FCASPL 291 (Changes to Title IV-E Single Cost Report Form [JFS 02911] and Instructions [JFS 02911-I])
Family, Children and Adult Services Procedure Letter No. 291
September 22, 2015
TO: Family, Children and Adult Services Manual Holders
FROM: Cynthia C. Dungey, Director
SUBJECT: Changes To Title IV-E Single Cost Report Form (JFS 02911) And Instructions (JFS 02911-I)

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, 2014, through June 30, 2015 (SFY 2015).

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


  • Transportation/Travel line in the Non-Personnel section of the Purchased Foster Care (PFC) and Residential (RES) service worksheets has been unbundled into separate line items entitled Transportation-Maintenance and Transportation-Administration; also, Transportation/Travel line on the Allocation of Administration Overhead worksheet has been retitled as Transportation-Administration. These changes will ensure calculated ceiling amounts incorporate proper federal reimbursable items.
  • All worksheet footers updated to reflect "JFS 02911 (Rev. 8/2015)."
  • Annual calculated inflation factor (.2%) added to the Title IV-E Reimbursement Ceilings and Cost Per Diems worksheet.


  • Identification of reportable cost items for the newly unbundled Transportation-Maintenance and Transportation-Administration line items (formerly Transportation/Travel) on the PFC and RES service worksheets. Note: For SFY 2015, if an agency's accounting system does not capture Transportation-Maintenance and Transportation-Administration costs separately, the agency must report such costs as Transportation-Administration. However, for SFY 2016, all agencies must ensure their accounting system is properly coded to distinguish between Transportation-Maintenance and Transportation-Administration cost items.
  • Diagrams were added to provide an illustration of the cost composition of the PFC and RES services on the Title IV-E Reimbursement Ceilings and Cost Per Diems worksheet.
  • Date references were revised to reflect proper reporting and effective periods.

An agency which seeks to establish Title IV-E reimbursement ceilings for the effective period April 1, 2016, through March 31, 2017, 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 2015.

FORMSJFS 02911 (Rev. 8/2014)JFS 02911 (Rev. 8/2015)
 JFS 02911-I (Rev. 8/2014)JFS 02911-I (Rev. 8/2015)