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12 <br /> Slate ofsanM Caroline <br /> Division of Social Services <br /> Contract Application Page 4 of 7 <br /> C. Reimbursement Reporting: <br /> 1. Expenditures <br /> The Provider will report expenditures monthly in accordance sent policy set forth by <br /> the Controller's Offices,Division of Social Services, issued via the Fiscal Manual. <br /> Expenditures are to be reported on to DSS Administrative Cost Repon(Form DSS- <br /> 1571,Pan ILL). Reports ate m be submitted to to Department by the fifth working <br /> day ofte month fallowing to month in which services were delivers. The <br /> Department will reimburse to Prervidermanday,usually by check upon receipt of a <br /> completed and correctly filed report <br /> 2. Reporting for to Smt raids Services Intbrmation System(SIS) <br /> In addition m the AdmiNShative Cast Report(DSS-15)l,Pan III),the Provider will <br /> submit m the Depmtmwt to Monthly Report of Service Delivery(DSS Form 1571, <br /> Pan IV). This should he submitted along with the Administrative Cast Report by the <br /> fifth working day of the month following the month in which smites were delivered. <br /> The units repeated in Column 12 of the 1571 Part IV are to units ofservice defined in <br /> Columt 5 of I.C.of this Attachment. Service definition end reporting wistmctietu are <br /> found in Family Services Manual,Volume VI, Chapter 1V. <br /> D. Audit Reepuiternwts <br /> The Pmvlder dull be responsible for come nswe with the audit requirements of <br /> Department of Health and Human Services federal regulation 45 CFR Part 74, <br /> Admiimstamon of Grants,or State Administrative PrOCWtes Moment fm Federal Black <br /> Greet Funds,whichever is applicable. These regulations stipulate that an mmual audit be <br /> performed for the fiscal year in which connect funds were received. <br /> O 1, NA <br /> Private,nan-pmfit if wwunt of reimbursement received is under$ 1,0M private, <br /> for Profit or individual <br /> (X) 2. (AMhec leteMvate,Nov-Profit Ptovidemifreimb.$I,OWorovs) <br /> M anmtal aadit is wbe performed m wmN=ce wit OMB Circular A-llo by m <br /> "independent auditor" Independent audimt'mews either: (a)a state govermnen[ <br /> audits from the Department of Human Resources or the Department of <br /> Arbouratretioo,Office to the Sta¢Auditor,or(b)a retuned public accountant. <br /> Upon completion of the audit,a copy of the audit report must be forwarded m to <br /> county department of social services. <br />