Prisma Community Care

Item: 2024-001 Assistance Listing Number: 93.914 Program: HIV Emergency Relief Project Grants Federal Agency: U.S. Department of Health and Human Services Pass-Through Agencies: Maricopa County Department of Public Health Services Pass-Through Grantor Identifying Number: A23MHSSWC, A24MHSSWC, A23MNSSWC, A24MNSSWC, A23MCMSWC, A24MCMSWC, A23NMCSWC, A24NMCSWC, A23FBMSWC, A24FBMSWC, A24SASSWC Award Year: March 1, 2023 - February 28, 2024; March 1, 2024 - February 28, 2025 Compliance Requirement: Allowable Activities and Costs Criteria: In accordance with 2 CFR § 200.405 – Allocable Costs - (d) If a cost benefits two or more projects or activities in proportions that can be determined without undue effort or cost, the cost must be allocated to the projects based on the proportional benefit. Condition: Costs charged to the federal program were based on an allocation methodology that was not properly updated for the current period. Questioned Costs: $865 Context: During testing of non-payroll costs charged to the program, we received a report from the organization showing the variances between expenses allocated for reimbursement to the program using an incorrect allocation methodology, and the correct amounts that should have been allocated. The variance between the amounts charged and the amounts incurred by the tested program, $10,869 and $10,004, respectively, was $865, which is trivial in nature. However, this is a repeat finding and is deemed to be a material weakness in internal control over compliance. Effect: The system of internal controls was not properly implemented. Cause: Turnover within key positions of the organization resulted in insufficient documentation and/or inadequate implementation of the control procedures. Additionally, issue not discovered until prior year audit discovery in August 2024. Identification as a Repeat Finding: Repeat finding – prior year 2023-002 Recommendation: The Organization should enhance its processes and controls to ensure that cost allocation methodologies utilized to bill federal awards are properly updated each reporting period as deemed necessary to accurately reflect the proportional benefit. Views of Responsible Officials: Management of the Organization concurs with the finding. See Corrective Action Plan.

Item: 2024-002 Assistance Listing Number: 93.940 Programs: HIV Prevention Activities Health Department Based Federal Agency: U.S. Department of Health and Human Services Pass-Through Agencies: Arizona Department of Health Services Pass-Through Grantor Identifying Number: 252026/152034 Award Year: August 1, 2023 – April 30, 2024; January 1, 2024 – May 31, 2025; May 1, 2024 – April 30, 2025 Compliance Requirement: Allowable Activities and Costs Criteria: In accordance with 2 CFR § 200.405 – Allocable Costs - (d) If a cost benefits two or more projects or activities in proportions that can be determined without undue effort or cost, the cost must be allocated to the projects based on the proportional benefit. Condition: Costs charged to the federal program were based on an allocation methodology that was not properly updated for the current period. Questioned Costs: $1,835 Context: In a population of over 109 non-payroll costs charged to the program, we conducted a non-statistical sample of 11 non-payroll costs charged to the program. In our sample of 11, we noted that 1 selection was charged to the program based on an allocation methodology that was not properly updated for the current period. The variance between the amounts charged and the amounts supported, $3,260 and $1,425, respectively, was $1,835, which is trivial in nature. However, this is deemed to be a material weakness in internal control over compliance. Effect: The system of internal controls was not properly implemented. Cause: Turnover within key positions of the organization resulted in insufficient documentation and/or inadequate implementation of the control procedures. Additionally, issue not discovered until prior year audit discovery in August 2024. Identification as a Repeat Finding: Not a repeat finding Recommendation: The Organization should enhance its processes and controls to ensure that cost allocation methodologies utilized to bill federal awards are properly updated each reporting period as deemed necessary to accurately reflect the proportional benefit. Views of Responsible Officials: Management of the Organization concurs with the finding. See Corrective Action Plan.

Item: 2024-003 Assistance Listing Number: 93.940 Programs: HIV Prevention Activities Health Department Based Federal Agency: U.S. Department of Health and Human Services Pass-Through Agencies: Arizona Department of Health Services Pass-Through Grantor Identifying Number: 252026/152034 Award Year: August 1, 2023 – April 30, 2024; January 1, 2024 – May 31, 2025; May 1, 2024 – April 30, 2025 Compliance Requirement: Reporting Criteria: Per the grant agreements, award recipients are required to submit monthly reimbursement report within a set number of days after month end. Condition: Financial reimbursement reports were submitted after the required due date. Questioned Costs: n/a Context: In a population of 56 required reports, we conducted a non-statistical sample of four programmatic and three financial reimbursement reports. In our sample of seven, we noted the three required financial reimbursement reports were not submitted to the granting agency timely. This is deemed to be a material weakness in internal control over compliance. Effect: The system of internal controls was not properly implemented. Cause: Weak communication with the grantor resulted in unclear deliverable and due date requirements. Identification as a Repeat Finding: Not a repeat finding Recommendation: The Organization should enhance its processes and controls to ensure that deliverables are submitted in the time frames laid out by the grant agreements.

Item: 2023-002 Assistance Listing Number: 93.914 Program: HIV Emergency Relief Project Grants Federal Agency: U.S. Department of Health and Human Services Pass-Through Agencies: Maricopa County Pass-Through Grantor Identifying Number: A22MHSSWC, A23MHSSWC, A22MNSSWC, A23MNSSW, A22MCMSWC, A23MCMSWC, A22NMCMSWC, A23NMCMSWC, A22FBMSWC, A23FBMSWC Award Year: March 1, 2022 - February 28, 2023; March 1, 2023 - February 28, 2024 Compliance Requirement: Allowable Activities and Costs Criteria: In accordance with 2 CFR § 200.405 – Allocable Costs - (d) If a cost benefits two or more projects or activities in proportions that can be determined without undue effort or cost, the cost must be allocated to the projects based on the proportional benefit. Condition: Costs charged to the federal program were based on an allocation methodology that was not properly updated for the current period. Questioned Costs: n/a Context: In a population of over 250 non-payroll costs charged to the program, we conducted a non-statistical sample of 40 non-payroll costs charged to the program. In our sample of 40, we noted that 1 selection was charged to the program based on an allocation methodology that was not properly updated for the current period. The variances between the amount charged and the amount supported, as well as the projected impact to the entire population, was trivial in nature. However, this is deemed to be a material weakness in internal control over compliance. Effect: The system of internal controls was not properly implemented. Cause: Turnover within key positions of the organization resulted in insufficient documentation and/or inadequate implementation of the control procedures. Identification as a Repeat Finding: Not a repeat finding Recommendation: The Organization should enhance its processes and controls to ensure that cost allocation methodologies utilized to bill federal awards are properly updated each reporting period as deemed necessary to accurately reflect the proportional benefit. Views of Responsible Officials: Management of the Organization concurs with the finding. See Corrective Action Plan.

Item: 2023-003 Assistance Listing Number: 93.940 Programs: HIV Prevention Activities Health Department Based Federal Agency: U.S. Department of Health and Human Services Pass-Through Agencies: Arizona Department of Health Services Pass-Through Grantor Identifying Number: CTR069364, CTR067201, CTR045489, ADHS19-207305 Award Year: April 1, 2022 to March 31, 2023; August 1, 2022 to July 31, 2023; January 1, 2023 to December 31, 2023; April 1, 2023 to March 31, 2024; August 1, 2023 to July 31, 2024 Compliance Requirement: Allowable Activities and Costs Criteria: In accordance with 2 CFR § 200.405 – Allocable Costs - (d) If a cost benefits two or more projects or activities in proportions that can be determined without undue effort or cost, the cost must be allocated to the projects based on the proportional benefit. Condition: Costs charged to the federal program were based on an allocation methodology that was not properly updated for the current period. Questioned Costs: n/a Context: In a population of over 250 non-payroll costs charged to the program, we conducted a non-statistical sample of 40 non-payroll costs charged to the program. In our sample of 40, we noted that 5 selections were charged to the program based on an allocation methodology that was not properly updated for the current period. The variances between the amounts charged and the amounts supported, as well as the projected impact to the entire population, was trivial in nature. However, this is deemed to be a material weakness in internal control over compliance. Effect: The system of internal controls was not properly implemented. Cause: Turnover within key positions of the organization resulted in insufficient documentation and/or inadequate implementation of the control procedures. Identification as a Repeat Finding: Not a repeat finding Recommendation: The Organization should enhance its processes and controls to ensure that cost allocation methodologies utilized to bill federal awards are properly updated each reporting period as deemed necessary to accurately reflect the proportional benefit. Views of Responsible Officials: Management of the Organization concurs with the finding. See Corrective Action Plan.

Item: 2023-004 Assistance Listing Number: 93.940 Programs: HIV Prevention Activities Health Department Based Federal Agency: U.S. Department of Health and Human Services Pass-Through Agencies: Arizona Department of Health Services Pass-Through Grantor Identifying Number: CTR069364, CTR067201, CTR045489, ADHS19-207305 Award Year: April 1, 2022 to March 31, 2023; August 1, 2022 to July 31, 2023; January 1, 2023 to December 31, 2023; April 1, 2023 to March 31, 2024; August 1, 2023 to July 31, 2024 Compliance Requirement: Allowable Activities and Costs Criteria: In accordance with 2 CFR § 200.430 – Compensation – charges to federal programs for salaries and wages should be supported by a system of internal controls which provides reasonable assurance the amounts charged are accurate, allowable and properly allocated. Condition: Incorrect allocation of employee hours were charged to the federal program. Questioned Costs: n/a Context: In a population of over 250 payroll costs charged to the program, we conducted a non-statistical sample of 40 payroll costs charged to the program. In our sample of 40, we noted that 1 selection in which the employee was paid at an outdated pay rate and paid overtime that was not supported by the employee timesheet. The variances between the amount charged and the amount supported, as well as the projected impact to the entire population, was trivial in nature. This is deemed to be a significant deficiency in internal control over compliance. Effect: The system of internal controls was not properly implemented. Cause: The entity’s system of internal controls did detect, or document the rationale for, instances in which the amounts charged to a federal program did not agree to the underlying supporting documentation maintained by the Organization. Identification as a Repeat Finding: Repeat finding – prior year 2022-004 Recommendation: The Organization should enhance its processes and controls to ensure that expenses are appropriately reviewed before submission of billing. Views of Responsible Officials: Management of the Organization concurs with the finding. See Corrective Action Plan.

Item: 2023-005 Assistance Listing Number: 93.940 Programs: HIV Prevention Activities Health Department Based Federal Agency: U.S. Department of Health and Human Services Pass-Through Agencies: Arizona Department of Health Services Pass-Through Grantor Identifying Number: CTR069364, CTR067201, CTR045489, ADHS19-207305 Award Year: April 1, 2022 to March 31, 2023; August 1, 2022 to July 31, 2023; January 1, 2023 to December 31, 2023; April 1, 2023 to March 31, 2024; August 1, 2023 to July 31, 2024 Compliance Requirement: Reporting Criteria: Per grant agreements the organization was required to submit multiple reports at various dates during the grant period. Condition: Required reports not submitted to granting agency and incomplete record retention to evidence the timely submission of reports to granting agencies. Questioned Costs: n/a Context: In a population of 52 required reports, we conducted a non-statistical sample of seven reports. In our sample of seven, we noted two required reports were not submitted to the granting agency. Additionally, management did not have contemporaneous documentation to evidence the timely submission of reports to certain granting agencies. This is deemed to be a material weakness in internal control over compliance. Effect: The system of internal controls was not properly implemented. Cause: Turnover within key positions of the organization resulted in insufficient documentation and/or inadequate implementation of the control procedures. Identification as a Repeat Finding: Not a repeat finding Recommendation: The Organization should enhance its processes and controls to ensure that required reports are submitted to granting agencies and to retain evidence of timely submission within the Organization's records. Views of Responsible Officials: Management of the Organization concurs with the finding. See Corrective Action Plan.