This chapter governs the provision of funding for local health services designated in Health-General Article, §2-304, Annotated Code of Maryland, and, at the discretion of the Secretary, any other State or federal funds that support these services. In this chapter, the following terms have the meanings indicated. Terms Defined. “Annual formula adjustment” means the amount calculated after applying the percentage change as determined by Health-General Article, §2-302(b)(2), Annotated Code of Maryland. “Department” means the Maryland Department of Health. “Federal non-matching funds” means federal funds made available annually by the State to a subdivision for local health services that do not require local matching funds. “Local health services” means the services specified in Health-General Article, §2-304, Annotated Code of Maryland. “Local matching funds” means the annual funding made available by a subdivision for local health services to qualify for State matching funds, plus any excess amount. “Secretary” means the Secretary of Health or the Secretary's designee. “State funds” means State matching funds plus federal nonmatching funds. “State matching funds” means the general funds made available annually to a subdivision by the State for local health services that require local matching funds. “Subdivision” means a county of this State and Baltimore City. For fiscal year 2013 and each subsequent fiscal year, each subdivision shall receive, at a minimum, the amount of State matching funds distributed in fiscal year 2012 for local health services. The annual formula adjustment and any other adjustments for local health services shall be allocated to each subdivision based on each subdivision's percentage share of State funds distributed in the previous fiscal year, and to address a substantial change in community health need, if any, as determined in the discretion of the Secretary after consultation with local health officers. As to appropriations referenced in Health-General Article, §2-302, Annotated Code of Maryland, local matching funds shall be required as a condition of any distribution to a subdivision. The local match percentage for each subdivision shall equal the percentage required for each subdivision for fiscal year 1996. An operating budget to implement each local health department's projects for the next fiscal year, funded partially or wholly from funds provided through local health services, shall be prepared in sufficient detail and submitted to the Department for the Secretary to determine the acceptability of the budget. The format, content, and submission date of the budget shall be as set forth in the annual local health department budget instructions available on the Department's website or as otherwise determined by the Secretary. Each position shall be accounted for in only one project; however, funding for a position may be split among several projects. An agreement form signed by the county executive authority and the health officer of the subdivision shall be transmitted to the Department by a date established by the Secretary for the upcoming State fiscal year. The agreement shall include, but is not limited to, the following: A statement showing the amount of the local matching funds, along with any qualifications which cover that funding; A statement indicating whether the subdivision elects to be the paying agent for items other than salaries, or requests that the Department act in that capacity, and, in the event of such a request, the names of the persons upon whose authority commitments and expenditures are authorized; and A statement indicating whether the subdivision wishes to audit those records of the Department pertaining to disbursements made on behalf of the subdivision. If the subdivision elects to make an audit as described in §D(3) of this regulation, the audit shall be done within 3 years after the close of the fiscal year that is the subject of the audit. On approval by the Secretary, the budget containing State and federal funds and the required local matching funds shall be used as the basis of operation by the health officer for State-supported services. Any substantive change in local health projects during the fiscal year is subject to Departmental review and approval, as set forth in the annual local health department budget instructions. Cash Transactions. The Department only assumes responsibility in any fiscal year for paying from its funds the State matching funds certified by the Secretary of Health in the agreement for local health services. If a subdivision elects the Department to be its disbursing agent, and the subdivision fails to deposit sufficient funds with the Department to satisfy the subdivision's share of local health services expenditures, the Department may not disburse funds for the subdivision until sufficient funds are deposited by the subdivision to meet the subdivision's financial obligations. If a subdivision elects the Department to be its disbursing agent, the Secretary may charge for the cost of the disbursement-related administrative services rendered by the Division of General Accounting. If the subdivision elects to be the disbursing agent: Disbursements shall be reported monthly to the Division of General Accounting of the Department, in the form and under the conditions as the Department may specify from time to time, in order that these disbursements may be entered on the central accounting records; Funds owed a subdivision shall be paid to the subdivision within 30 days following the end of each quarter, except that funds owed at fiscal year end shall be paid to the subdivision within 30 days following the completion of the annual cost settlement process; and Funds owed the State by a subdivision at fiscal year end shall be paid to the State within 30 days following the completion of the annual cost settlement process. Purpose of Expenditure. State funds and local matching funds may only be expended if the activity to be funded is: The responsibility of the local health officer, the Secretary, or the Secretary of the Environment, as established by the general public laws of Maryland; Delegated to the local health officer by the Secretary or the Secretary of the Environment; and With respect to §A(1) and (2) of this regulation, not budgeted for separately in the State budget. Procurement. If authorized by the principal executive or legislative authority of the subdivision's government in accordance with local ordinance, a local health department may use either the State procurement system or the procurement system of the subdivision in which the local health department is located. In the absence of such authorization, a local health department shall use the State procurement system in accordance with State Finance and Procurement Article, Annotated Code of Maryland, and COMAR Title 21. Expense Accounts. Amounts spent to reimburse personnel for travel expenses in accordance with COMAR 23.02.01 are eligible for State matching funds. Employee Fringe Benefits. The employer's payments for Social Security, retirement systems, health insurance, and unemployment insurance are eligible for State matching funds. Revenues. Amounts collected in accordance with COMAR 10.02.01 as the result of services rendered as part of local health services shall be treated as a reduction of expenditures for the corresponding project. Amounts collected by subdivisions shall be reported monthly to the Department. Interest. A subdivision shall: Deposit the collections and funds allocated to support local health services in a federally insured interest-bearing account when these funds are not required to meet current local health services expenses; and Treat interest income from the local health service revenues which generated the interest as a reduction of expenditures for the local health service which generated the interest. Prohibited Expenditures. State matching funds may not be used to support the following categories of expenditures: Hospitalization of clients; Equipment and appliances for individuals; Salary supplements; Utilities; Janitorial expenses; Landscaping; or Other items the Secretary may specify. State matching funds may not participate in the capital costs of or improvements to the physical facilities in which local health department operations are conducted. This regulation applies regardless of the manner in which this cost is defrayed including but not limited to rental, lease, and direct payment of contract for construction or installation. State matching funds may not be used to defray the cost of debt service if the construction or improvement is financed by the creation of a long-term debt. Insurance, Repair, and Maintenance of Physical Assets. The cost of insuring, repairing, or maintaining physical assets, the provision of which under this chapter is the responsibility of the subdivision, is not eligible for State matching funds. Reimbursement for Injuries. Amounts paid as compensation for injury incurred in the line of duty, and injury other than as a result of malpractice occurring on the premises of a facility of a local health department, as well as the cost of insuring for this liability, are eligible for State matching funds. Audits. All Department records of disbursements relating to local health department activities are available for audit by representatives of the county, if they so elect, as provided in Regulation .05D(3) and E of this chapter. All records of disbursements and revenues of the counties relating to local health department activities shall be available for audit by representatives of the Department for at least 5 years following the close of each fiscal year or until audited by the State, whichever comes first. Health-General Article, §§2-104(a), 2-105, 2-301—2-305; State Finance and Procurement Article, §12-109; Annotated Code of Maryland Effective date: July 1, 1956 Chapter revised effective March 20, 1989 (16:5 Md. R. 628) Chapter revised effective January 2, 1994 (20:26 Md. R. 2027) Regulation .03 amended effective September 23, 1996 (23:19 Md. R. 1376) Regulation .04 amended effective September 23, 1996 (23:19 Md. R. 1376) Regulation .07D amended effective May 22, 1995 (22:10 Md. R. 708) Regulations .01—.09 repealed and new Regulations .01—.06 adopted effective February 26, 2007 (34:4 Md. R. 400) Regulation .03B amended effective April 21, 2008 (35:8 Md. R. 804) Chapter revised effective November 14, 2011 (38:23 Md. R. 1421) It is the policy of the Maryland Department of Health to determine the ability of recipients of services, responsible relatives, and other chargeable persons to pay for in-patient or in-residence services to individuals in State-operated facilities. These regulations shall govern the assessment of these charges unless specific charges are established by statutory enactment. “Adjusted gross monthly income” means gross monthly income less allowable deductions as set forth in Regulation .04C(5), of this chapter. “Assets” means all accumulated personal wealth over which a person has the authority or power to liquidate his interest, including but not limited to cash savings, savings accounts, certificates of deposit, money market certificates, checking accounts, stocks, bonds, real property, personal property, mortgages, and mutual funds. “Chargeable person” means: Any responsible relative; and Except for a recipient of services, any other person who is legally responsible in an individual or representative capacity for the care of an individual. “Collectively” means pertaining to any combination of one or more responsible relatives. “College expenses” means tuition cost for undergraduate studies. “Department” means Maryland Department of Health. “Dependent” means any person who qualifies as a dependent under the dependency test of the Internal Revenue Service. “Gross monthly income” means total annual gross income divided by 12. “Income” means a recurrent money benefit from any source. “Individually” means pertaining to one sponsor. “In-patient” means a person admitted to a State-operated facility. “In-patient day.” The number of days of service received by a patient for in-patient services is always in units of full days; a day begins at midnight and ends 24 hours later. The midnight method is to be used for billing days of care of patients. A part of a day, including the day of admission, counts as a full day, however, the day of discharge, the day of death, or a day on which a patient begins a leave of absence is not counted as a day. If admission and discharge or admission and death occur the same day, the day is considered a day of admission and counts as one in-patient day. “Monthly rate” means the charge as developed under Regulation .04C(9)(a) of this chapter. “Patient” means in-patient. “Payroll taxes” means Social Security, federal, State, and local income taxes. “Rate” means monthly rate. “Recipient of services” means an individual who receives care, maintenance, treatment, and support in a facility or program that is operated or funded wholly or partly by the Department. “Responsible relative” means the: Spouse of a recipient of services; Parents of a recipient of services who is a minor; and Children of a recipient of services. “Secretary” means Secretary of Health. “Sponsor” means responsible relative. “State-operated facility” means those hospitals and centers as set forth in Health-General Article, §§7-305, 10-406, and 19-502, Annotated Code of Maryland. “Total lifetime hospitalization” means the sum total of all periods of inpatient hospitalization for a recipient of services in any State hospital or facility whether these periods are intermittent or continuous. “Treatment” means any process by which professional care or attention is given to a patient in a State-operated facility. A recipient of services' primary liability-to-pay in-patient charges established in accordance with COMAR 10.02.01.04 shall be determined by conducting a financial investigation of the individual's income, assets, and expenses. Notwithstanding any other provision of law to the contrary, the Department or its designated financial agent may obtain and use financial information and, if and when necessary, a summary of medical and psychological diagnoses regarding a recipient of services. If the obtaining and use of this information is connected to the Department's billing and collection functions under Health-General Article, Title 16, Annotated Code of Maryland: The Department shall obtain a release from the recipient of services or a chargeable person to secure information from a financial institution; The Department shall request either copies of the recipient of services' most recently filed federal and state income tax returns or an affidavit that the recipient of services did not file tax returns for the previous tax year; The failure of the recipient of services to provide the Department with the required documents of financial status, including the most recently filed federal and state income tax returns, may result in the Department charging and the recipient of services being liable for the full per-capita daily charge for services as set forth in COMAR 10.02.01.04; and Except as provided in §C of this regulation, all information obtained by the Department or its designated agent shall be treated as confidential. If the financial information is connected to the treatment or care of a recipient of services, the Department or its designated financial agent may disclose the financial information to a designated clinical representative of a facility. The Department may set the amount of payments retroactively: For a period of not more than 6 months from the date when the Department sets the amount of payments; and After inquiry by the Department, for a greater period, if the recipient of services, the responsible relatives of the recipient, or any other person, agency, or organization having a summary of financial information or medical or psychological diagnoses about the recipient of services has failed or refused to give that information to the Department when the obtaining and use of this information is connected to the Department's billing and collection functions under this subtitle. The Department shall make a claim against all available income or assets, or both, of a recipient of services. Health insurance coverage and other third party reimbursements correctly paid, or to be paid, for services provided by the Department shall be considered available for billing purposes. For purposes of determining a recipient of services' financial capacity to contribute towards the cost of his or her care, the Department shall consider all of the recipient of services' assets and income to be available for billing purposes subject to certain billing reductions. In recognition of an individual's ongoing financial needs, the Department shall consider a reduction in a recipient of services' billing by permitting the income allowances, asset exemptions, and allowable expenses indicated below. A billing reduction may not be permitted unless and until the recipient of services submits appropriate written documentation demonstrating his or her entitlement to the billing reduction. Permitted billing reductions are as follows: Exempted Assets. The following assets shall be excluded from the Department's ability to pay determinations: A primary residence, occupied by spouse or dependents. A primary residence unoccupied by a spouse or dependents. The assessed value of a recipient of services' primary residence may not be considered for the purpose of establishing charges incurred by the recipient of services during the first 6 months of the individual's hospitalization. An additional 6 months exemption may be allowed if the recipient of services provides written verification from the Department clinician who is primarily responsible for the individual's care which indicates that there is a reasonable clinical likelihood that the individual will be discharged from the facility not later than 12 months following his or her admission to the facility. Household furnishings. One motor vehicle plus other motor vehicles necessary for employment, education, medical care, or maintenance of family life. Liquid assets including but not limited to cash, certificates of deposit, savings and checking accounts, stocks and bonds whose total value does not exceed $2,500. Income allowances. The following sources of income shall be excluded from the Department's ability to pay determinations: Therapeutic work activity income earned in a Department sponsored or approved program which may not exceed $100 per month; If the recipient of services is not involved in a therapeutic work activity program, a monthly personal income allowance of $40. Allowable Expenses. The following documented expenses shall be deducted from the countable gross income in determining a person's ability-to-pay: Reasonable transportation expenses incurred by a recipient of services' relatives and designated visitors during the course of visits to a facility. Mileage allowances shall be calculated in accordance with the prevailing travel allowances permitted for State employees. Health insurance premiums. Life insurance premiums for policies which have a maximum face value which does not exceed $2,500. Reasonable allowances shall be made for necessary and appropriate purchases of clothing and other personal items which may be used by the recipient of services while in a residence or during the course of a clinically sponsored activity. Clinicians responsible for the recipient of services care and treatment shall be consulted to determine the appropriateness of the requested item. Reasonable income allowances reflecting the actual expenses incurred by a recipient of services in maintaining his or her primary residence or apartment provided that when the recipient of services: Is unmarried and has no dependents, the income allowance shall be permitted only for that period of time that the residence is afforded exempt status pursuant to Regulation .03G(1)(b); and Income constitutes the primary source of financial support for a spouse or other individual claimed as dependents on that individual's federal income tax return, an additional monthly income allowance shall be permitted in an amount equal to the appropriate base monthly deduction as set forth in Regulation .04C(8). Monthly Rate. If a combined income is available, the monthly rate charged to the recipient of services and spouse will be computed according to Regulation .04, of this chapter. Investigation of Financial Condition. A responsible relative's ability to pay will be determined by an investigation of the financial condition of the person or persons to be held liable for payment for the in-patient treatment rendered at a State-operated facility. The assets, income, and cost of living of responsible relatives will be the subject of the investigation. The Department shall request either copies of the responsible relative's most recently filed federal and state income tax returns or an affidavit that the responsible relative did not file tax returns for the previous tax year. The failure of the responsible relative to provide the Department with the required documents of financial status, including the most recently filed federal and state income tax returns, may result in the Department charging and the responsible relative being liable for the full per-capita daily charge for services as set forth in COMAR 10.02.01.04. A maximum monthly charge for which responsible relatives may be held liable, within the scope of these regulations, will be developed by the Department in the following manner: A charge will be developed by multiplying the daily charge set by the Secretary of the Department times 365 and dividing that product by 12. A responsible relative's ability to pay will be measured against the maximum monthly charge. Amounts assessed individually and collectively may not exceed the maximum monthly charge. When a rate is prorated because the total ability to pay of all responsible relatives exceeds the total of the responsible relatives' liability, charges to each responsible relative will be prorated by applying each responsible relatives' ability to pay as a percentage of all responsible relatives' ability to pay. Procedure to be Followed for Computation of Monthly Rate. The rate for which a person may be held liable will be determined from that person's adjusted gross monthly income as determined from the financial investigation required by §A, above. The adjusted gross monthly income will be determined by deducting from the gross monthly income all payroll taxes as computed on tax deduction charts developed by the Department and all applicable special or unusual expenses as set forth in these regulations. Self-employment tax paid will be considered in lieu of Social Security tax. Payment into the Federal Retirement Fund will be considered in lieu of Social Security. Special or unusual expenses which may be allowed are: Reasonable child care expenses incurred by the working sponsor; Child support or alimony payments if payments are made to a person who does not qualify as a dependent; College expenses for dependents not to exceed the amount charged for tuition by the University of Maryland at College Park for undergraduate programs; Union dues; Mandatory contributions to retirement plans; and Expenses for special work clothes or special work equipment. Rental Income. One half of gross rental income will be considered as net rental income and will be included in gross monthly income. This may be modified if justifiable reasons are substantiated. Medical Expenses. Paid medical expenses in excess of those used in the cost of living tables in §C(8) may be allowed as an additional deduction. Medical expenses which are covered by medical insurance will not be allowed. Medical insurance premiums will be allowed as medical expenses. Base Monthly Deduction. The Department will develop a base monthly deduction, using the figures established by the Department of Commerce, for the average monthly consumption of a family of four of moderate means in an urban area. The Department will, using 1991 as the base year, adjust annually the base monthly deduction by the percentage by which benefits under Title II of the Social Security Act (42 U.S.C. 401 through 433) are increased by the federal government to reflect changes in the cost of living, as that percentage change is reported in the Federal Register in accordance with 42 U.S.C. 415(a)(1)(D). The base monthly deduction shall be retained in the Office of the Division of Reimbursements and in the Financial Agents' Office located at the Department's in-patient facilities. Monthly Rate. The monthly rate will be determined by subtracting the base monthly deduction from the adjusted gross monthly income. The excess of the adjusted gross monthly income over the base monthly deduction will be the rate of charge for which the responsible relative will be held liable. If the base monthly deduction is equal to or greater than the adjusted gross monthly income, the rate will be zero. Rates will not be set if calculation of a rate results in an amount due of less than $5 per month. Total Lifetime Hospitalization. If a chargeable person has paid for 24 months total lifetime hospitalization of a recipient of services, the liability of that person for the recipient of services after that period may not exceed 15 percent of the charges for services set forth in this section. The sum of any proceeds of applicable insurance, group health plan, or prepaid medical care that the insurer or plan pays because of liability for the payment of or repayment for the cost of care provided to the recipient of services does not count as payments paid by a chargeable person for the purpose of determining a recipient of services, total lifetime hospitalization. Health-General Article, §§16-201—16-407, Annotated Code of Maryland Effective date: September 1, 1976 (3:18 Md. R. 981) Regulations .01—.03 amended effective May 5, 1986 (13:9 Md. R. 1028) Regulation .02 amended effective June 27, 1988 (15:13 Md. R. 1553) Regulation .02S amended effective June 28, 1999 (26:13 Md. R. 1019) Regulation .03 amended effective June 27, 1988 (15:13 Md. R. 1553) Regulation .03B amended effective October 15, 2001 (28:20 Md. R. 1782) Regulation .03G amended effective June 28, 1999 (26:13 Md. R. 1019) Regulation .04A amended effective October 15, 2001 (28:20 Md. R. 1782) Regulation .04C amended as an emergency provision effective December 2, 1983 (10:26 Md. R. 2336); emergency status expired May 10, 1984 (Emergency provisions are temporary and not printed in COMAR) Regulation .04C amended as an emergency provision effective June 6, 1984 (11:13 Md. R. 1169); adopted permanently effective October 8, 1984 (11:20 Md. R. 1742) Regulation .04C amended effective June 3, 1985 (12:11 Md. R. 1048); March 23, 1987 (14:6 Md. R. 715); June 27, 1988 (15:13 Md. R. 1553); June 26, 1989 (16:12 Md. R. 1335); September 2, 1991 (18:17 Md. R. 1918); August 27, 2007 (34:17 Md. R. 1507) Regulation .05 repealed effective May 5, 1986 (13:9 Md. R. 1028) Annotation: COMAR 10.04.02.03 cited in State of Maryland Central Collection Unit v. Stewart, 292 Md. 255, 438 A.2d 1311 (1981) The purpose of this chapter is to prescribe standards, policies, and procedures for the auditing of grants and contracts of the Maryland Department of Health with vendors, providers of service, and local health departments. This chapter shall apply to all contracts and grants made by the Maryland Department of Health with private vendors, grantees, and local health departments for which an audit is provided as described in State Finance and Procurement Article, §7-404, Annotated Code of Maryland. The audit shall determine whether funds were spent in accordance with the contract or grant agreement. The auditor shall review expenditures and revenues to determine if they are consistent with the approved budget and supported by documentation in accordance with the contract or grant agreement and generally accepted accounting principles. The audit shall establish amounts due to or from the State by comparison of budgeted, reported, and audited expenditures net of revenues and funded amounts. The audit findings shall be the basis for making a final settlement of the grant or contract. The following terms have the meanings indicated. Terms Defined. “Contract” means a formal agreement between the Maryland Department of Health and a provider of services to conduct a program or perform specified services for a consideration. “Expenditures” means disbursement of funds to pay vendors and employees for goods or services provided. “Grant” means an award of financial assistance to an eligible recipient under programs that provide for this assistance based on review and approval of an application setting forth a proposed activity or program. “Grantee” means that institution, public or private agency, corporation, organization, or other legally accountable entity that receives a grant and assumes legal and financial responsibility and accountability both for the awarded funds and for the performance of the grant supported activity. “Revenues” mean monies generated by the program, such as client fees, payments by third parties, contributions and interest earned on deposited grant funds. “Subgrantee” means one of two or more entities whose activities, individually and collectively, are intended to fulfill the purpose of the grant program pursuant to an agreement between the subgrantee and the grantee. The Secretary of Health shall provide for a periodic examination of the accounts and records of grantees and local health departments receiving funds under contracts and grants with the Department. In addition, periodic audits shall be conducted of the accounts and records of vendors providing purchase of care services for children, juveniles, and adults in non-governmental facilities. The purpose of the audit is to determine if the expenses incurred for which reimbursement was received were in accordance with allowable cost guidelines of the grant award and contractual agreement. The Audit Division of the Maryland Department of Health shall be responsible for auditing the accounts and records of all grantees, local health departments, and vendors providing purchase of care services under grants and contracts with the Department, except for those grants and contracts with local governments for which audits have been conducted in accordance with the Single Audit Act of 1984. If these audits are not conducted, or are conducted but do not satisfy the information requirements of the Department, the Audit Division shall be responsible for such further auditing as it deems necessary under the circumstances. The audits shall be conducted in accordance with the terms of the grant or contract, or both, and in accordance with allowable cost guidelines of the Maryland Department of Health and its various administrations. The Audit Division of the Maryland Department of Health may audit a subgrantee, notwithstanding the responsibility of the primary grantee when it is in the interest of the State to do so. The Department, when it elects to audit a subgrantee, shall inform the primary grantee, in writing, that the primary grantee is absolved of the responsibility stated in Regulation .05C, of this chapter. The Audit Division shall conduct an exit conference upon the conclusion of the audit. Before the exit conference the grantee, vendor, or local health department shall be given a draft audit report containing all findings, exceptions, and recommendations of the auditors. In addition, the draft report shall provide detailed information pertaining to amounts due to or from the State resulting from the audit. The Audit Division, after consideration and evaluation of additional information and evidence presented subsequent to the promulgation of the draft audit report, shall issue a final audit report. The final audit report shall be distributed to the: Grantee, provider, vendor, or local health department; Division of Program Cost and Analysis of the Maryland Department of Health, as applicable; Director of the appropriate program administration of the Maryland Department of Health. The Audit Division in the final audit report shall: Address and explain each exception identified by the auditor; Make recommendations for correction of each exception cited in the report; Specify amounts due and to whom; Comment on any other issue warranting attention. The audits shall be performed at the intervals and in the manner approved and determined by the Secretary of Health or Director of the appropriate program administration, after consultation with the Chief of the Audit Division. The grantee, provider, and local health departments shall provide full disclosure of all accounting, financial, and other records as needed, to the Audit Division during regular business hours of the audited organization. The grantee, provider, and local health department shall retain all accounts and records of the grant or contract for a period of 5 years following the close of each fiscal year for audit by the Department. Each primary grantee shall be responsible for auditing subgrantees in accordance with the chapter. Each grantee shall maintain detailed accounting records as to receipts and expenditures of grant funds pertaining to the direct administration of the program. Each subgrantee is accountable to the primary grantee, who is responsible directly to the Division of Program Cost and Analysis of the Maryland Department of Health. Revenues collected as a result of sale of goods and services rendered by persons or facilities receiving grant funds shall be credited to the grant program, and be applied as a reduction of the gross expenditures of the program. These revenues shall include fee collections, third-party payments, and proceeds from sales of goods obtained or manufactured with labor and materials paid for with grant funds. Revenues shall also include interest earned on deposited grant funds and contributions, with the exception of those contributions which are undesignated. The grantee, provider, or local health department shall have the right to present additional information and evidence to support its position relative to the audit findings. This information and evidence may be presented at the exit conference or at any time before the issuance of the final audit report. State Finance and Procurement Article, §7-404, Annotated Code of Maryland Effective date: August 12, 1985 (12:16 Md. R. 1605) Regulation .04G amended effective March 6, 1989 (16:4 Md. R. 497) Regulation .05D amended effective March 6, 1989 (16:4 Md. R. 497) The following terms have the meanings indicated. Terms Defined. “Agreement” means a legal document setting forth the rights and responsibilities of the Department and the vendor. “Department” means the Maryland Department of Health. “Human Services” means shelter, support and health or health-related care, including corollary operations necessary to the delivery of that care. “Vendor” means any organization, including a local health department, which delivers human services under a funding arrangement governed by an agreement. The Department may enter into an agreement with a vendor to provide human services. The agreement shall specify that the Department and the vendor comply with requirements and procedures set forth in the “Human Services Agreements Manual”, which is incorporated by reference. The Department shall supply each vendor with a copy of the “Human Services Agreements Manual”. Health-General Article, §2-104(b); State Government Article, §10-110; Annotated Code of Maryland Effective date: September 5, 1988 (15:18 Md. R. 2147) Effective date: March 14, 1994 (21:5 Md. R. 403) Regulations .01—.03 repealed effective March 31, 2014 (41:6 Md. R. 378) Effective date: Regulations .01—.05 adopted as an emergency provision effective July 1, 1996 (23:14) Md. R. 1006);adopted permanently effective October 7, 1996 (23:20 Md. R. 1422) Chapter repealed effective November 3, 1997 (24:22 Md. R. 1551)