Finding 481134 (2022-017)

Significant Deficiency
Requirement
G
Questioned Costs
-
Year
2022
Accepted
2024-08-15
Audit: 317252
Organization: Unity Health Care, Inc. (MD)
Auditor: Bdo USA PC

AI Summary

  • Core Issue: The Corporation lacks formal policies and procedures for managing matching or cost-sharing requirements, leading to insufficient evidence for compliance.
  • Impacted Requirements: Noncompliance with 2 CFR 200.303(a) and 2 CFR 200.306(b) regarding internal controls and criteria for shared costs.
  • Recommended Follow-Up: Establish formal internal controls and documentation processes to ensure compliance with matching requirements for Federal awards.

Finding Text

Criteria: 2 CFR 200.303(a) establishes that the auditee must establish and maintain effective internal control over the Federal award that provides assurance that the entity is managing the Federal award in compliance with Federal statutes, regulations, and the terms and conditions of the Federal award. 2 CFR 200.306(b) identifies the requirements for all Federal awards that any shared costs or matching funds and all contributions, including cash and third-party in-kind contributions, must be accepted as part of the non- Federal entity's cost sharing or matching when such contributions meet all of the following criteria: (1) Are verifiable from the non-Federal entity's records; (2) Are not included as contributions for any other Federal award; (3) Are necessary and reasonable for accomplishment of project or program objectives; (4) Are allowable under 2 CFR 200 Subpart E; (5) Are not paid by the Federal Government under another Federal award, except where the Federal statute authorizing a program specifically provides that Federal funds made available for such program can be applied to matching or cost sharing requirements of other Federal programs; (6) Are provided for in the approved budget when required by the Federal awarding agency; and (7) Conform to other provisions of this part, as applicable. Condition: During our testing, the Corporation was unable to provide sufficient and appropriate evidence to substantiate that the matched or shared cost were received and accepted in conformance with the criteria listed above or award agreement. Cause: The Corporation did not have formal policies and procedures over matching or cost sharing. Effect or Potential Effect: Without proper internal controls and policies and procedures in place to monitor and review the matching requirements could result in Federal noncompliance. Questioned costs: None Context: This is a condition identified per review of the Corporation’s compliance with specified requirements over matching or cost sharing. Repeat finding: No Recommendation: We recommend the Corporation establish formal internal controls, and documentation of their performance, relating to the matching requirements of the related grant award. View of Responsible Officials: Due to turnover of several key financial executives and personnel and lack of formal documentation of current policies and procedures, the Corporation did not maintain sufficient or appropriate evidence to substantiate that the matched or shared cost were spent in conformance with the criteria listed above or award agreement.

Corrective Action Plan

Management Response #2022-017: Due to the staff shortages and turnover in FY2020-2022 the company did not have adequate personnel in place to monitor or document grant activity. Formal documentation of policies and procedures were also deficient. Additionally, documents were not stored centrally, which made it extremely difficult to find supporting documentation. Corrective Action Plan: The procedures adopted in 2024 will be formally documented and published that will ensure proper cost sharing or matching are clearly understood and defined. The requirements for matching as well as consistent monitoring metrics will be outlined in the procedures document as well. Greater and enhanced documentation will be properly maintained and available for review as required. Responsible Party: Tamara Barnes, CFO

Categories

Matching / Level of Effort / Earmarking

Other Findings in this Audit

  • 481113 2022-004
    Material Weakness Repeat
  • 481114 2022-005
    Material Weakness Repeat
  • 481115 2022-006
    Material Weakness Repeat
  • 481116 2022-007
    Significant Deficiency Repeat
  • 481117 2022-009
    Material Weakness Repeat
  • 481118 2022-010
    Significant Deficiency Repeat
  • 481119 2022-011
    Significant Deficiency Repeat
  • 481120 2022-004
    Material Weakness Repeat
  • 481121 2022-005
    Material Weakness Repeat
  • 481122 2022-006
    Material Weakness Repeat
  • 481123 2022-007
    Significant Deficiency Repeat
  • 481124 2022-009
    Material Weakness Repeat
  • 481125 2022-010
    Significant Deficiency Repeat
  • 481126 2022-011
    Significant Deficiency Repeat
  • 481127 2022-004
    Material Weakness Repeat
  • 481128 2022-005
    Material Weakness Repeat
  • 481129 2022-006
    Material Weakness Repeat
  • 481130 2022-007
    Significant Deficiency Repeat
  • 481131 2022-012
    Significant Deficiency
  • 481132 2022-013
    Significant Deficiency
  • 481133 2022-016
    Significant Deficiency
  • 481135 2022-004
    Material Weakness Repeat
  • 481136 2022-005
    Material Weakness Repeat
  • 481137 2022-006
    Material Weakness Repeat
  • 481138 2022-008
    Significant Deficiency Repeat
  • 481139 2022-009
    Material Weakness Repeat
  • 481140 2022-016
    Significant Deficiency
  • 481141 2022-004
    Material Weakness Repeat
  • 481142 2022-005
    Material Weakness Repeat
  • 481143 2022-006
    Material Weakness Repeat
  • 481144 2022-007
    Significant Deficiency Repeat
  • 481145 2022-016
    Significant Deficiency
  • 481146 2022-004
    Material Weakness Repeat
  • 481147 2022-005
    Material Weakness Repeat
  • 481148 2022-006
    Material Weakness Repeat
  • 481149 2022-010
    Significant Deficiency Repeat
  • 481150 2022-014
    Material Weakness
  • 481151 2022-015
    Significant Deficiency
  • 481152 2022-016
    Significant Deficiency
  • 1057555 2022-004
    Material Weakness Repeat
  • 1057556 2022-005
    Material Weakness Repeat
  • 1057557 2022-006
    Material Weakness Repeat
  • 1057558 2022-007
    Significant Deficiency Repeat
  • 1057559 2022-009
    Material Weakness Repeat
  • 1057560 2022-010
    Significant Deficiency Repeat
  • 1057561 2022-011
    Significant Deficiency Repeat
  • 1057562 2022-004
    Material Weakness Repeat
  • 1057563 2022-005
    Material Weakness Repeat
  • 1057564 2022-006
    Material Weakness Repeat
  • 1057565 2022-007
    Significant Deficiency Repeat
  • 1057566 2022-009
    Material Weakness Repeat
  • 1057567 2022-010
    Significant Deficiency Repeat
  • 1057568 2022-011
    Significant Deficiency Repeat
  • 1057569 2022-004
    Material Weakness Repeat
  • 1057570 2022-005
    Material Weakness Repeat
  • 1057571 2022-006
    Material Weakness Repeat
  • 1057572 2022-007
    Significant Deficiency Repeat
  • 1057573 2022-012
    Significant Deficiency
  • 1057574 2022-013
    Significant Deficiency
  • 1057575 2022-016
    Significant Deficiency
  • 1057576 2022-017
    Significant Deficiency
  • 1057577 2022-004
    Material Weakness Repeat
  • 1057578 2022-005
    Material Weakness Repeat
  • 1057579 2022-006
    Material Weakness Repeat
  • 1057580 2022-008
    Significant Deficiency Repeat
  • 1057581 2022-009
    Material Weakness Repeat
  • 1057582 2022-016
    Significant Deficiency
  • 1057583 2022-004
    Material Weakness Repeat
  • 1057584 2022-005
    Material Weakness Repeat
  • 1057585 2022-006
    Material Weakness Repeat
  • 1057586 2022-007
    Significant Deficiency Repeat
  • 1057587 2022-016
    Significant Deficiency
  • 1057588 2022-004
    Material Weakness Repeat
  • 1057589 2022-005
    Material Weakness Repeat
  • 1057590 2022-006
    Material Weakness Repeat
  • 1057591 2022-010
    Significant Deficiency Repeat
  • 1057592 2022-014
    Material Weakness
  • 1057593 2022-015
    Significant Deficiency
  • 1057594 2022-016
    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) $4.41M
93.788 Opioid Str $1.46M
93.217 Family Planning_services $1.34M
10.557 Special Supplemental Nutrition Program for Women, Infants, and Children $1.29M
93.914 Hiv Emergency Relief Project Grants $898,253
93.918 Grants to Provide Outpatient Early Intervention Services with Respect to Hiv Disease $584,947
93.837 Cardiovascular Diseases Research $402,416
93.917 Hiv Care Formula Grants $367,131
93.426 Improving the Health of Americans Through Prevention and Management of Diabetes and Heart Disease and Stroke $178,078
93.994 Maternal and Child Health Services Block Grant to the States $169,521
93.268 Immunization Cooperative Agreements $167,318
93.236 Grants to States to Support Oral Health Workforce Activities $104,190
93.898 Cancer Prevention and Control Programs for State, Territorial and Tribal Organizations $81,214
93.526 Affordable Care Act (aca) Grants for Capital Development in Health Centers $77,935
93.889 National Bioterrorism Hospital Preparedness Program $33,398
93.279 Drug Abuse and Addiction Research Programs $31,446
93.297 Teenage Pregnancy Prevention Program $14,271
93.855 Allergy, Immunology and Transplantation Research $1,571