S Grant - Home and Community Care Block grant for Older Adults

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DOA-735 (revised 2/08) provider receives less than $500,000 in state funds. The Department of Health and Human Services will provide confirmation of federal and state expenditures at the close of the state fiscal year. Information on audit and fiscal reporting requirements can be found at http: //~~~-~-.ncaudi tor.net/nonprofitsite. The following provides a summary of reporting requirements under NCGS 143C-6-22 and 23 and OMB Circular A-133 based upon funding received and expended during the service provider's fiscal year. Annual Expenditures Report Required to AAA Allowable Cost for Reporting • Less than $25,000 in Certification form and State N/A State or Federal funds Grants Compliance Re- porting <$25,000 (item # 11, Activities and Accomplishments does not have to be completed) Yellow Book) Greater than $25,000 Certification form and Schedule of N/A and less that $500,000 Grantee Receipts >$25,000 and in State or Federal Funds Schedule of Receipts and Expendi- tures • $500,00+ in State funds and Federal pass through in an amount less than $500,00 • $500,000+ in State funds and $500,000+ in Federal pass through funds (i.e. at least $1,000,000) Audited Financial Statement in May use State funds, but compliance with GAO/GAS (i.e. not Federal Funds Yellow Book) Audited Financial Statement in May use State and Federal compliance with OMB Circular funds A-133 (i.e. Single Audit) Less than $500,000 in State Audited Financial Statement in May use Federal funds, funds and $500,000+ in compliance with OMB Circular but not State funds. Federal pass through funds A-133 (i.e. Single Audit) 12. Audit/Assessment Resolutions and Disallowed Cost. It is further understood that the community service providers are responsible to the Area Agency for clarifying any audit exceptions that may arise from any Area Agency assessment, county or community service 6of10