Health systems agencies and state health planning and development agencies; certificate of need reviews--Health Resources and Services Administration. Notice regarding adjustment of the expenditure minimum for capital expenditures and the expenditure minimum for annual operating costs

This notice provides necessary information for each State which chooses to adjust the capital expenditure and annual operating cost expenditure minimums that are used to determine whether proposals are subject to review under a State's certificate of need program. The notice also provides guidance to assist a State Health Planning and Development Agency (State Agency) in determining the exact minimum dollar figure it will use and in seeking further information.     

Health systems agencies and state health planning and development agencies; certificate of need reviews: Health Resources Administration. Notice regarding adjustment of the expenditure minimum for capital expenditures and the expenditure minimum for annual operating costs

This notice provides necessary information for each State which chooses to adjust the capital expenditure and annual operating cost expenditure minimums that are used to determine whether proposals are subject to review under a State's certificate of need program. The notice also provides guidance to assist a State Health Planning and Development Agency (State Agency) in determining the exact minimum dollar figure it will use and in seeking further information.     

Health systems agencies and state health planning development agencies; certificate of need reviews--HRSA. Notice regarding adjustment of the expenditure minimum for annual operating costs

This notice provides necessary information for each State which chooses to adjust the capital expenditure and annual operating cost expenditure minimums that are used to determine whether proposals are subject to review under a State's certificate of need program. The notice also provides guidance to assist a State Health Planning and Development Agency (State Agency) in determining the exact minimum dollar figure it will use and in seeking further information.     

Grants to state health planning and development agencies determination of population of the states--Health Resources and Services Administration

This notice provides the population figures the Department will use when it determines the amount of grants to State Health Planning and Development Agencies (State Agencies).     

Social Security Amendments of 1983--Public Health Service. Notice of changes in the review thresholds under Section 1122

This notice provides information on the Social Security Amendments of 1983 (Pub. L. 98-21) which were effective upon enactment on April 20, 1983. Under Section 1122 of the Social Security Act, the expenditure threshold for reviews of capital expenditures is changed from $100,000 to $600,000 and an exemption from review is provided for HMOs (and similar entities) if certain conditions are met. In addition, the amendments require all hospitals participating in the Medicare program to provide their overall 3-year capital expenditure plans to the designated planning agency or other appropriate health planning agency in the State.     

Medicaid program; deadline for submitting moratorium state plan amendments--HCFA. Notice

This notice announces the deadline for Medicaid State agencies to submit State plan amendments requesting moratorium protection under section 2373(c) of the Deficit Reduction Act of 1984, as amended by the Medicare and Medicaid Patient and Program Protection Act of 1987. Section 2373(c) initiated a moratorium period during which HCFA cannot take any compliance, disallowance, penalty or other regulatory action against a State agency whose State plan contains an income or resource methodology or standard for determining eligibility for medically needy and certain categorically needy groups that is less restrictive than the required standard or methodology. This notice provides formal notification to States that plan amendments requesting moratorium protection will not be accepted after the last day of the first full calendar quarter following publication of this notice in the Federal Register.     

Notification procedures for states implementing "alternative mechanisms" in the individual health insurance market--HCFA. Notice

This notice generally describes the statutory provisions under section 111 of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) that guarantee availability of individual health insurance coverage to certain individuals with prior group coverage. It also provides procedural guidance for States that intend to implement an alternative mechanism under section 111 of HIPAA. Finally, this notice describes the statutory provisions that will apply in a State that does not implement an acceptable alternative mechanism. This notice does not establish new policy or requirements.     

Medicare and Medicaid programs; mandatory use, collection, encoding, and transmission of Outcome and Assessment Information Set (OASIS) for home health agencies. Health Care Financing Administration (HCFA), HHS. Notice

This notice announces to home health agencies (HHAs), State survey agencies, Medicare and Medicaid beneficiaries, software vendors, and the general public changes to and effective dates for OASIS implementation. This notice announces the effective dates for the mandatory use, collection, encoding, and transmission of OASIS data for all Medicare/Medicaid patients receiving skilled services. For non-Medicare/non-Medicaid patients receiving skilled services, there will be no encoding and transmission until further notice, but HHAs must conduct comprehensive assessments and updates at the required time points. For patients receiving personal care only services, regardless of payor source, we are delaying the requirements regarding OASIS use, collection, encoding, and transmission until further notice. We expect to begin implementation of OASIS for non-Medicare/non-Medicaid patients receiving skilled care and for patients receiving personal care only services in the Spring of 2000. A separate Federal Register notice will be published with instructions at that time. In addition, software changes described at the end of this notice are of interest to software vendors and HHAs. Also, a companion notice concerning the OASIS System of Records (SOR) is published elsewhere in this Federal Register and is available via the HCFA Internet site (http://www.hcfa.gov).     

Grants to State Health Planning and Development Agencies--HRSA. Notice regarding grants to State Health Planning and Development Agencies--determination of population of the States

This notice provides the population figures the Department will use when it determines the amount of grants to State Health Planning and Development Agencies (States Agencies).     

Fiscal year 1993 state home per diem rates for domiciliary, nursing home, and hospital care--DVA. Notice of state home program per diem rates for FY 1993

Public Law 100-322, section 134(a)(2) provides for an increase in per diem rates for domiciliary, nursing home, and hospital care in State Veterans Homes. The VA is giving notice of increases for State home per diem for FY 1993 as follows: Domiciliary care--$11.79, nursing home care--$27.61, and hospital care--$27.61.     

Occupational exposure to bloodborne pathogens: request for information--OSHA. Request for information

OSHA requests information and comment on engineering and work practice controls used to eliminate or minimize the risk of exposure to bloodborne pathogens due to percutaneous injuries from contaminated needles and o ther contaminated sharps in occupational environments. Percutaneous injuries continue to be a concern in work settings where employees are exposed to bloodborne pathogens. The Agency is considering possible actions that it can undertake to assist in addressing this issue. Consequently, OSHA is interested in strategies for reducing percutaneous injury rates that have been successfully implemented in the work environment, including work practices and, in particular, the use of devices designed to limit the risk of such injuries. The information received in response to this notice will be carefully reviewed and will assist OSHA in determining effective approaches to reducing percutaneous injury rates and what role the Agency may have in these approaches.     

Approval of the Commission on Office Laboratory Accreditation for Immunohematology--HCFA. Notice

This notice announces the approval of the Commission on Office Laboratory Accreditation (COLA), which is an accrediting organization for clinical laboratories under the Clinical Laboratory Improvement Amendments (CLIA) program, for the addition of the full specialty of immunohematology. This approval adds immunohematology to the specialties and subspecialties approved by HCFA in a notice published in the Federal Register on December 23, 1993 (58 FR 68148). We have found that the accreditation process of this organization provides reasonable assurance that the laboratories accredited by it for immunohematology meet the conditions required by Federal law and regulations. Consequently, laboratories that voluntarily become accredited by COLA for the specialty of immunohematology in lieu of receiving direct Federal oversight and continue to meet COLA requirements would meet the CLIA immunohematology condition level requirements for laboratories. These laboratories performing immunohematology testing are not subject to routine inspection by State survey agencies to determine their compliance with applicable Federal requirements. They are, however, subject to validation and complaint investigation surveys.     

Designation of health services areas and health systems agency application information--HRSA. Notice designating health services areas in Ohio

This notice is issued to announce the establishment of ten health service areas for the State of Ohio and to provide information on the application procedures to become a federally designated and funded health systems agency.     

Protection of human subjects; reports of the President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research--Office of the Assistant Secretary for Health, HHS. Notice of availability of reports

This notice summarizes the reports of the President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research, provides information on how these reports may be obtained, and requests public comment on the reports. The following summaries are intended to highlight conclusions and recommendations and do not provide in themselves complete information. It is strongly suggested that interested persons obtain complete copies of reports in order to fully understand the context in which various conclusions and recommendations were made.     

Medicare program; coverage and payment of ambulance services; inflation update for CY 2004. Final rule with comment period

This final rule provides the sunset date for the interim bonus payment for rural ambulance mileage of 18 through 50 miles as required by the Medicare, Medicaid and State Child Health Insurance Program Benefits Improvement and Protection Act of 2000 (BIPA) and provides notice of the annual Ambulance Inflation Factor (AIF) for ambulance services for calendar year (CY) 2004. The statute requires that this inflation factor be applied in determining the fee schedule amounts and payment limits for ambulance services.     

Additional federal allotments to states for social services expenditures pursuant to the Title XX-Block Grants to States for Social Services--Office of Human Development Services, HHS

Section 2003 of the Social Security Act, as amended, authorizes $2.45 billion for allocation to the States for Social Services Block Grants--Fiscal Year 1983. Public Law 98-8, enacted March 245, 1983, appropriates an additional $225 million for Fiscal Year 1983. This notice contains State allotments and explanations of how the allotments were determined; conditions for receipt of these funds and other information.     

The electoral budget cycle on municipal police expenditure

This paper analyzes the effects of electoral cycles on municipal police expenditure. We use a database with information on Spanish municipalities with more than 20,000 inhabitants for the period 2001–2008. Our data show that incumbents increase police spending 1 year before the elections, thus we confirm an electoral budget cycle on police expenditure in Spain. We also find that conservative parties are associated with increased spending on public safety. Population has a positive and significant impact on police expenditures per capita, which indicates diseconomies of scale. The theory on sub-national government spending shows that intergovernmental transfers per capita and taxes per capita are believed to impact local expenditures. Our model fits this assumption, showing a significant and positive influence of both variables on police expenditures. Finally, our model reports a positive impact of both immigration and economic level on police spending.     

Designation of medically underserved populations and areas--HRSA. Notice

Under the provisions of section 330(b)(6) of the Public Health Service (PHS) Act, 42 U.S.C. 254c(b)(6), as amended by Pub. L. 99-280, the Governors of the States of Hawaii and Maine have asked the Secretary of Health and Human Services (HHS) to designate specific populations within their States as medically underserved populations (MUPs). Also, under section 330(b)(3) of the PHS Act, certain geographic areas in the States of Missouri, Nebraska, South Carolina, South Dakota, and Washington have been proposed for designation as medically underserved areas (MUAs). This notice provides an opportunity for State and local officials, State organizations representing Community Health Centers, and other interested parties in the above-mentioned States to provide recommendations and to comment on the proposals to designate as medically underserved the areas and populations described in this notice.     

Medicare and Medicaid programs; Medicare-Medicaid coverage data bank requirements: preliminary guidance--HCFA. Notice

This notice informs the public about section 1144 of the Social Security Act, which is self-implementing, and provides preliminary guidance to employers who are required to report information about all individuals covered by group health plans to a newly established Medicare-Medicaid Coverage Data Bank. Information in the data bank will be used to help identify situations where employer group health plans are responsible for making primary payments for services received by Medicare or Medicaid beneficiaries. This notice provides: information on the background and legislative authority for the data bank; definitions of key terms; reporting requirements; the identity of entities that are required to, or may, report; reporting dates; penalties for noncompliance; and methods of reporting.     

Child abuse and neglect prevention and treatment program--HHS. Notice of proposed rulemaking

This rule proposed changes in the regulations that implement the Child Abuse Prevention and Treatment Act. Recent amendments to this Act (Pub. L. 98-457) made changes in several definitions regarding child abuse and neglect which may require State regulatory changes. These and other proposed requirements are the subject of this notice. On December 10, 1984 (49 FR 48160), the Department published a notice of proposed rulemaking to implement the requirement for State child protective service agencies to establish programs and/or procedures for the protection and treatment of disabled infants with life-threatening conditions ("Baby Does"). These requirements were also a part of Pub. L. 98-457.