Presented by: Jason Mastrangelo and Stephanie Sowalsky Office of Federal Assistance Management...

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Presented by: Jason Mastrangelo and Stephanie Sowalsky Office of Federal Assistance Management (OFAM) Health Resources and Services Administration (HRSA) U.S. Department of Health and Human Services (HHS) HRSA’s Top 5 Most Common Audit Findings

Transcript of Presented by: Jason Mastrangelo and Stephanie Sowalsky Office of Federal Assistance Management...

Page 1: Presented by: Jason Mastrangelo and Stephanie Sowalsky Office of Federal Assistance Management (OFAM) Health Resources and Services Administration (HRSA)

Presented by:Jason Mastrangelo and Stephanie Sowalsky

Office of Federal Assistance Management (OFAM)Health Resources and Services Administration (HRSA)U.S. Department of Health and Human Services (HHS)

HRSA’s Top 5 Most Common Audit

Findings

Page 2: Presented by: Jason Mastrangelo and Stephanie Sowalsky Office of Federal Assistance Management (OFAM) Health Resources and Services Administration (HRSA)

Agenda• Overview• Top 5 Most Common Audit Findings - HRSA

grants• Define the finding • Why it occurred• How to resolve the finding• How to prevent findings in the future• Real-world examples

• Q & A Sessions• Both during and after presentation

• Closing Remarks

Page 3: Presented by: Jason Mastrangelo and Stephanie Sowalsky Office of Federal Assistance Management (OFAM) Health Resources and Services Administration (HRSA)

Overview

• Per Uniform Guidance 2 CFR Part 200 (f), formerly OMB Circular A-133, if an entity expends (or draws down) $750,000 or more in federal funds, it is required to receive a Single Audit. (Codified for HHS at 45 CFR Part at 45 CFR 75.500)

• During those audits, it is the responsibility of the auditor to identify weaknesses and develop findings which show areas of non-compliance.

Page 4: Presented by: Jason Mastrangelo and Stephanie Sowalsky Office of Federal Assistance Management (OFAM) Health Resources and Services Administration (HRSA)

Where do Audits come from?

CPA firm uploads audit to the

Federal Audit Clearinghouse

(FAC).

FAC transmits DHHS audits with findings to DHHS/OIG/NEAR. NEAR also sends a letter to the grantee asking them to respond to

HRSA regarding the findings.

DHHS/OIG/NEAR transmits audits

with HRSA findings to DFI

Page 5: Presented by: Jason Mastrangelo and Stephanie Sowalsky Office of Federal Assistance Management (OFAM) Health Resources and Services Administration (HRSA)

Overview (cont’d)Why are audit findings important?

• Why it is important to us? • Responsible to ensure tax payer dollars go towards the intended

use. • OFAM is responsible for ensuring findings from your audit reports

are resolved.

• Why its important to you, as the recipient of a Federal award? • Ensure quality of care and access to care is not compromised.• Future federal funding will not be in jeopardy.

*Adverse findings may lead to us asking for the money back, or even

the termination of a grant!

Page 6: Presented by: Jason Mastrangelo and Stephanie Sowalsky Office of Federal Assistance Management (OFAM) Health Resources and Services Administration (HRSA)

Overview (cont’d)Why are we doing this?

• Program Integrity Initiative

• Information Sharing

*By identifying these key issues, we can raise awareness to prevent future occurrences

of non-compliance.

Page 7: Presented by: Jason Mastrangelo and Stephanie Sowalsky Office of Federal Assistance Management (OFAM) Health Resources and Services Administration (HRSA)

Top 5 Most Common Findings

Page 8: Presented by: Jason Mastrangelo and Stephanie Sowalsky Office of Federal Assistance Management (OFAM) Health Resources and Services Administration (HRSA)

#5 - Cash Management

• 20% of audits received

• Cash Management (CM) covers the actual management, or handling, of funds pertaining to a Federal program, specifically on how Federal assistance (or a grant) is distributed to recipients and how recipients manage the funds until disbursement.

• Typical Types of CM findings include:• Advance Drawdown/Drawdown exceeds need• Deferred Revenue • Segregation of Duties

Page 9: Presented by: Jason Mastrangelo and Stephanie Sowalsky Office of Federal Assistance Management (OFAM) Health Resources and Services Administration (HRSA)

Cash ManagementContinued

• Sample Audit Finding• Criteria • Description of finding• Recommendation

• Corrective Action

Page 10: Presented by: Jason Mastrangelo and Stephanie Sowalsky Office of Federal Assistance Management (OFAM) Health Resources and Services Administration (HRSA)

Cash ManagementContinued

• Best Practices• Reimbursements, or claimed expenditures, are properly

supported by adequate documentation. • Advance payments are properly managed. • Interest earned on advance payments is inconsequential

(minimal). • Internal controls are in place over cash receipts and cash

disbursements , as well as, the safeguarding of assets.

*If you are engaging in these types of activities, then you are practicing effective cash management.

Page 11: Presented by: Jason Mastrangelo and Stephanie Sowalsky Office of Federal Assistance Management (OFAM) Health Resources and Services Administration (HRSA)

Cash Management

• Q & A session focusing cash management

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#4 – Program Income

• 25% of audits received

• Program income, as defined at 45 CFR Parts 74.2 and 92.25, includes several different categories of income. Program income includes income resulting from fees for services performed or the sale of commodities or items produced as part of project activities; income earned from the use or rental of property acquired under a grant; and license fees and royalties on patents and copyrights; and Principle and Interest on Loans made with federal awards.

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Program IncomeContinued

• Common occurrences seen at HRSA categorized under Program Income:

• Sliding Fee• Not properly recorded• Excess of $500

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Program IncomeContinued

• Auditors are looking at key areas for the treatment of program income:

• Was it properly calculated, typically by sliding fee schedule – income based? • Did grantee demonstrate that all program

income that should’ve been received was received?• Were proper alternatives were used?

Page 15: Presented by: Jason Mastrangelo and Stephanie Sowalsky Office of Federal Assistance Management (OFAM) Health Resources and Services Administration (HRSA)

Program IncomeContinued

• Treatment of Program Income – Alternatives

• Deductive alternative – under this alternative, program income is deducted from total allowable project/program costs to determine the net allowable costs on which the Federal share of costs is based. This is similar to an applicable credit being applied to reduce the amount of the Federal award.

• For most HRSA grants (and all non-research grants) Deductive is the default alternative.

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Program IncomeContinued

• Additive Alternative – Under this alternative, program income is added to the funds committed to the project or program and is used to further eligible project/program objectives. This alternative must be pre-approved.

• Awarding agency may, on a case-by-case basis, allow the use of program income for eligible costs of the project that might not otherwise be expressly allowable under the terms and conditions of the award.

• Under the additive alternative, non-federal entities must expend program income before requesting additional Federal payments.

Page 17: Presented by: Jason Mastrangelo and Stephanie Sowalsky Office of Federal Assistance Management (OFAM) Health Resources and Services Administration (HRSA)

Program IncomeContinued

• Cost Sharing or Matching Alternative• Awareness

• Sample Audit Finding• Criteria • Description of finding• Recommendation

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Program IncomeContinued

• Best Practices• It is policy that grantees be encouraged to earn program

income and to maximize such income, consistent with the purpose and nature of the grant or activities carried out under the grant. However, HHS policy does not require use of any particular program income alternatives.

• Regardless of the alternative(s) applied, program income may be used only for eligible costs, in accordance with the governing statue, any program regulations, cost principles, and the terms and conditions of the award.

Page 19: Presented by: Jason Mastrangelo and Stephanie Sowalsky Office of Federal Assistance Management (OFAM) Health Resources and Services Administration (HRSA)

Program Income

• Q & A session focusing program income

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#3 – Special Tests and Provisions

• 26% of audits received

• Vary and are unique to each federal program. (Ryan White, MIECHV, CIP, etc.)

Page 21: Presented by: Jason Mastrangelo and Stephanie Sowalsky Office of Federal Assistance Management (OFAM) Health Resources and Services Administration (HRSA)

Bonus Material – Subrecipient Monitoring

• 9% of audits received

• In accordance with 2 CFR 200.93 (also 75 CFR75.2) Subrecipient means a non-Federal entity that receives a subaward from a pass-through entity to carry out part of a Federal program; but not include an individual that is a beneficiary of such program. A subreciprient may also be a recipient of other Federal awards directly from a Federal awarding agency.

Page 22: Presented by: Jason Mastrangelo and Stephanie Sowalsky Office of Federal Assistance Management (OFAM) Health Resources and Services Administration (HRSA)

Subrecipient MonitoringContinued

• What makes me responsible? • Determines who is eligible to receive what Federal

assistance• Have performance measured in relation to whether

objectives of a Federal program were met• Have responsibility for programmatic decision making• Are responsible for adherence to applicable Federal

program requirements specified in the Federal award• Use the Federal funds to carry out a program for a public

purpose specified in authorizing statute

* The non-federal entity of record is responsible!

Page 23: Presented by: Jason Mastrangelo and Stephanie Sowalsky Office of Federal Assistance Management (OFAM) Health Resources and Services Administration (HRSA)

Subrecipient MonitoringContinued

• Examples of non-compliance regarding subrecipients:

• Pass-through agencies do not provide applicable oversight resulting in subrecipients:• not following laws, regulations and provisions of the grant

and performance goals.• not providing required reports.• not performing yearly audits to provide to the pass-

through non-Federal entity.• providing Federal benefits to ineligible clients in

accordance with Federal eligibility requirements.

Page 24: Presented by: Jason Mastrangelo and Stephanie Sowalsky Office of Federal Assistance Management (OFAM) Health Resources and Services Administration (HRSA)

Subrecipient Monitoring

Continued

• Sample Audit Finding• Criteria • Description of finding• Recommendation

Page 25: Presented by: Jason Mastrangelo and Stephanie Sowalsky Office of Federal Assistance Management (OFAM) Health Resources and Services Administration (HRSA)

Subrecipient MonitoringContinued

• Best Practices • Implement policies and procedures addressing

oversight and monitoring of subrecipients. These activities can include: • review of subrecipient’s eligibility procedures.• review subrecipient’s financial and performance reports.• Review subrecipient’s internal controls/policies and

procedures currently in place.

• Perform site visits of subrecpient.

• Maintain continuous discussions and contact with the subrecipient.

Page 26: Presented by: Jason Mastrangelo and Stephanie Sowalsky Office of Federal Assistance Management (OFAM) Health Resources and Services Administration (HRSA)

Subrecipient Monitoring

• Q & A session focusing subrecipient monitoring

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#2 – Allowable Costs/Cost Principles

• 32% of audits received

• In accordance with the 2 CFR Part 200 (e), in order for costs to be allowable they must:

• Be necessary and reasonable for the performance of the Federal award and be allocable thereto under these principles.

• Conform to any limitations or exclusions set forth in these principles or in the Federal award as to types or amount of cost items.

Page 28: Presented by: Jason Mastrangelo and Stephanie Sowalsky Office of Federal Assistance Management (OFAM) Health Resources and Services Administration (HRSA)

Allowable Costs/Cost Principles

Continued• Be consistent with policies and procedures that apply

uniformly to both federally-financed and other activities of the non-Federal entity.

• Be accorded consistent treatment.

• Be determined in accordance with generally accepted accounting principles (GAAP), except, for state and local governments and Indian tribes only, as otherwise provided for in this part.

• Not be included a costs or used to meet cost sharing or matching requirements of any other federally-financed program either current or a prior period.

• Be adequately documented.

Page 29: Presented by: Jason Mastrangelo and Stephanie Sowalsky Office of Federal Assistance Management (OFAM) Health Resources and Services Administration (HRSA)

Allowable Costs/Cost Principles

Continued

• Unallowable Cost Types

• Contributions and donations• Entertainment costs• Fund raising and investment management costs• Goods or services for personal use• Lobbying• Travel

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Allowable Costs/Cost Principles

Continued

• Most common deficiency – Lack of Supporting Documentation

• Adequate supporting documentation includes: • Invoices showing vendor, date and amount paid.• Receipt of purchase.• Dates on invoices and receipts should fall within the grant

period.• Copies of cancelled checks showing the amounts were

actually paid.• Connection to the grant (cost center, fund type code) – in

general ledger.

Page 31: Presented by: Jason Mastrangelo and Stephanie Sowalsky Office of Federal Assistance Management (OFAM) Health Resources and Services Administration (HRSA)

Allowable Costs/Cost Principles

Continued

• Adequate supporting documentation (cont’d): • Subgrantee agreements or contracts.• Costs should support only items listed in the grant

budget. • Travel logs. • Costs expended must not exceed total budgeted

amounts.• A cost accounting system in place that allows for costs

from different grants to be charged to specific grants.• Strong policies and procedures.

Page 32: Presented by: Jason Mastrangelo and Stephanie Sowalsky Office of Federal Assistance Management (OFAM) Health Resources and Services Administration (HRSA)

Allowable Costs/Cost Principles

Continued

• Sample Audit Finding• Criteria • Description of finding• Recommendation

Page 33: Presented by: Jason Mastrangelo and Stephanie Sowalsky Office of Federal Assistance Management (OFAM) Health Resources and Services Administration (HRSA)

Allowable Costs/Cost Principles

Continued

• Best Practices

• Stick to Budget • Intended Use/Purpose of grant• Follow proper procedures• Support, support, support!

Page 34: Presented by: Jason Mastrangelo and Stephanie Sowalsky Office of Federal Assistance Management (OFAM) Health Resources and Services Administration (HRSA)

Allowable Costs/Cost Principles

• Q & A session focusing allowable costs/cost principles

Page 35: Presented by: Jason Mastrangelo and Stephanie Sowalsky Office of Federal Assistance Management (OFAM) Health Resources and Services Administration (HRSA)

More Bonus Material – Eligibility

• 20% of audits received

• The specific requirements for eligibility are unique to each Federal program and are found in the laws, regulations, and the provisions of contract or grant agreements pertaining to the program.

• Income Verification

Page 36: Presented by: Jason Mastrangelo and Stephanie Sowalsky Office of Federal Assistance Management (OFAM) Health Resources and Services Administration (HRSA)

EligibilityContinued

• Sample Audit Finding• Criteria • Description of finding• Recommendation

Page 37: Presented by: Jason Mastrangelo and Stephanie Sowalsky Office of Federal Assistance Management (OFAM) Health Resources and Services Administration (HRSA)

EligibilityContinued

• Best Practices• Implement policy and procedures to

include financial intake process.• Ensure income verification performed on all

applications.• Proper formula being used on the sliding fee

scale.

• Implement policy and procedures to ensure application is on file that includes proper documentation to support eligibility.

Page 38: Presented by: Jason Mastrangelo and Stephanie Sowalsky Office of Federal Assistance Management (OFAM) Health Resources and Services Administration (HRSA)
Page 39: Presented by: Jason Mastrangelo and Stephanie Sowalsky Office of Federal Assistance Management (OFAM) Health Resources and Services Administration (HRSA)

#1 – Reporting

• 38% of audits received

• Single audit requirements 2 CFR 200 (f) - establishes that all recipients of federal awards must submit reports (whether financial, performance-related, or of special nature) to the Federal government to monitor Federal assistance activities and uses.

• The most common reports are pre-designed by the Federal agency, are approved by OMB, and are freely available to all recipients and the general public. The time deadlines for submitting them vary depending on the report.

Page 40: Presented by: Jason Mastrangelo and Stephanie Sowalsky Office of Federal Assistance Management (OFAM) Health Resources and Services Administration (HRSA)

ReportingContinued

• Common reason for Reporting finding:

• Federal reports are not submitted or completed timely.

• Financial information on the reports is inaccurate.

• Financial information not properly recorded in accordance with accounting standards.

Page 41: Presented by: Jason Mastrangelo and Stephanie Sowalsky Office of Federal Assistance Management (OFAM) Health Resources and Services Administration (HRSA)

ReportingContinued

• Sample Audit Finding• Criteria • Description of finding• Recommendation

Page 42: Presented by: Jason Mastrangelo and Stephanie Sowalsky Office of Federal Assistance Management (OFAM) Health Resources and Services Administration (HRSA)

ReportingContinued

• Best Practices• Establish procedures to ensure audits are

performed and submitted in a timely manner.

• Implement policies and procedures to ensure all grant funds are recorded properly on SEFA.

Page 43: Presented by: Jason Mastrangelo and Stephanie Sowalsky Office of Federal Assistance Management (OFAM) Health Resources and Services Administration (HRSA)

Reporting

• Q & A session focusing reporting

Page 44: Presented by: Jason Mastrangelo and Stephanie Sowalsky Office of Federal Assistance Management (OFAM) Health Resources and Services Administration (HRSA)

Open Q & A

• Any follow up questions for any of the audit findings?

Page 45: Presented by: Jason Mastrangelo and Stephanie Sowalsky Office of Federal Assistance Management (OFAM) Health Resources and Services Administration (HRSA)

Recap

1. Reporting2. Allowable Costs/Cost Principles3. Special Tests and Provisions4. Program Income5. Cash Management

Page 46: Presented by: Jason Mastrangelo and Stephanie Sowalsky Office of Federal Assistance Management (OFAM) Health Resources and Services Administration (HRSA)

Wrap Up

Jason Mastrangelo(301) 443-3626

Stephanie Sowalsky(215) 861-4392

[email protected]