[Federal Register Volume 62, Number 153 (Friday, August 8, 1997)]
[Rules and Regulations]
[Pages 42860-42883]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 97-20775]
[[Page 42859]]
_______________________________________________________________________
Part II
Department of Health and Human Services
_______________________________________________________________________
Health Care Financing Administration
_______________________________________________________________________
42 CFR Part 418
Medicare Program; Hospice Wage Index; Final Rule
Federal Register / Vol. 62, No. 153 / Friday, August 8, 1997 / Rules
and Regulations
[[Page 42860]]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Health Care Financing Administration
42 CFR Part 418
[BPD-820-F]
RIN 0938-AG93
Medicare Program; Hospice Wage Index
AGENCY: Health Care Financing Administration (HCFA), HHS.
ACTION: Final rule.
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SUMMARY: This final rule establishes a methodology to update the wage
index used to adjust Medicare payment rates for hospice care. It also
includes the new wage index, to be effective October 1, 1997. The wage
index is used to reflect local differences in wage levels. A new wage
index is needed because the index currently applied is based on 1981
wage and employment data and has not been updated since 1983. The
methodology is based on the recommendations of a negotiated rulemaking
advisory committee comprised of persons who represent interests
affected by the hospice rules.
EFFECTIVE DATE: October 1, 1997.
FOR FURTHER INFORMATION CONTACT: Carole Blackford, (410) 786-5909.
SUPPLEMENTARY INFORMATION:
I. Background
A. Statute and Regulations
Hospice care is an approach to treatment that recognizes that the
impending death of an individual warrants a change in focus from
curative care to palliative care (relief of pain and other
uncomfortable symptoms). The goal of hospice care is to help terminally
ill individuals continue life with minimal disruption to normal
activities while remaining primarily in the home environment. A hospice
uses an interdisciplinary approach to deliver medical, social,
psychological, emotional, and spiritual services through the use of a
broad spectrum of professional and other caregivers, with the goal of
making the individual as physically and emotionally comfortable as
possible. Counseling and respite services are available to the family
of the hospice patient. Hospice programs consider both the patient and
the family as a unit of care.
Section 1861(dd) of the Social Security Act (the Act) provides for
coverage of hospice care for terminally ill Medicare beneficiaries who
elect to receive care from a participating hospice. The statutory
authority for payment to hospices participating in the Medicare program
is contained in section 1814(i) of the Act.
Our existing regulations under 42 CFR part 418 (issued on December
16, 1983, effective for hospice services furnished on or after November
1, 1983) establish eligibility requirements and payment standards and
procedures, define covered services, and delineate the conditions a
hospice must meet to be approved for participation in the Medicare
program. Subpart G of Part 418 provides for payment to hospices based
on one of four prospectively determined rates for each day in which a
qualified Medicare beneficiary is under the care of a hospice. The four
rate categories are routine home care, continuous home care, inpatient
respite care, and general inpatient care. Payment rates are established
for each category.
The final rule of December 16, 1983 (48 FR 56034) provided for the
following in determining payment for hospice care:
Adjustment to the payment rates to reflect differences in
area wage levels. Since hospice care is labor-intensive, adjustment was
necessary to permit payment of higher rates in areas with relatively
high wage levels, and proportionately lower rates in areas with wage
levels below the national average.
Labor market areas based on the definitions of
Metropolitan Statistical Areas (MSAs) issued by the Office of
Management and Budget (OMB).
The wage index used to adjust the hospice payment rates to
be the wage index published in the Federal Register on September 1,
1983 (48 FR 39871) for purposes of determining Medicare inpatient
hospital prospective payment rates. This hospital wage index, which is
still in use for hospices, was based on calendar year 1981 hospital
wage and employment data obtained from the Bureau of Labor Statistics'
(BLS) ES 202 Employment, Wages and Contributions file for hospital
workers.
In applying the hospital wage index to the hospice rates,
use of an index value of 0.8 if the hospital wage index value were
lower than 0.8. The use of a wage index ``floor'' reflected our belief
that an index value below 0.8 would make payment levels very low. We
believed this would unduly jeopardize the availability of the benefit
in rural areas by discouraging participation in the Medicare hospice
program by hospices that are located in these areas, and by inhibiting
the ability of these rural hospices to attract and retain sufficient
skilled staff.
The hospice wage index has not been updated since it was issued in
1983. Over the ensuing years, we have instituted many changes in the
hospital wage index in order to ensure its continuing accuracy for
hospitals. Since these changes have not been applied to hospices, there
are widening differences between the existing hospice wage index and
actual wage levels. The existing hospice wage index is based on 1981
BLS hospital data; however, BLS data are no longer used in determining
the hospital wage index. Based on our concern that the BLS data did not
accurately reflect hospital wages, we conducted a survey of hospital
wage and wage related costs and, in fiscal year 1986, implemented a
hospital wage index based solely on HCFA survey data. We repeated the
survey in 1988 and implemented a revised hospital wage index during
fiscal year 1991.
Additionally, in fiscal year 1991, we began adjusting the hospital
wage index to take into account the geographic reclassification of
hospitals in accordance with sections 1886(d)(8)(B) and 1886(d)(10) of
the Act. Beginning in fiscal year 1994, in accordance with section
1886(d)(3)(E) of the Act, we have updated the hospital wage index
annually, based on a survey of wages and wage-related costs of short-
term, acute care hospitals.
The most recent hospital wage index was published in the Federal
Register on August 30, 1996 (61 FR 46166). It is based on the data
collected from the Medicare cost reports submitted by hospitals for
cost reporting periods beginning in fiscal year 1993.
B. Current Payment Procedures for Hospice Care
1. Current Annual Increases in Payment Rates
Section 1814(i)(1)(C)(ii) of the Act provides for an annual
increase in the hospice payment rates based on the rate of increase in
the hospital market basket index used to adjust payments for inpatient
hospital services under the prospective payment system for hospitals.
However, section 13504 of the Omnibus Budget Reconciliation Act of 1993
(Pub. L. 103-66) amended section 1814(ii) of the Act to decrease the
amount of the market basket percentage increase that is applied to
hospice rates for fiscal years 1994 through 1997. For hospice payments
in fiscal years 1996 and 1997, the market basket increase is reduced by
1.5 percent and 0.5 percent, respectively. For fiscal years after 1997,
hospices receive the full hospital market basket increase. The
following is a brief description of each level of care and the
[[Page 42861]]
current daily payment rates for the period October 1, 1996, through
September 30, 1997. The new wage index values set forth in this final
rule are effective on October 1, 1997. At that time, the fiscal
intermediaries will recalculate the current daily payment rates for the
remainder of the rate year using the new hospice wage index.
Routine Home Care--As specified in Sec. 418.302(d)(3) of
the regulations, the payment rate for routine home care is paid to the
hospice for each day during which a Medicare beneficiary is under the
care of the hospice, and not receiving the care described under
continuous home care, inpatient respite care, or general inpatient
care, regardless of the volume and intensity of the services provided
on any given day. The current routine home care rate is $94.17.
Continuous Home Care--The hospice is paid the continuous
home care rate when, in order to maintain the terminally ill patient at
home in a period of crisis, nursing care is required on a continuous
basis. Either home health aide or homemaker services or both may also
be provided. Medicare regulations at Sec. 418.302(e)(4) specify that
the hospice payment on a continuous home care day varies depending on
the number of hours of continuous care. The continuous home care rate
is divided by 24 to yield an hourly rate. The number of hours of
continuous home care furnished during a continuous home care day is
multiplied by the hourly rate to calculate the hospice payment amount
for that day. The hospice must furnish a minimum of 8 hours of
continuous home care on a particular day to qualify for the continuous
home care daily rate. The continuous home care rate is intended only
for periods of crisis when predominantly skilled continuous care is
necessary to achieve palliation or management of the patient's acute
medical symptoms and only as necessary to maintain the patient at home.
The current continuous home care hourly rate is $22.90 and the daily
payment rate is $549.65.
Inpatient Respite Care--The hospice is paid the inpatient
respite care rate for each day the patient is in a Medicare or Medicaid
approved inpatient facility receiving respite care. The inpatient
respite rate applies specifically to situations where the patient's
family members or other persons caring for the patient need a short
period of relief. Payment is limited to no more than 5 consecutive
days. Subsequent days of respite care are paid at the routine home care
rate. The current daily payment rate for inpatient respite care is
$97.41.
General Inpatient Care--The hospice is paid the general
inpatient care rate for each day the patient is in a Medicare or
Medicaid approved inpatient setting to receive services that are
reasonable and necessary for the palliation or management of acute and
severe clinical problems related to the terminal condition that cannot
be managed in other settings. The current daily payment rate for
general inpatient care is $418.93.
2. Adjustment for Wage Variations
In adjusting the payment rates, we separate the national payment
rates into components that reflect the estimated proportion of the rate
that is attributable to wage and nonwage costs. We then multiply the
wage component of each rate by the wage index value applicable to the
area in which the hospice is located (adjusted wage component). The
rate paid to a hospice is the sum of the nonwage component and the
adjusted wage component.
The following table indicates the current hospice payment rates and
the amount (in dollars) of each rate subject to adjustment by the wage
index:
------------------------------------------------------------------------
Component
Payment category National subject Nonwage
rate to index component
------------------------------------------------------------------------
Routine home............................ $94.17 $64.70 $29.47
Continuous home......................... 549.65 377.66 171.99
Inpatient respite....................... 97.41 52.73 44.68
General inpatient....................... 418.93 268.16 150.77
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II. Proposed Rule
A. General
On September 4, 1996, we published a proposed rule in the Federal
Register (61 FR 46579) in which we proposed to establish a methodology
to update the wage index used to adjust Medicare payment rates for
hospices. We also included an updated wage index for hospices.
The proposed rule was developed by a negotiated rulemaking advisory
committee, under the process established by the Negotiated Rulemaking
Act of 1990 (Pub. L. 101-648). This committee was established to
provide advice and make recommendations to the Secretary with respect
to the text or content of a proposed rule on the wage index used to
adjust payment rates for hospices under the Medicare program, to
reflect local differences in area wage levels. Committee members
included representatives of national hospice associations; rural,
urban, large, and small hospices; multi-site hospices; consumer groups;
and a government representative. In addition, during the process, when
the Committee identified large groups of hospices likely to suffer a
significant negative impact as a result of the revised wage index,
attempts were made to contact representatives of those groups for their
input, as well as to provide them an opportunity to participate in the
meetings and discussions.
The Committee met five times from November 1994 to April 1995. Its
deliberations focused on the following issues: the data source for the
wage index; the budget neutrality adjustment; continued application of
a wage index floor; the transition period; future updates; and the
effective date of a revised index. The Committee reached consensus on a
methodology that resulted in a hospice wage index. The Committee
Statement, with which all Committee members concurred, is attached as
an Appendix to this final rule.
B. Provisions of the Proposed Hospice Wage Index
Existing hospice regulations at Sec. 418.306(c) provide that the
payment rates established by HCFA are adjusted by the intermediary to
reflect local differences in wages. We proposed to amend
Sec. 418.306(c) to add that:
The hospice wage index is updated annually based on the
most current available hospital wage data; and
These data will include any changes to the definitions of
Metropolitan Statistical Areas.
As noted above, the revised hospice wage index is based on the
recommendations of a Negotiated Rulemaking Advisory Committee. In the
Agreement in which all Committee members concurred, HCFA agreed that it
would, to the maximum extent possible and consistent with the
applicable legal obligations, draft a proposed rule consistent with the
Committee Statement and publish it as a Notice of Proposed Rulemaking.
We stated our intent to interpret and apply the proposed rule, if
adopted in final form, in a manner fully consistent with the Committee
Statement.
We also stated that if the final rule were adopted without change
from the proposed rule, the only difference between the final rule and
the Committee Statement would be the calculation of the wage index
value for the Virgin Islands, as noted in section II.F below. The wage
index value for the
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Virgin Islands was not addressed by the Committee, since at the time of
its meetings there were no certified hospices located in the Virgin
Islands.
C. Computation of the Hospice Wage Index
We proposed that the hospice wage index be derived from the
following 1993 hospital cost report data:
Total short-term, acute care hospital salaries and hours.
Home office costs and hours.
Fringe benefits associated with hospital and home office
salaries.
Direct patient care related contract labor cost and hours.
The exclusion of salaries and hours for nonhospital type
services such as skilled nursing facility services, home health
services, or other subprovider components that are not subject to the
prospective payment system.
The raw hospital wage data would undergo a series of reviews and
edits to verify the wage data from the Medicare cost report. A detailed
description of this process is contained in both the September 1, 1995
(60 FR 45778) and the August 30, 1996 (60 FR 46166) hospital
prospective payment final rule.
As noted above, we proposed to base the fiscal year 1997 hospice
wage index on hospital wage data reported on the fiscal year 1993 cost
report prior to reclassification; that is, the hospital wage index will
not be adjusted to take into account the geographic reclassification of
hospitals in accordance with sections 1886(d)(8)(B) and 1886(d)(10) of
the Act. A detailed description of the method used to compute the
hospital wage index is contained in both the September 1, 1995 (60 FR
45778), and the August 30, 1996 (60 FR 46166), hospital prospective
payment final rule.
D. Budget Neutrality Adjustment and Application of Wage Index Floor for
the Proposed Hospice Index
We proposed that all hospice wage index values below 0.8 would
receive the greater of the following:
A 15-percent increase, subject to a maximum wage index
value of 0.8; or
An adjustment, by multiplying the hospice wage index value
for a given area by the budget neutrality adjustment factor. In this
way, wage areas with values below 0.8 would not receive both the wage
index floor adjustment and the budget neutrality adjustment. All
hospice wage index values of 0.8 or greater would receive a budget
neutrality adjustment, which would be calculated by multiplying the
hospice wage index value for a given area by the budget neutrality
factor.
To determine a budget neutrality adjustment factor, we established
the payments that would be made under the 1983 wage index. We did this
by calculating the labor-related payments for each of the four types of
hospice services using patient bills for the most recent completed
fiscal year (that is, fiscal year 1995 bills would be used to calculate
the fiscal year 1997 index). That dollar amount would be the target for
the budget neutrality calculation. Then payments would be calculated
separately for the labor-related portion of the rates using the wage
index proposed in this rule. The budget neutrality factor would be
calculated as the multiplier by which labor-related payments using the
proposed wage index must be adjusted to equal labor-related payments
using the 1983 wage index. The calculation would be made taking into
account the respective adjustments applicable to wage index values
below, at, or above the 0.8 threshold described above. The payments
would be for the total of labor-related payments for each of the four
types of hospice services. The budget neutrality factor would then be
applied to the wage index. To confirm the accuracy of the calculation,
total payments would then be calculated by using the new budget
neutrality adjusted wage index and would be compared to payments using
the 1983 wage index.
The budget neutrality factor would be calculated and applied
annually, both during and after the transition period. For the first
transition year, the budget neutrality factor will be 1.020768.
E. Transition and Annual Updates
We proposed a 3-year transition period with annual updates as noted
in the Committee Statement.
F. Wage Index Value for the Virgin Islands
At the time of negotiations, there were no certified hospices
located in the Virgin Islands. However, since that time, a hospice
program has been certified to provide services under Medicare. Since
the Virgin Islands is not an area designated under the prospective
payment system for hospitals, there is no hospital wage index value for
the Virgin Islands. Therefore, though this was not an issue discussed
by the Committee, we proposed that the methodology to calculate a wage
index value for the Virgin Islands would be to gather information from
the hospital cost report and compare hourly wages of the hospital
located in the Virgin Islands to the national average. This would
generate a wage index value of 0.6594.
III. Analysis of and Response to Public Comments
In response to the September 4, 1996 proposed rule, we received
four items of correspondence, three from hospices, and one from a
hospice association.
Comment: One commenter expressed concern that the wage index rates
continue to be based on the location of the hospice rather than the
location where the service is furnished.
Response: Hospices provide services in various locations. These may
include the patient's home, an inpatient facility, and the hospice
facility itself. Currently, the wage index for hospice services is
based on the location of the hospice rather than the location of
service delivery. Although this was not an issue addressed by this
rule, a proposal linking payments for hospice services to the
geographic location of the site where the service was furnished was
included in the Administration's Medicare and Medicaid Fraud, Abuse,
and Waste Prevention Amendments of 1997.
Comment: One commenter requested information on how best to bring
about a change in classification from a rural area to an urban area
because he believed that an urban designation better reflects his
costs.
Response: Each hospice's labor market area is established by the
MSA definitions issued by OMB on December 28, 1992, based on the 1990
census, and updated periodically by the Office of Management and Budget
(OMB). Any request for change in designation of MSA would have to be
made to OMB for consideration.
Comment: One commenter suggested that the wage index values for
Puerto Rico did not reflect the costs of providing services in that
area. The commenter believed that implementation of the wage index will
result in inaccessibility of hospice care in certain areas. The
commenter described several characteristics that, she believed, are
unique to providing hospice care in Puerto Rico. These include poor
access to many communities, lack of educational programs or other
curricula aimed at training professionals in hospice care, language
barriers, outdated communication technology, high cost-of-living, and
high operational costs due to necessary imports. The commenter also
believed that the hospital wage index does not accurately reflect costs
in Puerto Rico.
Response: As stated in the proposed rule, the committee solicited
participation from Puerto Rico and
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reviewed financial information provided by Puerto Rico hospices. The
committee considered many of the issues raised by representatives of
Puerto Rico and determined that, in order to maintain the viability of
hospice programs in rural and other low wage index areas, it was
appropriate to continue to assist those areas with wage index values
below 0.8 by providing an adjustment to the wage component of the rate.
The committee agreed that for those wage areas below 0.8, the revised
wage index for the area would be the greater of the pre-reclassified
hospital wage index value times a budget neutrality adjustment factor,
or the pre- reclassified hospital wage index value multiplied by 1.15,
but subject to a maximum wage index value of 0.8.
We believe that characteristics described by the commenter as being
unique to hospices in Puerto Rico are in fact shared by hospices in
many rural and urban areas. Access to communities and outdated
communications technology are often problematic in rural areas of the
continental United States. Additionally, many hospices in the
continental United States experience a lack of external educational
programs aimed at training hospice professionals and have to provide
that training internally. The problem of language barriers and the need
for bilingual staff can also be found in many areas in the United
States.
Moreover, some of the commenter's concerns were not relevant to the
development of a revised hospice wage index. The committee focused its
attention on the development of a revised hospice wage index and
therefore did not address some of the issues raised by the commenter.
For example, the commenter described how the operational costs of
hospices are high in Puerto Rico due to the costs associated with
importing supplies. The hospice wage index will affect only the wage
portion of the hospice daily payment rate. Operational costs would not
be reflected in this portion of the daily payment rate. Also, it is
expected that both hospices and hospitals in Puerto Rico will have
similar staffing problems, so the impact of the resulting higher
salaries should be reflected in the hospital wage index.
The issue of the hospital wage index not accurately reflecting the
costs in Puerto Rico was discussed in the August 30, 1996 Federal
Register (61 FR 46166). The notice recognized that hospitals in Puerto
Rico have experienced large swings in their wage index values, and that
these shifts can cause shifts in payments. Several options, including
the creation of a single MSA for Puerto Rico, which would limit these
types of swings, were discussed. However, it was decided that none of
the options would create a payment system that was fair and equitable
to all hospitals, regardless of location. While drafting the August 30,
1996 final rule discussed above, HCFA met with representatives of the
Puerto Rico Hospital Association to explore other solutions to the
problems faced by hospitals in the Commonwealth. In reviewing the
latest Medicare cost report data available at that time, we found that
hospitals in Puerto Rico continue to demonstrate average Medicare
operating margins comparable to all other prospective payment
hospitals.
This comment was forwarded to the negotiated rulemaking committee
members for review and consideration. Based on their responses, we
believe this comment would not have led the group to a different
consensus had it been available during the negotiations.
Comment: One commenter expressed concern that reduction of the wage
index value in his area would cause hospices to experience financial
hardship.
Response: We recognize that although the proposed hospice wage
index is budget neutral, some hospices will experience reductions in
wage index values. Wage index values below 0.8 percent will be adjusted
according to the adjustment factor. The revised wage index values would
be the greater of the pre-reclassification hospital wage index values
times the budget neutrality adjustment factor or the pre-
reclassification hospital wage index value multiplied by 1.15, but
subject to a maximum wage index value of 0.8 percent. The committee did
examine the overall effects of the various methodologies for computing
the wage index that were proposed during the negotiated rulemaking
process and chose the option with the least overall impact on hospices.
IV. Provisions of the Final Rule
This final rule essentially incorporates the provisions of the
proposed rule, in which we proposed to establish a methodology to
update the wage index used to adjust Medicare payment rates for
hospices. The few changes we made from the proposed rule are identified
below.
We are also publishing, in Tables A and B below, the updated urban
and rural wage indexes for hospices included in the proposed rule. The
values in Tables A and B published with this final rule are current and
will not be updated until October 1, 1998. The wage index values for
Tables A and B will be used for the first transition year, and have
already been subject to all adjustments.
A. Transition Period
Due to the delay in the publication of this final rule, the revised
wage index will become effective for care and services furnished on or
after October 1, 1997. Keeping with the spirit of the consensus
agreement, the revised wage index will continue to be subject to the
full 3-year transition period. The first year of the transition period
will begin October 1, 1997, and will end September 30, 1998.
B. Annual Updates
Annual updates will begin with the start of the second transition
year. We plan to coordinate the annual updates after the third
transition year with the hospital wage index updates. This may result
in the third transition year lasting somewhat longer than a year.
Annual updates will be published as a notice in the Federal Register,
rather than as a proposed rule as agreed to in the Consensus agreement.
We believe that this change is not contradictory to the intentions of
the rulemaking committee; rather, it will allow us to make timely
updates through a less burdensome administrative process. The annual
updates will update the hospice wage index values according to the
methodology agreed to by the rulemaking committee and implemented by
this final rule. In the event that we decide to change the methodology
by which the wage index is computed, this will be reflected in a
proposed rule published in the Federal Register.
C. Tables
Table A.--Hospice Wage Index for Urban Areas
------------------------------------------------------------------------
Wage
Urban area (constituent counties or county equivalents) index
-------------------------------------------------------------------\1\--
Abilene, TX
Taylor, TX.................................................. 0.9145
Aguadilla, PR
Aguada, PR.................................................. 0.6958
Aguadilla, PR............................................... 0.6958
Moca, PR.................................................... 0.6958
Akron, OH
Portage, OH................................................. 1.0657
Summit, OH.................................................. 1.0657
Albany, GA
Dougherty, GA............................................... 0.8987
Lee, GA..................................................... 0.8987
Albany-Schenectady-Troy, NY
Albany, NY.................................................. 0.9008
Montgomery, NY.............................................. 0.9008
Rensselaer, NY.............................................. 0.9008
Saratoga, NY................................................ 0.9008
[[Page 42864]]
Schenectady, NY............................................. 0.9008
Schoharie, NY............................................... 0.8866
Albuquerque, NM
Bernalillo, NM.............................................. 1.0378
Sandoval, NM................................................ 0.9503
Valencia, NM................................................ 0.9503
Alexandria, LA
Rapides, LA................................................. 0.9387
Allentown-Bethlehem-Easton, PA
Carbon, PA.................................................. 1.0557
Lehigh, PA.................................................. 1.0557
Northampton, PA............................................. 1.0557
Altoona, PA
Blair, PA................................................... 1.0210
Amarillo, TX
Potter, TX.................................................. 0.9569
Randall, TX................................................. 0.9569
Anchorage, AK
Anchorage, AK............................................... 1.4474
Ann Arbor, MI
Lenawee, MI................................................. 1.0416
Livingston, MI.............................................. 1.2129
Washtenaw, MI............................................... 1.2195
Anniston, AL
Calhoun, AL................................................. 0.8599
Appleton-Oshkosh-Neenah, WI
Calumet, WI................................................. 0.9629
Outagamie, WI............................................... 0.9629
Winnebago, WI............................................... 0.9629
Arecibo, PR
Arecibo, PR................................................. 0.7019
Camuy, PR................................................... 0.7019
Hatillo, PR................................................. 0.7019
Asheville, NC
Buncombe, NC................................................ 0.9646
Madison, NC................................................. 0.8962
Athens, GA
Clarke, GA.................................................. 0.9201
Madison, GA................................................. 0.9201
Oconee, GA.................................................. 0.9201
Atlanta, GA
Barrow, GA.................................................. 0.9822
Bartow, GA.................................................. 0.9200
Carroll, GA................................................. 0.9200
Cherokee, GA................................................ 0.9841
Clayton, GA................................................. 0.9822
Cobb, GA.................................................... 0.9822
Coweta, GA.................................................. 0.9822
De Kalb, GA................................................. 0.9822
Douglas, GA................................................. 0.9822
Fayette, GA................................................. 0.9822
Forsyth, GA................................................. 0.9822
Fulton, GA.................................................. 0.9822
Gwinnett, GA................................................ 0.9822
Henry, GA................................................... 0.9822
Newton, GA.................................................. 0.9822
Paulding, GA................................................ 0.9822
Pickens, GA................................................. 0.9200
Rockdale, GA................................................ 0.9822
Spalding, GA................................................ 0.9822
Walton, GA.................................................. 0.9822
Atlantic City-Cape May, NJ
Atlantic City, NJ........................................... 1.1016
Cape May, NJ................................................ 1.1016
Augusta-Aiken, GA-SC
Columbia, GA................................................ 0.9549
McDuffie, GA................................................ 0.9549
Richmond, GA................................................ 0.9549
Aiken, SC................................................... 0.9549
Edgefield, SC............................................... 0.8510
Austin-San Marcos, TX
Bastrop, TX................................................. 0.8677
Caldwell, TX................................................ 0.8677
Hays, TX.................................................... 1.0355
Travis, TX.................................................. 1.0355
Williamson, TX.............................................. 1.0355
Bakersfield, CA
Kern, CA.................................................... 1.1817
Baltimore, MD
Anne Arundel, MD............................................ 1.0724
Baltimore, MD............................................... 1.0724
Baltimore City, MD.......................................... 1.0724
Carroll, MD................................................. 1.0724
Harford, MD................................................. 1.0724
Howard, MD.................................................. 1.0724
Queen Annes, MD............................................. 1.0724
Bangor, ME
Penobscot, ME............................................... 0.9504
Barnstable-Yarmouth, MA
Barnstable, MA.............................................. 1.1253
Baton Rouge, LA
Ascension, LA............................................... 0.9793
East Baton Rouge, LA........................................ 0.9793
Livingston, LA.............................................. 0.9793
West Baton Rouge, LA........................................ 0.9793
Beaumont-Port Arthur, TX
Hardin, TX.................................................. 0.9637
Jefferson, TX............................................... 0.9637
Orange, TX.................................................. 0.9637
Bellingham, WA
Whatcom, WA................................................. 1.1026
Benton Harbor, MI
Berrien, MI................................................. 0.8838
Bergen-Passaic, NJ
Bergen, NJ.................................................. 1.1012
Passaic, NJ................................................. 1.1012
Billings, MT
Yellowstone, MT............................................. 0.9657
Biloxi-Gulfport-Pascagoula, MS
Hancock, MS................................................. 0.8838
Harrison, MS................................................ 0.8838
Jackson, MS................................................. 0.9810
Binghamton, NY
Broome, NY.................................................. 0.9484
Tioga, NY................................................... 0.9484
Birmingham, AL
Blount, AL.................................................. 0.9912
Jefferson, AL............................................... 0.9912
St. Clair, AL............................................... 0.9912
Shelby, AL.................................................. 0.9912
Bismarck, ND
Burleigh, ND................................................ 0.9569
Morton, ND.................................................. 0.9569
Bloomington, IN
Monroe, IN.................................................. 0.9166
Bloomington-Normal, IL
McLean, IL.................................................. 0.9959
Boise City, ID
Ada, ID..................................................... 1.0512
Canyon, ID.................................................. 0.9319
Boston-Brockton-Nashua, MA-NH
Bristol, MA................................................. 1.0526
Essex, MA................................................... 1.1402
Middlesex, MA............................................... 1.1402
Norfolk, MA................................................. 1.1402
Plymouth, MA................................................ 1.1402
Suffolk, MA................................................. 1.1402
Worcester, MA............................................... 1.0599
Hillsborough, NH............................................ 1.0311
Merrimack, NH............................................... 1.0311
Rockingham, NH.............................................. 0.9705
Strafford, NH............................................... 0.9705
Boulder-Longmont, CO
Boulder, CO................................................. 1.0033
Brazoria, TX
Brazoria, TX................................................ 0.8853
Bremerton, WA
Kitsap, WA.................................................. 0.9826
Brownsville-Harlingen-San Benito, TX
Cameron, TX................................................. 0.9179
Bryan-College Station, TX
Brazos, TX.................................................. 0.9189
Buffalo-Niagara Falls, NY
Erie, NY.................................................... 0.9759
Niagara, NY................................................. 0.9047
Burlington, VT
Chittenden, VT.............................................. 0.9995
Franklin, VT................................................ 0.9397
Grand Isle, VT.............................................. 0.9995
Caguas, PR
Caguas, PR.................................................. 0.7086
Cayey, PR................................................... 0.7086
Cidra, PR................................................... 0.7086
Gurabo, PR.................................................. 0.7086
San Lorenzo, PR............................................. 0.7086
Canton-Massillon, OH
Carroll, OH................................................. 0.9610
Stark, OH................................................... 0.9610
Casper, WY
Natrona, WY................................................. 0.9980
Cedar Rapids, IA
Linn, IA.................................................... 0.9260
Champaign-Urbana, IL
Champaign, IL............................................... 1.0167
Charleston-North Charleston, SC
Berkeley, SC................................................ 1.0033
Charleston, SC.............................................. 1.0033
Dorchester, SC.............................................. 1.0033
Charleston, WV
Kanawha, WV................................................. 1.0749
Putnam, WV.................................................. 1.0749
Charlotte-Gastonia-Rock Hill, NC-SC
Cabarrus, NC................................................ 0.9926
Gaston, NC.................................................. 0.9926
Lincoln, NC................................................. 0.9926
Mecklenburg, NC............................................. 0.9926
Rowan, NC................................................... 0.9926
Union, NC................................................... 0.9926
York, SC.................................................... 0.9926
Charlottesville, VA
Albemarle, VA............................................... 1.1911
Charlottesville City, VA.................................... 1.1911
Fluvanna, VA................................................ 1.1911
Greene, VA.................................................. 1.1911
Chattanooga, TN-GA
Catoosa, GA................................................. 0.9591
Dade, GA.................................................... 0.9591
Walker, GA.................................................. 0.9591
Hamilton, TN................................................ 0.9591
Marion, TN.................................................. 0.9591
Cheyenne, WY
Laramie, WY................................................. 0.9043
Chicago, IL
Cook, IL.................................................... 1.1961
De Kalb, IL................................................. 0.9570
Du Page, IL................................................. 1.1961
Grundy, IL.................................................. 1.1074
Kane, IL.................................................... 1.0438
[[Page 42865]]
Kendall, IL................................................. 1.0438
Lake, IL.................................................... 1.1205
McHenry, IL................................................. 1.1961
Will, IL.................................................... 1.1074
Chico-Paradise, CA
Butte, CA................................................... 1.0729
Cincinnati, OH-KY-IN
Dearborn, IN................................................ 1.0441
Ohio, IN.................................................... 0.9120
Boone, KY................................................... 1.0441
Campbell, KY................................................ 1.0441
Gallatin, KY................................................ 0.8805
Grant, KY................................................... 0.8805
Kenton, KY.................................................. 1.0441
Pendleton, KY............................................... 0.8805
Brown, OH................................................... 0.9480
Clermont, OH................................................ 1.0441
Hamilton, OH................................................ 1.0441
Warren, OH.................................................. 1.0441
Clarksville-Hopkinsville, TN-KY
Christian, KY............................................... 0.8228
Montgomery, TN.............................................. 0.8228
Cleveland-Lorain-Elyria, OH
Ashtabula, OH............................................... 0.9587
Cuyahoga, OH................................................ 1.1549
Geauga, OH.................................................. 1.1549
Lake, OH.................................................... 1.1549
Lorain, OH.................................................. 1.0542
Medina, OH.................................................. 1.1549
Colorado Springs, CO
El Paso, CO................................................. 1.0711
Columbia, MO
Boone, MO................................................... 1.0757
Columbia, SC
Lexington, SC............................................... 0.9652
Richland, SC................................................ 0.9652
Columbus, GA-AL
Russell, AL................................................. 0.8799
Chattanoochee, GA........................................... 0.8799
Harris, GA.................................................. 0.8335
Muscogee, GA................................................ 0.8799
Columbus, OH
Delaware, OH................................................ 1.0387
Fairfield, OH............................................... 1.0387
Franklin, OH................................................ 1.0387
Licking, OH................................................. 1.0387
Madison, OH................................................. 1.0387
Pickaway, OH................................................ 1.0387
Corpus Christi, TX
Nueces, TX.................................................. 0.9587
San Patricio, TX............................................ 0.9587
Cumberland, MD-WV
Allegany, MD................................................ 0.9388
Mineral, WV................................................. 0.9388
Dallas, TX
Collin, TX.................................................. 1.0642
Dallas, TX.................................................. 1.0642
Denton, TX.................................................. 1.0642
Ellis, TX................................................... 1.0642
Henderson, TX............................................... 0.8838
Hunt, TX.................................................... 0.8838
Kaufman, TX................................................. 1.0642
Rockwall, TX................................................ 1.0642
Danville, VA
Danville City, VA........................................... 0.8812
Pittsylvania, VA............................................ 0.8812
Davenport-Rock Island-Moline, IA-IL
Scott, IA................................................... 0.9537
Henry, IL................................................... 0.9537
Rock Island, IL............................................. 0.9537
Dayton-Springfield, OH
Clark, OH................................................... 1.0818
Greene, OH.................................................. 1.0818
Miami, OH................................................... 1.0818
Montgomery, OH.............................................. 1.0818
Daytona Beach, FL
Flagler, FL................................................. 0.8953
Volusia, FL................................................. 0.9615
Decatur, AL
Lawrence, AL................................................ 0.8297
Morgan, AL.................................................. 0.8297
Decatur, IL
Macon, IL................................................... 0.9360
Denver, CO
Adams, CO................................................... 1.1721
Arapahoe, CO................................................ 1.1721
Denver, CO.................................................. 1.1721
Douglas, CO................................................. 1.1721
Jefferson, CO............................................... 1.1721
Des Moines, IA
Dallas, IA.................................................. 1.0287
Polk, IA.................................................... 1.0287
Warren, IA.................................................. 1.0287
Detroit, MI
Lapeer, MI.................................................. 1.1810
Macomb, MI.................................................. 1.1810
Monroe, MI.................................................. 1.1810
Oakland, MI................................................. 1.1810
St. Clair, MI............................................... 1.1810
Wayne, MI................................................... 1.1810
Dothan, AL
Dale, AL.................................................... 0.8565
Houston, AL................................................. 0.8565
Dover, DE
Kent, DE.................................................... 0.9196
Dubuque, IA
Dubuque, IA................................................. 0.9757
Duluth-Superior, MN-WI
St. Louis, MN............................................... 0.9433
Douglas, WI................................................. 0.9433
Dutchess County, NY
Dutchess, NY................................................ 1.1033
Eau Claire, WI
Chippewa, WI................................................ 0.9556
Eau Claire, WI.............................................. 0.9556
El Paso, TX
El Paso, TX................................................. 0.9339
Elkhart-Goshen, IN
Elkhart, IN................................................. 0.9056
Elmira, NY
Chemung, NY................................................. 0.9844
Enid, OK
Garfield, OK................................................ 0.8812
Erie, PA
Erie, PA.................................................... 0.9872
Eugene-Springfield, OR
Lane, OR.................................................... 1.0560
Evansville-Henderson, IN-KY
Posey, IN................................................... 0.9925
Vanderburgh, IN............................................. 0.9925
Warrick, IN................................................. 0.9925
Henderson, KY............................................... 0.9925
Fargo-Moorhead, ND-MN
Clay, MN.................................................... 0.9917
Cass, ND.................................................... 0.9917
Fayetteville, NC
Cumberland, NC.............................................. 0.9410
Fayetteville-Springdale-Rogers, AR
Benton, AR.................................................. 0.8000
Washington, AR.............................................. 0.8205
Flagstaff, AZ-UT
Coconino, AZ................................................ 0.9159
Kane, UT.................................................... 0.8690
Flint, MI
Genesee, MI................................................. 1.1669
Florence, AL
Colbert, AL................................................. 0.8205
Lauderdale, AL.............................................. 0.8205
Florence, SC
Florence, SC................................................ 0.8417
Fort Collins-Loveland, CO
Larimer, CO................................................. 0.9908
Ft. Lauderdale, FL
Broward, FL................................................. 1.1146
Fort Myers-Cape Coral, FL
Lee, FL..................................................... 0.9362
Fort Pierce-Port St. Lucie, FL
Martin, FL.................................................. 1.0226
St. Lucie, FL............................................... 1.0226
Fort Smith, AR-OK
Crawford, AR................................................ 0.9280
Sebastian, AR............................................... 0.9280
Sequoyah, OK................................................ 0.9280
Fort Walton Beach, FL
Okaloosa, FL................................................ 0.8572
Fort Wayne, IN
Adams, IN................................................... 0.8858
Allen, IN................................................... 0.9422
De Kalb, IN................................................. 0.9422
Huntington, IN.............................................. 0.8858
Wells, IN................................................... 0.8858
Whitley, IN................................................. 0.9422
Fort Worth-Arlington, TX
Hood, TX.................................................... 0.8982
Johnson, TX................................................. 0.9770
Parker, TX.................................................. 0.9770
Tarrant, TX................................................. 0.9770
Frenso, CA
Fresno, CA.................................................. 1.1938
Madera, CA.................................................. 1.0684
Gadsden, AL
Etowah, AL.................................................. 0.9306
Gainesville, FL
Alachua, FL................................................. 0.9817
Galveston-Texas City, TX
Galveston, TX............................................... 1.1787
Gary, IN
Lake, IN.................................................... 1.0917
Porter, IN.................................................. 1.0917
Glens Falls, NY
Warren, NY.................................................. 0.8911
Washington, NY.............................................. 0.8911
Goldsboro, NC
Wayne, NC................................................... 0.8642
Grand Forks, ND-MN
Polk, MN.................................................... 0.8911
Grand Forks, ND............................................. 0.9709
Grand Junction, CO
Mesa, CO.................................................... 0.8500
Grand Rapids-Muskegon-Holland, MI
Allegan, MI................................................. 0.9891
Kent, MI.................................................... 1.0247
Muskegon, MI................................................ 0.9789
Ottawa, MI.................................................. 1.0247
Great Falls, MT
Cascade, MT................................................. 0.9968
Greeley, CO
Weld, CO.................................................... 1.0666
[[Page 42866]]
Green Bay, WI
Brown, WI................................................... 0.9863
Greensboro-Winston-Salem-High Point, NC
Alamance, NC................................................ 0.8946
Davidson, NC................................................ 0.9693
Davie, NC................................................... 0.9693
Forsyth, NC................................................. 0.9693
Guilford, NC................................................ 0.9693
Randolph, NC................................................ 0.9693
Stokes, NC.................................................. 0.9693
Yadkin, NC.................................................. 0.9693
Greenville, NC
Pitt, NC.................................................... 0.8875
Greenville-Spartanburg-Anderson, SC
Anderson, SC................................................ 0.8989
Cherokee, SC................................................ 0.8541
Greenville, SC.............................................. 0.9485
Pickens, SC................................................. 0.9485
Spartanburg, SC............................................. 0.9485
Hagerstown, MD
Washington, MD.............................................. 0.9989
Hamilton-Middletown, OH
Butler, OH.................................................. 1.0330
Harrisburg-Lebanon-Carlisle, PA
Cumberland, PA.............................................. 1.0504
Dauphin, PA................................................. 1.0504
Lebanon, PA................................................. 1.0504
Perry, PA................................................... 1.0504
Hartford, CT
Hartford, CT................................................ 1.1484
Litchfield, CT.............................................. 1.1484
Middlesex, CT............................................... 1.1484
Tolland, CT................................................. 1.1484
Hattiesburg, MS
Forrest, MS................................................. 0.8013
Lamar, MS................................................... 0.8013
Hickory-Morganton-Lenoir, NC
Alexander, NC............................................... 0.9402
Burke, NC................................................... 0.9402
Caldwell, NC................................................ 0.8721
Catawba, NC................................................. 0.9402
Honolulu, HI
Honolulu, HI................................................ 1.1706
Houma, LA
Lafourche, LA............................................... 0.9332
Terrebonne, LA.............................................. 0.9332
Houston, TX
Chambers, TX................................................ 0.8930
Fort Bend, TX............................................... 1.0969
Harris, TX.................................................. 1.0969
Liberty, TX................................................. 1.0969
Montgomery, TX.............................................. 1.0969
Waller, TX.................................................. 1.0969
Huntington-Ashland, WV-KY-OH
Boyd, KY.................................................... 0.9797
Carter, KY.................................................. 0.9797
Greenup, KY................................................. 0.9797
Lawrence, OH................................................ 0.9797
Cabell, WV.................................................. 0.9797
Wayne, WV................................................... 0.9797
Huntsville, AL
Limestone, AL............................................... 0.8236
Madison, AL................................................. 0.8910
Indianapolis, IN
Boone, IN................................................... 1.0552
Hamilton, IN................................................ 1.0552
Hancock, IN................................................. 1.0552
Hendricks, IN............................................... 1.0552
Johnson, IN................................................. 1.0552
Madison, IN................................................. 0.9964
Marion, IN.................................................. 1.0552
Morgan, IN.................................................. 1.0552
Shelby, IN.................................................. 1.0552
Iowa City, IA
Johnson, IA................................................. 1.0959
Jackson, MI
Jackson, MI................................................. 1.0074
Jackson, MS
Hinds, MS................................................... 0.8882
Madison, MS................................................. 0.8882
Rankin, MS.................................................. 0.8882
Jackson, TN
Madison, TN................................................. 0.8264
Jacksonville, FL
Clay, FL.................................................... 0.9838
Duval, FL................................................... 0.9838
Nassau, FL.................................................. 0.9838
St. Johns, FL............................................... 0.9838
Jacksonville, NC
Onslow, NC.................................................. 0.8565
Jamestown, NY
Chautaqua, NY............................................... 0.8477
Janesville-Beloit, WI
Rock, WI.................................................... 0.9003
Jersey City, NJ
Hudson, NJ.................................................. 1.1299
Johnson City-Kingsport-Bristol, TN-VA
Carter, TN.................................................. 0.9311
Hawkins, TN................................................. 0.9311
Sullivan, TN................................................ 0.9311
Unicoi, TN.................................................. 0.9311
Washington, TN.............................................. 0.9311
Bristol City, VA............................................ 0.9311
Scott, VA................................................... 0.9311
Washington, VA.............................................. 0.9311
Johnstown, PA
Cambria, PA................................................. 0.9856
Somerset, PA................................................ 0.9856
Joplin, MO
Jasper, MO.................................................. 0.9053
Newton, MO.................................................. 0.9053
Kalamazoo-Battlecreek, MI
Calhoun, MI................................................. 1.0800
Kalamazoo, MI............................................... 1.1936
Van Buren, MI............................................... 1.0035
Kankakee, IL
Kankakee, IL................................................ 0.9323
Kansas City, KS-MO
Johnson, KS................................................. 0.9883
Leavenworth, KS............................................. 0.9883
Miami, KS................................................... 0.9883
Wyandotte, KS............................................... 0.9883
Cass, MO.................................................... 0.9969
Clay, MO.................................................... 0.9969
Clinton, MO................................................. 0.8871
Jackson, MO................................................. 0.9969
Lafayette, MO............................................... 0.9969
Platte, MO.................................................. 0.9969
Ray, MO..................................................... 0.9969
Kenosha, WI
Kenosha, WI................................................. 1.0538
Killeen-Temple, TX
Bell, TX.................................................... 0.9934
Coryell, TX................................................. 0.9934
Knoxville, TN
Anderson, TN................................................ 0.9144
Blount, TN.................................................. 0.9144
Knox, TN.................................................... 0.9144
Loudon, TN.................................................. 0.8337
Sevier, TN.................................................. 0.9144
Union, TN................................................... 0.9144
Kokomo, IN
Howard, IN.................................................. 0.9463
Tipton, IN.................................................. 0.9463
La Crosse, WI-MN
Houston, MN................................................. 0.8777
La Crosse, WI............................................... 0.9331
Lafayette, LA
Acadia, LA.................................................. 0.8464
Lafayette, LA............................................... 0.9693
St. Landry, LA.............................................. 0.8464
St. Martin, LA.............................................. 0.9693
Lafayette, IN
Clinton, IN................................................. 0.8852
Tippecanoe, IN.............................................. 0.9189
Lake Charles, LA
Calcasieu, LA............................................... 0.9499
Lakeland-Winter Haven, FL
Polk, FL.................................................... 0.9298
Lancaster, PA
Lancaster, PA............................................... 1.0319
Lansing-East Lansing, MI
Clinton, MI................................................. 1.0561
Eaton, MI................................................... 1.0561
Ingham, MI.................................................. 1.0561
Laredo, TX
Webb, TX.................................................... 0.8374
Las Cruces, NM
Dona Ana, NM................................................ 0.8645
Las Vegas, NV-AZ
Mohave, AZ.................................................. 0.9788
Clark, NV................................................... 1.1994
Nye, NV..................................................... 1.0625
Lawrence, KS
Douglas, KS................................................. 0.9592
Lawton, OK
Comanche, OK................................................ 0.9159
Lewiston-Auburn, ME
Androscoggin, ME............................................ 0.9447
Lexington, KY
Bourbon, KY................................................. 0.9337
Clark, KY................................................... 0.9337
Fayette, KY................................................. 0.9337
Jessamine, KY............................................... 0.9337
Madison, KY................................................. 0.8371
Scott, KY................................................... 0.9337
Woodford, KY................................................ 0.9337
Lima, OH
Allen, OH................................................... 0.9767
Auglaize, OH................................................ 0.9767
Lincoln, NE
Lancaster, NE............................................... 0.9017
Little Rock-North Little Rock, AR
Faulkner, AR................................................ 0.9855
Lonoke, AR.................................................. 0.9855
Pulaski, AR................................................. 0.9855
Saline, AR.................................................. 0.9855
Longview-Marshall, TX
Gregg, TX................................................... 0.8767
Harrison, TX................................................ 0.8767
Upshur, TX.................................................. 0.8469
Los Angeles-Long Beach, CA
Los Angeles, CA............................................. 1.3072
Louisville, KY-IN
Clark, IN................................................... 1.0601
Floyd, IN................................................... 1.0601
Harrison, IN................................................ 1.0601
[[Page 42867]]
Scott, IN................................................... 0.9078
Bullitt, KY................................................. 1.0601
Jefferson, KY............................................... 1.0601
Oldham, KY.................................................. 1.0601
Lubbock, TX
Lubbock, TX................................................. 0.9760
Lynchburg, VA
Amherst, VA................................................. 0.9028
Bedford City, VA............................................ 0.8537
Bedford, VA................................................. 0.8537
Campbell, VA................................................ 0.9028
Lynchburg City, VA.......................................... 0.9028
Macon, GA
Bibb, GA.................................................... 0.9705
Houston, GA................................................. 0.9705
Jones, GA................................................... 0.9705
Peach, GA................................................... 0.9705
Twiggs, GA.................................................. 0.8788
Madison, WI
Dane, WI.................................................... 1.0391
Mansfield, OH
Crawford, OH................................................ 0.9124
Richland, OH................................................ 0.9145
Mayaguez, PR
Anasco, PR.................................................. 0.6949
Cabo Rojo, PR............................................... 0.6949
Hormigueros, PR............................................. 0.6949
Mayaguez, PR................................................ 0.6949
Sabana Grande, PR........................................... 0.6949
San German, PR.............................................. 0.6949
McAllen-Edinburg-Mission, TX
Hidalgo, TX................................................. 0.8588
Medford-Ashland, OR
Jackson, OR................................................. 1.0131
Melbourne-Titusville-Palm Bay, FL
Brevard, Fl................................................. 0.9437
Memphis, TN-AR-MS
Crittenden, AR.............................................. 1.0104
De Soto, MS................................................. 1.0104
Fayette, TN................................................. 0.8223
Shelby, TN.................................................. 1.0104
Tipton, TN.................................................. 1.0104
Merced, CA
Merced, CA.................................................. 1.0506
Miami, FL
Dade, FL.................................................... 1.1202
Middlesex-Somerset-Hunterdon, NJ
Hunterdon, NJ............................................... 1.0939
Middlesex, NJ............................................... 1.0939
Somerset, NJ................................................ 1.0939
Milwaukee-Waukesha, WI
Milwaukee, WI............................................... 1.0442
Ozaukee, WI................................................. 1.0442
Washington, WI.............................................. 1.0442
Waukesha, WI................................................ 1.0442
Minneapolis-St Paul, MN-WI
Anoka, MN................................................... 1.0656
Carver, MN.................................................. 1.0656
Chisago, MN................................................. 1.0656
Dakota, MN.................................................. 1.0656
Hennepin, MN................................................ 1.0656
Isanti, MN.................................................. 1.0656
Ramsey, MN.................................................. 1.0656
Scott, MN................................................... 1.0656
Sherburne, MN............................................... 0.9660
Washington, MN.............................................. 1.0656
Wright, MN.................................................. 1.0656
Pierce, WI.................................................. 0.9317
St. Croix, WI............................................... 1.0656
Mobile, AL
Baldwin, AL................................................. 0.9065
Mobile, AL.................................................. 0.9065
Modesto, CA
Stanislaus, CA.............................................. 1.0953
Monmouth-Ocean, NJ
Monmouth, NJ................................................ 1.0398
Ocean, NJ................................................... 1.0398
Monroe, LA
Ouachita, LA................................................ 0.9293
Montgomery, AL
Autauga, AL................................................. 0.9299
Elmore, AL.................................................. 0.9299
Montgomery, AL.............................................. 0.9299
Muncie, IN
Delaware, IN................................................ 0.9963
Myrtle Beach, SC
Horry, SC................................................... 0.8058
Naples, FL
Collier, FL................................................. 0.9405
Nashville, TN
Cheatham, TN................................................ 1.1451
Davidson, TN................................................ 1.1451
Dickson, TN................................................. 1.1451
Robertson, TN............................................... 1.1451
Rutherford TN............................................... 1.1451
Sumner, TN.................................................. 1.1451
Williamson, TN.............................................. 1.1451
Wilson, TN.................................................. 1.1451
Nassau-Suffolk, NY
Nassau, NY.................................................. 1.2839
Suffolk, NY................................................. 1.2839
New Haven-Bridgeport-Stamford-Danbury-Waterbury,
Fairfield, CT............................................... 1.2197
New Haven, CT............................................... 1.1582
New London-Norwich, CT
New London, CT.............................................. 1.1431
New Orleans, LA
Jefferson, LA............................................... 1.0079
Orleans, LA................................................. 1.0079
Plaquemines, LA............................................. 0.8849
St. Bernard, LA............................................. 1.0079
St. Charles, LA............................................. 1.0079
St. James, LA............................................... 0.8849
St. John The Baptist, LA.................................... 1.0079
St. Tammany, LA............................................. 1.0079
New York, NY
Bronx, NY................................................... 1.4110
Kings, NY................................................... 1.4110
New York, NY................................................ 1.4110
Putnam, NY.................................................. 1.4110
Queens, NY.................................................. 1.4110
Richmond, NY................................................ 1.4110
Rockland, NY................................................ 1.4110
Westchester, NY............................................. 1.4110
Newark, NJ
Essex, NJ................................................... 1.1684
Morris, NJ.................................................. 1.1684
Sussex, NJ.................................................. 1.1684
Union, NJ................................................... 1.1684
Warren, NJ.................................................. 1.1160
Newburgh, NY-PA
Orange, NY.................................................. 1.0522
Pike, PA.................................................... 1.0705
Norfolk-Virginia Beach-Newport News, VA-NC
Currituck, NC............................................... 0.8627
Chesapeake City, VA......................................... 0.9498
Gloucester, VA.............................................. 0.9498
Hampton City, VA............................................ 0.9498
Isle of Wight, VA........................................... 0.8638
James City, VA.............................................. 0.9498
Mathews, VA................................................. 0.8638
Newport News City, VA....................................... 0.9498
Norfolk City, VA............................................ 0.9498
Poquoson City, VA........................................... 0.9498
Portsmouth City, VA......................................... 0.9498
Suffolk City, VA............................................ 0.9498
Virginia Beach City VA...................................... 0.9498
Williamsburg City, VA....................................... 0.9498
York, VA.................................................... 0.9498
Oakland, CA
Alameda, CA................................................. 1.3685
Contra Costa, CA............................................ 1.3685
Ocala, FL
Marion, FL.................................................. 0.9971
Odessa-Midland, TX
Ector, TX................................................... 0.9539
Midland, TX................................................. 1.0224
Oklahoma City, OK
Canadian, OK................................................ 1.0043
Cleveland, OK............................................... 1.0043
Logan, OK................................................... 1.0043
McClain, OK................................................. 1.0043
Oklahoma, OK................................................ 1.0043
Pottawatomie, OK............................................ 1.0043
Olympia, WA
Thurston, WA................................................ 1.0832
Omaha, NE-IA
Pottawattamie, IA........................................... 0.9312
Cass, NE.................................................... 0.8670
Douglas, NE................................................. 0.9312
Sarpy, NE................................................... 0.9312
Washington, NE.............................................. 0.9312
Orange County, CA
Orange, CA.................................................. 1.2540
Orlando, FL
Lake, FL.................................................... 0.9157
Orange, FL.................................................. 1.0127
Osceola, FL................................................. 1.0127
Seminole, FL................................................ 1.0127
Owensboro, KY
Daviess, KY................................................. 0.8565
Panama City, FL
Bay, FL..................................................... 0.8920
Parkersburg-Marietta, WV-OH
Washington, OH.............................................. 0.9453
Wood, WV.................................................... 0.9453
Pensacola, FL
Escambia, FL................................................ 0.8990
Santa Rosa, FL.............................................. 0.8990
Peoria-Pekin, IL
Peoria, IL.................................................. 1.0623
Tazewell, IL................................................ 1.0623
Woodford, IL................................................ 1.0623
Philadelphia, PA-NJ
Burlington, NJ.............................................. 1.1826
Camden, NJ.................................................. 1.1826
Gloucester, NJ.............................................. 1.1826
Salem, NJ................................................... 1.1236
Bucks, PA................................................... 1.1826
Chester, PA................................................. 1.1826
Delaware, PA................................................ 1.1826
Montgomery, PA.............................................. 1.1826
Philadelphia, PA............................................ 1.1826
Phoenix-Mesa, AZ
Maricopa, AZ................................................ 1.0907
Pinal, AZ................................................... 0.9428
Pine Bluff, AR
Jefferson, AR............................................... 0.8654
[[Page 42868]]
Pittsburgh, PA
Allegheny, PA............................................... 1.1050
Beaver, PA.................................................. 1.0693
Butler, PA.................................................. 1.0330
Fayette, PA................................................. 1.1050
Washington, PA.............................................. 1.1050
Westmoreland, PA............................................ 1.1050
Pittsfield, MA
Berkshire, MA............................................... 1.0270
Ponce, PR
Guayanilla, PR.............................................. 0.7129
Juana Diaz, PR.............................................. 0.7129
Penuelas, PR................................................ 0.7129
Ponce, PR................................................... 0.7129
Villalba, PR................................................ 0.7129
Yauco, PR................................................... 0.7129
Portland, ME
Cumberland, ME.............................................. 0.9843
Sagadahoc, ME............................................... 0.9843
York, ME.................................................... 0.9843
Portland-Vancouver, OR-WA
Clackamas, OR............................................... 1.1440
Columbia, OR................................................ 1.0330
Multnomah, OR............................................... 1.1440
Washington, OR.............................................. 1.1440
Yamhill, OR................................................. 1.1440
Clark, WA................................................... 1.1192
Providence-Warwick, RI
Bristol, RI................................................. 1.0425
Kent, RI.................................................... 1.0425
Newport, RI................................................. 1.0425
Providence, RI.............................................. 1.0425
Washington, RI.............................................. 1.0425
Provo-Orem, UT
Utah, UT.................................................... 0.9887
Pueblo, CO
Pueblo, CO.................................................. 1.0713
Punta Gorda, FL
Charlotte, FL............................................... 0.8997
Racine, WI
Racine, WI.................................................. 0.9821
Raleigh-Durham-Chapel Hill, NC
Chatham, NC................................................. 0.9096
Durham, NC.................................................. 1.0210
Franklin, NC................................................ 1.0210
Johnston, NC................................................ 0.9096
Orange, NC.................................................. 1.0210
Wake, NC.................................................... 1.0210
Rapid City, SD
Pennington, SD.............................................. 0.8321
Reading, PA
Berks, PA................................................... 1.0213
Redding, CA
Shasta, CA.................................................. 1.1124
Reno, NV
Washoe, NV.................................................. 1.2587
Richland-Kennewick-Pasco, WA
Benton, WA.................................................. 0.9889
Franklin, WA................................................ 0.9889
Richmond-Petersburg, VA
Charles City County, VA..................................... 0.9162
Chesterfield, VA............................................ 0.9162
Colonial Heights City, VA................................... 0.9162
Dinwiddie, VA............................................... 0.9162
Goochland, VA............................................... 0.9162
Hanover, VA................................................. 0.9162
Henrico, VA................................................. 0.9162
Hopewell City, VA........................................... 0.9162
New Kent, VA................................................ 0.9162
Petersburg City, VA......................................... 0.9162
Powhatan, VA................................................ 0.9162
Prince George, VA........................................... 0.9162
Richmond City, VA........................................... 0.9162
Riverside-San Bernardino, CA
Riverside, CA............................................... 1.1870
San Bernardino, CA.......................................... 1.1870
Roanoke, VA
Botetourt, VA............................................... 0.9779
Roanoke, VA................................................. 0.9779
Roanoke City, VA............................................ 0.9779
Salem City, VA.............................................. 0.9779
Rochester, MN
Olmsted, MN................................................. 1.0527
Rochester, NY
Genesee, NY................................................. 0.9214
Livingston, NY.............................................. 1.0346
Monroe, NY.................................................. 1.0346
Ontario, NY................................................. 1.0346
Orleans, NY................................................. 1.0346
Wayne, NY................................................... 1.0346
Rockford, IL
Boone, IL................................................... 1.0159
Ogle, IL.................................................... 0.8969
Winnebago, IL............................................... 1.0159
Rocky Mount, NC
Edgecombe, NC............................................... 0.8833
Nash, NC.................................................... 0.8833
Sacramento, CA
El Dorado, CA............................................... 1.1975
Placer, CA.................................................. 1.1975
Sacramento, CA.............................................. 1.1975
Saginaw-Bay City-Midland, MI
Bay, MI..................................................... 1.0722
Midland, MI................................................. 1.0722
Saginaw, MI................................................. 1.0722
St. Cloud, MN
Benton, MN.................................................. 0.9210
Stearns, MN................................................. 0.9210
St. Joseph, MO
Andrews, MO................................................. 0.8556
Buchanan, MO................................................ 0.9630
St. Louis, MO-IL
Clinton, IL................................................. 0.9682
Jersey, IL.................................................. 0.9594
Madison, IL................................................. 0.9594
Monroe, IL.................................................. 1.0362
St. Clair, IL............................................... 0.9682
Franklin, MO................................................ 1.0362
Jefferson, MO............................................... 1.0362
Lincoln, MO................................................. 0.8716
St. Charles, MO............................................. 1.0362
St. Louis, MO............................................... 1.0362
St. Louis City, MO.......................................... 1.0362
Warren, MO.................................................. 0.8716
Salem, OR
Marion, OR.................................................. 1.0510
Polk, OR.................................................... 1.0510
Salinas, CA
Monterey, CA................................................ 1.3382
Salt Lake City-Ogden, UT
Davis, UT................................................... 0.9873
Salt Lake, UT............................................... 0.9873
Weber, UT................................................... 0.9873
San Angelo, TX
Tom Green, TX............................................... 0.8859
San Antonio, TX
Bexar, TX................................................... 1.0012
Comal, TX................................................... 1.0012
Guadalupe, TX............................................... 1.0012
Wilson, TX.................................................. 0.8383
San Diego, CA
San Diego, CA............................................... 1.2225
San Francisco, CA
Marin, CA................................................... 1.4362
San Francisco, CA........................................... 1.4362
San Mateo, CA............................................... 1.4362
San Jose, CA
Santa Clara, CA............................................. 1.3756
San Juan-Bayamon, PR
Aguas Buenas, PR............................................ 0.7061
Barceloneta, PR............................................. 0.7061
Bayamon, PR................................................. 0.7061
Canovanas, PR............................................... 0.7061
Carolina, PR................................................ 0.7061
Catano, PR.................................................. 0.7061
Ceiba, PR................................................... 0.7061
Comerio, PR................................................. 0.7061
Corozal, PR................................................. 0.7061
Dorado, PR.................................................. 0.7061
Fajardo, PR................................................. 0.7061
Florida, PR................................................. 0.7061
Guaynabo, PR................................................ 0.7061
Humacao, PR................................................. 0.7061
Juncos, PR.................................................. 0.7061
Los Piedras, PR............................................. 0.7061
Loiza, PR................................................... 0.7061
Luguillo, PR................................................ 0.7061
Manati, PR.................................................. 0.7061
Morovis, PR................................................. 0.7061
Naguabo, PR................................................. 0.7061
Naranjito, PR............................................... 0.7061
Rio Grande, PR.............................................. 0.7061
San Juan, PR................................................ 0.7061
Toa Alta, PR................................................ 0.7061
Toa Baja, PR................................................ 0.7061
Trujillo Alto, PR........................................... 0.7061
Vega Alta, PR............................................... 0.7061
Vega Baja, PR............................................... 0.7061
Yabucoa, PR................................................. 0.7061
San Luis Obispo-Atascadero-Paso Robles, CA
San Luis Obispo, CA......................................... 1.0812
Santa Barbara-Santa Maria-Lompoc, CA
Santa Barbara, CA........................................... 1.1390
Santa Cruz-Watsonville, CA
Santa Cruz, CA.............................................. 1.2349
Santa Fe, NM
Los Alamos, NM.............................................. 1.0007
Santa Fe, NM................................................ 1.0007
Santa Rosa, CA
Sonoma, CA.................................................. 1.2314
Sarasota-Bradenton, FL
Manatee, FL................................................. 0.9591
Sarasota, FL................................................ 1.0054
Savannah, GA
Bryan, GA................................................... 0.9069
Chatham, GA................................................. 0.9762
Effingham, GA............................................... 0.9762
Scranton--Wilkes-Barre--Hazleton, PA.
Columbia, PA................................................ 0.9621
Lackawanna, PA.............................................. 0.9621
Luzerne, PA................................................. 0.9621
Wyoming, PA................................................. 0.9621
Seattle-Bellevue-Everett, WA
Island, WA.................................................. 1.0337
King, WA.................................................... 1.1278
Snohomish, WA............................................... 1.1278
Sharon, PA
[[Page 42869]]
Mercer, PA.................................................. 0.9597
Sheboygan, WI
Sheboygan, WI............................................... 0.8571
Sherman-Denison, TX
Grayson, TX................................................. 0.9066
Shreveport-Bossier City, LA
Bossier, LA................................................. 1.0436
Caddo, LA................................................... 1.0436
Webster, LA................................................. 0.8871
Sioux City, IA-NE
Woodbury, IA................................................ 0.9853
Dakota, NE.................................................. 0.9853
Sioux Falls, SD
Lincoln, SD................................................. 0.8377
Minnehaha, SD............................................... 0.9362
South Bend, IN
St. Joseph, IN.............................................. 0.9497
Spokane, WA
Spokane, WA................................................. 1.1198
Springfield, IL
Menard, IL.................................................. 1.0720
Sangamon, IL................................................ 1.0720
Springfield, MO
Christian, MO............................................... 0.9025
Greene, MO.................................................. 0.9025
Webster, MO................................................. 0.8198
Springfield, MA
Hampden, MA................................................. 1.0322
Hampshire, MA............................................... 1.0322
State College, PA
Centre, PA.................................................. 1.0440
Steubenville-Weirton, OH-WV
Jefferson, OH............................................... 0.9456
Brooke, WV.................................................. 0.9456
Hancock, WV................................................. 0.9456
Stockton-Lodi, CA
San Joaquin, CA............................................. 1.1781
Sumter, SC
Sumter, SC.................................................. 0.8058
Syracuse, NY
Cayuga, NY.................................................. 0.9128
Madison, NY................................................. 1.3103
Onondaga, NY................................................ 1.3103
Oswego, NY.................................................. 1.3103
Tacoma, WA
Pierce, WA.................................................. 1.0803
Tallahassee, FL
Gadsden, FL................................................. 0.9137
Leon, FL.................................................... 0.9137
Tampa-St. Petersburg-Clearwater, FL
Hernando, FL................................................ 0.9941
Hillsborough, FL............................................ 0.9941
Pasco, FL................................................... 0.9941
Pinellas, FL................................................ 0.9941
Terre Haute, IN
Clay, IN.................................................... 0.8962
Vermillion, IN.............................................. 0.8787
Vigo, IN.................................................... 0.8962
Texarkana, AR-Texarkana, TX
Miller, AR.................................................. 1.0450
Bowie, TX................................................... 1.0450
Toledo, OH
Fulton, OH.................................................. 1.1236
Lucas, OH................................................... 1.1236
Wood, OH.................................................... 1.1236
Topeka, KS
Shawnee, KS................................................. 1.1007
Trenton, NJ
Mercer, NJ.................................................. 1.0657
Tucson, AZ
Pima, AZ.................................................... 1.0000
Tulsa, OK
Creek, OK................................................... 0.9826
Osage, OK................................................... 0.9826
Rogers, OK.................................................. 0.9826
Tulsa, OK................................................... 0.9826
Wagoner, OK................................................. 0.9826
Tuscaloosa, AL
Tuscaloosa, AL.............................................. 0.9457
Tyler, TX
Smith, TX................................................... 1.0226
Utica-Rome, NY
Herkimer, NY................................................ 0.9226
Oneida, NY.................................................. 0.9226
Vallejo-Fairfield-Napa, CA
Napa, CA.................................................... 1.3792
Solano, CA.................................................. 1.3792
Ventura, CA
Ventura, CA................................................. 1.2055
Victoria, TX
Victoria, TX................................................ 0.8731
Vineland-Millville-Bridgeton, NJ
Cumberland, NJ.............................................. 0.9864
Visalia-Tulare-Porterville, CA
Tulare, CA.................................................. 1.1180
Waco, TX
McLennan, TX................................................ 0.8220
Washington, DC-MD-VA-WV
District of Columbia, DC.................................... 1.1602
Calvert, MD................................................. 1.1602
Charles, MD................................................. 1.1602
Frederick, MD............................................... 1.1602
Montgomery, MD.............................................. 1.1602
Prince Georges, MD.......................................... 1.1602
Alexandria City, VA......................................... 1.1602
Arlington, VA............................................... 1.1602
Clarke, VA.................................................. 0.9480
Culpepper, VA............................................... 0.9480
Fairfax, VA................................................. 1.1602
Fairfax City, VA............................................ 1.1602
Falls Church City, VA....................................... 1.1602
Fauquier, VA................................................ 0.9480
Fredericksburg City, VA..................................... 0.9480
King George, VA............................................. 0.9480
Loudoun, VA................................................. 1.1602
Manassas City, VA........................................... 1.1602
Manassas Park City, VA...................................... 1.1602
Prince William, VA.......................................... 1.1602
Spotsylvania, VA............................................ 0.9480
Stafford, VA................................................ 1.1602
Warren, VA.................................................. 0.9480
Berkeley, WV................................................ 0.9931
Jefferson, WV............................................... 0.9931
Waterloo-Cedar Falls, IA
Black Hawk, IA.............................................. 0.9155
Wausau, WI
Marathon, WI................................................ 0.9851
West Palm Beach-Boca Raton, FL
Palm Beach, FL.............................................. 1.0144
Wheeling, OH-WV
Belmont, OH................................................. 0.9221
Marshall, WV................................................ 0.9221
Ohio, WV.................................................... 0.9221
Wichita, KS
Butler, KS.................................................. 1.0818
Harvey, KS.................................................. 0.8724
Sedgwick, KS................................................ 1.0818
Wichita Falls, TX
Archer, TX.................................................. 0.8264
Wichita, TX................................................. 0.8669
Williamsport, PA
Lycoming, PA................................................ 0.9864
Willington-Newark, DE-MD
New Castle, DE.............................................. 1.1263
Cecil, MD................................................... 1.1263
Willington, NC
Brunswick, NC............................................... 0.8864
New Hanover, NC............................................. 0.9213
Yakima, WA
Yakima, WA.................................................. 1.0243
Yolo, CA
Yolo, CA.................................................... 1.1667
York, PA
York, PA.................................................... 1.0112
Youngstown-Warren, OH
Columbiana, OH.............................................. 0.9538
Mahoning, OH................................................ 1.0828
Trumbull, OH................................................ 1.0828
Yuba City, CA
Sutter, CA.................................................. 1.0913
Yuba, CA.................................................... 1.0913
Yuma, AZ
Yuma, AZ.................................................... 0.9321
------------------------------------------------------------------------
\1\ Wage index values are based on fiscal year 1993 hospital cost report
data prior to reclassification. This wage index is further adjusted.
Wage index values greater than 0.8 are subject to a budget neutrality
adjustment of 1.020768. Wage index values below 0.8 are adjusted to be
the greater of a 15 percent increase, subject to a maximum wage index
value of 0.8, or an adjustment by multiplying the hospice wage index
value for a given area by the budget neutrality adjustment. All of
these adjustments are built into the wage index values reflected in
Table A.
Table B.--Wage Index for Rural Areas
------------------------------------------------------------------------
Wage
Nonurban area index
-------------------------------------------------------------------\2\--
Alabama:
Barbour, AL................................................. 0.8000
Bibb, AL.................................................... 0.8000
Bullock, AL................................................. 0.8000
Butler, AL.................................................. 0.8000
Chambers, AL................................................ 0.8000
Cherokee, AL................................................ 0.8000
Chilton, AL................................................. 0.8000
Choctaw, AL................................................. 0.8000
Clarke, AL.................................................. 0.8000
Clay, AL.................................................... 0.8000
Cleburne, AL................................................ 0.8000
Coffee, AL.................................................. 0.8000
Conecuh, AL................................................. 0.8000
Coosa, AL................................................... 0.8000
Covington, AL............................................... 0.8000
Crenshaw, AL................................................ 0.8000
Cullman, AL................................................. 0.8000
Dallas, AL.................................................. 0.8000
De Kalb, AL................................................. 0.8000
Escambia, AL................................................ 0.8000
Fayette, AL................................................. 0.8000
Franklin, AL................................................ 0.8000
Geneva, AL.................................................. 0.8000
Greene, AL.................................................. 0.8000
Hale, AL.................................................... 0.8000
[[Page 42870]]
Henry, AL................................................... 0.8000
Jackson, AL................................................. 0.8000
Lamar, AL................................................... 0.8000
Lee, AL..................................................... 0.8000
Lowndes, AL................................................. 0.8000
Macon, AL................................................... 0.8000
Marengo, AL................................................. 0.8000
Marion, AL.................................................. 0.8000
Marshall, AL................................................ 0.8000
Monroe, AL.................................................. 0.8000
Perry, AL................................................... 0.8000
Pickens, AL................................................. 0.8000
Pike, AL.................................................... 0.8000
Randolph, AL................................................ 0.8000
Sumter, AL.................................................. 0.8000
Talladega, AL............................................... 0.8000
Tallapoosa, AL.............................................. 0.8000
Walker, AL.................................................. 0.9365
Washington, AL.............................................. 0.8000
Wilcox, AL.................................................. 0.8000
Winston, AL................................................. 0.8000
Alaska:
Aleutians East, AK.......................................... 1.3603
Aleutians West, AK.......................................... 1.3603
Bethel, AK.................................................. 1.3603
Bristol Bay Borough, AK..................................... 1.3603
Dillingham, AK.............................................. 1.3603
Fairbanks North Star, AK.................................... 1.3603
Haines, AK.................................................. 1.3603
Juneau, AK.................................................. 1.3603
Kenai Peninsula............................................. 1.3603
Ketchikan Gateway, AK....................................... 1.3603
Kodiak Island, AK........................................... 1.3603
Lake and Peninsula, AK...................................... 1.3603
Matanuska-Susitna, AK....................................... 1.3603
Nome, AK.................................................... 1.3603
North Slope, AK............................................. 1.3603
Northwest Arctic, AK........................................ 1.3603
Pr. of Wales-out.Ketchikanak, AK............................ 1.3603
Sitka, AK................................................... 1.3603
Skagway-Yakutat-Angoon, AK.................................. 1.3603
Southeast Fairbanks, AK..................................... 1.3603
Valdez-Cordova, AK.......................................... 1.3603
Wade Hampton, AK............................................ 1.3603
Wrangell-Petersburg, AK..................................... 1.3603
Yukon-Koyukuk, AK........................................... 1.3603
Arizona:
Apache, AZ.................................................. 0.8787
Cochise, AZ................................................. 0.8787
Gila, AZ.................................................... 0.8787
Graham, AZ.................................................. 0.8787
Greenlee, AZ................................................ 0.8787
Lapaz, AZ................................................... 0.8787
Navajo, AZ.................................................. 0.8787
Santa Cruz, AZ.............................................. 0.8787
Yavapai, AZ................................................. 0.8787
Arkansas:
Arkansas, AR................................................ 0.7999
Ashley, AR.................................................. 0.7999
Baxter, AR.................................................. 0.7999
Boone, AR................................................... 0.7999
Bradley, AR................................................. 0.7999
Calhoun, AR................................................. 0.7999
Carroll, AR................................................. 0.7999
Chicot, AR.................................................. 0.7999
Clark, AR................................................... 0.7999
Clay, AR.................................................... 0.7999
Cleburne, AR................................................ 0.7999
Cleveland, AR............................................... 0.7999
Columbia, AR................................................ 0.7999
Conway, AR.................................................. 0.7999
Craighead, AR............................................... 0.7999
Cross, AR................................................... 0.7999
Dallas, AR.................................................. 0.7999
Desha, AR................................................... 0.7999
Drew, AR.................................................... 0.7999
Franklin, AR................................................ 0.7999
Fulton, AR.................................................. 0.7999
Garland, AR................................................. 0.7999
Grant, AR................................................... 0.7999
Greene, AR.................................................. 0.7999
Hempstead, AR............................................... 0.7999
Hot Springs, AR............................................. 0.7999
Howard, AR.................................................. 0.7999
Independence, AR............................................ 0.7999
Izard, AR................................................... 0.7999
Jackson, AR................................................. 0.7999
Johnson, AR................................................. 0.7999
Lafayette, AR............................................... 0.7999
Lawrence, AR................................................ 0.7999
Lee, AR..................................................... 0.7999
Lincoln, AR................................................. 0.7999
Little River, AR............................................ 0.7999
Logan, AR................................................... 0.7999
Madison, AR................................................. 0.7999
Marion, AR.................................................. 0.7999
Mississippi, AR............................................. 0.7999
Monroe, AR.................................................. 0.7999
Montgomery, AR.............................................. 0.7999
Nevada, AR.................................................. 0.7999
Newton, AR.................................................. 0.7999
Ouachita, AR................................................ 0.7999
Perry, AR................................................... 0.7999
Phillips, AR................................................ 0.7999
Pike, AR.................................................... 0.7999
Poinsett, AR................................................ 0.7999
Polk, AR.................................................... 0.7999
Pope, AR.................................................... 0.7999
Prairie, AR................................................. 0.7999
Randolph, AR................................................ 0.7999
St. Francis, AR............................................. 0.7999
Scott, AR................................................... 0.7999
Searcy, AR.................................................. 0.7999
Sevier, AR.................................................. 0.7999
Sharp, AR................................................... 0.7999
Stone, AR................................................... 0.7999
Union, AR................................................... 0.7999
Van Buren, AR............................................... 0.7999
White, AR................................................... 0.7999
Woodruff, AR................................................ 0.7999
Yell, AR.................................................... 0.7999
California:
Alpine, CA.................................................. 1.0282
Amador, CA.................................................. 1.0282
Calaveras, CA............................................... 1.0282
Colusa, CA.................................................. 1.0282
Del Norte, CA............................................... 1.0282
Glenn, CA................................................... 1.0282
Humboldt, CA................................................ 1.0282
Imperial, CA................................................ 1.0282
Inyo, CA.................................................... 1.0282
Kings, CA................................................... 1.0282
Lake, CA.................................................... 1.0282
Lassen, CA.................................................. 1.0282
Mariposa, CA................................................ 1.0282
Mendocino, CA............................................... 1.0282
Modoc, CA................................................... 1.0282
Mono, CA.................................................... 1.0282
Nevada, CA.................................................. 1.0282
Plumas, CA.................................................. 1.0282
San Enito, CA............................................... 1.0282
Sierra, CA.................................................. 1.0282
Siskiyou, CA................................................ 1.0282
Tehama, CA.................................................. 1.0282
Trinity, CA................................................. 1.0282
Tuolumne, CA................................................ 1.0282
Colorado:
Alamosa, CO................................................. 0.8417
Archuleta, CO............................................... 0.8417
Baca, CO.................................................... 0.8417
Bent, CO.................................................... 0.8417
Chaffee, CO................................................. 0.8417
Cheyenne, CO................................................ 0.8417
Clear Creek, CO............................................. 0.8417
Conejos, CO................................................. 0.8417
Costilla, CO................................................ 0.8417
Crowley, CO................................................. 0.8417
Custer, CO.................................................. 0.8417
Delta, CO................................................... 0.8417
Dolores, CO................................................. 0.8417
Eagle, CO................................................... 0.8417
Elbert, CO.................................................. 0.8417
Fremont, CO................................................. 0.8417
Garfield, CO................................................ 0.8417
Gilpin, CO.................................................. 0.8417
Grand, CO................................................... 0.8417
Gunnison, CO................................................ 0.8417
Hinsdale, CO................................................ 0.8417
Huerfano, CO................................................ 0.8417
Jackson, CO................................................. 0.8417
Kiowa, CO................................................... 0.8417
Kit Carson, CO.............................................. 0.8417
Lake, CO.................................................... 0.8417
La Plata, CO................................................ 0.8417
Las Animas, CO.............................................. 0.8417
Lincoln, CO................................................. 0.8417
Logan, CO................................................... 0.8417
Mineral, CO................................................. 0.8417
Moffat, CO.................................................. 0.8417
Montezuma, CO............................................... 0.8417
Montrose, CO................................................ 0.8417
Morgan, CO.................................................. 0.8417
Otero, CO................................................... 0.8417
Ouray, CO................................................... 0.8417
Park, CO.................................................... 0.8417
Phillips, CO................................................ 0.8417
Pitkin, CO.................................................. 0.8417
Prowers, CO................................................. 0.8417
Rio Blanco, CO.............................................. 0.8417
Rio Grande, CO.............................................. 0.8417
Routt, CO................................................... 0.8417
Saguache, CO................................................ 0.8417
San Juan, CO................................................ 0.8417
San Miguel, CO.............................................. 0.8417
Sedgwick, CO................................................ 0.8417
Summit, CO.................................................. 0.8417
Teller, CO.................................................. 0.8417
Washington, CO.............................................. 0.8417
Yuma, CO.................................................... 0.8417
Connecticut:
Windham, CT................................................. 1.1128
Delaware:
Sussex, DE.................................................. 0.9349
Florida:
Baker, FL................................................... 0.8884
Bradford, FL................................................ 0.9556
Calhoun, FL................................................. 0.8884
Citrus, FL.................................................. 0.8884
Columbia, FL................................................ 0.8884
De Soto, FL................................................. 0.8884
[[Page 42871]]
Dixie, FL................................................... 0.8884
Franklin, FL................................................ 0.8884
Gilchrist, FL............................................... 0.8884
Glades, FL.................................................. 0.8884
Gulf, FL.................................................... 0.8884
Hamilton, FL................................................ 0.8884
Hardee, FL.................................................. 0.8884
Hendry, FL.................................................. 0.8884
Highlands, FL............................................... 0.8884
Holmes, FL.................................................. 0.8884
Indian River, FL............................................ 0.8884
Jackson, FL................................................. 0.8884
Jefferson, FL............................................... 0.8884
Lafayette, FL............................................... 0.8884
Levy, FL.................................................... 0.8884
Liberty, FL................................................. 0.8884
Madison, FL................................................. 0.8884
Monroe, FL.................................................. 0.8884
Okeechobee, FL.............................................. 0.8884
Putnam, FL.................................................. 0.8884
Sumter, FL.................................................. 0.8884
Suwannee, FL................................................ 0.8884
Taylor, FL.................................................. 0.8884
Union, FL................................................... 0.8884
Wakulla, FL................................................. 0.8884
Walton, FL.................................................. 0.8884
Washington, FL.............................................. 0.8884
Georgia:
Appling, GA................................................. 0.8335
Atkinson, GA................................................ 0.8335
Bacon, GA................................................... 0.8335
Baker, GA................................................... 0.8335
Baldwin, GA................................................. 0.8335
Banks, GA................................................... 0.8335
Ben Hill, GA................................................ 0.8335
Berrien, GA................................................. 0.8335
Bleckley, GA................................................ 0.8335
Brantley, GA................................................ 0.8335
Brooks, GA.................................................. 0.8335
Bulloch, GA................................................. 0.8335
Burke, GA................................................... 0.8335
Butts, GA................................................... 0.8945
Calhoun, GA................................................. 0.8335
Camden, GA.................................................. 0.8335
Candler, GA................................................. 0.8335
Charlton, GA................................................ 0.8335
Chattooga, GA............................................... 0.8335
Clay, GA.................................................... 0.8335
Clinch, GA.................................................. 0.8335
Coffee, GA.................................................. 0.8335
Colquitt, GA................................................ 0.8335
Cook, GA.................................................... 0.8335
Crawford, GA................................................ 0.8335
Crisp, GA................................................... 0.8335
Dawson, GA.................................................. 0.8335
Decatur, GA................................................. 0.8335
Dodge, GA................................................... 0.8335
Dooly, GA................................................... 0.8335
Early, GA................................................... 0.8335
Echols, GA.................................................. 0.8335
Elbert, GA.................................................. 0.8335
Emanuel, GA................................................. 0.8335
Evans, GA................................................... 0.8335
Fannin, GA.................................................. 0.8335
Floyd, GA................................................... 0.8335
Franklin, GA................................................ 0.8335
Gilmer, GA.................................................. 0.8335
Glascock, GA................................................ 0.8335
Glynn, GA................................................... 0.8335
Gordon, GA.................................................. 0.8335
Grady, GA................................................... 0.8335
Greene, GA.................................................. 0.8335
Habersham, GA............................................... 0.8335
Hall, GA.................................................... 0.8335
Hancock, GA................................................. 0.8335
Haralson, GA................................................ 0.8335
Hart, GA.................................................... 0.8335
Heard, GA................................................... 0.8335
Irwin, GA................................................... 0.8335
Jackson, GA................................................. 0.8545
Jasper, GA.................................................. 0.8335
Jeff Davis, GA.............................................. 0.8335
Jefferson, GA............................................... 0.8335
Jenkins, GA................................................. 0.8335
Johnson, GA................................................. 0.8335
Lamar, GA................................................... 0.8335
Lanier, GA.................................................. 0.8335
Laurens, GA................................................. 0.8335
Liberty, GA................................................. 0.8335
Lincoln, GA................................................. 0.8335
Long, GA.................................................... 0.8335
Lowndes, GA................................................. 0.8335
Lumpkin, GA................................................. 0.8335
Mc Intosh, GA............................................... 0.8335
Macon, GA................................................... 0.8335
Marion, GA.................................................. 0.8335
Meriwether, GA.............................................. 0.8335
Miller, GA.................................................. 0.8335
Mitchell, GA................................................ 0.8335
Monroe, GA.................................................. 0.8335
Montgomery, GA.............................................. 0.8335
Morgan, GA.................................................. 0.8335
Murray, GA.................................................. 0.8335
Oglethorpe, GA.............................................. 0.8335
Pierce, GA.................................................. 0.8335
Pike, GA.................................................... 0.8335
Polk, GA.................................................... 0.8335
Pulaski, GA................................................. 0.8335
Putnam, GA.................................................. 0.8335
Quitman, GA................................................. 0.8335
Rabun, GA................................................... 0.8335
Randolph, GA................................................ 0.8335
Schley, GA.................................................. 0.8335
Screven, GA................................................. 0.8335
Seminole, GA................................................ 0.8335
Stephens, GA................................................ 0.8335
Stewart, GA................................................. 0.8335
Sumter, GA.................................................. 0.8335
Talbot, GA.................................................. 0.8335
Taliaferro, GA.............................................. 0.8335
Tattnall, GA................................................ 0.8335
Taylor, GA.................................................. 0.8335
Telfair, GA................................................. 0.8335
Terrell, GA................................................. 0.8335
Thomas, GA.................................................. 0.8335
Tift, GA.................................................... 0.8335
Toombs, GA.................................................. 0.8335
Towns, GA................................................... 0.8335
Treutlen, GA................................................ 0.8335
Troup, GA................................................... 0.8335
Turner, GA.................................................. 0.8335
Union, GA................................................... 0.8335
Upson, GA................................................... 0.8335
Ware, GA.................................................... 0.8335
Warren, GA.................................................. 0.8335
Washington, GA.............................................. 0.8335
Wayne, GA................................................... 0.8335
Webster, GA................................................. 0.8335
Wheeler, GA................................................. 0.8335
White, GA................................................... 0.8335
Whitfield, GA............................................... 0.8335
Wilcox, GA.................................................. 0.8335
Wilkes, GA.................................................. 0.8335
Wilkinson, GA............................................... 0.8335
Worth, GA................................................... 0.8335
Hawaii:
Hawaii, HI.................................................. 1.1496
Kalawao, HI................................................. 1.1496
Kauai, HI................................................... 1.1496
Maui, HI.................................................... 1.1496
Idaho:
Adams, ID................................................... 0.8942
Bannock, ID................................................. 0.8942
Bear Lake, ID............................................... 0.8942
Benewah, ID................................................. 0.8942
Bingham, ID................................................. 0.8942
Blaine, ID.................................................. 0.8942
Boise, ID................................................... 0.8942
Bonner, ID.................................................. 0.8942
Bonneville, ID.............................................. 0.8942
Boundary, ID................................................ 0.8942
Butte, ID................................................... 0.8942
Camas, ID................................................... 0.8942
Caribou, ID................................................. 0.8942
Cassia, ID.................................................. 0.8942
Clark, ID................................................... 0.8942
Clearwater, ID.............................................. 0.8942
Custer, ID.................................................. 0.8942
Elmore, ID.................................................. 0.8942
Franklin, ID................................................ 0.8942
Fremont, ID................................................. 0.8942
Gem, ID..................................................... 0.8942
Gooding, ID................................................. 0.8942
Idaho, ID................................................... 0.8942
Jefferson, ID............................................... 0.8942
Jerome, ID.................................................. 0.8942
Kootenai, ID................................................ 0.8942
Latah, ID................................................... 0.8942
Lemhi, ID................................................... 0.8942
Lewis, ID................................................... 0.8942
Lincoln, ID................................................. 0.8942
Madison, ID................................................. 0.8942
Minidoka, ID................................................ 0.8942
Nez Perce, ID............................................... 0.8942
Oneida, ID.................................................. 0.8942
Owyhee, ID.................................................. 0.8942
Payette, ID................................................. 0.8942
Power, ID................................................... 0.8942
Shoshone, ID................................................ 0.8942
Teton, ID................................................... 0.8942
Twin Falls, ID.............................................. 0.8942
Valley, ID.................................................. 0.8942
Washington, ID.............................................. 0.8942
Illinois:
Adams, IL................................................... 0.8455
Alexander, IL............................................... 0.8455
Bond, IL.................................................... 0.8455
Brown, IL................................................... 0.8455
Bureau, IL.................................................. 0.8455
Calhoun, IL................................................. 0.8455
Carroll, IL................................................. 0.8455
Cass, IL.................................................... 0.8455
Christian, IL............................................... 0.8455
Clark, IL................................................... 0.8455
Clay, IL.................................................... 0.8455
Coles, IL................................................... 0.8455
Crawford, IL................................................ 0.8455
Cumberland, IL.............................................. 0.8455
De Witt, IL................................................. 0.8455
Douglas, IL................................................. 0.8455
[[Page 42872]]
Edgar, IL................................................... 0.8455
Edwards, IL................................................. 0.8455
Effingham, IL............................................... 0.8455
Fayette, IL................................................. 0.8455
Ford, IL.................................................... 0.8455
Franklin, IL................................................ 0.8455
Fulton, IL.................................................. 0.8455
Gallatin, IL................................................ 0.8455
Greene, IL.................................................. 0.8455
Hamilton,IL................................................. 0.8455
Hancock, IL................................................. 0.8455
Hardin, IL.................................................. 0.8455
Henderson, IL............................................... 0.8455
Iroquois, IL................................................ 0.8455
Jackson, IL................................................. 0.8455
Jasper, IL.................................................. 0.8455
Jefferson, IL............................................... 0.8455
Jo Daviess, IL.............................................. 0.8455
Johnson, IL................................................. 0.8455
Knox, IL.................................................... 0.8455
La Salle, IL................................................ 0.8455
Lawrence, IL................................................ 0.8455
Lee, IL..................................................... 0.8455
Livingston, IL.............................................. 0.8455
Logan, IL................................................... 0.8455
McDonough, IL............................................... 0.8455
Macoupin, IL................................................ 0.8455
Marion, IL.................................................. 0.8455
Marshall, IL................................................ 0.8455
Mason, IL................................................... 0.8455
Massac, IL.................................................. 0.8455
Mercer, IL.................................................. 0.8455
Montgomery, IL.............................................. 0.8455
Morgan, IL.................................................. 0.8455
Moultrie, IL................................................ 0.8455
Perry, IL................................................... 0.8455
Piatt, IL................................................... 0.8455
Pike, IL.................................................... 0.8455
Pope, IL.................................................... 0.8455
Pulaski, IL................................................. 0.8455
Putnam, IL.................................................. 0.8455
Randolph, IL................................................ 0.8455
Richland, IL................................................ 0.8455
Saline, IL.................................................. 0.8455
Schuyler, IL................................................ 0.8455
Scott, IL................................................... 0.8455
Shelby, IL.................................................. 0.8455
Stark, IL................................................... 0.8455
Stephenson, IL.............................................. 0.8455
Union, IL................................................... 0.8455
Vermilion, IL............................................... 0.8455
Wabash, IL.................................................. 0.8455
Warren, IL.................................................. 0.8455
Washington, IL.............................................. 0.8455
Wayne, IL................................................... 0.8455
White, IL................................................... 0.8455
Whiteside, IL............................................... 0.8455
Williamson, IL.............................................. 0.8455
Indiana:
Bartholomew, IN............................................. 0.8628
Benton, IN.................................................. 0.8628
Blackford, IN............................................... 0.8628
Brown, IN................................................... 0.8628
Carroll, IN................................................. 0.8628
Cass, IN.................................................... 0.8628
Crawford, IN................................................ 0.8628
Daviess, IN................................................. 0.8628
Decatur, IN................................................. 0.8628
Dubois, IN.................................................. 0.8628
Fayette, IN................................................. 0.8628
Fountain, IN................................................ 0.8628
Franklin, IN................................................ 0.8628
Fulton, IN.................................................. 0.8628
Gibson, IN.................................................. 0.8628
Grant, IN................................................... 0.8628
Greene, IN.................................................. 0.8628
Henry, IN................................................... 0.8628
Jackson, IN................................................. 0.8628
Jasper, IN.................................................. 0.8628
Jay, IN..................................................... 0.8628
Jefferson, IN............................................... 0.8628
Jennings, IN................................................ 0.8628
Knox, IN.................................................... 0.8628
Kosciusko, IN............................................... 0.8628
Lagrange, IN................................................ 0.8628
La Porte, IN................................................ 0.8628
Lawrence, IN................................................ 0.8628
Marshall, IN................................................ 0.8628
Martin, IN.................................................. 0.8628
Miami, IN................................................... 0.8628
Montgomery, IN.............................................. 0.8628
Newton, IN.................................................. 0.8628
Noble, IN................................................... 0.8628
Orange, IN.................................................. 0.8628
Owen, IN.................................................... 0.8628
Parke, IN................................................... 0.8628
Perry, IN................................................... 0.8628
Pike, IN.................................................... 0.8628
Pulaski, IN................................................. 0.8628
Putnam, IN.................................................. 0.8628
Randolph, IN................................................ 0.8628
Ripley, IN.................................................. 0.8628
Rush, IN.................................................... 0.8628
Spencer, IN................................................. 0.8628
Starke, IN.................................................. 0.8628
Steuben, IN................................................. 0.8628
Sullivan, IN................................................ 0.8628
Switzerland, IN............................................. 0.8628
Union, IN................................................... 0.8628
Wabash, IN.................................................. 0.8628
Warren, IN.................................................. 0.8628
Washington, IN.............................................. 0.8628
Wayne, IN................................................... 0.8628
White, IN................................................... 0.8628
Iowa:
Adair, IA................................................... 0.8116
Adams, IA................................................... 0.8116
Allamakee, IA............................................... 0.8116
Appanoose, IA............................................... 0.8116
Audubon, IA................................................. 0.8116
Benton, IA.................................................. 0.8116
Boone, IA................................................... 0.8116
Bremer, IA.................................................. 0.8733
Buchanan, IA................................................ 0.8116
Buena Vista, IA............................................. 0.8116
Butler, IA.................................................. 0.8116
Calhoun, IA................................................. 0.8116
Carroll, IA................................................. 0.8116
Cass, IA.................................................... 0.8116
Cedar, IA................................................... 0.8116
Cerro Gordo, IA............................................. 0.8116
Cherokee, IA................................................ 0.8116
Chickasaw, IA............................................... 0.8116
Clarke, IA.................................................. 0.8116
Clay, IA.................................................... 0.8116
Clayton, IA................................................. 0.8116
Clinton, IA................................................. 0.8116
Crawford, IA................................................ 0.8116
Davis, IA................................................... 0.8116
Decatur, IA................................................. 0.8116
Delaware, IA................................................ 0.8116
Des Moines, IA.............................................. 0.8116
Dickinson, IA............................................... 0.8116
Emmet, IA................................................... 0.8116
Fayette, IA................................................. 0.8116
Floyd, IA................................................... 0.8116
Franklin, IA................................................ 0.8116
Fremont, IA................................................. 0.8116
Greene, IA.................................................. 0.8116
Grundy, IA.................................................. 0.8116
Guthrie, IA................................................. 0.8116
Hamilton, IA................................................ 0.8116
Hancock, IA................................................. 0.8116
Hardin, IA.................................................. 0.8116
Harrison, IA................................................ 0.8116
Henry, IA................................................... 0.8116
Howard, IA.................................................. 0.8116
Humboldt, IA................................................ 0.8116
Ida, IA..................................................... 0.8116
Iowa, IA.................................................... 0.8116
Jackson, IA................................................. 0.8116
Jasper, IA.................................................. 0.8116
Jefferson, IA............................................... 0.8116
Jones, IA................................................... 0.8116
Keokuk, IA.................................................. 0.8116
Kossuth, IA................................................. 0.8116
Lee, IA..................................................... 0.8116
Louisa, IA.................................................. 0.8116
Lucas, IA................................................... 0.8116
Lyon, IA.................................................... 0.8116
Madison, IA................................................. 0.8116
Mahaska, IA................................................. 0.8116
Marion, IA.................................................. 0.8116
Marshall, IA................................................ 0.8116
Mills, IA................................................... 0.8116
Mitchell, IA................................................ 0.8116
Monona, IA.................................................. 0.8116
Monroe, IA.................................................. 0.8116
Montgomery, IA.............................................. 0.8116
Muscatine, IA............................................... 0.8116
Obrien, IA.................................................. 0.8116
Osceola, IA................................................. 0.8116
Page, IA.................................................... 0.8116
Palo Alto, IA............................................... 0.8116
Plymouth, IA................................................ 0.8116
Pocahontas, IA.............................................. 0.8116
Poweshiek, IA............................................... 0.8116
Ringgold, IA................................................ 0.8116
Sac, IA..................................................... 0.8116
Shelby, IA.................................................. 0.8116
Sioux, IA................................................... 0.8116
Story, IA................................................... 0.8116
Tama, IA.................................................... 0.8116
Taylor, IA.................................................. 0.8116
Union, IA................................................... 0.8116
Van Buren, IA............................................... 0.8116
Wapello, IA................................................. 0.8116
Washington, IA.............................................. 0.8116
Wayne, IA................................................... 0.8116
Webster, IA................................................. 0.8116
Winnebago, IA............................................... 0.8116
Winneshiek, IA.............................................. 0.8116
Worth, IA................................................... 0.8116
Wright, IA.................................................. 0.8116
Kansas:
Allen, KS................................................... 0.8090
Anderson, KS................................................ 0.8090
Atchison, KS................................................ 0.8090
Barber, KS.................................................. 0.8090
Barton, KS.................................................. 0.8090
[[Page 42873]]
Bourbon, KS................................................. 0.8090
Brown, KS................................................... 0.8090
Chase, KS................................................... 0.8090
Chautauqua, KS.............................................. 0.8090
Cherokee, KS................................................ 0.8090
Cheyenne, KS................................................ 0.8090
Clark, KS................................................... 0.8090
Clay, KS.................................................... 0.8090
Cloud, KS................................................... 0.8090
Coffey, KS.................................................. 0.8090
Comanche, KS................................................ 0.8090
Cowley, KS.................................................. 0.8090
Crawford, KS................................................ 0.8090
Decatur, KS................................................. 0.8090
Dickinson, KS............................................... 0.8090
Doniphan, KS................................................ 0.8090
Edwards, KS................................................. 0.8090
Elk, KS..................................................... 0.8090
Ellis, KS................................................... 0.8090
Ellsworth, KS............................................... 0.8090
Finney, KS.................................................. 0.8090
Ford, KS.................................................... 0.8090
Franklin, KS................................................ 0.8090
Geary, KS................................................... 0.8090
Gove, KS.................................................... 0.8090
Graham, KS.................................................. 0.8090
Grant, KS................................................... 0.8090
Gray, KS.................................................... 0.8090
Greeley, KS................................................. 0.8090
Greenwood, KS............................................... 0.8090
Hamilton, KS................................................ 0.8090
Harper, KS.................................................. 0.8090
Haskell, KS................................................. 0.8090
Hodgeman, KS................................................ 0.8090
Jackson, KS................................................. 0.8090
Jefferson, KS............................................... 0.8090
Jewell, KS.................................................. 0.8090
Kearny, KS.................................................. 0.8090
Kingman, KS................................................. 0.8090
Kiowa, KS................................................... 0.8090
Labette, KS................................................. 0.8090
Lane, KS.................................................... 0.8090
Lincoln, KS................................................. 0.8090
Linn, KS.................................................... 0.8090
Logan, KS................................................... 0.8090
Lyon, KS.................................................... 0.8090
McPherson, KS............................................... 0.8090
Marion, KS.................................................. 0.8090
Marshall, KS................................................ 0.8090
Meade, KS................................................... 0.8090
Mitchell, KS................................................ 0.8090
Montgomery, KS.............................................. 0.8090
Morris, KS.................................................. 0.8090
Morton, KS.................................................. 0.8090
Nemaha, KS.................................................. 0.8090
Neosho, KS.................................................. 0.8090
Ness, KS.................................................... 0.8090
Norton, KS.................................................. 0.8090
Osage, KS................................................... 0.8090
Osborne, KS................................................. 0.8090
Ottawa, KS.................................................. 0.8090
Pawnee, KS.................................................. 0.8090
Phillips, KS................................................ 0.8090
Pottawatomie, KS............................................ 0.8090
Pratt, KS................................................... 0.8090
Rawlins, KS................................................. 0.8090
Reno, KS.................................................... 0.8090
Republic, KS................................................ 0.8090
Rice, KS.................................................... 0.8090
Riley, KS................................................... 0.8090
Rooks, KS................................................... 0.8090
Rush, KS.................................................... 0.8090
Russell, KS................................................. 0.8090
Saline, KS.................................................. 0.8090
Scott, KS................................................... 0.8090
Seward, KS.................................................. 0.8090
Sheridan, KS................................................ 0.8090
Sherman, KS................................................. 0.8090
Smith, KS................................................... 0.8090
Stafford, KS................................................ 0.8090
Stanton, KS................................................. 0.8090
Stevens, KS................................................. 0.8090
Sumner, KS.................................................. 0.8090
Thomas, KS.................................................. 0.8090
Trego, KS................................................... 0.8090
Wabaunsee, KS............................................... 0.8090
Wallace, KS................................................. 0.8090
Washington, KS.............................................. 0.8090
Wichita, KS................................................. 0.8090
Wilson, KS.................................................. 0.8090
Woodson, KS................................................. 0.8090
Kentucky:
Adair, KY................................................... 0.8103
Allen, KY................................................... 0.8103
Anderson, KY................................................ 0.8103
Ballard, KY................................................. 0.8103
Barren, KY.................................................. 0.8103
Bath, KY.................................................... 0.8103
Bell, KY.................................................... 0.8103
Boyle, KY................................................... 0.8103
Bracken, KY................................................. 0.8103
Breathitt, KY............................................... 0.8103
Breckinridge, KY............................................ 0.8103
Butler, KY.................................................. 0.8103
Caldwell, KY................................................ 0.8103
Calloway, KY................................................ 0.8103
Carlisle, KY................................................ 0.8103
Carroll, KY................................................. 0.8103
Casey, KY................................................... 0.8103
Clay, KY.................................................... 0.8103
Clinton, KY................................................. 0.8103
Crittenden, KY.............................................. 0.8103
Cumberland, KY.............................................. 0.8103
Edmonson, KY................................................ 0.8103
Elliott, KY................................................. 0.8103
Estill, KY.................................................. 0.8103
Fleming, KY................................................. 0.8103
Floyd, KY................................................... 0.8103
Franklin, KY................................................ 0.8103
Fulton, KY.................................................. 0.8103
Garrard, KY................................................. 0.8103
Graves, KY.................................................. 0.8103
Grayson, KY................................................. 0.8103
Green, KY................................................... 0.8103
Hancock, KY................................................. 0.8103
Hardin, KY.................................................. 0.8103
Harlan, KY.................................................. 0.8103
Harrison, KY................................................ 0.8103
Hart, KY.................................................... 0.8103
Henry, KY................................................... 0.8103
Hickman, KY................................................. 0.8103
Hopkins, KY................................................. 0.8103
Jackson, KY................................................. 0.8103
Johnson, KY................................................. 0.8103
Knott, KY................................................... 0.8103
Knox, KY.................................................... 0.8103
Larue, KY................................................... 0.8103
Laurel, KY.................................................. 0.8103
Lawrence, KY................................................ 0.8103
Lee, KY..................................................... 0.8103
Leslie, KY.................................................. 0.8103
Letcher, KY................................................. 0.8103
Lewis, KY................................................... 0.8103
Lincoln, KY................................................. 0.8103
Livingston, KY.............................................. 0.8103
Logan, KY................................................... 0.8103
Lyon, KY.................................................... 0.8103
McCracken, KY............................................... 0.8103
McCreary, KY................................................ 0.8103
McLean, KY.................................................. 0.8103
Magoffin, KY................................................ 0.8103
Marion, KY.................................................. 0.8103
Marshall, KY................................................ 0.8103
Martin, KY.................................................. 0.8103
Mason, KY................................................... 0.8103
Meade, KY................................................... 0.8103
Menifee, KY................................................. 0.8103
Mercer, KY.................................................. 0.8103
Metcalfe, KY................................................ 0.8103
Monroe, KY.................................................. 0.8103
Montgomery, KY.............................................. 0.8103
Morgan, KY.................................................. 0.8103
Muhlenberg, KY.............................................. 0.8103
Nelson, KY.................................................. 0.8103
Nicholas, KY................................................ 0.8103
Ohio, KY.................................................... 0.8103
Owen, KY.................................................... 0.8103
Owsley, KY.................................................. 0.8103
Perry, KY................................................... 0.8103
Pike, KY.................................................... 0.8103
Powell, KY.................................................. 0.8103
Pulaski, KY................................................. 0.8103
Robertson, KY............................................... 0.8103
Rockcastle, KY.............................................. 0.8103
Rowan, KY................................................... 0.8103
Russell, KY................................................. 0.8103
Shelby, KY.................................................. 0.9903
Simpson, KY................................................. 0.8103
Spencer, KY................................................. 0.8103
Taylor, KY.................................................. 0.8103
Todd, KY.................................................... 0.8103
Trigg, KY................................................... 0.8103
Trimble, KY................................................. 0.8103
Union, KY................................................... 0.8103
Warren, KY.................................................. 0.8103
Washington, KY.............................................. 0.8103
Wayne, KY................................................... 0.8103
Webster, KY................................................. 0.8103
Whitley, KY................................................. 0.8103
Wolfe, KY................................................... 0.8103
Louisiana:
Allen, LA................................................... 0.8237
Assumption, LA.............................................. 0.8237
Avoyelles, LA............................................... 0.8237
Beauregard, LA.............................................. 0.8237
Bienville, LA............................................... 0.8237
Caldwell, LA................................................ 0.8237
Cameron, LA................................................. 0.8237
Catahoula, LA............................................... 0.8237
Claiborne, LA............................................... 0.8237
Concordia, LA............................................... 0.8237
De Soto, LA................................................. 0.8237
East Carroll, LA............................................ 0.8237
East Feliciana, LA.......................................... 0.8237
Evangeline, LA.............................................. 0.8237
Franklin, LA................................................ 0.8237
Grant, LA................................................... 0.8237
Iberia, LA.................................................. 0.8237
Iberville, LA............................................... 0.8237
Jackson, LA................................................. 0.8237
[[Page 42874]]
Jefferson Davis, LA......................................... 0.8237
La Salle, LA................................................ 0.8237
Lincoln, LA................................................. 0.8237
Madison, LA................................................. 0.8237
Morehouse, LA............................................... 0.8237
Natchitoches, LA............................................ 0.8237
Pointe Coupee, LA........................................... 0.8237
Red River, LA............................................... 0.8237
Richland, LA................................................ 0.8237
Sabine, LA.................................................. 0.8237
St. Helena, LA.............................................. 0.8237
St. Mary, LA................................................ 0.8237
Tangipahoa, LA.............................................. 0.8237
Tensas, LA.................................................. 0.8237
Union, LA................................................... 0.8237
Vermilion, LA............................................... 0.8237
Vernon, LA.................................................. 0.8237
Washington, LA.............................................. 0.8237
West Carroll, LA............................................ 0.8237
West Feliciana, LA.......................................... 0.8237
Winn, LA.................................................... 0.8237
Maine:
Aroostook, ME............................................... 0.8731
Franklin, ME................................................ 0.8731
Hancock, ME................................................. 0.8731
Kennebec, ME................................................ 0.8731
Knox, ME.................................................... 0.8731
Lincoln, ME................................................. 0.8731
Oxford, ME.................................................. 0.8731
Piscataquis, ME............................................. 0.8731
Somerset, ME................................................ 0.8731
Waldo, ME................................................... 0.8731
Washington, ME.............................................. 0.8731
Maryland:
Caroline, MD................................................ 0.9206
Dorchester, MD.............................................. 0.9206
Garrett, MD................................................. 0.9206
Kent, MD.................................................... 0.9206
St. Marys, MD............................................... 0.9206
Somerset, MD................................................ 0.9206
Talbot, MD.................................................. 0.9206
Wicomico, MD................................................ 0.9206
Worcester, MD............................................... 0.9206
Massachusetts:
Dukes, MA................................................... 1.0272
Franklin, MA................................................ 1.0272
Nantucket, MA............................................... 1.0272
Michigan:
Alcona, MI.................................................. 0.9452
Alger, MI................................................... 0.9452
Alpena, MI.................................................. 0.9452
Antrim, MI.................................................. 0.9452
Arenac, MI.................................................. 0.9452
Baraga, MI.................................................. 0.9452
Barry, MI................................................... 0.9452
Benzie, MI.................................................. 0.9452
Branch, MI.................................................. 0.9452
Cass, MI.................................................... 0.9452
Charlevoix, MI.............................................. 0.9452
Cheboygan, MI............................................... 0.9452
Chippewa, MI................................................ 0.9452
Clare, MI................................................... 0.9452
Crawford, MI................................................ 0.9452
Delta, MI................................................... 0.9452
Dickinson, MI............................................... 0.9452
Emmet, MI................................................... 0.9452
Gladwin, MI................................................. 0.9452
Gogebic, MI................................................. 0.9452
Grand Traverse, MI.......................................... 0.9452
Gratiot, MI................................................. 0.9452
Hillsdale, MI............................................... 0.9452
Houghton, MI................................................ 0.9452
Huron, MI................................................... 0.9452
Ionia, MI................................................... 0.9452
Iosco, MI................................................... 0.9452
Iron, MI.................................................... 0.9452
Isabella, MI................................................ 0.9452
Kalkaska, MI................................................ 0.9452
Keweenaw, MI................................................ 0.9452
Lake, MI.................................................... 0.9452
Leelanau, MI................................................ 0.9452
Luce, MI.................................................... 0.9452
Mackinac, MI................................................ 0.9452
Manistee, MI................................................ 0.9452
Marquette, MI............................................... 0.9452
Mason, MI................................................... 0.9452
Mecosta, MI................................................. 0.9452
Menominee, MI............................................... 0.9452
Missaukee, MI............................................... 0.9452
Montcalm, MI................................................ 0.9452
Montmorency, MI............................................. 0.9452
Newaygo, MI................................................. 0.9452
Oceana, MI.................................................. 0.9452
Ogemaw, MI.................................................. 0.9452
Ontonagon, MI............................................... 0.9452
Osceola, MI................................................. 0.9452
Oscoda, MI.................................................. 0.9452
Otsego, MI.................................................. 0.9452
Presque Isle, MI............................................ 0.9452
Roscommon, MI............................................... 0.9452
St. Joseph, MI.............................................. 0.9452
Sanilac, MI................................................. 0.9452
Schoolcraft, MI............................................. 0.9452
Shiawassee, MI.............................................. 0.9452
Tuscola, MI................................................. 0.9452
Wexford, MI................................................. 0.9452
Minnesota:
Aitkin, MN.................................................. 0.8616
Becker, MN.................................................. 0.8616
Beltrami, MN................................................ 0.8616
Big Stone, MN............................................... 0.8616
Blue Earth, MN.............................................. 0.8616
Brown, MN................................................... 0.8616
Carlton, MN................................................. 0.8616
Cass, MN.................................................... 0.8616
Chippewa, MN................................................ 0.8616
Clearwater, MN.............................................. 0.8616
Cook, MN.................................................... 0.8616
Cottonwood, MN.............................................. 0.8616
Crow Wing, MN............................................... 0.8616
Dodge, MN................................................... 0.8616
Douglas, MN................................................. 0.8616
Faribault, MN............................................... 0.8616
Fillmore, MN................................................ 0.8616
Freeborn, MN................................................ 0.8616
Goodhue, MN................................................. 0.8616
Grant, MN................................................... 0.8616
Hubbard, MN................................................. 0.8616
Itasca, MN.................................................. 0.8616
Jackson, MN................................................. 0.8616
Kanabec, MN................................................. 0.8616
Kandiyohi, MN............................................... 0.8616
Kittson, MN................................................. 0.8616
Koochiching, MN............................................. 0.8616
Lac Qui Parle, MN........................................... 0.8616
Lake, MN.................................................... 0.8616
Lake of Woods, MN........................................... 0.8616
Le Sueur, MN................................................ 0.8616
Lincoln, MN................................................. 0.8616
Lyon, MN.................................................... 0.8616
Mc Leod, MN................................................. 0.8616
Mahnomen, MN................................................ 0.8616
Marshall, MN................................................ 0.8616
Martin, MN.................................................. 0.8616
Meeker, MN.................................................. 0.8616
Mille Lacs, MN.............................................. 0.8616
Morrison, MN................................................ 0.8616
Mower, MN................................................... 0.8616
Murray, MN.................................................. 0.8616
Nicollet, MN................................................ 0.8616
Nobles, MN.................................................. 0.8616
Norman, MN.................................................. 0.8616
Otter Tail, MN.............................................. 0.8616
Pennington, MN.............................................. 0.8616
Pine, MN.................................................... 0.8616
Pipestone, MN............................................... 0.8616
Pope, MN.................................................... 0.8616
Red Lake, MN................................................ 0.8616
Redwood, MN................................................. 0.8616
Renville, MN................................................ 0.8616
Rice, MN.................................................... 0.8616
Rock, MN.................................................... 0.8616
Roseau, MN.................................................. 0.8616
Sibley, MN.................................................. 0.8616
Steele, MN.................................................. 0.8616
Stevens, MN................................................. 0.8616
Swift, MN................................................... 0.8616
Todd, MN.................................................... 0.8616
Traverse, MN................................................ 0.8616
Wabasha, MN................................................. 0.8616
Wadena, MN.................................................. 0.8616
Waseca, MN.................................................. 0.8616
Watonwan, MN................................................ 0.8616
Wilkin, MN.................................................. 0.8616
Winona, MN.................................................. 0.8616
Yellow Medicine, MN......................................... 0.8616
Mississippi:
Adams, MS................................................... 0.7951
Alcorn, MS.................................................. 0.7951
Amite, MS................................................... 0.7951
Attala, MS.................................................. 0.7951
Benton, MS.................................................. 0.7951
Bolivar, MS................................................. 0.7951
Calhoun, MS................................................. 0.7951
Carroll, MS................................................. 0.7951
Chickasaw, MS............................................... 0.7951
Choctaw, MS................................................. 0.7951
Claiborne, MS............................................... 0.7951
Clarke, MS.................................................. 0.7951
Clay, MS.................................................... 0.7951
Coahoma, MS................................................. 0.7951
Copiah, MS.................................................. 0.7951
Covington, MS............................................... 0.7951
Franklin, MS................................................ 0.7951
George, MS.................................................. 0.7951
Greene, MS.................................................. 0.7951
Grenada, MS................................................. 0.7951
Holmes, MS.................................................. 0.7951
Humphreys, MS............................................... 0.7951
Issaquena, MS............................................... 0.7951
Itawamba, MS................................................ 0.7951
Jasper, MS.................................................. 0.7951
Jefferson, MS............................................... 0.7951
Jefferson Davis, MS......................................... 0.7951
Jones, MS................................................... 0.7951
Kemper, MS.................................................. 0.7951
Lafayette, MS............................................... 0.7951
Lauderdale, MS.............................................. 0.7951
Lawrence, MS................................................ 0.7951
Leake, MS................................................... 0.7951
[[Page 42875]]
Lee, MS..................................................... 0.7951
Leflore, MS................................................. 0.7951
Lincoln, MS................................................. 0.7951
Lowndes, MS................................................. 0.7951
Marion, MS.................................................. 0.7951
Marshall, MS................................................ 0.7951
Monroe, MS.................................................. 0.7951
Montgomery, MS.............................................. 0.7951
Neshoba, MS................................................. 0.7951
Newton, MS.................................................. 0.7951
Noxubee, MS................................................. 0.7951
Oktibbeha, MS............................................... 0.7951
Panola, MS.................................................. 0.7951
Pearl River, MS............................................. 0.7951
Perry, MS................................................... 0.7951
Pike, MS.................................................... 0.7951
Pontotoc, MS,............................................... 0.7951
Prentiss, MS................................................ 0.7951
Quitman, MS................................................. 0.7951
Scott, MS................................................... 0.7951
Sharkey, MS................................................. 0.7951
Simpson, MS................................................. 0.7951
Smith, MS................................................... 0.7951
Stone, MS................................................... 0.7951
Sunflower, MS............................................... 0.7951
Tallahatchie, MS............................................ 0.7951
Tate, MS.................................................... 0.7951
Tippah, MS.................................................. 0.7951
Tishomingo, MS.............................................. 0.7951
Tunica, MS.................................................. 0.7951
Union, MS................................................... 0.7951
Walthall, MS................................................ 0.7951
Warren, MS.................................................. 0.7951
Washington, MS.............................................. 0.7951
Wayne, MS................................................... 0.7951
Webster, MS................................................. 0.7951
Wilkinson, MS............................................... 0.7951
Winston, MS................................................. 0.7951
Yalobusha, MS............................................... 0.7951
Yazoo, MS................................................... 0.7951
Missouri:
Adair, MO................................................... 0.8198
Atchison, MO................................................ 0.8198
Audrain, MO................................................. 0.8198
Barry, MO................................................... 0.8198
Barton, MO.................................................. 0.8198
Bates, MO................................................... 0.8198
Benton, MO.................................................. 0.8198
Bollinger, MO............................................... 0.8198
Butler, MO.................................................. 0.8198
Caldwell, MO................................................ 0.8198
Callaway, MO................................................ 0.8198
Camden, MO.................................................. 0.8198
Cape Girardeau, MO.......................................... 0.8198
Carroll, MO................................................. 0.8198
Carter, MO.................................................. 0.8198
Cedar, MO................................................... 0.8198
Chariton, MO................................................ 0.8198
Clark, MO................................................... 0.8198
Cole, MO.................................................... 0.8198
Cooper, MO.................................................. 0.8198
Crawford, MO................................................ 0.8198
Dade, MO.................................................... 0.8198
Dallas, MO.................................................. 0.8198
Daviess, MO................................................. 0.8198
De Kalb, MO................................................. 0.8198
Dent, MO.................................................... 0.8198
Douglas, MO................................................. 0.8198
Dunklin, MO................................................. 0.8198
Gasconade, MO............................................... 0.8198
Gentry, MO.................................................. 0.8198
Grundy, MO.................................................. 0.8198
Harrison, MO................................................ 0.8198
Henry, MO................................................... 0.8198
Hickory, MO................................................. 0.8198
Holt, MO.................................................... 0.8198
Howard, MO.................................................. 0.8198
Howell, MO.................................................. 0.8198
Iron, MO.................................................... 0.8198
Johnson, MO................................................. 0.8198
Knox, MO.................................................... 0.8198
Laclede, MO................................................. 0.8198
Lawrence, MO................................................ 0.8198
Lewis, MO................................................... 0.8198
Linn, MO.................................................... 0.8198
Livingston, MO.............................................. 0.8198
McDonald, MO................................................ 0.8198
Macon, MO................................................... 0.8198
Madison, MO................................................. 0.8198
Maries, MO.................................................. 0.8198
Marion, MO.................................................. 0.8198
Mercer, MO.................................................. 0.8198
Miller, MO.................................................. 0.8198
Mississippi, MO............................................. 0.8198
Moniteau, MO................................................ 0.8198
Monroe, MO.................................................. 0.8198
Montgomery, MO.............................................. 0.8198
Morgan, MO.................................................. 0.8198
New Madrid, MO.............................................. 0.8198
Nodaway, MO................................................. 0.8198
Oregon, MO.................................................. 0.8198
Osage, MO................................................... 0.8198
Ozark, MO................................................... 0.8198
Pemiscot, MO................................................ 0.8198
Perry, MO................................................... 0.8198
Pettis, MO.................................................. 0.8198
Phelps, MO.................................................. 0.8198
Pike, MO.................................................... 0.8198
Polk, MO.................................................... 0.8198
Pulaski, MO................................................. 0.8198
Putnam, MO.................................................. 0.8198
Ralls, MO................................................... 0.8198
Randolph, MO................................................ 0.8198
Reynolds, MO................................................ 0.8198
Ripley, MO.................................................. 0.8198
St. Clair, MO............................................... 0.8198
St. Genevieve, MO........................................... 0.8198
St. Francois, MO............................................ 0.8198
Saline, MO.................................................. 0.8198
Schuyler, MO................................................ 0.8198
Scotland, MO................................................ 0.8198
Scott, MO................................................... 0.8198
Shannon, MO................................................. 0.8198
Shelby, MO.................................................. 0.8198
Stoddard, MO................................................ 0.8198
Stone, MO................................................... 0.8198
Sullivan, MO................................................ 0.8198
Taney, MO................................................... 0.8198
Texas, MO................................................... 0.8198
Vernon, MO.................................................. 0.8198
Washington, MO.............................................. 0.8198
Wayne, MO................................................... 0.8198
Worth, MO................................................... 0.8198
Wright, MO.................................................. 0.8198
Montana:
Beaverhead, MT.............................................. 0.8687
Big Horn, MT................................................ 0.8687
Blaine, MT.................................................. 0.8687
Broadwater, MT.............................................. 0.8687
Carbon, MT.................................................. 0.8687
Carter, MT.................................................. 0.8687
Chouteau, MT................................................ 0.8687
Custer, MT.................................................. 0.8687
Daniels, MT................................................. 0.8687
Dawson, MT.................................................. 0.8687
Deer Lodge, MT.............................................. 0.8687
Fallon, MT.................................................. 0.8687
Fergus, MT.................................................. 0.8687
Flathead, MT................................................ 0.8687
Gallatin, MT................................................ 0.8687
Garfield, MT................................................ 0.8687
Glacier, MT................................................. 0.8687
Golden Valley, MT........................................... 0.8687
Granite, MT................................................. 0.8687
Hill, MT.................................................... 0.8687
Jefferson, MT............................................... 0.8687
Judith Basin, MT............................................ 0.8687
Lake, MT.................................................... 0.8687
Lewis and Clark, MT......................................... 0.8687
Liberty, MT................................................. 0.8687
Lincoln, MT................................................. 0.8687
Mccone, MT.................................................. 0.8687
Madison, MT................................................. 0.8687
Meagher, MT................................................. 0.8687
Mineral, MT................................................. 0.8687
Missoula, MT................................................ 0.8687
Musselshell, MT............................................. 0.8687
Park, MT.................................................... 0.8687
Petroleum, MT............................................... 0.8687
Phillips, MT................................................ 0.8687
Pondera, MT................................................. 0.8687
Powder River, MT............................................ 0.8687
Powell, MT.................................................. 0.8687
Prairie, MT................................................. 0.8687
Ravalli, MT................................................. 0.8687
Richland, MT................................................ 0.8687
Roosevelt, MT............................................... 0.8687
Rosebud, MT................................................. 0.8687
Sanders, MT................................................. 0.8687
Sheridan, MT................................................ 0.8687
Silver bow, MT.............................................. 0.8687
Stillwater, MT.............................................. 0.8687
Sweet Grass, MT............................................. 0.8687
Teton, MT................................................... 0.8687
Toole, MT................................................... 0.8687
Treasure, MT................................................ 0.8687
Valley, MT.................................................. 0.8687
Wheatland, MT............................................... 0.8687
Wibaux, MT.................................................. 0.8687
Yellowstone Natl Park, MT................................... 0.8687
Nebraska:
Adams, NE................................................... 0.8000
Antelope, NE................................................ 0.8000
Arthur, NE.................................................. 0.8000
Banner, NE.................................................. 0.8000
Blaine, NE.................................................. 0.8000
Boone, NE................................................... 0.8000
Box Butte, NE............................................... 0.8000
Boyd, NE.................................................... 0.8000
Brown, NE................................................... 0.8000
Buffalo, NE................................................. 0.8000
Burt, NE.................................................... 0.8000
Butler, NE.................................................. 0.8000
Cedar, NE................................................... 0.8000
Chase, NE................................................... 0.8000
Cherry, NE.................................................. 0.8000
Cheyenne, NE................................................ 0.8000
Clay, NE.................................................... 0.8000
Colfax, NE.................................................. 0.8000
Cuming, NE.................................................. 0.8000
[[Page 42876]]
Custer, NE.................................................. 0.8000
Dawes, NE................................................... 0.8000
Dawson, NE.................................................. 0.8000
Deuel, NE................................................... 0.8000
Dixon, NE................................................... 0.8000
Dodge, NE................................................... 0.8000
Dundy, NE................................................... 0.8000
Fillmore, NE................................................ 0.8000
Franklin, NE................................................ 0.8000
Frontier, NE,............................................... 0.8000
Furnas, NE.................................................. 0.8000
Gage, NE.................................................... 0.8000
Garden, NE.................................................. 0.8000
Garfield, NE................................................ 0.8000
Gosper, NE.................................................. 0.8000
Grant, NE................................................... 0.8000
Greeley, NE................................................. 0.8000
Hall, NE.................................................... 0.8000
Hamilton, NE................................................ 0.8000
Harlan, NE.................................................. 0.8000
Hayes, NE................................................... 0.8000
Hitchcock, NE............................................... 0.8000
Holt, NE.................................................... 0.8000
Hooker, NE.................................................. 0.8000
Howard, NE.................................................. 0.8000
Jefferson, NE............................................... 0.8000
Johnson, NE................................................. 0.8000
Kearney, NE................................................. 0.8000
Keith, NE................................................... 0.8000
Keya Paha, NE............................................... 0.8000
Kimball, NE................................................. 0.8000
Knox, NE.................................................... 0.8000
Lincoln, NE................................................. 0.8000
Logan, NE................................................... 0.8000
Loup, NE.................................................... 0.8000
Mc Pherson, NE.............................................. 0.8000
Madison, NE................................................. 0.8000
Merrick, NE................................................. 0.8000
Morrill, NE................................................. 0.8000
Nance, NE................................................... 0.8000
Nemaha, NE.................................................. 0.8000
Nuckolls, NE................................................ 0.8000
Otoe, NE.................................................... 0.8000
Pawnee, NE.................................................. 0.8000
Perkins, NE................................................. 0.8000
Phelps, NE.................................................. 0.8000
Pierce, NE.................................................. 0.8000
Platte, NE.................................................. 0.8000
Polk, NE.................................................... 0.8000
Red Willow, NE.............................................. 0.8000
Richardson, NE.............................................. 0.8000
Rock, NE.................................................... 0.8000
Saline, NE.................................................. 0.8000
Saunders, NE................................................ 0.8000
Scott Bluff, NE............................................. 0.8000
Seward, NE.................................................. 0.8000
Sheridan, NE................................................ 0.8000
Sherman, NE................................................. 0.8000
Sioux, NE................................................... 0.8000
Stanton, NE................................................. 0.8000
Thayer, NE.................................................. 0.8000
Thomas, NE.................................................. 0.8000
Thurston, NE................................................ 0.8000
Valley, NE.................................................. 0.8000
Wayne, NE................................................... 0.8000
Webster, NE................................................. 0.8000
Wheeler, NE................................................. 0.8000
York, NE.................................................... 0.8000
Nevada:
Churchill, NV............................................... 0.9912
Douglas, NV................................................. 0.9912
Elko, NV.................................................... 0.9912
Esmeralda, NV............................................... 0.9912
Eureka, NV.................................................. 0.9912
Humboldt, NV................................................ 0.9912
Lander, NV.................................................. 0.9912
Lincoln, NV................................................. 0.9912
Lyon, NV.................................................... 0.9912
Mineral, NV................................................. 0.9912
Pershing, NV................................................ 0.9912
Storey, NV.................................................. 0.9912
White Pine, NV.............................................. 0.9912
Carson City, NV............................................. 0.9912
New Hampshire:
Belknap, NH................................................. 1.0337
Carroll, NH................................................. 1.0337
Cheshire, NH................................................ 1.0337
Coos, NH.................................................... 1.0337
Grafton, NH................................................. 1.0337
Sullivan, NH................................................ 1.0337
New Mexico:
Catron, NM.................................................. 0.9046
Chaves, NM.................................................. 0.9046
Cibola, NM.................................................. 0.9046
Colfax, NM.................................................. 0.9046
Curry, NM................................................... 0.9046
De Baca, NM................................................. 0.9046
Eddy, NM.................................................... 0.9046
Grant, NM................................................... 0.9046
Guadalupe, NM............................................... 0.9046
Harding, NM................................................. 0.9046
Hidalgo, NM................................................. 0.9046
Lea, NM..................................................... 0.9046
Lincoln, NM................................................. 0.9046
Luna, NM.................................................... 0.9046
Mckinley, NM................................................ 0.9046
Mora, NM.................................................... 0.9046
Otero, NM................................................... 0.9046
Quay, NM.................................................... 0.9046
Rio Arriba, NM.............................................. 0.9046
Roosevelt, NM............................................... 0.9046
San Juan, NM................................................ 0.9046
San Miguel, NM.............................................. 0.9046
Sierra, NM.................................................. 0.9046
Socorro, NM................................................. 0.9046
Taos, NM.................................................... 0.9046
Torrance, NM................................................ 0.9046
Union, NM................................................... 0.9046
New York:
Allegany, NY................................................ 0.8843
Cattaraugus, NY............................................. 0.8843
Chenango, NY................................................ 0.8843
Clinton, NY................................................. 0.8843
Columbia, NY................................................ 0.8843
Cortland, NY................................................ 0.8843
Delaware, NY................................................ 0.8843
Essex, NY................................................... 0.8843
Franklin, NY................................................ 0.8843
Fulton, NY.................................................. 0.8843
Greene, NY.................................................. 0.8985
Hamilton, NY................................................ 0.8843
Jefferson, NY............................................... 0.8843
Lewis, NY................................................... 0.8843
Otsego, NY.................................................. 0.8843
St. Lawrence, NY............................................ 0.8843
Schuyler, NY................................................ 0.8843
Seneca, NY.................................................. 0.8843
Steuben, NY................................................. 0.8843
Sullivan, NY................................................ 0.8843
Tompkins, NY................................................ 0.8843
Ulster, NY.................................................. 0.8843
Wyoming, NY................................................. 0.8843
Yates, NY................................................... 0.8843
North Carolina:
Alleghany, NC............................................... 0.8491
Anson, NC................................................... 0.8491
Ashe, NC.................................................... 0.8491
Avery, NC................................................... 0.8491
Beaufort, NC................................................ 0.8491
Bertie, NC.................................................. 0.8491
Bladen, NC.................................................. 0.8491
Camden, NC.................................................. 0.8491
Carteret, NC................................................ 0.8491
Caswell, NC................................................. 0.8491
Cherokee, NC................................................ 0.8491
Chowan, NC.................................................. 0.8491
Clay, NC.................................................... 0.8491
Cleveland, NC............................................... 0.8491
Columbus, NC................................................ 0.8491
Craven, NC.................................................. 0.8491
Dare, NC.................................................... 0.8491
Duplin, NC.................................................. 0.8491
Gates, NC................................................... 0.8491
Graham, NC.................................................. 0.8491
Granville, NC............................................... 0.8491
Greene, NC.................................................. 0.8491
Halifax, NC................................................. 0.8491
Harnett, NC................................................. 0.8491
Haywood, NC................................................. 0.8491
Henderson, NC............................................... 0.8491
Hertford, NC................................................ 0.8491
Hoke, NC.................................................... 0.8491
Hyde, NC.................................................... 0.8491
Iredell, NC................................................. 0.8491
Jackson, NC................................................. 0.8491
Jones, NC................................................... 0.8491
Lee, NC..................................................... 0.8491
Lenoir, NC.................................................. 0.8491
McDowell, NC................................................ 0.8491
Macon, NC................................................... 0.8491
Martin, NC.................................................. 0.8491
Mitchell, NC................................................ 0.8491
Montgomery, NC.............................................. 0.8491
Moore, NC................................................... 0.8491
Northampton, NC............................................. 0.8491
Pamlico, NC................................................. 0.8491
Pasquotank, NC.............................................. 0.8491
Pender, NC.................................................. 0.8491
Perquimans, NC.............................................. 0.8491
Person, NC.................................................. 0.8491
Polk, NC.................................................... 0.8491
Richmond, NC................................................ 0.8491
Robeson, NC................................................. 0.8491
Rockingham, NC.............................................. 0.8491
Rutherford, NC.............................................. 0.8491
Sampson, NC................................................. 0.8491
Scotland, NC................................................ 0.8491
Stanly, NC.................................................. 0.8491
Surry, NC................................................... 0.8491
Swain, NC................................................... 0.8491
Transylvania, NC............................................ 0.8491
Tyrrell, NC................................................. 0.8491
Vance, NC................................................... 0.8491
Warren, NC.................................................. 0.8491
Washington, NC.............................................. 0.8491
Watauga, NC................................................. 0.8491
Wilkes, NC.................................................. 0.8491
Wilson, NC.................................................. 0.8491
Yancey, NC.................................................. 0.8491
North Dakota:
[[Page 42877]]
Adams, ND................................................... 0.8217
Barnes, ND.................................................. 0.8217
Benson, ND.................................................. 0.8217
Billings, ND................................................ 0.8217
Bottineau, ND............................................... 0.8217
Bowman, ND.................................................. 0.8217
Burke, ND................................................... 0.8217
Cavalier, ND................................................ 0.8217
Dickey, ND.................................................. 0.8217
Divide, ND.................................................. 0.8217
Dunn, ND.................................................... 0.8217
Eddy, ND.................................................... 0.8217
Emmons, ND.................................................. 0.8217
Foster, ND.................................................. 0.8217
Golden Valley, ND........................................... 0.8217
Grant, ND................................................... 0.8217
Griggs, ND.................................................. 0.8217
Hettinger, ND............................................... 0.8217
Kidder, ND.................................................. 0.8217
La Moure, ND................................................ 0.8217
Logan, ND................................................... 0.8217
McHenry, ND................................................. 0.8217
McIntosh, ND................................................ 0.8217
McKenzie, ND................................................ 0.8217
McLean, ND.................................................. 0.8217
Mercer, ND.................................................. 0.8217
Mountrail, ND............................................... 0.8217
Nelson, ND.................................................. 0.8217
Oliver, ND.................................................. 0.8217
Pembina, ND................................................. 0.8217
Pierce, ND.................................................. 0.8217
Ramsey, ND.................................................. 0.8217
Ransom, ND.................................................. 0.8217
Renville, ND................................................ 0.8217
Richland, ND................................................ 0.8217
Rolette, ND................................................. 0.8217
Sargent, ND................................................. 0.8217
Sheridan, ND................................................ 0.8217
Sioux, ND................................................... 0.8217
Slope, ND................................................... 0.8217
Stark, ND................................................... 0.8217
Steele, ND.................................................. 0.8217
Stutsman, ND................................................ 0.8217
Towner, ND.................................................. 0.8217
Traill, ND.................................................. 0.8217
Walsh, ND................................................... 0.8217
Ward, ND.................................................... 0.8217
Wells, ND................................................... 0.8217
Williams, ND................................................ 0.8217
Ohio:
Adams, OH................................................... 0.9058
Ashland, OH................................................. 0.9058
Athens, OH.................................................. 0.9058
Champaign, OH............................................... 0.9058
Clinton, OH................................................. 0.9058
Coshocton, OH............................................... 0.9058
Darke, OH................................................... 0.9058
Defiance, OH................................................ 0.9058
Erie, OH.................................................... 0.9058
Fayette, OH................................................. 0.9058
Gallia, OH.................................................. 0.9058
Guernsey, OH................................................ 0.9058
Hancock, OH................................................. 0.9058
Hardin, OH.................................................. 0.9058
Harrison, OH................................................ 0.9058
Henry, OH................................................... 0.9058
Highland, OH................................................ 0.9058
Hocking, OH................................................. 0.9058
Holmes, OH.................................................. 0.9058
Huron, OH................................................... 0.9058
Jackson, OH................................................. 0.9058
Knox, OH.................................................... 0.9058
Logan, OH................................................... 0.9058
Marion, OH.................................................. 0.9058
Meigs, OH................................................... 0.9058
Mercer, OH.................................................. 0.9058
Monroe, OH.................................................. 0.9058
Morgan, OH.................................................. 0.9058
Morrow, OH.................................................. 0.9058
Muskingum, OH............................................... 0.9058
Noble, OH................................................... 0.9058
Ottawa, OH.................................................. 0.9058
Paulding, OH................................................ 0.9058
Perry, OH................................................... 0.9058
Pike, OH.................................................... 0.9058
Preble, OH.................................................. 0.9058
Putnam, OH.................................................. 0.9058
Ross, OH.................................................... 0.9058
Sandusky, OH................................................ 0.9058
Scioto, OH.................................................. 0.9058
Seneca, OH.................................................. 0.9058
Shelby, OH.................................................. 0.9058
Tuscarawas, OH.............................................. 0.9058
Union, OH................................................... 0.9928
Van Wert, OH................................................ 0.9058
Vinton, OH.................................................. 0.9058
Wayne, OH................................................... 0.9058
Williams, OH................................................ 0.9058
Wyandot, OH................................................. 0.9058
Oklahoma:
Adair, OK................................................... 0.8389
Alfalfa, OK................................................. 0.8389
Atoka, OK................................................... 0.8389
Beaver, OK.................................................. 0.8389
Beckham, OK................................................. 0.8389
Blaine, OK.................................................. 0.8389
Bryan, OK................................................... 0.8389
Caddo, OK................................................... 0.8389
Carter, OK.................................................. 0.8389
Cherokee, OK................................................ 0.8389
Choctaw, OK................................................. 0.8389
Cimarron, OK................................................ 0.8389
Coal, OK.................................................... 0.8389
Cotton, OK.................................................. 0.8389
Craig, OK................................................... 0.8389
Custer, OK.................................................. 0.8389
Delaware, OK................................................ 0.8389
Dewey, OK................................................... 0.8389
Ellis, OK................................................... 0.8389
Garvin, OK.................................................. 0.8389
Grady, OK................................................... 0.8389
Grant, OK................................................... 0.8389
Greer, OK................................................... 0.8389
Harmon, OK.................................................. 0.8389
Harper, OK.................................................. 0.8389
Haskell, OK................................................. 0.8389
Hughes, OK.................................................. 0.8389
Jackson, OK................................................. 0.8389
Jefferson, OK............................................... 0.8389
Johnston, OK................................................ 0.8389
Kay, OK..................................................... 0.8389
Kingfisher, OK.............................................. 0.8389
Kiowa, OK................................................... 0.8389
Latimer, OK................................................. 0.8389
Le Flore, OK................................................ 0.8389
Lincoln, OK................................................. 0.8389
Love, OK.................................................... 0.8389
Mccurtain, OK............................................... 0.8389
Mcintosh, OK................................................ 0.8389
Major, OK................................................... 0.8389
Marshall, OK................................................ 0.8389
Mayes, OK................................................... 0.8389
Murray, OK.................................................. 0.8389
Muskogee, OK................................................ 0.8389
Noble, OK................................................... 0.8389
Nowata, OK.................................................. 0.8389
Okfuskee, OK................................................ 0.8389
Okmulgee, OK................................................ 0.8389
Ottawa, OK.................................................. 0.8389
Pawnee, OK.................................................. 0.8389
Payne, OK................................................... 0.8389
Pittsburg, OK............................................... 0.8389
Pontotoc, OK................................................ 0.8389
Pushmataha, OK.............................................. 0.8389
Roger Mills, OK............................................. 0.8389
Seminole, OK................................................ 0.8389
Stephens, OK................................................ 0.8389
Texas, OK................................................... 0.8389
Tillman, OK................................................. 0.8389
Washington, OK.............................................. 0.8389
Washita, OK................................................. 0.8389
Woods, OK................................................... 0.8389
Woodward, OK................................................ 0.8389
Oregon:
Baker, OR................................................... 0.9795
Benton, OR.................................................. 0.9795
Clatsop, OR................................................. 0.9795
Coos, OR.................................................... 0.9795
Crook, OR................................................... 0.9795
Curry, OR................................................... 0.9795
Deschutes, OR............................................... 0.9795
Douglas, OR................................................. 0.9795
Gilliam, OR................................................. 0.9795
Grant, OR................................................... 0.9795
Harney, OR.................................................. 0.9795
Hood River, OR.............................................. 0.9795
Jefferson, OR............................................... 0.9795
Josephine, OR............................................... 0.9795
Klamath, OR................................................. 0.9795
Lake, OR.................................................... 0.9795
Lincoln, OR................................................. 0.9795
Linn, OR.................................................... 0.9795
Malheur, OR................................................. 0.9795
Morrow, OR.................................................. 0.9795
Sherman, OR................................................. 0.9795
Tillamook, OR............................................... 0.9795
Umatilla, OR................................................ 0.9795
Union, OR................................................... 0.9795
Wallowa, OR................................................. 0.9795
Wasco, OR................................................... 0.9795
Wheeler, OR................................................. 0.9795
Pennsylvania:
Adams, PA................................................... 0.9890
Armstrong, PA............................................... 0.9905
Bedford, PA................................................. 0.9905
Bradford, PA................................................ 0.9905
Cameron, PA................................................. 0.9905
Clarion, PA................................................. 0.9905
Clearfield, PA.............................................. 0.9905
Clinton, PA................................................. 0.9905
Crawford, PA................................................ 0.9905
Elk, PA..................................................... 0.9905
Forest, PA.................................................. 0.9905
Franklin, PA................................................ 0.9905
Fulton, PA.................................................. 0.9905
Greene, PA.................................................. 0.9905
Huntingdon, PA.............................................. 0.9905
Indiana, PA................................................. 0.9905
Jefferson, PA............................................... 0.9905
Juniata, PA................................................. 0.9905
[[Page 42878]]
Lawrence, PA................................................ 0.9905
McKean, PA.................................................. 0.9905
Mifflin, PA................................................. 0.9905
Monroe, PA.................................................. 0.9519
Montour, PA................................................. 0.9905
Northumberland, PA.......................................... 0.9905
Potter, PA.................................................. 0.9905
Schuylkill, PA.............................................. 0.9905
Snyder, PA.................................................. 0.9905
Sullivan, PA................................................ 0.9905
Tioga, PA................................................... 0.9905
Susquehanna, PA............................................. 0.9905
Union, PA................................................... 0.9905
Venango, PA................................................. 0.9905
Warren, PA.................................................. 0.9905
Wayne, PA................................................... 0.9905
Puerto Rico:
Adjuntas, PR................................................ 0.6877
Aibonito, PR................................................ 0.6877
Arroyo, PR.................................................. 0.6877
Barranquitas, PR............................................ 0.6877
Ciales, PR.................................................. 0.6877
Coamo, PR................................................... 0.6877
Culebra, PR................................................. 0.6877
Guanica, PR................................................. 0.6877
Guayama, PR................................................. 0.6877
Isabela, PR................................................. 0.6877
Jayuya, PR.................................................. 0.6877
Lajas, PR................................................... 0.6877
Lares, PR................................................... 0.6877
Las Marias, PR.............................................. 0.6877
Maricao, PR................................................. 0.6877
Maunabo, PR................................................. 0.6877
Orocovis, PR................................................ 0.6877
Patillas, PR................................................ 0.6877
Quebradillas, PR............................................ 0.6877
Rincon, PR.................................................. 0.6877
Salinas, PR................................................. 0.6877
San Sebastian, PR........................................... 0.6877
Santa Isabel, PR............................................ 0.6877
Utuado, PR.................................................. 0.6877
Vieques, PR................................................. 0.6877
Puerto Rico, Nfd, PR........................................ 0.6877
South Carolina:
Abbeville, SC............................................... 0.8058
Allendale, SC............................................... 0.8058
Bamberg, SC................................................. 0.8058
Barnwell, SC................................................ 0.8058
Beaufort, SC................................................ 0.8058
Calhoun, SC................................................. 0.8058
Chester, SC................................................. 0.8058
Chesterfield, SC............................................ 0.8058
Clarendon, SC............................................... 0.8058
Colleton, SC................................................ 0.8058
Darlington, SC.............................................. 0.8058
Dillon, SC.................................................. 0.8058
Fairfield, SC............................................... 0.8058
Georgetown, SC.............................................. 0.8058
Greenwood, SC............................................... 0.8058
Hampton, SC................................................. 0.8058
Jasper, SC.................................................. 0.8058
Kershaw, SC................................................. 0.8058
Lancaster, SC............................................... 0.8058
Laurens, SC................................................. 0.8058
Lee, SC..................................................... 0.8058
Mccormick, SC............................................... 0.8058
Marion, SC.................................................. 0.8058
Marlboro, SC................................................ 0.8058
Newberry, SC................................................ 0.8058
Oconee, SC.................................................. 0.8058
Orangeburg, SC.............................................. 0.8058
Saluda, SC.................................................. 0.8058
Union, SC................................................... 0.8058
Williamsburg, SC............................................ 0.8058
South Dakota:
Aurora, SD.................................................. 0.8000
Beadle, SD.................................................. 0.8000
Bennett, SD................................................. 0.8000
Bon Homme, SD............................................... 0.8000
Brookings, SD............................................... 0.8000
Brown, SD................................................... 0.8000
Brule, SD................................................... 0.8000
Buffalo, SD................................................. 0.8000
Butte, SD................................................... 0.8000
Campbell, SD................................................ 0.8000
Charles Mix, SD............................................. 0.8000
Clark, SD................................................... 0.8000
Clay, SD.................................................... 0.8000
Codington, SD............................................... 0.8000
Corson, SD.................................................. 0.8000
Custer, SD.................................................. 0.8000
Davison, SD................................................. 0.8000
Day, SD..................................................... 0.8000
Deuel, SD................................................... 0.8000
Dewey, SD................................................... 0.8000
Douglas, SD................................................. 0.8000
Edmunds, SD................................................. 0.8000
Fall River, SD.............................................. 0.8000
Faulk, SD................................................... 0.8000
Grant, SD................................................... 0.8000
Gregory, SD................................................. 0.8000
Haakon, SD.................................................. 0.8000
Hamlin, SD.................................................. 0.8000
Hand, SD.................................................... 0.8000
Hanson, SD.................................................. 0.8000
Harding, SD................................................. 0.8000
Hughes, SD.................................................. 0.8000
Hutchinson, SD.............................................. 0.8000
Hyde, SD.................................................... 0.8000
Jackson, SD................................................. 0.8000
Jerauld, SD................................................. 0.8000
Jones, SD................................................... 0.8000
Kingsbury, SD............................................... 0.8000
Lake, SD.................................................... 0.8000
Lawrence, SD................................................ 0.8000
Lyman, SD................................................... 0.8000
McCook, SD.................................................. 0.8000
McPherson, SD............................................... 0.8000
Marshall, SD................................................ 0.8000
Meade, SD................................................... 0.8000
Mellette, SD................................................ 0.8000
Miner, SD................................................... 0.8000
Moody, SD................................................... 0.8000
Perkins, SD................................................. 0.8000
Potter, SD.................................................. 0.8000
Roberts, SD................................................. 0.8000
Sanborn, SD................................................. 0.8000
Shannon, SD................................................. 0.8000
Spink, SD................................................... 0.8000
Stanley, SD................................................. 0.8000
Sully, SD................................................... 0.8000
Todd, SD.................................................... 0.8000
Tripp, SD................................................... 0.8000
Turner, SD.................................................. 0.8000
Union, SD................................................... 0.8000
Walworth, SD................................................ 0.8000
Washabaugh, SD.............................................. 0.8000
Yankton, SD................................................. 0.8000
Ziebach, SD................................................. 0.8000
Tennessee:
Bedford, TN................................................. 0.8000
Benton, TN.................................................. 0.8000
Bledsoe, TN................................................. 0.8000
Bradley, TN................................................. 0.8000
Campbell, TN................................................ 0.8000
Cannon, TN.................................................. 0.8000
Carroll, TN................................................. 0.8000
Chester, TN................................................. 0.8000
Claiborne, TN............................................... 0.8000
Clay, TN.................................................... 0.8000
Cocke, TN................................................... 0.8000
Coffee, TN.................................................. 0.8000
Crockett, TN................................................ 0.8000
Cumberland, TN.............................................. 0.8000
Decatur, TN................................................. 0.8000
DeKalb, TN.................................................. 0.8000
Dyer, TN.................................................... 0.8000
Fentress, TN................................................ 0.8000
Franklin, TN................................................ 0.8000
Gibson, TN.................................................. 0.8000
Giles, TN................................................... 0.8000
Grainger, TN................................................ 0.8791
Greene, TN.................................................. 0.8000
Grundy, TN.................................................. 0.8000
Hamblen, TN................................................. 0.8000
Hancock, TN................................................. 0.8000
Hardeman, TN................................................ 0.8000
Hardin, TN.................................................. 0.8000
Haywood, TN................................................. 0.8000
Henderson, TN............................................... 0.8000
Henry, TN................................................... 0.8000
Hickman, TN................................................. 0.8000
Houston, TN................................................. 0.8000
Humphreys, TN............................................... 0.8000
Jackson, TN................................................. 0.8000
Jefferson, TN............................................... 0.8791
Johnson, TN................................................. 0.8000
Lake, TN.................................................... 0.8000
Lauderdale, TN.............................................. 0.8000
Lawrence, TN................................................ 0.8000
Lewis, TN................................................... 0.8000
Lincoln, TN................................................. 0.8000
McMinn, TN.................................................. 0.8000
McNairy, TN................................................. 0.8000
Macon, TN................................................... 0.8000
Marshall, TN................................................ 0.8000
Maury, TN................................................... 0.8000
Meigs, TN................................................... 0.8000
Monroe, TN.................................................. 0.8000
Moore, TN................................................... 0.8000
Morgan, TN.................................................. 0.8000
Obion, TN................................................... 0.8000
Overton, TN................................................. 0.8000
Perry, TN................................................... 0.8000
Pickett, TN................................................. 0.8000
Polk, TN.................................................... 0.8000
Putnam, TN.................................................. 0.8000
Rhea, TN.................................................... 0.8000
Roane, TN................................................... 0.8000
Scott, TN................................................... 0.8000
Sequatchie, TN.............................................. 0.9114
Smith, TN................................................... 0.8000
Stewart, TN................................................. 0.8000
Trousdale, TN............................................... 0.8000
Van Buren, TN............................................... 0.8000
Warren, TN.................................................. 0.8000
Wayne, TN................................................... 0.8000
Weakley, TN................................................. 0.8000
White, TN................................................... 0.8000
Texas:
[[Page 42879]]
Anderson, TX................................................ 0.8082
Andrews, TX................................................. 0.8082
Angelina, TX................................................ 0.8082
Aransas, TX.,............................................... 0.8082
Armstrong, TX............................................... 0.8082
Atascosa, TX................................................ 0.8082
Austin, TX.................................................. 0.8082
Bailey, TX.................................................. 0.8082
Bandera, TX................................................. 0.8082
Baylor, TX.................................................. 0.8082
Bee, TX..................................................... 0.8082
Blanco, TX.................................................. 0.8082
Borden, TX.................................................. 0.8082
Bosque, TX.................................................. 0.8082
Brewster, TX................................................ 0.8082
Briscoe, TX................................................. 0.8082
Brooks, TX.................................................. 0.8082
Brown, TX................................................... 0.8082
Burleson, TX................................................ 0.8082
Burnet, TX.................................................. 0.8082
Calhoun, TX................................................. 0.8082
Callahan, TX................................................ 0.8082
Camp, TX.................................................... 0.8082
Carson, TX.................................................. 0.8082
Cass, TX.................................................... 0.8082
Castro, TX.................................................. 0.8082
Cherokee, TX................................................ 0.8082
Childress, TX............................................... 0.8082
Clay, TX.................................................... 0.8082
Cochran, TX................................................. 0.8082
Coke, TX.................................................... 0.8082
Coleman, TX................................................. 0.8082
Collingsworth, TX........................................... 0.8082
Colorado, TX................................................ 0.8082
Comanche, TX................................................ 0.8082
Concho, TX.................................................. 0.8082
Cooke, TX................................................... 0.8082
Cottle, TX,................................................. 0.8082
Crane, TX................................................... 0.8082
Crockett, TX................................................ 0.8082
Crosby, TX.................................................. 0.8082
Culberson, TX............................................... 0.8082
Dallam, TX.................................................. 0.8082
Dawson, TX.................................................. 0.8082
Deaf Smith, TX.............................................. 0.8082
Delta, TX................................................... 0.8082
De Witt, TX................................................. 0.8082
Dickens, TX................................................. 0.8082
Dimmit, TX.................................................. 0.8082
Donley, TX.................................................. 0.8082
Duval, TX................................................... 0.8082
Eastland, TX................................................ 0.8082
Edwards, TX................................................. 0.8082
Erath, TX................................................... 0.8082
Falls, TX................................................... 0.8082
Fannin, TX.................................................. 0.8082
Fayette, TX................................................. 0.8082
Fisher, TX.................................................. 0.8082
Floyd, TX................................................... 0.8082
Foard, TX................................................... 0.8082
Franklin, TX................................................ 0.8082
Freestone, TX............................................... 0.8082
Frio, TX.................................................... 0.8082
Gaines, TX.................................................. 0.8082
Garza, TX................................................... 0.8082
Gillespie, TX............................................... 0.8082
Glasscock, TX............................................... 0.8082
Goliad, TX.................................................. 0.8082
Gonzales, TX................................................ 0.8082
Gray, TX.................................................... 0.8082
Grimes, TX.................................................. 0.8082
Hale, TX.................................................... 0.8082
Hall, TX.................................................... 0.8082
Hamilton, TX................................................ 0.8082
Hansford, TX................................................ 0.8082
Hardeman, TX................................................ 0.8082
Hartley, TX................................................. 0.8082
Haskell, TX................................................. 0.8082
Hemphill, TX................................................ 0.8082
Hill, TX.................................................... 0.8082
Hockley, TX................................................. 0.8082
Hopkins, TX................................................. 0.8082
Houston, TX................................................. 0.8082
Howard, TX.................................................. 0.8082
Hudspeth, TX................................................ 0.8082
Hutchinson, TX.............................................. 0.8082
Irion, TX................................................... 0.8082
Jack, TX.................................................... 0.8082
Jackson, TX................................................. 0.8082
Jasper, TX.................................................. 0.8082
Jeff Davis, TX.............................................. 0.8082
Jim Hogg, TX................................................ 0.8082
Jim Wells, TX............................................... 0.8082
Jones, TX................................................... 0.8082
Karnes, TX.................................................. 0.8082
Kendall, TX................................................. 0.8082
Kenedy, TX.................................................. 0.8082
Kent, TX.................................................... 0.8082
Kerr, TX.................................................... 0.8082
Kimble, TX.................................................. 0.8082
King, TX.................................................... 0.8082
Kinney, TX.................................................. 0.8082
Kleberg, TX................................................. 0.8082
Knox, TX.................................................... 0.8082
Lamar, TX................................................... 0.8082
Lamb, TX.................................................... 0.8082
Lampasas, TX................................................ 0.8082
La Salle, TX................................................ 0.8082
Lavaca, TX.................................................. 0.8082
Lee, TX..................................................... 0.8082
Leon, TX.................................................... 0.8082
Limestone, TX............................................... 0.8082
Lipscomb, TX................................................ 0.8082
Live Oak, TX................................................ 0.8082
Llano, TX................................................... 0.8082
Loving, TX.................................................. 0.8082
Lynn, TX.................................................... 0.8082
Mc Culloch, TX.............................................. 0.8082
Mc Mullen, TX............................................... 0.8082
Madison, TX................................................. 0.8082
Marion, TX.................................................. 0.8082
Martin, TX.................................................. 0.8082
Mason, TX................................................... 0.8082
Matagorda, TX............................................... 0.8082
Maverick, TX................................................ 0.8082
Medina, TX.................................................. 0.8082
Menard, TX.................................................. 0.8082
Milam, TX................................................... 0.8082
Mills, TX................................................... 0.8082
Mitchell, TX................................................ 0.8082
Montague, TX................................................ 0.8082
Moore, TX................................................... 0.8082
Morris, TX.................................................. 0.8082
Motley, TX.................................................. 0.8082
Nacogdoches, TX............................................. 0.8082
Navarro, TX................................................. 0.8082
Newton, TX.................................................. 0.8082
Nolan, TX................................................... 0.8082
Ochiltree, TX............................................... 0.8082
Oldham, TX.................................................. 0.8082
Palo Pinto, TX.............................................. 0.8082
Panola, TX.................................................. 0.8082
Parmer, TX.................................................. 0.8082
Pecos, TX................................................... 0.8082
Polk, TX.................................................... 0.8082
Presidio, TX................................................ 0.8082
Rains, TX................................................... 0.8082
Reagan, TX.................................................. 0.8082
Real, TX.................................................... 0.8082
Red River, TX............................................... 0.8082
Reeves, TX.................................................. 0.8082
Refugio, TX................................................. 0.8082
Roberts, TX................................................. 0.8082
Robertson, TX............................................... 0.8082
Runnels, TX................................................. 0.8082
Rusk, TX.................................................... 0.8082
Sabine, TX.................................................. 0.8082
San Augustine, TX........................................... 0.8082
San Jacinto, TX............................................. 0.8082
San Saba, TX................................................ 0.8082
Schleicher, TX.............................................. 0.8082
Scurry, TX.................................................. 0.8082
Shackelford, TX............................................. 0.8082
Shelby, TX.................................................. 0.8082
Sherman, TX................................................. 0.8082
Somervell, TX............................................... 0.8082
Starr, TX................................................... 0.8082
Stephens, TX................................................ 0.8082
Sterling, TX................................................ 0.8082
Stonewall, TX............................................... 0.8082
Sutton, TX.................................................. 0.8082
Swisher, TX................................................. 0.8082
Terrell, TX................................................. 0.8082
Terry, TX................................................... 0.8082
Throckmorton, TX............................................ 0.8082
Titus, TX................................................... 0.8082
Trinity, TX................................................. 0.8082
Tyler, TX................................................... 0.8082
Upton, TX................................................... 0.8082
Uvalde, TX.................................................. 0.8082
Val Verde, TX............................................... 0.8082
Van Zandt, TX............................................... 0.8082
Walker, TX.................................................. 0.8082
Ward, TX.................................................... 0.8082
Washington, TX.............................................. 0.8082
Wharton, TX................................................. 0.8082
Wheeler, TX................................................. 0.8082
Wilbarger, TX............................................... 0.8082
Willacy, TX................................................. 0.8082
Winkler, TX................................................. 0.8082
Wise, TX.................................................... 0.8082
Wood, TX.................................................... 0.8082
Yoakum, TX.................................................. 0.8082
Young, TX................................................... 0.8082
Zapata, TX.................................................. 0.8082
Zavala, TX.................................................. 0.8082
Utah:
Beaver, UT.................................................. 0.8632
Box Elder, UT............................................... 0.8632
Cache, UT................................................... 0.8632
Carbon, UT.................................................. 0.8632
Daggett, UT................................................. 0.8632
Duchesne, UT................................................ 0.8632
Emery, UT................................................... 0.8632
Garfield, UT................................................ 0.8632
Grand, UT................................................... 0.8632
Iron, UT.................................................... 0.8632
Juab, UT.................................................... 0.8632
Millard, UT................................................. 0.8632
Morgan, UT.................................................. 0.8632
[[Page 42880]]
Piute, UT................................................... 0.8632
Rich, UT.................................................... 0.8632
San Juan, UT................................................ 0.8632
Sanpete, UT................................................. 0.8632
Sevier, UT.................................................. 0.8632
Summit, UT.................................................. 0.8632
Tooele, UT.................................................. 0.8632
Uintah, UT.................................................. 0.8632
Wasatch, UT................................................. 0.8632
Washington, UT.............................................. 0.8632
Wayne, UT................................................... 0.8632
Vermont:
Addison, VT................................................. 0.9006
Bennington, VT.............................................. 0.9006
Caledonia, VT............................................... 0.9006
Essex, VT................................................... 0.9006
Lamoille, VT................................................ 0.9006
Orange, VT.................................................. 0.9006
Orleans, VT................................................. 0.9006
Rutland, VT................................................. 0.9006
Washington, VT.............................................. 0.9006
Windham, VT................................................. 0.9006
Windsor, VT................................................. 0.9006
Virgin Islands................................................ 0.6594
Virginia:
Accomack, VA................................................ 0.8346
Alleghany, VA............................................... 0.8346
Amelia, VA.................................................. 0.8346
Appomattox, VA.............................................. 0.8346
Augusta, VA................................................. 0.8346
Bath, VA.................................................... 0.8346
Bland, VA................................................... 0.8346
Brunswick, VA............................................... 0.8346
Buchanan, VA................................................ 0.8346
Buckingham, VA.............................................. 0.8346
Caroline, VA................................................ 0.8346
Carroll, VA................................................. 0.8346
Charlotte, VA............................................... 0.8346
Craig, VA................................................... 0.8346
Cumberland, VA.............................................. 0.8346
Dickenson, VA............................................... 0.8346
Essex, VA................................................... 0.8346
Floyd, VA................................................... 0.8346
Franklin, VA................................................ 0.8346
Frederick, VA............................................... 0.8346
Giles, VA................................................... 0.8346
Grayson, VA................................................. 0.8346
Greensville, VA............................................. 0.8346
Halifax, VA................................................. 0.8346
Henry, VA................................................... 0.8346
Highland, VA................................................ 0.8346
King and Queen, VA.......................................... 0.8346
King William, VA............................................ 0.8346
Lancaster, VA............................................... 0.8346
Lee, VA..................................................... 0.8346
Louisa, VA.................................................. 0.8346
Lunenburg, VA............................................... 0.8346
Madison, VA................................................. 0.8346
Mecklenburg, VA............................................. 0.8346
Middlesex, VA............................................... 0.8346
Montgomery, VA.............................................. 0.8346
Nelson, VA.................................................. 0.8346
Northampton, VA............................................. 0.8346
Northumberlnd, VA........................................... 0.8346
Nottoway, VA................................................ 0.8346
Orange, VA.................................................. 0.8346
Page, VA.................................................... 0.8346
Patrick, VA................................................. 0.8346
Prince Edward, VA........................................... 0.8346
Pulaski, VA................................................. 0.8346
Rappahannock, VA............................................ 0.8346
Richmond, VA................................................ 0.8346
Rockbridge, VA.............................................. 0.8346
Rockingham, VA.............................................. 0.8346
Russell, VA................................................. 0.8346
Shenandoah, VA.............................................. 0.8346
Smyth, VA................................................... 0.8346
Southampton, VA............................................. 0.8346
Surry, VA................................................... 0.8346
Sussex, VA.................................................. 0.8346
Tazewell, VA................................................ 0.8346
Westmoreland, VA............................................ 0.8346
Wise, VA.................................................... 0.8346
Wythe, VA................................................... 0.8346
Buena Vista City, VA........................................ 0.8346
Clifton Forge City, VA...................................... 0.8346
Covington City, VA.......................................... 0.8346
Emporia City, VA............................................ 0.8346
Franklin City, VA........................................... 0.8346
Galax City, VA.............................................. 0.8346
Harrisonburg City, VA....................................... 0.8346
Lexington City, VA.......................................... 0.8346
Martinsville City, VA....................................... 0.8346
Nansemond City, VA.......................................... 0.8346
Norton City, VA............................................. 0.8346
Radford City, VA............................................ 0.8346
South Boston City, VA....................................... 0.8346
Staunton City, VA........................................... 0.8346
Waynesboro City, VA......................................... 0.8346
Winchester City, VA......................................... 0.8346
Washington:
Adams, WA................................................... 0.9843
Asotin, WA.................................................. 0.9843
Chelan, WA.................................................. 0.9843
Clallam, WA................................................. 0.9843
Columbia, WA................................................ 0.9843
Cowlitz, WA................................................. 0.9843
Douglas, WA................................................. 0.9843
Ferry, WA................................................... 0.9843
Garfield, WA................................................ 0.9843
Grant, WA................................................... 0.9843
Grays Harbor, WA............................................ 0.9843
Jefferson, WA............................................... 0.9843
Kittitas, WA................................................ 0.9843
Klickitat, WA............................................... 0.9843
Lewis, WA................................................... 0.9843
Lincoln, WA................................................. 0.9843
Mason, WA................................................... 0.9843
Okanogan, WA................................................ 0.9843
Pacific, WA................................................. 0.9843
Pend Oreille, WA............................................ 0.9843
San Juan, WA................................................ 0.9843
Skagit, WA.................................................. 0.9843
Skamania, WA................................................ 0.9843
Stevens, WA................................................. 0.9843
Wahkiakum, WA............................................... 0.9843
Walla Walla, WA............................................. 0.9843
Whitman, WA................................................. 0.9843
West Virginia:
Barbour, WV................................................. 0.8938
Boone, WV................................................... 0.8938
Braxton, WV................................................. 0.8938
Calhoun, WV................................................. 0.8938
Clay, WV.................................................... 0.8938
Doddridge, WV............................................... 0.8938
Fayette, WV................................................. 0.8938
Gilmer, WV.................................................. 0.8938
Grant, WV................................................... 0.8938
Greenbrier, WV.............................................. 0.8938
Hampshire, WV............................................... 0.8938
Hardy, WV................................................... 0.8938
Harrison, WV................................................ 0.8938
Jackson, WV................................................. 0.8938
Lewis, WV................................................... 0.8938
Lincoln, WV................................................. 0.8938
Logan, WV................................................... 0.8938
McDowell, WV................................................ 0.8938
Marion, WV.................................................. 0.8938
Mason, WV................................................... 0.8938
Mercer, WV.................................................. 0.8938
Mingo, WV................................................... 0.8938
Monongahela, WV............................................. 0.8938
Monroe, WV.................................................. 0.8938
Morgan, WV.................................................. 0.8938
Nicholas, WV................................................ 0.8938
Pendleton, WV............................................... 0.8938
Pleasants, WV............................................... 0.8938
Pocahontas, WV.............................................. 0.8938
Preston, WV................................................. 0.8938
Raleigh, WV................................................. 0.8938
Randolph, WV................................................ 0.8938
Ritchie, WV................................................. 0.8938
Roane, WV................................................... 0.8938
Summers, WV................................................. 0.8938
Taylor, WV.................................................. 0.8938
Tucker, WV.................................................. 0.8938
Tyler, WV................................................... 0.8938
Upshur, WV.................................................. 0.8938
Webster, WV................................................. 0.8938
Wetzel, WV.................................................. 0.8938
Wirt, WV.................................................... 0.8938
Wyoming, WV................................................. 0.8938
Wisconsin:
Adams, WI................................................... 0.8518
Ashland, WI,................................................ 0.8518
Barron, WI.................................................. 0.8518
Bayfield, WI................................................ 0.8518
Buffalo, WI................................................. 0.8518
Burnett, WI................................................. 0.8518
Clark, WI................................................... 0.8518
Columbia, WI................................................ 0.8518
Crawford, WI................................................ 0.8518
Dodge, WI................................................... 0.8518
Door, WI.................................................... 0.8518
Dunn, WI.................................................... 0.8518
Florence, WI................................................ 0.8518
Fond Du Lac, WI............................................. 0.8518
Forest, WI.................................................. 0.8518
Grant, WI................................................... 0.8518
Green, WI................................................... 0.8518
Green lake, WI.............................................. 0.8518
Iowa, WI.................................................... 0.8518
Iron, WI.................................................... 0.8518
Jackson, WI................................................. 0.8518
Jefferson, WI............................................... 0.8518
Juneau, WI.................................................. 0.8518
Kewaunee, WI................................................ 0.8518
Lafayette, WI............................................... 0.8518
Langlade, WI................................................ 0.8518
Lincoln, WI................................................. 0.8518
Manitowoc, WI............................................... 0.8518
Marinette, WI............................................... 0.8518
Marquette, WI............................................... 0.8518
Menomonee, WI............................................... 0.8518
Monroe, WI.................................................. 0.8518
Oconto, WI.................................................. 0.8518
Oneida, WI.................................................. 0.8518
Pepin, WI................................................... 0.8518
Polk, WI.................................................... 0.8518
Portage, WI................................................. 0.8518
[[Page 42881]]
Price, WI................................................... 0.8518
Richland, WI................................................ 0.8518
Rusk, WI.................................................... 0.8518
Sauk, WI.................................................... 0.8518
Sawyer, WI.................................................. 0.8518
Shawano, WI................................................. 0.8518
Taylor, WI.................................................. 0.8518
Trempealeau, WI............................................. 0.8518
Vernon, WI.................................................. 0.8518
Vilas, WI................................................... 0.8518
Walworth, WI................................................ 0.8518
Washburn, WI................................................ 0.8518
Waupaca, WI................................................. 0.8518
Waushara, WI................................................ 0.8518
Wood, WI.................................................... 0.8518
Wyoming:
Albany, WY.................................................. 0.9291
Big Horn, WY................................................ 0.9291
Campbell, WY................................................ 0.9291
Carbon, WY.................................................. 0.9291
Converse, WY................................................ 0.9291
Crook, WY................................................... 0.9291
Fremont, WY................................................. 0.9291
Goshen, WY.................................................. 0.9291
Hot Springs, WY............................................. 0.9291
Johnson, WY................................................. 0.9291
Lincoln, WY................................................. 0.9291
Niobrara, WY................................................ 0.9291
Park, WY.................................................... 0.9291
Platte, WY.................................................. 0.9291
Sheridan, WY................................................ 0.9291
Sublette, WY................................................ 0.9291
Sweetwater, WY.............................................. 0.9291
Teton, WY................................................... 0.9291
Uinta, WY................................................... 0.9291
Washakie, WY................................................ 0.9291
Weston, WY.................................................. 0.9291
------------------------------------------------------------------------
\2\ Wage index values are based on fiscal year 1993 hospital cost report
data prior to reclassification. This wage index is further adjusted.
Wage index values greater than 0.8 are subject to a budget neutrality
adjustment of 1.020768. Wage index values below 0.8 are adjusted to be
the greater of a 15 percent increase, subject to a maximum wage index
value of 0.8, or an adjustment by multiplying the hospice wage index
value for a given area by the budget neutrality adjustment. All of
these adjustments are built into the wage index values reflected in
Table B.
V. Regulatory Impact Statement
Consistent with the Regulatory Flexibility Act (RFA) (5 U.S.C. 601
through 612), we prepare a regulatory flexibility analysis unless we
certify that a rule will not have a significant economic impact on a
substantial number of small entities. For purposes of the RFA, all
hospices are considered to be small entities. Individuals and States
are not included in the definition of a small entity.
In addition, section 1102(b) of the Act requires us to prepare a
regulatory impact analysis if a rule has a significant impact on the
operations of a substantial number of small rural hospitals. Such an
analysis must conform to the provisions of section 603 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 50 beds.
This impact analysis compares hospice payments under the current
wage index (column 3 of the Table C) to the first transition year blend
(column 4). The wage index blend for the first transition year of the
3-year transition is two-thirds of the current wage index added to one-
third of the new wage index. The data used in developing the
quantitative analysis for this final rule were obtained from the June
1996 update of the national claims history file of all bills submitted
during fiscal year 1995. We deleted bills from hospices that have since
closed.
Table C demonstrates the results of our analysis. The table
categorizes hospices by various geographic and provider
characteristics. The top row of the table demonstrates that the overall
impact on the 1,834 hospices included in the analysis is budget
neutral. The next two rows of the table categorize hospices according
to their geographic location (urban and rural). There are 1,200
hospices located in urban areas included in our analysis and 634
hospices located in rural areas. The next two groupings in the table
indicate the number of hospices by census region, also broken down by
urban and rural hospices. The next grouping shows the impact on
hospices based on the size of the hospice's program. We determined that
the majority of hospice payments are made at the routine home care
rate; therefore, we based the size of each individual hospice's program
on the number of routine home care days provided in 1995. The next
grouping shows the impact on hospices by type of ownership. The final
grouping shows the impact on hospices defined by whether they are
provider-based or freestanding.
In column 2 of the table we indicate the number of routine home
care days that were included in our analysis, although the analysis was
performed on all types of hospice care. Columns 3 and 4 show the
payments that would have been made to hospices under the 1983 wage
index and payments that would be made under the 1997 wage index. As the
first row in column 4 indicates, the wage index is budget neutral. The
final column shows the percent change in hospice payments based on the
category of the hospice.
The results of our analysis show that the greatest increases are
for urban hospices in the New England and Pacific regions, 4.4 percent
and 1.7 percent respectively. The greatest decreases, besides Puerto
Rico, are the urban East South Central and West South Central regions
with 1.6 percent and 1.4 percent respectively. The most dramatic shift
occurs in Puerto Rico, where urban payments decrease by 7.3 percent and
rural payments decrease by 8.9 percent. The region most affected by the
revision to the wage index floor is Puerto Rico. This is because the
wage index values for the Puerto Rico region are more than 15 percent
below 0.8. Under the current wage index floor, Puerto Rico's wage index
value would have been adjusted to 0.8. Under the final wage index
floor, Puerto Rico's wage index will be the pre-reclassification
hospital wage index value multiplied by 1.15.
Small hospice programs show small decreases while larger programs
show slight increases. Proprietary hospices show slight decreases in
payment due to the wage index change while voluntary programs gain
slightly. Finally, freestanding and skilled nursing facility-based
hospices show small decreases while home health agency and hospital-
based hospice programs show small increases.
Table C.--Impact of Hospice Wage Index Change
Payments using
Number of new wage index Percent
Number of routine Payments using first change in
hospices home care old wage index transition hospice
days in in thousands year blend in payments
thousands thousands
(1) (2) (3) (4) (5)
----------------------------------------------------------------------------------------------------------------
All Hospices............................. 1,834 17,179 1,904,050 1,904,049 0.0
[[Page 42882]]
Urban Hospices........................... 1,200 14,811 1,685,552 1,686,214 0.0
Rural Hospices........................... 634 2,368 218,497 217,835 -0.3
Region (Urban):
New England.......................... 91 545 64,625 67,473 4.4
Middle Atlantic...................... 157 1,687 200,376 202,123 0.9
South Atlantic....................... 160 3,335 384,600 385,506 0.2
East North Cent...................... 202 2,631 297,586 295,001 -0.9
East South Cent...................... 77 639 72,432 71,261 -1.6
West North Cent...................... 85 989 102,553 102,139 -0.4
West South Cent...................... 158 1,883 195,386 192,709 -1.4
Mountain............................. 73 816 101,912 100,685 -1.2
Pacific.............................. 168 2,126 253,035 257,225 1.7
Puerto Rico.......................... 29 159 13,049 12,091 -7.3
Region (Rural):
New England.......................... 18 54 5,231 5,316 1.6
Middle Atlantic...................... 34 157 15,981 15,826 -1.0
South Atlantic....................... 103 511 46,636 46,436 -0.4
East North Cent...................... 111 455 42,290 42,203 -0.2
East South Cent...................... 67 322 28,309 28,202 -0.4
West North Cent...................... 131 339 31,020 30,898 -0.4
West South Cent...................... 67 227 19,860 19,783 -0.4
Mountain............................. 58 141 13,251 13,163 -0.7
Pacific.............................. 42 149 14,769 14,960 1.3
Puerto Rico.......................... 3 14 1,150 1,048 -8.9
Size (Routine Home Care Days):
0 - 1,551 Days....................... 458 323 33,983 33,923 -0.2
1,551 - 4385 Days.................... 459 1,310 132,410 132,086 -0.2
4,385 -10,110 Days................... 458 3,160 324,347 324,965 0.2
10,110 + Days........................ 459 12,387 1,413,310 1,413,075 0.0
Type of Ownership:
Voluntary............................ 1,272 12,517 1,370,153 1,372,430 0.2
Proprietary.......................... 388 4,152 482,816 480,497 -0.5
Government........................... 151 450 45,046 45,044 0.0
Other................................ 23 60 6,035 6,078 0.7
Hospice Base:
Freestanding......................... 674 9,375 1,046,456 1,042,436 -0.4
Home Health Agency................... 679 4,633 507,575 510,966 0.7
Hospital............................. 464 3,058 334,128 334,891 0.2
Skilled Nurs. Fac.................... 17 112 15,891 15,756 -0.9
----------------------------------------------------------------------------------------------------------------
We have concluded that this final regulation will have an impact on
small hospices. However, the provisions of this regulation were
determined by consensus through a negotiated rulemaking committee.
Based on all of the options considered, the committee determined that
the provisions in this regulation were favorable for the hospice
community as a whole, as well as for the beneficiaries that they serve.
We have also determined, and certify, that this final rule will not
result in a significant economic impact on a substantial number of
small entities and will not have a significant impact on the operations
of a substantial number of small rural hospitals. For these reasons, we
are not preparing analyses for the RFA or section 1102(b) of the Act.
In accordance with the provisions of Executive Order 12866, this
regulation was reviewed by the Office of Management and Budget.
VI. Collection of Information Requirements
This document does not impose information collection and
recordkeeping requirements. Consequently, it need not be reviewed by
the Office of Management and Budget under the authority of the
Paperwork Reduction Act of 1995 (44 U.S.C. 3501 et seq.).
Lists of Subjects for 42 CFR Part 418
Health facilities, Hospice care, Medicare, Reporting and
recordkeeping requirements.
42 CFR part 418 is amended as set forth below:
PART 418--HOSPICE CARE
1. The authority citation for part 418 continues to read as
follows:
Authority: Secs. 1102 and 1871 of the Social Security Act (42
U.S.C. 1302 and 1395hh).
2. In Sec. 418.306, paragraph (c) is revised to read as follows:;
Sec. 418.306 Determination of payment amounts.
* * * * *
(c) Adjustment for wage differences. HCFA will issue annually, in
the Federal Register, a hospice wage index based on the most current
available HCFA hospital wage data, including any
[[Page 42883]]
changes to the definitions of Metropolitan Statistical Areas. The
payment rates established by HCFA are adjusted by the intermediary to
reflect local differences in wages according to the revised wage index.
* * * * *
(Catalog of Federal Domestic Assistance Program No. 93.773,
Medicare--Hospital Insurance; and Program No. 93.774, Medicare--
Supplementary Medical Insurance Program)
Dated: April 16, 1997.
Bruce C. Vladeck,
Administrator, Health Care Financing Administration.
Appendix: Note This Appendix Will Not Appear in the Code of Federal
Regulations
United States Department of Health and Human Services Negotiating
Committee on the Medicare Hospice Wage Index
Committee Statement
April 13, 1995.
The Negotiating Committee on Medicare Hospice Wage Index has
concurred in the following recommendations, considered as a whole,
concerning the wage index used to adjust Medicare payment rates for
hospice services to reflect geographic differences in wages:
A. Data to be Used
The wage index for hospices will be based on the wage index used
by the Health Care Financing Administration (HCFA) for hospitals
under the Medicare Prospective Payment System, prior to
reclassification. This means that the hospital wage index will not
be adjusted to take into account the geographic reclassification of
hospitals in accordance with sections 1886(d)(8)(B) and 1886(d)(10)
of the Social Security Act.
The hospital wage index prior to reclassification will be
referred to in this statement as the Raw Index and will be adjusted
as provided below to calculate what will be referred to as the
Revised Wage Index.
Special provisions governing a transition period are described
in paragraph D below.
B. Budget Neutrality
HCFA will determine a Budget Neutrality Factor that will be
applied to achieve budget neutrality during and after the transition
period. Budget neutrality means that, in a given year, estimated
aggregate payments for Medicare hospice services using the Revised
Wage Index will equal estimated payments that would have been made
for the same services if the wage index adopted for hospices in 1983
(1983 Index) had remained in effect. HCFA will estimate aggregate
payments for Medicare hospice services using the best available
utilization data.
C. Adjustments
Each Raw Index value will be adjusted in one of two ways to
determine the Revised Wage Index value applicable to each area.
(1) If the Raw Index value for any area is 0.8 or greater, the
Revised Wage Index will be calculated by multiplying the Raw Index
value for that area by the Budget Neutrality Factor.
(2) If the Raw Index value for any area is less than 0.8, the
Revised Wage Index will be the greater of either:
(a) The Raw Index value for that area multiplied by the Budget
Neutrality Factor; or
(b) The Raw Index value for that area multiplied by 1.15 (in
effect, a 15-percent increase), but subject to a maximum index value
of 0.8.
D. Transition Period
The Revised Wage Index will be implemented over a 3-year
transition period beginning on or about October 1, 1996. For the
first year of the transition period, a blended index will be
calculated by adding two-thirds of each 1983 Index value for an area
to one-third of the Revised Wage Index value for that area. During
the second year of the transition period, the calculation will be
similar, except that the blend will be one-third of the 1983 Index
values and two-thirds of the Revised Wage Index values. During the
third year the Revised Wage Index will be fully implemented.
Throughout the transition period, new hospices will be treated
the same as existing hospices based in the same county.
E. Annual Updates
The Revised Wage Index will be updated annually, so that it is
based on the most current available data used by HCFA to construct
the hospital wage index, as well as on changes by the Office of
Management and Budget to Metropolitan Statistical Areas as adopted
by HCFA in calculating the hospital wage index.
HCFA will use the most current hospital cost report data
available that allows HCFA to publish a proposed rule containing
wage index values at least 4 months in advance of the effective date
of each annual update to the Revised Wage Index.
F. Effective Date
The effective date of a final rule revising the wage index as
stated above should be October 1, 1997.
G. Statement to Accompany Proposed and Final Hospice Wage Index Notice
The proposed rule is based upon a Committee Statement developed
by a Negotiating Committee on the Medicare hospice wage index which
was convened under the Negotiated Rulemaking Act. A new hospice wage
index is needed because the existing hospice wage index is based on
a 1983 wage index using 1981 Bureau of Labor Statistics (BLS) data
which is inaccurate and outdated.
The Committee reached consensus; however, this means only that
all Committee members could ``live with'' the agreement, considered
as a whole, even if elements of that agreement were not the
preferred choice of individual Committee members. The Committee
Statement reflects those issues upon which the Committee ultimately
concurred, but does not address many issues that were considered by
the Committee.
The Committee considered the appropriate data to be used to
construct a wage index, the appropriateness of retaining a 0.8
floor, budget neutrality, and how to structure a transition to
timely update the index yet ensure access to hospice care. In
particular, the Committee considered the problems faced by hospices
that would receive significant decreases under the new wage indices,
rural hospices, hospices with low wage indices, and hospices that
may have disproportionately high non-wage costs.
The Committee received extensive information from experts who
appeared before the Committee and from the hospice community, and
sought public input. While considerable data were reviewed, the
Committee acknowledges that hospice data collection is maturing and
encourages its continued development. In addition, while other
issues were identified, the scope of the Committee's negotiations
was limited by the notice of intent to negotiate.
Given these constraints, and taking into account the differing
and conflicting interests that would be significantly affected, the
Committee sought to develop a wage index that would be as accurate,
reliable, and equitable as possible, but would not threaten access
to hospice care.
The Committee recognizes that hospice care is still not
universally available. The Committee further recognizes that there
may be geographic or other circumstances that inhibit the provision
of hospice care. The Committee strongly requests that HCFA consider
options to address these access problems.
Reaching consensus was a long and deliberative process. The
Committee concurred that the wage index it recommends will be better
both for the hospice community as a whole, and for the Medicare
beneficiaries it serves, than a wage index developed by the
traditional rulemaking process.
[FR Doc. 97-20775 Filed 8-1-97; 4:55 pm]
BILLING CODE 4120-01-P