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<br />State of North Carolina <br />Division of Social Services <br />Contract Application <br />II. Fiscal Provisions <br />A. Amount of Reimbursement: <br />Reimbursement under the terms of this agreement will be limited to a <br />maximum of: <br /> <br />Page 6 of 10 <br /> <br />3,800 units of service x $14.13 per unit =: $53,694.00 total for 12 <br />months. <br />(950 hours x $56.52 rate per hour =: $53,694.00) <br /> <br />B. Method of Reimbursement: <br />a. The Department will pay the Provider monthly for twelve months for a total of $53,694.00. <br />Reimbursement can not be claimed for services in absence of authorization by the Department (DSS- <br />5027 form). <br /> <br />The provider must allow for annual and sick leave, staff development time, etc. This staff time does <br />not involve billable client contact activity but is necessary for the employee. However, the <br />Department requires that the Provider provide 3,800 units of service over the life of the contract <br />(950 hours) or an average of approximately 80 hours monthly. The Department will provide <br />payment based on the nuxp.ber of actual units provided. <br /> <br />The provider will conduct an internal audit of this contract quarterly. The provider reserves the <br />right to renegotiate the hourly rate if the average units per month are not covering the provider's <br />cost of this contract. <br /> <br />C. Reimbursement Reporting: <br />1. For Case Planning & Case Management, the Department will report expenditures monthly in <br />accordance with policy set forth by the controller's Office, Division of Social Service, issued via the <br />Fiscal Manual. Expenditures are to be reported by the provider on the Monthly Report of Service <br />Delivery, DSS-1571 Part IV. The Department will reimburse the Provider monthly, by check, upon <br />receipt of a completed and correctly filed bill of the actual number of units provided by the Provider. <br /> <br />2. Units of Service for Case Planning & Case Management. Bill in 15 minute units. Calculate units of <br />service by rounding the number of minutes of service provided to the client in a day to the nearest 15 <br />minute interval. To do this, total the amount of time spent on Case Planning & Case Management <br />for the client during the day; divide the total by 15 to get the number of whole units; and add an <br />additional unit if the remainder is 8 minutes or more. Service for less than 8 minutes may not be <br />billed. <br /> <br />i <br />Example: If a client receives 17 minutes of case management in the morning and 9 minutes in the <br />. J <br />afternoon - a total of 26 minutes for the day - two u1'1its may be billed. If a client receives 28 <br />minutes of case management inthe morning and 9 minutes in the afternoon - a total of37 minutes- <br />two units may be billed. <br /> <br />F-'7 <br />