Lafayette CountyLocal Government

Program Federal Assistance Listing and Title: 93.498 COVID-19 Provider Relief Fund Award Number: N/A Federal Agency: Department of Health and Human Services Pass-Through Agency: N/A Criteria: All recipients of Provider Relief Funds (PRF) payments must comply with the reporting requirements described in the PRF terms and conditions and specified in directions issued by the U.S. Department of Health and Human Services. Condition/Context: Of the two Provider Relief reports required to be submitted, the Period 2 Provider Relief report was selected for testing. The County elected to use the '2020 Budgeted Revenue' as their lost revenues reporting method. Under this method, the budget used in the calculation must have been approved prior to March 27, 2020. The 2021 budget used in the County's calculation of lost revenues was approved after this deadline, on November 10, 2020. Additionally, when testing the key line items on the Period 2 PRF report, a variance was noted when comparing the 2021 Budgeted Total Revenue/Net Charges from Patient Care included on the PRF report to the 2021 budget adopted by the County Board of Supervisors. This variance caused the 2021 Budgeted Total Revenue / Net Charges from Patient Care to be overstated on the PRF report by $148,350. A variance was also noted when comparing the 2021 Actual Total Revenue / Net Charges from Patient Care included on the PRF report to the 2021 audited revenue general ledger detail. This variance caused the 2021 Actual Total Revenue / Net Charges from Patient Care to be overstated on the PRF report by $505,430. Together, these two variances resulted in a lost revenue calculation that was $357,080 less than what should have been reported. This sample was not statistically valid. Cause: When calculating lost revenues, the County elected the wrong lost revenues reporting method. If this calculation of lost revenues was preferred, they should have elected to use the 'Alternate Method of Calculating Lost Revenues Attributable to Coronavirus' method. Additionally, when calculating both the 2021 Budgeted and 2021 Actual Total Revenue/Net Charges from Patient Care balances to be included on the PRF report, a few of the revenue and contra revenue general ledger accounts that should have been factored into the County's calculation were omitted. Effect: The amounts reported to Health Resources & Services Administration (HRSA) were not in accordance with established U.S. Department of Health and Human Services reporting guidance. Questioned Costs: None. Recommendation: We recommend that management implement procedures to ensure that the most recent guidance is reviewed and understood and that information used in preparation of the reports is reviewed, with errors addressed, prior to reporting. Management Response: Lafayette County recognizes that the 2021 budget was not approved prior to March 27, 2020, and that the 2021 revenue was overstated. Due to staff limitations and limited experience and resources for such programs and funding, along with unaudited 2021 financial statements, the 2021 data reported was submitted with errors. Overall, Lafayette County had enough lost patient service revenue and COVID related expenses in 2020 to justify the provider relief funding received, and the audited financial data submitted for 2020 is accurate. Lafayette County now understands zeros can be submitted on the reports where lost revenue is not being claimed, so they will correct the 2021 lost revenue to zero during Reporting Period 3 that is due September 30, 2022.

Program Federal Assistance Listing and Title: 21.019 COVID-19 Coronavirus Relief Funds Award Number: 43585-2 Federal Agency: Department of Treasury Pass-Through Agency: Wisconsin Department of Health Services Criteria: CFR 200.303 Internal Controls require that non-federal entities receiving federal awards establish and maintain internal control designed to reasonably ensure compliance with federal laws, regulations and program compliance requirements. To minimize the risk of errors, internal controls should be in place for all program compliance requirements, including appropriate review and approval of reports. Wisconsin DHS requires the County to submit monthly Community Aids Reporting System (CARS) Expenditure Reports for reimbursement. Condition/Context: Two out of a total population of thirteen CARS expenditure reports were tested and neither were reviewed or approved by someone other than the preparer prior to submission. The sample was not statistically valid. Cause: The County currently does not have proper internal controls in place over review and approval of reports for accuracy before being submitted to the state agency. Effect: Lack of effective controls over review and approval could result in reports being submitted with errors. Questioned Costs: None. Recommendation: The County should review its internal control procedures to ensure there are proper review and approval processes in place before reports are submitted to the state agency. Management Response: Lafayette County recognizes that many approvals and reviews of report submissions for state or federal awards have been verbal or were not conducted and need to be either physically signed off on or approved via email, for proper internal controls and audit standards. An email has been sent out to all county departments reminding them that review and approval, either written or emailed, must be present on all reports submitted for state and federal awards.