Finding 2022-001: Failure to Establish Subrecipient Monitoring Procedures Federal Agency: U.S. Department of Health and Human Services (HHS) Program Name: Research and Development Programs ALN and Program Expenditures: Various ($2,585,762) Federal Award Numbers: Various ? See schedule of award numbers Federal Award Year: Various ? See schedule of award numbers Questioned Costs: None Compliance Requirement: Subrecipient Monitoring Type of Finding: Significant Deficiency and Material Noncompliance Condition Found: The Carle Foundation did not perform a risk assessment or subrecipient monitoring procedures for subrecipients of Research and Development Programs for the year end December 31, 2022. Carle designated Vanderbilt University and the University of Illinois Urbana-Champaign as subrecipients for the programs. As a pass-through entity, Carle was responsible for: ? Identifying the award and applicable requirements, ? Evaluating the subrecipient?s risk of noncompliance for purposes of determining the appropriate monitoring procedures related to the subaward, ? Monitoring the activities of the subrecipient as necessary to ensure the subaward is used for authorized purposes, that the subrecipient complies with the terms and conditions of the subaward, that the subrecipient achieves performance goals, and ? Issuing a management decision for single audit findings pertaining to the federal award provided to the subrecipient, if applicable. During our testing, we noted Carle did not perform any subrecipient monitoring procedures over subrecipients with respect to the Research and Development Programs during the year ended December 31, 2022. Amounts passed through to subrecipients totaled $115,061 for the year ended December 31, 2022. Criteria or Requirement: Per 2 CFR 200.332(b), a pass-through entity must evaluate each subrecipient's risk of noncompliance for purposes of determining the appropriate subrecipient monitoring related to the subaward. According to 2 CFR 200.332(d), a pass-through entity is required to monitor the activities of subrecipients as necessary to ensure that federal awards are used for authorized purposes in compliance with laws, regulations, and the provisions of contracts or grant agreements and that performance goals are achieved. 2 CFR 200.332(d)(3) requires pass-through entities to issue management decisions for applicable audit findings pertaining to the federal awards provided to the subrecipient and 2 CFR 200.332(d)(4) requires pass through entities to resolve audit findings through corrective action plans (CAP). In addition, 2 CFR 200.303 requires non-Federal entities receiving Federal awards to establish and maintain internal controls designed to reasonably ensure compliance with Federal laws, regulations, and program compliance requirements. Effective internal controls should include establishing and performing monitoring procedures in accordance with Uniform Guidance and program requirements. Cause: The Grants Administration Office engaged with Clifton Larson Allen Consulting in the fall of 2022 to compose multiple, essential policies (including Sub-Recipient Monitoring) required to manage Carle?s growing grants portfolio and maintain compliance with per the terms and conditions of the awards, the awarding agencies? regulations, and 2 CFR Part 200, The Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards. The draft policies were circulated, reviewed, and discussed by the Grants Administration Office and leadership in Research, Accounting, Capital, and Compliance prior to finalizing, but were not able to be published prior to initiating subawards on an NIH R01 transfer for our new Director of Clinical Imaging Research, Dr. Bruce Damon. The Grants Administration Office had to accept Dr. Damon?s transfer from Vanderbilt when he joined Carle and initiate the subawards so that his grant activity kept pace with sponsor milestones and deliverables as required by the award. Possible Asserted Effect: Failure to perform required risk assessments and to adequately monitor subrecipients may result in the subrecipient not properly administering the federal program in accordance with laws, regulations, and the grant agreement. Repeat Finding: A similar finding was not reported in the prior year audit. Statistical Sampling: The sample was not intended to be, and was not, a statistically valid sample. Recommendation: We recommend The Carle Foundation implement subrecipient monitoring procedures in accordance with federal regulations. Views of Management: Carle did perform informal risk assessments of both sub-recipients prior to issuance in order to support Dr. Damon?s incoming NIH award and engage with both critical sub-recipient collaborators promptly. Activities at the University of Illinois and Vanderbilt had to continue on the planned research effort for his transferred NIH award even though our related policy was in final draft form and not yet published. In making the decision to proceed, the Grants Administration Office confirmed that the final draft of the Sub-Recipient Monitoring policy, as well as the Risk Assessment Matrix tool, attached to the policy, had been circulated with leadership and key stakeholders in Research, Accounting, Finance, and Compliance, and resulted in no material edits. Additionally, the Grants Administration Office judged both prospective institutions as viable recipients of federal funding based on their current and active SAM.gov registrations at the time of issuance, the integrity of these well-established academic institutions, as well as Carle?s longstanding relationship with the University of Illinois (with multiple types of agreements already in place). To ensure appropriate safeguards, Carle issued its subawards using a standard FDP Clearinghouse template, compliant with federal regulations. Included in the subaward terms and conditions were all of the required attestations that both institutions signed, regarding Conflict of Interest, Lobbying, Debarment, Audit, 2CFR 200, FFATA, Data Sharing, Copyrights, and Human Subjects Protection. All invoices from our sub-recipients were received monthly as per the agreement and reviewed by both the Grants Administration Office and Dr. Damon for allowability prior to payment.