Census

Census / en Mon, 28 Apr 2025 04:08:38 -0500 Mon, 10 May 21 15:04:49 -0500 AHA Letter on Proposed Census Bureau Criteria for Defining Urban Areas /lettercomment/2021-05-10-aha-letter-proposed-census-bureau-criteria-defining-urban-areas May 10, 2021 Vincent Osier Geographic Standards, Criteria, and Quality Branch Geography Division U.S. Census Bureau <a href="mailto:geo.urban@census.gov">geo.urban@census.gov</a> RE: Department of Commerce, Bureau of the Census 210212–0021: Urban Areas for the 2020 Census – Proposed Criteria, February 19, 2021. Dear Mr. Osier: On behalf of our nearly 5,000 member hospitals, health systems and other health care organizations, our clinician partners – including more than 270,000 affiliated physicians, 2 million nurses and other caregivers – and the 43,000 health care leaders who belong to our professional membership groups, the �� Association (AHA) appreciates the opportunity to comment on the Bureau of the Census’ (Census Bureau’s) proposed criteria for defining urban areas. If finalized, the new definition of urban areas could jeopardize the ability of certain health care providers to participate in programs that expand access to care in vulnerable communities. The Census Bureau’s current threshold for defining urban areas uses population density areas with at least 2,500 persons. Furthermore, the Census Bureau also uses “urbanized area” and “urban cluster” concepts to distinguish different types of urban areas<a href="#fn1">1</a>: <ul> <li>urbanized area describes areas with 50,000 or more persons; and</li> <li>urban cluster describes areas with at least 2,500 persons, but less than 50,000 persons.</li> </ul> The agency is now proposing to change its definition of an urban area to include only those with at least 4,000 housing units or 10,000 persons. It also would cease to distinguish between urbanized areas and urban clusters. The AHA strongly urges the Census Bureau to continue to distinguish between different types of urban areas. Specifically, we urge it to continue to recognize urbanized areas as areas with 50,000 or more persons, and to recognize urban cluster as areas with at least 10,000 persons, but less than 50,000 persons. The Census Bureau urban delineations directly affect program eligibility and funding formulas. For example, the Centers for Medicare &amp; Medicaid Services (CMS) uses different types of urban areas as the basis for certifying rural health clinics (RHCs). Currently, CMS defines a rural area as an area that is not an “urbanized area;” thus, RHCs can be currently certified in areas with less than 50,000 persons. Under the Census Bureau’s proposal, this may no longer be possible as there would no longer be specific recognition of areas with less than 50,000 persons – only those with less than 10,000 persons. We recognize the agency’s statement that “[i]n delineating urban areas, the Census Bureau does not take into account or attempt to meet the requirements of any nonstatistical uses of these areas or their associated data.” That said, our recommendation above would not only allow the Census Bureau to use its modified urban threshold of 4,000 housing units or 10,000 persons, but also allow other federal agencies to readily apply different types of urban area delineations to meet their own objectives. Indeed, urban areas with a population less than 50,000 are very different from urban areas with a population greater than 50,000, and that data reflecting those differences need to be maintained. For example, the Office of Management and Budget currently uses a 50,000-person threshold to qualify for the core of a metropolitan statistical area. Furthermore, the impact of adopting housing unit density as the proposed primary criterion to define an urban area is still to be determined. Thus, continuing to distinguish different types of urban areas per our recommendation above, while also making the Census Bureau’s proposed change to its urban threshold of at least 10,000 persons, would allow for continuity and provide more exact data to users. It is essential that proposed changes be as inclusive and flexible as possible in order to broaden opportunities for providers in various communities. Furthermore, the programs that rely on these delineations are critical to their communities. The RHC program provides essential health care services for individuals living in vulnerable communities. The program allows individuals to obtain access to high-quality, safe and effective health care services in their own communities, which in turn, improves their health outcomes. Thus, it is vital to maintain access to these RHCs. We thank you for your consideration of our comments. Please contact me if you have questions, or feel free to have a member of your team contact Shannon Wu, senior associate director of policy, at <a href="tel:1-202-626-2963">202-626-2963</a> or <a href="mailto:swu@aha.org">swu@aha.org</a>. Sincerely, /s/ Ashley Thompson Senior Vice President Public Policy Analysis and Development <hr /> <ol> <li id="fn1">The Census Bureau identifies <a href="https://www.census.gov/programs-surveys/geography/guidance/geo-areas/urban-rural/2010-urban-rural.html" target="_blank">two types of urban areas</a> – urbanized areas and urban clusters. “Rural” encompasses areas not included within an urban area.</li> </ol> Mon, 10 May 2021 15:04:49 -0500 Census Member Advisory: 2020 Census: Procedures for Interviewing Patients Who Live in Health Care Facilities The U.S. Census Bureau is required to count the nation’s population every 10 years. In February, Census Bureau workers will contact health care facilities to ensure that certain people living in hospitals, skilled nursing facilities (SNFs), and psychiatric hospital or psychiatric units for long-term care are accounted for appropriately in the 2020 census. While the majority of your patients will not be subjected to census taking at your facility, you will need to work with the Census Bureau to determine which individuals should be interviewed. AHA Take: The 2020 census is important, but it needs to be conducted in a manner that minimizes burden, avoids disrupting patient care and adheres to adequate confidentiality protections. This advisory describes the 2020 census process and provides an overview of pertinent patient confidentiality issues. Key Takeaways <ul> <li>This year the federal government will take a census of the U.S. population, including individuals living in health care facilities.</li> <li>Hospitals and health care facilities are required by federal law to cooperate with the census process.</li> <li>The Census Bureau will contact your facility in February to obtain identifying information about the facility, including a preferred enumeration method.</li> <li>Federal regulations prohibit hospitals from providing identifiable information about patients in federally assisted alcohol and substance use disorders treatment programs.</li> </ul> What You Can Do <ul> <li>Share this advisory with your senior management team.</li> <li>Ask relevant staff to review this advisory and determine whether actions by local census workers are consistent. If there are discrepancies, contact local census officials to clarify any misunderstandings. If that does not resolve the problem, contact your state hospital association or the AHA, and we will work to ensure that the Census Bureau provides better instructions to its local workers and supervisors.</li> <li>Determine what role your staff should play in obtaining information for census workers.</li> </ul> See the key&nbsp;resources below for details.&nbsp; &nbsp; Wed, 29 Jan 2020 09:13:44 -0600 Census