48292 Federal Register / Vol. 62, No. 178 / Monday, September 15, 1997 / Notices

request by an individual who is

considering the purchase of a hearing

aid, the dispenser is required to provide

a copy of the User Instructional

Brochure for that model hearing aid or

the name and address or telephone

number of the manufacturer or

distributor from whom a User

Instructional Brochure for the hearing

aid may be obtained. Under conditions

of sale of hearing aid devices,

manufacturers or distributors shall

provide sufficient copies of the User

Instructional Brochure to sellers for

distribution to users and prospective

users and provide a copy of the User

Instructional Brochure to any health

care professional, user, or prospective

user who requests a copy in writing.

The regulations also require that the

patient provide a written statement that

he or she has undergone a medical

evaluation within the previous 6

months before the hearing aid is

dispensed, although informed adults

may waive the medical evaluation

requirement by signing a written

statement. Finally, the regulation

requires that the dispenser retain for 3

years copies of all physician statements

or any waivers of medical evaluations.

The information obtained through this

collection of information is used by

FDA to ensure that hearing aids are sold

and used in a way consistent with the

public health.

The information contained in the User

Instructional Brochure is intended not

only for the hearing aid user but also for

the physician, audiologist, and

dispenser. The data is used by these

health care professionals to evaluate the

suitability of a hearing aid, to permit

proper fitting of it, and to facilitate

repairs. The data also permits the

comparison of the performance

characteristics of various hearing aids.

Noncompliance could result in a

substantial risk to the hearing impaired

because the physician, audiologist, or

dispenser would not have sufficient

data to match the aid to the needs of the

user.

The respondents to this collection of

information are hearing aid

manufacturers, distributors, dispensers,

health professionals, or other for profit

organizations.

In 1993, FDA conducted an audit of

hearing aid dispensers in four FDA

districts to determine the level of

compliance with existing hearing aid

requirements. The estimates relating to

§ 801.421(a)(1) and (a)(2) in the

reporting and recordkeeping burden

tables below are based on information

obtained in this audit. This audit

revealed that medical evaluations were

obtained in 32 percent of the sales and

signed waivers were obtained in 60

percent of the sales.

FDA estimates the burden of this

collection of information as follows:

TABLE 1.—ESTIMATED ANNUAL REPORTING BURDEN

21 CFR Section No. of

Respondents

Annual

Frequency per

Respondents

Total Annual

Responses

Hours per

Response Total Hours

801.420 40 5 200 40 8,000

801.421(a)(1) 9,900 52 514,800 0.10 51,480

801.421(a)(2) 19,900 97 960,300 0.30 288,090

801.421(b) 9,900 162 1,600,000 0.30 480,000

801.421(c) 9,940 5 49,700 0.17 8,449

Total Burden Hours 836,019

There are no capital costs or operating and maintenance costs associated with this collection of information.

TABLE 2.—ESTIMATED ANNUAL RECORDKEEPING BURDEN

21 CFR Section No. of

Recordkeepers

Annual

Frequency per

Recordkeeping

Total Annual

Records

Hours per

Recordkeeper Total Hours

801.421(d) 9,900 162 1,600,000 0.25 400,000

Total 400,000

There are no capital costs or operating and maintenance costs associated with this collection of information.

Dated: September 8, 1997.

William K. Hubbard,

Associate Commissioner for Policy

Coordination.

[FR Doc. 97–24348 Filed 9–12–97; 8:45 am]

BILLING CODE 4160–01–F

DEPARTMENT OF HEALTH AND

HUMAN SERVICES

Health Care Financing Administration

[MB–110–N]

RIN: 0938–AH93

Medicaid Program; Final Limitations

on Aggregate Payments to

Disproportionate Share Hospitals:

Federal Fiscal Year 1997

AGENCY: Health Care Financing

Administration (HCFA), HHS.

ACTION: Notice.

SUMMARY: This notice announces the

final Federal fiscal year (FFY) 1997

national target and individual State

allotments for Medicaid payment

adjustments made to hospitals that serve

a disproportionate number of Medicaid

recipients and low-income patients with

special needs. We are publishing this

notice in accordance with the

provisions of section 1923(f)(1)(C) of the

Social Security Act and implementing

regulations at 42 CFR 447.297 through

447.299. The final FFY 1997 State

disproportionate share hospital (DSH)

allotments published in this notice

supersede the preliminary FFY 1997

DSH allotments that were published in

the Federal Register on January 31,

1997.

EFFECTIVE DATE: The final DSH payment

adjustment expenditure limits included
Federal Register / Vol. 62, No. 178 / Monday, September 15, 1997 / Notices 48293

in this notice apply to Medicaid DSH

payment adjustments for FFY 1997.

FOR FURTHER INFORMATION CONTACT:

Richard Strauss, (410) 786–2019

SUPPLEMENTARY INFORMATION:

I. Background

Section 1902(a)(13)(A) of the Social

Security Act (the Act) requires States to

ensure that their Medicaid payment

rates include payment adjustments for

Medicaid-participating hospitals that

serve a large number of Medicaid

recipients and other low-income

individuals with special needs (referred

to as disproportionate share hospitals).

The DSH payment adjustments are

calculated on the basis of formulas

specified in section 1923 of the Act.

Section 1923(f) of the Act and

implementing Medicaid regulations at

42 CFR 447.297 through 447.299 require

us to estimate and publish in the

Federal Register a national aggregate

target and each State’s allotment for

DSH payments for each Federal fiscal

year (FFY). The implementing

regulations provide that the national

DSH payment limit for a FFY specified

in the Act is a target rather than an

absolute cap when determining the

amount that can be allocated for DSH

payments. The national DSH payment

target is 12 percent of the total amount

of medical assistance expenditures

(excluding total administrative costs)

that are projected to be made under

approved Medicaid State plans during

the FFY.

(Note: Whenever the phrases ‘‘total

medical assistance expenditures’’ or ‘‘total

administrative costs’’ are used in this notice,

they mean both the State and Federal share

of expenditures or costs.)

In addition to the national DSH

payment target, there is a specific State

DSH payment limit for each State for

each FFY. The State DSH payment limit

is a specified amount of DSH payment

adjustments applicable to a FFY above

which FFP will not be available. This is

called the ‘‘State DSH allotment.’’

Each State’s DSH allotment for FFY

1997 is calculated by first determining

whether the State is a ‘‘high-DSH State’’

or a ‘‘low-DSH State.’’ This is

determined by using the State’s ‘‘base

allotment.’’ A State’s base allotment is

the greater of the following amounts: (1)

The total amount of the State’s actual

and projected DSH payment

adjustments made under the State’s

approved State plan applicable to FFY

1992, as adjusted by HCFA; or (2)

$1,000,000.

A State whose base allotment exceeds

12 percent of the State’s total medical

assistance expenditures (excluding

administrative costs) projected to be

made in FFY 1997 is referred to as a

‘‘high-DSH State’’ for FFY 1997. The

FFY 1997 State DSH allotment for a

high-DSH State is limited to the State’s

base allotment.

A State whose base allotment is equal

to or less than 12 percent of the State’s

total medical assistance expenditures

(excluding administrative costs)

projected to be made in FFY 1997 is

referred to as a ‘‘low-DSH State.’’ The

FFY 1997 State DSH allotment for a

low-DSH State is equal to the State’s

DSH allotment for FFY 1996 increased

by growth amounts and supplemental

amounts, if any. However, the FFY 1997

DSH allotment for a low-DSH State

cannot exceed 12 percent of the State’s

total medical assistance expenditures

for FFY 1997 (excluding administrative

costs).

The growth amount for FFY 1997 is

equal to the projected percentage

increase (the growth factor) in a lowDSH State’s total Medicaid program

expenditures between FFY 1996 and

FFY 1997 multiplied by the State’s final

DSH allotment for FFY 1996. Because

the national DSH payment limit is

considered a target, low-DSH States

whose programs grow from one year to

the next can receive a growth amount

that would not be permitted if the

national DSH payment limit was viewed

as an absolute cap.

There is no growth factor and no

growth amount for any low-DSH State

whose Medicaid program does not grow

(that is, stayed the same or declined)

between FFY 1996 and FFY 1997.

Furthermore, because a low-DSH State’s

FFY 1997 DSH allotment cannot exceed

12 percent of the State’s total medical

assistance expenditures for FFY 1997, it

is possible for its FFY 1997 DSH

allotment to be lower than its FFY 1996

DSH allotment. This occurs when the

State’s prior FFY DSH allotment is

greater than 12 percent of the total

projected medical assistance

expenditures for the current FFY. For

FFY 1997, this is the case for the States

of California and Hawaii. For the State

of California, even though the State

projected Medicaid program growth

from FFY 1996 to FFY 1997, its FFY

1996 DSH allotment was greater than its

FFY 1997 12 percent limit. For the State

of Hawaii, the State projected a decrease

in its FFY 1997 medical assistance

expenditures such that its FFY 1997 12

percent limit was lower than its FFY

1996 DSH allotment.

When we published the preliminary

State DSH allotments for FFY 1997 in

the Federal Register on January 31,

1997, for the first time since we began

publishing the DSH allotments, there

were State supplemental amounts

available for redistribution to low-DSH

States for FFY 1997. However, in the

final FFY 1997 State DSH allotments

published in this notice, there are no

State supplemental amounts. This is

due to changes in the States’ estimated

expenditures for FFY 1997, and from

the use of the actual Medicaid

expenditures for FFY 1996 in these final

allotments from those used in

determining the preliminary FFY 1997

State DSH allotments.

Under section 1923(f)(3) of the Act

and implementing regulations at 42 CFR

447.298(e), the State supplemental

amount, if any, is equal to a low-DSH

State’s relative share of a pool of funds

(the redistribution pool). The

redistribution pool is equal to the

national 12-percent DSH payment target

reduced by the sum of: the total of the

base allotments for high-DSH States, the

total of the State DSH allotments for the

previous FFY for low-DSH States, and

the total of the low-DSH State growth

amounts. However, in determining the

final FFY 1997 State DSH allotments

published in this notice, the projected

FFY 1997 national 12-percent DSH

payment target is less than the sum of

these amounts. Therefore, there is no

redistribution pool and no supplemental

amounts available for low-DSH States

for FFY 1997.

In accordance with section 1923(f)(3)

of the Act and 42 CFR 447.298(e), we

determine each low-DSH State’s

supplemental amount by determining

the State’s relative share of the national

redistribution pool, if available, on the

basis of the State’s total medical

assistance expenditures for FFY 1997

compared to the sum of the medical

assistance expenditures for the year for

all low-DSH States. However, we will

not provide any low-DSH State with a

supplemental amount that would result

in the State’s total DSH allotment

exceeding 12 percent of the State’s

projected medical assistance

expenditures. Any supplemental

amounts that cannot be allocated to a

low-DSH State because of this limitation

will be reallocated to other low-DSH

States whose allotment does not exceed

this 12-percent limit.

As prescribed in the law and

regulations, no State’s DSH allotment

will be below a minimum of $1,000,000.

As an exception to the above

requirements, under section

1923(f)(1)(A)(i)(II) of the Act and

regulations at 42 CFR 447.296(b)(5) and

447.298(f), a State may make DSH

payments for a FFY in accordance with

the minimum payment adjustments

required by Medicare methodology

described in section 1923(c)(1) of the
48294 Federal Register / Vol. 62, No. 178 / Monday, September 15, 1997 / Notices

Act. The final FFY 1997 State DSH

allotments for the District of Columbia,

Iowa, and Nebraska have been

determined in accordance with this

exception.

We are publishing in this notice the

final FFY 1997 national DSH payment

target and State DSH allotments based

on the best available data we received

to date from the States, as adjusted by

HCFA. These data are taken from each

State’s actual Medicaid expenditures for

FFY 1996 as reported on the States’

quarterly expenditure report Form

HCFA–64 submissions and the FFY

1997 projected Medicaid expenditures

as reported on the February 15, 1997

Medicaid Budget Report (Form HCFA–

37) submission. All data are adjusted as

necessary.

II. Calculations of the Final FFY 1997

DSH Limits

The total of the final State DSH

allotments for FFY 1997 is equal to the

sum of: the base allotments for all highDSH States, the FFY 1996 State DSH

allotments for all low-DSH States

(including any adjustments required

because of the 12 percent limitation),

the growth amounts for all low-DSH

States, and the supplemental amounts

for all low-DSH States. A State-by-State

breakdown is presented in section III of

this notice.

We classified States as high-DSH or

low-DSH States. If a State’s base

allotment exceeded 12 percent of its

total unadjusted medical assistance

expenditures (excluding administrative

costs) projected to be made under the

State’s approved plan under title XIX of

the Act in FFY 1997, we classified that

State as a ‘‘high-DSH’’ State. If a State’s

base allotment was 12 percent or less of

its total unadjusted medical assistance

expenditures projected to be made

under the State’s approved plan under

title XIX of the Act in FFY 1997, we

classified that State as a ‘‘low-DSH’’

State. Based on this classification, there

are 37 low-DSH States and 13 high-DSH

States for FFY 1997.

Using the most recent data from the

States’ February 1997 budget projections

(Form HCFA–37), we estimate the

States’ FFY 1997 national total medical

assistance expenditures to be

$169,259,338,000. Thus, the overall

final FFY 1997 national DSH payment

target is $20,311,121,000 (12 percent of

$169,259,338,000).

In the final FFY 1997 State DSH

allotments, we provide a total of

$873,722,000 ($461,188,000 Federal

share) in growth amounts for 35 of the

37 low-DSH States. The FFY 1997

growth amounts for low-DSH States are

determined by multiplying the low-DSH

States’ final FFY 1996 State DSH

allotments by the growth factor

percentage for those States. The growth

factor percentage for each of the lowDSH States is determined by calculating

the States’ percentage change in

Medicaid program expenditures

(including administrative expenditures)

between FFY 1996 and FFY 1997. To

compute this percentage, we first

ascertained each low-DSH State’s total

FFY 1996 actual medical assistance and

administrative expenditures as reported

on the State’s four quarterly Medicaid

expenditure reports (Form HCFA–64)

for FFY 1996. Next, we compared those

expenditures to each low-DSH State’s

total estimated unadjusted FFY 1997

medical assistance and administrative

expenditures, as reported to HCFA on

the State’s February 15, 1997 Form

HCFA–37 through the ‘‘cutoff’’ date of

March 26, 1997. The cutoff date is the

date through which the State’s budget

estimates reported on the February 15,

1997 Form HCFA–37 are accepted and

applied in preparing the State’s

Medicaid grant award for the upcoming

quarter (in this case, April through June

1997).

No final FFY 1997 redistribution pool

is available, since the final FFY 1997

national DSH payment target of

$20,311,121,000 is less than

$20,335,510,000, representing the sum

of: the total of the base allotments for

high-DSH States ($7,375,265,000), the

total of the State DSH allotments for the

previous FFY for low-DSH States

($12,091,807,000), and the growth

amounts for low DSH States

($873,722,000) and the negative

adjustment for the States of California

and Hawaii due to the 12 percent

limitation requirement ($3,003,000 and

$2,281,000, respectively). That is, this

sum exceeds the national target by

$24,390,000.

The supplemental amount for each

low-DSH State is the low-DSH State’s

relative share of the redistribution pool,

determined by allocating the

redistribution pool on the basis of the

low-DSH State’s medical assistance

expenditures compared to the national

total medical assistance expenditures

for low-DSH States.

A low-DSH State’s growth amount

and supplemental amounts, if any, are

added to the low-DSH State’s final FFY

1996 DSH allotment amount to establish

the final total low-DSH State’s DSH

allotment for FFY 1997. If a low-DSH

State’s growth amount and

supplemental amount (if any), when

added to its final FFY 1996 DSH

allotment amount, exceed 12 percent of

its FFY 1997 estimated medical

assistance expenditures, the State can

only receive a partial growth amount

that, when added to its final FFY 1996

allotment, limits its total State DSH

allotment for FFY 1997 to 12 percent of

its estimated FFY 1997 medical

assistance expenditures. Eleven of the

low-DSH States were affected by the 12

percent limitation requirement. Nine of

these low-DSH States received partial

growth amounts, and two low-DSH

States’ (California and Hawaii) final FFY

1997 State DSH allotment are lower

than their final FFY 1996 State DSH

allotments.

Also, in accordance with the

minimum payment adjustments

required by Medicare methodology, the

final FFY 1997 State DSH allotments for

the District of Columbia, Iowa, and

Nebraska are $79,920,000, $16,910,000,

and $13,366,000, respectively.

In summary, the total of all final State

DSH allotments for FFY 1997 is

$20,335,510,000 ($11,475,206,000

Federal share). This total is composed of

the high-DSH States’ base allotments

($7,375,265,000), the low-DSH States’

prior FFY’s final State DSH allotments

($12,091,807,000), and the growth

amounts for all low-DSH States

($873,722,000), and the negative

adjustment for the States of California

and Hawaii due to the 12 percent

limitation requirement ($3,003,000 and

$2,281,000, respectively), plus

supplemental amounts for low-DSH

States ($0). The total of all final FFY

1997 State DSH allotments is 12.0

percent of the total medical assistance

expenditures (excluding administrative

costs) projected to be made by these

States in FFY 1997.

Each State should monitor and make

any necessary adjustments to its DSH

spending during FFY 1997 to ensure

that its actual FFY 1997 DSH payment

adjustment expenditures do not exceed

its State DSH allotment for FFY 1997

published in this notice. As the ongoing

reconciliation between actual FFY 1997

DSH payment adjustment expenditures

and the FFY 1997 DSH allotments takes

place, each State should amend its plan

as may be necessary to make any

adjustments to its FFY 1997 DSH

payment adjustment expenditure

patterns so that the State will not exceed

its FFY 1997 DSH allotment.

The FFY 1997 reconciliation of DSH

allotments to actual expenditures will

take place on an ongoing basis as States

file expenditure reports with HCFA for

DSH payment adjustment expenditures

applicable to FFY 1997. Additional DSH

payment adjustment expenditures made

in succeeding FFYs that are applicable

to FFY 1997 will continue to be

reconciled with each State’s FFY 1997

DSH allotment as additional
Federal Register / Vol. 62, No. 178 / Monday, September 15, 1997 / Notices 48295

expenditure reports are submitted to

ensure that the FFY 1997 DSH allotment

is not exceeded. As a result, any DSH

payment adjustment expenditures for

FFY 1997 in excess of the FFY 1997

DSH allotment will be disallowed, and

therefore, subject to the normal

Medicaid disallowance procedures.

III. Final FFY 1997 DSH Allotments

Key to Chart:

Column Description

Column A = ......................... Name of State

Column B = ......................... High or Low DSH State Designation for FFY 1997. ‘‘High’’ indicates the State is a high-DSH State and ‘‘Low’’ indicates the State is a low-DSH State.

Column C = ........................ Final FFY 1996 DSH Allotments for All States. These were published in the Federal Register on September 23,

1996 (61 FR 49781).

Column D = ........................ Base Allotments for High-DSH States. The base allotment is the greater of the high-DSH State’s FFY 1992 allowable DSH payment adjustment expenditures applicable to FFY 1992, or $1,000,000. ‘‘NA, LOW DSH’’ entries in

this column refer to low-DSH States.

Column E = ......................... Growth Amounts for Low-DSH States. The growth amount is an increase in a low-DSH State’s final FFY 1996

DSH allotment to the extent that the State’s Medicaid program grew between FFY 1996 and FFY 1997. ‘‘NA,

HIGH DSH’’ entries in this column refer to high-DSH States, which receive no growth. ‘‘NONE, NO GROWTH’’

entries in this column refer to low-DSH States whose Medicaid program had no increase or a decrease from

FFY 1996 to FFY 1997.

Column F = ......................... Supplemental Amounts for Low-DSH States. The supplemental amount is the low-DSH State’s relative share of

the national redistribution pool. ‘‘NA, HIGH DSH’’ entries in this column refer to high-DSH States, which do not

receive supplemental amounts. ‘‘NONE, LOW AT 12%’’ entries in this column refer to low-DSH States which do

not receive any supplemental amounts because their DSH allotments are already at the State specific 12 percent limit.

Column G = ........................ Final FFY 1997 State DSH Allotments. For a high-DSH State, this is equal to the base allotment from column D.

For a low-DSH State, this is equal to the final State DSH allotment for FFY 1996 from column C plus, if any, the

growth amount from column E and the supplemental amount from column F.

BILLING CODE 4120–01–P
48296 Federal Register / Vol. 62, No. 178 / Monday, September 15, 1997 / Notices

BILLING CODE 4120–01–C
Federal Register / Vol. 62, No. 178 / Monday, September 15, 1997 / Notices 48297

IV. Regulatory Impact Statement

The Regulatory Flexibility Act, 5

U.S.C. 601 through 612, requires a

regulatory flexibility analysis for every

rule subject to proposed rulemaking

procedures under the Administrative

Procedure Act, 5 U.S.C. 552, unless we

certify that the rule will not have a

significant economic impact on a

substantial number of small entities. For

purposes of a RFA, States and

individuals are not considered small

entities. However, providers are

considered small entities. Additionally,

section 1102(b) of the Act requires us to

prepare a regulatory impact analysis if

a notice may have a significant impact

on the operations of a substantial

number of small rural hospitals. Such

an analysis must conform to the

provisions of section 604 of the RFA.

For purposes of section 1102(b) of the

Act, we define a small rural hospital as

a hospital that is located outside of a

Metropolitan Statistical Area and has

fewer than 50 beds.

We do not believe that this notice will

have a significant economic impact on

a substantial number of small entities

because it reflects no new policies or

procedures, and should have an overall

positive impact on payments to

disproportionate share hospitals by

informing States of the extent to which

DSH payments may be increased

without violating statutory limitations.

This notice sets forth no changes in our

regulations; rather, it reflects the DSH

allotments for each State as determined

in accordance with 42 CFR 447.297

through 447.299.

We have discussed the method of

calculating the preliminary FFY 1997

national DSH payment target and the

preliminary FFY 1997 individual State

DSH allotments in the previous sections

of this preamble. These calculations

should have a positive impact on

payments to disproportionate share

hospitals. Allotments will not be

reduced for high-DSH States since we

interpret the 12-percent limit as a target.

Low-DSH States’ allotments are equal to

their prior FFY DSH allotments plus

their growth and supplemental

amounts, if any.

In accordance with the provisions of

Executive Order 12866, this notice was

reviewed by the Office of Management

and Budget.

(Catalog of Federal Assistance Program No.

93.778, Medical Assistance Program)

Dated: June 5, 1997.

Bruce C. Vladeck,

Administrator, Health Care Financing

Administration.

Dated: July 24, 1997.

Donna E. Shalala,

Secretary.

[FR Doc. 97–24281 Filed 9–12–97; 8:45 am]

BILLING CODE 4120–01–P

DEPARTMENT OF HEALTH AND

HUMAN SERVICES

Health Resources and Services

Administration

Agency Information Collection

Activities: Proposed Collection:

Comment Request

In compliance with the requirement

for opportunity for public comment on

proposed data collection projects

(section 3506(c)(2)(A) of Title 44, United

States Code, as amended by the

Paperwork Reduction Act of 1995,

Public Law 104–13), the Health

Resources and Services Administration

(HRSA) will publish periodic

summaries of proposed projects being

developed for submission to OMB under

the Paperwork Reduction Act of 1995.

To request more information on the

proposed project or to obtain a copy of

the data collection plans, call the HRSA

Reports Clearance Officer on (301) 443–

1129.

Comments are invited on: (a) Whether

the proposed collection of information

is necessary for the proper performance

of the functions of the agency, including

whether the information shall have

practical utility; (b) the accuracy of the

agency’s estimate of the burden of the

proposed collection of information; (c)

ways to enhance the quality, utility, and

clarity of the information to be

collected; and (d) ways to minimize the

burden of the collection of information

on respondents, including through the

use of automated collection techniques

or other forms of information

technology.

Proposed Project: Uniform Data

System (OMB No. 0915–0193)—

Extension and Revision—This is a

request for extension and revision of a

reporting system, the Uniform Data

System (UDS), that consolidated and

replaced annual reporting requirements

for the cluster of primary care grantees

funded by the Bureau of Primary Health

Care (BPHC), Health Resources and

Services Administration (HRSA). The

UDS includes reporting requirements

for grantees of the following primary

care programs: Community Health

Centers, Migrant Health Centers, Health

Care for the Homeless, Outreach and

Primary Health Services for Homeless

Children and Public Housing Primary

Care. Authorizing Legislation is found

in Public Law 104–299, Health Center

Consolidation Act of 1996, enacting

Section 330 of the Public Health Service

Act.

The Bureau of Primary Health Care

collects data on its programs to ensure

compliance with legislative mandates

and to report to Congress and policy

makers on program accomplishments.

To meet these objectives, BPHC requires

a core set of information collected

annually that is appropriate for

monitoring and evaluating performance

and reporting on annual trends. The

UDS includes two components: the

Universal Report, completed by all

grantees, provides data on services,

staffing, and financing; and the Grant

Report, completed by grantees funded

under the Homeless or Public Housing

Program as well as one of the other

programs, provides data on

characteristics of users whose services

fall within the scope of the Homeless or

Public Housing Program grant. The first

UDS reports were collected March 31,

1997 and analysis of data indicates that

several revisions should be made.

Program officials have noted that

additional information needs to be

collected which was included in

previous reporting systems but was

deleted from the UDS. Grantees will be

asked to provide information on the

charges, collections, bad debt write off

and contractual disallowances by payor

sources (Medicaid, Medicare, self pay

and private insurance). Existing UDS

forms are being reviewed to determine

how the revenue/income reporting can

be modified to accommodate these

changes. Additional revisions will

include annotating the forms to indicate

which lines are subtotals and the lines

to which they sum.

The proposed changes are not

expected to add significantly to the

reporting burden. Estimates of

annualized reporting burden are as

follows:

Type of report Number of

respondents

Hours per

response

Total burden

hours

Universal Report ........................................................................................................................... 694 24 16,656

Grant Report ................................................................................................................................. 88 16 1,408