Finding 1227859 (2023-006)

Material Weakness Repeat Finding
Requirement
C
Questioned Costs
-
Year
2023
Accepted
2026-08-26
Audit: 409789
Organization: Island Health, Inc. (MA)
Auditor: COHNREZNICK LLP

AI Summary

  • Core Issue: The Center lacks proper management review and approval for cash drawdowns, leading to potential inaccuracies.
  • Impacted Requirements: This finding violates federal guidelines under §200.305 and 2 CFR 200.302 and 200.303 regarding fund management controls.
  • Recommended Follow-Up: Establish written procedures for reviewing all drawdowns to ensure accuracy and maintain formal documentation of approvals.

Finding Text

Finding 2023.006: 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 COVID-19 Grants for New and Expanded Services under the Health Center Program Federal Assistance Listing Number: 93.224 and 93.527 Federal Award Identification Number and Year: H8026638 - 2022 and 2023, H8F40829 - 2021 and H8G48040-2023 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 7 drawdowns for testing of cash management. We noted there was no formal approval or evidence of review for all 7 drawdowns. Identification of Repeat Finding Yes, see finding 2022.006. 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 2023.006 – Cash Management 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

  • 1227841 2023-003
    Material Weakness Repeat
  • 1227842 2023-004
    Material Weakness Repeat
  • 1227843 2023-005
    Material Weakness Repeat
  • 1227844 2023-006
    Material Weakness Repeat
  • 1227845 2023-007
    Material Weakness Repeat
  • 1227846 2023-003
    Material Weakness Repeat
  • 1227847 2023-004
    Material Weakness Repeat
  • 1227848 2023-005
    Material Weakness Repeat
  • 1227849 2023-006
    Material Weakness Repeat
  • 1227850 2023-007
    Material Weakness Repeat
  • 1227851 2023-003
    Material Weakness Repeat
  • 1227852 2023-004
    Material Weakness Repeat
  • 1227853 2023-005
    Material Weakness Repeat
  • 1227854 2023-006
    Material Weakness Repeat
  • 1227855 2023-007
    Material Weakness Repeat
  • 1227856 2023-003
    Material Weakness Repeat
  • 1227857 2023-004
    Material Weakness Repeat
  • 1227858 2023-005
    Material Weakness Repeat
  • 1227860 2023-007
    Material Weakness Repeat

Programs in Audit

ALN Program Name Expenditures
93.224 Community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care $365,690
21.027 CORONAVIRUS STATE AND LOCAL FISCAL RECOVERY FUNDS $209,873
93.268 IMMUNIZATION COOPERATIVE AGREEMENTS $103,743
93.526 GRANTS FOR CAPITAL DEVELOPMENT IN HEALTH CENTERS $54,138
93.527 GRANTS FOR NEW AND EXPANDED SERVICES UNDER THE HEALTH CENTER PROGRAM $41,299