The International Training and Education Center for Health (I-TECH) is a global network that works with local partners—ministries of health, non-governmental organizations, academic institutions, civil society—to develop strong national health systems in resource-limited countries.
I-TECH is based within the Department of Global Health (DGH) in the Schools of Medicine and Public Health, at the University of Washington (UW) in Seattle. UW is a premier academic and research institution with over $1 billion in research-grant funding. As the largest center within DGH, I-TECH administers projects sponsored by the U.S. Centers for Disease Control and Prevention (CDC), the U.S. Health and Human Services’ Health Resources and Services Administration (HRSA), the U.S. Department of Defense, the Bill & Melinda Gates Foundation, the National Institutes of Health (NIH), and USAID.
As of 2019, I-TECH has an annual budget of more than $90 million, 13 offices, and nearly 2,000 staff working in Africa, Asia, the Caribbean, and Eastern Europe—85% of whom are locally hired, national staff. I-TECH works with 14 core and 40 affiliated faculty at UW, representing 12 departments and schools.
In addition to the support of UW’s systems, I-TECH has robust policies that provide the framework for strong financial management of international programs. These policies provide consistency and assurance of compliance with United States Government (USG), Washington State, and UW regulations. I-TECH and its local partners are accountable for meeting the reporting requirements for PEPFAR funding, including preparing quarterly reports and PEPFAR Semi-Annual (SAPR) and Annual (APR) progress reports. Additionally, I-TECH and its country offices are organized to comply fully with expenditure analysis reporting requirements, and their monitoring and evaluation (M&E) plans have robust data quality assurance and assessment procedures.
University of Washington Systems
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I-TECH Financial Systems
In addition to the overarching support of the UW’s systems, I-TECH has robust supplemental policies and procedures that provide structure for financial management of international programs. These polices are adapted in all I-TECH offices to provide consistency and assurance of compliance with USG, Washington State and UW regulations. Additionally, I-TECH programs use Quickbooks as a standard tool for accounting and tracking expenditures, and Host Analytics, a fiscal management software tool is used for all budget management. These two software tools compliment the UW’s financial systems and allow for tracking and reporting of program-specific costs.
Experience Managing Large Cooperative Agreements
I-TECH currently manages multiple CDC-funded cooperative agreements with budgets in excess of $1.5 million per year. I-TECH also has experience implementing large-scale multi-country cooperative agreements; the International AIDS Education and Training Center (IAETC) was first awarded to I-TECH by HRSA in 2002. With an average annual award of more than $25 million, I-TECH has carried out PEPFAR-supported activities in over 30 countries in Africa, Asia, Eastern Europe, and the Caribbean Region with the help of over 60 organizational partners, including ministries of health, universities and health training institutions, and local non-governmental organizations.
Experience Managing Subcontracts and Consultants
Subcontracts: I-TECH currently subcontracts just under $22.5 million to 29 sub-recipients across all I-TECH programs. In addition to the Office of Sponsored Programs, which is responsible for contracting with all sub-recipients on behalf of UW/I-TECH, I-TECH has a Contract Manager who liaises with subcontractors and UW to ensure that subcontract budgets, scopes of work, and contracts are in place and in compliance with sponsor policies.
I-TECH also performs a detailed needs assessment with sub-recipients in the beginning of the relationship to identify whether additional capacity building is necessary to ensure the proper stewardship of USG funds. Based on the information gleaned from the needs assessment, I-TECH provides orientations to USG funding processes/systems as well as trainings on Uniform Guidance and cost principles. The Contract Manager acts as an ongoing support and resource for any questions on allowability, allocability, and reasonableness of sub-recipient expenditures. Spot audits are conducted of sub-recipient invoice documentation and findings are used to further customize training and strengthen sub-recipient financial processes and expenditure files.
In collaboration/agreement with funders, I-TECH also undertakes more intensive capacity building with critical in-country partners, including provision of staff and consultants to work with subs on a longer-term basis to create and improve internal systems and controls.
Consultants: I-TECH currently manages over 800 consultant/contractors across all programs. Consultants are paid rates that are equitable for the assigned scope of work and required technical skills. The Principal Investigators, Country Directors, and Program Managers monitor consultants’ performance, review invoices in accordance with consultant agreements, and ensure consultants have the technical support from the team to meet the deliverables.
Procurement Procedures
The UW Office of Procurement Services reports to the Associate Vice President of Enterprise Services. UW procurement policies are extensive and attend to key aspects of compliance such as levels of authorizations, procurement limits and requirements for different purchase levels, separation of duties, vendor selection process, and integrated processes for invoice payments. As a program of the UW, I-TECH follows the UW’s procurement policy and standard operating procedures, which can be found at https://finance.uw.edu/ps/.
Recent Audits
The UW undergoes an annual independent audit by KPMG of Seattle. Their full reports for the past 17 years can be found at https://finance.uw.edu/financial-report-archive.
Additionally the UW is audited annually as part of the State of Washington’s Single Audit. The Single Audit Report is an entity audit of Washington State that includes both the financial statements and the expenditures of federal awards by all state agencies, including institutions of higher education. The audit reports for the past three years can be found at: https://ofm.wa.gov/accounting/financial-audit-reports/single-audit-report. The University of Washington is referenced as agency 360.
In all cases, the UW is recognized as having excellent, robust systems that are in compliance with applicable state and federal standards and regulations including 2 CFR 200 (Uniform Guidance) and 45 CFR Part 75 (Uniform Administrative Requirements for Awards and Sub-awards to Institutions of Higher Education, the equivalent of 22 CFR 226 for NGOs). When an audit finding does occur, it is typically minor and UW responds rapidly with corrective action and procedures.