[Federal Register Volume 75, Number 67 (Thursday, April 8, 2010)]
[Rules and Regulations]
[Pages 17859-17861]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2010-7791]


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DEPARTMENT OF VETERANS AFFAIRS

38 CFR Part 59

RIN 2900-AM70


Grants to States for Construction or Acquisition of State Home 
Facilities--Update of Authorized Beds

AGENCY: Department of Veterans Affairs.

ACTION: Final rule.

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SUMMARY: This document adopts as a final rule the proposed rule to 
amend Department of Veterans Affairs (VA) regulations regarding grants 
to States for construction or acquisition of State homes. This final 
rule updates the maximum number of nursing home and domiciliary beds 
designated for each State and amends the definition of ``State'' for 
purposes of these grants to include Guam, the Northern Mariana Islands, 
and American Samoa.

DATES: Effective Date: This final rule is effective May 10, 2010.

FOR FURTHER INFORMATION CONTACT: James F. Burris, MD, Chief Consultant, 
Geriatrics and Extended Care State Home Construction Grant Program 
(114), Veterans Health Administration, Department of Veterans Affairs, 
810 Vermont Avenue, NW., Washington, DC 20420, (202) 461-6774.

SUPPLEMENTARY INFORMATION: In a document published in the Federal 
Register on July 10, 2009 (74 FR 33192), VA proposed to amend its 
regulations at 38 CFR part 59 concerning grants to States for the 
construction or acquisition of State home facilities.
    Section 8134(a)(2) of title 38, U.S.C., mandates that VA prescribe 
for each State the maximum number of nursing home and domiciliary beds 
for which grants may be furnished. Section 8134(a)(4) requires that, 
not less often than every four years, VA must review and, as necessary, 
revise the regulations concerning the maximum number of State home beds 
designated for each State. In 2001, VA established the maximum number 
of State home beds for each State based on the projected demand for 
such beds in 2009, as required under section 8134(a)(2). VA now 
believes that Congress intended VA to recalculate the maximum number of 
beds for each State based on the projected demand for care ten years in 
the future and that this method would be consistent with the statutory 
requirement for establishing maximum State home bed numbers. 
Accordingly, VA proposed to revise the maximum number of nursing home 
and domiciliary beds for each State, for which grants may be furnished, 
based on the projected demand from veterans who, in 2020, are 65 years 
of age or older and reside in that State.
    To compute the maximum number of beds for each State, we first 
estimated that there would be a total population of 8,672,045 veterans 
65 years of age or older residing in all the States, projected to the 
year 2020. We then estimated that there would be a total demand of 
55,299 State home beds nationwide in 2009. We then allocated the 55,299 
beds based on the percentage of veterans who in

[[Page 17860]]

2020 are projected to reside in each State.
    VA provided a 60-day comment period that ended September 8, 2009. 
VA received no comments. Based on the rationale set forth in the 
proposed rule and in this document, we are adopting the proposed rule 
as a final rule without change.

Unfunded Mandates

    The Unfunded Mandates Reform Act of 1995 requires, at 2 U.S.C. 
1532, that agencies prepare an assessment of anticipated costs and 
benefits before issuing any rule that may result in expenditure by 
State, local, and tribal governments, in the aggregate, or by the 
private sector, of $100 million or more (adjusted annually for 
inflation) in any year. This final rule would have no such effect on 
State, local, and tribal governments, or on the private sector.

Paperwork Reduction Act of 1995

    This document contains no provisions constituting a new collection 
of information under the Paperwork Reduction Act of 1995 (44 U.S.C. 
3501-3521).

Executive Order 12866

    Executive Order 12866 directs agencies to assess all costs and 
benefits of available regulatory alternatives and, when regulation is 
necessary, to select regulatory approaches that maximize net benefits 
(including potential economic, environmental, public health and safety, 
and other advantages; distributive impacts; and equity). The Executive 
Order classifies a ``significant regulatory action,'' requiring review 
by the Office of Management and Budget (OMB) unless OMB waives such 
review, as any regulatory action that is likely to result in a rule 
that may: (1) Have an annual effect on the economy of $100 million or 
more or adversely affect in a material way the economy, a sector of the 
economy, productivity, competition, jobs, the environment, public 
health or safety, or State, local, or tribal governments or 
communities; (2) create a serious inconsistency or otherwise interfere 
with an action taken or planned by another agency; (3) materially alter 
the budgetary impact of entitlements, grants, user fees, or loan 
programs or the rights and obligations of recipients thereof; or (4) 
raise novel legal or policy issues arising out of legal mandates, the 
President's priorities, or the principles set forth in the Executive 
Order.
    The economic, interagency, budgetary, legal, and policy 
implications of this rule have been examined and it has been determined 
to be a significant regulatory action under the Executive Order because 
it may raise novel legal or policy issues arising out of legal 
mandates, the President's priorities, or the principles set forth in 
the Executive Order.

Regulatory Flexibility Act

    The Secretary of Veterans Affairs hereby certifies that this final 
rule will not have a significant economic impact on a substantial 
number of small entities as they are defined in the Regulatory 
Flexibility Act, 5 U.S.C. 601-612. The rule will affect grants to 
States and will not directly affect small entities. Therefore, pursuant 
to 5 U.S.C. 605(b), this final rule is exempt from the initial and 
final regulatory flexibility analysis requirements of sections 603 and 
604.

Catalog of Federal Domestic Assistance

    The Catalog of Federal Domestic Assistance program number and title 
for this rule is as follows: 64.005, Grants to States for Construction 
of State Home Facilities.

List of Subjects in 38 CFR Part 59

    Administrative practice and procedure, Alcohol abuse, Alcoholism, 
Claims, Day care, Dental health, Drug abuse, Foreign relations, 
Government contracts, Grant programs--health, Grant programs--veterans, 
Health care, Health facilities, Health professions, Health records, 
Homeless, Medical and dental schools, Medical devices, Medical 
research, Mental health programs, Nursing homes, Reporting and 
recordkeeping requirements, Travel and transportation expenses, and 
Veterans.

    Approved: March 9, 2010.
John R. Gingrich,
Chief of Staff, Department of Veterans Affairs.

0
For the reasons stated in the preamble, VA amends 38 CFR part 59 as 
follows:

PART 59--GRANTS TO STATES FOR CONSTRUCTION OR ACQUISITION OF STATE 
HOMES

0
1. The authority citation for part 59 is revised to read as follow:

    Authority: 38 U.S.C. 101, 501, 1710, 1742, 8105, 8131-8138.


0
2. Amend Sec.  59.2 by revising the definition of ``State'' to read as 
follows:


Sec.  59.2  Definitions.

* * * * *
    State means each of the several states, the District of Columbia, 
the Virgin Islands, the Commonwealth of Puerto Rico, Guam, the 
Commonwealth of the Northern Mariana Islands, and American Samoa.
* * * * *

0
3. Amend Sec.  59.40 by revising paragraph (a) to read as follows:


Sec.  59.40  Maximum number of nursing home care and domiciliary care 
beds for veterans by State.

    (a) Except as provided in paragraph (b) of this section, a state 
may not request a grant for a project to construct or acquire a new 
state home facility, to increase the number of beds available at a 
state home facility, or to replace beds at a state home facility if the 
project would increase the total number of state home nursing home and 
domiciliary beds in that state beyond the maximum number designated for 
that state, as shown in the following chart. The provisions of 38 
U.S.C. 8134 require VA to prescribe for each state the number of 
nursing home and domiciliary beds for which grants may be furnished 
(i.e., the unmet need). A state's unmet need for state home nursing 
home and domiciliary beds is the number in the following chart for that 
state minus the sum of the number of nursing home and domiciliary beds 
in operation at state home facilities and the number of state home 
nursing home and domiciliary beds not yet in operation but for which a 
grant has either been requested or awarded under this part.

------------------------------------------------------------------------
                                                         Maximum number
                                                         of state home,
                                                         nursing home &
                         State                             domiciliary
                                                         beds based  on
                                                              2020
                                                           projections
------------------------------------------------------------------------
Alabama...............................................              1007
Alaska................................................               179
Arizona...............................................              1520
Arkansas..............................................               653
California............................................              4363
Colorado..............................................              1114
Connecticut...........................................               559
Delaware..............................................               207
District of Columbia..................................                83
Florida...............................................              4049
Georgia...............................................              1975
Hawaii................................................               268
Idaho.................................................               394
Illinois..............................................              1754
Indiana...............................................              1216
Iowa..................................................               578
Kansas................................................               518
Kentucky..............................................               818
Louisiana.............................................               638
Maine.................................................               362
Maryland..............................................              1102
Massachusetts.........................................               944
Michigan..............................................              1786
Minnesota.............................................              1058
Mississippi...........................................               480
Missouri..............................................              1257
Montana...............................................               281

[[Page 17861]]

 
Nebraska..............................................               371
Nevada................................................               649
New Hampshire.........................................               361
New Jersey............................................               992
New Mexico............................................               417
New York..............................................              2209
North Carolina........................................              1900
North Dakota..........................................               137
Ohio..................................................              2143
Oklahoma..............................................               766
Oregon................................................               907
Pennsylvania..........................................              2336
Puerto Rico...........................................               288
Rhode Island..........................................               157
South Carolina........................................              1089
South Dakota..........................................               179
Tennessee.............................................              1311
Texas.................................................              4119
Utah..................................................               426
Vermont...............................................               142
Virginia..............................................              1903
Virgin Islands........................................                12
Washington............................................              1687
West Virginia.........................................               406
Wisconsin.............................................              1062
Wyoming...............................................               154
American Samoa........................................                 0
Guam..................................................                12
N. Mariana Islands....................................                 1
------------------------------------------------------------------------


    Note to paragraph (a):  The provisions of 38 U.S.C. 8134 require 
that the ``un-met need'' numbers be based on a 10-year projection of 
demand for nursing home and domiciliary care by veterans who at such 
time are 65 years of age or older and who reside in that state. In 
determining the projected demand, VA must take into account travel 
distances for veterans and their families.

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[FR Doc. 2010-7791 Filed 4-7-10; 8:45 am]
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