2021-169-E Health-NC DHHS FY22 consolidated agreement

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DocuSign Envelope ID:B749018F-351A-4D6F-9FC5-C2EB21856524 Consolidated Agreement FY22 Page 12 of 27 submitted to the Local Government Commission(LGC)by the County Administration(if single county LHD) or the District Health Department or Public Health Authority (if so organized) within six months following the close of the Agreement. Audit findings referred to the DHHS Internal Audit Office by LGC will be investigated and findings verified by the DHHS Controller's Office staff with assistance of DPH Program Staff. h. Local Appropriations Budget: The LHD shall prepare and maintain a Local Appropriations Budget (reflecting the plans to use local appropriations or earned fees) for each Agreement Addendum in a manner consistent with instructions provided in funding-specific budgetary guidance from DPH and the specific guidance from the respective programs. i. Local Earned Revenues Budgeting and Reporting: The LHD shall observe the following conditions when budgeting and reporting Local Earned Revenues: 1. Locally appropriated funds may not be withdrawn due to fee collection greater than projected in the budget or due to new grant funding except during the last two months of the fiscal year to allow the county to manage end of year budget close out. 2. All earned revenue (officially classified as local funds) must be budgeted and spent in the program that earned it except: a) Revenue generated by Women's and Children's Health (WCH) Section Programs may be budgeted and expended(consequently reported) in any WCH Section Program,unless a specific Agreement Addendum has a more restrictive requirement. b) Revenue generated by a local clinic or program that has no State-funded budget(no State or federal funds) shall be budgeted and associated expenditures reported in a State Program Activity that most closely matches the deliverables of the respective State program. This process will enable the collection of total expenditures in public health per program. 3. The LHD shall not use personal health program funds to support environmental health programs nor use environmental health program funds to support personal health programs. 4. Use of program income generated by the expenditure of federal categorical funds will be governed by applicable federal regulations, including,but not limited to, 2 CFR Part 200. 5. A local account shall be maintained for unexpended earned revenues (i.e., Title XIX fees,private insurance or private pay [cash]). Accounts shall be maintained in sufficient detail to identify the program source generating the fees. 6. The amount of Title XIX fees budgeted and expended in FY 2021-2022 must equal or exceed the amount of Title XIX revenues earned during FY 2019-2020. 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 LHD provides sufficient justification. j. Aid-to-Counties Database and Expenditure Reports: The LHD shall submit a monthly report of actual State, federal and local expenditures to the DHHS Controller's Office via the Aid-to-Counties Database (ATC). 1. Specific ATC instructions and training will be provided by LTATB to LHDs and will include guidance for reporting local programs (i.e., those programs that are not funded through DPH), examples include but are not limited to: Dental Clinic and Primary Care. 2. DPH shall produce an annual ATC report in order to provide information reported that summarizes LHD and statewide analysis and trending, including per capita analysis, when applicable. This report will be produced in collaboration with NCALHD and will be posted publicly on the DPH website.