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State of North Carolina <br />Division of Social Services <br />Contract Application <br />Page 4 of 7 <br />i? <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 Manuah <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 />Reporting for the Statewide Services Information System (SIS) <br />h1 addition to the Administrative Cost Report (DSS-1571, Pazt III), the Provider will <br />submit to the Department the Monthly Report of Service Delivery (DSS Fonn 1571, <br />Part N). 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 Cohunn 12 of the 1571 Pazt N are the units of service defined in <br />Column 5 of LC, ofthis Attachment. Service definition and reporting instructions aze <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 />O 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 ifreimb. $1,000 or over) <br />An annual audit is to be performed in accordance with OMB Circular A-110 by an <br />"independent auditor:" hrdependent 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 />