Step 2: Fiscal Needs Assessment Orientation to the Tools

1. Fund Matrix Federal Fund Sources State Fund Sources and Local Fund Sources Non Government Sources Identification Eligibility Child Services System Components

2. Fund Revenue Fund Source Federal Funds State Funds Match Local Funds Match Total Revenue Accessed at what level? Medicaid$3M900,000$3.9 MProviders bill Medicaid directly Medicaid$3M900,000$3.9 MProviders bill Medicaid directly

Section 2 Questions 3. At what level are providers reimbursed for services? (Check all that apply) 4. How are IDEA Part C funds for system components distributed to the local/regional level? 5. How are IDEA Part C funds for direct services distributed to the local/regional level?

Section 2 Questions 6. How are general funds allocated by the state lead agency? 7. Does your state have a system of payments for families? 8. If yes, how is the system of payment established? (check all that apply) 9. What family resources are included in the system of payments? (Check all that apply)

Section 2 Questions 10. How are these resources collected? (Check all that apply) 11. Where are the family cost participation revenues retained? 12. How is this revenue utilized? 13. What is the average direct service cost per child for a twelve month period?

Section 2 Questions 14. What is the average cost per child for the total system costs including both direct services and system components? 15. Check if you have any concerns regarding that status of your state as it relates to your obligations for: Prohibition against supplanting Payor of last resort 3.Edgar

Section 2 Questions 16. Check what type of data you collect and how it is collected? 1.Demographic 2.Family Income 3.Service Authorization 4.Service Utilization 5.Fund Resources 6.Other Program Eligibility 7.Other Paper or Electronic