Finding 386903 (2021-006)

Significant Deficiency
Requirement
N
Questioned Costs
-
Year
2021
Accepted
2024-03-28

AI Summary

  • Core Issue: CBNHC failed to maintain proper records and complete background checks for employees, violating federal requirements.
  • Impacted Requirements: Background check compliance under the Indian Self-Determination program was not met, affecting employee suitability determinations.
  • Recommended Follow-Up: CBNHC should enforce its background check policies to ensure timely processing and compliance, addressing staffing shortages and vendor delays.

Finding Text

2021-006 — Special Tests and Provisions – Background Checks Federal/state program information: Funding agency: U.S. Department of Health and Human Services Title: Indian Self-Determination ALN: 93.441 Award period: 10/1/2020 – 9/30/2021 Criteria: The AFA with I.H.S. requires CBNHC to conduct fingerprinting and background checks of employees, contractors, and patient care providers as required by applicable law (including 25 U.S.C. Section 3207 and 1647 (a)(b) and 42 C.F.R. Sections 136.401 to 136.418) and in accordance with the policies and procedures of CBNHC. Condition: CBNHC did not maintain records of the start/hire date, fingerprint charts, completed background check, and the suitability determination/adjudication for one employee. For one other employee, the suitability determination/adjudication was not completed until almost five years after their hire date (although the background check was completed within three months of their hire date). Context: Two of six employees tested for the Indian Self-Determination program. Questioned Costs: None Cause: CBNHC was significantly impacted by the COVID-19 pandemic, which caused turnover in the Human Resources department at CBNHC. Effect: CBNHC is not in compliance with background check requirements for the Indian Self-Determination program. Auditor’s Recommendations: CBNHC should implement its policies and procedures regarding background checks to ensure that all employees and contractors are subject to fingerprinting and background checks. Management’s Response: CBNHC experienced substantial staffing shortages and struggled with the impacts of the COVID-19 pandemic throughout fiscal year 2021. During this time, CBNHC continued with its recruiting of staff to carry out the human resource duties and responsibilities required for regulatory compliance; however, continued management vacancies and COVID-19 severely impacted its ability to obtain necessary human resources and other key staff. The Controller continued in the role of Acting CEO for the first half of fiscal year 2021 and formally assumed the CEO position as of March 18, 2021. The Acting CEO remained responsible for operations of the organization, the Finance Department, and Human Resources during this time. The Human Resources Director position was vacant throughout most of fiscal year 2021 and was finally filled in August 2021. The recruiting challenges and continued effects of the pandemic left CBNHC leadership severely short-staffed, causing significant delays in processing required background checks. The status of the approved Human Resources and associated administrative positions and their status at the close of fiscal year 2021 is summarized as follows: • Chief Executive Officer (Position Status: Vacant from June 11, 2020 – March 18, 2021) – Responsible for providing administrative oversight for all aspects of the efficient operations of CNBHC and serves as the administrative authority for the organization and its health programs. Interim CEO duties were assigned to the Controller, who formally accepted the position in March 2021. • Controller (Position Status: Vacant from March 18, 2021 – September 30, 2021) – Responsible for management, oversight, and administration of the CBNHC accounting, finance, payroll and tax functions, advises executive leadership on financial management and strategic planning; develops, modifies and enforces financial accounting safeguards. The Acting CEO was serving as Acting Controller. The Controller was appointed Acting CEO in February 2020 and formally accepted the position in March 2021. • Human Resource Director (Position Status: Vacant from October 1, 2020 – August 30, 2021) – Guides and manages the overall provision of Human Resources services, policies, and benefit programs for CBNHC. The Human Resources Director will assist in confirming payroll set-up, including rates and deductions, and will participate in reviewing benefit invoices to ensure accuracy. As noted above, the Human Resources Director (previously Manager) was vacant for most of fiscal year 2021, with the Controller maintaining responsibilities of the CEO, Controller, and Human Resources Director. Additionally, vendors that process and finalize CBNHC background checks experienced severe backlogs due to delays across the nation’s court systems in the aftermath of the pandemic and associated shutdowns. These delays contributed to further delays in CBNHC receiving adjudication and background results.

Corrective Action Plan

2021-006 – Special Tests and Provisions – Background Checks Corrective Action: In August 2021, CBNHC recruited and hired an experienced Human Resources Director. Filling this position allowed CBNHC to make progress in rectifying prior human resources weaknesses and improve processes. The position again became vacant in September 2022 and was most recently filled in March 2023. The addition of a Human Resources Assistant was approved in May 2023 and filled in January 2024. Filling these two positions has allowed CBNHC to further address gaps and delays in human resources operations and meeting compliance requirements. CBNHC is implementing the following corrective action plan to ensure compliance with the background check requirements of the Indian Self-Determination program. • Complete Human Resources Onboarding checklist recording all policies and background checks completed for every new employee to be stored in personnel files. • Build, maintain, and review (monthly) spreadsheets that record all CBNHC employees, contractors, and student interns, required background checks by vendor, date submitted/requested, date results received, and date next background check is required. • Audit of all employee background check files to identify and address any current deficiencies. • Develop and implement HR Standard Operating Procedures to ensure that processes for completing background checks are clearly documented for ease of execution. • Continue to monitor and reassess performance against current HR compliance requirements. • Monitor workload of HR staff in relation to continued organizational growth to determine if additional positions are necessary to ensure continued regulatory compliance. Person Responsible: Several individuals will be responsible for the corrective action plan, by area, as follows: • HR Standard Operating Procedures: The Human Resources Director (Christina Chavez) will create and maintain the detailed instructions for carrying out the functions and duties of the HR Department, to include the procedures for completing all required background checks in a timely manner to ensure compliance. • Background Check Spreadsheet: The Human Resources Director (Christina Chavez) will create the spreadsheet to include all CBNHC employees, contractors, and student interns, required background checks by vendor, date submitted/requested, date results received, and date next background check is required. The Human Resources Director (Christina Chavez) and Human Resources Assistant (Tiffany Begay) will jointly review the spreadsheet monthly, typically within the first 10 days of each month, to determine any necessary action. Both will participate in maintaining the data as appropriate. • Audit: The Human Resources Director (Christina Chavez) and Human Resources Assistant (Tiffany Begay) will complete an initial audit of all existing background check files to identify and address any current deficiencies. Going forward, the Human Resources Assistant (Tiffany Begay) will conduct a full audit of these files biannually, with the Human Resources Director (Christina Chavez) auditing three (3) random samples quarterly. Completion Date: Work in progress as of March 15, 2024. The HR Department staff meet daily to discuss progress on successes and challenges. The target date for completion of the background check spreadsheet and initial audit of existing files is April 26, 2024. The target date for completion of the HR Standard Operating Procedures is within six (6) months of this response (September 15, 2024).

Categories

Special Tests & Provisions Internal Control / Segregation of Duties

Other Findings in this Audit

  • 386898 2021-004
    Material Weakness Repeat
  • 386899 2021-004
    Material Weakness Repeat
  • 386900 2021-004
    Material Weakness Repeat
  • 386901 2021-004
    Material Weakness Repeat
  • 386902 2021-005
    Significant Deficiency
  • 386904 2021-007
    Significant Deficiency
  • 386905 2021-004
    Material Weakness Repeat
  • 386906 2021-004
    Material Weakness Repeat
  • 963340 2021-004
    Material Weakness Repeat
  • 963341 2021-004
    Material Weakness Repeat
  • 963342 2021-004
    Material Weakness Repeat
  • 963343 2021-004
    Material Weakness Repeat
  • 963344 2021-005
    Significant Deficiency
  • 963345 2021-006
    Significant Deficiency
  • 963346 2021-007
    Significant Deficiency
  • 963347 2021-004
    Material Weakness Repeat
  • 963348 2021-004
    Material Weakness Repeat

Programs in Audit

ALN Program Name Expenditures
93.441 Indian Self-Determination $8.23M
93.391 Activities to Support State, Tribal, Local and Territorial (stlt) Health Department Response to Public Health Or Healthcare Crises $242,298
93.237 Special Diabetes Program for Indians_diabetes Prevention and Treatment Projects $197,623
21.019 Coronavirus Relief Fund $118,317
93.772 Tribal Public Health Capacity Building and Quality Improvement Umbrella Cooperative Agreement $63,745
93.228 Indian Health Service_health Management Development Program $-53,186