Ayuda Inc., Financial InvoicesMIAMI BEACH
BUDGET AND PERFORMANCE IMPROVEMENT
Internal Audit Division
TO: Jimmy L. Morales, City Manager
INTERNAL AUDIT REPORT
VIA:
FROM:
DATE:
Cintya G. Ramos, Budget and P~ance Improvement Director
James J. Sutter, Internal Auditor/;~
September 26, 2016
AUDIT:
PERIOD:
Ayuda Inc. -Financial Invoices Audit
October 1, 2015 through June 30,2016
The City's Office of Community Services performed a review of the submitted supporting
documentation for services billed by Ayuda Inc. for the City's Success University program and
found reasons for concern. At their request, an internal audit was conducted of all the financial
invoices submitted for payment by Ayuda Inc. between October 1, 2015 and June 30, 2016.
This report summarizes the work performed and any discrepancies noted.
INTRODUCTION
Ayuda is a community based non-profit organization located in Miami Beach. Since its
establishment in 1977, Ayuda has served children, adolescents, adults, and the elderly.
Ayuda's mission is to help improve the lives of children and families who are underserved
and/or at risk in South Florida through education, life skills training, and programs that support
self-sufficiency. Ayuda provides care coordination and counseling services through the City of
Miami Beach Success University program.
Success University is a family support program which provides a variety of services to stabilize
children, youth, and their families, prepare them for success, and combat truancy. The program
utilizes an integrated care coordination model and partners with community-based
organizations, such as Ayuda, to ensure quality holistic services are provided to all at-risk Miami
Beach children and families. Success University is funded in part by The Children's Trust. The
Children's Trust is a dedicated source of revenue established by voter referendum to improve
the lives of children and families in Miami-Dade County.
On August 1, 2015, Ayuda entered into a professional services agreement with the City to
provide care coordination services for up to forty-five children and their families and mental
health services for up to eight children and/or their families enrolled in the City's Success
University program.
Care coordination services consist of:
• A care coordination assessment, conducted by an Ayuda facilitator, of the child's and/or
family's needs and a plan developed to specifically address identified needs,
• Two follow up visits by the facilitator in order to measure progress and address any
issues or concerns,
We are committed to providing excellent public service and safety to all who live, work, and play in our vibrant, tropical, historic community
Internal Audit Report
Ayuda Inc.-Financial Invoices Audit
September 26, 2016
• A flexible plan check-in consultation conducted over the phone to address any
unforeseen issues and/or concerns,
• And a care coordination close-out visit to conduct a final assessment and evaluation of
the child's and/or family's progress and conclude care coordination services.
Mental health services consist of:
• A mental health assessment to evaluate the child's and/or family's counseling needs
• And counseling services to address any issues and/or concerns identified in the mental
health assessment.
The following table lists the services, rates, number of services or units, the total funded amount
for each category, and the total amount stated in the agreement for the audit period October 1,
2015 through June 30, 2016:
Care Coordination Services
Care Coordination Assessment & Plan Development
Care Coordination Plan Follow-Up Visit (1)
Care Coordination Plan Follow-Up Visit (2)
Care Coordination Plan Flexible Check-In (Phone Consultation)*
Care Coordination Plan Close-Out
Counseling Services
Rate
$144.20
$ 78.75
$ 78.75
$ 27.81
$103.00
Total# of Contracted Units Total Funded Amount
45 $ 6,489.00 .
45 $ 3,543.75
45 $ 3,543.75
35 $ 875.00
45 $ 4,635.00
215 $ 19,086.50
Mental Health Assessment $ 250.00 8 $ 2,000.00
Counseling Sessions $ 75.00 96 $ 7,200.00
104 $ 9,200.00
Total 319 $ _ 28,286.50
*According to the signed agreement for the audit period October 1, 2015 through June 30, 2016, thirty-five Care
Coordination Plan Flexible Check-In consultations are to be utilized at a rate of $27.81 per check-in for a
maximum not to exceed $875 dollars. For information purposes only, thirty-five units of this service at a rate of
$27.81 amounts to $973.35. For audit purposes, the maximum amount, $875, was used.
PROCESS DESCRIPTION
1. The client is referred to the City's Success University program by any number of
persons, which may include teachers, extended family, neighbors, and friends.
2. The client is then contacted by the Office of Community Services in order to schedule an
assessment of the client's program needs.
3. The client is assigned to a contractor, in this case Ayuda, to contact and provide
services to the client.
4. An Ayuda facilitator contacts the client to schedule a care coordination assessment,
which is the first step in the care coordination process.
5. During the care coordination assessment, follow-up visits, an initial mental health
assessment, and counseling sessions are scheduled. The client may elect to not use
the contractor's counseling services.
6. Follow-up visits are conducted as well as optional flexible check-in consultations through
telephone communication if requested. A mental health assessment and counseling
sessions may occur simultaneously with care coordination services.
7. A care coordination plan close-out service is conducted and the care coordination
Page 2 of 10
Internal Audit Report
Ayuda Inc.-Financial Invoices Audit
September 26, 2016
FINDINGS, RECOMMENDATIONS AND MANAGEMENT RESPONSES
1. Finding -The Contractor Billed the City for Duplicate Sessions, Overlapping Sessions,
Sessions without Transition Time, and a Session without Supporting Documentation
totaling to $1,420.81.
In accordance with section 4.3 of the signed agreement, "Contractor shall provide the
City with a detailed invoice, on a monthly basis, that details all services performed by
contractor in a particular month.", financial invoices for services performed were
submitted to the City. However, a review of the financial invoices and the supporting
documentation submitted to the City by the Contractor revealed that duplicate sessions,
overlapping sessions, sessions without transition time, and a session without supporting
documentation, totaling $1,420.81, were billed to the City. The following table illustrates
the detailed amounts billed to the City for the above mentioned sessions:
Date Service Category Start of Session End of Session Service Units Billed Amount
Billed Sessions w Duplicate Times
02/19/2016 Care Coordination Follow-Up 2 3:30PM 4:30PM 1 $ 78.75
02/19/2016 Counseling Session 3:30PM 4:30PM 1 $ 75.00
03/23/2016 Care Coordination Follow-Up 1 6:00PM 7:00PM 1 $ 78.75
03/23/2016 Counseling Session 6:00PM 7:00PM 1 $ 75.00
4 $ 307.50
Billed Sessions w Overlapping Times
02/19/2016 Care Coordination Follow-Up 2* 3:00PM 4:00PM 1 $ 78.75
03/10/2016 Care Coordination Follow-Up 1 7:00PM 8:00PM 1 $ 78.75
03/10/2016 Care Coordination Close-Out 7:45PM 8:45PM 1 $ 103.00
04/08/2016 Counseling Session 2:15PM 3:15PM 1 $ 75.00
04/08/2016 Counseling Session 3:10PM 4:10PM 1 $ 75.00
5 $ 410.50
Billed Sessions w/o Transition Times
04/06/2016 Counseling Session 4:00PM 5:00PM 1 $ 75.00
04/06/2016 Counseling Session 5:00PM 6:00PM 1 $ 75.00
04/11/2016 Counseling Session 2:30PM 3:30PM 1 $ 75.00
04/11/2016 Counseling Session 3:30PM 4:30PM 1 $ 75.00
04/11/2016 Counseling Session 4:30PM 5:30PM 1 $ 75.00
04/25/2016 Counseling Session 2:30PM 3:30PM 1 $ 75.00
04/25/2016 Counseling Session 3:30PM 4:30PM 1 $ 75.00
05/17/2016 Counseling Session 4:30PM 5:30PM 1 $ 75.00
05/17/2016 Counseling Session 5:30PM 6:30PM 1 $ 75.00
9 $ 675.00
Billed Session w/o Supporting Documentation
05/20/2016 Care Coordination Flex Check-In N/A N/A 1 $ 27.81
1 $ 27.81
Grand Total 19 $ 1,420.81
*Overlapping session on 0211912016 occurs simultaneously with the above mentioned duplicate sessions.
For information purposes, one seNice unit for the above mentioned service categories is equivalent to a
minimum of 60 minutes in length, excluding Care Coordination Flexible Check-In services which require a
minimum of 45 minutes in length.
The information below provides a brief explanation of the categories identified in the
table above:
Page 4 of 10
Internal Audit Report
Ayuda Inc.-Financial Invoices Audit
September 26, 2016
• Billed sessions with duplicate times
Duplicate times and dates consist of sessions that occur on a specific date at the
same exact time interval as another by the same facilitator.
• Billed sessions with overlapping times
Overlapping time sessions occur when two separate sessions either begin or end
while another session occurs, overlapping by a minute or more, ranging from 5 to
30 minutes over for the tested transactions.
*Overlapping session on 02/1912016 occurs simultaneously with the above mentioned duplicate
sessions.
• Nine sessions without transition time
Transition time is the time between two separate sessions allowing for travel,
preparation, etc. between sessions. According to supporting documentation
provided by Ayuda, all sessions identified above were performed at distinct
locations.
• One session without supporting documentation
Supporting documentation for a session that occurred on May 20, 2016 could not
be found by Ayuda.
Additionally, seven overlapping sessions and four sessions without transition time were
not billed by Ayuda but appear in client record files. Ayuda did not bill these sessions
due to the City's Office of Community Services' initial detection of the discrepancies.
The table below exhibits the detail of the overlapping sessions and sessions without
transition that were excluded from the monthly invoices:
Date Service Category Start of Session End of Session Service Units Billed Amount
Sessions w Overlapping Times Not Billed
06/03/2016 Counseling Session 3:00PM 4:00PM 1 $ 75.00
06/03/2016 Counseling Session 3:40PM 4:30PM 1 $ 75.00
06/03/2016 Counseling Session 4:20PM 5:20PM 1 $ 75.00
06/03/2016 Counseling Session 5:00PM 6:00PM 1 $ 75.00
06/10/2016 Counseling Session 4:20PM 5:20PM 1 $ 75.00
06/10/2016 Counseling Session 5:00PM 6:00PM 1 $ 75.00
06/10/2016 Counseling Session 5:30PM 6:30PM 1 $ 75.00
7 $ 525.00
Sessions w/o Transition Times Not Billed
06/10/2016 Counseling Session* 6:30PM 7:30PM 1 $ 75.00
06/17/2016 Counseling Session 4:30PM 5:30PM 1 $ 75.00
06/17/2016 Counseling Session 5:30PM 6:30PM 1 $ 75.00
06/17/2016 Counseling Session 6:30PM 7:30PM 1 $ 75.00
4 $ 300.00
Grand Total 11 $ 825.00
*Session without transition time on 0611012016 occurs adjacent to overlapping session on 0611012016.
Ultimately, Ayuda verbally verified, with clients, that fourteen of the above mentioned
thirty sessions, billed and not billed, occurred at different times and provided a list of
Page 5 of 10
Internal Audit Report
Ayuda Inc.-Financial Invoices Audit
September 26, 2016
revised session times to correct overlapping sessions and sessions without transition.
However, no other supporting documentation was given to validate the list with the
revised session times and therefore cannot be accurately verified.
Recommendation(s):
Ayuda should review and verify all supporting documentation for services performed on
a monthly basis in order to ensure accurate recordkeeping of client files. The Office of
Community Services should address the billing of the $1,420.81 with Ayuda by either
requesting the funds to be returned or deducting the monetary amount from the
remaining balance of the agreement, decreasing the balance of funds and service units
available for the 2015-2016 agreement.
Management's Response (Ayuda):
Ayuda has moved forward in reviewing and verifying every Success University client file
and supporting documentation on a weekly basis in order to ensure accurate
recordkeeping of client files. Upon contract signing 2016-17, Ayuda will have a
designated person to ensure that all services contracted for are accurately cross-
referenced prior to invoicing the funding source.
Management's Response (Office of Community Services):
The City acknowledges that there were errors in the back-up documentation provided by
Ayuda. The City will ensure that Ayuda is reimbursed only for those services provided
with appropriate documentation. The City will also ensure that a fidelity review is
performed upon receipt of all future invoices.
2. Finding -The Contractor did not properly reconcile invoiced items to supporting
documentation and did not upload supporting documentation on to the City's designated
service partnership website in a timely manner. Additionally, the City did not reconcile
the invoices received to the supporting documentation uploaded on to the City's
designated service partnership website.
Ayuda creates monthly invoices for services performed to be billed to the City. These
invoices are submitted with a monthly client list that provides the client name, type of
service, date of service, date submitted to the City's designated service partnership
website, and the month billed. Ideally, all of the supporting documentation for the line
items on the client list should appear on the City's designated service partnership
website for verification and reconciliation of the invoices to the supporting
documentation. However, client files provided by the Office of Community Services
were missing supporting documentation for invoiced line items, revealing that the
contractor was not reconciling invoices to supporting documentation and not uploading
supporting documentation in a timely manner.
A comparison review of all invoiced sessions to client supporting documentation
provided by the Office of Community Services, for fiscal year 2015-2016, revealed that
fifty-eight invoiced sessions, beginning on October 26, 2015 and ending on June 22,
2016, required verification of supporting documentation. The chart below illustrates the
sessions by month, missing supporting documentation not in the Office of Community
Services files:
Page 6 of 10
Internal Audit Report
Ayuda Inc.-Financial Invoices Audit
September 26, 2016
Number Of Sessions Without Documentation in
the City's Files by Month Examined
18 ,-----------------------------------------------
17 +---------------------------------
16 +---------------------------------
15 +---------------------------------
14 +---------------------------------
13 +---------------------------------
12 +---------------------------------
11 +-----------------~--------------
10 +---------------------------------
9 +---------------------------------
8 +----------------------------------
7 +----------------
6 +-----------------
5 +-----------------
4 +-----------------
3 +-----------------
2 +-----
1 +--.---
0 +--L-...-,--
Oct-15 Nov-15 Dec-15 Jan-16 Feb-16 Mar-16 Apr-16 May-16 Jun-16
*As August 9, 2016, all of the fifty-eight sessions were verified by the contractor and supporling
documentation was uploaded on to the City's designated service parlnership website by the contractor.
Furthermore, Ayuda advised that previously a former employee of the Office of
Community Services would receive the monthly invoice through a notification email sent
by Ayuda. The City employee would then review and verify the invoiced line items with
supporting documentation uploaded to the City's designated service partnership website
by Ayuda. If any discrepancies and/or missing supporting documentation were identified,
the City employee would inform Ayuda and request the missing documents and/or
request that discrepancies be corrected. The City employee would then send the
corrected invoices to the City's Finance Department requesting payment to be sent to
Ayuda. This process allowed Ayuda to rely on the City to accurately verify and reconcile
invoices and supporting documentation, which is ultimately the responsibility of Ayuda.
Additionally, recent invoices provided by Ayuda were received and sent to the Finance
Department as done in the past, but it is evident that verification and reconciliation of the
invoiced items to uploaded supporting documentation did not occur on the City side as
well. It is unclear as to the responsibilities of the City employee from the Office of
Community Services submitting the invoice for payment, but the increase in occurrence
of missing supporting documentation, as illustrated in the chart above, affirms the lack of
verification and reconciliation of the invoices by the City.
However, the Office of Community Services did perform a review of the submitted
supporting documentation for services billed by Ayuda Inc. for the City's Success
University program and found reasons for concern. Their results indicated that a
thorough review was necessary in order to identify any previous deficiencies.
Recommendation( s):
Ayuda is ultimately responsible to submit accurate invoices and upload supporting
documentation timely for all clients serviced through the City's Success University
program. The Office of Community Services should verify and reconcile invoiced items
Page 7 of 10
Internal Audit Report
Ayuda Inc. -Financial Invoices Audit
September 26, 2016
to supporting documentation submitted by Ayuda. This task should be delegated to an
individual in the Office of Community Services.
Management's Response (Ayuda):
Ayuda agrees that the agency is ultimately responsible to submit accurate invoices and
upload supporting documentation in a timely manner for all clients serviced through the
City's Success University program. Ayuda will have a dedicated person reviewing and
cross-referencing all of the documentation for each client during our new contract year
2016-17 so that discrepancies won't re-occur.
Management's Response (Office of Community Services):
The City will ensure that Success University staff reviews and reconciles invoices with
supporting documentation to ensure that payment is released when appropriate.
3. Finding -The City has not executed an amendment allowing the contractor to serve
additional clients despite referring clients to the Contractor.
Ayuda advised that the City requested additional clients be assigned for care
coordination and mental health services. An amendment to the signed agreement was
requested by Ayuda to reflect the additional clients to be serviced along with the rates for
the services provided and an amended total contract amount. The contractor informed
Internal Audit that additional clients have been serviced, but the amendment has not
been executed. Furthermore, a Program Coordinator at the Office of Community
Services confirmed that the amendment has not been executed due to discrepancies
found in their review of the supporting documentation submitted by the contractor.
Recommendation(s):
An amendment to the professional services agreement between the City and Ayuda
should be executed before any additional clients can be serviced.
Management's Response (Ayuda)
We agree with the recommendation and will ensure that we only service clients that are
under contract. A contract amendment was finally executed on August 18, 2016. Ayuda
had been asking for the contract amendment since May, 2016 as we had been assigned
and were servicing additional clients. We had been advised that the delays were coming
from The Children's Trust side and the City's legal department. We know from
experience that The Children's Trust agency and the City's Legal Department often
experience delays and did not think anything of it. Discrepancies were not mentioned to
us until the conference call of July 12, 2016.
Management's Response (Office of Community Services):
While The Children's Trust provided verbal approval to move forward, City staff erred in
authorizing services prior to the execution of the contract amendment. The City will
ensure that contracted services will not be requested unless all contracts and
amendments authorizing said services have been fully executed by all parties regardless
of programming deadlines. Further, the City has addressed the importance of this with
The Children's Trust as its process could effectively delay approvals by 60 days
seriously impacting the City's contractual outcomes and the ability to properly
subcontract for services.
Page 8 of 10
Internal Audit Report
Ayuda Inc. -Financial Invoices Audit
September 26, 2016
4. Finding -Verification of Employees vs. Subcontractors for Individuals Providing
Services.
Section 10.3 of the signed agreement states "Contractor shall not subcontract, assign, or
transfer all or any portion of the work and/or service under this Agreement without the
prior written consent of the City Manager, which consent, if given at all, shall be in the
Manager's sole judgement and discretion. Neither this Agreement, nor any term or
provision hereof, or right hereunder, shall be assignable unless as approved pursuant to
this Section, and any attempt to make such assignment (unless approved) shall be void."
Yet, a review of Ayuda's payroll records revealed that independent contractors provided
services to clients during the audit period of October 1, 2015 through June 30, 2016.
Testing determined that two individuals were subcontracted and assigned work, by the
contractor, to perform services under the signed agreement without the City's approval.
Additionally, the review of the contractor's payroll records showed that the agency's
executive staff member's hourly rate was stated as $200, for in-kind purposes, on
invoices submitted to the City for payment and does not accurately reflect the
employee's actual monetary compensation. The contractor advised that the correct
hourly rate for this staff member should be $33.65, but disclosed that they are in the
process of re-evaluating this amount. The leverage/match or in-kind section of the
invoices submitted for payment to the City reports hours worked but not billed by the
contractor in regards to the services performed under the signed agreement.
Ultimately, the City's Office of Community Services is required to report these in-kind
contributions to The Children's Trust as part of their monthly report and leverage. The
inaccurate information provided by Ayuda to the City, regarding the value of their in-kind
contributions, represents an overvaluation of the contributions received, which misstates
amounts reported to The Children's Trust.
Recom mendation(s):
The contractor should seek the City's approval before delegating services, outlined
under the signed agreement, to independent contractors or subcontractors. Going
forward, the contractor should accurately state the hourly rates of employees for
reporting purposes on invoices submitted to the City. The City should determine whether
to revise its in-kind reporting to the Children's Trust to reflect a lower amount.
Management's Response (Ayuda):
Ayuda agrees and is in the process of submitting all of the required documentation for
any independent contractor that works for the Success University program. Please be
advised that Ayuda had been utilizing the same independent contractor for the past 3
years. The City has been monitoring us on an annual basis, checking staff and
independent contractor's files.
An hourly rate of $33.75, not $200.00, is what we internally value the executive staff
member's in-kind services. This is based on a $70,000 annual salary for the position,
should there be enough funds. The $200 hourly rate had been erroneously left in
Success University's paperwork for the past three years. The City had not mentioned nor
questioned it during monitoring.
Page 9 of 10
Internal Audit Report
Ayuda Inc.-Financial Invoices Audit
September 26, 2016
Management's Response (Office of Community Services):
Under its agreement with The Children's Trust, the City is required to document its total
operating costs for the operation of Success University and the Service Partnership. By
providing inaccurate information, Ayuda has caused the City, in turn, to report inaccurate
information to its funder. The City will have to provide a corrected summary as part of its
end-of-year report.
EXIT CONFERENCE
An exit conference was held on August 29, 2016 and the participants included Maria L. Ruiz
(Office of Housing & Community Services Department Director), Alba A. Tarre (Homeless
Outreach Team Program Coordinator), James Sutter (Internal Auditor) and Luis Medina
(Auditor). The agreed upon revisions were made in the draft audit report which were
subsequently emailed to the agency for review. Management responses were solicited and
included above. All parties were in agreement as to the contents of this report.
JJS:LM:Im
Audit performed by Auditor Luis Medina
F:\OBPI\$AUD\INTERNALAUDIT FILES\DOC15-16\REPORTS-FINAL\AYUDA FINANCIAL INVOICES AUDIT RPT.docx
cc:
Kathie G. Brooks, Assistant City Manager
Maria L. Ruiz, Office of Housing & Community Services -Department Director
Diana Susi, Ayuda Inc. -President/CEO
Cecilia De Loaf, Ayuda Inc. -Program Director
Page 10 of 10