59806 Federal Register / Vol. 85, No. 185 / Wednesday, September 23, 2020 / Notices 2020, has changed its format and time. resources and allow more of the rural Census. UCs are defined based on the The meeting will now be a 2-day populations within MSAs to access same criteria as UAs, but represent areas webinar and conference call only on services provided using grant funds. containing at least 2,500 but fewer than Tuesday, December 8, 2020, from 10:00 This notice seeks comments on the 50,000 people. Both UAs and UCs use a.m.–5:00 p.m. Eastern Time (ET) and proposed methodology for designating 500 persons per square mile as their Wednesday, December 9, 2020, from areas eligible for rural health grant minimum density criterion. 10:00 a.m.–2:00 p.m. ET. The webinar programs. The other major federal definition was link, conference dial in number, DATES: Submit written comments no based on the OMB’s list of counties that meeting materials, and updates will be later than October 23, 2020. are designated as part of a MSA. All available on the COGME website: counties that were not designated as a ADDRESSES: https://www.hrsa.gov/advisory- Written comments should part of a MSA were considered ‘‘rural’’ committees/graduate-medical-edu/ be submitted to [email protected]. or, more accurately, non-metropolitan. meetings/index.html. FOR FURTHER INFORMATION CONTACT: MSAs, in 1990, had to include ‘‘a city FOR FURTHER INFORMATION CONTACT: Steve Hirsch, Public Health Analyst of 50,000 or more population,’’ or ‘‘a Shane Rogers, Designated Federal FORHP, HRSA, 5600 Fishers Lane, Census Bureau defined urbanized area Official, Division of Medicine and Rockville, MD 20857, Phone number: of at least 50,000 population, provided Dentistry, Bureau of Health Workforce, (301) 443–0835 or Email: ruralpolicy@ that the component county/counties of HRSA, 5600 Fishers Lane, 15N142, hrsa.gov. the MSA have a total population of at Rockville, Maryland 20857; 301–443– SUPPLEMENTARY INFORMATION: FORHP least 100,000.’’ At that time, around 5260; or [email protected]. was authorized by Congress in the three quarters of all counties in the Correction: Meeting will be a 2-day Omnibus Budget Reconciliation Act of United States were non-metropolitan webinar and conference call only rather 1987, Public Law 100–203, codified at and not classified as parts of MSAs. than in-person as previously 42 U.S.C. 912, and located in HRSA. After the 2000 Census, OMB also announced. Congress charged FORHP with began to classify counties using a Maria G. Button, informing and advising the Department smaller urban core. The concept of a Director, Executive Secretariat. of Health and Human Services on Micropolitan statistical area closely parallels that of the MSA, but a [FR Doc. 2020–20940 Filed 9–22–20; 8:45 am] matters affecting rural hospitals and Micropolitan statistical area is based on BILLING CODE 4165–15–P health care and coordinating activities within the Department that relate to an urban core with a population of rural health care. Since the 1990s, 10,000 through 49,999 and Micropolitan DEPARTMENT OF HEALTH AND FORHP has also issued grants for counties are still considered non- HUMAN SERVICES programs of innovative models of health metropolitan. care delivery in rural areas. Historically, As currently classified, OMB builds Health Resources and Services applicant organizations for these grants, both MSAs and Micropolitan Statistical Administration authorized under Section 330A of the Areas around a central county, or Public Health Service Act, were counties, which contains an urban core. Revised Geographic Eligibility for required to be located in rural areas. Surrounding counties can be designated Federal Office of Rural Health Policy However, when the programs were as part of the Core Based Statistical Area Grants recently reauthorized under Section (CBSA) based on the presence of core AGENCY: Health Resources and Services 4214 of the Coronavirus Aid, Relief, and population and/or the commuting Administration (HRSA), Department of Economic Security Act the requirement patterns of the working population. A Health and Human Services. was amended to allow organizations to county may be included in only one CBSA. ACTION: Request for public comment. apply that are located in urban areas but serve rural areas. A county qualifies as a central county SUMMARY: HRSA’s Federal Office of Historically, there have been two of a CBSA if it meets the following Rural Health Policy (FORHP) has sought principal definitions of ‘‘rural’’ that requirements: to identify clear, consistent, and data- were in use by the Federal Government: (a) Has at least 50 percent of the driven methods of defining rural areas the Census Bureau definition (https:// population in urban areas of at least in the United States. FORHP uses the www.census.gov/programs-surveys/ 10,000 population; or Office of Management and Budget geography/guidance/geo-areas/urban- (b) Has within the boundaries a (OMB)’s list of counties designated as rural.html) and the OMB definition population of at least 5,000 located in a part of a Metropolitan Statistical Area (https://www.census.gov/programs- single urban area of at least 10,000 (MSA) as the basis for determining surveys/metro-micro.html). Neither population. eligibility to apply for or receive definition defined ‘‘rural’’ directly, but Since urban areas are not defined by services funded by its rural health grant rather defined ‘‘urban’’ areas and then administrative boundaries, such as city programs. FORHP designates all designated locations that do not meet limits or county borders, they can counties that are not part of a MSA as the ‘‘urban’’ definition as ‘‘rural.’’ extend into one or more counties as long ‘‘rural’’ and eligible for rural health In the early 1990s, the Census Bureau as the population density criterion (a grant funding or services. In addition, defined ‘‘rural’’ as all areas that were minimum of 500 people per square FORHP designates census tracts within not part of an urbanized area (UA) or mile) is met. MSAs as rural for grant purposes using were not part of an incorporated area of A county qualifies as an outlying Rural-Urban Commuting Area (RUCA) at least 2,500 persons. UAs were defined county of a CBSA if it meets the codes. FORHP is proposing as densely settled areas with a total following commuting requirements: modifications to how it designates areas population of at least 50,000 people. (a) At least 25 percent of the workers to be eligible for its rural health grant The building block of UAs is the census living in the county work in the central programs so that community block, a sub-unit of census tracts. The county or counties of the CBSA; or organizations serving rural populations Census Bureau introduced the urban (b) At least 25 percent of the within MSAs will be able to apply for cluster (UC) concept for the 2000 employment in the county is accounted VerDate Sep<11>2014 20:59 Sep 22, 2020 Jkt 250001 PO 00000 Frm 00072 Fmt 4703 Sfmt 4703 E:\FR\FM\23SEN1.SGM 23SEN1 khammond on DSKJM1Z7X2PROD with NOTICES Federal Register / Vol. 85, No. 185 / Wednesday, September 23, 2020 / Notices 59807 for by workers who reside in the central the Grand Canyon which is located in determine programmatic eligibility for county or counties of the CBSA. a MSA county. Consequently, one could rural areas inside of MSAs, identified as Outlying counties are not required to argue that the Census Bureau standard rural census tracts within these MSA include any UA or UC population. In includes an over count of the rural counties. some cases, counties may be considered population whereas the OMB standard RUCA codes classify census tracts outlying because of reverse commuting represents an undercount. To address using measures of population density, into the county from other counties in these concerns and find a middle urbanization, and daily commuting. the MSA. ground between the two definitions, RUCA codes are based on the same Because Micropolitan counties are not FORHP funded the development of theoretical concepts used by the OMB to included in MSAs, they are included in Rural-Urban Commuting Area Codes define county-level Metropolitan and the set of non-metropolitan counties (RUCAs) (https://www.ers.usda.gov/ Micropolitan areas. By using the smaller along with counties that are not part of data-products/rural-urban-commuting- census tract unit instead of the county, any CBSA. area-codes/) in partnership with the RUCAs permit a finer delineation of There are measurement challenges Economic Research Service (ERS) of the ‘‘rural’’ and ‘‘urban’’ areas to reflect the with both the Census and OMB Department of Agriculture. FORHP experience of residents. Using data from definitions. Some policy experts note believes RUCAs allow more accurate the Census Bureau, every census tract in that the Census definition classifies targeting of resources intended for the the United States is assigned a RUCA quite a bit of suburban area as rural. The rural population. Both FORHP and the code. Currently, there are ten primary OMB definition includes rural areas in Centers for Medicare & Medicaid RUCA codes with 21 secondary codes MSA counties including, for example, Services (CMS) have used RUCAs to (see Table 1). TABLE 1—PRIMARY RUCA CODES, 2010 Code classification Description 1 ..................................... Metropolitan area core: Primary flow within an urbanized area (UA). 2 ..................................... Metropolitan area high commuting: Primary flow 30% or more to a UA. 3 ..................................... Metropolitan area low commuting: Primary flow 10% to 30% to a UA. 4 ..................................... Micropolitan area core: Primary flow within an urban cluster of 10,000 to 49,999 (large UC). 5 ..................................... Micropolitan high commuting: Primary flow 30% or more to a large UC.