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12 <br />State of North Carolina <br />Division of Social Services <br />Contract Application Page ; of g <br />( ) 3. ( Applicable to Public ho,_�pi.tais, Colleges, and i�ers�_ies) <br />The annu -21 audit must be performed in acccrdar,ce uitt: <br />Circular A -11C. It is not necessary for the inst_tutien to <br />program audits performed separately from an al?- iIlcluslve <br />single audit which entails all revenues and expenditures of the <br />Public agency. However, it is the responsib-ilitr of the cc`ractor <br />to insure that the contract program is included ill tile Contractor <br />institutions sirlble annual audit. <br />A copy of the audit report must be provided to the County <br />department of social services upon completion of the annual audit. <br />(x) 4. (Applicable to State or Local Government Agencies) <br />An annual audit is to be performed in accordance with 0 "IE Circular <br />A -128 by an independent auditor. Upon completion of the audit, a <br />COPY of the audit report must be forwarded to the county <br />department of social services. <br />E. Client Fees for Service <br />(x) 1. No fees will be charged to individuals determined to be eligible <br />for services by the department of social services. <br />( ) 2. The service(s) under contract with the Provider are services for <br />which a client fee may be assessed. Policy regarding the <br />assessment and collection of fees is contained in Family Services <br />Manual, Volume VI, Chapter III. If a client is to be charged a <br />fee, the department will inform the Provider of the amount of the <br />fee to be charged and of any subsequent changes by way of the <br />Purchase of Service Referral and Authorization (DSS Form 1360+). <br />The Provider will establish a plan with the client for collecting <br />zhe fee on at least a monthly basis; and when fees are not paid <br />within ten days of the due date; will bill the client in writing <br />and send a copy of the bill to the Department. NO OTTER FEES FOR <br />SERVICES PiAY BE CHARGED TO THE CLIENT. Client fees are to be <br />reported on the Monthly Report of Service Delivery (DSS Form <br />1571, Part IV). <br />F. Management of the Funding/Matching Share keauirement <br />( ) 1. n cash transfer of the matching share will be made =o the cc=zv <br />department of social services in accordance with the terms <br />spec-4-fed in the Donation Agreement (DSS - 131_9). <br />DSS -1947 (4/67) <br />Family Services <br />