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tz <br /> State of North Carolina <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 with 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 the DSS Administrative Cost Report(Form DSS- <br /> 1571,Part III). Reports are to be submitted to the Department by the fifth working <br /> day of the month following the month in which services were delivered. The <br /> Department will reimburse the Provider monthly, usually by check,upon receipt of a <br /> completed and correctly filed report. <br /> 2. Reporting for the Statewide Services Information System(SIS) <br /> In addition to the Administrative Cost Report(DSS-1571,Part III),the Provider will <br /> submit to the Department the Monthly Report of Service Delivery(DSS Form 1571, <br /> Part M. This should be submitted along with the Administrative Cost Report by the <br /> fifth working day of the month following the month in which services were delivered. <br /> The units reported in Column 12 of the 1571 Part IV are the units of service defined in <br /> Column 5 of I.C. of this Attachment. Service definition and reporting instructions are <br /> found in Family Services Manual,Volume VI, Chapter IV. <br /> D. Audit Requirements <br /> The Provider shall be responsible for compliance with the audit requirements of <br /> Department of Health and Human Services federal regulation 45 CFR Part 74, <br /> Administration of Grants,or State Administrative Procedures Manual for Federal Block <br /> Grant Funds,whichever is applicable. These regulations stipulate that an annual audit be <br /> performed for the fiscal year in which contract funds were received. <br /> p Y <br /> M 1. NA <br /> Private,non-profit if amount of reimbursement received is under$ 1,000;private, <br /> for profit or individual <br /> O 2. (Applicable to Private,Non-Profit Providers if reimb. $1,000 or over) <br /> An annual audit is to be performed in accordance with OMB Circular A-110 by an <br /> "independent auditor." Independent auditor"means either: (a)a state government <br /> auditor from the Department of Human Resources or the Department of <br /> Administration, Office to the State Auditor; or(b) a certified public accountant. <br /> Upon completion of the audit, a copy of the audit report must be forwarded to the <br /> county department of social services. <br />