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Warning Text %XTableStyleMedium2PivotStyleLight16`_ enclosure 1D enclosure 2 enclosure 36 enclosure 4W enclosure 5  enclosure 6? cCopy of UPDATED HIV shell date FFY 2018 April-May-June 2018 dated August 10th 2018 ShellDY16Q2.xls InstructionsTotal Costs August 10 2018Sheet2Particip updatedrevisedtoDY16Q3Monitoring Assessment 06-30-18CMS64C FFY2018 Q3 downloadExp Target amountsExpansionDY16 Q3MedicaidDY16Q3Sheet1YYYYYYZ~cSA&]A@dFYA@pSA@]A@ ^AA]AUA@ؤ\A@QY]A]ABz_A aA aA@aA@C TAYYYY 2 Contact_Data_R1_Crosstab;  ;  ;sfVf@ @zr8 %3 A@@  BfIncomingOutgoing AdherenceAmbulance/TransportationCase Management Services Compliance EligibilityERIntroductory CallLaboratory/X-ray MedicationsOtherOut Dated ContactPharmacyPhone Call Follow UpPolicyProvider Services Unpaid Claim Viral Loads'Enclosure 5: Contact Tracking by ReasonContact ReasonTotal ContactsCollaboration Care coordination,Enclosure 6: Contact Tracking by Method Used Method UsedCallEmailFaxLetterFamily Planning%ADAP Funds Spent on MaineCare Clients Member Survey;Maine HIV/AIDS: Overall Service Costs by Demonstration YearDate Submitted to CMS:Quarter Report Period:0Population Group(s) (as identified in the MBES)Total Demo Year Costs ExpansionMedicaid-Actual Participation by Demonstration QuarterDemonstration Year 1:7/01/02 - 6/30/03 Quarter 1 Quarter 2 Quarter 3 Quarter 4Population Group(s) 7/01/02 - 9/30/0210/01/02 - 12/31/021/01/03 - 3/31/034/01/03 - 6/30/03Total Demo Year ParticipationDemonstration Year 2:7/1/03 - 6/30/047/01/03 - 9/30/0310/01/03 - 12/31/031/01/04 - 3/31/044/01/04 - 6/30/04Demonstration Year 3:7/01/04 - 6/30/057/01/04 - 9/30/0410/01/04 - 12/31/041/01/05 - 3/31/054/01/05 - 6/30/05Total Demo Year ParticpationDemonstration Year 4:7/1/05 - 6/30/067/01/05 - 9/30/0510/01/05 - 12/31/051/01/06 - 3/31/064/01/06 - 6/30/06Demonstration Year 5:7/1/06 - 6/30/077/01/06 - 9/30/0610/01/06 - 12/31/061/01/07 - 3/31/074/01/07 - 6/30/07Total Demo Year PartcipationDemonstration Year 6:7/1/07 - 6/30/087/01/07 - 9/30/0710/01/07 - 12/31/071/01/08 - 3/31/084/01/08 - 6/30/08Demonstration Year 7:7/1/08 - 6/30/097/01/08 - 9/30/0810/01/08 - 12/31/081/01/09 - 3/31/094/01/09 - 6/30/09Demonstration Year 8:7/1/09 - 6/30/107/01/09 - 9/30/0910/01/09 - 12/31/091/01/10 - 3/31/104/01/10 - 6/30/10Demonstration Year 9:7/1/10 - 6/30/117/01/10 - 9/30/1010/01/10 - 12/31/101/01/11 - 3/31/114/01/11 - 6/30/11Demonstration Year 10:7/1/11 - 6/30/127/01/1 - 9/30/1110/01/11 - 12/31/111/01/12 - 3/31/124/01/12 - 6/30/12Budget Neutrality Assessment 3(This page automatically calculates entered data.) Annual AssessmentTotal Computable CeilingCumulative Expenditure TargetsCosts Over/Under TargetDemonstration Year 117/1/12 - 6/30/137/01/12 - 9/30/1210/01/12 - 12/31/121/01/13 - 3/31/134/01/13 - 6/30/13 Total Demo Year Partcipation YTDMental Health/Substance Abuse Quarter 57/01/13 - 9/30/1310/01/13 - 12/31/131/01/14 - 3/31/144/01/14 - 6/30/14 Quarter 6Demonstration Year 1201/01/14 - 12/31/14Demonstration Year 11 plus7/1/13 - 12/31/13Expansion <=100% FPLExpansion >100% FPLExpansion Unknown FPLFEDERAL DOLLARS STATE DOLLARSDemonstration Populations0Average ADAP Expenditures for Prescription Drugs.Total ADAP Expenditures for Prescription Drugs&Average ADAP Expenditures for Premiums$Total ADAP Expenditures for Premiums3Average ADAP Expenditures for Copay Reimbursement1Total ADAP Expenditures for Copay Reimbursement InpatientDemonstration Year 1301/01/15 - 12/31/151/01/15 - 3/31/154/01/15 - 6/30/157/01/15 - 9/30/1510/01/15 - 12/31/15MBES (Federal Fiscal Year) DY - 1 FFY: 10/01/02 - 9/30/03DY - 2 FFY: 10/01/03 - 9/30/04DY - 3 FFY: 10/01/04 - 9/30/05DY - 4 FFY: 10/01/05 - 9/30/06DY - 5 FFY: 10/01/06 - 9/30/07DY - 6 FFY: 10/01/07 - 9/30/08DY - 7 FFY: 10/01/08 - 9/30/09DY - 8 FFY: 10/01/09 - 9/30/10DY - 9 FFY: 10/01/10 - 9/30/11DY - 10 FFY: 10/01/11 - 9/30/12DY - 11 FFY: 10/01/12 - 9/30/13DY - 12 FFY: 10/01/13 - 9/30/14DY - 13 FFY: 10/1/14 - 09/30/15Demonstration Year 1401/01/16 - 12/31/161/01/16 - 3/31/164/01/16 - 6/30/167/01/16 - 9/30/1610/01/16 - 12/31/16DY - 14 FFY: 10/1/15 - 09/30/16DY - 13: 1/1/15 - 12/31/15DY - 14: 1/1/16 - 12/31/16N/ADY - 15: 1/1/17 - 12/31/17DY - 15 FFY: 10/1/16 - 09/30/17Total Demo CostsNote - FFY15 Q2 (Waiver DY 12 2014): Updated the "Annual Expenditure Targets" with the figures provided in an email from CMS forwarded by Emily Bean on 5/20/015$ 7/01/14 - 9/30/1410/01/14 - 12/31/14Demonstration Year 1501/01/17 - 12/31/171/01/17 - 3/31/174/01/17 - 6/30/177/01/17 - 9/30/1710/01/17 - 12/31/17 ReadmissionFFY 201801/01/18 - 12/31/181/01/18 - 3/31/184/01/18 - 6/30/187/01/18 - 9/30/1810/01/18 - 12/31/18Date: 05/14/2018DY - 16 FFY: 10/1/17 - 09/30/18DY - 16: 1/1/18 - 12/31/18Demonstration Year 16;  Enrollees at or below 100% FPL: Demonstration  Enrollees  !1:6  Enrollees above 100% FPL: Demonstration  Enrollees  2  Members : HIV Positive and MaineCare eligibleApril 1, 2018 - June 30, 20184/1/2018 - 6/30/2018>J J2KLvLD~MLNN^O,PPhQ6 RRSZ DT T Uu V Wj XrY]LZ[e,\]ccB G r&  dMbP?_*+%&?'?(?)?M"Ricoh Aficio MP 4000B PCLDC odXXLetterDINU"D T"5 SMTJRicoh Aficio MP 4000B PCLInputBinAUTORESDLLUniresDLLSupportDocUiReplaceONAutoConfigONSupportSamplePrintONSupportSecurePrintONSupportHoldPrintONSupportStoredPrintONSupportStoreandPrintONSupportDocumentBoxONSupport8CharPasswordONSupportSupplyViewONSupportAccessRoleONHardDiskInstalledPaperSizeLETTERMediaTypeAutoSlipSheetOFFSlipSheetInputBinTray1OutputBinPrinterDefaultStaplingOFFPunchingOFFOrientationLANDSCAPE_CC90DuplexNONEEdgeToEdgePrintOFFResolution600dpiPrintDensityEconomodeOffPrintQualitySmoothingOffGraphicsModeHPGL2MODEPrintTextAsBlackOFFHalftoneHT_PATSIZE_8x8_MCollateONEmitOrientationCommandOption1 FAIRMDPR Times New RomanZ-22' B{_"1XX333333?333333?&<3U} qc} c}  c ,0 0 ,0@I@ +@      l"pppppppppppp m"oooooooooooon mklkjiiiiiiii  h h h h(mklkjiiiiiiiiiiii n(                 o p~ "`%HrA DcA%I}AD`mfA%|AD`;iA% ADqkA%A D_`A%ӒAD fA%;A D *AkA% LA DSeA& ܣYA D kA& 0uӠA D 5uA& f`A D `3hA f`AD f`A D f`ADf`ADf`A D ~cSAZ&]AZ@dFYAZ@pSAZ@]AZ@ ^AZA]AZ UAZ  @ؤ\AZ  @QY]A Z  ]A Z  Bz_A Z aA Z aA Z@aAZ@C TAZ#VA  %nn q! 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