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State Children’s Health Insurance Program

Phase 1 Effective Date: April 1, 1998

Revised: 1/26/98, 2/19/98, 3/3/98, 3/6/98 Phase 2 Effective Date: July 1, 1998

Revised: 8/20/98, 8/24/98, 10/1/99, 7/28/00, 1/31/01, 7/02/02, 7/22/02, 1/3/03, 2/13/04, 9/27/04, 11/15/04, 8/11/05, 10/1/06, 7/1/09, 7/1/10, 7/1/11, 7/1/12 117 After AHCA transmits the Title XXI federal reimbursement to the Department of Health, the Department's Office of Revenue Management disburses the funds directly to each of the participating county health departments' trust fund accounts based on their reported expenditures. The Department of Health Comprehensive and Full Service School Health Services Programs provided funding for the following during the most recent year (2010) for which data is available: • 662.15 comprehensive and full service school health FTEs hired by county health departments and 163.81 full service school positions hired by local school districts (through contractual agreements) located in participating schools in 66 counties. Twenty-one of the Department of Health county health departments contract with their local school districts to provide full service school services. To avoid the possibility of double-billing for the contracted staff through the Medicaid administrative claiming program and the Department of Health Title XXI school health initiative, the Department of Health backs out Medicaid enrolled students in its computation of the rate adjustment factor used for calculating federal reimbursement. Should a county health department choose to contract either or both its comprehensive and full service funds to a local school district, the resulting expenditures will be used to draw down the federal appropriation. Distinguishing between services funded by Title XXI funds and those funded by Title XIX funds: Florida will adopt a conservative methodology to discount the amount it claims in Title XXI funding to account for children who are enrolled in Medicaid and children ages 19 or over.

The state will distinguish between services paid for with Title XXI federal funding and Title XIX federal funding from a cost pool methodology based on expenditures submitted by county health departments for the Comprehensive and Full Service School Health Programs, reduced by an adjustment factor for students who are either enrolled in Medicaid or who are age 19 or older. The Florida Department of Health Comprehensive School Health Program also provides services to certain children under age five who attend schools that participate in the program. However, as an additional safeguard against duplicate billing, the state will not claim Title XXI funds for these children. The following methodology shows the calculation for the adjustment factor that will be used to reduce expenditures from the cost pool for students who are ineligible for