FCASPL 361 (Changes to Title IV-E Single Cost Report Form (JFS 02911) and Instructions (JFS 02911-I))
Family, Children and Adult Services Procedure Letter No. 361
September 30, 2020
TO: Family, Children and Adult Services Manual Holders
FROM: Kimberly Hall, 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 Title IV-E agencies, private child placing agencies (PCPA), private noncustodial agencies (PNA), residential care facilities, substance use disorder (SUD) facilities and a qualified residential treatment program (QRTP): 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, 2019, through June 30, 2020 (SFY 2020).

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


 All worksheet footers updated to reflect "JFS 02911 (Rev. 8/2020)."

  • Annual calculated inflation factor (1.1%) added to 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, 2021, through March 31, 2022, 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 2020.




FORMS JFS 02911 (Rev. 8/2019) JFS 02911 (Rev. 8/2020)
  JFS 02911-I (Rev. 8/2019) JFS 02911-I (Rev. 8/2020)