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Proposed Rule

Medicare Program; Home Health Prospective Payment System Rate Update for Calendar Year 2006

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Information about this document as published in the Federal Register.

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AGENCY:

Centers for Medicare & Medicaid Services (CMS), HHS.

ACTION:

Proposed rule.

SUMMARY:

This proposed rule would set forth an update to the 60-day national episode rates and the national per-visit amounts under the Medicare prospective payment system for home health agencies. We are also proposing to implement the revised area labor market Metropolitan Statistical Area designations for calendar year 2006.

DATES:

To be assured consideration, comments must be received at one of the addresses provided below, no later than 5 p.m. on September 6, 2005.

ADDRESSES:

In commenting, please refer to file code CMS-1301-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-1301-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 address, please call telephone number (410) 786-7195 in advance to schedule your arrival with one of our staff members.

Hubert H. Humphrey Building, Room 445-G, 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.

For information on viewing public comments, see the beginning of the SUPPLEMENTARY INFORMATION section.

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FOR FURTHER INFORMATION CONTACT:

Randy Throndset, (410) 786-0131. Sharon Ventura, (410) 786-1985.

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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-1301-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.

I. Background

[If you choose to comment on issues in this section, please include the caption “BACKGROUND” at the beginning of your comments.]

A. Statutory Background

The Balanced Budget Act of 1997 (BBA) (Pub. L. 105-33), enacted on August 5, 1997, significantly changed the way Medicare pays for Medicare home health services. Until the implementation of a home health prospective payment system (HH PPS) on October 1, 2000, home health agencies (HHAs) received payment under a cost-based reimbursement system. Section 4603 of the BBA governed the development of the HH PPS.

Section 4603(a) of the BBA provides the authority for the development of a PPS for all Medicare-covered home health services provided under a plan of care that were paid on a reasonable cost basis by adding section 1895, entitled “Prospective Payment For Home Health Services,” to the Social Security Act (the Act).

Section 1895(b)(1) of the Act requires the Secretary to establish a PPS for all costs of home health services paid under Medicare.

Section 1895(b)(3)(A) of the Act requires that (1) the computation of a standard prospective payment amount include all costs of home health services covered and paid for on a reasonable cost basis and be initially based on the most recent audited cost report data available to the Secretary, and (2) the prospective payment amounts be standardized to eliminate the effects of case-mix and wage levels among HHAs.

Section 1895(b)(3)(B) of the Act addresses the annual update to the standard prospective payment amounts by the home health applicable increase percentage as specified in the statute.

Section 1895(b)(4) of the Act governs the payment computation. Sections 1895(b)(4)(A)(i) and (b)(4)(A)(ii) of the Act require the standard prospective payment amount to be adjusted for case-mix and geographic differences in wage levels. Section 1895(b)(4)(B) of the Act requires the establishment of an appropriate case-mix adjustment factor that explains a significant amount of the variation in cost among different units of services. Similarly, section 1895(b)(4)(C) of the Act requires the establishment of wage adjustment factors that reflect the relative level of wages and wage-related costs applicable to the furnishing of home health services in a geographic area compared to the national average applicable level. These wage-adjustment factors may be the factors used by the Secretary for the different area wage levels for purposes of section 1886(d)(3)(E) of the Act.

Section 1895(b)(5) of the Act gives the Secretary the option to grant additions or adjustments to the payment amount otherwise made in the case of outliers because of unusual variations in the type or amount of medically necessary care. Total outlier payments in a given fiscal year cannot exceed 5 percent of total payments projected or estimated.Start Printed Page 40789

On December 8, 2003, the Congress enacted the Medicare Prescription Drug, Improvement, and Modernization Act (MMA) of 2003 (Pub. L. 108-173). This legislation affected how we make updates to HH payment rates.

Section 701 of the MMA changed the yearly update cycle of the HH PPS rates from that of a fiscal year to a calendar year update cycle for 2004 and any subsequent year. Generally, section 701(a) of the MMA changed the references in the statute to refer to the calendar year for 2004 and any subsequent year. The changes resulted in updates to the HH PPS rates described as “fiscal year” updates for 2002 and 2003 and as “calendar year” updates for 2004 and any subsequent year (section 1895(b)(3)(B)(i) of the Act. Beginning on January 1, 2005, HH PPS will now be updated on a calendar year update cycle.

In addition to changing the update cycle for HH PPS rates, section 701 of the MMA made adjustments to the home health applicable increase percentage for 2004, 2005, and 2006. Specifically, section 701(a)(2)(D) of the MMA left unchanged the home health market basket update for the last calendar year quarter of 2003 and the first calendar year quarter of 2004 (section 1895(b)(3)(B)(ii)(II) of the Act). Furthermore, section 701(b)(4) of the MMA set the home health applicable percentage increase for the last 3 quarters of 2004 as the home health market basket (3.1 percent) minus 0.8 percentage point (section 1895(b)(3)(B)(ii)(III) of the Act). We implemented this provision through Pub. 100-20, One Time Notification, Transmittal 59, issued February 20, 2004. Section 701(b)(4) of the MMA also provided that updates for CY 2005 and CY 2006 will equal the applicable home health market basket percentage increase minus 0.8 percentage point. Lastly, section 701(b)(3) of the MMA revised the statute to provide that HH PPS rates for CY 2007 and any subsequent year will be updated by that year's home health market basket percentage increase (section 1895(b)(3)(B)(ii)(IV) of the Act).

B. Updates

On July 3, 2000, we published a final rule (65 FR 41128) in the Federal Register to implement the HH PPS legislation. That final rule established requirements for the new PPS for HHAs as required by section 4603 of the BBA, and as subsequently amended by section 5101 of the Omnibus Consolidated and Emergency Supplemental Appropriations Act (OCESAA) for Fiscal Year 1999 (Pub. L. 105-277), enacted on October 21, 1998; and by sections 302, 305, and 306 of the Medicare, Medicaid, and SCHIP Balanced Budget Refinement Act (BBRA) of 1999 (Pub. L. 106-113), enacted on November 29, 1999. The requirements include the implementation of a PPS for HHAs, consolidated billing requirements, and a number of other related changes. The PPS described in that rule replaced the retrospective reasonable-cost-based system that was used by Medicare for the payment of home health services under Part A and Part B.

On October 22, 2004, we published a final rule (69 FR 62124), which set forth an update to the 60-day national episode rates and the national per-visit amounts under the Medicare prospective payment system for home health agencies. As part of that final rule, we rebased and revised the home health market basket to ensure it continues to adequately reflect the price changes of efficiently providing home health services. In addition, we revised the fixed dollar loss ratio, which is used in the calculation of outlier payments. That final rule was also the first update of the HH PPS rates on a calendar year update cycle. HH PPS was moved to a calendar year update cycle as a result the MMA.

C. System for Payment of Home Health Services

Generally, Medicare makes payment under the HH PPS on the basis of a national standardized 60-day episode payment, adjusted for case mix and wage index. For episodes with four or fewer visits, Medicare pays on the basis of a national per-visit amount by discipline, referred to as a low utilization payment adjustment (LUPA). Medicare also adjusts the 60-day episode payment for certain intervening events that give rise to a partial episode payment adjustment (PEP adjustment) or a significant change in condition adjustment (SCIC). For certain cases that exceed a specific cost threshold, an outlier adjustment may also be available. For a complete and full description of the HH PPS as required by the BBA and as amended by OCESAA and BBRA, see the July 3, 2000 HH PPS final rule (65 FR 41128).

II. Provisions of the Proposed Regulations

[If you choose to comment on issues in this section, please include the caption “PROVISIONS OF THE PROPOSED REGULATIONS” at the beginning of your comments.]

A. National Standardized 60-Day Episode Rate

Medicare HH PPS has been effective since October 1, 2000. As set forth in the final rule published July 3, 2000 in the Federal Register (65 FR 41128), the unit of payment under Medicare HH PPS is a national standardized 60-day episode rate. As set forth in 42 CFR 484.220, we adjust the national standardized 60-day episode rate by a case mix grouping and a wage index value based on the site of service for the beneficiary. The proposed CY 2006 HH PPS rates use the same case-mix methodology and application of the wage index adjustment to the labor portion of the HH PPS rates as set forth in the July 3, 2000 final rule. In the October 22, 2004 final rule, we rebased and revised the home health market basket, resulting in a labor related share of 76.775 percent and a non-labor portion of 23.225 percent (69 FR 62126). We multiply the national 60-day episode rate by the patient's applicable case-mix weight. We divide the case-mix adjusted amount into a labor and non-labor portion. We multiply the labor portion by the applicable wage index based on the site of service of the beneficiary. As the home health market basket was rebased and revised last year, we are not proposing to rebase it for CY 2006.

As required by section 1895(b)(3)(B) of the Act, we have updated the HH PPS rates annually in a separate Federal Register document. Section 484.225 sets forth the specific percentage update for fiscal years 2001 through 2008. As amended by section 701 of the MMA, § 484.225(f) sets the CY 2006 unadjusted national prospective 60-day episode payment rate equal to the rate from the previous calendar year (CY 2005), increased by the applicable home health market basket minus 0.8 percentage point.

For CY 2006, we are proposing to use again the design and case-mix methodology described in section III.G of the HH PPS July 3, 2000 final rule (65 FR 41192 through 41203). For CY 2006, we are proposing to base the wage index adjustment to the labor portion of the PPS rates on the most recent pre-floor and pre-reclassified hospital wage index as discussed in section II.D of this proposed rule (not including any reclassifications under section 1886(d)(8)(B)) of the Act.

As discussed in the July 3, 2000 HH PPS final rule, for episodes with four or fewer visits, Medicare pays the national per-visit amount by discipline, referred to as a LUPA. We update the national per-visit amounts by discipline annually by the applicable home health market Start Printed Page 40790basket percentage. We adjust the national per-visit amount by the appropriate wage index based on the site of service for the beneficiary as set forth in § 484.230. We propose to adjust the labor portion of the updated national per-visit amounts by discipline used to calculate the LUPA by the most recent pre-floor and pre-reclassified hospital wage index, as discussed in section II.D of this proposed rule.

Medicare pays the 60-day case-mix and wage-adjusted episode payment on a split percentage payment approach. The split percentage payment approach includes an initial percentage payment and a final percentage payment as set forth in § 484.205(b)(1) and (b)(2). We may base the initial percentage payment on the submission of a request for anticipated payment and the final percentage payment on the submission of the claim for the episode, as discussed in § 409.43. The claim for the episode that the HHA submits for the final percentage payment determines the total payment amount for the episode and whether we make an applicable adjustment to the 60-day case-mix and wage-adjusted episode payment. The end date of the 60-day episode as reported on the claim determines the rate level at which Medicare will pay the claim for the fiscal period.

We may also adjust the 60-day case-mix and wage-adjusted episode payment based on the information submitted on the claim to reflect the following:

  • A low utilization payment provided on a per-visit basis as set forth in § 484.205(c) and § 484.230.
  • A partial episode payment adjustment as set forth in § 484.205(d) and § 484.235.
  • A significant change in condition adjustment as set forth in § 484.205(e) and § 484.237.
  • An outlier payment as set forth in § 484.205(f) and § 484.240.

This proposed rule reflects the proposed updated CY 2006 rates that would be effective January 1, 2006.

B. Proposed CY 2006 Update to the Home Health Market Basket Index

Section 1895(b)(3)(B) of the Act, as amended by section 701 of the MMA, requires for CY 2006 that the standard prospective payment amounts be increased by a factor equal to the applicable home health market basket update minus 0.8 percentage point.

  • Proposed CY 2006 Adjustments

In calculating the annual update for the CY 2006 60-day episode rates, we are proposing to first look at the CY 2005 rates as a starting point. The CY 2005 national 60-day episode rate, as published in the Federal Register (69 FR 62124) is $2,264.28.

In order to calculate the CY 2006 national 60-day episode rate, we are proposing to multiply the CY 2005 national 60-day episode rate ($2,264.28) by the proposed estimated home health market basket update of 3.3 percent for CY 2006 minus 0.8 percentage point.

We would increase the CY 2005 60-day episode payment rate by the proposed estimated home health market basket update (3.3 percent) minus 0.8 percentage point ($2,264.28 × 2.5 percent) to yield the proposed updated CY 2006 national 60-day episode rate ($2,320.89) (see Table 1 below).

Table 1.—Proposed National 60-Day Episode Amounts Updated by the Proposed Estimated Home Health Market Basket Update for CY 2006, Minus 0.8 Percentage Point, Before Case-Mix Adjustment, Wage Index Adjustment Based on the Site of Service for the Beneficiary or Applicable Payment Adjustment

Total prospective payment amount per 60-day episode for CY 2005Multiply by the proposed estimated home health market basket update (3.3 percent) minus 0.8 percentage pointProposed CY 2006 updated national 60-day episode rate
$2,264.281.025$2,320.89

National Per-visit Amounts Used to Pay LUPAs and Compute Imputed Costs Used in Outlier Calculations

As discussed previously in this proposed rule, the policies governing the LUPAs and outlier calculations set forth in the July 3, 2000 HH PPS final rule will continue during CY 2006. In calculating the annual update for the CY 2006 national per-visit amounts we use to pay LUPAs and to compute the imputed costs in outlier calculations, we are proposing to look again at the CY 2005 rates as a starting point. We then are proposing to multiply those amounts by the proposed estimated home health market basket update minus 0.8 percentage point for CY 2006 to yield the updated per-visit amounts for each home health discipline for CY 2006 (see Table 2 below).

Table 2.—Proposed National Per-Visit Amounts for LUPAs and Outlier Calculations Updated by the Proposed Estimated Home Health Market Basket Update for CY 2006, Minus 0.8 Percentage Point, Before Wage Index Adjustment Based on the Site of Service for the Beneficiary

Home health discipline typeFinal per-visit amount per 60-day episode for CY 2005 for LUPAsMultiply by the proposed estimated home health market basket (3.3 percent) minus 0.8 percentage pointProposed per-visit payment amount per discipline for CY 2006 for LUPAs
Home Health Aide$44.761.025$45.88
Medical Social Services158.451.025162.41
Occupational Therapy108.811.025111.53
Physical Therapy108.081.025110.78
Skilled Nursing98.851.025101.32
Speech-Language Pathology117.441.025120.38
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C. Outliers and the Fixed Dollar Loss Ratio

Outlier payments are payments made in addition to regular 60-day case-mix and wage-adjusted episode payments for episodes that incur unusually large costs due to patient home health care needs. Outlier payments are made for episodes for which the estimated cost exceeds a threshold amount. The episode's estimated cost is the sum of the national wage-adjusted per-visit payment amounts for all visits delivered during the episode. The outlier threshold for each case-mix group, PEP adjustment, or total SCIC adjustment is defined as the 60-day episode payment amount, PEP adjustment, or total SCIC adjustment for that group plus a fixed dollar loss amount. Both components of the outlier threshold are wage-adjusted.

The wage-adjusted fixed dollar loss (FDL) amount represents the amount of loss that an agency must bear before an episode becomes eligible for outlier payments. The FDL is computed by multiplying the wage-adjusted 60-day episode payment amount by the fixed dollar loss ratio, which is a proportion expressed in terms of the national standardized episode payment amount. The outlier payment is defined to be a proportion of the wage-adjusted estimated costs beyond the wage-adjusted threshold. The proportion of additional costs paid as outlier payments is referred to as the loss-sharing ratio.

Section 1895(b)(5) of the Act requires that estimated total outlier payments are no more than 5 percent of total estimated HH PPS payments. In response to the concerns about potential financial losses that might result from unusually expensive cases expressed in comments to the October 28, 1999 proposed rule (64 FR 58133), the July 2000 final rule set the target for estimated outlier payments at the 5 percent level. The fixed dollar loss ratio and the loss-sharing ratio were then selected so that estimated total outlier payments would meet the 5 percent target.

For a given level of outlier payments, there is a trade-off between the values selected for the fixed dollar loss ratio and the loss-sharing ratio. A high fixed dollar loss ratio reduces the number of episodes that can receive outlier payments, but makes it possible to select a higher loss-sharing ratio and, therefore, increase outlier payments for outlier episodes. Alternatively, a lower fixed dollar loss ratio means that more episodes can qualify for outlier payments, but outlier payments per episode must be lower. As a result of public comments on the October 28, 1999 proposed rule, in our July 2000 final rule, we made the decision to attempt to cover a relatively high proportion of the costs of outlier cases for the most expensive episodes that would qualify for outlier payments within the 5 percent constraint.

In the July 2000 final rule, we chose a value of 0.80 for the loss-sharing ratio, which preserves incentives for agencies to attempt to provide care efficiently for outlier cases. A loss-sharing ratio of 0.80 was also consistent with the loss-sharing ratios used in other Medicare PPS outlier policies. Furthermore, we estimated the value of the fixed dollar loss ratio that would yield estimated total outlier payments that were 5 percent of total home health PPS payments. The resulting value for the fixed dollar loss ratio, for the July 2000 final rule, was 1.13.

Our CY 2005 update to the HH PPS rates (69 FR 62124) changed the fixed dollar loss ratio from the original 1.13 to 0.70 to allow more home health episodes to qualify for outlier payments and to better meet the estimated 5 percent target of outlier payments to total HH PPS payments. We stated in that CY 2005 update that we planned to continue to monitor the outlier expenditures on a yearly basis and to make adjustments as necessary (69 FR 62129). To do so, we planned on using the best Medicare data available at the time of publication. For the CY 2005 update, we used CY 2003 home health claims data. At this time, we do not have sufficient data to propose any update to the FDL ratio for the CY 2006 update to the HH PPS rates. However, depending on the availability of more recent data at the time of publication of the HH PPS rate update for CY 2006 final rule, we may, if necessary, implement an update to the FDL ratio for the CY 2006 update to the HH PPS rates. If so, we plan on using the same methodology performed in updating to the current FDL ratio described in the June 2, 2004 proposed rule using any more recent available data.

D. Hospital Wage Index

1. Revised OMB Definition for Geographical Statistical Areas

Sections 1895(b)(4)(A)(ii) and (b)(4)(C) of the Act require the Secretary to establish area wage adjustment factors that reflect the relative level of wages and wage-related costs applicable to the furnishing of home health services and to provide appropriate adjustments to the episode payment amounts under HH PPS to account for area wage differences. We apply the appropriate wage index value to the labor portion (76.775 percent; see (60 FR 62126)) of the HH PPS rates based on the geographic area in which the beneficiary received home health services as discussed in section II. A of this proposed rule. Generally, we determine each HHA's labor market area based on definitions of Metropolitan Statistical Areas (MSAs) issued by the Office of Management and Budget (OMB).

We acknowledged in our October 22, 2004 final rule that, on June 6, 2003, the OMB issued an OMB Bulletin (No. 03-04) announcing revised definitions for Metropolitan Statistical Areas (MSAs), new definitions for Micropolitan Statistical Areas and Combined Statistical Areas, and guidance on using the statistical definitions. 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 Core-Based Statistical Areas (CBSAs). After further analysis, we are proposing to use the OMB-revised definitions to adjust the proposed CY 2006 HH PPS payment rates. The Hospital Inpatient PPS (IPPS) is applying these revised definitions as discussed in the August 11, 2004 IPPS final rule (68 FR 49207).

a. Background. As discussed previously and set forth in the July 3, 2000 final rule, the statute provides that the wage adjustment factors may be the factors used by the Secretary for purposes of section 1886(d)(3)(E) of the Act for hospital wage adjustment factors. Again, as discussed in the July 3, 2000 final rule, we are proposing to use the pre-floor and pre-reclassified hospital wage index data to adjust the labor portion of the HH PPS rates based on the geographic area in which the beneficiary receives the home health services. We believe the use of the pre-floor and pre-reclassified hospital wage index data results in the appropriate adjustment to the labor portion of the costs as required by statute. For this proposed CY 2006 update to the home health payment rates, we propose to continue to use the most recent pre-floor and pre-reclassified hospital wage index available at the time of publication. See Addenda A and B of this proposed rule, respectively, for the proposed rural and urban hospital wage indices using the new MSA designations. For HH PPS rates addressed in this proposed rule, we are using preliminary 2006 pre-floor and pre-reclassified hospital wage index data. We will incorporate updated hospital wage index data for the 2006 pre-floor and pre-reclassified hospital wage index to be used in the final rule Start Printed Page 40792for the CY 2006 HH PPS update (not including any reclassifications under section 1886(d)(8)(B) of the Act).

As implemented under the HH PPS in the July 3, 2000 HH PPS final rule, each HHA's labor market is determined based on definitions of MSAs issued by OMB. In general, an urban area is defined as an MSA or New England County Metropolitan Area (NECMA) as defined by OMB. Under § 412.62(f)(1)(iii), a rural area is defined as any area outside of the urban area. The urban and rural area geographic classifications are defined in § 412.62(f)(1)(ii) and (f)(1)(iii), respectively, and have been used under HH PPS since it was implemented.

Under the HH PPS, the wage index value used is based upon the location of the beneficiary's home. As has been our longstanding practice, any area not included in an MSA (urban area) is considered to be nonurban (§ 412.64(b)(1)(ii)(C)) and receives the statewide rural wage index value (see, for example (65 FR 41173)).

Currently, the MSA definitions are used under other prospective payment systems such as the inpatient rehabilitation facility PPS (IRF PPS), the inpatient psychiatric facility PPS (IPF PPS), the skilled nursing facility PPS (SNF PPS), and Medicare payment for hospice care. In the August 11, 2004 IPPS final rule (69 FR 49206 through 49034), revised labor market area definitions were adopted under § 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.

As indicated above, we are proposing to implement the designations and definitions published by OMB. Details can be found in the June 6, 2003 OMB Bulletin (No. 03-04). In this proposed rule, we will address the new OMB definitions and their application to the home health wage index used by HH PPS. We are also proposing to revise § 484.202 (Definitions) to reflect those new designations and definitions. As we use the hospital inpatient wage data as the basis for determining the wage index used by HH PPS, we are generally adopting the same approach as taken by the hospital inpatient prospective payment system (IPPS). The changes in the hospital wage index based on the new OMB definitions are discussed in the inpatient prospective payment system (IPPS) proposed rule published in the Federal Register on May 18, 2004 (69 FR 28196) as well as in the IPPS final rule published on August 11, 2004 (69 FR 48916).

b. Current Labor Market Areas Based on MSAs. As noted above, we currently define labor market areas based on the definitions of Metropolitan Statistical Areas (MSAs), Primary MSAs (PMSAs), and New England County Metropolitan Areas (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 the purposes of the wage index, we use the PMSAs rather than the 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. Hospitals are assigned to either an MSA, PMSA, or NECMA based on whether the county in which the hospital is located is part of that area. All of the counties in a State outside a designated MSA, PMSA, or NECMA are designated 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.

c. 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), 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: Metropolitan Statistical Areas (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 further 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, 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 these new CBSA designations compared with 848 counties in the previous MSAs. Of these 1,090 counties, 737 are in the same MSA as they were before the changes, 65 are in different MSAs, 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 a 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 new CBSAs, refer to the August 11, 2004 IPPS final rule (67 FR 49026 through 49034).

d. Proposed Revision to the HH PPS Labor Market Areas. In its June 6, 2003 announcement, 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 HH PPS update for CY 2005 proposed rule (69 FR 31260, June 2, 2004), we noted that the recently published IPPS proposed rule for FY 2005 had discussed some of the issues associated with using these new definitions, and had invited public Start Printed Page 40793comment on them. Accordingly, we decided to defer proposing any new labor market definitions in the home health context at that time, in order to allow the public sufficient time and opportunity to consider and provide comments on this issue. In that HH PPS proposed rule, we also invited all interested parties to provide input on this issue in the specific context of the HH PPS. 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 HH PPS, the statute states that the Secretary shall establish area wage adjustment factors that reflect the relative level of wages and wage-related costs applicable to the furnishing of home health services in a geographic area compared to the national average applicable level. We believe MSAs are a reasonable and appropriate proxy for developing geographic areas for purposes of adjusting for wage differences in HH 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 have been used to define labor market areas for purposes of the wage index for many of the other Medicare payment systems (for example, IRF PPS, SNF PPS, hospice, and IPF PPS).

First, historically, Medicare prospective payment systems have used 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 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].” Section 1886(d)(10)(A), (D)(i)(II) of the Act. Thus, the Congress has accepted and ratified the use of MSAs as an inherently rational manner of dividing labor-market areas for purposes of Medicare payments.

The process used by OMB to develop the MSAs creates geographic areas 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. 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, we have reviewed alternative methods for determining geographic areas for purposes of the wage index, and in each case, have 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 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 OMB's CBSA designations.

Furthermore, when we implemented the wage index adjustment at § 484.210 under the HH PPS in the July 3, 2000 HH PPS final rule (65 FR 41213), we stated that an appropriate wage index was to be used to adjust for area wage differences. We also explained that in the adjustment to the national prospective 60-day episode payment rate, we have to account for the geographic differences in wage levels using an appropriate wage index based on the site of service of the beneficiary (65 FR 41213). Because we believe that OMB's CBSA designations based on Census 2000 data reflect the most recent available geographic classifications (MA definitions), as noted above we are proposing to revise the labor market area definitions used under the HH PPS. Specifically, we are proposing to revise the HH PPS labor market definitions based on OMB's new CBSA designations (as discussed in greater detail below), effective for HH PPS services occurring on or after January 1, 2006.

We note that OMB's new CBSA designations are the same labor market area definitions implemented under the IPPS at § 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 HH PPS includes the adoption in the initial implementation of the HH PPS of the same labor market area definitions under the HH PPS that existed under the IPPS at that time, as well as the use of acute care hospitals' wage data in calculating the HH PPS wage index. Therefore, we believe that proposing to revise the HH PPS labor market area definitions based on OMB's CBSA designations is consistent with our historical practice of generally modeling HH PPS wage index policy after IPPS wage index policy.

Below, we discuss the composition of the proposed HH PPS labor market areas based on OMB's new CBSA designations.

(1) New England County Metropolitan Areas. NECMAs are currently used to define labor market areas in New England, because they 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 new CBSA definition, OMB has now defined the MSAs and Micropolitan Areas in New England on the basis of counties. OMB also established New England City and Town Areas, which are similar to the previous New England MSAs. Therefore, to maintain consistency among all labor market areas and to maintain these areas on the basis of counties, under the HH PPS, 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, Start Printed Page 40794except 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 program payment because all 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 county, 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 HH 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 HH PPS labor market areas.

(2) Metropolitan Divisions. Under 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 lines. 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. 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. 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 (65 FR 82236). Metropolitan Divisions have been implemented under IPPS (69 FR 49029).

As noted above, in the past, OMB designated CMSAs as Metropolitan Areas with a population of one million or more and comprised of two or more PMSAs. Under the HH 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 accurately reflect the local labor costs of all of the individual hospitals included in that relatively “large” area. Similarly, we believe that Metropolitan Divisions under the CBSA designations may be too large an area to accurately reflect the local labor costs of all of the individual hospitals 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 HH 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 HH PPS would result in a more accurate adjustment for the variation in local labor market areas. 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 HH 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 served by HHAs in those relatively “smaller” areas.

Under CBSA definitions, 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 significantly altered.

Under the current HH 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 HH 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 HH PPS MSA designations to only 4 Metropolitan Divisions under the proposed CBSA-based labor market area designations. Five PMSAs in Connecticut under the current HH 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 HH 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 HH PPS labor market area designations.

Under the current HH 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 HH 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.

(3) Micropolitan Areas. Under OMB's new CBSA designations, Micropolitan Areas are essentially a third area definition comprised primarily of what are currently designated as rural areas, but also include some or all of areas that are currently designated as an urban MSA. As discussed in the August 11, 2004 IPPS final rule (69 FR 49029-49032), how these areas are treated would have significant impact on the calculation and application of the hospital wage index. Specifically, whether or not Micropolitan Areas are included as part of the respective statewide rural wage indices would affect the value of the statewide rural wage index of any State that contains a Micropolitan area. A hospital's Start Printed Page 40795classification as urban or rural affects which hospitals' wage data are included in the statewide rural wage index. As discussed in section II.D.1.b of this proposed rule, all counties in a State outside a designated urban area are combined 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 were recognized as independent labor market areas, because there would be so few hospitals in those areas to complete a wage index, the wage indices for those areas would become relatively unstable as they would change considerably from year to year.

Currently, we use MSAs to define urban labor market areas and group all 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 indices in the past for ease of reference. However, the introduction of Micropolitan Areas by OMB potentially complicates this terminology because these areas include many hospitals that are currently included in the statewide rural labor market areas. Thus, the term “rural” is now used to describe hospitals in counties that are not assigned to either MSA or Micropolitan areas.

We are proposing to treat Micropolitan Areas as rural labor market areas under the HH 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 the applicable HH PPS wage index (based on IPPS hospital wage index data, as discussed in greater detail below in section II.D. of this preamble), we propose that the wage index for an HHA servicing a home health beneficiary 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 that State.

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 independent labor market areas for hospitals paid under 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.

As 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 indices 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 because they result in the instability of payment levels from year to year, which makes fiscal planning difficult. 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 HH 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 HH 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 home health episodes of care for beneficiaries being served in those areas.

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 CY 2006 HH PPS proposed wage index. In addressing this situation, we are proposing approaches that we believe serve as proxies for hospital wage data and will provide an appropriate standard that accounts for area wage differences.

The first situation involves rural locations in Massachusetts and Puerto Rico. Under the proposed labor market areas, there are no rural hospitals in those 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). 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 HH 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 could not apply a similar averaging in rural areas because in the rural areas noted above, there is no rural hospital 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 CY 2006 and subsequent years.

(4) Implementation of the Proposed Revised Labor Market Designation. 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 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 indices is calculated for those acute care IPPS hospitals experiencing a drop in their wage indices 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 2007).

Unlike IPPS and some of the other payment systems where each entity uses a single MSA, HHAs may use various wage indices to compute their payments based upon the location of the beneficiary. Therefore, we do not believe that in the aggregate, HHAs would be impacted negatively by the new CBSA designations. While we understand that there are CBSAs that decrease based upon the new definitions, there are those that would be positively affected. For example, many counties that have been included in the rural definitions under the MSA designations are now designated as urban areas under the CBSA and would generally receive an increase in their wage index. We believe that adjustments made to CBSAs because of negative impact would necessitate adjustments to CBSAs that are Start Printed Page 40796positively impacted. Variability and changes in wage indices both positively and negatively have occurred under the MSA designations and occur as a result of geographic differences. As a result, we propose to adopt the CBSA definitions and resulting wage indices without transitions. The impact of CBSA designations is discussed in section V.B of this proposed rule. In estimating the impact of our proposal, we computed the projected expenditures for FY 2006 using geographic areas based upon existing MSAs as well as for areas using the new CBSA designations. Our impact analysis used the proposed CY 2006 payment rates and all of the CY 2003 claims files. In the final rule, we will use the best available home health data for CY 2004 in determining the potential impact of any change to the MSA designations. We also note that, in the past, the OMB has announced MSA changes on an annual basis due to population changes, and we have not proposed to transition these changes. Therefore, we do not propose transitioning the implementation of the new MSA designations.

We also 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 HH PPS.

As stated previously, we believe that OMB's latest labor market designations more accurately reflect the local economics and wage levels of the areas in which hospitals are currently located. We believe that OMB's CBSA designations based on Census 2000 data reflect the most recent available geographic classifications (MA definitions) and as a result reflect the relative hospital wage levels in the geographic area. As stated previously, since HHAs compete for the same staff as hospitals in any geographic area, we believe the hospital wage index used by HH PPS reflects the wages that are paid by HHAs.

To reflect our proposal to use the new OMB labor market areas for purposes of the HH PPS wage index, we are proposing to add, in § 484.202 (Definitions), the following definitions for rural and urban:

Rural area means, with respect to home health episodes ending on or after January 1, 2006, an area defined in § 412.64(b)(1)(ii)(C).

Urban area means, with respect to home health episodes ending on or after January 1, 2006, an area defined in § 412.64(b)(1)(ii)(A) and (B).

To facilitate an understanding of the proposed policies related to the proposed changes in the wage index as discussed in section V.B of this proposed rule, in addendum C, we are providing a listing of each Social Security Administration 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 proposed CBSA-based wage index value.

III. 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 (44 U.S.C. 35).

IV. Response to Comments

Because of the large number of public comments we normally receive on Federal Register documents, we are not able to acknowledge or respond to them individually. We will consider all comments we receive by the date and time specified in the DATES section of this preamble, and, when we proceed with a subsequent document, we will respond to the comments in the preamble to that document.

V. Regulatory Impact Analysis

[If you choose to comment on issues in this section, please include the caption “REGULATORY IMPACT” at the beginning of your comments.]

A. Overall Impact

We have examined the impacts of this rule as required by Executive Order 12866 (September 1993, Regulatory Planning and Review), the Regulatory Flexibility Act (RFA) (September 19, 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). The update set forth in this proposed rule would apply to Medicare payments under HH PPS in CY 2006. Accordingly, the following analysis describes the impact in CY 2006 only. We estimate that there would be an additional $330 million in CY 2006 expenditures attributable to the CY 2006 proposed estimated home health market basket update (3.3 percent) minus 0.8 percentage point, for a CY 2006 update of 2.5 percent.

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 hospitals and most other providers and suppliers are small entities, either by nonprofit status or by having revenues of $6 million to $29 million in any 1 year. For purposes of the RFA, approximately 75 percent of HHAs are considered small businesses according to the Small Business Administration's size standards with total revenues of $11.5 million or less in any 1 year. Individuals and States are not included in the definition of a small entity. As stated above, this proposed rule would provide an update to all HHAs for CY 2006 as required by statute. This proposed rule would have a significant positive effect upon small entities.

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 have determined that this proposed rule would not have a significant economic impact on the operations of a substantial number of small rural hospitals.

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. We believe this proposed rule would not mandate expenditures in that amount.

Executive Order 13132 establishes certain requirements that an agency Start Printed Page 40797must meet when it promulgates a proposed rule (and subsequent final rule) that imposes substantial direct requirement costs on State and local governments, preempts State law, or otherwise has Federalism implications. We have reviewed this rule under the threshold criteria of Executive Order 13132, Federalism. We have determined that this proposed rule would not have substantial direct effects on the rights, roles, and responsibilities of States.

B. Anticipated Effects

This proposed rule would update the HH PPS rates contained in the CY 2005 final rule (69 FR 62124, October 22, 2004). The impact analysis of this proposed rule presents the projected effects of the proposed change from MSA to CBSA designations in determining the wage index used to calculate the HH PPS rates for CY 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.

This analysis incorporates the latest estimates of growth in service use and payments under the Medicare home health benefit, based on the latest available Medicare claims from 2003. 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 of such possible events are newly-legislated general Medicare program funding changes by the Congress, or changes specifically related to HHAs. 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 HH 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 HHAs.

Our discussions for this proposed rule will focus on the impact of changes in the wage index, most notably the adoption of the CBSA designations. The impacts are shown in Table 3 below. The breakdown of the various impacts displayed in the table follows.

The rows display the estimated effect of the proposed changes on different categories. The first row of figures represents the estimated effects on all facilities. The next 2 rows show the effect on urban and rural facilities. This is followed, in the next 4 rows, by impacts on urban and rural facilities based on whether they are a hospital-based or freestanding facility. The next 20 rows show the effect on urban and rural facilities based on the census region in which they are located.

The first column shows the breakdown of all HHAs by urban or rural status, hospital-based or freestanding status, and census region.

The second column in the table shows the number of facilities in the impact database. A facility is considered urban if it is located in an MSA and, conversely, rural if it is not located in an MSA.

The third column of the table shows the effect of the proposed annual update to the wage index. This represents the effect of using the most recent wage data available to determine the proposed estimated home health market basket update. The total impact of this change is zero percent; however, there are distributional effects of the change.

The fourth column of the table reflects the impact of using the new OMB geographic designations based on CBSAs, compared to using the MSA designations. Specifically, the effect of using the CBSA-designated wage index values versus MSA-designated wage index values in determining payment for facilities in rural areas is, on average, an increase of 0.7 percent. On the other hand, facilities in an urban area do slightly worse, showing an average decrease of 0.1 percent. Rural HHAs, by region, generally do better using the CBSA-determined wage index (ranging from an increase of 0.1 percent to 2.2 percent), except for facilities in the Middle Atlantic and the Mountain regions where payments are estimated to decrease by 0.5 percent. The impact on urban HHAs, by region, is generally moderate using the CBSA determined wage index (ranging from no impact to a −0.8 percent decrease), except for facilities in the Middle Atlantic region, whose payments are estimated to increase slightly by 0.3 percent. By type of facility, the impact on rural facilities using the CBSA-determined wage index is positive, with payments to freestanding facilities estimated to increase by 0.8 percent and payments to hospital-based facilities estimated to increase by 0.7 percent. Conversely, hospital-based urban facilities are estimated to experience no impact while freestanding urban facilities are estimated to see a decrease in payments by 0.2 percent.

The fifth column of the table shows the effect of all of the changes on the CY 2006 payments. The update of 2.5 percentage points (market basket increase of 3.3 percent minus 0.8 percentage point, as mandated by the MMA) is constant for all providers and, though not shown individually, is included in this column. It is projected that total aggregate payments would increase by 2.5 percent; 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, HHAs in rural New England show the largest estimated increase in payment at 5.7 percent, while HHAs in the urban West North Central and East North Central regions show the smallest increase in payments at 1.5 percent. Rural HHAs do somewhat better than urban HHAs, seeing an estimated increase in payments of 3.5 percent and 2.3 percent, respectively. Amongst the different type of facility categories, freestanding rural HHAs do best, with an estimated increase in payments of 3.7 percent. Hospital-based rural HHAs are next with an estimated increase in payments of 3.3 percent with hospital-based urban and freestanding HHAs with estimated increases of 2.4 percent and 2.2 percent, respectively.

Table 3.—Projected Impact of CY 2006 Update to the HH PPS Final Column Includes Update of 2.5 Percent Urban/Rural Defined as MSA/Non-MSA

Number of facilitiesUpdated wage dataMSA to CBSATotal CY 2006 change
Total6,8900.00.02.5
Urban4,602−0.1−0.12.3
Rural2,2880.30.73.5
Start Printed Page 40798
Hospital based urban1,796−0.10.02.4
Freestanding urban2,806−0.1−0.22.2
Hospital based rural1,3670.10.73.3
Freestanding rural9210.40.83.7
Urban by region
New England246−0.6−0.31.6
Middle Atlantic4200.30.33.1
South Atlantic751−0.50.02.0
East North Central770−0.6−0.41.5
East South Central2050.3−0.32.5
West North Central259−0.9−0.11.5
West South Central1,0920.0−0.42.1
Mountain241−0.50.02.0
Pacific5811.10.03.6
Outlying370.9−0.82.6
Rural by region
New England463.00.15.7
Middle Atlantic77−0.1−0.51.9
South Atlantic283−0.50.42.4
East North Central3030.50.43.4
East South Central2320.40.83.7
West North Central524−0.20.32.6
West South Central4950.22.25.0
Mountain2000.8−0.52.8
Pacific1131.90.04.4
Outlying15−8.210.03.5

C. Conclusion

In accordance with the provisions of Executive Order 12866, this regulation was reviewed by the Office of Management and Budget.

Start List of Subjects

List of Subjects in 42 CFR Part 484

End List of Subjects

For the reasons set forth in the preamble, the Centers for Medicare & Medicaid Services proposes to amend 42 CFR chapter IV as set forth below:

Start Part

PART 484—HOME HEALTH SERVICES

1. The authority citation for part 484 continues to read as follows:

Start Authority

Authority: Secs. 1102 and 1871 of the Social Security Act (42 U.S.C. 1302 and 1395(hh)).

End Authority

Subpart E—Prospective Payment System for Home Health Agencies

2. In § 484.202, the definitions for “Rural area” and “Urban area” are added in alphabetical order to read as follows:

Definitions.
* * * * *

Rural area means, with respect to home health episodes ending on or after January 1, 2006, an area defined in § 412.64(b)(1)(ii)(C) of this chapter.

Urban area means, with respect to home health episodes ending on or after January 1, 2006, an area defined in § 412.64(b)(1)(ii)(A) and (B) of this chapter.

(Catalog of Federal Domestic Assistance Program No. 93.773, Medicare—Hospital Insurance; and Program No. 93.774, Medicare—Supplementary Medical Insurance Program)

Start Signature

Dated: May 12, 2005.

Mark B. McClellan,

Administrator, Centers for Medicare & Medicaid Services.

Approved: June 21, 2005.

Michael O. Leavitt,

Secretary.

End Signature Start Printed Page 40799

Note:

The following addenda will not be published in the Code of Federal Regulations.

Addendum A.—Proposed CY 2006 Wage Index for Rural Areas by CBSA; Applicable Pre-Floor and Pre-Reclassified Hospital Wage Index

CBSA codeNonurban areaWage index
01Alabama0.7477
02Alaska1.1990
03Arizona0.8777
04Arkansas0.7451
05California1.0857
06Colorado0.9389
07Connecticut1.1794
08Delaware0.9606
10Florida0.8598
11Georgia0.7666
12Hawaii1.0562
13Idaho0.8045
14Illinois0.8279
15Indiana0.8630
16Iowa0.8502
17Kansas0.7987
18Kentucky0.7774
19Louisiana0.7418
20Maine0.8852
21Maryland0.9095
22Massachusetts 11.0216
23Michigan0.8870
24Minnesota0.9183
25Mississippi0.7671
26Missouri0.7909
27Montana0.8833
28Nebraska0.8665
29Nevada0.9074
30New Hampshire1.0677
31New Jersey 1
32New Mexico0.8644
33New York0.8157
34North Carolina0.8567
35North Dakota0.7268
36Ohio0.8786
37Oklahoma0.7589
38Oregon0.9830
39Pennsylvania0.8302
40Puerto Rico 10.4047
41Rhode Island 1
42South Carolina0.8641
43South Dakota0.8484
44Tennessee0.7888
45Texas0.8007
46Utah0.8126
47Vermont0.9840
48Virgin Islands0.7026
49Virginia0.8012
50Washington1.0458
51West Virginia0.7725
52Wisconsin0.9480
53Wyoming0.9214
65Guam0.9611
1 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 proposing to use last year's wage index value.

Addendum B.—Proposed CY 2006 Wage Index for Urban Areas by CBSA; Applicable Pre-Floor and Pre-Reclassified Hospital Wage Index

CBSA codeUrban area (constituent counties)Wage index
10180Abilene, TX0.7904
Callahan County, TX
Jones County, TX
Taylor County, TX
10380Aguadilla-Isabela-San Sebastián, PR0.4743
Aguada Municipio, PR
Aguadilla Municipio, PR
Añasco Municipio, PR
Isabela Municipio, PR
Lares Municipio, PR
Moca Municipio, PR
Rincón Municipio, PR
San Sebastián Municipio, PR
10420Akron, OH0.8991
Portage County, OH
Summit County, OH
10500Albany, GA0.8636
Baker County, GA
Dougherty County, GA
Lee County, GA
Terrell County, GA
Worth County, GA
10580Albany-Schenectady-Troy, NY0.8545
Albany County, NY
Rensselaer County, NY
Saratoga County, NY
Schenectady County, NY
Schoharie County, NY
10740Albuquerque, NM0.9693
Bernalillo County, NM
Sandoval County, NM
Torrance County, NM
Valencia County, NM
10780Alexandria, LA0.8041
Grant Parish, LA
Rapides Parish, LA
10900Allentown-Bethlehem-Easton, PA-NJ0.9828
Start Printed Page 40800
Warren County, NJ
Carbon County, PA
Lehigh County, PA
Northampton County, PA
11020Altoona, PA0.8953
Blair County, PA
11100Amarillo, TX0.9166
Armstrong County, TX
Carson County, TX
Potter County, TX
Randall County, TX
11180Ames, IA0.9545
Story County, IA
11260Anchorage, AK1.2110
Anchorage Municipality, AK
Matanuska-Susitna Borough, AK
11300Anderson, IN0.8595
Madison County, IN
11340Anderson, SC0.8897
Anderson County, SC
11460Ann Arbor, MI1.0870
Washtenaw County, MI
11500Anniston-Oxford, AL0.7659
Calhoun County, AL
11540Appleton, WI0.9298
Calumet County, WI
Outagamie County, WI
11700Asheville, NC0.9294
Buncombe County, NC
Haywood County, NC
Henderson County, NC
Madison County, NC
12020Athens-Clarke County, GA0.9843
Clarke County, GA
Madison County, GA
Oconee County, GA
Oglethorpe County, GA
12060Atlanta-Sandy Springs-Marietta, GA0.9648
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
12100Atlantic City, NJ1.1633
Atlantic County, NJ
12220Auburn-Opelika, AL0.8108
Lee County, AL
Start Printed Page 40801
12260Augusta-Richmond County, GA-SC0.9565
Burke County, GA
Columbia County, GA
McDuffie County, GA
Richmond County, GA
Aiken County, SC
Edgefield County, SC
12420Austin-Round Rock, TX0.9450
Bastrop County, TX
Caldwell County, TX
Hays County, TX
Travis County, TX
Williamson County, TX
12540Bakersfield, CA1.0344
Kern County, CA
12580Baltimore-Towson, MD0.9907
Anne Arundel County, MD
Baltimore County, MD
Carroll County, MD
Harford County, MD
Howard County, MD
Queen Anne's County, MD
Baltimore City, MD
12620Bangor, ME1.0003
Penobscot County, ME
12700Barnstable Town, MA1.2527
Barnstable County, MA
12940Baton Rouge, LA0.8601
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
12980Battle Creek, MI0.9510
Calhoun County, MI
13020Bay City, MI0.9352
Bay County, MI
13140Beaumont-Port Arthur, TX0.8421
Hardin County, TX
Jefferson County, TX
Orange County, TX
13380Bellingham, WA1.1743
Whatcom County, WA
13460Bend, OR1.0796
Deschutes County, OR
13644Bethesda-Frederick-Gaithersburg, MD1.1495
Frederick County, MD
Montgomery County, MD
13740Billings, MT0.8843
Carbon County, MT
Yellowstone County, MT
13780Binghamton, NY0.8571
Broome County, NY
Tioga County, NY
13820Birmingham-Hoover, AL0.8979
Bibb County, AL
Blount County, AL
Chilton County, AL
Jefferson County, AL
St. Clair County, AL
Shelby County, AL
Walker County, AL
13900Bismarck, ND0.7519
Burleigh County, ND
Morton County, ND
13980Blacksburg-Christiansburg-Radford, VA0.7962
Start Printed Page 40802
Giles County, VA
Montgomery County, VA
Pulaski County, VA
Radford City, VA
14020Bloomington, IN0.8456
Greene County, IN
Monroe County, IN
Owen County, IN
14060Bloomington-Normal, IL0.9084
McLean County, IL
14260Boise City-Nampa, ID0.9061
Ada County, ID
Boise County, ID
Canyon County, ID
Gem County, ID
Owyhee County, ID
14484Boston-Quincy, MA1.1543
Norfolk County, MA
Plymouth County, MA
Suffolk County, MA
14500Boulder, CO0.9744
Boulder County, CO
14540Bowling Green, KY0.8220
Edmonson County, KY
Warren County, KY
14740Bremerton-Silverdale, WA1.0686
Kitsap County, WA
14860Bridgeport-Stamford-Norwalk, CT1.2598
Fairfield County, CT
15180Brownsville-Harlingen, TX0.9822
Cameron County, TX
15260Brunswick, GA0.9320
Brantley County, GA
Glynn County, GA
McIntosh County, GA
15380Buffalo-Niagara Falls, NY0.8889
Erie County, NY
Niagara County, NY
15500Burlington, NC0.8914
Alamance County, NC
15540Burlington-South Burlington, VT0.9446
Chittenden County, VT
Franklin County, VT
Grand Isle County, VT
15764Cambridge-Newton-Framingham, MA1.1084
Middlesex County, MA
15804Camden, NJ1.0528
Burlington County, NJ
Camden County, NJ
Gloucester County, NJ
15940Canton-Massillon, OH0.8944
Carroll County, OH
Stark County, OH
15980Cape Coral-Fort Myers, FL0.9366
Lee County, FL
16180Carson City, NV1.0244
Carson City, NV
16220Casper, WY0.9035
Natrona County, WY
16300Cedar Rapids, IA0.8617
Benton County, IA
Jones County, IA
Linn County, IA
16580Champaign-Urbana, IL0.9604
Champaign County, IL
Ford County, IL
Piatt County, IL
16620Charleston, WV0.8428
Boone County, WV
Clay County, WV
Start Printed Page 40803
Kanawha County, WV
Lincoln County, WV
Putnam County, WV
16700Charleston-North Charleston, SC0.9438
Berkeley County, SC
Charleston County, SC
Dorchester County, SC
16740Charlotte-Gastonia-Concord, NCSC0.9760
Anson County, NC
Cabarrus County, NC
Gaston County, NC
Mecklenburg County, NC
Union County, NC
York County, SC
16820Charlottesville, VA1.0234
Albemarle County, VA
Fluvanna County, VA
Greene County, VA
Nelson County, VA
Charlottesville City, VA
16860Chattanooga, TN-GA0.9098
Catoosa County, GA
Dade County, GA
Walker County, GA
Hamilton County, TN
Marion County, TN
Sequatchie County, TN
16940Cheyenne, WY0.8784
Laramie County, WY
16974Chicago-Naperville-Joliet, IL1.0848
Cook County, IL
DeKalb County, IL
DuPage County, IL
Grundy County, IL
Kane County, IL
Kendall County, IL
McHenry County, IL
Will County, IL
17020Chico, CA1.0522
Butte County, CA
17140Cincinnati-Middletown, OH-KY-IN0.9623
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
17300Clarksville, TN-KY0.8292
Christian County, KY
Trigg County, KY
Montgomery County, TN
Stewart County, TN
17420Cleveland, TN0.8141
Bradley County, TN
Polk County, TN
17460Cleveland-Elyria-Mentor, OH0.9204
Cuyahoga County, OH
Geauga County, OH
Lake County, OH
Lorain County, OH
Medina County, OH
Start Printed Page 40804
17660Coeur d'Alene, ID0.9657
Kootenai County, ID
17780College Station-Bryan, TX0.8909
Brazos County, TX
Burleson County, TX
Robertson County, TX
17820Colorado Springs, CO0.9478
El Paso County, CO
Teller County, CO
17860Columbia, MO0.8354
Boone County, MO
Howard County, MO
17900Columbia, SC0.9047
Calhoun County, SC
Fairfield County, SC
Kershaw County, SC
Lexington County, SC
Richland County, SC
Saluda County, SC
17980Columbus, GA-AL0.8568
Russell County, AL
Chattahoochee County, GA
Harris County, GA
Marion County, GA
Muscogee County, GA
18020Columbus, IN0.9598
Bartholomew County, IN
18140Columbus, OH0.9850
Delaware County, OH
Fairfield County, OH
Franklin County, OH
Licking County, OH
Madison County, OH
Morrow County, OH
Pickaway County, OH
Union County, OH
18580Corpus Christi, TX0.8559
Aransas County, TX
Nueces County, TX
San Patricio County, TX
18700Corvallis, OR1.0739
Benton County, OR
19060Cumberland, MD-WV0.9326
Allegany County, MD
Mineral County, WV
19124Dallas-Plano-Irving, TX1.0233
Collin County, TX
Dallas County, TX
Delta County, TX
Denton County, TX
Ellis County, TX
Hunt County, TX
Kaufman County, TX
Rockwall County, TX
19140Dalton, GA0.9044
Murray County, GA
Whitfield County, GA
19180Danville, IL0.9037
Vermilion County, IL
19260Danville, VA0.8497
Pittsylvania County, VA
Danville City, VA
19340Davenport-Moline-Rock Island, IA-IL0.8731
Henry County, IL
Mercer County, IL
Rock Island County, IL
Scott County, IA
19380Dayton, OH0.9073
Greene County, OH
Miami County, OH
Start Printed Page 40805
Montgomery County, OH
Preble County, OH
19460Decatur, AL0.8478
Lawrence County, AL
Morgan County, AL
19500Decatur, IL0.8076
Macon County, IL
19660Deltona-Daytona Beach-Ormond Beach, FL0.9308
Volusia County, FL
19740Denver-Aurora, CO1.0733
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
19780Des Moines, IA0.9651
Dallas County, IA
Guthrie County, IA
Madison County, IA
Polk County, IA
Warren County, IA
19804Detroit-Livonia-Dearborn, MI1.0441
Wayne County, MI
20020Dothan, AL0.7707
Geneva County, AL
Henry County, AL
Houston County, AL
20100Dover, DE0.9779
Kent County, DE
20220Dubuque, IA0.9135
Dubuque County, IA
20260Duluth, MN-WI1.0209
Carlton County, MN
St. Louis County, MN
Douglas County, WI
20500Durham, NC1.0303
Chatham County, NC
Durham County, NC
Orange County, NC
Person County, NC
20740Eau Claire, WI0.9210
Chippewa County, WI
Eau Claire County, WI
20764Edison, NJ1.1260
Middlesex County, NJ
Monmouth County, NJ
Ocean County, NJ
Somerset County, NJ
20940El Centro, CA0.8915
Imperial County, CA
21060Elizabethtown, KY0.8810
Hardin County, KY
Larue County, KY
21140Elkhart-Goshen, IN0.9637
Elkhart County, IN
21300Elmira, NY0.8259
Chemung County, NY
21340El Paso, TX0.8924
El Paso County, TX
21500Erie, PA0.8746
Erie County, PA
21604Essex County, MA1.0533
Essex County, MA
21660Eugene-Springfield, OR1.0829
Lane County, OR
Start Printed Page 40806
21780Evansville, IN-KY0.8721
Gibson County, IN
Posey County, IN
Vanderburgh County, IN
Warrick County, IN
Henderson County, KY
Webster County, KY
21820Fairbanks, AK1.1419
Fairbanks North Star Borough, AK
21940Fajardo, PR0.4157
Ceiba Municipio, PR
Fajardo Municipio, PR
Luquillo Municipio, PR
22020Fargo, ND-MN0.8495
Cass County, ND
Clay County, MN
22140Farmington, NM0.8518
San Juan County, NM
22180Fayetteville, NC0.9426
Cumberland County, NC
Hoke County, NC
22220Fayetteville-Springdale-Rogers, AR-MO0.8563
Benton County, AR
Madison County, AR
Washington County, AR
McDonald County, MO
22380Flagstaff, AZ1.2105
Coconino County, AZ
22420Flint, MI1.0663
Genesee County, MI
22500Florence, SC0.8964
Darlington County, SC
Florence County, SC
22520Florence-Muscle Shoals, AL0.8280
Colbert County, AL
Lauderdale County, AL
22540Fond du Lac, WI0.9650
Fond du Lac County, WI
22660Fort Collins-Loveland, CO1.0132
Larimer County, CO
22744Fort Lauderdale-Pompano Beach-Deerfield Beach, FL1.0442
Broward County, FL
22900Fort Smith, AROK0.8214
Crawford County, AR
Franklin County, AR
Sebastian County, AR
Le Flore County, OK
Sequoyah County, OK
23020Fort Walton Beach-Crestview-Destin, FL0.8881
Okaloosa County, FL
23060Fort Wayne, IN0.9803
Allen County, IN
Wells County, IN
Whitley County, IN
23104Fort Worth-Arlington, TX0.9510
Johnson County, TX
Parker County, TX
Tarrant County, TX
Wise County, TX
23420Fresno, CA1.0541
Fresno County, CA
23460Gadsden, AL0.7946
Etowah County, AL
23540Gainesville, FL0.9474
Alachua County, FL
Gilchrist County, FL
23580Gainesville, GA0.8883
Hall County, GA
23844Gary, IN0.9369
Jasper County, IN
Start Printed Page 40807
Lake County, IN
Newton County, IN
Porter County, IN
24020Glens Falls, NY0.8567
Warren County, NY
Washington County, NY
24140Goldsboro, NC0.8784
Wayne County, NC
24220Grand Forks, ND-MN1.1516
Polk County, MN
Grand Forks County, ND
24300Grand Junction, CO0.9560
Mesa County, CO
24340Grand Rapids-Wyoming, MI0.9400
Barry County, MI
Ionia County, MI
Kent County, MI
Newaygo County, MI
24500Great Falls, MT0.9061
Cascade County, MT
24540Greeley, CO0.9580
Weld County, CO
24580Green Bay, WI0.9452
Brown County, WI
Kewaunee County, WI
Oconto County, WI
24660Greensboro-High Point, NC0.9113
Guilford County, NC
Randolph County, NC
Rockingham County, NC
24780Greenville, NC0.9434
Greene County, NC
Pitt County, NC
24860Greenville, SC1.0165
Greenville County, SC
Laurens County, SC
Pickens County, SC
25020Guayama, PR0.3184
Arroyo Municipio, PR
Guayama Municipio, PR
Patillas Municipio, PR
25060Gulfport-Biloxi, MS0.8938
Hancock County, MS
Harrison County, MS
Stone County, MS
25180Hagerstown-Martinsburg, MD-WV0.9499
Washington County, MD
Berkeley County, WV
Morgan County, WV
25260Hanford-Corcoran, CA1.0046
Kings County, CA
25420Harrisburg-Carlisle, PA0.9322
Cumberland County, PA
Dauphin County, PA
Perry County, PA
25500Harrisonburg, VA0.9098
Rockingham County, VA
Harrisonburg City, VA
25540Hartford-West Hartford-East Hartford, CT1.1084
Hartford County, CT
Litchfield County, CT
Middlesex County, CT
Tolland County, CT
25620Hattiesburg, MS0.7609
Forrest County, MS
Lamar County, MS
Perry County, MS
25860Hickory-Lenoir-Morganton, NC0.8922
Alexander County, NC
Burke County, NC
Start Printed Page 40808
Caldwell County, NC
Catawba County, NC
25980 2Hinesville-Fort Stewart, GA0.9178
Liberty County, GA
Long County, GA
26100Holland-Grand Haven, MI0.9064
Ottawa County, MI
26180Honolulu, HI1.1208
Honolulu County, HI
26300Hot Springs, AR0.9053
Garland County, AR
26380Houma-Bayou Cane-Thibodaux, LA0.7902
Lafourche Parish, LA
Terrebonne Parish, LA
26420Houston-Baytown-Sugar Land, TX1.0005
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
26580Huntington-Ashland, WV-KY-OH0.9486
Boyd County, KY
Greenup County, KY
Lawrence County, OH
Cabell County, WV
Wayne County, WV
26620Huntsville, AL0.9149
Limestone County, AL
Madison County, AL
26820Idaho Falls, ID0.9429
Bonneville County, ID
Jefferson County, ID
26900Indianapolis, IN0.9930
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
26980Iowa City, IA0.9756
Johnson County, IA
Washington County, IA
27060Ithaca, NY0.9803
Tompkins County, NY
27100Jackson, MI0.9313
Jackson County, MI
27140Jackson, MS0.8319
Copiah County, MS
Hinds County, MS
Madison County, MS
Rankin County, MS
Simpson County, MS
27180Jackson, TN0.8973
Chester County, TN
Madison County, TN
27260Jacksonville, FL0.9299
Baker County, FL
Clay County, FL
Duval County, FL
Nassau County, FL
St. Johns County, FL
Start Printed Page 40809
27340Jacksonville, NC0.8244
Onslow County, NC
27500Janesville, WI0.9547
Rock County, WI
27620Jefferson City, MO0.8396
Callaway County, MO
Cole County, MO
Moniteau County, MO
Osage County, MO
27740Johnson City, TN0.7945
Carter County, TN
Unicoi County, TN
Washington County, TN
27780Johnstown, PA0.8362
Cambria County, PA
27860Jonesboro, AR0.7919
Craighead County, AR
Poinsett County, AR
27900Joplin, MO0.8590
Jasper County, MO
Newton County, MO
28020Kalamazoo-Portage, MI1.0391
Kalamazoo County, MI
Van Buren County, MI
28100Kankakee-Bradley, IL1.0974
Kankakee County, IL
28140Kansas City, MO-KS0.9467
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
28420Kennewick-Richland-Pasco, WA1.0630
Benton County, WA
Franklin County, WA
28660Killeen-Temple-Fort Hood, TX0.8535
Bell County, TX
Coryell County, TX
Lampasas County, TX
28700Kingsport-Bristol-Bristol, TN-VA0.8062
Hawkins County, TN
Sullivan County, TN
Bristol City, VA
Scott County, VA
Washington County, VA
28740Kingston, NY0.9257
Ulster County, NY
28940Knoxville, TN0.8454
Anderson County, TN
Blount County, TN
Knox County, TN
Loudon County, TN
Union County, TN
29020Kokomo, IN0.9517
Howard County, IN
Tipton County, IN
29100La Crosse, WI-MN0.9573
Houston County, MN
La Crosse County, WI
29140Lafayette, IN0.8745
Start Printed Page 40810
Benton County, IN
Carroll County, IN
Tippecanoe County, IN
29180Lafayette, LA0.8436
Lafayette Parish, LA
St. Martin Parish, LA
29340Lake Charles, LA0.7841
Calcasieu Parish, LA
Cameron Parish, LA
29404Lake County-Kenosha County, IL-WI1.0440
Lake County, IL
Kenosha County, WI
29460Lakeland, FL0.8921
Polk County, FL
29540Lancaster, PA0.9704
Lancaster County, PA
29620Lansing-East Lansing, MI0.9792
Clinton County, MI
Eaton County, MI
Ingham County, MI
29700Laredo, TX0.8076
Webb County, TX
29740Las Cruces, NM0.8475
Dona Ana County, NM
29820Las Vegas-Paradise, NV1.1449
Clark County, NV
29940Lawrence, KS0.8546
Douglas County, KS
30020Lawton, OK0.7880
Comanche County, OK
30140Lebanon, PA0.8468
Lebanon County, PA
30300Lewiston, ID-WA0.9896
Nez Perce County, ID
Asotin County, WA
30340Lewiston-Auburn, ME0.9341
Androscoggin County, ME
30460Lexington-Fayette, KY0.9084
Bourbon County, KY
Clark County, KY
Fayette County, KY
Jessamine County, KY
Scott County, KY
Woodford County, KY
30620Lima, OH0.9234
Allen County, OH
30700Lincoln, NE1.0225
Lancaster County, NE
Seward County, NE
30780Little Rock-North Little Rock, AR0.8756
Faulkner County, AR
Grant County, AR
Lonoke County, AR
Perry County, AR
Pulaski County, AR
Saline County, AR
30860Logan, UT-ID0.9173
Franklin County, ID
Cache County, UT
30980Longview, TX0.8739
Gregg County, TX
Rusk County, TX
Upshur County, TX
31020Longview, WA0.9523
Cowlitz County, WA
31084Los AngelesLong Beach-Glendale, CA1.1752
Los Angeles County, CA
31140Louisville, KY-IN0.9261
Clark County, IN
Floyd County, IN
Start Printed Page 40811
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
31180Lubbock, TX0.8792
Crosby County, TX
Lubbock County, TX
31340Lynchburg, VA0.8700
Amherst County, VA
Appomattox County, VA
Bedford County, VA
Campbell County, VA
Bedford City, VA
Lynchburg City, VA
31420Macon, GA0.9453
Bibb County, GA
Crawford County, GA
Jones County, GA
Monroe County, GA
Twiggs County, GA
31460Madera, CA0.8721
Madera County, CA
31540Madison, WI1.0635
Columbia County, WI
Dane County, WI
Iowa County, WI
31700Manchester-Nashua, NH1.0335
Hillsborough County, NH
Merrimack County, NH
31900 2Mansfield, OH0.8887
Richland County, OH
32420Mayagüez, PR0.4017
Hormigueros Municipio, PR
Mayagüez Municipio, PR
32580McAllen-Edinburg-Pharr, TX0.8943
Hidalgo County, TX
32780Medford, OR1.0235
Jackson County, OR
32820Memphis, TN-MS-AR0.9341
Crittenden County, AR
DeSoto County, MS
Marshall County, MS
Tate County, MS
Tunica County, MS
Fayette County, TN
Shelby County, TN
Tipton County, TN
32900Merced, CA1.1120
Merced County, CA
33124Miami-Miami Beach-Kendall, FL0.9759
Miami-Dade County, FL
33140Michigan CityLa Porte, IN0.9409
LaPorte County, IN
33260Midland, TX0.9523
Midland County, TX
33340Milwaukee-Waukesha-West Allis, WI1.0106
Milwaukee County, WI
Ozaukee County, WI
Washington County, WI
Waukesha County, WI
33460Minneapolis-St. Paul-Bloomington, MN-WI1.1078
Anoka County, MN
Carver County, MN
Start Printed Page 40812
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
33540Missoula, MT0.9482
Missoula County, MT
33660Mobile, AL0.7895
Mobile County, AL
33700Modesto, CA1.1804
Stanislaus County, CA
33740Monroe, LA0.8040
Ouachita Parish, LA
Union Parish, LA
33780Monroe, MI0.9478
Monroe County, MI
33860Montgomery, AL0.8588
Autauga County, AL
Elmore County, AL
Lowndes County, AL
Montgomery County, AL
34060Morgantown, WV0.8428
Monongalia County, WV
Preston County, WV
34100Morristown, TN0.8753
Grainger County, TN
Hamblen County, TN
Jefferson County, TN
34580Mount Vernon-Anacortes, WA1.0465
Skagit County, WA
34620Muncie, IN0.8939
Delaware County, IN
34740Muskegon-Norton Shores, MI0.9673
Muskegon County, MI
34820Myrtle Beach-Conway-North Myrtle Beach, SC0.8873
Horry County, SC
34900Napa, CA1.2656
Napa County, CA
34940Naples-Marco Island, FL1.0140
Collier County, FL
34980Nashville-Davidson-Murfreesboro, TN0.9769
Cannon County, TN
Cheatham County, TN
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
35004Nassau-Suffolk, NY1.2760
Nassau County, NY
Suffolk County, NY
35084Newark-Union, NJ-PA1.2195
Essex County, NJ
Hunterdon County, NJ
Morris County, NJ
Sussex County, NJ
Union County, NJ
Pike County, PA
Start Printed Page 40813
35300New Haven-Milford, CT1.1702
New Haven County, CT
35380New Orleans-Metairie-Kenner, LA0.9005
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
35644New York-Wayne-White Plains, NY-NJ1.3185
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
35660Niles-Benton Harbor, MI0.8888
Berrien County, MI
35980Norwich-New London, CT1.1356
New London County, CT
36084Oakland-Fremont-Hayward, CA1.5346
Alameda County, CA
Contra Costa County, CA
36100Ocala, FL0.8934
Marion County, FL
36140Ocean City, NJ1.1022
Cape May County, NJ
36220Odessa, TX0.9894
Ector County, TX
36260Ogden-Clearfield, UT0.9038
Davis County, UT
Morgan County, UT
Weber County, UT
36420Oklahoma City, OK0.9040
Canadian County, OK
Cleveland County, OK
Grady County, OK
Lincoln County, OK
Logan County, OK
McClain County, OK
Oklahoma County, OK
36500Olympia, WA1.0938
Thurston County, WA
36540Omaha-Council Bluffs, NE-IA0.9569
Harrison County, IA
Mills County, IA
Pottawattamie County, IA
Cass County, NE
Douglas County, NE
Sarpy County, NE
Saunders County, NE
Washington County, NE
36740Orlando, FL0.9459
Lake County, FL
Orange County, FL
Osceola County, FL
Seminole County, FL
36780Oshkosh-Neenah, WI0.9192
Winnebago County, WI
36980Owensboro, KY0.8789
Daviess County, KY
Hancock County, KY
McLean County, KY
37100Oxnard-Thousand Oaks-Ventura, CA1.1613
Start Printed Page 40814
Ventura County, CA
37340Palm Bay-Melbourne-Titusville, FL0.9835
Brevard County, FL
37460Panama City-Lynn Haven, FL0.7989
Bay County, FL
37620Parkersburg-Marietta, WV-OH0.8278
Washington County, OH
Pleasants County, WV
Wirt County, WV
Wood County, WV
37700Pascagoula, MS0.8165
George County, MS
Jackson County, MS
37860Pensacola-Ferry Pass-Brent, FL0.8104
Escambia County, FL
Santa Rosa County, FL
37900Peoria, IL0.8868
Marshall County, IL
Peoria County, IL
Stark County, IL
Tazewell County, IL
Woodford County, IL
37964Philadelphia, PA1.1040
Bucks County, PA
Chester County, PA
Delaware County, PA
Montgomery County, PA
Philadelphia County, PA
38060Phoenix-Mesa-Scottsdale, AZ1.0138
Maricopa County, AZ
Pinal County, AZ
38220Pine Bluff, AR0.8689
Cleveland County, AR
Jefferson County, AR
Lincoln County, AR
38300Pittsburgh, PA0.8853
Allegheny County, PA
Armstrong County, PA
Beaver County, PA
Butler County, PA
Fayette County, PA
Washington County, PA
Westmoreland County, PA
38340Pittsfield, MA1.0191
Berkshire County, MA
38540Pocatello, ID0.9360
Bannock County, ID
Power County, ID
38660Ponce, PR0.5177
Juana Díaz Municipio, PR
Ponce Municipio, PR
Villalba Municipio, PR
38860Portland-South Portland-Biddeford, ME1.0392
Cumberland County, ME
Sagadahoc County, ME
York County, ME
38900Portland-Vancouver-Beaverton, OR-WA1.1260
Clackamas County, OR
Columbia County, OR
Multnomah County, OR
Washington County, OR
Yamhill County, OR
Clark County, WA
Skamania County, WA
38940Port St. Lucie-Fort Pierce, FL1.0133
Martin County, FL
St. Lucie County, FL
39100Poughkeepsie-Newburgh-Middletown, NY1.0766
Dutchess County, NY
Orange County, NY
Start Printed Page 40815
39140Prescott, AZ0.9879
Yavapai County, AZ
39300Providence-New Bedford-Fall River, RI-MA1.0966
Bristol County, MA
Bristol County, RI
Kent County, RI
Newport County, RI
Providence County, RI
Washington County, RI
39340Provo-Orem, UT0.9510
Juab County, UT
Utah County, UT
39380Pueblo, CO0.8632
Pueblo County, CO
39460Punta Gorda, FL0.9264
Charlotte County, FL
39540Racine, WI0.9006
Racine County, WI
39580Raleigh-Cary, NC0.9733
Franklin County, NC
Johnston County, NC
Wake County, NC
39660Rapid City, SD0.9021
Meade County, SD
Pennington County, SD
39740Reading, PA0.9696
Berks County, PA
39820Redding, CA1.2215
Shasta County, CA
39900Reno-Sparks, NV1.0993
Storey County, NV
Washoe County, NV
40060Richmond, VA0.9338
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
40140Riverside-San Bernardino-Ontario, CA1.1022
Riverside County, CA
San Bernardino County, CA
40220Roanoke, VA0.8383
Botetourt County, VA
Craig County, VA
Franklin County, VA
Roanoke County, VA
Roanoke City, VA
Salem City, VA
40340Rochester, MN1.1142
Dodge County, MN
Olmsted County, MN
Wabasha County, MN
40380Rochester, NY0.9115
Livingston County, NY
Monroe County, NY
Start Printed Page 40816
Ontario County, NY
Orleans County, NY
Wayne County, NY
40420Rockford, IL0.9994
Boone County, IL
Winnebago County, IL
40484Rockingham County-Strafford County, NH1.0385
Rockingham County, NH
Strafford County, NH
40580Rocky Mount, NC0.8924
Edgecombe County, NC
Nash County, NC
40660Rome, GA0.9424
Floyd County, GA
40900Sacramento-Arden-Arcade-Roseville, CA1.2973
El Dorado County, CA
Placer County, CA
Sacramento County, CA
Yolo County, CA
40980Saginaw-Saginaw Township North, MI0.9420
Saginaw County, MI
41060St. Cloud, MN0.9975
Benton County, MN
Stearns County, MN
41100St. George, UT0.9402
Washington County, UT
41140St. Joseph, MO-KS0.9529
Doniphan County, KS
Andrew County, MO
Buchanan County, MO
DeKalb County, MO
41180St. Louis, MO-IL0.8949
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
Jefferson County, MO
Lincoln County, MO
St. Charles County, MO
St. Louis County, MO
Warren County, MO
Washington County, MO
St. Louis City, MO
41420Salem, OR1.0452
Marion County, OR
Polk County, OR
41500Salinas, CA1.4142
Monterey County, CA
41540Salisbury, MD0.9073
Somerset County, MD
Wicomico County, MD
41620Salt Lake City, UT0.9433
Salt Lake County, UT
Summit County, UT
Tooele County, UT
41660San Angelo, TX0.8280
Irion County, TX
Tom Green County, TX
41700San Antonio, TX0.8989
Atascosa County, TX
Bandera County, TX
Bexar County, TX
Comal County, TX
Guadalupe County, TX
Start Printed Page 40817
Kendall County, TX
Medina County, TX
Wilson County, TX
41740San Diego-Carlsbad-San Marcos, CA1.1424
San Diego County, CA
41780Sandusky, OH0.9025
Erie County, OH
41884San Francisco-San Mateo-Redwood City, CA1.4990
Marin County, CA
San Francisco County, CA
San Mateo County, CA
41900San Germán-Cabo Rojo, PR0.4655
Cabo Rojo Municipio, PR
Lajas Municipio, PR
Sabana Grande Municipio, PR
San Germán Municipio, PR
41940San Jose-Sunnyvale-Santa Clara, CA1.5125
San Benito County, CA
Santa Clara County, CA
41980San Juan-Caguas-Guaynabo, PR0.4686
Aguas Buenas Municipio, PR
Aibonito Municipio, PR
Arecibo Municipio, PR
Barceloneta Municipio, PR
Barranquitas Municipio, PR
Bayamón Municipio, PR
Caguas Municipio, PR
Camuy Municipio, PR
Canóvanas Municipio, PR
Carolina Municipio, PR
Cataño Municipio, PR
Cayey Municipio, PR
Ciales Municipio, PR
Cidra Municipio, PR
Comerío 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
Loíza Municipio, PR
Manatí Municipio, PR
Maunabo Municipio, PR
Morovis Municipio, PR
Naguabo Municipio, PR
Naranjito Municipio, PR
Orocovis Municipio, PR
Quebradillas Municipio, PR
Río 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
42020San Luis Obispo-Paso Robles, CA1.1360
San Luis Obispo County, CA
42044Santa Ana-Anaheim-Irvine, CA1.1576
Orange County, CA
42060Santa Barbara-Santa Maria-Goleta, CA1.1538
Santa Barbara County, CA
42100Santa Cruz-Watsonville, CA1.5182
Santa Cruz County, CA
42140Santa Fe, NM1.0931
Start Printed Page 40818
Santa Fe County, NM
42220Santa Rosa-Petaluma, CA1.3506
Sonoma County, CA
42260Sarasota-Bradenton-Venice, FL0.9555
Manatee County, FL
Sarasota County, FL
42340Savannah, GA0.9480
Bryan County, GA
Chatham County, GA
Effingham County, GA
42540Scranton-WilkesBarre, PA0.8548
Lackawanna County, PA
Luzerne County, PA
Wyoming County, PA
42644Seattle-Bellevue-Everett, WA1.1589
King County, WA
Snohomish County, WA
43100Sheboygan, WI0.8920
Sheboygan County, WI
43300Sherman-Denison, TX0.9516
Grayson County, TX
43340Shreveport-Bossier City, LA0.8769
Bossier Parish, LA
Caddo Parish, LA
De Soto Parish, LA
43580Sioux City, IA-NE-SD0.9376
Woodbury County, IA
Dakota County, NE
Dixon County, NE
Union County, SD
43620Sioux Falls, SD0.9645
Lincoln County, SD
McCook County, SD
Minnehaha County, SD
Turner County, SD
43780South Bend-Mishawaka, IN-MI0.9798
St. Joseph County, IN
Cass County, MI
43900Spartanburg, SC0.9181
Spartanburg County, SC
44060Spokane, WA1.0916
Spokane County, WA
44100Springfield, IL0.8885
Menard County, IL
Sangamon County, IL
44140Springfield, MA1.0259
Franklin County, MA
Hampden County, MA
Hampshire County, MA
44180Springfield, MO0.8246
Christian County, MO
Dallas County, MO
Greene County, MO
Polk County, MO
Webster County, MO
44220Springfield, OH0.8404
Clark County, OH
44300State College, PA0.8364
Centre County, PA
44700Stockton, CA1.1311
San Joaquin County, CA
44940Sumter, SC0.8386
Sumter County, SC
45060Syracuse, NY0.9581
Madison County, NY
Onondaga County, NY
Oswego County, NY
45104Tacoma, WA1.0753
Pierce County, WA
45220Tallahassee, FL0.8697
Start Printed Page 40819
Gadsden County, FL
Jefferson County, FL
Leon County, FL
Wakulla County, FL
45300Tampa-St. Petersburg-Clearwater, FL0.9193
Hernando County, FL
Hillsborough County, FL
Pasco County, FL
Pinellas County, FL
45460Terre Haute, IN0.8313
Clay County, IN
Sullivan County, IN
Vermillion County, IN
Vigo County, IN
45500Texarkana, TX-Texarkana, AR0.8291
Miller County, AR
Bowie County, TX
45780Toledo, OH0.9584
Fulton County, OH
Lucas County, OH
Ottawa County, OH
Wood County, OH
45820Topeka, KS0.8929
Jackson County, KS
Jefferson County, KS
Osage County, KS
Shawnee County, KS
Wabaunsee County, KS
45940Trenton-Ewing, NJ1.0845
Mercer County, NJ
46060Tucson, AZ0.8987
Pima County, AZ
46140Tulsa, OK0.8286
Creek County, OK
Okmulgee County, OK
Osage County, OK
Pawnee County, OK
Rogers County, OK
Tulsa County, OK
Wagoner County, OK
46220Tuscaloosa, AL0.8721
Greene County, AL
Hale County, AL
Tuscaloosa County, AL
46340Tyler, TX0.9307
Smith County, TX
46540Utica-Rome, NY0.8293
Herkimer County, NY
Oneida County, NY
46660Valdosta, GA0.8875
Brooks County, GA
Echols County, GA
Lanier County, GA
Lowndes County, GA
46700Vallejo-Fairfield, CA1.4899
Solano County, CA
46940Vero Beach, FL0.9444
Indian River County, FL
47020Victoria, TX0.8168
Calhoun County, TX
Goliad County, TX
Victoria County, TX
47220Vineland-Millville-Bridgeton, NJ0.9837
Cumberland County, NJ
47260Virginia Beach-Norfolk Newport News, VA-NC0.8808
Currituck County, NC
Gloucester County, VA
Isle of Wight County, VA
James City County, VA
Mathews County, VA
Start Printed Page 40820
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
47300Visalia-Porterville, CA1.0074
Tulare County, CA
47380Waco, TX0.8527
McLennan County, TX
47580Warner Robins, GA0.8654
Houston County, GA
47644Warren-Farmington Hills-Troy, MI0.9861
Lapeer County, MI
Livingston County, MI
Macomb County, MI
Oakland County, MI
St. Clair County, MI
47894Washington-Arlington-Alexandria, DC-VA-MD-WV1.0932
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
47940Waterloo-Cedar Falls, IA0.8566
Black Hawk County, IA
Bremer County, IA
Grundy County, IA
48140Wausau, WI0.9600
Marathon County, WI
48260Weirton-Steubenville, WV-OH0.7827
Jefferson County, OH
Brooke County, WV
Hancock County, WV
48300Wenatchee, WA1.0080
Chelan County, WA
Douglas County, WA
48424West Palm Beach-Boca Raton-Boynton Beach, FL1.0077
Palm Beach County, FL
48540Wheeling, WV-OH0.7168
Belmont County, OH
Marshall County, WV
Ohio County, WV
48620Wichita, KS0.9141
Butler County, KS
Harvey County, KS
Sedgwick County, KS
Sumner County, KS
48660Wichita Falls, TX0.8294
Archer County, TX
Start Printed Page 40821
Clay County, TX
Wichita County, TX
48700Williamsport, PA0.8377
Lycoming County, PA
48864Wilmington, DE-MD-NJ1.0482
New Castle County, DE
Cecil County, MD
Salem County, NJ
48900Wilmington, NC0.9592
Brunswick County, NC
New Hanover County, NC
Pender County, NC
49020Winchester, VA-WV1.0224
Frederick County, VA
Winchester City, VA
Hampshire County, WV
49180Winston Salem, NC0.8953
Davie County, NC
Forsyth County, NC
Stokes County, NC
Yadkin County, NC
49340Worcester, MA1.1039
Worcester County, MA
49420Yakima, WA1.0165
Yakima County, WA
49500Yauco, PR0.4413
Guánica Municipio, PR
Guayanilla Municipio, PR
Peñuelas Municipio, PR
Yauco Municipio, PR
49620York-Hanover, PA0.9420
York County, PA
49660Youngstown-Warren-Boardman, OH-PA0.8611
Mahoning County, OH
Trumbull County, OH
Mercer County, PA
49700Yuba City, CA1.0932
Sutter County, CA
Yuba County, CA
49740Yuma, AZ0.9135
Yuma County, AZ
2 At this time, there are no hospitals in these urban areas on which to base a wage index. Therefore, the urban wage index value is based on the average wage index of all urban areas within the State.

Addendum C.—MSA/CBSA Crosswalk

State/countyCounty nameMSAMSA WICBSA WICBSA
01000Autauga County, Alabama52400.85880.858833860
01010Baldwin County, Alabama51600.78660.747799901
01020Barbour County, Alabama010.74630.747799901
01030Bibb County, Alabama010.74630.897913820
01040Blount County, Alabama10000.90210.897913820
01050Bullock County, Alabama010.74630.747799901
01060Butler County, Alabama010.74630.747799901
01070Calhoun County, Alabama04500.76590.765911500
01080Chambers County, Alabama010.74630.747799901
01090Cherokee County, Alabama010.74630.747799901
01100Chilton County, Alabama010.74630.897913820
01110Choctaw County, Alabama010.74630.747799901
01120Clarke County, Alabama010.74630.747799901
01130Clay County, Alabama010.74630.747799901
01140Cleburne County, Alabama010.74630.747799901
01150Coffee County, Alabama010.74630.747799901
01160Colbert County, Alabama26500.82800.828022520
01170Conecuh County, Alabama010.74630.747799901
01180Coosa County, Alabama010.74630.747799901
01190Covington County, Alabama010.74630.747799901
Start Printed Page 40822
01200Crenshaw County, Alabama010.74630.747799901
01210Cullman County, Alabama010.74630.747799901
01220Dale County, Alabama21800.76870.747799901
01230Dallas County, Alabama010.74630.747799901
01240De Kalb County, Alabama010.74630.747799901
01250Elmore County, Alabama52400.85880.858833860
01260Escambia County, Alabama010.74630.747799901
01270Etowah County, Alabama28800.79460.794623460
01280Fayette County, Alabama010.74630.747799901
01290Franklin County, Alabama010.74630.747799901
01300Geneva County, Alabama010.74630.770720020
01310Greene County, Alabama010.74630.872146220
01320Hale County, Alabama010.74630.872146220
01330Henry County, Alabama010.74630.770720020
01340Houston County, Alabama21800.76870.770720020
01350Jackson County, Alabama010.74630.747799901
01360Jefferson County, Alabama10000.90210.897913820
01370Lamar County, Alabama010.74630.747799901
01380Lauderdale County, Alabama26500.82800.828022520
01390Lawrence County, Alabama20300.84780.847819460
01400Lee County, Alabama05800.81080.810812220
01410Limestone County, Alabama34400.91490.914926620
01420Lowndes County, Alabama010.74630.858833860
01430Macon County, Alabama010.74630.747799901
01440Madison County, Alabama34400.91490.914926620
01450Marengo County, Alabama010.74630.747799901
01460Marion County, Alabama010.74630.747799901
01470Marshall County, Alabama010.74630.747799901
01480Mobile County, Alabama51600.78660.789533660
01490Monroe County, Alabama010.74630.747799901
01500Montgomery County, Alabama52400.85880.858833860
01510Morgan County, Alabama20300.84780.847819460
01520Perry County, Alabama010.74630.747799901
01530Pickens County, Alabama010.74630.747799901
01540Pike County, Alabama010.74630.747799901
01550Randolph County, Alabama010.74630.747799901
01560Russell County, Alabama18000.85680.856817980
01570St Clair County, Alabama10000.90210.897913820
01580Shelby County, Alabama10000.90210.913820
01590Sumter County, Alabama010.74630.747799901
01600Talladega County, Alabama010.74630.747799901
01610Tallapoosa County, Alabama010.74630.747799901
01620Tuscaloosa County, Alabama86000.88420.872146220
01630Walker County, Alabama010.74630.897913820
01640Washington County, Alabama010.74630.747799901
01650Wilcox County, Alabama010.74630.747799901
01660Winston County, Alabama010.74630.747799901
02013Aleutians County East, Alaska021.19001.199099902
02016Aleutians County West, Alaska021.19001.199099902
02020Anchorage County, Alaska03801.20221.211011260
02030Angoon County, Alaska021.19001.199099902
02040Barrow-North Slope County, Alaska021.19001.199099902
02050Bethel County, Alaska021.19001.199099902
02060Bristol Bay Borough County, Alaska021.19001.199099902
02068Denali County, Alaska021.19001.199099902
02070Bristol Bay County, Alaska021.19001.199099902
02080Cordova-McCarthy County, Alaska021.19001.199099902
02090Fairbanks County, Alaska021.19001.141921820
02100Haines County, Alaska021.19001.199099902
02110Juneau County, Alaska021.19001.199099902
02120Kenai-Cook Inlet County, Alaska021.19001.199099902
02122Kenai Peninsula Borough, Alaska021.19001.199099902
02130Ketchikan County, Alaska021.19001.199099902
02140Kobuk County, Alaska021.19001.199099902
02150Kodiak County, Alaska021.19001.199099902
02160Kuskokwin County, Alaska021.19001.199099902
02164Lake and Peninsula Borough, Alaska021.19001.199099902
02170Matanuska County, Alaska021.19001.211011260
02180Nome County, Alaska021.19001.199099902
02185North Slope Borough, Alaska021.19001.199099902
02188Northwest Arctic Borough, Alaska021.19001.199099902
Start Printed Page 40823
02190Outer Ketchikan County, Alaska021.19001.199099902
02200Prince Of Wales County, Alaska021.19001.199099902
02201Prince of Wales Outer Ketchikan Census Area, Alaska021.19001.199099902
02210Seward County, Alaska021.19001.199099902
02220Sitka County, Alaska021.19001.199099902
02230Skagway-Yakutat County, Alaska021.19001.199099902
02231Skagway-Yakutat-Angoon Census Area, Alaska021.19001.199099902
02232Skagway-Hoonah-Angoon Census Area, Alaska021.19001.199099902
02240Southeast Fairbanks County, Alaska021.19001.199099902
02250Upper Yukon County, Alaska021.19001.199099902
02260Valdz-Chitna-Whitier County, Alaska021.19001.199099902
02261Valdex-Cordove Census Area, Alaska021.19001.199099902
02270Wade Hampton County, Alaska021.19001.199099902
02280Wrangel-lPetersburg County, Alaska021.19001.199099902
02282Yakutat Borough, Alaska021.19001.199099902
02290Yukon-Koyukuk County, Alaska021.19001.199099902
03000Apache County, Arizona030.90540.877799903
03010Cochise County, Arizona030.90540.877799903
03020Coconino County, Arizona26201.18571.210522380
03030Gila County, Arizona030.90540.877799903
03040Graham County, Arizona030.90540.877799903
03050Greenlee County, Arizona030.90540.877799903
03055La Paz County, Arizona030.90540.877799903
03060Maricopa County, Arizona62001.01381.013838060
03070Mohave County, Arizona41201.11660.877799903
03080Navajo County, Arizona030.90540.877799903
03090Pima County, Arizona85200.89870.898746060
03100Pinal County, Arizona62001.01381.013838060
03110Santa Cruz County, Arizona030.90540.877799903
03120Yavapai County, Arizona030.90540.987939140
03130Yuma County, Arizona93600.91350.913549740
04000Arkansas County, Arkansas040.77440.745199904
04010Ashley County, Arkansas040.77440.745199904
04020Baxter County, Arkansas040.77440.745199904
04030Benton County, Arkansas25800.85630.856322220
04040Boone County, Arkansas040.77440.745199904
04050Bradley County, Arkansas040.77440.745199904
04060Calhoun County, Arkansas040.77440.745199904
04070Carroll County, Arkansas040.77440.745199904
04080Chicot County, Arkansas040.77440.745199904
04090Clark County, Arkansas040.77440.745199904
04100Clay County, Arkansas040.77440.745199904
04110Cleburne County, Arkansas040.77440.745199904
04120Cleveland County, Arkansas040.77440.868938220
04130Columbia County, Arkansas040.77440.745199904
04140Conway County, Arkansas040.77440.745199904
04150Craighead County, Arkansas37000.79190.791927860
04160Crawford County, Arkansas27200.82290.821422900
04170Crittenden County, Arkansas49200.93600.934132820
04180Cross County, Arkansas040.77440.745199904
04190Dallas County, Arkansas040.77440.745199904
04200Desha County, Arkansas040.77440.745199904
04210Drew County, Arkansas040.77440.745199904
04220Faulkner County, Arkansas44000.87560.875630780
04230Franklin County, Arkansas040.77440.821422900
04240Fulton County, Arkansas040.77440.745199904
04250Garland County, Arkansas040.77440.905326300
04260Grant County, Arkansas040.77440.875630780
04270Greene County, Arkansas040.77440.745199904
04280Hempstead County, Arkansas040.77440.745199904
04290Hot Spring County, Arkansas040.77440.745199904
04300Howard County, Arkansas040.77440.745199904
04310Independence County, Arkansas040.77440.745199904
04320Izard County, Arkansas040.77440.745199904
04330Jackson County, Arkansas040.77440.745199904
04340Jefferson County, Arkansas62400.86890.868938220
04350Johnson County, Arkansas040.77440.745199904
04360Lafayette County, Arkansas040.77440.745199904
04370Lawrence County, Arkansas040.77440.745199904
04380Lee County, Arkansas040.77440.745199904
04390Lincoln County, Arkansas040.77440.868938220
Start Printed Page 40824
04400Little River County, Arkansas040.77440.745199904
04410Logan County, Arkansas040.77440.745199904
04420Lonoke County, Arkansas44000.87560.875630780
04430Madison County, Arkansas040.77440.856322220
04440Marion County, Arkansas040.77440.745199904
04450Miller County, Arkansas83600.82910.829145500
04460Mississippi County, Arkansas040.77440.745199904
04470Monroe County, Arkansas040.77440.745199904
04480Montgomery County, Arkansas040.77440.745199904
04490Nevada County, Arkansas040.77440.745199904
04500Newton County, Arkansas040.77440.745199904
04510Ouachita County, Arkansas040.77440.745199904
04520Perry County, Arkansas040.77440.875630780
04530Phillips County, Arkansas040.77440.745199904
04540Pike County, Arkansas040.77440.745199904
04550Poinsett County, Arkansas040.77440.791927860
04560Polk County, Arkansas040.77440.745199904
04570Pope County, Arkansas040.77440.745199904
04580Prairie County, Arkansas040.77440.745199904
04590Pulaski County, Arkansas44000.87560.875630780
04600Randolph County, Arkansas040.77440.745199904
04610St Francis County, Arkansas040.77440.745199904
04620Saline County, Arkansas44000.87560.875630780
04630Scott County, Arkansas040.77440.745199904
04640Searcy County, Arkansas040.77440.745199904
04650Sebastian County, Arkansas27200.82290.821422900
04660Sevier County, Arkansas040.77440.745199904
04670Sharp County, Arkansas040.77440.745199904
04680Stone County, Arkansas040.77440.745199904
04690Union County, Arkansas040.77440.745199904
04700Van Buren County, Arkansas040.77440.745199904
04710Washington County, Arkansas25800.85630.856322220
04720White County, Arkansas040.77440.745199904
04730Woodruff County, Arkansas040.77440.745199904
04740Yell County, Arkansas040.77440.745199904
05000Alameda County, California57751.53461.534636084
05010Alpine County, California051.06391.085799905
05020Amador County, California051.06391.085799905
05030Butte County, California16201.05221.052217020
05040Calaveras County, California051.06391.085799905
05050Colusa County, California051.06391.085799905
05060Contra Costa County, California57751.53461.534636084
05070Del Norte County, California051.06391.085799905
05080Eldorado County, California69201.31481.297340900
05090Fresno County, California28401.04321.054123420
05100Glenn County, California051.06391.085799905
05110Humboldt County, California051.06391.085799905
05120Imperial County, California051.06390.891520940
05130Inyo County, California051.06391.085799905
05140Kern County, California06801.03441.034412540
05150Kings County, California051.06391.004625260
05160Lake County, California051.06391.085799905
05170Lassen County, California051.06391.085799905
05200Los Angeles County, California44801.17521.175231084
05210Los Angeles County, California44801.17521.175231084
05300Madera County, California28401.04320.872131460
05310Marin County, California73601.49901.499041884
05320Mariposa County, California051.06391.085799905
05330Mendocino County, California051.06391.085799905
05340Merced County, California49401.11201.112032900
05350Modoc County, California051.06391.085799905
05360Mono County, California051.06391.085799905
05370Monterey County, California71201.41421.414241500
05380Napa County, California87201.39661.265634900
05390Nevada County, California051.06391.085799905
05400Orange County, California59451.15761.157642044
05410Placer County, California69201.31481.297340900
05420Plumas County, California051.06391.085799905
05430Riverside County, California67801.10221.102240140
05440Sacramento County, California69201.31481.297340900
05450San Benito County, California051.06391.512541940
Start Printed Page 40825
05460San Bernardino County, California67801.10221.102240140
05470San Diego County, California73201.14241.142441740
05480San Francisco County, California73601.49901.499041884
05490San Joaquin County, California81201.13111.131144700
05500San Luis Obispo County, California74601.13601.136042020
05510San Mateo County, California73601.49901.499041884
05520Santa Barbara County, California74801.15381.153842060
05530Santa Clara County, California74001.51441.512541940
05540Santa Cruz County, California74851.51821.518242100
05550Shasta County, California66901.22151.221539820
05560Sierra County, California051.06391.085799905
05570Siskiyou County, California051.06391.085799905
05580Solano County, California87201.39661.489946700
05590Sonoma County, California75001.35061.350642220
05600Stanislaus County, California51701.18041.180433700
05610Sutter County, California93401.09321.093249700
05620Tehama County, California051.06391.085799905
05630Trinity County, California051.06391.085799905
05640Tulare County, California87801.00741.007447300
05650Tuolumne County, California051.06391.085799905
05660Ventura County, California87351.16131.161337100
05670Yolo County, California92700.99491.297340900
05680Yuba County, California93401.09321.093249700
06000Adams County, Colorado20801.07331.073319740
06010Alamosa County, Colorado060.93890.938999906
06020Arapahoe County, Colorado20801.07331.073319740
06030Archuleta County, Colorado060.93890.938999906
06040Baca County, Colorado060.93890.938999906
06050Bent County, Colorado060.93890.938999906
06060Boulder County, Colorado11250.97440.974414500
06070Chaffee County, Colorado060.93890.938999906
06080Cheyenne County, Colorado060.93890.938999906
06090Clear Creek County, Colorado060.93891.073319740
06100Conejos County, Colorado060.93890.938999906
06110Costilla County, Colorado060.93890.938999906
06120Crowley County, Colorado060.93890.938999906
06130Custer County, Colorado060.93890.938999906
06140Delta County, Colorado060.93890.938999906
06150Denver County, Colorado20801.07331.073319740
06160Dolores County, Colorado060.93890.938999906
06170Douglas County, Colorado20801.07331.073319740
06180Eagle County, Colorado060.93890.938999906
06190Elbert County, Colorado060.93891.073319740
06200El Paso County, Colorado17200.94780.947817820
06210Fremont County, Colorado060.93890.938999906
06220Garfield County, Colorado060.93890.938999906
06230Gilpin County, Colorado060.93891.073319740
06240Grand County, Colorado060.93890.938999906
06250Gunnison County, Colorado060.93890.938999906
06260Hinsdale County, Colorado060.93890.938999906
06270Huerfano County, Colorado060.93890.938999906
06280Jackson County, Colorado060.93890.938999906
06290Jefferson County, Colorado20801.07331.073319740
06300Kiowa County, Colorado060.93890.938999906
06310Kit Carson County, Colorado060.93890.938999906
06320Lake County, Colorado060.93890.938999906
06330La Plata County, Colorado060.93890.938999906
06340Larimer County, Colorado26701.01321.013222660
06350Las Animas County, Colorado060.93890.938999906
06360Lincoln County, Colorado060.93890.938999906
06370Logan County, Colorado060.93890.938999906
06380Mesa County, Colorado29950.95600.956024300
06390Mineral County, Colorado060.93890.938999906
06400Moffat County, Colorado060.93890.938999906
06410Montezuma County, Colorado060.93890.938999906
06420Montrose County, Colorado060.93890.938999906
06430Morgan County, Colorado060.93890.938999906
06440Otero County, Colorado060.93890.938999906
06450Ouray County, Colorado060.93890.938999906
06460Park County, Colorado060.93891.073319740
06470Phillips County, Colorado060.93890.938999906
Start Printed Page 40826
06480Pitkin County, Colorado060.93890.938999906
06490Prowers County, Colorado060.93890.938999906
06500Pueblo County, Colorado65600.86320.863239380
06510Rio Blanco County, Colorado060.93890.938999906
06520Rio Grande County, Colorado060.93890.938999906
06530Routt County, Colorado060.93890.938999906
06540Saguache County, Colorado060.93890.938999906
06550San Juan County, Colorado060.93890.938999906
06560San Miguel County, Colorado060.93890.938999906
06570Sedgwick County, Colorado060.93890.938999906
06580Summit County, Colorado060.93890.938999906
06590Teller County, Colorado060.93890.947817820
06600Washington County, Colorado060.93890.938999906
06610Weld County, Colorado30600.95800.958024540
06620Yuma County, Colorado060.93890.938999906
06630Broomfield County, Colorado20801.07331.073319740
07000Fairfield County, Connecticut54831.20961.259814860
07010Hartford County, Connecticut32831.10841.108425540
07020Litchfield County, Connecticut32831.10841.108425540
07030Middlesex County, Connecticut32831.10841.108425540
07040New Haven County, Connecticut54831.20961.170235300
07050New London County, Connecticut55231.13561.135635980
07060Tolland County, Connecticut32831.10841.108425540
07070Windham County, Connecticut071.17941.179499907
08000Kent County, Delaware21900.97790.977920100
08010New Castle County, Delaware91601.05371.048248864
08020Sussex County, Delaware080.96060.960699908
09000Washington Dc County, Of Col Dist88401.09831.093247894
10000Alachua County, Florida29000.94740.947423540
10010Baker County, Florida100.86980.929927260
10020Bay County, Florida60150.79890.798937460
10030Bradford County, Florida100.86980.859899910
10040Brevard County, Florida49000.98350.983537340
10050Broward County, Florida26801.04421.044222744
10060Calhoun County, Florida100.86980.859899910
10070Charlotte County, Florida65800.92640.926439460
10080Citrus County, Florida100.86980.859899910
10090Clay County, Florida36000.93080.929927260
10100Collier County, Florida53451.01401.014034940
10110Columbia County, Florida100.86980.859899910
10120Dade County, Florida50000.97590.975933124
10130De Soto County, Florida100.86980.859899910
10140Dixie County, Florida100.86980.859899910
10150Duval County, Florida36000.93080.929927260
10160Escambia County, Florida60800.81040.810437860
10170Flagler County, Florida20200.93340.859899910
10180Franklin County, Florida100.86980.859899910
10190Gadsden County, Florida82400.86970.869745220
10200Gilchrist County, Florida100.86980.947423540
10210Glades County, Florida100.86980.859899910
10220Gulf County, Florida100.86980.859899910
10230Hamilton County, Florida100.86980.859899910
10240Hardee County, Florida100.86980.859899910
10250Hendry County, Florida100.86980.859899910
10260Hernando County, Florida82800.91930.919345300
10270Highlands County, Florida100.86980.859899910
10280Hillsborough County, Florida82800.91930.919345300
10290Holmes County, Florida100.86980.859899910
10300Indian River County, Florida100.86980.944446940
10310Jackson County, Florida100.86980.859899910
10320Jefferson County, Florida100.86980.869745220
10330Lafayette County, Florida100.86980.859899910
10340Lake County, Florida59600.94590.945936740
10350Lee County, Florida27000.93660.936615980
10360Leon County, Florida82400.86970.869745220
10370Levy County, Florida100.86980.859899910
10380Liberty County, Florida100.86980.859899910
10390Madison County, Florida100.86980.859899910
10400Manatee County, Florida75100.95550.955542260
10410Marion County, Florida57900.89340.893436100
10420Martin County, Florida27101.01331.013338940
Start Printed Page 40827
10430Monroe County, Florida100.86980.859899910
10440Nassau County, Florida36000.93080.929927260
10450Okaloosa County, Florida27500.88810.888123020
10460Okeechobee County, Florida100.86980.859899910
10470Orange County, Florida59600.94590.945936740
10480Osceola County, Florida59600.94590.945936740
10490Palm Beach County, Florida89601.00771.007748424
10500Pasco County, Florida82800.91930.919345300
10510Pinellas County, Florida82800.91930.919345300
10520Polk County, Florida39800.89210.892129460
10530Putnam County, Florida100.86980.859899910
10540Johns County, Florida36000.93080.929927260
10550St Lucie County, Florida27101.01331.013338940
10560Santa Rosa County, Florida60800.81040.810437860
10570Sarasota County, Florida75100.95550.955542260
10580Seminole County, Florida59600.94590.945936740
10590Sumter County, Florida100.86980.859899910
10600Suwannee County, Florida100.86980.859899910
10610Taylor County, Florida100.86980.859899910
10620Union County, Florida100.86980.859899910
10630Volusia County, Florida20200.93340.930819660
10640Wakulla County, Florida100.86980.869745220
10650Walton County, Florida100.86980.859899910
10660Washington County, Florida100.86980.859899910
11000Appling County, Georgia110.81650.766699911
11010Atkinson County, Georgia110.81650.766699911
11011Bacon County, Georgia110.81650.766699911
11020Baker County, Georgia110.81650.863610500
11030Baldwin County, Georgia110.81650.766699911
11040Banks County, Georgia110.81650.766699911
11050Barrow County, Georgia05200.96480.964812060
11060Bartow County, Georgia05200.96480.964812060
11070Ben Hill County, Georgia110.81650.766699911
11080Berrien County, Georgia110.81650.766699911
11090Bibb County, Georgia46800.92860.945331420
11100Bleckley County, Georgia110.81650.766699911
11110Brantley County, Georgia110.81650.932015260
11120Brooks County, Georgia110.81650.887546660
11130Bryan County, Georgia75200.94800.948042340
11140Bulloch County, Georgia110.81650.766699911
11150Burke County, Georgia110.81650.956512260
11160Butts County, Georgia110.81650.964812060
11161Calhoun County, Georgia110.81650.766699911
11170Camden County, Georgia110.81650.766699911
11180Candler County, Georgia110.81650.766699911
11190Carroll County, Georgia05200.96480.964812060
11200Catoosa County, Georgia15600.90980.909816860
11210Charlton County, Georgia110.81650.766699911
11220Chatham County, Georgia75200.94800.948042340
11230Chattahoochee County, Georgia18000.85680.856817980
11240Chattooga County, Georgia110.81650.766699911
11250Cherokee County, Georgia05200.96480.964812060
11260Clarke County, Georgia05000.98430.984312020
11270Clay County, Georgia110.81650.766699911
11280Clayton County, Georgia05200.96480.964812060
11281Clinch County, Georgia110.81650.766699911
11290Cobb County, Georgia05200.96480.964812060
11291Coffee County, Georgia110.81650.766699911
11300Colquitt County, Georgia110.81650.766699911
11310Columbia County, Georgia06000.96190.956512260
11311Cook County, Georgia110.81650.766699911
11320Coweta County, Georgia05200.96480.964812060
11330Crawford County, Georgia110.81650.945331420
11340Crisp County, Georgia110.81650.766699911
11341Dade County, Georgia15600.90980.909816860
11350Dawson County, Georgia110.81650.964812060
11360Decatur County, Georgia110.81650.766699911
11370De Kalb County, Georgia05200.96480.964812060
11380Dodge County, Georgia110.81650.766699911
11381Dooly County, Georgia110.81650.766699911
11390Dougherty County, Georgia01200.86360.863610500
Start Printed Page 40828
11400Douglas County, Georgia05200.96480.964812060
11410Early County, Georgia110.81650.766699911
11420Echols County, Georgia110.81650.887546660
11421Effingham County, Georgia75200.94800.948042340
11430Elbert County, Georgia110.81650.766699911
11440Emanuel County, Georgia110.81650.766699911
11441Evans County, Georgia110.81650.766699911
11450Fannin County, Georgia110.81650.766699911
11451Fayette County, Georgia05200.96480.964812060
11460Floyd County, Georgia110.81650.942440660
11461Forsyth County, Georgia05200.96480.964812060
11462Franklin County, Georgia110.81650.766699911
11470Fulton County, Georgia05200.96480.964812060
11471Gilmer County, Georgia110.81650.766699911
11480Glascock County, Georgia110.81650.766699911
11490Glynn County, Georgia110.81650.932015260
11500Gordon County, Georgia110.81650.766699911
11510Grady County, Georgia110.81650.766699911
11520Greene County, Georgia110.81650.766699911
11530Gwinnett County, Georgia05200.96480.964812060
11540Habersham County, Georgia110.81650.766699911
11550Hall County, Georgia110.81650.888323580
11560Hancock County, Georgia110.81650.766699911
11570Haralson County, Georgia110.81650.964812060
11580Harris County, Georgia18000.85680.856817980
11581Hart County, Georgia110.81650.766699911
11590Heard County, Georgia110.81650.964812060
11591Henry County, Georgia05200.96480.964812060
11600Houston County, Georgia46800.92860.865447580
11601Irwin County, Georgia110.81650.766699911
11610Jackson County, Georgia110.81650.766699911
11611Jasper County, Georgia110.81650.964812060
11612Jeff Davis County, Georgia110.81650.766699911
11620Jefferson County, Georgia110.81650.766699911
11630Jenkins County, Georgia110.81650.766699911
11640Johnson County, Georgia110.81650.766699911
11650Jones County, Georgia46800.92860.945331420
11651Lamar County, Georgia110.81650.964812060
11652Lanier County, Georgia110.81650.887546660
11660Laurens County, Georgia110.81650.766699911
11670Lee County, Georgia01200.86360.863610500
11680Liberty County, Georgia110.81650.917825980
11690Lincoln County, Georgia110.81650.766699911
11691Long County, Georgia110.81650.917825980
11700Lowndes County, Georgia110.81650.887546660
11701Lumpkin County, Georgia110.81650.766699911
11702Mc Duffie County, Georgia06000.96190.956512260
11703Mc Intosh County, Georgia110.81650.932015260
11710Macon County, Georgia110.81650.766699911
11720Madison County, Georgia05000.98430.984312020
11730Marion County, Georgia110.81650.856817980
11740Meriwether County, Georgia110.81650.964812060
11741Miller County, Georgia110.81650.766699911
11750Mitchell County, Georgia110.81650.766699911
11760Monroe County, Georgia110.81650.945331420
11770Montgomery County, Georgia110.81650.766699911
11771Morgan County, Georgia110.81650.766699911
11772Murray County, Georgia110.81650.904419140
11780Muscogee County, Georgia18000.85680.856817980
11790Newton County, Georgia05200.96480.964812060
11800Oconee County, Georgia05000.98430.984312020
11801Oglethorpe County, Georgia110.81650.984312020
11810Paulding County, Georgia05200.96480.964812060
11811Peach County, Georgia46800.92860.766699911
11812Pickens County, Georgia05200.96480.964812060
11820Pierce County, Georgia110.81650.766699911
11821Pike County, Georgia110.81650.964812060
11830Polk County, Georgia110.81650.766699911
11831Pulaski County, Georgia110.81650.766699911
11832Putnam County, Georgia110.81650.766699911
11833Quitman County, Georgia110.81650.766699911
Start Printed Page 40829
11834Rabun County, Georgia110.81650.766699911
11835Randolph County, Georgia110.81650.766699911
11840Richmond County, Georgia06000.96190.956512260
11841Rockdale County, Georgia05200.96480.964812060
11842Schley County, Georgia110.81650.766699911
11850Screven County, Georgia110.81650.766699911
11851Seminole County, Georgia110.81650.766699911
11860Spalding County, Georgia05200.96480.964812060
11861Stephens County, Georgia110.81650.766699911
11862Stewart County, Georgia110.81650.766699911
11870Sumter County, Georgia110.81650.766699911
11880Talbot County, Georgia110.81650.766699911
11881Taliaferro County, Georgia110.81650.766699911
11882Tattnall County, Georgia110.81650.766699911
11883Taylor County, Georgia110.81650.766699911
11884Telfair County, Georgia110.81650.766699911
11885Terrell County, Georgia110.81650.863610500
11890Thomas County, Georgia110.81650.766699911
11900Tift County, Georgia110.81650.766699911
11901Toombs County, Georgia110.81650.766699911
11902Towns County, Georgia110.81650.766699911
11903Treutlen County, Georgia110.81650.766699911
11910Troup County, Georgia110.81650.766699911
11911Turner County, Georgia110.81650.766699911
11912Twiggs County, Georgia46800.92860.945331420
11913Union County, Georgia110.81650.766699911
11920Upson County, Georgia110.81650.766699911
11921Walker County, Georgia15600.90980.909816860
11930Walton County, Georgia05200.96480.964812060
11940Ware County, Georgia110.81650.766699911
11941Warren County, Georgia110.81650.766699911
11950Washington County, Georgia110.81650.766699911
11960Wayne County, Georgia110.81650.766699911
11961Webster County, Georgia110.81650.766699911
11962Wheeler County, Georgia110.81650.766699911
11963White County, Georgia110.81650.766699911
11970Whitfield County, Georgia110.81650.904419140
11971Wilcox County, Georgia110.81650.766699911
11972Wilkes County, Georgia110.81650.766699911
11973Wilkinson County, Georgia110.81650.766699911
11980Worth County, Georgia110.81650.863610500
12005Kalawao County, Hawaii121.05621.056299912
12010Hawaii County, Hawaii121.05621.056299912
12020Honolulu County, Hawaii33201.12081.120826180
12040Kauai County, Hawaii121.05621.056299912
12050Maui County, Hawaii121.05621.056299912
13000Ada County, Idaho10800.90610.906114260
13010Adams County, Idaho130.91060.804599913
13020Bannock County, Idaho63400.93600.936038540
13030Bear Lake County, Idaho130.91060.804599913
13040Benewah County, Idaho130.91060.804599913
13050Bingham County, Idaho130.91060.804599913
13060Blaine County, Idaho130.91060.804599913
13070Boise County, Idaho130.91060.906114260
13080Bonner County, Idaho130.91060.804599913
13090Bonneville County, Idaho130.91060.942926820
13100Boundary County, Idaho130.91060.804599913
13110Butte County, Idaho130.91060.804599913
13120Camas County, Idaho130.91060.804599913
13130Canyon County, Idaho10800.90610.906114260
13140Caribou County, Idaho130.91060.804599913
13150Cassia County, Idaho130.91060.804599913
13160Clark County, Idaho130.91060.804599913
13170Clearwater County, Idaho130.91060.804599913
13180Custer County, Idaho130.91060.804599913
13190Elmore County, Idaho130.91060.804599913
13200Franklin County, Idaho130.91060.917330860
13210Fremont County, Idaho130.91060.804599913
13220Gem County, Idaho130.91060.906114260
13230Gooding County, Idaho130.91060.804599913
13240Idaho County, Idaho130.91060.804599913
Start Printed Page 40830
13250Jefferson County, Idaho130.91060.942926820
13260Jerome County, Idaho130.91060.804599913
13270Kootenai County, Idaho130.91060.965717660
13280Latah County, Idaho130.91060.804599913
13290Lemhi County, Idaho130.91060.804599913
13300Lewis County, Idaho130.91060.804599913
13310Lincoln County, Idaho130.91060.804599913
13320Madison County, Idaho130.91060.804599913
13330Minidoka County, Idaho130.91060.804599913
13340Nez Perce County, Idaho130.91060.989630300
13350Oneida County, Idaho130.91060.804599913
13360Owyhee County, Idaho130.91060.906114260
13370Payette County, Idaho130.91060.804599913
13380Power County, Idaho130.91060.936038540
13390Shoshone County, Idaho130.91060.804599913
13400Teton County, Idaho130.91060.804599913
13410Twin Falls County, Idaho130.91060.804599913
13420Valley County, Idaho130.91060.804599913
13430Washington County, Idaho130.91060.804599913
14000Adams County, Illinois140.83090.827999914
14010Alexander County, Illinois140.83090.827999914
14020Bond County, Illinois140.83090.894941180
14030Boone County, Illinois68800.99940.999440420
14040Brown County, Illinois140.83090.827999914
14050Bureau County, Illinois140.83090.827999914
14060Calhoun County, Illinois140.83090.894941180
14070Carroll County, Illinois140.83090.827999914
14080Cass County, Illinois140.83090.827999914
14090Champaign County, Illinois14000.96040.960416580
14100Christian County, Illinois140.83090.827999914
14110Clark County, Illinois140.83090.827999914
14120Clay County, Illinois140.83090.827999914
14130Clinton County, Illinois70400.89570.894941180
14140Coles County, Illinois140.83090.827999914
14141Cook County, Illinois16001.08381.084816974
14150Crawford County, Illinois140.83090.827999914
14160Cumberland County, Illinois140.83090.827999914
14170De Kalb County, Illinois16001.08381.084816974
14180De Witt County, Illinois140.83090.827999914
14190Douglas County, Illinois140.83090.827999914
14250Du Page County, Illinois16001.08381.084816974
14310Edgar County, Illinois140.83090.827999914
14320Edwards County, Illinois140.83090.827999914
14330Effingham County, Illinois140.83090.827999914
14340Fayette County, Illinois140.83090.827999914
14350Ford County, Illinois140.83090.960416580
14360Franklin County, Illinois140.83090.827999914
14370Fulton County, Illinois140.83090.827999914
14380Gallatin County, Illinois140.83090.827999914
14390Greene County, Illinois140.83090.827999914
14400Grundy County, Illinois16001.08381.084816974
14410Hamilton County, Illinois140.83090.827999914
14420Hancock County, Illinois140.83090.827999914
14421Hardin County, Illinois140.83090.827999914
14440Henderson County, Illinois140.83090.827999914
14450Henry County, Illinois19600.87310.873119340
14460Iroquois County, Illinois140.83090.827999914
14470Jackson County, Illinois140.83090.827999914
14480Jasper County, Illinois140.83090.827999914
14490Jefferson County, Illinois140.83090.827999914
14500Jersey County, Illinois70400.89570.894941180
14510Jo Daviess County, Illinois140.83090.827999914
14520Johnson County, Illinois140.83090.827999914
14530Kane County, Illinois16001.08381.084816974
14540Kankakee County, Illinois37401.09741.097428100
14550Kendall County, Illinois16001.08381.084816974
14560Knox County, Illinois140.83090.827999914
14570Lake County, Illinois16001.08381.044029404
14580La Salle County, Illinois140.83090.827999914
14590Lawrence County, Illinois140.83090.827999914
14600Lee County, Illinois140.83090.827999914
Start Printed Page 40831
14610Livingston County, Illinois140.83090.827999914
14620Logan County, Illinois140.83090.827999914
14630Mc Donough County, Illinois140.83090.827999914
14640Mc Henry County, Illinois16001.08381.084816974
14650Mclean County, Illinois10400.90840.908414060
14660Macon County, Illinois20400.80760.807619500
14670Macoupin County, Illinois140.83090.894941180
14680Madison County, Illinois70400.89570.894941180
14690Marion County, Illinois140.83090.827999914
14700Marshall County, Illinois140.83090.886837900
14710Mason County, Illinois140.83090.827999914
14720Massac County, Illinois140.83090.827999914
14730Menard County, Illinois78800.88850.888544100
14740Mercer County, Illinois140.83090.873119340
14750Monroe County, Illinois70400.89570.894941180
14760Montgomery County, Illinois140.83090.827999914
14770Morgan County, Illinois140.83090.827999914
14780Moultrie County, Illinois140.83090.827999914
14790Ogle County, Illinois68800.99940.827999914
14800Peoria County, Illinois61200.88680.886837900
14810Perry County, Illinois140.83090.827999914
14820Piatt County, Illinois140.83090.960416580
14830Pike County, Illinois140.83090.827999914
14831Pope County, Illinois140.83090.827999914
14850Pulaski County, Illinois140.83090.827999914
14860Putnam County, Illinois140.83090.827999914
14870Randolph County, Illinois140.83090.827999914
14880Richland County, Illinois140.83090.827999914
14890Rock Island County, Illinois19600.87310.873119340
14900St Clair County, Illinois70400.89570.894941180
14910Saline County, Illinois140.83090.827999914
14920Sangamon County, Illinois78800.88850.888544100
14921Schuyler County, Illinois140.83090.827999914
14940Scott County, Illinois140.83090.827999914
14950Shelby County, Illinois140.83090.827999914
14960Stark County, Illinois140.83090.886837900
14970Stephenson County, Illinois140.83090.827999914
14980Tazewell County, Illinois61200.88680.886837900
14981Union County, Illinois140.83090.827999914
14982Vermilion County, Illinois140.83090.903719180
14983Wabash County, Illinois140.83090.827999914
14984Warren County, Illinois140.83090.827999914
14985Washington County, Illinois140.83090.827999914
14986Wayne County, Illinois140.83090.827999914
14987White County, Illinois140.83090.827999914
14988Whiteside County, Illinois140.83090.827999914
14989Will County, Illinois16001.08381.084816974
14990Williamson County, Illinois140.83090.827999914
14991Winnebago County, Illinois68800.99940.999440420
14992Woodford County, Illinois61200.88680.886837900
15000Adams County, Indiana27600.97160.863099915
15010Allen County, Indiana27600.97160.980323060
15020Bartholomew County, Indiana150.87270.959818020
15030Benton County, Indiana150.87270.874529140
15040Blackford County, Indiana150.87270.863099915
15050Boone County, Indiana34800.98750.993026900
15060Brown County, Indiana150.87270.993026900
15070Carroll County, Indiana150.87270.874529140
15080Cass County, Indiana150.87270.863099915
15090Clark County, Indiana45200.93020.926131140
15100Clay County, Indiana83200.83450.831345460
15110Clinton County, Indiana39200.87450.863099915
15120Crawford County, Indiana150.87270.863099915
15130Daviess County, Indiana150.87270.863099915
15140Dearborn County, Indiana16400.97420.962317140
15150Decatur County, Indiana150.87270.863099915
15160De Kalb County, Indiana27600.97160.863099915
15170Delaware County, Indiana52800.89390.893934620
15180Dubois County, Indiana150.87270.863099915
15190Elkhart County, Indiana23300.96370.963721140
15200Fayette County, Indiana150.87270.863099915
Start Printed Page 40832
15210Floyd County, Indiana45200.93020.926131140
15220Fountain County, Indiana150.87270.863099915
15230Franklin County, Indiana150.87270.962317140
15240Fulton County, Indiana150.87270.863099915
15250Gibson County, Indiana150.87270.872121780
15260Grant County, Indiana150.87270.863099915
15270Greene County, Indiana150.87270.845614020
15280Hamilton County, Indiana34800.98750.993026900
15290Hancock County, Indiana34800.98750.993026900
15300Harrison County, Indiana45200.93020.926131140
15310Hendricks County, Indiana34800.98750.993026900
15320Henry County, Indiana150.87270.863099915
15330Howard County, Indiana38500.95170.951729020
15340Huntington County, Indiana27600.97160.863099915
15350Jackson County, Indiana150.87270.863099915
15360Jasper County, Indiana150.87270.936923844
15370Jay County, Indiana150.87270.863099915
15380Jefferson County, Indiana150.87270.863099915
15390Jennings County, Indiana150.87270.863099915
15400Johnson County, Indiana34800.98750.993026900
15410Knox County, Indiana150.87270.863099915
15420Kosciusko County, Indiana150.87270.863099915
15430Lagrange County, Indiana150.87270.863099915
15440Lake County, Indiana29600.94040.936923844
15450La Porte County, Indiana150.87270.940933140
15460Lawrence County, Indiana150.87270.863099915
15470Madison County, Indiana34800.98750.859511300
15480Marion County, Indiana34800.98750.993026900
15490Marshall County, Indiana150.87270.863099915
15500Martin County, Indiana150.87270.863099915
15510Miami County, Indiana150.87270.863099915
15520Monroe County, Indiana10200.84560.845614020
15530Montgomery County, Indiana150.87270.863099915
15540Morgan County, Indiana34800.98750.993026900
15550Newton County, Indiana150.87270.936923844
15560Noble County, Indiana150.87270.863099915
15570Ohio County, Indiana16400.97420.962317140
15580Orange County, Indiana150.87270.863099915
15590Owen County, Indiana150.87270.845614020
15600Parke County, Indiana150.87270.863099915
15610Perry County, Indiana150.87270.863099915
15620Pike County, Indiana150.87270.863099915
15630Porter County, Indiana29600.94040.936923844
15640Posey County, Indiana24400.87210.872121780
15650Pulaski County, Indiana150.87270.863099915
15660Putnam County, Indiana150.87270.993026900
15670Randolph County, Indiana150.87270.863099915
15680Ripley County, Indiana150.87270.863099915
15690Rush County, Indiana150.87270.863099915
15700St Joseph County, Indiana78000.97980.979843780
15710Scott County, Indiana45200.93020.863099915
15720Shelby County, Indiana34800.98750.993026900
15730Spencer County, Indiana150.87270.863099915
15740Starke County, Indiana150.87270.863099915
15750Steuben County, Indiana150.87270.863099915
15760Sullivan County, Indiana150.87270.831345460
15770Switzerland County, Indiana150.87270.863099915
15780Tippecanoe County, Indiana39200.87450.874529140
15790Tipton County, Indiana38500.95170.951729020
15800Union County, Indiana150.87270.863099915
15810Vanderburgh County, Indiana24400.87210.872121780
15820Vermillion County, Indiana83200.83450.831345460
15830Vigo County, Indiana83200.83450.831345460
15840Wabash County, Indiana150.87270.863099915
15850Warren County, Indiana150.87270.863099915
15860Warrick County, Indiana24400.87210.872121780
15870Washington County, Indiana150.87270.926131140
15880Wayne County, Indiana150.87270.863099915
15890Wells County, Indiana27600.97160.980323060
15900White County, Indiana150.87270.863099915
15910Whitley County, Indiana27600.97160.980323060
Start Printed Page 40833
16000Adair County, Iowa160.85880.850299916
16010Adams County, Iowa160.85880.850299916
16020Allamakee County, Iowa160.85880.850299916
16030Appanoose County, Iowa160.85880.850299916
16040Audubon County, Iowa160.85880.850299916
16050Benton County, Iowa160.85880.861716300
16060Black Hawk County, Iowa89200.85660.856647940
16070Boone County, Iowa160.85880.850299916
16080Bremer County, Iowa160.85880.856647940
16090Buchanan County, Iowa160.85880.850299916
16100Buena Vista County, Iowa160.85880.850299916
16110Butler County, Iowa160.85880.850299916
16120Calhoun County, Iowa160.85880.850299916
16130Carroll County, Iowa160.85880.850299916
16140Cass County, Iowa160.85880.850299916
16150Cedar County, Iowa160.85880.850299916
16160Cerro Gordo County, Iowa160.85880.850299916
16170Cherokee County, Iowa160.85880.850299916
16180Chickasaw County, Iowa160.85880.850299916
16190Clarke County, Iowa160.85880.850299916
16200Clay County, Iowa160.85880.850299916
16210Clayton County, Iowa160.85880.850299916
16220Clinton County, Iowa160.85880.850299916
16230Crawford County, Iowa160.85880.850299916
16240Dallas County, Iowa21200.96510.965119780
16250Davis County, Iowa160.85880.850299916
16260Decatur County, Iowa160.85880.850299916
16270Delaware County, Iowa160.85880.850299916
16280Des Moines County, Iowa160.85880.850299916
16290Dickinson County, Iowa160.85880.850299916
16300Dubuque County, Iowa22000.91350.913520220
16310Emmet County, Iowa160.85880.850299916
16320Fayette County, Iowa160.85880.850299916
16330Floyd County, Iowa160.85880.850299916
16340Franklin County, Iowa160.85880.850299916
16350Fremont County, Iowa160.85880.850299916
16360Greene County, Iowa160.85880.850299916
16370Grundy County, Iowa160.85880.856647940
16380Guthrie County, Iowa160.85880.965119780
16390Hamilton County, Iowa160.85880.850299916
16400Hancock County, Iowa160.85880.850299916
16410Hardin County, Iowa160.85880.850299916
16420Harrison County, Iowa160.85880.956936540
16430Henry County, Iowa160.85880.850299916
16440Howard County, Iowa160.85880.850299916
16450Humboldt County, Iowa160.85880.850299916
16460Ida County, Iowa160.85880.850299916
16470Iowa County, Iowa160.85880.850299916
16480Jackson County, Iowa160.85880.850299916
16490Jasper County, Iowa160.85880.850299916
16500Jefferson County, Iowa160.85880.850299916
16510Johnson County, Iowa35000.97560.975626980
16520Jones County, Iowa160.85880.861716300
16530Keokuk County, Iowa160.85880.850299916
16540Kossuth County, Iowa160.85880.850299916
16550Lee County, Iowa160.85880.850299916
16560Linn County, Iowa13600.86170.861716300
16570Louisa County, Iowa160.85880.850299916
16580Lucas County, Iowa160.85880.850299916
16590Lyon County, Iowa160.85880.850299916
16600Madison County, Iowa160.85880.965119780
16610Mahaska County, Iowa160.85880.850299916
16620Marion County, Iowa160.85880.850299916
16630Marshall County, Iowa160.85880.850299916
16640Mills County, Iowa160.85880.956936540
16650Mitchell County, Iowa160.85880.850299916
16660Monona County, Iowa160.85880.850299916
16670Monroe County, Iowa160.85880.850299916
16680Montgomery County, Iowa160.85880.850299916
16690Muscatine County, Iowa160.85880.850299916
16700O Brien County, Iowa160.85880.850299916
Start Printed Page 40834
16710Osceola County, Iowa160.85880.850299916
16720Page County, Iowa160.85880.850299916
16730Palo Alto County, Iowa160.85880.850299916
16740Plymouth County, Iowa160.85880.850299916
16750Pocahontas County, Iowa160.85880.850299916
16760Polk County, Iowa21200.96510.965119780
16770Pottawattamie County, Iowa59200.95690.956936540
16780Poweshiek County, Iowa160.85880.850299916
16790Ringgold County, Iowa160.85880.850299916
16800Sac County, Iowa160.85880.850299916
16810Scott County, Iowa19600.87310.873119340
16820Shelby County, Iowa160.85880.850299916
16830Sioux County, Iowa160.85880.850299916
16840Story County, Iowa160.85880.954511180
16850Tama County, Iowa160.85880.850299916
16860Taylor County, Iowa160.85880.850299916
16870Union County, Iowa160.85880.850299916
16880Van Buren County, Iowa160.85880.850299916
16890Wapello County, Iowa160.85880.850299916
16900Warren County, Iowa21200.96510.965119780
16910Washington County, Iowa160.85880.975626980
16920Wayne County, Iowa160.85880.850299916
16930Webster County, Iowa160.85880.850299916
16940Winnebago County, Iowa160.85880.850299916
16950Winneshiek County, Iowa160.85880.850299916
16960Woodbury County, Iowa77200.94110.937643580
16970Worth County, Iowa160.85880.850299916
16980Wright County, Iowa160.85880.850299916
17000Allen County, Kansas170.79940.798799917
17010Anderson County, Kansas170.79940.798799917
17020Atchison County, Kansas170.79940.798799917
17030Barber County, Kansas170.79940.798799917
17040Barton County, Kansas170.79940.798799917
17050Bourbon County, Kansas170.79940.798799917
17060Brown County, Kansas170.79940.798799917
17070Butler County, Kansas90400.91630.914148620
17080Chase County, Kansas170.79940.798799917
17090Chautauqua County, Kansas170.79940.798799917
17100Cherokee County, Kansas170.79940.798799917
17110Cheyenne County, Kansas170.79940.798799917
17120Clark County, Kansas170.79940.798799917
17130Clay County, Kansas170.79940.798799917
17140Cloud County, Kansas170.79940.798799917
17150Coffey County, Kansas170.79940.798799917
17160Comanche County, Kansas170.79940.798799917
17170Cowley County, Kansas170.79940.798799917
17180Crawford County, Kansas170.79940.798799917
17190Decatur County, Kansas170.79940.798799917
17200Dickinson County, Kansas170.79940.798799917
17210Doniphan County, Kansas170.79940.952941140
17220Douglas County, Kansas41500.85460.854629940
17230Edwards County, Kansas170.79940.798799917
17240Elk County, Kansas170.79940.798799917
17250Ellis County, Kansas170.79940.798799917
17260Ellsworth County, Kansas170.79940.798799917
17270Finney County, Kansas170.79940.798799917
17280Ford County, Kansas170.79940.798799917
17290Franklin County, Kansas170.79940.946728140
17300Geary County, Kansas170.79940.798799917
17310Gove County, Kansas170.79940.798799917
17320Graham County, Kansas170.79940.798799917
17330Grant County, Kansas170.79940.798799917
17340Gray County, Kansas170.79940.798799917
17350Greeley County, Kansas170.79940.798799917
17360Greenwood County, Kansas170.79940.798799917
17370Hamilton County, Kansas170.79940.798799917
17380Harper County, Kansas170.79940.798799917
17390Harvey County, Kansas90400.91630.914148620
17391Haskell County, Kansas170.79940.798799917
17410Hodgeman County, Kansas170.79940.798799917
17420Jackson County, Kansas170.79940.892945820
Start Printed Page 40835
17430Jefferson County, Kansas170.79940.892945820
17440Jewell County, Kansas170.79940.798799917
17450Johnson County, Kansas37600.94810.946728140
17451Kearny County, Kansas170.79940.798799917
17470Kingman County, Kansas170.79940.798799917
17480Kiowa County, Kansas170.79940.798799917
17490Labette County, Kansas170.79940.798799917
17500Lane County, Kansas170.79940.798799917
17510Leavenworth County, Kansas37600.94810.946728140
17520Lincoln County, Kansas170.79940.798799917
17530Linn County, Kansas170.79940.946728140
17540Logan County, Kansas170.79940.798799917
17550Lyon County, Kansas170.79940.798799917
17560Mc Pherson County, Kansas170.79940.798799917
17570Marion County, Kansas170.79940.798799917
17580Marshall County, Kansas170.79940.798799917
17590Meade County, Kansas170.79940.798799917
17600Miami County, Kansas37600.94810.946728140
17610Mitchell County, Kansas170.79940.798799917
17620Montgomery County, Kansas170.79940.798799917
17630Morris County, Kansas170.79940.798799917
17640Morton County, Kansas170.79940.798799917
17650Nemaha County, Kansas170.79940.798799917
17660Neosho County, Kansas170.79940.798799917
17670Ness County, Kansas170.79940.798799917
17680Norton County, Kansas170.79940.798799917
17690Osage County, Kansas170.79940.892945820
17700Osborne County, Kansas170.79940.798799917
17710Ottawa County, Kansas170.79940.798799917
17720Pawnee County, Kansas170.79940.798799917
17730Phillips County, Kansas170.79940.798799917
17740Pottawatomie County, Kansas170.79940.798799917
17750Pratt County, Kansas170.79940.798799917
17760Rawlins County, Kansas170.79940.798799917
17770Reno County, Kansas170.79940.798799917
17780Republic County, Kansas170.79940.798799917
17790Rice County, Kansas170.79940.798799917
17800Riley County, Kansas170.79940.798799917
17810Rooks County, Kansas170.79940.798799917
17820Rush County, Kansas170.79940.798799917
17830Russell County, Kansas170.79940.798799917
17840Saline County, Kansas170.79940.798799917
17841Scott County, Kansas170.79940.798799917
17860Sedgwick County, Kansas90400.91630.914148620
17870Seward County, Kansas170.79940.798799917
17880Shawnee County, Kansas84400.89290.892945820
17890Sheridan County, Kansas170.79940.798799917
17900Sherman County, Kansas170.79940.798799917
17910Smith County, Kansas170.79940.798799917
17920Stafford County, Kansas170.79940.798799917
17921Stanton County, Kansas170.79940.798799917
17940Stevens County, Kansas170.79940.798799917
17950Sumner County, Kansas170.79940.914148620
17960Thomas County, Kansas170.79940.798799917
17970Trego County, Kansas170.79940.798799917
17980Wabaunsee County, Kansas170.79940.892945820
17981Wallace County, Kansas170.79940.798799917
17982Washington County, Kansas170.79940.798799917
17983Wichita County, Kansas170.79940.798799917
17984Wilson County, Kansas170.79940.798799917
17985Woodson County, Kansas170.79940.798799917
17986Wyandotte County, Kansas37600.94810.946728140
18000Adair County, Kentucky180.78660.777499918
18010Allen County, Kentucky180.78660.777499918
18020Anderson County, Kentucky180.78660.777499918
18030Ballard County, Kentucky180.78660.777499918
18040Barren County, Kentucky180.78660.777499918
18050Bath County, Kentucky180.78660.777499918
18060Bell County, Kentucky180.78660.777499918
18070Boone County, Kentucky16400.97420.962317140
18080Bourbon County, Kentucky42800.89970.908430460
Start Printed Page 40836
18090Boyd County, Kentucky34000.94860.948626580
18100Boyle County, Kentucky180.78660.777499918
18110Bracken County, Kentucky180.78660.962317140
18120Breathitt County, Kentucky180.78660.777499918
18130Breckinridge County, Kentucky180.78660.777499918
18140Bullitt County, Kentucky45200.93020.926131140
18150Butler County, Kentucky180.78660.777499918
18160Caldwell County, Kentucky180.78660.777499918
18170Calloway County, Kentucky180.78660.777499918
18180Campbell County, Kentucky16400.97420.962317140
18190Carlisle County, Kentucky180.78660.777499918
18191Carroll County, Kentucky180.78660.777499918
18210Carter County, Kentucky34000.94860.777499918
18220Casey County, Kentucky180.78660.777499918
18230Christian County, Kentucky16600.82920.829217300
18240Clark County, Kentucky42800.89970.908430460
18250Clay County, Kentucky180.78660.777499918
18260Clinton County, Kentucky180.78660.777499918
18270Crittenden County, Kentucky180.78660.777499918
18271Cumberland County, Kentucky180.78660.777499918
18290Daviess County, Kentucky59900.87890.878936980
18291Edmonson County, Kentucky180.78660.822014540
18310Elliott County, Kentucky180.78660.777499918
18320Estill County, Kentucky180.78660.777499918
18330Fayette County, Kentucky42800.89970.908430460
18340Fleming County, Kentucky180.78660.777499918
18350Floyd County, Kentucky180.78660.777499918
18360Franklin County, Kentucky180.78660.777499918
18361Fulton County, Kentucky180.78660.777499918
18362Gallatin County, Kentucky16400.97420.962317140
18390Garrard County, Kentucky180.78660.777499918
18400Grant County, Kentucky16400.97420.962317140
18410Graves County, Kentucky180.78660.777499918
18420Grayson County, Kentucky180.78660.777499918
18421Green County, Kentucky180.78660.777499918
18440Greenup County, Kentucky34000.94860.948626580
18450Hancock County, Kentucky180.78660.878936980
18460Hardin County, Kentucky180.78660.881021060
18470Harlan County, Kentucky180.78660.777499918
18480Harrison County, Kentucky180.78660.777499918
18490Hart County, Kentucky180.78660.777499918
18500Henderson County, Kentucky24400.87210.872121780
18510Henry County, Kentucky180.78660.926131140
18511Hickman County, Kentucky180.78660.777499918
18530Hopkins County, Kentucky180.78660.777499918
18540Jackson County, Kentucky180.78660.777499918
18550Jefferson County, Kentucky45200.93020.926131140
18560Jessamine County, Kentucky42800.89970.908430460
18570Johnson County, Kentucky180.78660.777499918
18580Kenton County, Kentucky16400.97420.962317140
18590Knott County, Kentucky180.78660.777499918
18600Knox County, Kentucky180.78660.777499918
18610Larue County, Kentucky180.78660.881021060
18620Laurel County, Kentucky180.78660.777499918
18630Lawrence County, Kentucky180.78660.777499918
18640Lee County, Kentucky180.78660.777499918
18650Leslie County, Kentucky180.78660.777499918
18660Letcher County, Kentucky180.78660.777499918
18670Lewis County, Kentucky180.78660.777499918
18680Lincoln County, Kentucky180.78660.777499918
18690Livingston County, Kentucky180.78660.777499918
18700Logan County, Kentucky180.78660.777499918
18710Lyon County, Kentucky180.78660.777499918
18720McCracken County, Kentucky180.78660.777499918
18730McCreary County, Kentucky180.78660.777499918
18740McLean County, Kentucky180.78660.878936980
18750Madison County, Kentucky42800.89970.777499918
18760Magoffin County, Kentucky180.78660.777499918
18770Marion County, Kentucky180.78660.777499918
18780Marshall County, Kentucky180.78660.777499918
18790Martin County, Kentucky180.78660.777499918
Start Printed Page 40837
18800Mason County, Kentucky180.78660.777499918
18801Meade County, Kentucky180.78660.926131140
18802Menifee County, Kentucky180.78660.777499918
18830Mercer County, Kentucky180.78660.777499918
18831Metcalfe County, Kentucky180.78660.777499918
18850Monroe County, Kentucky180.78660.777499918
18860Montgomery County, Kentucky180.78660.777499918
18861Morgan County, Kentucky180.78660.777499918
18880Muhlenberg County, Kentucky180.78660.777499918
18890Nelson County, Kentucky180.78660.926131140
18900Nicholas County, Kentucky180.78660.777499918
18910Ohio County, Kentucky180.78660.777499918
18920Oldham County, Kentucky45200.93020.926131140
18930Owen County, Kentucky180.78660.777499918
18931Owsley County, Kentucky180.78660.777499918
18932Pendleton County, Kentucky16400.97420.962317140
18960Perry County, Kentucky180.78660.777499918
18970Pike County, Kentucky180.78660.777499918
18971Powell County, Kentucky180.78660.777499918
18972Pulaski County, Kentucky180.78660.777499918
18973Robertson County, Kentucky180.78660.777499918
18974Rockcastle County, Kentucky180.78660.777499918
18975Rowan County, Kentucky180.78660.777499918
18976Russell County, Kentucky180.78660.777499918
18977Scott County, Kentucky42800.89970.908430460
18978Shelby County, Kentucky180.78660.926131140
18979Simpson County, Kentucky180.78660.777499918
18980Spencer County, Kentucky180.78660.926131140
18981Taylor County, Kentucky180.78660.777499918
18982Todd County, Kentucky180.78660.777499918
18983Trigg County, Kentucky180.78660.829217300
18984Trimble County, Kentucky180.78660.926131140
18985Union County, Kentucky180.78660.777499918
18986Warren County, Kentucky180.78660.822014540
18987Washington County, Kentucky180.78660.777499918
18988Wayne County, Kentucky180.78660.777499918
18989Webster County, Kentucky180.78660.872121780
18990Whitley County, Kentucky180.78660.777499918
18991Wolfe County, Kentucky180.78660.777499918
18992Woodford County, Kentucky42800.89970.908430460
19000Acadia County, Louisiana38800.82600.741899919
19010Allen County, Louisiana190.73480.741899919
19020Ascension County, Louisiana07600.86520.860112940
19030Assumption County, Louisiana190.73480.741899919
19040Avoyelles County, Louisiana190.73480.741899919
19050Beauregard County, Louisiana190.73480.741899919
19060Bienville County, Louisiana190.73480.741899919
19070Bossier County, Louisiana76800.87460.876943340
19080Caddo County, Louisiana76800.87460.876943340
19090Calcasieu County, Louisiana39600.78660.784129340
19100Caldwell County, Louisiana190.73480.741899919
19110Cameron County, Louisiana190.73480.784129340
19120Catahoula County, Louisiana190.73480.741899919
19130Claiborne County, Louisiana190.73480.741899919
19140Concordia County, Louisiana190.73480.741899919
19150De Soto County, Louisiana190.73480.876943340
19160East Baton Rouge County, Louisiana07600.86520.860112940
19170East Carroll County, Louisiana190.73480.741899919
19180East Feliciana County, Louisiana190.73480.860112940
19190Evangeline County, Louisiana190.73480.741899919
19200Franklin County, Louisiana190.73480.741899919
19210Grant County, Louisiana190.73480.804110780
19220Iberia County, Louisiana190.73480.741899919
19230Iberville County, Louisiana190.73480.860112940
19240Jackson County, Louisiana190.73480.741899919
19250Jefferson County, Louisiana55600.90050.900535380
19260Jefferson Davis County, Louisiana190.73480.741899919
19270Lafayette County, Louisiana38800.82600.843629180
19280Lafourche County, Louisiana33500.79020.790226380
19290La Salle County, Louisiana190.73480.741899919
19300Lincoln County, Louisiana190.73480.741899919
Start Printed Page 40838
19310Livingston County, Louisiana07600.86520.860112940
19320Madison County, Louisiana190.73480.741899919
19330Morehouse County, Louisiana190.73480.741899919
19340Natchitoches County, Louisiana190.73480.741899919
19350Orleans County, Louisiana55600.90050.900535380
19360Ouachita County, Louisiana52000.80520.804033740
19370Plaquemines County, Louisiana55600.90050.900535380
19380Pointe Coupee County, Louisiana190.73480.860112940
19390Rapides County, Louisiana02200.80410.804110780
19400Red River County, Louisiana190.73480.741899919
19410Richland County, Louisiana190.73480.741899919
19420Sabine County, Louisiana190.73480.741899919
19430St Bernard County, Louisiana55600.90050.900535380
19440St Charles County, Louisiana55600.90050.900535380
19450St Helena County, Louisiana190.73480.860112940
19460St James County, Louisiana55600.90050.741899919
19470St John Baptist County, Louisiana55600.90050.900535380
19480St Landry County, Louisiana38800.82600.741899919
19490St Martin County, Louisiana38800.82600.843629180
19500St Mary County, Louisiana190.73480.41899919
19510St Tammany County, Louisiana55600.90050.900535380
19520Tangipahoa County, Louisiana190.73480.741899919
19530Tensas County, Louisiana190.73480.741899919
19540Terrebonne County, Louisiana33500.79020.790226380
19550Union County, Louisiana190.73480.804033740
19560Vermilion County, Louisiana190.73480.741899919
19570Vernon County, Louisiana190.73480.741899919
19580Washington County, Louisiana190.73480.741899919
19590Webster County, Louisiana76800.87460.741899919
19600West Baton Rouge County, Louisiana07600.86520.860112940
19610West Carroll County, Louisiana190.73480.741899919
19620West Feliciana County, Louisiana190.73480.860112940
19630Winn County, Louisiana190.73480.741899919
20000Androscoggin County, Maine42430.93410.934130340
20010Aroostook County, Maine200.88520.885299920
20020Cumberland County, Maine64031.03921.039238860
20030Franklin County, Maine200.88520.885299920
20040Hancock County, Maine200.88520.885299920
20050Kennebec County, Maine200.88520.885299920
20060Knox County, Maine200.88520.885299920
20070Lincoln County, Maine200.88520.885299920
20080Oxford County, Maine200.88520.885299920
20090Penobscot County, Maine07331.00031.000312620
20100Piscataquis County, Maine200.88520.885299920
20110Sagadahoc County, Maine64031.03921.039238860
20120Somerset County, Maine200.88520.885299920
20130Waldo County, Maine200.88520.885299920
20140Washington County, Maine200.88520.885299920
20150York County, Maine64031.03921.039238860
21000Allegany County, Maryland19000.93260.932619060
21010Anne Arundel County, Maryland07200.99070.990712580
21020Baltimore County, Maryland07200.99070.990712580
21030Baltimore City County, Maryland07200.99070.990712580
21040Calvert County, Maryland88401.09831.093247894
21050Caroline County, Maryland210.90850.909599921
21060Carroll County, Maryland07200.99070.990712580
21070Cecil County, Maryland91601.05371.048248864
21080Charles County, Maryland88401.09831.093247894
21090Dorchester County, Maryland210.90850.909599921
21100Frederick County, Maryland88401.09831.149513644
21110Garrett County, Maryland210.90850.909599921
21120Harford County, Maryland07200.99070.990712580
21130Howard County, Maryland07200.99070.990712580
21140Kent County, Maryland210.90850.909599921
21150Montgomery County, Maryland88401.09831.149513644
21160Prince Georges County, Maryland88401.09831.093247894
21170Queen Annes County, Maryland07200.99070.990712580
21180St Marys County, Maryland210.90850.909599921
21190Somerset County, Maryland210.90850.907341540
21200Talbot County, Maryland210.90850.909599921
21210Washington County, Maryland31800.98790.949925180
Start Printed Page 40839
21220Wicomico County, Maryland210.90850.907341540
21230Worcester County, Maryland210.90850.909599921
22000Barnstable County, Massachusetts07431.25271.252712700
22010Berkshire County, Massachusetts63231.01911.019138340
22020Bristol County, Massachusetts11231.11521.096639300
22030Dukes County, Massachusetts221.00501.021699922
22040Essex County, Massachusetts11231.11521.053321604
22060Franklin County, Massachusetts221.00501.025944140
22070Hampden County, Massachusetts80031.02731.025944140
22080Hampshire County, Massachusetts80031.02731.025944140
22090Middlesex County, Massachusetts11231.11521.108415764
22120Nantucket County, Massachusetts221.00501.021699922
22130Norfolk County, Massachusetts11231.11521.154314484
22150Plymouth County, Massachusetts11231.11521.154314484
22160Suffolk County, Massachusetts11231.11521.154314484
22170Worcester County, Massachusetts11231.11521.103949340
23000Alcona County, Michigan230.88130.887099923
23010Alger County, Michigan230.88130.887099923
23020Allegan County, Michigan30000.94550.887099923
23030Alpena County, Michigan230.88130.887099923
23040Antrim County, Michigan230.88130.887099923
23050Arenac County, Michigan230.88130.887099923
23060Baraga County, Michigan230.88130.887099923
23070Barry County, Michigan230.88130.940024340
23080Bay County, Michigan69600.94150.935213020
23090Benzie County, Michigan230.88130.887099923
23100Berrien County, Michigan08700.88880.888835660
23110Branch County, Michigan230.88130.887099923
23120Calhoun County, Michigan37201.01510.951012980
23130Cass County, Michigan230.88130.979843780
23140Charlevoix County, Michigan230.88130.887099923
23150Cheboygan County, Michigan230.88130.887099923
23160Chippewa County, Michigan230.88130.887099923
23170Clare County, Michigan230.88130.887099923
23180Clinton County, Michigan40400.97920.979229620
23190Crawford County, Michigan230.88130.887099923
23200Delta County, Michigan230.88130.887099923
23210Dickinson County, Michigan230.88130.887099923
23220Eaton County, Michigan40400.97920.979229620
23230Emmet County, Michigan230.88130.887099923
23240Genesee County, Michigan26401.06631.066322420
23250Gladwin County, Michigan230.88130.887099923
23260Gogebic County, Michigan230.88130.887099923
23270Grand Traverse County, Michigan230.88130.887099923
23280Gratiot County, Michigan230.88130.887099923
23290Hillsdale County, Michigan230.88130.887099923
23300Houghton County, Michigan230.88130.887099923
23310Huron County, Michigan230.88130.887099923
23320Ingham County, Michigan40400.97920.979229620
23330Ionia County, Michigan230.88130.940024340
23340Iosco County, Michigan230.88130.887099923
23350Iron County, Michigan230.88130.887099923
23360Isabella County, Michigan230.88130.887099923
23370Jackson County, Michigan35200.93130.931327100
23380Kalamazoo County, Michigan37201.01511.039128020
23390Kalkaska County, Michigan230.88130.887099923
23400Kent County, Michigan30000.94550.940024340
23410Keweenaw County, Michigan230.88130.887099923
23420Lake County, Michigan230.88130.887099923
23430Lapeer County, Michigan21601.01520.986147644
23440Leelanau County, Michigan230.88130.887099923
23450Lenawee County, Michigan04401.07180.887099923
23460Livingston County, Michigan04401.07180.986147644
23470Luce County, Michigan230.88130.887099923
23480Mackinac County, Michigan230.88130.887099923
23490Macomb County, Michigan21601.01520.986147644
23500Manistee County, Michigan230.88130.887099923
23510Marquette County, Michigan230.88130.887099923
23520Mason County, Michigan230.88130.887099923
23530Mecosta County, Michigan230.88130.887099923
23540Menominee County, Michigan230.88130.887099923
Start Printed Page 40840
23550Midland County, Michigan69600.94150.887099923
23560Missaukee County, Michigan230.88130.887099923
23570Monroe County, Michigan21601.01520.947833780
23580Montcalm County, Michigan230.88130.887099923
23590Montmorency County, Michigan230.88130.887099923
23600Muskegon County, Michigan30000.94550.967334740
23610Newaygo County, Michigan230.88130.940024340
23620Oakland County, Michigan21601.01520.986147644
23630Oceana County, Michigan230.88130.887099923
23640Ogemaw County, Michigan230.88130.887099923
23650Ontonagon County, Michigan230.88130.887099923
23660Osceola County, Michigan230.88130.887099923
23670Oscoda County, Michigan230.88130.887099923
23680Otsego County, Michigan230.88130.887099923
23690Ottawa County, Michigan30000.94550.906426100
23700Presque Isle County, Michigan230.88130.887099923
23710Roscommon County, Michigan230.88130.887099923
23720Saginaw County, Michigan69600.94150.942040980
23730St Clair County, Michigan21601.01520.986147644
23740St Joseph County, Michigan230.88130.887099923
23750Sanilac County, Michigan230.88130.887099923
23760Schoolcraft County, Michigan230.88130.887099923
23770Shiawassee County, Michigan230.88130.887099923
23780Tuscola County, Michigan230.88130.887099923
23790Van Buren County, Michigan37201.01511.039128020
23800Washtenaw County, Michigan04401.07181.087011460
23810Wayne County, Michigan21601.01521.044119804
23830Wexford County, Michigan230.88130.887099923
24000Aitkin County, Minnesota240.91930.918399924
24010Anoka County, Minnesota51201.10781.107833460
24020Becker County, Minnesota240.91930.918399924
24030Beltrami County, Minnesota240.91930.918399924
24040Benton County, Minnesota69800.99750.997541060
24050Big Stone County, Minnesota240.91930.918399924
24060Blue Earth County, Minnesota240.91930.918399924
24070Brown County, Minnesota240.91930.918399924
24080Carlton County, Minnesota240.91931.020920260
24090Carver County, Minnesota51201.10781.107833460
24100Cass County, Minnesota240.91930.918399924
24110Chippewa County, Minnesota240.91930.918399924
24120Chisago County, Minnesota51201.10781.107833460
24130Clay County, Minnesota25200.84950.849522020
24140Clearwater County, Minnesota240.91930.918399924
24150Cook County, Minnesota240.91930.918399924
24160Cottonwood County, Minnesota240.91930.918399924
24170Crow Wing County, Minnesota240.91930.918399924
24180Dakota County, Minnesota51201.10781.107833460
24190Dodge County, Minnesota240.91931.114240340
24200Douglas County, Minnesota240.91930.918399924
24210Faribault County, Minnesota240.91930.918399924
24220Fillmore County, Minnesota240.91930.918399924
24230Freeborn County, Minnesota240.91930.918399924
24240Goodhue County, Minnesota240.91930.918399924
24250Grant County, Minnesota240.91930.918399924
24260Hennepin County, Minnesota51201.10781.107833460
24270Houston County, Minnesota38700.95730.957329100
24280Hubbard County, Minnesota240.91930.918399924
24290Isanti County, Minnesota51201.10781.107833460
24300Itasca County, Minnesota240.91930.918399924
24310Jackson County, Minnesota240.91930.918399924
24320Kanabec County, Minnesota240.91930.918399924
24330Kandiyohi County, Minnesota240.91930.918399924
24340Kittson County, Minnesota240.91930.918399924
24350Koochiching County, Minnesota240.91930.918399924
24360Lac Qui Parle County, Minnesota240.91930.918399924
24370Lake County, Minnesota240.91930.918399924
24380Lake Of Woods County, Minnesota240.91930.918399924
24390Le Sueur County, Minnesota240.91930.918399924
24400Lincoln County, Minnesota240.91930.918399924
24410Lyon County, Minnesota240.91930.918399924
24420Mc Leod County, Minnesota240.91930.918399924
Start Printed Page 40841
24430Mahnomen County, Minnesota240.91930.918399924
24440Marshall County, Minnesota240.91930.918399924
24450Martin County, Minnesota240.91930.918399924
24460Meeker County, Minnesota240.91930.918399924
24470Mille Lacs County, Minnesota240.91930.918399924
24480Morrison County, Minnesota240.91930.918399924
24490Mower County, Minnesota240.91930.918399924
24500Murray County, Minnesota240.91930.918399924
24510Nicollet County, Minnesota240.91930.918399924
24520Nobles County, Minnesota240.91930.918399924
24530Norman County, Minnesota240.91930.918399924
24540Olmsted County, Minnesota68201.11421.114240340
24550Otter Tail County, Minnesota240.91930.918399924
24560Pennington County, Minnesota240.91930.918399924
24570Pine County, Minnesota240.91930.918399924
24580Pipestone County, Minnesota240.91930.918399924
24590Polk County, Minnesota29851.15161.151624220
24600Pope County, Minnesota240.91930.918399924
24610Ramsey County, Minnesota51201.10781.107833460
24620Red Lake County, Minnesota240.91930.918399924
24630Redwood County, Minnesota240.91930.918399924
24640Renville County, Minnesota240.91930.918399924
24650Rice County, Minnesota240.91930.918399924
24660Rock County, Minnesota240.91930.918399924
24670Roseau County, Minnesota240.91930.918399924
24680St Louis County, Minnesota22401.02231.020920260
24690Scott County, Minnesota51201.10781.107833460
24700Sherburne County, Minnesota51201.10781.107833460
24710Sibley County, Minnesota240.91930.918399924
24720Stearns County, Minnesota69800.99750.997541060
24730Steele County, Minnesota240.91930.918399924
24740Stevens County, Minnesota240.91930.918399924
24750Swift County, Minnesota240.91930.918399924
24760Todd County, Minnesota240.91930.918399924
24770Traverse County, Minnesota240.91930.918399924
24780Wabasha County, Minnesota240.91931.114240340
24790Wadena County, Minnesota240.91930.918399924
24800Waseca County, Minnesota240.91930.918399924
24810Washington County, Minnesota51201.10781.107833460
24820Watonwan County, Minnesota240.91930.918399924
24830Wilkin County, Minnesota240.91930.918399924
24840Winona County, Minnesota240.91930.918399924
24850Wright County, Minnesota51201.10781.107833460
24860Yellow Medicine County, Minnesota240.91930.918399924
25000Adams County, Mississippi250.76310.767199925
25010Alcorn County, Mississippi250.76310.767199925
25020Amite County, Mississippi250.76310.767199925
25030Attala County, Mississippi250.76310.767199925
25040Benton County, Mississippi250.76310.767199925
25050Bolivar County, Mississippi250.76310.767199925
25060Calhoun County, Mississippi250.76310.767199925
25070Carroll County, Mississippi250.76310.767199925
25080Chickasaw County, Mississippi250.76310.767199925
25090Choctaw County, Mississippi250.76310.767199925
25100Claiborne County, Mississippi250.76310.767199925
25110Clarke County, Mississippi250.76310.767199925
25120Clay County, Mississippi250.76310.767199925
25130Coahoma County, Mississippi250.76310.767199925
25140Copiah County, Mississippi250.76310.831927140
25150Covington County, Mississippi250.76310.767199925
25160Desoto County, Mississippi49200.93600.934132820
25170Forrest County, Mississippi32850.76090.760925620
25180Franklin County, Mississippi250.76310.767199925
25190George County, Mississippi250.76310.816537700
25200Greene County, Mississippi250.76310.767199925
25210Grenada County, Mississippi250.76310.767199925
25220Hancock County, Mississippi09200.87150.893825060
25230Harrison County, Mississippi09200.87150.893825060
25240Hinds County, Mississippi35600.83910.831927140
25250Holmes County, Mississippi250.76310.767199925
25260Humphreys County, Mississippi250.76310.767199925
Start Printed Page 40842
25270Issaquena County, Mississippi250.76310.767199925
25280Itawamba County, Mississippi250.76310.767199925
25290Jackson County, Mississippi09200.87150.816537700
25300Jasper County, Mississippi250.76310.767199925
25310Jefferson County, Mississippi250.76310.767199925
25320Jefferson Davis County, Mississippi250.76310.767199925
25330Jones County, Mississippi250.76310.767199925
25340Kemper County, Mississippi250.76310.767199925
25350Lafayette County, Mississippi250.76310.767199925
25360Lamar County, Mississippi32850.76090.760925620
25370Lauderdale County, Mississippi250.76310.767199925
25380Lawrence County, Mississippi250.76310.767199925
25390Leake County, Mississippi250.76310.767199925
25400Lee County, Mississippi250.76310.767199925
25410Leflore County, Mississippi250.76310.767199925
25420Lincoln County, Mississippi250.76310.767199925
25430Lowndes County, Mississippi250.76310.767199925
25440Madison County, Mississippi35600.83910.831927140
25450Marion County, Mississippi250.76310.767199925
25460Marshall County, Mississippi250.76310.934132820
25470Monroe County, Mississippi250.76310.767199925
25480Montgomery County, Mississippi250.76310.767199925
25490Neshoba County, Mississippi250.76310.767199925
25500Newton County, Mississippi250.76310.767199925
25510Noxubee County, Mississippi250.76310.767199925
25520Oktibbeha County, Mississippi250.76310.767199925
25530Panola County, Mississippi250.76310.767199925
25540Pearl River County, Mississippi250.76310.767199925
25550Perry County, Mississippi250.76310.760925620
25560Pike County, Mississippi250.76310.767199925
25570Pontotoc County, Mississippi250.76310.767199925
25580Prentiss County, Mississippi250.76310.767199925
25590Quitman County, Mississippi250.76310.767199925
25600Rankin County, Mississippi35600.83910.831927140
25610Scott County, Mississippi250.76310.767199925
25620Sharkey County, Mississippi250.76310.767199925
25630Simpson County, Mississippi250.76310.831927140
25640Smith County, Mississippi250.76310.767199925
25650Stone County, Mississippi250.76310.893825060
25660Sunflower County, Mississippi250.76310.767199925
25670Tallahatchie County, Mississippi250.76310.767199925
25680Tate County, Mississippi250.76310.934132820
25690Tippah County, Mississippi250.76310.767199925
25700Tishomingo County, Mississippi250.76310.767199925
25710Tunica County, Mississippi250.76310.934132820
25720Union County, Mississippi250.76310.767199925
25730Walthall County, Mississippi250.76310.767199925
25740Warren County, Mississippi250.76310.767199925
25750Washington County, Mississippi250.76310.767199925
25760Wayne County, Mississippi250.76310.767199925
25770Webster County, Mississippi250.76310.767199925
25780Wilkinson County, Mississippi250.76310.767199925
25790Winston County, Mississippi250.76310.767199925
25800Yalobusha County, Mississippi250.76310.767199925
25810Yazoo County, Mississippi250.76310.767199925
26000Adair County, Missouri260.79680.790999926
26010Andrew County, Missouri70000.95290.952941140
26020Atchison County, Missouri260.79680.790999926
26030Audrain County, Missouri260.79680.790999926
26040Barry County, Missouri260.79680.790999926
26050Barton County, Missouri260.79680.790999926
26060Bates County, Missouri260.79680.946728140
26070Benton County, Missouri260.79680.790999926
26080Bollinger County, Missouri260.79680.790999926
26090Boone County, Missouri17400.83540.835417860
26100Buchanan County, Missouri70000.95290.952941140
26110Butler County, Missouri260.79680.790999926
26120Caldwell County, Missouri260.79680.946728140
26130Callaway County, Missouri260.79680.839627620
26140Camden County, Missouri260.79680.790999926
26150Cape Girardeau County, Missouri260.79680.790999926
Start Printed Page 40843
26160Carroll County, Missouri260.79680.790999926
26170Carter County, Missouri260.79680.790999926
26180Cass County, Missouri37600.94810.946728140
26190Cedar County, Missouri260.79680.790999926
26200Chariton County, Missouri260.79680.790999926
26210Christian County, Missouri79200.82590.824644180
26220Clark County, Missouri260.79680.790999926
26230Clay County, Missouri37600.94810.946728140
26240Clinton County, Missouri37600.94810.946728140
26250Cole County, Missouri260.79680.839627620
26260Cooper County, Missouri260.79680.790999926
26270Crawford County, Missouri260.79680.894941180
26280Dade County, Missouri260.79680.790999926
26290Dallas County, Missouri260.79680.824644180
26300Daviess County, Missouri260.79680.790999926
26310De Kalb County, Missouri260.79680.952941140
26320Dent County, Missouri260.79680.790999926
26330Douglas County, Missouri260.79680.790999926
26340Dunklin County, Missouri260.79680.790999926
26350Franklin County, Missouri70400.89570.894941180
26360Gasconade County, Missouri260.79680.790999926
26370Gentry County, Missouri260.79680.790999926
26380Greene County, Missouri79200.82590.824644180
26390Grundy County, Missouri260.79680.790999926
26400Harrison County, Missouri260.79680.790999926
26410Henry County, Missouri260.79680.790999926
26411Hickory County, Missouri260.79680.790999926
26412Holt County, Missouri260.79680.790999926
26440Howard County, Missouri260.79680.835417860
26450Howell County, Missouri260.79680.790999926
26460Iron County, Missouri260.79680.790999926
26470Jackson County, Missouri37600.94810.946728140
26480Jasper County, Missouri37100.85900.859027900
26490Jefferson County, Missouri70400.89570.894941180
26500Johnson County, Missouri260.79680.790999926
26510Knox County, Missouri260.79680.790999926
26520Laclede County, Missouri260.79680.790999926
26530Lafayette County, Missouri37600.94810.946728140
26540Lawrence County, Missouri260.79680.790999926
26541Lewis County, Missouri260.79680.790999926
26560Lincoln County, Missouri70400.89570.894941180
26570Linn County, Missouri260.79680.790999926
26580Livingston County, Missouri260.79680.790999926
26590Mc Donald County, Missouri260.79680.856322220
26600Macon County, Missouri260.79680.790999926
26601Madison County, Missouri260.79680.790999926
26620Maries County, Missouri260.79680.790999926
26630Marion County, Missouri260.79680.790999926
26631Mercer County, Missouri260.79680.790999926
26650Miller County, Missouri260.79680.790999926
26660Mississippi County, Missouri260.79680.790999926
26670Moniteau County, Missouri260.79680.839627620
26680Monroe County, Missouri260.79680.790999926
26690Montgomery County, Missouri260.79680.790999926
26700Morgan County, Missouri260.79680.790999926
26710New Madrid County, Missouri260.79680.790999926
26720Newton County, Missouri37100.85900.859027900
26730Nodaway County, Missouri260.79680.790999926
26740Oregon County, Missouri260.79680.790999926
26750Osage County, Missouri260.79680.839627620
26751Ozark County, Missouri260.79680.790999926
26770Pemiscot County, Missouri260.79680.790999926
26780Perry County, Missouri260.79680.790999926
26790Pettis County, Missouri260.79680.790999926
26800Phelps County, Missouri260.79680.790999926
26810Pike County, Missouri260.79680.790999926
26820Platte County, Missouri37600.94810.946728140
26821Polk County, Missouri260.79680.824644180
26840Pulaski County, Missouri260.79680.790999926
26850Putnam County, Missouri260.79680.790999926
26860Ralls County, Missouri260.79680.790999926
Start Printed Page 40844
26870Randolph County, Missouri260.79680.790999926
26880Ray County, Missouri37600.94810.946728140
26881Reynolds County, Missouri260.79680.790999926
26900Ripley County, Missouri260.79680.790999926
26910St Charles County, Missouri70400.89570.894941180
26911St Clair County, Missouri260.79680.790999926
26930St Francois County, Missouri260.79680.790999926
26940St Louis County, Missouri70400.89570.894941180
26950St Louis City County, Missouri70400.89570.894941180
26960Ste Genevieve County, Missouri260.79680.790999926
26970Saline County, Missouri260.79680.790999926
26980Schuyler County, Missouri260.79680.790999926
26981Scotland County, Missouri260.79680.790999926
26982Scott County, Missouri260.79680.790999926
26983Shannon County, Missouri260.79680.790999926
26984Shelby County, Missouri260.79680.790999926
26985Stoddard County, Missouri260.79680.790999926
26986Stone County, Missouri260.79680.790999926
26987Sullivan County, Missouri260.79680.790999926
26988Taney County, Missouri260.79680.790999926
26989Texas County, Missouri260.79680.790999926
26990Vernon County, Missouri260.79680.790999926
26991Warren County, Missouri70400.89570.894941180
26992Washington County, Missouri260.79680.894941180
26993Wayne County, Missouri260.79680.790999926
26994Webster County, Missouri79200.82590.824644180
26995Worth County, Missouri260.79680.790999926
26996Wright County, Missouri260.79680.790999926
27000Beaverhead County, Montana270.88330.883399927
27010Big Horn County, Montana270.88330.883399927
27020Blaine County, Montana270.88330.883399927
27030Broadwater County, Montana270.88330.883399927
27040Carbon County, Montana270.88330.884313740
27050Carter County, Montana270.88330.883399927
27060Cascade County, Montana30400.90610.906124500
27070Chouteau County, Montana270.88330.883399927
27080Custer County, Montana270.88330.883399927
27090Daniels County, Montana270.88330.883399927
27100Dawson County, Montana270.88330.883399927
27110Deer Lodge County, Montana270.88330.883399927
27113Yellowstone National Park, Montana270.88330.883399927
27120Fallon County, Montana270.88330.883399927
27130Fergus County, Montana270.88330.883399927
27140Flathead County, Montana270.88330.883399927
27150Gallatin County, Montana270.88330.883399927
27160Garfield County, Montana270.88330.883399927
27170Glacier County, Montana270.88330.883399927
27180Golden Valley County, Montana270.88330.883399927
27190Granite County, Montana270.88330.883399927
27200Hill County, Montana270.88330.883399927
27210Jefferson County, Montana270.88330.883399927
27220Judith Basin County, Montana270.88330.883399927
27230Lake County, Montana270.88330.883399927
27240Lewis And Clark County, Montana270.88330.883399927
27250Liberty County, Montana270.88330.883399927
27260Lincoln County, Montana270.88330.883399927
27270Mc Cone County, Montana270.88330.883399927
27280Madison County, Montana270.88330.883399927
27290Meagher County, Montana270.88330.883399927
27300Mineral County, Montana270.88330.883399927
27310Missoula County, Montana51400.94820.948233540
27320Musselshell County, Montana270.88330.883399927
27330Park County, Montana270.88330.883399927
27340Petroleum County, Montana270.88330.883399927
27350Phillips County, Montana270.88330.883399927
27360Pondera County, Montana270.88330.883399927
27370Powder River County, Montana270.88330.883399927
27380Powell County, Montana270.88330.883399927
27390Prairie County, Montana270.88330.883399927
27400Ravalli County, Montana270.88330.883399927
27410Richland County, Montana270.88330.883399927
Start Printed Page 40845
27420Roosevelt County, Montana270.88330.883399927
27430Rosebud County, Montana270.88330.883399927
27440Sanders County, Montana270.88330.883399927
27450Sheridan County, Montana270.88330.883399927
27460Silver Bow County, Montana270.88330.883399927
27470Stillwater County, Montana270.88330.883399927
27480Sweet Grass County, Montana270.88330.883399927
27490Teton County, Montana270.88330.883399927
27500Toole County, Montana270.88330.883399927
27510Treasure County, Montana270.88330.883399927
27520Valley County, Montana270.88330.883399927
27530Wheatland County, Montana270.88330.883399927
27540Wibaux County, Montana270.88330.883399927
27550Yellowstone County, Montana08800.88430.884313740
28000Adams County, Nebraska280.86650.866599928
28010Antelope County, Nebraska280.86650.866599928
28020Arthur County, Nebraska280.86650.866599928
28030Banner County, Nebraska280.86650.866599928
28040Blaine County, Nebraska280.86650.866599928
28050Boone County, Nebraska280.86650.866599928
28060Box Butte County, Nebraska280.86650.866599928
28070Boyd County, Nebraska280.86650.866599928
28080Brown County, Nebraska280.86650.866599928
28090Buffalo County, Nebraska280.86650.866599928
28100Burt County, Nebraska280.86650.866599928
28110Butler County, Nebraska280.86650.866599928
28120Cass County, Nebraska59200.95690.956936540
28130Cedar County, Nebraska280.86650.866599928
28140Chase County, Nebraska280.86650.866599928
28150Cherry County, Nebraska280.86650.866599928
28160Cheyenne County, Nebraska280.86650.866599928
28170Clay County, Nebraska280.86650.866599928
28180Colfax County, Nebraska280.86650.866599928
28190Cuming County, Nebraska280.86650.866599928
28200Custer County, Nebraska280.86650.866599928
28210Dakota County, Nebraska77200.94110.937643580
28220Dawes County, Nebraska280.86650.866599928
28230Dawson County, Nebraska280.86650.866599928
28240Deuel County, Nebraska280.86650.866599928
28250Dixon County, Nebraska280.86650.937643580
28260Dodge County, Nebraska280.86650.866599928
28270Douglas County, Nebraska59200.95690.956936540
28280Dundy County, Nebraska280.86650.866599928
28290Fillmore County, Nebraska280.86650.866599928
28300Franklin County, Nebraska280.86650.866599928
28310Frontier County, Nebraska280.86650.866599928
28320Furnas County, Nebraska280.86650.866599928
28330Gage County, Nebraska280.86650.866599928
28340Garden County, Nebraska280.86650.866599928
28350Garfield County, Nebraska280.86650.866599928
28360Gosper County, Nebraska280.86650.866599928
28370Grant County, Nebraska280.86650.866599928
28380Greeley County, Nebraska280.86650.866599928
28390Hall County, Nebraska280.86650.866599928
28400Hamilton County, Nebraska280.86650.866599928
28410Harlan County, Nebraska280.86650.866599928
28420Hayes County, Nebraska280.86650.866599928
28430Hitchcock County, Nebraska280.86650.866599928
28440Holt County, Nebraska280.86650.866599928
28450Hooker County, Nebraska280.86650.866599928
28460Howard County, Nebraska280.86650.866599928
28470Jefferson County, Nebraska280.86650.866599928
28480Johnson County, Nebraska280.86650.866599928
28490Kearney County, Nebraska280.86650.866599928
28500Keith County, Nebraska280.86650.866599928
28510Keya Paha County, Nebraska280.86650.866599928
28520Kimball County, Nebraska280.86650.866599928
28530Knox County, Nebraska280.86650.866599928
28540Lancaster County, Nebraska43601.02251.022530700
28550Lincoln County, Nebraska280.86650.866599928
28560Logan County, Nebraska280.86650.866599928
Start Printed Page 40846
28570Loup County, Nebraska280.86650.866599928
28580McPherson County, Nebraska280.86650.866599928
28590Madison County, Nebraska280.86650.866599928
28600Merrick County, Nebraska280.86650.866599928
28610Morrill County, Nebraska280.86650.866599928
28620Nance County, Nebraska280.86650.866599928
28630Nemaha County, Nebraska280.86650.866599928
28640Nuckolls County, Nebraska280.86650.866599928
28650Otoe County, Nebraska280.86650.866599928
28660Pawnee County, Nebraska280.86650.866599928
28670Perkins County, Nebraska280.86650.866599928
28680Phelps County, Nebraska280.86650.866599928
28690Pierce County, Nebraska280.86650.866599928
28700Platte County, Nebraska280.86650.866599928
28710Polk County, Nebraska280.86650.866599928
28720Redwillow County, Nebraska280.86650.866599928
28730Richardson County, Nebraska280.86650.866599928
28740Rock County, Nebraska280.86650.866599928
28750Saline County, Nebraska280.86650.866599928
28760Sarpy County, Nebraska59200.95690.956936540
28770Saunders County, Nebraska280.86650.956936540
28780cotts Bluff County, Nebraska280.86650.866599928
28790Seward County, Nebraska280.86651.022530700
28800Sheridan County, Nebraska280.86650.866599928
28810Sherman County, Nebraska280.86650.866599928
28820Sioux County, Nebraska280.86650.866599928
28830Stanton County, Nebraska280.86650.866599928
28840Thayer County, Nebraska280.86650.866599928
28850Thomas County, Nebraska280.86650.866599928
28860Thurston County, Nebraska280.86650.866599928
28870Valley County, Nebraska280.86650.866599928
28880Washington County, Nebraska59200.95690.956936540
28890Wayne County, Nebraska280.86650.866599928
28900Webster County, Nebraska280.86650.866599928
28910Wheeler County, Nebraska280.86650.866599928
28920York County, Nebraska280.86650.866599928
29000Churchill County, Nevada290.96970.907499929
29010Clark County, Nevada41201.11661.144929820
29020Douglas County, Nevada290.96970.907499929
29030Elko County, Nevada290.96970.907499929
29040Esmeralda County, Nevada290.96970.907499929
29050Eureka County, Nevada290.96970.907499929
29060Humboldt County, Nevada290.96970.907499929
29070Lander County, Nevada290.96970.907499929
29080Lincoln County, Nevada290.96970.907499929
29090Lyon County, Nevada290.96970.907499929
29100Mineral County, Nevada290.96970.907499929
29110Nye County, Nevada41201.11660.907499929
29120Carson City County, Nevada290.96971.024416180
29130Pershing County, Nevada290.96970.907499929
29140Storey County, Nevada290.96971.099339900
29150Washoe County, Nevada67201.09931.099339900
29160White Pine County, Nevada290.96970.907499929
30000Belknap County, New Hampshire301.06771.067799930
30010Carroll County, New Hampshire301.06771.067799930
30020Cheshire County, New Hampshire301.06771.067799930
30030Coos County, New Hampshire301.06771.067799930
30040Grafton County, New Hampshire301.06771.067799930
30050Hillsboro County, New Hampshire11231.11521.033531700
30060Merrimack County, New Hampshire11231.11521.033531700
30070Rockingham County, New Hampshire11231.11521.038540484
30080Strafford County, New Hampshire11231.11521.038540484
30090Sullivan County, New Hampshire301.06771.067799930
31000Atlantic County, New Jersey05601.15131.163312100
1100Bergen County, New Jersey08751.16601.318535644
31150Burlington County, New Jersey61601.09261.052815804
31160Camden County, New Jersey61601.09261.052815804
31180Cape May County, New Jersey05601.15131.102236140
31190Cumberland County, New Jersey87600.98370.983747220
31200Essex County, New Jersey56401.21411.219535084
31220Gloucester County, New Jersey61601.09261.052815804
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31230Hudson County, New Jersey36401.13491.318535644
31250Hunterdon County, New Jersey50151.11781.219535084
31260Mercer County, New Jersey84801.08451.084545940
31270Middlesex County, New Jersey50151.11781.126020764
31290Monmouth County, New Jersey51901.12711.126020764
31300Morris County, New Jersey56401.21411.219535084
31310Ocean County, New Jersey51901.12711.126020764
31320Passaic County, New Jersey08751.16601.318535644
31340Salem County, New Jersey61601.09261.048248864
31350Somerset County, New Jersey50151.11781.126020764
31360Sussex County, New Jersey56401.21411.219535084
31370Union County, New Jersey56401.21411.219535084
31390Warren County, New Jersey56401.21410.982810900
32000Bernalillo County, New Mexico02000.96930.969310740
32010Catron County, New Mexico320.85710.864499932
32020Chaves County, New Mexico320.85710.864499932
32025Cibola County, New Mexico320.85710.864499932
32030Colfax County, New Mexico320.85710.864499932
32040Curry County, New Mexico320.85710.864499932
32050De Baca County, New Mexico320.85710.864499932
32060Dona Ana County, New Mexico41000.84750.847529740
32070Eddy County, New Mexico320.85710.864499932
32080Grant County, New Mexico320.85710.864499932
32090Guadalupe County, New Mexico32