Report (2020-03-05)

Full text

Department of Health and Human Services
Office of Inspector General
Office of Audit Services
February 2025 | A-02-23-02008
Florida Generally Used CDC Public
Health Crisis Response Cooperative
Agreement Program Funds in
Accordance With Federal
Requirements
OIG.HHS.GOV

HHS Office of Inspector General
REPORT
HIGHLIGHTS
February 2025 | A-02-23-02008
Florida Generally Used CDC Public Health Crisis Response Cooperative
Agreement Program Funds in Accordance With Federal Requirements
Why OIG Did This Audit
• Congress appropriated approximately $10 billion to CDC for it to establish the Public Health Crisis
Response cooperative agreement program. Florida was awarded $41.2 million in cooperative
agreement program funds for the period March 5, 2020, through March 15, 2022 (audit period).
• The program allowed States and other award recipients to acquire the resources needed to prevent,
prepare for, and respond to the COVID-19 public health emergency.  Due to the speed at which funds
were awarded, there is a risk that award recipients may not have established adequate procedures to
ensure that funds were used appropriately.
• This audit assessed whether Florida expended cooperative agreement program funds in accordance
with Federal requirements and applicable award terms and conditions.
What OIG Found
• Florida maintained adequate documentation to support 101 of the 106 sampled expenditures and all
indirect expenditures and interagency funds transferred for COVID-19 PHE-related purchases under
the cooperative agreement. However, for the remaining five sampled direct expenditures, the State
agency did not maintain adequate documentation to support time charged by contracted employees.
As a result, we determined that Florida made $218,504 of improper expenditures under its cooperative
agreement program.
• Florida did not ensure that the Federal closeout reports on its cooperative agreement program
activities were accurately completed and timely submitted to CDC.
• These deficiencies occurred because the State agency did not establish adequate procedures or did not
follow its existing policies and procedures to ensure that expenditures and reporting of cooperative
agreement funds met Federal requirements and program terms and conditions.
What OIG Recommends
We recommend that Florida refund $218,504 to the Federal Government and improve its processes related to
its cooperative agreement program.  The full recommendations are in the report. Of the three
recommendations in our draft report, Florida disagreed with two recommendations and did not indicate its
concurrence or nonconcurrence with the remaining recommendation.  Based on Florida’s response to the
draft report, we revised our recommendations as appropriate.
OIG.HHS.GOV

TABLE OF CONTENTS
INTRODUCTION............................................................................................................................. 1
The State Agency Did Not Maintain Adequate Documentation Supporting
The State Agency’s Federal Closeout Reports Did Not Properly Account
For Equipment Purchases And Were Not Timely Submitted to the
Causes For Noncompliance With Federal Requirements And Cooperative Agreement
APPENDICES
Why We Did This Audit .................................................................................................... 1
Objective .......................................................................................................................... 1
Background ....................................................................................................................... 1
Public Health Crisis Response Program ................................................................ 1
Florida Department of Health’s Cooperative Agreement Award Program.......... 2
How We Conducted This Audit......................................................................................... 2
FINDINGS....................................................................................................................................... 3
Contracted Employees’ Charged Time ……………………… ................................................. 3
Centers for Disease Control and Prevention............................................................... 4
Program Terms And Conditions..................................................................................... 5
RECOMMENDATIONS ................................................................................................................... 6
STATE AGENCY COMMENTS AND OFFICE OF INSPECTOR GENERAL RESPONSE ...........................6
A: Audit Scope and Methodology..................................................................................... 8
B: Statistical Sampling Methodology .............................................................................. 10
C: Sample Results............................................................................................................ 12
D: State Agency Comments ............................................................................................ 13
Florida's CDC Public Health Crisis Response Cooperative Agreement Program Award (A-02-23-02008)

INTRODUCTION
WHY WE DID THIS AUDIT
Congress appropriated approximately $10 billion to the Centers for Disease Control and
Prevention (CDC) for it to establish the Public Health Crisis Response cooperative agreement
program.1 The program allowed States and other award recipients to acquire the resources
needed to prevent, prepare for, and respond to the COVID-19 public health emergency (PHE).
The Florida Department of Health (the State agency) was awarded approximately $41.2 million
through the cooperative agreement program for the period March 5, 2020, through March 15,
2022 (audit period).2 Due to the speed at which CDC awarded these funds, there was a risk that
award recipients may not have established adequate procedures to ensure that funds were
used appropriately.
OBJECTIVE
Our objective was to determine whether the State agency expended CDC Public Health Crisis
Response cooperative agreement program funds in accordance with Federal requirements and
applicable award terms and conditions.
BACKGROUND
Public Health Crisis Response Program
The CDC’s Public Health Crisis Response cooperative agreement program provides awards to
State, local, and Tribal governments to enhance the Nation’s ability to rapidly respond to PHEs.
Funding recipients are approved in advance to receive funds and are awarded the funds after a
notice of funding opportunity (NOFO) is issued and recipients submit applications.  During
Federal fiscal years (FYs) 2020 and 2021, CDC awarded 130 cooperative agreements under the
program, totaling approximately $2.7 billion, to 65 recipients.  During the COVID-19 PHE, these
funds were to be used on a wide range of goods and services (e.g., supplies), including
surveillance, epidemiology, laboratory capacity, infection control, mitigation, communications,
and other preparedness and response activities (e.g., lodging expenditures).3
1 The appropriations were made through the Coronavirus Preparedness and Response Supplemental
Appropriations Act, 2020 (P.L. No. 116-123) and the American Rescue Plan Act of 2021 (P.L. No. 117-2).
2 The original project period was from March 5, 2020, through September 4, 2020; however, CDC approved an
18-month extension to the State agency, thereby extending the period through March 15, 2022.
3 Response activities included hiring and training certain contracted temporary clinical staff (e.g., physicians and
nurses) and administrative staff, purchasing equipment and supplies, and administrative support services.
Florida's CDC Public Health Crisis Response Cooperative Agreement Program Award (A-02-23-02008)
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Program fund recipients were also required to submit Federal closeout reports, including a
“Tangible Personal Property Report” to CDC.  CDC used these reports to assess whether
recipients achieved program goals, measure recipients’ performance, oversee program funds,
and inform stakeholders about program outcomes.
Florida Department of Health’s Cooperative Agreement Award Program
For our audit period, CDC awarded the State agency $41.2 million in cooperative agreement
program funds.  As a program fund recipient, the State agency agreed to comply with the terms
and conditions of the award and exercise proper stewardship over these Federal funds.4 For
our audit period, the State agency withdrew and spent approximately $41.1 million on its Public
Health Crisis Response program. The State agency used its existing accounting system, the
Florida Accounting Information Resource (FLAIR) system, to track all cooperative agreement
program expenditures.
To prevent personnel shortages caused by the COVID-19 PHE, the State agency contracted with
vendors to hire additional employees.5 The State agency relied on these vendors to track the
time and effort charged by the contracted employees to the cooperative agreement award in
their timekeeping systems and to maintain supporting documentation (i.e., approved
timesheets). In addition, the State agency used the funds to pay for various direct services
(e.g., consulting, medical, and information technology), equipment and supplies, and in-state
travel expenses related to COVID-19 response activities. The State agency’s policies and
procedures required that expenses be reviewed, approved, and certified by contract managers
to properly account for and report these award activities.
HOW WE CONDUCTED THIS AUDIT
We obtained from the State agency’s accounting system all cooperative agreement program
direct expenditures over $100, totaling $31,474,469, made by the State agency during our audit
period. From these expenditures, we selected for review a stratified random sample of 106
direct expenditures totaling $8.8 million.  We also selected for review all indirect expenditures
and interagency funds transferred for COVID-19 PHE-related purchases totaling $9.7 million.6, 7
We reviewed documentation from the State agency to support cooperative agreement
4 Terms and conditions are outlined in CDC’s NOFO and the Notice of Award.
5 Examples of employees contracted through vendors include infection control nurses, security guards, airport
screeners, and medical transcriptionists.
6 The cooperative agreement expenditures that we separately reviewed included $2 million in indirect
expenditures and $7.7 million in direct expenditures representing interagency funds transferred for COVID-19
related purchases.
7 We reviewed whether approved indirect cost rates were appropriately applied to the direct expenditures made
under the cooperative agreement.
Florida's CDC Public Health Crisis Response Cooperative Agreement Program Award (A-02-23-02008)
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program expenditures and whether required Federal closeout reports prepared by the State
agency were accurate and submitted timely to CDC.
We conducted this performance audit in accordance with generally accepted government
auditing standards. Those standards require that we plan and perform the audit to obtain
sufficient, appropriate evidence to provide a reasonable basis for our findings and conclusions
based on our audit objectives. We believe that the evidence obtained provides a reasonable
basis for our findings and conclusions based on our audit objectives.
Appendix A contains the details of our audit scope and methodology and Appendix B describes
our statistical sampling methodology.
FINDINGS
The State agency generally used CDC Public Health Crisis Response cooperative agreement
program funds in accordance with Federal requirements. Specifically, 101 of the 106 sampled
direct expenditures and all indirect expenditures and interagency funds transferred for
COVID-19 PHE-related purchases under the cooperative agreement complied with Federal
requirements and applicable award terms and conditions. However, for the remaining five
sampled direct expenditures, the State agency did not maintain adequate documentation to
support that time charged by contracted employees complied with Federal requirements and
applicable program terms and conditions. In addition, the State agency did not accurately
complete and timely submit its Federal closeout reports to CDC.
These deficiencies occurred because the State agency did not establish adequate procedures or
did not follow its existing policies and procedures to ensure that expenditures and reporting of
cooperative agreement funds met Federal requirements and program terms and conditions.
For the sampled direct expenditures, we determined that the State agency made $218,504 of
unallowable expenditures under its cooperative agreement program. In addition, because the
State agency’s closeout reports were not always accurate and submitted timely, CDC may not
have been able to properly evaluate and report on the performance of the Public Health Crisis
Response cooperative agreement program to its stakeholders.
THE STATE AGENCY DID NOT MAINTAIN ADEQUATE DOCUMENTATION SUPPORTING
CONTRACTED EMPLOYEES’ CHARGED TIME
Cooperative agreement program costs must comply with the award recipient’s policies and
procedures and be adequately documented. Also, activities charged to the cooperative
agreement must be allowable, allocable, and reasonable.8 Cooperative agreement recipients
must maintain records that accurately reflect the work performed.  The records must provide
reasonable assurance that the charges are accurate, allowable and properly allocated, and they
8 45 CFR §§ 75.403 and 75.405.
Florida's CDC Public Health Crisis Response Cooperative Agreement Program Award (A-02-23-02008)
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must comply with the established accounting policies and practices of the non-Federal entity.
The awarding agency may require personnel activity reports, including prescribed certifications,
or equivalent documentation if the records do not meet these standards.9 Contractors are also
required to comply with the terms and conditions of the award. States must expend and
account for Federal award funds in accordance with their own State laws and procedures for
expending State funds. The State’s and other non-Federal entities’ financial management
systems must be sufficient to trace funds to establish that such funds have been used according
to Federal requirements.10
For five sampled direct expenditures, totaling $218,504, the State agency did not maintain
adequate documentation supporting work performed by contracted employees that was
charged to the cooperative agreement program.  The State agency relied on its vendors to
maintain supporting documentation for the time charged by contracted employees to the
cooperative agreement program. However, timesheets that were maintained either
electronically or in hard copy provided by the State agency were missing required employees’
and approving managers’ signatures.
THE STATE AGENCY’S FEDERAL CLOSEOUT REPORTS DID NOT PROPERLY ACCOUNT FOR
EQUIPMENT PURCHASES AND WERE NOT TIMELY SUBMITTED TO THE CENTERS FOR DISEASE
CONTROL AND PREVENTION
Non-Federal entities are required to have financial systems that produce accurate, current, and
complete disclosure of the financial results of each Federal award or program in accordance
with the reporting requirements.11 Non-Federal entities awarded Federal funds must also take
certain actions for the awarding agency to timely close out Federal awards.12 To do this, States
must have effective controls and safeguards in place to ensure accountability over Federal
funds.13 Further, the cooperative agreement program’s NOFO required Federal closeout
reports to be submitted to CDC within 90 days from the end of the program’s performance
period, which was by June 15, 2022. Closeout reports consist of all required programmatic and
financial reports after the period of performance end date and includes any adjustments for
remaining amounts due. These reports include information on the status of all Federal funds
used during the performance period and any unobligated balances, an inventory of all
equipment, and a final programmatic progress report.14
9 45 CFR § 75.430(i).
10 45 CFR § 75.302.
11 45 CFR §§ 75.302 and 75.341.
12 45 CFR § 75.381.
13 45 CFR § 75.302(b)(4).
14 Required closeout reports for the cooperative agreement program include the Final Federal Financial Report,
Tangible Personal Property Report, Final Performance Report, and the Final Invention Statement.
Florida's CDC Public Health Crisis Response Cooperative Agreement Program Award (A-02-23-02008)
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The State agency’s closeout reports did not properly account for equipment purchases and
were not timely submitted to CDC for its cooperative agreement. Specifically, the State
submitted its reports between 114 to 121 days after the June 15, 2022, deadline.15 Also, the
State agency did not accurately list the equipment purchased under the cooperative agreement
program on its property report.  Specifically, its report did not account for approximately
$10 million in equipment.16 Further, on the same report, the State agency made a clerical error
and reported that some equipment was purchased after the budget period.
CDC uses the Federal closeout reports to assess whether cooperative agreement award
recipients achieved program goals and maintained adequate program and financial oversight
over program funds.  As a result of having inaccurate property reports, CDC was not able to
adequately monitor how the State agency used cooperative agreement program funds to
purchase and retain equipment. Further, due to the inaccurate property report and the
closeout reports not being timely submitted, CDC may not have been able to properly evaluate
and report on the performance of the Public Health Crisis Response cooperative agreement
program to its stakeholders.
CAUSES FOR NONCOMPLIANCE WITH FEDERAL REQUIREMENTS AND COOPERATIVE
AGREEMENT PROGRAM TERMS AND CONDITIONS
The noncompliance with documentation requirements occurred because the State agency
relied on its vendors to maintain supporting documentation for the time charged by contracted
employees to the cooperative agreement program and did not have processes to verify that its
vendors submitted signed and approved timesheets.
The State agency did not comply with requirements to submit accurate and timely closeout
reports because it relied on data systems managed by another State entity and inadvertently
excluded some codes when completing its property report. 17 Additionally, State agency
officials explained that they thought the State agency had obtained an approval from CDC to
extend the deadline to submit its closeout reports to CDC.  However, CDC stated that it did not
approve a request from the State agency to extend the deadline to submit these reports.
15 The original cooperative agreement’s project period was from March 5, 2020, through September 4, 2020;
however, CDC approved an 18-month extension to the State agency.
16 As part of the cooperative agreement program award closeout process, CDC required recipients to annually
submit a Tangible Personal Property report which details equipment that was purchased and maintained.  We
found that the State agency did not include some equipment that it purchased under the cooperative agreement
program such as various lab equipment, test collection kits, and a mobile vaccine unit.
17 Florida’s Division of Emergency Management was designated as the State’s lead agency to purchase equipment
related to emergency preparedness and response activities during the PHE and coordinated with the State agency
to deliver needed equipment for the cooperative agreement program.  However, since the equipment was not
purchased under the State agency’s procurement systems, the State agency inadvertently excluded some
equipment on its property report.
Florida's CDC Public Health Crisis Response Cooperative Agreement Program Award (A-02-23-02008)
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RECOMMENDATIONS
We recommend that the Florida Department of Health:
• refund $218,504 to the Federal Government,
• establish policies and procedures to verify that vendors submit approved timesheets
to support the time and effort charged to the cooperative agreement program by
contracted employees, and
• strengthen its existing processes for ensuring that Federal closeout reports are
accurate and timely submitted.
STATE AGENCY COMMENTS AND OFFICE OF INSPECTOR GENERAL RESPONSE
In written comments on our draft report, the State agency disagreed with “aspects of the
report,” including the report title and the scope of our audit being limited to the State agency,
and two of our recommendations. The State agency did not indicate its concurrence or
nonconcurrence with our remaining recommendation.  Specifically, the State agency disagreed
with our finding and recommendation (financial disallowance) related to unallowable
expenditures.
Under separate cover, the State agency provided additional documentation related to supplies
and lodging expenditures identified in our draft report as unsupported.18 Further, the State
agency indicated that it believes it maintained adequate documentation for cooperative
agreement program expenditures for contracted employees’ charged time.  The State agency
contended that vendors that employed these individuals utilized various methods to document
timesheets for contracted employees and indicated that these vendors could not have altered
their processes for documenting how time was charged to the cooperative agreement program.
However, the State agency explained that it was unclear if the procedures its contracted
vendors utilized were acceptable and acknowledged that process improvements could be
implemented. The State agency’s comments are included as Appendix D.
Based on our review of the State agency’s comments and additional documentation provided,
we revised our findings and related recommendations for two sampled direct expenditures.
Among our revisions, we reduced the amount of our first recommendation from $1,163,554 to
$218,504. We maintain that our findings and recommendations, as revised, are valid.
18 The documentation related to two sampled expenditures: (1) $938,700 in supplies that the State agency
documented was for the purchase of 200,000 isolation/surgical gowns and (2) an invoice that included lodging
costs for in-state travel expenses related to COVID-19 response activities for multiple State agency employees
totaling $6,350.
Florida's CDC Public Health Crisis Response Cooperative Agreement Program Award (A-02-23-02008)
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---
We also modified the title of the report to reflect our updated findings.  Additionally, we
revised Appendix A to clarify how the State agency was chosen as the entity that was audited.
Specifically, we chose to audit the State agency based on a combination of factors that included
the award amount, whether the award was fully drawn down and FFRs were submitted to CDC,
and total confirmed COVID-19 cases within the award recipient’s jurisdiction. Furthermore, we
agree with the State agency’s assertion that its normal operating processes needed to be
changed quickly due to the PHE.  For that reason, we considered the risks associated with
award recipients timely establishing adequate procedures due to the speed at which CDC
awarded funds to recipients.  However, this was only a factor for why we did this audit—not
meant to serve as a singular cause for any findings we identified.
Florida's CDC Public Health Crisis Response Cooperative Agreement Program Award (A-02-23-02008)
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APPENDIX A: AUDIT SCOPE AND METHODOLOGY
SCOPE
Our audit covered 14,004 cooperative agreement direct expenditures of $100 or more that
were made by the State agency during our audit period, totaling $31,474,469. From these
expenditures, we selected a stratified random sample of 106 direct expenditures totaling
$8,768,509. We also selected all indirect expenditures and interagency funds transferred for
COVID-19 PHE-related purchases, totaling $9.7 million. We selected the State agency as the
entity being audited based on a combination of factors that included the award amount,
whether the award was fully drawn down and FFRs were submitted to CDC, and total confirmed
COVID-19 cases within the recipient’s jurisdiction.
We limited our review of the State agency’s internal controls to those applicable to the
administration of its cooperative agreement program. Specifically, we reviewed the State
agency’s policies and procedures for charging program expenditures, maintaining required
documentation, and preparing and submitting required closeout reports.
We conducted our audit from May 2023 through November 2024.
METHODOLOGY
To accomplish our objective, we:
• reviewed applicable Federal laws, guidance, and cooperative agreement requirements;
• met with State agency officials to gain an understanding of the cooperative agreement
program and obtained their policies and procedures for administering the program;
• obtained from the State agency all expenditure transactions totaling $41,401,390 that it
used under its cooperative agreement program during our audit period;
• reconciled the total amount of cooperative agreement program funds that the State
agency received to the amounts detailed in its accounting system;
• created a sampling frame of 14,004 direct expenditures of $100 or more from the State
agency’s accounting system with cooperative agreement program amounts totaling
$31,474,469;
• selected a stratified random sample of 106 expenditures from our sampling frame, and
for each sampled expenditure, obtained and reviewed documentation from the State
agency to support cooperative agreement program expenditures;
Florida's CDC Public Health Crisis Response Cooperative Agreement Program Award (A-02-23-02008)
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• separately reviewed indirect expenditures totaling $1,974,217 made by the State agency
under its cooperative agreement program;
• separately reviewed interagency cooperative agreement program funds transferred for
COVID-19 PHE-related purchases totaling $7,656,532;
• obtained and reviewed closeout reports submitted to CDC;
• determined the total amount of unallowable expenditures made by the State agency
under its cooperative agreement program during our audit period; and
• discussed our results with State agency’s officials.
We conducted this performance audit in accordance with generally accepted government
auditing standards. Those standards require that we plan and perform the audit to obtain
sufficient, appropriate evidence to provide a reasonable basis for our findings and conclusions
based on our audit objectives. We believe that the evidence obtained provides a reasonable
basis for our findings and conclusions based on our audit objectives.
Florida's CDC Public Health Crisis Response Cooperative Agreement Program Award (A-02-23-02008)
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APPENDIX B: STATISTICAL SAMPLING METHODOLOGY
SAMPLING FRAME
The sampling frame consisted of 14,004 cooperative agreement direct expenditures of $100 or
more that were incurred by the State agency during our audit period, totaling $31,474,469.19
SAMPLE UNIT
The sample unit was a cooperative agreement direct expenditure.
SAMPLE DESIGN AND SAMPLE SIZE
We used a stratified random sample as follows:
Stratum
Number
Dollar Range of Cooperative
Agreement Direct Expenditures
Number
of
Frame
Units
Value of Frame
Sample Size
1
≥$100.00 and ≤$1,004.40
10,184
$4,188,777
20
2
>$1,004.40 and ≤$3,612.60
3,134
$5,194,130
20
3
>$3,612.60 and ≤$24,751.00
517
$4,206,933
20
4
>$24,751.00 and ≤$101,179.33
129
$6,628,871
22
5
>$101,179.33
40
$11,255,758
24
Total
14,004
$31,474,469
106
SOURCE OF RANDOM NUMBERS
We generated the random numbers using the OIG Office of Audit Services (OIG/OAS) statistical
software.
METHOD OF SELECTING SAMPLE ITEMS
We sorted the items by the unique expenditure identification number in ascending order,
consecutively numbered the policies in each stratum, generated random numbers in
19 As part of this audit, we separately reviewed indirect expenditures made by the State agency under its
cooperative agreement and any interagency funds transfers.
Florida's CDC Public Health Crisis Response Cooperative Agreement Program Award (A-02-23-02008)
10

accordance with our sample design, and then selected the corresponding frame items for
review.
ESTIMATION METHODOLOGY
We have chosen not to report any estimates of unallowable expenditures in the sampling frame
because the lower limit of the two-sided 90-percent confidence interval was less than the
known unallowable expenditures in the sample. Therefore, we are recommending recovery of
only the unallowable expenditures for the items in our sample.
Florida's CDC Public Health Crisis Response Cooperative Agreement Program Award (A-02-23-02008)
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APPENDIX C: SAMPLE RESULTS
Table: Sample Results
Stratum
Number
Number of
Frame Units
Value of
Frame
Sample
Size
Value of
Sample
Number of
Units
Containing
Unallowable
Expenditures
in Sample
Value of
Unallowable
Expenditures
in Sample
1
10,184
$4,188,777
20
$8,990
0
$0
2
3,134
5,194,130
20
29,285
0
0
3
517
4,206,933
20
145,440
1
3,444
4
129
6,628,871
22
1,138,058
3
140,469
5
40
11,255,758
24
7,446,736
1
74,591
Total
14,004
$31,474,469
106
$8,768,509
5
$218,504
Florida's CDC Public Health Crisis Response Cooperative Agreement Program Award (A-02-23-02008)
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Envelope ID: 01A7C607-D417-45E0-9CA0-1 EC8DBB52B9D
Mission:
To protect, promote and l't'lprove the health
of all people in Florida through integrated
state, county, and community efforts.
Ron Desantis
Governor
Joseph A. Ladapo, MD, PhD
State Surgeon General
Vision: To be the Healthiest State ii the Nation
Jennifer Webb
Regional Inspector General for Audit Services
26 Federal Plaza, Room 3900
New York, NY 10278
Dear Ms. Webb:
December 11 , 2024
The Florida Department of Health (FDOH) has reviewed the draft report of the CDC OIG audit A-02-23-
02008, received on November 26, 2024, and respectfully disagrees with aspects of the report and two
of the recommendations.
Transparency and Accountability
We welcome audits as an opportunity to validate our commitment to transparency and accountability.
However, the Department believes the title of this report does not accurately reflect the findings
documented in the report nor does it appear to be consistent with the "Why OIG Did This Audit".
Particularly, the first bullet states "Congress appropriated approximately $10 billion to the CDC for it to
establish the Public Health Crisis Response cooperative agreement program." Of which, FDOH
received less than 1 % at $41 .2 million. Additionally, the scope of the audit appears to be limited to the
State of Florida, only, as evidenced in a question presented to the auditing team regarding "other states
under audit or was there a plan to audit them?". To date, FDOH is not aware of any other audits
opened in other states, nor of a plan by the HHS to open them.
The second bullet under "Why OIG Did this Audit" states, "Due to the speed at which funds were
awarded, there is a risk that the award recipients may not have established adequate procedures to
ensure that the funds were used appropriately." While this is a valid reason for undertaking such an
audit, the Public Health Crisis had a direct impact on vendors, local, state, and federal agencies
resulting in disruption of supply chains and the implementation of mass telework to required shutdowns
aimed at preventing exposure and spread of the COVID-19 virus. Furthermore, the processes
previously completed physically, had to be quickly adapted to account for a remote workforce. FDOH
shifted most of its focus primarily to testing and contract tracing. Thus, many of the findings within the
draft report are procedural in nature but are not a result of the "speed at which funds were awarded,"
but rather a result of the challenges FDOH faced resulting from a global pandemic .
Florida Department of Health
Deputy Secretary for Operations
4052 Bald Cypress Way, Bin 8-09 •Tallahassee, FL 32399
PHONE: 850-245-4259
FloridaH ealth.gov
•
.
Accredited Health Department
Public Health Accrecitation Board
APPENDIX D: STATE AGENCY COMMENTS
Florida's CDC Public Health Crisis Response Cooperative Agreement Program Award (A-02-23-02008)
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ign Envelope ID: 01 A7C607-D417-45E0-9CA0-1 EC8DBB52B9D
Ms. Jennifer Webb
Page Two
December 11, 2024
Findings and Recommendations
FDOH does not agree with refunding $1, 163,554 to the Federal Government. FDOH worked with the
auditors to fully address each finding. As to the $938,700 finding related to itemized documentation to
support the purchase of supplies, FDOH believed this had been resolved. FDOH has additional
documentation to show there were not multiple types of items purchased, but specifically, 200,000
isolation/surgical gowns.
For the $6,350 identified in the report, FDOH has contract manager approval and has previously
submitted this documentation.
Regarding the $218,504, there were several vendor contracts reviewed where vendors provided staff to
preform services for FDOH. These individuals are employees of the vendor and not FDOH. Various
timesheet documentation, and in some cases, invoices, signed by the vendor supervisor of the project
were provided. Cases where a time report was used, rather than a signed timesheet, was due to the
approval process of the vendor. One example is of vendors providing a call-in phone number to use as
a timeclock for their employees. It is unclear to FDOH if these types of procedures are not acceptable
or how it would have accomplished aspects of its response efforts, understanding these are the payroll
systems and processes of the vendor. We do not believe they would have been able to alter their
process, other than possibly having someone sign/certify the full-time report. Regardless how this is
viewed, process improvement can be implemented; however, FDOH does not agree that
documentation to support the hours related to work performed did not exist for the Public Health Crisis
Response.
Sincerely,
C
DocuSigned by:
l=-M
~2p,3Fc5't5~'0'fil'wkins, MPA, PMP
Deputy Secretary for Operations
Florida's CDC Public Health Crisis Response Cooperative Agreement Program Award (A-02-23-02008)
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1

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