Finding 35677 (2022-001)

Significant Deficiency
Requirement
I
Questioned Costs
$1
Year
2022
Accepted
2023-06-29
Audit: 24227
Organization: City of Hope (CA)

AI Summary

  • Core Issue: There are significant internal control deficiencies in procurement processes, leading to potential noncompliance with federal regulations.
  • Impacted Requirements: Failure to obtain adequate price quotations and to check vendor suspension/debarment status violates Title 2, Subtitle A, Chapter II, Part 200 regulations.
  • Recommended Follow-Up: Implement stronger internal controls to ensure compliance with procurement standards and conduct regular audits to verify vendor eligibility.

Finding Text

Finding 2022-001: Internal control deficiency and noncompliance over Procurement and Suspension and Debarment. Identification of the federal program: Research and Development Cluster See findings text for the table. Criteria or specific requirement (including statutory, regulatory or other citation): Title 2, Subtitle A, Chapter II, Part 200, Subpart D, 200.303 ? Internal controls. The non-Federal entity must: (a) Establish and maintain effective internal control over the Federal award that provides reasonable assurance that the non-Federal entity is managing the Federal award in compliance with Federal statutes, regulations, and the terms and conditions of the Federal award. These internal controls should be in compliance with guidance in ?Standards for Internal Control in the Federal Government? issued by the Comptroller General of the United States or the ?Internal Control Integrated Framework?, issued by the Committee of Sponsoring Organizations of the Treadway Commission (COSO). Title 2, Subtitle A, Chapter II, Part 200, Subpart D, 200.318(i) ? General procurement standards states: The non-Federal entity must maintain records sufficient to detail the history of procurement. These records will include, but are not necessarily limited to, the following: Rationale for the method of procurement, selection of contract type, contractor selection or rejection, and the basis for the contract price. Title 2, Subtitle A, Chapter II, Part 200, Subpart D, 200.320 ? Methods of procurement to be followed ? the non-Federal entity must have and use documented procurements procedures, consistent with the standards of this section and 200.317, 200.318, and 200.319 for any of the following methods of procurement used for the acquisition of property or services required under a Federal award or sub-award: (a) (2) Small purchases ? (i) small purchase procedures ? the acquisition of property or services, the aggregate dollar amount of which is higher than the micro-purchase threshold but does not exceed the simplified acquisition threshold. If small purchase procedures are used, price or rate quotations must be obtained from an adequate number of qualified sources as determined appropriate by the non-Federal entity; (b) Formal procurement methods ? when the value of the procurement for property or services under a Federal financial assistance award exceeds the simplified acquisition threshold, formal procurement methods are required. Formal procurement methods require following documented procedures. The following formal methods of procurement are used for procurement of property or services above the simplified acquisition threshold ? (1) sealed bids ? a procurement method in which bids are publicly solicited and a firm fixed-price contract (lump sum or unit price) is awarded to the responsible bidder whose bid, conforming with all the material terms and conditions of the invitation for bids, is the lowest in price; (2) proposals ? a procurement method in which either a fixed price or cost-reimbursement type contract is awarded. Title 2, Subtitle A, Chapter II, Part 200, Subpart C 200.214 ? Suspension and debarment ? Non-Federal entities are subject to the non-procurement debarment and suspension regulations that restrict awards, subawards, and contracts with certain parties that are debarred, suspended, or otherwise excluded from or ineligible for participation in Federal assistance programs or activities. Condition: During our testing over small purchase procurements and formal procurement methods, we observed management did not have effective internal controls in place to ensure that price or rate quotations were obtained from an adequate number of qualified sources at the time of procurement and sealed bids or proposals were obtained. In addition, during our testing over suspension and debarment, we observed management did not have effective internal controls in place to ensure vendors with covered transactions greater than $25,000 were not suspended or debarred. Cause: Management did not have effective internal controls in place over the compliance requirement as stated in the criteria or specific requirement section above. Effect or potential effect: Small purchase procurements and formal procurement methods were not supported by effective internal controls and could potentially include unreasonable prices or rates. In addition, if a search for suspension and debarment is not conducted, the entity could contract with vendors that are suspended or debarred. Questioned costs: $560,068 ? Assistance Listing Numbers 10.025, 10.310, 12.351, 12.420, 12.910, 93.103, 93.113, 93.121, 93.172, 93.226, 93.242, 93.273, 93.286, 93.301, 93.307, 93.310, 93.353, 93.361, 93.393, 93.394, 93.395, 93.396, 93.397, 93.398, 93.399, 93.837, 93.838, 93.839, 93.847, 93.853, 93.855, 93.859, 93.865, 93.866, 93.867, 93.879. See corresponding award identification numbers in the identification of federal award section above. Questioned costs were computed by taking the total small purchase procurements, formal procurements, and suspension and debarment procurements that were not supported by adequate documentation of $196,639 ($54,000 + $28,560 + $114,079), $300,300, and $63,129, respectively for a total of $560,068. Context: Testing over procurement and suspension and debarment were performed over City of Hope and Translational Genomics Research Institute separately as they operate under different internal control environments. During our testing over small purchase procurements for City of Hope, we obtained a listing of 26 small purchase procurements and selected a sample of 5. The total value of the 5 small purchases selected was $282,719 out of the total population of $1,510,159. There was 1 ($54,000) out of 5 ($282,719) selections where management didn't follow its procurement policy to fill out the "Supplier Selection Justification" form, which is required to be completed for all small purchase procurements. There was 1 ($28,560) out of 5 ($282,719) selections where price or rate quotations were not obtained from an adequate number of qualified sources at the time of procurement. There were 2 ($114,079) out of 5 ($282,719) selections where management didn?t follow its procurement policy to evaluate existing contracts at the end of the contract term. During our testing over formal procurements for City of Hope, we obtained a listing of 2 formal procurements and selected a sample of 2. The total value of the 2 formal procurements were $663,744. There was 1 ($300,300) out of 2 ($663,744) selections where management didn?t follow its procurement policy to evaluate existing contracts at the end of the contract term. During our testing over suspension and debarment for Translational Genomics Research Institute, we obtained a listing of 18 vendors with covered transactions greater than $25,000 and selected a sample of 6. The total value of the 6 vendors selected was $244,467 out of the total population of $1,332,111. There was 1 ($63,129) out of 6 ($244,467) selections where a search for suspension and debarment was not completed. Identification as a repeat finding, if applicable: No. Recommendation: We recommend that management develop and implement effective internal controls to ensure small purchase procurements were supported by price or rate quotations from an adequate number of qualified suppliers, formal methods of procurement included sealed bids or proposals, and vendors with covered transactions greater than $25,000 were not suspended or debarred. Views of responsible officials: In response to this finding City of Hope will implement the following: 1. Procurement Operations to provide training to reinforce current policy requirements. Training will also include Strategic Sourcing and Research personnel to emphasize procurement guidelines prior to requisition submission. 2. Corporate Accounting will select a sample size of federally funded procurement spend to ensure controls have been appropriately remediated. 3. Procurement and Sourcing department will review current long-term contracts pertaining to federal funding to ensure adherence with documented compliance standards. 4. To ensure controls are operating effectively around suspension and debarment reviews, finance leadership will work with the purchasing department to update internal control policies to confirm there is a full review of all vendors engaged to work on federally funded programs. 5. Purchasing department will perform a review of existing contracts to ensure suspension and debarment reviews have been completed.

Categories

Questioned Costs Procurement, Suspension & Debarment

Other Findings in this Audit

  • 35632 2022-001
    Significant Deficiency
  • 35633 2022-001
    Significant Deficiency
  • 35634 2022-001
    Significant Deficiency
  • 35635 2022-001
    Significant Deficiency
  • 35636 2022-001
    Significant Deficiency
  • 35637 2022-001
    Significant Deficiency
  • 35638 2022-001
    Significant Deficiency
  • 35639 2022-001
    Significant Deficiency
  • 35640 2022-001
    Significant Deficiency
  • 35641 2022-001
    Significant Deficiency
  • 35642 2022-001
    Significant Deficiency
  • 35643 2022-001
    Significant Deficiency
  • 35644 2022-001
    Significant Deficiency
  • 35645 2022-001
    Significant Deficiency
  • 35646 2022-001
    Significant Deficiency
  • 35647 2022-001
    Significant Deficiency
  • 35648 2022-001
    Significant Deficiency
  • 35649 2022-001
    Significant Deficiency
  • 35650 2022-001
    Significant Deficiency
  • 35651 2022-001
    Significant Deficiency
  • 35652 2022-001
    Significant Deficiency
  • 35653 2022-001
    Significant Deficiency
  • 35654 2022-001
    Significant Deficiency
  • 35655 2022-001
    Significant Deficiency
  • 35656 2022-001
    Significant Deficiency
  • 35657 2022-001
    Significant Deficiency
  • 35658 2022-001
    Significant Deficiency
  • 35659 2022-001
    Significant Deficiency
  • 35660 2022-001
    Significant Deficiency
  • 35661 2022-001
    Significant Deficiency
  • 35662 2022-001
    Significant Deficiency
  • 35663 2022-001
    Significant Deficiency
  • 35664 2022-001
    Significant Deficiency
  • 35665 2022-001
    Significant Deficiency
  • 35666 2022-001
    Significant Deficiency
  • 35667 2022-001
    Significant Deficiency
  • 35668 2022-001
    Significant Deficiency
  • 35669 2022-001
    Significant Deficiency
  • 35670 2022-001
    Significant Deficiency
  • 35671 2022-001
    Significant Deficiency
  • 35672 2022-001
    Significant Deficiency
  • 35673 2022-001
    Significant Deficiency
  • 35674 2022-001
    Significant Deficiency
  • 35675 2022-001
    Significant Deficiency
  • 35676 2022-001
    Significant Deficiency
  • 35678 2022-001
    Significant Deficiency
  • 35679 2022-001
    Significant Deficiency
  • 35680 2022-001
    Significant Deficiency
  • 35681 2022-001
    Significant Deficiency
  • 35682 2022-001
    Significant Deficiency
  • 35683 2022-001
    Significant Deficiency
  • 35684 2022-001
    Significant Deficiency
  • 35685 2022-001
    Significant Deficiency
  • 35686 2022-001
    Significant Deficiency
  • 35687 2022-001
    Significant Deficiency
  • 35688 2022-001
    Significant Deficiency
  • 35689 2022-001
    Significant Deficiency
  • 35690 2022-001
    Significant Deficiency
  • 35691 2022-001
    Significant Deficiency
  • 35692 2022-001
    Significant Deficiency
  • 35693 2022-001
    Significant Deficiency
  • 35694 2022-001
    Significant Deficiency
  • 35695 2022-001
    Significant Deficiency
  • 35696 2022-001
    Significant Deficiency
  • 35697 2022-001
    Significant Deficiency
  • 35698 2022-001
    Significant Deficiency
  • 35699 2022-001
    Significant Deficiency
  • 35700 2022-001
    Significant Deficiency
  • 35701 2022-001
    Significant Deficiency
  • 35702 2022-001
    Significant Deficiency
  • 35703 2022-001
    Significant Deficiency
  • 35704 2022-001
    Significant Deficiency
  • 35705 2022-001
    Significant Deficiency
  • 35706 2022-001
    Significant Deficiency
  • 35707 2022-001
    Significant Deficiency
  • 35708 2022-001
    Significant Deficiency
  • 35709 2022-001
    Significant Deficiency
  • 35710 2022-001
    Significant Deficiency
  • 35711 2022-001
    Significant Deficiency
  • 35712 2022-001
    Significant Deficiency
  • 35713 2022-001
    Significant Deficiency
  • 35714 2022-001
    Significant Deficiency
  • 35715 2022-001
    Significant Deficiency
  • 35716 2022-001
    Significant Deficiency
  • 35717 2022-001
    Significant Deficiency
  • 35718 2022-001
    Significant Deficiency
  • 35719 2022-001
    Significant Deficiency
  • 35720 2022-001
    Significant Deficiency
  • 35721 2022-001
    Significant Deficiency
  • 35722 2022-001
    Significant Deficiency
  • 35723 2022-001
    Significant Deficiency
  • 35724 2022-001
    Significant Deficiency
  • 35725 2022-001
    Significant Deficiency
  • 35726 2022-001
    Significant Deficiency
  • 35727 2022-001
    Significant Deficiency
  • 35728 2022-001
    Significant Deficiency
  • 35729 2022-001
    Significant Deficiency
  • 35730 2022-001
    Significant Deficiency
  • 35731 2022-001
    Significant Deficiency
  • 35732 2022-001
    Significant Deficiency
  • 35733 2022-001
    Significant Deficiency
  • 35734 2022-001
    Significant Deficiency
  • 35735 2022-001
    Significant Deficiency
  • 35736 2022-001
    Significant Deficiency
  • 35737 2022-001
    Significant Deficiency
  • 35738 2022-001
    Significant Deficiency
  • 35739 2022-001
    Significant Deficiency
  • 35740 2022-001
    Significant Deficiency
  • 35741 2022-001
    Significant Deficiency
  • 35742 2022-001
    Significant Deficiency
  • 35743 2022-001
    Significant Deficiency
  • 35744 2022-001
    Significant Deficiency
  • 35745 2022-001
    Significant Deficiency
  • 35746 2022-001
    Significant Deficiency
  • 35747 2022-001
    Significant Deficiency
  • 35748 2022-001
    Significant Deficiency
  • 35749 2022-001
    Significant Deficiency
  • 35750 2022-001
    Significant Deficiency
  • 35751 2022-001
    Significant Deficiency
  • 35752 2022-001
    Significant Deficiency
  • 35753 2022-001
    Significant Deficiency
  • 35754 2022-001
    Significant Deficiency
  • 35755 2022-001
    Significant Deficiency
  • 35756 2022-001
    Significant Deficiency
  • 35757 2022-001
    Significant Deficiency
  • 35758 2022-001
    Significant Deficiency
  • 35759 2022-001
    Significant Deficiency
  • 35760 2022-001
    Significant Deficiency
  • 35761 2022-001
    Significant Deficiency
  • 35762 2022-001
    Significant Deficiency
  • 35763 2022-001
    Significant Deficiency
  • 35764 2022-001
    Significant Deficiency
  • 35765 2022-001
    Significant Deficiency
  • 35766 2022-001
    Significant Deficiency
  • 35767 2022-001
    Significant Deficiency
  • 35768 2022-001
    Significant Deficiency
  • 35769 2022-001
    Significant Deficiency
  • 35770 2022-001
    Significant Deficiency
  • 35771 2022-001
    Significant Deficiency
  • 35772 2022-001
    Significant Deficiency
  • 35773 2022-001
    Significant Deficiency
  • 35774 2022-001
    Significant Deficiency
  • 35775 2022-001
    Significant Deficiency
  • 35776 2022-001
    Significant Deficiency
  • 35777 2022-001
    Significant Deficiency
  • 35778 2022-001
    Significant Deficiency
  • 35779 2022-001
    Significant Deficiency
  • 35780 2022-001
    Significant Deficiency
  • 35781 2022-001
    Significant Deficiency
  • 35782 2022-001
    Significant Deficiency
  • 35783 2022-001
    Significant Deficiency
  • 35784 2022-001
    Significant Deficiency
  • 35785 2022-001
    Significant Deficiency
  • 35786 2022-001
    Significant Deficiency
  • 35787 2022-001
    Significant Deficiency
  • 35788 2022-001
    Significant Deficiency
  • 612074 2022-001
    Significant Deficiency
  • 612075 2022-001
    Significant Deficiency
  • 612076 2022-001
    Significant Deficiency
  • 612077 2022-001
    Significant Deficiency
  • 612078 2022-001
    Significant Deficiency
  • 612079 2022-001
    Significant Deficiency
  • 612080 2022-001
    Significant Deficiency
  • 612081 2022-001
    Significant Deficiency
  • 612082 2022-001
    Significant Deficiency
  • 612083 2022-001
    Significant Deficiency
  • 612084 2022-001
    Significant Deficiency
  • 612085 2022-001
    Significant Deficiency
  • 612086 2022-001
    Significant Deficiency
  • 612087 2022-001
    Significant Deficiency
  • 612088 2022-001
    Significant Deficiency
  • 612089 2022-001
    Significant Deficiency
  • 612090 2022-001
    Significant Deficiency
  • 612091 2022-001
    Significant Deficiency
  • 612092 2022-001
    Significant Deficiency
  • 612093 2022-001
    Significant Deficiency
  • 612094 2022-001
    Significant Deficiency
  • 612095 2022-001
    Significant Deficiency
  • 612096 2022-001
    Significant Deficiency
  • 612097 2022-001
    Significant Deficiency
  • 612098 2022-001
    Significant Deficiency
  • 612099 2022-001
    Significant Deficiency
  • 612100 2022-001
    Significant Deficiency
  • 612101 2022-001
    Significant Deficiency
  • 612102 2022-001
    Significant Deficiency
  • 612103 2022-001
    Significant Deficiency
  • 612104 2022-001
    Significant Deficiency
  • 612105 2022-001
    Significant Deficiency
  • 612106 2022-001
    Significant Deficiency
  • 612107 2022-001
    Significant Deficiency
  • 612108 2022-001
    Significant Deficiency
  • 612109 2022-001
    Significant Deficiency
  • 612110 2022-001
    Significant Deficiency
  • 612111 2022-001
    Significant Deficiency
  • 612112 2022-001
    Significant Deficiency
  • 612113 2022-001
    Significant Deficiency
  • 612114 2022-001
    Significant Deficiency
  • 612115 2022-001
    Significant Deficiency
  • 612116 2022-001
    Significant Deficiency
  • 612117 2022-001
    Significant Deficiency
  • 612118 2022-001
    Significant Deficiency
  • 612119 2022-001
    Significant Deficiency
  • 612120 2022-001
    Significant Deficiency
  • 612121 2022-001
    Significant Deficiency
  • 612122 2022-001
    Significant Deficiency
  • 612123 2022-001
    Significant Deficiency
  • 612124 2022-001
    Significant Deficiency
  • 612125 2022-001
    Significant Deficiency
  • 612126 2022-001
    Significant Deficiency
  • 612127 2022-001
    Significant Deficiency
  • 612128 2022-001
    Significant Deficiency
  • 612129 2022-001
    Significant Deficiency
  • 612130 2022-001
    Significant Deficiency
  • 612131 2022-001
    Significant Deficiency
  • 612132 2022-001
    Significant Deficiency
  • 612133 2022-001
    Significant Deficiency
  • 612134 2022-001
    Significant Deficiency
  • 612135 2022-001
    Significant Deficiency
  • 612136 2022-001
    Significant Deficiency
  • 612137 2022-001
    Significant Deficiency
  • 612138 2022-001
    Significant Deficiency
  • 612139 2022-001
    Significant Deficiency
  • 612140 2022-001
    Significant Deficiency
  • 612141 2022-001
    Significant Deficiency
  • 612142 2022-001
    Significant Deficiency
  • 612143 2022-001
    Significant Deficiency
  • 612144 2022-001
    Significant Deficiency
  • 612145 2022-001
    Significant Deficiency
  • 612146 2022-001
    Significant Deficiency
  • 612147 2022-001
    Significant Deficiency
  • 612148 2022-001
    Significant Deficiency
  • 612149 2022-001
    Significant Deficiency
  • 612150 2022-001
    Significant Deficiency
  • 612151 2022-001
    Significant Deficiency
  • 612152 2022-001
    Significant Deficiency
  • 612153 2022-001
    Significant Deficiency
  • 612154 2022-001
    Significant Deficiency
  • 612155 2022-001
    Significant Deficiency
  • 612156 2022-001
    Significant Deficiency
  • 612157 2022-001
    Significant Deficiency
  • 612158 2022-001
    Significant Deficiency
  • 612159 2022-001
    Significant Deficiency
  • 612160 2022-001
    Significant Deficiency
  • 612161 2022-001
    Significant Deficiency
  • 612162 2022-001
    Significant Deficiency
  • 612163 2022-001
    Significant Deficiency
  • 612164 2022-001
    Significant Deficiency
  • 612165 2022-001
    Significant Deficiency
  • 612166 2022-001
    Significant Deficiency
  • 612167 2022-001
    Significant Deficiency
  • 612168 2022-001
    Significant Deficiency
  • 612169 2022-001
    Significant Deficiency
  • 612170 2022-001
    Significant Deficiency
  • 612171 2022-001
    Significant Deficiency
  • 612172 2022-001
    Significant Deficiency
  • 612173 2022-001
    Significant Deficiency
  • 612174 2022-001
    Significant Deficiency
  • 612175 2022-001
    Significant Deficiency
  • 612176 2022-001
    Significant Deficiency
  • 612177 2022-001
    Significant Deficiency
  • 612178 2022-001
    Significant Deficiency
  • 612179 2022-001
    Significant Deficiency
  • 612180 2022-001
    Significant Deficiency
  • 612181 2022-001
    Significant Deficiency
  • 612182 2022-001
    Significant Deficiency
  • 612183 2022-001
    Significant Deficiency
  • 612184 2022-001
    Significant Deficiency
  • 612185 2022-001
    Significant Deficiency
  • 612186 2022-001
    Significant Deficiency
  • 612187 2022-001
    Significant Deficiency
  • 612188 2022-001
    Significant Deficiency
  • 612189 2022-001
    Significant Deficiency
  • 612190 2022-001
    Significant Deficiency
  • 612191 2022-001
    Significant Deficiency
  • 612192 2022-001
    Significant Deficiency
  • 612193 2022-001
    Significant Deficiency
  • 612194 2022-001
    Significant Deficiency
  • 612195 2022-001
    Significant Deficiency
  • 612196 2022-001
    Significant Deficiency
  • 612197 2022-001
    Significant Deficiency
  • 612198 2022-001
    Significant Deficiency
  • 612199 2022-001
    Significant Deficiency
  • 612200 2022-001
    Significant Deficiency
  • 612201 2022-001
    Significant Deficiency
  • 612202 2022-001
    Significant Deficiency
  • 612203 2022-001
    Significant Deficiency
  • 612204 2022-001
    Significant Deficiency
  • 612205 2022-001
    Significant Deficiency
  • 612206 2022-001
    Significant Deficiency
  • 612207 2022-001
    Significant Deficiency
  • 612208 2022-001
    Significant Deficiency
  • 612209 2022-001
    Significant Deficiency
  • 612210 2022-001
    Significant Deficiency
  • 612211 2022-001
    Significant Deficiency
  • 612212 2022-001
    Significant Deficiency
  • 612213 2022-001
    Significant Deficiency
  • 612214 2022-001
    Significant Deficiency
  • 612215 2022-001
    Significant Deficiency
  • 612216 2022-001
    Significant Deficiency
  • 612217 2022-001
    Significant Deficiency
  • 612218 2022-001
    Significant Deficiency
  • 612219 2022-001
    Significant Deficiency
  • 612220 2022-001
    Significant Deficiency
  • 612221 2022-001
    Significant Deficiency
  • 612222 2022-001
    Significant Deficiency
  • 612223 2022-001
    Significant Deficiency
  • 612224 2022-001
    Significant Deficiency
  • 612225 2022-001
    Significant Deficiency
  • 612226 2022-001
    Significant Deficiency
  • 612227 2022-001
    Significant Deficiency
  • 612228 2022-001
    Significant Deficiency
  • 612229 2022-001
    Significant Deficiency
  • 612230 2022-001
    Significant Deficiency

Programs in Audit

ALN Program Name Expenditures
93.498 Covid-19 - Provider Relief Fund and American Rescue Plan (arp) Rural Distribution $18.80M
12.910 Research and Technology Development $906,836
93.172 Human Genome Research $692,366
93.226 Research on Healthcare Costs, Quality and Outcomes $419,747
93.353 21st Century Cures Act - Beau Biden Cancer Moonshot $397,644
93.113 Environmental Health $359,481
93.855 Allergy and Infectious Diseases Research $329,168
93.103 Food and Drug Administration Research $297,742
93.879 Medical Library Assistance $277,114
93.867 Vision Research $273,375
93.273 Alcohol Research Programs $249,082
32.006 Covid-19 - Covid-19 Telehealth Program $188,777
93.310 Trans-Nih Research Support $170,751
93.399 Cancer Control $157,322
93.865 Child Health and Human Development Extramural Research $151,223
12.420 Military Medical Research and Development $149,208
93.361 Nursing Research $137,118
93.393 Cancer Cause and Prevention Research $99,938
93.397 Cancer Centers Support Grants $92,407
93.838 Lung Diseases Research $82,856
93.396 Cancer Biology Research $75,653
93.286 Discovery and Applied Research for Technological Innovations to Improve Human Health $57,591
93.866 Aging Research $55,688
93.398 Cancer Research Manpower $54,653
93.307 Minority Health and Health Disparities Research $49,330
10.025 Plant and Animal Disease, Pest Control, and Animal Care $36,966
10.310 Agriculture and Food Research Initiative (afri) $30,736
93.394 Cancer Detection and Diagnosis Research $30,595
93.847 Diabetes, Digestive, and Kidney Diseases Extramural Research $23,934
93.121 Oral Diseases and Disorders Research $23,462
93.853 Extramural Research Programs in the Neurosciences and Neurological Disorders $19,705
12.351 Scientific Research - Combating Weapons of Mass Destruction $19,289
93.859 Biomedical Research and Research Training $18,808
93.837 Cardiovascular Diseases Research $17,469
93.839 Blood Diseases and Resources Research $1,452
93.301 Small Rural Hospital Improvement Grant Program $832
93.242 Mental Health Research Grants $-588
93.395 Cancer Treatment Research $-53,651