State Children's Health Insurance Program; Final Allotments to States, the District of Columbia, and U.S. Territories and Commonwealths for Fiscal Year 2007, 42854-42859 [E6-12031]
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Federal Register / Vol. 71, No. 145 / Friday, July 28, 2006 / Notices
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Dated: July 14, 2006.
Mark B. McClellan
Administrator, Centers for Medicare &
Medicaid Services.
[FR Doc. E6–11948 Filed 7–27–06; 8:45 am]
BILLING CODE 4120–01–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Medicare & Medicaid
Services
[CMS–2251–N]
RIN 0938–ZA17
State Children’s Health Insurance
Program; Final Allotments to States,
the District of Columbia, and U.S.
Territories and Commonwealths for
Fiscal Year 2007
Centers for Medicare &
Medicaid Services (CMS), HHS.
ACTION: Notice.
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AGENCY:
SUMMARY: Title XXI of the Social
Security Act (the Act) authorizes
payment of Federal matching funds to
States, the District of Columbia, and
U.S. Territories and Commonwealths to
initiate and expand health insurance
coverage to uninsured, low-income
children under the State Children’s
Health Insurance Program (SCHIP). This
notice sets forth the final allotments of
Federal funding available to each State,
the District of Columbia, and each U.S.
Territory and Commonwealth for fiscal
year 2007. States may implement SCHIP
through a separate State program under
title XXI of the Act, an expansion of a
State Medicaid program under title XIX
of the Act, or a combination of both.
EFFECTIVE DATE: This notice is effective
on August 28, 2006. Final allotments are
available for expenditures after October
1, 2006.
FOR FURTHER INFORMATION CONTACT:
Richard Strauss, (410) 786–2019.
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SUPPLEMENTARY INFORMATION:
I. Purpose of This Notice
This notice sets forth the allotments
available to each State, the District of
Columbia, and each U.S. Territory and
Commonwealth for fiscal year (FY) 2007
under title XXI of the Social Security
Act (the Act). Final allotments for a
fiscal year are available to match
expenditures under an approved State
child health plan for 3 fiscal years,
including the year for which the final
allotment was provided. The FY 2007
allotments will be available to States for
FY 2007, and unexpended amounts may
be carried over to 2008 and 2009.
Federal funds appropriated for title XXI
are limited, and the law specifies a
formula to divide the total annual
appropriation into individual allotments
available for each State, the District of
Columbia, and each U.S. Territory and
Commonwealth with an approved child
health plan.
Section 2104(b) of the Act requires
States, the District of Columbia, and
U.S. Territories and Commonwealths to
have an approved child health plan for
the fiscal year in order for the Secretary
to provide an allotment for that fiscal
year. All States, the District of
Columbia, and U.S. Territories and
Commonwealths have approved plans
for FY 2007. Therefore, the FY 2007
allotments contained in this notice
pertain to all States, the District of
Columbia, and U.S. Territories and
Commonwealths.
II. Methodology for Determining Final
Allotments for States, the District of
Columbia, and U.S. Territories and
Commonwealths
This notice specifies, in the table
under section III, the final FY 2007
allotments available to individual
States, the District of Columbia, and
U.S. Territories and Commonwealths for
either child health assistance
expenditures under approved State
child health plans or for claiming an
enhanced Federal medical assistance
percentage rate for certain SCHIPrelated Medicaid expenditures. As
discussed below, the FY 2007 final
allotments have been calculated to
reflect the methodology for determining
an allotment amount for each State, the
District of Columbia, and each U.S.
Territory and Commonwealth as
prescribed by section 2104(b) of the Act.
Section 2104(a) of the Act provides
that, for purposes of providing
allotments to the 50 States and the
District of Columbia, the following
amounts are appropriated:
$4,295,000,000 for FY 1998;
$4,275,000,000 for each FY 1999
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through FY 2001; $3,150,000,000 for
each FY 2002 through FY 2004;
$4,050,000,000 for each FY 2005
through FY 2006; and $5,000,000,000
for FY 2007. However, under section
2104(c) of the Act, 0.25 percent of the
total amount appropriated each year is
available for allotment to the U.S.
Territories and Commonwealths of
Puerto Rico, Guam, the Virgin Islands,
American Samoa, and the Northern
Mariana Islands. The total amounts are
allotted to the U.S. Territories and
Commonwealths according to the
following percentages: Puerto Rico, 91.6
percent; Guam, 3.5 percent; the Virgin
Islands, 2.6 percent; American Samoa,
1.2 percent; and the Northern Mariana
Islands, 1.1 percent.
Section 2104(c)(4)(B) of the Act
provides for additional amounts for
allotment to the Territories and
Commonwealths: $34,200,000 for each
FY 2000 through FY 2001; $25,200,000
for each FY 2002 through FY 2004;
$32,400,000 for each FY 2005 through
FY 2006; and $40,000,000 for FY 2007.
Since, for FY 2007, title XXI of the Act
provides an additional $40,000,000 for
allotment to the U.S. Territories and
Commonwealths, the total amount
available for allotment to the U.S.
Territories and Commonwealths in FY
2007 is $52,500,000; that is, $40,000,000
plus $12,500,000 (0.25 percent of the FY
2007 appropriation of $5,000,000,000).
Therefore, the total amount available
nationally for allotment for the 50 States
and the District of Columbia for FY 2007
was determined in accordance with the
following formula:
AT = S2104(a)—T2104(c)
AT = Total amount available for
allotment to the 50 States and the
District of Columbia for the fiscal
year.
S2104(a) = Total appropriation for the
fiscal year indicated in section
2104(a) of the Act. For FY 2007, this
is $5,000,000,000.
T2104(c) = Total amount available for
allotment for the U.S. Territories
and Commonwealths; determined
under section 2104(c) of the Act as
0.25 percent of the total
appropriation for the 50 States and
the District of Columbia. For FY
2007, this is: .0025 × $5,000,000,000
= $12,500,000.
Therefore, for FY 2007, the total amount
available for allotment to the 50 States
and the District of Columbia is
$4,987,500,000. This was determined as
follows: AT ($4,987,500,000) = S2104(a)
($5,000,000,000)—T2104(c) ($12,500,000).
For purposes of the following
discussion, the term ‘‘State,’’ as defined
in section 2104(b)(1)(D)(ii) of the Act,
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‘‘means one of the 50 States or the
District of Columbia.’’
Under section 2104(b) of the Act, the
determination of the number of children
applied in determining the SCHIP
allotment for a particular fiscal year is
based on the three most recent March
supplements to the Current Population
Survey (CPS) of the Bureau of the
Census officially available before the
beginning of the calendar year in which
the fiscal year begins. The
determination of the State cost factor is
based on the annual average wages per
employee in the health services
industry, which is determined using the
most recent 3 years of such wage data
as reported and determined as final by
the Bureau of Labor Statistics (BLS) of
the Department of Labor to be officially
available before the beginning of the
calendar year in which the fiscal year
begins. Since FY 2007 begins on
October 1, 2006 (that is, in calendar year
2006), in determining the FY 2007
SCHIP allotments, we are using the most
recent official data from the Bureau of
the Census and the BLS, respectively,
available before January 1 of calendar
year 2006 (that is, through the end of
December 31, 2005).
Number of Children
For FY 2007, as specified by section
2104(b)(2)(A)(iii) of the Act, the number
of children is calculated as the sum of
50 percent of the number of lowincome, uninsured children in the State,
and 50 percent of the number of lowincome children in the State. The
number of children factor for each State
is developed from data provided by the
Bureau of the Census based on the
standard methodology used to
determine official poverty status and
uninsured status in the annual CPS on
these topics. As part of a continuing
formal process between the Centers for
Medicare & Medicaid Services (CMS)
and the Bureau of the Census, each
fiscal year we obtain the number of
children data officially from the Bureau
of the Census.
Under section 2104(b)(2)(B) of the
Act, the number of children for each
State (provided in thousands) was
determined and provided by the Bureau
of the Census based on the arithmetic
average of the number of low-income
children and low-income children with
no health insurance as calculated from
the three most recent March
supplements to the CPS officially
available from the Bureau of the Census
before the beginning of the 2006
calendar year. In particular, through
December 31, 2005, the most recent
official data available from the Bureau
of the Census on the numbers of
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children were data from the three March
CPSs conducted in March 2003, 2004,
and 2005 (representing data for years
2002, 2003, and 2004).
State Cost Factor
The State cost factor is based on
annual average wages in the health
services industry in the State. The State
cost factor for a State is equal to the sum
of: 0.15 and 0.85 multiplied by the ratio
of the annual average wages in the
health industry per employee for the
State to the annual wages per employee
in the health industry for the 50 States
and the District of Columbia.
Under section 2104(b)(3)(B) of the
Act, as amended by the Balanced
Budget Refinement Act of 1999 (BBRA)
Public Law 106–113, enacted on
November 29, 1999, the State cost factor
for each State for a fiscal year is
calculated based on the average of the
annual wages for employees in the
health industry for each State using data
for each of the most recent 3 years as
reported and determined as final by the
BLS in the Department of Labor and
available before the beginning of the
calendar year in which the fiscal year
begins. Therefore, the State cost factor
for FY 2007 is based on the most recent
3 years of BLS data officially available
as final before January 1, 2006 (the
beginning of the calendar year in which
FY 2007 begins); that is, it is based on
the BLS data available as final through
December 31, 2005. In accordance with
these requirements, we used the final
State cost factor data available from BLS
for 2002, 2003, and 2004 in calculating
the FY 2007 final allotments.
The State cost factor is determined
based on the calculation of the ratio of
each State’s average annual wages in the
health industry to the national average
annual wages in the health care
industry. Since BLS is required to
suppress certain State-specific data in
providing us with the State-specific
average wages per health services
industry employee due to the Privacy
Act, we calculated the national average
wages directly from the State-specific
data provided by BLS. As part of a
continuing formal process between CMS
and the BLS, each fiscal year CMS
obtains these wage data officially from
the BLS.
Section 2104(b)(3)(B) of the Act, as
amended by the BBRA, refers to wage
data as reported by BLS under the
‘‘Standard Industrial Classification’’
(SIC) system. However, in calendar year
2002, BLS phased-out the SIC wage and
employment reporting system and
replaced it with the ‘‘North American
Industry Classification System’’
(NAICS). In accordance with section
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2104(b)(3)(B) of the Act, for purposes of
calculating the FY 2007 allotments, BLS
provided wage data for the 3 most
recent years as available through
December 31, 2005; in this case, the 3
years of wage data are 2002, 2003, and
2004. Because of the wage and
employment classification change at
BLS, the BLS wage data used in
calculating the FY 2007 SCHIP
allotments necessarily reflect NAICS
data, rather than SIC data, to obtain the
3-year average required for the
allotments.
Under the SIC system, BLS provided
CMS with wage data for each State
under the SIC Code. However, the wage
data codes under the SIC system do not
map exactly to the wage data codes
under the NAICS. As a result, BLS
provided us with wage data using three
NAICS wage data codes that represent
approximately 98 percent of the wage
data that would have been provided
under the related SIC Code 80.
Specifically, in lieu of SIC Code 80 data,
BLS provided CMS data that are based
on the following three NAICS codes:
NAICS Code 621 (Ambulatory health
care services), Code 622 (Hospitals), and
Code 623 (Nursing and residential care
facilities).
Under section 2104(b)(4) of the Act,
each State and the District of Columbia
is allotted a ‘‘proportion’’ of the total
amount available nationally for
allotment to the States. The term
‘‘proportion’’ is defined in section
2104(b)(4)(D)(i) of the Act and refers to
a State’s share of the total amount
available for allotment for any given
fiscal year. In order for the entire total
amount available to be allotted to the
States, the sum of the proportions for all
States must exactly equal one. Under
the statutory definition, a State’s
proportion for a fiscal year is equal to
the State’s allotment for the fiscal year
divided by the total amount available
nationally for allotment for the fiscal
year. In general, a State’s allotment for
a fiscal year is calculated by multiplying
the State’s proportion for the fiscal year
by the national total amount available
for allotment for that fiscal year in
accordance with the following formula:
SAi = Pi x AT
SAi = Allotment for a State or District
of Columbia for a fiscal year.
Pi = Proportion for a State or District of
Columbia for a fiscal year.
AT = Total amount available for
allotment to the 50 States and the
District of Columbia for the fiscal
year. For FY 2007, this is
$4,987,500,000.
In accordance with the statutory
formula for determining allotments, the
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State proportions are determined under
two steps, which are described below in
further detail.
Under the first step, each State’s
proportion is calculated by multiplying
the State’s Number of Children and the
State Cost Factor to determine a
‘‘product’’ for each State. The products
for all States are then summed. Finally,
the product for a State is divided by the
sum of the products for all States,
thereby yielding the State’s preadjusted
proportion.
Application of Floors and Ceiling
Under the second step, the
preadjusted proportions are subject to
the application of proportion floors,
ceiling, and a reconciliation process, as
appropriate. The SCHIP statute specifies
three proportion floors, or minimum
proportions, that apply in determining
States’ allotments. The first proportion
floor is equal to $2,000,000 divided by
the total of the amount available
nationally for the fiscal year. This
proportion ensures that a State’s
minimum allotment would be
$2,000,000. For FY 2007, no State’s
preadjusted proportion is below this
floor. The second proportion floor is
equal to 90 percent of the allotment
proportion for the State for the previous
fiscal year; that is, a State’s proportion
for a fiscal year must not be lower than
10 percent below the previous fiscal
year’s proportion. The third proportion
floor is equal to 70 percent of the
allotment proportion for the State for FY
1999; that is, the proportion for a fiscal
year must not be lower than 30 percent
below the FY 1999 proportion.
Each State’s allotment proportion for
a fiscal year is also limited by a
maximum ceiling amount, equal to 145
percent of the State’s proportion for FY
1999; that is, a State’s proportion for a
fiscal year must be no higher than 45
percent above the State’s proportion for
FY 1999. The floors and ceiling are
intended to minimize the fluctuation of
State allotments from year to year and
over the life of the program as compared
to FY 1999. The floors and ceiling on
proportions are not applicable in
determining the allotments of the U.S.
Territories and Commonwealths; they
receive a fixed percentage specified in
the statute of the total allotment
available to the U.S. Territories and
Commonwealths.
As determined under the first step for
determining the States’ preadjusted
proportions, which is applied before the
application of any floors or ceiling, the
sum of the proportions for all the States
and the District of Columbia will be
equal to exactly one. However, the
application of the floors and ceiling
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under the second step may change the
proportions for certain States; that is,
some States’ proportions may need to be
raised to the floors, while other States’
proportions may need to be lowered to
the maximum ceiling. If this occurs, the
sum of the proportions for all States and
the District of Columbia may not exactly
equal one. In that case, the statute
requires the proportions to be adjusted,
under a method that is determined by
whether the sum of the proportions is
greater or less than one.
The sum of the proportions would be
greater than one if the application of the
floors and ceiling resulted in raising the
proportions of some States (due to the
application of the floors) to a greater
degree than the proportions of other
States were lowered (due to the
application of the ceiling). If, after
application of the floors and ceiling, the
sum of the proportions is greater than
one, the statute requires the Secretary to
determine a maximum percentage
increase limit, which, when applied to
the State proportions, would result in
the sum of the proportions being exactly
one.
If, after the application of the floors
and ceiling, the sum of the proportions
is less than one, the statute requires the
States’ proportions to be increased in a
‘‘pro rata’’ manner so that the sum of the
proportions again equals one. Finally, it
is also possible, although unlikely, that
the sum of the proportions (after the
application of the floors and ceiling)
will be exactly one; in that case, the
proportions would require no further
adjustment.
Determination of Preadjusted
Proportions
The following is an explanation of
how we applied the two State-related
factors specified in the statute to
determine the States’ ‘‘preadjusted’’
proportions for FY 2007. The term
‘‘preadjusted,’’ as used here, refers to
the States’’ proportions before the
application of the floors and ceiling and
adjustments, as specified in the SCHIP
statute. The determination of each State
and the District of Columbia’s
preadjusted proportion for FY 2007 is in
accordance with the following formula:
PPi = (Ci × SCFi)/ Σ (Ci x SCFi)
PPi = Preadjusted proportion for a State
or District of Columbia for a fiscal
year.
Ci = Number of children in a State
(section 2104(b)(1)(A)(i) of the Act)
for a fiscal year. This number is
based on the number of low-income
children for a State for a fiscal year
and the number of low-income
uninsured children for a State for a
fiscal year determined on the basis
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of the arithmetic average of the
number of such children as
reported and defined in the three
most recent March supplements to
the CPS of the Bureau of the
Census, officially available before
the beginning of the calendar year
in which the fiscal year begins. (See
section 2104(b)(2)(B) of the Act.)
For fiscal year 2007, the number of
children is equal to the sum of 50
percent of the number of low-income
uninsured children in the State for the
fiscal year and 50 percent of the number
of low-income children in the State for
the fiscal year. (See section
2104(b)(2)(A)(iii) of the Act.)
SCFi = State Cost Factor for a State
(section 2104(b)(1)(A)(ii) of the
Act). For a fiscal year, this is equal
to: 0.15 + 0.85 × (Wi/WN)
Wi = The annual average wages per
employee for a State for such year
(section 2104(b)(3)(A)(ii)(I) of the
Act).
WN = The annual average wages per
employee for the 50 States and the
District of Columbia (section
2104(b)(3)(A)(ii)(II) of the Act).
The annual average wages per employee
for a State or for all States and the
District of Columbia for a fiscal year is
equal to the average of such wages for
employees in the health services
industry, as reported and determined as
final by the BLS of the Department of
Labor for each of the most recent 3 years
officially available before the beginning
of the calendar year in which the fiscal
year begins. (See section 2104(b)(3)(B) of
the Act).
S (Ci × SCFi) = The sum of the products
of (Ci × SCFi) for each State (section
2104(b)(1)(B) of the Act).
The resulting proportions would then
be subject to the application of the
floors and ceiling specified in the SCHIP
statute and reconciled, as necessary, to
eliminate any deficit or surplus of the
allotments because the sum of the
proportions was either greater than or
less than one.
Section 2104(e) of the Act requires
that the amounts allotted to a State for
a fiscal year be available to the State for
a total of 3 years; the fiscal year for
which the amounts are allotted, and the
2 following fiscal years.
III. Table of State Children’s Health
Insurance Program Final Allotments for
FY 2007
Key to Table
Column/Description
Column A = State. Name of State,
District of Columbia, U.S.
Commonwealth or Territory.
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Column B = Number of Children. The
number of children for each State
(provided in thousands) was determined
and provided by the Bureau of the
Census based on the arithmetic average
of the number of low-income children
and low-income uninsured children,
and is based on the three most recent
March supplements to the CPS of the
Bureau of the Census officially available
before the beginning of the calendar
year in which the fiscal year begins. The
FY 2007 allotments were based on the
2003, 2004, and 2005 March
supplements to the CPS. These data
represent the number of people in each
State under 19 years of age whose
family income is at or below 200
percent of the poverty threshold
appropriate for that family, and who are
reported to be without health insurance
coverage. The number of children for
each State was developed by the Bureau
of the Census based on the standard
methodology used to determine official
poverty status and uninsured status in
its annual March CPS on these topics.
For FY 2007, the number of children
is equal to the sum of 50 percent of the
number of low-income uninsured
children in the State and 50 percent of
the number of low-income children in
the State.
Column C = State Cost Factor. The
State cost factor for a State is equal to
the sum of: 0.15, and 0.85 multiplied by
the ratio of the annual average wages in
the health industry per employee for the
State to the annual wages per employee
in the health industry for the 50 States
and the District of Columbia. The State
cost factor for each State was calculated
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based on such wage data for each State
as reported and determined as final by
the BLS in the Department of Labor for
each of the most recent 3 years and
available before the beginning of the
calendar year in which the fiscal year
begins. The FY 2007 allotments were
based on final BLS wage data for 2002,
2003, and 2004.
Column D = Product. The Product for
each State was calculated by
multiplying the Number of Children in
Column B by the State Cost Factor in
Column C. The sum of the Products for
all 50 States and the District of
Columbia is below the Products for each
State in Column D. The Product for each
State and the sum of the Products for all
States provides the basis for allotment to
States and the District of Columbia.
Column E = Proportion of Total. This
is the calculated percentage share for
each State of the total allotment
available to the 50 States and the
District of Columbia. The Percent Share
of Total is calculated as the ratio of the
Product for each State in Column D to
the sum of the Products for all 50 States
and the District of Columbia below the
Products for each State in Column D.
Column F = Adjusted Proportion of
Total. This is the calculated percentage
share for each State of the total
allotment available after the application
of the floors and ceiling and after any
further reconciliation needed to ensure
that the sum of the State proportions is
equal to one. The three floors specified
in the statute are: (1) The percentage
calculated by dividing $2,000,000 by the
total of the amount available for all
allotments for the fiscal year; (2) an
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annual floor of 90 percent of (that is, 10
percent below) the preceding fiscal
year’s allotment proportion; and (3) a
cumulative floor of 70 percent of (that
is, 30 percent below) the FY 1999
allotment proportion. There is also a
cumulative ceiling of 145 percent of
(that is, 45 percent above) the FY 1999
allotment proportion.
Column G = Allotment. This is the
SCHIP allotment for each State,
Commonwealth, or Territory for the
fiscal year. For each of the 50 States and
the District of Columbia, this is
determined as the Adjusted Proportion
of Total in Column F for the State
multiplied by the total amount available
for allotment for the 50 States and the
District of Columbia for the fiscal year.
For each of the U.S. Territory and
Commonwealths, the allotment is
determined as the Proportion of Total in
Column E multiplied by the total
amount available for allotment to the
U.S. Territories and Commonwealths.
For the U.S. Territories and
Commonwealths, the Proportion of
Total in Column E is specified in
section 2104(c) of the Act. The total
amount is then allotted to the U.S.
Territories and Commonwealths
according to the percentages specified
in section 2104 of the Act. There is no
adjustment made to the allotments of
the U.S. Territories and
Commonwealths as they are not subject
to the application of the floors and
ceiling. As a result, Column F in the
table, the Adjusted Proportion of Total,
is empty for the U.S. Territories and
Commonwealths.
BILLING CODE 4120–01–P
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IV. Regulatory Impact Statement
We have examined the impacts of this
rule as required by Executive Order
12866 (September 1993, Regulatory
Planning and Review), the Regulatory
Flexibility Act (RFA) (September 19,
1980, Pub. L. 96–354), section 1102(b) of
the Social Security Act, the Unfunded
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Mandates Reform Act of 1995 (Pub. L.
104–4), and Executive Order 13132.
We have examined the impact of this
notice as required by Executive Order
12866. Executive Order 12866 directs
agencies to assess all costs and benefits
of available regulatory alternatives and,
when rules are necessary, to select
regulatory approaches that maximize
net benefits (including potential
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economic environments, public health
and safety, other advantages,
distributive impacts, and equity). We
believe that this notice is consistent
with the regulatory philosophy and
principles identified in the Executive
Order. The formula for the allotments is
specified in the statute. Since the
formula is specified in the statute, we
have no discretion in determining the
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Federal Register / Vol. 71, No. 145 / Friday, July 28, 2006 / Notices
allotments. This notice merely
announces the results of our application
of this formula, and therefore does not
reach the economic significance
threshold of $100 million in any one
year.
The RFA requires agencies to analyze
options for regulatory relief of small
businesses. For purposes of the RFA,
small entities include small businesses,
nonprofit organizations, and
government jurisdictions. Most
hospitals and most other providers and
suppliers are small entities, either by
nonprofit status or by having revenues
of $6 million to $29 million in any one
year. Individuals and States are not
included in the definition of a small
entity; therefore, this requirement does
not apply.
In addition, section 1102(b) of the Act
requires us to prepare a regulatory
impact analysis if a rule may have a
significant impact on the operations of
a substantial number of small rural
hospitals. This analysis must conform to
the provisions of section 604 of the
RFA. For purposes of section 1102(b) of
the Act, we define a small rural hospital
as a hospital that is located outside of
a Metropolitan Statistical Area and has
fewer than 100 beds.
The Unfunded Mandates Reform Act
of 1995 requires that agencies prepare
an assessment of anticipated costs and
benefits before publishing any notice
that may result in an annual
expenditure by State, local, and tribal
governments, in the aggregate, or by the
private sector, of $120 million or more
(adjusted each year for inflation) in any
one year. Since participation in the
SCHIP program on the part of States is
voluntary, any payments and
expenditures States make or incur on
behalf of the program that are not
reimbursed by the Federal government
are made voluntarily. This notice will
not create an unfunded mandate on
States, tribal, or local governments
because it merely notifies states of their
SCHIP allotment for FY 2006. Therefore,
we are not required to perform an
assessment of the costs and benefits of
this notice.
Low-income children will benefit
from payments under SCHIP through
increased opportunities for health
insurance coverage. We believe this
notice will have an overall positive
impact by informing States, the District
of Columbia, and U.S. Territories and
Commonwealths of the extent to which
they are permitted to expend funds
under their child health plans using
their FY 2007 allotments.
Under Executive Order 13132, we are
required to adhere to certain criteria
regarding Federalism. We have
VerDate Aug<31>2005
17:47 Jul 27, 2006
Jkt 208001
reviewed this notice and determined
that it does not significantly affect
States’ rights, roles, and responsibilities
because it does not set forth any new
policies.
For these reasons, we are not
preparing analyses for either the RFA or
section 1102(b) of the Act because we
have determined, and we certify, that
this notice will not have a significant
economic impact on a substantial
number of small entities or a significant
impact on the operations of a substantial
number of small rural hospitals.
In accordance with the provisions of
Executive Order 12866, this notice was
reviewed by the Office of Management
and Budget.
Authority: (Section 1102 of the Social
Security Act (42 U.S.C. 1302))
(Catalog of Federal Domestic Assistance
Program No. 93.767, State Children’s Health
Insurance Program)
Dated: May 17, 2006.
Mark B. McClellan,
Administrator, Centers for Medicare &
Medicaid Services.
Dated: May 25, 2006.
Michael O. Leavitt,
Secretary, Department of Health and Human
Services.
[FR Doc. E6–12031 Filed 7–27–06; 8:45 am]
BILLING CODE 4120–01–C
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
National Institutes of Health
Government-Owned Inventions;
Availability for Licensing
National Institutes of Health,
Public Health Service, HHS.
ACTION: Notice.
AGENCY:
SUMMARY: The inventions listed below
are owned by an agency of the U.S.
Government and are available for
licensing in the U.S. in accordance with
35 U.S.C. 207 to achieve expeditious
commercialization of results of
federally-funded research and
development. Foreign patent
applications are filed on selected
inventions to extend market coverage
for companies and may also be available
for licensing.
ADDRESSES: Licensing information and
copies of the U.S. patent applications
listed below may be obtained by writing
to the indicated licensing contact at the
Office of Technology Transfer, National
Institutes of Health, 6011 Executive
Boulevard, Suite 325, Rockville,
Maryland 20852–3804; telephone: 301–
496–7057; fax: 301–402–0220. A signed
PO 00000
Frm 00065
Fmt 4703
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42859
Confidential Disclosure Agreement will
be required to receive copies of the
patent applications.
On-Demand Protein Microarrays: In
Vitro Assembly of Protein Microarrays
Description of Technology: Protein
microarrays are becoming an
indispensable biomedical tool to
facilitate rapid high-throughput
detection of protein-protein, proteindrug and protein-DNA interactions for
large groups of proteins. The novel
Protein Microarray of this invention is
essentially a DNA microarray that
becomes a protein microarray on
demand and provides an efficient
systematic approach to the study of
protein interactions and drug target
identification and validation, thereby
speeding up the discovery process. The
technology allows a large number of
proteins to be synthesized and
immobilized at their individual site of
expression on an ordered array without
the need for protein purification. As a
result, proteins are ready for subsequent
use in binding studies and other
analysis.
The Protein Microarray is based on
high affinity and high specificity of the
protein-nucleic acid interaction of the
Tus protein and the Ter site of E. coli.
The DNA templates are arrayed on the
microarray to perform dual function: (1)
synthesizing the protein in situ (cell-free
protein synthesis) in the array and (2) at
the same time capturing the protein it
synthesizes by DNA-protein interaction.
This method utilizes an expression
vector containing a DNA sequence
which serves a dual purpose: (a)
encoding proteins of interest fused to
the Tus protein for in vitro synthesis of
the protein and (b) encoding the Ter
sequence, which captures the fusion
protein through the high affinity
interaction with the Tus protein.
Applications: (1) Simultaneous
analysis of interactions of many proteins
with other proteins, antibodies, nucleic
acids, lipids, drugs, etc, in a single
experiment; (2) Efficient discovery of
novel drugs and drug targets.
Development Status: The technology
is in early stages of development.
Inventors: Deb K. Chatterjee,
Kalavathy Sitaraman, James L. Hartley,
David J. Munroe, Cassio Baptista (NCI).
Patent Status: U.S. Patent Application
No. 11/252,735 filed 19 Oct 2005 (HHS
Reference No. E–244–2005/0-US–01).
Licensing Status: Available for nonexclusive and exclusive licensing.
Licensing Contact: Cristina
Thalhammer-Reyero, Ph.D., M.B.A.;
301–435–4507; thalhamc@mail.nih.gov.
Collaborative Research Opportunity:
The National Cancer Institute Protein
E:\FR\FM\28JYN1.SGM
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Agencies
[Federal Register Volume 71, Number 145 (Friday, July 28, 2006)]
[Notices]
[Pages 42854-42859]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: E6-12031]
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[CMS-2251-N]
RIN 0938-ZA17
State Children's Health Insurance Program; Final Allotments to
States, the District of Columbia, and U.S. Territories and
Commonwealths for Fiscal Year 2007
AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS.
ACTION: Notice.
-----------------------------------------------------------------------
SUMMARY: Title XXI of the Social Security Act (the Act) authorizes
payment of Federal matching funds to States, the District of Columbia,
and U.S. Territories and Commonwealths to initiate and expand health
insurance coverage to uninsured, low-income children under the State
Children's Health Insurance Program (SCHIP). This notice sets forth the
final allotments of Federal funding available to each State, the
District of Columbia, and each U.S. Territory and Commonwealth for
fiscal year 2007. States may implement SCHIP through a separate State
program under title XXI of the Act, an expansion of a State Medicaid
program under title XIX of the Act, or a combination of both.
EFFECTIVE DATE: This notice is effective on August 28, 2006. Final
allotments are available for expenditures after October 1, 2006.
FOR FURTHER INFORMATION CONTACT: Richard Strauss, (410) 786-2019.
SUPPLEMENTARY INFORMATION:
I. Purpose of This Notice
This notice sets forth the allotments available to each State, the
District of Columbia, and each U.S. Territory and Commonwealth for
fiscal year (FY) 2007 under title XXI of the Social Security Act (the
Act). Final allotments for a fiscal year are available to match
expenditures under an approved State child health plan for 3 fiscal
years, including the year for which the final allotment was provided.
The FY 2007 allotments will be available to States for FY 2007, and
unexpended amounts may be carried over to 2008 and 2009. Federal funds
appropriated for title XXI are limited, and the law specifies a formula
to divide the total annual appropriation into individual allotments
available for each State, the District of Columbia, and each U.S.
Territory and Commonwealth with an approved child health plan.
Section 2104(b) of the Act requires States, the District of
Columbia, and U.S. Territories and Commonwealths to have an approved
child health plan for the fiscal year in order for the Secretary to
provide an allotment for that fiscal year. All States, the District of
Columbia, and U.S. Territories and Commonwealths have approved plans
for FY 2007. Therefore, the FY 2007 allotments contained in this notice
pertain to all States, the District of Columbia, and U.S. Territories
and Commonwealths.
II. Methodology for Determining Final Allotments for States, the
District of Columbia, and U.S. Territories and Commonwealths
This notice specifies, in the table under section III, the final FY
2007 allotments available to individual States, the District of
Columbia, and U.S. Territories and Commonwealths for either child
health assistance expenditures under approved State child health plans
or for claiming an enhanced Federal medical assistance percentage rate
for certain SCHIP-related Medicaid expenditures. As discussed below,
the FY 2007 final allotments have been calculated to reflect the
methodology for determining an allotment amount for each State, the
District of Columbia, and each U.S. Territory and Commonwealth as
prescribed by section 2104(b) of the Act.
Section 2104(a) of the Act provides that, for purposes of providing
allotments to the 50 States and the District of Columbia, the following
amounts are appropriated: $4,295,000,000 for FY 1998; $4,275,000,000
for each FY 1999 through FY 2001; $3,150,000,000 for each FY 2002
through FY 2004; $4,050,000,000 for each FY 2005 through FY 2006; and
$5,000,000,000 for FY 2007. However, under section 2104(c) of the Act,
0.25 percent of the total amount appropriated each year is available
for allotment to the U.S. Territories and Commonwealths of Puerto Rico,
Guam, the Virgin Islands, American Samoa, and the Northern Mariana
Islands. The total amounts are allotted to the U.S. Territories and
Commonwealths according to the following percentages: Puerto Rico, 91.6
percent; Guam, 3.5 percent; the Virgin Islands, 2.6 percent; American
Samoa, 1.2 percent; and the Northern Mariana Islands, 1.1 percent.
Section 2104(c)(4)(B) of the Act provides for additional amounts
for allotment to the Territories and Commonwealths: $34,200,000 for
each FY 2000 through FY 2001; $25,200,000 for each FY 2002 through FY
2004; $32,400,000 for each FY 2005 through FY 2006; and $40,000,000 for
FY 2007. Since, for FY 2007, title XXI of the Act provides an
additional $40,000,000 for allotment to the U.S. Territories and
Commonwealths, the total amount available for allotment to the U.S.
Territories and Commonwealths in FY 2007 is $52,500,000; that is,
$40,000,000 plus $12,500,000 (0.25 percent of the FY 2007 appropriation
of $5,000,000,000).
Therefore, the total amount available nationally for allotment for
the 50 States and the District of Columbia for FY 2007 was determined
in accordance with the following formula:
AT = S2104(a)--T2104(c)
AT = Total amount available for allotment to the 50 States
and the District of Columbia for the fiscal year.
S2104(a) = Total appropriation for the fiscal year indicated
in section 2104(a) of the Act. For FY 2007, this is $5,000,000,000.
T2104(c) = Total amount available for allotment for the U.S.
Territories and Commonwealths; determined under section 2104(c) of the
Act as 0.25 percent of the total appropriation for the 50 States and
the District of Columbia. For FY 2007, this is: .0025 x $5,000,000,000
= $12,500,000.
Therefore, for FY 2007, the total amount available for allotment to the
50 States and the District of Columbia is $4,987,500,000. This was
determined as follows: AT ($4,987,500,000) =
S2104(a) ($5,000,000,000)--T2104(c)
($12,500,000).
For purposes of the following discussion, the term ``State,'' as
defined in section 2104(b)(1)(D)(ii) of the Act,
[[Page 42855]]
``means one of the 50 States or the District of Columbia.''
Under section 2104(b) of the Act, the determination of the number
of children applied in determining the SCHIP allotment for a particular
fiscal year is based on the three most recent March supplements to the
Current Population Survey (CPS) of the Bureau of the Census officially
available before the beginning of the calendar year in which the fiscal
year begins. The determination of the State cost factor is based on the
annual average wages per employee in the health services industry,
which is determined using the most recent 3 years of such wage data as
reported and determined as final by the Bureau of Labor Statistics
(BLS) of the Department of Labor to be officially available before the
beginning of the calendar year in which the fiscal year begins. Since
FY 2007 begins on October 1, 2006 (that is, in calendar year 2006), in
determining the FY 2007 SCHIP allotments, we are using the most recent
official data from the Bureau of the Census and the BLS, respectively,
available before January 1 of calendar year 2006 (that is, through the
end of December 31, 2005).
Number of Children
For FY 2007, as specified by section 2104(b)(2)(A)(iii) of the Act,
the number of children is calculated as the sum of 50 percent of the
number of low-income, uninsured children in the State, and 50 percent
of the number of low-income children in the State. The number of
children factor for each State is developed from data provided by the
Bureau of the Census based on the standard methodology used to
determine official poverty status and uninsured status in the annual
CPS on these topics. As part of a continuing formal process between the
Centers for Medicare & Medicaid Services (CMS) and the Bureau of the
Census, each fiscal year we obtain the number of children data
officially from the Bureau of the Census.
Under section 2104(b)(2)(B) of the Act, the number of children for
each State (provided in thousands) was determined and provided by the
Bureau of the Census based on the arithmetic average of the number of
low-income children and low-income children with no health insurance as
calculated from the three most recent March supplements to the CPS
officially available from the Bureau of the Census before the beginning
of the 2006 calendar year. In particular, through December 31, 2005,
the most recent official data available from the Bureau of the Census
on the numbers of children were data from the three March CPSs
conducted in March 2003, 2004, and 2005 (representing data for years
2002, 2003, and 2004).
State Cost Factor
The State cost factor is based on annual average wages in the
health services industry in the State. The State cost factor for a
State is equal to the sum of: 0.15 and 0.85 multiplied by the ratio of
the annual average wages in the health industry per employee for the
State to the annual wages per employee in the health industry for the
50 States and the District of Columbia.
Under section 2104(b)(3)(B) of the Act, as amended by the Balanced
Budget Refinement Act of 1999 (BBRA) Public Law 106-113, enacted on
November 29, 1999, the State cost factor for each State for a fiscal
year is calculated based on the average of the annual wages for
employees in the health industry for each State using data for each of
the most recent 3 years as reported and determined as final by the BLS
in the Department of Labor and available before the beginning of the
calendar year in which the fiscal year begins. Therefore, the State
cost factor for FY 2007 is based on the most recent 3 years of BLS data
officially available as final before January 1, 2006 (the beginning of
the calendar year in which FY 2007 begins); that is, it is based on the
BLS data available as final through December 31, 2005. In accordance
with these requirements, we used the final State cost factor data
available from BLS for 2002, 2003, and 2004 in calculating the FY 2007
final allotments.
The State cost factor is determined based on the calculation of the
ratio of each State's average annual wages in the health industry to
the national average annual wages in the health care industry. Since
BLS is required to suppress certain State-specific data in providing us
with the State-specific average wages per health services industry
employee due to the Privacy Act, we calculated the national average
wages directly from the State-specific data provided by BLS. As part of
a continuing formal process between CMS and the BLS, each fiscal year
CMS obtains these wage data officially from the BLS.
Section 2104(b)(3)(B) of the Act, as amended by the BBRA, refers to
wage data as reported by BLS under the ``Standard Industrial
Classification'' (SIC) system. However, in calendar year 2002, BLS
phased-out the SIC wage and employment reporting system and replaced it
with the ``North American Industry Classification System'' (NAICS). In
accordance with section 2104(b)(3)(B) of the Act, for purposes of
calculating the FY 2007 allotments, BLS provided wage data for the 3
most recent years as available through December 31, 2005; in this case,
the 3 years of wage data are 2002, 2003, and 2004. Because of the wage
and employment classification change at BLS, the BLS wage data used in
calculating the FY 2007 SCHIP allotments necessarily reflect NAICS
data, rather than SIC data, to obtain the 3-year average required for
the allotments.
Under the SIC system, BLS provided CMS with wage data for each
State under the SIC Code. However, the wage data codes under the SIC
system do not map exactly to the wage data codes under the NAICS. As a
result, BLS provided us with wage data using three NAICS wage data
codes that represent approximately 98 percent of the wage data that
would have been provided under the related SIC Code 80. Specifically,
in lieu of SIC Code 80 data, BLS provided CMS data that are based on
the following three NAICS codes: NAICS Code 621 (Ambulatory health care
services), Code 622 (Hospitals), and Code 623 (Nursing and residential
care facilities).
Under section 2104(b)(4) of the Act, each State and the District of
Columbia is allotted a ``proportion'' of the total amount available
nationally for allotment to the States. The term ``proportion'' is
defined in section 2104(b)(4)(D)(i) of the Act and refers to a State's
share of the total amount available for allotment for any given fiscal
year. In order for the entire total amount available to be allotted to
the States, the sum of the proportions for all States must exactly
equal one. Under the statutory definition, a State's proportion for a
fiscal year is equal to the State's allotment for the fiscal year
divided by the total amount available nationally for allotment for the
fiscal year. In general, a State's allotment for a fiscal year is
calculated by multiplying the State's proportion for the fiscal year by
the national total amount available for allotment for that fiscal year
in accordance with the following formula:
SAi = Pi x AT
SAi = Allotment for a State or District of Columbia for a
fiscal year.
Pi = Proportion for a State or District of Columbia for a
fiscal year.
AT = Total amount available for allotment to the 50 States
and the District of Columbia for the fiscal year. For FY 2007, this is
$4,987,500,000.
In accordance with the statutory formula for determining
allotments, the
[[Page 42856]]
State proportions are determined under two steps, which are described
below in further detail.
Under the first step, each State's proportion is calculated by
multiplying the State's Number of Children and the State Cost Factor to
determine a ``product'' for each State. The products for all States are
then summed. Finally, the product for a State is divided by the sum of
the products for all States, thereby yielding the State's preadjusted
proportion.
Application of Floors and Ceiling
Under the second step, the preadjusted proportions are subject to
the application of proportion floors, ceiling, and a reconciliation
process, as appropriate. The SCHIP statute specifies three proportion
floors, or minimum proportions, that apply in determining States'
allotments. The first proportion floor is equal to $2,000,000 divided
by the total of the amount available nationally for the fiscal year.
This proportion ensures that a State's minimum allotment would be
$2,000,000. For FY 2007, no State's preadjusted proportion is below
this floor. The second proportion floor is equal to 90 percent of the
allotment proportion for the State for the previous fiscal year; that
is, a State's proportion for a fiscal year must not be lower than 10
percent below the previous fiscal year's proportion. The third
proportion floor is equal to 70 percent of the allotment proportion for
the State for FY 1999; that is, the proportion for a fiscal year must
not be lower than 30 percent below the FY 1999 proportion.
Each State's allotment proportion for a fiscal year is also limited
by a maximum ceiling amount, equal to 145 percent of the State's
proportion for FY 1999; that is, a State's proportion for a fiscal year
must be no higher than 45 percent above the State's proportion for FY
1999. The floors and ceiling are intended to minimize the fluctuation
of State allotments from year to year and over the life of the program
as compared to FY 1999. The floors and ceiling on proportions are not
applicable in determining the allotments of the U.S. Territories and
Commonwealths; they receive a fixed percentage specified in the statute
of the total allotment available to the U.S. Territories and
Commonwealths.
As determined under the first step for determining the States'
preadjusted proportions, which is applied before the application of any
floors or ceiling, the sum of the proportions for all the States and
the District of Columbia will be equal to exactly one. However, the
application of the floors and ceiling under the second step may change
the proportions for certain States; that is, some States' proportions
may need to be raised to the floors, while other States' proportions
may need to be lowered to the maximum ceiling. If this occurs, the sum
of the proportions for all States and the District of Columbia may not
exactly equal one. In that case, the statute requires the proportions
to be adjusted, under a method that is determined by whether the sum of
the proportions is greater or less than one.
The sum of the proportions would be greater than one if the
application of the floors and ceiling resulted in raising the
proportions of some States (due to the application of the floors) to a
greater degree than the proportions of other States were lowered (due
to the application of the ceiling). If, after application of the floors
and ceiling, the sum of the proportions is greater than one, the
statute requires the Secretary to determine a maximum percentage
increase limit, which, when applied to the State proportions, would
result in the sum of the proportions being exactly one.
If, after the application of the floors and ceiling, the sum of the
proportions is less than one, the statute requires the States'
proportions to be increased in a ``pro rata'' manner so that the sum of
the proportions again equals one. Finally, it is also possible,
although unlikely, that the sum of the proportions (after the
application of the floors and ceiling) will be exactly one; in that
case, the proportions would require no further adjustment.
Determination of Preadjusted Proportions
The following is an explanation of how we applied the two State-
related factors specified in the statute to determine the States'
``preadjusted'' proportions for FY 2007. The term ``preadjusted,'' as
used here, refers to the States'' proportions before the application of
the floors and ceiling and adjustments, as specified in the SCHIP
statute. The determination of each State and the District of Columbia's
preadjusted proportion for FY 2007 is in accordance with the following
formula:
PPi = (Ci x SCFi)/ [Sigma]
(Ci x SCFi)
PPi = Preadjusted proportion for a State or District of
Columbia for a fiscal year.
Ci = Number of children in a State (section 2104(b)(1)(A)(i)
of the Act) for a fiscal year. This number is based on the number of
low-income children for a State for a fiscal year and the number of
low-income uninsured children for a State for a fiscal year determined
on the basis of the arithmetic average of the number of such children
as reported and defined in the three most recent March supplements to
the CPS of the Bureau of the Census, officially available before the
beginning of the calendar year in which the fiscal year begins. (See
section 2104(b)(2)(B) of the Act.)
For fiscal year 2007, the number of children is equal to the sum of
50 percent of the number of low-income uninsured children in the State
for the fiscal year and 50 percent of the number of low-income children
in the State for the fiscal year. (See section 2104(b)(2)(A)(iii) of
the Act.)
SCFi = State Cost Factor for a State (section
2104(b)(1)(A)(ii) of the Act). For a fiscal year, this is equal to:
0.15 + 0.85 x (Wi/WN)
Wi = The annual average wages per employee for a State for
such year (section 2104(b)(3)(A)(ii)(I) of the Act).
WN = The annual average wages per employee for the 50 States
and the District of Columbia (section 2104(b)(3)(A)(ii)(II) of the
Act).
The annual average wages per employee for a State or for all States and
the District of Columbia for a fiscal year is equal to the average of
such wages for employees in the health services industry, as reported
and determined as final by the BLS of the Department of Labor for each
of the most recent 3 years officially available before the beginning of
the calendar year in which the fiscal year begins. (See section
2104(b)(3)(B) of the Act).
[Sigma] (Ci x SCFi) = The sum of the products of
(Ci x SCFi) for each State (section 2104(b)(1)(B)
of the Act).
The resulting proportions would then be subject to the application
of the floors and ceiling specified in the SCHIP statute and
reconciled, as necessary, to eliminate any deficit or surplus of the
allotments because the sum of the proportions was either greater than
or less than one.
Section 2104(e) of the Act requires that the amounts allotted to a
State for a fiscal year be available to the State for a total of 3
years; the fiscal year for which the amounts are allotted, and the 2
following fiscal years.
III. Table of State Children's Health Insurance Program Final
Allotments for FY 2007
Key to Table
Column/Description
Column A = State. Name of State, District of Columbia, U.S.
Commonwealth or Territory.
[[Page 42857]]
Column B = Number of Children. The number of children for each
State (provided in thousands) was determined and provided by the Bureau
of the Census based on the arithmetic average of the number of low-
income children and low-income uninsured children, and is based on the
three most recent March supplements to the CPS of the Bureau of the
Census officially available before the beginning of the calendar year
in which the fiscal year begins. The FY 2007 allotments were based on
the 2003, 2004, and 2005 March supplements to the CPS. These data
represent the number of people in each State under 19 years of age
whose family income is at or below 200 percent of the poverty threshold
appropriate for that family, and who are reported to be without health
insurance coverage. The number of children for each State was developed
by the Bureau of the Census based on the standard methodology used to
determine official poverty status and uninsured status in its annual
March CPS on these topics.
For FY 2007, the number of children is equal to the sum of 50
percent of the number of low-income uninsured children in the State and
50 percent of the number of low-income children in the State.
Column C = State Cost Factor. The State cost factor for a State is
equal to the sum of: 0.15, and 0.85 multiplied by the ratio of the
annual average wages in the health industry per employee for the State
to the annual wages per employee in the health industry for the 50
States and the District of Columbia. The State cost factor for each
State was calculated based on such wage data for each State as reported
and determined as final by the BLS in the Department of Labor for each
of the most recent 3 years and available before the beginning of the
calendar year in which the fiscal year begins. The FY 2007 allotments
were based on final BLS wage data for 2002, 2003, and 2004.
Column D = Product. The Product for each State was calculated by
multiplying the Number of Children in Column B by the State Cost Factor
in Column C. The sum of the Products for all 50 States and the District
of Columbia is below the Products for each State in Column D. The
Product for each State and the sum of the Products for all States
provides the basis for allotment to States and the District of
Columbia.
Column E = Proportion of Total. This is the calculated percentage
share for each State of the total allotment available to the 50 States
and the District of Columbia. The Percent Share of Total is calculated
as the ratio of the Product for each State in Column D to the sum of
the Products for all 50 States and the District of Columbia below the
Products for each State in Column D.
Column F = Adjusted Proportion of Total. This is the calculated
percentage share for each State of the total allotment available after
the application of the floors and ceiling and after any further
reconciliation needed to ensure that the sum of the State proportions
is equal to one. The three floors specified in the statute are: (1) The
percentage calculated by dividing $2,000,000 by the total of the amount
available for all allotments for the fiscal year; (2) an annual floor
of 90 percent of (that is, 10 percent below) the preceding fiscal
year's allotment proportion; and (3) a cumulative floor of 70 percent
of (that is, 30 percent below) the FY 1999 allotment proportion. There
is also a cumulative ceiling of 145 percent of (that is, 45 percent
above) the FY 1999 allotment proportion.
Column G = Allotment. This is the SCHIP allotment for each State,
Commonwealth, or Territory for the fiscal year. For each of the 50
States and the District of Columbia, this is determined as the Adjusted
Proportion of Total in Column F for the State multiplied by the total
amount available for allotment for the 50 States and the District of
Columbia for the fiscal year.
For each of the U.S. Territory and Commonwealths, the allotment is
determined as the Proportion of Total in Column E multiplied by the
total amount available for allotment to the U.S. Territories and
Commonwealths. For the U.S. Territories and Commonwealths, the
Proportion of Total in Column E is specified in section 2104(c) of the
Act. The total amount is then allotted to the U.S. Territories and
Commonwealths according to the percentages specified in section 2104 of
the Act. There is no adjustment made to the allotments of the U.S.
Territories and Commonwealths as they are not subject to the
application of the floors and ceiling. As a result, Column F in the
table, the Adjusted Proportion of Total, is empty for the U.S.
Territories and Commonwealths.
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[GRAPHIC] [TIFF OMITTED] TN28JY06.017
IV. Regulatory Impact Statement
We have examined the impacts of this rule as required by Executive
Order 12866 (September 1993, Regulatory Planning and Review), the
Regulatory Flexibility Act (RFA) (September 19, 1980, Pub. L. 96-354),
section 1102(b) of the Social Security Act, the Unfunded Mandates
Reform Act of 1995 (Pub. L. 104-4), and Executive Order 13132.
We have examined the impact of this notice as required by Executive
Order 12866. Executive Order 12866 directs agencies to assess all costs
and benefits of available regulatory alternatives and, when rules are
necessary, to select regulatory approaches that maximize net benefits
(including potential economic environments, public health and safety,
other advantages, distributive impacts, and equity). We believe that
this notice is consistent with the regulatory philosophy and principles
identified in the Executive Order. The formula for the allotments is
specified in the statute. Since the formula is specified in the
statute, we have no discretion in determining the
[[Page 42859]]
allotments. This notice merely announces the results of our application
of this formula, and therefore does not reach the economic significance
threshold of $100 million in any one year.
The RFA requires agencies to analyze options for regulatory relief
of small businesses. For purposes of the RFA, small entities include
small businesses, nonprofit organizations, and government
jurisdictions. Most hospitals and most other providers and suppliers
are small entities, either by nonprofit status or by having revenues of
$6 million to $29 million in any one year. Individuals and States are
not included in the definition of a small entity; therefore, this
requirement does not apply.
In addition, section 1102(b) of the Act requires us to prepare a
regulatory impact analysis if a rule may have a significant impact on
the operations of a substantial number of small rural hospitals. This
analysis must conform to the provisions of section 604 of the RFA. For
purposes of section 1102(b) of the Act, we define a small rural
hospital as a hospital that is located outside of a Metropolitan
Statistical Area and has fewer than 100 beds.
The Unfunded Mandates Reform Act of 1995 requires that agencies
prepare an assessment of anticipated costs and benefits before
publishing any notice that may result in an annual expenditure by
State, local, and tribal governments, in the aggregate, or by the
private sector, of $120 million or more (adjusted each year for
inflation) in any one year. Since participation in the SCHIP program on
the part of States is voluntary, any payments and expenditures States
make or incur on behalf of the program that are not reimbursed by the
Federal government are made voluntarily. This notice will not create an
unfunded mandate on States, tribal, or local governments because it
merely notifies states of their SCHIP allotment for FY 2006. Therefore,
we are not required to perform an assessment of the costs and benefits
of this notice.
Low-income children will benefit from payments under SCHIP through
increased opportunities for health insurance coverage. We believe this
notice will have an overall positive impact by informing States, the
District of Columbia, and U.S. Territories and Commonwealths of the
extent to which they are permitted to expend funds under their child
health plans using their FY 2007 allotments.
Under Executive Order 13132, we are required to adhere to certain
criteria regarding Federalism. We have reviewed this notice and
determined that it does not significantly affect States' rights, roles,
and responsibilities because it does not set forth any new policies.
For these reasons, we are not preparing analyses for either the RFA
or section 1102(b) of the Act because we have determined, and we
certify, that this notice will not have a significant economic impact
on a substantial number of small entities or a significant impact on
the operations of a substantial number of small rural hospitals.
In accordance with the provisions of Executive Order 12866, this
notice was reviewed by the Office of Management and Budget.
Authority: (Section 1102 of the Social Security Act (42 U.S.C.
1302))
(Catalog of Federal Domestic Assistance Program No. 93.767, State
Children's Health Insurance Program)
Dated: May 17, 2006.
Mark B. McClellan,
Administrator, Centers for Medicare & Medicaid Services.
Dated: May 25, 2006.
Michael O. Leavitt,
Secretary, Department of Health and Human Services.
[FR Doc. E6-12031 Filed 7-27-06; 8:45 am]
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