Finding 1206310 (2022-006)

Material Weakness Repeat Finding
Requirement
C
Questioned Costs
-
Year
2022
Accepted
2026-04-10
Audit: 398372
Organization: Island Health, Inc. (MA)
Auditor: COHNREZNICK

AI Summary

  • Core Issue: The Center lacks proper management review and approval for cash drawdowns, risking inaccuracies.
  • Impacted Requirements: This finding violates federal guidelines on fund management as outlined in §200.305 and 2 CFR 200.302 and 200.303.
  • Recommended Follow-Up: Establish written procedures for reviewing and approving all drawdowns to ensure compliance and accuracy.

Finding Text

Finding 2022.006: Cash Management - Material Weakness Name of Federal Agency: U.S. Department of Health and Human Services Federal Program Names: Health Center Program Cluster: Health Center Program (Community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care) COVID-19 Health Center Program (Community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care) Grants for New and Expanded Services under the Health Center Program Federal Assistance Listing Numbers: 93.224 and 93.527 Federal Award Identification Number and Year: H80CS26638 - 2022 and 2023, H8DCS35487 - 2021, and H8F40829 - 2023 Criteria In accordance with §200.305, Federal Payment, grantees and subgrantees that receive grant funds are responsible for maintaining controls regarding the management of federal program funds under the Uniform Guidance in 2 CFR 200.302 and 200.303. Condition The Center's drawdowns did not illustrate review and approval by management. Cause The Center did not have adequate controls to ensure drawdowns were properly approved and such approval is documented. Effect or Potential Effect The condition may lead to inaccurate or improper drawdowns. Questioned Costs None. Context We selected 9 drawdowns for testing of cash management. We noted there was no formal approval or evidence of review for all 9 drawdowns. Identification of Repeat Finding Yes, see finding 2021-006. Recommendation The Center should develop written procedures to review all drawdowns that occur in order to ensure accuracy. Views of Responsible Officials Management and the Board of Directors agree with the finding and will implement additional controls to ensure there is formal evidence of review being performed.

Corrective Action Plan

Item 2022.006 - Cash Manaaement Recommendation The Center should develop written procedures to review all drawdowns that occur in order to ensure accuracy. Repeat Finding Yes Action Taken Island Health Care will take the following actions to address this recommendation: • Prepare written procedures to document the process for Drawdown requests, including the initial review, documented approval process, submission to the funding agency, and the recording of the drawdown in the accounting system immediately after submission • Maintain detailed records of all drawdown requests, supporting documentation, approvals, and correspondence • Conduct regular internal reviews of drawdown activities to ensure compliance with procedures and maintain audit trail • Review drawdown procedures annually to ensure they remain current with funding agency guidelines and best practices

Categories

Cash Management HUD Housing Programs Material Weakness

Other Findings in this Audit

  • 1206298 2022-007
    Material Weakness Repeat
  • 1206299 2022-006
    Material Weakness Repeat
  • 1206300 2022-005
    Material Weakness Repeat
  • 1206301 2022-004
    Material Weakness Repeat
  • 1206302 2022-003
    Material Weakness Repeat
  • 1206303 2022-006
    Material Weakness Repeat
  • 1206304 2022-007
    Material Weakness Repeat
  • 1206305 2022-005
    Material Weakness Repeat
  • 1206306 2022-004
    Material Weakness Repeat
  • 1206307 2022-003
    Material Weakness Repeat
  • 1206308 2022-003
    Material Weakness Repeat
  • 1206309 2022-007
    Material Weakness Repeat
  • 1206311 2022-004
    Material Weakness Repeat
  • 1206312 2022-005
    Material Weakness Repeat

Programs in Audit

ALN Program Name Expenditures
93.527 GRANTS FOR NEW AND EXPANDED SERVICES UNDER THE HEALTH CENTER PROGRAM $1.50M
93.224 HEALTH CENTER PROGRAM (COMMUNITY HEALTH CENTERS, MIGRANT HEALTH CENTERS, HEALTH CARE FOR THE HOMELESS, AND PUBLIC HOUSING PRIMARY CARE) $913,971
93.268 IMMUNIZATION COOPERATIVE AGREEMENTS $50,000
93.526 GRANTS FOR CAPITAL DEVELOPMENT IN HEALTH CENTERS $2,000