Fiscal Year:
    
Primary Budget:
Comparison Budget:

   reductions  imposed on or after October 1, 2008, shall be to compare the
   average  unit appropriation with actual average unit cost as follows: 1)
   the average unit appropriation shall be determined by dividing the total
   appropriation  in  Specific  Appropriation 220 by the total bed days for
   the past fiscal year; 2) the total actual cost as generated based on the
   July  1 rate setting shall be divided by the total bed days for the past
   fiscal  year  to determine the actual unit cost; 3) the actual unit cost
   shall  be  reduced  to a Reduced Actual Unit Cost by the same percentage
   used  to  calculate  the legislative appropriation to account for client
   participation contributions; 4) no negative adjustment to the rates paid
   to  providers  shall  occur  so  long as the Reduced Actual Unit Cost is
   equal  to  or  less  than  the average unit appropriation; and 5) in the
   event  the  Reduced   Actual  Unit Cost is greater than the average unit
   appropriation,  a prorated reduction shall be imposed on all rates after
   all  Quality  Assessment Fee funds have been exhausted to cover the rate
   reductions.

   The  Agency  for  Health  Care  Administration  shall  not pay any legal
   judgments,  settlements, lawsuit damages or awards imposed by a court as
   the  result  of  any  legal  proceeding  relating  to prior fiscal years
   without specific authority in the General Appropriations Act.

   From  the  funds  in Specific Appropriation 220, $7,178,569 in recurring
   funds  from  the General Revenue Fund and $11,143,456 in recurring funds
   from  the  Medical Care Trust Fund are provided to establish a new level
   of  reimbursement  for  Medicaid-eligible  individuals  residing  in  or
   seeking  admission to an Intermediate Care Facility for Individuals with
   Intellectual  Disabilities  (ICF/IID)  who have severe behavioral needs.
   These  funds  shall  be  placed  in  reserve. The Agency for Health Care
   Administration shall submit a budget amendment requesting release of the
   funds held in reserve pursuant to Chapter 216, Florida Statutes. Release
   of  the  funds  is contingent upon the agency demonstrating the need and
   identifying  individuals who have serve behavioral needs and who qualify
   for this level of care.

 221   SPECIAL CATEGORIES
       NURSING HOME CARE
        FROM GENERAL REVENUE FUND  . . . . .       29,037,157
        FROM HEALTH CARE TRUST FUND  . . . .                        16,729,472
        FROM GRANTS AND DONATIONS TRUST
         FUND  . . . . . . . . . . . . . . .                        29,921,212
        FROM MEDICAL CARE TRUST FUND . . . .                       121,783,861

   From  the  funds  in  Specific  Appropriation 221, the Agency for Health
   Care  Administration  is authorized to transfer funds in accordance with
   the   provisions     of  Chapter  216,  Florida  Statutes,  to  Specific
   Appropriation  218  specifically  for  slots  under the Model Waiver and
   Specific   Appropriation  222  for  the  Statewide Medicaid Managed Care
   Long-Term  Care  Waiver to transition the greatest number of appropriate
   eligible    beneficiaries    from    skilled   nursing   facilities   to
   community-based   alternatives  in  order  to  maximize the reduction in
   Medicaid  nursing  home  occupancy.  Priority for the use of these funds
   will  be  given  to  the  planning  and  service areas with the greatest
   potential for transition success.

   From  the  funds  in  Specific  Appropriation  221 and 222, $415,669,471
   from  the  Grants  and  Donations  Trust  Fund and $645,253,119 from the
   Medical  Care  Trust Fund are provided to buy back nursing facility rate
   reductions, effective on or after January 1, 2008, and are contingent on
   the   nonfederal  share  being  provided  through  nursing  home quality
   assessments. Authority is granted to buy back rate reductions up to, but
   not  higher  than, the amounts available under the budgeted authority in
   these  Specific  Appropriations.   In  the  event that the funds are not
   available  in  the Grants and Donations Trust Fund, the State of Florida
   is not obligated to continue reimbursements at the higher amount.

 222   SPECIAL CATEGORIES
       PREPAID HEALTH PLAN/LONG TERM CARE
        FROM GENERAL REVENUE FUND  . . . . .    1,336,885,838
        FROM HEALTH CARE TRUST FUND  . . . .                       308,100,403
        FROM GRANTS AND DONATIONS TRUST
         FUND  . . . . . . . . . . . . . . .                       429,017,638
        FROM MEDICAL CARE TRUST FUND . . . .                     3,348,451,050

 223   SPECIAL CATEGORIES
       STATE MENTAL HEALTH HOSPITAL PROGRAM
        FROM MEDICAL CARE TRUST FUND . . . .                         6,314,346