Family Cost Participation in Georgia Part C/Babies Can’t Wait Program

Why FCP in Georgia? Precedent Initial Planning Stakeholder Involvement

GA Part C Demographics Part C serving 4,457 children (6/30/03) and over 7,000 per year Moderate eligibility criteria 62.6% Medicaid eligible 39.1% Private Insurance 4.8% PeachCare (S-CHIP)

Georgia Demographics Median Income of families with children (2000) = $44,800 ($50,000 nationally) Percentage of Children Living in Poverty: 21% in 1990; 18% in 2000 Percentage of Children in Extreme Poverty (below 50% Poverty level) = 8% (7% nationally) Source: GA Kids Count 2003

Why does FCP Work for Georgia? Consistent policies & procedures Same criteria is applied to all families Scheduled updates & revisions

Ongoing Monitoring Demographics: FCP scale is reviewed and updated annually to include most current Federal Poverty Guidelines and other necessary changes

Modifications are Based on Ongoing Monitoring Local monitoring & site reviews Complaints Identification of new fund sources

Revisions that Occurred in Response to Ongoing Monitoring Revised Policies: FCP & Medicaid-eligibility - Provisions applied family cost participation to non-covered services for all families

Revisions that Occurred in Response to Ongoing Monitoring Revised Policies: “Spend Down” & Adjusted Income - Revisions to refine, clarify, and define allowable and disallowed “spend downs”

Revisions that Occurred in Response to Ongoing Monitoring Revised Criteria: For families with multiple children enrolled in Part C - Provisions to reduce FCP percentage by 5% for each child after the first enrolled child

Revisions that Occurred in Response to Ongoing Monitoring New Funding Sources & Coordination: Private Insurance provisions Expansion of FCP to Title V

Things we Considered but did not do in GA Out of pocket maximum costs per year for each family Separate scales for families who access insurance and those who deny access

Why does FCP Work for GA? Consistent Policies: Determination of “inability to pay” Ongoing Monitoring: Widespread acceptance & expectations

Family Cost Participation - What’s Next in GA? Changes in Political and Economic Context: Look at FCP fee scale, levels Infrastructure Changes: Data system enhancements

What Does It Take to Get the Job Done? Stakeholders Data Other options Authority needed Consider this as you study FCP in your state…

Any Questions??? Georgia’s FCP forms are available for your reference. Contact me at or