55402 Federal Register / Vol. 70, No. 182 / Wednesday, September 21, 2005 / Notices 

increases in costs of Medicaid services 

specifically. 

In summary, the State lacks a clear 

and auditable methodology for setting 

the payment rate and justifying the 

proposed payment increase consistent 

with the requirement of sections 

1902(a)(4) and 1902(a)(30)(A). 

For the reasons cited above, and after 

consulting with the Secretary of Health 

and Human Services, as required by 

Federal regulations at 42 CFR 

430.15(c)(2), CMS disapproved 

Oklahoma SPA 04–06. 

Section 1116 of the Act and Federal 

regulations at 42 CFR part 430, establish 

Department procedures that provide an 

administrative hearing for 

reconsideration of a disapproval of a 

State plan or plan amendment. CMS is 

required to publish a copy of the notice 

to a State Medicaid agency that informs 

the agency of the time and place of the 

hearing, and the issues to be considered. 

If we subsequently notify the agency of 

additional issues that will be considered 

at the hearing, we will also publish that 

notice. 

Any individual or group that wants to 

participate in the hearing as a party 

must petition the presiding officer 

within 15 days after publication of this 

notice, in accordance with the 

requirements contained at 42 CFR 

430.76(b)(2). Any interested person or 

organization that wants to participate as 

amicus curiae must petition the 

presiding officer before the hearing 

begins in accordance with the 

requirements contained at 42 CFR 

430.76(c). If the hearing is later 

rescheduled, the presiding officer will 

notify all participants. 

The notice to Oklahoma announcing 

an administrative hearing to reconsider 

the disapproval of its SPA reads as 

follows: 

Mr. Howard J. Pallotta, 

General Counsel, 

Oklahoma Health Care Authority, 

Lincoln Plaza, 4545 N. Lincoln Boulevard, 

Suite 124, Oklahoma City, OK 73105. 

Dear Mr. Pallotta: I am responding to your 

request for reconsideration of the decision to 

disapprove Oklahoma State plan amendment 

(SPA) 04–06, which was submitted on 

September 23, 2004, and disapproved on 

June 20, 2005. 

Under SPA 04–06, Oklahoma sought to 

increase the per diem rate for residential 

behavioral management services provided to 

children residing in therapeutic foster care 

homes. The Centers for Medicare & Medicaid 

Services (CMS) disapproved the SPA because 

it does not comport with the requirements set 

forth in title XIX of the Act. 

At issue in this reconsideration is whether 

the State’s payment methodology complies 

with section 1902(a)(4) of the Act, which 

requires that the State plan must provide for 

such methods of administration as are found 

by the Secretary to be necessary for the 

proper and efficient administration of the 

plan. The regulations at sections 42 CFR 

430.10 and 430.12 require that the State plan 

and amendments contain all information 

necessary for CMS to determine whether the 

plan can be approved to serve as a basis for 

Federal financial participation in the State 

program. The State’s payment methodology 

is not explained in sufficient detail for CMS 

to determine whether the proposed increase 

is consistent with proper and efficient 

administration of the plan, as required by 

section 1902(a)(4). 

Also at issue is whether an increase in the 

State’s per diem rate is consistent with 

section 1902(a)(30)(A) of the Act, which 

requires that States have methods and 

procedures to assure that payments are 

consistent with efficiency, economy, and 

quality of care. The State’s per diem rate 

represents a bundled payment methodology 

wherein the State pays a single rate for one 

or more of a group of different services 

furnished to an eligible individual during a 

fixed period of time. The payment is the 

same regardless of the number of services 

furnished, or the specific costs, or otherwise 

available rates. The State has not provided 

sufficient information to determine whether 

the bundled rate for behavioral management 

services, and the proposed increase, 

accurately reflect true costs or reasonable fees 

for the services included in the bundle and 

whether the proposed increase in Medicaid 

payment is due to permissible increases in 

costs of Medicaid services specifically. 

In summary, the State lacks a clear and 

auditable methodology for setting the 

payment rate and justifying the proposed 

payment increase consistent with the 

requirement of sections 1902(a)(4) and 

1902(a)(30)(A). 

For the reasons cited above, and after 

consulting with the Secretary of Health and 

Human Services, as required by Federal 

regulations at 42 CFR section 430.15(c)(2), 

CMS disapproved Oklahoma SPA 04–06. 

I am scheduling a hearing to be held on 

October 27, 2005, at 9 a.m. at 1301 Young 

Street, Conference Room 820, Dallas, Texas, 

to reconsider the decision to disapprove SPA 

04–06. If this date is not acceptable, we 

would be glad to set another date that is 

mutually agreeable to the parties. The 

hearing will be governed by the procedures 

prescribed at 42 CFR part 430. 

I am designating Ms. Kathleen ScullyHayes as the presiding officer. If these 

arrangements present any problems, please 

contact the presiding officer. In order to 

facilitate any communication which may be 

necessary between the parties to the hearing, 

please notify the presiding officer to indicate 

acceptability of the hearing date that has 

been scheduled and provide names of the 

individuals who will represent the State at 

the hearing. The presiding officer may be 

reached at (410) 786–2055. 

Sincerely, 

Mark B. McClellan, M.D., Ph.D. 

Section 1116 of the Social Security Act (42 

U.S.C. section 1316); 42 CFR section 

430.18. 

(Catalog of Federal Domestic Assistance 

Program No. 13.714, Medicaid Assistance 

Program) 

Dated: September 15, 2005. 

Mark B. McClellan, 

Administrator, Centers for Medicare & 

Medicaid Services. 

[FR Doc. 05–18843 Filed 9–20–05; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Administration for Children and 

Families 

Proposed Information Collection 

Activity; Comment Request 

Proposed Projects: 

Title: Evaluation of Child Care 

Subsidy Strategies. 

OMB No.: New Collection. 

Description: To conduct four 

experiments to test aspects of the child 

care subsidy system. Two simultaneous 

experiments will occur in Cook County, 

Illinois; one will occur in Washington 

State; and one will occur in 

Massachusetts. 

Illinois. The State of Illinois has 

agreed to conduct two simultaneous 

experiments, which will occur in Cook 

County. The first will test the impact of 

receiving a child care subsidy on 

parental employment and income, and 

on the stability of child care 

arrangements; the second experiment 

will test the impact of losing a subsidy 

on the same set of outcomes. For the 

first experiment, families with incomes 

above the current income eligibility 

ceiling who apply for subsidies will be 

approved to receive subsidies. In the 

second experiment, families in the 

treatment group with incomes above the 

eligibility ceiling who apply to be 

recertified to continue using subsidies 

will remain eligible. In addition, each 

experiment will test the effects of a 

longer certification period by certifying 

eligibility for some families for six 

months and other families for one year. 

Families in the two treatment groups 

will retain eligibility for subsidies over 

the two-year study period, provided 

their income remains below the 

experimental limit and they comply 

with other requirements (e.g., continue 

to work). Outcomes will be measured 

through administrative records and 

periodic interviews with parents. 

Washington. In Washington State, the 

study will test a co-payment schedule 

that smoothes out what are currently 

abrupt increases in co-payments that 

occur when a family moves from one 

income category to the next and reduces 

the co-payment burden for many 

Federal Register / Vol. 70, No. 182 / Wednesday, September 21, 2005 / Notices 55403 

families. Families that apply (or 

reapply) for subsidies and are 

determined to be eligible under current 

rules will be randomly assigned to the 

experimental co-payment schedule or 

the existing schedule. (Families with copayments from the experimental 

schedule will either pay the same 

amount, or less, than families whose copayments are calculated using the 

existing schedule.) Families will retain 

the same co-payment schedule for two 

years, provided they continue to be 

eligible for subsidies. Outcomes will be 

measured through analysis of 

administrative data and periodic 

interviews with parents. 

Massachusetts. In Massachusetts, the 

study is an experimental test of the 

effectiveness of a developmental 

curriculum implemented in family child 

care homes. Family child care providers 

who serve subsidized and other lowincome children and are linked to 

family child care networks will be 

randomly assigned to a treatment or 

control group. Providers in the 

treatment group will use the 

developmental curriculum and be 

trained through regular visits to the 

home by specially trained mentors. 

These providers will receive materials 

to use with children from 0 to 5 years 

of age. Providers in the control group 

will receive the more general technical 

assistance and support visits that they 

currently receive. Impacts on provider 

behavior and the home environment 

will be measured through direct 

observations in the homes. Child 

assessments will be conducted through 

provider reports for the younger 

children and through standardized tests 

for children 30 months and older. 

Respondents: Illinois. Parents who 

apply (or reapply) for subsidies and are 

eligible and agree to be in the study will 

be interviewed by telephone up to three 

times in the 24 months after they enter 

the study. 

Washington State. Parents who apply 

(or reapply) for subsidies and are 

eligible and agree to be in the study will 

be interviewed by telephone up to three 

times over the 24 months of the study. 

Approximately 30 state employees 

working at the Department of Health 

and Human Services in the Division of 

Child Care and Early Learning or the 

Division of Community Service will be 

interviewed as part of the 

implementation study. 

Massachusetts. Children will be 

assessed 7 months after implementing 

the curriculum, after 11 months, and 

after 23 months. Providers will be asked 

to respond to a brief survey 7 and 23 

months after the study begins. 

ANNUAL BURDEN ESTIMATES

Instrument Number of 

respondents 

Number of 

responses per 

respondent 

Average 

burden hours 

per response 

Total 

burden hours 

Illinois parent survey .................................................................................... 5,000 1 .5 .58 4,350 

Washington parent survey ........................................................................... 2,000 1 .5 .58 1,740 

Washington process study interview ........................................................... 30 .5 .5 8 

Massachusetts child assessments .............................................................. 700 1 .5 .5 525 

Massachusetts provider questionnaire ........................................................ 350 1 .16 56 

Estimated Total Annual Burden 

Hours: 6,679. 

In compliance with the requirements 

of Section 3506(c)(2)(A) of the 

Paperwork Reduction Act of 1995, the 

Administration for Children and 

Families is soliciting public comment 

on the specific aspects of the 

information colleciton described above. 

Copies of the proposed collection of 

information can be obtained and 

comments may be forwarded by writing 

to the Administration for Children and 

Families, Office of Administration, 

Office of Information Services, 370 

L’Enfant Promenade, SW., Washington, 

DC 20447, Attn: ACF Reports Clearance 

Officer. E-mail address: 

grjohnson@acf.hhs.gov. All requests 

should be identified by the title of the 

information collection. 

The Department specifically requests 

comments 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) 

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. 

Consideration will be given to 

comments and suggestions submitted 

within 60 days of this publication. 

Dated: September 15, 2005. 

Robert Sargis, 

Reports Clearance, Officer. 

[FR Doc. 05–18771 Filed 9–20–05; 8:45 am] 

BILLING CODE 4184–01–M 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Office of Refugee Resettlement 

Grant to United States Conference of 

Catholic Bishops 

AGENCY: Office of Refugee Resettlement, 

Administration for Children and 

Families (ACF), Department of Health 

and Human Services (DHHS). 

ACTION: Award announcement. 

CFDA#: The Catalog of Federal Domestic 

Assistance (CFDA) number for this program 

is 93.576. The title is the Refugee Family 

Enrichment Program. 

Amount of Award: $194,000. 

SUMMARY: Notice is hereby given that a 

noncompetitive single source program 

expansion supplement to an ongoing 

competitive award is being made to the 

United States Conference of Catholic 

Bishops (USCCB) in response to an 

unsolicited application. The application 

is not within the scope of any existing 

or expected to be issued program 

announcement for the Fiscal Year 2006. 

USCCB’s application is expected to 

address issues critical to the 

development and implementation of 

marriage education programs for 

refugees by opening three new program 

sites. 

In September of 2003, ORR awarded 

USCCB a grant of $1,000,000,000 to 

develop a Refugee Family Enrichment 

program which included technical 

assistance to subgrantees. Over the past 

two years, USCCB has established an 

effective program in sites that have 

successfully prepared thousands of 

refugee families for the challenges they 

will face during resettlement. Because 

other Refugee Marriage Enrichment 

grantees are primarily regional in scope, 

we believe USCCB is uniquely suited to 

effectively implement this supplemental 

award. USCCB has affiliates across the 

country and has no physical or