Finding 33457 (2022-003)

Significant Deficiency
Requirement
M
Questioned Costs
-
Year
2022
Accepted
2023-09-28
Audit: 29220
Organization: Choice Regional Health Network (WA)
Auditor: Clark Nuber P S

AI Summary

  • Core Issue: There are significant deficiencies in internal controls over compliance, particularly in monitoring subrecipients.
  • Impacted Requirements: The organization failed to assess the risk of noncompliance for subrecipients and did not obtain necessary approvals for fixed fee awards.
  • Recommended Follow-Up: Update the subrecipient monitoring policy to include risk assessments and ensure prior approval for fixed fee awards is obtained from the federal funder.

Finding Text

Significant deficiency in internal controls over compliance and instances of noncompliance related to subrecipient monitoring. Federal Agency: Department of Health and Human Services Program Title: National Organizations of State and Local Officials CFDA Number: 93.011 Award Numbers: 1 G32HS42592-01-00 Award Period: July 31, 2021 - July 31, 2023 Criteria 2 U.S. Code of Federal Regulations (CFR) 200 Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (Uniform Guidance) Subpart D (as codified by the Department of Health and Human Services [DHHS] in 45 CFR 75) requires a pass-through entity to adopt compliance policies to ensure sub-recipients comply with requirements under the award, and evaluate each subrecipient?s risk of noncompliance with Federal statutes, regulations, and the terms and conditions of such agreements for the purposes of determining appropriate subrecipient monitoring. Condition/Context for Evaluation In a population of three subrecipients, no documentation was available showing an assessment of the risk of noncompliance of the subrecipients. For one subrecipient, a fixed fee award was issued that had not received prior approval by the federal funder. As such, when the payment to the subrecipient was made based on a fixed amount, the Organization was not monitoring to ensure the subrecipient was minimizing the time lapse between the receipt of payment and expenditures incurred. Questioned Costs Not applicable. Cause The Organization?s subrecipient monitoring policy did not include all the required provisions outlined in 2 CFR 200.332. Effect or Potential Effect The Organization did not fully comply with the requirements regarding subrecipient monitoring. Repeat Finding Not applicable. Recommendation We recommend that the Organization update the subrecipient monitoring policy to ensure a risk assessment is performed over all subrecipients and that any fixed fee awards receive prior approval from the federal funder. Views of Responsible Officials of Auditee Management concurs with the finding and has provided the accompanying corrective action plan.

Corrective Action Plan

Significant deficiency in internal controls over compliance and instances of noncompliance related to subrecipient monitoring. Contact Person(s): Beth Mizushima, Chief Operating Officer, mizushimab@crhn.org; and Connie Sowa, Compliance, Governance and Contracts Officer, sowac@crhn.org. Explanation and specific reasons for disagreement with the audit finding or that corrective action is not required (if applicable): Not applicable. Corrective action planned: In FY23 we have established a Compliance, Governance and Contracts Officer staff position (1.0 FTE) that provides compliance support. We have also developed and implemented training around our Ethics and Compliance Manual, which includes 14 new policies and procedures related to ensuring subrecipient compliance standards are met for all grant awards. Since July 1, 2023, we have completed assessments for the risk of noncompliance with all partner agencies before executing contracts. In FY23 we have also amended contracts to be on a reimbursement for allowable expenditures structure rather than fixed amount. We believe that the former leadership team who established the fixed fee award may have misinterpreted the guidance around providing flexibility to reduce burden for financial assistance during COVID response. Furthermore, it is our belief that the former program officer and staff discussed the details of their work and contracts, but we cannot find documentation of receiving prior approval. To address this issue, we have amended contracts in FY23 to include specific contract wording requiring prior approval to implement a fixed fee contract. Additionally, we are in the process of implementing a contract and portal partners management platform. The new contract management system and the improvements in compliance process will ensure that we adhere to the provisions as outlined in 2 CFR200.332. Anticipated completed process September 30, 2023

Categories

Subrecipient Monitoring

Other Findings in this Audit

  • 33456 2022-002
    Material Weakness
  • 33458 2022-004
    Significant Deficiency
  • 609898 2022-002
    Material Weakness
  • 609899 2022-003
    Significant Deficiency
  • 609900 2022-004
    Significant Deficiency

Programs in Audit

ALN Program Name Expenditures
93.011 National Organizations of State and Local Officials $416,881
93.912 Rural Health Care Services Outreach, Rural Health Network Development and Small Health Care Provider Quality Improvement $246,182
93.185 Immunization Research, Demonstration, Public Information and Education_training and Clinical Skills Improvement Projects $68,245
93.322 Csels Partnership: Strengthening Public Health Laboratories $42,100