Nationwide Audit of State and Local Government Efforts to Record and Monitor Subrecipients' Use of

Page 2 – Elizabeth M. Duke, Ph.D. priority planning area, critical benchmark, and funds allocated to hospitals and other health care entities. • Twelve awardees had developed procedures to track and monitor subrecipient expenditures, but there were opportunities for improvement. • All 18 awardees had unobligated balances of Federal bioterrorism funds as of August 30, 2003 totaling approximately $19.2 million, or 23 percent of the $83.1 million awarded. Improvements are needed to ensure that bioterrorism program funds are efficiently and effectively utilized. We recommend that HRSA: • identify awardees not meeting budget restrictions and ensure that all awardees account for funds in accordance with their cooperative agreements • provide guidance to awardees on monitoring subrecipient expenditures and measuring subrecipient performance, including emphasizing the need for awardees to make site visits to directly review subrecipients’ expenditures and assess subrecipients’ progress in improving bioterrorism preparedness • identify the reasons for large unobligated balances and assist the awardees in overcoming barriers to a more timely use of funds Officials in your office have concurred with our recommendations, set forth on page 7 of the attached report, and have taken, or agreed to take, corrective action. We appreciate the cooperation given us in this audit. We would appreciate your views and the status of any further action taken ...