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Model Application Template for the State Children’s Health Insurance Program
Effective Date:
Approval Date: 51
The source for the state match will be state general funds and cash funds, except for the local share provided by certain providers performing part of the eligibility process. Cash funds for this program are designated for this purpose as Children's Health Insurance Case Fund per LB 1070 of the 1998 Nebraska Legislature.
Costs FFY 1998 Costs FFY 1999
Costs FFY 2000
Persons FFY 1998
Persons FFY 1999
Persons FFY 2000
Standard Change - Children Title XXI
$67,200 $9,262,000
$15,21,800
1,250
12,450
16,050
Presumptiv e Eligibility Title XXI
$69,400 $1,912,500
$3,040,900
250
2,450
3,100
12-Month Cont. Elig. Title XXI
NA $381,300
$600,500
0
0
0
Total Program Title XXI
$136,000 11,555,800
19,263,200
1,500
14,900
19,150
Admin. & Outreach
$13,600 $1,155,580
$1,926,320
Federal Share of Program & Admin.
$108,982 $9,281,850
15,472,588
*Note: Matching rate estimated at FFY 99 level. If expenditures exceed current year allotment, funds from prior years will be used