Finding 366881 (2022-003)

Significant Deficiency
Requirement
I
Questioned Costs
-
Year
2022
Accepted
2024-02-12

AI Summary

  • Core Issue: Two out of four vendors lacked documentation proving they were not suspended or debarred before transactions.
  • Impacted Requirements: Compliance with 2 CFR section 180.995 and 2 CFR 200.303 regarding vendor verification.
  • Recommended Follow-Up: Implement a policy to maintain evidence of vendor compliance, such as checking the GSA website or obtaining vendor certifications.

Finding Text

2022-003: Suspension & Debarment Federal agency: Department of Health and Human Services Federal program: Substance Abuse and Mental Health Services Administration (SAMHSA) – Health Clinic (CCBHC) Expansion Assistance Listing Numbers: 93.829 Federal Award Identification Number and Year: 5H79SM085197-02 Award Period: January 1, 2022 – December 31, 2022 Type of Finding: • Significant Deficiency in Internal Control over Compliance • Compliance - Other Matter Criteria or specific requirement: When a non-federal entity enters into a covered transaction with an entity at a lower tier, the non-federal entity must verify that the entity, as defined in 2 CFR section 180.995 and agency adopting regulations, is not suspended or debarred or otherwise excluded from participating in the transaction. This verification may be accomplished by (1) checking the System for Award Management (SAM) Exclusions maintained by the General Services Administration (GSA) and available at https://www.beta.sam.gov, (2) collecting a certification from the entity, or (3) adding a clause or condition to the covered transaction with that entity (2 CFR section 180.300). In addition, 2 CFR 200.303 in the federal regulations cover internal controls over compliance. Condition: We identified two of the four vendors sampled that lacked documentation supporting the vendor was not suspended or debarred prior to entering into a covered transaction. Questioned costs: None Context: Of the four covered transactions tested, two lacked documentation supporting the Organization verified the vendor was not suspended or debarred prior to entering into a covered transaction. Cause: Management did not retain evidence demonstrating they verified the vendors were not suspended or debarred prior to entering into the covered transaction. Effect: By not retaining evidence that management verified vendors were not suspended or debarred, management may erroneously enter into a covered transaction with vendors that were suspended or debarred. Repeat finding: No Recommendation: We recommend management adopt a policy to ensure evidence of compliance to suspension and debarment regulations are maintained. This can include maintaining evidence that management reviewed the GSA website, maintaining a certification from the vendor, or including a clause in a contract with vendors that they are not suspended or debarred. Views of responsible officials: Management did request and receive pre-approval from the federal granting agency to use the two specified vendors, but agree that we did not also retain explicit suspension and debarment documentation of those vendors at that time. We did subsequently verify they were not suspended or debarred.

Corrective Action Plan

Significant Deficiency 2023-003 Control over Compliance – Suspension & Debarment Documentation Assistance Listing No. 93.829– Substance Abuse and Mental Health Services Administration (SAMHSA)– Health Clinic(CCBHC) Expansion Recommendation: We recommend management adopt a policy to ensure evidence of compliance to suspension and debarment regulations are maintained. This can include maintaining evidence that management reviewed the GSA website, maintaining a certification from the vendor, or including a clause in a contract with vendors that they are not suspended or debarred. Management Response: Management requested and received pre-approval from the federal granting agency to use the two specified vendors identified in the audit finding. The two vendors are a reputable research nonprofit (and sole source for this work in Minnesota) and a reputable company used before to maintain our Electronic Health Records system. We could not show documentation of verifying the vendor’s suspension and debarment credentials prior to entering into the contract, so the auditors determined that they must report this matter since the control over reviewing the vendors’ suspension and debarment qualifications was not documented prior to signing a contract with them. We have met internally to ensure our procurement procedures account retain such documentation going forward, but Management reiterates that the federal granting agency approved the use of these vendors prior to entering into contract. Action taken in response to finding: Management received notification of this matter in June 2023 and conducted suspension and debarred verification. Upon notification of this matter, the VP of Finance and Administration and the Controller initiated improved processes and guidelines with the leads of our Procurement and Accounting teams to ensure documentation of suspension & debarment qualifications of current and future vendors/consultants for our programs and clinical services. In addition, our template contract for external services has been updated to require this verification prior to entering into a contract with external consultants/vendors so we can ensure compliance with this federal requirement. Name of the contact person responsible for corrective action: Ryan Robinson (VPFA) Planned completion date for corrective action plan: June 2023

Categories

Procurement, Suspension & Debarment

Other Findings in this Audit

  • 943323 2022-003
    Significant Deficiency

Programs in Audit

ALN Program Name Expenditures
93.829 Section 223 Demonstration Programs to Improve Community Mental Health Services $2.49M
21.019 Coronavirus Relief Fund $555,359
17.277 Workforce Investment Act (wia) National Emergency Grants $317,384
93.596 Child Care Mandatory and Matching Funds of the Child Care and Development Fund $303,834
93.870 Maternal, Infant and Early Childhood Home Visiting Grant $269,786
93.558 Temporary Assistance for Needy Families $190,900
16.017 Sexual Assault Services Formula Program $185,113
14.231 Emergency Solutions Grant Program $153,775
10.551 Supplemental Nutrition Assistance Program $140,792
21.023 Emergency Rental Assistance Program $96,617
21.009 Volunteer Income Tax Assistance (vita) Matching Grant Program $81,701
16.023 Sexual Assault Services Cuturally Specific Program $55,732
84.425 Education Stabilization Fund $34,582
93.044 Special Programs for the Aging_title Iii, Part B_grants for Supportive Services and Senior Centers $31,536
93.958 Block Grants for Community Mental Health Services $30,763
93.788 Opioid Str $27,740
14.218 Community Development Block Grants/entitlement Grants $25,863
93.959 Block Grants for Prevention and Treatment of Substance Abuse $6,392
21.027 Coronavirus State and Local Fiscal Recovery Funds $4,713
14.169 Housing Counseling Assistance Program $2,500