Page 58

Effective Date: April 1, 2009

Approval Date: ____________ 55

See Attachment 9.

9.9.2-P Public notice for pregnant women eligible pursuant to Section 4.1-P was provided through newspaper notice, posting in county offices and on the State website. Also, eligible pregnant women had been covered under the State’s Section 1115 waiver, prior to the enactment of CHIPRA and until March 31, 2009, with all required public notices. The transition from Section 1115 waiver to Title XXI services will be seamless for beneficiaries.

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.

See Attachment 9. .

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Page 58

Official source

Effective Date: April 1, 2009

Approval Date: ____________ 55

See Attachment 9.

9.9.2-P Public notice for pregnant women eligible pursuant to Section 4.1-P was provided through newspaper notice, posting in county offices and on the State website. Also, eligible pregnant women had been covered under the State’s Section 1115 waiver, prior to the enactment of CHIPRA and until March 31, 2009, with all required public notices. The transition from Section 1115 waiver to Title XXI services will be seamless for beneficiaries.

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.

See Attachment 9. .