Finding 1220572 (2025-001)

Material Weakness Repeat Finding
Requirement
I
Questioned Costs
-
Year
2025
Accepted
2026-06-29
Audit: 405426
Auditor: KPMG LLP

AI Summary

  • Core Issue: Brown Health failed to consistently retain documentation for 9 out of 21 procurement transactions, which is required to demonstrate compliance with procurement policies.
  • Impacted Requirements: Compliance with 2 CFR 200.320 was not met, specifically regarding the need for multiple price quotations or sole source justifications for transactions between the micro-purchase and simplified acquisition thresholds.
  • Recommended Follow-Up: Strengthen internal controls over procurement processes, revise review procedures to ensure documentation retention, and conduct a comprehensive review of past transactions to ensure compliance.

Finding Text

Finding 2025-001 Program Name: Research and Development Cluster Federal Department/Agency: Various Assistance Listing Number: Various assistance listing numbers Federal Award Year: October 1, 2024 – September 30, 2025 Compliance Requirements: Procurement Criteria Per 2 CFR 200.320, an organization is required to follow simplified acquisition procedures if the aggregate dollar amount of a procurement transaction is higher than the micro-purchase threshold but does not exceed the simplified acquisition threshold. If simplified acquisition procedures are used, price or rate quotations must be obtained from an adequate number of qualified sources. Unless specified by the Federal agency, the recipient or subrecipient may exercise judgment in determining what number is adequate. Condition 40 procurement transactions were selected from all procurement transactions and Brown Health’s records were inspected for compliance with Brown Health’s procurement policy, which satisfied the requirements set forth within 2 CFR 200.320. Of the 40 transactions selected, 21 were transactions between the micro-purchase threshold and the simplified acquisition threshold. For 9 of the 21 procurement transactions selected, evidence could not be located to support that the procurement policy was followed. Specifically, evidence could not be located to support that Brown Health had obtained multiple price or rate quotations for each transaction or had documented its rationale for a sole sourced purchase. Cause As a result of turnover during the fiscal year, internal controls were not operating effectively regarding the retention of procurement documentation evidencing that the procurement policy was followed. Specifically, evidence of the gathering of multiple quotations or sole source justification was not routinely retained. Possible Asserted Effect Absent procurement controls operating effectively, Brown Health could initiate procurement transactions above the micro-purchase threshold without following the requisite protocols, which could result in noncompliance with Federal regulations. Questioned costs None. Statistical Sample The sample was not intended to be, and was not, a statistically valid sample. Repeat Finding This is not a repeat finding. Recommendation We recommend that Brown Health management strengthen its internal controls over the procurement process to ensure compliance with Federal regulations. Specifically, Brown Health should revise its procurement review procedures to require the retention of evidence of obtaining multiple price quotations or sole source justification. View of Responsible Officials Brown Health management concurs with this finding. Based on the review, the underlying procurement procedures were generally performed in accordance with established policy; however, supporting documentation was not consistently retained to evidence compliance. We have already initiated re-training at the department level and will be performing a detailed review of current purchase history to ensure appropriate documentation is retained. For fiscal year 2026, we will be reviewing all federal grant activity to ensure the appropriate documentation is maintained and/or sole source documentation is prepared including a lookback analysis of expenditures to date that did not retain the proper documentation. Additionally, we will review automated control enhancements within our ERP system where possible to assist in recognizing compliance rules in advance of spend. We will report our results to the granting agency by October 31, 2026.

Corrective Action Plan

Corrective Action Plan Year Ended September 30, 2025 Finding 2024-001 AL Numbers: Various assistance listing numbers Program: Research and Development Cluster Correction Action: Brown Health management concurs with this finding. Based on the review, the underlying procurement procedures were generally performed in accordance with established policy; however, supporting documentation was not consistently retained to evidence compliance. We have already initiated re-training at the department level and will be performing a detailed review of current purchase history to ensure appropriate documentation is retained. For fiscal year 2026, we will be reviewing all federal grant activity to ensure the appropriate documentation is maintained and/or sole source documentation is prepared including a lookback analysis of expenditures to date that did not retain the proper documentation. Additionally, we will review automated control enhancements within our ERP system where possible to assist in recognizing compliance rules in advance of spend. Contacts: Stephen Almonte, Vice President and Corporate Controller Salmonte3@brownhealth.org Bharat Ramratnam, MD, Senior Vice President of Research BRamratnam@brownhealth.org Planned Completion Date: October 31, 2026

Categories

Procurement, Suspension & Debarment

Other Findings in this Audit

  • 1220322 2025-001
    Material Weakness Repeat
  • 1220323 2025-001
    Material Weakness Repeat
  • 1220324 2025-001
    Material Weakness Repeat
  • 1220325 2025-001
    Material Weakness Repeat
  • 1220326 2025-001
    Material Weakness Repeat
  • 1220327 2025-001
    Material Weakness Repeat
  • 1220328 2025-001
    Material Weakness Repeat
  • 1220329 2025-001
    Material Weakness Repeat
  • 1220330 2025-001
    Material Weakness Repeat
  • 1220331 2025-001
    Material Weakness Repeat
  • 1220332 2025-001
    Material Weakness Repeat
  • 1220333 2025-001
    Material Weakness Repeat
  • 1220334 2025-001
    Material Weakness Repeat
  • 1220335 2025-001
    Material Weakness Repeat
  • 1220336 2025-001
    Material Weakness Repeat
  • 1220337 2025-001
    Material Weakness Repeat
  • 1220338 2025-001
    Material Weakness Repeat
  • 1220339 2025-001
    Material Weakness Repeat
  • 1220340 2025-001
    Material Weakness Repeat
  • 1220341 2025-001
    Material Weakness Repeat
  • 1220342 2025-001
    Material Weakness Repeat
  • 1220343 2025-001
    Material Weakness Repeat
  • 1220344 2025-001
    Material Weakness Repeat
  • 1220345 2025-001
    Material Weakness Repeat
  • 1220346 2025-001
    Material Weakness Repeat
  • 1220347 2025-001
    Material Weakness Repeat
  • 1220348 2025-001
    Material Weakness Repeat
  • 1220349 2025-001
    Material Weakness Repeat
  • 1220350 2025-001
    Material Weakness Repeat
  • 1220351 2025-001
    Material Weakness Repeat
  • 1220352 2025-001
    Material Weakness Repeat
  • 1220353 2025-001
    Material Weakness Repeat
  • 1220354 2025-001
    Material Weakness Repeat
  • 1220355 2025-001
    Material Weakness Repeat
  • 1220356 2025-001
    Material Weakness Repeat
  • 1220357 2025-001
    Material Weakness Repeat
  • 1220358 2025-001
    Material Weakness Repeat
  • 1220359 2025-001
    Material Weakness Repeat
  • 1220360 2025-001
    Material Weakness Repeat
  • 1220361 2025-001
    Material Weakness Repeat
  • 1220362 2025-001
    Material Weakness Repeat
  • 1220363 2025-001
    Material Weakness Repeat
  • 1220364 2025-001
    Material Weakness Repeat
  • 1220365 2025-001
    Material Weakness Repeat
  • 1220366 2025-001
    Material Weakness Repeat
  • 1220367 2025-001
    Material Weakness Repeat
  • 1220368 2025-001
    Material Weakness Repeat
  • 1220369 2025-001
    Material Weakness Repeat
  • 1220370 2025-001
    Material Weakness Repeat
  • 1220371 2025-001
    Material Weakness Repeat
  • 1220372 2025-001
    Material Weakness Repeat
  • 1220373 2025-001
    Material Weakness Repeat
  • 1220374 2025-001
    Material Weakness Repeat
  • 1220375 2025-001
    Material Weakness Repeat
  • 1220376 2025-001
    Material Weakness Repeat
  • 1220377 2025-001
    Material Weakness Repeat
  • 1220378 2025-001
    Material Weakness Repeat
  • 1220379 2025-001
    Material Weakness Repeat
  • 1220380 2025-001
    Material Weakness Repeat
  • 1220381 2025-001
    Material Weakness Repeat
  • 1220382 2025-001
    Material Weakness Repeat
  • 1220383 2025-001
    Material Weakness Repeat
  • 1220384 2025-001
    Material Weakness Repeat
  • 1220385 2025-001
    Material Weakness Repeat
  • 1220386 2025-001
    Material Weakness Repeat
  • 1220387 2025-001
    Material Weakness Repeat
  • 1220388 2025-001
    Material Weakness Repeat
  • 1220389 2025-001
    Material Weakness Repeat
  • 1220390 2025-001
    Material Weakness Repeat
  • 1220391 2025-001
    Material Weakness Repeat
  • 1220392 2025-001
    Material Weakness Repeat
  • 1220393 2025-001
    Material Weakness Repeat
  • 1220394 2025-001
    Material Weakness Repeat
  • 1220395 2025-001
    Material Weakness Repeat
  • 1220396 2025-001
    Material Weakness Repeat
  • 1220397 2025-001
    Material Weakness Repeat
  • 1220398 2025-001
    Material Weakness Repeat
  • 1220399 2025-001
    Material Weakness Repeat
  • 1220400 2025-001
    Material Weakness Repeat
  • 1220401 2025-001
    Material Weakness Repeat
  • 1220402 2025-001
    Material Weakness Repeat
  • 1220403 2025-001
    Material Weakness Repeat
  • 1220404 2025-001
    Material Weakness Repeat
  • 1220405 2025-001
    Material Weakness Repeat
  • 1220406 2025-001
    Material Weakness Repeat
  • 1220407 2025-001
    Material Weakness Repeat
  • 1220408 2025-001
    Material Weakness Repeat
  • 1220409 2025-001
    Material Weakness Repeat
  • 1220410 2025-001
    Material Weakness Repeat
  • 1220411 2025-001
    Material Weakness Repeat
  • 1220412 2025-001
    Material Weakness Repeat
  • 1220413 2025-001
    Material Weakness Repeat
  • 1220414 2025-001
    Material Weakness Repeat
  • 1220415 2025-001
    Material Weakness Repeat
  • 1220416 2025-001
    Material Weakness Repeat
  • 1220417 2025-001
    Material Weakness Repeat
  • 1220418 2025-001
    Material Weakness Repeat
  • 1220419 2025-001
    Material Weakness Repeat
  • 1220420 2025-001
    Material Weakness Repeat
  • 1220421 2025-001
    Material Weakness Repeat
  • 1220422 2025-001
    Material Weakness Repeat
  • 1220423 2025-001
    Material Weakness Repeat
  • 1220424 2025-001
    Material Weakness Repeat
  • 1220425 2025-001
    Material Weakness Repeat
  • 1220426 2025-001
    Material Weakness Repeat
  • 1220427 2025-001
    Material Weakness Repeat
  • 1220428 2025-001
    Material Weakness Repeat
  • 1220429 2025-001
    Material Weakness Repeat
  • 1220430 2025-001
    Material Weakness Repeat
  • 1220431 2025-001
    Material Weakness Repeat
  • 1220432 2025-001
    Material Weakness Repeat
  • 1220433 2025-001
    Material Weakness Repeat
  • 1220434 2025-001
    Material Weakness Repeat
  • 1220435 2025-001
    Material Weakness Repeat
  • 1220436 2025-001
    Material Weakness Repeat
  • 1220437 2025-001
    Material Weakness Repeat
  • 1220438 2025-001
    Material Weakness Repeat
  • 1220439 2025-001
    Material Weakness Repeat
  • 1220440 2025-001
    Material Weakness Repeat
  • 1220441 2025-001
    Material Weakness Repeat
  • 1220442 2025-001
    Material Weakness Repeat
  • 1220443 2025-001
    Material Weakness Repeat
  • 1220444 2025-001
    Material Weakness Repeat
  • 1220445 2025-001
    Material Weakness Repeat
  • 1220446 2025-001
    Material Weakness Repeat
  • 1220447 2025-001
    Material Weakness Repeat
  • 1220448 2025-001
    Material Weakness Repeat
  • 1220449 2025-001
    Material Weakness Repeat
  • 1220450 2025-001
    Material Weakness Repeat
  • 1220451 2025-001
    Material Weakness Repeat
  • 1220452 2025-001
    Material Weakness Repeat
  • 1220453 2025-001
    Material Weakness Repeat
  • 1220454 2025-001
    Material Weakness Repeat
  • 1220455 2025-001
    Material Weakness Repeat
  • 1220456 2025-001
    Material Weakness Repeat
  • 1220457 2025-001
    Material Weakness Repeat
  • 1220458 2025-001
    Material Weakness Repeat
  • 1220459 2025-001
    Material Weakness Repeat
  • 1220460 2025-001
    Material Weakness Repeat
  • 1220461 2025-001
    Material Weakness Repeat
  • 1220462 2025-001
    Material Weakness Repeat
  • 1220463 2025-001
    Material Weakness Repeat
  • 1220464 2025-001
    Material Weakness Repeat
  • 1220465 2025-001
    Material Weakness Repeat
  • 1220466 2025-001
    Material Weakness Repeat
  • 1220467 2025-001
    Material Weakness Repeat
  • 1220468 2025-001
    Material Weakness Repeat
  • 1220469 2025-001
    Material Weakness Repeat
  • 1220470 2025-001
    Material Weakness Repeat
  • 1220471 2025-001
    Material Weakness Repeat
  • 1220472 2025-001
    Material Weakness Repeat
  • 1220473 2025-001
    Material Weakness Repeat
  • 1220474 2025-001
    Material Weakness Repeat
  • 1220475 2025-001
    Material Weakness Repeat
  • 1220476 2025-001
    Material Weakness Repeat
  • 1220477 2025-001
    Material Weakness Repeat
  • 1220478 2025-001
    Material Weakness Repeat
  • 1220479 2025-001
    Material Weakness Repeat
  • 1220480 2025-001
    Material Weakness Repeat
  • 1220481 2025-001
    Material Weakness Repeat
  • 1220482 2025-001
    Material Weakness Repeat
  • 1220483 2025-001
    Material Weakness Repeat
  • 1220484 2025-001
    Material Weakness Repeat
  • 1220485 2025-001
    Material Weakness Repeat
  • 1220486 2025-001
    Material Weakness Repeat
  • 1220487 2025-001
    Material Weakness Repeat
  • 1220488 2025-001
    Material Weakness Repeat
  • 1220489 2025-001
    Material Weakness Repeat
  • 1220490 2025-001
    Material Weakness Repeat
  • 1220491 2025-001
    Material Weakness Repeat
  • 1220492 2025-001
    Material Weakness Repeat
  • 1220493 2025-001
    Material Weakness Repeat
  • 1220494 2025-001
    Material Weakness Repeat
  • 1220495 2025-001
    Material Weakness Repeat
  • 1220496 2025-001
    Material Weakness Repeat
  • 1220497 2025-001
    Material Weakness Repeat
  • 1220498 2025-001
    Material Weakness Repeat
  • 1220499 2025-001
    Material Weakness Repeat
  • 1220500 2025-001
    Material Weakness Repeat
  • 1220501 2025-001
    Material Weakness Repeat
  • 1220502 2025-001
    Material Weakness Repeat
  • 1220503 2025-001
    Material Weakness Repeat
  • 1220504 2025-001
    Material Weakness Repeat
  • 1220505 2025-001
    Material Weakness Repeat
  • 1220506 2025-001
    Material Weakness Repeat
  • 1220507 2025-001
    Material Weakness Repeat
  • 1220508 2025-001
    Material Weakness Repeat
  • 1220509 2025-001
    Material Weakness Repeat
  • 1220510 2025-001
    Material Weakness Repeat
  • 1220511 2025-001
    Material Weakness Repeat
  • 1220512 2025-001
    Material Weakness Repeat
  • 1220513 2025-001
    Material Weakness Repeat
  • 1220514 2025-001
    Material Weakness Repeat
  • 1220515 2025-001
    Material Weakness Repeat
  • 1220516 2025-001
    Material Weakness Repeat
  • 1220517 2025-001
    Material Weakness Repeat
  • 1220518 2025-001
    Material Weakness Repeat
  • 1220519 2025-001
    Material Weakness Repeat
  • 1220520 2025-001
    Material Weakness Repeat
  • 1220521 2025-001
    Material Weakness Repeat
  • 1220522 2025-001
    Material Weakness Repeat
  • 1220523 2025-001
    Material Weakness Repeat
  • 1220524 2025-001
    Material Weakness Repeat
  • 1220525 2025-001
    Material Weakness Repeat
  • 1220526 2025-001
    Material Weakness Repeat
  • 1220527 2025-001
    Material Weakness Repeat
  • 1220528 2025-001
    Material Weakness Repeat
  • 1220529 2025-001
    Material Weakness Repeat
  • 1220530 2025-001
    Material Weakness Repeat
  • 1220531 2025-001
    Material Weakness Repeat
  • 1220532 2025-001
    Material Weakness Repeat
  • 1220533 2025-001
    Material Weakness Repeat
  • 1220534 2025-001
    Material Weakness Repeat
  • 1220535 2025-001
    Material Weakness Repeat
  • 1220536 2025-001
    Material Weakness Repeat
  • 1220537 2025-001
    Material Weakness Repeat
  • 1220538 2025-001
    Material Weakness Repeat
  • 1220539 2025-001
    Material Weakness Repeat
  • 1220540 2025-001
    Material Weakness Repeat
  • 1220541 2025-001
    Material Weakness Repeat
  • 1220542 2025-001
    Material Weakness Repeat
  • 1220543 2025-001
    Material Weakness Repeat
  • 1220544 2025-001
    Material Weakness Repeat
  • 1220545 2025-001
    Material Weakness Repeat
  • 1220546 2025-001
    Material Weakness Repeat
  • 1220547 2025-001
    Material Weakness Repeat
  • 1220548 2025-001
    Material Weakness Repeat
  • 1220549 2025-001
    Material Weakness Repeat
  • 1220550 2025-001
    Material Weakness Repeat
  • 1220551 2025-001
    Material Weakness Repeat
  • 1220552 2025-001
    Material Weakness Repeat
  • 1220553 2025-001
    Material Weakness Repeat
  • 1220554 2025-001
    Material Weakness Repeat
  • 1220555 2025-001
    Material Weakness Repeat
  • 1220556 2025-001
    Material Weakness Repeat
  • 1220557 2025-001
    Material Weakness Repeat
  • 1220558 2025-001
    Material Weakness Repeat
  • 1220559 2025-001
    Material Weakness Repeat
  • 1220560 2025-001
    Material Weakness Repeat
  • 1220561 2025-001
    Material Weakness Repeat
  • 1220562 2025-001
    Material Weakness Repeat
  • 1220563 2025-001
    Material Weakness Repeat
  • 1220564 2025-001
    Material Weakness Repeat
  • 1220565 2025-001
    Material Weakness Repeat
  • 1220566 2025-001
    Material Weakness Repeat
  • 1220567 2025-001
    Material Weakness Repeat
  • 1220568 2025-001
    Material Weakness Repeat
  • 1220569 2025-001
    Material Weakness Repeat
  • 1220570 2025-001
    Material Weakness Repeat
  • 1220571 2025-001
    Material Weakness Repeat
  • 1220573 2025-002
    Material Weakness Repeat
  • 1220574 2025-002
    Material Weakness Repeat
  • 1220575 2025-002
    Material Weakness Repeat
  • 1220576 2025-002
    Material Weakness Repeat
  • 1220577 2025-002
    Material Weakness Repeat
  • 1220578 2025-002
    Material Weakness Repeat
  • 1220579 2025-002
    Material Weakness Repeat
  • 1220580 2025-002
    Material Weakness Repeat
  • 1220581 2025-002
    Material Weakness Repeat
  • 1220582 2025-002
    Material Weakness Repeat
  • 1220583 2025-002
    Material Weakness Repeat
  • 1220584 2025-002
    Material Weakness Repeat
  • 1220585 2025-002
    Material Weakness Repeat
  • 1220586 2025-002
    Material Weakness Repeat

Programs in Audit

ALN Program Name Expenditures
97.036 DISASTER GRANTS - PUBLIC ASSISTANCE (PRESIDENTIALLY DECLARED DISASTERS) $7.98M
93.233 NATIONAL CENTER ON SLEEP DISORDERS RESEARCH $1.21M
84.419 PRESCHOOL DEVELOPMENT GRANTS $1.04M
93.696 CERTIFIED COMMUNITY BEHAVIORAL HEALTH CLINIC EXPANSION GRANTS $916,891
93.918 GRANTS TO PROVIDE OUTPATIENT EARLY INTERVENTION SERVICES WITH RESPECT TO HIV DISEASE $874,363
93.247 ADVANCED NURSING EDUCATION WORKFORCE GRANT PROGRAM $461,230
21.027 CORONAVIRUS STATE AND LOCAL FISCAL RECOVERY FUNDS $361,032
93.350 NATIONAL CENTER FOR ADVANCING TRANSLATIONAL SCIENCES $347,720
93.U01 National Institute of Health Other $341,683
16.560 NATIONAL INSTITUTE OF JUSTICE RESEARCH, EVALUATION, AND DEVELOPMENT PROJECT GRANTS $312,831
93.870 MATERNAL, INFANT AND EARLY CHILDHOOD HOME VISITING GRANT $288,537
93.855 ALLERGY AND INFECTIOUS DISEASES RESEARCH $273,577
93.243 SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES PROJECTS OF REGIONAL AND NATIONAL SIGNIFICANCE $197,906
93.U03 National Institute of Health Other $174,452
20.616 NATIONAL PRIORITY SAFETY PROGRAMS $172,037
93.116 PROJECT GRANTS AND COOPERATIVE AGREEMENTS FOR TUBERCULOSIS CONTROL PROGRAMS $153,029
97.008 NON-PROFIT SECURITY PROGRAM $150,000
17.258 WIOA ADULT PROGRAM $122,423
93.145 HIV-RELATED TRAINING AND TECHNICAL ASSISTANCE $121,653
93.853 EXTRAMURAL RESEARCH PROGRAMS IN THE NEUROSCIENCES AND NEUROLOGICAL DISORDERS $117,731
93.083 PREVENTION OF DISEASE, DISABILITY, AND DEATH THROUGH IMMUNIZATION AND CONTROL OF RESPIRATORY AND RELATED DISEASES $117,129
93.110 SPECIAL PROJECTS OF REGIONAL AND NATIONAL SIGNIFICANCE $103,989
93.865 CHILD HEALTH AND HUMAN DEVELOPMENT EXTRAMURAL RESEARCH $102,056
93.839 BLOOD DISEASES AND RESOURCES RESEARCH $98,142
93.495 COMMUNITY HEALTH WORKERS FOR PUBLIC HEALTH RESPONSE AND RESILIENT $87,573
93.365 SICKLE CELL TREATMENT DEMONSTRATION PROGRAM $84,598
12.750 UNIFORMED SERVICES UNIVERSITY MEDICAL RESEARCH PROJECTS $74,559
93.846 ARTHRITIS, MUSCULOSKELETAL AND SKIN DISEASES RESEARCH $69,502
10.555 NATIONAL SCHOOL LUNCH PROGRAM $68,793
93.U02 National Institute of Health Other $66,471
93.121 ORAL DISEASES AND DISORDERS RESEARCH $64,327
14.218 COMMUNITY DEVELOPMENT BLOCK GRANTS/ENTITLEMENT GRANTS $61,507
94.013 AMERICORPS VOLUNTEERS IN SERVICE TO AMERICA 94.013 $60,711
93.994 MATERNAL AND CHILD HEALTH SERVICES BLOCK GRANT TO THE STATES $59,291
93.788 OPIOID STR $58,713
93.310 TRANS-NIH RESEARCH SUPPORT $56,930
93.394 CANCER DETECTION AND DIAGNOSIS RESEARCH $51,693
16.015 MISSING ALZHEIMER'S DISEASE PATIENT ASSISTANCE PROGRAM $50,780
93.307 MINORITY HEALTH AND HEALTH DISPARITIES RESEARCH $50,275
16.575 CRIME VICTIM ASSISTANCE $50,250
93.226 RESEARCH ON HEALTHCARE COSTS, QUALITY AND OUTCOMES $48,273
43.083 Office of Integrative Activities $46,851
93.866 AGING RESEARCH $45,521
93.847 DIABETES, DIGESTIVE, AND KIDNEY DISEASES EXTRAMURAL RESEARCH $44,977
93.977 SEXUALLY TRANSMITTED DISEASES (STD) PREVENTION AND CONTROL GRANTS $41,668
93.113 ENVIRONMENTAL HEALTH $41,135
93.395 CANCER TREATMENT RESEARCH $40,724
93.213 RESEARCH AND TRAINING IN COMPLEMENTARY AND INTEGRATIVE HEALTH $33,560
10.553 SCHOOL BREAKFAST PROGRAM $29,936
47.070 COMPUTER AND INFORMATION SCIENCE AND ENGINEERING $28,799
93.393 CANCER CAUSE AND PREVENTION RESEARCH $27,948
93.493 CONGRESSIONAL DIRECTIVES $26,717
93.778 GRANTS TO STATES FOR MEDICAID $25,766
93.273 EMERGENCY MEDICAL SERVICES FOR CHILDREN $25,449
93.037 Childcare Development Block Grant $23,019
93.286 DISCOVERY AND APPLIED RESEARCH FOR TECHNOLOGICAL INNOVATIONS TO IMPROVE HUMAN HEALTH $22,522
93.153 COORDINATED SERVICES AND ACCESS TO RESEARCH FOR WOMEN, INFANTS, CHILDREN, AND YOUTH $21,345
93.397 CANCER CENTERS SUPPORT GRANTS $20,695
93.575 CHILD CARE AND DEVELOPMENT BLOCK GRANT $19,908
93.080 BLOOD DISORDER PROGRAM: PREVENTION, SURVEILLANCE, AND RESEARCH $19,481
93.349 PACKAGING AND SPREADING PROVEN PEDIATRIC WEIGHT MANAGEMENT INTERVENTIONS FOR USE BY LOW-INCOME FAMILIES $17,947
93.361 NURSING RESEARCH $17,089
93.879 MEDICAL LIBRARY ASSISTANCE $16,641
47.041 ENGINEERING $12,753
93.U04 National Institute of Health Other $12,746
10.561 STATE ADMINISTRATIVE MATCHING GRANTS FOR THE SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM $11,693
93.242 MENTAL HEALTH RESEARCH GRANTS $10,906
93.838 LUNG DISEASES RESEARCH $9,087
93.988 COOPERATIVE AGREEMENTS FOR DIABETES CONTROL PROGRAMS $8,786
93.U01 National Institute of Health Research $7,839
93.959 BLOCK GRANTS FOR PREVENTION AND TREATMENT OF SUBSTANCE ABUSE $6,432
93.351 RESEARCH INFRASTRUCTURE PROGRAMS $6,146
10.582 FRESH FRUIT AND VEGETABLE PROGRAM $5,005
93.989 INTERNATIONAL RESEARCH AND RESEARCH TRAINING $1,738
93.859 BIOMEDICAL RESEARCH AND RESEARCH TRAINING $1,454
93.837 CARDIOVASCULAR DISEASES RESEARCH $571
93.U01 Research Other $0
12.420 MILITARY MEDICAL RESEARCH AND DEVELOPMENT $-153
93.136 INJURY PREVENTION AND CONTROL RESEARCH AND STATE AND COMMUNITY BASED PROGRAMS $-172
93.396 CANCER BIOLOGY RESEARCH $-1,067
93.928 SPECIAL PROJECTS OF NATIONAL SIGNIFICANCE $-9,663
93.279 DRUG USE AND ADDICTION RESEARCH PROGRAMS $-12,338
12.U01 Advancement of Military Medicine $-13,127
93.127 EMERGENCY MEDICAL SERVICES FOR CHILDREN $-61,202