Finding 1124393 (2024-007)

Material Weakness
Requirement
G
Questioned Costs
-
Year
2024
Accepted
2025-03-31
Audit: 351885
Auditor: Kmh LLP

AI Summary

  • Core Issue: The state did not meet the requirement to spend at least 10% of grant funds on evidence-based programs for early serious mental illness, falling short by $629,057.
  • Impacted Requirements: Noncompliance with 42 USC 300x-9c and 42 USC 300x regarding earmarking funds for mental health programs.
  • Recommended Follow-Up: Program management should enhance monitoring of earmarking requirements to ensure compliance moving forward.

Finding Text

Criteria: 42 USC 300x-9c states that “a state shall expend not less than 10 percent of grant funds for carrying out evidence-based programs that address the needs of individuals with early serious mental illness, including psychotic disorders, regardless of the age of the individual at onset.” 42 USC 300x states that “a state shall expend at least 5 percent of grant funds to support evidence-based programs that address the crisis care needs of individuals with serious mental illnesses (SMI) and children with serious emotional disturbances (SED), which may include individuals experiencing mental health crises demonstrating serious mental illness or serious emotional disturbance, as applicable. Condition: We noted that the earmarking requirement was not met. Context: The State shall expend not less than 10 percent of grant funds for carrying out evidence-based programs that address the needs of individuals with early serious mental illness, including psychotic disorders, regardless of the age of the individual at onset. Evidence-based programs are interventions that are guided by the best research evidence with practice-based expertise, cultural competence, and the values of the persons receiving the services that promote individual-level or population-level outcomes. Instead of expending 10 percent of the amount received for a fiscal year, a state may elect to expend not less than 20 percent of such amount by the end of the succeeding fiscal year. During the audit, we noted that the program expended $145,953 of grant funds for carrying out evidence-based programs, which was $629,057 less than the required amount. Cause: Based on further inquiry with Department personnel, we noted that the failure to meet earmarking requirements is due to the lack of adequate personnel. Effect: Failure to meet the required earmarking results in noncompliance with the Earmarking requirement. Questioned Costs: None Identification as a Repeat Finding, if applicable: Not applicable Recommendation: We recommend program management be more diligent in monitoring earmarking requirements. Views of Responsible Officials: Client agrees with finding, and the unabridged version of their response can be found in the Corrective Action Plan issued by the Department.

Categories

Matching / Level of Effort / Earmarking Subrecipient Monitoring

Other Findings in this Audit

  • 547945 2024-004
    Material Weakness Repeat
  • 547946 2024-005
    Material Weakness Repeat
  • 547947 2024-006
    Material Weakness Repeat
  • 547948 2024-007
    Material Weakness
  • 547949 2024-008
    Material Weakness
  • 547950 2024-009
    Material Weakness Repeat
  • 547951 2024-007
    Material Weakness
  • 547952 2024-008
    Material Weakness
  • 547953 2024-009
    Material Weakness Repeat
  • 1124387 2024-004
    Material Weakness Repeat
  • 1124388 2024-005
    Material Weakness Repeat
  • 1124389 2024-006
    Material Weakness Repeat
  • 1124390 2024-007
    Material Weakness
  • 1124391 2024-008
    Material Weakness
  • 1124392 2024-009
    Material Weakness Repeat
  • 1124394 2024-008
    Material Weakness
  • 1124395 2024-009
    Material Weakness Repeat

Programs in Audit

ALN Program Name Expenditures
10.557 Wic Special Supplemental Nutrition Program for Women, Infants, and Children $31.52M
21.027 Coronavirus State and Local Fiscal Recovery Funds $22.74M
66.458 Clean Water State Revolving Fund $22.45M
66.468 Drinking Water State Revolving Fund $17.34M
93.391 Activities to Support State, Tribal, Local and Territorial (stlt) Health Department Response to Public Health Or Healthcare Crises $8.55M
93.959 Block Grants for Prevention and Treatment of Substance Abuse $7.63M
93.788 Opioid Str $5.44M
93.069 Public Health Emergency Preparedness $5.29M
93.958 Block Grants for Community Mental Health Services $3.84M
93.777 State Survey and Certification of Health Care Providers and Suppliers (title Xviii) Medicare $3.52M
93.045 Special Programs for the Aging, Title Iii, Part C, Nutrition Services $3.38M
93.870 Maternal, Infant and Early Childhood Home Visiting Grant $3.32M
93.104 Comprehensive Community Mental Health Services for Children with Serious Emotional Disturbances (sed) $2.96M
93.323 Epidemiology and Laboratory Capacity for Infectious Diseases (elc) $2.76M
93.994 Maternal and Child Health Services Block Grant to the States $2.41M
93.136 Injury Prevention and Control Research and State and Community Based Programs $2.34M
93.243 Substance Abuse and Mental Health Services Projects of Regional and National Significance $2.30M
93.268 Immunization Cooperative Agreements $2.21M
93.917 Hiv Care Formula Grants $2.15M
66.419 Water Pollution Control State, Interstate, and Tribal Program Support $2.15M
93.044 Special Programs for the Aging, Title Iii, Part B, Grants for Supportive Services and Senior Centers $1.86M
93.495 Community Health Workers for Public Health Response and Resilient $1.63M
93.696 Certified Community Behavioral Health Clinic Expansion Grants $1.42M
66.460 Nonpoint Source Implementation Grants $1.32M
66.040 Diesel Emissions Reduction Act (dera) State Grants $1.15M
93.387 National and State Tobacco Control Program $1.12M
93.116 Project Grants and Cooperative Agreements for Tuberculosis Control Programs $1.10M
93.889 National Bioterrorism Hospital Preparedness Program $1.09M
66.817 State and Tribal Response Program Grants $1.06M
93.940 Hiv Prevention Activities Health Department Based $1.03M
66.001 Air Pollution Control Program Support $1.01M
93.426 The National Cardiovascular Health Program $976,207
93.991 Preventive Health and Health Services Block Grant $888,441
93.898 Cancer Prevention and Control Programs for State, Territorial and Tribal Organizations $885,555
93.215 Hansen's Disease National Ambulatory Care Program $864,346
93.110 Maternal and Child Health Federal Consolidated Programs $843,647
93.052 National Family Caregiver Support, Title Iii, Part E $824,417
93.630 Developmental Disabilities Basic Support and Advocacy Grants $693,740
93.977 Sexually Transmitted Diseases (std) Prevention and Control Grants $676,171
93.053 Nutrition Services Incentive Program $674,011
93.241 State Rural Hospital Flexibility Program $636,165
93.336 Behavioral Risk Factor Surveillance System $613,726
93.778 Medical Assistance Program $606,125
93.590 Community-Based Child Abuse Prevention Grants $558,596
84.181 Special Education-Grants for Infants and Families $545,273
66.432 State Public Water System Supervision $535,561
93.048 Special Programs for the Aging, Title Iv, and Title Ii, Discretionary Projects $521,305
93.967 Centers for Disease Control and Prevention Collaboration with Academia to Strengthen Public Health $493,096
66.805 Leaking Underground Storage Tank Trust Fund Corrective Action Program $489,236
66.801 Hazardous Waste Management State Program Support $481,724
12.113 State Memorandum of Agreement Program for the Reimbursement of Technical Services $469,169
93.197 Childhood Lead Poisoning Prevention Projects, State and Local Childhood Lead Poisoning Prevention and Surveillance of Blood Lead Levels in Children $409,251
93.000 Prospective Comparison of Tst Vs. Igras $402,821
93.810 Paul Coverdell National Acute Stroke Program National Center for Chronic Disease Prevention and Health Promotion $396,784
93.000 US Fda Tobacco Retail Inspection Contract/hawaii State Enforcement $394,764
93.324 State Health Insurance Assistance Program $394,484
93.000 Vscp Data & Vscp Special Projects $360,016
93.103 Food and Drug Administration Research $349,144
66.608 Environmental Information Exchange Network Grant Program and Related Assistance $340,000
97.032 Crisis Counseling $296,155
66.472 Beach Monitoring and Notification Program Implementation Grants $293,582
66.802 Superfund State, Political Subdivision, and Indian Tribe Site-Specific Cooperative Agreements $278,715
93.982 Mental Health Disaster Assistance and Emergency Mental Health $262,030
93.988 Cooperative Agreements for Diabetes Control Programs $243,617
93.913 Grants to States for Operation of State Offices of Rural Health $231,145
66.804 Underground Storage Tank (ust) Prevention, Detection, and Compliance Program $211,024
93.130 Cooperative Agreements to States/territories for the Coordination and Development of Primary Care Offices $188,078
93.270 Viral Hepatitis Prevention and Control $178,764
93.155 Rural Health Research Centers $178,482
93.127 Emergency Medical Services for Children $177,398
93.946 Cooperative Agreements to Support State-Based Safe Motherhood and Infant Health Initiative Programs $175,804
93.334 The Healthy Brain Initiative: Technical Assistance to Implement Public Health Actions Related to Cognitive Health, Cognitive Impairment, and Caregiving at the State and Local Levels $174,630
66.605 Performance Partnership Grants $167,350
66.454 Water Quality Management Planning $166,194
66.443 Reducing Lead in Drinking Water (sdwa 1459b) $161,486
93.071 Medicare Enrollment Assistance Program $160,449
93.314 Early Hearing Detection and Intervention Information System (ehdi-Is) Surveillance Program $154,947
10.025 Plant and Animal Disease, Pest Control, and Animal Care $139,969
10.578 Wic Grants to States (wgs) $137,551
93.251 Early Hearing Detection and Intervention $120,476
93.092 Affordable Care Act (aca) Personal Responsibility Education Program $113,856
93.301 Small Rural Hospital Improvement Grant Program $112,295
93.042 Special Programs for the Aging, Title Vii, Chapter 2, Long Term Care Ombudsman Services for Older Individuals $107,304
93.665 Emergency Grants to Address Mental and Substance Use Disorders During Covid-19 $98,585
93.150 Projects for Assistance in Transition From Homelessness (path) $94,688
93.000 Hawaii State Mental Health Data Infrastructure Contract for Quality Improvement $91,649
93.354 Public Health Emergency Response: Cooperative Agreement for Emergency Response: Public Health Crisis Response $60,534
93.043 Special Programs for the Aging, Title Iii, Part D, Disease Prevention and Health Promotion Services $55,504
93.436 Well-Integrated Screening and Evaluation for Women Across the Nation (wisewoman) $53,393
93.000 Drug and Alcohol Services Information System $51,449
99.103 Hawaii's Fern Microbiology Laboratory's Role in Keeping Human Food Products Safe $43,691
93.041 Special Programs for the Aging, Title Vii, Chapter 3, Programs for Prevention of Elder Abuse, Neglect, and Exploitation $41,345
93.000 Transformation Transfer Initiative $28,600
66.034 Surveys, Studies, Research, Investigations, Demonstrations, and Special Purpose Activities Relating to the Clean Air Act $17,309
93.747 Elder Abuse Prevention Interventions Program $12,390
66.204 Multipurpose Grants to States and Tribes $10,000
16.812 Second Chance Act Reentry Initiative $7,698
93.304 Racial and Ethnic Approaches to Community Health $7,598
93.421 Strengthening Public Health Systems and Services Through National Partnerships to Improve and Protect the Nation’s Health $3,421
66.701 Toxic Substances Compliance Monitoring Cooperative Agreements $373