasing Staffing Levels: o By April 1, 2025, the County will have 11 newly trained Eligibility Specialists who are fully trained to process Medi-Cal applications. o Ongoing recruitment efforts will continue to fill vacant positions, including the hiring additional trainees to build capacity for timely eligibility determinations. • Improving Internal Processes: o The County is conducting a review of workflows to identify inefficiencies and implement streamlined processes that eliminate bottlenecks. o Digital tools and automation are being introduced to enhance efficiency and accuracy case processing. • Providing Additional Support: o Overtime opportunities are being offered to eligibility specialists to expedite the processing of pending cases. o Applications are being assigned to Eligibility Specialists on a weekly basis to ensure consistent progress in reducing the backlog. • Enhancing Monitoring and Reporting: o Administrative staff are generating weekly reports from CalSAWS to track the status Medi-Cal pending applications and monitor progress. o Weekly meetings are being held with supervisors to review performance, discuss challenges, and adjust strategies as needed. • Strengthening Internal Controls: o The County is improving its internal controls to prevent future delays, including increased use of system reports to identify applications nearing the 45-day processing requirement, regular audits of the eligibility determination process and enhanced compliance training for staff. • Ongoing Evaluation and Adaptation: o Progress will be assessed weekly to ensure the implemented measures are effective. Adjustments will be made as needed to maintain compliance with the 45-day requirement. Proposed Completion Date: The county has already implemented this process and expects it to be completed by July 31, 2026.

View Audit 351887

Finding 547950 (2024-009)

Material Weakness 2024

State of Hawaii Department of Health

HI

Subrecipient Monitoring Reporting

Reporting - FSRS Block Grants for Prevention & Treatment of Substance Abuse - FSRS were not timely submitted resulting in noncompliance with the reporting requirement. Corrective Action Plan: ADAD will meet with the program staff to complete the implementation of the policies and procedures relating...

Reporting - FSRS Block Grants for Prevention & Treatment of Substance Abuse - FSRS were not timely submitted resulting in noncompliance with the reporting requirement. Corrective Action Plan: ADAD will meet with the program staff to complete the implementation of the policies and procedures relating to the reporting of subawards to the new FSRS system to comply with the Federal reporting requirements. Implementation Date: July 1, 2025 Responding Official: John Valera and Melanie Muraoka, Administrative Officer/Alcohol and Drug Abuse Division

View Audit 351885

Finding 547949 (2024-008)

Material Weakness 2024

State of Hawaii Department of Health

HI

Subrecipient Monitoring § 200.331

Subrecipient Monitoring Non-compliance with its inconsistent documented monitoring procedures. Corrective Action Plan: AMHD will review and revise their monitoring procedures to ensure that subrecipient expenditures are monitored and single audit reports are reviewed, as applicable. Implementation D...

Subrecipient Monitoring Non-compliance with its inconsistent documented monitoring procedures. Corrective Action Plan: AMHD will review and revise their monitoring procedures to ensure that subrecipient expenditures are monitored and single audit reports are reviewed, as applicable. Implementation Date: July 1, 2025 Responding Official: Chanel Daluddung, Performance, Information, Evaluation and Research Branch Chief, Adult Mental Health Division

View Audit 351885

Finding 547948 (2024-007)

Material Weakness 2024

State of Hawaii Department of Health

HI

Matching / Level of Effort / Earmarking Subrecipient Monitoring

Earmarking Earmarking requirement was not met. Corrective Action Plan: State Procurement rules occasionally make it difficult to spend the earmark by the deadline. In the future, the committee that governs these earmarks will be more proactive about monitoring planned procurements to ensure they are...

Earmarking Earmarking requirement was not met. Corrective Action Plan: State Procurement rules occasionally make it difficult to spend the earmark by the deadline. In the future, the committee that governs these earmarks will be more proactive about monitoring planned procurements to ensure they are moving through the process so funds can be spent. In addition, vacancies contributed to falling short of the earmarking requirement, since those personnel funds were not spent. Vacancies will be monitored quarterly for re-allocation opportunities, and workforce development strategies will be developed and implemented to address shortages. Implementation Date: July 1, 2025 Responding Official: Keli, Acquaro, Administrator, Child & Adolescent Mental Health Division

View Audit 351885

Finding 547947 (2024-006)

Material Weakness 2024

State of Hawaii Department of Health

HI

Reporting § 200.327

Reporting - FSRS Opioid STR - FSRS were not timely submitted resulting in noncompliance with the reporting requirement. Corrective Action Plan: ADAD will meet with the program staff to complete the implementation of the policies and procedures relating to the reporting of subawards to the new FSRS s...

Reporting - FSRS Opioid STR - FSRS were not timely submitted resulting in noncompliance with the reporting requirement. Corrective Action Plan: ADAD will meet with the program staff to complete the implementation of the policies and procedures relating to the reporting of subawards to the new FSRS system to comply with the Federal reporting requirements. Implementation Date: July 1, 2025 Responding Official: John Valera and Melanie Muraoka, Administrative Officer/Alcohol and Drug Abuse Division

View Audit 351885

Finding 547946 (2024-005)

Material Weakness 2024

State of Hawaii Department of Health

HI

Subrecipient Monitoring Reporting

Reporting - FSRS Substance Abuse and Mental Health Services - FSRS were not timely submitted resulting in noncompliance with the reporting requirement. Corrective Action Plan: Complete the implementation of the policies and procedures relating to the reporting of subawards to the new FSRS system to ...

Reporting - FSRS Substance Abuse and Mental Health Services - FSRS were not timely submitted resulting in noncompliance with the reporting requirement. Corrective Action Plan: Complete the implementation of the policies and procedures relating to the reporting of subawards to the new FSRS system to comply with the Federal reporting requirements. Implementation Date: April 1, 2025 Responding Official: John Valera and Melanie Muraoka, Administrative Officer/Alcohol and Drug Abuse Division

View Audit 351885

Finding 547945 (2024-004)

Material Weakness 2024

State of Hawaii Department of Health

HI

Cash Management § 200.303 § 200.305

Reporting - Cash Management During the testing of the Department's cash management procedures, it was determined that eight out of sixty payments tested were not distributed within 21 days of the draw down of funds. For the items tested, the time elapsed between draw down and payment ranged from 22 ...

Reporting - Cash Management During the testing of the Department's cash management procedures, it was determined that eight out of sixty payments tested were not distributed within 21 days of the draw down of funds. For the items tested, the time elapsed between draw down and payment ranged from 22 to 44 days. Corrective Action Plan:WIC has developed a Quality Control Plan, procedures and a workflow to ensure invoices are timely released to ASO-Fiscal for processing. Implementation Date: April 1, 2025 Responding Official: Melanie Murakami, WIC Branch Chief

View Audit 351885

Finding 547944 (2024-003)

None 2024

Richland School District

WI

Cash Management

2024-003- Medical Assistance (Medicaid School Based Services) Criteria: For an agency to bill Wisconsin Medicaid for School Based Services (SBS), an IEP, and Consent to Bill Wisconsin Medicaid for Medically Related Special Education and Related Services (DPI Form M-5) must be current, signed, and d...

2024-003- Medical Assistance (Medicaid School Based Services) Criteria: For an agency to bill Wisconsin Medicaid for School Based Services (SBS), an IEP, and Consent to Bill Wisconsin Medicaid for Medically Related Special Education and Related Services (DPI Form M-5) must be current, signed, and dated by the parent or guardian of a student with an IEP before claims can be submitted. The School District must obtain parental consent before the District accesses Wisconsin Medicaid for the first time. Condition: There were two students tested that did not have signed consent to bill forms on file. The District received reimbursements for services provided to these two students from Medicaid SBS. Without the signed consent to bill forms, theses services are not eligible for reimbursement. Cause: The District had a transition in staffing and the process step to verify signed consent to bill forms was missed. Effect: A reimbursement request was made for services that were not eligible to be reimbursed and did not comply with Medicaid SBS requirements. Auditor's Recommendation: Establish controls to verify all student services billed to Medicaid SBS have a signed consent to bill on file. Grantee Response: The District will review Medicaid SBS consent to bill forms and verify signed copies are on file going forward. Contact Person: Jon Bosworth Anticipated Completion: On-going

View Audit 351880

Finding 547943 (2024-003)

Significant Deficiency 2024

City of Costa Mesa

CA

Questioned Costs

City staff will reconcile the employee’s time records to ensure accurate reporting.

View Audit 351875 Questioned Costs: $1

Finding 547940 (2024-003)

Significant Deficiency 2024

New River Health Association, Inc.

WV

Special Tests & Provisions

Management will work with Athena to correct the workflow to ensure slide fees are adjusted at the correct updated Federal Poverty Level at the beginning of the new year. Organization contact persons responsible for corrective action: Michele Sarrett Anticipated completion date: 12/31/2025

View Audit 351868

Finding 547937 (2024-002)

Significant Deficiency 2024

New River Health Association, Inc.

WV

Procurement, Suspension & Debarment HUD Housing Programs Reporting

Management agrees with the auditors' recommendations. The UDS formulas were updated and the issues corrected for the 2024 UDS report. In the upcoming year it is expected that new accounting leadership and Grant Management will work together to ensure the accuracy of the UDS Report. Organization con...

Management agrees with the auditors' recommendations. The UDS formulas were updated and the issues corrected for the 2024 UDS report. In the upcoming year it is expected that new accounting leadership and Grant Management will work together to ensure the accuracy of the UDS Report. Organization contact persons responsible for corrective action: Michele Sarrett Anticipated completion date: 12/31/2025

View Audit 351868

Finding 547935 (2024-003)

Significant Deficiency 2024

Clackamas County, Oregon

OR

Allowable Costs / Cost Principles Reporting Significant Deficiency

Finding 2024-003: Allowable Costs – Significant Deficiency in Internal Control over Compliance and Instance of Noncompliance Management agrees with the finding and the auditor’s recommendation. Contact Person responsible for corrective action: Elizabeth Comfort Finance Director ecomfort@clackamas.us...

Finding 2024-003: Allowable Costs – Significant Deficiency in Internal Control over Compliance and Instance of Noncompliance Management agrees with the finding and the auditor’s recommendation. Contact Person responsible for corrective action: Elizabeth Comfort Finance Director ecomfort@clackamas.us 503-936-5345 Corrective Action Planned: Procedures will be incorporated into the County workflow to provide additional monitoring, and oversight. These will include: • Departments will ensure that all expenses are reviewed to confirm alignment with the specific terms and conditions of the grant before reallocating any charges. • Redistribution of Award expenses will be reviewed and approved by Division Director and/or Finance Grant Manager • Federal Awards quarterly reporting will be reviewed and approved by Finance Grant Manager prior to submission • Journal Entries will be for correcting entries and not move funded expenditures to other funding revenues • All Journal Entries will have complete supporting documentation reviewed and signed by Director level staff at the Division or by Finance Grant Management Anticipated Completion Date: Implementation of controls by March 24, 2025.

View Audit 351867

Finding 547933 (2024-002)

Significant Deficiency 2024

Clackamas County, Oregon

OR

Procurement, Suspension & Debarment

Finding 2024-002: Procurement, Suspension and Debarment – Significant Deficiency in Internal Control over Compliance and Instance of Noncompliance Management agrees with the finding and the auditor’s recommendation. Contact Person responsible for corrective action: Elizabeth Comfort Finance Director...

Finding 2024-002: Procurement, Suspension and Debarment – Significant Deficiency in Internal Control over Compliance and Instance of Noncompliance Management agrees with the finding and the auditor’s recommendation. Contact Person responsible for corrective action: Elizabeth Comfort Finance Director ecomfort@clackamas.us 503-936-5345 Corrective Action Planned: Procedures will be incorporated into the County workflow to provide additional monitoring, oversight, and record retention related to reporting. These will include: • Timely verification from SAM.gov to verify non-suspension or disbarment status • Procurement to download the timestamped report from SAM.gov • Retain documentation of verification from SAM.gov • Procurement to include appropriate language on all Federal funded awards Anticipated Completion Date: Implemented as a control by the Finance Procurement Division each award March 19, 2025.

View Audit 351867

Finding 547928 (2024-001)

Significant Deficiency 2024

Clackamas County, Oregon

OR

Subrecipient Monitoring Reporting

Finding 2024-001: Reporting – Significant Deficiency in Internal Control over Compliance and Instance of Noncompliance Management agrees with the finding and the auditor’s recommendation. Contact Person responsible for corrective action: Elizabeth Comfort Finance Director ecomfort@clackamas.us 503-9...

Finding 2024-001: Reporting – Significant Deficiency in Internal Control over Compliance and Instance of Noncompliance Management agrees with the finding and the auditor’s recommendation. Contact Person responsible for corrective action: Elizabeth Comfort Finance Director ecomfort@clackamas.us 503-936-5345 Corrective Action Planned: Procedures will be incorporated into the County workflow to provide additional monitoring, oversight, and record retention related to reporting of subawards greater or equal to $30,000. These will include: • Timely monitoring for the status of FFATA subaward reporting • Receive the FFATA subaward report to SAM.gov confirmation from Sub Recipient contractor • Retain documentation of submission to SAM.gov • Include quarterly cash-on-hand reports to award checklist to be completed in the Finance office • Compile listing of current open subrecipient agreements for adherence to FFATA contractor award reporting to ensure compliance Anticipated Completion Date: Implemented as a control to the Finance Grant checklist for each award March 20, 2025.

View Audit 351867

Corrective Action Plans

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