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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, 7/1/12 118 Title XXI funding. The calculations are based on school enrollments (minus children under age 5 or age 19 or older) and Medicaid enrollment in the 66 Florida counties.

TITLE XXI BILLING METHODOLOGY FOR 66 COUNTIES (adjustment factor) Students in 66 Florida county schools (Pre-K to 12th grade) for 2009-2010 = 2,555,310 Number of Medicaid children in 66 counties ages 4 through 18 (7/2010) = 914,731 Students in Kindergarten-12th grade age 19 or older = 16,000 Students in Kindergarten-12th grade less ineligible students = 1,624,579 Adjustment Factor (1,624,579/2,555,310): 0.0.636 The calculation for federal Title XXI Reimbursement is: Expenditures for the quarter x 0.636 x FMAP = Amount of Title XXI federal funds requested

SUMMARY: The Florida KidCare Program uses Title XXI administrative funds to: • Provide Comprehensive and Full Service School health services to eligible students in 66 out of 67 counties in the state; • Assure that no duplicative billing (Title XIX and Title XXI) will occur in this program by backing out Medicaid enrolled students in its computation of the adjustment factor for calculating state match and in this manner increasing the amount of state match funds required to receive Title XXI. • Purge from the claiming methodology all children under age 5 or age 19 and older. • The total School Health Services Initiative cost appears as a separate line under Administrative Costs in the CHIP Budget Plan Template. The amount shown represents the amount appropriated by the Florida Legislature. For the SFY 2011/2012, the Florida Legislature appropriated a total of $ 17 million for the