Finding 403363 (2023-001)

Material Weakness
Requirement
A
Questioned Costs
-
Year
2023
Accepted
2024-06-27
Audit: 310494
Organization: Genesee Health System (MI)

AI Summary

  • Core Issue: Significant lack of documentation for approximately $241,151 in expenses charged to the grant.
  • Impacted Requirements: Failure to comply with 2 CFR 200.402 regarding allowable costs and proper documentation.
  • Recommended Follow-Up: Implement stronger internal controls to ensure all grant expenses are backed by appropriate documentation.

Finding Text

Finding 2023-001 – ACTIVITIES ALLOWED OR UNALLOWED and ALLOWABLE COSTS/COST PRINCIPLES Type: Material Weakness in Internal Control Program: Health Center Cluster (ALN 93.224) Criteria: As detailed by 2 CFR 200.402, “The total cost of a Federal award is the sum of the allowable direct and allocable indirect costs less any applicable credits.” Condition: The CMHSP was unable to provide supporting documentation for some expenses charged to the grants. Cause/Effect: In previous years, the process to charge injectable supplies expenses to the grant was to allocate these expenses from Health Center program to the grant through a journal entry. During fiscal year 2023, the cost of injectable supplies paid through the Health Center program decreased significantly. However, when journal entries were prepared, a review of actual costs was not done to ensure that the expenses allocated through the journal entry were supported by appropriate documentation. Therefore, some costs charged to the grant for injectable supplies exceeded amounts that were supported by appropriate documentation. Approximately $241,151 of injectable supplies expenses charged to the grant were not supported by appropriate documentation (i.e.: invoices). Context: These unsupported injectable supplies expenses could have been completely replaced with allowable payroll and related fringe benefit expenses. Recommendation: We recommend that the CMHSP establish internal controls to ensure that all expenses charged to the grant are supported with appropriate documentation. Management’s Resp: We are in agreement with this finding.

Corrective Action Plan

Finding 2023-001: Activities Allowed or Unallowed and Allowable Cost/Cost Principles Description of Finding: Material Weakness in Internal Control – CMHSP unable to provide supporting documentation for some expenses charged to the grant. Corrective Action: GHS agrees with the finding and that there were sufficient costs in other cost centers, allowable by the budget submitted to HRSA, to replace the unsupported expenses. We also acknowledge the fact that the controls in place were not effectively applied to identify the issue prior to the single audit testing began. GHS has already taken steps to eliminate the risk of such an issue in the future by automating the coding process through the payroll system and increasing the number of reviewers of grant related expenditures on a monthly basis. The following steps have been put in place for future years: • Once the grant budget has been approved by the Board of Directors and submitted to HRSA, staff allocated to the grant will be coded in the payroll system directly to the grant cost center. • Any other costs included in the submitted grant budget will be directly coded to that cost center as incurred on a monthly basis as well. • A review of the costs assigned to the grant cost center will be completed, comparing the actual costs each month to allocated monthly budgeted amount that was approved and submitted to HRSA. • This review will be done by the accounting manager responsible for grant reporting as well as the accounting manager responsible for the FQHC financial reporting as a whole. The Executive Director of the FQHC and the CFO will provide the final review of the monthly expenditures charged to the grant. • Any questions or needed changes will be communicated to the grant accountant for explanation or modification each month. Name of Contact Person: Glen Chipman, CFO 1040 W Bristol Rd Flint, MI 48732 810-496-5487 gchipman@genhs.org Projected Completion Date: The above outlined steps have been put in place as of 6/15/2024 and will be reviewed periodically for continued compliance.

Categories

Allowable Costs / Cost Principles

Other Findings in this Audit

  • 403364 2023-002
    Significant Deficiency
  • 979805 2023-001
    Material Weakness
  • 979806 2023-002
    Significant Deficiency

Programs in Audit

ALN Program Name Expenditures
93.224 Consolidated Health Centers (community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care) $2.09M
93.997 Assisted Outpatient Treatment $850,295
93.767 Children's Health Insurance Program $315,307
14.267 Continuum of Care Program $248,709
93.778 Medical Assistance Program $247,917
93.696 Certified Community Behavioral Health Clinic Expansion Grants $229,345
14.218 Community Development Block Grants/entitlement Grants $203,389
93.665 Emergency Grants to Address Mental and Substance Use Disorders During Covid-19 $126,608
93.323 Epidemiology and Laboratory Capacity for Infectious Diseases (elc) $117,541
93.530 Affordable Care Act - Teaching Health Center Graduate Medical Education Payments Program $88,111
93.575 Child Care and Development Block Grant $51,750
93.958 Block Grants for Community Mental Health Services $40,242
93.526 Affordable Care Act (aca) Grants for Capital Development in Health Centers $38,850
93.994 Maternal and Child Health Services Block Grant to the States $16,500
93.268 Immunization Cooperative Agreements $3,225