WASHINGTON COUNTY AMBULANCE DISTRICT

Substance Abuse and Mental Health Services Projects of Regional and National Significance ALN 93.243 U.S. Department of Health and Human Services Criteria or specific condition – Management is responsible for complying with suspension and debarment requirements applicable to federal awards. Condition – During testing of suspension and debarment, it was noted the District was not performing any procedures related to this compliance requirement. Cause – The District did not have procedures in place to verify that vendors or applicable parties were not suspended or debarred prior to entering into covered transactions. Effect or potential effect – The District could enter into transactions with parties that are suspended or debarred, resulting in noncompliance with federal award requirements. Questioned costs - None Context – The District internal controls were not adequate to complete suspension and debarment compliance requirements. Identification as a repeat finding, if applicable – Not a repeat finding. Recommendation – Management should establish and implement procedures to verify suspension and debarment status, such as reviewing SAM.gov or obtaining appropriate certifications, before entering into covered transactions. Views of responsible officials and planned corrective actions – Washington County Ambulance District agrees with the finding for the 2025 audit and has implemented a policy in place to complete suspension and debarment and include in the procurement of new vendors soured by federal funds. This will be overseen by Amber Coleman, Chief Administrative Officer, with a target date of completion of December 31, 2026.

Substance Abuse and Mental Health Services Projects of Regional and National Significance ALN 93.243 U.S. Department of Health and Human Services Criteria or specific requirement – Cash Management ((2 CFR 200.305(b) and 45 CFR 75.305(b)) Condition – The District is required to request reimbursement for program costs only after those costs have been incurred and paid. Certain expenditures were paid after reimbursement was received. Context – One of the two reimbursement tested had certain expenses that were not paid by the District before reimbursement was received. The sample is not and is not expected to be a statistical sample. Effect or potential effect – The District did not properly comply with the cash management requirements. Cause – The Districts internal control did not properly identify certain expenditures were not paid before reimbursement was received. Questioned costs - none Identification as a repeat finding – Not a repeat finding. Recommendation – The District should enhance controls to ensure that all expenditures included in reimbursement request have been paid prior to requesting federal funds. This may include implementing a review procedure to verify payment status before submission. Views of Responsible Officials and Planned Corrective Actions - Washington County Ambulance District agrees with the reported finding. The underlying cause was a clerical error that was determined after reimbursement had been requested. Upon identifying the issue, additional acceptable expenses were substituted for this clerical error. Additional review will be completed on each required submission. This will be overseen by Amber Coleman, Chief Administrative Officer, with a target date of completion of December 31, 2026.

Substance Abuse and Mental Health Services Projects of Regional and National Significance ALN 93.243 U.S. Department of Health and Human Services Criteria or specific requirement – Management is responsible for complying with reporting requirements applicable to federal awards. Condition – During testing of reporting requirements, it was noted that one of the reports selected for testing was not submitted by the required due dates. Specifically, an annual programmatic progress report due October 29, 2025 was submitted on October 31, 2025. Questioned costs – none Cause – The District’s internal controls did not ensure that required performance reports were submitted by the applicable due dates. Effect or potential effect – Required reports were not submitted timely, resulting in noncompliance with federal reporting requirements. Context – The Districts internal controls did not properly identify all reporting dates required in a timely manner. Identified as a repeat finding – Not a repeat finding. Recommendation – Management should establish internal controls to track required report due dates and review submissions to ensure reports are completed and submitted timely. Views of Responsible Officials and Planned Corrective Actions - Washington County Ambulance District agrees with the finding and has implanted additional reminders and levels of review to ensure reports are submitted timely. This will be overseen by Amber Coleman, Chief Administrative Officer, with a target date of completion of December 31, 2026.