[Federal Register Volume 75, Number 195 (Friday, October 8, 2010)]
[Notices]
[Pages 62395-62399]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2010-25344]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Calculation of Annual Federal Medical Assistance Percentages for
Indian Tribes for Use in the Title IV-E Foster Care, Adoption
Assistance, and Kinship Guardianship Assistance Programs
AGENCY: Office of the Secretary, DHHS.
ACTION: Notice with comment period.
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SUMMARY: The Fostering Connections to Success and Increasing Adoptions
Act of 2008 (Pub. L. 110-351) directed HHS to establish assistance
payment reimbursement rates for Indian Tribes, tribal organizations and
tribal consortia participating in certain child welfare programs
authorized under title IV-E of the Social Security Act. These
reimbursement rates will be calculated in a manner similar to the
Federal Medical Assistance Percentage (FMAP) rates used to reimburse
States. This notice describes the Department's proposed methodology for
calculating these rates.
DATES: Effective Date: The methodology described in this applies to
Fiscal Years 2010 and beyond. The FMAP rates included in this notice
apply to Fiscal Years 2010 and 2011.
Comment Date: To be assured consideration, comments must be
received at the address provided below, no later than 5 p.m. on
December 7, 2010.
ADDRESSES: Comments may be submitted via either regular mail or e-mail.
If you submit written comments via regular mail, please send one
original and one copy of your comments to the following address only:
Department of Health and Human Services, Room 404-E, Attention: Tribal
FMAP Notice, 200 Independence Ave., SW., Washington, DC 20201.
Comments via e-mail should be sent to the following e-mail address:
[email protected].
Submitting Comments: We welcome comments from the public on the
calculation methodology set forth in this notice with comment period to
assist us in fully considering issues and developing policies. Please
provide a reference to the section on which you choose to comment.
A. Background
The Fostering Connections to Success and Increasing Adoptions Act
of 2008 (``Fostering Connections Act'') [Pub. L. 110-351], authorizes
Indian Tribes, tribal organizations and tribal consortia to receive
funding directly for Foster Care, Adoption Assistance, and Kinship
Guardianship Assistance Programs under title IV-E of the Social
Security Act. Such direct funding may begin in FY 2010 for Indian
Tribes, tribal organizations or tribal consortia with approved title
IV-E plans, or eligible Tribes may submit plans to operate such
programs at any time in the future. Indian Tribes not operating their
own programs may receive title IV-E funds through agreements with the
States within which they are located, as authorized under prior law. To
date, 86 Indian Tribes have submitted letters of intent to the
Administration for Children and Families (ACF) indicating an interest
in operating title IV-E programs. Seven Indian Tribes have received
title IV-E plan development grants intended to assist Indian Tribes to
develop their programs and prepare an approvable title IV-E plan, and
one Indian Tribe has submitted a title IV-E plan that is currently
under review within ACF. Approximately 90 Indian Tribes currently
operate programs under title IV-E agreements with States.
The Federal share of assistance payments for the Title IV-E Foster
Care, Adoption Assistance and Kinship Guardianship Assistance Programs
is calculated using the Federal Medical Assistance Percentage (FMAP),
which is the match rate developed originally for use in the Medicaid
Program. FMAP is calculated annually for each State by HHS according to
a formula specified in statute (section 1905(b) of the Social Security
Act, 42 U.S.C. 1396d(b)). A table displaying each State's FMAP is
published annually in the Federal Register and is used by the Centers
for Medicare & Medicaid Services (CMS) and others, including the
Administration for Children and Families (ACF), in calculating the
Federal share of State and territorial
[[Page 62396]]
expenditures for programs that use the FMAP for determining Federal
financial participation. The FMAP formula involves comparing the
State's average per capita income over a three year period with the
average per capita income of the U.S. as a whole for the same three
year period, and results in FMAP rates that vary between statutory
minimum and maximum levels of 50 and 83 percent. The formula produces
higher Federal matching rates for jurisdictions with lower average per
capita incomes relative to the U.S. average. Indian Tribes previously
have not been authorized to administer Federal programs that use FMAPs
and therefore tribal FMAPs have not previously been calculated.
Section 301 of the Fostering Connections Act added Section 479B to
the Social Security Act defining Tribal title IV-E Programs. Section
479B(d) provides for the funding of foster care and adoption assistance
programs operated by Indian Tribes and requires HHS to establish FMAP
rates for Indian Tribes, tribal organizations, or tribal consortia.
Each Tribe's annual FMAP shall be based on the per capita income of the
service population of the Indian Tribe, tribal organization, or tribal
consortium. However, no tribal FMAP shall be lower than the FMAP of any
State in which the Indian Tribe, tribal organization, or tribal
consortium is located. That is, for Indian Tribes located in multiple
States, the Indian Tribe's FMAP (and that to be used with respect to
claiming through any title IV-E agreements between the Indian Tribe and
a State title IV-E agency) will be at least as high as that of
whichever of the States in which it is located that has the highest
FMAP. The FMAP described here will be used for Indian Tribes' title IV-
E Foster Care, Adoption Assistance, and Kinship Guardianship Assistance
programs whether they are administered directly by the Indian Tribe or
through an agreement with a title IV-E State agency. The specific
statutory language reads as follows:
(d) Determination of Federal Medical Assistance Percentage for
Foster Care Maintenance and Adoption Assistance Payments:
(1) Per Capita Income--For purposes of determining the Federal
medical assistance percentage applicable to an Indian Tribe, a tribal
organization, or a tribal consortium under paragraphs (1), (2), and (5)
of section 474(a), the calculation of the per capita income of the
Indian Tribe, tribal organization, or tribal consortium shall be based
upon the service population of the Indian Tribe, tribal organization,
or tribal consortium, except that in no case shall an Indian Tribe, a
tribal organization, or a tribal consortium receive less than the
Federal medical assistance percentage for any State in which the Tribe,
organization, or consortium is located.
(2) Consideration of Other Information--Before making a calculation
under paragraph (1), the Secretary shall consider any information
submitted by an Indian Tribe, a tribal organization, or a tribal
consortium that the Indian Tribe, tribal organization, or tribal
consortium considers relevant to making the calculation of the per
capita income of the Indian Tribe, tribal organization, or tribal
consortium.
The law also requires the application of the tribal FMAP, if higher
than the State FMAP, for assistance payments claimed by a State IV-E
agency under title IV-E agreements and contracts between States and
Indian Tribes. (See Section 474(a)(1) and (2) of the Social Security
Act.)
B. Calculation of FMAP for Indian Tribes
The formula for calculating FMAP for States is specified in title
XIX of the Social Security Act (section 1905(b), 42 U.S.C. 1396d(b)).
FMAP is calculated according to the following formula:
1-0.45 ((State Per Capita Income)\2\/(U.S. Per Capita Income)\2\)
The FMAP for a State cannot be less than 50 percent or more than 83
percent. HHS proposes to use the same formula to calculate FMAP for
Indian Tribes for title IV-E programs, substituting the Indian Tribe's
per capita income data for that of the State. That is: 1-0.45((Indian
Tribe's Per Capita Income)\2\/(U.S. Per Capita Income)\2\).
As required by statute, the minimum rate of 50% and the maximum
rate of 83% will apply to Indian Tribes. The FMAP rate for each Indian
Tribe will be calculated each year in advance of the upcoming fiscal
year. Rather than use decimal places, tribal FMAP rates will be rounded
up to the next highest whole number (up to a maximum of 83 percent).
C. Data Sources for Calculation of FMAP for Indian Tribes
When calculating FMAP for States, HHS uses data on per capita
income produced by the Bureau of Economic Analysis (BEA) within the
Department of Commerce, as required by the Medicaid statute (Section
1101(a)(8)(B) of the Social Security Act, 42 U.S.C. 1301(a)(8)(B)).
However, BEA does not have data available regarding per capita income
for Indian Tribes. Alternative data sources must therefore be used to
calculate FMAP for Indian Tribes. HHS has researched available sources
of income data for Indian Tribes and has concluded that up to date
annual data on per capita income are not currently available for most
Indian Tribes.
The U.S. Census Bureau produces the only consistent national data
regarding per capita income for each Indian Tribe. However, the source
of these data is currently in transition. Per capita income that has in
the past been collected every 10 years through the decennial census
``long form'' will in the future be collected by the Census Bureau
using the American Community Survey (ACS), an ongoing data collection
mechanism. ACS data will be updated more frequently than Decennial
Census data, leading to more current estimates in the future. The ACS
provides annual (1-year) estimates for geographic areas with
populations of 65,000 or more. By pooling responses from multiple years
of ACS data, 3-year estimates are currently produced for geographic
areas with populations of 20,000 or more. Few Indian Tribes, however,
are large enough for either annual or 3-year estimates to be produced.
Of the 86 Tribes and tribal organizations that submitted letters of
intent to ACF indicating an interest in operating title IV-E programs,
3-year ACS data is available for only eight. Beginning late in calendar
year 2010 (during Federal Fiscal Year 2011) 5-year estimates will
become available from the Census Bureau for smaller geographic areas,
including all Indian Tribes and tribal lands for which Decennial Census
data has previously been collected. The 3-year and 5-year estimates
will be updated annually beginning in calendar year 2011.
HHS plans to use ACS 5-year estimates as the data source for FMAP
calculations applying to the fiscal year following the April in which
such data are available. The Census Bureau currently projects that
these data will become available by the end of calendar year 2010.
Assuming the data are released as expected or no later than April 2011,
HHS will use ACS 5-year estimates for 2012 FMAP calculations for Indian
Tribes.
Until ACS data become consistently available, the only complete
source of per capita income data for Indian Tribes and tribal
communities is that of the 2000 Decennial Census, which reports 1999
per capita income data for Indian tribal lands. However, these data are
now ten years old and may not represent current tribal income levels.
While current levels are preferable for use in calculating the FMAP,
such data do not yet exist. In the absence of more
[[Page 62397]]
recent data, HHS determined that relying on data from the 2000
Decennial Census is the most viable option until the ACS data becomes
available for all Indian Tribes.
We considered whether to use ACS estimates for the several Indian
Tribes for which it is available, but decided that it would be more
equitable to use the same data source for calculating FMAP for all
participating Indian Tribes, tribal organizations and tribal consortia.
Therefore, for tribal FMAP rates applying to Fiscal Years 2010 and
2011, HHS will rely on per capita income data from the 2000 Decennial
Census, which is the most current data source identified that contains
information about per capita incomes for the full range of Indian
Tribes.
The law requires that FMAP be calculated on the basis of the Indian
Tribe's ``service population'' for its title IV-E program. Census
Bureau data regarding per capita income (including that produced for
the Decennial Census and the ACS) can be presented (a) For the total
population (all races) living on or near the tribal lands; (b) for the
population of individuals identifying themselves only as American
Indian or Alaska Native (AI/AN); or (c) for the population who identify
themselves as either AI/AN alone or in combination with another race
(that is, including multiracial individuals who identify themselves as
part AI/AN). Data for populations described in (a) and (b) are standard
figures available through the Census Bureau's ``American Factfinder''
Web site (www.factfinder.census.gov). Data on the ``AI/AN alone or in
combination'' population is available only through special tabulations
which may be purchased from the Census Bureau.
In the absence of information on how to characterize Indian Tribes'
intended title IV-E service populations, HHS proposes to use per capita
income data for the population of individuals identifying themselves
only as American Indian or Alaska Native. These data are readily
available without special tabulation and does not typically differ
substantially from the ``AI/AN alone or in combination'' population. It
is our understanding that figures for the total population living on or
near tribal lands includes many persons who are not enrolled members of
the Indian Tribe and therefore may not accurately reflect the incomes
of the service population. We encourage comments on the issue of which
conceptualization of the population should be used in selecting data
for FMAP calculations.
Table 1 shows the FMAP rates resulting from various per capita
income figures in the 2000 Decennial Census. To determine an Indian
Tribe's Federal Medical Assistance Percentage (FMAP) for Fiscal Years
2010 and 2011, the Indian Tribe's per capita income as shown in the
2000 Decennial Census may be matched to the figures in Table 1. Figures
falling between any two percentage rates will be rounded up to the next
whole number. Per capita income figures of $13,054 or less in the 2000
Decennial Census result in the maximum FMAP of 83%. Most Indian Tribes
have relatively low per capita incomes and would therefore qualify for
the maximum rate.
Per capita income data for individual Indian Tribes may be found on
the Census Bureau Web site at www.factfinder.census.gov. The relevant
information is in Census 2000 Summary File 3. Under ``custom tables,''
the geographic type ``American Indian Area/Alaska Native Area/Hawaiian
Homelands'' identifies Indian Tribes. The per capita income figure the
Department intends to use for FMAP calculations is found in table
P157C.
D. Calculations for Tribal Organizations and Tribal Consortia
As specified in The Fostering Connections Act, tribal IV-E programs
may be operated by federally-recognized Indian Tribes, tribal
organizations and consortia of Indian Tribes. In the case of tribal
organizations and consortia, data on an individual Indian Tribe will
not be sufficient for the calculation of the appropriate FMAP. In the
case of a tribal organization or tribal consortium composed of two or
more Tribes, HHS will calculate FMAP by weighting the per capita income
data according to the proportional representation of each Tribe's
service population relative to the total service population of the
organization or consortium. For instance, if Tribe A with a population
of 6,000 members and Tribe B with a population of 4,000 members
together operate a title IV-E program, the applicable FMAP would be
calculated by weighting the per capita income figures for the two, such
that Tribe A's per capita income is multiplied by the ratio of its
population (6,000) to the combined population of the consortia
(10,000), that is 6,000/10,000 or 0.6, and Tribe B's per capita income
is multiplied by 4,000/10,000 (or 0.4) and the two weighted per capita
income figures would be added to produce the per capita income figure
for the FMAP formula.
E. Procedures for Producing Annual Updates to Federal Medical
Assistance Percentages for Indian Tribes
For fiscal years beyond 2011, the Department plans to use American
Community Survey 5-year data for the per capita income estimates of
Indian Tribes as well as for the U.S. per capita income information
necessary for the FMAP formula. At that point, FMAP rates will be
updated annually based on the most recent ACS 5-year estimates
available. The formula for the calculation will remain as described
above. In the third quarter of each fiscal year ACF regional office
staff will communicate with each Indian Tribe, tribal organization, or
tribal consortium their tribal FMAP rate for the upcoming fiscal year.
Because most Indian Tribes will be receiving the maximum FMAP rate and
per capita incomes do not tend to change rapidly, it is likely that
many programs will see little, if any, matching rate shifts from year
to year. A link to a table similar to the one at the end of this notice
will be posted annually on ACF's Web site (http://www.acf.hhs.gov)
displaying the per capita income thresholds for each FMAP rate for the
fiscal year.
F. Consideration of Supplemental Data
The Fostering Connections Act specifies that before the tribal FMAP
calculations for each fiscal year become effective the Secretary shall
consider relevant data (e.g., ACS 3-year data) the Indian Tribe, tribal
organization or tribal consortium may submit relating to the per capita
income calculation.
In the absence of supplemental data, HHS will use the data and
procedures described above to calculate the applicable FMAP for the
grantee. Indian Tribes, tribal organizations and tribal consortia may
submit additional relevant data for the Department's consideration in
making the FMAP calculation and such data will be evaluated by the
Division of Mandatory Grants in the Office of Grants Management at ACF.
Such data may be submitted to the attention of Joseph Lonergan,
Director, Division of Mandatory Grant, ACF Office of Grants Management,
at 202-401-6603 (phone); 202-401-5644 (fax); or e-mail:
[email protected]. Supplemental data may relate to matters such as the
per capita income of the Indian Tribe, tribal organization or
consortium, the numbers and/or geographic locations of its service
population, and/or defining the grantee's service population to include
individuals other than those who identified themselves as American
Indian only to be considered for the
[[Page 62398]]
purposes of calculating the applicable per capita income.
Data to be considered for a given fiscal year's calculation should
be submitted no less than 30 days before the beginning of the next
fiscal year (September 1) in order to provide sufficient time for the
Department to evaluate the suitability of the additional data. Tribal
leadership will be consulted prior to a final decision by the
Department regarding the suitability of any supplemental data
submitted. The Department will also work closely with tribal leaders
before establishing a final FMAP for the upcoming fiscal year.
G. Application of Temporary Increases to Tribal Federal Medical
Assistance Percentages
From time to time Congress provides for adjustments to FMAP rates
in response to economic conditions or other circumstances. At present
and continuing through the first quarter of Fiscal Year 2011 (that is,
December 30, 2010), States are receiving a temporary increase in their
FMAP rates, including a temporary increase of 6.2 percentage points
that is applicable to all title IV-E programs in which assistance
payments are claimed. The statutory authorization for the temporary
increase is found in section 5001 of the American Recovery and
Reinvestment Act (ARRA), Public Law 111-5. In addition, Public Law 111-
226, the Education, Jobs and Medicaid Assistance Act, provides for
rates of 3.2 percentage points above regular FMAP rates for the second
quarter of Fiscal Year 2011 (January 1, 2011 through March 31, 2011)
and 1.2 percentage points above regular FMAP rates for the third
quarter of Fiscal Year 2011 (April 1, 2011 through June 30, 2011).
Increased rates authorized by Public Law 111-226 apply to States only
if the State's Chief Executive Officer certifies by September 24, 2010
that the State will request and use the additional funds.
To the extent permitted by statute, it is HHS's intention to treat
Indian Tribes, tribal organizations, and tribal consortia in the same
manner as States. We have determined that the temporary FMAP increases
described above will apply to tribal FMAP as they do to States. In the
table at the end of this announcement, both standard and temporarily
adjusted FMAP applicable through December 30, 2010 are shown. The
temporary increases applicable to the second and third quarters of
Fiscal Year 2011 are not shown on the table but may be similarly
calculated. The applicability of any future FMAP adjustments to Indian
Tribes, tribal organizations, and tribal consortia will depend on the
specific statutory language enacting such adjustments.
We encourage interested parties to provide comments on the
methodology and data sources for calculating the Tribal FMAP rates for
title IV-E programs. Specifically, we invite comment on the definition
of service population adopted in this notice and alternate data sources
for per capita income of Indian tribes, tribal organizations, and
tribal consortia.
FOR FURTHER INFORMATION CONTACT: Laura Radel, Office of the Assistant
Secretary for Planning and Evaluation, Room 404-E--Hubert H. Humphrey
Building, 200 Independence Avenue, SW., Washington, DC 20201; 202-690-
5938; [email protected].
(Catalog of Federal Domestic Assistance Program Nos. 93.658: Foster
Care Title IV-E; 93.659: Adoption Assistance; 93.090: Guardianship
Assistance)
Dated: July 1, 2010.
Kathleen Sebelius,
Secretary.
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1999 Tribal per capita income range FMAP including
from 2000 decennial census data 6.2 percentage
------------------------------------- point increase
Resulting FMAP authorized by
(percent) ARRA through the
Income greater Income less than first quarter of
than or equal to or equal to FY 2011
(percent)
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Per Capita Income Levels
Matched to FY 2010/FY 2011 Federal Medical Assistance Percentage
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To determine an Indian Tribe's Federal Medical Assistance Percentage
(FMAP) for Fiscal Years 2010 and 2011, find the Indian Tribe's per
capita income from the 2000 Decennial Census (American Indian Alone
population) in the list of FMAPs below.
1999 Per Capita Income from the 2000 Decennial Census Data: U.S.
Estimate = $21,587
FMAP Formula: 1-0.45 x (Indian Tribe Per Capita Income \2\/U.S. Per
Capita Income \2\)
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$0 $13,652 83 89.2
13,653 14,027 82 88.2
14,028 14,391 81 87.2
14,392 14,746 80 86.2
14,747 15,093 79 85.2
15,094 15,433 78 84.2
15,434 15,765 77 83.2
15,766 16,090 76 82.2
16,091 16,408 75 81.2
16,409 16,721 74 80.2
16,722 17,028 73 79.2
17,029 17,329 72 78.2
17,330 17,625 71 77.2
17,626 17,917 70 76.2
17,918 18,203 69 75.2
18,204 18,486 68 74.2
18,487 18,764 67 73.2
18,765 19,038 66 72.2
19,039 19,308 65 71.2
19,309 19,574 64 70.2
19,575 19,837 63 69.2
19,838 20,096 62 68.2
20,097 20,352 61 67.2
20,353 20,605 60 66.2
20,606 20,855 59 65.2
[[Page 62399]]
20,856 21,102 58 64.2
21,103 21,346 57 63.2
21,347 21,587 56 62.2
21,588 21,825 55 61.2
21,826 22,061 54 60.2
22,062 22,295 53 59.2
22,296 22,526 52 58.2
22,527 22,754 51 57.2
22,755 ................. 50 56.2
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[FR Doc. 2010-25344 Filed 10-7-10; 8:45 am]
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