NORTHEAST FLORIDA HEALTH SERVICES, INC.

Finding 2024-001, Cash Disbursement Process (Second year repeat comment) Information on the Federal Program - Assistance Listing Number 93.224 Health Care Center Program (Direct Health Center Program Cluster). Compliance Requirements: Activities Allowed or Unallowed. Type of Finding: Material Weakness in internal control over financial reporting and internal controls over Federal major programs. Criteria - Based on documented internal controls, the Organization should be able to provide support for cash disbursements with management's approval. Condition - In 9 instances out of 25 items tested, invoices were not approved by management. In one instance, the supporting invoice was not able to be located. Cause - Discussions with Organization employees indicate the cause of missing documentation and approvals was due to lack of oversight and the new ERP system did not maintain the approvals from the prior ERP system. Effect - The missing support and missing approvals could result in improper nonpayroll expenditures. Questioned Costs - Zero Recommendation - We recommend the Organization follow the documented cash disbursement process and ensure reviews and approvals are documented.

Finding 2024-001, Cash Disbursement Policy Recommendation We recommend the organization follow the documented cash disbursement process and ensure reviews and approvals are documented. Response NEFHS self-identified such inconsistencies through its normal internal control process and implemented a Payable Invoice Management (PIM} system in November 2023. With the loss of personnel this system became too cumbersome and inefficient. All invoices were eventually approved by management with the final approval coming from the CEO when signed. NEFHS has moved to a new financial software platform with an integrated accounts payable system. All invoices are approved for payment before checks are cut and distributed.

2023-002

Finding 2023-001, Payroll Process (Second Year repeat comment): Information on the Federal Program - Assistance Listing Number 93.224 Health Care Center Program (Direct Health Center Program Cluster). Compliance Requirements: Activities Allowed or Unallowed. Type of Finding: Significant Deficiency in internal control over financial reporting and internal controls over Federal major programs Cause - Discussions with Organization employees indicate the cause of missing documentation, approvals and inconsistencies was due to an issue with the payroll software. Criteria - Based on documented internal controls, the Organization should be able to provide approved support for employee pay rates and approved time cards in which the documented hours agree to payroll reports. There should be no inconsistences between time on timecards and payroll reports. Condition - In 18 instances out of 40 items tested,, the timecard was not electronically approved either by employee or by supervisor. In one instance, one of the timecards did not have any hours recorded. Effect - The missing support and missing approvals could result in improper payroll expenditures. Questioned Costs - Zero Recommendation - We recommend the Organization follow the documented payroll process and ensure reviews and approvals are documented.

Finding 2023-001. Payroll Process. Recommendation: We recommend the Organization follow the documented payroll process and ensure reviews and approvals are documented. Response: NEFHS transitioned to a different third -party payroll provider as of January 2023. Many of the findings identified stemmed from a sample period that occurred two months into the transition period of payroll providers. The updates and adjustment made by NEFHS had very little time to materialize, however, we have incorporated hard stops within the process to prompt for required approvals of timecards by supervisors before payroll can be processed in full. NEFHS will also incorporate quarterly reviews to ensure the process is being administered as intended.

2022-001

Finding 2023-002, Cash Disbursement Process Information on the Federal Program - Assistance Listing Number 93.224 Health Care Center Program (Direct Health Center Program Cluster). Compliance Requirements: Activities Allowed or Unallowed. Type of Finding: Significant Deficiency in internal control over financial reporting and internal controls over Federal major programs Criteria - Based on documented internal controls, the Organization should be able to provide support for cash disbursements with management's approval. Condition - In 3 instances out of 25 items tested, invoices were not approved by management. In one instance, the supporting invoice was not able to be located. Cause - Discussions with Organization employees indicate the cause of missing documentation and approvals was due to lack of oversight. Effect - The missing support and missing approvals could result in improper nonpayroll expenditures. Questioned Costs - Zero Recommendation - We recommend the Organization follow the documented cash disbursement process and ensure reviews and approvals are documented.

Finding 2023-002. Cash Disbursement Process. Recommendation: We recommend the Organization follow the documented cash disbursement process and ensure reviews and approvals are documented. Response: NEFHS self-identified such inconsistencies through their normal internal controls process. To ensure such inconsistencies can be mitigated in the future, NEFHS implemented a Payable Invoice Management (PIM) system in November of 2023. The system enhances AP automation, with streamlined workflows for approval and payment processing.

Finding 2022-001, Payroll Process. Information on the Federal Program - Assistance Listing Number 93.224 Health Care Center Program (Direct Health Center Program Cluster). Compliance Requirements: Activities Allowed or Unallowed. Type of Finding: Significant Deficiency. Cause - Discussions with Organization employees indicate the cause of missing documentation, approvals and inconsistencies was due to an issue with the payroll software. Criteria - Based on documented internal controls, the Organization should be able to provide approved support for employee pay rates and approved time cards in which the documented hours agree to payroll reports. There should be no inconsistences between time on timecards and payroll reports. Condition - In one instance, the Organization was not able to provide support for an employee's most recent approved payrate. In 13 instances, there was no employee or supervisor approval for an employee's time card. In 11 instances, gross pay could not be recalculated due to inconsistences between timecards and payroll reports. Effect - The missing support and missing approvals could result in improper payroll expenditures. Questioned Costs - Zero. Recommendation - We recommend the Organization follow the documented payroll process and ensure reviews and approvals are documented.

Finding 2022-001, Payroll Process, Assistance Listing Number 93.224 Health Care Center Program (Direct Health Center Program Cluster). Recommendation: We recommend the Organization follow the documented payroll process and ensure reviews and approvals are documented. Response: NEFHS believes the nature of this finding stemmed from the third-party company being utilized to process payroll. NEFHS has transitioned third-party payroll companies as of January 2023. We have incorporated hard stops within the process to prompt for required approvals of timecards by supervisors before payroll can be processed in full. NEFHS will also incorporate quarterly reviews to ensure the process is being administered as intended.