Exhibit 1! - Territory of American Samoa

LIST OF STATE CLEARANCE TIMES

(Rounded Dollar-Weighted Average Day of Clearance)
Clearance Times Where the Timing of A Draw Down Is Based on A Clearance

Pattern

10.551 {Supplemental Nutrition | Department of Human 70.0 |Program Payment Average Clearance 7 Days
Assistance Program and Social Services it}

10.551 |Supplemental Nutrition {Department of Human 30.0 |Administrative Cost Average Clearance 3 Days
Assistance Program and Social Services 0 gay and Indirect

st}

10.555 | National School Lunch Department of Education |30.0 |Administrative Cost Average Clearance 3 Days
Program i} (payroll and Indirect Cost)

410.555 [National School Lunch —_|Department of Education {70.0 {Program Payment Average Clearance 7 Days
Program i]

10,557 |Special Supplemental Department of Human 40.0 | Administrative Cost Average Clearance 3 Days
Nutrition Program for and Social Services 0 (Payroll and Indirect
Women, Infants, and ost)
Children

10.557 |Special Supplemental Department of Human 60.0 |Program Payment Average Clearance 7 Days
Nutrition Program for and Social Services 0
Women, Infants, and
Children

44.225 |Community Development |Department of 80.0 {Program Payment Average Clearance 7 Days
Block Grants/Special ‘Commerce 0
Purpose Grants/insular
Areas

14.225 |Community Development |Department of 20.0 |Administrative Cost Average Clearance 3 Days
Block Grants/Special Commerce 0 Payroll and Indirect
Purpose Grants/Insular ‘ostO
Areas

15.875 |Economic, Social, and Department of 4.00 | Program Payments Average Clearance 7 Days
Political Development of |Commerce
ithe Territories and the
Freely Associated States

15.875 |Economic, Social, and Department of 4.00 {Administrative Cost Average Clearance 3 Days
Political Development of {Commerce (Payroll and Indirect
the Territories and the Cost)
Freely Associated States

15.875 |Economic, Social, and Department of Human 2.00 {Program Payment Average Clearance 7 Days
Political Development of |and Social Services
the Territories and the
Freely Associated States

15.875 | Economic, Social, and Department of Marine 4.00 | Program Payment Average Clearance 7 Days
Political Development of |and Wildlife Resources
the Territories and the
Freely Associated States

15.875 |Economic, Social, and Department of Marine 1.00 |Administrative Cost Average Clearance 3 Days
Political Development of |and Wildlife Resources {Payroll and Indirect
the Territories and the Cost)
Freely Associated States

15.875 |Economic, Social, and Department of Public 1.00 |Program Payment Average Clearance 7 Days
Political Development of |Works
the Territories and the
Freely Associated States

Page 20 of 23



7.7 The State shall adjust each clearance pattern to reflect the dollar-weighted proportion of funds paid out by EFT/Direct
payroll, with the following exceptions:

When developing each pattern, the Territory shall track at least 99% of the funds disbursed, from the issuance to
clearance, for a period of at least three months.

The State shail also adjust each clearance pattern to reflect:
None
7.8 Each of the State's clearance patterns is calculated in calendar days.

7.9 An authorized State official shall certify that each clearance pattern developed by the State accurately corresponds to
the clearance activity of the programs to which it is applied. This certification shall be provided to the Fiscal Service prior
to the effective date of the Agreement. The State shall recertify its clearance patterns at least every five years.

7.10 The State shall follow the procedures of 31 CFR 206 if it has actual or constructive knowledge, at any time, that a
clearance pattern does not correspond to a program's clearance activity.

8.0 INTEREST CALCULATION METHODOLOGY
8.1 General Terms

8.1.1 The State and the Secretary agree that no interest liabilities will be incurred for transfers of funds made in
accordance with the procedures specified in section 6 of this Agreement where the following funding techniques are
applied:

Average Clearance

8.1.2 The State shall maintain information on disbursements and receipts of funds to verify the implementation of any
funding technique and document interest liabilities.

For each disbursement, the State shall be able to identify:

(1) amount of the issuance

(2) date of issuance

(3) date Federal funds are received and credited to a State account

(4) amount of Federal funds received

(5) date funds were requested

8.2 Federal Interest Liabilities

8.2.1 A Federal interest liability shall accrue from the day the State pays out its own funds for program purposes to the
day Federal funds are credited to a State account. With regard to funds transferred out of the Federal Highway Trust
Fund, if a State does not bill at least weekly for current project costs, the Federal interest liability shall not accrue prior to
the day the State submits a request for funds.

8.2.2 The State shall use the following method to calculate Federal interest liabilities:

Actual Activity:

For all transactions where the State pays out its own funds for program purposes prior to receiving Federal funds, the
State shall track each payment from the date it is paid out of a State account to the date Federal funds are subsequently
credited to a State account to cover that outlay. The Federal interest liability on each payment shall be based on the

Page 14 of 23



the request. The State will be notified by the Regional Office when the supplemental award has been transmitted to the
Payment Management System (PMS) and when it may initiate drawdowns against the supplemental funding.

Additional guidance on this policy is provided in the U.S. Department of Health & Human Services, Administration for
Children and Families, letter (May 19, 2004) to State Administrators from the Deputy Assistant Secretary for
Administration.

6.2 Description of Funding Techniques

6.2.1 The following are terms under which standard funding techniques shall be implemented for all transfers of funds to
which the funding technique is applied in section 6.3.2 of this Agreement.

Average Clearance

The State shall request funds such that they are deposited by ACH on the dollar-weighted average day of clearance for
the disbursement, in accordance with the clearance pattern specified in Exhibit Il. The request shall be made in
accordance with the appropriate Federal agency cut-off time specified in Exhibit |. The amount of the request shall be for
the exact amount of that disbursement. This funding technique is interest neutral.

6.2.2 The following are terms under which funding techniques for administrative costs shall be implemented for all
transfers of funds to which the funding technique is applied in section 6.3.2 of this Agreement.

There are no funding techniques listed in Section 6.2.2

6.2.3 The following are terms under which miscellaneous funding techniques shall be implemented for all transfers of
funds to which the funding technique is applied in section 6.3.2 of this Agreement.

There are no funding techniques listed in Section 6.2.3

6.2.4 The following are terms under which State unique funding techniques shall be implemented for all transfers of funds
to which the funding technique is applied in section 6.3.2 of this Agreement.

Modified Issuance - Federal Highway Program

The state shall request funds monthly for vendor payments based on the current month expenses. Therefore, after
program review and approval by FHWA Honolulu Regional Office it is then submitted to FHWA Headquarters for final
approval. State will issue vendor payments within 3 business days of funds deposited in account. Timing of payment
aligned with FHWA review and approval. Requested amount based on current month expenses. This funding technique
is not interest neutral.

Reimbursement Schedule - Federal Highway Program

Administrative costs including salaries will be requested monthly by the State using the amount of funds disbursed the
previous month. State does not bill on a weekly basis so a Federal interest liability will not accrue prior to the State
submitting a request for funds. Request will be made in accordance with time stipulated above. Amounted request based
on administrative cost incurred during the period. This funding technique is not interest neutral.

6.3 Application of Funding Techniques to Programs

6.3.1 The State shall apply the following funding techniques when requesting Federal funds for the component cash flows
of the programs listed in sections 4.2 and 4.3 of this Agreement.

Page 5 of 23



15.875 |Economic, Social, and Department of Treasury {40.0 |Program Payment Average Clearance 30 Days
Political Development of te)
the Territories and the
Freely Associated States
15,875 |Economic, Social, and Department of Treasury |5.00 |Administrative Cost Average Clearance 3 Days
Political Development of (Payroll and Indirect
the Territories and the Cost)
Freely Associated States
15.875 {Economic, Social, and Office of the Governor 37.0 |Program Payment Average Clearance 15 Days
Political Development of 0
the Territories and the
Freely Associated States
45.875 Economic, Social, and Office of the Governor 2.00 {Administrative Cost Average Clearance 3 Days
Political Development of Payroll and Indirect
the Territories and the ost)
Freely Associated States
17.235 |Senior Community Territorial Administration |25.0 | Program Payment Average Clearance 7 Days
Service Employment on Aging 0
Program
17.235 —|Senior Community Territorial Administration |75.0 |Administrative Cost Average Clearance 3 Days
Service Employment ‘on Aging 0 (Payroll)
Program
20.106 | Airport Improvement Department of Port 10.0 |Program Payment Average Clearance 7 Days
Program Administration Q
20.106 [Airport Improvement Department of Port 10.0 |Administrative Cost Average Clearance 3 Days
Program Administration i?) ‘Payroll and Indirect :
ost)
20.106 | Airport Improvement Office of Disaster 80.0 |Program Payments Average Clearance 30 Days
Program Assistance and 0
Petroleum Management
20.205 |Highway Planning and —_ | Department of Public 3.00 | Administrative Reimbursement N/A
Construction Works Costs(Payroll and Schedule - Federal
Indirect) Highway Program
20.205 |Highway Planning and Department of Public 97.0 |Program Payments Modified Issuance - NIA
Construction Works 0 Federal Highway
Program
20.509 | Public Transportation for |Department of Public 40.0 |Administrative Cost Average Clearance 3 Days
Nonurbanized Areas Works 0 Payroll and Indirect
OS!
20.509 {Public Transportation for |Department of Public 60.0 | Program Payment Average Clearance 7 Days
Nonurbanized Areas Works 0
66.600 |EPA Consolidated Grant |Enviromental Protection 60.0 Program Payments Average Clearance 7 Days
Agency
66,600 |EPA Consolidated Grant |Enviromental Protection /50.0 |Administrative Cost Average Clearance 3 Days
Agency 0 Payroll and Indirect
ost)
84.027 |Special Education -- Department of Education |40.0 |Program Payments Average Clearance 30 Days
Grants to States 0
84.027 |Special Education -- Department of Education |60.0 {Administrative Average Clearance 3 Days
Grants to States 0 Costs(Payroll and Indirect
Costs)
84.126 |Rehabilitation Services -- | Office of Vocational 60.0 | Program Payment Average Clearance 7 Days
Vocational Rehabilitation /Rehabilitation - 0
Grants to States Governor's Office
84.126 | Rehabilitation Services -- | Office of Vocational 40.0 |Administrative Cost Average Clearance 3 Days
Vocational Rehabilitation |Rehabilitation - Qo (Payroll and Indirect
Grants to States Governor's Office Cost0
84.372 |Statewide Longitudinal {Department of Education | 10.0 {Administrative Cost Average Clearance 3 Days
Data Systems ie) (Payroll and Indirect
Cost)
84.372 |Statewide Longitudinal |Department of Education |90.0 |Program Payment Average Clearance 30 Days
Data Systems 0

Page 21 of 23



Printed Name:

Certifying Signature:

Title:

Page 23 of 23



12.0 AUTHORIZED SIGNATURES

Ueligitone Tonumaipea

Treasurer of America moa Government

Signature:

Date Signed: FVe2E. /9

Date Submitted 07/21/2017

Corvelli A. McDaniel

Assistant Commissioner

Revenue Collections Management
Bureau of the Fiscal Service

US. Department of the Treasury

Signature: Q. (Lon >4

Date Signed: gle "2

Page 18 of 23



Technique: Average Clearance
Average Day of Clearance: 7 Days

84.027 Special Education -- Grants to States

Recipient: Department of Education

% of Funds Agency Receives: 60.00

Component: Administrative Costs(Payroll and Indirect Costs)
Technique: Average Clearance

Average Day of Clearance: 3 Days

Recipient: Department of Education
% of Funds Agency Receives: 40.00
Component: Program Payments
Technique: Average Clearance
Average Day of Clearance: 30 Days

84.126 Rehabilitation Services -- Vocational Rehabilitation Grants to States
Recipient: Office of Vocational Rehabilitation - Governor's Office

% of Funds Agency Receives: 40.00

Component: Administrative Cost (Payroll and Indirect Cost0

Technique: Average Clearance

Average Day of Clearance: 3 Days

Recipient: Office of Vocational Rehabilitation - Governor's Office
% of Funds Agency Receives: 60.00

Component: Program Payment

Technique: Average Clearance

Average Day of Clearance: 7 Days

84.372 Statewide Longitudinal Data Systems

Recipient: Department of Education

% of Funds Agency Receives: 10.00

Component: Administrative Cost (Payroll and Indirect Cost)
Technique: Average Clearance

Average Day of Clearance: 3 Days

Recipient: Department of Education
% of Funds Agency Receives: 90.00
Component: Program Payment
Technique: Average Clearance
Average Day of Clearance: 30 Days

84.403 Consolidated Grant to the Outlying Areas
Recipient: Department of Education
% of Funds Agency Receives: 65.00

Page 10 of 23



Component: Administrative Cost (Payroll and Indirect Cost0
Technique: Average Clearance
Average Day of Clearance: 3 Days

Recipient: Department of Commerce
% of Funds Agency Receives: 80.00
Component: Program Payment
Technique: Average Clearance
Average Day of Clearance: 7 Days

15.875 Economic, Social, and Political Development of the Territories and the Freely Associated States

Recipient: Office of the Governor

% of Funds Agency Receives: 37.00
Component: Program Payment
Technique: Average Clearance
Average Day of Clearance: 15 Days

Recipient: Department of Marine and Wildlife Resources

% of Funds Agency Receives: 1.00

Component: Administrative Cost (Payroll and Indirect Cost)
Technique: Average Clearance

Average Day of Clearance: 3 Days

Recipient: Office of the Governor

% of Funds Agency Receives: 2.00

Component: Administrative Cost (Payroll and Indirect Cost)
Technique: Average Clearance

Average Day of Clearance: 3 Days

Recipient: Department of Commerce

% of Funds Agency Receives: 4.00

Component: Administrative Cost (Payroll and Indirect Cost)
Technique: Average Clearance

Average Day of Clearance: 3 Days

Recipient: Department of Treasury

% of Funds Agency Receives: 5.00

Component: Administrative Cost (Payroll and Indirect Cost)
Technique: Average Clearance

Average Day of Clearance: 3 Days

Recipient: Department of Treasury
% of Funds Agency Receives: 40.00
Component: Program Payment
Technique: Average Clearance
Average Day of Clearance: 30 Days

Page 7 of 23



6.3.2 Programs
Below are programs listed in Section 4.2 and Section 4.3.

10.551 Supplemental Nutrition Assistance Program
Recipient: Department of Human and Social Services

% of Funds Agency Receives: 30.00

Component: Administrative Cost (Payroll and Indirect Cost)
Technique: Average Clearance

Average Day of Clearance: 3 Days

Recipient: Department of Human and Social Services
% of Funds Agency Receives: 70.00

Component: Program Payment

Technique: Average Clearance

Average Day of Clearance: 7 Days

10.555 National School Lunch Program

Recipient: Department of Education

% of Funds Agency Receives: 30.00

Component: Administrative Cost (payroll and Indirect Cost)
Technique: Average Clearance

Average Day of Clearance: 3 Days

Recipient: Department of Education
% of Funds Agency Receives: 70.00
Component: Program Payment
Technique: Average Clearance
Average Day of Clearance: 7 Days

10.557 Special Supplemental Nutrition Program for Women, Infants, and Children
Recipient: Department of Human and Social Services

% of Funds Agency Receives: 40.00

Component: Administrative Cost (Payroll and Indirect Cost)

Technique: Average Clearance

Average Day of Clearance: 3 Days

Recipient: Department of Human and Social Services
% of Funds Agency Receives: 60.00

Component: Program Payment

Technique: Average Clearance

Average Day of Clearance: 7 Days

14.225 Community Development Block Grants/Special Purpose Grants/Insular Areas
Recipient: Department of Commerce
% of Funds Agency Receives: 20.00

Page 6 of 23



Exhibit | - Funds Request and Receipt Times Schedule
Territory of American Samoa

Agriculture-FNS ACH 11:59 PM iday
Agriculture-FNS_ Fedwire 5:45 PM. O day
Agriculture-FS ACH 3:00 PM iday
Air National Guard ACH 12:00 PM 15 days
Army National Guard ACH 12:00 PM 15 days
‘Commerce-NOAA ACH 2:00 PM 1 day
Dept of Homeland Security (FEMA) Fedwire 2:00 PM 2 days
Dept of Homeland Security (ODP) ACH 2:00 PM. 2 days
Dept of Homeland Security (ODP) Fedwire 2:00 PM. 2 days
EPA ACH 2:00 PM 2 days
EPA Fedwire 2:00 PM 0 day
Education ACH 3:00 PM. 1 day
Education Fedwire 2:00 PM. 0 day
Energy ACH 4:00 PM 1 day
Energy Fedwire 3:00 PM 0 day
HHS. ACH 6:30 PM i day
HHS Fedwire 3:00 PM 0 day
HUD ACH 5:30 PM 2 days
HUD Fedwire 3:00 PM 0 day
Interlor-FWS ACH 11:59 PM. 4 day
Interior-FWS Fedwire 5:45 PM 0 day
Interior-OSM ACH 3:00 PM iday
Interior-OSM Fedwire 1:00 PM 0 day
Justice ACH 14:00 PM 6 days
Justice Fedwire 2:00 PM 2 days
Labor-Non-UTF ACH 3:00 PM 1 day
Labor-UTF ACH 3:00 PM day
Labor-UTF Fedwire 3:00 PM Q day
National Science Foundation (NSF) ACH 8:00 PM tday
National Science Foundation (NSF) Fedwire 5:45 PM 0 day
Social Security Administration ACH 11:59 PM 4 day
Social Security Administration Fedwire 5:45 PM. 0 day
Transportation (FAA) ACH 2:00 PM 1day
Transportation (FHWA) ACH 12:00 PM 3 days
Transportation (FHWA) Fedwire 12:00 PM O day
‘Transportation (FTA) ACH 2:00 PM. 1 day
Veterans Administration ACH 12:00 PM 3 days

Page 19 of 23



Component: Program Payments
Technique: Average Clearance
Average Day of Clearance: 30 Days

Recipient: Department of Port Administration
% of Funds Agency Receives: 10.00
Component: Program Payment

Technique: Average Clearance

Average Day of Clearance: 7 Days

20.205 Highway Planning and Construction

Recipient: Department of Public Works

% of Funds Agency Receives: 97.00

Component: Program Payments

Technique: Modified Issuance - Federal Highway Program
Average Day of Clearance: N/A

Recipient: Department of Public Works

% of Funds Agency Receives: 3.00

Component: Administrative Costs(Payroll and Indirect)
Technique: Reimbursement Schedule - Federal Highway Program
Average Day of Clearance: N/A

20.509 Public Transportation for Nonurbanized Areas
Recipient: Department of Public Works

% of Funds Agency Receives: 40.00

Component: Administrative Cost (Payroll and Indirect Cost0
Technique: Average Clearance

Average Day of Clearance: 3 Days

Recipient: Department of Public Works
% of Funds Agency Receives: 60.00
Component: Program Payment
Technique: Average Clearance
Average Day of Clearance: 7 Days

66.600 EPA Consolidated Grant

Recipient: Enviromental Protection Agency

% of Funds Agency Receives: 50.00

Component: Administrative Cost (Payroll and Indirect Cost)
Technique: Average Clearance

Average Day of Clearance: 3 Days

Recipient: Enviromental Protection Agency
% of Funds Agency Receives: 50.00
Component: Program Payments

Page 9 of 23



Cash Management Improvement Act Agreement
between
The Territory of American Samoa
and
The Secretary of the Treasury,
United States Department of the Treasury

The Secretary of the Treasury, United States Department of the Treasury (hereafter 'Secretary’), and Territory of
American Samoa (hereafter 'State’), in order to implement Section 5 of the Cash Management Improvement Act of 1990,
as amended (hereafter 'Act’), agree as follows:

4.0 AGENTS OF THE AGREEMENT

1.1 The Authorized Official(s) for the Territory of American Samoa shall be the Treasurer of the American Samoa
Government in all matters concerning this Agreement.

4.2 The Assistant Commissioner, Revenue Collections Management, Bureau of the Fiscal Service (Fiscal Service), U.S.
Department of the Treasury, shall act as the Secretary's representative in all matters concerning this Agreement.

2.0 AUTHORITY

2.1 The authority for this Agreement is the Cash Management Improvement Act of 1990 (Public Law 101-453), as
amended by the Cash Management Improvement Act of 1992 (Public Law 102-589), codified at 31 U.S.C. 6501 and 31
U.S.C. 6503.

2.2 The regulations codified at 31 CFR Part 205 shall apply to all matters pertaining to this Agreement, and are
incorporated herein by reference. In the event of any inconsistency between this Agreement and 31 CFR Part 205, the
regulations shall govern.

3.0 DURATION, AMENDING, TERMINATING, AND MISCELLANEOUS PROVISIONS
3.1 This Agreement shall take effect on 10/01/2017 and shall remain in effect until 09/30/2018.

3.2 This Agreement may be amended at any time by written, mutual consent of the State and the Fiscal Service. This
Agreement shall be amended annually to incorporate new programs that qualify as major Federal assistance programs
and remove programs that no longer qualify as major Federal assistance programs. A State must notify the Fiscal Service
in writing within 30 days of the time the State becomes aware of a change that involves additions or deletions of programs
subject to Subpart A, changes in funding techniques, and/or changes in clearance patterns. The notification must include
a proposed amendment for review by the Fiscal Service.

3.3 Notwithstanding section 3.2, in the event of Federal or State non-compliance with Subpart B of 31 CFR, Part 205, the
Fiscal Service may amend this Agreement at any time to incorporate additional programs and the entities that administer
those programs.

3.4 This Agreement may be terminated by either party with 30 days written notice. If this Agreement is terminated, the
Fiscal Service will prescribe the funding techniques, clearance patterns, and methods for calculating interest liabilities to
be used by the State.

Page 1 of 23



Technique: Average Clearance
Average Day of Clearance: 7 Days

93.600 Head Start

Recipient: Department of Education

% of Funds Agency Receives: 50.00

Component: Administrative Cost (Payroll & Indirect Cost)
Technique: Average Clearance

Average Day of Clearance: 3 Days

Recipient: Department of Education
% of Funds Agency Receives: 50.00
Component: Program Payments
Technique: Average Clearance
Average Day of Clearance: 7 Days

93.667 Social Services Block Grant

Recipient: Department of Human and Social Services

% of Funds Agency Receives: 40.00

Component: Administrative Cost (Payroll and Indirect Cost)
Technique: Average Clearance

Average Day of Clearance: 3 Days

Recipient: Department of Human and Social Services
% of Funds Agency Receives: 60.00

Component: Program Payment

Technique: Average Clearance

Average Day of Clearance: 7 Days

93.778 Medical Assistance Program

Recipient: American Samoa Medicaid State Agency

% of Funds Agency Receives: 10.00

Component: Administrative Cost (Payroll and Indirect Cost)
Technique: Average Clearance

Average Day of Clearance: 3 Days

Recipient: American Samoa Medicaid State Agency
% of Funds Agency Receives: 90.00

Component: Program Payment

Technique: Average Clearance

Average Day of Clearance: 7 Days

97.036 Disaster Grants - Public Assistance (Presidentially Declared Disasters)

Recipient: Department of Homeland Security
% of Funds Agency Receives: 20.00

Page 12 of 23



Component: Administrative (Payroll and Indirect Cost)
Technique: Average Clearance
Average Day of Clearance: 3 Days

Recipient: Department of Education
% of Funds Agency Receives: 35.00
Component: Program Payment
Technique: Average Clearance
Average Day of Clearance: 30 Days

93.224 Consolidated Health Centers

Recipient: Department of Public Health

% of Funds Agency Receives, 65.00

Component: Administrative Cost (Payroll and Indirect Cost)
Technique: Average Clearance

Average Day of Clearance: 3 Days

Recipient: Department of Public Health
% of Funds Agency Receives: 35.00
Component: Program Payments
Technique: Average Clearance
Average Day of Clearance: 7 Days

93.569 Community Services Block Grant

Recipient: Department of Commerce

% of Funds Agency Receives: 15.00

Component: Administrative Cost (Payroll and Indirect Cost)
Technique: Average Clearance

Average Day of Clearance: 3 Days

Recipient: Department of Commerce
% of Funds Agency Receives: 85.00
Component: Program Payment
Technique: Average Clearance
Average Day of Clearance: 7 Days

93.575 Child Care and Development Block Grant

Recipient: Department of Human and Social Services

% of Funds Agency Receives: 30.00

Component: Administrative Costs (Payroll and Indirect Costs)
Technique: Average Clearance

Average Day of Clearance: 3 Days

Recipient: Department of Human and Social Services
% of Funds Agency Receives: 70.00
Component: Program Payments

Page 11 of 23



Recipient: Department of Public Works
% of Funds Agency Receives: 1.00
Component: Program Payment
Technique: Average Clearance
Average Day of Clearance: 7 Days

Recipient: Department of Human and Social Services
% of Funds Agency Receives: 2.00

Component: Program Payment

Technique: Average Clearance

Average Day of Clearance: 7 Days

Recipient: Department of Marine and Wildlife Resources
% of Funds Agency Receives: 4.00

Component: Program Payment

Technique: Average Clearance

Average Day of Clearance: 7 Days

Recipient: Department of Commerce
% of Funds Agency Receives: 4.00
Component: Program Payments
Technique: Average Clearance
Average Day of Clearance: 7 Days

17.235 Senior Community Service Employment Program
Recipient: Territorial Administration on Aging

% of Funds Agency Receives: 75.00

Component: Administrative Cost (Payroll)

Technique: Average Clearance

Average Day of Clearance: 3 Days

Recipient: Territorial Administration on Aging
% of Funds Agency Receives: 25.00
Component: Program Payment

Technique: Average Clearance

Average Day of Clearance: 7 Days

20.106 Airport Improvement Program

Recipient: Department of Port Administration

% of Funds Agency Receives: 10.00

Component: Administrative Cost (Payroll and Indirect Cost)
Technique: Average Clearance

Average Day of Clearance: 3 Days

Recipient: Office of Disaster Assistance and Petroleum Management
% of Funds Agency Receives: 80.00

Page 8 of 23



een BeEeE
84.403 |Consolidated Grant to the |Department of Education |65.0 | Administrative (Payroll Average Clearance 3 Days
Outlying Areas 0 and Indirect Cost)
84.403 {Consolidated Grant to the |Department of Education {35.0 |Program Payment Average Clearance 30 Days
Outlying Areas 0
93.224 {Consolidated Health Department of Public 35.0 | Program Payments Average Clearance 7 Days
Centers Health 0
93.224 | Consolidated Health Department of Public 65.0 {Administrative Cost Average Clearance 3 Days
Centers Health 0 (Payroll and Indirect
Cost)
93.569 |Community Services Department of 15.0 |Administrative Cost Average Clearance 3 Days
Block Grant Commerce 0 Payroll and Indirect
OS!
93.569 |Community Services Department of 85.0 [Program Payment Average Clearance 7 Days
Block Grant Commerce ie)
93.575 —|Child Care and Department of Human 30.0 |Administrative Costs Average Clearance 3 Days
Development Block Grant|and Social Services 0 rays and Indirect
‘osts.
93.575 | Child Care and Department of Human 70.0 |Program Payments Average Clearance 7 Days
Development Block Grant|and Social Services i}
93.600 |Head Start Department of Education |50.0 |Administrative Cost Average Clearance 3 Days
i} (Payroll & Indirect Cost)
93.600 |Head Start Department of Education |50.0 |Program Payments Average Clearance 7 Days
0
93.667 {Social Services Block Department of Human 40.0 jAdministrative Cost Average Clearance 3 Days
Grant and Social Services te} (Payroll and Indirect
st)
93.667 Social Services Block Department of Human 60.0 | Program Payment Average Clearance 7 Days
Grant and Social Services i}
93.778 |Medical Assistance American Samoa 90.0 |Program Payment Average Clearance 7 Days
Program Medicaid State Agency _|0
93.778 |Medical Assistance American Samoa 10.0 |Administrative Cost Average Clearance 3 Days
Program Medicaid State Agency {0 Payroll and Indirect
Cost)
97.036 |Disaster Grants - Public {Department of Homeland {20.0 | Program Payments Average Clearance 7 Days
Assistance (Presidentially | Security 0
Declared Disasters)
97.036 Disaster Grants - Public | Office of Disaster 80.0 |Program Payments Average Clearance 7 Days
Assistance (Presidentially | Assistance and 0
Declared Disasters) Petroleum Management

I hereby certify that an authorized State official has certified at least every five years that the "Rounded Days of Clearance" listed In

Exhibit 2 of this Treasury-State Agreement:

4. Have been prepared in accordance with the standards provided in 31 CFR 205.20;

2. Accurately represent the flow of Federal funds under the Federal assistance programs to which they apply;

3. Reflect seasonal or other periodic variations in the clearance activities; and,

4, Are auditable.

Date:

Page 22 of 23



The State will comply with all Federal program agency policies and procedures for requesting supplemental grant funding.

The State will comply with the following guidelines when requesting supplemental funding for the Medical Assistance
Program and associated administrative payments (CFDA 93.778):

The State must submit a revised Medicaid Program Budget Report (CMS-37) to request supplemental funding. The CMS
guidelines and instructions for completing the CMS-37 are provided in Section 2600F of the State Medicaid Manual
(SMM). The CMS/CO must receive the revised Form CMS-37 through the Medicaid Budget Expenditure
System/Children's Budget Expenditure System (MBES/CBES) no later than 10 calendar days before the end of the
quarter for which the supplemental grant award is being requested.

Additional guidance on this policy is available from the respective CMS Regional Office, U.S. Department of Health &
Human Services.

The State will comply with the following guidelines when requesting supplemental funding for TANF (CFDA 93.558),
CCDF (CFDA 93.575), CSE (93.563), and the FC/AA (CFDA 93.658 and CFDA 93.659) programs administered by the
U.S. Department of Human Services, Administration for Children and Families (HHS/ACF):

a. Timing of the Request

A State should initiate its request for supplemental funding during a quarter as soon as it becomes aware of the fact that a
shortfall does/will exist. For the TANF and CCDF grants, supplemental funding requests (estimates) may be submitted by
a State, for consideration by ACF, up through and including the 15th day of the third month of the first, second or third
quarter of any fiscal year. Since TANF and CCDF are block grant programs, all unawarded portions of the annual
allotment will automatically be issued at the beginning of the fourth quarter. Therefore, supplemental funding requests will
not be available during the fourth quarter for these programs. For the CSE and FC/AA programs, supplemental funding
requests may be submitted by a state, for consideration by ACF, up through and including the 15th day of the third month
of any quarter of a fiscal year.

b. Justification for the Request

The request for a supplemental funding for any of the above mentioned programs should contain a justification clearly
documenting the need for the additional funding authority during the current quarter. This documentation should be in the
form of State accounting records or similar documents that will show the actual expenditures through the most recent
month for which such data are available, as well as the State's most accurate projection of its anticipated expenditures
during the remaining month(s) of the quarter. For either the TANF or the CCDF program, the State's justification should
also include an explanation of the activities requiring the obligation and/or expenditure of amounts that exceed the normal
quarterly grant award restrictions and why these activities could not have been delayed until the next quarter.

ce. Form Submittal
Supplemental funding requests should be made by completing the appropriate ACF quarterly report of expenditures and
estimates applicable to the particular program for which the grant award request is being made.

d. Approval Process

Upon receipt of the state's request for additional funding authority for a quarter, the ACF Regional Office will promptly
review the supporting documentation. If the request is properly justified, so long as ACF has adequate funding
availability, the State's request will be expedited and supplemental funding will be issued within 5 days of ACF receiving

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difference in whole days between the two events. With Federal-State matching programs, interest shall be calculated on
the Federal percentage of the disbursement.

8.3 The Unemployment Trust Fund

8.3.1 The State shall use the following method to calculate State interest liabilities on funds withdrawn from the several
accounts in the Unemployment Trust Fund:

Not Applicable
8.4 Refund Liabilities

8.4.1 The State shall be liable for interest on refunds from the date the refund is credited to a State account until the date
the refund is debited from the State account for program purposes. The State shall apply a $50,000 refund transaction
threshold below which the State shall not incur or calculate interest liabilities on refunds. A transaction is defined as a
single deposit.

8.4.2 For each refund, the State shall maintain information identifying:

(1) date a refund is credited to a State account

(2) date of the subsequent deposit of Federal funds against which the refund is offset
(3) amount of the refund

8.4.3 The State shall use the following methodology to calculate interest liabilities on refunds:

With programs to which applicable interest neutral funding techniques are applied, the State interest liability shall be
based on the difference in whole days between the date the refund is deposited in a State account and the date the
refund is offset against a subsequent deposit of Federal funds.

8.5 Exemptions

8.5.1 Where more than one State agency is a recipient of Federal funds under a program, a particular State agency's
funding may be excluded from interest calculation procedures if the State agency receives an amount of funds less than 5
% of the State's threshold for major Federal assistance programs. Notwithstanding this potential exemption, however, in
no case shall less than 80% of a program's total funding be subject to interest calculation procedures.

Proration of calculations: If less than total program funding is subject to interest calculation procedures, the resulting
interest liability calculations shall be prorated to 100% of program funding.

8.6 State Interest Liabilities

8.6.1 The State shall be liable for interest on Federal funds from the date Federal funds are credited to a State account
until the date those funds are paid out for program purposes.

8.6.2 The State shall use the following method to calculate State interest liabilities on Federal funds:
8.6.2.1 Measuring Time Funds Are Held

To determine the total time Federal funds are held, the State shall measure the time between the date Federal funds are
received and credit to a State's account and the date those funds are debited from the State's account.

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11.0 NON-COMPLIANCE

11.1 The provisions of 31 CFR Part 205.29 and 31 CFR Part 205.30 shall apply in cases of non-compliance with the
terms of this Agreement.

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American Samoa Medicaid State Agency
Department of Commerce

Department of Education

Department of Homeland Security

Department of Human and Social Services
Department of Marine and Wildlife Resources
Department of Port Administration

Department of Public Health

Department of Public Works

Department of Treasury

Enviromental Protection Agency

Office of Disaster Assistance and Petroleum Management
Office of the Governor

Office of Vocational Rehabilitation - Governor's Office
Territorial Administration on Aging

§.2 Entities that meet the definition of a Fiscal Agent per 31 CFR Part 205 shall be subject to the terms of this Agreement.
The following is a list of Fiscal Agents that administer funds under the programs listed in the Section 4.0 of this
Agreement:

There are currently no fiscal agencies listed for Section 5.2.
6.0 FUNDING TECHNIQUES
6.1 General Terms

6.1.1 The State shall request Federal funds in accordance with the appropriate cut-off times shown in Exhibit | to ensure
funds will be received and credited to a State account by the times specified in the funding techniques. Exhibit | is
incorporated by reference herein.

6.1.2 The State shall schedule the receipt of Federal funds such that the funds are received and credited to a State
account in accordance with the clearance patterns specified in Exhibit !I - List of State Clearance Patterns. Exhibit Il is
incorporated by reference herein.

6.1.3 In instances where the receipt of funds is scheduled for a Saturday, the State shall request funds for deposit on
Friday. In instances where the receipt of funds is scheduled for a Sunday, the State shall request funds for deposit on
Monday. In instances where the receipt of Federal funds is scheduled for deposit on a day when the State is not open for
business, the State shall request funds for deposit the day following the scheduled day; in instances where the receipt of
Federal funds is scheduled for deposit on a day when the Federal Government is not open for business, the State shall
request funds for deposit the day prior to the scheduled day.

6.1.4 Estimates and Reconciliation of Estimates:

Where estimated expenditures are used to determine the amount of the drawdown, the State will indicate in the terms of
the State unique funding technique how the estimated amount is determined and when and how the State will reconcile
the difference between the estimate and the State's actual expenditures.

6.1.5 Supplemental Funding:
Unless otherwise defined by program rules, Supplemental Funding is the award of additional funds to provide for an
increase in costs due to unforeseen circumstances.

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4.0 PROGRAMS COVERED

4.1 The State's threshold and its major Federal assistance programs shall be determined based on Single Audit Report for
fiscal year ending 09/30/2016.

All major Federal assistance programs shall be covered by this Agreement, unless otherwise specified in section 4.4 of
this Agreement.

4.2 The State's threshold for major Federal assistance programs is $966,361.
The following programs meet or exceed the threshold and are not excluded in Section 4.4:

10.551 Supplemental Nutrition Assistance Program

10.555 National School Lunch Program

10.557 Special Supplemental Nutrition Program for Women, Infants, and Children
44,225 Community Development Block Grants/Special Purpose Grants/Insular Areas
45.875 Economic, Social, and Political Development of the Territories and the Freely Associated States
17.235 Senior Community Service Employment Program

20.106 Airport Improvement Program

20.205 Highway Planning and Construction

20.509 Public Transportation for Nonurbanized Areas

66.600 EPA Consolidated Grant

84,027 Special Education -- Grants to States

84.126 Rehabilitation Services -- Vocational Rehabilitation Grants to States
84,372 Statewide Longitudinal Data Systems

84.403 Consolidated Grant to the Outlying Areas

93.224 Consolidated Health Centers

93.569 Community Services Block Grant

93.575 Child Care and Development Block Grant

93.600 Head Start

93.667 Social Services Block Grant

93.778 Medical Assistance Program

97.036 Disaster Grants - Public Assistance (Presidentially Declared Disasters)

4.3 The following programs fall below the State's threshold but have been required to be covered by Fiscal Service in
accordance with the non-compliance provisions of Subpart B of 31 CFR Part 205:

There are currently no programs listed for Section 4.3.

4.4 The following programs exceed the State's threshold but have been excluded from coverage for the reason indicated:
97,067 Homeland Security Grant Program --- Exclusion:Federai Statute - Full Exemption

5.0 ENTITIES COVERED

5.1 State agencies and instrumentalities that meet the definition of a State per 31 CFR Part 205, shall be subject to the
terms of this Agreement. The following is a list of such entities that administer funds under the programs listed in Section
4.0 of this Agreement:

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Component: Program Payments
Technique: Average Clearance
Average Day of Clearance: 7 Days

Recipient: Office of Disaster Assistance and Petroleum Management

% of Funds Agency Receives: 80.00

Component: Program Payments

Technique: Average Clearance

Average Day of Clearance: 7 Days

6.3.3 Materiality Exemptions

Agencies exempt from coverage on the basis of materiality:

none

7.0 CLEARANCE PATTERNS

7.1 The State shall develop separate clearance patterns for each of the following:

Functional payments for program expenses, payroll and administrative costs.

7.2 The following shall develop the State's clearance patterns:

American Samoa Government Treasury Department will develop the clearance patterns.

7.3 The sources of data the State shall use when developing its clearance patterns are as follows:
Integrated Financial Accounting Software, Bank of Hawaii, Zion Bank, and ANZ Amerika Samoa.

7.4 The State shall use the following methodology when developing its clearance patterns:

When developing each clearance pattern, the State shall track at least 99% of the funds disbursed, from issuance to
clearance, for a period of at least three months.

7.5 The State shall identify for each check or warrant (hereafter, check) in the population: (1) the date the check was
released for payment; (2) the date the check was debited from the State's account, and, (3) the amount of the check.

7.6 The State shall use the following method to calculate the dollar-weighted average day of clearance:

To determine the number of days each check was outstanding (clearance time), the issue date shall be subtracted from
the date the check cleared the State's account.

To determine the percentage of the disbursement paid out each day following issuance, the amount of the checks that
clear the State's account each day shall be summed and then divided by the amount of the total disbursement.

For each day following issuance, the clearance time of the checks paid out that day shall be multiplied by the percentage
of the total disbursement those checks represent. This product is the clearance factor.

The dollar-weighted average day of clearance for the disbursement shall be determined by summing the clearance factor
of each day following the disbursement.

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8.6.2.2 Source of Data

Central Accounting System:
The time period from 10/01/2017 to 9/30/2018 shall be determined from information captured by ASG/Treasury One
Solution System.

8.6.2.3 Standards Applied

The average daily cash balance of Federal Funds In the program's account reflects the actual activity of each draw from
the date of deposit to the date of issuance or clearance, whichever is pertinent.

8.6.2.4 Calculation Procedure

Average Daily Balance + Clearance Pattern:
1 = {ADB x R} + {P xr x T}, where

1 = State's total interest liability

ADB = Average Daily Balance of cash in a program's account, measured from deposit to clearance

R = Annualized rate equal to the average equivalent yields of 13-week Treasury bills auctioned during a State's fiscal year
P = Total annual expenditures of Federal funds for program or component cash flow of program

t= R/365 days

T = Dollar-weighted average day of clearance, as determined by the appropriate clearance pattern in Exhibit 1
9.0 REVERSE FLOW PROGRAMS:

The State is not required to cover any reverse flow programs under the terms of this Agreement because the State does
not participate in the program.

10.0 INTEREST CALCULATION COSTS

10.4 As set forth in 31 CFR 205.27, interest calculation costs are defined as those costs necessary for the actual
calculation of interest, including the cost of developing and maintaining clearance patterns in support of the interest
calculations. Interest calculation costs do not include expenses for normal disbursing services, such as processing of
checks or maintaining records for accounting and reconciliation of cash balances, or expenses for upgrading or
modernizing accounting systems. Interest calculation costs in excess of $50,000 in any year are not eligible for
reimbursement, unless the State provides justification with the annual report.

10.2 The State expects to incur the following types of interest calculation costs:

The Territory expects to incur interest calculation cost claims for calculating interest and development and maintenance of
clearance patterns.

40.3 The State shall submit all claims for reimbursement of interest calculation costs with its Annual Report in accordance
with 31 CFR 205.

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