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        <FormAndLineReferenceDesc>Part I, Line 2 - Grantmakers Explanation For Monitoring Use of Funds Outside US</FormAndLineReferenceDesc>
        <ExplanationTxt>To ensure compliance with applicable regulations, country laws, and grant regulations each new project has an established budget which details allowable costs. Field Offices are required to obtain Headquarter pre-approval for the monthly expenses incurred in the field.The actual vs. budget reports are reviewed on a monthly basis by the regional Finance and Operation Director and any under/overspent is discussed with the Country Project Managers, the Headquarter program team and the Executive Director. Funds are transferred from MedGlobal Headquarters to the field offices as per a fund request approved by the head of the program and reviewed by the HQ Program and finance team. Before submitting any new request, Field Offices must provide support documents to clear the initial request. All program activities and expenses are monitored against budget and grant documents to ensure full compliance with the terms and conditions of each grant. Segregation of duties is required at both levels: Headquarter and fields offices. Subrecipients:Once the oversight committee identifies the correct Subrecipient, the Subrecipient is required to provide their recent audit reports and a proof of registration that they are legally allowed to work in the area of implementation.High-risk subrecipients are identified prior to dealing with any new partners by conducting pre-award risk assessment and background check as well as reviewing the partners annual reports and the historical programs to ensure that the partners have the ability to implement the project activities. In order for the Subrecipients to receive funds, it is required to sign and acknowledge MedGlobal compliance policies such as our Anti-Bribery, Code of Conduct and Ethics Statement, Conflict of Interest and Whistleblower Policy. They must also provide MedGlobal with a project monitoring plan, follow a procurement threshold and Measurable Program &amp; Effectiveness Policy. Subrecipients are required to follow the the terms and conditions set forth by the original grantor requirements and donors regulations.Monitoring reviews/feedback are used to provide technical assistance and trainings for subrecipients to enable subrecipients to maintain funding and follow the applicable rules and regulations to ensure that MedGlobal subrecipients comply with Grant Subaward requirements and maintain their funding. Ongoing program, financial and administrative training and technical assistance is provided.MedGlobal Program Managers conduct periodic visits to review a subrecipient's overall implementation of the program, adherence to program guidelines, and achievement of Grant Subaward goals and objectives and to identify issues and provide technical assistance as needed. MedGlobals Headquarter team is responsible for: 1. Payment reviews of invoices and other documents supporting a reimbursement claimed by and made to the subrecipient 2. Monitor subrecipients during the term of the Grant Subaward3. Monitor efforts and focus on the areas of most significant risk4. All monitoring findings are addressed through appropriate corrective actions</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, Line 11b</FormAndLineReferenceDesc>
        <ExplanationTxt>No review was or will be conducted.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, Line 12c</FormAndLineReferenceDesc>
        <ExplanationTxt>Annually, board members are requested to complete and update the conflict of interest disclosure form as part of the audit process.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, Line 15a</FormAndLineReferenceDesc>
        <ExplanationTxt>ED compensation is based on budget, funding and approval from board of directors</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, Line 15b</FormAndLineReferenceDesc>
        <ExplanationTxt>Director of Advocacy &amp; Communication and Director of Finance compensation is based on budget, funding and approval from board of directors</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section C, Line 18</FormAndLineReferenceDesc>
        <ExplanationTxt>MedGlobal makes its annual audited financial statement &amp; 990s available to the public through its website and its Guidestar profile.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section C, Line 19</FormAndLineReferenceDesc>
        <ExplanationTxt>No documents available to the public.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
  </ReturnData>
</Return>
