Finding 571382 (2023-006)

Significant Deficiency
Requirement
L
Questioned Costs
-
Year
2023
Accepted
2025-07-15

AI Summary

  • Core Issue: The organization lacks formal internal controls for allocating shared costs and employee time across federal programs, leading to potential noncompliance with federal cost principles.
  • Impacted Requirements: Compliance with 2 CFR §200.405 and §200.430(i) is at risk due to inadequate documentation and approval processes for cost allocations.
  • Recommended Follow-Up: Implement a written cost allocation policy, document allocation methodologies, and establish review and approval controls for reimbursement requests.

Finding Text

Finding number: 2023-006 Significant Deficiency in Internal Control Over Compliance: Allowable Costs and Activities Federal Program #1 HIV Emergency Relief Project Grants: CFDA Number 93.914 Federal Program #2 HIV Care Formula Grants: CFDA Number 93.917 Federal Program #2 HIV Prevention Activities: CFDA Number: 93.941 Name of federal agency: U.S. Department of Health and Human Services (HHS) AIDS Arms, Inc. dba Prism Health North Texas and Subsidiary Schedule of Findings and Questioned Costs For the Year Ended December 31, 2023 SECTION III - SUMMARY OF FEDERAL AWARD FINDINGS AND QUESTIONED COSTS (continued) Name of pass-through entity: Multiple Repeat finding: No Criteria: 2 CFR §200.405 requires that costs be allocable to the federal program based on relative benefits received and be supported by appropriate documentation. For personnel costs, 2 CFR §200.430(i) requires that compensation for employees whose time is charged to federal awards be based on records that accurately reflect the work performed, such as time and effort reporting or equivalent documentation. For shared costs, 2 CFR §200.412-200.414 requires that cost allocations be based on documented methodologies that are reasonable and supported by underlying calculations. Condition: The Organization does not have formalized internal controls to support the rationale for allocation of shared costs and employee time across federal programs. Specifically:  Time and effort is being tracked and maintained by employees, including hours charged to the specific efforts for the programs. Often, employees charge hours to specific programs in excess of amounts allocated to the program as expenditures. The specific amount of employee salaries and wages that are allocated to specific federal programs for reimbursement, and which are less than the amounts reflected in the time and effort records, are determined by members of the finance staff. The rationale for the amount actually allocated for reimbursement, if less than the amount reflected in the time and effort records, is not documented.  Review and approval of the allocation of employee compensation to specific federal programs reimbursement requests is not maintained. Cause: The deficiency exists because the Organization has not implemented a structured process for documenting the extent to which allowable compensation costs will be allocated for reimbursement to specific federal programs in instances where the allowable compensation cost exceeds the amount allocated for reimbursement. AIDS Arms, Inc. dba Prism Health North Texas and Subsidiary Schedule of Findings and Questioned Costs For the Year Ended December 31, 2023 SECTION III - SUMMARY OF FEDERAL AWARD FINDINGS AND QUESTIONED COSTS (continued) Possible effect: The absence of documented allocation methodologies in instances where allowable compensation costs exceed the amount allocated for reimbursement increases the risk that:  Costs may be improperly allocated between federal programs, resulting in potential noncompliance with federal cost principles.  Federal expenditures may be misstated, impacting financial and grant reporting. Although questioned costs were not identified, the lack of specific supporting documentation and controls represents a significant deficiency in internal control over compliance. Questioned cost: None identified at this time. Recommendation: We recommend that the Organization implement the following corrective actions: 1. Develop and Implement a Written Cost Allocation Policy – Establish a formal policy outlining the methodology for allocating shared costs and personnel time across programs, especially in instances where allowable costs exceed amounts allocated for reimbursement, ensuring compliance with 2 CFR Part 200 cost principles. 2. Document Allocation Methodologies for Shared Costs – Ensure that allocations for shared costs (e.g., rent, utilities, and administrative expenses) are based on a reasonable and documented methodology that can be reviewed and reperformed. 3. Retain Evidence of Implementation of Internal Controls - Implement review and approval controls over all requests for reimbursement, including review and approval of allocation of personnel and shared costs to specific funding sources. In circumstances where costs can be appropriately allocated to multiple funding sources, document the rationale for allocating the specific amount to each funding source. AIDS Arms, Inc. dba Prism Health North Texas and Subsidiary Schedule of Findings and Questioned Costs For the Year Ended December 31, 2023 SECTION III - SUMMARY OF FEDERAL AWARD FINDINGS AND QUESTIONED COSTS (continued) Views of responsible officials: Management respectfully disagrees with this Finding. Under Condition, the finding states, “Time and effort is being tracked and maintained by employees, including hours charged to the specific efforts for the programs.…” This is not accurate. Employees report their time worked each day, including the amount of time they worked on different projects if applicable. Employees report this in our commercial HRIS/Payroll system, where it is maintained and where it is reviewed and approved by the employee’s manager. The employees report the time they worked and which project(s) they worked on, their managers review and approve the time and the distribution, and the data is tracked and maintained in our HRIS/Payroll system (ExponentHR). Also under Condition, the finding states, “The specific amount of employee salaries and wages that are allocated to specific federal programs for reimbursement, and which are less than the amounts reflected in time and effort records, are determined by members of the finance staff.” It is correct that we would have to invoice sponsors for less than the total cost of an employee’s allocated time and effort if a sponsor’s budget is not sufficient to cover that full amount. This is the correct procedure to follow. Employees correctly continue documenting their hours worked on a specific project even if the budget is expended and the accounting staff can no longer bill the sponsor. If a particular grant does not have sufficient sponsor funds, then the Grants Accounting staff reduce the bill accordingly. Also under Condition, the finding states, “The rationale for the amount actually allocated for reimbursement, if less than the amount reflected in time and effort records, is not documented”. This is incorrect. Our monthly invoices to each sponsor accumulate, with each invoice clearly showing not only that month’s expense but also the year-to-date expense and remaining balance, which forces the sponsor invoice to stop at an amount less than the total cost of employees’ time and effort when the budget is exhausted. Also under Condition, the finding states, “Review and approval of the allocation of employee compensation to specific federal programs reimbursement requests is not maintained.” Each employee records their hours worked, and the project(s) on which they worked those hours, in our HRIS/Payroll system. The employee’s manager reviews and approves both the hours worked and the projects on which the hours were worked. This review and approval is maintained in our HRIS/Payroll system. Financial staff calculate the amount to allocate to specific federal programs based on these HRIS/Payroll system records (or other records such as clinical units produced, based on the terms of each grant). Separate accounting staff review the sponsor invoice and post the Receivable once they deem the invoice correct. Under Cause, the finding states, “…..the Organization has not implemented a structured process for documenting the extent to which allowable [emphasis added] compensation costs will be allocated for reimbursement to specific federal programs in instances where the allowable compensation cost exceeds the amount allocated for reimbursement.” This means that we do not have a AIDS Arms, Inc. dba Prism Health North Texas and Subsidiary Schedule of Findings and Questioned Costs For the Year Ended December 31, 2023 SECTION III - SUMMARY OF FEDERAL AWARD FINDINGS AND QUESTIONED COSTS (continued) process for documenting how much of a payroll expense already deemed allowable on a particular grant will actually be invoiced there. We disagree and believe that the presence and documentation of a limited sponsor budget, along with cumulative tracking and documentation of compensation expenses against that budget, proves and documents why sometimes full compensation costs are not charged to a grant. Under Possible Effect, the finding addresses possible effects of “the absence of documented allocation methodologies.” We don’t agree that our process could lead to improper allocation between federal programs (as the finding states) nor to misstating federal expenditures (as the finding states). When a sponsor’s budget is insufficient to cover its appropriately allocated compensation costs, those costs are paid from unrestricted, non-federal funds. As also noted in the finding, no questioned costs were identified.

Categories

Allowable Costs / Cost Principles

Other Findings in this Audit

  • 571359 2023-004
    Material Weakness
  • 571360 2023-005
    Significant Deficiency
  • 571361 2023-006
    Significant Deficiency
  • 571362 2023-004
    Material Weakness
  • 571363 2023-005
    Significant Deficiency
  • 571364 2023-006
    Significant Deficiency
  • 571365 2023-004
    Material Weakness
  • 571366 2023-005
    Significant Deficiency
  • 571367 2023-006
    Significant Deficiency
  • 571368 2023-004
    Material Weakness
  • 571369 2023-005
    Significant Deficiency
  • 571370 2023-006
    Significant Deficiency
  • 571371 2023-004
    Material Weakness
  • 571372 2023-005
    Significant Deficiency
  • 571373 2023-006
    Significant Deficiency
  • 571374 2023-004
    Material Weakness
  • 571375 2023-005
    Significant Deficiency
  • 571376 2023-006
    Significant Deficiency
  • 571377 2023-004
    Material Weakness
  • 571378 2023-005
    Significant Deficiency
  • 571379 2023-006
    Significant Deficiency
  • 571380 2023-004
    Material Weakness
  • 571381 2023-005
    Significant Deficiency
  • 571383 2023-004
    Material Weakness
  • 571384 2023-005
    Significant Deficiency
  • 571385 2023-006
    Significant Deficiency
  • 1147801 2023-004
    Material Weakness
  • 1147802 2023-005
    Significant Deficiency
  • 1147803 2023-006
    Significant Deficiency
  • 1147804 2023-004
    Material Weakness
  • 1147805 2023-005
    Significant Deficiency
  • 1147806 2023-006
    Significant Deficiency
  • 1147807 2023-004
    Material Weakness
  • 1147808 2023-005
    Significant Deficiency
  • 1147809 2023-006
    Significant Deficiency
  • 1147810 2023-004
    Material Weakness
  • 1147811 2023-005
    Significant Deficiency
  • 1147812 2023-006
    Significant Deficiency
  • 1147813 2023-004
    Material Weakness
  • 1147814 2023-005
    Significant Deficiency
  • 1147815 2023-006
    Significant Deficiency
  • 1147816 2023-004
    Material Weakness
  • 1147817 2023-005
    Significant Deficiency
  • 1147818 2023-006
    Significant Deficiency
  • 1147819 2023-004
    Material Weakness
  • 1147820 2023-005
    Significant Deficiency
  • 1147821 2023-006
    Significant Deficiency
  • 1147822 2023-004
    Material Weakness
  • 1147823 2023-005
    Significant Deficiency
  • 1147824 2023-006
    Significant Deficiency
  • 1147825 2023-004
    Material Weakness
  • 1147826 2023-005
    Significant Deficiency
  • 1147827 2023-006
    Significant Deficiency

Programs in Audit

ALN Program Name Expenditures
93.941 Hiv Demonstration, Research, Public and Professional Education Projects $887,872
93.332 Cooperative Agreement to Support Navigators in Federally-Facilitated Exchanges $720,011
93.940 Hiv Prevention Activities Health Department Based $638,227
93.243 Substance Abuse and Mental Health Services Projects of Regional and National Significance $470,256
93.939 Hiv Prevention Activities Non-Governmental Organization Based $420,071
93.994 Maternal and Child Health Services Block Grant to the States $391,322
93.914 Hiv Emergency Relief Project Grants $263,463
93.917 Hiv Care Formula Grants $243,462
93.918 Grants to Provide Outpatient Early Intervention Services with Respect to Hiv Disease $150,000
93.145 Hiv-Related Training and Technical Assistance $106,520
93.153 Coordinated Services and Access to Research for Women, Infants, Children, and Youth $66,691
93.855 Allergy and Infectious Diseases Research $24,615
93.837 Cardiovascular Diseases Research $10,356
93.977 Sexually Transmitted Diseases (std) Prevention and Control Grants $3,788