Medicare: Skilled nursing facilities; prospective payment system and consolidated billing; update,
[Federal Register: May 19, 2005 (Volume 70, Number 96)]
[Proposed Rules]
[Page 29069-29162]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr19my05-37]
[[Page 29069]]
Part V
Department of Health and Human Services
Centers for Medicare & Medicaid Services
42 CFR Part 424
Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities for FY 2006; Proposed Rule
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
42 CFR Part 424
[CMS-1282-P]
RIN 0938-AN65
Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities for FY 2006
AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS.
ACTION: Proposed rule.
SUMMARY: This proposed rule would update the payment rates used under the prospective payment system (PPS) for skilled nursing facilities (SNFs), for fiscal year (FY) 2006, as required by statute. Annual updates to the PPS rates are required by section 1888(e) of the Social Security Act (the Act), as amended by the Medicare, Medicaid, and SCHIP Balanced Budget Refinement Act of 1999 (BBRA), the Medicare, Medicaid, and State Children's Health Insurance Program (SCHIP) Benefits Improvement and Protection Act of 2000 (BIPA), and the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA), relating to Medicare payments and consolidated billing for SNFs. As part of this year's annual update, we are proposing to introduce refinements in the Resource Utilization Groups, version III (RUG-III), the case-mix classification system used under the SNF PPS.
DATES: To be assured consideration, comments must be received at one of the addresses provided below, no later than 5 p.m. on July 12, 2005.
ADDRESSES: In commenting, please refer to file code CMS-1282-P. Because of staff and resource limitations, we cannot accept comments by facsimile (FAX) transmission.
You may submit comments in one of three ways (no duplicates, please):
1. Electronically. You may submit electronic comments on specific issues in this regulation to http://www.cms.hhs.gov/regulations/ecomments. (Attachments should be in Microsoft Word, WordPerfect, or
Excel; however, we prefer Microsoft Word.)
2. By mail. You may mail written comments (one original and two copies) to the following address ONLY: Centers for Medicare & Medicaid Services, Department of Health and Human Services, Attention: CMS-1282- P, P.O. Box 8016, Baltimore, MD 21244-8016.
Please allow sufficient time for mailed comments to be received before the close of the comment period.
3. By hand or courier. If you prefer, you may deliver (by hand or courier) your written comments (one original and two copies) before the close of the comment period to one of the following addresses. If you intend to deliver your comments to the Baltimore, Maryland address, please call telephone number (410) 786-9994 in advance to schedule your arrival with one of our staff members. Room 445-G, Hubert H. Humphrey Building, 200 Independence Avenue, SW., Washington, DC 20201; or 7500 Security Boulevard, Baltimore, MD 21244-1850.
(Because access to the interior of the HHH Building is not readily available to persons without Federal Government identification, commenters are encouraged to leave their comments in the CMS drop slots located in the main lobby of the building. A stamp-in clock is available for persons wishing to retain a proof of filing by stamping in and retaining an extra copy of the comments being filed.)
Comments mailed to the addresses indicated as appropriate for hand or courier delivery may be delayed and received after the comment period.
Submission of comments on paperwork requirements. You may submit comments on this document's paperwork requirements by mailing your comments to the addresses provided at the end of the ``Collection of Information Requirements'' section in this document.
For information on viewing public comments, see the beginning of the SUPPLEMENTARY INFORMATION section.
FOR FURTHER INFORMATION CONTACT: Ellen Gay, (410) 786-4528 (for information related to the case-mix classification methodology, and for information related to swing-bed providers).
Jeanette Kranacs, (410) 786-9385 (for information related to the development of the payment rates, and for information related to the wage index).
Bill Ullman, (410) 786-5667 (for information related to coverage requirements, level of care determinations, consolidated billing, and general information).
SUPPLEMENTARY INFORMATION:
Submitting Comments: We welcome comments from the public on all issues set forth in this rule to assist us in fully considering issues and developing policies. You can assist us by referencing the file code CMS-1282-P and the specific ``issue identifier'' that precedes the section on which you choose to comment.
Inspection of Public Comments: All comments received before the close of the comment period are available for viewing by the public, including any personally identifiable or confidential business information that is included in a comment. CMS posts all electronic comments received before the close of the comment period on its public Web site as soon as possible after they have been received. Hard copy comments received timely will be available for public inspection as they are received, generally beginning approximately 3 weeks after publication of a document, at the headquarters of the Centers for Medicare & Medicaid Services, 7500 Security Boulevard, Baltimore, Maryland 21244, Monday through Friday of each week from 8:30 a.m. to 4 p.m. To schedule an appointment to view public comments, phone 1-800- 743-3951.
To assist readers in referencing sections contained in this document, we are providing the following Table of Contents.
Table of Contents
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Background
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Current System for Payment of Skilled Nursing Facility Services Under Part A of the Medicare Program
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Requirements of the Balanced Budget Act of 1997 (the BBA) for Updating the Prospective Payment System for Skilled Nursing Facilities
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The Medicare, Medicaid, and SCHIP Balanced Budget Refinement Act of 1999 (the BBRA)
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The Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act of 2000 (the BIPA)
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The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (the MMA)
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Skilled Nursing Facility Prospective Payment--General Overview
1. Payment Provisions--Federal Rates
2. Payment Provisions--Initial Transition Period
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Use of the Skilled Nursing Facility Market Basket Index II. Update of Payment Rates Under the Prospective Payment System for Skilled Nursing Facilities
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Federal Prospective Payment System
1. Costs and Services Covered by the Federal Rates
2. Methodology Used for the Calculation of the Federal Rates
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Case-Mix Adjustment and Other Clinical Issues
1. Background
2. Case-Mix Refinement Research
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Data Sources and Analyses
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Constructing the New RUG-III Groups
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Development of the Case-Mix Indexes
3. Proposed Refinements to the Case-Mix Classification System
4. Implementation Issues
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5. Assessment Timeframes
6. SNF Certifications and Recertifications Performed by Nurse Practitioners and Clinical Nurse Specialists
7. Concurrent Therapy
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Wage Index Adjustment to Federal Rates
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Proposed Area Wage Index
1. Proposed Revision of SNF PPS Geographic Classifications
2. Current SNF PPS Labor Market Areas Based on MSAs
3. Core-Based Statistical Areas
4. Proposed Revisions to the SNF PPS Labor Market Areas
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New England MSAs
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Metropolitan Divisions
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Micropolitan Areas
5. Implementation of the Revised Labor Market Areas
6. Wage Index Data
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Updates to the Federal Rates
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Relationship of RUG-III Classification System to Existing Skilled Nursing Facility Level-of-Care Criteria
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Initial Three-Year Transition Period From Facility Specific to Federal Rates
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Example of Computation of Adjusted PPS Rates and SNF Payment III. The Skilled Nursing Facility Market Basket Index
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Use of the Skilled Nursing Facility Market Basket Percentage
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Market Basket Forecast Error Adjustment
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Federal Rate Update Factor IV. Consolidated Billing V. Application of the SNF PPS to SNF Services Furnished by Swing-Bed Hospitals VI. Qualifying Three-Day Inpatient Hospital Stay Requirement VII. Provisions of the Proposed Rule VIII. Collection of Information Requirements IX. Regulatory Impact Analysis
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Overall Impact
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Anticipated Effects
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Accounting Statement
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Alternatives Considered Regulation Text Addendum: Table 8 (Proposed Wage Index For Urban Areas Based On Core-Based Statistical Area (CBSA) Labor Market Areas); Table 9 (Proposed Wage Index For Rural Areas Based On CBSA Labor Market Areas); and Table A (Metropolitan Statistical Area (MSA)/CBSA Crosswalk)
In addition, because of the many terms to which we refer by abbreviation in this proposed rule, we are listing these abbreviations and their corresponding terms in alphabetical order below:
ADL Activity of Daily Living AHE Average Hourly Earnings ARD Assessment Reference Date BBA Balanced Budget Act of 1997, Pub. L. 105-33 BBRA Medicare, Medicaid and SCHIP Balanced Budget Refinement Act of 1999, Pub. L. 106-113 BEA (U.S. Department of Commerce) Bureau of Economic Analysis BIPA Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act of 2000, Pub. L. 106-554 CAH Critical Access Hospital CBSA Core-Based Statistical Area CFR Code of Federal Regulations CMS Centers for Medicare & Medicaid Services CMSA Consolidated Metropolitan Statistical Area CPT (Physicians') Current Procedural Terminology DRG Diagnosis Related Group FI Fiscal Intermediary FR Federal Register FY Fiscal Year GAO Government Accountability Office HCPCS Healthcare Common Procedure Coding System ICD-9-CM International Classification of Diseases, Ninth Edition, Clinical Modification IFC Interim Final Rule with Comment Period MDS Minimum Data Set MEDPAR Medicare Provider Analysis and Review File MIP Medicare Integrity Program MMA Medicare Prescription Drug, Improvement, and Modernization Act of 2003, Pub. L. 108-173 MSA Metropolitan Statistical Area NECMA New England County Metropolitan Area OIG Office of Inspector General OMRA Other Medicare Required Assessment PCE Personal Care Expenditures PMSA Primary Metropolitan Statistical Area PPI Producer Price Index PPS Prospective Payment System PRM Provider Reimbursement Manual RAI Resident Assessment Instrument RAP Resident Assessment Protocol RAVEN Resident Assessment Validation Entry RFA Regulatory Flexibility Act, Pub. L. 96-354 RIA Regulatory Impact Analysis RUG Resource Utilization Groups SCHIP State Children's Health Insurance Program SNF Skilled Nursing Facility STM Staff Time Measure UMRA Unfunded Mandates Reform Act, Pub. L. 104-4
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Background
On July 30, 2004, we published a notice in the Federal Register (69 FR 45775) that set forth updates to the payment rates used under the prospective payment system (PPS) for skilled nursing facilities (SNFs), for fiscal year (FY) 2005. Annual updates to the PPS rates are required by section 1888(e) of the Social Security Act (the Act), as amended by the Medicare, Medicaid, and SCHIP Balanced Budget Refinement Act of 1999 (the BBRA) and the Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act of 2000 (the BIPA), relating to Medicare payments and consolidated billing for SNFs.
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Current System for Payment of Skilled Nursing Facility Services Under Part A of the Medicare Program
Section 4432 of the Balanced Budget Act of 1997 (the BBA) amended section 1888 of the Act to provide for the implementation of a per diem PPS for SNFs, covering all costs (routine, ancillary, and capital- related) of covered SNF services furnished to Medicare beneficiaries under Part A of the Medicare program, effective for cost reporting periods beginning on or after July 1, 1998. In this proposed rule, we propose to update the per diem payment rates for SNFs for FY 2006. Major elements of the SNF PPS include:
Rates. Per diem Federal rates were established for urban and rural areas using allowable costs from FY 1995 cost reports. These rates also included an estimate of the cost of services that, before July 1, 1998, had been paid under Part B but were furnished to Medicare beneficiaries in a SNF during a Part A covered stay. The rates were adjusted annually using a SNF market basket index. Rates were case-mix adjusted using a classification system (Resource Utilization Groups, version III (RUG-III)) based on beneficiary assessments (using the Minimum Data Set (MDS) 2.0). The rates were also adjusted by the hospital wage index to account for geographic variation in wages. (In section II.C of this preamble, we discuss the wage index adjustment in detail.)
Correction notices were published in the Federal Register on October 7, 2004 (69 FR 60158) and on December 30, 2004 (69 FR 78445), announcing corrections to several of the wage factors. Additionally, as noted in sections I.C through I.E of this proposed rule, section 101 of the BBRA, sections 311, 312, and 314 of the BIPA, and section 511 of the MMA also affect the payment rate.
Transition. The SNF PPS included an initial 3-year, phased transition that blended a facility-specific payment rate with the Federal case-mix adjusted rate. For each cost reporting period after a facility migrated to the new system, the facility-specific portion of the blend decreased and the Federal portion increased in 25 percentage point increments. For most facilities, the facility-specific rate was based on allowable costs from FY 1995; however, since the last year of the transition was FY 2001, all facilities were paid at the full Federal rate by the following fiscal year (FY 2002). Therefore, as discussed in section I.F.2 of this proposed rule, we are no longer including adjustment
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factors related to facility-specific rates for the coming fiscal year.
Coverage. The establishment of the SNF PPS did not change Medicare's fundamental requirements for SNF coverage. However, because RUG-III classification is based, in part, on the beneficiary's need for skilled nursing care and therapy, we have attempted, where possible, to coordinate claims review procedures involving level of care determinations with the outputs of beneficiary assessment and RUG-III classifying activities. We discuss this coordination in greater detail in section II.F of this preamble. Moreover, the Part A SNF benefit has not only level of care requirements, but also a set of technical, or ``posthospital'' requirements as well. In section VI of this preamble, we discuss one aspect of the technical requirement for a qualifying prior inpatient hospital stay of at least 3 consecutive days, on which we invite comment.
Consolidated Billing. The SNF PPS includes a consolidated billing provision (described in greater detail in section IV of this proposed rule) that requires a SNF to submit consolidated Medicare bills for almost all of the services that its residents receive during the course of a covered Part A stay. (In addition, this provision places the Medicare billing responsibility for physical, occupational, and speech-language therapy that the resident receives during a noncovered stay with the SNF.) The statute excludes from the consolidated billing provision a small list of services--primarily those of physicians and certain other types of practitioners--which remain separately billable to Part B by the outside entity that furnishes them.
Application of the SNF PPS to SNF services furnished by swing-bed hospitals. Section 1883 of the Act permits certain small, rural hospitals to enter into a Medicare swing-bed agreement, under which the hospital can use its beds to provide either acute or SNF care, as needed. For critical access hospitals (CAHs), Part A pays on a reasonable cost basis for SNF services furnished under a swing-bed agreement. However, in accordance with section 1888(e)(7) of the Act, those swing-bed SNF services furnished by non-CAH rural hospitals are paid under the SNF PPS, effective with cost reporting periods beginning on or after July 1, 2002. A more detailed discussion of this provision appears in section V of this proposed rule.
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Requirements of the Balanced Budget Act of 1997 (the BBA) for Updating the Prospective Payment System for Skilled Nursing Facilities
Section 1888(e)(4)(H) of the Act requires that we publish in the Federal Register:
1. The unadjusted Federal per diem rates to be applied to days of covered SNF services furnished during the FY.
2. The case-mix classification system to be applied with respect to these services during the FY.
3. The factors to be applied in making the area wage adjustment with respect to these services.
In the July 30, 1999 final rule (64 FR 41670), we indicated that we would announce any changes to the guidelines for Medicare level of care determinations related to modifications in the RUG-III classification structure (see section II.F of this proposed rule).
Along with a number of other revisions discussed later in this preamble, this proposed rule provides the annual updates to the Federal rates as mandated by the Act.
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The Medicare, Medicaid, and SCHIP Balanced Budget Refinement Act of 1999 (the BBRA)
There were several provisions in the BBRA that resulted in adjustments to the SNF PPS. These provisions were described in detail in the final rule that we published in the Federal Register on July 31, 2000 (65 FR 46770). In particular, section 101 of the BBRA provided for a temporary 20 percent increase in the per diem adjusted payment rates for 15 specified RUG-III groups (SE3, SE2, SE1, SSC, SSB, SSA, CC2, CC1, CB2, CB1, CA2, CA1, RHC, RMC, and RMB). Under the law, this temporary increase remains in effect until the later of October 1, 2000, or the implementation of case-mix refinements in the PPS. A discussion of the case-mix refinements that we are proposing to implement appears in section II.B of this proposed rule. Section 101 also included a 4 percent across-the-board increase in the adjusted Federal per diem payment rates each year for FYs 2001 and 2002, exclusive of the 20 percent increase.
We included further information on all of the provisions of the BBRA that affect the SNF PPS in Program Memoranda A-99-53 and A-99-61 (December 1999), and Program Memorandum AB-00-18 (March 2000). In addition, for swing-bed hospitals with more than 49 (but less than 100) beds, section 408 of the BBRA provided for the repeal of certain statutory restrictions on length of stay and aggregate payment for patient days, effective with the end of the SNF PPS transition period described in section 1888(e)(2)(E) of the Act. In the July 31, 2001 final rule (66 FR 39562), we made conforming changes to the regulations in 42 CFR section 413.114(d), effective for services furnished in cost reporting periods beginning on or after July 1, 2002, to reflect section 408 of the BBRA.
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The Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act of 2000 (the BIPA)
The BIPA also included several provisions that resulted in adjustments to the PPS for SNFs. These provisions were described in detail in the final rule that we published in the Federal Register on July 31, 2001 (66 FR 39562) as follows:
Section 203 of the BIPA exempted critical access hospital (CAH) swing-beds from the SNF PPS; we included further information on this provision in Program Memorandum A-01-09 (January 16, 2001).
Section 311 of the BIPA eliminated the 1 percent reduction in the SNF market basket that the statutory update formula had previously specified for FY 2001, and changed the 1 percent reduction specified for FYs 2002 and 2003 to a 0.5 percent reduction. As discussed in section II.B of this proposed rule, this provision also required us to conduct a study of alternative case-mix classification systems for the SNF PPS, and to submit a report to the Congress on the results of the study.
Section 312 of the BIPA provided for a temporary 16.66 percent increase in the nursing component of the case-mix adjusted Federal rate for services furnished on or after April 1, 2001, and before October 1, 2002. This section also required the Government Accountability Office (GAO) to conduct an audit of SNF nursing staff ratios and submit a report to the Congress on whether the temporary increase in the nursing component should be continued. GAO issued this report (GAO-03-176) in November 2002.
Section 313 of the BIPA repealed the consolidated billing requirement for services (other than physical, occupational, and speech-language therapy) furnished to SNF residents during noncovered stays, effective January 1, 2001.
Section 314 of the BIPA adjusted the payment rates for all of the 14 rehabilitation RUGs (RUC, RUB, RUA, RVC, RVB, RVA, RHC, RHB, RHA, RMC, RMB, RMA, RLB, and RLA), in order to correct an anomaly under which the existing payment rates for three
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particular rehabilitation RUGs--RHC, RMC, and RMB--were higher than the rates for some other, more intensive rehabilitation RUGs. Under the BIPA adjustment, the temporary increase that section 101(a) of the BBRA had applied to the RHC, RMC, and RMB rehabilitation RUGs was revised from 20 percent to 6.7 percent, and the BIPA adjustment also applied this temporary 6.7 percent increase to each of the other 11 rehabilitation RUGs.
Section 315 of the BIPA authorized us to establish a geographic reclassification procedure that is specific to SNFs, but only after collecting the data necessary to establish a SNF wage index that is based on wage data from nursing homes.
We included further information on several of these provisions in Program Memorandum A-01-08 (January 16, 2001).
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The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (the MMA)
A provision of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) resulted in a further adjustment to the PPS for SNFs. Specifically, section 511 of the MMA amended paragraph (12) of section 1888(e) of the Act to provide for a temporary 128 percent increase in the PPS per diem payment for any SNF resident with Acquired Immune Deficiency Syndrome (AIDS), effective with services furnished on or after October 1, 2004. As discussed in Transmittal 160 (Change Request 3291, April 30, 2004), this add- on applies to claims with diagnosis code 042. Like the temporary add-on payments created by section 101(a) of the BBRA (as amended by section 314 of the BIPA), this special AIDS add-on was not intended to remain in effect indefinitely. As amended by section 511 of the MMA, section 1888(e)(12)(B) of the Act specifies that this temporary increase for patients with AIDS is to remain in effect only until ``* * * such date as the Secretary certifies that there is an appropriate adjustment in the case mix * * * to compensate for the increased costs associated with [such] residents * * *.'' As discussed elsewhere in this proposed rule, we are not proposing at this time to address the issue of such certification and, accordingly, the temporary add-on payments created by section 511 of the MMA will remain in effect during FY 2006.
The law further provided that the 128 percent increase in payment under the AIDS add-on is to be `` * * * determined without regard to any increase'' under section 101 of the BBRA (as amended by section 314 of the BIPA). As explained in the MMA Conference report, this means that if a resident qualifies for the temporary 128 percent increase in payment under the special AIDS add-on, ``the BBRA temporary RUG add-on does not apply in this case * * *.'' (H.R. Conf. Rep. No. 108-391 at 662). The AIDS add-on was also discussed in Transmittal 160 (Change Request 3291), issued on April 30, 2004, which is available online at http://www.cms.hhs.gov/manuals/pm_trans/2004/transmittals/comm_date_dsc.asp .
In addition, section 410 of the MMA contained a provision that affects the consolidated billing requirement, which we discuss in section IV of this proposed rule.
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Skilled Nursing Facility Prospective Payment--General Overview
The Medicare SNF PPS was implemented for cost reporting periods beginning on or after July 1, 1998. Under the PPS, we pay SNFs through prospective, case-mix adjusted per diem payment rates applicable to all covered SNF services. These payment rates cover all the costs of furnishing covered skilled nursing services (routine, ancillary, and capital-related costs) other than costs associated with approved educational activities. Covered SNF services include post-hospital services for which benefits are provided under Part A and all items and services that, before July 1, 1998, had been paid under Part B (other than physician and certain other services specifically excluded under the BBA) but furnished to Medicare beneficiaries in a SNF during a covered Part A stay. A complete discussion of these provisions appears in the May 12, 1998 interim final rule (63 FR 26252). 1. Payment Provisions--Federal Rate
The PPS uses per diem Federal payment rates based on mean SNF costs in a base year updated for inflation to the first effective period of the PPS. We developed the Federal payment rates using allowable costs from hospital-based and freestanding SNF cost reports for reporting periods beginning in FY 1995. The data used in developing the Federal rates also incorporated an estimate of the amounts that would be payable under Part B for covered SNF services furnished to individuals during the course of a covered Part A stay in a SNF.
In developing the rates for the initial period, we updated costs to the first effective year of PPS (the 15-month period beginning July 1, 1998) using a SNF market basket, and then standardized for the costs of facility differences in case-mix and for geographic variations in wages. Providers that received new provider exemptions from the routine cost limits were excluded from the database used to compute the Federal payment rates, as well as costs related to payments for exceptions to the routine cost limits. In accordance with the formula prescribed in the BBA, we set the Federal rates at a level equal to the weighted mean of freestanding costs plus 50 percent of the difference between the freestanding mean and weighted mean of all SNF costs (hospital-based and freestanding) combined. We computed and applied separately the payment rates for facilities located in urban and rural areas. In addition, we adjusted the portion of the Federal rate attributable to wage-related costs by a wage index.
The Federal rate also incorporates adjustments to account for facility case-mix, using a classification system that accounts for the relative resource utilization of different patient types. This classification system, Resource Utilization Groups, version III (RUG- III), uses beneficiary assessment data from the Minimum Data Set (MDS) completed by SNFs to assign beneficiaries to one of 44 RUG-III groups. The May 12, 1998 interim final rule (63 FR 26252) included a complete and detailed description of the RUG-III classification system, and a further discussion appears in section II.B of this proposed rule.
The Federal rates in this proposed rule reflect an update to the rates that we published for FY 2005 equal to the full change in the SNF market basket index. According to section 1888(e)(4)(E)(ii)(IV) of the Act, for FY 2006, we would update the rate by adjusting the current rates by the full SNF market basket index. 2. Payment Provisions--Initial Transition Period
The SNF PPS included an initial, phased transition from a facility- specific rate (which reflected the individual facility's historical cost experience) to the Federal case-mix adjusted rate. The transition extended through the facility's first three cost reporting periods under the PPS, up to and including the one that began in FY 2001. Accordingly, starting with cost reporting periods beginning in FY 2002, we base payments entirely on the Federal rates and, as indicated in section II.G of this proposed rule, we no longer include adjustment factors related to facility-specific rates for the coming fiscal year.
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Use of the Skilled Nursing Facility Market Basket Index
Section 1888(e)(5) of the Act requires us to establish a SNF market basket index that reflects changes over time in the prices of an appropriate mix of goods and services included in the covered SNF services. The SNF market basket index is used to update the Federal rates on an annual basis. The final rule published on July 31, 2001 (66 FR 39562) revised and rebased the market basket to reflect 1997 total cost data.
In addition, as explained in the FY 2004 final rule (68 FR 46058, August 4, 2003) and in section III.B of this proposed rule, the annual update of the payment rates includes, as appropriate, an adjustment to account for market basket forecast error. This adjustment takes into account the forecast error from the most recently available fiscal year for which there are final data, and is applied whenever the difference between the forecasted and actual change in the market basket exceeds a 0.25 percentage point threshold. For FY 2004 (the most recently available fiscal year for which there are final data), the estimated increase in the market basket index was 3.0 percentage points, while the actual increase was 3.1 percentage points. Therefore, the payment rates for FY 2006 do not include a forecast error adjustment, as the difference between the estimated and actual amounts of change does not exceed the 0.25 percentage point threshold. Table 1 below shows the forecasted and actual market basket amounts for FY 2004.
Table 1.--FY 2004 Forecast Error Correction for CMS SNF Market Basket
FY 2004 Forecasted Actual FY forecast Index
FY 2004
2004
error increase * increase ** correction ***
SNF...........................
3.0
3.1
0.0
* Published in August 4, 2003 Federal Register; based on second quarter 2003 Global Insight/DRI-WEFA forecast. ** Based on the fourth quarter 2004 Global Insight/DRI-WEFA forecast. *** The FY 2004 forecast error correction will be applied to the FY 2006 PPS update. Any forecast error less than 0.25 percentage points is not reflected in the update.
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Update of Payment Rates Under the Prospective Payment System for Skilled Nursing Facilities
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Federal Prospective Payment System
This proposed rule sets forth a schedule of Federal prospective payment rates applicable to Medicare Part A SNF services beginning October 1, 2005. The schedule incorporates per diem Federal rates that provide Part A payment for all costs of services furnished to a beneficiary in a SNF during a Medicare-covered stay. 1. Costs and Services Covered by the Federal Rates
The Federal rates apply to all costs (routine, ancillary, and capital-related costs) of covered SNF services other than costs associated with approved educational activities as defined in Sec. 413.85. Under section 1888(e)(2) of the Act, covered SNF services include post-hospital SNF services for which benefits are provided under Part A (the hospital insurance program), as well as all items and services (other than those services excluded by statute) that, before July 1, 1998, were paid under Part B (the supplementary medical insurance program) but furnished to Medicare beneficiaries in a SNF during a Part A covered stay. (These excluded service categories are discussed in greater detail in section V.B.2 of the May 12, 1998 interim final rule (63 FR 26295 through 63 FR 26297)). 2. Methodology Used for the Calculation of the Federal Rates
The proposed FY 2006 rates would reflect an update using the full amount of the latest market basket index. The FY 2006 market basket increase factor is estimated to be 3.0 percent. Consistent with previous years, this factor may be revised in the final rule when later forecast data are available. For a complete description of the multi- step process, see the May 12, 1998 interim final rule (63 FR 26252). We note that in accordance with section 101(a) of the BBRA and section 314 of the BIPA, the existing, temporary increase in the per diem adjusted payment rates of 20 percent for certain specified clinically complex RUGs (and 6.7 percent for rehabilitation RUGs) remains in effect until the implementation of case-mix refinements. (A discussion of the case- mix refinements that we now propose to implement appears in section II.B of this preamble.)
We used the SNF market basket to adjust each per diem component of the Federal rates forward to reflect cost increases occurring between the midpoint of the Federal fiscal year beginning October 1, 2004, and ending September 30, 2005, and the midpoint of the Federal fiscal year beginning October 1, 2005, and ending September 30, 2006, to which the payment rates apply. In accordance with section 1888(e)(4)(E)(ii)(IV) of the Act, the payment rates for FY 2006 are updated by a factor equal to the full market basket index percentage. The rates would be further adjusted by a wage index budget neutrality factor, described later in this section. The unadjusted rates are the same under both the existing 44 group RUG classification system and the proposed RUG-53 classification system. Tables 2 and 3 reflect the updated components of the unadjusted Federal rates for FY 2006.
Table 2.--FY 2006 Unadjusted Federal Rate Per Diem--Urban
Nursing--case- Therapy--case- Therapy--non- Rate component
mix
mix
case-mix Non-case-mix
Per Diem Amount....................................
$137.44
$103.53
$13.63
$70.15
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Table 3.--FY 2006 Unadjusted Federal Rate Per Diem--Rural
Nursing--case- Therapy--case- Therapy--non- Rate component
mix
mix
case-mix Non-case-mix
Per Diem Amount....................................
$131.30
$119.38
$14.56
$71.45
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Case-Mix Adjustment and Other Clinical Issues
[If you choose to comment on issues in this section, please include the caption ``Case-Mix Adjustment and Other Clinical Issues'' at the beginning of your comments.]
Under the BBA, we must publish the SNF PPS case-mix classification methodology applicable for the next Federal FY before August 1 of each year. As discussed in the following sections, we propose to begin utilizing a refinement to the RUG-III case-mix classification system applicable to the SNF PPS during FY 2006, and we specifically solicit comments on the proposed refinement. 1. Background
The SNF PPS replaced the cost-based structure that had been in effect since the inception of the Medicare program. Under the SNF PPS, providers have more flexibility in the use of Medicare funds but are responsible not only for furnishing the full range of services to Medicare beneficiaries, but for the cost effectiveness of their purchasing decisions. Like the inpatient hospital PPS, reimbursement for all services, including therapy and other ancillaries such as diagnostic tests, supplies, and pharmacy, were for the first time included in the SNF Part A ``bundle of services'' and reimbursed directly to the SNF rather than to the actual entity furnishing the service.
In addition, in response to over a decade of rapidly rising Medicare SNF payments, the SNF PPS instituted controls to adjust for identified overutilization and inflated charge structures for therapy and other ancillary services. By restructuring the payment system to reflect a more appropriate expenditure level, there was an aggregate decrease in Medicare expenditure levels for the first SNF PPS year. Providers responded to the SNF PPS by restructuring their operations and practice patterns in an effort to adapt to the new payment structure and incentives.
These rapid changes in facility practices and Medicare payment also generated significant concerns that the transition to a prospective payment system would impede access for beneficiaries with complex medical needs and, by decreasing aggregate payments to SNFs, negatively affect the quality of care in nursing homes across the country. The research presented in this proposed rule was initiated as part of a broad-based effort to investigate and respond to access, quality, and payment concerns raised by industry, advocates, and other stakeholders.
During the course of this effort, CMS developed tools to monitor and evaluate quality of care that are now integral components of our program oversight activities, including the use of Quality Indicators, Quality Measures, and Nursing Home Compare. As discussed later in this section, the development of these new capabilities has also positioned us to move forward in new areas. The refinements discussed in this section are based on research originally conducted by Abt Associates (and later validated by the Urban Institute) that was initiated immediately after the introduction of the SNF PPS in 1999.
In the BBRA, the Congress acted to address these access and quality concerns by enacting a series of temporary payment adjustments. At present, only one of these payment adjustments is still in effect, a 20 percent increase in the per diem adjusted payment rates for 12 complex medical RUG-III groups (SE3, SE2, SE1, SSC, SSB, SSA, CC2, CC1, CB2, CB1, CA2, and CA1,) and a 6.7 percent increase to all 14 rehabilitation groups. This legislation specified that the payment adjustments would continue until the later of: (1) October 1, 2000, or (2) implementation of a refined case-mix classification system under section 1888(e)(4)(G)(i) of the Act that would better account for medically complex patients.
As we noted in the SNF PPS proposed rule for FY 2001 (65 FR 19190, April 10, 2000), this mandated rate increase was intended to serve as a temporary, interim adjustment to the payment rates and RUG-III case-mix classification system as published in the final rule of July 30, 1999, until implementation of the case-mix refinements described in the legislation. In that FY 2001 proposed rule, we included a proposal for an extensive, comprehensive set of refinements to the existing case-mix classification system that collectively would have resulted in expanding the existing 44-group structure to well over 150 groups.
The speed with which we conducted this initial evaluation of the SNF PPS demonstrated our commitment to ensuring the accuracy and equity of the new payment system, but the evaluation had important limitations. Comprehensive SNF PPS data were not yet available, and the research was conducted using 1995-1997 data housed in a large, cross- linked research database collected from only six states that had implemented a RUG-III payment system prior to July 1998 (either through the Federal case-mix demonstration project or for state Medicaid payment). These limitations were explained in the proposed rule along with our plans to validate the data using a national SNF PPS database (65 FR 19193, April 10, 2000).
In conducting the validation analyses, it became clear that the introduction of the SNF PPS and SNF consolidated billing had caused changes in facility practice patterns and billing. Some of these changes could also have been related to the use of a national database and to changing industry practices during the early stages of the SNF PPS implementation. While it was still true that beneficiaries requiring both rehabilitation and extensive medical services used greater amounts of ancillary services, the distribution patterns for those high-cost ancillaries (such as medications and respiratory therapy) had changed from the patterns in the six-state data. These results, in conjunction with the high degree of intra-group and inter- group variability in ancillary utilization identified in both the initial and validation analyses, raised new questions that needed to be addressed prior to implementing refinements. For these reasons, we decided not to implement such refinements at that time. (See the FY 2001 final rule, 65 FR 46773, July 31, 2000.)
Several months later, the Congress enacted the BIPA. Of the various provisions of this legislation that addressed the SNF PPS, one directive also addressed the future development of the SNF PPS. Specifically, section 311(e) of the BIPA directed us to conduct a study of the different systems for categorizing patients in Medicare SNFs in a manner that accounts for the
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relative resource utilization of different patient types and to issue a report with any appropriate recommendations to the Congress.
Based upon the broad language describing the purpose of this study, and the multi-year timeframe provided for conducting it, we believe that the Congress clearly intended for this study to address comprehensive changes, by evaluating a number of different classification systems and considering the full range of patient types. In contrast, since the BBRA specifically ties the duration of its temporary payment increases to the implementation of a case-mix refinement that would ``better account for medically complex patients,'' we believe that even case-mix refinements of a more incremental nature would meet this more targeted mandate to better account for medically complex patients, and need not await the completion of the broader changes envisioned in the BIPA provision.
Moreover, ongoing analysis of the SNF PPS showed that providers have adjusted to it, and that the SNF PPS rates have generally covered the cost of care to Medicare beneficiaries. For example, in its March 2005 report, MedPAC estimated 2005 profit margins for freestanding SNFs of 13 percent. In this environment, it is appropriate to reevaluate the need for maintaining payment adjustments that were always intended to be temporary. 2. Case-Mix Refinement Research
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Data Sources and Analyses
In July 2001, we awarded a contract to the Urban Institute (Urban) for performance of research to aid us in making refinements to the case-mix classification system under section 1888(e)(4)(G)(i) of the Act and starting the case-mix study mandated by section 311(e) of the BIPA. The first phase of the contract focused on developing options for refining the case-mix classification system under section 1888(e)(4)(G)(i) of the Act to account for medically complex patients. As part of this research, Urban updated and broadened the database created for the previous refinement analyses by using 1999 matched MDS and SNF claims, and applied the latest cost report data (1998 and 1999) to estimate costs more accurately for non-therapy ancillary and other services.
We then used this updated and broadened database to replicate and validate the earlier studies conducted by Abt. The study used Medicare SNF claims data for calendar year 1999 and MDS data from our National MDS Repository. We matched the claims to the MDS assessments upon which they were based, yielding approximately 2.7 million MDS segments, resulting in every national facility that billed Medicare for a Part A SNF stay in 1999 being represented in the database. We allocated the non-therapy ancillary costs to the portion of the stay in which they were most likely to have been incurred according to a set of decision rules. We performed comparative analyses of cost and charge data to other existing administrative data sets in order to establish the validity of these data. We also performed a further regression analysis of costs and RUG-III groups.
In addition, we constructed anew the case-mix indexes using our Staff Time Measurement (STM) study data. The STM data were collected in 1990, 1995, and 1997, and are described in the May 12, 1998 interim final rule (63 FR 26252) that implemented the SNF PPS.
Urban then analyzed 270,215 records, a 10 percent sample of this updated and broadened database. As expected, our analyses again verified that non-therapy ancillary costs are higher for Medicare beneficiaries who classify into the Extensive Services category than for those who classify to other categories. In these analyses, Urban found that the addition of a combined Rehabilitation plus Extensive group improved the predictive power of the model. These results were very similar to the preliminary Abt results discussed in our FY 2001 proposed rule, and provided validation for the preliminary Abt analyses (that is, both studies showed an increase in the R-square (explanation of variance) for non-therapy ancillaries from approximately 4.1 percent in the 44-group model to 8 percent in the 58-group model that added nine Rehabilitation plus Extensive groups).
Urban then replicated its results with 2001 data using the same analytic protocols. In this study, Urban found that the addition of a new RUG-III Rehabilitation plus Extensive category was consistent with the prior research. Urban used a 163,386 record test sample and found that the R-square for non-therapy ancillaries improved to 9.5 percent from the previous result of 4.1 percent mentioned above. The analyses were repeated on a 170,253 record validation sample with a comparable result; that is, an R-square of 10.3 percent.
While maintaining the general structure of the RUG-III system, we found that the most viable way to refine the system at the present time would be to add groups to the top of the hierarchy to capture beneficiaries who qualify for both the Extensive Services category and the Rehabilitation Therapy category. In addition, beneficiaries who qualify for Extensive Services and receive rehabilitation services have assumed a larger percentage of the Medicare patient population in SNFs in recent years. Therefore, we believe that the RUG-III case-mix classification system can provide even more accurate payment for these beneficiaries if refined to create a new RUG-III category for beneficiaries who qualify for both the Extensive Services and Rehabilitation Therapy categories.
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Constructing the New RUG-III Groups
Our research findings showed little or no correlation between the groups within the Extensive Services category (that is, SE1, SE2, SE3) and the level of rehabilitation services used. For this reason, the structure for this new hierarchy level would closely mirror that of the existing Rehabilitation Therapy groups. Normally, this methodology would result in the creation of 14 new groups, the number that was originally proposed in the FY 2001 proposed rule. However, for the reasons discussed below, the more recent research (Urban 2003) has shown that a smaller number of RUG-III groups are sufficient to address the needs of beneficiaries eligible for a new RUG-III category, Combined Rehabilitation and Extensive Care.
First, we found that several of the groups had very few beneficiaries assigned to them. In fact, no beneficiaries at all were assigned to several of the lowest ADL score rehabilitation groups. Second, under the present structure, each Rehabilitation group is sub- divided into three levels based on the activities of daily living (ADL) score. The lowest level ADL score for the Rehabilitation groups is either 4-7 or 4-8, and very few beneficiaries currently classify into those groups. No beneficiaries who would qualify for the proposed newly created groups would classify into such a low ADL score level, as a minimum ADL score of seven is required for classification into an Extensive Care group.
Therefore, it appears that stratification for the lowest level ADL scores for the proposed new groups would add needless complexity and, thus, would not be warranted. Instead, we propose to combine that level with the next higher level, and would no longer use the ADL scores lower than 7. Thus, the proposed new groups would be stratified only by two levels of ADL score. For example, the Rehabilitation High plus Extensive Services group would be subdivided into only two ADL levels, ADL scores of 7-12 and 13-18. This left us with only
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one level for Rehabilitation Low plus Extensive Services and with only two levels at each of the other sub-categories in the new category, for a total of 9 new groups. As a result, we are proposing the addition of 9 new RUG-III groups.
Table 3a.--Crosswalk Between Existing RUG-III Rehabilitation Groups and the Proposed Extensive Plus Rehabilitation Groups
New combined extensive plus Current rehabilitation groups
rehabilitation groups
Rehab Ultra......................... RUC-ADL 16-18.............. RUX-ADL 16-18. RUB-ADL 9-15............... RUL-ADL 7-15. RUA-ADL 4-8................ Rehab Very High..................... RVC-ADL 16-18.............. RVX-ADL 16-18. RVB-ADL 9-15............... RVL-ADL 7-15. RVA-ADL 4-8................ Rehab High.......................... RHC-ADL 13-18.............. RUX-ADL 13-18. RHB-ADL 8-12 .............. RUL-ADL 7-12. RHA-ADL 4-7................ Rehab Medium........................ RHC-ADL 15-18.............. RUX-ADL 15-18. RHB-ADL 8-14............... RUL-ADL 7-14. RHA-ADL 4-7................ Rehab Low........................... RLB-ADL 14-18.............. RUX-ADL 7-18 RLA-ADL 4-13...............
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Development of the Case-Mix Indexes
We developed the case-mix indexes for the proposed refined RUG-III system using the same method used for calculating the initial SNF PPS case-mix indexes. The original staff time studies conducted in 1990, 1995, and 1997 resulted in the assignment of resident-specific and non- resident specific time (minutes) to individual SNF residents. In the initial determination of the case-mix indexes, the residents were classified into the 44-group system and the minutes of staff time, nursing, and therapy services, where appropriate, remained associated with those residents. All of the staff time was stratified by type of staff providing the minutes of time (for example, RN, LPN, etc.), and the minutes were weighted for salary.
In order to calculate weights for the proposed refined system, we used the minutes as originally assigned at the individual patient level. We reclassified the patients into the proposed 53 groups with their associated wage-weighted minutes of resident-specific and nonresident-specific staff time. The next step was to apply these wage- weighted minutes to the entire sample population of 26 million days. We multiplied the population in each group by the wage-weighted minutes for each of the staff types. We then derived an average for the group using the sum of the wage-weighted minutes for all staff (nursing and therapy staff minutes were calculated separately) xxdivided by the total population for that group. The relative weight was then calculated by dividing that average by the average minutes across all of the RUG-III groups.
The nursing weights changed more than the therapy weights, due to the redistribution of patients from existing groups to the newly created proposed groups. Even though many of the beneficiaries who move into one of the proposed new groups are from an existing therapy group, the therapy weights are affected only slightly. This is because the amount of therapy time does not change significantly between the existing groups and the proposed new groups. The therapy groups were already narrowly stratified by minutes of therapy provided. The groups' weights would be affected only to the extent that the individual beneficiaries who are reclassified into one of the proposed new groups have unusually high or low minutes of therapy within the specific limits. The nursing weights are more affected by the reclassifications, as those are based on a much broader scope of possible minute values.
The therapy weights for the nine proposed Rehabilitation Therapy plus Extensive Services groups were identical to those for the comparable existing RUG-III rehabilitation therapy groups. Although we are capturing increased medical/clinical complexity with the proposed new groups, the therapy contribution remains the same as for the existing therapy groups. In this way, the Rehabilitation High therapy weight is identical to the new Rehabilitation High plus Extensive Services sub-category.
The effect of the increased number of groups and changes in the case-mix indexes should be distributional. By this we mean that the relative weights assigned to each RUG-III group would shift so that the proposed new Rehabilitation plus Extensive groups would have the highest relative weights and the weights for other RUG-III groups would decrease proportionally.
The results of applying these methods to index calculation worked well and yielded hierarchically sound indexes for all of the groups; that is, the indexes for the highest groups in the hierarchy are higher than for those below it, and this pattern holds throughout the proposed new category.
The nursing indexes in the new category, as well as in the existing rehabilitation category, are naturally more compressed (that is, encompass a smaller range) than those in the 44-group RUG-III rehabilitation groups. The groups within the new Rehabilitation plus Extensive category are more homogeneous than were the rehabilitation groups of the 44-group system. By removing the most clinically complex cases and better accounting for them by putting them in rehabilitation groups of their own, both the resulting proposed new category and the remaining rehabilitation category groups would be more homogeneous and, therefore, the relative weights for each set of groups would exhibit less variance.
Next, we simulated payments using the existing weights compared to the new weights to ensure that the refinement did not result in greater or lesser aggregate payments. The simulation results showed an almost exact match in payments under both case-mix models. However, the proposed new 53-group model did yield a slight decrease (less than 1 percent) in aggregate Medicare payments. To
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remove this minor variance, we then applied a factor of +.02 to calibrate the nursing indexes and re-ran the simulation. Using this calibration factor of +.02, we are able to ensure absolute parity of aggregate payment under the 53-group RUG-III system compared to the 44- group system.
Finally, we propose to provide for an additional adjustment to the nursing component of the case-mix weights (which includes non-therapy ancillary services) for all RUG-53 groups. As discussed further in section II.B.3 of this proposed rule, we have reviewed data that show a high degree of variability in non-therapy ancillary utilization, not only within but across RUG groups. Therefore, we believe that it is appropriate to adjust the case-mix weights for all 53 groups (that is, the existing 44 RUG-III groups plus the 9 new groups that we are proposing to create in this proposed rule) to better account for non- therapy ancillary variability. We would do this under our authority in section 1888(e)(4)(G)(i) of the Act to establish an ``appropriate adjustment to account for case mix * * * *''
In determining the size of this adjustment, we considered not only the high degree of variability in non-therapy ancillary costs, but also the absence of an outlier policy under the SNF PPS. Accordingly, we looked at the outlier pool established under another post-acute care PPS, the one for inpatient rehabilitation facility (IRF) services, which is set at 3 percent of aggregate expenditures. For the purpose of this refinement, our calculations employed a comparable funding level that could be targeted toward payment of non-therapy ancillaries. Based on this analysis, we are proposing an increase to the nursing component of the case-mix weights (the component that includes non-therapy ancillaries) of approximately 8.4 percent, which equates to approximately 3 percent of aggregate expenditures under the SNF PPS. The final RUG-53 nursing indexes are presented in Tables 4a and 5a. Further information regarding this adjustment can be found in section II.B.3 of this proposed rule. 3. Proposed Refinements to the Case-Mix Classification System
[If you choose to comment on issues in this section, please include the caption ``Proposed Refinements to the Case-Mix Classification System'' at the beginning of your comments.]
We note that, of the various individual refinements that were collectively set forth in the FY 2001 proposed rule (65 FR 19194), the particular refinement that entailed the least amount of added complexity (yet addressed the medically complex patient) involved the creation of several additional groups that would comprise a new, combined Rehabilitation plus Extensive Services category. As we noted in that proposed rule:
There are * * * a significant number of beneficiaries who would classify into the Extensive Services category based on clinical conditions but who, because they are also receiving rehabilitation services, classify into one of the Rehabilitation groups instead (due to the hierarchical logic of the RUG-III classification system). These beneficiaries carry with them the same non-therapy ancillary costs associated with their complex clinical needs even though they are classified into a RUG-III Rehabilitation category. The high costs for beneficiaries in the Extensive Services category suggest that the payment rate for Extensive Services should be increased. However, increasing the payment rate without further adjustments could adversely affect provider incentives to provide therapy to beneficiaries requiring Extensive Services. Therefore, we expanded the scope of the proposed refinement to include new categories for beneficiaries who qualify for both Extensive Services and a RUG-III Rehabilitation category.
Further, as our subsequent research (discussed in the previous section) confirmed, the creation of a proposed new Rehabilitation plus Extensive category would be a means of accounting more accurately for the costs of certain medically complex patients, with the added benefit of a minimal degree of added complexity. We note that, in the past, some support has been expressed for making this particular type of modification to the existing case-mix classification system.
Therefore, we propose to refine the case-mix classification system under section 1888(e)(4)(G)(i) of the Act by creating a new, combined Rehabilitation plus Extensive category, that better accounts for medically complex patients, as required in section 101 of the BBRA. Accordingly, the payment rates set forth in this proposed rule reflect the use of the refined 53-group RUG classification system that we are proposing. The nine groups that we propose to add to the existing RUG- III system are as follows:
RUX Rehabilitation Ultra High plus Extensive Services, High RUL Rehabilitation Ultra High plus Extensive Services, Low RVX Rehabilitation Very High plus Extensive Services, High RVL Rehabilitation Very High plus Extensive Services, Low RHX Rehabilitation High plus Extensive Services, High RHL Rehabilitation High plus Extensive Services, Low RMX Rehabilitation Medium plus Extensive Services, High RML Rehabilitation Medium plus Extensive Services, Low RLX Rehabilitation Low plus Extensive Services
We note that, like our current proposal, the case-mix refinement that we considered in our FY 2001 proposed rule would have reconfigured the RUGs themselves, in a general effort to allocate payments more accurately under the SNF PPS. However, that earlier proposal also included an additional element, which was intended to help ensure more accurate allocation of payments specifically with regard to non-therapy ancillaries (such as drugs and medications, laboratory services, supplies and other equipment). For example, it proposed moving the non- therapy ancillary costs used in establishing the nursing case-mix component of the payment rates to a separate, newly created ``medical ancillary'' component (65 FR 19192, April 10, 2000). In addition, it suggested a number of possible models, both weighted and unweighted, for a new non-therapy ancillary index (65 FR 19248ff). As noted in the FY 2001 final rule, these elements ultimately were not adopted when subsequent research indicated that their added complexity would outweigh their increased predictive power (65 FR 46774, July 31, 2000).
Following the publication of that final rule, further research in this area revealed a high degree of variability in non-therapy ancillary utilization, both within and across the various RUG-III groups. This finding suggested that using an index model to address non-therapy ancillary services might require the creation of such a high number of groups as to be impractical.
In fact, the ability of the SNF PPS to account adequately for non- therapy ancillary services has been the subject of attention (and a focus of our research) since the very inception of the system. When the Congress originally enacted the SNF PPS in the BBA, it expressed concern in the accompanying legislative history ``* * * that under a prospective payment system that includes all services there may be incentives to decrease the use of ancillary services' (H. Rep. No. 105- 149 at 1318). Subsequent legislative initiatives, such as the BBRA mandate to develop case-mix refinements that better account for
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``medically complex'' patients, and the directive in section 311(d) of the BIPA for the GAO to conduct a study of the adequacy of Medicare's SNF payment rates, can all be viewed in the context of an ongoing Congressional concern in this area.
For those reasons, and because the data that we have show wide variability in non-therapy ancillary utilization within each RUG, we believe the refinement that we now propose should include not only a reconfiguration of the RUGs that addresses the accuracy of payment allocation in general terms, but also an additional element that improves the accuracy of payment allocation and accounts more directly for cost variations related to non-therapy ancillary services. Accordingly, as part of our proposed refinement, we propose to increase the case-mix indexes of the existing 44 RUG-III groups (as well as those of the nine proposed new Rehabilitation plus Extensive Services RUGs), by calculating a percentage increase that would increase aggregate payments.
As noted previously, we have reviewed data that show great variability in the ancillary services (such as pharmacy) utilized by different SNF residents who are classified into the same RUG-III group. For example, two different patients, both classified into the SE3 group, might utilize markedly different amounts of ancillary services for reasons that are not captured within the current RUG-III classification methodology. Our data show that the same is true across all of the existing 44 RUG-III groups. The addition of the 9 new groups does not, in itself, compensate for this discrepancy. Although the SNF payment system is designed as a prospective payment system, under which SNFs that treat patients grouped into the same clinical condition should receive the same base payment, the variability in ancillary usage that our data show makes it difficult to account fully for non- therapy ancillary costs by adjusting the number of groups. Therefore, we believe that it is appropriate, considering the data that we have available to us, to provide for an adjustment to each RUG case-mix weight to account for the variability in non-therapy ancillaries, using the authority that we have under section 1888(e)(4)(G)(i) of the Act.
Additionally, we have found a high degree of variability in non- therapy ancillaries not only within but across RUG groups. We have reviewed data showing that an individual patient who is classified into a less intensive RUG may nonetheless be significantly more expensive to treat in terms of non-therapy ancillaries than an individual patient in a more intensive RUG. The data that we have do not adequately explain these discrepancies, and the addition of the 9 new RUGs does not eliminate them. Our data show that the same is true across all 44 RUG- III groups. We note that in creating the SNF PPS, the Congress enacted the only PPS legislation in the Medicare program that does not establish an outlier policy to capture high variability in resource utilization. Therefore, in view of the data that we have available to us that demonstrates wide disparities in non-therapy ancillary resources consumed by patients both within and across RUG-III groups, we believe that it is appropriate to adjust the case-mix weights for all 53 groups (that is, the existing 44 RUG-III groups plus the 9 new groups that we are proposing to create in this proposed rule) to better account for non-therapy ancillary variability. We would do this by exercising our authority under section 1888(e)(4)(G)(i) of the Act to establish an ``appropriate adjustment to account for case mix,'' in order to maintain access and quality of care for heavy-care patients.
In determining the size of this adjustment, we considered the high degree of variability in non-therapy ancillary costs (which was not yet known at the time that the BBA and the BBRA were enacted), and the absence of an outlier policy under the SNF PPS. Accordingly, we looked at the outlier pool established under another PPS for post-acute care, the inpatient rehabilitation facility prospective payment system (IRF PPS), which is set at 3 percent of aggregate expenditures. For the purpose of this refinement, we calculated the SNF dollars needed to achieve a comparable funding level that could be targeted towards payment of non-therapy ancillaries. Based on this analysis, we are proposing an increase to the nursing component of the case-mix weights (the component that includes non-therapy ancillaries) of approximately 8.4 percent, which equates to approximately 3 percent of aggregate expenditures under the SNF PPS.
Moreover, we believe that this type of adjustment can essentially serve as a proxy for the non-therapy ancillary index that we proposed previously as a means of achieving more appropriate payment for these services, without the potential drawbacks of our earlier proposal in terms of complexity and addressing variability in utilization. In fact, while we are confident that the decision to maintain a relatively small number of RUG groups is correct in terms of the overall operation of the SNF PPS, it is still true that this number of groups made it extremely difficult to distinguish different levels of non-therapy ancillary use. The problem may be less severe in other PPSs that use a greater number of groups. For example, the IRF PPS was initially structured to have 100 groups, and the inpatient hospital PPS (IPPS) has over 500 diagnosis-related groups. Similarly, there are over 7,000 relative value units under the resource-based relative value scale that determines the payment rates for physician and other Part B services. By contrast, under this proposed rule, there will be only 53 RUGs. By definition, then, there will be wider variation in the resource needs of patients classified into a particular RUG. We, therefore, believe that it is appropriate to provide for a further adjustment to the case- mix index to compensate for these broad discrepancies.
We note that we are advancing these proposed changes under our authority in section 101(a) of the BBRA to establish case-mix refinements, and that the changes we are hereby proposing will represent the final adjustments made under this authority. Accordingly, any future changes to the case-mix weights or other components of the SNF PPS would be accomplished through staff time measures and other validated analytical studies.
As further explained in section II.B.4 of this proposed rule, these additional payments would partially offset the expiration of the temporary add-on payments that will occur, under the terms of section 101(c) of the BBRA, upon the implementation of this proposed case-mix refinement. We believe that implementing the proposed case-mix refinement in this manner will carry out Congressional intent that the BBRA's temporary payment add-ons should not continue indefinitely into the future, while at the same time ensuring that payments under the SNF PPS continue to support the quality of care furnished in this setting.
Further, the creation of the proposed new Rehabilitation plus Extensive Services groups underscores the importance of ensuring the accuracy of patient classifications, particularly with regard to those categories, such as Extensive Services, that encompass medically complex patients. One way to accomplish this could be by ensuring that the MDS data used in making such classifications reflect only those services that are actually furnished during the SNF stay itself rather than during the preadmission period (for example,
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during the prior qualifying hospital stay). In the July 30, 1999 SNF PPS final rule (64 FR 41668 through 41669), we noted a public comment that questioned the appropriateness of the MDS's 14-day ``look-back'' provision in the specific context of the SNF level of care presumption. While we made no revisions to the look-back provision at that time, we specifically reserved the right to reconsider the continued use of this mechanism in the future.
Subsequent analysis in this area has focused on the four items contained in the Special Service section of the MDS (P1a--IV medications, suctioning, tracheostomy care, and use of a ventilator/ respirator) that serve to classify residents into Extensive Care, the category used for the most medically complex SNF patients under the RUG-III classification system. This analysis indicates that the use of the look-back provision has caused a significant number of residents to classify to the Extensive Services category based solely on services (such as intravenous medications) that were furnished exclusively during the period before SNF admission. Depending on how such a proposal was formulated, it has the potential to reduce overall SNF payments by better aligning them with the services actually provided. Therefore, we seek comment on the potential savings and other impacts of revising the MDS Manual instructions to include only those special care treatments and programs (MDS Section P1a) furnished to the resident since admission or re-admission to the SNF, similar to the requirement for P1b. We anticipate that this change can be accomplished through an update to the MDS Manual instructions, and will not involve system changes at the facility, State agency, or Federal level.
In addition, we are inviting comments on other policy options that could enhance the accuracy of the payment system and improve the quality of care provided to Medicare beneficiaries during an SNF stay, without limiting access to post-acute care. For example, we have received recommendations to decrease or eliminate the grace day period specifically for the 5-day PPS MDS assessment. We invite comments on this specific recommendation as well as decreasing or eliminating the grace periods associated with all PPS MDS assessments. Another example of a possible policy change on which we invite comment would be whether it might be appropriate to eliminate the projection of anticipated therapy services during the 5-day PPS assessment. We invite comments on these and other existing SNF policies that may have an impact on the quality of care in this setting.
In accordance with section 101 of the BBRA, implementing these proposed refinements to the case-mix system means that the payment rates set forth in this proposed rule would no longer reflect the temporary add-ons to the Federal rates for specified RUG-III groups. We understand that the expiration of the temporary payment increases, provided for in that legislation, results in a significant reduction in Medicare's payments between FY 2005 and FY 2006. In fact, MedPAC has consistently urged that, until CMS can design a new payment methodology, some or all of the temporary add-on payments be retained and allocated towards beneficiaries with complex medical needs.
While this proposed rule sets forth refinements to the existing case-mix classification system and RUG-III categories, we are soliciting comments on the economic impact of the resulting payment changes, as well as their potential impact on beneficiaries' access to quality SNF care. We also invite comments on possible ways in which the case-mix classification system itself might be further modified to help mitigate the effect of the payment changes.
We note that the expiration of the BBRA add-on payments would not necessarily affect the temporary 128 percent increase in the per diem adjusted payment rates for SNF residents with AIDS. In enacting that temporary increase, the Congress cited past research indicating that ``* * * AIDS patients have much higher costs than other patients in the same resource utilization groups in skilled nursing facilities'' (H. Rep. No. 108-178, Part 2, at 221). This underscored the Congress' view that AIDS patients are unique among SNF residents in that they incur significantly higher care costs than residents with other diagnoses, including those who classify to the same RUG-III group. We believe that even if a case-mix refinement can meet the BBRA criterion of better accounting for the needs of medically complex patients generally, this still might not enable the Secretary to certify under section 1888(e)(12)(B) of the Act ``* * * that there is an appropriate adjustment in the case mix * * * to compensate for the increased costs'' specifically associated with this particular group of patients. Thus, while the implementation of case-mix refinements will trigger the expiration of the 20 percent and 6.7 percent add-on payments under section 101(a) of the BBRA (as amended by section 314 of the BIPA), this may not necessarily be the case for the AIDS add-on payments under section 511 of the MMA. Accordingly, pending further examination of this issue, we believe that it would be premature at this time for the Secretary to make the required certification under section 1888(e)(12)(B) of the Act with respect to the unique conditions that pertain to the care of SNF residents with AIDS. As a result, the 128 percent add-on payments for SNF residents with AIDS will remain in effect during FY 2006.
The case-mix adjusted payment rates are listed separately for urban and rural SNFs for the existing 44 group RUG and proposed RUG-53 classification systems in Tables 4, 4a, 5, and 5a, with the corresponding case-mix index values.
We also remain committed to our long-term efforts to monitor the RUG-III case-mix classification system and to an ongoing effort to increase the accuracy and efficiency of the SNF PPS. A series of analyses, including the studies used to develop the refinements discussed above, will be discussed in a forthcoming report to the Congress. In this report, we will discuss the findings and put forth a series of next steps that will provide a framework for future progress. In addition, we have posted data describing the research conducted by ABT and the Urban Institute on our SNF PPS Web site at http://www.cms.hhs.gov/providers/SNF PPS. Commenters may wish to consult this
material to facilitate a more in depth understanding of the proposals contained in this document.
Moreover, we would like to take this opportunity to discuss our thinking related to broader initiatives in this area related to quality of care. Through the Nursing Home Quality Initiative, the Long Term Care Task Force and other forums for collaborative action, CMS has worked with the SNF industry on the development of valid quality measures, and a variety of quality improvement efforts focused on nursing homes. These efforts and others have resulted in improvements in the quality of care, particularly in facilities that adopt a culture that promotes quality through continuous quality initiatives (CQI), culture change, and other similar programs. Pay for performance is a tool that could provide additional support to improve the quality of care provided in nursing homes. In this way, we could recognize and support the ongoing efforts of nursing homes to improve quality.
Designing Pay for Performance programs for the SNF setting presents some significant issues. While Medicare beneficiaries are the primary users of
[[Page 29081]]
SNF services, only a small percentage of these beneficiaries (that is, approximately 10 percent) receive services that are reimbursed under Medicare Part A. The majority of beneficiaries receive services that are reimbursed by multiple payers, including Medicare Part B, Medicaid, and private insurance, and that are delivered within different parts of a nursing facility. Therefore, it is not enough to change practice patterns in just a part of a nursing home (that is, skilled units), as Medicare beneficiaries can be placed anywhere in the facility. In addition, the focus of the nursing, rehabilitative, and medical interventions will typically vary for persons who are receiving short- term skilled nursing facility services versus those persons who are long-term residents in nursing facilities.
For these reasons, quality measures must be carefully constructed; that is, broad-based and designed to effect change across the mix of patients residing in the facility. Similarly, we need to consider how to design effective incentives; that is, superior performance measured against pre-established benchmarks and/or performance improvements.
In addition, while our efforts to develop the various post-acute care PPSs (including the SNF PPS) have generated substantial improvements over the preexisting cost-based systems, each of these individual systems was developed independently. As a result, we have focused on phases of a patient's illness as defined by a specific site of service, rather than on the entirety of the post-acute episode from the standpoint of the patient rather than the facility. As the various provider types (such as SNFs and inpatient rehabilitation facilities (IRFs)) provide similar types of services in some cases, and as the opportunities to provide similar services in different settings increase, we need to investigate a more coordinated approach to payment and delivery of post-acute services that focuses on the overall post- acute episode.
This could entail a strategy of developing payment policy that is as neutral as possible regarding provider and patient decisions about the use of particular post-acute services. That is, Medicare should provide payments sufficient to ensure that beneficiaries receive high quality care in the most appropriate setting, so that admissions and any transfers between settings occur only when consistent with good care, rather than to generate additional revenues. In order to accomplish this objective, we need to collect and compare clinical data across different sites of service.
In fact, in the long run, our ability to compare clinical data across care settings is one of the benefits that will be realized as a basic component of our interest in the use of standardized electronic health records (EHRs) and other steps to promote continuity of care across all settings, including nursing homes. It is also important to recognize the complexity of the effort, not only in developing an integrated assessment tool that is designed using health information standards, but in examining the various provider-centric prospective payment methodologies and considering patient-centric payment approaches that are based on patient characteristics and outcomes. MedPAC has recently taken a preliminary look at the challenges in improving the coordination of our post-acute care payment methods, and suggested that it may be appropriate to explore additional options for reimbursing post-acute services. We agree that CMS, in conjunction with MedPAC and other stakeholders, should consider a full range of options in analyzing our post-acute care payment methods, including the SNF PPS.
We also want to encourage incremental changes that will help us build toward these longer-term objectives. For example, several automated medical record tools are now available that could allow hospitals and SNFs to coordinate discharge planning procedures more closely. These tools can be used to ensure communication of a standardized data set that can also be used to establish a comprehensive SNF care plan. Improved communications may reduce the incidence of potentially avoidable re-hospitalizations and other negative effects on quality of care that occur when patients are transferred to SNFs without a full understanding of their care needs. CMS is looking at ways that Medicare providers can use these tools to generate timely data to support continuity across settings. We are also interested in comments on payment reforms that could promote and reward such continuity, and avoid the medical complications and additional costs associated with re-hospitalization.
Some of the ideas discussed here may exceed CMS's current statutory authority. However, we believe that it is useful to encourage discussion of a broad range of ideas for debate of the relative advantages and disadvantages of the various policies affecting this important component of the health care sector, to ensure that our administrative actions provide maximum support for further steps toward higher quality post-acute care. We welcome comments on these and other approaches. 4. Implementation Issues
[If you choose to comment on issues in this section, please include the caption ``Implementation Issues'' at the beginning of your comments.]
As noted previously in this proposed rule, the temporary add-on payments enacted by section 101(a) of the BBRA expire upon the implementation of case-mix refinements. Section 101(c) of the BBRA specifies that the actual date on which these temporary add-on payments are to expire is ``the later of--(1) October 1, 2000; or (2) the date on which the Secretary implements a refined case mix classification system under section 1888(e)(4)(G)(i) of the Social Security Act (42 U.S.C. 1395yy(e)(4)(G)(i)) to better account for medically complex patients''. Section 1888(e)(4)(G)(i) of the Act, in turn, specifies that the Secretary shall provide for an ``appropriate adjustment'' to account for case mix.
While this proposed rule sets forth proposed updates to the SNF PPS payment rates that are to take effect as of October 1, 2005, we recognize that adopting the proposed refinements to the case-mix classification system will likely entail significant changes for SNFs as well as for Medicare contractors. Therefore, in order to allow sufficient time for preparation and to ease the transition to the proposed refinements, we believe that it would be appropriate under section 1888(e)(4)(G)(i) of the Act to make a case-mix adjustment that reflects the implementation of the refinements described below.
Accordingly, from October 1, 2005, through December 31, 2005, we propose to make payment based entirely on the existing 44-group RUG-III classification system. Beginning on January 1, 2006, we propose to make payment based entirely on the proposed new RUG-53 classification system. This means that under the terms of section 101(c) of the BBRA, the temporary add-on payments for certain designated RUG-III groups will expire as of January 1, 2006. We note that the resulting reduction in payment will be partially offset by the increase in the RUG case-mix indexes, as explained previously in section II.B.3 of this proposed rule. We invite comments on all aspects of implementing the proposed case-mix refinements, including our plan to defer implementation until January 1, 2006.
Further, along with those matters relating specifically to the case-mix classification system, we have identified a number of broader clinical issues that
[[Page 29082]]
we are also taking this opportunity to address: 5. Assessment Timeframes
We would like to take this opportunity to clarify existing requirements regarding completion of Other Medicare Required Assessments (OMRAs) for beneficiaries reimbursed under the SNF PPS. An OMRA is due 8 to 10 days after the cessation of all therapy (occupational and physical therapies and speech-language pathology services) in all situations where the beneficiary was assigned a rehabilitation RUG-III group on the previous assessment.
The ``last day of therapy'' is the last day on which a therapy service was furnished. It is not the day the discharge order for therapy was received and/or written on the resident's medical record. Therefore, when the last day that therapy was provided falls on a Friday, the Saturday and Sunday directly following are counted as days 1 and 2, respectively, toward the total 8 to 10 days of the OMRA window. The same principles apply when the ``midnight rule'' is initiated during a beneficiary's Part A SNF stay.
In addition, in the relatively uncommon situations where a resident starts a leave of absence after the therapy services have been discontinued and is out of the facility for part of the 8 to 10 day period during which the OMRA must be completed, those therapeutic leave days are to be counted when determining the OMRA due date. While this information is not new, we determined that it would be beneficial to clarify and remind the public of these specific issues involving the OMRA. 6. SNF Certifications and Recertifications Performed by Nurse Practitioners and Clinical Nurse Specialists
[If you choose to comment on issues in this section, please include the caption ``SNF Certifications and Recertifications Performed by Nurse Practitioners and Clinical Nurse Specialists'' at the beginning of your comments.]
We are taking this opportunity to clarify the requirement for physician signature on the certification and recertification of the need for SNF care (Sec. 424.20(e)(2)) as it relates to nurse practitioners (NPs) and clinical nurse specialists (CNSs). In section 6028 of the Omnibus Budget Reconciliation Act of 1989, the Congress amended section 1814(a)(2) of the Act. As amended, the Act specifies that an NP or CNS ``* * * who does not have a direct or indirect employment relationship'' with the facility but is working in collaboration with a physician may sign the required certification (or recertification) for a beneficiary's SNF stay. (Section 1819(b)(6)(A) of the Act further specifies that the medical care of each SNF resident must be under the supervision of a physician (see also the regulations at 42 CFR 483.40(a)(1)).) This provision that bars NPs and CNSs from having a direct or indirect employment relationship with a SNF in order to sign a certification or recertification of the need for care is very restrictive. By contrast, a similar statutory limitation (see section 1919(b)(6)(A) of the Act) on the delegation of physician tasks in Medicaid nursing facilities only bars NPs, CNSs, and physician assistants (PAs) from performing delegated tasks if they are actually employed by the facility.
Following the enactment of this legislation, we received numerous inquiries asking us to define ``direct'' and ``indirect'' employment relationships in greater detail. In the July 26, 1995 final rule (60 FR 38268), we stated that factors indicating whether a NP or CNS has a direct or indirect employment relationship include, but are not limited to the following:
The facility or someone on its medical staff has the authority to hire or fire the nurse;
The facility or someone on its medical staff furnishes the equipment or place to work, sets the hours, and pays the nurse by the hour, week, or month;
The facility or someone on its medical staff restricts the nurse's ability to work for someone else or provides training and requires the nurse to follow instructions.
We note that the longstanding common law test, as set forth in regulations at 20 CFR 404.1005, 404.1007, and 404.1009, continues to determine the presence of a direct employment relationship for the purposes of this provision. However, numerous inquiries from providers and other stakeholders continue to request that we specifically clarify the definition of an ``indirect'' employment relationship in those situations where no direct employment relationship exists. Accordingly, we propose to revise the regulations at Sec. 424.20(e)(2) to identify the existence of an indirect employment relationship in terms of the type of services that the practitioner performs in the SNF. We note that NPs and CNSs who are employed by SNFs not only perform the types of delegated physician tasks that are permitted under the long-term care facility requirements for participation at 42 CFR 483.40(e), but typically perform general nursing services as well. We believe that, even in the absence of a direct employment relationship, an SNF that has an NP or CNS perform these general nursing services is essentially utilizing the NP or CNS in the same manner as it would an employee, so that an indirect employment relationship can be considered to exist. Accordingly, in situations where there is no direct employment relationship between the SNF and the NP or CNS, we propose that an indirect employment relationship exists whenever the NP or CNS not only performs delegated physician tasks, but also provides nursing services under the regulations at 42 CFR 409.21, which include such services within the scope of coverage under the Part A SNF benefit. We believe that this criterion is appropriate, because there would be a potential conflict of interest if an NP or CNS who is engaged in furnishing covered Part A nursing services to an SNF's resident were also permitted to certify as to that resident's need for Part A SNF care. We invite comments on the effects of establishing our proposed distinction in this context. 7. Concurrent Therapy
[If you choose to comment on issues in this section, please include the caption ``Concurrent Therapy'' at the beginning of your comments.]
The SNF PPS proposed rule for FY 2002 (66 FR 23991, May 10, 2001) included a discussion of concurrent therapy, a practice also known as ``dovetailing.'' In that discussion, we noted that this practice involves a single professional therapist treating more than one Medicare beneficiary at a time--in some cases, many more than one individual at a time. In contrast to group therapy, in which all participants are working on some common skill development, each beneficiary who receives concurrent therapy likely is not receiving services that relate to those needed by any of the other participants. Although the care that each beneficiary receives may be prescribed in his or her individual plan of treatment, it may not conform to Medicare coverage guidelines; that is, the therapy is not being provided individually, and it is unlikely that the services being delivered are at the complex skill level required for coverage by Medicare. We expressed particular concern over instances in which facility management might inappropriately attempt to increase productivity by coercing a therapist, against his or her own professional judgment, to perform concurrent therapy.
[[Page 29083]]
In the SNF PPS final rule for FY 2002 (66 FR 39567, July 31, 2001), we noted that most of the public comments that we received on this discussion urged us to continue to recognize concurrent therapy as skilled therapy, and contended that therapists are treating more than one beneficiary concurrently only when appropriate. However, others indicated that our concerns regarding concurrent therapy were, in fact, warranted. They reported that since the implementation of the SNF PPS, professional therapists are encountering increased pressure to be more productive than they have in the past, including the need to see more than one patient at a time, and performing documentation and collaboration with other members of the care team as non-reimbursed time. In response to the comments, we acknowledged that concurrent therapy can have a legitimate place in the spectrum of care options available to therapists treating Medicare beneficiaries, as long as its use is driven by valid clinical considerations. However, while we declined to make any specific policy changes at that time, we reiterated that it is inappropriate for a facility to require, as a condition of employment, that a therapist agree to treat more than one beneficiary at a time in situations where providing treatment in such a manner would compromise the therapist's professional judgment. We also noted that we might revisit this issue in the future should the need to do so arise.
Since that time, we have continued to encounter reports of facilities that attempt to override the therapist's professional judgment and have concurrent therapy performed in the absence of valid clinical considerations. Accordingly, we believe it is appropriate at this time to consider once again whether there is a need to issue additional guidelines to preclude the inappropriate provision of concurrent therapy. We invite comment on the most effective way to prevent the abuse of this practice, and to ensure that concurrent therapy is performed only in those instances where it is clinically justified.
We propose to establish an effective date of January 1, 2006, as the beginning date for the use of the proposed case-mix refinements. Accordingly, from October 1, 2005, through December 31, 2005, we propose to make payment based entirely on the existing 44-group RUG-III classification system. Tables 4, 5, 6, and 7 reflect the corresponding rate information for the existing 44 group RUG-III classification system to be used during this time.
Beginning on January 1, 2006, we propose to make payment based on the proposed new RUG-53 classification system (and, thus, would not include the add-on payments). Tables 4a, 5a, 6a, and 7a reflect the corresponding rate information for the proposed RUG-53 classification system.
Tables 4 and 5 reflect the updated SNF Federal rates for FY 2006 for the existing 44 group RUG-III classification system. Tables 4a and 5a reflect the updated SNF Federal rates for FY 2006 for the RUG-53 classification system. The first nine groups listed in the tables are for new Rehabilitation plus Extensive Services groups.
Table 4.--RUG-44, Case-Mix Adjusted Federal Rates and Associated Indexes--Urban
Non-case Non-case RUG III category
Nursing Therapy Nursing Therapy mix therapy mix Total rate index
index component component component component
RUC..........................................................
1.30
2.25 178.67 232.94 ...........
70.15 481.76 RUB..........................................................
0.95
2.25 130.57 232.94 ...........
70.15 433.66 RUA..........................................................
0.78
2.25 107.20 232.94 ...........
70.15 410.29 RVC..........................................................
1.13
1.41 155.31 145.98 ...........
70.15 371.44 RVB..........................................................
1.04
1.41 142.94 145.98 ...........
70.15 359.07 RVA..........................................................
0.81
1.41 111.33 145.98 ...........
70.15 327.46 RHC..........................................................
1.26
0.94 173.17
97.32 ...........
70.15 340.64 RHB..........................................................
1.06
0.94 145.69
97.32 ...........
70.15 313.16 RHA..........................................................
0.87
0.94 119.57
97.32 ...........
70.15 287.04 RMC..........................................................
1.35
0.77 185.54
79.72 ...........
70.15 335.41 RMB..........................................................
1.09
0.77 149.81
79.72 ...........
70.15 299.68 RMA..........................................................
0.96
0.77 131.94
79.72 ...........
70.15 281.81 RLB..........................................................
1.11
0.43 152.56
44.52 ...........
70.15 267.23 RLA..........................................................
0.80
0.43 109.95
44.52 ...........
70.15 224.62 SE3..........................................................
1.70 ........... 233.65 ...........
13.63
70.15 317.43 SE2..........................................................
1.39 ........... 191.04 ...........
13.63
70.15 274.82 SE1..........................................................
1.17 ........... 160.80 ...........
13.63
70.15 244.58 SSC..........................................................
1.13 ........... 155.31 ...........
13.63
70.15 239.09 SSB..........................................................
1.05 ........... 144.31 ...........
13.63
70.15 228.09 SSA..........................................................
1.01 ........... 138.81 ...........
13.63
70.15 222.59 CC2..........................................................
1.12 ........... 153.93 ...........
13.63
70.15 237.71 CC1..........................................................
0.99 ........... 136.07 ...........
13.63
70.15 219.85 CB2..........................................................
0.91 ........... 125.07 ...........
13.63
70.15 208.85 CB1..........................................................
0.84 ........... 115.45 ...........
13.63
70.15 199.23 CA2..........................................................
0.83 ........... 114.08 ...........
13.63
70.15 197.86 CA1..........................................................
0.75 ........... 103.08 ...........
13.63
70.15 186.86 IB2..........................................................
0.69 ...........
94.83 ...........
13.63
70.15 178.61 IB1..........................................................
0.67 ...........
92.08 ...........
13.63
70.15 175.86 IA2..........................................................
0.57 ...........
78.34 ...........
13.63
70.15 162.12 IA1..........................................................
0.53 ...........
72.84 ...........
13.63
70.15 156.62 BB2..........................................................
0.68 ...........
93.46 ...........
13.63
70.15 177.24 BB1..........................................................
0.65 ...........
89.34 ...........
13.63
70.15 173.12 BA2..........................................................
0.56 ...........
76.97 ...........
13.63
70.15 160.75 BA1..........................................................
0.48 ...........
65.97 ...........
13.63
70.15 149.75 PE2..........................................................
0.79 ........... 108.58 ...........
13.63
70.15 192.36 PE1..........................................................
0.77 ........... 105.83 ...........
13.63
70.15 189.61 PD2..........................................................
0.72 ...........
98.96 ...........
13.63
70.15 182.74
[[Page 29084]]
PD1..........................................................
0.70 ...........
96.21 ...........
13.63
70.15 179.99 PC2..........................................................
0.65 ...........
89.34 ...........
13.63
70.15 173.12 PC1..........................................................
0.64 ...........
87.96 ...........
13.63
70.15 171.74 PB2..........................................................
0.51 ...........
70.09 ...........
13.63
70.15 153.87 PB1..........................................................
0.50 ...........
68.72 ...........
13.63
70.15 152.50 PA2..........................................................
0.49 ...........
67.35 ...........
13.63
70.15 151.13 PA1..........................................................
0.46 ...........
63.22 ...........
13.63
70.15 147.00
Table 4a.--RUG-53, Case-Mix Adjusted Federal Rates and Associated Indexes--Urban
Non-case Non-case RUG-53 category
Nursing Therapy Nursing Therapy mix therapy mix Total rate index
index component component component component
RUX..........................................................
1.80
2.24 247.39 231.91 ...........
70.15 549.45 RUL..........................................................
1.33
2.24 182.80 231.91 ...........
70.15 484.86 RVX..........................................................
1.46
1.32 200.66 136.66 ...........
70.15 407.47 RVL..........................................................
1.26
1.32 173.17 136.66 ...........
70.15 379.98 RHX..........................................................
1.34
1.10 184.17 113.88 ...........
70.15 368.20 RHL..........................................................
1.30
1.10 178.67 113.88 ...........
70.15 362.70 RMX..........................................................
1.83
1.03 251.52 106.64 ...........
70.15 428.31 RML..........................................................
1.60
1.03 219.90 106.64 ...........
70.15 396.69 RLX..........................................................
1.25
0.79 171.80
81.79 ...........
70.15 323.74 RUC..........................................................
1.21
2.24 166.30 231.91 ...........
70.15 468.36 RUB..........................................................
0.94
2.24 129.19 231.91 ...........
70.15 431.25 RUA..........................................................
0.79
2.24 108.58 231.91 ...........
70.15 410.64 RVC..........................................................
1.16
1.32 159.43 136.66 ...........
70.15 366.24 RVB..........................................................
1.02
1.32 140.19 136.66 ...........
70.15 347.00 RVA..........................................................
0.79
1.32 108.58 136.66 ...........
70.15 315.39 RHC..........................................................
1.15
1.10 158.06 113.88 ...........
70.15 342.09 RHB..........................................................
1.05
1.10 144.31 113.88 ...........
70.15 328.34 RHA..........................................................
0.89
1.10 122.32 113.88 ...........
70.15 306.35 RMC..........................................................
1.09
1.03 149.81 106.64 ...........
70.15 326.60 RMB..........................................................
1.02
1.03 140.19 106.64 ...........
70.15 316.98 RMA..........................................................
0.99
1.03 136.07 106.64 ...........
70.15 312.86 RLB..........................................................
1.08
0.79 148.44
81.79 ...........
70.15 300.38 RLA..........................................................
0.80
0.79 109.95
81.79 ...........
70.15 261.89 SE3..........................................................
1.76 ........... 241.89 ...........
13.63
70.15 325.67 SE2..........................................................
1.41 ........... 193.79 ...........
13.63
70.15 277.57 SE1..........................................................
1.19 ........... 163.55 ...........
13.63
70.15 247.33 SSC..........................................................
1.16 ........... 159.43 ...........
13.63
70.15 243.21 SSB..........................................................
1.07 ........... 147.06 ...........
13.63
70.15 230.84 SSA..........................................................
1.03 ........... 141.56 ...........
13.63
70.15 225.34 CC2..........................................................
1.15 ........... 158.06 ...........
13.63
70.15 241.84 CC1..........................................................
1.01 ........... 138.81 ...........
13.63
70.15 222.59 CB2..........................................................
0.93 ........... 127.82 ...........
13.63
70.15 211.60 CB1..........................................................
0.86 ........... 118.20 ...........
13.63
70.15 201.98 CA2..........................................................
0.85 ........... 116.82 ...........
13.63
70.15 200.60 CA1..........................................................
0.77 ........... 105.83 ...........
13.63
70.15 189.61 IB2..........................................................
0.70 ...........
96.21 ...........
13.63
70.15 179.99 IB1..........................................................
0.68 ...........
93.46 ...........
13.63
70.15 177.24 IA2..........................................................
0.59 ...........
81.09 ...........
13.63
70.15 164.87 IA1..........................................................
0.54 ...........
74.22 ...........
13.63
70.15 158.00 BB2..........................................................
0.69 ...........
94.83 ...........
13.63
70.15 178.61 BB1..........................................................
0.66 ...........
90.71 ...........
13.63
70.15 174.49 BA2..........................................................
0.57 ...........
78.34 ...........
13.63
70.15 162.12 BA1..........................................................
0.49 ...........
67.35 ...........
13.63
70.15 151.13 PE2..........................................................
0.80 ........... 109.95 ...........
13.63
70.15 193.73 PE1..........................................................
0.78 ........... 107.20 ...........
13.63
70.15 190.98 PD2..........................................................
0.74 ........... 101.71 ...........
13.63
70.15 185.49 PD1..........................................................
0.72 ...........
98.96 ...........
13.63
70.15 182.74 PC2..........................................................
0.67 ...........
92.08 ...........
13.63
70.15 175.86 PC1..........................................................
0.65 ...........
89.34 ...........
13.63
70.15 173.12 PB2..........................................................
0.52 ...........
71.47 ...........
13.63
70.15 155.25 PB1..........................................................
0.51 ...........
70.09 ...........
13.63
70.15 153.87 PA2..........................................................
0.50 ...........
68.72 ...........
13.63
70.15 152.50 PA1..........................................................
0.48 ...........
65.97 ...........
13.63
70.15 149.75
[[Page 29085]]
Table 5.--RUG-44, Case-Mix Adjusted Federal Rates and Associated Indexes--Rural
Non-case Non-case RUG III category
Nursing Therapy Nursing Therapy mix therapy mix Total rate index
index component component component component
RUC..........................................................
1.30
2.25 170.69 268.61 ...........
71.45 510.75 RUB..........................................................
0.95
2.25 124.74 268.61 ...........
71.45 464.80 RUA..........................................................
0.78
2.25 102.41 268.61 ...........
71.45 442.47 RVC..........................................................
1.13
1.41 148.37 168.33 ...........
71.45 388.15 RVB..........................................................
1.04
1.41 136.55 168.33 ...........
71.45 376.33 RVA..........................................................
0.81
1.41 106.35 168.33 ...........
71.45 346.13 RHC..........................................................
1.26
0.94 165.44 112.22 ...........
71.45 349.11 RHB..........................................................
1.06
0.94 139.18 112.22 ...........
71.45 322.85 RHA..........................................................
0.87
0.94 114.23 112.22 ...........
71.45 297.90 RMC..........................................................
1.35
0.77 177.26
91.92 ...........
71.45 340.63 RMB..........................................................
1.09
0.77 143.12
91.92 ...........
71.45 306.49 RMA..........................................................
0.96
0.77 126.05
91.92 ...........
71.45 289.42 RLB..........................................................
1.11
0.43 145.74
51.33 ...........
71.45 268.52 RLA..........................................................
0.80
0.43 105.04
51.33 ...........
71.45 227.82 SE3..........................................................
1.70 ........... 223.21 ...........
14.56
71.45 309.22 SE2..........................................................
1.39 ........... 182.51 ...........
14.56
71.45 268.52 SE1..........................................................
1.17 ........... 153.62 ...........
14.56
71.45 239.63 SSC..........................................................
1.13 ........... 148.37 ...........
14.56
71.45 234.38 SSB..........................................................
1.05 ........... 137.87 ...........
14.56
71.45 223.88 SSA..........................................................
1.01 ........... 132.61 ...........
14.56
71.45 218.62 CC2..........................................................
1.12 ........... 147.06 ...........
14.56
71.45 233.07 CC1..........................................................
0.99 ........... 129.99 ...........
14.56
71.45 216.00 CB2..........................................................
0.91 ........... 119.48 ...........
14.56
71.45 205.49 CB1..........................................................
0.84 ........... 110.29 ...........
14.56
71.45 196.30 CA2..........................................................
0.83 ........... 108.98 ...........
14.56
71.45 194.99 CA1..........................................................
0.75 ...........
98.48 ...........
14.56
71.45 184.49 IB2..........................................................
0.69 ...........
90.60 ...........
14.56
71.45 176.61 IB1..........................................................
0.67 ...........
87.97 ...........
14.56
71.45 173.98 IA2..........................................................
0.57 ...........
74.84 ...........
14.56
71.45 160.85 IA1..........................................................
0.53 ...........
69.59 ...........
14.56
71.45 155.60 BB2..........................................................
0.68 ...........
89.28 ...........
14.56
71.45 175.29 BB1..........................................................
0.65 ...........
85.35 ...........
14.56
71.45 171.36 BA2..........................................................
0.56 ...........
73.53 ...........
14.56
71.45 159.54 BA1..........................................................
0.48 ...........
63.02 ...........
14.56
71.45 149.03 PE2..........................................................
0.79 ........... 103.73 ...........
14.56
71.45 189.74 PE1..........................................................
0.77 ........... 101.10 ...........
14.56
71.45 187.11 PD2..........................................................
0.72 ...........
94.54 ...........
14.56
71.45 180.55 PD1..........................................................
0.70 ...........
91.91 ...........
14.56
71.45 177.92 PC2..........................................................
0.65 ...........
85.35 ...........
14.56
71.45 171.36 PC1..........................................................
0.64 ...........
84.03 ...........
14.56
71.45 170.04 PB2..........................................................
0.51 ...........
66.96 ...........
14.56
71.45 152.97 PB1..........................................................
0.50 ...........
65.65 ...........
14.56
71.45 151.66 PA2..........................................................
0.49 ...........
64.34 ...........
14.56
71.45 150.35 PA1..........................................................
0.46 ...........
60.40 ...........
14.56
71.45 146.41
Table 5a.--RUG-53, Case-Mix Adjusted Federal Rates and Associated Indexes--Rural
Non-case Non-case RUG-53 category
Nursing Therapy Nursing Therapy mix therapy mix Total rate index
index component component component component
RUX..........................................................
1.8
2.24 236.34 267.41 ...........
71.45 575.20 RUL..........................................................
1.33
2.24 174.63 267.41 ...........
71.45 513.49 RVX..........................................................
1.46
1.32 191.70 157.58 ...........
71.45 420.73 RVL..........................................................
1.26
1.32 165.44 157.58 ...........
71.45 394.47 RHX..........................................................
1.34
1.10 175.94 131.32 ...........
71.45 378.71 RHL..........................................................
1.3
1.10 170.69 131.32 ...........
71.45 373.46 RMX..........................................................
1.83
1.03 240.28 122.96 ...........
71.45 434.69 RML..........................................................
1.6
1.03 210.08 122.96 ...........
71.45 404.49 RLX..........................................................
1.25
0.79 164.13
94.31 ...........
71.45 329.89 RUC..........................................................
1.21
2.24 158.87 267.41 ...........
71.45 497.73 RUB..........................................................
0.94
2.24 123.42 267.41 ...........
71.45 462.28 RUA..........................................................
0.79
2.24 103.73 267.41 ...........
71.45 442.59 RVC..........................................................
1.16
1.32 152.31 157.58 ...........
71.45 381.34 RVB..........................................................
1.02
1.32 133.93 157.58 ...........
71.45 362.96 RVA..........................................................
0.79
1.32 103.73 157.58 ...........
71.45 332.76 RHC..........................................................
1.15
1.10 151.00 131.32 ...........
71.45 353.77 RHB..........................................................
1.05
1.10 137.87 131.32 ...........
71.45 340.64 RHA..........................................................
0.89
1.10 116.86 131.32 ...........
71.45 319.63 RMC..........................................................
1.09
1.03 143.12 122.96 ...........
71.45 337.53
[[Page 29086]]
RMB..........................................................
1.02
1.03 133.93 122.96 ...........
71.45 328.34 RMA..........................................................
0.99
1.03 129.99 122.96 ...........
71.45 324.40 RLB..........................................................
1.08
0.79 141.80
94.31 ...........
71.45 307.56 RLA..........................................................
0.80
0.79 105.04
94.31 ...........
71.45 270.80 SE3..........................................................
1.76 ........... 231.09 ...........
14.56
71.45 317.10 SE2..........................................................
1.41 ........... 185.13 ...........
14.56
71.45 271.14 SE1..........................................................
1.19 ........... 156.25 ...........
14.56
71.45 242.26 SSC..........................................................
1.16 ........... 152.31 ...........
14.56
71.45 238.32 SSB..........................................................
1.07 ........... 140.49 ...........
14.56
71.45 226.50 SSA..........................................................
1.03 ........... 135.24 ...........
14.56
71.45 221.25 CC2..........................................................
1.15 ........... 151.00 ...........
14.56
71.45 237.01 CC1..........................................................
1.01 ........... 132.61 ...........
14.56
71.45 218.62 CB2..........................................................
0.93 ........... 122.11 ...........
14.56
71.45 208.12 CB1..........................................................
0.86 ........... 112.92 ...........
14.56
71.45 198.93 CA2..........................................................
0.85 ........... 111.61 ...........
14.56
71.45 197.62 CA1..........................................................
0.77 ........... 101.10 ...........
14.56
71.45 187.11 IB2..........................................................
0.70 ...........
91.91 ...........
14.56
71.45 177.92 IB1..........................................................
0.68 ...........
89.28 ...........
14.56
71.45 175.29 IA2..........................................................
0.59 ...........
77.47 ...........
14.56
71.45 163.48 IA1..........................................................
0.54 ...........
70.90 ...........
14.56
71.45 156.91 BB2..........................................................
0.69 ...........
90.60 ...........
14.56
71.45 176.61 BB1..........................................................
0.66 ...........
86.66 ...........
14.56
71.45 172.67 BA2..........................................................
0.57 ...........
74.84 ...........
14.56
71.45 160.85 BA1..........................................................
0.49 ...........
64.34 ...........
14.56
71.45 150.35 PE2..........................................................
0.80 ........... 105.04 ...........
14.56
71.45 191.05 PE1..........................................................
0.78 ........... 102.41 ...........
14.56
71.45 188.42 PD2..........................................................
0.74 ...........
97.16 ...........
14.56
71.45 183.17 PD1..........................................................
0.72 ...........
94.54 ...........
14.56
71.45 180.55 PC2..........................................................
0.67 ...........
87.97 ...........
14.56
71.45 173.98 PC1..........................................................
0.65 ...........
85.35 ...........
14.56
71.45 171.36 PB2..........................................................
0.52 ...........
68.28 ...........
14.56
71.45 154.29 PB1..........................................................
0.51 ...........
66.96 ...........
14.56
71.45 152.97 PA2..........................................................
0.50 ...........
65.65 ...........
14.56
71.45 151.66 PA1..........................................................
0.48 ...........
63.02 ...........
14.56
71.45 149.03
-
-
Wage Index Adjustment to Federal Rates
Section 1888(e)(4)(G)(ii) of the Act requires that we adjust the Federal rates to account for differences in area wage levels, using a wage index that we find appropriate. Since the inception of a PPS for SNFs, we have used hospital wage data in developing a wage index to be applied to SNFs. We propose to continue that practice for FY 2006, as we continue to believe that in the absence of SNF-specific wage data, using the hospital wage index is appropriate and reasonable for the SNF PPS.
The wage index adjustment would be applied to the proposed labor- related portion of the Federal rate, which is 76.087 percent of the total rate. This percentage reflects the labor-related relative importance for FY 2006. The labor-related relative importance is calculated from the SNF market basket, and approximates the labor- related portion of the total costs after taking into account historical and projected price changes between the base year and FY 2006. The price proxies that move the different cost categories in the market basket do not necessarily change at the same rate, and the relative importance captures these changes. Accordingly, the relative importance figure more closely reflects the cost share weights for FY 2006 than the base year weights from the SNF market basket.
We calculate the labor-related relative importance for FY 2006 in four steps. First, we compute the FY 2006 price index level for the total market basket and each cost category of the market basket. Second, we calculate a ratio for each cost category by dividing the FY 2006 price index level for that cost category by the total market basket price index level. Third, we determine the FY 2006 relative importance for each cost category by multiplying this ratio by the base year (FY 1997) weight. Finally, we sum the FY 2006 relative importance for each of the labor-related cost categories (wages and salaries, employee benefits, nonmedical professional fees, labor-intensive services, and capital-related expenses) to produce the FY 2006 labor- related relative importance. Tables 6 and 7 show the Federal rates by labor-related and non-labor-related components for the existing 44 group RUG classification system. Tables 6a and 7a show the Federal rates by labor-related and non-labor-related components for the proposed RUG-53 classification system.
Table 6.--RUG-44, Case-Mix Adjusted Federal Rates for Urban SNFs by Labor and Non-Labor Component
Labor Non-labor RUG III category
Total rate portion portion
RUC...........................
481.76
366.56
115.20 RUB...........................
433.66
329.96
103.70
[[Page 29087]]
RUA...........................
410.29
312.18
98.11 RVC...........................
371.44
282.62
88.82 RVB...........................
359.07
273.21
85.86 RVA...........................
327.46
249.15
78.31 RHC...........................
340.64
259.18
81.46 RHB...........................
313.16
238.27
74.89 RHA...........................
287.04
218.40
68.64 RMC...........................
335.41
255.20
80.21 RMB...........................
299.68
228.02
71.66 RMA...........................
281.81
214.42
67.39 RLB...........................
267.23
203.33
63.90 RLA...........................
224.62
170.91
53.71 SE3...........................
317.43
241.52
75.91 SE2...........................
274.82
209.10
65.72 SE1...........................
244.58
186.09
58.49 SSC...........................
239.09
181.92
57.17 SSB...........................
228.09
173.55
54.54 SSA...........................
222.59
169.36
53.23 CC2...........................
237.71
180.87
56.84 CC1...........................
219.85
167.28
52.57 CB2...........................
208.85
158.91
49.94 CB1...........................
199.23
151.59
47.64 CA2...........................
197.86
150.55
47.31 CA1...........................
186.86
142.18
44.68 IB2...........................
178.61
135.90
42.71 IB1...........................
175.86
133.81
42.05 IA2...........................
162.12
123.35
38.77 IA1...........................
156.62
119.17
37.45 BB2...........................
177.24
134.86
42.38 BB1...........................
173.12
131.72
41.40 BA2...........................
160.75
122.31
38.44 BA1...........................
149.75
113.94
35.81 PE2...........................
192.36
146.36
46.00 PE1...........................
189.61
144.27
45.34 PD2...........................
182.74
139.04
43.70 PD1...........................
179.99
136.95
43.04 PC2...........................
173.12
131.72
41.40 PC1...........................
171.74
130.67
41.07 PB2...........................
153.87
117.08
36.79 PB1...........................
152.50
116.03
36.47 PA2...........................
151.13
114.99
36.14 PA1...........................
147.00
111.85
35.15
Table 6A.--RUG-53, Case-Mix Adjusted Federal Rates for Urban SNFs by Labor and Non-Labor Component
Labor Non-labor RUG 53 category
Total rate portion portion
RUX...........................
549.45
418.06
131.39 RUL...........................
484.86
368.92
115.94 RVX...........................
407.47
310.03
97.44 RVL...........................
379.98
289.12
90.86 RHX...........................
368.20
280.15
88.05 RHL...........................
362.70
275.97
86.73 RMX...........................
428.31
325.89
102.42 RML...........................
396.69
301.83
94.86 RLX...........................
323.74
246.32
77.42 RUC...........................
468.36
356.36
112.00 RUB...........................
431.25
328.13
103.12 RUA...........................
410.64
312.44
98.20 RVC...........................
366.24
278.66
87.58 RVB...........................
347.00
264.02
82.98 RVA...........................
315.39
239.97
75.42 RHC...........................
342.09
260.29
81.80 RHB...........................
328.34
249.82
78.52 RHA...........................
306.35
233.09
73.26 RMC...........................
326.60
248.50
78.10 RMB...........................
316.98
241.18
75.80 RMA...........................
312.86
238.05
74.81
[[Page 29088]]
RLB...........................
300.38
228.55
71.83 RLA...........................
261.89
199.26
62.63 SE3...........................
325.67
247.79
77.88 SE2...........................
277.57
211.19
66.38 SE1...........................
247.33
188.19
59.14 SSC...........................
243.21
185.05
58.16 SSB...........................
230.84
175.64
55.20 SSA...........................
225.34
171.45
53.89 CC2...........................
241.84
184.01
57.83 CC1...........................
222.59
169.36
53.23 CB2...........................
211.60
161.00
50.60 CB1...........................
201.98
153.68
48.30 CA2...........................
200.60
152.63
47.97 CA1...........................
189.61
144.27
45.34 IB2...........................
179.99
136.95
43.04 IB1...........................
177.24
134.86
42.38 IA2...........................
164.87
125.44
39.43 IA1...........................
158.00
120.22
37.78 BB2...........................
178.61
135.90
42.71 BB1...........................
174.49
132.76
41.73 BA2...........................
162.12
123.35
38.77 BA1...........................
151.13
114.99
36.14 PE2...........................
193.73
147.40
46.33 PE1...........................
190.98
145.31
45.67 PD2...........................
185.49
141.13
44.36 PD1...........................
182.74
139.04
43.70 PC2...........................
175.86
133.81
42.05 PC1...........................
173.12
131.72
41.40 PB2...........................
155.25
118.13
37.12 PB1...........................
153.87
117.08
36.79 PA2...........................
152.50
116.03
36.47 PA1...........................
149.75
113.94
35.81
Table 7.--RUG-44, Case-Mix Adjusted Federal Rates for Rural SNFs by Labor and Non-Labor Component
Labor Non-labor RUG III category
Total rate portion portion
RUC...........................
510.75
388.61
122.14 RUB...........................
464.80
353.65
111.15 RUA...........................
442.47
336.66
105.81 RVC...........................
388.15
295.33
92.82 RVB...........................
376.33
286.34
89.99 RVA...........................
346.13
263.36
82.77 RHC...........................
349.11
265.63
83.48 RHB...........................
322.85
245.65
77.20 RHA...........................
297.90
226.66
71.24 RMC...........................
340.63
259.18
81.45 RMB...........................
306.49
233.20
73.29 RMA...........................
289.42
220.21
69.21 RLB...........................
268.52
204.31
64.21 RLA...........................
227.82
173.34
54.48 SE3...........................
309.22
235.28
73.94 SE2...........................
268.52
204.31
64.21 SE1...........................
239.63
182.33
57.30 SSC...........................
234.38
178.33
56.05 SSB...........................
223.88
170.34
53.54 SSA...........................
218.62
166.34
52.28 CC2...........................
233.07
177.34
55.73 CC1...........................
216.00
164.35
51.65 CB2...........................
205.49
156.35
49.14 CB1...........................
196.30
149.36
46.94 CA2...........................
194.99
148.36
46.63 CA1...........................
184.49
140.37
44.12 IB2...........................
176.61
134.38
42.23 IB1...........................
173.98
132.38
41.60 IA2...........................
160.85
122.39
38.46 IA1...........................
155.60
118.39
37.21 BB2...........................
175.29
133.37
41.92
[[Page 29089]]
BB1...........................
171.36
130.38
40.98 BA2...........................
159.54
121.39
38.15 BA1...........................
149.03
113.39
35.64 PE2...........................
189.74
144.37
45.37 PE1...........................
187.11
142.37
44.74 PD2...........................
180.55
137.38
43.17 PD1...........................
177.92
135.37
42.55 PC2...........................
171.36
130.38
40.98 PC1...........................
170.04
129.38
40.66 PB2...........................
152.97
116.39
36.58 PB1...........................
151.66
115.39
36.27 PA2...........................
150.35
114.40
35.95 PA1...........................
146.41
111.40
35.01
Table 7a.--RUG-53 Case-Mix Adjusted Federal Rates for Rural SNFs by Labor and Non-Labor Component
Labor Non-labor RUG-53 category
Total rate portion portion
RUX...........................
575.20
437.65
137.55 RUL...........................
513.49
390.70
122.79 RVX...........................
420.73
320.12
100.61 RVL...........................
394.47
300.14
94.33 RHX...........................
378.71
288.15
90.56 RHL...........................
373.46
284.15
89.31 RMX...........................
434.69
330.74
103.95 RML...........................
404.49
307.76
96.73 RLX...........................
329.89
251.00
78.89 RUC...........................
497.73
378.71
119.02 RUB...........................
462.28
351.73
110.55 RUA...........................
442.59
336.75
105.84 RVC...........................
381.34
290.15
91.19 RVB...........................
362.96
276.17
86.79 RVA...........................
332.76
253.19
79.57 RHC...........................
353.77
269.17
84.60 RHB...........................
340.64
259.18
81.46 RHA...........................
319.63
243.20
76.43 RMC...........................
337.53
256.82
80.71 RMB...........................
328.34
249.82
78.52 RMA...........................
324.40
246.83
77.57 RLB...........................
307.56
234.01
73.55 RLA...........................
270.80
206.04
64.76 SE3...........................
317.10
241.27
75.83 SE2...........................
271.14
206.30
64.84 SE1...........................
242.26
184.33
57.93 SSC...........................
238.32
181.33
56.99 SSB...........................
226.50
172.34
54.16 SSA...........................
221.25
168.34
52.91 CC2...........................
237.01
180.33
56.68 CC1...........................
218.62
166.34
52.28 CB2...........................
208.12
158.35
49.77 CB1...........................
198.93
151.36
47.57 CA2...........................
197.62
150.36
47.26 CA1...........................
187.11
142.37
44.74 IB2...........................
177.92
135.37
42.55 IB1...........................
175.29
133.37
41.92 IA2...........................
163.48
124.39
39.09 IA1...........................
156.91
119.39
37.52 BB2...........................
176.61
134.38
42.23 BB1...........................
172.67
131.38
41.29 BA2...........................
160.85
122.39
38.46 BA1...........................
150.35
114.40
35.95 PE2...........................
191.05
145.36
45.69 PE1...........................
188.42
143.36
45.06 PD2...........................
183.17
139.37
43.80 PD1...........................
180.55
137.38
43.17 PC2...........................
173.98
132.38
41.60 PC1...........................
171.36
130.38
40.98 PB2...........................
154.29
117.39
36.90
[[Page 29090]]
PB1...........................
152.97
116.39
36.58 PA2...........................
151.66
115.39
36.27 PA1...........................
149.03
113.39
35.64
Section 1888(e)(4)(G)(ii) of the Act also requires that we apply this wage index in a manner that does not result in aggregate payments that are greater or lesser than would otherwise be made in the absence of the wage adjustment. For FY 2006 (Federal rates effective October 1, 2005), we would apply the most recent wage index using the hospital wage data, and apply an adjustment to fulfill the budget neutrality requirement. This requirement would be met by multiplying each of the components of the unadjusted Federal rates by a factor equal to the ratio of the volume weighted mean wage adjustment factor (using the wage index from the previous year) to the volume weighted mean wage adjustment factor, using the wage index for the FY beginning October 1, 2005. The same volume weights are used in both the numerator and denominator and will be derived from 1997 Medicare Provider Analysis and Review File (MEDPAR) data. The wage adjustment factor used in this calculation is defined as the labor share of the rate component multiplied by the wage index plus the non-labor share. The proposed budget neutrality factor for this year is 1.0011. However, this may change in the final rule. In order to give the public a sense of the magnitude of this adjustment, last year's factor was 1.0011.
-
Proposed Area Wage Index
Section 1888(e)(4)(G)(ii) of the Act requires that we adjust the Federal rates to account for differences in area wage levels, using a wage index that we find appropriate. Since the inception of a PPS for SNFs, we have used hospital wage data in developing a wage index to be applied to SNFs. As noted previously, we are proposing to continue that practice for FY 2006.
In our July 30, 2004 update notice, we acknowledged that on June 6, 2003, the Office of Management and Budget (OMB) issued ``OMB Bulletin No.03-04,'' which announced revised definitions for Metropolitan Statistical Areas, and new definitions of Micropolitan Statistical Areas and Combined Statistical Areas. A copy of the Bulletin may be obtained at the following Internet address: http://www.whitehouse.gov/omb/bulletins/b03-04.html. At that time, we did not propose to apply
these new definitions known as the Core-Based Statistical Areas (CBSAs). After further analysis, we are proposing to use the OMB- revised definitions to adjust the FY 2006 SNF PPS payment rates. The Hospital Inpatient PPS (IPPS) is applying these revised definitions as discussed in the August 11, 2004 IPPS final rule (69 FR 49207). 1. Proposed Revision of SNF PPS Geographic Classifications
As discussed in the May 12, 1998 SNF PPS interim final rule, which implemented the SNF PPS (63 FR 26252), in establishing an adjustment for area wage levels under Sec. 413.337(a)(ii), the labor-related portion of a SNF's Federal prospective payment is adjusted by using an appropriate wage index. As set forth in Sec. 413.337(a)(ii), a SNF's wage index is determined based on the location of the SNF in an urban or rural area as defined in Sec. 412.62(f)(1)(ii) and (f)(1)(iii), respectively. In general, an urban area is defined as a Metropolitan Statistical Area (MSA) or New England County Metropolitan Area (NECMA) as defined by OMB. Under Sec. 412.62(f)(1)(iii), a rural area is defined as any area outside of an urban area. The urban and rural area geographic classifications defined in Sec. 412.62(f)(1)(ii) and (f)(1)(iii), respectively, were used under the IPPS from FYs 1985 through 2004 (Sec. 412.63(b)), and have been used under the SNF PPS since it was implemented for cost reporting periods beginning on or after July 1, 1998. The wage index used for the SNF PPS is calculated using the IPPS wage index data on the basis of the labor market area in which the acute care hospital is located, but without taking into account geographic reclassification under sections 1886(d)(8) and (d)(10) of the Act. The applicable SNF wage index value is assigned to a SNF on the basis of the labor market area in which the SNF is geographically located.
Section 4410 of the BBA provides that for the purposes of section 1886(d)(3)(E) of the Act, the area wage index applicable to hospitals located in an urban area of a State may not be less than the area wage index applicable to hospitals located in rural areas in the State. Consistent with past SNF policy, we treat this provision, commonly referred to as the ``rural floor,'' as applicable to acute inpatient hospitals and not SNFs. Therefore, the hospital wage index used for SNFs is commonly referred to as ``pre-floor,'' indicating that the ``rural floor'' provision is not applied.
The current SNF PPS labor market areas are defined based on the definitions of MSAs, Primary MSAs (PMSAs), and NECMAs issued by the OMB (commonly referred to collectively as ``MSAs''). These MSA definitions, which are discussed in greater detail below, are currently used under the SNF PPS and other prospective payment systems such as the long-term care hospital PPS (LTCH PPS), the inpatient psychiatric facility PPS (IPF PPS), the home health agency PPS (HHA PPS), and the inpatient rehabilitation facility PPS (IRF PPS). In the August 11, 2004 IPPS final rule (67 FR 49026 through 49034), revised labor market area definitions were adopted under Sec. 412.64(b), which were effective October 1, 2004 for acute care hospitals. The new standards, CBSAs, were announced by OMB in late 2000 and are discussed in greater detail below. 2. Current SNF PPS Labor Market Areas Based on MSAs
As noted above, we currently define labor market areas based on the definitions of MSAs, PMSAs, and NECMAs issued by the OMB. The OMB also designates Consolidated MSAs (CMSAs). A CMSA is a metropolitan area with a population of one million or more, comprising two or more PMSAs (identified by their separate economic and social character). For purposes of the wage index, we use the PMSAs rather than CMSAs because they allow a more precise breakdown of labor costs. If a metropolitan area is not designated as part of a PMSA, we use the applicable MSA.
These different designations use counties as the building blocks upon which they are based. Therefore, providers are assigned to either an MSA,
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PMSA, or NECMA based on whether the county in which the provider is located is part of that area. All of the counties in a State outside a designated MSA, PMSA, or NECMA are designated as rural. For the purposes of calculating the wage index, we combine all of the counties in a State outside a designated MSA, PMSA, or NECMA together to calculate the statewide rural wage index for each State. 3. Core-Based Statistical Areas
The OMB reviews its Metropolitan Area (MA) definitions preceding each decennial census. As discussed in the August 11, 2004 IPPS final rule (69 FR 49207), in the fall of 1998, the OMB chartered the Metropolitan Area Standards Review Committee to examine the MA standards and develop recommendations for possible changes to those standards. Three notices related to the review of the standards, providing an opportunity for public comment on the recommendations of the Committee, were published in the Federal Register on the following dates: December 21, 1998 (63 FR 70526); October 20, 1999 (64 FR 56628); and August 22, 2000 (65 FR 51060).
In the December 27, 2000 Federal Register (65 FR 82228 through 82238), the OMB announced its new standards. In that notice, the OMB defines a Core-Based Statistical Area (CBSA), beginning in 2003, as ``a geographic entity associated with at least one core of 10,000 or more population, plus adjacent territory that has a high degree of social and economic integration with the core as measured by commuting ties.'' The standards designate and define two categories of CBSAs: MSAs and Micropolitan Statistical Areas (65 FR 82235).
According to the OMB, MSAs are based on urbanized areas of 50,000 or more population, and Micropolitan Statistical Areas (referred to in this discussion as Micropolitan Areas) are based on urban clusters of at least 10,000 population, but less than 50,000 population. Counties that do not fall within CBSAs (either MSAs or Micropolitan Areas) are deemed ``Outside CBSAs.'' In the past, the OMB defined MSAs around areas with a minimum core population of 50,000, and smaller areas were ``Outside MSAs.'' On June 6, 2003, the OMB announced the new CBSAs, comprised of MSAs and the new Micropolitan Areas based on Census 2000 data. (A copy of the announcement may be obtained at the following Internet address: http://www.whitehouse.gov/omb/bulletins/fy04/b04-03.html. )
The new CBSA designations recognize 49 new (urban) MSAs and 565 new Micropolitan Areas, and revise the composition of many of the existing (urban) MSAs. There are 1,090 counties in MSAs under the new CBSA designations (previously, there were 848 counties in MSAs). Of these 1,090 counties, 737 are in the same MSA as they were before the change in designations, 65 are in a different MSA, and 288 were not previously designated to any MSA. There are 674 counties in Micropolitan Areas. Of these, 41 were previously in an MSA, while 633 were not previously designated to an MSA. There are five counties that previously were designated to an MSA but are no longer designated to either an MSA or a new Micropolitan Area: Carter County, KY; St. James Parish, LA; Kane County, UT; Culpepper County, VA; and King George County, VA. For a more detailed discussion of the conceptual basis of the new CBSAs, refer to the August 11, 2004 IPPS final rule (67 FR 49026 through 49034). 4. Proposed Revisions to the SNF PPS Labor Market Areas
[If you choose to comment on issues in this section, please include the caption ``Proposed Revisions to the SNF PPS Labor Market Areas'' at the beginning of your comments.]
In its June 6, 2003 announcement, the OMB cautioned that these new definitions ``should not be used to develop and implement Federal, State, and local nonstatistical programs and policies without full consideration of the effects of using these definitions for such purposes. These areas should not serve as a general-purpose geographic framework for nonstatistical activities, and they may or may not be suitable for use in program funding formulas.''
In the SNF PPS update notice for FY 2005 (69 FR 45786, July 30, 2004), we noted that the recently-published IPPS proposed rule for FY 2005 had discussed some of the problems and concerns associated with using these new definitions, and had invited public comment on them. Accordingly, we decided to defer proposing any new labor market definitions in the SNF context at that time, in order to allow the public sufficient time and opportunity to consider and provide comments on this issue. Although the June 30, 2004 update notice also invited comments on the possible application of the new definitions to the SNF PPS, we received no written comments on the use of the new definitions specifically in the SNF context; however, we did receive a few phone calls inquiring about the methodology applied in the August 11, 2004 IPPS final rule (69 FR 49207). We believe that sufficient time has now elapsed for interested parties to consider and react to the new OMB definitions and, accordingly, we are now proposing to make the changes discussed below.
We have continued to use MSAs to define labor market areas for purposes of the wage index. For the SNF prospective payment system, the statute provides the Secretary with broad authority to use an ``appropriate wage index as determined by the Secretary.'' We believe MSAs are a reasonable and appropriate proxy for developing geographic areas for purposes of adjusting for wage differences in SNF PPS and for many of the same reasons stated in the various IPPS rules over the years where this issue has been exhaustively examined. We also note that MSAs are used to define labor market areas for purposes of the wage index for many of the other Medicare payment systems (for example, IRF PPS, HHA PPS, and IPF PPS).
First, historically, Medicare prospective payment systems have utilized MA definitions developed by OMB. For example, in discussing the adoption of the MSA designation for the IPPS area labor adjustment, the IPPS proposed rule for FY 1985 (49 FR 27426, July 3, 1984) stated:
[i]n administering a national payment system, we must have a national classification system built on clear, objective standards. Otherwise the program becomes increasingly difficult to administer because the distinction between rural and urban hospitals is blurred. We believe that the MSA system is the only one that currently meets the requirements for use as a classification system in a national payment program. The MSA classification system is a statistical standard developed for use by Federal agencies in the production, analysis, and publication of data on metropolitan areas. The standards have been developed with the aim of producing definitions that will be as consistent as possible for all MSAs nationwide.
In addition, in numerous instances, the Congress has recognized that the areas developed by OMB may be used for differentiating among geographic areas for Medicare payment purposes. For example, in the IPPS statutory sections, the Congress defines an ``urban area'' as ``an area within a Metropolitan Statistical Area (as defined by the Office of Management and Budget) or within such similar area as the Secretary has recognized'' (section 1886(d)(2)(D) of the Act). Similarly, in the sections of the
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statute governing the guidelines to be used by the Medicare Geographic Classification Review Board for purposes of reclassification, the Congress directed the Secretary to create guidelines for ``determining whether the county in which the hospital is located should be treated as being a part of a particular [MSA]'' (sections 1886(d)(10)(A) and 1886(d)(10)(D)(i)(II) of the Act). Thus, the Congress has accepted and ratified the use of MSAs as an inherently rational manner of dividing up labor-market areas for purposes of Medicare payments.
The process used by OMB to develop the MSAs creates geographic areas based upon characteristics that we believe also generally reflect the characteristics of unified labor market areas. For example, the CBSAs reflect a core population plus an adjacent territory that reflects a high degree of social and economic integration. This integration is measured by commuting ties, thus demonstrating that these areas may draw workers from the same general areas. In addition, the most recent CBSAs reflect the most up to date information. The OMB reviews its MA definitions preceding each decennial census to reflect recent population changes, and the CBSAs are based on the Census 2000 data. Finally, in the context of the IPPS, CMS has reviewed alternative methods for determining geographic areas for purposes of the wage index, and in each case, has decided to retain the OMB designations rather than replace these designations with alternatives.
Because we believe that we have broad authority to create labor market areas, and because we also believe that the OMB's latest MA designations accurately reflect the local economies and wage levels of the areas in which hospitals are currently located, we are proposing to adopt the revised labor market area designations based on the OMB's CBSA designations.
When we implemented the wage index adjustment at Sec. 413.337(a)(ii) under the SNF PPS in the May 12, 1998 SNF PPS interim final rule (63 FR 26252), we explained that the SNF PPS wage index adjustment was intended to reflect the relative hospital wage levels in the geographic area of the hospital as compared to the national average hospital wage level. Because we believe that the OMB's CBSA designations based on Census 2000 data reflect the most recent available geographic classifications (MA definitions), we are proposing to revise the labor market area definitions used under the SNF PPS. Specifically, we are proposing to revise the SNF PPS labor market definitions based on the OMB's new CBSA designations (as discussed in greater detail below) effective for SNF PPS services occurring on or after October 1, 2005. Accordingly, we are proposing to revise Sec. 413.337(a)(ii) to specify that for services furnished on or after October 1, 2005, the application of the wage index under the SNF PPS would be made on the basis of the location of the facility in an urban or rural area as defined in Sec. 412.64(b)(1)(ii)(A) through (C).
We note that the OMB's new CBSA designations are the same labor market area definitions implemented under the IPPS at Sec. 412.64(b), which were effective for those hospitals beginning October 1, 2004, as discussed in the August 11, 2004 IPPS final rule (69 FR 49026 through 49034). The similarity between the IPPS and the SNF PPS includes the adoption in the initial implementation of the SNF PPS of the same labor market area definitions under the SNF PPS that existed under the IPPS at that time, as well as the use of acute care hospitals' wage data in calculating the SNF PPS wage index. Therefore, we believe that proposing to revise the SNF PPS labor market area definitions based on OMB's CBSA designations is consistent with our historical practice of generally modeling SNF PPS wage index policy after IPPS wage index policy.
Below, we discuss the composition of the proposed SNF PPS labor market areas based on the OMB's new CBSA designations.
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New England MSAs
As stated above, under the SNF PPS, we currently use NECMAs to define labor market areas in New England, because these are county- based designations rather than the 1990 MSA definitions for New England, which used minor civil divisions such as cities and towns. Under the current MSA definitions, NECMAs provided more consistency in labor market definitions for New England compared with the rest of the country, where MSAs are county-based. Under the new CBSAs, the OMB has now defined the MSAs and Micropolitan Areas in New England on the basis of counties. The OMB also established New England City and Town Areas, which are similar to the previous New England MSAs.
In order to create consistency among all labor market areas and to maintain these areas on the basis of counties, we are proposing to use the county-based areas for all MSAs in the nation, including those in New England. Census 2000 has now defined the New England area based on counties, creating a city- and town-based system as an alternative. We believe that adopting county-based labor market areas for the entire country except those in New England would lead to inconsistencies in our designations. Adopting county-based labor market areas for the entire country provides consistency and stability in Medicare SNF PPS program payment because all of the labor market areas throughout the country, including New England, would be defined using the same system (that is, counties) rather than different systems in different areas of the country, thus minimizing programmatic complexity.
In addition, we have consistently employed a county-based system for New England for precisely that reason: To maintain consistency with the labor market definitions used throughout the country. We note that this is consistent with the implementation of the CBSA designations under the IPPS for New England (see August 11, 2004 (69 FR 49028)). Accordingly, under the SNF PPS we are proposing to use the New England MSAs as determined under the proposed new CBSA-based labor market area definitions in defining the proposed revised SNF PPS labor market areas.
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Metropolitan Divisions
Under the OMB's new CBSA designations, a Metropolitan Division is a county or group of counties within a CBSA that contains a core population of at least 2.5 million, representing an employment center, plus adjacent counties associated with the main county or counties through commuting ties. A county qualifies as a main county if 65 percent or more of its employed residents work within the county and the ratio of the number of jobs located in the county to the number of employed residents is at least 0.75 percent. A county qualifies as a secondary county if 50 percent or more, but less than 65 percent, of its employed residents work within the county and the ratio of the number of jobs located in the county to the number of employed residents is at least 0.75 percent. After all the main and secondary counties are identified and grouped, each additional county that already has qualified for inclusion in the MSA falls within the Metropolitan Division associated with the main/secondary county or counties with which the county at issue has the highest employment interchange measure. Counties in a Metropolitan Division must be contiguous (see 65 FR 82236).
As noted above, in the past, the OMB designated CMSAs as Metropolitan Areas with a population of one million
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or more and comprised of two or more PMSAs. Under the SNF PPS, we currently use the PMSAs rather than CMSAs to define labor market areas because they comprise a smaller geographic area with potentially varying labor costs due to different local economies. We believe that CMSAs may be too large an area to reflect accurately the local labor costs of all of the individual SNFs included in that relatively ``large'' area. Similarly, we believe that Metropolitan Divisions under the CBSA designations may be too large an area to reflect accurately the local labor costs of all of the individual SNFs included in that relatively ``large'' area. Further, Metropolitan Divisions represent the closest approximation to PMSAs and, therefore, would most accurately maintain our current structuring of the SNF PPS labor market areas. Therefore, as implemented under the IPPS (69 FR 49029), we are proposing to use the Metropolitan Divisions where applicable (as described below) under the proposed new CBSA-based labor market area definitions.
In addition to being comparable to the organization of the labor market areas under current MSA designations, we believe that proposing to use Metropolitan Divisions where applicable (as described below) under the SNF PPS would result in a more accurate adjustment for the variation in local labor market areas for SNFs. Specifically, if we recognize the relatively ``larger'' CBSA that comprises two or more Metropolitan Divisions as an independent labor market area for purposes of the wage index, it would be too large and would include the data from too many hospitals to compute a wage index that would accurately reflect the various local labor costs of all of the individual hospitals included in that relatively ``large'' CBSA. By proposing to recognize Metropolitan Divisions where applicable (as described below) under the proposed new CBSA-based labor market area definitions under the SNF PPS, we believe that the local labor costs would be more accurately reflected, thereby resulting in a wage index adjustment that better reflects the variation in the local labor costs of the local economies of the SNFs located in those relatively ``smaller'' areas.
Under the CBSA designations, there are 11 MSAs containing Metropolitan Divisions: Boston; Chicago; Dallas; Detroit; Los Angeles; Miami; New York; Philadelphia; San Francisco; Seattle; and Washington, D.C. Although these MSAs were also CMSAs under the prior definitions, in some cases their areas have been altered. Under the current SNF PPS MSA designations, Boston was a single NECMA. Under the proposed CBSA- based labor market area designations, it would be comprised of 4 Metropolitan Divisions. Los Angeles would go from 4 PMSAs under the current SNF PPS MSA designations to 2 Metropolitan Divisions under the proposed CBSA-based labor market area designations. The New York CMSA would go from 15 PMSAs under the current SNF PPS MSA designations to only 4 Metropolitan Divisions under the proposed CBSA-based labor market area designations. Five PMSAs in Connecticut under the current SNF PPS MSA designations would become separate MSAs under the proposed CBSA-based labor market area designations. The number of PMSAs in New Jersey, under the current SNF PPS MSA designations would go from 5 to 2, with the consolidation of 2 New Jersey PMSAs (Bergen-Passaic and Jersey City) into the New York-Wayne-White Plains, NY-NJ Division, under the proposed CBSA-based labor market area designations. In San Francisco, under the proposed CBSA-based labor market area designations there are only 2 Divisions. Currently, there are 6 PMSAs, some of which are now separate MSAs under the current SNF PPS labor market area designations.
Under the current SNF PPS labor market area designations, Cincinnati, Cleveland, Denver, Houston, Milwaukee, Portland, Sacramento, and San Juan are all designated as CMSAs, but would no longer be designated as CMSAs under the proposed CBSA-based labor market area designations. As noted previously, the population threshold to be designated a CMSA under the current SNF PPS labor market area designations is one million. In most of these cases, counties currently in a PMSA would become a separate, independent MSA under the proposed CBSA-based labor market area designations, leaving only the MSA for the core area under the proposed CBSA-based labor market area designations.
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Micropolitan Areas
Under the OMB's new CBSA designations, Micropolitan Areas are essentially a third area definition consisting primarily of areas that are currently rural, but also include some or all of areas that are currently designated as urban MSAs. As discussed in greater detail in the August 11, 2004 IPPS final rule (69 FR 49029 through 49032), how these areas are treated would have significant impacts on the calculation and application of the wage index. Specifically, whether or not Micropolitan Areas are included as part of the respective statewide rural wage indexes would affect the value of the Statewide rural wage index of any State that contains a Micropolitan Area. A hospital's classification as urban or rural affects which hospitals' wage data are included in the statewide rural wage index. As discussed above in section II.D.3, we combine all of the counties in a State outside a designated urban area to calculate the statewide rural wage index for each State.
Micropolitan Areas included as part of the statewide rural labor market area would result in an increase to the statewide rural wage index because hospitals located in those Micropolitan Areas typically have higher labor costs than other rural hospitals in the State. Alternatively, as discussed in greater detail below, if Micropolitan Areas would be recognized as independent labor market areas, because there would be so few hospitals in those areas to complete a wage index, the wage indexes for SNFs in those areas could become relatively unstable as they would change considerably from year to year.
We currently use MSAs to define urban labor market areas and group all of the hospitals in counties within each State that are not assigned to an MSA into a statewide rural labor market area. Therefore, we used the terms ``urban'' and ``rural'' wage indexes in the past for ease of reference. However, the introduction of Micropolitan Areas by the OMB potentially complicates this terminology because these areas include many hospitals that are currently included in the statewide rural labor market areas.
We are proposing to treat Micropolitan Areas as rural labor market areas under the SNF PPS for the reasons outlined below. That is, counties that are assigned to a Micropolitan area under the CBSA designations would be treated the same as other ``rural'' counties that are not assigned to either an MSA (Metropolitan Area) or a Micropolitan Area. Therefore, in determining an SNF's applicable wage index (based on IPPS hospital wage index data, as discussed in greater detail below in section II.D.6 of this preamble), we propose that a SNF in a Micropolitan Area under the OMB's CBSA designations would be classified as ``rural'' and would be assigned the statewide rural wage index for the State in which it resides.
In the August 11, 2004 IPPS final rule (69 FR 49029 through 49032), we discussed the impact of treating Micropolitan areas as part of the statewide rural labor market area instead of treating Micropolitan Areas as
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independent labor market areas for hospitals paid under the IPPS. As discussed in greater detail in that same final rule, Micropolitan Areas encompass smaller populations than MSAs and tend to include fewer hospitals per Micropolitan Area.
Thus, since Micropolitan Areas tend to include fewer hospitals, recognizing Micropolitan Areas as independent labor market areas would generally increase the potential for dramatic shifts in those areas' wage indexes from one year to the next, because a single hospital (or group of hospitals) could have a disproportionate effect on the wage index of the area. Dramatic shifts in an area's wage index from year to year are problematic and create instability in the payment levels from year to year, which could make fiscal planning for SNFs difficult if we adopted this approach. Therefore, in order to minimize the potential instability in payment levels from year to year, we believe it would be appropriate to treat Micropolitan Areas as part of the statewide rural labor market area under the SNF PPS.
Consistent with the treatment of these areas under the IPPS, we are proposing that Micropolitan Areas be considered a part of the Statewide rural labor market area. Accordingly, we are proposing that the SNF PPS Statewide rural wage index would be determined using acute-care IPPS hospital wage data from hospitals located in non-MSA areas and that the Statewide rural wage index would be assigned to SNFs located in those areas.
When the revised labor market areas based on the OMB's new CBSA designations were adopted under the IPPS beginning on October 1, 2004, a transition to the new designations was established due to the scope and magnitude of the change, in order to mitigate the resulting adverse impact on certain hospitals. As discussed in the August 11, 2004 IPPS final rule (69 FR 49032), during FY 2005, a blend of wage indexes is calculated for those acute care IPPS hospitals experiencing a drop in their wage indexes because of the adoption of the new labor market areas. Also, as described in that same final rule (69 FR 49032), under the IPPS, hospitals that previously had been located in an urban MSA but became rural under the new CBSA definitions are assigned the wage index value of the urban area to which they belonged previously, for 3 years (FYs 2005 through FYs 2007).
We recognize that SNFs will be subject to the same impact as hospitals, and that some SNFs may experience decreases in their wage index as a result of the proposed labor market area changes. At the same time, a significant number of SNFs will benefit from these proposed changes. However, as explained below, we are not proposing a transition period in this proposed rule. 5. Implementation of the Revised Labor Market Areas
Under section 1888(e)(4)(G)(ii) of the Act, the Secretary has the authority to adjust for geographic variations in labor costs by using an appropriate wage index. Moreover, the adjustment must be made in a manner such that aggregate payments would not change if such adjustment were not made.
To facilitate an understanding of the proposed policies related to the proposed change to the SNF PPS labor market areas discussed above, in Table A (MSA/CBSA Crosswalk) of the Addendum of this proposed rule, we are providing a listing of each Social Security Administration (SSA) State and county location code; State and county name; existing MSA- based labor market area designation; MSA-based wage index value; CBSA- based labor market area; and the new CBSA-based wage index value.
When the revised labor market areas based on OMB's new CBSA designations were adopted under the IPPS beginning on October 1, 2004, a transition to the new designations was established due to the scope and fiscal impact of these new boundaries. As discussed in the IPPS final rule (69 FR 49032), during FY 2005, a blend of wage indexes is calculated for those acute care IPPS hospitals experiencing a drop in their wage indexes because of the adoption of the new labor market areas. The most significant impacts will generally be for MSA-based urban hospitals that were designated as rural under the CBSA-based designations.
Because the former MSA-based labor market areas used under the IPPS had been used for payment for over 10 years, we believed it was necessary to provide additional protection, given the scope and potentially significant implications (and the subsequent adverse impact) of these new labor market areas on numerous acute-care hospitals. Therefore, we implemented a transition under the IPPS from the former MSA-based labor market area designation to the new CBSA- based labor market area designation for acute-care hospitals that would receive a lower wage index as a result of the change in the labor market area designations.
As we recognize that SNFs may experience similar changes in their wage indexes as a result of the proposed labor market area changes, we carefully evaluated the impact of the conversion to the proposed wage index structure. During our analysis, we found that a majority of SNFs (61 percent) either maintained the same wage index or would get an increased wage index based on CBSA definitions. Only a very small number of SNFs (4 percent) would experience a decline of 5 percent or more in the wage index based on CBSA designations. We also found that only a very small number of SNFs would experience a change in either rural or urban designation under the CBSA based definitions. Furthermore, we believe the new CBSA definitions may have a positive impact on many counties. For example, most counties which had been included in the rural definitions under the MSA designations but are now designated as urban areas under CBSAs will generally receive an increase in their wage index.
Although a majority of SNFs would not be significantly affected, and we believe that it is not appropriate or necessary to propose a transition to the proposed new CBSA-based labor market areas for the purpose of the SNF PPS wage index, we recognize that there are many options in efficiently implementing the new CBSA geographic designations. Thus, we considered several budget neutral options that would most effectively implement the adoption of the proposed CBSA designations as discussed below.
One option we considered institutes a one-year transition with a blended wage index for all providers. The wage index for each provider would consist of a blend of 50 percent of the FY 2006 MSA-based wage index and 50 percent of the FY 2006 CBSA-based wage index (both based on the FY 2002 hospital wage data). However, we found that while this would help some SNFs that would be adversely affected by the proposed changes to the MSAs, it would also reduce the wage index values (compared to fully adopting the CBSA wage index value) for those SNFs that would be positively affected by the changes. In addition, the budget neutrality factor calculated based on the blended wage index for all SNFs would slightly reduce the unadjusted payment rate for all providers.
A second option we considered was a one-year transition with a blended wage index limited to providers that would experience a decrease due solely to the changes in the labor market definitions. Providers that experience a decrease in their FY 2006 wage index under the CBSA-based definitions compared to the wage index they would have received under the MSA-based definitions (in both cases using FY 2002 hospital wage data) would receive a blended wage
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index. The wage index for these providers would consist of a blend of 50 percent of the FY 2006 MSA wage index and 50 percent of the FY 2006 CBSA wage index (both based on the FY 2002 hospital wage data). Providers that would experience a decrease due to changes in the labor market definitions would receive the full FY 2006 CBSA wage index.
When we performed our analysis, we found that the unadjusted payment amounts decreased substantially more under this option than they did either by using the first option discussed above or by fully adopting the CBSA designations. As with the first option, the positive impact of blending in order to decrease the impacts for a relatively small number of SNFs would require reduced payment rates for all providers, including the SNFs receiving a blended wage index.
We also recognize that during FY 2005, as discussed in the August 11, 2004 IPPS final rule (69 FR 49032), a hold harmless policy under IPPS was implemented to minimize the overall impact on hospitals that are currently designated as urban under the MSA designations, but would become rural under the CBSA designations. We considered adopting a hold harmless policy for SNFs, to allow facilities that are currently urban under the MSA definitions (but become rural under the CBSA definitions) to maintain their urban status under the CBSA definitions for one year. However, our analysis shows that only an extremely small number of SNFs would qualify for such a hold harmless policy. As any adjustment requires payments to be made in a budget neutral manner, all providers would have the payment rates reduced for the benefit of that small number of SNFs (1.4 percent) which lose their urban designations. Accordingly, we do not believe it is appropriate or necessary to adopt a hold harmless policy under the SNF PPS for facilities that will experience a change in designation under the CBSA definitions.
We are proposing to adopt for the SNF PPS the new CBSA-based labor market area definitions beginning with the 2006 SNF PPS rate year without a transition period and without a hold harmless policy. We also note that OMB in the past has announced MSA changes on an annual basis due to population changes and we have not transitioned these changes under the SNF PPS.
As noted previously, our data analysis shows that a minimal number of SNFs would experience a decrease of more than 5 percent in the wage index. In addition, under the CBSA designation, an even smaller number of SNFs would experience a change from their current urban or rural designation. Therefore, the aggregate impact on SNFs under the MSA- based designations as compared to the CBSA-based designations does not result in a dramatic change overall.
As explained above, we believe that it is not appropriate or necessary to propose a transition to the proposed new CBSA-based labor market area for the SNF PPS wage index adjustment. In addition, as noted above, we believe the data suggest that the potential benefit of a hold harmless policy for an extremely small number of providers would be outweighed by the resulting decrease in payment rates for all providers. However, we specifically invite public comments on our proposed approach, as well as on the various transition options discussed above.
Finally, we note that section 505 of the MMA established new section 1886(d)(13) of the Act. The new section 1886(d)(13) requires that the Secretary establish a process to make adjustments to the hospital wage index based on commuting patterns of hospital employees. We believe that this requirement for an ``out-commuting'' or ``out- migration'' adjustment applies specifically to the Hospital Inpatient Prospective Payment System. Therefore, we will not be establishing such an adjustment for the SNF PPS. 6. Wage Index Data
[If you choose to comment on issues in this section, please include the caption ``Wage Index Data'' at the beginning of your comments.]
In the FY 2005 SNF PPS update notice (69 FR 45775, July 30, 2004), we established SNF PPS wage index values for the 2005 SNF PPS rate year calculated from the same data (generated in cost reporting periods beginning during FY 2001) used to compute the FY 2005 acute care hospital inpatient wage index data, without taking into account geographic reclassification under sections 1886(d)(8) and 1886(d)(10) of the Act and without applying the ``rural floor'' under section 4410 of the BBA. We subsequently published correction notices to update the wage index values. The SNF wage index values applicable for services furnished on or after October 1, 2004 through August 31, 2005 are shown in Table 8 (for urban areas) and Table 9 (for rural areas) in the December 30, 2004 correction notice (69 FR 78445).
Acute care hospital inpatient wage index data is also used to establish the wage index adjustment used in the LTCH PPS, IPF PPS, HHA PPS, and IRF PPS. As we discussed in the May 12, 1998 SNF PPS interim final rule (63 FR 26252), as hospitals that are excluded from the IPPS are not required to provide wage-related information on the Medicare cost report, and because we would need to establish instructions for the collection of these SNF data in order to establish a geographic reclassification adjustment under the SNF PPS, the wage adjustment established under the SNF PPS is based on a SNF's actual location without regard to the urban or rural designation of any related or affiliated provider.
In this proposed rule, for the FY 2006 SNF PPS rate year, we propose to use acute care hospital inpatient wage index data generated from cost reporting periods beginning during FY 2002 (without taking into account geographic reclassification under sections 1886(d)(8) and 1886(d)(10) of the Act and without applying the ``rural floor'' under section 4410 of the BBA) to determine the applicable wage index values under the SNF PPS, because these data (FY 2002) are the most recent complete data. We realize that there has been some interest in developing a SNF-specific wage index. However, considering the impact of converting to the new OMB classification methodology discussed above, we believe a second major change would be inappropriate at this time. In making this decision, one of our primary concerns is that the combined effect of changing both the wage area categories and the actual wage index could result in an inaccurate impact assessment for one or both of these changes. As discussed in several of the previous SNF PPS rules, we also remain concerned about the potential volatility and unreliability of unaudited data (see, for example, the final rule for FY 2002 (66 FR 39579 through 39596, July 31, 2001), and the final rule for FY 2004 (68 FR 46045 through 46046, August 3, 2003)).
We are proposing to adopt OMB's new labor market designations for CY 2006, effective January 1, 2006. In adopting the CBSA designations, we identified some geographic areas where there were no hospitals, and thus no hospital wage index data on which to base the calculation of the FY 2006 SNF PPS proposed wage index. In addressing this situation, we are proposing approaches that we believe serve as proxies for hospital wage data and would provide an appropriate standard that accounts for geographic variation in labor costs.
The first situation involves rural locations in Massachusetts and Puerto Rico. Under these labor market areas, there are no rural hospitals in those
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locations. Because there is no reasonable proxy for more recent rural data within those areas, we are proposing to use last year's wage index value for rural Massachusetts and rural Puerto Rico.
The second situation has to do with the urban areas of Hinesville, GA (CBSA 25980) and Mansfield, OH (CBSA 31900). Again, under the proposed new labor market areas there are no urban hospitals within those areas. We propose to use all of the urban areas within the State to serve as a reasonable proxy for the urban areas without specific hospital wage index data in determining the SNF PPS wage index. Therefore, in this proposed rule, we calculated the urban wage index value for purposes of the wage index for these areas without urban hospital data as the average wage index for all urban areas within the State. We note that we could not apply a similar averaging in rural areas, because in the rural areas there are no State rural hospital wage data available for averaging on a State-wide basis. We solicit comments on these approaches to calculating the wage index values for areas without hospitals for FY 2006 and subsequent years.
The proposed wage index values that would be applicable for SNF PPS services furnished on or after October 1, 2005 through August 31, 2006 are shown in Tables 8 and 9 in the Addendum of this proposed rule.
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Updates to the Federal Rates
In accordance with section 1888(e)(4)(E) of the Act and section 311 of the BIPA, the proposed payment rates listed here reflect a proposed update equal to the full SNF market basket, estimated at 3.0 percentage points. We will continue to disseminate the rates, wage index, and case-mix classification methodology through the Federal Register before August 1 preceding the start of each succeeding fiscal year. We discuss the Federal rate update factor in greater detail in section III.C of this preamble.
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Relationship of RUG-III Classification System to Existing Skilled Nursing Facility Level-of-Care Criteria
As discussed in Sec. 413.345, we include in each update of the Federal payment rates in the Federal Register the designation of those specific RUGs under the classification system that represent the required SNF level of care, as provided in Sec. 409.30. This designation reflects an administrative presumption under the current 44-group RUG-III classification system. Our presumption is that any beneficiary who is correctly assigned to one of the upper 26 RUG-III groups in the initial 5-day, Medicare-required assessment is automatically classified as meeting the SNF level of care definition up to the assessment reference date for that assessment.
Any beneficiary assigned to any of the lower 18 groups is not automatically classified as either meeting or not meeting the definition, but instead receives an individual level of care determination using the existing administrative criteria. This presumption recognizes the strong likelihood that beneficiaries assigned to one of the upper 26 groups during the immediate post- hospital period require a covered level of care, which would be significantly less likely for those beneficiaries assigned to one of the lower 18 groups.
As discussed in section II.B of this preamble, we propose to refine the existing 44-group RUG-III classification system by adding an additional 9 groups, comprising a new Rehabilitation plus Extensive Services category. In effect, the groups in this new category would encompass care that is at least as intensive as that identified by any of the upper 26 RUG-III groups under the original, 44-group RUG-III classification system. Accordingly, for purposes of the administrative presumption, we propose to designate the upper 35 groups of the proposed 53-group refined case-mix classification system (including the upper 26 groups that we have identified as representing a covered level of care under the existing 44-group system, plus the additional 9 groups set forth in this proposed rule), consisting of the following RUG classifications: All groups within the proposed new Rehabilitation plus Extensive Services category; all groups within the Ultra High Rehabilitation category; all groups within the Very High Rehabilitation category; all groups within the High Rehabilitation category; all groups within the Medium Rehabilitation category; all groups within the Low Rehabilitation category; all groups within the Extensive Services category; all groups within the Special Care category; and, all groups within the Clinically Complex category.
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Initial 3-Year Transition Period From Facility Specific to Federal Rates
As noted previously in section I.A and section I.F.2 of this proposed rule, the PPS is no longer operating under the initial 3-year transition period from facility-specific to Federal rates. Therefore, payment now equals the adjusted Federal per diem rate.
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Example of Computation of Adjusted PPS Rates and SNF Payment
As explained in section II.B of this proposed rule, from October 1, 2005, through December 31, 2005, we propose to make payment based entirely on the existing 44-group RUG-III classification system (including any associated add-on payments). Using the model SNF (XYZ) described in Table 10, the following shows the adjustments made to the Federal per diem rate to compute the provider's actual per diem PPS for the time period mentioned above using the existing 44 group RUG-III classification system.
Table 10.--RUG-44, SNF XYZ: Located in State College, PA, Wage Index: 0.8364
Adjustment
Adjustment Percent Medicare RUG group
Labor Wage index labor Non-labor rate adjustment days Payment
RVC............................................. $282.62 0.8364 $236.38 $88.82 $325.20 * $346.99
14 $4,858 RHA............................................. 218.40 0.8364 182.67
68.64 251.31 * 268.15
16
4,290 CC2............................................. 180.87 0.8364 151.28
56.84 208.12 ** 474.51
10
4,745 SE3............................................. 241.52 0.8364 202.01
75.91 277.92 *** 333.50
30 10,005 IA2............................................. 123.35 0.8364 103.17
38.77 141.94 141.94
30
4,258
Total....................................... ........... ........... ........... ........... ........... ...........
100 28,156
* Reflects a 6.7 percent adjustment from section 314 of the BIPA. ** Reflects a 128 percent adjustment from section 511 of the MMA. Section 101(a) of the BBRA no longer applies because of the MMA section 511 adjustment. *** Reflects a 20 percent adjustment from section 101(a) of the BBRA.
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Beginning January 1, 2006, we propose to make payment based on the proposed new RUG-53 classification system (and, thus, would not include the add-on payments). Table 10a shows an example of the actual per diem PPS payments under the RUG-53 classification system.
Table 10a.--RUG-53, SNF XYZ: Located in State College, PA, Wage Index: 0.8364
Adjustment
Adjustment Percent Medicare RUG group
Labor Wage index labor Non-labor rate adjustment days Payment
RVX............................................. $310.03 0.8364 $259.31 $97.44 $356.75 $356.75
14 $4,994 RHA............................................. 233.09 0.8364 194.96
73.26 268.22 268.22
16
4,291 CC2............................................. 184.01 0.8364 153.91
57.83 211.74 * 482.76
10
4,828 RLX............................................. 246.32 0.8364 206.02
77.42 283.44 283.44
30
8,503 IA2............................................. 125.44 0.8364 104.92
39.43 144.35 144.35
30
4,330
Total....................................... ........... ........... ........... ........... ........... ...........
100 26,946
* Reflects a 128 percent adjustment from section 511 of the MMA.
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The Skilled Nursing Facility Market Basket Index
Section 1888(e)(5)(A) of the Act requires us to establish a SNF market basket index (input price index) that reflects changes over time in the prices of an appropriate mix of goods and services included in the SNF PPS. This proposed rule incorporates the latest available projections of the SNF market basket index. The final rule will incorporate updated projections based on the latest available projections at that time. Accordingly, we have developed a SNF market basket index that encompasses the most commonly used cost categories for SNF routine services, ancillary services, and capital-related expenses. In the July 31, 2001 Federal Register (66 FR 39562), we included a complete discussion on the rebasing of the SNF market basket to FY 1997. There are 21 separate cost categories and respective price proxies. These cost categories were illustrated in Table 10.A, Table 10.B, and Appendix A, along with other relevant information, in the July 31, 2001 Federal Register.
Each year, we calculate a revised labor-related share based on the relative importance of labor-related cost categories in the input price index. Table 11 summarizes the proposed updated labor-related share for FY 2006.
Table 11.--FY 2006 Labor-Related Share
Relative Relative importance, importance, labor- labor- related, related, FY 2005 FY 2006 (97 index) (97 index)
Wages and salaries............................ 54.720 54.572 Employee benefits............................. 11.595 11.691 Nonmedical professional fees..................
2.688
2.702 Labor-intensive services......................
4.125
4.116 Capital-related...............................
3.094
3.006 Total....................................... 76.222 76.087
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Use of the Skilled Nursing Facility Market Basket Percentage
Section 1888(e)(5)(B) of the Act defines the SNF market basket percentage as the percentage change in the SNF market basket index, as described in the previous section, from the average index level of the prior fiscal year to the average index level of the current fiscal year. For the Federal rates established in this proposed rule, this percentage increase in the SNF market basket index would be used to compute the update factor occurring between FY 2005 and FY 2006. We used the Global Insight, Inc. (formerly DRI-WEFA), 1st quarter 2005 forecasted percentage increase in the FY 1997-based SNF market basket index for routine, ancillary, and capital-related expenses, described in the previous section, to compute the update factor. Finally, we no longer compute update factors to adjust a facility-specific portion of the SNF PPS rates, because the 3-year transition period from facility- specific to full Federal rates that started with cost reporting periods beginning in July 1998 has expired.
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Market Basket Forecast Error Adjustment
As discussed in the June 10, 2003, supplemental proposed rule (68 FR 34768) and finalized in the August 4, 2003, final rule (68 FR 46067), the regulations at Sec. 413.337(d)(2) provide for an adjustment to account for market basket forecast error. The initial adjustment applied to the update of the FY 2003 rate that occurred in FY 2004, and took into account the cumulative forecast error for the period from FY 2000 through FY 2002. Subsequent adjustments in succeeding FYs take into account the forecast error from the most recently available fiscal year for which there are final data, and are applied whenever the difference between the forecasted and actual change in the market basket exceeds a 0.25 percentage point threshold. As discussed previously in section I.G of this proposed rule, as the difference between the estimated and actual amounts of increase in the market basket index for FY 2004 (the most recently available fiscal year for which there are final data) did not exceed the 0.25 percentage point threshold, the payment rates for FY 2006 do not include a forecast error adjustment.
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Federal Rate Update Factor
Section 1888(e)(4)(E)(ii)(IV) of the Act requires that the update factor used to establish the FY 2006 Federal rates be at a level equal to the full market basket percentage change. Accordingly, to establish the update factor, we determined the total growth from the average market basket level for the period of October 1, 2004 through September 30, 2005 to the average market basket level for the period of October 1, 2005 through September 30, 2006. Using this process, the proposed update factor for FY 2006 SNF Federal rates is 3.0 percentage points. We used this revised proposed update factor to compute the proposed Federal portion of the SNF PPS rate shown in Tables 2 and 3.
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Consolidated Billing
As established by section 4432(b) of the BBA, the consolidated billing requirement places with the SNF the
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Medicare billing responsibility for virtually all of the services that the SNF's residents receive, except for a small number of services that the statute specifically identifies as being excluded from this provision. Section 103 of the BBRA amended this provision by further excluding a number of high-cost, low probability services (identified by Healthcare Common Procedure Coding System (HCPCS) codes) within several broader categories that otherwise remained subject to the provision. Section 313 of the BIPA further amended this provision by repealing its Part B aspect; that is, its applicability to services furnished to a resident during a SNF stay that Medicare does not cover. (However, physical, occupational, and speech-language therapy remain subject to consolidated billing, regardless of whether the resident who receives these services is in a covered Part A stay.)
Further, while the services of rural health clinics (RHCs) and Federally Qualified Health Centers (FQHCs) generally are subject to SNF consolidated billing, section 410 of the MMA provided that when an RHC or FQHC furnishes the services of a physician (or another type of service that section 1888(e)(2)(A)(ii) of the Act identifies as being excluded from SNF consolidated billing), those services do not become subject to consolidated billing merely by virtue of being furnished under the auspices of the RHC or FQHC. In effect, this provision (which applies to services furnished on or after January 1, 2005) enables those services to retain their separate identity as excluded ``practitioner'' services in this context, rather than being treated as bundled ``RHC'' or ``FQHC'' services. As such, these services would remain separately billable to Part B when furnished to a resident of the SNF during a covered Part A stay.
To date, the Congress has enacted no further legislation affecting the consolidated billing provision. However, as we noted in the proposed rule of April 10, 2000 (65 FR 19232), section 1888(e)(2)(A)(iii) of the Act, as added by section 103 of the BBRA, not only identified for exclusion from this provision a number of particular service codes within four specified categories (that is, chemotherapy items, chemotherapy administration services, radioisotope services, and customized prosthetic devices), but `` * * * also gives the Secretary the authority to designate additional, individual services for exclusion within each of the specified service categories.'' In that proposed rule, we also noted that the BBRA Conference report (H.R. Conf. Rep. No. 106-479 at 854) characterizes the individual services that this legislation targets for exclusion as ``* * * high-cost, low probability events that could have devastating financial impacts because their costs far exceed the payment [SNFs] receive under the prospective payment system * * *'' According to the conferees, section 103(a) ``is an attempt to exclude from the PPS certain services and costly items that are provided infrequently in SNFs * * *.'' By contrast, we noted that the Congress declined to designate for exclusion any of the remaining services within those four categories (thus leaving all of those services subject to SNF consolidated billing), because they are relatively inexpensive and are furnished routinely in SNFs.
As we further explained in the final rule of July 31, 2000 (65 FR 46790), any additional service codes that we might designate for exclusion under our discretionary authority must meet the same criteria that the Congress used in identifying the original codes excluded from consolidated billing under section 103(a) of the BBRA: They must fall within one of the four service categories specified in the BBRA, and they also must meet the same standards of high cost and low probability in the SNF setting. Accordingly, we characterized this statutory authority to identify additional service codes for exclusion ``* * * as essentially affording the flexibility to revise the list of excluded codes in response to changes of major significance that may occur over time (for example, the development of new medical technologies or other advances in the state of medical practice)'' (65 FR 46791). In view of the amount of time that has elapsed since we last invited comments on this issue, we believe it is appropriate at this point once again to invite public comments that identify codes in any of these four service categories representing recent medical advances that might meet the BBRA criteria for exclusion from SNF consolidated billing.
We note that the original BBRA legislation (as well as the implementing regulations) identified a set of excluded services by means of specifying HCPCS codes that were in effect as of a particular date (for example July 1, 1999). Identifying the excluded services in this manner made it possible for us to utilize a Program Memorandum as the vehicle for accomplishing routine updates of the excluded codes, in order to reflect any minor revisions that might subsequently occur in the coding system itself (for example, the assignment of a different code number to the same service). Accordingly, for any new services that would actually represent a substantive change in the scope of services that are excluded from the SNF consolidated billing provision, we would identify these additional excluded services by means of the HCPCS codes that are in effect as of a specific date (in this case, October 1, 2005). By making any new exclusions in this manner, we could similarly accomplish routine future updates of these additional codes through the issuance of program instructions.
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Application of the SNF PPS to SNF Services Furnished by Swing-Bed Hospitals
In accordance with section 1888(e)(7) of the Act (as amended by section 203 of the BIPA), Part A pays critical access hospitals (CAHs) on a reasonable cost basis for SNF services furnished under a swing-bed agreement. However, as noted previously in section I.A of this notice, the services furnished by non-CAH rural hospitals are paid under the SNF PPS. In the July 31, 2001 final rule (66 FR 39562), we announced the conversion of swing-bed rural hospitals to the SNF PPS, effective with the start of the provider's first cost reporting period beginning on or after July 1, 2002. We selected this date consistent with the statutory provision to integrate swing-bed rural hospitals into the SNF PPS by the end of the SNF transition period, June 30, 2002.
As of June 30, 2003, all swing-bed rural hospitals have come under the SNF PPS. Therefore, all rates and wage indexes outlined in earlier sections of this notice for SNF PPS also apply to all swing-bed rural hospitals. A complete discussion of assessment schedules, the MDS, and the transmission software (Raven-SB for Swing Beds) can be found in the July 31, 2001 final rule (66 FR 39562). The latest changes in the MDS for swing-bed rural hospitals are listed on our SNF PPS Web site, http://www.cms.hhs.gov/providers/snfpps/default.asp.
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Qualifying Three-Day Inpatient Hospital Stay Requirement
As indicated in section I.A of this proposed rule, the SNF benefit includes not only level of care requirements, but also a set of technical, or ``posthospital'' eligibility requirements as well. These requirements date back to the original Medicare legislation (section 102(a) of the Social Security Amendments of 1965, Public Law 89-97), when the Congress defined the intended scope of this benefit. The SNF benefit was never intended to cover long-term, relatively low-level ``custodial'' care; rather, the Congress envisioned this benefit more
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narrowly, in terms of serving as a less expensive alternative to what would otherwise be the final, convalescent portion of an acute care stay of several days as an inpatient at a hospital. In order to target the SNF benefit more effectively at the limited segment of the nursing home population that the benefit was actually designed to cover (that is, those beneficiaries requiring a short-term, fairly intensive stay in a SNF as a continuation of an acute hospital stay of several days), the Congress established as a prerequisite for SNF coverage a requirement that a beneficiary must first be a hospital inpatient for ``not less than 3 consecutive days before his discharge from the hospital'' (section 1861(i) of the Act). From the very inception of the Medicare program, in determining the three-day inpatient requirement for purposes of triggering the SNF benefit, ``inpatient'' status has been determined as commencing with ``the calendar day of admission'' to the hospital (see 20 CFR Sec. 405.120 (1966)). The current guidelines in the CMS Internet Online Manual (IOM) at Publication 100-02 (Medicare Benefit Policy Manual), Chapter 8 (Coverage of Extended Care (SNF) Services Under Hospital Insurance), Sec. 20.1 (Three-Day Prior Hospitalization) reflect this determination.
More recently, it has been suggested that because of changes in hospital admission practices that have occurred since the Congress enacted this provision in 1965, some patients who at that time would have been a hospital inpatient for at least 3 days are instead now placed in observation status initially, before being formally admitted as a hospital inpatient. Observation status is a distinct service that is discussed in the IOM in Publication 100-02 (Medicare Benefit Policy Manual), Chapter 6 (Hospital Services Covered Under Part B), Sec. 70.4 (Outpatient Observation Services), in which a patient who needs more care than can be provided in an emergency room is moved from the emergency room, placed in a hospital bed in the appropriate hospital unit, and monitored by the unit nursing and physician staff. We recognize that coverage of observation services under the outpatient prospective payment system is connected to patients with three specific diagnoses: chest pain, asthma, and congestive heart failure.
However, as we noted previously, the longstanding policy interpretation of the SNF benefit's prior hospital stay requirement does not count hospital observation time that immediately precedes an inpatient admission toward meeting the requirement. We have received occasional inquiries about the effect of this policy on those beneficiaries who would be able to satisfy the SNF benefit's 3-day hospital stay requirement only if time spent in observation status immediately prior to the formal inpatient admission were counted. These inquiries assert that in such situations, the care furnished during observation may be indistinguishable from the inpatient care that follows the formal admission, so that the beneficiaries themselves often learn of the difference only after they were transferred to the SNF and failed to meet the SNF benefit's prior hospital stay requirement. The inquirers argue that it is unfair to deny SNF coverage to such a beneficiary based solely on what they characterize as a mere recordkeeping convention on the part of the hospital rather than a substantive change in the actual care that the beneficiary receives there.
We note that the current SNF benefit policy (which counts only time following the formal inpatient admission to the hospital toward meeting the qualifying hospital stay requirement) is based directly on the applicable portion of the Medicare law at section 1861(i) of the Act, which defines the SNF benefit's qualifying hospital stay as one in which the beneficiary ``* * * was an inpatient for not less than 3 consecutive days * * *'' (emphasis added). An inpatient is a person who has been admitted to a hospital for bed occupancy for purposes of receiving inpatient hospital services as defined in section 1861 of the Act. Moreover, although at the time that this provision was enacted, the concept of observation status itself was not yet even envisioned, to date, the Congress has not chosen to amend section 1861(i) of the Act specifically to reflect use of observation time as triggering the SNF benefit. However, we are aware that over time, practice and treatment of observation time may have changed; thus, the effect of not counting this observation time under the existing policy ultimately might be to restrict SNF coverage to a narrower segment of the beneficiary population than the Congress originally intended.
Accordingly, with regard to those beneficiaries whose formal admission to the hospital as an inpatient is immediately preceded by time spent in hospital observation status, we invite comments on whether we should consider the possibility of counting the time spent in observation status toward meeting the SNF benefit's qualifying 3-day hospital stay requirement. We note that in evaluating the potential impact of such a change, it is necessary not only to consider its effect on those beneficiaries who might not otherwise be able to meet the SNF benefit's prior qualifying hospital stay requirement, but also to assess potential negative consequences. Possible examples could include altering the nature of the SNF benefit in a manner that is inconsistent with Congressional intent in establishing this requirement, or creating a ``woodwork effect'' of unanticipated consequences, such as routine placement of patients in observation status prior to formal admission, even in situations where observation is not appropriate.
In soliciting these comments, moreover, we wish to distinguish the possible use of observation time from time spent in the hospital's emergency room. Although both observation services and emergency room services are directed at patients who are expected to spend only a short period of time in that service area, they are in many other ways dissimilar. Other than for patients with scheduled admissions, the emergency room generally serves as the hospital's overall point of entry, irrespective of the degree of severity of a particular patient's condition; thus, many hospital patients typically would commence their hospital encounter by spending at least some time initially in the emergency room. However, the time in the emergency room is not considered a substitute for or equivalent to inpatient hospital care. Clearly, many visits to the ER are for treatment of problems requiring no inpatient hospitalization (for example, most wounds, broken or sprained limbs, or minor respiratory illnesses) and often patients come to the ER because their regular physician is unavailable. Situations involving observation status, however, tend to be relatively infrequent compared to the care of all patients that present to the hospital (for example, excessive bleeding or complications during surgery necessitating a longer-than-normal recovery period, or non-specific significant abdominal pain). Further, as emergency room services typically represent the patient's initial medical encounter for new or worsening symptoms, such services focus on identifying, managing, and stabilizing the patient's acute condition. By contrast, observation services are furnished to a patient for whom there is already at least a working diagnosis, and involve ongoing assessment and short-term treatment that is specifically directed at that condition so that a subsequent determination about
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hospital admission or discharge can be made. (With respect to continuing assessment and treatment, observation services would appear to share some common elements with inpatient care, although the latter involves a condition that is expected to require care for a significantly longer duration, and that also may well require medical intervention at a level of complexity that does not occur on an outpatient basis.)
We recognize that, under section 1886(a) of the Act, the statute defines ``operating costs of inpatient hospital services'' as including the costs of certain services furnished prior to a patient's admission to the hospital. That is, the costs of certain services furnished prior to an individual's admission as an inpatient are deemed by statute to be operating costs of inpatient hospital services. However, it is worth noting that section 1886(a) addresses costs, and neither section 1886(a) nor section 1861(i) provides that a patient be deemed an inpatient during the time prior to admission for purposes of the 3-day requirement for SNF coverage. Moreover, the deeming requirement in section 1886(a) and the 3-day requirement for SNF coverage in section 1861(i) serve different purposes. The deeming requirement in section 1886(a) was intended to prevent hospitals from ``unbundling'' services from the inpatient stay and inappropriately seeking separate payment. See 59 FR 1654, 1656 (Jan. 12, 1994). That consideration does not apply in the context of SNF coverage. As discussed above, the purpose of the 3-day inpatient stay requirement for SNF coverage is to target SNF coverage to individuals requiring a short-term, fairly intensive stay in a SNF as a continuation of an acute hospital stay. The Congress chose to target SNF coverage to individuals who had been inpatients for at least 3 consecutive days; the Congress could have chosen a shorter time, or it could have specified that certain time before admission must be counted for purposes of the 3-day requirement, but it did not. Given the differences in statutory language and statutory purpose, we believe the requirement in section 1886(a) of the Act (to treat certain preadmission costs as inpatient costs) is consistent with not counting time spent in the hospital prior to an individual's inpatient admission as inpatient time, for purposes of the 3-day requirement for SNF coverage under section 1861(i) of the Act.
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Provisions of the Proposed Rule
In this proposed rule, we propose to make the following revision to the existing text of the regulations:
We would revise the regulations at Sec. 424.20(e)(2), regarding the performance of SNF certifications and recertifications by NPs and CNSs, to clarify the distinction between ``direct'' and ``indirect'' employment relationships. We would also make a minor technical correction in the definition of ``HCPCS'' that appears in Sec. 424.3.
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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.
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Regulatory Impact Analysis
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Overall Impact
We have examined the impacts of this proposed rule as required by Executive Order 12866 (September 1993, Regulatory Planning and Review), the Regulatory Flexibility Act (RFA, September 16, 1980, Pub. L. 96- 354), section 1102(b) of the Social Security Act, the Unfunded Mandates Reform Act of 1995 (Pub. L. 104-4), and Executive Order 13132.
Executive Order 12866 (as amended by Executive Order 13258, which merely reassigns responsibility of duties) directs agencies to assess all costs and benefits of available regulatory alternatives and, if regulation is necessary, to select regulatory approaches that maximize net benefits (including potential economic, environmental, public health and safety effects, distributive impacts, and equity). A regulatory impact analysis (RIA) must be prepared for major rules with economically significant effects ($100 million or more in any 1 year). This proposed rule is major, as defined in Title 5, United States Code, section 804(2), because we estimate the impact to the Medicare program, and the annual effects to the overall economy, would be more than $100 million.
The RFA requires agencies to analyze options for regulatory relief of small businesses. For purposes of the RFA, small entities include small businesses, nonprofit organizations, and government agencies. Most SNFs and most other providers and suppliers are small entities, either by their nonprofit status or by having revenues of $11.5 million or less in any 1 year. For purposes of the RFA, approximately 53 percent of SNFs are considered small businesses according to the Small Business Administration's latest size standards, with total revenues of $11.5 million or less in any 1 year (for further information, see 65 FR 69432, November 17, 2000). Individuals and States are not included in the definition of a small entity. In addition, approximately 29 percent of SNFs are nonprofit organizations.
This proposed rule proposes to update the SNF PPS rates published in the FY 2005 update notice on July 30, 2004 (69 FR 45775) and the associated correction notices published on October 7, 2004 (69 FR 60158), and December 30, 2004 (69 FR 78445).
In addition, section 1102(b) of the Act requires us to prepare a regulatory impact analysis if a rule may have a significant impact on the operations of a substantial number of small rural hospitals. This analysis must conform to the provisions of section 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 100 beds. We anticipate that the impact on swing-bed facilities will be similar to the impact on rural hospital-based facilities, which benefit from the case-mix refinement (see Table 12 below).
Section 202 of the Unfunded Mandates Reform Act of 1995 also requires that agencies assess anticipated costs and benefits before issuing any rule that may result in expenditure in any 1 year by State, local, or tribal governments, in the aggregate, or by the private sector, of $110 million or more. This proposed rule would not have a substantial effect on the governments mentioned, or on private sector costs.
Executive Order 13132 establishes certain requirements that an agency must meet when it promulgates a proposed rule that impose substantial direct requirement costs on State and local governments, preempts State law, or otherwise has Federalism implications. As stated above, this proposed rule would not have a substantial effect on State and local governments.
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Anticipated Effects
This proposed rule sets forth updates of the SNF PPS rates contained in the FY 2005 update notice (69 FR 45775), and the associated correction notices (69 FR 60158 and 69 FR 78445) and presents a refinement to the RUG-III case-mix classification system to be incorporated into the Medicare SNF PPS effective January 1, 2006. As described
[[Page 29101]]
in Section II.B.4, providers would continue to be paid under the current 44 group RUG-III system from October 1, 2005 through December 31, 2005. Beginning January 1, 2006, we propose that providers would be paid the proposed new RUG-53 payment.
Based on the above, we estimate the FY 2006 impact to be a net impact of $0 million on payments (this reflects a $1.02 billion reduction from the expiration of temporary payment increases, offset by a $510 million increase from the proposed refined case-mix classification system and a $510 million increase from the update to the payment rates, as explained in greater detail later in this section). The impact analysis in Table 12 of this proposed rule represents the projected effects of the proposed policy changes in the SNF PPS from FY 2005 to FY 2006. We estimate the effects by estimating payments while holding all other payment variables constant. We use the best data available, but we do not attempt to predict behavioral responses to these changes, and we do not make adjustments for future changes in such variables as days or case-mix.
We note that certain events may combine to limit the scope or accuracy of our impact analysis, because such an analysis is future- oriented and, thus, susceptible to forecasting errors due to other changes in the forecasted impact time period. Some examples are newly- legislated general Medicare program funding changes by the Congress, or changes specifically related to SNFs. In addition, changes to the Medicare program may continue to be made as a result of the BBA, the BBRA, the BIPA, the MMA, or new statutory provisions. Although these changes may not be specific to the SNF PPS, the nature of the Medicare program is such that the changes may interact, and the complexity of the interaction of these changes could make it difficult to predict accurately the full scope of the impact upon SNFs.
In accordance with section 1888(e)(4)(E) of the Act, we are updating the payment rates for FY 2006. The BBRA, BIPA, and MMA provided for several temporary adjustments to the SNF PPS payment rates that together, using the most recent data available, accounted for an estimated $1.4 billion per year in payments to the nursing home industry.
We note that in accordance with section 101(a) of the BBRA and section 314 of the BIPA, the existing, temporary increase in the per diem adjusted payment rates of 20 percent for certain specified clinically complex RUGs (and 6.7 percent for other, rehabilitation RUGs) would expire with the implementation of the proposed case-mix refinements in the SNF PPS. As explained in section II.B.3 of this proposed rule, section 511 of the MMA, which provides for a 128 percent increase in the PPS per diem payment for any SNF resident with Acquired Immune Deficiency Syndrome (AIDS), remains in effect. However, we have not provided a separate impact analysis for the MMA provision. Our latest estimates indicate that there are less than 2,000 beneficiaries who qualify for this add-on payment. The impact to Medicare is included in the ``total'' column of Table 12.
In proposing to update the rates for FY 2006, we made a number of standard annual revisions and clarifications mentioned elsewhere in this proposed rule (for example, the update to the wage and market basket indexes used for adjusting the Federal rates). These revisions would increase payments to SNFs by approximately $510 million.
The aggregate change in payments associated with this proposed rule is estimated to be $0 million for FY 2006. The decrease of $1.02 billion due to the elimination of the temporary add-ons as of January 1, 2006, together with the additional payment due to the proposed refined case-mix classification system of $510 million and the market basket increase of $510 million, results in a net change in payments of $0 million. There are two areas of change that produce this impact on SNFs:
1. The implementation of a refined case-mix classification system under section 1888(e)(4)(G)(i) of the Act and, consequently, the reduction of the temporary 20 percent/6.7 percent add-ons to the Federal rates for the specified RUG groups.
2. The total change in payments from FY 2005 levels to FY 2006 levels. This includes all of the previously noted changes in addition to the effect of the update to the rates.
The impacts are shown in Table 12. The breakdown of the various categories of data in the table follows.
The first column shows the breakdown of all SNFs by urban or rural status, hospital-based or freestanding status, and census region.
The first row of figures in the first column describes the estimated effects of the various changes on all facilities. The next 6 rows show the effects on facilities split by hospital-based, freestanding, urban, and rural categories. The next 20 rows show the effects on urban versus rural status by census region.
The second column in the table shows the number of facilities in the impact database.
The third column of the table shows the effect of the annual update to the wage index. This represents the effect of using the most recent wage data available. The total impact of this change is zero percent; however, there are distributional effects of the change.
The fourth column of the table shows the effect of using the new OMB geographic designations based on CBSAs.
The fifth column of the table shows the effect of the elimination of the add-on for specified RUG groups. As expected, this results in a decrease in payments for all providers.
The sixth column of the table shows the effect of the proposed refinements to the case-mix classification system. Table 12 shows that there is a positive three percent overall impact from the proposed case-mix refinements. Distributional effects are noted for specific providers. For example, hospital-based facilities are expected to receive greater than a 5.6 percent increase in payment, compared with freestanding facilities that show an increase in payments of between 2.4 and 2.9 percent. Additionally, rural Census regions show increases in payments of 3.4 percent.
The seventh column of the table shows the effect of all of the changes on the FY 2006 payments. As the market basket increase of 3.0 percentage points is constant for all providers, it is not shown individually; however, we note that the ``Total FY 2006 change'' column does incorporate this increase. It is projected that aggregate payments would not change in total, assuming facilities do not change their care delivery and billing practices in response.
As can be seen from this table, the combined effects of all of the changes would vary by specific types of providers and by location. For example, though facilities in the rural South Atlantic and rural Mountain region experience payment decreases of 2.3 and 1.8 percent respectively, some providers such as the rural Pacific and rural New England show increases of 4.1 and 2.6 percent respectively. Payment increases for facilities in the Rural Pacific area of the country are the highest for any provider type.
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Table 12.--Projected Impact to the SNF PPS for FY 2006
Eliminate Update wage
add-on to Case-mix Total FY Number of data MSA to CBSA certain refinements 2006 change facilities (percent) (percent) RUGs (percent) (percent) (percent)
Total............................. 15,675
0.0
0.0
-6.0
3.0
0.0 Urban............................. 10,599
0.0
0.2
-6.0
2.9
0.1 Rural.............................
5,076
0.1
-0.8
-6.0
3.4
-0.3 Hospital based urban..............
1,097
0.0
0.2
-6.3
5.6
2.5 Freestanding urban................
8,693
0.0
0.2
-5.9
2.4
-0.3 Hospital based rural..............
1,160
0.0
-0.7
-6.8
5.9
1.3 Freestanding rural................
3,372
0.2
-1.0
-5.9
2.9
-0.8 Urban by region:
New England...................
917
-0.4
-0.4
-6.4
3.0
-1.2
Middle Atlantic...............
1,499
0.2
0.3
-6.1
3.4
0.8
South Atlantic................
1,739
-0.3
0.3
-5.9
2.6
-0.3
East North Central............
2,009
-0.3
0.0
-5.7
2.8
-0.2
East South Central............
531
0.4
0.7
-6.0
2.7
0.8
West North Central............
836
-0.4
0.4
-5.9
3.7
0.8
West South Central............
1,093
-0.1
0.5
-5.8
2.7
0.3
Mountain......................
467
-0.2
0.5
-5.6
3.0
0.7
Pacific.......................
1,501
1.2
0.0
-6.2
2.7
0.7 Rural by region:
New England...................
139
1.9
-0.1
-5.7
3.5
2.6
Middle Atlantic...............
283
0.0
-0.8
-6.0
3.7
-0.1
South Atlantic................
612
-0.3
-1.7
-6.2
2.9
-2.3
East North Central............
947
0.2
-0.8
-5.9
3.5
0.1
East South Central............
571
0.4
-0.6
-6.3
2.9
-0.6
West North Central............
1,219
-0.4
-0.3
-6.2
4.0
0.1
West South Central............
823
0.3
-0.8
-6.2
2.9
-0.7
Mountain......................
298
0.8
-3.4
-5.9
3.8
-1.8
Pacific.......................
182
1.3
0.5
-4.2
3.5
4.1 Ownership:
Government....................
693
0.1
0.3
-6.5
3.2
0.0
Proprietary...................
9,317
0.0
0.0
-5.9
2.9
0.0
Voluntary.....................
3,493
-0.1
-0.1
-6.0
3.1
-0.1
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Accounting Statement
As required by OMB Circular A-4 (available at http://www.whitehouse.gov/omb/circulars/a004/a-4.pdf ), in Table 13 below, we
have prepared an accounting statement showing the classification of the expenditures associated with the provisions of this proposed rule. This table provides our best estimate of the change in Medicare payments under the SNF PPS as a result of the proposals presented in this proposed rule based on the data for 15,675 SNFs in our database. All expenditures are classified as transfers to Medicare providers (that is, SNFs).
Table 13.--Accounting Statement: Classification of Estimated Expenditures, from the 2005 SNF PPS Rate Year to the 2006 SNF PPS Rate Year (in Millions)
Category
Transfers
Annualized Monetized Transfers............ $0 million. From Whom To Whom?........................ No Transfer.
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Alternatives Considered
Section 1888(e) of the Act establishes the SNF PPS for the payment of Medicare SNF services for cost reporting periods beginning on or after July 1, 1998. This section of the statute prescribes a detailed formula for calculating payment rates under the SNF PPS, and does not provide for the use of any alternative methodology. It specifies that the base year cost data to be used for computing the RUG-III payment rates must be from FY 1995 (October 1, 1994, through September 30, 1995.) In accordance with the statute, we also incorporated a number of elements into the SNF PPS, such as case-mix classification methodology, the MDS assessment schedule, a market basket index, a wage index, and the urban and rural distinction used in the development or adjustment of the Federal rates. Further, section 1888(e)(4)(H) of the Act specifically requires us to disseminate the payment rates for each new fiscal year through the Federal Register, and to do so before the August 1 that precedes the start of the new fiscal year.
As discussed previously in section II.B of this proposed rule, we propose to implement refinements to the RUG-III case-mix classification system under section 1888(e)(4)(G)(i) of the Act. At the same time, we continue to evaluate longer-range, more comprehensive changes in the case-mix classification system. One alternative that we considered was to defer proposing refinements at this time until our evaluation of longer-range, more comprehensive changes is complete. However, we believe that the refinements that we are proposing would serve to improve the distribution of payments under the PPS, in a manner that more accurately accounts for the care needs of the most medically complex patients. As noted in section II of this preamble, a number of analyses have demonstrated an increase in the explanatory power (R- square) of the proposed refined case-mix classification system model, compared to the 44-group model that is currently in use. While our additional research may identify more comprehensive modifications, it is not currently known when the results of this research would become available. Therefore, we have decided to propose the refinements discussed elsewhere in this proposed
[[Page 29103]]
rule. In addition, as noted previously, we specifically solicit comments on the economic impact of the payment changes discussed in this proposed rule, as well as their potential impact on beneficiaries' access to quality SNF care.
We considered other options intended to help ensure more accurate allocation of payments specifically with regard to non-therapy ancillaries. One of these options included moving the non-therapy ancillary costs used in establishing the nursing case-mix component of the payment rates to a separate, newly created ``medically ancillary'' component (65 FR 19192, April 10, 2000). In addition, we looked at a number of possible models, both weighted and unweighted, for a new non- therapy ancillary index (65 FR 19248ff.). Finally, we also researched the application of models such as Diagnosis-Related Groups (DRGs) and All Patient Refined DRGs (APR-DRGs). However, at this stage in our analysis, none of these alternatives offered a significant improvement over the RUG-53 model in accounting for the variability of non-therapy ancillary costs.
In accordance with the provisions of Executive Order 12866, this regulation was reviewed by the Office of Management and Budget.
List of Subjects in 42 CFR Part 424
Emergency medical services, Health facilities, Health professions, Medicare.
For the reasons set forth in the preamble, the Centers for Medicare & Medicaid Services proposes to amend 42 CFR chapter IV as follows:
PART 424--CONDITIONS FOR MEDICARE PAYMENT
1. The authority citation for part 424 continues to read as follows:
Authority: Secs. 1102 and 1871 of the Social Security Act (42 U.S.C. 1302 and 1395hh).
Subpart A--General Provisions
Sec. 424.3 [Amended]
2. In Sec. 424.3, in the definition of ``HCPCS'' remove the word ``CMS'' and add the word ``Healthcare'' in its place.
Subpart B--Certification and Plan of Treatment Requirements
3. In Sec. 424.20, paragraph (e)(2) is revised to read as follows:
Sec. 424.20 Requirements for posthospital SNF care.
* * * * *
(e) * * *
(2) A nurse practitioner or clinical nurse specialist, neither of whom has a direct or indirect employment relationship with the facility but who is working in collaboration with a physician. For purposes of this section--
(i) Collaboration means a process whereby a nurse practitioner or clinical nurse specialist works with a doctor of medicine or osteopathy to deliver health care services. The services are delivered within the scope of the nurse's professional expertise, with medical direction and appropriate supervision as provided for in guidelines jointly developed by the nurse and the physician or other mechanisms defined by Federal regulations and the law of the State in which the services are performed.
(ii) A direct employment relationship with the facility is one meeting the common law test specified in 20 CFR 404.1005, 404.1007, and 404.1009. When this test is not met, the facility is considered to have an indirect employment relationship with any nurse practitioner or clinical nurse specialist who performs nursing services for the facility under Sec. 409.21 of this subchapter (however, the performance of only delegated physician tasks under Sec. 483.40(e) of this chapter does not, in itself, establish the existence of an indirect employment relationship). * * * * *
(Catalog of Federal Domestic Assistance Program No. 93.773, Medicare-Hospital Insurance Program; and No. 93.774, Medicare- Supplementary Medical Insurance Program)
Dated: March 31, 2005. Mark B. McClellan, Administrator, Centers for Medicare & Medicaid Services.
Dated: May 13, 2005. Michael O. Leavitt, Secretary.
-
-
Addendum
This section contains the tables referred to throughout the preamble to this proposed rule. Tables 8 ``Proposed Wage Index For Urban Areas Based On CBSA Labor Market Areas,'' Table 9 ``Proposed Wage Index Based On CBSA Labor Market Areas For Rural Areas'' and Table A ``MSA/CBSA Crosswalk'' are presented below.
Table 8.--Proposed Wage Index For Urban Areas Based On CBSA Labor Market Areas
Urban Area (Constituent
Wage CBSA Code
Counties)
Index
10180........................ Abilene, TX................... 0.7904 Callahan County, TX........... Jones County, TX.............. Taylor County, TX............. 10380........................ Aguadilla-Isabela-San
0.4743 Sebastian, PR. Aguada Municipio, PR.......... Aguadilla Municipio, PR....... A[ntilde]asco Municipio, PR... Isabela Municipio, PR......... Lares Municipio, PR........... Moca Municipio, PR............ Rinc[oacute]n Municipio, PR... San Sebastian Municipio, PR... 10420........................ Akron, OH..................... 0.8991 Portage County, OH............ Summit County, OH............. 10500........................ Albany, GA.................... 0.8636 Baker County, GA.............. Dougherty County, GA.......... Lee County, GA................ Terrell County, GA............ Worth County, GA.............. 10580........................ Albany-Schenectady-Troy, NY... 0.8545 Albany County, NY............. Rensselaer County, NY......... Saratoga County, NY........... Schenectady County, NY........ Schoharie County, NY.......... 10740........................ Albuquerque, NM............... 0.9693 Bernalillo County, NM......... Sandoval County, NM........... Torrance County, NM........... Valencia County, NM........... 10780........................ Alexandria, LA................ 0.8041 Grant Parish, LA.............. Rapides Parish, LA............ 10900........................ Allentown-Bethlehem-Easton, PA- 0.9828 NJ. Warren County, NJ............. Carbon County, PA............. Lehigh County, PA............. Northampton County, PA........ 11020........................ Altoona, PA................... 0.8953 Blair County, PA.............. 11100........................ Amarillo, TX.................. 0.9166 Armstrong County, TX..........
[[Page 29104]]
Carson County, TX............. Potter County, TX............. Randall County, TX............ 11180........................ Ames, IA...................... 0.9545 Story County, IA.............. 11260........................ Anchorage, AK................. 1.2110 Anchorage Municipality, AK.... Matanuska-Susitna Borough, AK. 11300........................ Anderson, IN.................. 0.8595 Madison County, IN............ 11340........................ Anderson, SC.................. 0.8897 Anderson County, SC........... 11460........................ Ann Arbor, MI................. 1.0870 Washtenaw County, MI.......... 11500........................ Anniston-Oxford, AL........... 0.7659 Calhoun County, AL............ 11540........................ Appleton, WI.................. 0.9298 Calumet County, WI............ Outagamie County, WI.......... 11700........................ Asheville, NC................. 0.9294 Buncombe County, NC........... Haywood County, NC............ Henderson County, NC.......... Madison County, NC............ 12020........................ Athens-Clarke County, GA...... 0.9843 Clarke County, GA............. Madison County, GA............ Oconee County, GA............. Oglethorpe County, GA......... 12060........................ Atlanta-Sandy Springs-
0.9648 Marietta, GA. Barrow County, GA............. Bartow County, GA............. Butts County, GA.............. Carroll County, GA............ Cherokee County, GA........... Clayton County, GA............ Cobb County, GA............... Coweta County, GA............. Dawson County, GA............. DeKalb County, GA............. Douglas County, GA............ Fayette County, GA............ Forsyth County, GA............ Fulton County, GA............. Gwinnett County, GA........... Haralson County, GA........... Heard County, GA.............. Henry County, GA.............. Jasper County, GA............. Lamar County, GA.............. Meriwether County, GA......... Newton County, GA............. Paulding County, GA........... Pickens County, GA............ Pike County, GA............... Rockdale County, GA........... Spalding County, GA........... Walton County, GA............. 12100........................ Atlantic City, NJ............. 1.1633 Atlantic County, NJ........... 12220........................ Auburn-Opelika, AL............ 0.8108 Lee County, AL................ 12260........................ Augusta-Richmond County, GA-SC 0.9565 Burke County, GA.............. Columbia County, GA........... McDuffie County, GA........... Richmond County, GA........... Aiken County, SC.............. Edgefield County, SC.......... 12420........................ Austin-Round Rock, TX......... 0.9450 Bastrop County, TX............ Caldwell County, TX........... Hays County, TX............... Travis County, TX............. Williamson County, TX......... 12540........................ Bakersfield, CA............... 1.0344 Kern County, CA............... 12580........................ Baltimore-Towson, MD.......... 0.9907 Anne Arundel County, MD....... Baltimore County, MD.......... Carroll County, MD............ Harford County, MD............ Howard County, MD............. Queen Anne's County, MD....... Baltimore City, MD............ 12620........................ Bangor, ME.................... 1.0003 Penobscot County, ME.......... 12700........................ Barnstable Town, MA........... 1.2527 Barnstable County, MA......... 12940........................ Baton Rouge, LA............... 0.8601 Ascension Parish, LA.......... East Baton Rouge Parish, LA... East Feliciana Parish, LA..... Iberville Parish, LA.......... Livingston Parish, LA......... Pointe Coupee Parish, LA...... St. Helena Parish, LA......... West Baton Rouge Parish, LA... West Feliciana Parish, LA..... 12980........................ Battle Creek, MI.............. 0.9510 Calhoun County, MI............ 13020........................ Bay City, MI.................. 0.9352 Bay County, MI................ 13140........................ Beaumont-Port Arthur, TX...... 0.8421 Hardin County, TX............. Jefferson County, TX.......... Orange County, TX............. 13380........................ Bellingham, WA................ 1.1743 Whatcom County, WA............ 13460........................ Bend, OR...................... 1.0796 Deschutes County, OR.......... 13644........................ Bethesda-Frederick-
1.1495 Gaithersburg, MD. Frederick County, MD.......... Montgomery County, MD......... 13740........................ Billings, MT.................. 0.8843 Carbon County, MT............. Yellowstone County, MT........ 13780........................ Binghamton, NY................ 0.8571 Broome County, NY............. Tioga County, NY.............. 13820........................ Birmingham-Hoover, AL......... 0.8979 Bibb County, AL............... Blount County, AL............. Chilton County, AL............ Jefferson County, AL.......... St. Clair County, AL.......... Shelby County, AL............. Walker County, AL............. 13900........................ Bismarck, ND.................. 0.7519 Burleigh County, ND........... Morton County, ND............. 13980........................ Blacksburg-Christiansburg-
0.7962 Radford, VA. Giles County, VA.............. Montgomery County, VA......... Pulaski County, VA............ Radford City, VA.............. 14020........................ Bloomington, IN............... 0.8456 Greene County, IN............. Monroe County, IN............. Owen County, IN............... 14060........................ Bloomington-Normal, IL........ 0.9084 McLean County, IL............. 14260........................ Boise City-Nampa, ID.......... 0.9061
[[Page 29105]]
Ada County, ID................ Boise County, ID.............. Canyon County, ID............. Gem County, ID................ Owyhee County, ID............. 14484........................ Boston-Quincy, MA............. 1.1543 Norfolk County, MA............ Plymouth County, MA........... Suffolk County, MA............ 14500........................ Boulder, CO................... 0.9744 Boulder County, CO............ 14540........................ Bowling Green, KY............. 0.8220 Edmonson County, KY........... Warren County, KY............. 14740........................ Bremerton-Silverdale, WA...... 1.0686 Kitsap County, WA............. 14860........................ Bridgeport-Stamford-Norwalk, 1.2598 CT. Fairfield County, CT.......... 15180........................ Brownsville-Harlingen, TX..... 0.9822 Cameron County, TX............ 15260........................ Brunswick, GA................. 0.9320 Brantley County, GA........... Glynn County, GA.............. McIntosh County, GA........... 15380........................ Buffalo-Niagara Falls, NY..... 0.8889 Erie County, NY............... Niagara County, NY............ 15500........................ Burlington, NC................ 0.8914 Alamance County, NC........... 15540........................ Burlington-South Burlington, 0.9446 VT. Chittenden County, VT......... Franklin County, VT........... Grand Isle County, VT......... 15764........................ Cambridge-Newton-Framingham, 1.1084 MA. Middlesex County, MA.......... 15804........................ Camden, NJ.................... 1.0528 Burlington County, NJ......... Camden County, NJ............. Gloucester County, NJ......... 15940........................ Canton-Massillon, OH.......... 0.8944 Carroll County, OH............ Stark County, OH.............. 15980........................ Cape Coral-Fort Myers, FL..... 0.9366 Lee County, FL................ 16180........................ Carson City, NV............... 1.0244 16220........................ Casper, WY.................... 0.9035 Natrona County, WY............ 16300........................ Cedar Rapids, IA.............. 0.8617 Benton County, IA............. Jones County, IA.............. Linn County, IA............... 16580........................ Champaign-Urbana, IL.......... 0.9604 Champaign County, IL.......... Ford County, IL............... Piatt County, IL.............. 16620........................ Charleston, WV................ 0.8428 Boone County, WV.............. Clay County, WV............... Kanawha County, WV............ Lincoln County, WV............ Putnam County, WV............. 16700........................ Charleston-North Charleston, 0.9438 SC. Berkeley County, SC........... Charleston County, SC......... Dorchester County, SC......... 16740........................ Charlotte-Gastonia-Concord, NC- 0.9760 SC. Anson County, NC.............. Cabarrus County, NC........... Gaston County, NC............. Mecklenburg County, NC........ Union County, NC.............. York County, SC............... 16820........................ Charlottesville, VA........... 1.0234 Albemarle County, VA.......... Fluvanna County, VA........... Greene County, VA............. Nelson County, VA............. Charlottesville City, VA...... 16860........................ Chattanooga, TN-GA............ 0.9098 Catoosa County, GA............ Dade County, GA............... Walker County, GA............. Hamilton County, TN........... Marion County, TN............. Sequatchie County, TN......... 16940........................ Cheyenne, WY.................. 0.8784 Laramie County, WY............ 16974........................ Chicago-Naperville-Joliet, IL. 1.0848 Cook County, IL............... DeKalb County, IL............. DuPage County, IL............. Grundy County, IL............. Kane County, IL............... Kendall County, IL............ McHenry County, IL............ Will County, IL............... 17020........................ Chico, CA..................... 1.0522 Butte County, CA.............. 17140........................ Cincinnati-Middletown, OH-KY- 0.9623 IN. Dearborn County, IN........... Franklin County, IN........... Ohio County, IN............... Boone County, KY.............. Bracken County, KY............ Campbell County, KY........... Gallatin County, KY........... Grant County, KY.............. Kenton County, KY............. Pendleton County, KY.......... Brown County, OH.............. Butler County, OH............. Clermont County, OH........... Hamilton County, OH........... Warren County, OH............. 17300........................ Clarksville, TN-KY............ 0.8292 Christian County, KY.......... Trigg County, KY.............. Montgomery County, TN......... Stewart County, TN............ 17420........................ Cleveland, TN................. 0.8141 Bradley County, TN............ Polk County, TN............... 17460........................ Cleveland-Elyria-Mentor, OH... 0.9204 Cuyahoga County, OH........... Geauga County, OH............. Lake County, OH............... Lorain County, OH............. Medina County, OH............. 17660........................ Coeur d'Alene, ID............. 0.9657 Kootenai County, ID........... 17780........................ College Station-Bryan, TX..... 0.8909 Brazos County, TX............. Burleson County, TX........... Robertson County, TX.......... 17820........................ Colorado Springs, CO.......... 0.9478 El Paso County, CO............ Teller County, CO............. 17860........................ Columbia, MO.................. 0.8354 Boone County, MO.............. Howard County, MO............. 17900........................ Columbia, SC.................. 0.9047 Calhoun County, SC............ Fairfield County, SC.......... Kershaw County, SC............ Lexington County, SC.......... Richland County, SC........... Saluda County, SC............. 17980........................ Columbus, GA-AL............... 0.8568 Russell County, AL............
[[Page 29106]]
Chattahoochee County, GA...... Harris County, GA............. Marion County, GA............. Muscogee County, GA........... 18020........................ Columbus, IN.................. 0.9598 Bartholomew County, IN........ 18140........................ Columbus, OH.................. 0.9850 Delaware County, OH........... Fairfield County, OH.......... Franklin County, OH........... Licking County, OH............ Madison County, OH............ Morrow County, OH............. Pickaway County, OH........... Union County, OH.............. 18580........................ Corpus Christi, TX............ 0.8559 Aransas County, TX............ Nueces County, TX............. San Patricio County, TX....... 18700........................ Corvallis, OR................. 1.0739 Benton County, OR............. 19060........................ Cumberland, MD-WV............. 0.9326 Allegany County, MD........... Mineral County, WV............ 19124........................ Dallas-Plano-Irving, TX....... 1.0233 Collin County, TX............. Dallas County, TX............. Delta County, TX.............. Denton County, TX............. Ellis County, TX.............. Hunt County, TX............... Kaufman County, TX............ Rockwall County, TX........... 19140........................ Dalton, GA.................... 0.9044 Murray County, GA............. Whitfield County, GA.......... 19180........................ Danville, IL.................. 0.9037 Vermilion County, IL.......... 19260........................ Danville, VA.................. 0.8497 Pittsylvania County, VA....... Danville City, VA............. 19340........................ Davenport-Moline-Rock Island, 0.8731 IA-IL. Henry County, IL.............. Mercer County, IL............. Rock Island County, IL........ Scott County, IA.............. 19380........................ Dayton, OH.................... 0.9073 Greene County, OH............. Miami County, OH.............. Montgomery County, OH......... Preble County, OH............. 19460........................ Decatur, AL................... 0.8478 Lawrence County, AL........... Morgan County, AL............. 19500........................ Decatur, IL................... 0.8076 Macon County, IL.............. 19660........................ Deltona-Daytona Beach-Ormond 0.9308 Beach, FL. Volusia County, FL............ 19740........................ Denver-Aurora, CO............. 1.0733 Adams County, CO.............. Arapahoe County, CO........... Broomfield County, CO......... Clear Creek County, CO........ Denver County, CO............. Douglas County, CO............ Elbert County, CO............. Gilpin County, CO............. Jefferson County, CO.......... Park County, CO............... 19780........................ Des Moines, IA................ 0.9651 Dallas County, IA............. Guthrie County, IA............ Madison County, IA............ Polk County, IA............... Warren County, IA............. 19804........................ Detroit-Livonia-Dearborn, MI.. 1.0441 Wayne County, MI.............. 20020........................ Dothan, AL.................... 0.7707 Geneva County, AL............. Henry County, AL.............. Houston County, AL............ 20100........................ Dover, DE..................... 0.9779 Kent County, DE............... 20220........................ Dubuque, IA................... 0.9135 Dubuque County, IA............ 20260........................ Duluth, MN-WI................. 1.0209 Carlton County, MN............ St. Louis County, MN.......... Douglas County, WI............ 20500........................ Durham, NC.................... 1.0303 Chatham County, NC............ Durham County, NC............. Orange County, NC............. Person County, NC............. 20740........................ Eau Claire, WI................ 0.9210 Chippewa County, WI........... Eau Claire County, WI......... 20764........................ Edison, NJ.................... 1.1260 Middlesex County, NJ.......... Monmouth County, NJ........... Ocean County, NJ.............. Somerset County, NJ........... 20940........................ El Centro, CA................. 0.8915 Imperial County, CA........... 21060........................ Elizabethtown, KY............. 0.8810 Hardin County, KY............. Larue County, KY.............. 21140........................ Elkhart-Goshen, IN............ 0.9637 Elkhart County, IN............ 21300........................ Elmira, NY.................... 0.8259 Chemung County, NY............ 21340........................ El Paso, TX................... 0.8924 El Paso County, TX............ 21500........................ Erie, PA...................... 0.8746 Erie County, PA............... 21604........................ Essex County, MA.............. 1.0533 Essex County, MA.............. 21660........................ Eugene-Springfield, OR........ 1.0829 Lane County, OR............... 21780........................ Evansville, IN-KY............. 0.8721 Gibson County, IN............. Posey County, IN.............. Vanderburgh County, IN........ Warrick County, IN............ Henderson County, KY.......... Webster County, KY............ 21820........................ Fairbanks, AK................. 1.1419 Fairbanks North Star Borough, AK. 21940........................ Fajardo, PR................... 0.4157 Ceiba Municipio, PR........... Fajardo Municipio, PR......... Luquillo Municipio, PR........ 22020........................ Fargo, ND-MN.................. 0.8495 Cass County, ND............... Clay County, MN............... 22140........................ Farmington, NM................ 0.8518 San Juan County, NM........... 22180........................ Fayetteville, NC.............. 0.9426 Cumberland County, NC......... Hoke County, NC............... 22220........................ Fayetteville-Springdale-
0.8563 Rogers, AR-MO. Benton County, AR............. Madison County, AR............ Washington County, AR......... McDonald County, MO........... 22380........................ Flagstaff, AZ................. 1.2105 Coconino County, AZ........... 22420........................ Flint, MI..................... 1.0663 Genesee County, MI............ 22500........................ Florence, SC.................. 0.8964 Darlington County, SC......... Florence County, SC...........
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22520........................ Florence-Muscle Shoals, AL.... 0.8280 Colbert County, AL............ Lauderdale County, AL......... 22540........................ Fond du Lac, WI............... 0.9650 Fond du Lac County, WI........ 22660........................ Fort Collins-Loveland, CO..... 1.0132 Larimer County, CO............ 22744........................ Fort Lauderdale-Pompano Beach- 1.0442 Deerfield Beach, FL. Broward County, FL............ 22900........................ Fort Smith, AR-OK............. 0.8214 Crawford County, AR........... Franklin County, AR........... Sebastian County, AR.......... Le Flore County, OK........... Sequoyah County, OK........... 23020........................ Fort Walton Beach-Crestview- 0.8881 Destin, FL. Okaloosa County, FL........... 23060........................ Fort Wayne, IN................ 0.9803 Allen County, IN.............. Wells County, IN.............. Whitley County, IN............ 23104........................ Fort Worth-Arlington, TX...... 0.9510 Johnson County, TX............ Parker County, TX............. Tarrant County, TX............ Wise County, TX............... 23420........................ Fresno, CA.................... 1.0541 Fresno County, CA............. 23460........................ Gadsden, AL................... 0.7946 Etowah County, AL............. 23540........................ Gainesville, FL............... 0.9474 Alachua County, FL............ Gilchrist County, FL.......... 23580........................ Gainesville, GA............... 0.8883 Hall County, GA............... 23844........................ Gary, IN...................... 0.9369 Jasper County, IN............. Lake County, IN............... Newton County, IN............. Porter County, IN............. 24020........................ Glens Falls, NY............... 0.8567 Warren County, NY............. Washington County, NY......... 24140........................ Goldsboro, NC................. 0.8784 Wayne County, NC.............. 24220........................ Grand Forks, ND-MN............ 1.1516 Polk County, MN............... Grand Forks County, ND........ 24300........................ Grand Junction, CO............ 0.9560 Mesa County, CO............... 24340........................ Grand Rapids-Wyoming, MI...... 0.9400 Barry County, MI.............. Ionia County, MI.............. Kent County, MI............... Newaygo County, MI............ 24500........................ Great Falls, MT............... 0.9061 Cascade County, MT............ 24540........................ Greeley, CO................... 0.9580 Weld County, CO............... 24580........................ Green Bay, WI................. 0.9452 Brown County, WI.............. Kewaunee County, WI........... Oconto County, WI............. 24660........................ Greensboro-High Point, NC..... 0.9113 Guilford County, NC........... Randolph County, NC........... Rockingham County, NC......... 24780........................ Greenville, NC................ 0.9434 Greene County, NC............. Pitt County, NC............... 24860........................ Greenville, SC................ 1.0165 Greenville County, SC......... Laurens County, SC............ Pickens County, SC............ 25020........................ Guayama, PR................... 0.3184 Arroyo Municipio, PR.......... Guayama Municipio, PR......... Patillas Municipio, PR........ 25060........................ Gulfport-Biloxi, MS........... 0.8938 Hancock County, MS............ Harrison County, MS........... Stone County, MS.............. 25180........................ Hagerstown-Martinsburg, MD-WV. 0.9499 Washington County, MD......... Berkeley County, WV........... Morgan County, WV............. 25260........................ Hanford-Corcoran, CA.......... 1.0046 Kings County, CA.............. 25420........................ Harrisburg-Carlisle, PA....... 0.9322 Cumberland County, PA......... Dauphin County, PA............ Perry County, PA.............. 25500........................ Harrisonburg, VA.............. 0.9098 Rockingham County, VA......... Harrisonburg City, VA......... 25540........................ Hartford-West Hartford-East
1.1084 Hartford, CT. Hartford County, CT........... Litchfield County, CT......... Middlesex County, CT.......... Tolland County, CT............ 25620........................ Hattiesburg, MS............... 0.7609 Forrest County, MS............ Lamar County, MS.............. Perry County, MS.............. 25860........................ Hickory-Lenoir-Morganton, NC.. 0.8922 Alexander County, NC.......... Burke County, NC.............. Caldwell County, NC........... Catawba County, NC............ 25980........................ Hinesville-Fort Stewart, GA
0.9178 \1\. Liberty County, GA............ Long County, GA............... 26100........................ Holland-Grand Haven, MI....... 0.9064 Ottawa County, MI............. 26180........................ Honolulu, HI.................. 1.1208 Honolulu County, HI........... 26300........................ Hot Springs, AR............... 0.9053 Garland County, AR............ 26380........................ Houma-Bayou Cane-Thibodaux, LA 0.7902 Lafourche Parish, LA.......... Terrebonne Parish, LA......... 26420........................ Houston-Baytown-Sugar Land, TX 1.0005 Austin County, TX............. Brazoria County, TX........... Chambers County, TX........... Fort Bend County, TX.......... Galveston County, TX.......... Harris County, TX............. Liberty County, TX............ Montgomery County, TX......... San Jacinto County, TX........ Waller County, TX............. 26580........................ Huntington-Ashland, WV-KY-OH.. 0.9486 Boyd County, KY............... Greenup County, KY............ Lawrence County, OH........... Cabell County, WV............. Wayne County, WV.............. 26620........................ Huntsville, AL................ 0.9149
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Limestone County, AL.......... Madison County, AL............ 26820........................ Idaho Falls, ID............... 0.9429 Bonneville County, ID......... Jefferson County, ID.......... 26900........................ Indianapolis, IN.............. 0.9930 Boone County, IN.............. Brown County, IN.............. Hamilton County, IN........... Hancock County, IN............ Hendricks County, IN.......... Johnson County, IN............ Marion County, IN............. Morgan County, IN............. Putnam County, IN............. Shelby County, IN............. 26980........................ Iowa City, IA................. 0.9756 Johnson County, IA............ Washington County, IA......... 27060........................ Ithaca, NY.................... 0.9803 Tompkins County, NY........... 27100........................ Jackson, MI................... 0.9313 Jackson County, MI............ 27140........................ Jackson, MS................... 0.8319 Copiah County, MS............. Hinds County, MS.............. Madison County, MS............ Rankin County, MS............. Simpson County, MS............ 27180........................ Jackson, TN................... 0.8973 Chester County, TN............ Madison County, TN............ 27260........................ Jacksonville, FL.............. 0.9299 Baker County, FL.............. Clay County, FL............... Duval County, FL.............. Nassau County, FL............. St. Johns County, FL.......... 27340........................ Jacksonville, NC.............. 0.8244 Onslow County, NC............. 27500........................ Janesville, WI................ 0.9547 Rock County, WI............... 27620........................ Jefferson City, MO............ 0.8396 Callaway County, MO........... Cole County, MO............... Moniteau County, MO........... Osage County, MO.............. 27740........................ Johnson City, TN.............. 0.7945 Carter County, TN............. Unicoi County, TN............. Washington County, TN......... 27780........................ Johnstown, PA................. 0.8362 Cambria County, PA............ 27860........................ Jonesboro, AR................. 0.7919 Craighead County, AR.......... Poinsett County, AR........... 27900........................ Joplin, MO.................... 0.8590 Jasper County, MO............. Newton County, MO............. 28020........................ Kalamazoo-Portage, MI......... 1.0391 Kalamazoo County, MI.......... Van Buren County, MI.......... 28100........................ Kankakee-Bradley, IL.......... 1.0974 Kankakee County, IL........... 28140........................ Kansas City, MO-KS............ 0.9467 Franklin County, KS........... Johnson County, KS............ Leavenworth County, KS........ Linn County, KS............... Miami County, KS.............. Wyandotte County, KS.......... Bates County, MO.............. Caldwell County, MO........... Cass County, MO............... Clay County, MO............... Clinton County, MO............ Jackson County, MO............ Lafayette County, MO.......... Platte County, MO............. Ray County, MO................ 28420........................ Kennewick-Richland-Pasco, WA.. 1.0630 Benton County, WA............. Franklin County, WA........... 28660........................ Killeen-Temple-Fort Hood, TX.. 0.8535 Bell County, TX............... Coryell County, TX............ Lampasas County, TX........... 28700........................ Kingsport-Bristol-Bristol, TN- 0.8062 VA. Hawkins County, TN............ Sullivan County, TN........... Bristol City, VA.............. Scott County, VA.............. Washington County, VA......... 28740........................ Kingston, NY.................. 0.9257 Ulster County, NY............. 28940........................ Knoxville, TN................. 0.8454 Anderson County, TN........... Blount County, TN............. Knox County, TN............... Loudon County, TN............. Union County, TN.............. 29020........................ Kokomo, IN.................... 0.9517 Howard County, IN............. Tipton County, IN............. 29100........................ La Crosse, WI-MN.............. 0.9573 Houston County, MN............ La Crosse County, WI.......... 29140........................ Lafayette, IN................. 0.8745 Benton County, IN............. Carroll County, IN............ Tippecanoe County, IN......... 29180........................ Lafayette, LA................. 0.8436 Lafayette Parish, LA.......... St. Martin Parish, LA......... 29340........................ Lake Charles, LA.............. 0.7841 Calcasieu Parish, LA.......... Cameron Parish, LA............ 29404........................ Lake County-Kenosha County, IL- 1.0440 WI. Lake County, IL............... Kenosha County, WI............ 29460........................ Lakeland, FL.................. 0.8921 Polk County, FL............... 29540........................ Lancaster, PA................. 0.9704 Lancaster County, PA.......... 29620........................ Lansing-East Lansing, MI...... 0.9792 Clinton County, MI............ Eaton County, MI.............. Ingham County, MI............. 29700........................ Laredo, TX.................... 0.8076 Webb County, TX............... 29740........................ Las Cruces, NM................ 0.8475 Dona Ana County, NM........... 29820........................ Las Vegas-Paradise, NV........ 1.1449 Clark County, NV.............. 29940........................ Lawrence, KS.................. 0.8546 Douglas County, KS............ 30020........................ Lawton, OK.................... 0.7880 Comanche County, OK........... 30140........................ Lebanon, PA................... 0.8468 Lebanon County, PA............ 30300........................ Lewiston, ID-WA............... 0.9896 Nez Perce County, ID.......... Asotin County, WA............. 30340........................ Lewiston-Auburn, ME........... 0.9341 Androscoggin County, ME....... 30460........................ Lexington-Fayette, KY......... 0.9084 Bourbon County, KY............ Clark County, KY.............. Fayette County, KY............ Jessamine County, KY.......... Scott County, KY.............. Woodford County, KY........... 30620........................ Lima, OH...................... 0.9234 Allen County, OH..............
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30700........................ Lincoln, NE................... 1.0225 Lancaster County, NE.......... Seward County, NE............. 30780........................ Little Rock-North Little Rock, 0.8756 AR. Faulkner County, AR........... Grant County, AR.............. Lonoke County, AR............. Perry County, AR.............. Pulaski County, AR............ Saline County, AR............. 30860........................ Logan, UT-ID.................. 0.9173 Franklin County, ID........... Cache County, UT.............. 30980........................ Longview, TX.................. 0.8739 Gregg County, TX.............. Rusk County, TX............... Upshur County, TX............. 31020........................ Longview, WA.................. 0.9523 Cowlitz County, WA............ 31084........................ Los Angeles-Long Beach-
1.1752 Glendale, CA. Los Angeles County, CA........ 31140........................ Louisville, KY-IN............. 0.9261 Clark County, IN.............. Floyd County, IN.............. Harrison County, IN........... Washington County, IN......... Bullitt County, KY............ Henry County, KY.............. Jefferson County, KY.......... Meade County, KY.............. Nelson County, KY............. Oldham County, KY............. Shelby County, KY............. Spencer County, KY............ Trimble County, KY............ 31180........................ Lubbock, TX................... 0.8792 Crosby County, TX............. Lubbock County, TX............ 31340........................ Lynchburg, VA................. 0.8700 Amherst County, VA............ Appomattox County, VA......... Bedford County, VA............ Campbell County, VA........... Bedford City, VA.............. Lynchburg City, VA............ 31420........................ Macon, GA..................... 0.9453 Bibb County, GA............... Crawford County, GA........... Jones County, GA.............. Monroe County, GA............. Twiggs County, GA............. 31460........................ Madera, CA.................... 0.8721 Madera County, CA............. 31540........................ Madison, WI................... 1.0635 Columbia County, WI........... Dane County, WI............... Iowa County, WI............... 31700........................ Manchester-Nashua, NH......... 1.0335 Hillsborough County, NH....... Merrimack County, NH.......... 31900........................ Mansfield, OH \1\............. 0.8887 Richland County, OH........... 32420........................ Mayag[uuml]ez, PR............. 0.4017 Hormigueros Municipio, PR..... Mayag[uuml]ez Municipio, PR... 32580........................ McAllen-Edinburg-Pharr, TX.... 0.8943 Hidalgo County, TX............ 32780........................ Medford, OR................... 1.0235 Jackson County, OR............ 32820........................ Memphis, TN-MS-AR............. 0.9341 Crittenden County, AR......... DeSoto County, MS............. Marshall County, MS........... Tate County, MS............... Tunica County, MS............. Fayette County, TN............ Shelby County, TN............. Tipton County, TN............. 32900........................ Merced, CA.................... 1.1120 Merced County, CA............. 33124........................ Miami-Miami Beach-Kendall, FL. 0.9759 Miami-Dade County, FL......... 33140........................ Michigan City-La Porte, IN.... 0.9409 LaPorte County, IN............ 33260........................ Midland, TX................... 0.9523 Midland County, TX............ 33340........................ Milwaukee-Waukesha-West Allis, 1.0106 WI. Milwaukee County, WI.......... Ozaukee County, WI............ Washington County, WI......... Waukesha County, WI........... 33460........................ Minneapolis-St. Paul-
1.1078 Bloomington, MN-WI. Anoka County, MN.............. Carver County, MN............. Chisago County, MN............ Dakota County, MN............. Hennepin County, MN........... Isanti County, MN............. Ramsey County, MN............. Scott County, MN.............. Sherburne County, MN.......... Washington County, MN......... Wright County, MN............. Pierce County, WI............. St. Croix County, WI.......... 33540........................ Missoula, MT.................. 0.9482 Missoula County, MT........... 33660........................ Mobile, AL.................... 0.7895 Mobile County, AL............. 33700........................ Modesto, CA................... 1.1804 Stanislaus County, CA......... 33740........................ Monroe, LA.................... 0.8040 Ouachita Parish, LA........... Union Parish, LA.............. 33780........................ Monroe, MI.................... 0.9478 Monroe County, MI............. 33860........................ Montgomery, AL................ 0.8588 Autauga County, AL............ Elmore County, AL............. Lowndes County, AL............ Montgomery County, AL......... 34060........................ Morgantown, WV................ 0.8428 Monongalia County, WV......... Preston County, WV............ 34100........................ Morristown, TN................ 0.8753 Grainger County, TN........... Hamblen County, TN............ Jefferson County, TN.......... 34580........................ Mount Vernon-Anacortes, WA.... 1.0465 Skagit County, WA............. 34620........................ Muncie, IN.................... 0.8939 Delaware County, IN........... 34740........................ Muskegon-Norton Shores, MI.... 0.9673 Muskegon County, MI........... 34820........................ Myrtle Beach-Conway-North
0.8873 Myrtle Beach, SC. Horry County, SC.............. 34900........................ Napa, CA...................... 1.2656 Napa County, CA............... 34940........................ Naples-Marco Island, FL....... 1.0140 Collier County, FL............ 34980........................ Nashville-Davidson--
0.9769 Murfreesboro, TN. Cannon County, TN............. Cheatham County, TN...........
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Davidson County, TN........... Dickson County, TN............ Hickman County, TN............ Macon County, TN.............. Robertson County, TN.......... Rutherford County, TN......... Smith County, TN.............. Sumner County, TN............. Trousdale County, TN.......... Williamson County, TN......... Wilson County, TN............. 35004........................ Nassau-Suffolk, NY............ 1.2760 Nassau County, NY............. Suffolk County, NY............ 35084........................ Newark-Union, NJ-PA........... 1.2195 Essex County, NJ.............. Hunterdon County, NJ.......... Morris County, NJ............. Sussex County, NJ............. Union County, NJ.............. Pike County, PA............... 35300........................ New Haven-Milford, CT......... 1.1702 New Haven County, CT.......... 35380........................ New Orleans-Metairie-Kenner, 0.9005 LA. Jefferson Parish, LA.......... Orleans Parish, LA............ Plaquemines Parish, LA........ St. Bernard Parish, LA........ St. Charles Parish, LA........ St. John the Baptist Parish, LA. St. Tammany Parish, LA........ 35644........................ New York-Wayne-White Plains, 1.3185 NY-NJ. Bergen County, NJ............. Hudson County, NJ............. Passaic County, NJ............ Bronx County, NY.............. Kings County, NY.............. New York County, NY........... Putnam County, NY............. Queens County, NY............. Richmond County, NY........... Rockland County, NY........... Westchester County, NY........ 35660........................ Niles-Benton Harbor, MI....... 0.8888 Berrien County, MI............ 35980........................ Norwich-New London, CT........ 1.1356 New London County, CT......... 36084........................ Oakland-Fremont-Hayward, CA... 1.5346 Alameda County, CA............ Contra Costa County, CA....... 36100........................ Ocala, FL..................... 0.8934 Marion County, FL............. 36140........................ Ocean City, NJ................ 1.1022 Cape May County, NJ........... 36220........................ Odessa, TX.................... 0.9894 Ector County, TX.............. 36260........................ Ogden-Clearfield, UT.......... 0.9038 Davis County, UT.............. Morgan County, UT............. Weber County, UT.............. 36420........................ Oklahoma City, OK............. 0.9040 Canadian County, OK........... Cleveland County, OK.......... Grady County, OK.............. Lincoln County, OK............ Logan County, OK.............. McClain County, OK............ Oklahoma County, OK........... 36500........................ Olympia, WA................... 1.0938 Thurston County, WA........... 36540........................ Omaha-Council Bluffs, NE-IA... 0.9569 Harrison County, IA........... Mills County, IA.............. Pottawattamie County, IA...... Cass County, NE............... Douglas County, NE............ Sarpy County, NE.............. Saunders County, NE........... Washington County, NE......... 36740........................ Orlando, FL................... 0.9459 Lake County, FL............... Orange County, FL............. Osceola County, FL............ Seminole County, FL........... 36780........................ Oshkosh-Neenah, WI............ 0.9192 Winnebago County, WI.......... 36980........................ Owensboro, KY................. 0.8789 Daviess County, KY............ Hancock County, KY............ McLean County, KY............. 37100........................ Oxnard-Thousand Oaks-Ventura, 1.1613 CA. Ventura County, CA............ 37340........................ Palm Bay-Melbourne-Titusville, 0.9835 FL. Brevard County, FL............ 37460........................ Panama City-Lynn Haven, FL.... 0.7989 Bay County, FL................ 37620........................ Parkersburg-Marietta, WV-OH... 0.8278 Washington County, OH......... Pleasants County, WV.......... Wirt County, WV............... Wood County, WV............... 37700........................ Pascagoula, MS................ 0.8165 George County, MS............. Jackson County, MS............ 37860........................ Pensacola-Ferry Pass-Brent, FL 0.8104 Escambia County, FL........... Santa Rosa County, FL......... 37900........................ Peoria, IL.................... 0.8868 Marshall County, IL........... Peoria County, IL............. Stark County, IL.............. Tazewell County, IL........... Woodford County, IL........... 37964........................ Philadelphia, PA.............. 1.1040 Bucks County, PA.............. Chester County, PA............ Delaware County, PA........... Montgomery County, PA......... Philadelphia County, PA....... 38060........................ Phoenix-Mesa-Scottsdale, AZ... 1.0138 Maricopa County, AZ........... Pinal County, AZ.............. 38220........................ Pine Bluff, AR................ 0.8689 Cleveland County, AR.......... Jefferson County, AR.......... Lincoln County, AR............ 38300........................ Pittsburgh, PA................ 0.8853 Allegheny County, PA.......... Armstrong County, PA.......... Beaver County, PA............. Butler County, PA............. Fayette County, PA............ Washington County, PA......... Westmoreland County, PA....... 38340........................ Pittsfield, MA................ 1.0191
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Berkshire County, MA.......... 38540........................ Pocatello, ID................. 0.9360 Bannock County, ID............ Power County, ID.............. 38660........................ Ponce, PR..................... 0.5177 Juana D[iacute]az Municipio, PR. Ponce Municipio, PR........... Villalba Municipio, PR........ 38860........................ Portland-South Portland-
1.0392 Biddeford, ME. Cumberland County, ME......... Sagadahoc County, ME.......... York County, ME............... 38900........................ Portland-Vancouver-Beaverton, 1.1260 OR-WA. Clackamas County, OR.......... Columbia County, OR........... Multnomah County, OR.......... Washington County, OR......... Yamhill County, OR............ Clark County, WA.............. Skamania County, WA........... 38940........................ Port St. Lucie-Fort Pierce, FL 1.0133 Martin County, FL............. St. Lucie County, FL.......... 39100........................ Poughkeepsie-Newburgh-
1.0766 Middletown, NY. Dutchess County, NY........... Orange County, NY............. 39140........................ Prescott, AZ.................. 0.9879 Yavapai County, AZ............ 39300........................ Providence-New Bedford-Fall
1.0966 River, RI-MA. Bristol County, MA............ Bristol County, RI............ Kent County, RI............... Newport County, RI............ Providence County, RI......... Washington County, RI......... 39340........................ Provo-Orem, UT................ 0.9510 Juab County, UT............... Utah County, UT............... 39380........................ Pueblo, CO.................... 0.8632 Pueblo County, CO............. 39460........................ Punta Gorda, FL............... 0.9264 Charlotte County, FL.......... 39540........................ Racine, WI.................... 0.9006 Racine County, WI............. 39580........................ Raleigh-Cary, NC.............. 0.9733 Franklin County, NC........... Johnston County, NC........... Wake County, NC............... 39660........................ Rapid City, SD................ 0.9021 Meade County, SD.............. Pennington County, SD......... 39740........................ Reading, PA................... 0.9696 Berks County, PA.............. 39820........................ Redding, CA................... 1.2215 Shasta County, CA............. 39900........................ Reno-Sparks, NV............... 1.0993 Storey County, NV............. Washoe County, NV............. 40060........................ Richmond, VA.................. 0.9338 Amelia County, VA............. Caroline County, VA........... Charles City County, VA....... Chesterfield County, VA....... Cumberland County, VA......... Dinwiddie County, VA.......... Goochland County, VA.......... Hanover County, VA............ Henrico County, VA............ King and Queen County, VA..... King William County, VA....... Louisa County, VA............. New Kent County, VA........... Powhatan County, VA........... Prince George County, VA...... Sussex County, VA............. Colonial Heights City, VA..... Hopewell City, VA............. Petersburg City, VA........... Richmond City, VA............. 40140........................ Riverside-San Bernardino-
1.1022 Ontario, CA. Riverside County, CA.......... San Bernardino County, CA..... 40220........................ Roanoke, VA................... 0.8383 Botetourt County, VA.......... Craig County, VA.............. Franklin County, VA........... Roanoke County, VA............ Roanoke City, VA.............. Salem City, VA................ 40340........................ Rochester, MN................. 1.1142 Dodge County, MN.............. Olmsted County, MN............ Wabasha County, MN............ 40380........................ Rochester, NY................. 0.9115 Livingston County, NY......... Monroe County, NY............. Ontario County, NY............ Orleans County, NY............ Wayne County, NY.............. 40420........................ Rockford, IL.................. 0.9994 Boone County, IL.............. Winnebago County, IL.......... 40484........................ Rockingham County-Strafford
1.0385 County, NH. Rockingham County, NH......... Strafford County, NH.......... 40580........................ Rocky Mount, NC............... 0.8924 Edgecombe County, NC.......... Nash County, NC............... 40660........................ Rome, GA...................... 0.9424 Floyd County, GA.............. 40900........................ Sacramento--Arden-Arcade--
1.2973 Roseville, CA. El Dorado County, CA.......... Placer County, CA............. Sacramento County, CA......... Yolo County, CA............... 40980........................ Saginaw-Saginaw Township
0.9420 North, MI. Saginaw County, MI............ 41060........................ St. Cloud, MN................. 0.9975 Benton County, MN............. Stearns County, MN............ 41100........................ St. George, UT................ 0.9402 Washington County, UT......... 41140........................ St. Joseph, MO-KS............. 0.9529 Doniphan County, KS........... Andrew County, MO............. Buchanan County, MO........... DeKalb County, MO............. 41180........................ St. Louis, MO-IL.............. 0.8949 Bond County, IL............... Calhoun County, IL............ Clinton County, IL............ Jersey County, IL............. Macoupin County, IL........... Madison County, IL............ Monroe County, IL............. St. Clair County, IL.......... Crawford County, MO........... Franklin County, MO...........
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Jefferson County, MO.......... Lincoln County, MO............ St. Charles County, MO........ St. Louis County, MO.......... Warren County, MO............. Washington County, MO......... St. Louis City, MO............ 41420........................ Salem, OR..................... 1.0452 Marion County, OR............. Polk County, OR............... 41500........................ Salinas, CA................... 1.4142 Monterey County, CA........... 41540........................ Salisbury, MD................. 0.9073 Somerset County, MD........... Wicomico County, MD........... 41620........................ Salt Lake City, UT............ 0.9433 Salt Lake County, UT.......... Summit County, UT............. Tooele County, UT............. 41660........................ San Angelo, TX................ 0.8280 Irion County, TX.............. Tom Green County, TX.......... 41700........................ San Antonio, TX............... 0.8989 Atascosa County, TX........... Bandera County, TX............ Bexar County, TX.............. Comal County, TX.............. Guadalupe County, TX.......... Kendall County, TX............ Medina County, TX............. Wilson County, TX............. 41740........................ San Diego-Carlsbad-San Marcos, 1.1424 CA. San Diego County, CA.......... 41780........................ Sandusky, OH.................. 0.9025 Erie County, OH............... 41884........................ San Francisco-San Mateo-
1.4990 Redwood City, CA. Marin County, CA.............. San Francisco County, CA...... San Mateo County, CA.......... 41900........................ San Germ[aacute]n-Cabo Rojo, 0.4655 PR. Cabo Rojo Municipio, PR....... Lajas Municipio, PR........... Sabana Grande Municipio, PR... San Germ[aacute]n Municipio, PR. 41940........................ San Jose-Sunnyvale-Santa
1.5125 Clara, CA. San Benito County, CA......... Santa Clara County, CA........ 41980........................ San Juan-Caguas-Guaynabo, PR.. 0.4686 Aguas Buenas Municipio, PR.... Aibonito Municipio, PR........ Arecibo Municipio, PR......... Barceloneta Municipio, PR..... Barranquitas Municipio, PR.... Bayam[oacute]n Municipio, PR.. Caguas Municipio, PR.......... Camuy Municipio, PR........... Can[oacute]vanas Municipio, PR Carolina Municipio, PR........ Cata[ntilde]o Municipio, PR... Cayey Municipio, PR........... Ciales Municipio, PR.......... Cidra Municipio, PR........... Comer[iacute]o Municipio, PR.. Corozal Municipio, PR......... Dorado Municipio, PR.......... Florida Municipio, PR......... Guaynabo Municipio, PR........ Gurabo Municipio, PR.......... Hatillo Municipio, PR......... Humacao Municipio, PR......... Juncos Municipio, PR.......... Las Piedras Municipio, PR..... Lo[iacute]za Municipio, PR.... Manat[iacute] Municipio, PR... Maunabo Municipio, PR......... Morovis Municipio, PR......... Naguabo Municipio, PR......... Naranjito Municipio, PR....... Orocovis Municipio, PR........ Quebradillas Municipio, PR.... R[iacute]o Grande Municipio, PR. San Juan Municipio, PR........ San Lorenzo Municipio, PR..... Toa Alta Municipio, PR........ Toa Baja Municipio, PR........ Trujillo Alto Municipio, PR... Vega Alta Municipio, PR....... Vega Baja Municipio, PR....... Yabucoa Municipio, PR......... 42020........................ San Luis Obispo-Paso Robles, 1.1360 CA. San Luis Obispo County, CA.... 42044........................ Santa Ana-Anaheim-Irvine, CA.. 1.1576 Orange County, CA............. 42060........................ Santa Barbara-Santa Maria-
1.1538 Goleta, CA. Santa Barbara County, CA...... 42100........................ Santa Cruz-Watsonville, CA.... 1.5182 Santa Cruz County, CA......... 42140........................ Santa Fe, NM.................. 1.0931 Santa Fe County, NM........... 42220........................ Santa Rosa-Petaluma, CA....... 1.3506 Sonoma County, CA............. 42260........................ Sarasota-Bradenton-Venice, FL. 0.9555 Manatee County, FL............ Sarasota County, FL........... 42340........................ Savannah, GA.................. 0.9480 Bryan County, GA.............. Chatham County, GA............ Effingham County, GA.......... 42540........................ Scranton--Wilkes-Barre, PA.... 0.8548 Lackawanna County, PA......... Luzerne County, PA............ Wyoming County, PA............ 42644........................ Seattle-Bellevue-Everett, WA.. 1.1589 King County, WA...............
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Snohomish County, WA.......... 43100........................ Sheboygan, WI................. 0.8920 Sheboygan County, WI.......... 43300........................ Sherman-Denison, TX........... 0.9516 Grayson County, TX............ 43340........................ Shreveport-Bossier City, LA... 0.8769 Bossier Parish, LA............ Caddo Parish, LA.............. De Soto Parish, LA............ 43580........................ Sioux City, IA-NE-SD.......... 0.9376 Woodbury County, IA........... Dakota County, NE............. Dixon County, NE.............. Union County, SD.............. 43620........................ Sioux Falls, SD............... 0.9645 Lincoln County, SD............ McCook County, SD............. Minnehaha County, SD.......... Turner County, SD............. 43780........................ South Bend-Mishawaka, IN-MI... 0.9798 St. Joseph County, IN......... Cass County, MI............... 43900........................ Spartanburg, SC............... 0.9181 Spartanburg County, SC........ 44060........................ Spokane, WA................... 1.0916 Spokane County, WA............ 44100........................ Springfield, IL............... 0.8885 Menard County, IL............. Sangamon County, IL........... 44140........................ Springfield, MA............... 1.0259 Franklin County, MA........... Hampden County, MA............ Hampshire County, MA.......... 44180........................ Springfield, MO............... 0.8246 Christian County, MO.......... Dallas County, MO............. Greene County, MO............. Polk County, MO............... Webster County, MO............ 44220........................ Springfield, OH............... 0.8404 Clark County, OH.............. 44300........................ State College, PA............. 0.8364 Centre County, PA............. 44700........................ Stockton, CA.................. 1.1311 San Joaquin County, CA........ 44940........................ Sumter, SC.................... 0.8386 Sumter County, SC............. 45060........................ Syracuse, NY.................. 0.9581 Madison County, NY............ Onondaga County, NY........... Oswego County, NY............. 45104........................ Tacoma, WA.................... 1.0753 Pierce County, WA............. 45220........................ Tallahassee, FL............... 0.8697 Gadsden County, FL............ Jefferson County, FL.......... Leon County, FL............... Wakulla County, FL............ 45300........................ Tampa-St. Petersburg-
0.9193 Clearwater, FL. Hernando County, FL........... Hillsborough County, FL....... Pasco County, FL.............. Pinellas County, FL........... 45460........................ Terre Haute, IN............... 0.8313 Clay County, IN............... Sullivan County, IN........... Vermillion County, IN......... Vigo County, IN............... 45500........................ Texarkana, TX-Texarkana, AR... 0.8291 Miller County, AR............. Bowie County, TX.............. 45780........................ Toledo, OH.................... 0.9584 Fulton County, OH............. Lucas County, OH.............. Ottawa County, OH............. Wood County, OH............... 45820........................ Topeka, KS.................... 0.8929 Jackson County, KS............ Jefferson County, KS.......... Osage County, KS.............. Shawnee County, KS............ Wabaunsee County, KS.......... 45940........................ Trenton-Ewing, NJ............. 1.0845 Mercer County, NJ............. 46060........................ Tucson, AZ.................... 0.8987 Pima County, AZ............... 46140........................ Tulsa, OK..................... 0.8286 Creek County, OK.............. Okmulgee County, OK........... Osage County, OK.............. Pawnee County, OK............. Rogers County, OK............. Tulsa County, OK.............. Wagoner County, OK............ 46220........................ Tuscaloosa, AL................ 0.8721 Greene County, AL............. Hale County, AL............... Tuscaloosa County, AL......... 46340........................ Tyler, TX..................... 0.9307 Smith County, TX.............. 46540........................ Utica-Rome, NY................ 0.8293 Herkimer County, NY........... Oneida County, NY............. 46660........................ Valdosta, GA.................. 0.8875 Brooks County, GA............. Echols County, GA............. Lanier County, GA............. Lowndes County, GA............ 46700........................ Vallejo-Fairfield, CA......... 1.4899 Solano County, CA............. 46940........................ Vero Beach, FL................ 0.9444 Indian River County, FL....... 47020........................ Victoria, TX.................. 0.8168 Calhoun County, TX............ Goliad County, TX............. Victoria County, TX........... 47220........................ Vineland-Millville-Bridgeton, 0.9837 NJ. Cumberland County, NJ......... 47260........................ Virginia Beach-Norfolk-Newport 0.8808 News, VA-NC. Currituck County, NC.......... Gloucester County, VA......... Isle of Wight County, VA...... James City County, VA......... Mathews County, VA............ Surry County, VA.............. York County, VA............... Chesapeake City, VA........... Hampton City, VA.............. Newport News City, VA......... Norfolk City, VA.............. Poquoson City, VA............. Portsmouth City, VA........... Suffolk City, VA.............. Virginia Beach City, VA....... Williamsburg City, VA......... 47300........................ Visalia-Porterville, CA....... 1.0074 Tulare County, CA............. 47380........................ Waco, TX...................... 0.8527 McLennan County, TX........... 47580........................ Warner Robins, GA............. 0.8654 Houston County, GA............ 47644........................ Warren-Farmington Hills-Troy, 0.9861 MI. Lapeer County, MI............. Livingston County, MI......... Macomb County, MI............. Oakland County, MI............ St. Clair County, MI..........
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47894........................ Washington-Arlington-
1.0932 Alexandria, DC-VA-MD-WV. District of Columbia, DC...... Calvert County, MD............ Charles County, MD............ Prince George's County, MD.... Arlington County, VA.......... Clarke County, VA............. Fairfax County, VA............ Fauquier County, VA........... Loudoun County, VA............ Prince William County, VA..... Spotsylvania County, VA....... Stafford County, VA........... Warren County, VA............. Alexandria City, VA........... Fairfax City, VA.............. Falls Church City, VA......... Fredericksburg City, VA....... Manassas City, VA............. Manassas Park City, VA........ Jefferson County, WV.......... 47940........................ Waterloo-Cedar Falls, IA...... 0.8566 Black Hawk County, IA......... Bremer County, IA............. Grundy County, IA............. 48140........................ Wausau, WI.................... 0.9600 Marathon County, WI........... 48260........................ Weirton-Steubenville, WV-OH... 0.7827 Jefferson County, OH.......... Brooke County, WV............. Hancock County, WV............ 48300........................ Wenatchee, WA................. 1.0080 Chelan County, WA............. Douglas County, WA............ 48424........................ West Palm Beach-Boca Raton-
1.0077 Boynton Beach, FL. Palm Beach County, FL......... 48540........................ Wheeling, WV-OH............... 0.7168 Belmont County, OH............ Marshall County, WV........... Ohio County, WV............... 48620........................ Wichita, KS................... 0.9141 Butler County, KS............. Harvey County, KS............. Sedgwick County, KS........... Sumner County, KS............. 48660........................ Wichita Falls, TX............. 0.8294 Archer County, TX............. Clay County, TX............... Wichita County, TX............ 48700........................ Williamsport, PA.............. 0.8377 Lycoming County, PA........... 48864........................ Wilmington, DE-MD-NJ.......... 1.0482 New Castle County, DE......... Cecil County, MD.............. Salem County, NJ.............. 48900........................ Wilmington, NC................ 0.9592 Brunswick County, NC.......... New Hanover County, NC........ Pender County, NC............. 49020........................ Winchester, VA-WV............. 1.0224 Frederick County, VA.......... Winchester City, VA........... Hampshire County, WV.......... 49180........................ Winston-Salem, NC............. 0.8953 Davie County, NC.............. Forsyth County, NC............ Stokes County, NC............. Yadkin County, NC............. 49340........................ Worcester, MA................. 1.1039 Worcester County, MA.......... 49420........................ Yakima, WA.................... 1.0165 Yakima County, WA............. 49500........................ Yauco, PR..................... 0.4413 Gu[aacute]nica Municipio, PR.. Guayanilla Municipio, PR...... Pe[ntilde]uelas Municipio, PR. Yauco Municipio, PR........... 49620........................ York-Hanover, PA.............. 0.9420 York County, PA............... 49660........................ Youngstown-Warren-Boardman, OH- 0.8611 PA. Mahoning County, OH........... Trumbull County, OH........... Mercer County, PA............. 49700........................ Yuba City, CA................. 1.0932 Sutter County, CA............. Yuba County, CA............... 49740........................ Yuma, AZ...................... 0.9135 Yuma County, AZ ..............
\1\At this time, there are no hospitals located in these urban areas on which to base a wage index. Therefore, the urban wage index value is based on the average wage index for all urban areas within the state.
Table 9.--Proposed Wage Index Based On CBSA Labor Market Areas For Rural Areas
Wage CBSA Code
Nonurban Area
Index
01........................... Alabama....................... 0.7477 02........................... Alaska........................ 1.1990 03........................... Arizona....................... 0.8777 04........................... Arkansas...................... 0.7451 05........................... California.................... 1.0857 06........................... Colorado...................... 0.9389 07........................... Connecticut................... 1.1794 08........................... Delaware...................... 0.9606 10........................... Florida....................... 0.8598 11........................... Georgia....................... 0.7666 12........................... Hawaii........................ 1.0562 13........................... Idaho......................... 0.8045 14........................... Illinois...................... 0.8279 15........................... Indiana....................... 0.8630 16........................... Iowa.......................... 0.8502 17........................... Kansas........................ 0.7987 18........................... Kentucky...................... 0.7774 19........................... Louisiana..................... 0.7418 20........................... Maine......................... 0.8852 21........................... Maryland...................... 0.9095 22........................... Massachusetts \2\............. 1.0216 23........................... Michigan...................... 0.8870 24........................... Minnesota..................... 0.9183 25........................... Mississippi................... 0.7671 26........................... Missouri...................... 0.7909 27........................... Montana....................... 0.8833 28........................... Nebraska...................... 0.8665 29........................... Nevada........................ 0.9074 30........................... New Hampshire................. 1.0677 31........................... New Jersey \2\................ ......... 32........................... New Mexico.................... 0.8644 33........................... New York...................... 0.8157 34........................... North Carolina................ 0.8567 35........................... North Dakota.................. 0.7268 36........................... Ohio.......................... 0.8786 37........................... Oklahoma...................... 0.7589 38........................... Oregon........................ 0.9830 39........................... Pennsylvania.................. 0.8302 40........................... Puerto Rico \2\............... 0.4047 41........................... Rhode Island \2\.............. ......... 42........................... South Carolina................ 0.8641 43........................... South Dakota.................. 0.8484 44........................... Tennessee..................... 0.7888 45........................... Texas......................... 0.8007 46........................... Utah.......................... 0.8126 47........................... Vermont....................... 0.9840 48........................... Virgin Islands................ 0.7026 49........................... Virginia...................... 0.8012 50........................... Washington.................... 1.0458 51........................... West Virginia................. 0.7725 52........................... Wisconsin..................... 0.9480 53........................... Wyoming....................... 0.9214
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65........................... Guam.......................... 0.9611
\2\ All counties within the State are classified as urban, with the exception of Massachusetts and Puerto Rico. Massachusetts and Puerto Rico have areas designated as rural, however, no short-term, acute care hospitals are located in the area(s) for FY 2006. Because more recent data is not available for those areas, we are using last year's wage index value.
Table A.--MSA/CBSA Crosswalk
2006 MSA- 2006 SSA State/County Code
County and State Name
MSA
based CBSA- CBSA Number WI based WI Number
01000........................... Autauga County, Alabama........... 5240 0.8588 0.8588 33860 01010........................... Baldwin County, Alabama........... 5160 0.7866 0.7477 99901 01020........................... Barbour County, Alabama...........
01 0.7463 0.7477 99901 01030........................... Bibb County, Alabama..............
01 0.7463 0.8979 13820 01040........................... Blount County, Alabama............ 1000 0.9021 0.8979 13820 01050........................... Bullock County, Alabama...........
01 0.7463 0.7477 99901 01060........................... Butler County, Alabama............
01 0.7463 0.7477 99901 01070........................... Calhoun County, Alabama........... 0450 0.7659 0.7659 11500 01080........................... Chambers County, Alabama..........
01 0.7463 0.7477 99901 01090........................... Cherokee County, Alabama..........
01 0.7463 0.7477 99901 01100........................... Chilton County, Alabama...........
01 0.7463 0.8979 13820 01110........................... Choctaw County, Alabama...........
01 0.7463 0.7477 99901 01120........................... Clarke County, Alabama............
01 0.7463 0.7477 99901 01130........................... Clay County, Alabama..............
01 0.7463 0.7477 99901 01140........................... Cleburne County, Alabama..........
01 0.7463 0.7477 99901 01150........................... Coffee County, Alabama............
01 0.7463 0.7477 99901 01160........................... Colbert County, Alabama........... 2650 0.8280 0.8280 22520 01170........................... Conecuh County, Alabama...........
01 0.7463 0.7477 99901 01180........................... Coosa County, Alabama.............
01 0.7463 0.7477 99901 01190........................... Covington County, Alabama.........
01 0.7463 0.7477 99901 01200........................... Crenshaw County, Alabama..........
01 0.7463 0.7477 99901 01210........................... Cullman County, Alabama...........
01 0.7463 0.7477 99901 01220........................... Dale County, Alabama.............. 2180 0.7687 0.7477 99901 01230........................... Dallas County, Alabama............
01 0.7463 0.7477 99901 01240........................... De Kalb County, Alabama...........
01 0.7463 0.7477 99901 01250........................... Elmore County, Alabama............ 5240 0.8588 0.8588 33860 01260........................... Escambia County, Alabama..........
01 0.7463 0.7477 99901 01270........................... Etowah County, Alabama............ 2880 0.7946 0.7946 23460 01280........................... Fayette County, Alabama...........
01 0.7463 0.7477 99901 01290........................... Franklin County, Alabama..........
01 0.7463 0.7477 99901 01300........................... Geneva County, Alabama............
01 0.7463 0.7707 20020 01310........................... Greene County, Alabama............
01 0.7463 0.8721 46220 01320........................... Hale County, Alabama..............
01 0.7463 0.8721 46220 01330........................... Henry County, Alabama.............
01 0.7463 0.7707 20020 01340........................... Houston County, Alabama........... 2180 0.7687 0.7707 20020 01350........................... Jackson County, Alabama...........
01 0.7463 0.7477 99901 01360........................... Jefferson County, Alabama......... 1000 0.9021 0.8979 13820 01370........................... Lamar County, Alabama.............
01 0.7463 0.7477 99901 01380........................... Lauderdale County, Alabama........ 2650 0.8280 0.8280 22520 01390........................... Lawrence County, Alabama.......... 2030 0.8478 0.8478 19460 01400........................... Lee County, Alabama............... 0580 0.8108 0.8108 12220 01410........................... Limestone County, Alabama......... 3440 0.9149 0.9149 26620 01420........................... Lowndes County, Alabama...........
01 0.7463 0.8588 33860 01430........................... Macon County, Alabama.............
01 0.7463 0.7477 99901 01440........................... Madison County, Alabama........... 3440 0.9149 0.9149 26620 01450........................... Marengo County, Alabama...........
01 0.7463 0.7477 99901 01460........................... Marion County, Alabama............
01 0.7463 0.7477 99901 01470........................... Marshall County, Alabama..........
01 0.7463 0.7477 99901 01480........................... Mobile County, Alabama............ 5160 0.7866 0.7895 33660 01490........................... Monroe County, Alabama............
01 0.7463 0.7477 99901 01500........................... Montgomery County, Alabama........ 5240 0.8588 0.8588 33860
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01510........................... Morgan County, Alabama............ 2030 0.8478 0.8478 19460 01520........................... Perry County, Alabama.............
01 0.7463 0.7477 99901 01530........................... Pickens County, Alabama...........
01 0.7463 0.7477 99901 01540........................... Pike County, Alabama..............
01 0.7463 0.7477 99901 01550........................... Randolph County, Alabama..........
01 0.7463 0.7477 99901 01560........................... Russell County, Alabama........... 1800 0.8568 0.8568 17980 01570........................... St Clair County, Alabama.......... 1000 0.9021 0.8979 13820 01580........................... Shelby County, Alabama............ 1000 0.9021 0.8979 13820 01590........................... Sumter County, Alabama............
01 0.7463 0.7477 99901 01600........................... Talladega County, Alabama.........
01 0.7463 0.7477 99901 01610........................... Tallapoosa County, Alabama........
01 0.7463 0.7477 99901 01620........................... Tuscaloosa County, Alabama........ 8600 0.8842 0.8721 46220 01630........................... Walker County, Alabama............
01 0.7463 0.8979 13820 01640........................... Washington County, Alabama........
01 0.7463 0.7477 99901 01650........................... Wilcox County, Alabama............
01 0.7463 0.7477 99901 01660........................... Winston County, Alabama...........
01 0.7463 0.7477 99901 02013........................... Aleutians County East, Alaska.....
02 1.1900 1.1990 99902 02016........................... Aleutians County West, Alaska.....
02 1.1900 1.1990 99902 02020........................... Anchorage County, Alaska.......... 0380 1.2022 1.2110 11260 02030........................... Angoon County, Alaska.............
02 1.1900 1.1990 99902 02040........................... Barrow-North Slope County, Alaska.
02 1.1900 1.1990 99902 02050........................... Bethel County, Alaska.............
02 1.1900 1.1990 99902 02060........................... Bristol Bay Borough County, Alaska
02 1.1900 1.1990 99902 02068........................... Denali County, Alaska.............
02 1.1900 1.1990 99902 02070........................... Bristol Bay County, Alaska........
02 1.1900 1.1990 99902 02080........................... Cordova-Mc Carthy County, Alaska..
02 1.1900 1.1990 99902 02090........................... Fairbanks County, Alaska..........
02 1.1900 1.1419 21820 02100........................... Haines County, Alaska.............
02 1.1900 1.1990 99902 02110........................... Juneau County, Alaska.............
02 1.1900 1.1990 99902 02120........................... Kenai-Cook Inlet County, Alaska...
02 1.1900 1.1990 99902 02122........................... Kenai Peninsula Borough, Alaska...
02 1.1900 1.1990 99902 02130........................... Ketchikan County, Alaska..........
02 1.1900 1.1990 99902 02140........................... Kobuk County, Alaska..............
02 1.1900 1.1990 99902 02150........................... Kodiak County, Alaska.............
02 1.1900 1.1990 99902 02160........................... Kuskokwin County, Alaska..........
02 1.1900 1.1990 99902 02164........................... Lake and Peninsula Borough, Alaska
02 1.1900 1.1990 99902 02170........................... Matanuska County, Alaska..........
02 1.1900 1.2110 11260 02180........................... Nome County, Alaska...............
02 1.1900 1.1990 99902 02185........................... North Slope Borough, Alaska.......
02 1.1900 1.1990 99902 02188........................... Northwest Arctic Borough, Alaska..
02 1.1900 1.1990 99902 02190........................... Outer Ketchikan County, Alaska....
02 1.1900 1.1990 99902 02200........................... Prince Of Wales County, Alaska....
02 1.1900 1.1990 99902 02201........................... Prince of Wales-Outer Ketchikan
02 1.1900 1.1990 99902 Census Area, Alaska. 02210........................... Seward County, Alaska.............
02 1.1900 1.1990 99902 02220........................... Sitka County, Alaska..............
02 1.1900 1.1990 99902 02230........................... Skagway-Yakutat County, Alaska....
02 1.1900 1.1990 99902 02231........................... Skagway-Yakutat-Angoon Census
02 1.1900 1.1990 99902 Area, Alaska. 02232........................... Skagway-Hoonah-Angoon Census Area,
02 1.1900 1.1990 99902 Alaska. 02240........................... Southeast Fairbanks County, Alaska
02 1.1900 1.1990 99902 02250........................... Upper Yukon County, Alaska........
02 1.1900 1.1990 99902 02260........................... Valdz-Chitna-Whitier County,
02 1.1900 1.1990 99902 Alaska. 02261........................... Valdex-Cordove Census Area, Alaska
02 1.1900 1.1990 99902 02270........................... Wade Hampton County, Alaska.......
02 1.1900 1.1990 99902 02280........................... Wrangell-Petersburg County, Alaska
02 1.1900 1.1990 99902 02282........................... Yakutat Borough, Alaska...........
02 1.1900 1.1990 99902 02290........................... Yukon-Koyukuk County, Alaska......
02 1.1900 1.1990 99902 03000........................... Apache County, Arizona............
03 0.9054 0.8777 99903 03010........................... Cochise County, Arizona...........
03 0.9054 0.8777 99903 03020........................... Coconino County, Arizona.......... 2620 1.1857 1.2105 22380 03030........................... Gila County, Arizona..............
03 0.9054 0.8777 99903 03040........................... Graham County, Arizona............
03 0.9054 0.8777 99903 03050........................... Greenlee County, Arizona..........
03 0.9054 0.8777 99903 03055........................... La Paz County, Arizona............
03 0.9054 0.8777 99903 03060........................... Maricopa County, Arizona.......... 6200 1.0138 1.0138 38060 03070........................... Mohave County, Arizona............ 4120 1.1166 0.8777 99903 03080........................... Navajo County, Arizona............
03 0.9054 0.8777 99903 03090........................... Pima County, Arizona.............. 8520 0.8987 0.8987 46060 03100........................... Pinal County, Arizona............. 6200 1.0138 1.0138 38060 03110........................... Santa Cruz County, Arizona........
03 0.9054 0.8777 99903
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03120........................... Yavapai County, Arizona...........
03 0.9054 0.9879 39140 03130........................... Yuma County, Arizona.............. 9360 0.9135 0.9135 49740 04000........................... Arkansas County, Arkansas.........
04 0.7744 0.7451 99904 04010........................... Ashley County, Arkansas...........
04 0.7744 0.7451 99904 04020........................... Baxter County, Arkansas...........
04 0.7744 0.7451 99904 04030........................... Benton County, Arkansas........... 2580 0.8563 0.8563 22220 04040........................... Boone County, Arkansas............
04 0.7744 0.7451 99904 04050........................... Bradley County, Arkansas..........
04 0.7744 0.7451 99904 04060........................... Calhoun County, Arkansas..........
04 0.7744 0.7451 99904 04070........................... Carroll County, Arkansas..........
04 0.7744 0.7451 99904 04080........................... Chicot County, Arkansas...........
04 0.7744 0.7451 99904 04090........................... Clark County, Arkansas............
04 0.7744 0.7451 99904 04100........................... Clay County, Arkansas.............
04 0.7744 0.7451 99904 04110........................... Cleburne County, Arkansas.........
04 0.7744 0.7451 99904 04120........................... Cleveland County, Arkansas........
04 0.7744 0.8689 38220 04130........................... Columbia County, Arkansas.........
04 0.7744 0.7451 99904 04140........................... Conway County, Arkansas...........
04 0.7744 0.7451 99904 04150........................... Craighead County, Arkansas........ 3700 0.7919 0.7919 27860 04160........................... Crawford County, Arkansas......... 2720 0.8229 0.8214 22900 04170........................... Crittenden County, Arkansas....... 4920 0.9360 0.9341 32820 04180........................... Cross County, Arkansas............
04 0.7744 0.7451 99904 04190........................... Dallas County, Arkansas...........
04 0.7744 0.7451 99904 04200........................... Desha County, Arkansas............
04 0.7744 0.7451 99904 04210........................... Drew County, Arkansas.............
04 0.7744 0.7451 99904 04220........................... Faulkner County, Arkansas......... 4400 0.8756 0.8756 30780 04230........................... Franklin County, Arkansas.........
04 0.7744 0.8214 22900 04240........................... Fulton County, Arkansas...........
04 0.7744 0.7451 99904 04250........................... Garland County, Arkansas..........
04 0.7744 0.9053 26300 04260........................... Grant County, Arkansas............
04 0.7744 0.8756 30780 04270........................... Greene County, Arkansas...........
04 0.7744 0.7451 99904 04280........................... Hempstead County, Arkansas........
04 0.7744 0.7451 99904 04290........................... Hot Spring County, Arkansas.......
04 0.7744 0.7451 99904 04300........................... Howard County, Arkansas...........
04 0.7744 0.7451 99904 04310........................... Independence County, Arkansas.....
04 0.7744 0.7451 99904 04320........................... Izard County, Arkansas............
04 0.7744 0.7451 99904 04330........................... Jackson County, Arkansas..........
04 0.7744 0.7451 99904 04340........................... Jefferson County, Arkansas........ 6240 0.8689 0.8689 38220 04350........................... Johnson County, Arkansas..........
04 0.7744 0.7451 99904 04360........................... Lafayette County, Arkansas........
04 0.7744 0.7451 99904 04370........................... Lawrence County, Arkansas.........
04 0.7744 0.7451 99904 04380........................... Lee County, Arkansas..............
04 0.7744 0.7451 99904 04390........................... Lincoln County, Arkansas..........
04 0.7744 0.8689 38220 04400........................... Little River County, Arkansas.....
04 0.7744 0.7451 99904 04410........................... Logan County, Arkansas............
04 0.7744 0.7451 99904 04420........................... Lonoke County, Arkansas........... 4400 0.8756 0.8756 30780 04430........................... Madison County, Arkansas..........
04 0.7744 0.8563 22220 04440........................... Marion County, Arkansas...........
04 0.7744 0.7451 99904 04450........................... Miller County, Arkansas........... 8360 0.8291 0.8291 45500 04460........................... Mississippi County, Arkansas......
04 0.7744 0.7451 99904 04470........................... Monroe County, Arkansas...........
04 0.7744 0.7451 99904 04480........................... Montgomery County, Arkansas.......
04 0.7744 0.7451 99904 04490........................... Nevada County, Arkansas...........
04 0.7744 0.7451 99904 04500........................... Newton County, Arkansas...........
04 0.7744 0.7451 99904 04510........................... Ouachita County, Arkansas.........
04 0.7744 0.7451 99904 04520........................... Perry County, Arkansas............
04 0.7744 0.8756 30780 04530........................... Phillips County, Arkansas.........
04 0.7744 0.7451 99904 04540........................... Pike County, Arkansas.............
04 0.7744 0.7451 99904 04550........................... Poinsett County, Arkansas.........
04 0.7744 0.7919 27860 04560........................... Polk County, Arkansas.............
04 0.7744 0.7451 99904 04570........................... Pope County, Arkansas.............
04 0.7744 0.7451 99904 04580........................... Prairie County, Arkansas..........
04 0.7744 0.7451 99904 04590........................... Pulaski County, Arkansas.......... 4400 0.8756 0.8756 30780 04600........................... Randolph County, Arkansas.........
04 0.7744 0.7451 99904 04610........................... St Francis County, Arkansas.......
04 0.7744 0.7451 99904 04620........................... Saline County, Arkansas........... 4400 0.8756 0.8756 30780 04630........................... Scott County, Arkansas............
04 0.7744 0.7451 99904 04640........................... Searcy County, Arkansas...........
04 0.7744 0.7451 99904 04650........................... Sebastian County, Arkansas........ 2720 0.8229 0.8214 22900 04660........................... Sevier County, Arkansas...........
04 0.7744 0.7451 99904
[[Page 29118]]
04670........................... Sharp County, Arkansas............
04 0.7744 0.7451 99904 04680........................... Stone County, Arkansas............
04 0.7744 0.7451 99904 04690........................... Union County, Arkansas............
04 0.7744 0.7451 99904 04700........................... Van Buren County, Arkansas........
04 0.7744 0.7451 99904 04710........................... Washington County, Arkansas....... 2580 0.8563 0.8563 22220 04720........................... White County, Arkansas............
04 0.7744 0.7451 99904 04730........................... Woodruff County, Arkansas.........
04 0.7744 0.7451 99904 04740........................... Yell County, Arkansas.............
04 0.7744 0.7451 99904 05000........................... Alameda County, California........ 5775 1.5346 1.5346 36084 05010........................... Alpine County, California.........
05 1.0639 1.0857 99905 05020........................... Amador County, California.........
05 1.0639 1.0857 99905 05030........................... Butte County, California.......... 1620 1.0522 1.0522 17020 05040........................... Calaveras County, California......
05 1.0639 1.0857 99905 05050........................... Colusa County, California.........
05 1.0639 1.0857 99905 05060........................... Contra Costa County, California... 5775 1.5346 1.5346 36084 05070........................... Del Norte County, California......
05 1.0639 1.0857 99905 05080........................... Eldorado County, California....... 6920 1.3148 1.2973 40900 05090........................... Fresno County, California......... 2840 1.0432 1.0541 23420 05100........................... Glenn County, California..........
05 1.0639 1.0857 99905 05110........................... Humboldt County, California.......
05 1.0639 1.0857 99905 05120........................... Imperial County, California.......
05 1.0639 0.8915 20940 05130........................... Inyo County, California...........
05 1.0639 1.0857 99905 05140........................... Kern County, California........... 0680 1.0344 1.0344 12540 05150........................... Kings County, California..........
05 1.0639 1.0046 25260 05160........................... Lake County, California...........
05 1.0639 1.0857 99905 05170........................... Lassen County, California.........
05 1.0639 1.0857 99905 05200........................... Los Angeles County, California.... 4480 1.1752 1.1752 31084 05210........................... Los Angeles County, California.... 4480 1.1752 1.1752 31084 05300........................... Madera County, California......... 2840 1.0432 0.8721 31460 05310........................... Marin County, California.......... 7360 1.4990 1.4990 41884 05320........................... Mariposa County, California.......
05 1.0639 1.0857 99905 05330........................... Mendocino County, California......
05 1.0639 1.0857 99905 05340........................... Merced County, California......... 4940 1.1120 1.1120 32900 05350........................... Modoc County, California..........
05 1.0639 1.0857 99905 05360........................... Mono County, California...........
05 1.0639 1.0857 99905 05370........................... Monterey County, California....... 7120 1.4142 1.4142 41500 05380........................... Napa County, California........... 8720 1.3966 1.2656 34900 05390........................... Nevada County, California.........
05 1.0639 1.0857 99905 05400........................... Orange County, California......... 5945 1.1576 1.1576 42044 05410........................... Placer County, California......... 6920 1.3148 1.2973 40900 05420........................... Plumas County, California.........
05 1.0639 1.0857 99905 05430........................... Riverside County, California...... 6780 1.1022 1.1022 40140 05440........................... Sacramento County, California..... 6920 1.3148 1.2973 40900 05450........................... San Benito County, California.....
05 1.0639 1.5125 41940 05460........................... San Bernardino County, California. 6780 1.1022 1.1022 40140 05470........................... San Diego County, California...... 7320 1.1424 1.1424 41740 05480........................... San Francisco County, California.. 7360 1.4990 1.4990 41884 05490........................... San Joaquin County, California.... 8120 1.1311 1.1311 44700 05500........................... San Luis Obispo County, California 7460 1.1360 1.1360 42020 05510........................... San Mateo County, California...... 7360 1.4990 1.4990 41884 05520........................... Santa Barbara County, California.. 7480 1.1538 1.1538 42060 05530........................... Santa Clara County, California.... 7400 1.5144 1.5125 41940 05540........................... Santa Cruz County, California..... 7485 1.5182 1.5182 42100 05550........................... Shasta County, California......... 6690 1.2215 1.2215 39820 05560........................... Sierra County, California.........
05 1.0639 1.0857 99905 05570........................... Siskiyou County, California.......
05 1.0639 1.0857 99905 05580........................... Solano County, California......... 8720 1.3966 1.4899 46700 05590........................... Sonoma County, California......... 7500 1.3506 1.3506 42220 05600........................... Stanislaus County, California..... 5170 1.1804 1.1804 33700 05610........................... Sutter County, California......... 9340 1.0932 1.0932 49700 05620........................... Tehama County, California.........
05 1.0639 1.0857 99905 05630........................... Trinity County, California........
05 1.0639 1.0857 99905 05640........................... Tulare County, California......... 8780 1.0074 1.0074 47300 05650........................... Tuolumne County, California.......
05 1.0639 1.0857 99905 05660........................... Ventura County, California........ 8735 1.1613 1.1613 37100 05670........................... Yolo County, California........... 9270 0.9949 1.2973 40900 05680........................... Yuba County, California........... 9340 1.0932 1.0932 49700 06000........................... Adams County, Colorado............ 2080 1.0733 1.0733 19740 06010........................... Alamosa County, Colorado..........
06 0.9389 0.9389 99906
[[Page 29119]]
06020........................... Arapahoe County, Colorado......... 2080 1.0733 1.0733 19740 06030........................... Archuleta County, Colorado........
06 0.9389 0.9389 99906 06040........................... Baca County, Colorado.............
06 0.9389 0.9389 99906 06050........................... Bent County, Colorado.............
06 0.9389 0.9389 99906 06060........................... Boulder County, Colorado.......... 1125 0.9744 0.9744 14500 06070........................... Chaffee County, Colorado..........
06 0.9389 0.9389 99906 06080........................... Cheyenne County, Colorado.........
06 0.9389 0.9389 99906 06090........................... Clear Creek County, Colorado......
06 0.9389 1.0733 19740 06100........................... Conejos County, Colorado..........
06 0.9389 0.9389 99906 06110........................... Costilla County, Colorado.........
06 0.9389 0.9389 99906 06120........................... Crowley County, Colorado..........
06 0.9389 0.9389 99906 06130........................... Custer County, Colorado...........
06 0.9389 0.9389 99906 06140........................... Delta County, Colorado............
06 0.9389 0.9389 99906 06150........................... Denver County, Colorado........... 2080 1.0733 1.0733 19740 06160........................... Dolores County, Colorado..........
06 0.9389 0.9389 99906 06170........................... Douglas County, Colorado.......... 2080 1.0733 1.0733 19740 06180........................... Eagle County, Colorado............
06 0.9389 0.9389 99906 06190........................... Elbert County, Colorado...........
06 0.9389 1.0733 19740 06200........................... El Paso County, Colorado.......... 1720 0.9478 0.9478 17820 06210........................... Fremont County, Colorado..........
06 0.9389 0.9389 99906 06220........................... Garfield County, Colorado.........
06 0.9389 0.9389 99906 06230........................... Gilpin County, Colorado...........
06 0.9389 1.0733 19740 06240........................... Grand County, Colorado............
06 0.9389 0.9389 99906 06250........................... Gunnison County, Colorado.........
06 0.9389 0.9389 99906 06260........................... Hinsdale County, Colorado.........
06 0.9389 0.9389 99906 06270........................... Huerfano County, Colorado.........
06 0.9389 0.9389 99906 06280........................... Jackson County, Colorado..........
06 0.9389 0.9389 99906 06290........................... Jefferson County, Colorado........ 2080 1.0733 1.0733 19740 06300........................... Kiowa County, Colorado............
06 0.9389 0.9389 99906 06310........................... Kit Carson County, Colorado.......
06 0.9389 0.9389 99906 06320........................... Lake County, Colorado.............
06 0.9389 0.9389 99906 06330........................... La Plata County, Colorado.........
06 0.9389 0.9389 99906 06340........................... Larimer County, Colorado.......... 2670 1.0132 1.0132 22660 06350........................... Las Animas County, Colorado.......
06 0.9389 0.9389 99906 06360........................... Lincoln County, Colorado..........
06 0.9389 0.9389 99906 06370........................... Logan County, Colorado............
06 0.9389 0.9389 99906 06380........................... Mesa County, Colorado............. 2995 0.9560 0.9560 24300 06390........................... Mineral County, Colorado..........
06 0.9389 0.9389 99906 06400........................... Moffat County, Colorado...........
06 0.9389 0.9389 99906 06410........................... Montezuma County, Colorado........
06 0.9389 0.9389 99906 06420........................... Montrose County, Colorado.........
06 0.9389 0.9389 99906 06430........................... Morgan County, Colorado...........
06 0.9389 0.9389 99906 06440........................... Otero County, Colorado............
06 0.9389 0.9389 99906 06450........................... Ouray County, Colorado............
06 0.9389 0.9389 99906 06460........................... Park County, Colorado.............
06 0.9389 1.0733 19740 06470........................... Phillips County, Colorado.........
06 0.9389 0.9389 99906 06480........................... Pitkin County, Colorado...........
06 0.9389 0.9389 99906 06490........................... Prowers County, Colorado..........
06 0.9389 0.9389 99906 06500........................... Pueblo County, Colorado........... 6560 0.8632 0.8632 39380 06510........................... Rio Blanco County, Colorado.......
06 0.9389 0.9389 99906 06520........................... Rio Grande County, Colorado.......
06 0.9389 0.9389 99906 06530........................... Routt County, Colorado............
06 0.9389 0.9389 99906 06540........................... Saguache County, Colorado.........
06 0.9389 0.9389 99906 06550........................... San Juan County, Colorado.........
06 0.9389 0.9389 99906 06560........................... San Miguel County, Colorado.......
06 0.9389 0.9389 99906 06570........................... Sedgwick County, Colorado.........
06 0.9389 0.9389 99906 06580........................... Summit County, Colorado...........
06 0.9389 0.9389 99906 06590........................... Teller County, Colorado...........
06 0.9389 0.9478 17820 06600........................... Washington County, Colorado.......
06 0.9389 0.9389 99906 06610........................... Weld County, Colorado............. 3060 0.9580 0.9580 24540 06620........................... Yuma County, Colorado.............
06 0.9389 0.9389 99906 06630........................... Broomfield County, Colorado....... 2080 1.0733 1.0733 19740 07000........................... Fairfield County, Connecticut..... 5483 1.2096 1.2598 14860 07010........................... Hartford County, Connecticut...... 3283 1.1084 1.1084 25540 07020........................... Litchfield County, Connecticut.... 3283 1.1084 1.1084 25540 07030........................... Middlesex County, Connecticut..... 3283 1.1084 1.1084 25540 07040........................... New Haven County, Connecticut..... 5483 1.2096 1.1702 35300 07050........................... New London County, Connecticut.... 5523 1.1356 1.1356 35980 07060........................... Tolland County, Connecticut....... 3283 1.1084 1.1084 25540
[[Page 29120]]
07070........................... Windham County, Connecticut.......
07 1.1794 1.1794 99907 08000........................... Kent County, Delaware............. 2190 0.9779 0.9779 20100 08010........................... New Castle County, Delaware....... 9160 1.0537 1.0482 48864 08020........................... Sussex County, Delaware...........
08 0.9606 0.9606 99908 09000........................... Washington Dc County, Dist Of Col. 8840 1.0983 1.0932 47894 10000........................... Alachua County, Florida........... 2900 0.9474 0.9474 23540 10010........................... Baker County, Florida.............
10 0.8698 0.9299 27260 10020........................... Bay County, Florida............... 6015 0.7989 0.7989 37460 10030........................... Bradford County, Florida..........
10 0.8698 0.8598 99910 10040........................... Brevard County, Florida........... 4900 0.9835 0.9835 37340 10050........................... Broward County, Florida........... 2680 1.0442 1.0442 22744 10060........................... Calhoun County, Florida...........
10 0.8698 0.8598 99910 10070........................... Charlotte County, Florida......... 6580 0.9264 0.9264 39460 10080........................... Citrus County, Florida............
10 0.8698 0.8598 99910 10090........................... Clay County, Florida.............. 3600 0.9308 0.9299 27260 10100........................... Collier County, Florida........... 5345 1.0140 1.0140 34940 10110........................... Columbia County, Florida..........
10 0.8698 0.8598 99910 10120........................... Dade County, Florida.............. 5000 0.9759 0.9759 33124 10130........................... De Soto County, Florida...........
10 0.8698 0.8598 99910 10140........................... Dixie County, Florida.............
10 0.8698 0.8598 99910 10150........................... Duval County, Florida............. 3600 0.9308 0.9299 27260 10160........................... Escambia County, Florida.......... 6080 0.8104 0.8104 37860 10170........................... Flagler County, Florida........... 2020 0.9334 0.8598 99910 10180........................... Franklin County, Florida..........
10 0.8698 0.8598 99910 10190........................... Gadsden County, Florida........... 8240 0.8697 0.8697 45220 10200........................... Gilchrist County, Florida.........
10 0.8698 0.9474 23540 10210........................... Glades County, Florida............
10 0.8698 0.8598 99910 10220........................... Gulf County, Florida..............
10 0.8698 0.8598 99910 10230........................... Hamilton County, Florida..........
10 0.8698 0.8598 99910 10240........................... Hardee County, Florida............
10 0.8698 0.8598 99910 10250........................... Hendry County, Florida............
10 0.8698 0.8598 99910 10260........................... Hernando County, Florida.......... 8280 0.9193 0.9193 45300 10270........................... Highlands County, Florida.........
10 0.8698 0.8598 99910 10280........................... Hillsborough County, Florida...... 8280 0.9193 0.9193 45300 10290........................... Holmes County, Florida............
10 0.8698 0.8598 99910 10300........................... Indian River County, Florida......
10 0.8698 0.9444 46940 10310........................... Jackson County, Florida...........
10 0.8698 0.8598 99910 10320........................... Jefferson County, Florida.........
10 0.8698 0.8697 45220 10330........................... Lafayette County, Florida.........
10 0.8698 0.8598 99910 10340........................... Lake County, Florida.............. 5960 0.9459 0.9459 36740 10350........................... Lee County, Florida............... 2700 0.9366 0.9366 15980 10360........................... Leon County, Florida.............. 8240 0.8697 0.8697 45220 10370........................... Levy County, Florida..............
10 0.8698 0.8598 99910 10380........................... Liberty County, Florida...........
10 0.8698 0.8598 99910 10390........................... Madison County, Florida...........
10 0.8698 0.8598 99910 10400........................... Manatee County, Florida........... 7510 0.9555 0.9555 42260 10410........................... Marion County, Florida............ 5790 0.8934 0.8934 36100 10420........................... Martin County, Florida............ 2710 1.0133 1.0133 38940 10430........................... Monroe County, Florida............
10 0.8698 0.8598 99910 10440........................... Nassau County, Florida............ 3600 0.9308 0.9299 27260 10450........................... Okaloosa County, Florida.......... 2750 0.8881 0.8881 23020 10460........................... Okeechobee County, Florida........
10 0.8698 0.8598 99910 10470........................... Orange County, Florida............ 5960 0.9459 0.9459 36740 10480........................... Osceola County, Florida........... 5960 0.9459 0.9459 36740 10490........................... Palm Beach County, Florida........ 8960 1.0077 1.0077 48424 10500........................... Pasco County, Florida............. 8280 0.9193 0.9193 45300 10510........................... Pinellas County, Florida.......... 8280 0.9193 0.9193 45300 10520........................... Polk County, Florida.............. 3980 0.8921 0.8921 29460 10530........................... Putnam County, Florida............
10 0.8698 0.8598 99910 10540........................... Johns County, Florida............. 3600 0.9308 0.9299 27260 10550........................... St Lucie County, Florida.......... 2710 1.0133 1.0133 38940 10560........................... Santa Rosa County, Florida........ 6080 0.8104 0.8104 37860 10570........................... Sarasota County, Florida.......... 7510 0.9555 0.9555 42260 10580........................... Seminole County, Florida.......... 5960 0.9459 0.9459 36740 10590........................... Sumter County, Florida............
10 0.8698 0.8598 99910 10600........................... Suwannee County, Florida..........
10 0.8698 0.8598 99910 10610........................... Taylor County, Florida............
10 0.8698 0.8598 99910 10620........................... Union County, Florida.............
10 0.8698 0.8598 99910 10630........................... Volusia County, Florida........... 2020 0.9334 0.9308 19660
[[Page 29121]]
10640........................... Wakulla County, Florida...........
10 0.8698 0.8697 45220 10650........................... Walton County, Florida............
10 0.8698 0.8598 99910 10660........................... Washington County, Florida........
10 0.8698 0.8598 99910 11000........................... Appling County, Georgia...........
11 0.8165 0.7666 99911 11010........................... Atkinson County, Georgia..........
11 0.8165 0.7666 99911 11011........................... Bacon County, Georgia.............
11 0.8165 0.7666 99911 11020........................... Baker County, Georgia.............
11 0.8165 0.8636 10500 11030........................... Baldwin County, Georgia...........
11 0.8165 0.7666 99911 11040........................... Banks County, Georgia.............
11 0.8165 0.7666 99911 11050........................... Barrow County, Georgia............ 0520 0.9648 0.9648 12060 11060........................... Bartow County, Georgia............ 0520 0.9648 0.9648 12060 11070........................... Ben Hill County, Georgia..........
11 0.8165 0.7666 99911 11080........................... Berrien County, Georgia...........
11 0.8165 0.7666 99911 11090........................... Bibb County, Georgia.............. 4680 0.9286 0.9453 31420 11100........................... Bleckley County, Georgia..........
11 0.8165 0.7666 99911 11110........................... Brantley County, Georgia..........
11 0.8165 0.9320 15260 11120........................... Brooks County, Georgia............
11 0.8165 0.8875 46660 11130........................... Bryan County, Georgia............. 7520 0.9480 0.9480 42340 11140........................... Bulloch County, Georgia...........
11 0.8165 0.7666 99911 11150........................... Burke County, Georgia.............
11 0.8165 0.9565 12260 11160........................... Butts County, Georgia.............
11 0.8165 0.9648 12060 11161........................... Calhoun County, Georgia...........
11 0.8165 0.7666 99911 11170........................... Camden County, Georgia............
11 0.8165 0.7666 99911 11180........................... Candler County, Georgia...........
11 0.8165 0.7666 99911 11190........................... Carroll County, Georgia........... 0520 0.9648 0.9648 12060 11200........................... Catoosa County, Georgia........... 1560 0.9098 0.9098 16860 11210........................... Charlton County, Georgia..........
11 0.8165 0.7666 99911 11220........................... Chatham County, Georgia........... 7520 0.9480 0.9480 42340 11230........................... Chattahoochee County, Georgia..... 1800 0.8568 0.8568 17980 11240........................... Chattooga County, Georgia.........
11 0.8165 0.7666 99911 11250........................... Cherokee County, Georgia.......... 0520 0.9648 0.9648 12060 11260........................... Clarke County, Georgia............ 0500 0.9843 0.9843 12020 11270........................... Clay County, Georgia..............
11 0.8165 0.7666 99911 11280........................... Clayton County, Georgia........... 0520 0.9648 0.9648 12060 11281........................... Clinch County, Georgia............
11 0.8165 0.7666 99911 11290........................... Cobb County, Georgia.............. 0520 0.9648 0.9648 12060 11291........................... Coffee County, Georgia............
11 0.8165 0.7666 99911 11300........................... Colquitt County, Georgia..........
11 0.8165 0.7666 99911 11310........................... Columbia County, Georgia.......... 0600 0.9619 0.9565 12260 11311........................... Cook County, Georgia..............
11 0.8165 0.7666 99911 11320........................... Coweta County, Georgia............ 0520 0.9648 0.9648 12060 11330........................... Crawford County, Georgia..........
11 0.8165 0.9453 31420 11340........................... Crisp County, Georgia.............
11 0.8165 0.7666 99911 11341........................... Dade County, Georgia.............. 1560 0.9098 0.9098 16860 11350........................... Dawson County, Georgia............
11 0.8165 0.9648 12060 11360........................... Decatur County, Georgia...........
11 0.8165 0.7666 99911 11370........................... De Kalb County, Georgia........... 0520 0.9648 0.9648 12060 11380........................... Dodge County, Georgia.............
11 0.8165 0.7666 99911 11381........................... Dooly County, Georgia.............
11 0.8165 0.7666 99911 11390........................... Dougherty County, Georgia......... 0120 0.8636 0.8636 10500 11400........................... Douglas County, Georgia........... 0520 0.9648 0.9648 12060 11410........................... Early County, Georgia.............
11 0.8165 0.7666 99911 11420........................... Echols County, Georgia............
11 0.8165 0.8875 46660 11421........................... Effingham County, Georgia......... 7520 0.9480 0.9480 42340 11430........................... Elbert County, Georgia............
11 0.8165 0.7666 99911 11440........................... Emanuel County, Georgia...........
11 0.8165 0.7666 99911 11441........................... Evans County, Georgia.............
11 0.8165 0.7666 99911 11450........................... Fannin County, Georgia............
11 0.8165 0.7666 99911 11451........................... Fayette County, Georgia........... 0520 0.9648 0.9648 12060 11460........................... Floyd County, Georgia.............
11 0.8165 0.9424 40660 11461........................... Forsyth County, Georgia........... 0520 0.9648 0.9648 12060 11462........................... Franklin County, Georgia..........
11 0.8165 0.7666 99911 11470........................... Fulton County, Georgia............ 0520 0.9648 0.9648 12060 11471........................... Gilmer County, Georgia............
11 0.8165 0.7666 99911 11480........................... Glascock County, Georgia..........
11 0.8165 0.7666 99911 11490........................... Glynn County, Georgia.............
11 0.8165 0.9320 15260 11500........................... Gordon County, Georgia............
11 0.8165 0.7666 99911 11510........................... Grady County, Georgia.............
11 0.8165 0.7666 99911 11520........................... Greene County, Georgia............
11 0.8165 0.7666 99911
[[Page 29122]]
11530........................... Gwinnett County, Georgia.......... 0520 0.9648 0.9648 12060 11540........................... Habersham County, Georgia.........
11 0.8165 0.7666 99911 11550........................... Hall County, Georgia..............
11 0.8165 0.8883 23580 11560........................... Hancock County, Georgia...........
11 0.8165 0.7666 99911 11570........................... Haralson County, Georgia..........
11 0.8165 0.9648 12060 11580........................... Harris County, Georgia............ 1800 0.8568 0.8568 17980 11581........................... Hart County, Georgia..............
11 0.8165 0.7666 99911 11590........................... Heard County, Georgia.............
11 0.8165 0.9648 12060 11591........................... Henry County, Georgia............. 0520 0.9648 0.9648 12060 11600........................... Houston County, Georgia........... 4680 0.9286 0.8654 47580 11601........................... Irwin County, Georgia.............
11 0.8165 0.7666 99911 11610........................... Jackson County, Georgia...........
11 0.8165 0.7666 99911 11611........................... Jasper County, Georgia............
11 0.8165 0.9648 12060 11612........................... Jeff Davis County, Georgia........
11 0.8165 0.7666 99911 11620........................... Jefferson County, Georgia.........
11 0.8165 0.7666 99911 11630........................... Jenkins County, Georgia...........
11 0.8165 0.7666 99911 11640........................... Johnson County, Georgia...........
11 0.8165 0.7666 99911 11650........................... Jones County, Georgia............. 4680 0.9286 0.9453 31420 11651........................... Lamar County, Georgia.............
11 0.8165 0.9648 12060 11652........................... Lanier County, Georgia............
11 0.8165 0.8875 46660 11660........................... Laurens County, Georgia...........
11 0.8165 0.7666 99911 11670........................... Lee County, Georgia............... 0120 0.8636 0.8636 10500 11680........................... Liberty County, Georgia...........
11 0.8165 0.9178 25980 11690........................... Lincoln County, Georgia...........
11 0.8165 0.7666 99911 11691........................... Long County, Georgia..............
11 0.8165 0.9178 25980 11700........................... Lowndes County, Georgia...........
11 0.8165 0.8875 46660 11701........................... Lumpkin County, Georgia...........
11 0.8165 0.7666 99911 11702........................... Mc Duffie County, Georgia......... 0600 0.9619 0.9565 12260 11703........................... Mc Intosh County, Georgia.........
11 0.8165 0.9320 15260 11710........................... Macon County, Georgia.............
11 0.8165 0.7666 99911 11720........................... Madison County, Georgia........... 0500 0.9843 0.9843 12020 11730........................... Marion County, Georgia............
11 0.8165 0.8568 17980 11740........................... Meriwether County, Georgia........
11 0.8165 0.9648 12060 11741........................... Miller County, Georgia............
11 0.8165 0.7666 99911 11750........................... Mitchell County, Georgia..........
11 0.8165 0.7666 99911 11760........................... Monroe County, Georgia............
11 0.8165 0.9453 31420 11770........................... Montgomery County, Georgia........
11 0.8165 0.7666 99911 11771........................... Morgan County, Georgia............
11 0.8165 0.7666 99911 11772........................... Murray County, Georgia............
11 0.8165 0.9044 19140 11780........................... Muscogee County, Georgia.......... 1800 0.8568 0.8568 17980 11790........................... Newton County, Georgia............ 0520 0.9648 0.9648 12060 11800........................... Oconee County, Georgia............ 0500 0.9843 0.9843 12020 11801........................... Oglethorpe County, Georgia........
11 0.8165 0.9843 12020 11810........................... Paulding County, Georgia.......... 0520 0.9648 0.9648 12060 11811........................... Peach County, Georgia............. 4680 0.9286 0.7666 99911 11812........................... Pickens County, Georgia........... 0520 0.9648 0.9648 12060 11820........................... Pierce County, Georgia............
11 0.8165 0.7666 99911 11821........................... Pike County, Georgia..............
11 0.8165 0.9648 12060 11830........................... Polk County, Georgia..............
11 0.8165 0.7666 99911 11831........................... Pulaski County, Georgia...........
11 0.8165 0.7666 99911 11832........................... Putnam County, Georgia............
11 0.8165 0.7666 99911 11833........................... Quitman County, Georgia...........
11 0.8165 0.7666 99911 11834........................... Rabun County, Georgia.............
11 0.8165 0.7666 99911 11835........................... Randolph County, Georgia..........
11 0.8165 0.7666 99911 11840........................... Richmond County, Georgia.......... 0600 0.9619 0.9565 12260 11841........................... Rockdale County, Georgia.......... 0520 0.9648 0.9648 12060 11842........................... Schley County, Georgia............
11 0.8165 0.7666 99911 11850........................... Screven County, Georgia...........
11 0.8165 0.7666 99911 11851........................... Seminole County, Georgia..........
11 0.8165 0.7666 99911 11860........................... Spalding County, Georgia.......... 0520 0.9648 0.9648 12060 11861........................... Stephens County, Georgia..........
11 0.8165 0.7666 99911 11862........................... Stewart County, Georgia...........
11 0.8165 0.7666 99911 11870........................... Sumter County, Georgia............
11 0.8165 0.7666 99911 11880........................... Talbot County, Georgia............
11 0.8165 0.7666 99911 11881........................... Taliaferro County, Georgia........
11 0.8165 0.7666 99911 11882........................... Tattnall County, Georgia..........
11 0.8165 0.7666 99911 11883........................... Taylor County, Georgia............
11 0.8165 0.7666 99911 11884........................... Telfair County, Georgia...........
11 0.8165 0.7666 99911 11885........................... Terrell County, Georgia...........
11 0.8165 0.8636 10500
[[Page 29123]]
11890........................... Thomas County, Georgia............
11 0.8165 0.7666 99911 11900........................... Tift County, Georgia..............
11 0.8165 0.7666 99911 11901........................... Toombs County, Georgia............
11 0.8165 0.7666 99911 11902........................... Towns County, Georgia.............
11 0.8165 0.7666 99911 11903........................... Treutlen County, Georgia..........
11 0.8165 0.7666 99911 11910........................... Troup County, Georgia.............
11 0.8165 0.7666 99911 11911........................... Turner County, Georgia............
11 0.8165 0.7666 99911 11912........................... Twiggs County, Georgia............ 4680 0.9286 0.9453 31420 11913........................... Union County, Georgia.............
11 0.8165 0.7666 99911 11920........................... Upson County, Georgia.............
11 0.8165 0.7666 99911 11921........................... Walker County, Georgia............ 1560 0.9098 0.9098 16860 11930........................... Walton County, Georgia............ 0520 0.9648 0.9648 12060 11940........................... Ware County, Georgia..............
11 0.8165 0.7666 99911 11941........................... Warren County, Georgia............
11 0.8165 0.7666 99911 11950........................... Washington County, Georgia........
11 0.8165 0.7666 99911 11960........................... Wayne County, Georgia.............
11 0.8165 0.7666 99911 11961........................... Webster County, Georgia...........
11 0.8165 0.7666 99911 11962........................... Wheeler County, Georgia...........
11 0.8165 0.7666 99911 11963........................... White County, Georgia.............
11 0.8165 0.7666 99911 11970........................... Whitfield County, Georgia.........
11 0.8165 0.9044 19140 11971........................... Wilcox County, Georgia............
11 0.8165 0.7666 99911 11972........................... Wilkes County, Georgia............
11 0.8165 0.7666 99911 11973........................... Wilkinson County, Georgia.........
11 0.8165 0.7666 99911 11980........................... Worth County, Georgia.............
11 0.8165 0.8636 10500 12005........................... Kalawao County, Hawaii............
12 1.0562 1.0562 99912 12010........................... Hawaii County, Hawaii.............
12 1.0562 1.0562 99912 12020........................... Honolulu County, Hawaii........... 3320 1.1208 1.1208 26180 12040........................... Kauai County, Hawaii..............
12 1.0562 1.0562 99912 12050........................... Maui County, Hawaii...............
12 1.0562 1.0562 99912 13000........................... Ada County, Idaho................. 1080 0.9061 0.9061 14260 13010........................... Adams County, Idaho...............
13 0.9106 0.8045 99913 13020........................... Bannock County, Idaho............. 6340 0.9360 0.9360 38540 13030........................... Bear Lake County, Idaho...........
13 0.9106 0.8045 99913 13040........................... Benewah County, Idaho.............
13 0.9106 0.8045 99913 13050........................... Bingham County, Idaho.............
13 0.9106 0.8045 99913 13060........................... Blaine County, Idaho..............
13 0.9106 0.8045 99913 13070........................... Boise County, Idaho...............
13 0.9106 0.9061 14260 13080........................... Bonner County, Idaho..............
13 0.9106 0.8045 99913 13090........................... Bonneville County, Idaho..........
13 0.9106 0.9429 26820 13100........................... Boundary County, Idaho............
13 0.9106 0.8045 99913 13110........................... Butte County, Idaho...............
13 0.9106 0.8045 99913 13120........................... Camas County, Idaho...............
13 0.9106 0.8045 99913 13130........................... Canyon County, Idaho.............. 1080 0.9061 0.9061 14260 13140........................... Caribou County, Idaho.............
13 0.9106 0.8045 99913 13150........................... Cassia County, Idaho..............
13 0.9106 0.8045 99913 13160........................... Clark County, Idaho...............
13 0.9106 0.8045 99913 13170........................... Clearwater County, Idaho..........
13 0.9106 0.8045 99913 13180........................... Custer County, Idaho..............
13 0.9106 0.8045 99913 13190........................... Elmore County, Idaho..............
13 0.9106 0.8045 99913 13200........................... Franklin County, Idaho............
13 0.9106 0.9173 30860 13210........................... Fremont County, Idaho.............
13 0.9106 0.8045 99913 13220........................... Gem County, Idaho.................
13 0.9106 0.9061 14260 13230........................... Gooding County, Idaho.............
13 0.9106 0.8045 99913 13240........................... Idaho County, Idaho...............
13 0.9106 0.8045 99913 13250........................... Jefferson County, Idaho...........
13 0.9106 0.9429 26820 13260........................... Jerome County, Idaho..............
13 0.9106 0.8045 99913 13270........................... Kootenai County, Idaho............
13 0.9106 0.9657 17660 13280........................... Latah County, Idaho...............
13 0.9106 0.8045 99913 13290........................... Lemhi County, Idaho...............
13 0.9106 0.8045 99913 13300........................... Lewis County, Idaho...............
13 0.9106 0.8045 99913 13310........................... Lincoln County, Idaho.............
13 0.9106 0.8045 99913 13320........................... Madison County, Idaho.............
13 0.9106 0.8045 99913 13330........................... Minidoka County, Idaho............
13 0.9106 0.8045 99913 13340........................... Nez Perce County, Idaho...........
13 0.9106 0.9896 30300 13350........................... Oneida County, Idaho..............
13 0.9106 0.8045 99913 13360........................... Owyhee County, Idaho..............
13 0.9106 0.9061 14260 13370........................... Payette County, Idaho.............
13 0.9106 0.8045 99913 13380........................... Power County, Idaho...............
13 0.9106 0.9360 38540 13390........................... Shoshone County, Idaho............
13 0.9106 0.8045 99913
[[Page 29124]]
13390........................... Teton County, Idaho...............
13 0.9106 0.8045 99913 13410........................... Twin Falls County, Idaho..........
13 0.9106 0.8045 99913 13420........................... Valley County, Idaho..............
13 0.9106 0.8045 99913 13430........................... Washington County, Idaho..........
13 0.9106 0.8045 99913 14000........................... Adams County, Illinois............
14 0.8309 0.8279 99914 14010........................... Alexander County, Illinois........
14 0.8309 0.8279 99914 14020........................... Bond County, Illinois.............
14 0.8309 0.8949 41180 14030........................... Boone County, Illinois............ 6880 0.9994 0.9994 40420 14040........................... Brown County, Illinois............
14 0.8309 0.8279 99914 14050........................... Bureau County, Illinois...........
14 0.8309 0.8279 99914 14060........................... Calhoun County, Illinois..........
14 0.8309 0.8949 41180 14070........................... Carroll County, Illinois..........
14 0.8309 0.8279 99914 14080........................... Cass County, Illinois.............
14 0.8309 0.8279 99914 14090........................... Champaign County, Illinois........ 1400 0.9604 0.9604 16580 14100........................... Christian County, Illinois........
14 0.8309 0.8279 99914 14110........................... Clark County, Illinois............
14 0.8309 0.8279 99914 14120........................... Clay County, Illinois.............
14 0.8309 0.8279 99914 14130........................... Clinton County, Illinois.......... 7040 0.8957 0.8949 41180 14140........................... Coles County, Illinois............
14 0.8309 0.8279 99914 14141........................... Cook County, Illinois............. 1600 1.0838 1.0848 16974 14150........................... Crawford County, Illinois.........
14 0.8309 0.8279 99914 14160........................... Cumberland County, Illinois.......
14 0.8309 0.8279 99914 14170........................... De Kalb County, Illinois.......... 1600 1.0838 1.0848 16974 14180........................... De Witt County, Illinois..........
14 0.8309 0.8279 99914 14190........................... Douglas County, Illinois..........
14 0.8309 0.8279 99914 14250........................... Du Page County, Illinois.......... 1600 1.0838 1.0848 16974 14310........................... Edgar County, Illinois............
14 0.8309 0.8279 99914 14320........................... Edwards County, Illinois..........
14 0.8309 0.8279 99914 14330........................... Effingham County, Illinois........
14 0.8309 0.8279 99914 14340........................... Fayette County, Illinois..........
14 0.8309 0.8279 99914 14350........................... Ford County, Illinois.............
14 0.8309 0.9604 16580 14360........................... Franklin County, Illinois.........
14 0.8309 0.8279 99914 14370........................... Fulton County, Illinois...........
14 0.8309 0.8279 99914 14380........................... Gallatin County, Illinois.........
14 0.8309 0.8279 99914 14390........................... Greene County, Illinois...........
14 0.8309 0.8279 99914 14400........................... Grundy County, Illinois........... 1600 1.0838 1.0848 16974 14410........................... Hamilton County, Illinois.........
14 0.8309 0.8279 99914 14420........................... Hancock County, Illinois..........
14 0.8309 0.8279 99914 14421........................... Hardin County, Illinois...........
14 0.8309 0.8279 99914 14440........................... Henderson County, Illinois........
14 0.8309 0.8279 99914 14450........................... Henry County, Illinois............ 1960 0.8731 0.8731 19340 14460........................... Iroquois County, Illinois.........
14 0.8309 0.8279 99914 14470........................... Jackson County, Illinois..........
14 0.8309 0.8279 99914 14480........................... Jasper County, Illinois...........
14 0.8309 0.8279 99914 14490........................... Jefferson County, Illinois........
14 0.8309 0.8279 99914 14500........................... Jersey County, Illinois........... 7040 0.8957 0.8949 41180 14510........................... Jo Daviess County, Illinois.......
14 0.8309 0.8279 99914 14520........................... Johnson County, Illinois..........
14 0.8309 0.8279 99914 14530........................... Kane County, Illinois............. 1600 1.0838 1.0848 16974 14540........................... Kankakee County, Illinois......... 3740 1.0974 1.0974 28100 14550........................... Kendall County, Illinois.......... 1600 1.0838 1.0848 16974 14560........................... Knox County, Illinois.............
14 0.8309 0.8279 99914 14570........................... Lake County, Illinois............. 1600 1.0838 1.0440 29404 14580........................... La Salle County, Illinois.........
14 0.8309 0.8279 99914 14590........................... Lawrence County, Illinois.........
14 0.8309 0.8279 99914 14600........................... Lee County, Illinois..............
14 0.8309 0.8279 99914 14610........................... Livingston County, Illinois.......
14 0.8309 0.8279 99914 14620........................... Logan County, Illinois............
14 0.8309 0.8279 99914 14630........................... Mc Donough County, Illinois.......
14 0.8309 0.8279 99914 14640........................... Mc Henry County, Illinois......... 1600 1.0838 1.0848 16974 14650........................... Mclean County, Illinois........... 1040 0.9084 0.9084 14060 14660........................... Macon County, Illinois............ 2040 0.8076 0.8076 19500 14670........................... Macoupin County, Illinois.........
14 0.8309 0.8949 41180 14680........................... Madison County, Illinois.......... 7040 0.8957 0.8949 41180 14690........................... Marion County, Illinois...........
14 0.8309 0.8279 99914 14700........................... Marshall County, Illinois.........
14 0.8309 0.8868 37900 14710........................... Mason County, Illinois............
14 0.8309 0.8279 99914 14720........................... Massac County, Illinois...........
14 0.8309 0.8279 99914 14730........................... Menard County, Illinois........... 7880 0.8885 0.8885 44100
[[Page 29125]]
14740........................... Mercer County, Illinois...........
14 0.8309 0.8731 19340 14750........................... Monroe County, Illinois........... 7040 0.8957 0.8949 41180 14760........................... Montgomery County, Illinois.......
14 0.8309 0.8279 99914 14770........................... Morgan County, Illinois...........
14 0.8309 0.8279 99914 14780........................... Moultrie County, Illinois.........
14 0.8309 0.8279 99914 14790........................... Ogle County, Illinois............. 6880 0.9994 0.8279 99914 14800........................... Peoria County, Illinois........... 6120 0.8868 0.8868 37900 14810........................... Perry County, Illinois............
14 0.8309 0.8279 99914 14820........................... Piatt County, Illinois............
14 0.8309 0.9604 16580 14830........................... Pike County, Illinois.............
14 0.8309 0.8279 99914 14831........................... Pope County, Illinois.............
14 0.8309 0.8279 99914 14850........................... Pulaski County, Illinois..........
14 0.8309 0.8279 99914 14860........................... Putnam County, Illinois...........
14 0.8309 0.8279 99914 14870........................... Randolph County, Illinois.........
14 0.8309 0.8279 99914 14880........................... Richland County, Illinois.........
14 0.8309 0.8279 99914 14890........................... Rock Island County, Illinois...... 1960 0.8731 0.8731 19340 14900........................... St Clair County, Illinois......... 7040 0.8957 0.8949 41180 14910........................... Saline County, Illinois...........
14 0.8309 0.8279 99914 14920........................... Sangamon County, Illinois......... 7880 0.8885 0.8885 44100 14921........................... Schuyler County, Illinois.........
14 0.8309 0.8279 99914 14940........................... Scott County, Illinois............
14 0.8309 0.8279 99914 14950........................... Shelby County, Illinois...........
14 0.8309 0.8279 99914 14960........................... Stark County, Illinois............
14 0.8309 0.8868 37900 14970........................... Stephenson County, Illinois.......
14 0.8309 0.8279 99914 14980........................... Tazewell County, Illinois......... 6120 0.8868 0.8868 37900 14981........................... Union County, Illinois............
14 0.8309 0.8279 99914 14982........................... Vermilion County, Illinois........
14 0.8309 0.9037 19180 14983........................... Wabash County, Illinois...........
14 0.8309 0.8279 99914 14984........................... Warren County, Illinois...........
14 0.8309 0.8279 99914 14985........................... Washington County, Illinois.......
14 0.8309 0.8279 99914 14986........................... Wayne County, Illinois............
14 0.8309 0.8279 99914 14987........................... White County, Illinois............
14 0.8309 0.8279 99914 14988........................... Whiteside County, Illinois........
14 0.8309 0.8279 99914 14989........................... Will County, Illinois............. 1600 1.0838 1.0848 16974 14990........................... Williamson County, Illinois.......
14 0.8309 0.8279 99914 14991........................... Winnebago County, Illinois........ 6880 0.9994 0.9994 40420 14992........................... Woodford County, Illinois......... 6120 0.8868 0.8868 37900 15000........................... Adams County, Indiana............. 2760 0.9716 0.8630 99915 15010........................... Allen County, Indiana............. 2760 0.9716 0.9803 23060 15020........................... Bartholomew County, Indiana.......
15 0.8727 0.9598 18020 15030........................... Benton County, Indiana............
15 0.8727 0.8745 29140 15040........................... Blackford County, Indiana.........
15 0.8727 0.8630 99915 15050........................... Boone County, Indiana............. 3480 0.9875 0.9930 26900 15060........................... Brown County, Indiana.............
15 0.8727 0.9930 26900 15070........................... Carroll County, Indiana...........
15 0.8727 0.8745 29140 15080........................... Cass County, Indiana..............
15 0.8727 0.8630 99915 15090........................... Clark County, Indiana............. 4520 0.9302 0.9261 31140 15100........................... Clay County, Indiana.............. 8320 0.8345 0.8313 45460 15110........................... Clinton County, Indiana........... 3920 0.8745 0.8630 99915 15120........................... Crawford County, Indiana..........
15 0.8727 0.8630 99915 15130........................... Daviess County, Indiana...........
15 0.8727 0.8630 99915 15140........................... Dearborn County, Indiana.......... 1640 0.9742 0.9623 17140 15150........................... Decatur County, Indiana...........
15 0.8727 0.8630 99915 15160........................... De Kalb County, Indiana........... 2760 0.9716 0.8630 99915 15170........................... Delaware County, Indiana.......... 5280 0.8939 0.8939 34620 15180........................... Dubois County, Indiana............
15 0.8727 0.8630 99915 15190........................... Elkhart County, Indiana........... 2330 0.9637 0.9637 21140 15200........................... Fayette County, Indiana...........
15 0.8727 0.8630 99915 15210........................... Floyd County, Indiana............. 4520 0.9302 0.9261 31140 15220........................... Fountain County, Indiana..........
15 0.8727 0.8630 99915 15230........................... Franklin County, Indiana..........
15 0.8727 0.9623 17140 15240........................... Fulton County, Indiana............
15 0.8727 0.8630 99915 15250........................... Gibson County, Indiana............
15 0.8727 0.8721 21780 15260........................... Grant County, Indiana.............
15 0.8727 0.8630 99915 15270........................... Greene County, Indiana............
15 0.8727 0.8456 14020 15280........................... Hamilton County, Indiana.......... 3480 0.9875 0.9930 26900 15290........................... Hancock County, Indiana........... 3480 0.9875 0.9930 26900 15300........................... Harrison County, Indiana.......... 4520 0.9302 0.9261 31140 15310........................... Hendricks County, Indiana......... 3480 0.9875 0.9930 26900
[[Page 29126]]
15320........................... Henry County, Indiana.............
15 0.8727 0.8630 99915 15330........................... Howard County, Indiana............ 3850 0.9517 0.9517 29020 15340........................... Huntington County, Indiana........ 2760 0.9716 0.8630 99915 15350........................... Jackson County, Indiana...........
15 0.8727 0.8630 99915 15360........................... Jasper County, Indiana............
15 0.8727 0.9369 23844 15370........................... Jay County, Indiana...............
15 0.8727 0.8630 99915 15380........................... Jefferson County, Indiana.........
15 0.8727 0.8630 99915 15390........................... Jennings County, Indiana..........
15 0.8727 0.8630 99915 15400........................... Johnson County, Indiana........... 3480 0.9875 0.9930 26900 15410........................... Knox County, Indiana..............
15 0.8727 0.8630 99915 15420........................... Kosciusko County, Indiana.........
15 0.8727 0.8630 99915 15430........................... Lagrange County, Indiana..........
15 0.8727 0.8630 99915 15440........................... Lake County, Indiana.............. 2960 0.9404 0.9369 23844 15450........................... La Porte County, Indiana..........
15 0.8727 0.9409 33140 15460........................... Lawrence County, Indiana..........
15 0.8727 0.8630 99915 15470........................... Madison County, Indiana........... 3480 0.9875 0.8595 11300 15480........................... Marion County, Indiana............ 3480 0.9875 0.9930 26900 15490........................... Marshall County, Indiana..........
15 0.8727 0.8630 99915 15500........................... Martin County, Indiana............
15 0.8727 0.8630 99915 15510........................... Miami County, Indiana.............
15 0.8727 0.8630 99915 15520........................... Monroe County, Indiana............ 1020 0.8456 0.8456 14020 15530........................... Montgomery County, Indiana........
15 0.8727 0.8630 99915 15540........................... Morgan County, Indiana............ 3480 0.9875 0.9930 26900 15550........................... Newton County, Indiana............
15 0.8727 0.9369 23844 15560........................... Noble County, Indiana.............
15 0.8727 0.8630 99915 15570........................... Ohio County, Indiana.............. 1640 0.9742 0.9623 17140 15580........................... Orange County, Indiana............
15 0.8727 0.8630 99915 15590........................... Owen County, Indiana..............
15 0.8727 0.8456 14020 15600........................... Parke County, Indiana.............
15 0.8727 0.8630 99915 15610........................... Perry County, Indiana.............
15 0.8727 0.8630 99915 15620........................... Pike County, Indiana..............
15 0.8727 0.8630 99915 15630........................... Porter County, Indiana............ 2960 0.9404 0.9369 23844 15640........................... Posey County, Indiana............. 2440 0.8721 0.8721 21780 15650........................... Pulaski County, Indiana...........
15 0.8727 0.8630 99915 15660........................... Putnam County, Indiana............
15 0.8727 0.9930 26900 15670........................... Randolph County, Indiana..........
15 0.8727 0.8630 99915 15680........................... Ripley County, Indiana............
15 0.8727 0.8630 99915 15690........................... Rush County, Indiana..............
15 0.8727 0.8630 99915 15700........................... St Joseph County, Indiana......... 7800 0.9798 0.9798 43780 15710........................... Scott County, Indiana............. 4520 0.9302 0.8630 99915 15720........................... Shelby County, Indiana............ 3480 0.9875 0.9930 26900 15730........................... Spencer County, Indiana...........
15 0.8727 0.8630 99915 15740........................... Starke County, Indiana............
15 0.8727 0.8630 99915 15750........................... Steuben County, Indiana...........
15 0.8727 0.8630 99915 15760........................... Sullivan County, Indiana..........
15 0.8727 0.8313 45460 15770........................... Switzerland County, Indiana.......
15 0.8727 0.8630 99915 15780........................... Tippecanoe County, Indiana........ 3920 0.8745 0.8745 29140 15790........................... Tipton County, Indiana............ 3850 0.9517 0.9517 29020 15800........................... Union County, Indiana.............
15 0.8727 0.8630 99915 15810........................... Vanderburgh County, Indiana....... 2440 0.8721 0.8721 21780 15820........................... Vermillion County, Indiana........ 8320 0.8345 0.8313 45460 15830........................... Vigo County, Indiana.............. 8320 0.8345 0.8313 45460 15840........................... Wabash County, Indiana............
15 0.8727 0.8630 99915 15840........................... Warren County, Indiana............
15 0.8727 0.8630 99915 15860........................... Warrick County, Indiana........... 2440 0.8721 0.8721 21780 15870........................... Washington County, Indiana........
15 0.8727 0.9261 31140 15880........................... Wayne County, Indiana.............
15 0.8727 0.8630 99915 15890........................... Wells County, Indiana............. 2760 0.9716 0.9803 23060 15900........................... White County, Indiana.............
15 0.8727 0.8630 99915 15910........................... Whitley County, Indiana........... 2760 0.9716 0.9803 23060 16000........................... Adair County, Iowa................
16 0.8588 0.8502 99916 16010........................... Adams County, Iowa................
16 0.8588 0.8502 99916 16020........................... Allamakee County, Iowa............
16 0.8588 0.8502 99916 16030........................... Appanoose County, Iowa............
16 0.8588 0.8502 99916 16040........................... Audubon County, Iowa..............
16 0.8588 0.8502 99916 16050........................... Benton County, Iowa...............
16 0.8588 0.8617 16300 16060........................... Black Hawk County, Iowa........... 8920 0.8566 0.8566 47940 16070........................... Boone County, Iowa................
16 0.8588 0.8502 99916 16080........................... Bremer County, Iowa...............
16 0.8588 0.8566 47940
[[Page 29127]]
16090........................... Buchanan County, Iowa.............
16 0.8588 0.8502 99916 16100........................... Buena Vista County, Iowa..........
16 0.8588 0.8502 99916 16110........................... Butler County, Iowa...............
16 0.8588 0.8502 99916 16120........................... Calhoun County, Iowa..............
16 0.8588 0.8502 99916 16130........................... Carroll County, Iowa..............
16 0.8588 0.8502 99916 16140........................... Cass County, Iowa.................
16 0.8588 0.8502 99916 16150........................... Cedar County, Iowa................
16 0.8588 0.8502 99916 16160........................... Cerro Gordo County, Iowa..........
16 0.8588 0.8502 99916 16170........................... Cherokee County, Iowa.............
16 0.8588 0.8502 99916 16180........................... Chickasaw County, Iowa............
16 0.8588 0.8502 99916 16190........................... Clarke County, Iowa...............
16 0.8588 0.8502 99916 16200........................... Clay County, Iowa.................
16 0.8588 0.8502 99916 16210........................... Clayton County, Iowa..............
16 0.8588 0.8502 99916 16220........................... Clinton County, Iowa..............
16 0.8588 0.8502 99916 16230........................... Crawford County, Iowa.............
16 0.8588 0.8502 99916 16240........................... Dallas County, Iowa............... 2120 0.9651 0.9651 19780 16250........................... Davis County, Iowa................
16 0.8588 0.8502 99916 16260........................... Decatur County, Iowa..............
16 0.8588 0.8502 99916 16270........................... Delaware County, Iowa.............
16 0.8588 0.8502 99916 16280........................... Des Moines County, Iowa...........
16 0.8588 0.8502 99916 16290........................... Dickinson County, Iowa............
16 0.8588 0.8502 99916 16300........................... Dubuque County, Iowa.............. 2200 0.9135 0.9135 20220 16310........................... Emmet County, Iowa................
16 0.8588 0.8502 99916 16320........................... Fayette County, Iowa..............
16 0.8588 0.8502 99916 16330........................... Floyd County, Iowa................
16 0.8588 0.8502 99916 16340........................... Franklin County, Iowa.............
16 0.8588 0.8502 99916 16350........................... Fremont County, Iowa..............
16 0.8588 0.8502 99916 16360........................... Greene County, Iowa...............
16 0.8588 0.8502 99916 16370........................... Grundy County, Iowa...............
16 0.8588 0.8566 47940 16380........................... Guthrie County, Iowa..............
16 0.8588 0.9651 19780 16390........................... Hamilton County, Iowa.............
16 0.8588 0.8502 99916 16400........................... Hancock County, Iowa..............
16 0.8588 0.8502 99916 16410........................... Hardin County, Iowa...............
16 0.8588 0.8502 99916 16420........................... Harrison County, Iowa.............
16 0.8588 0.9569 36540 16430........................... Henry County, Iowa................
16 0.8588 0.8502 99916 16440........................... Howard County, Iowa...............
16 0.8588 0.8502 99916 16450........................... Humboldt County, Iowa.............
16 0.8588 0.8502 99916 16460........................... Ida County, Iowa..................
16 0.8588 0.8502 99916 16470........................... Iowa County, Iowa.................
16 0.8588 0.8502 99916 16480........................... Jackson County, Iowa..............
16 0.8588 0.8502 99916 16490........................... Jasper County, Iowa...............
16 0.8588 0.8502 99916 16500........................... Jefferson County, Iowa............
16 0.8588 0.8502 99916 16510........................... Johnson County, Iowa.............. 3500 0.9756 0.9756 26980 16520........................... Jones County, Iowa................
16 0.8588 0.8617 16300 16530........................... Keokuk County, Iowa...............
16 0.8588 0.8502 99916 16540........................... Kossuth County, Iowa..............
16 0.8588 0.8502 99916 16550........................... Lee County, Iowa..................
16 0.8588 0.8502 99916 16560........................... Linn County, Iowa................. 1360 0.8617 0.8617 16300 16570........................... Louisa County, Iowa...............
16 0.8588 0.8502 99916 16580........................... Lucas County, Iowa................
16 0.8588 0.8502 99916 16590........................... Lyon County, Iowa.................
16 0.8588 0.8502 99916 16600........................... Madison County, Iowa..............
16 0.8588 0.9651 19780 16610........................... Mahaska County, Iowa..............
16 0.8588 0.8502 99916 16620........................... Marion County, Iowa...............
16 0.8588 0.8502 99916 16630........................... Marshall County, Iowa.............
16 0.8588 0.8502 99916 16640........................... Mills County, Iowa................
16 0.8588 0.9569 36540 16650........................... Mitchell County, Iowa.............
16 0.8588 0.8502 99916 16660........................... Monona County, Iowa...............
16 0.8588 0.8502 99916 16670........................... Monroe County, Iowa...............
16 0.8588 0.8502 99916 16680........................... Montgomery County, Iowa...........
16 0.8588 0.8502 99916 16690........................... Muscatine County, Iowa............
16 0.8588 0.8502 99916 16700........................... OBrien County, Iowa...............
16 0.8588 0.8502 99916 16710........................... Osceola County, Iowa..............
16 0.8588 0.8502 99916 16720........................... Page County, Iowa.................
16 0.8588 0.8502 99916 16730........................... Palo Alto County, Iowa............
16 0.8588 0.8502 99916 16740........................... Plymouth County, Iowa.............
16 0.8588 0.8502 99916 16750........................... Pocahontas County, Iowa...........
16 0.8588 0.8502 99916 16760........................... Polk County, Iowa................. 2120 0.9651 0.9651 19780 16770........................... Pottawattamie County, Iowa........ 5920 0.9569 0.9569 36540
[[Page 29128]]
16780........................... Poweshiek County, Iowa............
16 0.8588 0.8502 99916 16790........................... Ringgold County, Iowa.............
16 0.8588 0.8502 99916 16800........................... Sac County, Iowa..................
16 0.8588 0.8502 99916 16810........................... Scott County, Iowa................ 1960 0.8731 0.8731 19340 16820........................... Shelby County, Iowa...............
16 0.8588 0.8502 99916 16830........................... Sioux County, Iowa................
16 0.8588 0.8502 99916 16840........................... Story County, Iowa................
16 0.8588 0.9545 11180 16850........................... Tama County, Iowa.................
16 0.8588 0.8502 99916 16860........................... Taylor County, Iowa...............
16 0.8588 0.8502 99916 16870........................... Union County, Iowa................
16 0.8588 0.8502 99916 16880........................... Van Buren County, Iowa............
16 0.8588 0.8502 99916 16890........................... Wapello County, Iowa..............
16 0.8588 0.8502 99916 16900........................... Warren County, Iowa............... 2120 0.9651 0.9651 19780 16910........................... Washington County, Iowa...........
16 0.8588 0.9756 26980 16920........................... Wayne County, Iowa................
16 0.8588 0.8502 99916 16930........................... Webster County, Iowa..............
16 0.8588 0.8502 99916 16940........................... Winnebago County, Iowa............
16 0.8588 0.8502 99916 16950........................... Winneshiek County, Iowa...........
16 0.8588 0.8502 99916 16960........................... Woodbury County, Iowa............. 7720 0.9411 0.9376 43580 16970........................... Worth County, Iowa................
16 0.8588 0.8502 99916 16980........................... Wright County, Iowa...............
16 0.8588 0.8502 99916 17000........................... Allen County, Kansas..............
17 0.7994 0.7987 99917 17010........................... Anderson County, Kansas...........
17 0.7994 0.7987 99917 17020........................... Atchison County, Kansas...........
17 0.7994 0.7987 99917 17030........................... Barber County, Kansas.............
17 0.7994 0.7987 99917 17040........................... Barton County, Kansas.............
17 0.7994 0.7987 99917 17050........................... Bourbon County, Kansas............
17 0.7994 0.7987 99917 17060........................... Brown County, Kansas..............
17 0.7994 0.7987 99917 17070........................... Butler County, Kansas............. 9040 0.9163 0.9141 48620 17080........................... Chase County, Kansas..............
17 0.7994 0.7987 99917 17090........................... Chautauqua County, Kansas.........
17 0.7994 0.7987 99917 17100........................... Cherokee County, Kansas...........
17 0.7994 0.7987 99917 17110........................... Cheyenne County, Kansas...........
17 0.7994 0.7987 99917 17120........................... Clark County, Kansas..............
17 0.7994 0.7987 99917 17130........................... Clay County, Kansas...............
17 0.7994 0.7987 99917 17140........................... Cloud County, Kansas..............
17 0.7994 0.7987 99917 17150........................... Coffey County, Kansas.............
17 0.7994 0.7987 99917 17160........................... Comanche County, Kansas...........
17 0.7994 0.7987 99917 17170........................... Cowley County, Kansas.............
17 0.7994 0.7987 99917 17180........................... Crawford County, Kansas...........
17 0.7994 0.7987 99917 17190........................... Decatur County, Kansas............
17 0.7994 0.7987 99917 17200........................... Dickinson County, Kansas..........
17 0.7994 0.7987 99917 17210........................... Doniphan County, Kansas...........
17 0.7994 0.9529 41140 17220........................... Douglas County, Kansas............ 4150 0.8546 0.8546 29940 17230........................... Edwards County, Kansas............
17 0.7994 0.7987 99917 17240........................... Elk County, Kansas................
17 0.7994 0.7987 99917 17250........................... Ellis County, Kansas..............
17 0.7994 0.7987 99917 17260........................... Ellsworth County, Kansas..........
17 0.7994 0.7987 99917 17270........................... Finney County, Kansas.............
17 0.7994 0.7987 99917 17280........................... Ford County, Kansas...............
17 0.7994 0.7987 99917 17290........................... Franklin County, Kansas...........
17 0.7994 0.9467 28140 17300........................... Geary County, Kansas..............
17 0.7994 0.7987 99917 17310........................... Gove County, Kansas...............
17 0.7994 0.7987 99917 17320........................... Graham County, Kansas.............
17 0.7994 0.7987 99917 17330........................... Grant County, Kansas..............
17 0.7994 0.7987 99917 17340........................... Gray County, Kansas...............
17 0.7994 0.7987 99917 17350........................... Greeley County, Kansas............
17 0.7994 0.7987 99917 17360........................... Greenwood County, Kansas..........
17 0.7994 0.7987 99917 17370........................... Hamilton County, Kansas...........
17 0.7994 0.7987 99917 17380........................... Harper County, Kansas.............
17 0.7994 0.7987 99917 17390........................... Harvey County, Kansas............. 9040 0.9163 0.9141 48620 17391........................... Haskell County, Kansas............
17 0.7994 0.7987 99917 17410........................... Hodgeman County, Kansas...........
17 0.7994 0.7987 99917 17420........................... Jackson County, Kansas............
17 0.7994 0.8929 45820 17430........................... Jefferson County, Kansas..........
17 0.7994 0.8929 45820 17440........................... Jewell County, Kansas.............
17 0.7994 0.7987 99917 17450........................... Johnson County, Kansas............ 3760 0.9481 0.9467 28140 17451........................... Kearny County, Kansas.............
17 0.7994 0.7987 99917 17470........................... Kingman County, Kansas............
17 0.7994 0.7987 99917
[[Page 29129]]
17480........................... Kiowa County, Kansas..............
17 0.7994 0.7987 99917 17490........................... Labette County, Kansas............
17 0.7994 0.7987 99917 17500........................... Lane County, Kansas...............
17 0.7994 0.7987 99917 17510........................... Leavenworth County, Kansas........ 3760 0.9481 0.9467 28140 17520........................... Lincoln County, Kansas............
17 0.7994 0.7987 99917 17530........................... Linn County, Kansas...............
17 0.7994 0.9467 28140 17540........................... Logan County, Kansas..............
17 0.7994 0.7987 99917 17550........................... Lyon County, Kansas...............
17 0.7994 0.7987 99917 17560........................... Mc Pherson County, Kansas.........
17 0.7994 0.7987 99917 17570........................... Marion County, Kansas.............
17 0.7994 0.7987 99917 17580........................... Marshall County, Kansas...........
17 0.7994 0.7987 99917 17590........................... Meade County, Kansas..............
17 0.7994 0.7987 99917 17600........................... Miami County, Kansas.............. 3760 0.9481 0.9467 28140 17610........................... Mitchell County, Kansas...........
17 0.7994 0.7987 99917 17620........................... Montgomery County, Kansas.........
17 0.7994 0.7987 99917 17630........................... Morris County, Kansas.............
17 0.7994 0.7987 99917 17640........................... Morton County, Kansas.............
17 0.7994 0.7987 99917 17650........................... Nemaha County, Kansas.............
17 0.7994 0.7987 99917 17660........................... Neosho County, Kansas.............
17 0.7994 0.7987 99917 17670........................... Ness County, Kansas...............
17 0.7994 0.7987 99917 17680........................... Norton County, Kansas.............
17 0.7994 0.7987 99917 17690........................... Osage County, Kansas..............
17 0.7994 0.8929 45820 17700........................... Osborne County, Kansas............
17 0.7994 0.7987 99917 17710........................... Ottawa County, Kansas.............
17 0.7994 0.7987 99917 17720........................... Pawnee County, Kansas.............
17 0.7994 0.7987 99917 17730........................... Phillips County, Kansas...........
17 0.7994 0.7987 99917 17740........................... Pottawatomie County, Kansas.......
17 0.7994 0.7987 99917 17750........................... Pratt County, Kansas..............
17 0.7994 0.7987 99917 17760........................... Rawlins County, Kansas............
17 0.7994 0.7987 99917 17770........................... Reno County, Kansas...............
17 0.7994 0.7987 99917 17780........................... Republic County, Kansas...........
17 0.7994 0.7987 99917 17790........................... Rice County, Kansas...............
17 0.7994 0.7987 99917 17800........................... Riley County, Kansas..............
17 0.7994 0.7987 99917 17810........................... Rooks County, Kansas..............
17 0.7994 0.7987 99917 17820........................... Rush County, Kansas...............
17 0.7994 0.7987 99917 17830........................... Russell County, Kansas............
17 0.7994 0.7987 99917 17840........................... Saline County, Kansas.............
17 0.7994 0.7987 99917 17841........................... Scott County, Kansas..............
17 0.7994 0.7987 99917 17860........................... Sedgwick County, Kansas........... 9040 0.9163 0.9141 48620 17870........................... Seward County, Kansas.............
17 0.7994 0.7987 99917 17880........................... Shawnee County, Kansas............ 8440 0.8929 0.8929 45820 17890........................... Sheridan County, Kansas...........
17 0.7994 0.7987 99917 17900........................... Sherman County, Kansas............
17 0.7994 0.7987 99917 17910........................... Smith County, Kansas..............
17 0.7994 0.7987 99917 17920........................... Stafford County, Kansas...........
17 0.7994 0.7987 99917 17921........................... Stanton County, Kansas............
17 0.7994 0.7987 99917 17940........................... Stevens County, Kansas............
17 0.7994 0.7987 99917 17950........................... Sumner County, Kansas.............
17 0.7994 0.9141 48620 17960........................... Thomas County, Kansas.............
17 0.7994 0.7987 99917 17970........................... Trego County, Kansas..............
17 0.7994 0.7987 99917 17980........................... Wabaunsee County, Kansas..........
17 0.7994 0.8929 45820 17981........................... Wallace County, Kansas............
17 0.7994 0.7987 99917 17982........................... Washington County, Kansas.........
17 0.7994 0.7987 99917 17983........................... Wichita County, Kansas............
17 0.7994 0.7987 99917 17984........................... Wilson County, Kansas.............
17 0.7994 0.7987 99917 17985........................... Woodson County, Kansas............
17 0.7994 0.7987 99917 17986........................... Wyandotte County, Kansas.......... 3760 0.9481 0.9467 28140 18000........................... Adair County, Kentucky............
18 0.7866 0.7774 99918 18010........................... Allen County, Kentucky............
18 0.7866 0.7774 99918 18020........................... Anderson County, Kentucky.........
18 0.7866 0.7774 99918 18030........................... Ballard County, Kentucky..........
18 0.7866 0.7774 99918 18040........................... Barren County, Kentucky...........
18 0.7866 0.7774 99918 18050........................... Bath County, Kentucky.............
18 0.7866 0.7774 99918 18060........................... Bell County, Kentucky.............
18 0.7866 0.7774 99918 18070........................... Boone County, Kentucky............ 1640 0.9742 0.9623 17140 18080........................... Bourbon County, Kentucky.......... 4280 0.8997 0.9084 30460 18090........................... Boyd County, Kentucky............. 3400 0.9486 0.9486 26580 18100........................... Boyle County, Kentucky............
18 0.7866 0.7774 99918 18110........................... Bracken County, Kentucky..........
18 0.7866 0.9623 17140
[[Page 29130]]
18120........................... Breathitt County, Kentucky........
18 0.7866 0.7774 99918 18130........................... Breckinridge County, Kentucky.....
18 0.7866 0.7774 99918 18140........................... Bullitt County, Kentucky.......... 4520 0.9302 0.9261 31140 18150........................... Butler County, Kentucky...........
18 0.7866 0.7774 99918 18160........................... Caldwell County, Kentucky.........
18 0.7866 0.7774 99918 18170........................... Calloway County, Kentucky.........
18 0.7866 0.7774 99918 18180........................... Campbell County, Kentucky......... 1640 0.9742 0.9623 17140 18190........................... Carlisle County, Kentucky.........
18 0.7866 0.7774 99918 18191........................... Carroll County, Kentucky..........
18 0.7866 0.7774 99918 18210........................... Carter County, Kentucky........... 3400 0.9486 0.7774 99918 18220........................... Casey County, Kentucky............
18 0.7866 0.7774 99918 18230........................... Christian County, Kentucky........ 1660 0.8292 0.8292 17300 18240........................... Clark County, Kentucky............ 4280 0.8997 0.9084 30460 18250........................... Clay County, Kentucky.............
18 0.7866 0.7774 99918 18260........................... Clinton County, Kentucky..........
18 0.7866 0.7774 99918 18270........................... Crittenden County, Kentucky.......
18 0.7866 0.7774 99918 18271........................... Cumberland County, Kentucky.......
18 0.7866 0.7774 99918 18290........................... Daviess County, Kentucky.......... 5990 0.8789 0.8789 36980 18291........................... Edmonson County, Kentucky.........
18 0.7866 0.8220 14540 18310........................... Elliott County, Kentucky..........
18 0.7866 0.7774 99918 18320........................... Estill County, Kentucky...........
18 0.7866 0.7774 99918 18330........................... Fayette County, Kentucky.......... 4280 0.8997 0.9084 30460 18340........................... Fleming County, Kentucky..........
18 0.7866 0.7774 99918 18350........................... Floyd County, Kentucky............
18 0.7866 0.7774 99918 18360........................... Franklin County, Kentucky.........
18 0.7866 0.7774 99918 18361........................... Fulton County, Kentucky...........
18 0.7866 0.7774 99918 18362........................... Gallatin County, Kentucky......... 1640 0.9742 0.9623 17140 18390........................... Garrard County, Kentucky..........
18 0.7866 0.7774 99918 18400........................... Grant County, Kentucky............ 1640 0.9742 0.9623 17140 18410........................... Graves County, Kentucky...........
18 0.7866 0.7774 99918 18420........................... Grayson County, Kentucky..........
18 0.7866 0.7774 99918 18421........................... Green County, Kentucky............
18 0.7866 0.7774 99918 18440........................... Greenup County, Kentucky.......... 3400 0.9486 0.9486 26580 18450........................... Hancock County, Kentucky..........
18 0.7866 0.8789 36980 18460........................... Hardin County, Kentucky...........
18 0.7866 0.8810 21060 18470........................... Harlan County, Kentucky...........
18 0.7866 0.7774 99918 18480........................... Harrison County, Kentucky.........
18 0.7866 0.7774 99918 18490........................... Hart County, Kentucky.............
18 0.7866 0.7774 99918 18500........................... Henderson County, Kentucky........ 2440 0.8721 0.8721 21780 18510........................... Henry County, Kentucky............
18 0.7866 0.9261 31140 18511........................... Hickman County, Kentucky..........
18 0.7866 0.7774 99918 18530........................... Hopkins County, Kentucky..........
18 0.7866 0.7774 99918 18540........................... Jackson County, Kentucky..........
18 0.7866 0.7774 99918 18550........................... Jefferson County, Kentucky........ 4520 0.9302 0.9261 31140 18560........................... Jessamine County, Kentucky........ 4280 0.8997 0.9084 30460 18570........................... Johnson County, Kentucky..........
18 0.7866 0.7774 99918 18580........................... Kenton County, Kentucky........... 1640 0.9742 0.9623 17140 18590........................... Knott County, Kentucky............
18 0.7866 0.7774 99918 18600........................... Knox County, Kentucky.............
18 0.7866 0.7774 99918 18610........................... Larue County, Kentucky............
18 0.7866 0.8810 21060 18620........................... Laurel County, Kentucky...........
18 0.7866 0.7774 99918 18630........................... Lawrence County, Kentucky.........
18 0.7866 0.7774 99918 18640........................... Lee County, Kentucky..............
18 0.7866 0.7774 99918 18650........................... Leslie County, Kentucky...........
18 0.7866 0.7774 99918 18660........................... Letcher County, Kentucky..........
18 0.7866 0.7774 99918 18670........................... Lewis County, Kentucky............
18 0.7866 0.7774 99918 18680........................... Lincoln County, Kentucky..........
18 0.7866 0.7774 99918 18690........................... Livingston County, Kentucky.......
18 0.7866 0.7774 99918 18700........................... Logan County, Kentucky............
18 0.7866 0.7774 99918 18710........................... Lyon County, Kentucky.............
18 0.7866 0.7774 99918 18720........................... Mc Cracken County, Kentucky.......
18 0.7866 0.7774 99918 18730........................... Mc Creary County, Kentucky........
18 0.7866 0.7774 99918 18740........................... Mc Lean County, Kentucky..........
18 0.7866 0.8789 36980 18750........................... Madison County, Kentucky.......... 4280 0.8997 0.7774 99918 18760........................... Magoffin County, Kentucky.........
18 0.7866 0.7774 99918 18770........................... Marion County, Kentucky...........
18 0.7866 0.7774 99918 18780........................... Marshall County, Kentucky.........
18 0.7866 0.7774 99918 18790........................... Martin County, Kentucky...........
18 0.7866 0.7774 99918 18800........................... Mason County, Kentucky............
18 0.7866 0.7774 99918
[[Page 29131]]
18801........................... Meade County, Kentucky............
18 0.7866 0.9261 31140 18802........................... Menifee County, Kentucky..........
18 0.7866 0.7774 99918 18830........................... Mercer County, Kentucky...........
18 0.7866 0.7774 99918 18831........................... Metcalfe County, Kentucky.........
18 0.7866 0.7774 99918 18850........................... Monroe County, Kentucky...........
18 0.7866 0.7774 99918 18860........................... Montgomery County, Kentucky.......
18 0.7866 0.7774 99918 18861........................... Morgan County, Kentucky...........
18 0.7866 0.7774 99918 18880........................... Muhlenberg County, Kentucky.......
18 0.7866 0.7774 99918 18890........................... Nelson County, Kentucky...........
18 0.7866 0.9261 31140 18900........................... Nicholas County, Kentucky.........
18 0.7866 0.7774 99918 18910........................... Ohio County, Kentucky.............
18 0.7866 0.7774 99918 18920........................... Oldham County, Kentucky........... 4520 0.9302 0.9261 31140 18930........................... Owen County, Kentucky.............
18 0.7866 0.7774 99918 18931........................... Owsley County, Kentucky...........
18 0.7866 0.7774 99918 18932........................... Pendleton County, Kentucky........ 1640 0.9742 0.9623 17140 18960........................... Perry County, Kentucky............
18 0.7866 0.7774 99918 18970........................... Pike County, Kentucky.............
18 0.7866 0.7774 99918 18971........................... Powell County, Kentucky...........
18 0.7866 0.7774 99918 18972........................... Pulaski County, Kentucky..........
18 0.7866 0.7774 99918 18973........................... Robertson County, Kentucky........
18 0.7866 0.7774 99918 18974........................... Rockcastle County, Kentucky.......
18 0.7866 0.7774 99918 18975........................... Rowan County, Kentucky............
18 0.7866 0.7774 99918 18976........................... Russell County, Kentucky..........
18 0.7866 0.7774 99918 18977........................... Scott County, Kentucky............ 4280 0.8997 0.9084 30460 18978........................... Shelby County, Kentucky...........
18 0.7866 0.9261 31140 18979........................... Simpson County, Kentucky..........
18 0.7866 0.7774 99918 18980........................... Spencer County, Kentucky..........
18 0.7866 0.9261 31140 18981........................... Taylor County, Kentucky...........
18 0.7866 0.7774 99918 18982........................... Todd County, Kentucky.............
18 0.7866 0.7774 99918 18983........................... Trigg County, Kentucky............
18 0.7866 0.8292 17300 18984........................... Trimble County, Kentucky..........
18 0.7866 0.9261 31140 18985........................... Union County, Kentucky............
18 0.7866 0.7774 99918 18986........................... Warren County, Kentucky...........
18 0.7866 0.8220 14540 18987........................... Washington County, Kentucky.......
18 0.7866 0.7774 99918 18988........................... Wayne County, Kentucky............
18 0.7866 0.7774 99918 18989........................... Webster County, Kentucky..........
18 0.7866 0.8721 21780 18990........................... Whitley County, Kentucky..........
18 0.7866 0.7774 99918 18991........................... Wolfe County, Kentucky............
18 0.7866 0.7774 99918 18992........................... Woodford County, Kentucky......... 4280 0.8997 0.9084 30460 19000........................... Acadia County, Louisiana.......... 3880 0.8260 0.7418 99919 19010........................... Allen County, Louisiana...........
19 0.7348 0.7418 99919 19020........................... Ascension County, Louisiana....... 0760 0.8652 0.8601 12940 19030........................... Assumption County, Louisiana......
19 0.7348 0.7418 99919 19040........................... Avoyelles County, Louisiana.......
19 0.7348 0.7418 99919 19050........................... Beauregard County, Louisiana......
19 0.7348 0.7418 99919 19060........................... Bienville County, Louisiana.......
19 0.7348 0.7418 99919 19070........................... Bossier County, Louisiana......... 7680 0.8746 0.8769 43340 19080........................... Caddo County, Louisiana........... 7680 0.8746 0.8769 43340 19090........................... Calcasieu County, Louisiana....... 3960 0.7866 0.7841 29340 19100........................... Caldwell County, Louisiana........
19 0.7348 0.7418 99919 19110........................... Cameron County, Louisiana.........
19 0.7348 0.7841 29340 19120........................... Catahoula County, Louisiana.......
19 0.7348 0.7418 99919 19130........................... Claiborne County, Louisiana.......
19 0.7348 0.7418 99919 19140........................... Concordia County, Louisiana.......
19 0.7348 0.7418 99919 19150........................... De Soto County, Louisiana.........
19 0.7348 0.8769 43340 19160........................... East Baton Rouge County, Louisiana 0760 0.8652 0.8601 12940 19170........................... East Carroll County, Louisiana....
19 0.7348 0.7418 99919 19180........................... East Feliciana County, Louisiana..
19 0.7348 0.8601 12940 19190........................... Evangeline County, Louisiana......
19 0.7348 0.7418 99919 19200........................... Franklin County, Louisiana........
19 0.7348 0.7418 99919 19210........................... Grant County, Louisiana...........
19 0.7348 0.8041 10780 19220........................... Iberia County, Louisiana..........
19 0.7348 0.7418 99919 19230........................... Iberville County, Louisiana.......
19 0.7348 0.8601 12940 19240........................... Jackson County, Louisiana.........
19 0.7348 0.7418 99919 19250........................... Jefferson County, Louisiana....... 5560 0.9005 0.9005 35380 19260........................... Jefferson Davis County, Louisiana.
19 0.7348 0.7418 99919 19270........................... Lafayette County, Louisiana....... 3880 0.8260 0.8436 29180 19280........................... Lafourche County, Louisiana....... 3350 0.7902 0.7902 26380 19290........................... La Salle County, Louisiana........
19 0.7348 0.7418 99919
[[Page 29132]]
19300........................... Lincoln County, Louisiana.........
19 0.7348 0.7418 99919 19310........................... Livingston County, Louisiana...... 0760 0.8652 0.8601 12940 19320........................... Madison County, Louisiana.........
19 0.7348 0.7418 99919 19330........................... Morehouse County, Louisiana.......
19 0.7348 0.7418 99919 19340........................... Natchitoches County, Louisiana....
19 0.7348 0.7418 99919 19350........................... Orleans County, Louisiana......... 5560 0.9005 0.9005 35380 19360........................... Ouachita County, Louisiana........ 5200 0.8052 0.8040 33740 19370........................... Plaquemines County, Louisiana..... 5560 0.9005 0.9005 35380 19380........................... Pointe Coupee County, Louisiana...
19 0.7348 0.8601 12940 19390........................... Rapides County, Louisiana......... 0220 0.8041 0.8041 10780 19400........................... Red River County, Louisiana.......
19 0.7348 0.7418 99919 19410........................... Richland County, Louisiana........
19 0.7348 0.7418 99919 19420........................... Sabine County, Louisiana..........
19 0.7348 0.7418 99919 19430........................... St Bernard County, Louisiana...... 5560 0.9005 0.9005 35380 19440........................... St Charles County, Louisiana...... 5560 0.9005 0.9005 35380 19450........................... St Helena County, Louisiana.......
19 0.7348 0.8601 12940 19460........................... St James County, Louisiana........ 5560 0.9005 0.7418 99919 19470........................... St John Baptist County, Louisiana. 5560 0.9005 0.9005 35380 19480........................... St Landry County, Louisiana....... 3880 0.8260 0.7418 99919 19490........................... St Martin County, Louisiana....... 3880 0.8260 0.8436 29180 19500........................... St Mary County, Louisiana.........
19 0.7348 0.7418 99919 19510........................... St Tammany County, Louisiana...... 5560 0.9005 0.9005 35380 19520........................... Tangipahoa County, Louisiana......
19 0.7348 0.7418 99919 19530........................... Tensas County, Louisiana..........
19 0.7348 0.7418 99919 19540........................... Terrebonne County, Louisiana...... 3350 0.7902 0.7902 26380 19550........................... Union County, Louisiana...........
19 0.7348 0.8040 33740 19560........................... Vermilion County, Louisiana.......
19 0.7348 0.7418 99919 19570........................... Vernon County, Louisiana..........
19 0.7348 0.7418 99919 19580........................... Washington County, Louisiana......
19 0.7348 0.7418 99919 19590........................... Webster County, Louisiana......... 7680 0.8746 0.7418 99919 19600........................... West Baton Rouge County, Louisiana 0760 0.8652 0.8601 12940 19610........................... West Carroll County, Louisiana....
19 0.7348 0.7418 99919 19620........................... West Feliciana County, Louisiana..
19 0.7348 0.8601 12940 19630........................... Winn County, Louisiana............
19 0.7348 0.7418 99919 20000........................... Androscoggin County, Maine........ 4243 0.9341 0.9341 30340 20010........................... Aroostook County, Maine...........
20 0.8852 0.8852 99920 20020........................... Cumberland County, Maine.......... 6403 1.0392 1.0392 38860 20030........................... Franklin County, Maine............
20 0.8852 0.8852 99920 20040........................... Hancock County, Maine.............
20 0.8852 0.8852 99920 20050........................... Kennebec County, Maine............
20 0.8852 0.8852 99920 20060........................... Knox County, Maine................
20 0.8852 0.8852 99920 20070........................... Lincoln County, Maine.............
20 0.8852 0.8852 99920 20080........................... Oxford County, Maine..............
20 0.8852 0.8852 99920 20090........................... Penobscot County, Maine........... 0733 1.0003 1.0003 12620 20100........................... Piscataquis County, Maine.........
20 0.8852 0.8852 99920 20110........................... Sagadahoc County, Maine........... 6403 1.0392 1.0392 38860 20120........................... Somerset County, Maine............
20 0.8852 0.8852 99920 20130........................... Waldo County, Maine...............
20 0.8852 0.8852 99920 20140........................... Washington County, Maine..........
20 0.8852 0.8852 99920 20150........................... York County, Maine................ 6403 1.0392 1.0392 38860 21000........................... Allegany County, Maryland......... 1900 0.9326 0.9326 19060 21010........................... Anne Arundel County, Maryland..... 0720 0.9907 0.9907 12580 21020........................... Baltimore County, Maryland........ 0720 0.9907 0.9907 12580 21030........................... Baltimore City County, Maryland... 0720 0.9907 0.9907 12580 21040........................... Calvert County, Maryland.......... 8840 1.0983 1.0932 47894 21050........................... Caroline County, Maryland.........
21 0.9085 0.9095 99921 21060........................... Carroll County, Maryland.......... 0720 0.9907 0.9907 12580 21070........................... Cecil County, Maryland............ 9160 1.0537 1.0482 48864 21080........................... Charles County, Maryland.......... 8840 1.0983 1.0932 47894 21090........................... Dorchester County, Maryland.......
21 0.9085 0.9095 99921 21100........................... Frederick County, Maryland........ 8840 1.0983 1.1495 13644 21110........................... Garrett County, Maryland..........
21 0.9085 0.9095 99921 21120........................... Harford County, Maryland.......... 0720 0.9907 0.9907 12580 21130........................... Howard County, Maryland........... 0720 0.9907 0.9907 12580 21140........................... Kent County, Maryland.............
21 0.9085 0.9095 99921 21150........................... Montgomery County, Maryland....... 8840 1.0983 1.1495 13644 21160........................... Prince Georges County, Maryland... 8840 1.0983 1.0932 47894 21170........................... Queen Annes County, Maryland...... 0720 0.9907 0.9907 12580 21180........................... St Marys County, Maryland.........
21 0.9085 0.9095 99921
[[Page 29133]]
21190........................... Somerset County, Maryland.........
21 0.9085 0.9073 41540 21200........................... Talbot County, Maryland...........
21 0.9085 0.9095 99921 21210........................... Washington County, Maryland....... 3180 0.9879 0.9499 25180 21220........................... Wicomico County, Maryland.........
21 0.9085 0.9073 41540 21230........................... Worcester County, Maryland........
21 0.9085 0.9095 99921 22000........................... Barnstable County, Massachusetts.. 0743 1.2527 1.2527 12700 22010........................... Berkshire County, Massachusetts... 6323 1.0191 1.0191 38340 22020........................... Bristol County, Massachusetts..... 1123 1.1152 1.0966 39300 22030........................... Dukes County, Massachusetts.......
22 1.0050 1.0216 99922 22040........................... Essex County, Massachusetts....... 1123 1.1152 1.0533 21604 22060........................... Franklin County, Massachusetts....
22 1.0050 1.0259 44140 22070........................... Hampden County, Massachusetts..... 8003 1.0273 1.0259 44140 22080........................... Hampshire County, Massachusetts... 8003 1.0273 1.0259 44140 22090........................... Middlesex County, Massachusetts... 1123 1.1152 1.1084 15764 22120........................... Nantucket County, Massachusetts...
22 1.0050 1.0216 99922 22130........................... Norfolk County, Massachusetts..... 1123 1.1152 1.1543 14484 22150........................... Plymouth County, Massachusetts.... 1123 1.1152 1.1543 14484 22160........................... Suffolk County, Massachusetts..... 1123 1.1152 1.1543 14484 22170........................... Worcester County, Massachusetts... 1123 1.1152 1.1039 49340 23000........................... Alcona County, Michigan...........
23 0.8813 0.8870 99923 23010........................... Alger County, Michigan............
23 0.8813 0.8870 99923 23020........................... Allegan County, Michigan.......... 3000 0.9455 0.8870 99923 23030........................... Alpena County, Michigan...........
23 0.8813 0.8870 99923 23040........................... Antrim County, Michigan...........
23 0.8813 0.8870 99923 23050........................... Arenac County, Michigan...........
23 0.8813 0.8870 99923 23060........................... Baraga County, Michigan...........
23 0.8813 0.8870 99923 23070........................... Barry County, Michigan............
23 0.8813 0.9400 24340 23080........................... Bay County, Michigan.............. 6960 0.9415 0.9352 13020 23090........................... Benzie County, Michigan...........
23 0.8813 0.8870 99923 23100........................... Berrien County, Michigan.......... 0870 0.8888 0.8888 35660 23110........................... Branch County, Michigan...........
23 0.8813 0.8870 99923 23120........................... Calhoun County, Michigan.......... 3720 1.0151 0.9510 12980 23130........................... Cass County, Michigan.............
23 0.8813 0.9798 43780 23140........................... Charlevoix County, Michigan.......
23 0.8813 0.8870 99923 23150........................... Cheboygan County, Michigan........
23 0.8813 0.8870 99923 23160........................... Chippewa County, Michigan.........
23 0.8813 0.8870 99923 23170........................... Clare County, Michigan............
23 0.8813 0.8870 99923 23180........................... Clinton County, Michigan.......... 4040 0.9792 0.9792 29620 23190........................... Crawford County, Michigan.........
23 0.8813 0.8870 99923 23200........................... Delta County, Michigan............
23 0.8813 0.8870 99923 23210........................... Dickinson County, Michigan........
23 0.8813 0.8870 99923 23220........................... Eaton County, Michigan............ 4040 0.9792 0.9792 29620 23230........................... Emmet County, Michigan............
23 0.8813 0.8870 99923 23240........................... Genesee County, Michigan.......... 2640 1.0663 1.0663 22420 23250........................... Gladwin County, Michigan..........
23 0.8813 0.8870 99923 23260........................... Gogebic County, Michigan..........
23 0.8813 0.8870 99923 23270........................... Grand Traverse County, Michigan...
23 0.8813 0.8870 99923 23280........................... Gratiot County, Michigan..........
23 0.8813 0.8870 99923 23290........................... Hillsdale County, Michigan........
23 0.8813 0.8870 99923 23300........................... Houghton County, Michigan.........
23 0.8813 0.8870 99923 23310........................... Huron County, Michigan............
23 0.8813 0.8870 99923 23320........................... Ingham County, Michigan........... 4040 0.9792 0.9792 29620 23330........................... Ionia County, Michigan............
23 0.8813 0.9400 24340 23340........................... Iosco County, Michigan............
23 0.8813 0.8870 99923 23350........................... Iron County, Michigan.............
23 0.8813 0.8870 99923 23360........................... Isabella County, Michigan.........
23 0.8813 0.8870 99923 23370........................... Jackson County, Michigan.......... 3520 0.9313 0.9313 27100 23380........................... Kalamazoo County, Michigan........ 3720 1.0151 1.0391 28020 23390........................... Kalkaska County, Michigan.........
23 0.8813 0.8870 99923 23400........................... Kent County, Michigan............. 3000 0.9455 0.9400 24340 23410........................... Keweenaw County, Michigan.........
23 0.8813 0.8870 99923 23420........................... Lake County, Michigan.............
23 0.8813 0.8870 99923 23430........................... Lapeer County, Michigan........... 2160 1.0152 0.9861 47644 23440........................... Leelanau County, Michigan.........
23 0.8813 0.8870 99923 23450........................... Lenawee County, Michigan.......... 0440 1.0718 0.8870 99923 23460........................... Livingston County, Michigan....... 0440 1.0718 0.9861 47644 23470........................... Luce County, Michigan.............
23 0.8813 0.8870 99923 23480........................... Mackinac County, Michigan.........
23 0.8813 0.8870 99923 23490........................... Macomb County, Michigan........... 2160 1.0152 0.9861 47644
[[Page 29134]]
23500........................... Manistee County, Michigan.........
23 0.8813 0.8870 99923 23510........................... Marquette County, Michigan........
23 0.8813 0.8870 99923 23520........................... Mason County, Michigan............
23 0.8813 0.8870 99923 23530........................... Mecosta County, Michigan..........
23 0.8813 0.8870 99923 23540........................... Menominee County, Michigan........
23 0.8813 0.8870 99923 23550........................... Midland County, Michigan.......... 6960 0.9415 0.8870 99923 23560........................... Missaukee County, Michigan........
23 0.8813 0.8870 99923 23570........................... Monroe County, Michigan........... 2160 1.0152 0.9478 33780 23580........................... Montcalm County, Michigan.........
23 0.8813 0.8870 99923 23590........................... Montmorency County, Michigan......
23 0.8813 0.8870 99923 23600........................... Muskegon County, Michigan......... 3000 0.9455 0.9673 34740 23610........................... Newaygo County, Michigan..........
23 0.8813 0.9400 24340 23620........................... Oakland County, Michigan.......... 2160 1.0152 0.9861 47644 23630........................... Oceana County, Michigan...........
23 0.8813 0.8870 99923 23640........................... Ogemaw County, Michigan...........
23 0.8813 0.8870 99923 23650........................... Ontonagon County, Michigan........
23 0.8813 0.8870 99923 23660........................... Osceola County, Michigan..........
23 0.8813 0.8870 99923 23670........................... Oscoda County, Michigan...........
23 0.8813 0.8870 99923 23680........................... Otsego County, Michigan...........
23 0.8813 0.8870 99923 23690........................... Ottawa County, Michigan........... 3000 0.9455 0.9064 26100 23700........................... Presque Isle County, Michigan.....
23 0.8813 0.8870 99923 23710........................... Roscommon County, Michigan........
23 0.8813 0.8870 99923 23720........................... Saginaw County, Michigan.......... 6960 0.9415 0.9420 40980 23730........................... St Clair County, Michigan......... 12160 1.0152 0.9861 47644 23740........................... St Joseph County, Michigan........
23 0.8813 0.8870 99923 23750........................... Sanilac County, Michigan..........
23 0.8813 0.8870 99923 23760........................... Schoolcraft County, Michigan......
23 0.8813 0.8870 99923 23770........................... Shiawassee County, Michigan.......
23 0.8813 0.8870 99923 23780........................... Tuscola County, Michigan..........
23 0.8813 0.8870 99923 23790........................... Van Buren County, Michigan........ 3720 1.0151 1.0391 28020 23800........................... Washtenaw County, Michigan........ 0440 1.0718 1.0870 11460 23810........................... Wayne County, Michigan............ 2160 1.0152 1.0441 19804 23830........................... Wexford County, Michigan..........
23 0.8813 0.8870 99923 24000........................... Aitkin County, Minnesota..........
24 0.9193 0.9183 99924 24010........................... Anoka County, Minnesota........... 5120 1.1078 1.1078 33460 24020........................... Becker County, Minnesota..........
24 0.9193 0.9183 99924 24030........................... Beltrami County, Minnesota........
24 0.9193 0.9183 99924 24040........................... Benton County, Minnesota.......... 6980 0.9975 0.9975 41060 24050........................... Big Stone County, Minnesota.......
24 0.9193 0.9183 99924 24060........................... Blue Earth County, Minnesota......
24 0.9193 0.9183 99924 24070........................... Brown County, Minnesota...........
24 0.9193 0.9183 99924 24080........................... Carlton County, Minnesota.........
24 0.9193 1.0209 20260 24090........................... Carver County, Minnesota.......... 5120 1.1078 1.1078 33460 24100........................... Cass County, Minnesota............
24 0.9193 0.9183 99924 24110........................... Chippewa County, Minnesota........
24 0.9193 0.9183 99924 24120........................... Chisago County, Minnesota......... 5120 1.1078 1.1078 33460 24130........................... Clay County, Minnesota............ 2520 0.8495 0.8495 22020 24140........................... Clearwater County, Minnesota......
24 0.9193 0.9183 99924 24150........................... Cook County, Minnesota............
24 0.9193 0.9183 99924 24160........................... Cottonwood County, Minnesota......
24 0.9193 0.9183 99924 24170........................... Crow Wing County, Minnesota.......
24 0.9193 0.9183 99924 24180........................... Dakota County, Minnesota.......... 5120 1.1078 1.1078 33460 24190........................... Dodge County, Minnesota...........
24 0.9193 1.1142 40340 24200........................... Douglas County, Minnesota.........
24 0.9193 0.9183 99924 24210........................... Faribault County, Minnesota.......
24 0.9193 0.9183 99924 24220........................... Fillmore County, Minnesota........
24 0.9193 0.9183 99924 24230........................... Freeborn County, Minnesota........
24 0.9193 0.9183 99924 24240........................... Goodhue County, Minnesota.........
24 0.9193 0.9183 99924 24250........................... Grant County, Minnesota...........
24 0.9193 0.9183 99924 24260........................... Hennepin County, Minnesota........ 5120 1.1078 1.1078 33460 24270........................... Houston County, Minnesota......... 3870 0.9573 0.9573 29100 24280........................... Hubbard County, Minnesota.........
24 0.9193 0.9183 99924 24290........................... Isanti County, Minnesota.......... 5120 1.1078 1.1078 33460 24300........................... Itasca County, Minnesota..........
24 0.9193 0.9183 99924 24310........................... Jackson County, Minnesota.........
24 0.9193 0.9183 99924 24320........................... Kanabec County, Minnesota.........
24 0.9193 0.9183 99924 24330........................... Kandiyohi County, Minnesota.......
24 0.9193 0.9183 99924 24340........................... Kittson County, Minnesota.........
24 0.9193 0.9183 99924 24350........................... Koochiching County, Minnesota.....
24 0.9193 0.9183 99924
[[Page 29135]]
24360........................... Lac Qui Parle County, Minnesota...
24 0.9193 0.9183 99924 24370........................... Lake County, Minnesota............
24 0.9193 0.9183 99924 24380........................... Lake Of Woods County, Minnesota...
24 0.9193 0.9183 99924 24390........................... Le Sueur County, Minnesota........
24 0.9193 0.9183 99924 24400........................... Lincoln County, Minnesota.........
24 0.9193 0.9183 99924 24410........................... Lyon County, Minnesota............
24 0.9193 0.9183 99924 24420........................... Mc Leod County, Minnesota.........
24 0.9193 0.9183 99924 24430........................... Mahnomen County, Minnesota........
24 0.9193 0.9183 99924 24440........................... Marshall County, Minnesota........
24 0.9193 0.9183 99924 24450........................... Martin County, Minnesota..........
24 0.9193 0.9183 99924 24460........................... Meeker County, Minnesota..........
24 0.9193 0.9183 99924 24470........................... Mille Lacs County, Minnesota......
24 0.9193 0.9183 99924 24480........................... Morrison County, Minnesota........
24 0.9193 0.9183 99924 24490........................... Mower County, Minnesota...........
24 0.9193 0.9183 99924 24500........................... Murray County, Minnesota..........
24 0.9193 0.9183 99924 24510........................... Nicollet County, Minnesota........
24 0.9193 0.9183 99924 24520........................... Nobles County, Minnesota..........
24 0.9193 0.9183 99924 24530........................... Norman County, Minnesota..........
24 0.9193 0.9183 99924 24540........................... Olmsted County, Minnesota......... 6820 1.1142 1.1142 40340 24550........................... Otter Tail County, Minnesota......
24 0.9193 0.9183 99924 24560........................... Pennington County, Minnesota......
24 0.9193 0.9183 99924 24570........................... Pine County, Minnesota............
24 0.9193 0.9183 99924 24580........................... Pipestone County, Minnesota.......
24 0.9193 0.9183 99924 24590........................... Polk County, Minnesota............ 2985 1.1516 1.1516 24220 24600........................... Pope County, Minnesota............
24 0.9193 0.9183 99924 24610........................... Ramsey County, Minnesota.......... 5120 1.1078 1.1078 33460 24620........................... Red Lake County, Minnesota........
24 0.9193 0.9183 99924 24630........................... Redwood County, Minnesota.........
24 0.9193 0.9183 99924 24640........................... Renville County, Minnesota........
24 0.9193 0.9183 99924 24650........................... Rice County, Minnesota............
24 0.9193 0.9183 99924 24660........................... Rock County, Minnesota............
24 0.9193 0.9183 99924 24670........................... Roseau County, Minnesota..........
24 0.9193 0.9183 99924 24680........................... St Louis County, Minnesota........ 2240 1.0223 1.0209 20260 24690........................... Scott County, Minnesota........... 5120 1.1078 1.1078 33460 24700........................... Sherburne County, Minnesota....... 5120 1.1078 1.1078 33460 24710........................... Sibley County, Minnesota..........
24 0.9193 0.9183 99924 24720........................... Stearns County, Minnesota......... 6980 0.9975 0.9975 41060 24730........................... Steele County, Minnesota..........
24 0.9193 0.9183 99924 24740........................... Stevens County, Minnesota.........
24 0.9193 0.9183 99924 24750........................... Swift County, Minnesota...........
24 0.9193 0.9183 99924 24760........................... Todd County, Minnesota............
24 0.9193 0.9183 99924 24770........................... Traverse County, Minnesota........
24 0.9193 0.9183 99924 24780........................... Wabasha County, Minnesota.........
24 0.9193 1.1142 40340 24790........................... Wadena County, Minnesota..........
24 0.9193 0.9183 99924 24800........................... Waseca County, Minnesota..........
24 0.9193 0.9183 99924 24810........................... Washington County, Minnesota...... 5120 1.1078 1.1078 33460 24820........................... Watonwan County, Minnesota........
24 0.9193 0.9183 99924 24830........................... Wilkin County, Minnesota..........
24 0.9193 0.9183 99924 24840........................... Winona County, Minnesota..........
24 0.9193 0.9183 99924 24850........................... Wright County, Minnesota.......... 5120 1.1078 1.1078 33460 24860........................... Yellow Medicine County, Minnesota.
24 0.9193 0.9183 99924 25000........................... Adams County, Mississippi.........
25 0.7631 0.7671 99925 25010........................... Alcorn County, Mississippi........
25 0.7631 0.7671 99925 25020........................... Amite County, Mississippi.........
25 0.7631 0.7671 99925 25030........................... Attala County, Mississippi........
25 0.7631 0.7671 99925 25040........................... Benton County, Mississippi........
25 0.7631 0.7671 99925 25050........................... Bolivar County, Mississippi.......
25 0.7631 0.7671 99925 25060........................... Calhoun County, Mississippi.......
25 0.7631 0.7671 99925 25070........................... Carroll County, Mississippi.......
25 0.7631 0.7671 99925 25080........................... Chickasaw County, Mississippi.....
25 0.7631 0.7671 99925 25090........................... Choctaw County, Mississippi.......
25 0.7631 0.7671 99925 25100........................... Claiborne County, Mississippi.....
25 0.7631 0.7671 99925 25110........................... Clarke County, Mississippi........
25 0.7631 0.7671 99925 25120........................... Clay County, Mississippi..........
25 0.7631 0.7671 99925 25130........................... Coahoma County, Mississippi.......
25 0.7631 0.7671 99925 25140........................... Copiah County, Mississippi........
25 0.7631 0.8319 27140 25150........................... Covington County, Mississippi.....
25 0.7631 0.7671 99925 25160........................... Desoto County, Mississippi........ 4920 0.9360 0.9341 32820 25170........................... Forrest County, Mississippi....... 3285 0.7609 0.7609 25620
[[Page 29136]]
25180........................... Franklin County, Mississippi......
25 0.7631 0.7671 99925 25190........................... George County, Mississippi........
25 0.7631 0.8165 37700 25200........................... Greene County, Mississippi........
25 0.7631 0.7671 99925 25210........................... Grenada County, Mississippi.......
25 0.7631 0.7671 99925 25220........................... Hancock County, Mississippi....... 0920 0.8715 0.8938 25060 25230........................... Harrison County, Mississippi...... 0920 0.8715 0.8938 25060 25240........................... Hinds County, Mississippi......... 3560 0.8391 0.8319 27140 25250........................... Holmes County, Mississippi........
25 0.7631 0.7671 99925 25260........................... Humphreys County, Mississippi.....
25 0.7631 0.7671 99925 25270........................... Issaquena County, Mississippi.....
25 0.7631 0.7671 99925 25280........................... Itawamba County, Mississippi......
25 0.7631 0.7671 99925 25290........................... Jackson County, Mississippi....... 0920 0.8715 0.8165 37700 25300........................... Jasper County, Mississippi........
25 0.7631 0.7671 99925 25310........................... Jefferson County, Mississippi.....
25 0.7631 0.7671 99925 25320........................... Jefferson Davis County,
25 0.7631 0.7671 99925 Mississippi. 25330........................... Jones County, Mississippi.........
25 0.7631 0.7671 99925 25340........................... Kemper County, Mississippi........
25 0.7631 0.7671 99925 25350........................... Lafayette County, Mississippi.....
25 0.7631 0.7671 99925 25360........................... Lamar County, Mississippi......... 3285 0.7609 0.7609 25620 25370........................... Lauderdale County, Mississippi....
25 0.7631 0.7671 99925 25380........................... Lawrence County, Mississippi......
25 0.7631 0.7671 99925 25390........................... Leake County, Mississippi.........
25 0.7631 0.7671 99925 25400........................... Lee County, Mississippi...........
25 0.7631 0.7671 99925 25410........................... Leflore County, Mississippi.......
25 0.7631 0.7671 99925 25420........................... Lincoln County, Mississippi.......
25 0.7631 0.7671 99925 25430........................... Lowndes County, Mississippi.......
25 0.7631 0.7671 99925 25440........................... Madison County, Mississippi....... 3560 0.8391 0.8319 27140 25450........................... Marion County, Mississippi........
25 0.7631 0.7671 99925 25460........................... Marshall County, Mississippi......
25 0.7631 0.9341 32820 25470........................... Monroe County, Mississippi........
25 0.7631 0.7671 99925 25480........................... Montgomery County, Mississippi....
25 0.7631 0.7671 99925 25490........................... Neshoba County, Mississippi.......
25 0.7631 0.7671 99925 25500........................... Newton County, Mississippi........
25 0.7631 0.7671 99925 25510........................... Noxubee County, Mississippi.......
25 0.7631 0.7671 99925 25520........................... Oktibbeha County, Mississippi.....
25 0.7631 0.7671 99925 25530........................... Panola County, Mississippi........
25 0.7631 0.7671 99925 25540........................... Pearl River County, Mississippi...
25 0.7631 0.7671 99925 25550........................... Perry County, Mississippi.........
25 0.7631 0.7609 25620 25560........................... Pike County, Mississippi..........
25 0.7631 0.7671 99925 25570........................... Pontotoc County, Mississippi......
25 0.7631 0.7671 99925 25580........................... Prentiss County, Mississippi......
25 0.7631 0.7671 99925 25590........................... Quitman County, Mississippi.......
25 0.7631 0.7671 99925 25600........................... Rankin County, Mississippi........ 3560 0.8391 0.8319 27140 25610........................... Scott County, Mississippi.........
25 0.7631 0.7671 99925 25620........................... Sharkey County, Mississippi.......
25 0.7631 0.7671 99925 25630........................... Simpson County, Mississippi.......
25 0.7631 0.8319 27140 25640........................... Smith County, Mississippi.........
25 0.7631 0.7671 99925 25650........................... Stone County, Mississippi.........
25 0.7631 0.8938 25060 25660........................... Sunflower County, Mississippi.....
25 0.7631 0.7671 99925 25670........................... Tallahatchie County, Mississippi..
25 0.7631 0.7671 99925 25680........................... Tate County, Mississippi..........
25 0.7631 0.9341 32820 25690........................... Tippah County, Mississippi........
25 0.7631 0.7671 99925 25700........................... Tishomingo County, Mississippi....
25 0.7631 0.7671 99925 25710........................... Tunica County, Mississippi........
25 0.7631 0.9341 32820 25720........................... Union County, Mississippi.........
25 0.7631 0.7671 99925 25730........................... Walthall County, Mississippi......
25 0.7631 0.7671 99925 25740........................... Warren County, Mississippi........
25 0.7631 0.7671 99925 25750........................... Washington County, Mississippi....
25 0.7631 0.7671 99925 25760........................... Wayne County, Mississippi.........
25 0.7631 0.7671 99925 25770........................... Webster County, Mississippi.......
25 0.7631 0.7671 99925 25780........................... Wilkinson County, Mississippi.....
25 0.7631 0.7671 99925 25790........................... Winston County, Mississippi.......
25 0.7631 0.7671 99925 25800........................... Yalobusha County, Mississippi.....
25 0.7631 0.7671 99925 25810........................... Yazoo County, Mississippi.........
25 0.7631 0.7671 99925 26000........................... Adair County, Missouri............
26 0.7968 0.7909 99926 26010........................... Andrew County, Missouri........... 7000 0.9529 0.9529 41140 26020........................... Atchison County, Missouri.........
26 0.7968 0.7909 99926 26030........................... Audrain County, Missouri..........
26 0.7968 0.7909 99926 26040........................... Barry County, Missouri............
26 0.7968 0.7909 99926
[[Page 29137]]
26050........................... Barton County, Missouri...........
26 0.7968 0.7909 99926 26060........................... Bates County, Missouri............
26 0.7968 0.9467 28140 26070........................... Benton County, Missouri...........
26 0.7968 0.7909 99926 26080........................... Bollinger County, Missouri........
26 0.7968 0.7909 99926 26090........................... Boone County, Missouri............ 1740 0.8354 0.8354 17860 26100........................... Buchanan County, Missouri......... 7000 0.9529 0.9529 41140 26110........................... Butler County, Missouri...........
26 0.7968 0.7909 99926 26120........................... Caldwell County, Missouri.........
26 0.7968 0.9467 28140 26130........................... Callaway County, Missouri.........
26 0.7968 0.8396 27620 26140........................... Camden County, Missouri...........
26 0.7968 0.7909 99926 26150........................... Cape Girardeau County, Missouri...
26 0.7968 0.7909 99926 26160........................... Carroll County, Missouri..........
26 0.7968 0.7909 99926 26170........................... Carter County, Missouri...........
26 0.7968 0.7909 99926 26180........................... Cass County, Missouri............. 3760 0.9481 0.9467 28140 26190........................... Cedar County, Missouri............
26 0.7968 0.7909 99926 26200........................... Chariton County, Missouri.........
26 0.7968 0.7909 99926 26210........................... Christian County, Missouri........ 7920 0.8259 0.8246 44180 26220........................... Clark County, Missouri............
26 0.7968 0.7909 99926 26230........................... Clay County, Missouri............. 3760 0.9481 0.9467 28140 26240........................... Clinton County, Missouri.......... 3760 0.9481 0.9467 28140 26250........................... Cole County, Missouri.............
26 0.7968 0.8396 27620 26260........................... Cooper County, Missouri...........
26 0.7968 0.7909 99926 26270........................... Crawford County, Missouri.........
26 0.7968 0.8949 41180 26280........................... Dade County, Missouri.............
26 0.7968 0.7909 99926 26290........................... Dallas County, Missouri...........
26 0.7968 0.8246 44180 26300........................... Daviess County, Missouri..........
26 0.7968 0.7909 99926 26310........................... De Kalb County, Missouri..........
26 0.7968 0.9529 41140 26320........................... Dent County, Missouri.............
26 0.7968 0.7909 99926 26330........................... Douglas County, Missouri..........
26 0.7968 0.7909 99926 26340........................... Dunklin County, Missouri..........
26 0.7968 0.7909 99926 26350........................... Franklin County, Missouri......... 7040 0.8957 0.8949 41180 26360........................... Gasconade County, Missouri........
26 0.7968 0.7909 99926 26370........................... Gentry County, Missouri...........
26 0.7968 0.7909 99926 26380........................... Greene County, Missouri........... 7920 0.8259 0.8246 44180 26390........................... Grundy County, Missouri...........
26 0.7968 0.7909 99926 26400........................... Harrison County, Missouri.........
26 0.7968 0.7909 99926 26410........................... Henry County, Missouri............
26 0.7968 0.7909 99926 26411........................... Hickory County, Missouri..........
26 0.7968 0.7909 99926 26412........................... Holt County, Missouri.............
26 0.7968 0.7909 99926 26440........................... Howard County, Missouri...........
26 0.7968 0.8354 17860 26450........................... Howell County, Missouri...........
26 0.7968 0.7909 99926 26460........................... Iron County, Missouri.............
26 0.7968 0.7909 99926 26470........................... Jackson County, Missouri.......... 3760 0.9481 0.9467 28140 26480........................... Jasper County, Missouri........... 3710 0.8590 0.8590 27900 26490........................... Jefferson County, Missouri........ 7040 0.8957 0.8949 41180 26500........................... Johnson County, Missouri..........
26 0.7968 0.7909 99926 26510........................... Knox County, Missouri.............
26 0.7968 0.7909 99926 26520........................... Laclede County, Missouri..........
26 0.7968 0.7909 99926 26530........................... Lafayette County, Missouri........ 3760 0.9481 0.9467 28140 26540........................... Lawrence County, Missouri.........
26 0.7968 0.7909 99926 26541........................... Lewis County, Missouri............
26 0.7968 0.7909 99926 26560........................... Lincoln County, Missouri.......... 7040 0.8957 0.8949 41180 26570........................... Linn County, Missouri.............
26 0.7968 0.7909 99926 26580........................... Livingston County, Missouri.......
26 0.7968 0.7909 99926 26590........................... Mc Donald County, Missouri........
26 0.7968 0.8563 22220 26600........................... Macon County, Missouri............
26 0.7968 0.7909 99926 26601........................... Madison County, Missouri..........
26 0.7968 0.7909 99926 26620........................... Maries County, Missouri...........
26 0.7968 0.7909 99926 26630........................... Marion County, Missouri...........
26 0.7968 0.7909 99926 26631........................... Mercer County, Missouri...........
26 0.7968 0.7909 99926 26650........................... Miller County, Missouri...........
26 0.7968 0.7909 99926 26660........................... Mississippi County, Missouri......
26 0.7968 0.7909 99926 26670........................... Moniteau County, Missouri.........
26 0.7968 0.8396 27620 26680........................... Monroe County, Missouri...........
26 0.7968 0.7909 99926 26690........................... Montgomery County, Missouri.......
26 0.7968 0.7909 99926 26700........................... Morgan County, Missouri...........
26 0.7968 0.7909 99926 26710........................... New Madrid County, Missouri.......
26 0.7968 0.7909 99926 26720........................... Newton County, Missouri........... 3710 0.8590 0.8590 27900 26730........................... Nodaway County, Missouri..........
26 0.7968 0.7909 99926
[[Page 29138]]
26740........................... Oregon County, Missouri...........
26 0.7968 0.7909 99926 26750........................... Osage County, Missouri............
26 0.7968 0.8396 27620 26751........................... Ozark County, Missouri............
26 0.7968 0.7909 99926 26770........................... Pemiscot County, Missouri.........
26 0.7968 0.7909 99926 26780........................... Perry County, Missouri............
26 0.7968 0.7909 99926 26790........................... Pettis County, Missouri...........
26 0.7968 0.7909 99926 26800........................... Phelps County, Missouri...........
26 0.7968 0.7909 99926 26810........................... Pike County, Missouri.............
26 0.7968 0.7909 99926 26820........................... Platte County, Missouri........... 3760 0.9481 0.9467 28140 26821........................... Polk County, Missouri.............
26 0.7968 0.8246 44180 26840........................... Pulaski County, Missouri..........
26 0.7968 0.7909 99926 26850........................... Putnam County, Missouri...........
26 0.7968 0.7909 99926 26860........................... Ralls County, Missouri............
26 0.7968 0.7909 99926 26870........................... Randolph County, Missouri.........
26 0.7968 0.7909 99926 26880........................... Ray County, Missouri.............. 3760 0.9481 0.9467 28140 26881........................... Reynolds County, Missouri.........
26 0.7968 0.7909 99926 26900........................... Ripley County, Missouri...........
26 0.7968 0.7909 99926 26910........................... St Charles County, Missouri....... 7040 0.8957 0.8949 41180 26911........................... St Clair County, Missouri.........
26 0.7968 0.7909 99926 26930........................... St Francois County, Missouri......
26 0.7968 0.7909 99926 26940........................... St Louis County, Missouri......... 7040 0.8957 0.8949 41180 26950........................... St Louis City County, Missouri.... 7040 0.8957 0.8949 41180 26960........................... Ste Genevieve County, Missouri....
26 0.7968 0.7909 99926 26970........................... Saline County, Missouri...........
26 0.7968 0.7909 99926 26980........................... Schuyler County, Missouri.........
26 0.7968 0.7909 99926 26981........................... Scotland County, Missouri.........
26 0.7968 0.7909 99926 26982........................... Scott County, Missouri............
26 0.7968 0.7909 99926 26983........................... Shannon County, Missouri..........
26 0.7968 0.7909 99926 26984........................... Shelby County, Missouri...........
26 0.7968 0.7909 99926 26985........................... Stoddard County, Missouri.........
26 0.7968 0.7909 99926 26986........................... Stone County, Missouri............
26 0.7968 0.7909 99926 26987........................... Sullivan County, Missouri.........
26 0.7968 0.7909 99926 26988........................... Taney County, Missouri............
26 0.7968 0.7909 99926 26989........................... Texas County, Missouri............
26 0.7968 0.7909 99926 26990........................... Vernon County, Missouri...........
26 0.7968 0.7909 99926 26991........................... Warren County, Missouri........... 7040 0.8957 0.8949 41180 26992........................... Washington County, Missouri.......
26 0.7968 0.8949 41180 26993........................... Wayne County, Missouri............
26 0.7968 0.7909 99926 26994........................... Webster County, Missouri.......... 7920 0.8259 0.8246 44180 26995........................... Worth County, Missouri............
26 0.7968 0.7909 99926 26996........................... Wright County, Missouri...........
26 0.7968 0.7909 99926 27000........................... Beaverhead County, Montana........
27 0.8833 0.8833 99927 27010........................... Big Horn County, Montana..........
27 0.8833 0.8833 99927 27020........................... Blaine County, Montana............
27 0.8833 0.8833 99927 27030........................... Broadwater County, Montana........
27 0.8833 0.8833 99927 27040........................... Carbon County, Montana............
27 0.8833 0.8843 13740 27050........................... Carter County, Montana............
27 0.8833 0.8833 99927 27060........................... Cascade County, Montana........... 3040 0.9061 0.9061 24500 27070........................... Chouteau County, Montana..........
27 0.8833 0.8833 99927 27080........................... Custer County, Montana............
27 0.8833 0.8833 99927 27090........................... Daniels County, Montana...........
27 0.8833 0.8833 99927 27100........................... Dawson County, Montana............
27 0.8833 0.8833 99927 27110........................... Deer Lodge County, Montana........
27 0.8833 0.8833 99927 27113........................... Yellowstone National Park, Montana
27 0.8833 0.8833 99927 27120........................... Fallon County, Montana............
27 0.8833 0.8833 99927 27130........................... Fergus County, Montana............
27 0.8833 0.8833 99927 27140........................... Flathead County, Montana..........
27 0.8833 0.8833 99927 27150........................... Gallatin County, Montana..........
27 0.8833 0.8833 99927 27160........................... Garfield County, Montana..........
27 0.8833 0.8833 99927 27170........................... Glacier County, Montana...........
27 0.8833 0.8833 99927 27180........................... Golden Valley County, Montana.....
27 0.8833 0.8833 99927 27190........................... Granite County, Montana...........
27 0.8833 0.8833 99927 27200........................... Hill County, Montana..............
27 0.8833 0.8833 99927 27210........................... Jefferson County, Montana.........
27 0.8833 0.8833 99927 27220........................... Judith Basin County, Montana......
27 0.8833 0.8833 99927 27230........................... Lake County, Montana..............
27 0.8833 0.8833 99927 27240........................... Lewis And Clark County, Montana...
27 0.8833 0.8833 99927 27250........................... Liberty County, Montana...........
27 0.8833 0.8833 99927 27260........................... Lincoln County, Montana...........
27 0.8833 0.8833 99927
[[Page 29139]]
27270........................... Mc Cone County, Montana...........
27 0.8833 0.8833 99927 27280........................... Madison County, Montana...........
27 0.8833 0.8833 99927 27290........................... Meagher County, Montana...........
27 0.8833 0.8833 99927 27300........................... Mineral County, Montana...........
27 0.8833 0.8833 99927 27310........................... Missoula County, Montana.......... 5140 0.9482 0.9482 33540 27320........................... Musselshell County, Montana.......
27 0.8833 0.8833 99927 27330........................... Park County, Montana..............
27 0.8833 0.8833 99927 27340........................... Petroleum County, Montana.........
27 0.8833 0.8833 99927 27350........................... Phillips County, Montana..........
27 0.8833 0.8833 99927 27360........................... Pondera County, Montana...........
27 0.8833 0.8833 99927 27370........................... Powder River County, Montana......
27 0.8833 0.8833 99927 27380........................... Powell County, Montana............
27 0.8833 0.8833 99927 27390........................... Prairie County, Montana...........
27 0.8833 0.8833 99927 27400........................... Ravalli County, Montana...........
27 0.8833 0.8833 99927 27410........................... Richland County, Montana..........
27 0.8833 0.8833 99927 27420........................... Roosevelt County, Montana.........
27 0.8833 0.8833 99927 27430........................... Rosebud County, Montana...........
27 0.8833 0.8833 99927 27440........................... Sanders County, Montana...........
27 0.8833 0.8833 99927 27450........................... Sheridan County, Montana..........
27 0.8833 0.8833 99927 27460........................... Silver Bow County, Montana........
27 0.8833 0.8833 99927 27470........................... Stillwater County, Montana........
27 0.8833 0.8833 99927 27480........................... Sweet Grass County, Montana.......
27 0.8833 0.8833 99927 27490........................... Teton County, Montana.............
27 0.8833 0.8833 99927 27500........................... Toole County, Montana.............
27 0.8833 0.8833 99927 27510........................... Treasure County, Montana..........
27 0.8833 0.8833 99927 27520........................... Valley County, Montana............
27 0.8833 0.8833 99927 27530........................... Wheatland County, Montana.........
27 0.8833 0.8833 99927 27540........................... Wibaux County, Montana............
27 0.8833 0.8833 99927 27550........................... Yellowstone County, Montana....... 0880 0.8843 0.8843 13740 28000........................... Adams County, Nebraska............
28 0.8665 0.8665 99928 28010........................... Antelope County, Nebraska.........
28 0.8665 0.8665 99928 28020........................... Arthur County, Nebraska...........
28 0.8665 0.8665 99928 28030........................... Banner County, Nebraska...........
28 0.8665 0.8665 99928 28040........................... Blaine County, Nebraska...........
28 0.8665 0.8665 99928 28050........................... Boone County, Nebraska............
28 0.8665 0.8665 99928 28060........................... Box Butte County, Nebraska........
28 0.8665 0.8665 99928 28070........................... Boyd County, Nebraska.............
28 0.8665 0.8665 99928 28080........................... Brown County, Nebraska............
28 0.8665 0.8665 99928 28090........................... Buffalo County, Nebraska..........
28 0.8665 0.8665 99928 28100........................... Burt County, Nebraska.............
28 0.8665 0.8665 99928 28110........................... Butler County, Nebraska...........
28 0.8665 0.8665 99928 28120........................... Cass County, Nebraska............. 5920 0.9569 0.9569 36540 28130........................... Cedar County, Nebraska............
28 0.8665 0.8665 99928 28140........................... Chase County, Nebraska............
28 0.8665 0.8665 99928 28150........................... Cherry County, Nebraska...........
28 0.8665 0.8665 99928 28160........................... Cheyenne County, Nebraska.........
28 0.8665 0.8665 99928 28170........................... Clay County, Nebraska.............
28 0.8665 0.8665 99928 28180........................... Colfax County, Nebraska...........
28 0.8665 0.8665 99928 28190........................... Cuming County, Nebraska...........
28 0.8665 0.8665 99928 28200........................... Custer County, Nebraska...........
28 0.8665 0.8665 99928 28210........................... Dakota County, Nebraska........... 7720 0.9411 0.9376 43580 28220........................... Dawes County, Nebraska............
28 0.8665 0.8665 99928 28230........................... Dawson County, Nebraska...........
28 0.8665 0.8665 99928 28240........................... Deuel County, Nebraska............
28 0.8665 0.8665 99928 28250........................... Dixon County, Nebraska............
28 0.8665 0.9376 43580 28260........................... Dodge County, Nebraska............
28 0.8665 0.8665 99928 28270........................... Douglas County, Nebraska.......... 5920 0.9569 0.9569 36540 28280........................... Dundy County, Nebraska............
28 0.8665 0.8665 99928 28290........................... Fillmore County, Nebraska.........
28 0.8665 0.8665 99928 28300........................... Franklin County, Nebraska.........
28 0.8665 0.8665 99928 28310........................... Frontier County, Nebraska.........
28 0.8665 0.8665 99928 28320........................... Furnas County, Nebraska...........
28 0.8665 0.8665 99928 28330........................... Gage County, Nebraska.............
28 0.8665 0.8665 99928 28340........................... Garden County, Nebraska...........
28 0.8665 0.8665 99928 28350........................... Garfield County, Nebraska.........
28 0.8665 0.8665 99928 28360........................... Gosper County, Nebraska...........
28 0.8665 0.8665 99928 28370........................... Grant County, Nebraska............
28 0.8665 0.8665 99928 28380........................... Greeley County, Nebraska..........
28 0.8665 0.8665 99928 28390........................... Hall County, Nebraska.............
28 0.8665 0.8665 99928
[[Page 29140]]
28400........................... Hamilton County, Nebraska.........
28 0.8665 0.8665 99928 28410........................... Harlan County, Nebraska...........
28 0.8665 0.8665 99928 28420........................... Hayes County, Nebraska............
28 0.8665 0.8665 99928 28430........................... Hitchcock County, Nebraska........
28 0.8665 0.8665 99928 28440........................... Holt County, Nebraska.............
28 0.8665 0.8665 99928 28450........................... Hooker County, Nebraska...........
28 0.8665 0.8665 99928 28460........................... Howard County, Nebraska...........
28 0.8665 0.8665 99928 28470........................... Jefferson County, Nebraska........
28 0.8665 0.8665 99928 28480........................... Johnson County, Nebraska..........
28 0.8665 0.8665 99928 28490........................... Kearney County, Nebraska..........
28 0.8665 0.8665 99928 28500........................... Keith County, Nebraska............
28 0.8665 0.8665 99928 28510........................... Keya Paha County, Nebraska........
28 0.8665 0.8665 99928 28520........................... Kimball County, Nebraska..........
28 0.8665 0.8665 99928 28530........................... Knox County, Nebraska.............
28 0.8665 0.8665 99928 28540........................... Lancaster County, Nebraska........ 4360 1.0225 1.0225 30700 28550........................... Lincoln County, Nebraska..........
28 0.8665 0.8665 99928 28560........................... Logan County, Nebraska............
28 0.8665 0.8665 99928 28570........................... Loup County, Nebraska.............
28 0.8665 0.8665 99928 28580........................... Mc Pherson County, Nebraska.......
28 0.8665 0.8665 99928 28590........................... Madison County, Nebraska..........
28 0.8665 0.8665 99928 28600........................... Merrick County, Nebraska..........
28 0.8665 0.8665 99928 28610........................... Morrill County, Nebraska..........
28 0.8665 0.8665 99928 28620........................... Nance County, Nebraska............
28 0.8665 0.8665 99928 28630........................... Nemaha County, Nebraska...........
28 0.8665 0.8665 99928 28640........................... Nuckolls County, Nebraska.........
28 0.8665 0.8665 99928 28650........................... Otoe County, Nebraska.............
28 0.8665 0.8665 99928 28660........................... Pawnee County, Nebraska...........
28 0.8665 0.8665 99928 28670........................... Perkins County, Nebraska..........
28 0.8665 0.8665 99928 28680........................... Phelps County, Nebraska...........
28 0.8665 0.8665 99928 28690........................... Pierce County, Nebraska...........
28 0.8665 0.8665 99928 28700........................... Platte County, Nebraska...........
28 0.8665 0.8665 99928 28710........................... Polk County, Nebraska.............
28 0.8665 0.8665 99928 28720........................... Redwillow County, Nebraska........
28 0.8665 0.8665 99928 28730........................... Richardson County, Nebraska.......
28 0.8665 0.8665 99928 28740........................... Rock County, Nebraska.............
28 0.8665 0.8665 99928 28750........................... Saline County, Nebraska...........
28 0.8665 0.8665 99928 28760........................... Sarpy County, Nebraska............ 5920 0.9569 0.9569 36540 28770........................... Saunders County, Nebraska.........
28 0.8665 0.9569 36540 28780........................... Scotts Bluff County, Nebraska.....
28 0.8665 0.8665 99928 28790........................... Seward County, Nebraska...........
28 0.8665 1.0225 30700 28800........................... Sheridan County, Nebraska.........
28 0.8665 0.8665 99928 28810........................... Sherman County, Nebraska..........
28 0.8665 0.8665 99928 28820........................... Sioux County, Nebraska............
28 0.8665 0.8665 99928 28830........................... Stanton County, Nebraska..........
28 0.8665 0.8665 99928 28840........................... Thayer County, Nebraska...........
28 0.8665 0.8665 99928 28850........................... Thomas County, Nebraska...........
28 0.8665 0.8665 99928 28860........................... Thurston County, Nebraska.........
28 0.8665 0.8665 99928 28870........................... Valley County, Nebraska...........
28 0.8665 0.8665 99928 28880........................... Washington County, Nebraska....... 5920 0.9569 0.9569 36540 28890........................... Wayne County, Nebraska............
28 0.8665 0.8665 99928 28900........................... Webster County, Nebraska..........
28 0.8665 0.8665 99928 28910........................... Wheeler County, Nebraska..........
28 0.8665 0.8665 99928 28920........................... York County, Nebraska.............
28 0.8665 0.8665 99928 29000........................... Churchill County, Nevada..........
29 0.9697 0.9074 99929 29010........................... Clark County, Nevada.............. 4120 1.1166 1.1449 29820 29020........................... Douglas County, Nevada............
29 0.9697 0.9074 99929 29030........................... Elko County, Nevada...............
29 0.9697 0.9074 99929 29040........................... Esmeralda County, Nevada..........
29 0.9697 0.9074 99929 29050........................... Eureka County, Nevada.............
29 0.9697 0.9074 99929 29060........................... Humboldt County, Nevada...........
29 0.9697 0.9074 99929 29070........................... Lander County, Nevada.............
29 0.9697 0.9074 99929 29080........................... Lincoln County, Nevada............
29 0.9697 0.9074 99929 29090........................... Lyon County, Nevada...............
29 0.9697 0.9074 99929 29100........................... Mineral County, Nevada............
29 0.9697 0.9074 99929 29110........................... Nye County, Nevada................ 4120 1.1166 0.9074 99929 29120........................... Carson City County, Nevada........
29 0.9697 1.0244 16180 29130........................... Pershing County, Nevada...........
29 0.9697 0.9074 99929 29140........................... Storey County, Nevada.............
29 0.9697 1.0993 39900 29150........................... Washoe County, Nevada............. 6720 1.0993 1.0993 39900
[[Page 29141]]
29160........................... White Pine County, Nevada.........
29 0.9697 0.9074 99929 30000........................... Belknap County, New Hampshire.....
30 1.0677 1.0677 99930 30010........................... Carroll County, New Hampshire.....
30 1.0677 1.0677 99930 30020........................... Cheshire County, New Hampshire....
30 1.0677 1.0677 99930 30030........................... Coos County, New Hampshire........
30 1.0677 1.0677 99930 30040........................... Grafton County, New Hampshire.....
30 1.0677 1.0677 99930 30050........................... Hillsboro County, New Hampshire... 1123 1.1152 1.0335 31700 30060........................... Merrimack County, New Hampshire... 1123 1.1152 1.0335 31700 30070........................... Rockingham County, New Hampshire.. 1123 1.1152 1.0385 40484 30080........................... Strafford County, New Hampshire... 1123 1.1152 1.0385 40484 30090........................... Sullivan County, New Hampshire....
30 1.0677 1.0677 99930 31000........................... Atlantic County, New Jersey....... 0560 1.1513 1.1633 12100 31100........................... Bergen County, New Jersey......... 0875 1.1660 1.3185 35644 31150........................... Burlington County, New Jersey..... 6160 1.0926 1.0528 15804 31160........................... Camden County, New Jersey......... 6160 1.0926 1.0528 15804 31180........................... Cape May County, New Jersey....... 0560 1.1513 1.1022 36140 31190........................... Cumberland County, New Jersey..... 8760 0.9837 0.9837 47220 31200........................... Essex County, New Jersey.......... 5640 1.2141 1.2195 35084 31220........................... Gloucester County, New Jersey..... 6160 1.0926 1.0528 15804 31230........................... Hudson County, New Jersey......... 3640 1.1349 1.3185 35644 31250........................... Hunterdon County, New Jersey...... 5015 1.1178 1.2195 35084 31260........................... Mercer County, New Jersey......... 8480 1.0845 1.0845 45940 31270........................... Middlesex County, New Jersey...... 5015 1.1178 1.1260 20764 31290........................... Monmouth County, New Jersey....... 5190 1.1271 1.1260 20764 31300........................... Morris County, New Jersey......... 5640 1.2141 1.2195 35084 31310........................... Ocean County, New Jersey.......... 5190 1.1271 1.1260 20764 31320........................... Passaic County, New Jersey........ 0875 1.1660 1.3185 35644 31340........................... Salem County, New Jersey.......... 6160 1.0926 1.0482 48864 31350........................... Somerset County, New Jersey....... 5015 1.1178 1.1260 20764 31360........................... Sussex County, New Jersey......... 5640 1.2141 1.2195 35084 31370........................... Union County, New Jersey.......... 5640 1.2141 1.2195 35084 31390........................... Warren County, New Jersey......... 5640 1.2141 0.9828 10900 32000........................... Bernalillo County, New Mexico..... 0200 0.9693 0.9693 10740 32010........................... Catron County, New Mexico.........
32 0.8571 0.8644 99932 32020........................... Chaves County, New Mexico.........
32 0.8571 0.8644 99932 32025........................... Cibola County, New Mexico.........
32 0.8571 0.8644 99932 32030........................... Colfax County, New Mexico.........
32 0.8571 0.8644 99932 32040........................... Curry County, New Mexico..........
32 0.8571 0.8644 99932 32050........................... De Baca County, New Mexico........
32 0.8571 0.8644 99932 32060........................... Dona Ana County, New Mexico....... 4100 0.8475 0.8475 29740 32070........................... Eddy County, New Mexico...........
32 0.8571 0.8644 99932 32080........................... Grant County, New Mexico..........
32 0.8571 0.8644 99932 32090........................... Guadalupe County, New Mexico......
32 0.8571 0.8644 99932 32100........................... Harding County, New Mexico........
32 0.8571 0.8644 99932 32110........................... Hidalgo County, New Mexico........
32 0.8571 0.8644 99932 32120........................... Lea County, New Mexico............
32 0.8571 0.8644 99932 32130........................... Lincoln County, New Mexico........
32 0.8571 0.8644 99932 32131........................... Los Alamos County, New Mexico..... 7490 1.0759 0.8644 99932 32140........................... Luna County, New Mexico...........
32 0.8571 0.8644 99932 32150........................... Mc Kinley County, New Mexico......
32 0.8571 0.8644 99932 32160........................... Mora County, New Mexico...........
32 0.8571 0.8644 99932 32170........................... Otero County, New Mexico..........
32 0.8571 0.8644 99932 32180........................... Quay County, New Mexico...........
32 0.8571 0.8644 99932 32190........................... Rio Arriba County, New Mexico.....
32 0.8571 0.8644 99932 32200........................... Roosevelt County, New Mexico......
32 0.8571 0.8644 99932 32210........................... Sandoval County, New Mexico....... 0200 0.9693 0.9693 10740 32220........................... San Juan County, New Mexico.......
32 0.8571 0.8518 22140 32230........................... San Miguel County, New Mexico.....
32 0.8571 0.8644 99932 32240........................... Santa Fe County, New Mexico....... 7490 1.0759 1.0931 42140 32250........................... Sierra County, New Mexico.........
32 0.8571 0.8644 99932 32260........................... Socorro County, New Mexico........
32 0.8571 0.8644 99932 32270........................... Taos County, New Mexico...........
32 0.8571 0.8644 99932 32280........................... Torrance County, New Mexico.......
32 0.8571 0.9693 10740 32290........................... Union County, New Mexico..........
32 0.8571 0.8644 99932 32300........................... Valencia County, New Mexico....... 0200 0.9693 0.9693 10740 33000........................... Albany County, New York........... 0160 0.8518 0.8545 10580 33010........................... Allegany County, New York.........
33 0.8395 0.8157 99933 33020........................... Bronx County, New York............ 5600 1.3465 1.3185 35644 33030........................... Broome County, New York........... 0960 0.8571 0.8571 13780
[[Page 29142]]
33040........................... Cattaraugus County, New York......
33 0.8395 0.8157 99933 33050........................... Cayuga County, New York........... 8160 0.9499 0.8157 99933 33060........................... Chautauqua County, New York....... 3610 0.7552 0.8157 99933 33070........................... Chemung County, New York.......... 2335 0.8259 0.8259 21300 33080........................... Chenango County, New York.........
33 0.8395 0.8157 99933 33090........................... Clinton County, New York..........
33 0.8395 0.8157 99933 33200........................... Columbia County, New York.........
33 0.8395 0.8157 99933 33210........................... Cortland County, New York.........
33 0.8395 0.8157 99933 33220........................... Delaware County, New York.........
33 0.8395 0.8157 99933 33230........................... Dutchess County, New York......... 2281 1.0183 1.0766 39100 33240........................... Erie County, New York............. 1280 0.8889 0.8889 15380 33260........................... Essex County, New York............
33 0.8395 0.8157 99933 33270........................... Franklin County, New York.........
33 0.8395 0.8157 99933 33280........................... Fulton County, New York...........
33 0.8395 0.8157 99933 33290........................... Genesee County, New York.......... 6840 0.9044 0.8157 99933 33300........................... Greene County, New York...........
33 0.8395 0.8157 99933 33310........................... Hamilton County, New York.........
33 0.8395 0.8157 99933 33320........................... Herkimer County, New York......... 8680 0.8293 0.8293 46540 33330........................... Jefferson County, New York........
33 0.8395 0.8157 99933 33331........................... Kings County, New York............ 5600 1.3465 1.3185 35644 33340........................... Lewis County, New York............
33 0.8395 0.8157 99933 33350........................... Livingston County, New York....... 6840 0.9044 0.9115 40380 33360........................... Madison County, New York.......... 8160 0.9499 0.9581 45060 33370........................... Monroe County, New York........... 6840 0.9044 0.9115 40380 33380........................... Montgomery County, New York....... 0160 0.8518 0.8157 99933 33400........................... Nassau County, New York........... 5380 1.2760 1.2760 35004 33420........................... New York County, New York......... 5600 1.3465 1.3185 35644 33500........................... Niagara County, New York.......... 1280 0.8889 0.8889 15380 33510........................... Oneida County, New York........... 8680 0.8293 0.8293 46540 33520........................... Onondaga County, New York......... 8160 0.9499 0.9581 45060 33530........................... Ontario County, New York.......... 6840 0.9044 0.9115 40380 33540........................... Orange County, New York........... 5660 1.1218 1.0766 39100 33550........................... Orleans County, New York.......... 6840 0.9044 0.9115 40380 33560........................... Oswego County, New York........... 8160 0.9499 0.9581 45060 33570........................... Otsego County, New York...........
33 0.8395 0.8157 99933 33580........................... Putnam County, New York........... 5600 1.3465 1.3185 35644 33590........................... Queens County, New York........... 5600 1.3465 1.3185 35644 33600........................... Rensselaer County, New York....... 0160 0.8518 0.8545 10580 33610........................... Richmond County, New York......... 5600 1.3465 1.3185 35644 33620........................... Rockland County, New York......... 5600 1.3465 1.3185 35644 33630........................... St Lawrence County, New York......
33 0.8395 0.8157 99933 33640........................... Saratoga County, New York......... 0160 0.8518 0.8545 10580 33650........................... Schenectady County, New York...... 0160 0.8518 0.8545 10580 33660........................... Schoharie County, New York........ 0160 0.8518 0.8545 10580 33670........................... Schuyler County, New York.........
33 0.8395 0.8157 99933 33680........................... Seneca County, New York...........
33 0.8395 0.8157 99933 33690........................... Steuben County, New York..........
33 0.8395 0.8157 99933 33700........................... Suffolk County, New York.......... 5380 1.2760 1.2760 35004 33710........................... Sullivan County, New York.........
33 0.8395 0.8157 99933 33720........................... Tioga County, New York............ 0960 0.8571 0.8571 13780 33730........................... Tompkins County, New York.........
33 0.8395 0.9803 27060 33740........................... Ulster County, New York...........
33 0.8395 0.9257 28740 33750........................... Warren County, New York........... 2975 0.8567 0.8567 24020 33760........................... Washington County, New York....... 2975 0.8567 0.8567 24020 33770........................... Wayne County, New York............ 6840 0.9044 0.9115 40380 33800........................... Westchester County, New York...... 5600 1.3465 1.3185 35644 33900........................... Wyoming County, New York..........
33 0.8395 0.8157 99933 33910........................... Yates County, New York............
33 0.8395 0.8157 99933 34000........................... Alamance County, N Carolina....... 3120 0.9027 0.8914 15500 34010........................... Alexander County, N Carolina...... 3290 0.8922 0.8922 25860 34020........................... Alleghany County, N Carolina......
34 0.8490 0.8567 99934 34030........................... Anson County, N Carolina..........
34 0.8490 0.9760 16740 34040........................... Ashe County, N Carolina...........
34 0.8490 0.8567 99934 34050........................... Avery County, N Carolina..........
34 0.8490 0.8567 99934 34060........................... Beaufort County, N Carolina.......
34 0.8490 0.8567 99934 34070........................... Bertie County, N Carolina.........
34 0.8490 0.8567 99934 34080........................... Bladen County, N Carolina.........
34 0.8490 0.8567 99934 34090........................... Brunswick County, N Carolina...... 9200 0.9592 0.9592 48900 34100........................... Buncombe County, N Carolina....... 0480 0.9747 0.9294 11700
[[Page 29143]]
34110........................... Burke County, N Carolina.......... 3290 0.8922 0.8922 25860 34120........................... Cabarrus County, N Carolina....... 1520 0.9725 0.9760 16740 34130........................... Caldwell County, N Carolina....... 3290 0.8922 0.8922 25860 34140........................... Camden County, N Carolina.........
34 0.8490 0.8567 99934 34150........................... Carteret County, N Carolina.......
34 0.8490 0.8567 99934 34160........................... Caswell County, N Carolina........
34 0.8490 0.8567 99934 34170........................... Catawba County, N Carolina........ 3290 0.8922 0.8922 25860 34180........................... Chatham County, N Carolina........ 6640 1.0087 1.0303 20500 34190........................... Cherokee County, N Carolina.......
34 0.8490 0.8567 99934 34200........................... Chowan County, N Carolina.........
34 0.8490 0.8567 99934 34210........................... Clay County, N Carolina...........
34 0.8490 0.8567 99934 34220........................... Cleveland County, N Carolina......
34 0.8490 0.8567 99934 34230........................... Columbus County, N Carolina.......
34 0.8490 0.8567 99934 34240........................... Craven County, N Carolina.........
34 0.8490 0.8567 99934 34250........................... Cumberland County, N Carolina..... 2560 0.9426 0.9426 22180 34251........................... Currituck County, N Carolina...... 5720 0.8808 0.8808 47260 34270........................... Dare County, N Carolina...........
34 0.8490 0.8567 99934 34280........................... Davidson County, N Carolina....... 3120 0.9027 0.8567 99934 34290........................... Davie County, N Carolina.......... 3120 0.9027 0.8953 49180 34300........................... Duplin County, N Carolina.........
34 0.8490 0.8567 99934 34310........................... Durham County, N Carolina......... 6640 1.0087 1.0303 20500 34320........................... Edgecombe County, N Carolina...... 6895 0.8924 0.8924 40580 34330........................... Forsyth County, N Carolina........ 3120 0.9027 0.8953 49180 34340........................... Franklin County, N Carolina....... 6640 1.0087 0.9733 39580 34350........................... Gaston County, N Carolina......... 1520 0.9725 0.9760 16740 34360........................... Gates County, N Carolina..........
34 0.8490 0.8567 99934 34370........................... Graham County, N Carolina.........
34 0.8490 0.8567 99934 34380........................... Granville County, N Carolina......
34 0.8490 0.8567 99934 34390........................... Greene County, N Carolina.........
34 0.8490 0.9434 24780 34400........................... Guilford County, N Carolina....... 3120 0.9027 0.9113 24660 34410........................... Halifax County, N Carolina........
34 0.8490 0.8567 99934 34420........................... Harnett County, N Carolina........
34 0.8490 0.8567 99934 34430........................... Haywood County, N Carolina........
34 0.8490 0.9294 11700 34440........................... Henderson County, N Carolina......
34 0.8490 0.9294 11700 34450........................... Hertford County, N Carolina.......
34 0.8490 0.8567 99934 34460........................... Hoke County, N Carolina...........
34 0.8490 0.9426 22180 34470........................... Hyde County, N Carolina...........
34 0.8490 0.8567 99934 34480........................... Iredell County, N Carolina........
34 0.8490 0.8567 99934 34490........................... Jackson County, N Carolina........
34 0.8490 0.8567 99934 34500........................... Johnston County, N Carolina....... 6640 1.0087 0.9733 39580 34510........................... Jones County, N Carolina..........
34 0.8490 0.8567 99934 34520........................... Lee County, N Carolina............
34 0.8490 0.8567 99934 34530........................... Lenoir County, N Carolina.........
34 0.8490 0.8567 99934 34540........................... Lincoln County, N Carolina........ 1520 0.9725 0.8567 99934 34550........................... Mc Dowell County, N Carolina......
34 0.8490 0.8567 99934 34560........................... Macon County, N Carolina..........
34 0.8490 0.8567 99934 34570........................... Madison County, N Carolina........ 0480 0.9747 0.9294 11700 34580........................... Martin County, N Carolina.........
34 0.8490 0.8567 99934 34590........................... Mecklenburg County, N Carolina.... 1520 0.9725 0.9760 16740 34600........................... Mitchell County, N Carolina.......
34 0.8490 0.8567 99934 34610........................... Montgomery County, N Carolina.....
34 0.8490 0.8567 99934 34620........................... Moore County, N Carolina..........
34 0.8490 0.8567 99934 34630........................... Nash County, N Carolina........... 6895 0.8924 0.8924 40580 34640........................... New Hanover County, N Carolina.... 9200 0.9592 0.9592 48900 34650........................... Northampton County, N Carolina....
34 0.8490 0.8567 99934 34660........................... Onslow County, N Carolina......... 3605 0.8244 0.8244 27340 34670........................... Orange County, N Carolina......... 6640 1.0087 1.0303 20500 34680........................... Pamlico County, N Carolina........
34 0.8490 0.8567 99934 34690........................... Pasquotank County, N Carolina.....
34 0.8490 0.8567 99934 34700........................... Pender County, N Carolina.........
34 0.8490 0.9592 48900 34710........................... Perquimans County, N Carolina.....
34 0.8490 0.8567 99934 34720........................... Person County, N Carolina.........
34 0.8490 1.0303 20500 34730........................... Pitt County, N Carolina........... 3150 0.9434 0.9434 24780 34740........................... Polk County, N Carolina...........
34 0.8490 0.8567 99934 34750........................... Randolph County, N Carolina....... 3120 0.9027 0.9113 24660 34760........................... Richmond County, N Carolina.......
34 0.8490 0.8567 99934 34770........................... Robeson County, N Carolina........
34 0.8490 0.8567 99934 34780........................... Rockingham County, N Carolina.....
34 0.8490 0.9113 24660 34790........................... Rowan County, N Carolina.......... 1520 0.9725 0.8567 99934
[[Page 29144]]
34800........................... Rutherford County, N Carolina.....
34 0.8490 0.8567 99934 34810........................... Sampson County, N Carolina........
34 0.8490 0.8567 99934 34820........................... Scotland County, N Carolina.......
34 0.8490 0.8567 99934 34830........................... Stanly County, N Carolina......... 1520 0.9725 0.9760 16740 34840........................... Stokes County, N Carolina......... 3120 0.9027 0.8953 49180 34850........................... Surry County, N Carolina..........
34 0.8490 0.8567 99934 34860........................... Swain County, N Carolina..........
34 0.8490 0.8567 99934 34870........................... Transylvania County, N Carolina...
34 0.8490 0.8567 99934 34880........................... Tyrrell County, N Carolina........
34 0.8490 0.8567 99934 34890........................... Union County, N Carolina.......... 1520 0.9725 0.9760 16740 34900........................... Vance County, N Carolina..........
34 0.8490 0.8567 99934 34910........................... Wake County, N Carolina........... 6640 1.0087 0.9733 39580 34920........................... Warren County, N Carolina.........
34 0.8490 0.8567 99934 34930........................... Washington County, N Carolina.....
34 0.8490 0.8567 99934 34940........................... Watauga County, N Carolina........
34 0.8490 0.8567 99934 34950........................... Wayne County, N Carolina.......... 2980 0.8784 0.8784 24140 34960........................... Wilkes County, N Carolina.........
34 0.8490 0.8567 99934 34970........................... Wilson County, N Carolina.........
34 0.8490 0.8567 99934 34980........................... Yadkin County, N Carolina......... 3120 0.9027 0.8953 49180 34981........................... Yancey County, N Carolina.........
34 0.8490 0.8567 99934 35000........................... Adams County, N Dakota............
35 0.7268 0.7268 99935 35010........................... Barnes County, N Dakota...........
35 0.7268 0.7268 99935 35020........................... Benson County, N Dakota...........
35 0.7268 0.7268 99935 35030........................... Billings County, N Dakota.........
35 0.7268 0.7268 99935 35040........................... Bottineau County, N Dakota........
35 0.7268 0.7268 99935 35050........................... Bowman County, N Dakota...........
35 0.7268 0.7268 99935 35060........................... Burke County, N Dakota............
35 0.7268 0.7268 99935 35070........................... Burleigh County, N Dakota......... 1010 0.7519 0.7519 13900 35080........................... Cass County, N Dakota............. 2520 0.8495 0.8495 22020 35090........................... Cavalier County, N Dakota.........
35 0.7268 0.7268 99935 35100........................... Dickey County, N Dakota...........
35 0.7268 0.7268 99935 35110........................... Divide County, N Dakota...........
35 0.7268 0.7268 99935 35120........................... Dunn County, N Dakota.............
35 0.7268 0.7268 99935 35130........................... Eddy County, N Dakota.............
35 0.7268 0.7268 99935 35140........................... Emmons County, N Dakota...........
35 0.7268 0.7268 99935 35150........................... Foster County, N Dakota...........
35 0.7268 0.7268 99935 35160........................... Golden Valley County, N Dakota....
35 0.7268 0.7268 99935 35170........................... Grand Forks County, N Dakota...... 2985 1.1516 1.1516 24220 35180........................... Grant County, N Dakota............
35 0.7268 0.7268 99935 35190........................... Griggs County, N Dakota...........
35 0.7268 0.7268 99935 35200........................... Hettinger County, N Dakota........
35 0.7268 0.7268 99935 35210........................... Kidder County, N Dakota...........
35 0.7268 0.7268 99935 35220........................... La Moure County, N Dakota.........
35 0.7268 0.7268 99935 35230........................... Logan County, N Dakota............
35 0.7268 0.7268 99935 35240........................... Mc Henry County, N Dakota.........
35 0.7268 0.7268 99935 35250........................... Mc Intosh County, N Dakota........
35 0.7268 0.7268 99935 35260........................... Mc Kenzie County, N Dakota........
35 0.7268 0.7268 99935 35270........................... Mc Lean County, N Dakota..........
35 0.7268 0.7268 99935 35280........................... Mercer County, N Dakota...........
35 0.7268 0.7268 99935 35290........................... Morton County, N Dakota........... 1010 0.7519 0.7519 13900 35300........................... Mountrail County, N Dakota........
35 0.7268 0.7268 99935 35310........................... Nelson County, N Dakota...........
35 0.7268 0.7268 99935 35320........................... Oliver County, N Dakota...........
35 0.7268 0.7268 99935 35330........................... Pembina County, N Dakota..........
35 0.7268 0.7268 99935 35340........................... Pierce County, N Dakota...........
35 0.7268 0.7268 99935 35350........................... Ramsey County, N Dakota...........
35 0.7268 0.7268 99935 35360........................... Ransom County, N Dakota...........
35 0.7268 0.7268 99935 35370........................... Renville County, N Dakota.........
35 0.7268 0.7268 99935 35380........................... Richland County, N Dakota.........
35 0.7268 0.7268 99935 35390........................... Rolette County, N Dakota..........
35 0.7268 0.7268 99935 35400........................... Sargent County, N Dakota..........
35 0.7268 0.7268 99935 35410........................... Sheridan County, N Dakota.........
35 0.7268 0.7268 99935 35420........................... Sioux County, N Dakota............
35 0.7268 0.7268 99935 35430........................... Slope County, N Dakota............
35 0.7268 0.7268 99935 35440........................... Stark County, N Dakota............
35 0.7268 0.7268 99935 35450........................... Steele County, N Dakota...........
35 0.7268 0.7268 99935 35460........................... Stutsman County, N Dakota.........
35 0.7268 0.7268 99935 35470........................... Towner County, N Dakota...........
35 0.7268 0.7268 99935 35480........................... Traill County, N Dakota...........
35 0.7268 0.7268 99935
[[Page 29145]]
35490........................... Walsh County, N Dakota............
35 0.7268 0.7268 99935 35500........................... Ward County, N Dakota.............
35 0.7268 0.7268 99935 35510........................... Wells County, N Dakota............
35 0.7268 0.7268 99935 35520........................... Williams County, N Dakota.........
35 0.7268 0.7268 99935 36000........................... Adams County, Ohio................
36 0.8886 0.8786 99936 36010........................... Allen County, Ohio................ 4320 0.9128 0.9234 30620 36020........................... Ashland County, Ohio..............
36 0.8886 0.8786 99936 36030........................... Ashtabula County, Ohio............ 1680 0.9174 0.8786 99936 36040........................... Athens County, Ohio...............
36 0.8886 0.8786 99936 36050........................... Auglaize County, Ohio............. 4320 0.9128 0.8786 99936 36060........................... Belmont County, Ohio.............. 9000 0.7168 0.7168 48540 36070........................... Brown County, Ohio................ 1640 0.9742 0.9623 17140 36080........................... Butler County, Ohio............... 3200 0.8960 0.9623 17140 36090........................... Carroll County, Ohio.............. 1320 0.8944 0.8944 15940 36100........................... Champaign County, Ohio............
36 0.8886 0.8786 99936 36110........................... Clark County, Ohio................ 2000 0.8989 0.8404 44220 36120........................... Clermont County, Ohio............. 1640 0.9742 0.9623 17140 36130........................... Clinton County, Ohio..............
36 0.8886 0.8786 99936 36140........................... Columbiana County, Ohio........... 9320 0.8857 0.8786 99936 36150........................... Coshocton County, Ohio............
36 0.8886 0.8786 99936 36160........................... Crawford County, Ohio............. 4800 0.8886 0.8786 99936 36170........................... Cuyahoga County, Ohio............. 1680 0.9174 0.9204 17460 36190........................... Darke County, Ohio................
36 0.8886 0.8786 99936 36200........................... Defiance County, Ohio.............
36 0.8886 0.8786 99936 36210........................... Delaware County, Ohio............. 1840 0.9864 0.9850 18140 36220........................... Erie County, Ohio.................
36 0.8886 0.9025 41780 36230........................... Fairfield County, Ohio............ 1840 0.9864 0.9850 18140 36240........................... Fayette County, Ohio..............
36 0.8886 0.8786 99936 36250........................... Franklin County, Ohio............. 1840 0.9864 0.9850 18140 36260........................... Fulton County, Ohio............... 8400 0.9584 0.9584 45780 36270........................... Gallia County, Ohio...............
36 0.8886 0.8786 99936 36280........................... Geauga County, Ohio............... 1680 0.9174 0.9204 17460 36290........................... Greene County, Ohio............... 2000 0.8989 0.9073 19380 36300........................... Guernsey County, Ohio.............
36 0.8886 0.8786 99936 36310........................... Hamilton County, Ohio............. 1640 0.9742 0.9623 17140 36330........................... Hancock County, Ohio..............
36 0.8886 0.8786 99936 36340........................... Hardin County, Ohio...............
36 0.8886 0.8786 99936 36350........................... Harrison County, Ohio.............
36 0.8886 0.8786 99936 36360........................... Henry County, Ohio................
36 0.8886 0.8786 99936 36370........................... Highland County, Ohio.............
36 0.8886 0.8786 99936 36380........................... Hocking County, Ohio..............
36 0.8886 0.8786 99936 36390........................... Holmes County, Ohio...............
36 0.8886 0.8786 99936 36400........................... Huron County, Ohio................
36 0.8886 0.8786 99936 36410........................... Jackson County, Ohio..............
36 0.8886 0.8786 99936 36420........................... Jefferson County, Ohio............ 8080 0.7827 0.7827 48260 36430........................... Knox County, Ohio.................
36 0.8886 0.8786 99936 36440........................... Lake County, Ohio................. 1680 0.9174 0.9204 17460 36450........................... Lawrence County, Ohio............. 3400 0.9486 0.9486 26580 36460........................... Licking County, Ohio.............. 1840 0.9864 0.9850 18140 36470........................... Logan County, Ohio................
36 0.8886 0.8786 99936 36480........................... Lorain County, Ohio............... 1680 0.9174 0.9204 17460 36490........................... Lucas County, Ohio................ 8400 0.9584 0.9584 45780 36500........................... Madison County, Ohio.............. 1840 0.9864 0.9850 18140 36510........................... Mahoning County, Ohio............. 9320 0.8857 0.8611 49660 36520........................... Marion County, Ohio...............
36 0.8886 0.8786 99936 36530........................... Medina County, Ohio............... 1680 0.9174 0.9204 17460 36540........................... Meigs County, Ohio................
36 0.8886 0.8786 99936 36550........................... Mercer County, Ohio...............
36 0.8886 0.8786 99936 36560........................... Miami County, Ohio................ 2000 0.8989 0.9073 19380 36570........................... Monroe County, Ohio...............
36 0.8886 0.8786 99936 36580........................... Montgomery County, Ohio........... 2000 0.8989 0.9073 19380 36590........................... Morgan County, Ohio...............
36 0.8886 0.8786 99936 36600........................... Morrow County, Ohio...............
36 0.8886 0.9850 18140 36610........................... Muskingum County, Ohio............
36 0.8886 0.8786 99936 36620........................... Noble County, Ohio................
36 0.8886 0.8786 99936 36630........................... Ottawa County, Ohio...............
36 0.8886 0.9584 45780 36640........................... Paulding County, Ohio.............
36 0.8886 0.8786 99936 36650........................... Perry County, Ohio................
36 0.8886 0.8786 99936 36660........................... Pickaway County, Ohio............. 1840 0.9864 0.9850 18140
[[Page 29146]]
36670........................... Pike County, Ohio.................
36 0.8886 0.8786 99936 36680........................... Portage County, Ohio.............. 0080 0.8991 0.8991 10420 36690........................... Preble County, Ohio...............
36 0.8886 0.9073 19380 36700........................... Putnam County, Ohio...............
36 0.8886 0.8786 99936 36710........................... Richland County, Ohio............. 4800 0.8886 0.8887 31900 36720........................... Ross County, Ohio.................
36 0.8886 0.8786 99936 36730........................... Sandusky County, Ohio.............
36 0.8886 0.8786 99936 36740........................... Scioto County, Ohio...............
36 0.8886 0.8786 99936 36750........................... Seneca County, Ohio...............
36 0.8886 0.8786 99936 36760........................... Shelby County, Ohio...............
36 0.8886 0.8786 99936 36770........................... Stark County, Ohio................ 1320 0.8944 0.8944 15940 36780........................... Summit County, Ohio............... 0080 0.8991 0.8991 10420 36790........................... Trumbull County, Ohio............. 9320 0.8857 0.8611 49660 36800........................... Tuscarawas County, Ohio...........
36 0.8886 0.8786 99936 36810........................... Union County, Ohio................
36 0.8886 0.9850 18140 36820........................... Van Wert County, Ohio.............
36 0.8886 0.8786 99936 36830........................... Vinton County, Ohio...............
36 0.8886 0.8786 99936 36840........................... Warren County, Ohio............... 1640 0.9742 0.9623 17140 36850........................... Washington County, Ohio........... 6020 0.8278 0.8278 37620 36860........................... Wayne County, Ohio................
36 0.8886 0.8786 99936 36870........................... Williams County, Ohio.............
36 0.8886 0.8786 99936 36880........................... Wood County, Ohio................. 8400 0.9584 0.9584 45780 36890........................... Wyandot County, Ohio..............
36 0.8886 0.8786 99936 37000........................... Adair County, Oklahoma............
37 0.7450 0.7589 99937 37010........................... Alfalfa County, Oklahoma..........
37 0.7450 0.7589 99937 37020........................... Atoka County, Oklahoma............
37 0.7450 0.7589 99937 37030........................... Beaver County, Oklahoma...........
37 0.7450 0.7589 99937 37040........................... Beckham County, Oklahoma..........
37 0.7450 0.7589 99937 37050........................... Blaine County, Oklahoma...........
37 0.7450 0.7589 99937 37060........................... Bryan County, Oklahoma............
37 0.7450 0.7589 99937 37070........................... Caddo County, Oklahoma............
37 0.7450 0.7589 99937 37080........................... Canadian County, Oklahoma......... 5880 0.9034 0.9040 36420 37090........................... Carter County, Oklahoma...........
37 0.7450 0.7589 99937 37100........................... Cherokee County, Oklahoma.........
37 0.7450 0.7589 99937 37110........................... Choctaw County, Oklahoma..........
37 0.7450 0.7589 99937 37120........................... Cimarron County, Oklahoma.........
37 0.7450 0.7589 99937 37130........................... Cleveland County, Oklahoma........ 5880 0.9034 0.9040 36420 37140........................... Coal County, Oklahoma.............
37 0.7450 0.7589 99937 37150........................... Comanche County, Oklahoma......... 4200 0.7880 0.7880 30020 37160........................... Cotton County, Oklahoma...........
37 0.7450 0.7589 99937 37170........................... Craig County, Oklahoma............
37 0.7450 0.7589 99937 37180........................... Creek County, Oklahoma............ 8560 0.8322 0.8286 46140 37190........................... Custer County, Oklahoma...........
37 0.7450 0.7589 99937 37200........................... Delaware County, Oklahoma.........
37 0.7450 0.7589 99937 37210........................... Dewey County, Oklahoma............
37 0.7450 0.7589 99937 37220........................... Ellis County, Oklahoma............
37 0.7450 0.7589 99937 37230........................... Garfield County, Oklahoma......... 2340 0.8675 0.7589 99937 37240........................... Garvin County, Oklahoma...........
37 0.7450 0.7589 99937 37250........................... Grady County, Oklahoma............
37 0.7450 0.9040 36420 37260........................... Grant County, Oklahoma............
37 0.7450 0.7589 99937 37270........................... Greer County, Oklahoma............
37 0.7450 0.7589 99937 37280........................... Harmon County, Oklahoma...........
37 0.7450 0.7589 99937 37290........................... Harper County, Oklahoma...........
37 0.7450 0.7589 99937 37300........................... Haskell County, Oklahoma..........
37 0.7450 0.7589 99937 37310........................... Hughes County, Oklahoma...........
37 0.7450 0.7589 99937 37320........................... Jackson County, Oklahoma..........
37 0.7450 0.7589 99937 37330........................... Jefferson County, Oklahoma........
37 0.7450 0.7589 99937 37340........................... Johnston County, Oklahoma.........
37 0.7450 0.7589 99937 37350........................... Kay County, Oklahoma..............
37 0.7450 0.7589 99937 37360........................... Kingfisher County, Oklahoma.......
37 0.7450 0.7589 99937 37370........................... Kiowa County, Oklahoma............
37 0.7450 0.7589 99937 37380........................... Latimer County, Oklahoma..........
37 0.7450 0.7589 99937 37390........................... Le Flore County, Oklahoma.........
37 0.7450 0.8214 22900 37400........................... Lincoln County, Oklahoma..........
37 0.7450 0.9040 36420 37410........................... Logan County, Oklahoma............ 5880 0.9034 0.9040 36420 37420........................... Love County, Oklahoma.............
37 0.7450 0.7589 99937 37430........................... Mc Clain County, Oklahoma......... 5880 0.9034 0.9040 36420 37440........................... Mc Curtain County, Oklahoma.......
37 0.7450 0.7589 99937 37450........................... Mc Intosh County, Oklahoma........
37 0.7450 0.7589 99937
[[Page 29147]]
37460........................... Major County, Oklahoma............
37 0.7450 0.7589 99937 37470........................... Marshall County, Oklahoma.........
37 0.7450 0.7589 99937 37480........................... Mayes County, Oklahoma............
37 0.7450 0.7589 99937 37490........................... Murray County, Oklahoma...........
37 0.7450 0.7589 99937 37500........................... Muskogee County, Oklahoma.........
37 0.7450 0.7589 99937 37510........................... Noble County, Oklahoma............
37 0.7450 0.7589 99937 37520........................... Nowata County, Oklahoma...........
37 0.7450 0.7589 99937 37530........................... Okfuskee County, Oklahoma.........
37 0.7450 0.7589 99937 37540........................... Oklahoma County, Oklahoma......... 5880 0.9034 0.9040 36420 37550........................... Okmulgee County, Oklahoma.........
37 0.7450 0.8286 46140 37560........................... Osage County, Oklahoma............ 8560 0.8322 0.8286 46140 37570........................... Ottawa County, Oklahoma...........
37 0.7450 0.7589 99937 37580........................... Pawnee County, Oklahoma...........
37 0.7450 0.8286 46140 37590........................... Payne County, Oklahoma............
37 0.7450 0.7589 99937 37600........................... Pittsburg County, Oklahoma........
37 0.7450 0.7589 99937 37610........................... Pontotoc County, Oklahoma.........
37 0.7450 0.7589 99937 37620........................... Pottawatomie County, Oklahoma..... 5880 0.9034 0.7589 99937 37630........................... Pushmataha County, Oklahoma.......
37 0.7450 0.7589 99937 37640........................... Roger Mills County, Oklahoma......
37 0.7450 0.7589 99937 37650........................... Rogers County, Oklahoma........... 8560 0.8322 0.8286 46140 37660........................... Seminole County, Oklahoma.........
37 0.7450 0.7589 99937 37670........................... Sequoyah County, Oklahoma......... 2720 0.8229 0.8214 22900 37680........................... Stephens County, Oklahoma.........
37 0.7450 0.7589 99937 37690........................... Texas County, Oklahoma............
37 0.7450 0.7589 99937 37700........................... Tillman County, Oklahoma..........
37 0.7450 0.7589 99937 37710........................... Tulsa County, Oklahoma............ 8560 0.8322 0.8286 46140 37720........................... Wagoner County, Oklahoma.......... 8560 0.8322 0.8286 46140 37730........................... Washington County, Oklahoma.......
37 0.7450 0.7589 99937 37740........................... Washita County, Oklahoma..........
37 0.7450 0.7589 99937 37750........................... Woods County, Oklahoma............
37 0.7450 0.7589 99937 37760........................... Woodward County, Oklahoma.........
37 0.7450 0.7589 99937 38000........................... Baker County, Oregon..............
38 1.0057 0.9830 99938 38010........................... Benton County, Oregon............. 1890 1.0739 1.0739 18700 38020........................... Clackamas County, Oregon.......... 6440 1.1260 1.1260 38900 38030........................... Clatsop County, Oregon............
38 1.0057 0.9830 99938 38040........................... Columbia County, Oregon........... 6440 1.1260 1.1260 38900 38050........................... Coos County, Oregon...............
38 1.0057 0.9830 99938 38060........................... Crook County, Oregon..............
38 1.0057 0.9830 99938 38070........................... Curry County, Oregon..............
38 1.0057 0.9830 99938 38080........................... Deschutes County, Oregon..........
38 1.0057 1.0796 13460 38090........................... Douglas County, Oregon............
38 1.0057 0.9830 99938 38100........................... Gilliam County, Oregon............
38 1.0057 0.9830 99938 38110........................... Grant County, Oregon..............
38 1.0057 0.9830 99938 38120........................... Harney County, Oregon.............
38 1.0057 0.9830 99938 38130........................... Hood River County, Oregon.........
38 1.0057 0.9830 99938 38140........................... Jackson County, Oregon............ 4890 1.0235 1.0235 32780 38150........................... Jefferson County, Oregon..........
38 1.0057 0.9830 99938 38160........................... Josephine County, Oregon..........
38 1.0057 0.9830 99938 38170........................... Klamath County, Oregon............
38 1.0057 0.9830 99938 38180........................... Lake County, Oregon...............
38 1.0057 0.9830 99938 38190........................... Lane County, Oregon............... 2400 1.0829 1.0829 21660 38200........................... Lincoln County, Oregon............
38 1.0057 0.9830 99938 38210........................... Linn County, Oregon...............
38 1.0057 0.9830 99938 38220........................... Malheur County, Oregon............
38 1.0057 0.9830 99938 38230........................... Marion County, Oregon............. 7080 1.0452 1.0452 41420 38240........................... Morrow County, Oregon.............
38 1.0057 0.9830 99938 38250........................... Multnomah County, Oregon.......... 6440 1.1260 1.1260 38900 38260........................... Polk County, Oregon............... 7080 1.0452 1.0452 41420 38270........................... Sherman County, Oregon............
38 1.0057 0.9830 99938 38280........................... Tillamook County, Oregon..........
38 1.0057 0.9830 99938 38290........................... Umatilla County, Oregon...........
38 1.0057 0.9830 99938 38300........................... Union County, Oregon..............
38 1.0057 0.9830 99938 38310........................... Wallowa County, Oregon............
38 1.0057 0.9830 99938 38320........................... Wasco County, Oregon..............
38 1.0057 0.9830 99938 38330........................... Washington County, Oregon......... 6440 1.1260 1.1260 38900 38340........................... Wheeler County, Oregon............
38 1.0057 0.9830 99938 38350........................... Yamhill County, Oregon............ 6440 1.1260 1.1260 38900 39000........................... Adams County, Pennsylvania........
39 0.8331 0.8302 99939 39010........................... Allegheny County, Pennsylvania.... 6280 0.8868 0.8853 38300
[[Page 29148]]
39070........................... Armstrong County, Pennsylvania....
39 0.8331 0.8853 38300 39080........................... Beaver County, Pennsylvania....... 6280 0.8868 0.8853 38300 39100........................... Bedford County, Pennsylvania......
39 0.8331 0.8302 99939 39110........................... Berks County, Pennsylvania........ 6680 0.9696 0.9696 39740 39120........................... Blair County, Pennsylvania........ 0280 0.8953 0.8953 11020 39130........................... Bradford County, Pennsylvania.....
39 0.8331 0.8302 99939 39140........................... Bucks County, Pennsylvania........ 6160 1.0926 1.1040 37964 39150........................... Butler County, Pennsylvania....... 6280 0.8868 0.8853 38300 39160........................... Cambria County, Pennsylvania...... 3680 0.8094 0.8362 27780 39180........................... Cameron County, Pennsylvania......
39 0.8331 0.8302 99939 39190........................... Carbon County, Pennsylvania....... 0240 0.9855 0.9828 10900 39200........................... Centre County, Pennsylvania....... 8050 0.8364 0.8364 44300 39210........................... Chester County, Pennsylvania...... 6160 1.0926 1.1040 37964 39220........................... Clarion County, Pennsylvania......
39 0.8331 0.8302 99939 39230........................... Clearfield County, Pennsylvania...
39 0.8331 0.8302 99939 39240........................... Clinton County, Pennsylvania......
39 0.8331 0.8302 99939 39250........................... Columbia County, Pennsylvania..... 7560 0.8533 0.8302 99939 39260........................... Crawford County, Pennsylvania.....
39 0.8331 0.8302 99939 39270........................... Cumberland County, Pennsylvania... 3240 0.9242 0.9322 25420 39280........................... Dauphin County, Pennsylvania...... 3240 0.9242 0.9322 25420 39290........................... Delaware County, Pennsylvania..... 6160 1.0926 1.1040 37964 39310........................... Elk County, Pennsylvania..........
39 0.8331 0.8302 99939 39320........................... Erie County, Pennsylvania......... 2360 0.8746 0.8746 21500 39330........................... Fayette County, Pennsylvania...... 6280 0.8868 0.8853 38300 39340........................... Forest County, Pennsylvania.......
39 0.8331 0.8302 99939 39350........................... Franklin County, Pennsylvania.....
39 0.8331 0.8302 99939 39360........................... Fulton County, Pennsylvania.......
39 0.8331 0.8302 99939 39370........................... Greene County, Pennsylvania.......
39 0.8331 0.8302 99939 39380........................... Huntingdon County, Pennsylvania...
39 0.8331 0.8302 99939 39390........................... Indiana County, Pennsylvania......
39 0.8331 0.8302 99939 39400........................... Jefferson County, Pennsylvania....
39 0.8331 0.8302 99939 39410........................... Juniata County, Pennsylvania......
39 0.8331 0.8302 99939 39420........................... Lackawanna County, Pennsylvania... 7560 0.8533 0.8548 42540 39440........................... Lancaster County, Pennsylvania.... 4000 0.9704 0.9704 29540 39450........................... Lawrence County, Pennsylvania.....
39 0.8331 0.8302 99939 39460........................... Lebanon County, Pennsylvania...... 3240 0.9242 0.8468 30140 39470........................... Lehigh County, Pennsylvania....... 0240 0.9855 0.9828 10900 39480........................... Luzerne County, Pennsylvania...... 7560 0.8533 0.8548 42540 39510........................... Lycoming County, Pennsylvania..... 9140 0.8377 0.8377 48700 39520........................... Mc Kean County, Pennsylvania......
39 0.8331 0.8302 99939 39530........................... Mercer County, Pennsylvania....... 7610 0.7801 0.8611 49660 39540........................... Mifflin County, Pennsylvania......
39 0.8331 0.8302 99939 39550........................... Monroe County, Pennsylvania.......
39 0.8331 0.8302 99939 39560........................... Montgomery County, Pennsylvania... 6160 1.0926 1.1040 37964 39580........................... Montour County, Pennsylvania......
39 0.8331 0.8302 99939 39590........................... Northampton County, Pennsylvania.. 0240 0.9855 0.9828 10900 39600........................... Northumberland County,
39 0.8331 0.8302 99939 Pennsylvania. 39610........................... Perry County, Pennsylvania........ 3240 0.9242 0.9322 25420 39620........................... Philadelphia County, Pennsylvania. 6160 1.0926 1.1040 37964 39630........................... Pike County, Pennsylvania......... 5660 1.1218 1.2195 35084 39640........................... Potter County, Pennsylvania.......
39 0.8331 0.8302 99939 39650........................... Schuylkill County, Pennsylvania...
39 0.8331 0.8302 99939 39670........................... Snyder County, Pennsylvania.......
39 0.8331 0.8302 99939 39680........................... Somerset County, Pennsylvania..... 3680 0.8094 0.8302 99939 39690........................... Sullivan County, Pennsylvania.....
39 0.8331 0.8302 99939 39700........................... Susquehanna County, Pennsylvania..
39 0.8331 0.8302 99939 39710........................... Tioga County, Pennsylvania........
39 0.8331 0.8302 99939 39720........................... Union County, Pennsylvania........
39 0.8331 0.8302 99939 39730........................... Venango County, Pennsylvania......
39 0.8331 0.8302 99939 39740........................... Warren County, Pennsylvania.......
39 0.8331 0.8302 99939 39750........................... Washington County, Pennsylvania... 6280 0.8868 0.8853 38300 39760........................... Wayne County, Pennsylvania........
39 0.8331 0.8302 99939 39770........................... Westmoreland County, Pennsylvania. 6280 0.8868 0.8853 38300 39790........................... Wyoming County, Pennsylvania...... 7560 0.8533 0.8548 42540 39800........................... York County, Pennsylvania......... 9280 0.9420 0.9420 49620 40010........................... Adjuntas County, Puerto Rico......
40 0.3608 0.4047 99940 40020........................... Aguada County, Puerto Rico........ 0060 0.4881 0.4743 10380 40030........................... Aguadilla County, Puerto Rico..... 0060 0.4881 0.4743 10380 40040........................... Aguas Buenas County, Puerto Rico.. 7440 0.4855 0.4686 41980
[[Page 29149]]
40050........................... Aibonito County, Puerto Rico......
40 0.3608 0.4686 41980 40060........................... Anasco County, Puerto Rico........ 4840 0.4246 0.4743 10380 40070........................... Arecibo County, Puerto Rico....... 0470 0.4116 0.4686 41980 40080........................... Arroyo County, Puerto Rico........
40 0.3608 0.3184 25020 40090........................... Barceloneta County, Puerto Rico... 7440 0.4855 0.4686 41980 40100........................... Barranquitas County, Puerto Rico..
40 0.3608 0.4686 41980 40110........................... Bayamon County, Puerto Rico....... 7440 0.4855 0.4686 41980 40120........................... Cabo Rojo County, Puerto Rico..... 4840 0.4246 0.4655 41900 40130........................... Caguas County, Puerto Rico........ 1310 0.4020 0.4686 41980 40140........................... Camuy County, Puerto Rico......... 0470 0.4116 0.4686 41980 40145........................... Canovanas County, Puerto Rico..... 7440 0.4855 0.4686 41980 40150........................... Carolina County, Puerto Rico...... 7440 0.4855 0.4686 41980 40160........................... Catano County, Puerto Rico........ 7440 0.4855 0.4686 41980 40170........................... Cayey County, Puerto Rico......... 1310 0.4020 0.4686 41980 40180........................... Ceiba County, Puerto Rico......... 7440 0.4855 0.4157 21940 40190........................... Ciales County, Puerto Rico........
40 0.3608 0.4686 41980 40200........................... Cidra County, Puerto Rico......... 1310 0.4020 0.4686 41980 40210........................... Coamo County, Puerto Rico.........
40 0.3608 0.4047 99940 40220........................... Comerio County, Puerto Rico....... 7440 0.4855 0.4686 41980 40230........................... Corozal County, Puerto Rico....... 7440 0.4855 0.4686 41980 40240........................... Culebra County, Puerto Rico.......
40 0.3608 0.4047 99940 40250........................... Dorado County, Puerto Rico........ 7440 0.4855 0.4686 41980 40260........................... Fajardo County, Puerto Rico....... 7440 0.4855 0.4157 21940 40265........................... Florida County, Puerto Rico....... 7440 0.4855 0.4686 41980 40270........................... Guanica County, Puerto Rico.......
40 0.3608 0.4413 49500 40280........................... Guayama County, Puerto Rico.......
40 0.3608 0.3184 25020 40290........................... Guayanilla County, Puerto Rico.... 6360 0.5091 0.4413 49500 40300........................... Guaynabo County, Puerto Rico...... 7440 0.4855 0.4686 41980 40310........................... Gurabo County, Puerto Rico........ 1310 0.4020 0.4686 41980 40320........................... Hatillo County, Puerto Rico....... 0470 0.4116 0.4686 41980 40330........................... Hormigueros County, Puerto Rico... 4840 0.4246 0.4017 32420 40340........................... Humacao County, Puerto Rico....... 7440 0.4855 0.4686 41980 40350........................... Isabela County, Puerto Rico.......
40 0.3608 0.4743 10380 40360........................... Jayuya County, Puerto Rico........
40 0.3608 0.4047 99940 40370........................... Juana Diaz County, Puerto Rico.... 6360 0.5091 0.5177 38660 40380........................... Juncos County, Puerto Rico........ 7440 0.4855 0.4686 41980 40390........................... Lajas County, Puerto Rico.........
40 0.3608 0.4655 41900 40400........................... Lares County, Puerto Rico.........
40 0.3608 0.4743 10380 40410........................... Las Marias County, Puerto Rico....
40 0.3608 0.4047 99940 40420........................... Las Piedras County, Puerto Rico... 7440 0.4855 0.4686 41980 40430........................... Loiza County, Puerto Rico......... 7440 0.4855 0.4686 41980 40440........................... Luquillo County, Puerto Rico...... 7440 0.4855 0.4157 21940 40450........................... Manati County, Puerto Rico........ 7440 0.4855 0.4686 41980 40460........................... Maricao County, Puerto Rico.......
40 0.3608 0.4047 99940 40470........................... Maunabo County, Puerto Rico.......
40 0.3608 0.4686 41980 40480........................... Mayaguez County, Puerto Rico...... 4840 0.4246 0.4017 32420 40490........................... Moca County, Puerto Rico.......... 0060 0.4881 0.4743 10380 40500........................... Morovis County, Puerto Rico....... 7440 0.4855 0.4686 41980 40510........................... Naguabo County, Puerto Rico....... 7440 0.4855 0.4686 41980 40520........................... Naranjito County, Puerto Rico..... 7440 0.4855 0.4686 41980 40530........................... Orocovis County, Puerto Rico......
40 0.3608 0.4686 41980 40540........................... Patillas County, Puerto Rico......
40 0.3608 0.3184 25020 40550........................... Penuelas County, Puerto Rico...... 6360 0.5091 0.4413 49500 40560........................... Ponce County, Puerto Rico......... 6360 0.5091 0.5177 38660 40570........................... Quebradillas County, Puerto Rico..
40 0.3608 0.4686 41980 40580........................... Rincon County, Puerto Rico........
40 0.3608 0.4743 10380 40590........................... Rio Grande County, Puerto Rico.... 7440 0.4855 0.4686 41980 40610........................... Sabana Grande County, Puerto Rico. 4840 0.4246 0.4655 41900 40620........................... Salinas County, Puerto Rico.......
40 0.3608 0.4047 99940 40630........................... San German County, Puerto Rico.... 4840 0.4246 0.4655 41900 40640........................... San Juan County, Puerto Rico...... 7440 0.4855 0.4686 41980 40650........................... San Lorenzo County, Puerto Rico... 1310 0.4020 0.4686 41980 40660........................... San Sebastian County, Puerto Rico.
40 0.3608 0.4743 10380 40670........................... Santa Isabel County, Puerto Rico..
40 0.3608 0.4047 99940 40680........................... Toa Alta County, Puerto Rico...... 7440 0.4855 0.4686 41980 40690........................... Toa Baja County, Puerto Rico...... 7440 0.4855 0.4686 41980 40700........................... Trujillo Alto County, Puerto Rico. 7440 0.4855 0.4686 41980 40710........................... Utuado County, Puerto Rico........
40 0.3608 0.4047 99940 40720........................... Vega Alta County, Puerto Rico..... 7440 0.4855 0.4686 41980
[[Page 29150]]
40730........................... Vega Baja County, Puerto Rico..... 7440 0.4855 0.4686 41980 40740........................... Vieques County, Puerto Rico.......
40 0.3608 0.4047 99940 40750........................... Villalba County, Puerto Rico...... 6360 0.5091 0.5177 38660 40760........................... Yabucoa County, Puerto Rico....... 7440 0.4855 0.4686 41980 40770........................... Yauco County, Puerto Rico......... 6360 0.5091 0.4413 49500 41000........................... Bristol County, Rhode Island...... 6483 1.1060 1.0966 39300 41010........................... Kent County, Rhode Island......... 6483 1.1060 1.0966 39300 41020........................... Newport County, Rhode Island...... 6483 1.1060 1.0966 39300 41030........................... Providence County, Rhode Island... 6483 1.1060 1.0966 39300 41050........................... Washington County, Rhode Island... 6483 1.1060 1.0966 39300 42000........................... Abbeville County, S Carolina......
42 0.8634 0.8641 99942 42010........................... Aiken County, S Carolina.......... 0600 0.9619 0.9565 12260 42020........................... Allendale County, S Carolina......
42 0.8634 0.8641 99942 42030........................... Anderson County, S Carolina....... 3160 0.9677 0.8897 11340 42040........................... Bamberg County, S Carolina........
42 0.8634 0.8641 99942 42050........................... Barnwell County, S Carolina.......
42 0.8634 0.8641 99942 42060........................... Beaufort County, S Carolina.......
42 0.8634 0.8641 99942 42070........................... Berkeley County, S Carolina....... 1440 0.9438 0.9438 16700 42080........................... Calhoun County, S Carolina........
42 0.8634 0.9047 17900 42090........................... Charleston County, S Carolina..... 1440 0.9438 0.9438 16700 42100........................... Cherokee County, S Carolina....... 3160 0.9677 0.8641 99942 42110........................... Chester County, S Carolina........
42 0.8634 0.8641 99942 42120........................... Chesterfield County, S Carolina...
42 0.8634 0.8641 99942 42130........................... Clarendon County, S Carolina......
42 0.8634 0.8641 99942 42140........................... Colleton County, S Carolina.......
42 0.8634 0.8641 99942 42150........................... Darlington County, S Carolina.....
42 0.8634 0.8964 22500 42160........................... Dillon County, S Carolina.........
42 0.8634 0.8641 99942 42170........................... Dorchester County, S Carolina..... 1440 0.9438 0.9438 16700 42180........................... Edgefield County, S Carolina...... 0600 0.9619 0.9565 12260 42190........................... Fairfield County, S Carolina......
42 0.8634 0.9047 17900 42200........................... Florence County, S Carolina....... 2655 0.9060 0.8964 22500 42210........................... Georgetown County, S Carolina.....
42 0.8634 0.8641 99942 42220........................... Greenville County, S Carolina..... 3160 0.9677 1.0165 24860 42230........................... Greenwood County, S Carolina......
42 0.8634 0.8641 99942 42240........................... Hampton County, S Carolina........
42 0.8634 0.8641 99942 42250........................... Horry County, S Carolina.......... 5330 0.8873 0.8873 34820 42260........................... Jasper County, S Carolina.........
42 0.8634 0.8641 99942 42270........................... Kershaw County, S Carolina........
42 0.8634 0.9047 17900 42280........................... Lancaster County, S Carolina......
42 0.8634 0.8641 99942 42290........................... Laurens County, S Carolina........
42 0.8634 1.0165 24860 42300........................... Lee County, S Carolina............
42 0.8634 0.8641 99942 42310........................... Lexington County, S Carolina...... 1760 0.9071 0.9047 17900 42320........................... Mc Cormick County, S Carolina.....
42 0.8634 0.8641 99942 42330........................... Marion County, S Carolina.........
42 0.8634 0.8641 99942 42340........................... Marlboro County, S Carolina.......
42 0.8634 0.8641 99942 42350........................... Newberry County, S Carolina.......
42 0.8634 0.8641 99942 42360........................... Oconee County, S Carolina.........
42 0.8634 0.8641 99942 42370........................... Orangeburg County, S Carolina.....
42 0.8634 0.8641 99942 42380........................... Pickens County, S Carolina........ 3160 0.9677 1.0165 24860 42390........................... Richland County, S Carolina....... 1760 0.9071 0.9047 17900 42400........................... Saluda County, S Carolina.........
42 0.8634 0.9047 17900 42410........................... Spartanburg County, S Carolina.... 3160 0.9677 0.9181 43900 42420........................... Sumter County, S Carolina......... 8140 0.8386 0.8386 44940 42430........................... Union County, S Carolina..........
42 0.8634 0.8641 99942 42440........................... Williamsburg County, S Carolina...
42 0.8634 0.8641 99942 42450........................... York County, S Carolina........... 1520 0.9725 0.9760 16740 43010........................... Aurora County, S Dakota...........
43 0.8476 0.8484 99943 43020........................... Beadle County, S Dakota...........
43 0.8476 0.8484 99943 43030........................... Bennett County, S Dakota..........
43 0.8476 0.8484 99943 43040........................... Bon Homme County, S Dakota........
43 0.8476 0.8484 99943 43050........................... Brookings County, S Dakota........
43 0.8476 0.8484 99943 43060........................... Brown County, S Dakota............
43 0.8476 0.8484 99943 43070........................... Brule County, S Dakota............
43 0.8476 0.8484 99943 43080........................... Buffalo County, S Dakota..........
43 0.8476 0.8484 99943 43090........................... Butte County, S Dakota............
43 0.8476 0.8484 99943 43100........................... Campbell County, S Dakota.........
43 0.8476 0.8484 99943 43110........................... Charles Mix County, S Dakota......
43 0.8476 0.8484 99943 43120........................... Clark County, S Dakota............
43 0.8476 0.8484 99943 43130........................... Clay County, S Dakota.............
43 0.8476 0.8484 99943
[[Page 29151]]
43140........................... Codington County, S Dakota........
43 0.8476 0.8484 99943 43150........................... Corson County, S Dakota...........
43 0.8476 0.8484 99943 43160........................... Custer County, S Dakota...........
43 0.8476 0.8484 99943 43170........................... Davison County, S Dakota..........
43 0.8476 0.8484 99943 43180........................... Day County, S Dakota..............
43 0.8476 0.8484 99943 43190........................... Deuel County, S Dakota............
43 0.8476 0.8484 99943 43200........................... Dewey County, S Dakota............
43 0.8476 0.8484 99943 43210........................... Douglas County, S Dakota..........
43 0.8476 0.8484 99943 43220........................... Edmunds County, S Dakota..........
43 0.8476 0.8484 99943 43230........................... Fall River County, S Dakota.......
43 0.8476 0.8484 99943 43240........................... Faulk County, S Dakota............
43 0.8476 0.8484 99943 43250........................... Grant County, S Dakota............
43 0.8476 0.8484 99943 43260........................... Gregory County, S Dakota..........
43 0.8476 0.8484 99943 43270........................... Haakon County, S Dakota...........
43 0.8476 0.8484 99943 43280........................... Hamlin County, S Dakota...........
43 0.8476 0.8484 99943 43290........................... Hand County, S Dakota.............
43 0.8476 0.8484 99943 43300........................... Hanson County, S Dakota...........
43 0.8476 0.8484 99943 43310........................... Harding County, S Dakota..........
43 0.8476 0.8484 99943 43320........................... Hughes County, S Dakota...........
43 0.8476 0.8484 99943 43330........................... Hutchinson County, S Dakota.......
43 0.8476 0.8484 99943 43340........................... Hyde County, S Dakota.............
43 0.8476 0.8484 99943 43350........................... Jackson County, S Dakota..........
43 0.8476 0.8484 99943 43360........................... Jerauld County, S Dakota..........
43 0.8476 0.8484 99943 43370........................... Jones County, S Dakota............
43 0.8476 0.8484 99943 43380........................... Kingsbury County, S Dakota........
43 0.8476 0.8484 99943 43390........................... Lake County, S Dakota.............
43 0.8476 0.8484 99943 43400........................... Lawrence County, S Dakota.........
43 0.8476 0.8484 99943 43410........................... Lincoln County, S Dakota.......... 7760 0.9645 0.9645 43620 43420........................... Lyman County, S Dakota............
43 0.8476 0.8484 99943 43430........................... Mc Cook County, S Dakota..........
43 0.8476 0.9645 43620 43440........................... Mc Pherson County, S Dakota.......
43 0.8476 0.8484 99943 43450........................... Marshall County, S Dakota.........
43 0.8476 0.8484 99943 43460........................... Meade County, S Dakota............
43 0.8476 0.9021 39660 43470........................... Mellette County, S Dakota.........
43 0.8476 0.8484 99943 43480........................... Miner County, S Dakota............
43 0.8476 0.8484 99943 43490........................... Minnehaha County, S Dakota........ 7760 0.9645 0.9645 43620 43500........................... Moody County, S Dakota............
43 0.8476 0.8484 99943 43510........................... Pennington County, S Dakota....... 6660 0.9021 0.9021 39660 43520........................... Perkins County, S Dakota..........
43 0.8476 0.8484 99943 43530........................... Potter County, S Dakota...........
43 0.8476 0.8484 99943 43540........................... Roberts County, S Dakota..........
43 0.8476 0.8484 99943 43550........................... Sanborn County, S Dakota..........
43 0.8476 0.8484 99943 43560........................... Shannon County, S Dakota..........
43 0.8476 0.8484 99943 43570........................... Spink County, S Dakota............
43 0.8476 0.8484 99943 43580........................... Stanley County, S Dakota..........
43 0.8476 0.8484 99943 43590........................... Sully County, S Dakota............
43 0.8476 0.8484 99943 43600........................... Todd County, S Dakota.............
43 0.8476 0.8484 99943 43610........................... Tripp County, S Dakota............
43 0.8476 0.8484 99943 43620........................... Turner County, S Dakota...........
43 0.8476 0.9645 43620 43630........................... Union County, S Dakota............
43 0.8476 0.9376 43580 43640........................... Walworth County, S Dakota.........
43 0.8476 0.8484 99943 43650........................... Washabaugh County, S Dakota.......
43 0.8476 0.8484 99943 43670........................... Yankton County, S Dakota..........
43 0.8476 0.8484 99943 43680........................... Ziebach County, S Dakota..........
43 0.8476 0.8484 99943 44000........................... Anderson County, Tennessee........ 3840 0.8411 0.8454 28940 44010........................... Bedford County, Tennessee.........
44 0.7988 0.7888 99944 44020........................... Benton County, Tennessee..........
44 0.7988 0.7888 99944 44030........................... Bledsoe County, Tennessee.........
44 0.7988 0.7888 99944 44040........................... Blount County, Tennessee.......... 3840 0.8411 0.8454 28940 44050........................... Bradley County, Tennessee.........
44 0.7988 0.8141 17420 44060........................... Campbell County, Tennessee........
44 0.7988 0.7888 99944 44070........................... Cannon County, Tennessee..........
44 0.7988 0.9769 34980 44080........................... Carroll County, Tennessee.........
44 0.7988 0.7888 99944 44090........................... Carter County, Tennessee.......... 3660 0.8015 0.7945 27740 44100........................... Cheatham County, Tennessee........ 5360 0.9787 0.9769 34980 44110........................... Chester County, Tennessee......... 3580 0.8973 0.8973 27180 44120........................... Claiborne County, Tennessee.......
44 0.7988 0.7888 99944 44130........................... Clay County, Tennessee............
44 0.7988 0.7888 99944 44140........................... Cocke County, Tennessee...........
44 0.7988 0.7888 99944
[[Page 29152]]
44150........................... Coffee County, Tennessee..........
44 0.7988 0.7888 99944 44160........................... Crockett County, Tennessee........
44 0.7988 0.7888 99944 44170........................... Cumberland County, Tennessee......
44 0.7988 0.7888 99944 44180........................... Davidson County, Tennessee........ 5360 0.9787 0.9769 34980 44190........................... Decatur County, Tennessee.........
44 0.7988 0.7888 99944 44200........................... De Kalb County, Tennessee.........
44 0.7988 0.7888 99944 44210........................... Dickson County, Tennessee......... 5360 0.9787 0.9769 34980 44220........................... Dyer County, Tennessee............
44 0.7988 0.7888 99944 44230........................... Fayette County, Tennessee......... 4920 0.9360 0.9341 32820 44240........................... Fentress County, Tennessee........
44 0.7988 0.7888 99944 44250........................... Franklin County, Tennessee........
44 0.7988 0.7888 99944 44260........................... Gibson County, Tennessee..........
44 0.7988 0.7888 99944 44270........................... Giles County, Tennessee...........
44 0.7988 0.7888 99944 44280........................... Grainger County, Tennessee........
44 0.7988 0.8753 34100 44290........................... Greene County, Tennessee..........
44 0.7988 0.7888 99944 44300........................... Grundy County, Tennessee..........
44 0.7988 0.7888 99944 44310........................... Hamblen County, Tennessee.........
44 0.7988 0.8753 34100 44320........................... Hamilton County, Tennessee........ 1560 0.9098 0.9098 16860 44330........................... Hancock County, Tennessee.........
44 0.7988 0.7888 99944 44340........................... Hardeman County, Tennessee........
44 0.7988 0.7888 99944 44350........................... Hardin County, Tennessee..........
44 0.7988 0.7888 99944 44360........................... Hawkins County, Tennessee......... 3660 0.8015 0.8062 28700 44370........................... Haywood County, Tennessee.........
44 0.7988 0.7888 99944 44380........................... Henderson County, Tennessee.......
44 0.7988 0.7888 99944 44390........................... Henry County, Tennessee...........
44 0.7988 0.7888 99944 44400........................... Hickman County, Tennessee.........
44 0.7988 0.9769 34980 44410........................... Houston County, Tennessee.........
44 0.7988 0.7888 99944 44420........................... Humphreys County, Tennessee.......
44 0.7988 0.7888 99944 44430........................... Jackson County, Tennessee.........
44 0.7988 0.7888 99944 44440........................... Jefferson County, Tennessee.......
44 0.7988 0.8753 34100 44450........................... Johnson County, Tennessee.........
44 0.7988 0.7888 99944 44460........................... Knox County, Tennessee............ 3840 0.8411 0.8454 28940 44470........................... Lake County, Tennessee............
44 0.7988 0.7888 99944 44480........................... Lauderdale County, Tennessee......
44 0.7988 0.7888 99944 44490........................... Lawrence County, Tennessee........
44 0.7988 0.7888 99944 44500........................... Lewis County, Tennessee...........
44 0.7988 0.7888 99944 44510........................... Lincoln County, Tennessee.........
44 0.7988 0.7888 99944 44520........................... Loudon County, Tennessee.......... 3840 0.8411 0.8454 28940 44530........................... Mc Minn County, Tennessee.........
44 0.7988 0.7888 99944 44540........................... Mc Nairy County, Tennessee........
44 0.7988 0.7888 99944 44550........................... Macon County, Tennessee...........
44 0.7988 0.9769 34980 44560........................... Madison County, Tennessee......... 3580 0.8973 0.8973 27180 44570........................... Marion County, Tennessee.......... 1560 0.9098 0.9098 16860 44580........................... Marshall County, Tennessee........
44 0.7988 0.7888 99944 44590........................... Maury County, Tennessee...........
44 0.7988 0.7888 99944 44600........................... Meigs County, Tennessee...........
44 0.7988 0.7888 99944 44610........................... Monroe County, Tennessee..........
44 0.7988 0.7888 99944 44620........................... Montgomery County, Tennessee...... 1660 0.8292 0.8292 17300 44630........................... Moore County, Tennessee...........
44 0.7988 0.7888 99944 44640........................... Morgan County, Tennessee..........
44 0.7988 0.7888 99944 44650........................... Obion County, Tennessee...........
44 0.7988 0.7888 99944 44660........................... Overton County, Tennessee.........
44 0.7988 0.7888 99944 44670........................... Perry County, Tennessee...........
44 0.7988 0.7888 99944 44680........................... Pickett County, Tennessee.........
44 0.7988 0.7888 99944 44690........................... Polk County, Tennessee............
44 0.7988 0.8141 17420 44700........................... Putnam County, Tennessee..........
44 0.7988 0.7888 99944 44710........................... Rhea County, Tennessee............
44 0.7988 0.7888 99944 44720........................... Roane County, Tennessee...........
44 0.7988 0.7888 99944 44730........................... Robertson County, Tennessee....... 5360 0.9787 0.9769 34980 44740........................... Rutherford County, Tennessee...... 5360 0.9787 0.9769 34980 44750........................... Scott County, Tennessee...........
44 0.7988 0.7888 99944 44760........................... Sequatchie County, Tennessee......
44 0.7988 0.9098 16860 44770........................... Sevier County, Tennessee.......... 3840 0.8411 0.7888 99944 44780........................... Shelby County, Tennessee.......... 4920 0.9360 0.9341 32820 44790........................... Smith County, Tennessee...........
44 0.7988 0.9769 34980 44800........................... Stewart County, Tennessee.........
44 0.7988 0.8292 17300 44810........................... Sullivan County, Tennessee........ 3660 0.8015 0.8062 28700 44820........................... Sumner County, Tennessee.......... 5360 0.9787 0.9769 34980 44830........................... Tipton County, Tennessee.......... 4920 0.9360 0.9341 32820
[[Page 29153]]
44840........................... Trousdale County, Tennessee.......
44 0.7988 0.9769 34980 44850........................... Unicoi County, Tennessee.......... 3660 0.8015 0.7945 27740 44860........................... Union County, Tennessee........... 3840 0.8411 0.8454 28940 44870........................... Van Buren County, Tennessee.......
44 0.7988 0.7888 99944 44880........................... Warren County, Tennessee..........
44 0.7988 0.7888 99944 44890........................... Washington County, Tennessee...... 3660 0.8015 0.7945 27740 44900........................... Wayne County, Tennessee...........
44 0.7988 0.7888 99944 44910........................... Weakley County, Tennessee.........
44 0.7988 0.7888 99944 44920........................... White County, Tennessee...........
44 0.7988 0.7888 99944 44930........................... Williamson County, Tennessee...... 5360 0.9787 0.9769 34980 44940........................... Wilson County, Tennessee.......... 5360 0.9787 0.9769 34980 45000........................... Anderson County, Texas............
45 0.7936 0.8007 99945 45010........................... Andrews County, Texas.............
45 0.7936 0.8007 99945 45020........................... Angelina County, Texas............
45 0.7936 0.8007 99945 45030........................... Aransas County, Texas.............
45 0.7936 0.8559 18580 45040........................... Archer County, Texas.............. 9080 0.8373 0.8294 48660 45050........................... Armstrong County, Texas...........
45 0.7936 0.9166 11100 45060........................... Atascosa County, Texas............
45 0.7936 0.8989 41700 45070........................... Austin County, Texas..............
45 0.7936 1.0005 26420 45080........................... Bailey County, Texas..............
45 0.7936 0.8007 99945 45090........................... Bandera County, Texas.............
45 0.7936 0.8989 41700 45100........................... Bastrop County, Texas............. 0640 0.9450 0.9450 12420 45110........................... Baylor County, Texas..............
45 0.7936 0.8007 99945 45113........................... Bee County, Texas.................
45 0.7936 0.8007 99945 45120........................... Bell County, Texas................ 3810 0.8535 0.8535 28660 45130........................... Bexar County, Texas............... 7240 0.8993 0.8989 41700 45140........................... Blanco County, Texas..............
45 0.7936 0.8007 99945 45150........................... Borden County, Texas..............
45 0.7936 0.8007 99945 45160........................... Bosque County, Texas..............
45 0.7936 0.8007 99945 45170........................... Bowie County, Texas............... 8360 0.8291 0.8291 45500 45180........................... Brazoria County, Texas............ 1145 0.8572 1.0005 26420 45190........................... Brazos County, Texas.............. 1260 0.8909 0.8909 17780 45200........................... Brewster County, Texas............
45 0.7936 0.8007 99945 45201........................... Briscoe County, Texas.............
45 0.7936 0.8007 99945 45210........................... Brooks County, Texas..............
45 0.7936 0.8007 99945 45220........................... Brown County, Texas...............
45 0.7936 0.8007 99945 45221........................... Burleson County, Texas............
45 0.7936 0.8909 17780 45222........................... Burnet County, Texas..............
45 0.7936 0.8007 99945 45223........................... Caldwell County, Texas............ 0640 0.9450 0.9450 12420 45224........................... Calhoun County, Texas.............
45 0.7936 0.8168 47020 45230........................... Callahan County, Texas............
45 0.7936 0.7904 10180 45240........................... Cameron County, Texas............. 1240 0.9822 0.9822 15180 45250........................... Camp County, Texas................
45 0.7936 0.8007 99945 45251........................... Carson County, Texas..............
45 0.7936 0.9166 11100 45260........................... Cass County, Texas................
45 0.7936 0.8007 99945 45270........................... Castro County, Texas..............
45 0.7936 0.8007 99945 45280........................... Chambers County, Texas............ 3360 1.0101 1.0005 26420 45281........................... Cherokee County, Texas............
45 0.7936 0.8007 99945 45290........................... Childress County, Texas...........
45 0.7936 0.8007 99945 45291........................... Clay County, Texas................
45 0.7936 0.8294 48660 45292........................... Cochran County, Texas.............
45 0.7936 0.8007 99945 45300........................... Coke County, Texas................
45 0.7936 0.8007 99945 45301........................... Coleman County, Texas.............
45 0.7936 0.8007 99945 45310........................... Collin County, Texas.............. 1920 1.0211 1.0233 19124 45311........................... Collingsworth County, Texas.......
45 0.7936 0.8007 99945 45312........................... Colorado County, Texas............
45 0.7936 0.8007 99945 45320........................... Comal County, Texas............... 7240 0.8993 0.8989 41700 45321........................... Comanche County, Texas............
45 0.7936 0.8007 99945 45330........................... Concho County, Texas..............
45 0.7936 0.8007 99945 45340........................... Cooke County, Texas...............
45 0.7936 0.8007 99945 45341........................... Coryell County, Texas............. 3810 0.8535 0.8535 28660 45350........................... Cottle County, Texas..............
45 0.7936 0.8007 99945 45360........................... Crane County, Texas...............
45 0.7936 0.8007 99945 45361........................... Crockett County, Texas............
45 0.7936 0.8007 99945 45362........................... Crosby County, Texas..............
45 0.7936 0.8792 31180 45370........................... Culberson County, Texas...........
45 0.7936 0.8007 99945 45380........................... Dallam County, Texas..............
45 0.7936 0.8007 99945 45390........................... Dallas County, Texas.............. 1920 1.0211 1.0233 19124 45391........................... Dawson County, Texas..............
45 0.7936 0.8007 99945
[[Page 29154]]
45392........................... Deaf Smith County, Texas..........
45 0.7936 0.8007 99945 45400........................... Delta County, Texas...............
45 0.7936 1.0233 19124 45410........................... Denton County, Texas.............. 1920 1.0211 1.0233 19124 45420........................... De Witt County, Texas.............
45 0.7936 0.8007 99945 45421........................... Dickens County, Texas.............
45 0.7936 0.8007 99945 45430........................... Dimmit County, Texas..............
45 0.7936 0.8007 99945 45431........................... Donley County, Texas..............
45 0.7936 0.8007 99945 45440........................... Duval County, Texas...............
45 0.7936 0.8007 99945 45450........................... Eastland County, Texas............
45 0.7936 0.8007 99945 45451........................... Ector County, Texas............... 5800 0.9751 0.9894 36220 45460........................... Edwards County, Texas.............
45 0.7936 0.8007 99945 45470........................... Ellis County, Texas............... 1920 1.0211 1.0233 19124 45480........................... El Paso County, Texas............. 2320 0.8924 0.8924 21340 45490........................... Erath County, Texas...............
45 0.7936 0.8007 99945 45500........................... Falls County, Texas...............
45 0.7936 0.8007 99945 45510........................... Fannin County, Texas..............
45 0.7936 0.8007 99945 45511........................... Fayette County, Texas.............
45 0.7936 0.8007 99945 45520........................... Fisher County, Texas..............
45 0.7936 0.8007 99945 45521........................... Floyd County, Texas...............
45 0.7936 0.8007 99945 45522........................... Foard County, Texas...............
45 0.7936 0.8007 99945 45530........................... Fort Bend County, Texas........... 3360 1.0101 1.0005 26420 45531........................... Franklin County, Texas............
45 0.7936 0.8007 99945 45540........................... Freestone County, Texas...........
45 0.7936 0.8007 99945 45541........................... Frio County, Texas................
45 0.7936 0.8007 99945 45542........................... Gaines County, Texas..............
45 0.7936 0.8007 99945 45550........................... Galveston County, Texas........... 2920 0.9645 1.0005 26420 45551........................... Garza County, Texas...............
45 0.7936 0.8007 99945 45552........................... Gillespie County, Texas...........
45 0.7936 0.8007 99945 45560........................... Glasscock County, Texas...........
45 0.7936 0.8007 99945 45561........................... Goliad County, Texas..............
45 0.7936 0.8168 47020 45562........................... Gonzales County, Texas............
45 0.7936 0.8007 99945 45563........................... Gray County, Texas................
45 0.7936 0.8007 99945 45564........................... Grayson County, Texas............. 7640 0.9516 0.9516 43300 45570........................... Gregg County, Texas............... 4420 0.8897 0.8739 30980 45580........................... Grimes County, Texas..............
45 0.7936 0.8007 99945 45581........................... Guadaloupe County, Texas.......... 7240 0.8993 0.8989 41700 45582........................... Hale County, Texas................
45 0.7936 0.8007 99945 45583........................... Hall County, Texas................
45 0.7936 0.8007 99945 45590........................... Hamilton County, Texas............
45 0.7936 0.8007 99945 45591........................... Hansford County, Texas............
45 0.7936 0.8007 99945 45592........................... Hardeman County, Texas............
45 0.7936 0.8007 99945 45600........................... Hardin County, Texas.............. 0840 0.8421 0.8421 13140 45610........................... Harris County, Texas.............. 3360 1.0101 1.0005 26420 45620........................... Harrison County, Texas............ 4420 0.8897 0.8007 99945 45621........................... Hartley County, Texas.............
45 0.7936 0.8007 99945 45630........................... Haskell County, Texas.............
45 0.7936 0.8007 99945 45631........................... Hays County, Texas................ 0640 0.9450 0.9450 12420 45632........................... Hemphill County, Texas............
45 0.7936 0.8007 99945 45640........................... Henderson County, Texas........... 1920 1.0211 0.8007 99945 45650........................... Hidalgo County, Texas............. 4880 0.8943 0.8943 32580 45651........................... Hill County, Texas................
45 0.7936 0.8007 99945 45652........................... Hockley County, Texas.............
45 0.7936 0.8007 99945 45653........................... Hood County, Texas................ 2800 0.9545 0.8007 99945 45654........................... Hopkins County, Texas.............
45 0.7936 0.8007 99945 45660........................... Houston County, Texas.............
45 0.7936 0.8007 99945 45661........................... Howard County, Texas..............
45 0.7936 0.8007 99945 45662........................... Hudspeth County, Texas............
45 0.7936 0.8007 99945 45670........................... Hunt County, Texas................ 1920 1.0211 1.0233 19124 45671........................... Hutchinson County, Texas..........
45 0.7936 0.8007 99945 45672........................... Irion County, Texas...............
45 0.7936 0.8280 41660 45680........................... Jack County, Texas................
45 0.7936 0.8007 99945 45681........................... Jackson County, Texas.............
45 0.7936 0.8007 99945 45690........................... Jasper County, Texas..............
45 0.7936 0.8007 99945 45691........................... Jeff Davis County, Texas..........
45 0.7936 0.8007 99945 45700........................... Jefferson County, Texas........... 0840 0.8421 0.8421 13140 45710........................... Jim Hogg County, Texas............
45 0.7936 0.8007 99945 45711........................... Jim Wells County, Texas...........
45 0.7936 0.8007 99945 45720........................... Johnson County, Texas............. 2800 0.9545 0.9510 23104 45721........................... Jones County, Texas...............
45 0.7936 0.7904 10180
[[Page 29155]]
45722........................... Karnes County, Texas..............
45 0.7936 0.8007 99945 45730........................... Kaufman County, Texas............. 1920 1.0211 1.0233 19124 45731........................... Kendall County, Texas.............
45 0.7936 0.8989 41700 45732........................... Kenedy County, Texas..............
45 0.7936 0.8007 99945 45733........................... Kent County, Texas................
45 0.7936 0.8007 99945 45734........................... Kerr County, Texas................
45 0.7936 0.8007 99945 45740........................... Kimble County, Texas..............
45 0.7936 0.8007 99945 45741........................... King County, Texas................
45 0.7936 0.8007 99945 45742........................... Kinney County, Texas..............
45 0.7936 0.8007 99945 45743........................... Kleberg County, Texas.............
45 0.7936 0.8007 99945 45744........................... Knox County, Texas................
45 0.7936 0.8007 99945 45750........................... Lamar County, Texas...............
45 0.7936 0.8007 99945 45751........................... Lamb County, Texas................
45 0.7936 0.8007 99945 45752........................... Lampasas County, Texas............
45 0.7936 0.8535 28660 45753........................... La Salle County, Texas............
45 0.7936 0.8007 99945 45754........................... Lavaca County, Texas..............
45 0.7936 0.8007 99945 45755........................... Lee County, Texas.................
45 0.7936 0.8007 99945 45756........................... Leon County, Texas................
45 0.7936 0.8007 99945 45757........................... Liberty County, Texas............. 3360 1.0101 1.0005 26420 45758........................... Limestone County, Texas...........
45 0.7936 0.8007 99945 45759........................... Lipscomb County, Texas............
45 0.7936 0.8007 99945 45760........................... Live Oak County, Texas............
45 0.7936 0.8007 99945 45761........................... Llano County, Texas...............
45 0.7936 0.8007 99945 45762........................... Loving County, Texas..............
45 0.7936 0.8007 99945 45770........................... Lubbock County, Texas............. 4600 0.8792 0.8792 31180 45771........................... Lynn County, Texas................
45 0.7936 0.8007 99945 45772........................... Mc Culloch County, Texas..........
45 0.7936 0.8007 99945 45780........................... Mc Lennan County, Texas........... 8800 0.8527 0.8527 47380 45781........................... Mc Mullen County, Texas...........
45 0.7936 0.8007 99945 45782........................... Madison County, Texas.............
45 0.7936 0.8007 99945 45783........................... Marion County, Texas..............
45 0.7936 0.8007 99945 45784........................... Martin County, Texas..............
45 0.7936 0.8007 99945 45785........................... Mason County, Texas...............
45 0.7936 0.8007 99945 45790........................... Matagorda County, Texas...........
45 0.7936 0.8007 99945 45791........................... Maverick County, Texas............
45 0.7936 0.8007 99945 45792........................... Medina County, Texas..............
45 0.7936 0.8989 41700 45793........................... Menard County, Texas..............
45 0.7936 0.8007 99945 45794........................... Midland County, Texas............. 5800 0.9751 0.9523 33260 45795........................... Milam County, Texas...............
45 0.7936 0.8007 99945 45796........................... Mills County, Texas...............
45 0.7936 0.8007 99945 45797........................... Mitchell County, Texas............
45 0.7936 0.8007 99945 45800........................... Montague County, Texas............
45 0.7936 0.8007 99945 45801........................... Montgomery County, Texas.......... 3360 1.0101 1.0005 26420 45802........................... Moore County, Texas...............
45 0.7936 0.8007 99945 45803........................... Morris County, Texas..............
45 0.7936 0.8007 99945 45804........................... Motley County, Texas..............
45 0.7936 0.8007 99945 45810........................... Nacogdoches County, Texas.........
45 0.7936 0.8007 99945 45820........................... Navarro County, Texas.............
45 0.7936 0.8007 99945 45821........................... Newton County, Texas..............
45 0.7936 0.8007 99945 45822........................... Nolan County, Texas...............
45 0.7936 0.8007 99945 45830........................... Nueces County, Texas.............. 1880 0.8559 0.8559 18580 45831........................... Ochiltree County, Texas...........
45 0.7936 0.8007 99945 45832........................... Oldham County, Texas..............
45 0.7936 0.8007 99945 45840........................... Orange County, Texas.............. 0840 0.8421 0.8421 13140 45841........................... Palo Pinto County, Texas..........
45 0.7936 0.8007 99945 45842........................... Panola County, Texas..............
45 0.7936 0.8007 99945 45843........................... Parker County, Texas.............. 2800 0.9545 0.9510 23104 45844........................... Parmer County, Texas..............
45 0.7936 0.8007 99945 45845........................... Pecos County, Texas...............
45 0.7936 0.8007 99945 45850........................... Polk County, Texas................
45 0.7936 0.8007 99945 45860........................... Potter County, Texas.............. 0320 0.9166 0.9166 11100 45861........................... Presidio County, Texas............
45 0.7936 0.8007 99945 45870........................... Rains County, Texas...............
45 0.7936 0.8007 99945 45871........................... Randall County, Texas............. 0320 0.9166 0.9166 11100 45872........................... Reagan County, Texas..............
45 0.7936 0.8007 99945 45873........................... Real County, Texas................
45 0.7936 0.8007 99945 45874........................... Red River County, Texas...........
45 0.7936 0.8007 99945 45875........................... Reeves County, Texas..............
45 0.7936 0.8007 99945 45876........................... Refugio County, Texas.............
45 0.7936 0.8007 99945
[[Page 29156]]
45877........................... Roberts County, Texas.............
45 0.7936 0.8007 99945 45878........................... Robertson County, Texas...........
45 0.7936 0.8909 17780 45879........................... Rockwall County, Texas............ 1920 1.0211 1.0233 19124 45880........................... Runnels County, Texas.............
45 0.7936 0.8007 99945 45881........................... Rusk County, Texas................
45 0.7936 0.8739 30980 45882........................... Sabine County, Texas..............
45 0.7936 0.8007 99945 45883........................... San Augustine County, Texas.......
45 0.7936 0.8007 99945 45884........................... San Jacinto County, Texas.........
45 0.7936 1.0005 26420 45885........................... San Patricio County, Texas........ 1880 0.8559 0.8559 18580 45886........................... San Saba County, Texas............
45 0.7936 0.8007 99945 45887........................... Schleicher County, Texas..........
45 0.7936 0.8007 99945 45888........................... Scurry County, Texas..............
45 0.7936 0.8007 99945 45889........................... Shackelford County, Texas.........
45 0.7936 0.8007 99945 45890........................... Shelby County, Texas..............
45 0.7936 0.8007 99945 45891........................... Sherman County, Texas.............
45 0.7936 0.8007 99945 45892........................... Smith County, Texas............... 8640 0.9307 0.9307 46340 45893........................... Somervell County, Texas...........
45 0.7936 0.8007 99945 45900........................... Starr County, Texas...............
45 0.7936 0.8007 99945 45901........................... Stephens County, Texas............
45 0.7936 0.8007 99945 45902........................... Sterling County, Texas............
45 0.7936 0.8007 99945 45903........................... Stonewall County, Texas...........
45 0.7936 0.8007 99945 45904........................... Sutton County, Texas..............
45 0.7936 0.8007 99945 45905........................... Swisher County, Texas.............
45 0.7936 0.8007 99945 45910........................... Tarrant County, Texas............. 2800 0.9545 0.9510 23104 45911........................... Taylor County, Texas.............. 0040 0.8062 0.7904 10180 45912........................... Terrell County, Texas.............
45 0.7936 0.8007 99945 45913........................... Terry County, Texas...............
45 0.7936 0.8007 99945 45920........................... Throckmorton County, Texas........
45 0.7936 0.8007 99945 45921........................... Titus County, Texas...............
45 0.7936 0.8007 99945 45930........................... Tom Green County, Texas........... 7200 0.8280 0.8280 41660 45940........................... Travis County, Texas.............. 0640 0.9450 0.9450 12420 45941........................... Trinity County, Texas.............
45 0.7936 0.8007 99945 45942........................... Tyler County, Texas...............
45 0.7936 0.8007 99945 45943........................... Upshur County, Texas.............. 4420 0.8897 0.8739 30980 45944........................... Upton County, Texas...............
45 0.7936 0.8007 99945 45945........................... Uvalde County, Texas..............
45 0.7936 0.8007 99945 45946........................... Val Verde County, Texas...........
45 0.7936 0.8007 99945 45947........................... Van Zandt County, Texas...........
45 0.7936 0.8007 99945 45948........................... Victoria County, Texas............ 8750 0.8168 0.8168 47020 45949........................... Walker County, Texas..............
45 0.7936 0.8007 99945 45950........................... Waller County, Texas.............. 3360 1.0101 1.0005 26420 45951........................... Ward County, Texas................
45 0.7936 0.8007 99945 45952........................... Washington County, Texas..........
45 0.7936 0.8007 99945 45953........................... Webb County, Texas................ 4080 0.8076 0.8076 29700 45954........................... Wharton County, Texas.............
45 0.7936 0.8007 99945 45955........................... Wheeler County, Texas.............
45 0.7936 0.8007 99945 45960........................... Wichita County, Texas............. 9080 0.8373 0.8294 48660 45961........................... Wilbarger County, Texas...........
45 0.7936 0.8007 99945 45962........................... Willacy County, Texas.............
45 0.7936 0.8007 99945 45970........................... Williamson County, Texas.......... 0640 0.9450 0.9450 12420 45971........................... Wilson County, Texas.............. 7240 0.8993 0.8989 41700 45972........................... Winkler County, Texas.............
45 0.7936 0.8007 99945 45973........................... Wise County, Texas................
45 0.7936 0.9510 23104 45974........................... Wood County, Texas................
45 0.7936 0.8007 99945 45980........................... Yoakum County, Texas..............
45 0.7936 0.8007 99945 45981........................... Young County, Texas...............
45 0.7936 0.8007 99945 45982........................... Zapata County, Texas..............
45 0.7936 0.8007 99945 45983........................... Zavala County, Texas..............
45 0.7936 0.8007 99945 46000........................... Beaver County, Utah...............
46 0.8779 0.8126 99946 46010........................... Box Elder County, Utah............
46 0.8779 0.8126 99946 46020........................... Cache County, Utah................
46 0.8779 0.9173 30860 46030........................... Carbon County, Utah...............
46 0.8779 0.8126 99946 46040........................... Daggett County, Utah..............
46 0.8779 0.8126 99946 46050........................... Davis County, Utah................ 7160 0.9350 0.9038 36260 46060........................... Duchesne County, Utah.............
46 0.8779 0.8126 99946 46070........................... Emery County, Utah................
46 0.8779 0.8126 99946 46080........................... Garfield County, Utah.............
46 0.8779 0.8126 99946 46090........................... Grand County, Utah................
46 0.8779 0.8126 99946 46100........................... Iron County, Utah.................
46 0.8779 0.8126 99946
[[Page 29157]]
46110........................... Juab County, Utah.................
46 0.8779 0.9510 39340 46120........................... Kane County, Utah................. 2620 1.1857 0.8126 99946 46130........................... Millard County, Utah..............
46 0.8779 0.8126 99946 46140........................... Morgan County, Utah...............
46 0.8779 0.9038 36260 46150........................... Piute County, Utah................
46 0.8779 0.8126 99946 46160........................... Rich County, Utah.................
46 0.8779 0.8126 99946 46170........................... Salt Lake County, Utah............ 7160 0.9350 0.9433 41620 46180........................... San Juan County, Utah.............
46 0.8779 0.8126 99946 46190........................... Sanpete County, Utah..............
46 0.8779 0.8126 99946 46200........................... Sevier County, Utah...............
46 0.8779 0.8126 99946 46210........................... Summit County, Utah...............
46 0.8779 0.9433 41620 46220........................... Tooele County, Utah...............
46 0.8779 0.9433 41620 46230........................... Uintah County, Utah...............
46 0.8779 0.8126 99946 46240........................... Utah County, Utah................. 6520 0.9510 0.9510 39340 46250........................... Wasatch County, Utah..............
46 0.8779 0.8126 99946 46260........................... Washington County, Utah...........
46 0.8779 0.9402 41100 46270........................... Wayne County, Utah................
46 0.8779 0.8126 99946 46280........................... Weber County, Utah................ 7160 0.9350 0.9038 36260 47000........................... Addison County, Vermont...........
47 0.9840 0.9840 99947 47010........................... Bennington County, Vermont........
47 0.9840 0.9840 99947 47020........................... Caledonia County, Vermont.........
47 0.9840 0.9840 99947 47030........................... Chittenden County, Vermont........ 1303 0.9446 0.9446 15540 47040........................... Essex County, Vermont.............
47 0.9840 0.9840 99947 47050........................... Franklin County, Vermont.......... 1303 0.9446 0.9446 15540 47060........................... Grand Isle County, Vermont........ 1303 0.9446 0.9446 15540 47070........................... Lamoille County, Vermont..........
47 0.9840 0.9840 99947 47080........................... Orange County, Vermont............
47 0.9840 0.9840 99947 47090........................... Orleans County, Vermont...........
47 0.9840 0.9840 99947 47100........................... Rutland County, Vermont...........
47 0.9840 0.9840 99947 47110........................... Washington County, Vermont........
47 0.9840 0.9840 99947 47120........................... Windham County, Vermont...........
47 0.9840 0.9840 99947 47130........................... Windsor County, Vermont...........
47 0.9840 0.9840 99947 49000........................... Accomack County, Virginia.........
49 0.8420 0.8012 99949 49010........................... Albemarle County, Virginia........ 1540 1.0234 1.0234 16820 49011........................... Alexandria City County, Virginia.. 8840 1.0983 1.0932 47894 49020........................... Alleghany County, Virginia........
49 0.8420 0.8012 99949 49030........................... Amelia County, Virginia...........
49 0.8420 0.9338 40060 49040........................... Amherst County, Virginia.......... 4640 0.8700 0.8700 31340 49050........................... Appomattox County, Virginia.......
49 0.8420 0.8700 31340 49060........................... Arlington County, Virginia........ 8840 1.0983 1.0932 47894 49070........................... Augusta County, Virginia..........
49 0.8420 0.8012 99949 49080........................... Bath County, Virginia.............
49 0.8420 0.8012 99949 49088........................... Bedford City County, Virginia..... 4640 0.8700 0.8700 31340 49090........................... Bedford County, Virginia.......... 4640 0.8700 0.8700 31340 49100........................... Bland County, Virginia............
49 0.8420 0.8012 99949 49110........................... Botetourt County, Virginia........ 6800 0.8395 0.8383 40220 49111........................... Bristol City County, Virginia..... 3660 0.8015 0.8062 28700 49120........................... Brunswick County, Virginia........
49 0.8420 0.8012 99949 49130........................... Buchanan County, Virginia.........
49 0.8420 0.8012 99949 49140........................... Buckingham County, Virginia.......
49 0.8420 0.8012 99949 49141........................... Buena Vista City County, Virginia.
49 0.8420 0.8012 99949 49150........................... Campbell County, Virginia......... 4640 0.8700 0.8700 31340 49160........................... Caroline County, Virginia.........
49 0.8420 0.9338 40060 49170........................... Carroll County, Virginia..........
49 0.8420 0.8012 99949 49180........................... Charles City County, Virginia..... 6760 0.9338 0.9338 40060 49190........................... Charlotte County, Virginia........
49 0.8420 0.8012 99949 49191........................... Charlottesville City County,
1540 1.0234 1.0234 16820 Virginia. 49194........................... Chesapeake County, Virginia....... 5720 0.8808 0.8808 47260 49200........................... Chesterfield County, Virginia..... 6760 0.9338 0.9338 40060 49210........................... Clarke County, Virginia........... 8840 1.0983 1.0932 47894 49211........................... Clifton Forge City County,
49 0.8420 0.8012 99949 Virginia. 49212........................... Colonial Heights County, Virginia. 6760 0.9338 0.9338 40060 49213........................... Covington City County, Virginia...
49 0.8420 0.8012 99949 49220........................... Craig County, Virginia............
49 0.8420 0.8383 40220 49230........................... Culpeper County, Virginia......... 8840 1.0983 0.8012 99949 49240........................... Cumberland County, Virginia.......
49 0.8420 0.9338 40060 49241........................... Danville City County, Virginia.... 1950 0.8497 0.8497 19260 49250........................... Dickenson County, Virginia........
49 0.8420 0.8012 99949 49260........................... Dinniddie County, Virginia........ 6760 0.9338 0.9338 40060
[[Page 29158]]
49270........................... Emporia County, Virginia..........
49 0.8420 0.8012 99949 49280........................... Essex County, Virginia............
49 0.8420 0.8012 99949 49288........................... Fairfax City County, Virginia..... 8840 1.0983 1.0932 47894 49290........................... Fairfax County, Virginia.......... 8840 1.0983 1.0932 47894 49291........................... Falls Church City County, Virginia 8840 1.0983 1.0932 47894 49300........................... Fauquier County, Virginia......... 8840 1.0983 1.0932 47894 49310........................... Floyd County, Virginia............
49 0.8420 0.8012 99949 49320........................... Fluvanna County, Virginia......... 1540 1.0234 1.0234 16820 49328........................... Franklin City County, Virginia....
49 0.8420 0.8012 99949 49330........................... Franklin County, Virginia.........
49 0.8420 0.8383 40220 49340........................... Frederick County, Virginia........
49 0.8420 1.0224 49020 49342........................... Fredericksburg City County,
8840 1.0983 1.0932 47894 Virginia. 49343........................... Galax City County, Virginia.......
49 0.8420 0.8012 99949 49350........................... Giles County, Virginia............
49 0.8420 0.7962 13980 49360........................... Gloucester County, Virginia....... 5720 0.8808 0.8808 47260 49370........................... Goochland County, Virginia........ 6760 0.9338 0.9338 40060 49380........................... Grayson County, Virginia..........
49 0.8420 0.8012 99949 49390........................... Greene County, Virginia........... 1540 1.0234 1.0234 16820 49400........................... Greensville County, Virginia......
49 0.8420 0.8012 99949 49410........................... Halifax County, Virginia..........
49 0.8420 0.8012 99949 49411........................... Hampton City County, Virginia..... 5720 0.8808 0.8808 47260 49420........................... Hanover County, Virginia.......... 6760 0.9338 0.9338 40060 49421........................... Harrisonburg City County, Virginia
49 0.8420 0.9098 25500 49430........................... Henrico County, Virginia.......... 6760 0.9338 0.9338 40060 49440........................... Henry County, Virginia............
49 0.8420 0.8012 99949 49450........................... Highland County, Virginia.........
49 0.8420 0.8012 99949 49451........................... Hopewell City County, Virginia.... 6760 0.9338 0.9338 40060 49460........................... Isle Of Wight County, Virginia.... 5720 0.8808 0.8808 47260 49470........................... James City Co County, Virginia.... 5720 0.8808 0.8808 47260 49480........................... King And Queen County, Virginia...
49 0.8420 0.9338 40060 49490........................... King George County, Virginia...... 8840 1.0983 0.8012 99949 49500........................... King William County, Virginia.....
49 0.8420 0.9338 40060 49510........................... Lancaster County, Virginia........
49 0.8420 0.8012 99949 49520........................... Lee County, Virginia..............
49 0.8420 0.8012 99949 49522........................... Lexington County, Virginia........
49 0.8420 0.8012 99949 49530........................... Loudoun County, Virginia.......... 8840 1.0983 1.0932 47894 49540........................... Louisa County, Virginia...........
49 0.8420 0.9338 40060 49550........................... Lunenburg County, Virginia........
49 0.8420 0.8012 99949 49551........................... Lynchburg City County, Virginia... 4640 0.8700 0.8700 31340 49560........................... Madison County, Virginia..........
49 0.8420 0.8012 99949 49561........................... Martinsville City County, Virginia
49 0.8420 0.8012 99949 49563........................... Manassas City County, Virginia.... 8840 1.0983 1.0932 47894 49565........................... Manassas Park City County,
8840 1.0983 1.0932 47894 Virginia. 49570........................... Mathews County, Virginia.......... 5720 0.8808 0.8808 47260 49580........................... Mecklenburg County, Virginia......
49 0.8420 0.8012 99949 49590........................... Middlesex County, Virginia........
49 0.8420 0.8012 99949 49600........................... Montgomery County, Virginia.......
49 0.8420 0.7962 13980 49610........................... Nansemond County, Virginia........
49 0.8420 0.8012 99949 49620........................... Nelson County, Virginia...........
49 0.8420 1.0234 16820 49621........................... New Kent County, Virginia......... 6760 0.9338 0.9338 40060 49622........................... Newport News City County, Virginia 5720 0.8808 0.8808 47260 49641........................... Norfolk City County, Virginia..... 5720 0.8808 0.8808 47260 49650........................... Northampton County, Virginia......
49 0.8420 0.8012 99949 49660........................... Northumberland County, Virginia...
49 0.8420 0.8012 99949 49661........................... Norton City County, Virginia......
49 0.8420 0.8012 99949 49670........................... Nottoway County, Virginia.........
49 0.8420 0.8012 99949 49680........................... Orange County, Virginia...........
49 0.8420 0.8012 99949 49690........................... Page County, Virginia.............
49 0.8420 0.8012 99949 49700........................... Patrick County, Virginia..........
49 0.8420 0.8012 99949 49701........................... Petersburg City County, Virginia.. 6760 0.9338 0.9338 40060 49710........................... Pittsylvania County, Virginia..... 1950 0.8497 0.8497 19260 49711........................... Portsmouth City County, Virginia.. 5720 0.8808 0.8808 47260 49712........................... Poquoson City County, Virginia.... 5720 0.8808 0.8808 47260 49720........................... Powhatan County, Virginia......... 6760 0.9338 0.9338 40060 49730........................... Prince Edward County, Virginia....
49 0.8420 0.8012 99949 49740........................... Prince George County, Virginia.... 6760 0.9338 0.9338 40060 49750........................... Prince William County, Virginia... 8840 1.0983 1.0932 47894 49770........................... Pulaski County, Virginia..........
49 0.8420 0.7962 13980 49771........................... Radford City County, Virginia.....
49 0.8420 0.7962 13980
[[Page 29159]]
49780........................... Rappahannock County, Virginia.....
49 0.8420 0.8012 99949 49790........................... Richmond County, Virginia.........
49 0.8420 0.8012 99949 49791........................... Richmond City County, Virginia.... 6760 0.9338 0.9338 40060 49800........................... Roanoke County, Virginia.......... 6800 0.8395 0.8383 40220 49801........................... Roanoke City County, Virginia..... 6800 0.8395 0.8383 40220 49810........................... Rockbridge County, Virginia.......
49 0.8420 0.8012 99949 49820........................... Rockingham County, Virginia.......
49 0.8420 0.9098 25500 49830........................... Russell County, Virginia..........
49 0.8420 0.8012 99949 49838........................... Salem County, Virginia............ 6800 0.8395 0.8383 40220 49840........................... Scott County, Virginia............ 3660 0.8015 0.8062 28700 49850........................... Shenandoah County, Virginia.......
49 0.8420 0.8012 99949 49860........................... Smyth County, Virginia............
49 0.8420 0.8012 99949 49867........................... South Boston City County, Virginia
49 0.8420 0.8012 99949 49870........................... Southampton County, Virginia......
49 0.8420 0.8012 99949 49880........................... Spotsylvania County, Virginia..... 8840 1.0983 1.0932 47894 49890........................... Stafford County, Virginia......... 8840 1.0983 1.0932 47894 49891........................... Staunton City County, Virginia....
49 0.8420 0.8012 99949 49892........................... Suffolk City County, Virginia..... 5720 0.8808 0.8808 47260 49900........................... Surry County, Virginia............
49 0.8420 0.8808 47260 49910........................... Sussex County, Virginia...........
49 0.8420 0.9338 40060 49920........................... Tazewell County, Virginia.........
49 0.8420 0.8012 99949 49921........................... Virginia Beach City County,
5720 0.8808 0.8808 47260 Virginia. 49930........................... Warren County, Virginia........... 8840 1.0983 1.0932 47894 49950........................... Washington County, Virginia....... 3660 0.8015 0.8062 28700 49951........................... Waynesboro City County, Virginia..
49 0.8420 0.8012 99949 49960........................... Westmoreland County, Virginia.....
49 0.8420 0.8012 99949 49961........................... Williamsburg City County, Virginia 5720 0.8808 0.8808 47260 49962........................... Winchester City County, Virginia..
49 0.8420 1.0224 49020 49970........................... Wise County, Virginia.............
49 0.8420 0.8012 99949 49980........................... Wythe County, Virginia............
49 0.8420 0.8012 99949 49981........................... York County, Virginia............. 5720 0.8808 0.8808 47260 50000........................... Adams County, Washington..........
50 1.0194 1.0458 99950 50010........................... Asotin County, Washington.........
50 1.0194 0.9896 30300 50020........................... Benton County, Washington......... 6740 1.0630 1.0630 28420 50030........................... Chelan County, Washington.........
50 1.0194 1.0080 48300 50040........................... Clallam County, Washington........
50 1.0194 1.0458 99950 50050........................... Clark County, Washington.......... 6440 1.1260 1.1260 38900 50060........................... Columbia County, Washington.......
50 1.0194 1.0458 99950 50070........................... Cowlitz County, Washington........
50 1.0194 0.9523 31020 50080........................... Douglas County, Washington........
50 1.0194 1.0080 48300 50090........................... Ferry County, Washington..........
50 1.0194 1.0458 99950 50100........................... Franklin County, Washington....... 6740 1.0630 1.0630 28420 50110........................... Garfield County, Washington.......
50 1.0194 1.0458 99950 50120........................... Grant County, Washington..........
50 1.0194 1.0458 99950 50130........................... Grays Harbor County, Washington...
50 1.0194 1.0458 99950 50140........................... Island County, Washington......... 7600 1.1579 1.0458 99950 50150........................... Jefferson County, Washington......
50 1.0194 1.0458 99950 50160........................... King County, Washington........... 7600 1.1579 1.1589 42644 50170........................... Kitsap County, Washington......... 1150 1.0686 1.0686 14740 50180........................... Kittitas County, Washington.......
50 1.0194 1.0458 99950 50190........................... Klickitat County, Washington......
50 1.0194 1.0458 99950 50200........................... Lewis County, Washington..........
50 1.0194 1.0458 99950 50210........................... Lincoln County, Washington........
50 1.0194 1.0458 99950 50220........................... Mason County, Washington..........
50 1.0194 1.0458 99950 50230........................... Okanogan County, Washington.......
50 1.0194 1.0458 99950 50240........................... Pacific County, Washington........
50 1.0194 1.0458 99950 50250........................... Pend Oreille County, Washington...
50 1.0194 1.0458 99950 50260........................... Pierce County, Washington......... 8200 1.0753 1.0753 45104 50270........................... San Juan County, Washington.......
50 1.0194 1.0458 99950 50280........................... Skagit County, Washington.........
50 1.0194 1.0465 34580 50290........................... Skamania County, Washington.......
50 1.0194 1.1260 38900 50300........................... Snohomish County, Washington...... 7600 1.1579 1.1589 42644 50310........................... Spokane County, Washington........ 7840 1.0916 1.0916 44060 50320........................... Stevens County, Washington........
50 1.0194 1.0458 99950 50330........................... Thurston County, Washington....... 5910 1.0938 1.0938 36500 50340........................... Wahkiakum County, Washington......
50 1.0194 1.0458 99950 50350........................... Walla Walla County, Washington....
50 1.0194 1.0458 99950 50360........................... Whatcom County, Washington........ 0860 1.1743 1.1743 13380 50370........................... Whitman County, Washington........
50 1.0194 1.0458 99950
[[Page 29160]]
50380........................... Yakima County, Washington......... 9260 1.0165 1.0165 49420 51000........................... Barbour County, W Virginia........
51 0.7908 0.7725 99951 51010........................... Berkeley County, W Virginia....... 8840 1.0983 0.9499 25180 51020........................... Boone County, W Virginia..........
51 0.7908 0.8428 16620 51030........................... Braxton County, W Virginia........
51 0.7908 0.7725 99951 51040........................... Brooke County, W Virginia......... 8080 0.7827 0.7827 48260 51050........................... Cabell County, W Virginia......... 3400 0.9486 0.9486 26580 51060........................... Calhoun County, W Virginia........
51 0.7908 0.7725 99951 51070........................... Clay County, W Virginia...........
51 0.7908 0.8428 16620 51080........................... Doddridge County, W Virginia......
51 0.7908 0.7725 99951 51090........................... Fayette County, W Virginia........
51 0.7908 0.7725 99951 51100........................... Gilmer County, W Virginia.........
51 0.7908 0.7725 99951 51110........................... Grant County, W Virginia..........
51 0.7908 0.7725 99951 51120........................... Greenbrier County, W Virginia.....
51 0.7908 0.7725 99951 51130........................... Hampshire County, W Virginia......
51 0.7908 1.0224 49020 51140........................... Hancock County, W Virginia........ 8080 0.7827 0.7827 48260 51150........................... Hardy County, W Virginia..........
51 0.7908 0.7725 99951 51160........................... Harrison County, W Virginia.......
51 0.7908 0.7725 99951 51170........................... Jackson County, W Virginia........
51 0.7908 0.7725 99951 51180........................... Jefferson County, W Virginia...... 8840 1.0983 1.0932 47894 51190........................... Kanawha County, W Virginia........ 1480 0.8428 0.8428 16620 51200........................... Lewis County, W Virginia..........
51 0.7908 0.7725 99951 51210........................... Lincoln County, W Virginia........
51 0.7908 0.8428 16620 51220........................... Logan County, W Virginia..........
51 0.7908 0.7725 99951 51230........................... Mc Dowell County, W Virginia......
51 0.7908 0.7725 99951 51240........................... Marion County, W Virginia.........
51 0.7908 0.7725 99951 51250........................... Marshall County, W Virginia....... 9000 0.7168 0.7168 48540 51260........................... Mason County, W Virginia..........
51 0.7908 0.7725 99951 51270........................... Mercer County, W Virginia.........
51 0.7908 0.7725 99951 51280........................... Mineral County, W Virginia........ 1900 0.9326 0.9326 19060 51290........................... Mingo County, W Virginia..........
51 0.7908 0.7725 99951 51300........................... Monongalia County, W Virginia.....
51 0.7908 0.8428 34060 51310........................... Monroe County, W Virginia.........
51 0.7908 0.7725 99951 51320........................... Morgan County, W Virginia.........
51 0.7908 0.9499 25180 51330........................... Nicholas County, W Virginia.......
51 0.7908 0.7725 99951 51340........................... Ohio County, W Virginia........... 9000 0.7168 0.7168 48540 51350........................... Pendleton County, W Virginia......
51 0.7908 0.7725 99951 51360........................... Pleasants County, W Virginia......
51 0.7908 0.8278 37620 51370........................... Pocahontas County, W Virginia.....
51 0.7908 0.7725 99951 51380........................... Preston County, W Virginia........
51 0.7908 0.8428 34060 51390........................... Putnam County, W Virginia......... 1480 0.8428 0.8428 16620 51400........................... Raleigh County, W Virginia........
51 0.7908 0.7725 99951 51410........................... Randolph County, W Virginia.......
51 0.7908 0.7725 99951 51420........................... Ritchie County, W Virginia........
51 0.7908 0.7725 99951 51430........................... Roane County, W Virginia..........
51 0.7908 0.7725 99951 51440........................... Summers County, W Virginia........
51 0.7908 0.7725 99951 51450........................... Taylor County, W Virginia.........
51 0.7908 0.7725 99951 51460........................... Tucker County, W Virginia.........
51 0.7908 0.7725 99951 51470........................... Tyler County, W Virginia..........
51 0.7908 0.7725 99951 51480........................... Upshur County, W Virginia.........
51 0.7908 0.7725 99951 51490........................... Wayne County, W Virginia.......... 3400 0.9486 0.9486 26580 51500........................... Webster County, W Virginia........
51 0.7908 0.7725 99951 51510........................... Wetzel County, W Virginia.........
51 0.7908 0.7725 99951 51520........................... Wirt County, W Virginia...........
51 0.7908 0.8278 37620 51530........................... Wood County, W Virginia........... 6020 0.8278 0.8278 37620 51540........................... Wyoming County, W Virginia........
51 0.7908 0.7725 99951 52000........................... Adams County, Wisconsin...........
52 0.9446 0.9480 99952 52010........................... Ashland County, Wisconsin.........
52 0.9446 0.9480 99952 52020........................... Barron County, Wisconsin..........
52 0.9446 0.9480 99952 52030........................... Bayfield County, Wisconsin........
52 0.9446 0.9480 99952 52040........................... Brown County, Wisconsin........... 3080 0.9452 0.9452 24580 52050........................... Buffalo County, Wisconsin.........
52 0.9446 0.9480 99952 52060........................... Burnett County, Wisconsin.........
52 0.9446 0.9480 99952 52070........................... Calumet County, Wisconsin......... 0460 0.9248 0.9298 11540 52080........................... Chippewa County, Wisconsin........ 2290 0.9210 0.9210 20740 52090........................... Clark County, Wisconsin...........
52 0.9446 0.9480 99952 52100........................... Columbia County, Wisconsin........
52 0.9446 1.0635 31540 52110........................... Crawford County, Wisconsin........
52 0.9446 0.9480 99952 52120........................... Dane County, Wisconsin............ 4720 1.0764 1.0635 31540
[[Page 29161]]
52130........................... Dodge County, Wisconsin...........
52 0.9446 0.9480 99952 52140........................... Door County, Wisconsin............
52 0.9446 0.9480 99952 52150........................... Douglas County, Wisconsin......... 2240 1.0223 1.0209 20260 52160........................... Dunn County, Wisconsin............
52 0.9446 0.9480 99952 52170........................... Eau Claire County, Wisconsin...... 2290 0.9210 0.9210 20740 52180........................... Florence County, Wisconsin........
52 0.9446 0.9480 99952 52190........................... Fond Du Lac County, Wisconsin.....
52 0.9446 0.9650 22540 52200........................... Forest County, Wisconsin..........
52 0.9446 0.9480 99952 52210........................... Grant County, Wisconsin...........
52 0.9446 0.9480 99952 52220........................... Green County, Wisconsin...........
52 0.9446 0.9480 99952 52230........................... Green Lake County, Wisconsin......
52 0.9446 0.9480 99952 52240........................... Iowa County, Wisconsin............
52 0.9446 1.0635 31540 52250........................... Iron County, Wisconsin............
52 0.9446 0.9480 99952 52260........................... Jackson County, Wisconsin.........
52 0.9446 0.9480 99952 52270........................... Jefferson County, Wisconsin.......
52 0.9446 0.9480 99952 52280........................... Juneau County, Wisconsin..........
52 0.9446 0.9480 99952 52290........................... Kenosha County, Wisconsin......... 3800 0.9770 1.0440 29404 52300........................... Kewaunee County, Wisconsin........
52 0.9446 0.9452 24580 52310........................... La Crosse County, Wisconsin....... 3870 0.9573 0.9573 29100 52320........................... Lafayette County, Wisconsin.......
52 0.9446 0.9480 99952 52330........................... Langlade County, Wisconsin........
52 0.9446 0.9480 99952 52340........................... Lincoln County, Wisconsin.........
52 0.9446 0.9480 99952 52350........................... Manitowoc County, Wisconsin.......
52 0.9446 0.9480 99952 52360........................... Marathon County, Wisconsin........ 8940 0.9600 0.9600 48140 52370........................... Marinette County, Wisconsin.......
52 0.9446 0.9480 99952 52380........................... Marquette County, Wisconsin.......
52 0.9446 0.9480 99952 52381........................... Menominee County, Wisconsin.......
52 0.9446 0.9480 99952 52390........................... Milwaukee County, Wisconsin....... 5080 1.0106 1.0106 33340 52400........................... Monroe County, Wisconsin..........
52 0.9446 0.9480 99952 52410........................... Oconto County, Wisconsin..........
52 0.9446 0.9452 24580 52420........................... Oneida County, Wisconsin..........
52 0.9446 0.9480 99952 52430........................... Outagamie County, Wisconsin....... 0460 0.9248 0.9298 11540 52440........................... Ozaukee County, Wisconsin......... 5080 1.0106 1.0106 33340 52450........................... Pepin County, Wisconsin...........
52 0.9446 0.9480 99952 52460........................... Pierce County, Wisconsin.......... 5120 1.1078 1.1078 33460 52470........................... Polk County, Wisconsin............
52 0.9446 0.9480 99952 52480........................... Portage County, Wisconsin.........
52 0.9446 0.9480 99952 52490........................... Price County, Wisconsin...........
52 0.9446 0.9480 99952 52500........................... Racine County, Wisconsin.......... 6600 0.9006 0.9006 39540 52510........................... Richland County, Wisconsin........
52 0.9446 0.9480 99952 52520........................... Rock County, Wisconsin............ 3620 0.9547 0.9547 27500 52530........................... Rusk County, Wisconsin............
52 0.9446 0.9480 99952 52540........................... St Croix County, Wisconsin........ 5120 1.1078 1.1078 33460 52550........................... Sauk County, Wisconsin............
52 0.9446 0.9480 99952 52560........................... Sawyer County, Wisconsin..........
52 0.9446 0.9480 99952 52570........................... Shawano County, Wisconsin.........
52 0.9446 0.9480 99952 52580........................... Sheboygan County, Wisconsin....... 7620 0.8920 0.8920 43100 52590........................... Taylor County, Wisconsin..........
52 0.9446 0.9480 99952 52600........................... Trempealeau County, Wisconsin.....
52 0.9446 0.9480 99952 52610........................... Vernon County, Wisconsin..........
52 0.9446 0.9480 99952 52620........................... Vilas County, Wisconsin...........
52 0.9446 0.9480 99952 52630........................... Walworth County, Wisconsin........
52 0.9446 0.9480 99952 52640........................... Washburn County, Wisconsin........
52 0.9446 0.9480 99952 52650........................... Washington County, Wisconsin...... 5080 1.0106 1.0106 33340 52660........................... Waukesha County, Wisconsin........ 5080 1.0106 1.0106 33340 52670........................... Waupaca County, Wisconsin.........
52 0.9446 0.9480 99952 52680........................... Waushara County, Wisconsin........
52 0.9446 0.9480 99952 52690........................... Winnebago County, Wisconsin....... 0460 0.9248 0.9192 36780 52700........................... Wood County, Wisconsin............
52 0.9446 0.9480 99952 53000........................... Albany County, Wyoming............
53 0.9214 0.9214 99953 53010........................... Big Horn County, Wyoming..........
53 0.9214 0.9214 99953 53020........................... Campbell County, Wyoming..........
53 0.9214 0.9214 99953 53030........................... Carbon County, Wyoming............
53 0.9214 0.9214 99953 53040........................... Converse County, Wyoming..........
53 0.9214 0.9214 99953 53050........................... Crook County, Wyoming.............
53 0.9214 0.9214 99953 53060........................... Fremont County, Wyoming...........
53 0.9214 0.9214 99953 53070........................... Goshen County, Wyoming............
53 0.9214 0.9214 99953 53080........................... Hot Springs County, Wyoming.......
53 0.9214 0.9214 99953 53090........................... Johnson County, Wyoming...........
53 0.9214 0.9214 99953
[[Page 29162]]
53100........................... Laramie County, Wyoming........... 1580 0.8784 0.8784 16940 53110........................... Lincoln County, Wyoming...........
53 0.9214 0.9214 99953 53120........................... Natrona County, Wyoming........... 1350 0.9035 0.9035 16220 53130........................... Niobrara County, Wyoming..........
53 0.9214 0.9214 99953 53140........................... Park County, Wyoming..............
53 0.9214 0.9214 99953 53150........................... Platte County, Wyoming............
53 0.9214 0.9214 99953 53160........................... Sheridan County, Wyoming..........
53 0.9214 0.9214 99953 53170........................... Sublette County, Wyoming..........
53 0.9214 0.9214 99953 53180........................... Sweetwater County, Wyoming........
53 0.9214 0.9214 99953 53190........................... Teton County, Wyoming.............
53 0.9214 0.9214 99953 53200........................... Uinta County, Wyoming.............
53 0.9214 0.9214 99953 53210........................... Washakie County, Wyoming..........
53 0.9214 0.9214 99953 53220........................... Weston County, Wyoming............
53 0.9214 0.9214 99953
[FR Doc. 05-9934 Filed 5-13-05; 4:15 pm]
BILLING CODE 4120-01-P
