Finding 1057439 (2023-002)

Significant Deficiency
Requirement
L
Questioned Costs
-
Year
2023
Accepted
2024-08-13

AI Summary

  • Core Issue: Indiana University Health, Inc. submitted a CAPER that incorrectly excluded $3,600 in eligible expenses due to ineffective internal controls over the reporting process.
  • Impacted Requirements: Compliance with Section 200.303 of Title 2 U.S. Code and 24 CFR section 574.520 regarding accurate performance reporting and internal control standards.
  • Recommended Follow-up: Ensure thorough review of CAPER submissions and maintain documentation of review procedures to prevent discrepancies before submission.

Finding Text

Finding 2023-002 (L. Reporting) Identification of the federal program: Federal Agency: United States Department of Housing and Urban Development Assistance Listing No.: 14.241 – Housing Opportunities for Persons with AIDS (HOPWA) Pass-through Entities and Award Periods: Indiana Housing and Community Development Authority (IHCDA) – July 1, 2022 through June 30, 2023 and July 1, 2023 through June 30, 2024 and City of Indianapolis – April 1, 2022 through March 31, 2023 and April 1, 2024 through March 31, 2024 Criteria or specific requirement (Including statutory, regulatory or other citation): Section 200.303 of Title 2 U.S. Code of Federal Regulations Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (Uniform Guidance) states the following regarding internal control: “The non-Federal entity must: (a) Establish and maintain effective internal control over the Federal award that provides reasonable assurance that the non-Federal entity is managing the Federal award in compliance with Federal statutes, regulations, and the terms and conditions of the Federal award. These internal controls should be in compliance with guidance in “Standards for Internal Control in the Federal Government” issued by the Comptroller General of the United States or the “Internal Control Integrated Framework”, issued by the Committee of Sponsoring Organizations of the Treadway Commission (COSO).” Under the grant agreements, HOPWA grantees are required to submit performance reporting, specifically a HUD-40-110-D, HOPWA Consolidated Annual Performance and Evaluation Report (CAPER), no later than 90 days after the close of the program or operating year, as required per 24 CFR section 574.520. Condition: The CAPER submission submitted by Indiana University Health, Inc. and Subsidiaries for the IHCDA grant for the period July 1, 2022 through June 30, 2023, incorrectly excluded $3,600 in funds expended on eligible activities (specifically, support services). For both the HOPWA CAPER submissions, the documentation retained did not support the extent of the review procedures performed prior to the CAPER submissions. Cause: Indiana University Health, Inc. and Subsidiaries’ internal control over the CAPER reporting process was not operating effectively during the year ended December 31, 2023. Effect or potential effect: Incorrect CAPER submissions were filed with HUD as a result of the control not operating effectively. Questioned costs: None. Context: Indiana University Health, Inc. and Subsidiaries submitted two CAPER reports during the year ended December 31, 2023. EY tested both CAPER reports for testing of internal controls over compliance and compliance for HOPWA reporting. The CAPER submission for the IHCDA grant for the period July 1, 2022 through June 30, 2023, incorrectly excluded $3,600 in funds expended on eligible activities. The documentation retained for both reports filed did not support the extent of the review procedures performed prior to the CAPER submissions. Total federal expenditures for Assistance Listing No. 14.241 totaled $1,201,378 for the year ended December 31, 2023. Identification as a repeat finding, if applicable: This is not a repeat finding. Recommendation: Indiana University Health, Inc. and Subsidiaries should ensure the completed CAPER and underlying support are sufficiently reviewed to identify discrepancies and documentation of those review procedures are maintained prior to submitting the CAPER. Views of responsible officials: Indiana University Health, Inc. and Subsidiaries believes it appropriately designed procedures and internal controls over the HOPWA reporting requirements. Indiana University Health, Inc. and Subsidiaries agrees that the CAPER submission for the IHCDA grant for the period of July 1, 2022 through June 30, 2023, contained incomplete and inaccurate information. Indiana University Health, Inc. has revisited the internal control over HOPWA performance reporting

Categories

Allowable Costs / Cost Principles HUD Housing Programs Reporting Matching / Level of Effort / Earmarking Internal Control / Segregation of Duties

Other Findings in this Audit

Programs in Audit

ALN Program Name Expenditures
93.498 Provider Relief Fund $15.94M
93.917 Hiv Care Formula Grants $2.65M
10.557 Special Supplemental Nutrition Program for Women, Infants, and Children $1.73M
14.241 Housing Opportunities for Persons with Aids $1.20M
93.767 Children's Health Insurance Program $698,726
93.253 Poison Center Support and Enhancement Grant $605,947
93.912 Rural Health Care Services Outreach, Rural Health Network Development and Small Health Care Provider Quality Improvement $488,487
93.866 Aging Research $423,834
93.940 Hiv Prevention Activities_health Department Based $409,083
93.211 Telehealth Programs $348,722
14.267 Continuum of Care Program $297,072
32.006 Covid-19 Telehealth Program $249,879
93.243 Substance Abuse and Mental Health Services_projects of Regional and National Significance $201,317
93.914 Hiv Emergency Relief Project Grants $188,985
93.391 Activities to Support State, Tribal, Local and Territorial (stlt) Health Department Response to Public Health Or Healthcare Crises $147,634
16.560 National Institute of Justice Research, Evaluation, and Development Project Grants $144,574
93.959 Block Grants for Prevention and Treatment of Substance Abuse $128,200
93.994 Maternal and Child Health Services Block Grant to the States $105,199
93.889 National Bioterrorism Hospital Preparedness Program $94,495
16.575 Crime Victim Assistance $88,532
93.461 Covid-19 Testing for the Uninsured $64,002
93.969 Pphf Geriatric Education Centers $43,333
93.847 Diabetes, Digestive, and Kidney Diseases Extramural Research $32,896
93.354 Public Health Emergency Response: Cooperative Agreement for Emergency Response: Public Health Crisis Response $32,500
93.270 Adult Viral Hepatitis Prevention and Control $16,026
93.838 Lung Diseases Research $10,100
93.941 Hiv Demonstration, Research, Public and Professional Education Projects $5,726
93.837 Cardiovascular Diseases Research $200