Finding 565127 (2024-004)

Material Weakness
Requirement
ABH
Questioned Costs
-
Year
2024
Accepted
2025-06-17

AI Summary

  • Core Issue: The Clinic lacks effective internal controls for reviewing and approving expenditures related to federal awards, leading to unsupported costs.
  • Impacted Requirements: Noncompliance with 2 CFR 200.303 (a) due to inadequate documentation and incorrect calculation of indirect costs.
  • Recommended Follow-Up: Enhance internal control policies to ensure proper review, approval, and documentation of all expenditures related to the federal program.

Finding Text

Department of Health and Human Services Federal Assistance Listing #93.912 Rural Health Care Services Outreach, Rural Health Network Development and Small Health Care Provider Quality Improvement Activities Allowed or Unallowed and Allowable Costs/Costs Principles and Period of Performance Material Weakness in Internal Control Over Compliance Criteria: 2 CFR 200.303 (a) establishes that the auditee must establish and maintain effective internal control over federal awards that provides reasonable assurance that the entity is managing the federal award in compliance with federal statutes, regulations and conditions of the federal award. Condition: During our testing, it was noted that some expenditures were not fully supported by underlying documentation. In addition, some of the expenditures tested did not have documentation of the review and approval of the allocation of the expenditure to the federal program. The Clinic also calculated their indirect cost rate based on the total grant budget and claimed an equal amount of indirect costs per month instead of calculating the indirect cost rate per direct expenditures for each month. Cause: The Clinic did not have an internal control policy in place to ensure the review and approval of expenditures and the allocation of expenditures to the federal program was documented. In addition, the Clinic did not have an internal control process in place to ensure the correct amounts of indirect costs were requested based on the direct costs for the same period. Effect: The lack of adequate policies governing review and approval over expenditures and the allocation of expenditures to the federal program increases the risk that employees participating in the federal award administration may not be able to detect and correct noncompliance in a timely manner. Questioned Costs: None reported. Context/Sampling: A nonstatistical sample of 15 expenditures were selected for testing, which accounted for $199,720 of $613,623 direct program expenditures. Eight of the expenditures did not contain evidence of a secondary review to verify that expenditures met the terms and conditions of the program and was properly allocated to the program. A nonstatistical sample of 3 expenditures were selected for testing, which accounted for $11,153 of $22,307 indirect program expenditures. None of the expenditures were calculated based off of actual direct costs or contained evidence of a secondary review to verify that expenditures met the terms and conditions of the program. Repeat Finding from Prior Years: No Recommendation: We recommend the Clinic enhance internal control policies to ensure expenditures and the allocation of expenditures to the federal program are reviewed and approved and all of that information is retained to ensure that all payments are necessary, correct, and meet the requirements of the federal program. View of Responsible Officials: Management agrees with the finding.

Corrective Action Plan

Finding 2024-004 Federal Agency Name: Department of Health and Human Services Program Name: Rural Health Care Services Outreach, Rural Health Network Development and Small Health Care Provider Quality Improvement Federal Financial Assistance Listing #93.912 Compliance Requirement: Activities Allowed or Unallowed and Allowable Costs/Costs Principles and Period of Performance Finding Summary: Some expenditures were not fully supported by underlying documentation. In addition, some of the expenditures tested did not have documentation of the review and approval of the allocation of the expenditure to the federal program. The Clinic also calculated their indirect cost rate based on the total grant budget and claimed an equal amount of indirect costs per month instead of calculating the indirect cost rate per direct expenditures for each month. Responsible Individuals: Kayla Trent, Finance Director Corrective Action Plan: Management agrees with the finding and has reviewed the operating procedures of Robert C. Byrd Clinic. Furthermore, we have implemented procedures to retain expenditure listings and other support for federal awards as well as the related review. The Clinic began retaining expense reconciliations for all Grants. Anticipated Completion Date: July 1, 2024

Categories

Allowable Costs / Cost Principles Material Weakness Period of Performance

Other Findings in this Audit

  • 565126 2024-003
    Material Weakness
  • 1141568 2024-003
    Material Weakness
  • 1141569 2024-004
    Material Weakness

Programs in Audit

ALN Program Name Expenditures
93.912 Rural Health Care Services Outreach, Rural Health Network Development and Small Health Care Provider Quality Improvement $635,929
93.788 Opioid Str $430,415
97.008 Non-Profit Security Program $69,542