For purposes of this article, the following definitions apply: (a) âBase yearâ means the fiscal year ending three years prior to the fiscal year for which the redirected amount is calculated. (b) âBlended CPI trend factorâ means the blended percent change applicable for the fiscal year that is derived from the nonseasonally adjusted Consumer Price Index for All Urban Consumers (CPI-U), United States City Average, for Hospital and Related Services, weighted at 75 percent, and for Medical Care Services, weighted at 25 percent, all as published by the United States Bureau of Labor Statistics, computed as follows: (1) For each prior fiscal year within the period to be trended through the state fiscal year, the annual average of the monthly index amounts shall be determined separately for the Hospital and Related Services Index and the Medical Care Services Index. (2) The year-to-year percentage changes in the annual averages determined in paragraph (1) for each of the Hospital and Related Services Index and the Medical Care Services Index shall be determined. (3) A weighted average annual percentage change for each year-to-year period shall be calculated from the determinations made in paragraph (2), with the percentage changes in the Hospital and Related Services Index weighted at 75 percent, and the percentage changes in the Medical Care Services Index weighted at 25 percent. The resulting average annual percentage changes shall be expressed as a fraction, and increased by 1.00. (4) The product of the successive year-to-year amounts determined in paragraph (3) shall be the blended CPI trend factor. (c) âCalculated cost per personâ is determined by dividing county indigent program costs by the number of indigent program individuals for the applicable fiscal year. If a county expands eligibility, the enrollment count is limited to those indigent program individuals who would have been eligible for services under the eligibility requirements in existence on July 1, 2013, except if approved as an exception allowed pursuant to paragraph (3) of subdivision (d). (d) âCost containment limitâ means the countyâs indigent program costs determined for the 2014â15 fiscal year and each subsequent fiscal year, to be adjusted as follows: (1) (A) The countyâs indigent program costs for the state fiscal year shall be determined as indigent program costs for purposes of this paragraph for the relevant fiscal period. (B) The countyâs calculated costs per person for the base year will be multiplied by the blended CPI trend factor and then multiplied by the countyâs fiscal year indigent program individuals. The base year costs used shall not reflect any adjustments under this subdivision. (C) The fiscal year amount determined in subparagraph (A) shall be compared to the trended amount in subparagraph (B). If the amount in subparagraph (B) exceeds the amount in subparagraph (A), the county will be deemed to have satisfied the cost containment limit. If the amount in subparagraph (A) exceeds the amount in subparagraph (B), the calculation in paragraph (2) shall be performed. (2) If a countyâs costs as determined in subparagraph (A) of paragraph (1) exceed the amount determined in subparagraph (B) of paragraph (1), the following costs, as allocated to the countyâs indigent care program, shall be added to the cost and reflected in any containment limit: (A) Costs related to state or federally mandated activities, requirements, or benefit changes. (B) Costs resulting from a court order or settlement. (C) Costs incurred as a result of a natural disaster or act of terrorism. (3) If a countyâs costs as determined in subparagraph (A) of paragraph (1) exceed the amount determined in subparagraph (B) of paragraph (1), as adjusted by paragraph (2), the county may request that the department consider other costs as adjustments to the cost containment limit. These costs would require departmental approval. (e) âCountyâ for purpo
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