2002 S Health - N.C. Dept of Health & Human Services Consolidated

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Consolidated Agreement - Final Page 7 of 13 iii. Line item 102 on the program budget must be used to budget TXIX Medicaid earned revenues. iv. Line item 103 on the program budget must be used to budget other earned revenues (e.g., Home Health Fees, Environmental Health Fees, Patient fees (cash), Other insurances, and other grants and donations.). f. When reporting expenditures (local appropriations or earned fees)the department must use the electronic spreadsheet (Local Health Department/District Form DHHS 2949 revised 5/03/01)— hereafter referred as DHHS Spreadsheet— prepared and maintained by the DHHS Controller's Office. This report must be submitted monthly in an electronic format (DHHS 2949— Local Health Dept/District Expenditure Report - Excel Spreadsheet File) as an attachment to an email to designated staff in the Benefits and Payment Section of the Controller's Office. At the time the electronic report is emailed to the DHHS Controller's Office, a "Certification of Expenditures" signed by the health director, shall be faxed to the DHHS Controller's Office. The "Certification" verifies in writing that the total State and Federal expenditures reported were valid. Local expenditures are part of the Expenditure report, but are not included in the amount verified in the"Certification." i. Line item 101 on the DHHS Form 2949 Spreadsheet must be used to report local appropriations that were expended ii. Line item 102 on the DHHS Form 2949 Spreadsheet must be used to report TXIX (Medicaid) earned revenues that were expended. iii. Line item 103 on the DHHS Form 2949 Spreadsheet must be used to report other earned revenues that were expended. g. A local account shall be maintained for unexpended earned revenues (i.e., TXIX fees, private Insurance or private pay(cash)]. Accounts shall be maintained in sufficient detail to identify the program source generating the fees. h. The amount of Title XIX fees budgeted and expended in FY 2002-2003 must equal or exceed the amount of Title XIX revenues earned during FY 2000-2001. The state will not approve program activity budgets that do not include an amount of Title XIX fees sufficient to meet the requirements of this section. The State may waive this requirement if the Department provides sufficient justification. 4. (State/ Federal Revenues)The Department shall submit a monthly report of actual expenditures (State and/or Federal) to the DHHS Controller's Office on the DHHS (Electronic) Spreadsheet (same electronic Spreadsheet DHHS 2949 as referenced in 3 above)—all reported in one spreadsheet, but separated here for clarity of instructions. a. The Department shall submit monthly expenditures for all programs via DHHS 2949 (Electronic) Spreadsheet to the DHHS Controller's Office according to their schedule published annually in December for the next calendar year. The schedule reflects a general period of 15-20 days from the end of the reporting month for submission of the DHHS Spreadsheet, based on weekends and holidays, to allow processing time for the payment. Failure to meet the reporting deadline, as published, MAY result in the exclusion of those expenditures in the Steps-Out payment for that month. The Department must submit these monthly expenditure reports, via this DHHS Spreadsheet, consecutively throughout the agreement period.