This letter transmits revisions to the JFS 02911 Single Cost Report form and JFS 02911-I Single Cost Report Instructions which are used pursuant to OAC 5101:2-47-26.1 Public children services agencies (PCSA), private child placing agencies (PCPA), private noncustodial agencies (PNA): Title IV-E cost report filing requirements, record retention requirements and related party disclosure requirements.The revised form and instructions are to be used for the state fiscal year reporting period of July 1, 2013, through June 30, 2014 (SFY 2014).

An explanation of the revisions to the cost report form and instructions appears below:

Due to the rescission of Ohio Department of Mental Health and Addiction Services' (ODMHAS) cost report requirements (see Family, Children, and Adult Services Manual Procedure Letter No. 263), Forms A-1, A-2, A-3, and A-4 and their related instructions were removed from the JFS 02911 Single Cost Report. However, to ensure 100% reporting of an agency's total costs, a single line on the JFS 02911's Total Agency Cost Summary worksheet is designated to report ODMHAS aggregate Medicaid and non-Medicaid program costs.

There are no additional modifications to the SFY 2014 form except to update the revision date in the footer of the worksheets to reflect "JFS 02911 (Rev. 8/2014)." Furthermore, the calculated annual inflation factor of 3.7% was added to the reimbursement ceilings worksheet.

There are no substantive changes to the SFY 2014 instructions except for removal of instructions related to the previously mentioned ODMHAS' worksheets. Additionally, date references were revised to reflect proper reporting and effective periods.

Note: An agency which seeks to establish Title IV-E reimbursement ceilings for the effective period April 1, 2015, through March 31, 2016, must complete the filing requirements as outlined in OAC 5101:2-47-26.1 (cost report) and OAC 5101:2-47-26.2 (agreed-upon procedures) for SFY 2014.

The JFS 02911 is intended to be used in an automated format.

When downloading the Microsoft Excel version of the JFS 02911 Single Cost Report form, the macro security level must be lowered in order for the macro buttons to work properly. To lower the macro security level, open Microsoft Excel, click Tools, Options, and then the Security tab. Change the security level from high to low. At this point, the file can be downloaded. Once downloaded, open the file. A prompt will appear requesting that the macros be either disabled or enabled. Click Enable Macros. If the macro security level is not changed to low and the macros are not enabled, the macro buttons will not work when the file is opened.