The following information is based on a survey sent to each state association. (Note: In states not listed, counties do not contribute financially to Medicaid, according to state associations of counties.)
Under the Health Care Cost Containment System (a statewide Medicaid demonstration program), counties pay 100 percent of the non-federal share for long-term care for the elderly and physically disabled, and fund a variable portion of acute care.
Counties provide the state with a subsidy of $239 million for the disproportionate share hospital program. Counties are also “taxed” 33-1/3 percent of the amounts they receive from claiming up to $20 million under the Medical Administrative Claiming Program.
Counties pay no more than 20 percent of the non-federal share of administrative costs related to eligibility determination.
Counties pay $55 per month for each nursing home resident, and 35 percent of the non-federal share for the 13th through 45th inpatient hospital days.
County tax levies provide approximately 50 percent of the non-federal share for Medicaid administrative costs at the county level. Counties contribute to a "Medical Assistance to Wards" fund used to pay the non-federal share of Medicaid for wards of the county office or juvenile court who are not eligible for AFDC foster care.
Counties pay 50 percent of the non-federal share of targeted case management for persons with chronic mental illness, mental retardation or developmental disabilities, and partial hospitalization and day treatment.
Some Kansas counties levy property taxes which are remitted to the state and used to supplement the states’ share of the Medicaid match for mental health and mental retardation services.
Counties pay 10 percent of the non-federal share for Medicaid mental health services delivered by county community mental health agencies. Counties with medical care facilities (nursing homes) provide a variable maintenance of effort payment for Medicaid patients in the facility.
Counties pay 100 percent of the non-federal share of administrative costs related to client services. Counties loan funds to the state, without interest, for a portion of the state's benefit payments for the first six months of each fiscal year. As managed care is implemented in counties throughout the state, some administrative allocation is made to HMOs and counties by the state. Full implementation of managed care is expected by 1998.
Counties pay 50 percent of the non-federal share of administrative costs related to eligibility determination.
Counties pay 100 percent of the non-federal share of long-term care for the aged, blind and disabled whose net monthly income exceeds $750 but is less than the maximum percent of the Supplemental Security Income Federal Benefit Rate (SSI/FBR), which is $470 per month for an individual or $705 per month for a couple. Counties are required to pay the total administrative costs for the federal match program.
Counties pay 100 percent of the non-federal share of the Medicaid Audit unit. Counties pay 61.1 percent of the non-federal share of long-term care and 50 percent of the non-federal share of Aid to the Permanently and Totally Disabled and Old-Age Assistance.
Counties fund the non-federal share of administrative cost for eligibility determinations of non-SSI Medicaid applicants.
Counties contribute about seven percent of the total Medicaid budget through the use of intergovernmental transfers used by the state as Medicaid match.
Counties pay 50 percent of the non-federal share of services, excluding long-term care, for which they contribute 20 percent.
Counties pay 15 percent of the non-federal share of services and 100 percent of the non-federal share of administrative costs.
Counties pay 15 percent of the non-federal share of all program costs, except for ICF/MR, clinic services, and waivered home and community-based services for mentally retarded/developmentally disabled residents. The non-federal share for program costs associated with this group of residents has no county financial participation. Additionally, counties pay 100 percent of the non-federal share of local administration costs for all eligibility determination and related supervision.
Counties pay a maximum of 10 percent of the non-federal share of administrative costs related to eligibility determination, with some limitations.
For children, counties must provide case management and control cost of services at a $15,000 per client cap.
Counties pay 10 percent of the non-federal share for county nursing homes. Counties operate community mental health, drug and alcohol, and mental retardation systems. Medicaid pays approximately 50 percent of the cost. Child welfare, also operated by counties, uses Medicaid as a resource at about five percent.
Counties provide 50 cents per capita to provide Medicaid services. An additional $13 million is assessed for use as matching funds for Medicaid. The Medicaid Expansion Fund receives $7.5 million of this amount.
Counties pay $60 per month for each ICF/MR resident and $200 per month for each mentally ill resident in state inpatient facilities.
Urban county hospital districts contribute funding to match federal disproportionate share funds.
Counties provide 20 percent of the state's non-federal payment.
Counties pay a minimum of 20 percent of the non-federal share of administrative costs related to eligibility determination.
Counties contribute in varying amounts local mileage to the non-federal share for public health, chemical dependency, developmental disabilities, mental health, emergency primary care and jail health. There is no set percentage nor uniform state mandate that counties contribute.
Counties pay the non-federal share for certain mental health programs (e.g., community support services and targeted case management).