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9.10. Provide a one year projected budget. A suggested financial form for the budget is attached. The budget must describe: (Section 2107(d)) (42CFR 457.140) • Planned use of funds, including -- - Projected amount to be spent on health services; - Projected amount to be spent on administrative costs, such as outreach, child health initiatives, and evaluation; and - Assumptions on which the budget is based, including cost per child and expected enrollment. • Projected sources of non-Federal plan expenditures, including any requirements for cost-sharing by enrollees. Attached are 3 budget sheets which update the Healthy Families Program budget. The non-Federal share for the Rural Health Demonstration Projects is from funds derived from a tax imposed on tobacco products through a State Proposition (Prop 99). Payments to AIM Health Plans. AIM is administered by the MRMIB, which contracts with the private sector to provide subsidized coverage for beneficiaries. To cover the full cost of care, California uses Proposition 99 tobacco tax monies to subsidize subscriber copayments and contributions, while the subscriber enrolled prior to July 1, 2004 pays two percent of their annual income. A subscriber (200-300% FPL) enrolled after July 1, 2004 pays 1.5% of their annual income. AIM rates paid to health plans reflect the use of bundled costs for prenatal care, delivery services, and 60 days postpartum care. These services will be claimed under Title XXI pursuant to the newly established eligibles. Payments to Medi-Cal Program (0-200% FPL). The Medi-Cal Program, administered by the California Department of Health Services, provides services through contracts with various health plans as well as a fee for service environment with payments made directly to providers of service. Eligibles from confirmed pregnancy through birth in household with incomes at or below 200% FPL will receive coverage through the Medi-Cal Program. Prenatal services provided from the confirmed pregnancy through birth, to those who are not eligible for the federally funded non-emergency services under the Medi-Cal Program will be claimed under Title XXI. Medi-Cal payments Effective Date: Approval Date: November 1, 2009 HFP Family Contribution Increase November 1, 2009 HFP Co-Payment Increase November 1, 2009 HFP Limited Dental Plan Choice for New Subscribers

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