Sample records for user fee system

  1. User fees for public health care services in Hungary: expectations, experience, and acceptability from the perspectives of different stakeholders.

    PubMed

    Baji, Petra; Pavlova, Milena; Gulácsi, László; Groot, Wim

    2011-10-01

    The introduction of user fees for health care services is a new phenomenon in Central-Eastern European Countries. In Hungary, user fees were first introduced in 2007, but abolished one year later after a referendum. The aim of our study is to describe the experiences and expectations of health system stakeholders in Hungary related to user fees as well as their approval of such fees. For our analysis we use both qualitative and quantitative data from focus-group discussions with health care consumers and physicians, and in-depth interviews with policy makers and health insurance representatives. Our findings suggest that the reasons behind the unpopularity of user fees might be (a) the rejection of the objectives of user fees defined by the government, (b) negative personal experiences with user fees, and (c) the general mistrust of the Hungarian population when it comes to the utilization of public resources. Successful policy implementation of user fees requires social consensus on the policy objectives, also there should be real improvements in health care provision noticeable for consumers, to assure the fees acceptance. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  2. Mileage-based user fees : defining a path toward implementation phase 2, an assessment of technology issues : final report

    DOT National Transportation Integrated Search

    2009-10-01

    This report reviews technology options for a mileage-based user fee system in the state of Texas. The report was : compiled based on input from a diverse range of sources, including a literature review of existing mileage-based : user fee technical w...

  3. Hidden costs: the direct and indirect impact of user fees on access to malaria treatment and primary care in Mali.

    PubMed

    Johnson, Ari; Goss, Adeline; Beckerman, Jessica; Castro, Arachu

    2012-11-01

    About 20 years after initial calls for the introduction of user fees in health systems in sub-Saharan Africa, a growing coalition is advocating for their removal. Several African countries have abolished user fees for health care for some or all of their citizens. However, fee-for-service health care delivery remains a primary health care funding model in many countries in sub-Saharan Africa. Although the impact of user fees on utilization of health services and household finances has been studied extensively, further research is needed to characterize the multi-faceted health and social problems associated with charging user fees. This ethnographic study aims to identify consequences of user fees on gender inequality, food insecurity, and household decision-making for a group of women living in poverty. Ethnographic life history interviews were conducted with 24 women in Yirimadjo, Mali in 2007. Purposive sampling selected participants across a broad socio-economic spectrum. Semi-structured interviews addressed participants' past medical history, socio-economic status, social and family history, and access to health care. Interview transcripts were coded using the guiding analytical framework of structural violence. Interviews revealed that user fees for health care not only decreased utilization of health services, but also resulted in delayed presentation for care, incomplete or inadequate care, compromised food security and household financial security, and reduced agency for women in health care decision making. The effects of user fees were amplified by conditions of poverty, as well as gender and health inequality; user fees in turn reinforced the inequalities created by those very conditions. The qualitative data reveal multi-faceted health and socioeconomic effects of user fees, and illustrate that user fees for health care may impact quality of care, health outcomes, food insecurity, and gender inequality, in addition to impacting health care utilization and household finances. As many countries consider user fee abolition policies, these findings indicate the need to create a broader evaluation framework-one that can measure the health and socioeconomic impacts of user fee polices and of their removal. Copyright © 2012 Elsevier Ltd. All rights reserved.

  4. Establishment of revisit user fee program for Medicare survey and certification activities. Final rule.

    PubMed

    2007-09-19

    This final rule will establish a system of revisit user fees applicable to health care facilities that have been cited for deficiencies during initial certification, recertification, or substantiated complaint surveys and require a revisit to confirm that corrections to previously-identified deficiencies have been remedied. Consistent with the President's long-term goal to promote quality of health care and to cut the deficit in half by fiscal year (FY) 2009, the FY 2007 Department of Health and Human Services' (HHS) budget request included both new mandatory savings proposals and a requirement that user fees be applied to health care providers that have failed to comply with Federal quality of care requirements. The "Revisit User Fees" will affect only those providers or suppliers for which a revisit is required to confirm that previously-identified failures to meet federal quality of care requirements have been remedied. The fees are estimated at $37.3 million annually and will recover the costs associated with the Medicare Survey and Certification program's revisit surveys. The fees will take effect on the date of publication of the final rule and will be in effect until the date that the continued authority provided by Congress expires. At the time of publication of this regulation the applicable date is September 30, 2007. If no legislation is enacted, the fees are not retroactive to the beginning of the fiscal year. Any provider or supplier that has a revisit survey conducted on or after the date of publication will be assessed a revisit user fee and will be notified of the assessment upon data system reconciliation which can occur following the closing of the fiscal year. The fees will be available to CMS until expended. The revisit user fee is included in the President's proposed FY 2008 budget. We note through the publication of this final rule that if authority for the revisit user fee is continued, we will use the current fee schedule in this rule for the assessment of such fees until such time as a new fee schedule notice is proposed and published in final form.

  5. Economic Impacts of the Generic Drug User Fee Act Fee Structure.

    PubMed

    Dong, Ke; Boehm, Garth; Zheng, Qiang

    2017-06-01

    A Food and Drug Administration (FDA) Generic Drug User system, Generic Drug User Fee Amendment of 2012 (GDUFA), started October 1, 2012, and has been in place for over 3 years. There is controversy about the GDUFA fee structure but no analysis of GDUFA data that we could find. To look at the economic impact of the GDUFA fee structure. We compared the structure of GDUFA with that of other FDA Human Drug User fees. We then, using FDA-published information, analyzed where GDUFA facility and Drug Master File fees are coming from. We used the Orange Book to identify the sponsors of all approved Abbreviated New Drug Applications (ANDAs) and the S&P Capital IQ database to find the ultimate parent companies of sponsors of approved ANDAs. The key differences between the previous structure for Human Drug User fees and the GDUFA are as follows: GDUFA has no approved product fee and no first-time or small business fee exemptions and GDUFA charges facility fees from the time of filing and charges a foreign facility levy. Most GDUFA fees are paid by or on behalf of foreign entities. The top 10 companies hold nearly 50% of all approved ANDAs but pay about 14% of GDUFA facility fees. We conclude that the regressive nature of the GDUFA fee structure penalizes small, new, and foreign firms while benefiting the large established firms. A progressive fee structure in line with other human drug user fees is needed to ensure a healthy generic drug industry. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  6. From fuel taxes to mileage-based user fees : rationale, technology, and transitional issues.

    DOT National Transportation Integrated Search

    2011-08-01

    Two national commissions established by the U.S. Congress recommend replacing the current system of funding : transportation based on fuel taxes with a new distance-based system of user fees. The State of Oregon has done a : pilot project demonstrati...

  7. Effects of user fee exemptions on the provision and use of maternal health services: a review of literature.

    PubMed

    Hatt, Laurel E; Makinen, Marty; Madhavan, Supriya; Conlon, Claudia M

    2013-12-01

    User fee removal has been put forward as an approach to increasing priority health service utilization, reducing impoverishment, and ultimately reducing maternal and neonatal mortality. However, user fees are a source of facility revenue in many low-income countries, often used for purchasing drugs and supplies and paying incentives to health workers. This paper reviews evidence on the effects of user fee exemptions on maternal health service utilization, service provision, and outcomes, including both supply-side and demand-side effects. We reviewed 19 peer-reviewed research articles addressing user fee exemptions and maternal health services or outcomes published since 1990. Studies were identified through a USAID-commissioned call for evidence, key word search, and screening process. Teams of reviewers assigned criteria-based quality scores to each paper and prepared structured narrative reviews. The grade of the evidence was found to be relatively weak, mainly from short-term, non-controlled studies. The introduction of user fee exemptions appears to have resulted in increased rates of facility-based deliveries and caesarean sections in some contexts. Impacts on maternal and neonatal mortality have not been conclusively demonstrated; exemptions for delivery care may contribute to modest reductions in institutional maternal mortality but the evidence is very weak. User fee exemptions were found to have negative, neutral, or inconclusive effects on availability of inputs, provider motivation, and quality of services. The extent to which user fee revenue lost by facilities is replaced can directly affect service provision and may have unintended consequences for provider motivation. Few studies have looked at the equity effects of fee removal, despite clear evidence that fees disproportionately burden the poor. This review highlights potential and documented benefits (increased use of maternity services) as well as risks (decreased provider motivation and quality) of user fee exemption policies for maternal health services. Governments should link user fee exemption policies with the replacement of lost revenue for facilities as well as broader health system improvements, including facility upgrades, ensured supply of needed inputs, and improved human resources for health. Removing user fees may increase uptake but will not reduce mortality proportionally if the quality of facility-based care is poor. More rigorous evaluations of both demand- and supply-side effects of mature fee exemption programmes are needed.

  8. 76 FR 44014 - Generic Drug User Fee; Public Meeting; Request for Comments

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-22

    ...] Generic Drug User Fee; Public Meeting; Request for Comments AGENCY: Food and Drug Administration, HHS... development of a generic drug user fee program. A user fee program could provide necessary supplemental... generic drug user fees. New legislation would be required for FDA to establish and collect user fees for...

  9. 9 CFR 130.10 - User fees for pet birds.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 9 Animals and Animal Products 1 2012-01-01 2012-01-01 false User fees for pet birds. 130.10... AGRICULTURE USER FEES USER FEES § 130.10 User fees for pet birds. (a) User fees for pet birds of U.S. origin returning to the United States, except pet birds of U.S. origin returning from Canada, are as follows...

  10. 9 CFR 130.10 - User fees for pet birds.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 9 Animals and Animal Products 1 2013-01-01 2013-01-01 false User fees for pet birds. 130.10... AGRICULTURE USER FEES USER FEES § 130.10 User fees for pet birds. (a) User fees for pet birds of U.S. origin returning to the United States, except pet birds of U.S. origin returning from Canada, are as follows...

  11. 9 CFR 130.10 - User fees for pet birds.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 9 Animals and Animal Products 1 2014-01-01 2014-01-01 false User fees for pet birds. 130.10... AGRICULTURE USER FEES USER FEES § 130.10 User fees for pet birds. (a) User fees for pet birds of U.S. origin returning to the United States, except pet birds of U.S. origin returning from Canada, are as follows...

  12. 9 CFR 130.10 - User fees for pet birds.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 9 Animals and Animal Products 1 2010-01-01 2010-01-01 false User fees for pet birds. 130.10... AGRICULTURE USER FEES USER FEES § 130.10 User fees for pet birds. (a) User fees for pet birds of U.S. origin returning to the United States, except pet birds of U.S. origin returning from Canada, are as follows...

  13. 9 CFR 130.10 - User fees for pet birds.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 9 Animals and Animal Products 1 2011-01-01 2011-01-01 false User fees for pet birds. 130.10... AGRICULTURE USER FEES USER FEES § 130.10 User fees for pet birds. (a) User fees for pet birds of U.S. origin returning to the United States, except pet birds of U.S. origin returning from Canada, are as follows...

  14. Maintaining quality of health services after abolition of user fees: A Uganda case study

    PubMed Central

    Nabyonga-Orem, Juliet; Karamagi, Humphrey; Atuyambe, Lynn; Bagenda, Fred; Okuonzi, Sam A; Walker, Oladapo

    2008-01-01

    Background It has been argued that quality improvements that result from user charges reduce their negative impact on utilization especially of the poor. In Uganda, because there was no concrete evidence for improvements in quality of care following the introduction of user charges, the government abolished user fees in all public health units on 1st March 2001. This gave us the opportunity to prospectively study how different aspects of quality of care change, as a country changes its health financing options from user charges to free services, in a developing country setting. The outcome of the study may then provide insights into policy actions to maintain quality of care following removal of user fees. Methods A population cohort and representative health facilities were studied longitudinally over 3 years after the abolition of user fees. Quantitative and qualitative methods were used to obtain data. Parameters evaluated in relation to quality of care included availability of drugs and supplies and; health worker variables. Results Different quality variables assessed showed that interventions that were put in place were able to maintain, or improve the technical quality of services. There were significant increases in utilization of services, average drug quantities and stock out days improved, and communities reported health workers to be hardworking, good and dedicated to their work to mention but a few. Communities were more appreciative of the services, though expectations were lower. However, health workers felt they were not adequately motivated given the increased workload. Conclusion The levels of technical quality of care attained in a system with user fees can be maintained, or even improved without the fees through adoption of basic, sustainable system modifications that are within the reach of developing countries. However, a trade-off between residual perceptions of reduced service quality, and the welfare gains from removal of user fees should guide such a policy change. PMID:18471297

  15. 9 CFR 130.17 - User fees for other veterinary diagnostic laboratory tests performed at NVSL (excluding FADDL) or...

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 9 Animals and Animal Products 1 2011-01-01 2011-01-01 false User fees for other veterinary... FEES USER FEES § 130.17 User fees for other veterinary diagnostic laboratory tests performed at NVSL (excluding FADDL) or at authorized sites. (a) User fees for veterinary diagnostics tests performed at the...

  16. 9 CFR 130.17 - User fees for other veterinary diagnostic laboratory tests performed at NVSL (excluding FADDL) or...

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 9 Animals and Animal Products 1 2010-01-01 2010-01-01 false User fees for other veterinary... FEES USER FEES § 130.17 User fees for other veterinary diagnostic laboratory tests performed at NVSL (excluding FADDL) or at authorized sites. (a) User fees for veterinary diagnostics tests performed at the...

  17. 19 CFR 360.106 - Fees.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 19 Customs Duties 3 2010-04-01 2010-04-01 false Fees. 360.106 Section 360.106 Customs Duties INTERNATIONAL TRADE ADMINISTRATION, DEPARTMENT OF COMMERCE STEEL IMPORT MONITORING AND ANALYSIS SYSTEM § 360.106 Fees. No fees will be charged for obtaining a user identification number, issuing a steel import...

  18. 19 CFR 360.106 - Fees.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 19 Customs Duties 3 2014-04-01 2014-04-01 false Fees. 360.106 Section 360.106 Customs Duties INTERNATIONAL TRADE ADMINISTRATION, DEPARTMENT OF COMMERCE STEEL IMPORT MONITORING AND ANALYSIS SYSTEM § 360.106 Fees. No fees will be charged for obtaining a user identification number, issuing a steel import...

  19. 19 CFR 360.106 - Fees.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 19 Customs Duties 3 2011-04-01 2011-04-01 false Fees. 360.106 Section 360.106 Customs Duties INTERNATIONAL TRADE ADMINISTRATION, DEPARTMENT OF COMMERCE STEEL IMPORT MONITORING AND ANALYSIS SYSTEM § 360.106 Fees. No fees will be charged for obtaining a user identification number, issuing a steel import...

  20. 19 CFR 360.106 - Fees.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 19 Customs Duties 3 2012-04-01 2012-04-01 false Fees. 360.106 Section 360.106 Customs Duties INTERNATIONAL TRADE ADMINISTRATION, DEPARTMENT OF COMMERCE STEEL IMPORT MONITORING AND ANALYSIS SYSTEM § 360.106 Fees. No fees will be charged for obtaining a user identification number, issuing a steel import...

  1. 19 CFR 360.106 - Fees.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 19 Customs Duties 3 2013-04-01 2013-04-01 false Fees. 360.106 Section 360.106 Customs Duties INTERNATIONAL TRADE ADMINISTRATION, DEPARTMENT OF COMMERCE STEEL IMPORT MONITORING AND ANALYSIS SYSTEM § 360.106 Fees. No fees will be charged for obtaining a user identification number, issuing a steel import...

  2. 76 FR 24035 - Generic Drug User Fee; Public Meeting; Request for Comments

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-29

    ...] Generic Drug User Fee; Public Meeting; Request for Comments AGENCY: Food and Drug Administration, HHS... development of a generic drug user fee program. A user fee program could provide necessary supplemental... announcing its intention to hold a public meeting related to generic drug user fees. The Agency continues to...

  3. 9 CFR 130.15 - User fees for veterinary diagnostic isolation and identification tests performed at NVSL...

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 9 Animals and Animal Products 1 2011-01-01 2011-01-01 false User fees for veterinary diagnostic isolation and identification tests performed at NVSL (excluding FADDL) or other authorized site. 130.15... AGRICULTURE USER FEES USER FEES § 130.15 User fees for veterinary diagnostic isolation and identification...

  4. 9 CFR 130.15 - User fees for veterinary diagnostic isolation and identification tests performed at NVSL...

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 9 Animals and Animal Products 1 2010-01-01 2010-01-01 false User fees for veterinary diagnostic isolation and identification tests performed at NVSL (excluding FADDL) or other authorized site. 130.15... AGRICULTURE USER FEES USER FEES § 130.15 User fees for veterinary diagnostic isolation and identification...

  5. 9 CFR 130.14 - User fees for FADDL veterinary diagnostics.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 9 Animals and Animal Products 1 2011-01-01 2011-01-01 false User fees for FADDL veterinary..., DEPARTMENT OF AGRICULTURE USER FEES USER FEES § 130.14 User fees for FADDL veterinary diagnostics. (a... 167.00 Rabbit antiserum, any agent 1 mL 179.00 185.00 190.00 196.00 (b) Veterinary diagnostics tests...

  6. 9 CFR 130.14 - User fees for FADDL veterinary diagnostics.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 9 Animals and Animal Products 1 2010-01-01 2010-01-01 false User fees for FADDL veterinary..., DEPARTMENT OF AGRICULTURE USER FEES USER FEES § 130.14 User fees for FADDL veterinary diagnostics. (a... 167.00 Rabbit antiserum, any agent 1 mL 179.00 185.00 190.00 196.00 (b) Veterinary diagnostics tests...

  7. 40 CFR 700.41 - Radon user fees.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 30 2010-07-01 2010-07-01 false Radon user fees. 700.41 Section 700.41 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) TOXIC SUBSTANCES CONTROL ACT GENERAL Fees § 700.41 Radon user fees. User fees relating to radon proficiency programs authorized under the...

  8. 40 CFR 700.41 - Radon user fees.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 31 2011-07-01 2011-07-01 false Radon user fees. 700.41 Section 700.41 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) TOXIC SUBSTANCES CONTROL ACT GENERAL Fees § 700.41 Radon user fees. User fees relating to radon proficiency programs authorized under the...

  9. What is greener than a VMT tax? The case for an indexed energy user fee to finance us surface transportation

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Greene, David L

    Highway finance in the United States is perceived by many to be in a state of crisis, primarily due to the erosion of motor fuel tax revenues due to inflation, fuel economy improvement, increased use of alternative sources of energy and diversion of revenues to other purposes. Monitoring vehicle miles of travel (VMT) and charging highway users per mile has been proposed as a replacement for the motor fuel tax. A VMT user fee, however, does not encourage energy efficiency in vehicle design, purchase and operation, as would a user fee levied on all forms of commercial energy used formore » transportation and indexed to the average efficiency of vehicles on the road and to inflation. An indexed roadway user toll on energy (IRoUTE) would induce two to four times as much reduction in greenhouse gas (GHG) emissions and petroleum use as a pure VMT user fee. However, it is not a substitute for pricing GHG emissions and would make only a small but useful contribution to reducing petroleum dependence. An indexed energy user fee cannot adequately address the problems of traffic congestion and heavy vehicle cost responsibility. It could, however, be a key component of a comprehensive system of financing surface transportation that would eventually also include time and place specific monitoring of VMT for congestion pricing, externality charges and heavy vehicle user fees.« less

  10. Road user fee task force report to the 72nd Oregon Legislative Assembly on the possible alternatives of the current system of taxing highway use through motor vehicle fuel taxes

    DOT National Transportation Integrated Search

    2003-03-01

    Recognizing that the fuel tax is a declining revenue source for Oregon's road system, the 2001 Oregon Legislative Assembly passed House Bill 3946, mandating the formation of the Road User Fee Task Force with the mission to develop a design for revenu...

  11. 76 FR 31823 - Technical Amendment to List of User Fee Airports: Addition of Dallas Love Field Municipal Airport...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-02

    ...] Technical Amendment to List of User Fee Airports: Addition of Dallas Love Field Municipal Airport, Dallas... fee airport designation for Dallas Love Field Municipal Airport, in Dallas, Texas. User fee airports... Love Field Municipal Airport. This document updates the list of user fee airports by adding Dallas Love...

  12. Measuring users' response to higher recreation fees

    Treesearch

    Stephen D. Reiling; Hsiang Tai Cheng; Cheryl Trott

    1992-01-01

    One of the arguments against higher fees at publicly-provided recreational facilities is that higher fees may force low-income users to reduce their use of facilities more than high-income users, or force them to stop using the facilities altogether if they cannot afford the higher fee. Measuring the impact of higher fees on current users with different income levels...

  13. A practical tool for modeling biospecimen user fees.

    PubMed

    Matzke, Lise; Dee, Simon; Bartlett, John; Damaraju, Sambasivarao; Graham, Kathryn; Johnston, Randal; Mes-Masson, Anne-Marie; Murphy, Leigh; Shepherd, Lois; Schacter, Brent; Watson, Peter H

    2014-08-01

    The question of how best to attribute the unit costs of the annotated biospecimen product that is provided to a research user is a common issue for many biobanks. Some of the factors influencing user fees are capital and operating costs, internal and external demand and market competition, and moral standards that dictate that fees must have an ethical basis. It is therefore important to establish a transparent and accurate costing tool that can be utilized by biobanks and aid them in establishing biospecimen user fees. To address this issue, we built a biospecimen user fee calculator tool, accessible online at www.biobanking.org . The tool was built to allow input of: i) annual operating and capital costs; ii) costs categorized by the major core biobanking operations; iii) specimen products requested by a biobank user; and iv) services provided by the biobank beyond core operations (e.g., histology, tissue micro-array); as well as v) several user defined variables to allow the calculator to be adapted to different biobank operational designs. To establish default values for variables within the calculator, we first surveyed the members of the Canadian Tumour Repository Network (CTRNet) management committee. We then enrolled four different participants from CTRNet biobanks to test the hypothesis that the calculator tool could change approaches to user fees. Participants were first asked to estimate user fee pricing for three hypothetical user scenarios based on their biobanking experience (estimated pricing) and then to calculate fees for the same scenarios using the calculator tool (calculated pricing). Results demonstrated significant variation in estimated pricing that was reduced by calculated pricing, and that higher user fees are consistently derived when using the calculator. We conclude that adoption of this online calculator for user fee determination is an important first step towards harmonization and realistic user fees.

  14. 78 FR 53702 - User Fees for Processing Installment Agreements and Offers in Compromise

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-30

    ... User Fees for Processing Installment Agreements and Offers in Compromise AGENCY: Internal Revenue... document contains proposed amendments to the regulations that provide user fees for installment agreements... agencies to prescribe regulations that establish charges for services provided by the agencies (user fees...

  15. The impact of user fees on health services utilization and infectious disease diagnoses in Neno District, Malawi: a longitudinal, quasi-experimental study.

    PubMed

    Watson, S I; Wroe, E B; Dunbar, E L; Mukherjee, J; Squire, S B; Nazimera, L; Dullie, L; Lilford, R J

    2016-10-20

    User fees have generally fallen out of favor across Africa, and they have been associated with reductions in access to healthcare. We examined the effects of the introduction and removal of user fees on outpatient attendances and new diagnoses of HIV, malaria, and tuberculosis in Neno District, Malawi where user fees were re-instated at three of 13 health centres in 2013 and subsequently removed at one of these in 2015. We conducted two analyses. Firstly, an unadjusted comparison of outpatient visits and new diagnoses over three periods between July 2012 and October 2015: during the period with no user fees, at the re-introduction of user fees at four centres, and after the removal of user fees at one centre. Secondly, we estimated a linear model of the effect of user fees on the outcome of interest that controlled for unobserved health centre effects, monthly effects, and a linear time trend. The introduction of user fees was associated with a change in total attendances of -68 % [95 % CI: -89 %, -12 %], similar reductions were observed for new malaria and HIV diagnoses. The removal of user fees was associated with an increase in total attendances of 352 % [213 %, 554 %] with similar increases for malaria diagnoses. The results were not sensitive to control group or model specification. User fees for outpatient healthcare services present a barrier to patients accessing healthcare and reduce detection of serious infectious diseases.

  16. 75 FR 75170 - APHIS User Fee Web Site

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-02

    ...] APHIS User Fee Web Site AGENCY: Animal and Plant Health Inspection Service, USDA. ACTION: Notice... recover the costs of providing certain services. This notice announces the availability of a Web site that contains information about the Agency's user fees. ADDRESSES: The Agency's user fee Web site is located at...

  17. 77 FR 35992 - Agency Information Collection Activities: User Fees

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-15

    ... Activities: User Fees AGENCY: U.S. Customs and Border Protection (CBP), Department of Homeland Security... User Fees. This request for comment is being made pursuant to the Paperwork Reduction Act of 1995 (Pub... soliciting comments concerning the following information collection: Title: User Fees. OMB Number: 1651-0052...

  18. 75 FR 63845 - Medical Device User Fees; Public Meeting; Extension of Comment Period

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-18

    ...] Medical Device User Fees; Public Meeting; Extension of Comment Period AGENCY: Food and Drug Administration... stakeholders on the Agency's medical user fee program and requested suggestions regarding the commitments FDA... interested stakeholders to discuss the Agency's medical user fee program and requested suggestions regarding...

  19. 75 FR 24970 - FBI Records Management Division National Name Check Program Section User Fees

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-06

    ... Division National Name Check Program Section User Fees AGENCY: Federal Bureau of Investigation (FBI), Justice. ACTION: Notice. SUMMARY: This notice establishes the user fee schedule for federal agencies... user fees for federal agencies requesting noncriminal name-based background checks of the Central...

  20. 78 FR 19714 - User Fees and Refunds for Premarket Approval Applications and Device Biologics License...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-02

    ...] User Fees and Refunds for Premarket Approval Applications and Device Biologics License Applications... availability of the guidance entitled ``User Fees and Refunds for Premarket Approval Applications (PMAs) and... for single copies of the guidance document entitled ``User Fees and Refunds for Premarket Approval...

  1. 78 FR 28926 - Self-Regulatory Organizations; NYSE MKT LLC; Notice of Filing and Immediate Effectiveness of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-16

    ... Establishing Non- Display Usage Fees and Amending the Professional End-User Fees for NYSE Amex Options Market... proposes to establish non-display usage fees and to amend the Professional End-User fees for NYSE Amex... The Exchange proposes to establish non-display usage fees and to amend the Professional End-User fees...

  2. 77 FR 74201 - Customs Brokers User Fee Payment for 2013

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-13

    ... DEPARTMENT OF HOMELAND SECURITY U.S. Customs and Border Protection Customs Brokers User Fee... of the 2013 Customs Broker User Fee is due February 15, 2013. FOR FURTHER INFORMATION CONTACT: Craig... establish that effective April 1, 2007, an annual user fee of $138 is to be assessed for each customs broker...

  3. 77 FR 51818 - Agency Information Collection Activities; User Fees

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-27

    ... Activities; User Fees AGENCY: U.S. Customs and Border Protection, Department of Homeland Security. ACTION: 30... review and approval in accordance with the Paperwork Reduction Act: User Fees. This is a proposed...: User Fees. OMB Number: 1651-0052. Form Number: CBP Forms 339A, 339C and 339V. Abstract: The...

  4. 76 FR 65741 - Customs Brokers User Fee Payment for 2012

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-24

    ... DEPARTMENT OF HOMELAND SECURITY Customs and Border Protection Customs Brokers User Fee Payment for... 2012 in accordance with the Tax Reform Act of 1986. DATES: Payment of the 2012 Customs Broker User Fee..., an annual user fee of $138 is to be assessed for each customs broker permit and national permit held...

  5. 76 FR 1626 - Customs Brokers User Fee Payment for 2011

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-11

    ... DEPARTMENT OF HOMELAND SECURITY U.S. Customs and Border Protection Customs Brokers User Fee... in accordance with the Tax Reform Act of 1986. DATES: Payment of the 2011 Customs Broker User Fee is... annual user fee of $138 is to be assessed for each customs broker permit and national permit held by an...

  6. 19 CFR 122.15 - User fee airports.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 19 Customs Duties 1 2014-04-01 2014-04-01 false User fee airports. 122.15 Section 122.15 Customs... AIR COMMERCE REGULATIONS Classes of Airports § 122.15 User fee airports. (a) Permission to land. The procedures for obtaining permission to land at a user fee airport are the same procedures as those set forth...

  7. 19 CFR 122.15 - User fee airports.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 19 Customs Duties 1 2012-04-01 2012-04-01 false User fee airports. 122.15 Section 122.15 Customs... AIR COMMERCE REGULATIONS Classes of Airports § 122.15 User fee airports. (a) Permission to land. The procedures for obtaining permission to land at a user fee airport are the same procedures as those set forth...

  8. 19 CFR 122.15 - User fee airports.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 19 Customs Duties 1 2013-04-01 2013-04-01 false User fee airports. 122.15 Section 122.15 Customs... AIR COMMERCE REGULATIONS Classes of Airports § 122.15 User fee airports. (a) Permission to land. The procedures for obtaining permission to land at a user fee airport are the same procedures as those set forth...

  9. 76 FR 13629 - Revised Draft Guidance for Industry on User Fee Waivers, Reductions, and Refunds for Drug and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-14

    ...] Revised Draft Guidance for Industry on User Fee Waivers, Reductions, and Refunds for Drug and Biological... entitled ``User Fee Waivers, Reductions, and Refunds for Drug and Biological Products.'' This revised draft... industry entitled ``User Fee Waivers, Reductions, and Refunds for Drug and Biological Products.'' This...

  10. Biospecimen User Fees: Global Feedback on a Calculator Tool.

    PubMed

    Matzke, Lise A M; Babinszky, Sindy; Slotty, Alex; Meredith, Anna; Castillo-Pelayo, Tania; Henderson, Marianne K; Simeon-Dubach, Daniel; Schacter, Brent; Watson, Peter H

    2017-02-01

    The notion of attributing user fees to researchers for biospecimens provided by biobanks has been discussed frequently in the literature. However, the considerations around how to attribute the cost for these biospecimens and data have, until recently, not been well described. Common across most biobank disciplines are similar factors that influence user fees such as capital and operating costs, internal and external demand, and market competition. A biospecimen user fee calculator tool developed by CTRNet, a tumor biobank network, was published in 2014 and is accessible online at www.biobanking.org . The next year a survey was launched that tested the applicability of this user fee tool among a global health research biobank user base, including both cancer and noncancer biobanking. Participants were first asked to estimate user fee pricing for three hypothetical user scenarios based on their biobanking experience (estimated pricing) and then to calculate fees for the same scenarios using the calculator tool (calculated pricing). Results demonstrated variation in estimated pricing that was reduced by calculated pricing. These results are similar to those found in a similar previous study restricted to a group of Canadian tumor biobanks. We conclude that the use of a biospecimen user fee calculator contributes to reduced variation of user fees and for biobank groups (e.g., biobank networks), could become an important part of a harmonization strategy.

  11. Biospecimen User Fees: Global Feedback on a Calculator Tool

    PubMed Central

    Babinszky, Sindy; Slotty, Alex; Meredith, Anna; Castillo-Pelayo, Tania; Henderson, Marianne K.; Simeon-Dubach, Daniel; Schacter, Brent; Watson, Peter H.

    2017-01-01

    The notion of attributing user fees to researchers for biospecimens provided by biobanks has been discussed frequently in the literature. However, the considerations around how to attribute the cost for these biospecimens and data have, until recently, not been well described. Common across most biobank disciplines are similar factors that influence user fees such as capital and operating costs, internal and external demand, and market competition. A biospecimen user fee calculator tool developed by CTRNet, a tumor biobank network, was published in 2014 and is accessible online at www.biobanking.org. The next year a survey was launched that tested the applicability of this user fee tool among a global health research biobank user base, including both cancer and noncancer biobanking. Participants were first asked to estimate user fee pricing for three hypothetical user scenarios based on their biobanking experience (estimated pricing) and then to calculate fees for the same scenarios using the calculator tool (calculated pricing). Results demonstrated variation in estimated pricing that was reduced by calculated pricing. These results are similar to those found in a similar previous study restricted to a group of Canadian tumor biobanks. We conclude that the use of a biospecimen user fee calculator contributes to reduced variation of user fees and for biobank groups (e.g., biobank networks), could become an important part of a harmonization strategy. PMID:27576065

  12. 78 FR 46970 - Medical Device User Fee Rates for Fiscal Year 2014

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-02

    ...] Medical Device User Fee Rates for Fiscal Year 2014 AGENCY: Food and Drug Administration, HHS. ACTION... procedures for medical device user fees for fiscal year (FY) 2014. The Federal Food, Drug, and Cosmetic Act.... The FY 2014 fee rates are provided in this document. These fees apply from October 1, 2013, through...

  13. 75 FR 45641 - Medical Device User Fee Rates for Fiscal Year 2011

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-03

    ...] Medical Device User Fee Rates for Fiscal Year 2011 AGENCY: Food and Drug Administration, HHS. ACTION... payment procedures for medical device user fees for fiscal year (FY) 2011. The Federal Food, Drug, and Cosmetic Act (the act), as amended by the Medical Device User Fee Amendments of 2007 (title II of the Food...

  14. 76 FR 33307 - Generic Drug User Fee; Notice of Public Meeting; Extension of Comment Period

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-08

    ...] Generic Drug User Fee; Notice of Public Meeting; Extension of Comment Period AGENCY: Food and Drug... on the development of a generic drug user fee program. The Agency is taking this action to allow..., 75 FR 47820, FDA published a notice soliciting comment on development of a generic drug user fee...

  15. 78 FR 53152 - Prescription Drug User Fee Rates for Fiscal Year 2014; Correction

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-28

    ...] Prescription Drug User Fee Rates for Fiscal Year 2014; Correction AGENCY: Food and Drug Administration, HHS... ``Prescription Drug User Fee Rates for Fiscal Year 2014'' that appeared in the Federal Register of August 2, 2013 (78 FR 46980). The document announced the Fiscal Year 2014 fee rates for the Prescription Drug User...

  16. 9 CFR 130.19 - User fees for other veterinary diagnostic services or materials provided at NVSL (excluding FADDL).

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 9 Animals and Animal Products 1 2011-01-01 2011-01-01 false User fees for other veterinary... User fees for other veterinary diagnostic services or materials provided at NVSL (excluding FADDL). (a) User fees for other veterinary diagnostic services or materials available from NVSL (excluding FADDL...

  17. 9 CFR 130.19 - User fees for other veterinary diagnostic services or materials provided at NVSL (excluding FADDL).

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 9 Animals and Animal Products 1 2010-01-01 2010-01-01 false User fees for other veterinary... User fees for other veterinary diagnostic services or materials provided at NVSL (excluding FADDL). (a) User fees for other veterinary diagnostic services or materials available from NVSL (excluding FADDL...

  18. 9 CFR 130.16 - User fees for veterinary diagnostic serology tests performed at NVSL (excluding FADDL) or at...

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 9 Animals and Animal Products 1 2011-01-01 2011-01-01 false User fees for veterinary diagnostic serology tests performed at NVSL (excluding FADDL) or at authorized sites. 130.16 Section 130.16 Animals... USER FEES § 130.16 User fees for veterinary diagnostic serology tests performed at NVSL (excluding...

  19. 9 CFR 130.16 - User fees for veterinary diagnostic serology tests performed at NVSL (excluding FADDL) or at...

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 9 Animals and Animal Products 1 2010-01-01 2010-01-01 false User fees for veterinary diagnostic serology tests performed at NVSL (excluding FADDL) or at authorized sites. 130.16 Section 130.16 Animals... USER FEES § 130.16 User fees for veterinary diagnostic serology tests performed at NVSL (excluding...

  20. 7 CFR 504.4 - Exemptions from user fee charges.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... OF AGRICULTURE USER FEES § 504.4 Exemptions from user fee charges. (a) USDA laboratories and ARS cooperators designated by the Curator of the ARS Patent Culture Collection are exempt from fee assessments. (b) The Curator of the ARS Patent Culture Collection is delegated the authority to approve and revoke...

  1. 7 CFR 504.4 - Exemptions from user fee charges.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... OF AGRICULTURE USER FEES § 504.4 Exemptions from user fee charges. (a) USDA laboratories and ARS cooperators designated by the Curator of the ARS Patent Culture Collection are exempt from fee assessments. (b) The Curator of the ARS Patent Culture Collection is delegated the authority to approve and revoke...

  2. 7 CFR 504.4 - Exemptions from user fee charges.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... OF AGRICULTURE USER FEES § 504.4 Exemptions from user fee charges. (a) USDA laboratories and ARS cooperators designated by the Curator of the ARS Patent Culture Collection are exempt from fee assessments. (b) The Curator of the ARS Patent Culture Collection is delegated the authority to approve and revoke...

  3. 7 CFR 504.4 - Exemptions from user fee charges.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... OF AGRICULTURE USER FEES § 504.4 Exemptions from user fee charges. (a) USDA laboratories and ARS cooperators designated by the Curator of the ARS Patent Culture Collection are exempt from fee assessments. (b) The Curator of the ARS Patent Culture Collection is delegated the authority to approve and revoke...

  4. 7 CFR 504.4 - Exemptions from user fee charges.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... OF AGRICULTURE USER FEES § 504.4 Exemptions from user fee charges. (a) USDA laboratories and ARS cooperators designated by the Curator of the ARS Patent Culture Collection are exempt from fee assessments. (b) The Curator of the ARS Patent Culture Collection is delegated the authority to approve and revoke...

  5. Implementation of patient charges at primary care facilities in Kenya: implications of low adherence to user fee policy for users and facility revenue

    PubMed Central

    Opwora, Antony; Waweru, Evelyn; Toda, Mitsuru; Noor, Abdisalan; Edwards, Tansy; Fegan, Greg; Molyneux, Sassy; Goodman, Catherine

    2015-01-01

    With user fees now seen as a major hindrance to universal health coverage, many countries have introduced fee reduction or elimination policies, but there is growing evidence that adherence to reduced fees is often highly imperfect. In 2004, Kenya adopted a reduced and uniform user fee policy providing fee exemptions to many groups. We present data on user fee implementation, revenue and expenditure from a nationally representative survey of Kenyan primary health facilities. Data were collected from 248 randomly selected public health centres and dispensaries in 2010, comprising an interview with the health worker in charge, exit interviews with curative outpatients, and a financial record review. Adherence to user fee policy was assessed for eight tracer conditions based on health worker reports, and patients were asked about actual amounts paid. No facilities adhered fully to the user fee policy across all eight tracers, with adherence ranging from 62.2% for an adult with tuberculosis to 4.2% for an adult with malaria. Three quarters of exit interviewees had paid some fees, with a median payment of US dollars (USD) 0.39, and a quarter of interviewees were required to purchase additional medical supplies at a later stage from a private drug retailer. No consistent pattern of association was identified between facility characteristics and policy adherence. User fee revenues accounted for almost all facility cash income, with average revenue of USD 683 per facility per year. Fee revenue was mainly used to cover support staff, non-drug supplies and travel allowances. Adherence to user fee policy was very low, leading to concerns about the impact on access and the financial burden on households. However, the potential to ensure adherence was constrained by the facilities’ need for revenue to cover basic operating costs, highlighting the need for alternative funding strategies for peripheral health facilities. PMID:24837638

  6. 49 CFR 1002.3 - Updating user fees.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... updating fees. Each fee shall be updated by updating the cost components comprising the fee. Cost... direct labor costs are direct labor costs determined by the cost study set forth in Revision of Fees For... by total office costs for the Offices directly associated with user fee activity. Actual updating of...

  7. A Comparative Analysis for Wilderness User Fee Policy.

    ERIC Educational Resources Information Center

    Leuschner, William A.; And Others

    1987-01-01

    Two similar wilderness areas, one of which charges user fees, were sampled in order to compare user characteristics, trip characteristics, and travel cost demand functions. The purpose was to examine the effect fees had on user behavior and choices of area. Results are presented. (MT)

  8. The Pricing of Information--A Search-Based Approach to Pricing an Online Search Service.

    ERIC Educational Resources Information Center

    Boyle, Harry F.

    1982-01-01

    Describes innovative pricing structure consisting of low connect time fee, print fees, and search fees, offered by Chemical Abstracts Service (CAS) ONLINE--an online searching system used to locate chemical substances. Pricing options considered by CAS, the search-based pricing approach, and users' reactions to pricing structures are noted. (EJS)

  9. 77 FR 72359 - Animal Generic Drug User Fee Act; Public Meeting; Request for Comments

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-05

    ... increase the revenue stream stability and reduce application fee costs. III. What information should you...] Animal Generic Drug User Fee Act; Public Meeting; Request for Comments AGENCY: Food and Drug... announcing the following meeting: Animal Generic Drug User Fee Act. The topic to be discussed is proposed...

  10. 77 FR 51814 - Draft Guidance for Industry on Generic Drug User Fee Amendments of 2012: Questions and Answers...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-27

    ... costs to industry. GDUFA enables FDA to assess user fees to support critical and measurable enhancements... critical and measurable enhancements to FDA's generic drugs program. GDUFA establishes fees for abbreviated... current thinking on generic drug user fee amendments of 2012. It does not create or confer any rights for...

  11. 78 FR 46955 - Animal Drug User Fee Rates and Payment Procedures for Fiscal Year 2014

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-02

    ...] Animal Drug User Fee Rates and Payment Procedures for Fiscal Year 2014 AGENCY: Food and Drug... payment procedures for fiscal year (FY) 2014 animal drug user fees. The Federal Food, Drug, and Cosmetic... submissions. This notice establishes the fee rates for FY 2014. FOR FURTHER INFORMATION CONTACT: Visit FDA's...

  12. 9 CFR 130.51 - Penalties for nonpayment or late payment.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... payment. 130.51 Section 130.51 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE USER FEES USER FEES § 130.51 Penalties for nonpayment or late payment. (a) Unpaid... payment is due; (ii) For billed fees, the user fee is unpaid 60 days after date of bill; (iii) The person...

  13. 9 CFR 130.51 - Penalties for nonpayment or late payment.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... payment. 130.51 Section 130.51 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE USER FEES USER FEES § 130.51 Penalties for nonpayment or late payment. (a) Unpaid... payment is due; (ii) For billed fees, the user fee is unpaid 60 days after date of bill; (iii) The person...

  14. 9 CFR 130.51 - Penalties for nonpayment or late payment.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... payment. 130.51 Section 130.51 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE USER FEES USER FEES § 130.51 Penalties for nonpayment or late payment. (a) Unpaid... payment is due; (ii) For billed fees, the user fee is unpaid 60 days after date of bill; (iii) The person...

  15. 9 CFR 130.51 - Penalties for nonpayment or late payment.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... payment. 130.51 Section 130.51 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE USER FEES USER FEES § 130.51 Penalties for nonpayment or late payment. (a) Unpaid... payment is due; (ii) For billed fees, the user fee is unpaid 60 days after date of bill; (iii) The person...

  16. 9 CFR 130.51 - Penalties for nonpayment or late payment.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... payment. 130.51 Section 130.51 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE USER FEES USER FEES § 130.51 Penalties for nonpayment or late payment. (a) Unpaid... payment is due; (ii) For billed fees, the user fee is unpaid 60 days after date of bill; (iii) The person...

  17. 7 CFR 500.25 - Payment of fees.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... enters into an agreement to allow USNA visitors and users to make payment in the form of a credit card, USNA visitors and users who are assessed user fees may pay those fees with a credit card subject to the...

  18. 7 CFR 500.25 - Payment of fees.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... enters into an agreement to allow USNA visitors and users to make payment in the form of a credit card, USNA visitors and users who are assessed user fees may pay those fees with a credit card subject to the...

  19. 7 CFR 500.25 - Payment of fees.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... enters into an agreement to allow USNA visitors and users to make payment in the form of a credit card, USNA visitors and users who are assessed user fees may pay those fees with a credit card subject to the...

  20. 7 CFR 500.25 - Payment of fees.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... enters into an agreement to allow USNA visitors and users to make payment in the form of a credit card, USNA visitors and users who are assessed user fees may pay those fees with a credit card subject to the...

  1. 7 CFR 500.25 - Payment of fees.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... enters into an agreement to allow USNA visitors and users to make payment in the form of a credit card, USNA visitors and users who are assessed user fees may pay those fees with a credit card subject to the...

  2. Implementation of patient charges at primary care facilities in Kenya: implications of low adherence to user fee policy for users and facility revenue.

    PubMed

    Opwora, Antony; Waweru, Evelyn; Toda, Mitsuru; Noor, Abdisalan; Edwards, Tansy; Fegan, Greg; Molyneux, Sassy; Goodman, Catherine

    2015-05-01

    With user fees now seen as a major hindrance to universal health coverage, many countries have introduced fee reduction or elimination policies, but there is growing evidence that adherence to reduced fees is often highly imperfect. In 2004, Kenya adopted a reduced and uniform user fee policy providing fee exemptions to many groups. We present data on user fee implementation, revenue and expenditure from a nationally representative survey of Kenyan primary health facilities. Data were collected from 248 randomly selected public health centres and dispensaries in 2010, comprising an interview with the health worker in charge, exit interviews with curative outpatients, and a financial record review. Adherence to user fee policy was assessed for eight tracer conditions based on health worker reports, and patients were asked about actual amounts paid. No facilities adhered fully to the user fee policy across all eight tracers, with adherence ranging from 62.2% for an adult with tuberculosis to 4.2% for an adult with malaria. Three quarters of exit interviewees had paid some fees, with a median payment of US dollars (USD) 0.39, and a quarter of interviewees were required to purchase additional medical supplies at a later stage from a private drug retailer. No consistent pattern of association was identified between facility characteristics and policy adherence. User fee revenues accounted for almost all facility cash income, with average revenue of USD 683 per facility per year. Fee revenue was mainly used to cover support staff, non-drug supplies and travel allowances. Adherence to user fee policy was very low, leading to concerns about the impact on access and the financial burden on households. However, the potential to ensure adherence was constrained by the facilities' need for revenue to cover basic operating costs, highlighting the need for alternative funding strategies for peripheral health facilities. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2014.

  3. National Environmental Data Referral Service (NEDRES) User Survey. Final Report.

    ERIC Educational Resources Information Center

    MAXIMA Corp., Silver Spring, MD.

    A survey was conducted to assess environmental data users' interest in a referral system such as the National Environmental Data Referral Service (NEDRES) and to gauge user willingness to participate in a proposed NEDRES network and to comply with a system of NEDRES user fees. Twenty-one organizations were identified and 3,200 individuals were…

  4. 7 CFR 504.3 - Payment of fees.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 6 2010-01-01 2010-01-01 false Payment of fees. 504.3 Section 504.3 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL RESEARCH SERVICE, DEPARTMENT OF AGRICULTURE USER FEES § 504.3 Payment of fees. (a) Payment of user fees must accompany a culture deposit or...

  5. Elimination of User-Fees in Tertiary Education: A Distributive Analysis for Ecuador

    ERIC Educational Resources Information Center

    Ponce, Juan; Loayza, Yessenia

    2012-01-01

    This paper offers new evidence and methods for understanding the distributive effect of a universal government policy to eliminate user fees in public universities in Ecuador. The main argument to eliminate user fees in higher education is that it will increase enrollment among the poor. In this regard, eliminating tuition fees is supposed to be a…

  6. 76 FR 76424 - Biologics Price Competition and Innovation Act of 2009; Proposed Recommendations for a User Fee...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-07

    ...] Biologics Price Competition and Innovation Act of 2009; Proposed Recommendations for a User Fee Program for... meeting to discuss the proposed recommendations for a user fee program for biosimilar biological products... 20993-0002, (301) 796-4463, Fax: (301) 847-8443, Email: BiosimilarsUser[email protected

  7. 78 FR 5133 - Technical Corrections Regarding the Methods of Collection of Certain User Fees by CBP

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-24

    ...] Technical Corrections Regarding the Methods of Collection of Certain User Fees by CBP AGENCY: U.S. Customs... electronic payments through the DTOPS. While CBP's preferred method of receiving user fee prepayment requests...

  8. Funding sources for Canadian biorepositories: the role of user fees and strategies to help fill the gap.

    PubMed

    Barnes, Rebecca O; Schacter, Brent; Kodeeswaran, Sugy; Watson, Peter H

    2014-10-01

    Biorepositories, the coordinating hubs for the collection and annotation of biospecimens, are under increasing financial pressure and are challenged to remain sustainable. To gain a better understanding of the current funding situation for Canadian biorepositories and the relative contributions they receive from different funding sources, the Canadian Tumour Repository Network (CTRNet) conducted two surveys. The first survey targeted CTRNet's six main nodes to ascertain the relative funding sources and levels of user fees. The second survey was targeted to a broader range of biorepositories (n=45) to ascertain business practices in application of user fees. The results show that >70% of Canadian biorepositories apply user fees and that the majority apply differential fees to different user groups (academic vs. industry, local vs. international). However, user fees typically comprise only 6% of overall operational budgets. We conclude that while strategies to drive up user fee levels need to be implemented, it is essential for the many stakeholders in the biomedical health research sector to consider this issue in order to ensure the ongoing availability of research biospecimens and data that are standardized, high-quality, and that are therefore capable of meeting research needs.

  9. Transversal analysis of public policies on user fees exemptions in six West African countries.

    PubMed

    Ridde, Valéry; Queuille, Ludovic; Kafando, Yamba; Robert, Emilie

    2012-11-20

    While more and more West African countries are implementing public user fees exemption policies, there is still little knowledge available on this topic. The long time required for scientific production, combined with the needs of decision-makers, led to the creation in 2010 of a project to support implementers in aggregating knowledge on their experiences. This article presents a transversal analysis of user fees exemption policies implemented in Benin, Burkina Faso, Mali, Niger, Togo and Senegal. This was a multiple case study with several embedded levels of analysis. The cases were public user fees exemption policies selected by the participants because of their instructive value. The data used in the countries were taken from documentary analysis, interviews and questionnaires. The transversal analysis was based on a framework for studying five implementation components and five actors' attitudes usually encountered in these policies. The analysis of the implementation components revealed: a majority of State financing; maintenance of centrally organized financing; a multiplicity of reimbursement methods; reimbursement delays and/or stock shortages; almost no implementation guides; a lack of support measures; communication plans that were rarely carried out, funded or renewed; health workers who were given general information but not details; poorly informed populations; almost no evaluation systems; ineffective and poorly funded coordination systems; low levels of community involvement; and incomplete referral-evacuation systems. With regard to actors' attitudes, the analysis revealed: objectives that were appreciated by everyone; dissatisfaction with the implementation; specific tensions between healthcare providers and patients; overall satisfaction among patients, but still some problems; the perception that while the financial barrier has been removed, other barriers persist; occasionally a reorganization of practices, service rationing due to lack of reimbursement, and some overcharging or shifting of resources. This transversal analysis confirms the need to assign a great deal of importance to the implementation of user fees exemption policies once these decisions have been taken. It also highlights some practices that suggest avenues of future research.

  10. 24 CFR 200.934 - User fee system for the technical suitability of products program.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... section establishes fee requirements for the issuance of Structural Engineering Bulletins (SEBs), Mechanical Engineering Bulletins (MEBs), Truss Connector Bulletins (TCBs), Area Letters of Acceptance (ALAs... Department. (i) With respect to Mechanical Engineering Bulletins (MEBs), Structural Engineering Bulletins...

  11. 24 CFR 200.934 - User fee system for the technical suitability of products program.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... section establishes fee requirements for the issuance of Structural Engineering Bulletins (SEBs), Mechanical Engineering Bulletins (MEBs), Truss Connector Bulletins (TCBs), Area Letters of Acceptance (ALAs... Department. (i) With respect to Mechanical Engineering Bulletins (MEBs), Structural Engineering Bulletins...

  12. 24 CFR 200.934 - User fee system for the technical suitability of products program.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... section establishes fee requirements for the issuance of Structural Engineering Bulletins (SEBs), Mechanical Engineering Bulletins (MEBs), Truss Connector Bulletins (TCBs), Area Letters of Acceptance (ALAs... Department. (i) With respect to Mechanical Engineering Bulletins (MEBs), Structural Engineering Bulletins...

  13. 24 CFR 200.934 - User fee system for the technical suitability of products program.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... section establishes fee requirements for the issuance of Structural Engineering Bulletins (SEBs), Mechanical Engineering Bulletins (MEBs), Truss Connector Bulletins (TCBs), Area Letters of Acceptance (ALAs... Department. (i) With respect to Mechanical Engineering Bulletins (MEBs), Structural Engineering Bulletins...

  14. Stated choice models for predicting the impact of user fees at public recreation sites

    Treesearch

    Herbert W. Schroeder; Jordan Louviere

    1999-01-01

    A crucial question in the implementation of fee programs is how the users of recreation sites will respond to various levels and types of fees. Stated choice models can help managers anticipate the impact of user fees on people's choices among the alternative recreation sites available to them. Models developed for both day and overnight trips to several areas and...

  15. Fairness of prices, user fee policy and willingness to pay among visitors to a national forest

    Treesearch

    Jin Young Chung; Gerard T. Kyle; James F. Petrick; James D. Absher

    2011-01-01

    Imposing user fees in Nature-Based Tourism (NBT) contexts has been a controversial issue. Based on the notions of justice and fairness, this study extended previous work examining the relationship between attitudes toward user fees and spending support. In a proposed structural model of price fairness, fee spending support, and willingness to pay (WTP), this paper...

  16. Support for wilderness recreation fees: The influence of fee purpose and day versus overnight use

    Treesearch

    Christine A. Vogt; Daniel R. Williams

    1999-01-01

    This paper examines public support for new user fees established at the Desolation Wilderness in California as part of the Fee Demonstration Program. Traditional approaches to fee policy evaluations have typically focused on economic or revenue issues and equity impacts of various pricing strategies. Support for fees has been shown to vary by users in terms of...

  17. 24 CFR 200.934 - User fee system for the technical suitability of products program.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... COMMISSIONER, DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT GENERAL INTRODUCTION TO FHA PROGRAMS Minimum Property... section establishes fee requirements for the issuance of Structural Engineering Bulletins (SEBs), Mechanical Engineering Bulletins (MEBs), Truss Connector Bulletins (TCBs), Area Letters of Acceptance (ALAs...

  18. Data transmission options for VMT data and fee collection centers.

    DOT National Transportation Integrated Search

    2002-11-01

    The Oregon Road User Fee Task Force (RUFTF) is charged with developing a design for revenue collection for Oregon's roads and highways that will replace the current system for revenue collection for all light vehicles in the state. One option under c...

  19. 77 FR 16239 - Medical Device User Fee Act; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-20

    ...] Medical Device User Fee Act; Public Meeting AGENCY: Food and Drug Administration, HHS. ACTION: Notice of... public meeting to discuss proposed recommendations for the reauthorization of the Medical Device User Fee... use them for the process for the review of medical device applications. The current legislative...

  20. Discrimination through User Fees: Fact or Fiction?

    ERIC Educational Resources Information Center

    Manning, Robert E.; Baker, Sidney C.

    1981-01-01

    In addition to raising operating funds, user fees can alter types of park users and activities. A study was done in which the establishment of a dollar per car entrance fee was shown to have positive financial as well as environmental effects for a city-owned recreational park. (JN)

  1. 77 FR 45634 - Biosimilar User Fee Rates for Fiscal Year 2013

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-01

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2012-N-0007] Biosimilar User Fee Rates for Fiscal Year 2013 AGENCY: Food and Drug Administration, HHS. ACTION: Notice. SUMMARY: The Food and Drug Administration (FDA) is announcing the rates for biosimilar user fees for...

  2. ‘Rowing against the current’: the policy process and effects of removing user fees for caesarean sections in Benin

    PubMed Central

    Cresswell, Jenny A; Makoutodé, Patrick; De Brouwere, Vincent; Witter, Sophie; Filippi, Veronique; Kanhonou, Lydie G; Goufodji, Sourou B; Lange, Isabelle L; Lawin, Lionel; Affo, Fabien; Marchal, Bruno

    2018-01-01

    Background In 2009, the Benin government introduced a user fee exemption policy for caesarean sections. We analyse this policy with regard to how the existing ideas and institutions related to user fees influenced key steps of the policy cycle and draw lessons that could inform the policy dialogue for universal health coverage in the West African region. Methods Following the policy stages model, we analyse the agenda setting, policy formulation and legitimation phase, and assess the implementation fidelity and policy results. We adopted an embedded case study design, using quantitative and qualitative data collected with 13 tools at the national level and in seven hospitals implementing the policy. Results We found that the initial political goal of the policy was not to reduce maternal mortality but to eliminate the detention in hospitals of mothers and newborns who cannot pay the user fees by exempting a comprehensive package of maternal health services. We found that the policy development process suffered from inadequate uptake of evidence and that the policy content and process were not completely in harmony with political and public health goals. The initial policy intention clashed with the neoliberal orientation of the political system, the fee recovery principles institutionalised since the Bamako Initiative and the prevailing ideas in favour of user fees. The policymakers did not take these entrenched factors into account. The resulting tension contributed to a benefit package covering only caesarean sections and to the variable implementation and effectiveness of the policy. Conclusion The influence of organisational culture in the decision-making processes in the health sector is often ignored but must be considered in the design and implementation of any policy aimed at achieving universal health coverage in West African countries. PMID:29564156

  3. 77 FR 15033 - Privacy Act Systems of Records; APHIS Veterinary Services User Fee System

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-14

    ... UFS tracks the accuracy of expenditures and collections transactions of credit accounts. Information obtained in the credit account application is entered into the Foundation Financial Information System... information about the user's credit account, including charges and payments made, date(s) and type of service...

  4. The intersection of urban form and mileage fees : findings from the Oregon road user fee pilot program

    DOT National Transportation Integrated Search

    2011-03-01

    This report analyzes data from the 2006-2007 Oregon Road User Fee Pilot Program to assess if and how urban form variables correlate with travel behavior changes that participants made in response to the mileage fee program. The study tested the impac...

  5. 76 FR 79195 - Animal Drug User Fee Act; Reopening of the Comment Period

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-21

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2011-N-0656] Animal Drug User Fee Act; Reopening of the Comment Period AGENCY: Food and Drug Administration, HHS... notice, FDA requested comments on the Animal Drug User Fee Act (ADUFA) program to date and solicited...

  6. 76 FR 2617 - User Fees Relating to Enrolled Agents and Enrolled Retirement Plan Agents; Hearing Cancellation

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-14

    ... User Fees Relating to Enrolled Agents and Enrolled Retirement Plan Agents; Hearing Cancellation AGENCY... regulations relating to the imposition of user fees for enrolled agents and enrolled retirement plan agents... FURTHER INFORMATION CONTACT: Richard A. Hurst of the Publications and Regulations Branch, Legal Processing...

  7. 49 CFR 360.5 - Updating user fees.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... updating the cost components comprising the fee. Cost components shall be updated as follows: (1) Direct... determined by the cost study in Regulations Governing Fees For Service, 1 I.C.C. 2d 60 (1984), or subsequent... by total office costs for the office directly associated with user fee activity. Actual updating of...

  8. Structural equation modeling of users' response to wilderness recreation fees

    Treesearch

    Daniel R. Williams; Christine A. Vogt; Joar Vitterso

    1999-01-01

    This paper examines wilderness users' response to recently established overnight camping fees at the Desolation Wilderness in California. Fee program evaluations have typically focused on economic or revenue issues, distributional or equity impacts of various pricing strategies, and questions of price fairness. In the case of wilderness recreation fees, it is also...

  9. 75 FR 34319 - User Fees for 2010 Crop Cotton Classification Services to Growers

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-17

    ...-AC99 User Fees for 2010 Crop Cotton Classification Services to Growers AGENCY: Agricultural Marketing... fees for cotton producers for 2010 crop cotton classification services under the Cotton Statistics and Estimates Act at the same level as in 2009. These fees are also authorized under the Cotton Standards Act of...

  10. 77 FR 33289 - User Fees for 2012 Crop Cotton Classification Services to Growers

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-06

    ... User Fees for 2012 Crop Cotton Classification Services to Growers AGENCY: Agricultural Marketing... fees for cotton producers for 2012 crop cotton classification services under the Cotton Statistics and Estimates Act and the Cotton Standards Act of 1923 at $2.20 per bale--the same level as in 2011. This fee...

  11. 76 FR 25533 - User Fees for 2011 Crop Cotton Classification Services to Growers

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-05

    ...-AD11 User Fees for 2011 Crop Cotton Classification Services to Growers AGENCY: Agricultural Marketing... fees for cotton producers for 2011 crop cotton classification services under the Cotton Statistics and Estimates Act at the same level as in 2010. These fees are also authorized under the Cotton Standards Act of...

  12. 9 CFR 130.30 - Hourly rate and minimum user fees.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... covered by a flat rate user fee in § 130.7. (14) Export-related bird banding for identification. (15..., except those services covered by flat rate user fees elsewhere in this part, will be calculated at the... activities covered in § 130.11. (3) Obtaining samples required to be tested, either to obtain import permits...

  13. 77 FR 35878 - Establishment of User Fees for Filovirus Testing of Nonhuman Primate Liver Samples

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-15

    ... Establishment of User Fees for Filovirus Testing of Nonhuman Primate Liver Samples AGENCY: Centers for Disease... comment on the establishment of user fees for filovirus testing of all nonhuman primates that die during... nonhuman primates. HHS/CDC took this action because (1) testing is no longer being offered by the only...

  14. 78 FR 55261 - Draft Guidance for Industry on Generic Drug User Fee Amendments of 2012: Questions and Answers...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-10

    ... public and reduce costs to industry. GDUFA enables FDA to assess user fees to support critical and... assess user fees to support critical and measurable enhancements to FDA's generic drugs program. GDUFA...). The draft guidance, when finalized, will represent the Agency's current thinking on ``Generic Drug...

  15. 78 FR 18898 - User Fees for 2013 Crop Cotton Classification Services to Growers

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-28

    ... Service 7 CFR Part 28 [AMS-CN-12-0074] RIN 0581-AD30 User Fees for 2013 Crop Cotton Classification... Agricultural Marketing Service (AMS) is proposing to maintain user fees for cotton producers for 2013 crop cotton classification services under the Cotton Statistics and Estimates Act at the same level as in 2012...

  16. 76 FR 16321 - User Fees for 2011 Crop Cotton Classification Services to Growers

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-23

    ... Service 7 CFR Part 28 [AMS-CN-10-0111; CN-11-001] RIN 0581-AD11 User Fees for 2011 Crop Cotton...: The Agricultural Marketing Service (AMS) is proposing to maintain user fees for cotton producers for 2011 crop cotton classification services under the Cotton Statistics and Estimates Act at the same...

  17. 77 FR 21684 - User Fees for 2012 Crop Cotton Classification Services to Growers

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-11

    ... Service 7 CFR Part 28 [Doc. AMS-CN-12-0005] RIN 0581-AD23 User Fees for 2012 Crop Cotton Classification... Agricultural Marketing Service (AMS) is proposing to maintain user fees for cotton producers for 2012 crop cotton classification services under the Cotton Statistics and Estimates Act at the same level as in 2011...

  18. 75 FR 22026 - User Fees for 2010 Crop Cotton Classification Services to Growers

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-27

    ... Service 7 CFR Part 28 [AMS-CN-10-0001; CN-10-001] RIN 0581-AC99 User Fees for 2010 Crop Cotton...: The Agricultural Marketing Service (AMS) is proposing to maintain user fees for cotton producers for 2010 crop cotton classification services under the Cotton Statistics and Estimates Act at the same...

  19. 19 CFR 122.15 - User fee airports.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 19 Customs Duties 1 2010-04-01 2010-04-01 false User fee airports. 122.15 Section 122.15 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND SECURITY; DEPARTMENT OF THE TREASURY AIR COMMERCE REGULATIONS Classes of Airports § 122.15 User fee airports. (a) Permission to land. The procedures for obtaining permission to land at...

  20. 19 CFR 122.15 - User fee airports.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 19 Customs Duties 1 2011-04-01 2011-04-01 false User fee airports. 122.15 Section 122.15 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND SECURITY; DEPARTMENT OF THE TREASURY AIR COMMERCE REGULATIONS Classes of Airports § 122.15 User fee airports. (a) Permission to land. The procedures for obtaining permission to land at...

  1. Modeling Freight Ocean Rail and Truck Transportation Flows to Support Policy Analyses

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Gearhart, Jared Lee; Wang, Hao; Nozick, Linda Karen

    Freight transportation represents about 9.5% of GDP, is responsible for about 8% of greenhouse gas emissions and supports the import and export of about 3.6 trillion in international trade; hence it is important that our national freight transportation system is designed and operated efficiently and embodies user fees and other policies that balance costs and environmental consequences. Hence, this paper develops a mathematical model to estimate international and domestic freight flows across ocean, rail and truck modes which can be used to study the impacts of changes in our infrastructure as well as the imposition of new user fees andmore » changes in operating policies. This model is applied to two case studies: (1) a disruption of the maritime ports at Los Angeles/Long Beach similar to the impacts that would be felt in an earthquake; and (2) implementation of new user fees at the California ports.« less

  2. From institutionalization of user fees to their abolition in West Africa: a story of pilot projects and public policies

    PubMed Central

    2015-01-01

    This article analyzes the historical background of the institutionalization of user fees and their subsequent abolition in West Africa. Based on a narrative review, we present the context that frames the different articles in this supplement. We first show that a general consensus has emerged internationally against user fees, which were imposed widely in Africa in the 1980s and 1990s; at that time, the institutionalization of user fees was supported by evidence from pilot projects funded by international aid agencies. Since then there have been other pilot projects studying the abolition of user fees in the 2000s, but these have not yet had any real influence on public policies, which are often still chaotic. This perplexing situation might be explained more by ideologies and political will than by insufficient financial capacity of states. PMID:26559564

  3. Demand for Primary Schooling in Rural Mali: Should User Fees Be Increased?

    ERIC Educational Resources Information Center

    Birdsall, Nancy; Orivel, Francois

    1996-01-01

    Assesses the effect of school fees on primary school attendance, using household and school survey data from rural Mali. Estimates elasticity of demand regarding fees and compares it with effects of distance and quality on enrollment. User fees can provide a partial solution to the quality/enrollment problem, but cannot solve the distance problem.…

  4. Does User Fee Removal Policy Provide Financial Protection from Catastrophic Health Care Payments? Evidence from Zambia

    PubMed Central

    Masiye, Felix; Kaonga, Oliver; Kirigia, Joses M

    2016-01-01

    Background Out-of-pocket payments in health care have been shown to impose significant burden on households in Sub-Saharan Africa, leading to constrained access to health care and impoverishment. In an effort to reduce the financial burden imposed on households by user fees, some countries in Sub-Saharan Africa have abolished user fees in the health sector. Zambia is one of few countries in Sub-Saharan Africa to abolish user fees in primary health care facilities with a view to alleviating financial burden of out-of-pocket payments among the poor. The main aim of this paper was to examine the extent and patterns of financial protection from fees following the decision to abolish user fees in public primary health facilities. Methods Our analysis is based on a nationally representative health expenditure and utilization survey conducted in 2014. We calculated the incidence and intensity of catastrophic health expenditure based on households’ out-of-pocket payments during a visit as a percentage of total household consumption expenditure. We further show the intensity of the problem of catastrophic health expenditure (CHE) experienced by households. Results Our analysis show that following the removal of user fees, a majority of patients who visited public health facilities benefitted from free care at the point of use. Further, seeking care at public primary health facilities is associated with a reduced likelihood of incurring CHE after controlling for economic wellbeing and other covariates. However, 10% of households are shown to suffer financial catastrophe as a result of out-of-pocket payments. Further, there is considerable inequality in the incidence of CHE whereby the poorest expenditure quintile experienced a much higher incidence. Conclusion Despite the removal of user fees at primary health care level, CHE is high among the poorest sections of the population. This study also shows that cost of transportation is mainly responsible for limiting the protective effectiveness of user fee removal on CHE among particularly poorest households. PMID:26795620

  5. Does User Fee Removal Policy Provide Financial Protection from Catastrophic Health Care Payments? Evidence from Zambia.

    PubMed

    Masiye, Felix; Kaonga, Oliver; Kirigia, Joses M

    2016-01-01

    Out-of-pocket payments in health care have been shown to impose significant burden on households in Sub-Saharan Africa, leading to constrained access to health care and impoverishment. In an effort to reduce the financial burden imposed on households by user fees, some countries in Sub-Saharan Africa have abolished user fees in the health sector. Zambia is one of few countries in Sub-Saharan Africa to abolish user fees in primary health care facilities with a view to alleviating financial burden of out-of-pocket payments among the poor. The main aim of this paper was to examine the extent and patterns of financial protection from fees following the decision to abolish user fees in public primary health facilities. Our analysis is based on a nationally representative health expenditure and utilization survey conducted in 2014. We calculated the incidence and intensity of catastrophic health expenditure based on households' out-of-pocket payments during a visit as a percentage of total household consumption expenditure. We further show the intensity of the problem of catastrophic health expenditure (CHE) experienced by households. Our analysis show that following the removal of user fees, a majority of patients who visited public health facilities benefitted from free care at the point of use. Further, seeking care at public primary health facilities is associated with a reduced likelihood of incurring CHE after controlling for economic wellbeing and other covariates. However, 10% of households are shown to suffer financial catastrophe as a result of out-of-pocket payments. Further, there is considerable inequality in the incidence of CHE whereby the poorest expenditure quintile experienced a much higher incidence. Despite the removal of user fees at primary health care level, CHE is high among the poorest sections of the population. This study also shows that cost of transportation is mainly responsible for limiting the protective effectiveness of user fee removal on CHE among particularly poorest households.

  6. 77 FR 20825 - Guidance for Industry and Food and Drug Administration Staff; User Fees for 513(g) Requests for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-06

    ...] Guidance for Industry and Food and Drug Administration Staff; User Fees for 513(g) Requests for Information... Administration (FDA) is announcing the availability of the guidance entitled ``Guidance for Industry and Food and... ``Guidance for Industry and Food and Drug Administration Staff; User Fees for 513(g) Requests for Information...

  7. 78 FR 46958 - Animal Generic Drug User Fee Rates and Payment Procedures for Fiscal Year 2014

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-02

    ...] Animal Generic Drug User Fee Rates and Payment Procedures for Fiscal Year 2014 AGENCY: Food and Drug... and payment procedures for fiscal year (FY) 2014 generic new animal drug user fees. The Federal Food... for FY 2014. FOR FURTHER INFORMATION CONTACT: Visit FDA's Web site at http://www.fda.gov/ForIndustry...

  8. 9 CFR 156.7 - User fees under 9 CFR part 130.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 9 Animals and Animal Products 1 2012-01-01 2012-01-01 false User fees under 9 CFR part 130. 156.7 Section 156.7 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE VOLUNTARY INSPECTION AND CERTIFICATION SERVICE VOLUNTARY INSPECTION AND CERTIFICATION SERVICE § 156.7 User fees under 9 CFR part 130. Use...

  9. 9 CFR 156.7 - User fees under 9 CFR part 130.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 9 Animals and Animal Products 1 2011-01-01 2011-01-01 false User fees under 9 CFR part 130. 156.7 Section 156.7 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE VOLUNTARY INSPECTION AND CERTIFICATION SERVICE VOLUNTARY INSPECTION AND CERTIFICATION SERVICE § 156.7 User fees under 9 CFR part 130. Use...

  10. 9 CFR 156.7 - User fees under 9 CFR part 130.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 9 Animals and Animal Products 1 2013-01-01 2013-01-01 false User fees under 9 CFR part 130. 156.7 Section 156.7 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE VOLUNTARY INSPECTION AND CERTIFICATION SERVICE VOLUNTARY INSPECTION AND CERTIFICATION SERVICE § 156.7 User fees under 9 CFR part 130. Use...

  11. 9 CFR 156.7 - User fees under 9 CFR part 130.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 9 Animals and Animal Products 1 2014-01-01 2014-01-01 false User fees under 9 CFR part 130. 156.7 Section 156.7 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE VOLUNTARY INSPECTION AND CERTIFICATION SERVICE VOLUNTARY INSPECTION AND CERTIFICATION SERVICE § 156.7 User fees under 9 CFR part 130. Use...

  12. Impact of user fees on day use attendance at New Hampshire state parks

    Treesearch

    Allison A. Rechisky; Bradford N. Williamson

    1992-01-01

    This paper examines state park day use attendance data over a ten year period, 1980 - 1990, for variations in attendance effected by increases in user fees. A non-controllable variable the weather has been taken into account. The results of this paper suggest that user fees can be successfully collected at specific locations and provide positive income without...

  13. 9 CFR 130.18 - User fees for veterinary diagnostic reagents produced at NVSL or other authorized site (excluding...

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 9 Animals and Animal Products 1 2011-01-01 2011-01-01 false User fees for veterinary diagnostic reagents produced at NVSL or other authorized site (excluding FADDL). 130.18 Section 130.18 Animals and... § 130.18 User fees for veterinary diagnostic reagents produced at NVSL or other authorized site...

  14. 9 CFR 130.18 - User fees for veterinary diagnostic reagents produced at NVSL or other authorized site (excluding...

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 9 Animals and Animal Products 1 2010-01-01 2010-01-01 false User fees for veterinary diagnostic reagents produced at NVSL or other authorized site (excluding FADDL). 130.18 Section 130.18 Animals and... § 130.18 User fees for veterinary diagnostic reagents produced at NVSL or other authorized site...

  15. 75 FR 58411 - Center for Veterinary Medicine eSubmitter Workshop; Public Workshop; Request for Comments

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-24

    ... health industry that submits new animal drug applications to CVM's Office of New Animal Drug Evaluation... agreed to in the Animal Drug User Fee Amendments (ADUFA II) of 2008 ( http://www.fda.gov/ForIndustry/UserFees/AnimalDrugUserFeeActADUFA/ucm044941.htm ). The ONADE will be soliciting feedback on both the e...

  16. Recreation users fees on federal lands: a test of structural change between 1995 and 2003

    Treesearch

    J.M. Bowker; Gary Green; Dan MuCullom; Ken Cordell

    2008-01-01

    Federal lands provide many recreation facilities and services. On some of these lands, fees have been and are currently being charged for certain recreational services. This study examined the attitudes of users, between 1995 and 2003, towards recreation user fees on public lands. Data from the National Survey on Recreation and the Environment on recreational...

  17. Transversal analysis of public policies on user fees exemptions in six West African countries

    PubMed Central

    2012-01-01

    Background While more and more West African countries are implementing public user fees exemption policies, there is still little knowledge available on this topic. The long time required for scientific production, combined with the needs of decision-makers, led to the creation in 2010 of a project to support implementers in aggregating knowledge on their experiences. This article presents a transversal analysis of user fees exemption policies implemented in Benin, Burkina Faso, Mali, Niger, Togo and Senegal. Methods This was a multiple case study with several embedded levels of analysis. The cases were public user fees exemption policies selected by the participants because of their instructive value. The data used in the countries were taken from documentary analysis, interviews and questionnaires. The transversal analysis was based on a framework for studying five implementation components and five actors’ attitudes usually encountered in these policies. Results The analysis of the implementation components revealed: a majority of State financing; maintenance of centrally organized financing; a multiplicity of reimbursement methods; reimbursement delays and/or stock shortages; almost no implementation guides; a lack of support measures; communication plans that were rarely carried out, funded or renewed; health workers who were given general information but not details; poorly informed populations; almost no evaluation systems; ineffective and poorly funded coordination systems; low levels of community involvement; and incomplete referral-evacuation systems. With regard to actors’ attitudes, the analysis revealed: objectives that were appreciated by everyone; dissatisfaction with the implementation; specific tensions between healthcare providers and patients; overall satisfaction among patients, but still some problems; the perception that while the financial barrier has been removed, other barriers persist; occasionally a reorganization of practices, service rationing due to lack of reimbursement, and some overcharging or shifting of resources. Conclusions This transversal analysis confirms the need to assign a great deal of importance to the implementation of user fees exemption policies once these decisions have been taken. It also highlights some practices that suggest avenues of future research. PMID:23167598

  18. Improving financial access to health care in the Kisantu district in the Democratic Republic of Congo: acting upon complexity.

    PubMed

    Stasse, Stéphanie; Vita, Dany; Kimfuta, Jacques; da Silveira, Valèria Campos; Bossyns, Paul; Criel, Bart

    2015-01-01

    Comzmercialization of health care has contributed to widen inequities between the rich and the poor, especially in settings with suboptimal regulatory frameworks of the health sector. Poorly regulated fee-for-service payment systems generate inequity and initiate a vicious circle in which access to quality health care gradually deteriorates. Although the abolition of user fees is high on the international health policy agenda, the sudden removal of user fees may have disrupting effects on the health system and may not be affordable or sustainable in resource-constrained countries, such as the Democratic Republic of Congo. Between 2008 and 2011, the Belgian development aid agency (BTC) launched a set of reforms in the Kisantu district, in the province of Bas Congo, through an action-research process deemed appropriate for the implementation of change within open complex systems such as the Kisantu local health system. Moreover, the entire process contributed to strengthen the stewardship capacity of the Kisantu district management team. The reforms mainly comprised the rationalization of resources and the regulation of health services financing. Flat fees per episode of disease were introduced as an alternative to fee-for-service payments by patients. A financial subsidy from BTC allowed to reduce the height of the flat fees. The provision of the subsidy was made conditional upon a range of measures to rationalize the use of resources. The results in terms of enhancing people access to quality health care were immediate and substantial. The Kisantu experience demonstrates that a systems approach is essential in addressing complex problems. It provides useful lessons for other districts in the country.

  19. Improving financial access to health care in the Kisantu district in the Democratic Republic of Congo: acting upon complexity

    PubMed Central

    Stasse, Stéphanie; Vita, Dany; Kimfuta, Jacques; da Silveira, Valèria Campos; Bossyns, Paul; Criel, Bart

    2015-01-01

    Background Comzmercialization of health care has contributed to widen inequities between the rich and the poor, especially in settings with suboptimal regulatory frameworks of the health sector. Poorly regulated fee-for-service payment systems generate inequity and initiate a vicious circle in which access to quality health care gradually deteriorates. Although the abolition of user fees is high on the international health policy agenda, the sudden removal of user fees may have disrupting effects on the health system and may not be affordable or sustainable in resource-constrained countries, such as the Democratic Republic of Congo. Methods and Results Between 2008 and 2011, the Belgian development aid agency (BTC) launched a set of reforms in the Kisantu district, in the province of Bas Congo, through an action-research process deemed appropriate for the implementation of change within open complex systems such as the Kisantu local health system. Moreover, the entire process contributed to strengthen the stewardship capacity of the Kisantu district management team. The reforms mainly comprised the rationalization of resources and the regulation of health services financing. Flat fees per episode of disease were introduced as an alternative to fee-for-service payments by patients. A financial subsidy from BTC allowed to reduce the height of the flat fees. The provision of the subsidy was made conditional upon a range of measures to rationalize the use of resources. Conclusions The results in terms of enhancing people access to quality health care were immediate and substantial. The Kisantu experience demonstrates that a systems approach is essential in addressing complex problems. It provides useful lessons for other districts in the country. PMID:25563450

  20. The coping strategies of front-line health workers in the context of user fee exemptions in Niger

    PubMed Central

    2015-01-01

    When user fee exemptions were introduced for children under five years of age in Niger, front-line staff in the health system were not consulted in advance, and various obstacles seriously hindered the policy's implementation. Health workers developed two types of coping strategies. The first dealt with shortcomings of the policy implementation process related to management tools, drug stocks, co-existence of the fee exemption and cost recovery systems, and, above all, supply management for medicines (ordering from private companies, issuing makeshift prescriptions). The second involved clientelism, circumvention of regulations, and misappropriation of resources. Adverse effects have arisen due to both the failings of the health system and the practices of health workers. These include a focus on the commercial management of patients, the most 'costly' of whom sometimes find themselves being refused treatment, patients roaming in search of medicines and treatment, and a decline in quality of care. PMID:26558816

  1. The impact of user fees on access to health services in low- and middle-income countries.

    PubMed

    Lagarde, Mylene; Palmer, Natasha

    2011-04-13

    Following an international push for financing reforms, many low- and middle-income countries introduced user fees to raise additional revenue for health systems. User fees are charges levied at the point of use and are supposed to help reduce 'frivolous' consumption of health services, increase quality of services available and, as a result, increase utilisation of services. To assess the effectiveness of introducing, removing or changing user fees to improve access to care in low-and middle-income countries We searched 25 international databases, including the Cochrane Effective Practice and Organisation of Care (EPOC) Group's Trials Register, CENTRAL, MEDLINE and EMBASE. We also searched the websites and online resources of international agencies, organisations and universities to find relevant grey literature. We conducted the original searches between November 2005 and April 2006 and the updated search in CENTRAL (DVD-ROM 2011, Issue 1); MEDLINE In-Process & Other Non-Indexed Citations, Ovid (January 25, 2011); MEDLINE, Ovid (1948 to January Week 2 2011); EMBASE, Ovid (1980 to 2011 Week 03) and EconLit, CSA Illumina (1969 - present) on the 26th of January 2011. We included randomised controlled trials, interrupted time-series studies and controlled before-and-after studies that reported an objective measure of at least one of the following outcomes: healthcare utilisation, health expenditures, or health outcomes. We re-analysed studies with longitudinal data. We computed price elasticities of demand for health services in controlled before-and-after studies as a standardised measure. Due to the diversity of contexts and outcome measures, we did not perform meta-analysis. Instead, we undertook a narrative summary of evidence. We included 16 studies out of the 243 identified. Most of the included studies showed methodological weaknesses that hamper the strength and reliability of their findings. When fees were introduced or increased, we found the use of health services decreased significantly in most studies. Two studies found increases in health service use when quality improvements were introduced at the same time as user fees. However, these studies have a high risk of bias. We found no evidence of effects on health outcomes or health expenditure. The review suggests that reducing or removing user fees increases the utilisation of certain healthcare services. However, emerging evidence suggests that such a change may have unintended consequences on utilisation of preventive services and service quality. The review also found that introducing or increasing fees can have a negative impact on health services utilisation, although some evidence suggests that when implemented with quality improvements these interventions could be beneficial. Most of the included studies suffered from important methodological weaknesses. More rigorous research is needed to inform debates on the desirability and effects of user fees.

  2. 8 CFR 286.1 - Definitions.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Nationality DEPARTMENT OF HOMELAND SECURITY IMMIGRATION REGULATIONS IMMIGRATION USER FEE § 286.1 Definitions... Management, Immigration and Naturalization Service, Room 6307, 425 I Street NW., Washington, DC 20536. (f) The term fee means the immigration user fee. (g) The term port of entry means a port or place...

  3. A process evaluation of user fees abolition for pregnant women and children under five years in two districts in Niger (West Africa)

    PubMed Central

    Ridde, Valéry; Diarra, Aissa

    2009-01-01

    Background African policy-makers are increasingly considering abolishing user fees as a solution to improve access to health care systems. There is little evidence on this subject in West Africa, and particularly in countries that have organized their healthcare system on the basis of the Bamako Initiative. This article presents a process evaluation of an NGO intervention to abolish user fees in Niger for children under five years and pregnant women. Methods The intervention was launched in 2006 in two health districts and 43 health centres. The intervention consisted of abolishing user fees and improving the quality of services (drugs, ambulance, etc.). We carried out a process evaluation in April 2007 using qualitative and quantitative data. Three data collection methods were used: i) individual in-depth interviews (n = 85) and focus groups (n = 8); ii) participant observation in 12 health centres; and iii) self-administered structured questionnaires (n = 51 health staff). Results The population favoured abolition; health officials and local decision-makers were in favour, but they worried about its sustainability. Among health workers, opposition to providing free services was more widespread. The strengths of the process were: a top-down phase of information and raising community awareness; appropriate incentive measures; a good drug supply system; and the organization of a medical evacuation system. The major weaknesses of the process were: the perverse effects of incentive bonuses; the lack of community-based management committees' involvement in the management; the creation of a system running in parallel with the BI system; the lack of action to support the service offer; and the poor coordination of the availability of free services at different levels of the health pyramid. Some unintended outcomes are also documented. Conclusion The linkages between systems in which some patients pay (Bamako Initiative) and some do not should be carefully considered and organized in accordance with the local reality. For the poorest patients to really benefit, it is essential that, at the same time, the quality of services be improved and mechanisms be put in place to prevent abuses. Much remains to be done to generate knowledge on the processes for abolishing fees in West Africa. PMID:19493354

  4. Financial accessibility and user fee reforms for maternal healthcare in five sub-Saharan countries: a quasi-experimental analysis.

    PubMed

    Leone, Tiziana; Cetorelli, Valeria; Neal, Sarah; Matthews, Zoë

    2016-01-28

    Evidence on whether removing fees benefits the poorest is patchy and weak. The aim of this paper is to measure the impact of user fee reforms on the probability of giving birth in an institution or undergoing a caesarean section (CS) in Ghana, Burkina Faso, Zambia, Cameroon and Nigeria for the poorest strata of the population. Women's experience of user fees in 5 African countries. Using quasi-experimental regression analysis we tested the impact of user fee reforms on facilities' births and CS differentiated by wealth, education and residence in Burkina Faso and Ghana. Mapping of the literature followed by key informant interviews are used to verify details of reform implementation and to confirm and support our countries' choice. We analysed data from consecutive surveys in 5 countries: 2 case countries that experienced reforms (Ghana and Burkina Faso) by contrast with 3 that did not experience reforms (Zambia, Cameroon, Nigeria). User fee reforms are associated with a significant percentage of the increase in access to facility births (27 percentage points) and to a much lesser extent to CS (0.7 percentage points). Poor (but not the poorest), and non-educated women, and those in rural areas benefitted the most from the reforms. User fees reforms have had a higher impact in Burkina Faso compared with Ghana. Findings show a clear positive impact on access when user fees are removed, but limited evidence for improved availability of CS for those most in need. More women from rural areas and from lower socioeconomic backgrounds give birth in health facilities after fee reform. Speed and quality of implementation might be the key reason behind the differences between the 2 case countries. This calls for more research into the impact of reforms on quality of care. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  5. Financial accessibility and user fee reforms for maternal healthcare in five sub-Saharan countries: a quasi-experimental analysis

    PubMed Central

    Leone, Tiziana; Cetorelli, Valeria; Neal, Sarah; Matthews, Zoë

    2016-01-01

    Objectives Evidence on whether removing fees benefits the poorest is patchy and weak. The aim of this paper is to measure the impact of user fee reforms on the probability of giving birth in an institution or undergoing a caesarean section (CS) in Ghana, Burkina Faso, Zambia, Cameroon and Nigeria for the poorest strata of the population. Setting Women's experience of user fees in 5 African countries. Primary and secondary outcome measures Using quasi-experimental regression analysis we tested the impact of user fee reforms on facilities’ births and CS differentiated by wealth, education and residence in Burkina Faso and Ghana. Mapping of the literature followed by key informant interviews are used to verify details of reform implementation and to confirm and support our countries’ choice. Participants We analysed data from consecutive surveys in 5 countries: 2 case countries that experienced reforms (Ghana and Burkina Faso) by contrast with 3 that did not experience reforms (Zambia, Cameroon, Nigeria). Results User fee reforms are associated with a significant percentage of the increase in access to facility births (27 percentage points) and to a much lesser extent to CS (0.7 percentage points). Poor (but not the poorest), and non-educated women, and those in rural areas benefitted the most from the reforms. User fees reforms have had a higher impact in Burkina Faso compared with Ghana. Conclusions Findings show a clear positive impact on access when user fees are removed, but limited evidence for improved availability of CS for those most in need. More women from rural areas and from lower socioeconomic backgrounds give birth in health facilities after fee reform. Speed and quality of implementation might be the key reason behind the differences between the 2 case countries. This calls for more research into the impact of reforms on quality of care. PMID:26823178

  6. 7 CFR 354.4 - User fees for certain domestic services.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE OVERTIME SERVICES RELATING TO IMPORTS AND EXPORTS; AND USER... appropriate, his or her agent, agrees to maintain a balance in the user fee payment account equal to the cost...

  7. 7 CFR 354.4 - User fees for certain domestic services.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE OVERTIME SERVICES RELATING TO IMPORTS AND EXPORTS; AND USER... appropriate, his or her agent, agrees to maintain a balance in the user fee payment account equal to the cost...

  8. 76 FR 40965 - Self-Regulatory Organizations; Chicago Board Options Exchange, Incorporated: Notice of Filing and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-12

    ... way of background, the PULSe workstation is a front-end order entry system designed for use with... extend a fee waiver related to the PULSe workstation and to adopt a limited fee waiver for new users of the PULSe workstation. In addition, the Exchange is proposing to make a non-substantive numbering...

  9. 75 FR 18887 - FBI Criminal Justice Information Services Division User Fees

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-13

    .... SUMMARY: This notice establishes the user fee schedule for fingerprint- based and name-based criminal... fingerprint-based and other identification services as authorized by federal law. These fees apply to federal, state and any other authorized entities requesting fingerprint identification records and name checks...

  10. The sudden removal of user fees: the perspective of a frontline manager in Burundi.

    PubMed

    Nimpagaritse, Manassé; Bertone, Maria Paola

    2011-11-01

    In May 2006, the President of Burundi announced the removal of user fees in all health centres and hospitals for children under 5 and women giving birth. As other studies also point out, the policy was adopted extremely suddenly, without much reflection on its ultimate aims and on the operational dimension of its implementation. From the perspective of a frontline manager, this paper provides a descriptive case study of the abolition of user fees in the Muramvya District and a first-hand account of the effects of the sudden reform in the management of a district and a district hospital. The analysis highlights the challenges that the district and hospital teams faced. The main issues were: the reduction of financial flows, which prevented the possibility of investments and caused frequent drugs stock-outs; the reduced quality of the services and the disruption of the referral system; the motivation of the health staff who saw the administrative workload increase (not necessarily because of increased utilization) and faced 'ethical dilemmas' caused by the imprecise targeting of the reform. Undoubtedly, the removal of user fees for certain groups was an equitable and necessary measure in an extremely poor country such as Burundi. However, the suddenness of the decision and the lack of preparation had critical and long-lasting consequences for the entire health system. This analysis, performed from the frontline perspective, clarifies the importance of a rigorous planning of any reform, as well as of involving peripheral actors and understanding the complex challenges that they face.

  11. 32 CFR 204.6 - Collections.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 2 2010-07-01 2010-07-01 false Collections. 204.6 Section 204.6 National... USER FEES § 204.6 Collections. (a) Collections of fees will be made in advance or simultaneously with..., and managing cash and debt collections. (b) Unless a statute provides otherwise, user fee collections...

  12. User fees and maternity services in Ethiopia.

    PubMed

    Pearson, Luwei; Gandhi, Meena; Admasu, Keseteberhan; Keyes, Emily B

    2011-12-01

    To examine user fees for maternity services and how they relate to provision, quality, and use of maternity services in Ethiopia. The national assessment of emergency obstetric and newborn care (EmONC) examined user fees for maternity services in 751 health facilities that provided childbirth services in 2008. Overall, only about 6.6% of women gave birth in health facilities. Among facilities that provided delivery care, 68% charged a fee in cash or kind for normal delivery. Health centers should be providing maternity services free of charge (the healthcare financing proclamation), yet 65% still charge for some aspect of care, including drugs and supplies. The average cost for normal and cesarean delivery was US $7.70 and US $51.80, respectively. Nineteen percent of these facilities required payment in advance for treatment of an obstetric emergency. The health facilities that charged user fees had, on average, more delivery beds, deliveries (normal and cesarean), direct obstetric complications treated, and a higher ratio of skilled birth attendants per 1000 deliveries than those that did not charge. The case fatality rate was 3.8% and 7.1% in hospitals that did and did not charge user fees, respectively. Utilization of maternal health services is extremely low in Ethiopia and, although there is a government decree against charging for maternity service, 65% of health centers do charge for some aspects of maternal care. As health facilities are not reimbursed by the government for the costs of maternity services, this loss of revenue may account for the more and better services offered in facilities that continue to charge user fees. User fees are not the only factor that determines utilization in settings where the coverage of maternity services is extremely low. Additional factors include other out-of-pocket payments such as cost of transport and food and lodging for accompanying relatives. It is important to keep quality of care in mind when user fees are under discussion. Copyright © 2011 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  13. Assessing the elimination of user fees for delivery services in Laos.

    PubMed

    Boudreaux, Chantelle; Chanthala, Phetdara; Lindelow, Magnus

    2014-01-01

    A pilot eliminating user fees associated with delivery at the point of services was introduced in two districts of Laos in March 2009. Following two years of implementation, an evaluation was conducted to assess the pilot impact, as well as to document the pilot design and implementation challenges. Study results show that, even in the presence of the substantial access and cultural barriers, user fees associated with delivery at health facilities act as a serious deterrent to care seeking behavior. We find a tripling of facility-based delivery rates in the intervention areas, compared to a 40% increase in the control areas. While findings from the control region suggest that facility-based delivery rates may be on the rise across the country, the substantially higher increase in the pilot areas highlight the impact of financial burden associated with facility-based delivery fees. These fees can play an important role in rapidly increasing the uptake of facility delivery to reach the national targets and, ultimately, to improve maternal and child health outcomes. The pilot achieved important gains while relying heavily on capacity and systems already in place. However, the high cost associated with monitoring and evaluation suggest broad-scale expansion of the pilot activities is likely to necessitate targeted capacity building initiatives, especially in areas with limited district level capacity to manage funds and deliver detailed and timely reports.

  14. Relationship between pharmaceutical company user fees and drug approvals in Canada and Australia: a hypothesis-generating study.

    PubMed

    Lexchin, Joel

    2006-12-01

    Since the early- to mid-1990s, drug companies have paid fees for a variety of activities carried out by the Therapeutic Products Directorate in Canada and the Therapeutic Goods Administration in Australia. To explore whether changes in approval times for new active substances and in the percentage of new drug submissions receiving positive decisions coincided with the level of user fees. Data were collected from a range of Canadian and Australian government publications on the following topics: total funding for and workload of the regulatory agencies, the percentage of income that came from tax revenue and user fees, the percentage of new drug submissions that received a positive decision, and-for Canada only-the percent of submissions that were approved on first review. In both countries, there was a moderate-to-strong positive association between the level of industry funding and the percent of submissions that received a positive decision and a moderate-to-strong (Canada) and moderate (Australia) negative association between the level of industry funding and approval times. Changes observed in both countries are favorable to the pharmaceutical industry. Other than user fees leading to a pro-industry bias in the regulatory authorities, other possible explanations include a more efficient use of resources, a smaller workload (Canada), an improvement in the quality of drug submissions (Canada), and more resources (Australia). Further research strategies are needed to either confirm or refute the hypothesis that the level of industry funding affects decisions made in drug regulatory systems.

  15. An assessment of the effect of user fee policy reform on facility-based deliveries in rural Zambia.

    PubMed

    Chama-Chiliba, Chitalu Miriam; Koch, Steven Fredric

    2016-12-07

    Improving maternal health outcomes by reducing barriers to accessing maternal health services is a key goal for most developing countries. This paper analyses the effect of user fee removal, which was announced for rural areas of Zambia in April 2006, on the use of public health facilities for childbirth. Data from the 2007 Zambia Demographic and Health Survey, including birth histories for the five years preceding the survey, is linked to administrative data and geo-referenced health facility census data. We exploit a difference-in-differences design, due to a differential change in user fees at the district level; fees were removed in 54 rural districts, but not in the 18 remaining urban districts. We use multilevel modelling to estimate the effect of this policy change, based on 4018 births from May 2002 to September 2007, covering a period before and after the policy announcement in April 2006. The difference-in-difference estimates point to statistically insignificant changes in the proportion of women giving birth at home and in public facilities, but significant changes are found for deliveries in private (faith-based) facilities. Thus, the abolition of delivery fees is found to have some effect on where Zambian mothers choose to have their children born. The removal of user fees has not overcome barriers to the utilisation of delivery services at public facilities. User fee removal may also yield unintended consequences deterring the utilisation of delivery services. Therefore, abolishing user fees, alone, may not be sufficient to affect changes in utilisation; instead, other efforts, such as improving service quality, may have a greater impact.

  16. Global health actors no longer in favor of user fees: a documentary study.

    PubMed

    Robert, Emilie; Ridde, Valéry

    2013-07-26

    Since the advent of health user fees in low- and middle-income countries in the 1980s, the discourse of global health actors (GHAs) has changed to the disadvantage of this type of healthcare financing mechanism. The aim of the study was to identify and analyze the stance of GHAs in the debate on user fees. We conducted documentary research using public documents published by and officially attributed to GHAs from 2005 to 2011. We categorized GHAs into four groups: intergovernmental organizations, international non-governmental organizations, government agencies, and working groups and networks. We then classified the GHAs according to their stance relative to the abolition of user fees, and conducted a thematic analysis of their discourse to understand the arguments used by each GHA to justify its stance. We identified 56 GHAs, for which we analyzed 140 documents. Among them, 55% were in favor of the abolition of user fees or in favor of free care at the point of delivery. None of the GHAs stated that they were in favor of user fees; however, 30% did not take a stand. Only the World Bank declares that it is both in favor of user fees and in favor of free care at point of service. GHAs generally circumscribe their stance to specific populations (pregnant women, children under 5 years, etc.) or to specific health services (primary, basic, essential). Three types of arguments are used by GHAs to justify their stance: economic, moral and ethical, and pragmatic. The principle of "user pays" seems to have fizzled. Production and dissemination of evidence, as well as certain advocacy networks, may have contributed to this change in discourse. However, GHAs should go a step further and translate their words into action, so that free healthcare at the point of delivery becomes a reality in low- and middle-income countries. They should provide technical and financial support to those countries that have chosen to implement user fee exemption policies, sometimes influenced by a GHA.

  17. Global health actors no longer in favor of user fees: a documentary study

    PubMed Central

    2013-01-01

    Background Since the advent of health user fees in low- and middle-income countries in the 1980s, the discourse of global health actors (GHAs) has changed to the disadvantage of this type of healthcare financing mechanism. The aim of the study was to identify and analyze the stance of GHAs in the debate on user fees. Methods We conducted documentary research using public documents published by and officially attributed to GHAs from 2005 to 2011. We categorized GHAs into four groups: intergovernmental organizations, international non-governmental organizations, government agencies, and working groups and networks. We then classified the GHAs according to their stance relative to the abolition of user fees, and conducted a thematic analysis of their discourse to understand the arguments used by each GHA to justify its stance. Results We identified 56 GHAs, for which we analyzed 140 documents. Among them, 55% were in favor of the abolition of user fees or in favor of free care at the point of delivery. None of the GHAs stated that they were in favor of user fees; however, 30% did not take a stand. Only the World Bank declares that it is both in favor of user fees and in favor of free care at point of service. GHAs generally circumscribe their stance to specific populations (pregnant women, children under 5 years, etc.) or to specific health services (primary, basic, essential). Three types of arguments are used by GHAs to justify their stance: economic, moral and ethical, and pragmatic. Conclusions The principle of “user pays” seems to have fizzled. Production and dissemination of evidence, as well as certain advocacy networks, may have contributed to this change in discourse. However, GHAs should go a step further and translate their words into action, so that free healthcare at the point of delivery becomes a reality in low- and middle-income countries. They should provide technical and financial support to those countries that have chosen to implement user fee exemption policies, sometimes influenced by a GHA. PMID:23889807

  18. 14 CFR Appendix B to Subpart 1214... - Occupancy Fee Schedule

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... FLIGHT Reimbursement for Shuttle Services Provided to Civil U.S. Government Users and Foreign Users Who... flight one year or less, but more than six months before launch, the user shall reimburse NASA an... shared flight six months or less before launch, the user shall reimburse NASA an occupancy fee of 90% of...

  19. 14 CFR Appendix B to Subpart 1214... - Occupancy Fee Schedule

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... FLIGHT Reimbursement for Shuttle Services Provided to Civil U.S. Government Users and Foreign Users Who... flight one year or less, but more than six months before launch, the user shall reimburse NASA an... shared flight six months or less before launch, the user shall reimburse NASA an occupancy fee of 90% of...

  20. 14 CFR Appendix B to Subpart 1214... - Occupancy Fee Schedule

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... FLIGHT Reimbursement for Shuttle Services Provided to Civil U.S. Government Users and Foreign Users Who... flight one year or less, but more than six months before launch, the user shall reimburse NASA an... shared flight six months or less before launch, the user shall reimburse NASA an occupancy fee of 90% of...

  1. 14 CFR Appendix B to Subpart 1214... - Occupancy Fee Schedule

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... FLIGHT Reimbursement for Shuttle Services Provided to Civil U.S. Government Users and Foreign Users Who... flight one year or less, but more than six months before launch, the user shall reimburse NASA an... shared flight six months or less before launch, the user shall reimburse NASA an occupancy fee of 90% of...

  2. Feasibility of mileage-based user fees : application in rural/small urban areas of northeast Texas, final report, October 31, 2008.

    DOT National Transportation Integrated Search

    2008-10-31

    This study explores the application of mileage-based user fees, or vehicle-miles traveled (VMT) fees, as an : alternative to the fuel tax in rural and small urban areas. The purpose of the study is to identify the issues : associated with implementat...

  3. Interstate Variation in the Use of Fees To Fund K-12 Public Education.

    ERIC Educational Resources Information Center

    Wassmer, Robert W.; Fisher, Ronald C.

    2002-01-01

    Reviews state reliance of various user fees in public education; discusses conceptual issues regarding the use of school district user charges; analyzes statewide variations in school district user charges; suggests reasons for observed variations. (Contains 25 references.) (PKP)

  4. Abolishing user fees for children and pregnant women trebled uptake of malaria-related interventions in Kangaba, Mali.

    PubMed

    Ponsar, Frédérique; Van Herp, Michel; Zachariah, Rony; Gerard, Séco; Philips, Mit; Jouquet, Guillaume

    2011-11-01

    Malaria is the most common cause of morbidity and mortality in children under 5 in Mali. Health centres provide primary care, including malaria treatment, under a system of cost recovery. In 2005, Médecins sans Frontieres (MSF) started supporting health centres in Kangaba with the provision of rapid malaria diagnostic tests and artemisinin-based combination therapy. Initially MSF subsidized malaria tests and drugs to reduce the overall cost for patients. In a second phase, MSF abolished fees for all children under 5 irrespective of their illness and for pregnant women with fever. This second phase was associated with a trebling of both primary health care utilization and malaria treatment coverage for these groups. MSF's experience in Mali suggests that removing user fees for vulnerable groups significantly improves utilization and coverage of essential health services, including for malaria interventions. This effect is far more marked than simply subsidizing or providing malaria drugs and diagnostic tests free of charge. Following the free care strategy, utilization of services increased significantly and under-5 mortality was reduced. Fee removal also allowed for more efficient use of existing resources, reducing average cost per patient treated. These results are particularly relevant for the context of Mali and other countries with ambitious malaria treatment coverage objectives, in accordance with the United Nations Millennium Development Goals. This article questions the effectiveness of the current national policy, and the effectiveness of reducing the cost of drugs only (i.e. partial subsidies) or providing malaria tests and drugs free for under-5s, without abolishing other related fees. National and international budgets, in particular those that target health systems strengthening, could be used to complement existing subsidies and be directed towards effective abolition of user fees. This would contribute to increasing the impact of interventions on population health and, in turn, the effectiveness of aid.

  5. 76 FR 79267 - Self-Regulatory Organizations; NYSE Arca, Inc.; Order Approving a Proposed Rule Change Expanding...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-21

    ... Potential ``Users'' of Its Co-Location Services To Include Any Market Participant That Requests To Receive Co-Location Services Directly From the Exchange and Amending Its Fee Schedule To Establish a Fee for... ``Users'' of its co-location services, and to amend its Fee Schedule. The proposed rule change was...

  6. User Fees in Primary Education

    ERIC Educational Resources Information Center

    Kattan, Raja Bentaouet; Burnett, Nicholas

    2004-01-01

    There are a large number of different "fees" that private households sometimes have to pay for publicly provided primary education, including tuition fees, textbook fees or costs and/or rental payments, compulsory uniforms, PTA dues, and various special fees such as exam fees, contributions to district education boards, and the like. In many…

  7. Global Positioning System wide area augmentation system (WAAS) performance standard.

    DOT National Transportation Integrated Search

    2008-10-31

    The U.S. Global Positioning System (GPS) Standard Positioning Service (SPS) consists of spacebased : positioning, navigation, and timing (PNT) signals generated from space vehicles orbiting the : earth and delivered free of direct user fees for civil...

  8. The generic drug user fee amendments: an economic perspective

    PubMed Central

    Berndt, Ernst R; Murphy, Stephen J

    2018-01-01

    Abstract Since the vast majority of prescription drugs consumed by Americans are off patent (‘generic’), their regulation and supply is of wide interest. We describe events leading up to the US Congress's 2012 passage of the Generic Drug User Fee Amendments (GDUFA I) as part of the Food and Drug Administration Safety and Innovation Act (FDASIA). Under GDUFA I, generic manufacturers agreed to pay approximately $300 million in fees each year of the five-year program. In exchange, the US Food and Drug Administration (FDA) committed to performance goals. We describe GDUFA I’s FDA commitments, provisions, goals, and annual fee structure and compare it to that entailed in the authorization and implementation of GDUFA II on October 1, 2017. We explain how user fees required under GDUFA I erected barriers to entry and created scale and scope economies for incumbent manufacturers. Congress changed user fees under GDUFA II in part to lessen these incentives. In order to initiate and sustain user fees under GDUFA legislation, FDA requires the submission of self-reported data on generic manufacturers including domestic and foreign facilities. These data are public and our examination of them provides an unprecedented window into the recent organization of generic drug manufacturers supplying the US market. Our results suggest that generic drug manufacturing is increasingly concentrated and foreign. We discuss the implications of this observed market structure for GDUFA II’s implementation among other outcomes. PMID:29707218

  9. Unchartered innovation? Local reforms of national formal water management in the Mkoji sub-catchment, Tanzania

    NASA Astrophysics Data System (ADS)

    Mehari, Abraham; Koppen, Barbara Van; McCartney, Matthew; Lankford, Bruce

    Tanzania is currently attempting to improve water resources management through formal water rights and water fees systems, and formal institutions. The water rights system is expected to facilitate water allocation. The water fees system aims at cost-recovery for water resources management services. To enhance community involvement in water management, Water User Associations (WUAs) are being established and, in areas with growing upstream-downstream conflicts, apex bodies of all users along the stressed river stretch. The Mkoji sub-catchment (MSC) in the Rufiji basin is one of the first where these formal water management systems are being attempted. This paper analyzes the effectiveness of these systems in the light of their expected merits and the consequences of the juxtaposition of contemporary laws with traditional approaches. The study employed mainly qualitative, but also quantitative approaches on social and technical variables. Major findings were: (1) a good mix of formal (water fees and WUAs) and traditional (rotation-based water sharing, the Zamu) systems improved village-level water management services and reduced intra-scheme conflicts; (2) the water rights system has not brought abstractions into line with allocations and (3) so far, the MSC Apex body failed to mitigate inter-scheme conflicts. A more sophisticated design of allocation infrastructure and institutions is recommended.

  10. [Third-party payment system. Analysis of surveys performed in the province of Limbourg and in the department of Louvain].

    PubMed

    Hoffbauer, J; Serneels, F; Vanbelle, G

    1990-01-01

    Two inquiries were set up to analyse the attitude to and the use of the direct payment system. This system implies a direct payment of the dentist by the social assurance organisations. Because of the potential fraud, this system is very controversial. Both users and non-users suggested better controls simplified administration and a legal obligation to demand the franchise part of the fees.

  11. Global Positioning System Standard Positioning Service Performance Standard

    DOT National Transportation Integrated Search

    2008-09-01

    The U.S. Global Positioning System (GPS) Standard Positioning Service (SPS) consists of space-based positioning, navigation, and timing (PNT) signals delivered free of direct user fees for peaceful civil, commercial, and scientific uses worldwide. Th...

  12. User fee exemptions and excessive household spending for normal delivery in Burkina Faso: the need for careful implementation.

    PubMed

    Ben Ameur, Amal; Ridde, Valéry; Bado, Aristide R; Ingabire, Marie-Gloriose; Queuille, Ludovic

    2012-11-21

    In 2006, the Parliament of Burkina Faso passed a policy to reduce the direct costs of obstetric services and neonatal care in the country's health centres, aiming to lower the country's high national maternal mortality and morbidity rates. Implementation was via a "partial exemption" covering 80% of the costs. In 2008 the German NGO HELP launched a pilot project in two health districts to eliminate the remaining 20% of user fees. Regardless of any exemptions, women giving birth in Burkina Faso's health centres face additional expenses that often represent an additional barrier to accessing health services. We compared the total cost of giving birth in health centres offering partial exemption versus those with full exemption to assess the impact on additional out-of-pocket fees. A case-control study was performed to compare medical expenses. Case subjects were women who gave birth in 12 health centres located in the Dori and Sebba districts, where HELP provided full fee exemption for obstetric services and neonatal care. Controls were from six health centres in the neighbouring Djibo district where a partial fee exemption was in place. A random sample of approximately 50 women per health centre was selected for a total of 870 women. There was an implementation gap regarding the full exemption for obstetric services and neonatal care. Only 1.1% of the sample from Sebba but 17.5% of the group from Dori had excessive spending on birth related costs, indicating that women who delivered in Sebba were much less exposed to excessive medical expenses than women from Dori. Additional out-of-pocket fees in the full exemption health districts took into account household ability to pay, with poorer women generally paying less. We found that the elimination of fees for facility-based births benefits especially the poorest households. The existence of excessive spending related to direct costs of giving birth is of concern, making it urgent for the government to remove all direct fees for obstetric and neonatal care. However, the policy of completely abolishing user fees is insufficient; the implementation process must have a thorough monitoring system to reduce implementation gaps.

  13. 9 CFR 130.5 - User fees for services at privately owned permanent and temporary import quarantine facilities.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... owned permanent and temporary import quarantine facilities. 130.5 Section 130.5 Animals and Animal... User fees for services at privately owned permanent and temporary import quarantine facilities. (a... privately operated permanent or temporary import quarantine facility will be calculated at the hourly user...

  14. 9 CFR 130.5 - User fees for services at privately owned permanent and temporary import quarantine facilities.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... owned permanent and temporary import quarantine facilities. 130.5 Section 130.5 Animals and Animal... User fees for services at privately owned permanent and temporary import quarantine facilities. (a... privately operated permanent or temporary import quarantine facility will be calculated at the hourly user...

  15. 9 CFR 130.5 - User fees for services at privately owned permanent and temporary import quarantine facilities.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... owned permanent and temporary import quarantine facilities. 130.5 Section 130.5 Animals and Animal... User fees for services at privately owned permanent and temporary import quarantine facilities. (a... privately operated permanent or temporary import quarantine facility will be calculated at the hourly user...

  16. 9 CFR 130.5 - User fees for services at privately owned permanent and temporary import quarantine facilities.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... owned permanent and temporary import quarantine facilities. 130.5 Section 130.5 Animals and Animal... User fees for services at privately owned permanent and temporary import quarantine facilities. (a... privately operated permanent or temporary import quarantine facility will be calculated at the hourly user...

  17. 9 CFR 130.5 - User fees for services at privately owned permanent and temporary import quarantine facilities.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... owned permanent and temporary import quarantine facilities. 130.5 Section 130.5 Animals and Animal... User fees for services at privately owned permanent and temporary import quarantine facilities. (a... privately operated permanent or temporary import quarantine facility will be calculated at the hourly user...

  18. 75 FR 49502 - Medical Device User Fee Act; Public Meeting; Request for Comments

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-13

    ... Federal Food, Drug, and Cosmetic Act (FD&C Act) requires that before FDA begins negotiations with the...)) requires that, before FDA begins negotiations with the regulated industry on user fee reauthorization, we...

  19. 9 CFR 130.9 - [Reserved

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 9 Animals and Animal Products 1 2010-01-01 2010-01-01 false [Reserved] 130.9 Section 130.9 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE USER FEES USER FEES § 130.9 [Reserved] ...

  20. Royalty Fees Part I: The Copyright Clearance Center and Publishers.

    ERIC Educational Resources Information Center

    Eiblum, Paula; Ardito, Stephanie C.

    1998-01-01

    Discussion of copyrights, royalty fees, and intellectual property focuses on the Copyright Clearance Center and publishers. Topics include results of a survey of library and information science journal publishers; how users verify royalty fees; how publishers determine fees; royalty fee reporting; and terms and conditions imposed on electronic…

  1. Competition, Jobs, and Information Policy: The Case for Private-Sector Information Services: U.S. Patents.

    ERIC Educational Resources Information Center

    Ebersole, Joseph L.

    1994-01-01

    Discusses the argument for private-sector involvement in the distribution of government information, using U.S. patents as an example. Highlights include industry competitiveness; jobs creation; public access; identifying users; costs; user fees; existing systems of information dissemination; and implications of the Internet and NREN (National…

  2. gulf_of_mexico_90mwindspeed_off

    Science.gov Websites

    using their MesoMap system and historical weather data. This shapefile was generated from raster "). The user is granted the right, without any fee or cost, to use, copy, modify, alter, enhance copies of the data. Further, the user of this data agrees to credit NREL in any publications or software

  3. Mileage-Based User Fees : Prospects and Challenges

    DOT National Transportation Integrated Search

    2012-06-01

    This report reviews the current research regarding mileage-based user fees for vehicle travel (MBUF), possibly as a replacement or supplement to fuel taxes, which is currently the primary source of transportation revenues in New York State and the na...

  4. Development of a mileage-based user fee research website.

    DOT National Transportation Integrated Search

    2011-01-01

    The University Transportation Center for Mobility (UTCM) previously funded several research projects : related to mileage-based user fees (MBUFs). As part of these research efforts a website was developed to : support the planning for the first-ever ...

  5. Removing user fees for basic health services: a pilot study and national roll-out in Afghanistan

    PubMed Central

    Steinhardt, Laura C; Aman, Iqbal; Pakzad, Iqbalshah; Kumar, Binay; Singh, Lakhwinder P; Peters, David H

    2011-01-01

    Background User fees for primary care tend to suppress utilization, and many countries are experimenting with fee removal. Studies show that additional inputs are needed after removing fees, although well-documented experiences are lacking. This study presents data on the effects of fee removal on facility quality and utilization in Afghanistan, based on a pilot experiment and subsequent nationwide ban on fees. Methods Data on utilization and observed structural and perceived overall quality of health care were compared from before-and-after facility assessments, patient exit interviews and catchment area household surveys from eight facilities where fees were removed and 14 facilities where fee levels remained constant, as part of a larger health financing pilot study from 2005 to 2007. After a national user fee ban was instituted in 2008, health facility administrative data were analysed to assess subsequent changes in utilization and quality. Results The pilot study analysis indicated that observed and perceived quality increased across facilities but did not differ by fee removal status. Difference-in-difference analysis showed that utilization at facilities previously charging both service and drug fees increased by 400% more after fee removal, prompting additional inputs from service providers, compared with facilities that previously only charged service fees or had no change in fees (P = 0.001). Following the national fee ban, visits for curative care increased significantly (P < 0.001), but institutional deliveries did not. Services typically free before the ban—immunization and antenatal care—had immediate increases in utilization but these were not sustained. Conclusion Both pilot and nationwide data indicated that curative care utilization increased following fee removal, without differential changes in quality. Concerns raised by non-governmental organizations, health workers and community leaders over the effects of lost revenue and increased utilization require continued effort to raise revenues, monitor health worker and patient perceptions, and carefully manage health facility performance. PMID:22027924

  6. 77 FR 518 - Self-Regulatory Organizations; Chicago Board Options Exchange, Incorporated; Notice of Filing and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-01-05

    ... two monthly login IDs (so, $600 for one), or a fee of $2,400 for a higher- volume user.\\6\\ The NASDAQ... a minimum of two monthly login IDs and does not have a separate fee for a higher-volume user. See.... 78f(b)(4). The proposed changes to increase the fees assessed for CMI Login IDs and FIX Login IDs are...

  7. 77 FR 51816 - Notice of Opportunity To Withdraw Abbreviated New Drug Applications To Avoid Backlog Fee Obligations

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-27

    ...] Notice of Opportunity To Withdraw Abbreviated New Drug Applications To Avoid Backlog Fee Obligations... to avoid paying a fee. The fee in question is a one-time backlog fee that was established through enactment of the Generic Drug User Fee Amendments of 2012 (GDUFA). It will apply to any original ANDA that...

  8. 32 CFR 204.9 - Schedule of fees and rates.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 32 National Defense 2 2014-07-01 2014-07-01 false Schedule of fees and rates. 204.9 Section 204.9 National Defense Department of Defense (Continued) OFFICE OF THE SECRETARY OF DEFENSE (CONTINUED) MISCELLANEOUS USER FEES § 204.9 Schedule of fees and rates. (a) Schedule of fees and rates. (1) This schedule...

  9. 32 CFR 204.5 - Fees.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 32 National Defense 2 2014-07-01 2014-07-01 false Fees. 204.5 Section 204.5 National Defense Department of Defense (Continued) OFFICE OF THE SECRETARY OF DEFENSE (CONTINUED) MISCELLANEOUS USER FEES § 204.5 Fees. (a) General. (1) All fees shall be based on full cost to the U.S. Government or market...

  10. 25 CFR 700.251 - Fees.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 25 Indians 2 2010-04-01 2010-04-01 false Fees. 700.251 Section 700.251 Indians THE OFFICE OF... § 700.251 Fees. (a) Services for which fees may be charged. (1) Unless waived pursuant to the provisions of paragraph (c) of this section, user fees shall be charged for document search and duplication...

  11. User fee exemption policies in Mali: sustainability jeopardized by the malfunctioning of the health system

    PubMed Central

    2015-01-01

    In Mali, where rates of attendance at healthcare facilities remain far below what is needed, three user fee exemption policies were instituted to promote access to care. These related to HIV/AIDS treatment, as of 2004, caesarean sections, since 2005, and treatment of malaria in children under five and pregnant women, since 2007. Our qualitative study compared these three policies, looking at their implementation provisions, functioning and outcomes. In each healthcare facility, we analysed documentation and carried out three months of on-site observations. We also conducted a total of 254 formal and informal interviews with health personnel and patients. While these exemptions substantially improved users' access to care, their implementation revealed deep dysfunctions in the health system that undermined them all, regardless of the policy studied. These policies provoked resistance among health professionals that manifested in their practices and revealed, in particular, the profit-generation logic within which they operate today. These dysfunctions reflect the State's incapacity to exercise its regulatory role and to establish policies that are aligned with the way the health system really works. PMID:26559879

  12. 76 FR 48189 - Self-Regulatory Organizations; The NASDAQ Stock Market LLC; Notice of Filing and Immediate...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-08

    ... terminal is a basic front- end user interface used by NASDAQ members to connect to, and enter orders in... is necessary for users to enter orders through VTE. The two fees assessed under Rule 7015(h) relate... $100 monthly, and raised the minimum commission fee for users executing orders totaling less than 100...

  13. Abolishing Fees at Health Centers in the Context of Community Case Management of Malaria: What Effects on Treatment-Seeking Practices for Febrile Children in Rural Burkina Faso?

    PubMed

    Druetz, Thomas; Fregonese, Federica; Bado, Aristide; Millogo, Tieba; Kouanda, Seni; Diabaté, Souleymane; Haddad, Slim

    2015-01-01

    Burkina Faso started nationwide community case management of malaria (CCMm) in 2010. In 2011, health center user fees for children under five were abolished in some districts. To assess the effects of concurrent implementation of CCMm and user fees abolition on treatment-seeking practices for febrile children. This is a natural experiment conducted in the districts of Kaya (CCMm plus user fees abolition) and Zorgho (CCMm only). Registry data from 2005 to 2014 on visits for malaria were collected from all eight rural health centers in the study area. Annual household surveys were administered during malaria transmission season in 2011 and 2012 in 1,035 randomly selected rural households. Interrupted time series models were fitted for registry data and Fine and Gray's competing risks models for survey data. User fees abolition in Kaya significantly increased health center use by eligible children with malaria (incidence rate ratio for intercept change = 2.1, p <0.001). In 2011, in Kaya, likelihood of health center use for febrile children was three times higher and CHW use three times lower when caregivers knew services were free. Among the 421 children with fever in 2012, the delay before visiting a health center was significantly shorter in Kaya than in Zorgho (1.46 versus 1.79 days, p <0.05). Likelihood of visiting a health center on the first day of fever among households <2.5 km or <5 km from a health center was two and three times higher in Kaya than in Zorgho, respectively (p <0.001). User fees abolition reduced visit delay for febrile children living close to health centers. It also increased demand for and use of health center for children with malaria. Concurrently, demand for CHWs' services diminished. User fees abolition and CCMm should be coordinated to maximize prompt access to treatment in rural areas.

  14. The effect of user fee exemption on the utilization of maternal health care at mission health facilities in Malawi

    PubMed Central

    Manthalu, Gerald; Yi, Deokhee; Farrar, Shelley; Nkhoma, Dominic

    2016-01-01

    The Government of Malawi has signed contracts called service level agreements (SLAs) with mission health facilities in order to exempt their catchment populations from paying user fees. Government in turn reimburses the facilities for the services that they provide. SLAs started in 2006 with 28 out of 165 mission health facilities and increased to 74 in 2015. Most SLAs cover only maternal, neonatal and in some cases child health services due to limited resources. This study evaluated the effect of user fee exemption on the utilization of maternal health services. The difference-in-differences approach was combined with propensity score matching to evaluate the causal effect of user fee exemption. The gradual uptake of the policy provided a natural experiment with treated and control health facilities. A second control group, patients seeking non-maternal health care at CHAM health facilities with SLAs, was used to check the robustness of the results obtained using the primary control group. Health facility level panel data for 142 mission health facilities from 2003 to 2010 were used. User fee exemption led to a 15% (P <  0.01) increase in the mean proportion of women who made at least one antenatal care (ANC) visit during pregnancy, a 12% (P < 0.05) increase in average ANC visits and an 11% (P < 0.05) increase in the mean proportion of pregnant women who delivered at the facilities. No effects were found for the proportion of pregnant women who made the first ANC visit in the first trimester and the proportion of women who made postpartum care visits. We conclude that user fee exemption is an important policy for increasing maternal health care utilization. For certain maternal services, however, other determinants may be more important. PMID:27175033

  15. Free versus subsidised healthcare: options for fee exemptions, access to care for vulnerable groups and effects on the health system in Burkina Faso.

    PubMed

    Yaogo, Maurice

    2017-07-12

    The many forms of healthcare fee exemptions implemented in Burkina Faso since the 2000s have varied between total exemption (free) and cost subsidisation. This article examines both options, their contextual variations and the ways in which they affect access to healthcare for vulnerable people as well as the operation of the health system. This research is part of an interdisciplinary regional program on the elimination of user fees for health services in West Africa (Burkina Faso, Mali and Niger). A conceptual framework and a chronological review of policy interventions are used as references to summarise the results of the three qualitative studies presented. Historical reference points are used to describe the emergence of healthcare fee exemption policies in Burkina Faso and the events that influenced their adoption. The joint analysis of opinions on options for fee exemption focuses on the different types of repercussions on access to healthcare and the operation of the health system. In conjunction with the twists and turns of the gradual development of a national health policy and in response to international recommendations, healthcare fee exemptions have evolved since colonisation. The limitations of the changes introduced with cost recovery and the barriers to healthcare access for the poorest people led to the adoption of the current sectorial fee exemptions. The results provide information on the reasons for the changes that have occurred over time. The nuanced perspectives of different categories of people surveyed about fee exemption options show that, beyond the perceived effects on healthcare access and the health system, the issue is one of more equitable governance. In principle, the fee exemption measures are intended to provide improved healthcare access for vulnerable groups. In practice, the negative effects on the operation of the health system advocate for reforms to harmonise the changes to multifaceted fee exemptions and the actual needs to promote effectiveness and sustainability.

  16. Protocol: a realist review of user fee exemption policies for health services in Africa.

    PubMed

    Robert, Emilie; Ridde, Valéry; Marchal, Bruno; Fournier, Pierre

    2012-01-01

    Background Four years prior to the Millenium Development Goals (MDGs) deadline, low- and middle-income countries and international stakeholders are looking for evidence-based policies to improve access to healthcare for the most vulnerable populations. User fee exemption policies are one of the potential solutions. However, the evidence is disparate, and systematic reviews have failed to provide valuable lessons. The authors propose to produce an innovative synthesis of the available evidence on user fee exemption policies in Africa to feed the policy-making process. Methods The authors will carry out a realist review to answer the following research question: what are the outcomes of user fee exemption policies implemented in Africa? why do they produce such outcomes? and what contextual elements come into play? This type of review aims to understand how contextual elements influence the production of outcomes through the activation of specific mechanisms, in the form of context-mechanism-outcome configurations. The review will be conducted in five steps: (1) identifying with key stakeholders the mechanisms underlying user fee exemption policies to develop the analytical framework, (2) searching for and selecting primary data, (3) assessing the quality of evidence using the Mixed-Method Appraisal Tool, (4) extracting the data using the analytical framework and (5) synthesising the data in the form of context-mechanism-outcomes configurations. The output will be a middle-range theory specifying how user fee exemption policies work, for what populations and under what circumstances. Ethics and dissemination The two main target audiences are researchers who are looking for examples to implement a realist review, and policy-makers and international stakeholders looking for lessons learnt on user fee exemption. For the latter, a knowledge-sharing strategy involving local scientific and policy networks will be implemented. The study has been approved by the ethics committee of the CHUM Research Centre (CR-CHUM). It received funding from the Canadian Institutes of Health Research. The funders will not have any role in study design; collection, management, analysis, and interpretation of data; writing of the report and the decision to submit the report for publication, including who will have ultimate authority over each of these activities.

  17. 26 CFR 300.7 - Enrollment of enrolled actuary fee.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 26 Internal Revenue 18 2014-04-01 2014-04-01 false Enrollment of enrolled actuary fee. 300.7... AND ADMINISTRATION USER FEES § 300.7 Enrollment of enrolled actuary fee. (a) Applicability. This section applies to the initial enrollment of enrolled actuaries with the Joint Board for the Enrollment of...

  18. 26 CFR 300.7 - Enrollment of enrolled actuary fee.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 26 Internal Revenue 18 2013-04-01 2013-04-01 false Enrollment of enrolled actuary fee. 300.7... AND ADMINISTRATION USER FEES § 300.7 Enrollment of enrolled actuary fee. (a) Applicability. This section applies to the initial enrollment of enrolled actuaries with the Joint Board for the Enrollment of...

  19. 26 CFR 300.7 - Enrollment of enrolled actuary fee.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 26 Internal Revenue 18 2011-04-01 2011-04-01 false Enrollment of enrolled actuary fee. 300.7... AND ADMINISTRATION USER FEES § 300.7 Enrollment of enrolled actuary fee. (a) Applicability. This section applies to the initial enrollment of enrolled actuaries with the Joint Board for the Enrollment of...

  20. 26 CFR 300.7 - Enrollment of enrolled actuary fee.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 26 Internal Revenue 18 2012-04-01 2012-04-01 false Enrollment of enrolled actuary fee. 300.7... AND ADMINISTRATION USER FEES § 300.7 Enrollment of enrolled actuary fee. (a) Applicability. This section applies to the initial enrollment of enrolled actuaries with the Joint Board for the Enrollment of...

  1. 26 CFR 300.7 - Enrollment of enrolled actuary fee.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 26 Internal Revenue 18 2010-04-01 2010-04-01 false Enrollment of enrolled actuary fee. 300.7... AND ADMINISTRATION USER FEES § 300.7 Enrollment of enrolled actuary fee. (a) Applicability. This section applies to the initial enrollment of enrolled actuaries with the Joint Board for the Enrollment of...

  2. 8 CFR 286.4 - Fee collection responsibility.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 8 Aliens and Nationality 1 2010-01-01 2010-01-01 false Fee collection responsibility. 286.4 Section 286.4 Aliens and Nationality DEPARTMENT OF HOMELAND SECURITY IMMIGRATION REGULATIONS IMMIGRATION USER FEE § 286.4 Fee collection responsibility. (a) It is the responsibility of the air or sea carriers...

  3. 42 CFR 488.30 - Revisit user fee for revisit surveys.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ..., or substantiated complaint survey and that is designed to evaluate the extent to which previously... 42 Public Health 5 2012-10-01 2012-10-01 false Revisit user fee for revisit surveys. 488.30... SERVICES (CONTINUED) STANDARDS AND CERTIFICATION SURVEY, CERTIFICATION, AND ENFORCEMENT PROCEDURES General...

  4. 42 CFR 488.30 - Revisit user fee for revisit surveys.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ..., or substantiated complaint survey and that is designed to evaluate the extent to which previously... 42 Public Health 5 2013-10-01 2013-10-01 false Revisit user fee for revisit surveys. 488.30... SERVICES (CONTINUED) STANDARDS AND CERTIFICATION SURVEY, CERTIFICATION, AND ENFORCEMENT PROCEDURES General...

  5. 42 CFR 488.30 - Revisit user fee for revisit surveys.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ..., or substantiated complaint survey and that is designed to evaluate the extent to which previously... 42 Public Health 5 2014-10-01 2014-10-01 false Revisit user fee for revisit surveys. 488.30... SERVICES (CONTINUED) STANDARDS AND CERTIFICATION SURVEY, CERTIFICATION, AND ENFORCEMENT PROCEDURES General...

  6. 42 CFR 488.30 - Revisit user fee for revisit surveys.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ..., or substantiated complaint survey and that is designed to evaluate the extent to which previously... 42 Public Health 5 2011-10-01 2011-10-01 false Revisit user fee for revisit surveys. 488.30... SERVICES (CONTINUED) STANDARDS AND CERTIFICATION SURVEY, CERTIFICATION, AND ENFORCEMENT PROCEDURES General...

  7. 42 CFR 488.30 - Revisit user fee for revisit surveys.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ..., or substantiated complaint survey and that is designed to evaluate the extent to which previously... 42 Public Health 5 2010-10-01 2010-10-01 false Revisit user fee for revisit surveys. 488.30... SERVICES (CONTINUED) STANDARDS AND CERTIFICATION SURVEY, CERTIFICATION, AND ENFORCEMENT PROCEDURES General...

  8. 76 FR 79198 - Generic Drug User Fee; Public Meeting; Correction

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-21

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2010-N-0381] Generic Drug User Fee; Public Meeting; Correction AGENCY: Food and Drug Administration, HHS. ACTION: Notice; correction. SUMMARY: The Food and Drug Administration (FDA) is correcting a notice that appeared...

  9. Where the rubber meets the road : reforming California's roadway system

    DOT National Transportation Integrated Search

    1995-08-01

    The current system of roadway pricing and finance in California primarily employs fees applied to retail motor fuel sales. Consequently, most users of roadways pay a price for road use that is in proportion to fuel consumed, rather than in a manner t...

  10. 49 CFR 1002.3 - Updating user fees.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... Services, 1 I.C.C.2d 60 (1984) or subsequent cost studies. The base period for measuring changes shall be... material in the Federal Register. (e) Rounding of updated fees. Updated fees shall be rounded in the...

  11. 49 CFR 1002.3 - Updating user fees.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... Services, 1 I.C.C.2d 60 (1984) or subsequent cost studies. The base period for measuring changes shall be... material in the Federal Register. (e) Rounding of updated fees. Updated fees shall be rounded in the...

  12. 49 CFR 1002.3 - Updating user fees.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... Services, 1 I.C.C.2d 60 (1984) or subsequent cost studies. The base period for measuring changes shall be... material in the Federal Register. (e) Rounding of updated fees. Updated fees shall be rounded in the...

  13. Report on Surface Transportation Board's user fees

    DOT National Transportation Integrated Search

    1998-11-17

    The objective of Inspector Generals's (IG) audit was to evaluate Surface : Transportation Board's (STB) use of fees to fund its operations. To : accomplish this objective, the IG determined whether: (1) STB is assessing : fees for all billable servic...

  14. 9 CFR 130.30 - Hourly rate and minimum user fees.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... food testing. (16) Export-related services provided at animal auctions. (17) Various export-related... 9 Animals and Animal Products 1 2010-01-01 2010-01-01 false Hourly rate and minimum user fees. 130.30 Section 130.30 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT...

  15. 76 FR 76738 - Generic Drug User Fee; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-08

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2010-N-0381] Generic Drug User Fee; Public Meeting AGENCY: Food and Drug Administration, HHS. ACTION: Notice of public meeting; request for comments. The Food and Drug Administration (FDA) is announcing a public meeting to...

  16. 78 FR 78366 - Draft Generic Drug User Fee Act Information Technology Plan; Availability for Comment

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-26

    ...] Draft Generic Drug User Fee Act Information Technology Plan; Availability for Comment AGENCY: Food and... the availability for public comment of the draft information technology (IT) plan entitled ``GDUFA Information Technology Plan.'' This plan is intended to provide FDA's approach for enhancing business...

  17. 76 FR 58020 - Prescription Drug User Fee Act IV Information Technology Plan

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-19

    ...] Prescription Drug User Fee Act IV Information Technology Plan AGENCY: Food and Drug Administration, HHS. ACTION... information technology (IT) plan entitled ``PDUFA IV Information Technology Plan'' (updated plan) to achieve... Information Technology Plan.'' This plan will meet one of the performance goals agreed to under the 2007...

  18. 78 FR 78367 - Draft Prescription Drug User Fee Act V Information Technology Plan; Availability for Comment

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-26

    ...] Draft Prescription Drug User Fee Act V Information Technology Plan; Availability for Comment AGENCY... announcing the availability for public comment of the draft information technology (IT) plan entitled ``PDUFA V Information Technology Plan.'' This plan is intended to provide FDA's approach for enhancing...

  19. 9 CFR 156.7 - User fees under 9 CFR part 130.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 9 Animals and Animal Products 1 2010-01-01 2010-01-01 false User fees under 9 CFR part 130. 156.7 Section 156.7 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE VOLUNTARY INSPECTION AND CERTIFICATION SERVICE VOLUNTARY INSPECTION AND CERTIFICATION SERVICE...

  20. 76 FR 78950 - FBI Criminal Justice Information Services Division; Revised User Fee Schedule

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-20

    ... fingerprint-based Criminal History Record Information (CHRI) checks for noncriminal justice purposes. DATES... user fees for authorized agencies requesting noncriminal fingerprint-based CHRI checks at 28 CFR 20.31(e). The FBI will periodically review the process of fingerprint- based CHRI checks to determine the...

  1. 26 CFR 300.8 - Renewal of enrollment of enrolled actuary fee.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 26 Internal Revenue 18 2014-04-01 2014-04-01 false Renewal of enrollment of enrolled actuary fee...) PROCEDURE AND ADMINISTRATION USER FEES § 300.8 Renewal of enrollment of enrolled actuary fee. (a) Applicability. This section applies to the renewal of enrollment of enrolled actuaries with the Joint Board for...

  2. 26 CFR 300.8 - Renewal of enrollment of enrolled actuary fee.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 26 Internal Revenue 18 2013-04-01 2013-04-01 false Renewal of enrollment of enrolled actuary fee...) PROCEDURE AND ADMINISTRATION USER FEES § 300.8 Renewal of enrollment of enrolled actuary fee. (a) Applicability. This section applies to the renewal of enrollment of enrolled actuaries with the Joint Board for...

  3. 26 CFR 300.8 - Renewal of enrollment of enrolled actuary fee.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 26 Internal Revenue 18 2012-04-01 2012-04-01 false Renewal of enrollment of enrolled actuary fee...) PROCEDURE AND ADMINISTRATION USER FEES § 300.8 Renewal of enrollment of enrolled actuary fee. (a) Applicability. This section applies to the renewal of enrollment of enrolled actuaries with the Joint Board for...

  4. 26 CFR 300.8 - Renewal of enrollment of enrolled actuary fee.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 26 Internal Revenue 18 2011-04-01 2011-04-01 false Renewal of enrollment of enrolled actuary fee...) PROCEDURE AND ADMINISTRATION USER FEES § 300.8 Renewal of enrollment of enrolled actuary fee. (a) Applicability. This section applies to the renewal of enrollment of enrolled actuaries with the Joint Board for...

  5. 26 CFR 300.8 - Renewal of enrollment of enrolled actuary fee.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 26 Internal Revenue 18 2010-04-01 2010-04-01 false Renewal of enrollment of enrolled actuary fee...) PROCEDURE AND ADMINISTRATION USER FEES § 300.8 Renewal of enrollment of enrolled actuary fee. (a) Applicability. This section applies to the renewal of enrollment of enrolled actuaries with the Joint Board for...

  6. Technology evaluation for implementation of VMT based revenue collection systems : final report.

    DOT National Transportation Integrated Search

    2002-11-01

    The Road User Fee Task Force (RUFTF) was created as part of House Bill 3946 with the purpose of developing a new revenue collection system design for Oregons roads and highways. The Oregon Department of Transportation (ODOT) is required by House B...

  7. Using willingness to pay to investigate regressiveness of user fees in health facilities in Tanzania.

    PubMed

    Bonu, Sekhar; Rani, Manju; Bishai, David

    2003-12-01

    The study uses data from the Tanzania Human Resources Development Survey (1994) on willingness to pay (WTP) for desired quality of health care at lower-level health facilities to assess potential regressiveness of user fees - a disproportionately higher negative effect of user fees on utilization of health services among the poor compared with the rich. Despite reports of extensive bypassing of the lower-level health facilities in Tanzania, the WTP for quality health care at these health facilities is surprisingly large. WTP was lower among the poor, female and elderly respondents. Almost one-quarter of the poorest 40% of the population was not willing to pay even when the quality of services met their expectations. The results suggest that: the utilization of health services at lower-level health facilities can be increased by improving the quality of care; and the implementation of uniform user charges in the public facilities may be regressive, adversely affecting utilization among the poor, women and the elderly. An effective system of exemptions and waivers will be required for the very poor who may not be able to pay even when quality of services is improved. The findings of the study have policy implications for the Tanzanian government's recent attempts to expand cost-sharing through community health funds at lower-level health facilities, being introduced since 1998.

  8. Decentralization in Zambia: resource allocation and district performance.

    PubMed

    Bossert, Thomas; Chitah, Mukosha Bona; Bowser, Diana

    2003-12-01

    Zambia implemented an ambitious process of health sector decentralization in the mid 1990s. This article presents an assessment of the degree of decentralization, called 'decision space', that was allowed to districts in Zambia, and an analysis of data on districts available at the national level to assess allocation choices made by local authorities and some indicators of the performance of the health systems under decentralization. The Zambian officials in health districts had a moderate range of choice over expenditures, user fees, contracting, targeting and governance. Their choices were quite limited over salaries and allowances and they did not have control over additional major sources of revenue, like local taxes. The study found that the formula for allocation of government funding which was based on population size and hospital beds resulted in relatively equal per capita expenditures among districts. Decentralization allowed the districts to make decisions on internal allocation of resources and on user fee levels and expenditures. General guidelines for the allocation of resources established a maximum and minimum percentage to be allocated to district offices, hospitals, health centres and communities. Districts tended to exceed the maximum for district offices, but the large urban districts and those without public district hospitals were not even reaching the minimum for hospital allocations. Wealthier and urban districts were more successful in raising revenue through user fees, although the proportion of total expenditures that came from user fees was low. An analysis of available indicators of performance, such as the utilization of health services, immunization coverage and family planning activities, found little variation during the period 1995-98 except for a decline in immunization coverage, which may have also been affected by changes in donor funding. These findings suggest that decentralization may not have had either a positive or negative impact on services.

  9. The 2011 mileage-based user fee symposium.

    DOT National Transportation Integrated Search

    2011-09-01

    "The fuel tax is rapidly losing its ability to support system needs. Federal environmental : regulations and the escalating price of fossil fuels have created a strong incentive to develop and : utilize more fuel-efficient vehicles, which will drive ...

  10. Health worker perspectives on user fee removal in Zambia

    PubMed Central

    2012-01-01

    Background User fees for primary care services were removed in rural districts in Zambia in 2006. Experience from other countries has suggested that health workers play a key role in determining the success of a fee removal policy, but also find the implementation of such a policy challenging. The policy was introduced against a backdrop of a major shortage in qualified health staff. Methods As part of a larger study on the experience and effect of user fee removal in Zambia, a number of case studies at the facility level were conducted. As part of these, quantitative and qualitative data were collected to evaluate health workers’ satisfaction and experiences in charging and non-charging facilities. Results Our findings show that health-care workers have mixed feelings about the policy change and its consequences. We found some evidence that personnel motivation was higher in non-charging facilities compared to facilities still charging. Yet it is unclear whether this effect was due to differences in the user fee policy or to the fact that a lot of staff interviewed in non-charging facilities were working in mission facilities, where we found a significantly higher motivation. Health workers expressed satisfaction with an apparent increase in the number of patients visiting the facilities and the removal of a deterring factor for many needy patients, but also complained about an increased workload. Furthermore, working conditions were said to have worsened, which staff felt was linked to the absence of additional resources to deal with the increased demand or replace the loss of revenue generated by fees. Conclusion These findings highlight the need to pay attention to supply-side measures when removing demand-side barriers such as user fees and in particular to be concerned about the burden that increased demand can place on already over-stretched health workers. PMID:23110690

  11. Who benefits from removing user fees for facility-based delivery services? Evidence on socioeconomic differences from Ghana, Senegal and Sierra Leone.

    PubMed

    McKinnon, Britt; Harper, Sam; Kaufman, Jay S

    2015-06-01

    Coverage of skilled delivery care has been increasing across most low-income countries; however, it remains far from universal and is very unequally distributed according to socioeconomic position. In an effort to increase coverage of skilled delivery care and reduce socioeconomic inequalities, governments of several countries in sub-Saharan Africa have recently adopted policies that remove user fees for facility-based delivery services. There is little rigorous evidence of the impact of these policies and few studies have examined effects on socioeconomic inequalities. This study investigates the impact of recent delivery fee exemption policies in Ghana, Senegal, and Sierra Leone on socioeconomic differences in the use of facility-based delivery services. Using Demographic and Health Survey data from nine sub-Saharan African countries, we evaluated the user fee policy changes using a difference-in-differences approach that accounts for underlying common secular trends and time invariant differences among countries, and allows for differential effects of the policy by socioeconomic position. Removing user fees was consistent with meaningful increases in facility deliveries across all categories of household wealth and maternal education. We found little evidence of differential effects of removing user fees across quartiles of household wealth, with increases of 5.4 facility deliveries per hundred live births (95% CI: 2.1, 8.8) among women in the poorest quartile and 6.8 per hundred live births (95% CI: 4.0, 9.7) for women in the richest quartile. However, our results suggest that educated women benefited more from removing user fees compared to women with no education. For women with at least some secondary education, the estimated effect was 8.6 facility deliveries per hundred live births (95% CI: 5.4, 11.9), but only 4.6 per hundred live births (95% CI: 2.2, 7.0) for women with no education (heterogeneity p-value = 0.04). Thus, while removing fees at the point of service increased facility deliveries across the socioeconomic gradient, it did not reduce inequalities defined by household wealth and may have contributed to a widening of educational inequalities. These findings emphasize the need for concerted efforts to address financial and other barriers that contribute to large and persistent socioeconomic inequalities in delivery care. Copyright © 2015 Elsevier Ltd. All rights reserved.

  12. Public Opinion toward User Fees in Public Libraries.

    ERIC Educational Resources Information Center

    Kinnucan, Mark T.; Estabrook, Leigh; Ferguson, Mark R.

    1998-01-01

    A reanalysis of data from a national telephone poll (n1181) conducted in 1991 determined that if local libraries faced a fiscal crisis, 47% favored raising taxes, 44% preferred instituting user fees, and 9% advocated reducing services. Frequent library use, urban residence, higher level of education, and greater income were associated with a…

  13. User fees for recreation services on public lands: a national assessment

    Treesearch

    J. Michael Bowker; H. Ken Cordell; Cassandra Y. Johnson

    1999-01-01

    A portion of the 1995 National Survey on Recreation and the Environment examined public opinion toward user fees as a means of funding recreation services on public lands, including campgrounds, boat ramps, trails, picnic areas, historic sites, restrooms, parking areas, special exhibits and presentations, visitor centers, and other facilities. Respondents were offered...

  14. 9 CFR 130.20 - User fees for endorsing export certificates.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... vaccinations are listed in the following table. The user fees apply to each export health certificate 5... health certificates that require the verification of tests or vaccinations are listed in the following... on the number of animals or birds covered by the certificate and the number of tests or vaccinations...

  15. 9 CFR 130.20 - User fees for endorsing export certificates.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... vaccinations are listed in the following table. The user fees apply to each export health certificate 5... health certificates that require the verification of tests or vaccinations are listed in the following... on the number of animals or birds covered by the certificate and the number of tests or vaccinations...

  16. 9 CFR 130.20 - User fees for endorsing export certificates.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... vaccinations are listed in the following table. The user fees apply to each export health certificate 5... health certificates that require the verification of tests or vaccinations are listed in the following... on the number of animals or birds covered by the certificate and the number of tests or vaccinations...

  17. 9 CFR 130.14 - User fees for FADDL veterinary diagnostics.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... slides or plates Slide 49.00 50.00 51.00 53.00 Reference animal tissues for immunohistochemistry Set 171... 9 Animals and Animal Products 1 2012-01-01 2012-01-01 false User fees for FADDL veterinary diagnostics. 130.14 Section 130.14 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE...

  18. 9 CFR 130.14 - User fees for FADDL veterinary diagnostics.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... slides or plates Slide 49.00 50.00 51.00 53.00 Reference animal tissues for immunohistochemistry Set 171... 9 Animals and Animal Products 1 2013-01-01 2013-01-01 false User fees for FADDL veterinary diagnostics. 130.14 Section 130.14 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE...

  19. 9 CFR 130.14 - User fees for FADDL veterinary diagnostics.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... slides or plates Slide 49.00 50.00 51.00 53.00 Reference animal tissues for immunohistochemistry Set 171... 9 Animals and Animal Products 1 2014-01-01 2014-01-01 false User fees for FADDL veterinary diagnostics. 130.14 Section 130.14 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE...

  20. 75 FR 53702 - Medical Device User Fee Act; Public Meeting; Request for Comments; Amendment of Notice

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-01

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. 2010-N-0389] Medical Device User Fee Act; Public Meeting; Request for Comments; Amendment of Notice AGENCY: Food and Drug Administration, HHS. ACTION: Notice. SUMMARY: The Food and Drug Administration (FDA) is announcing...

  1. 75 FR 76472 - Biologics Price Competition and Innovation Act of 2009; Meetings on User Fee Program for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-08

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2010-N-0602] Biologics Price Competition and Innovation Act of 2009; Meetings on User Fee Program for Biosimilar and Interchangeable Biological Product Applications; Request for Notification of Stakeholder Intention To Participate...

  2. 78 FR 46962 - Biosimilar User Fee Rates for Fiscal Year 2014

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-02

    ...] Biosimilar User Fee Rates for Fiscal Year 2014 AGENCY: Food and Drug Administration, HHS. ACTION: Notice... fiscal year (FY) 2014. The Federal Food, Drug, and Cosmetic Act (the FD&C Act), as amended by the... October 1, 2013, and will remain in effect through September 30, 2014. FOR FURTHER INFORMATION CONTACT...

  3. 9 CFR 130.20 - User fees for endorsing export certificates.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... vaccinations are listed in the following table. The user fees apply to each export health certificate 5... health certificates that require the verification of tests or vaccinations are listed in the following... on the number of animals or birds covered by the certificate and the number of tests or vaccinations...

  4. 77 FR 51814 - Generic Drug User Fee Amendments of 2012; Public Meeting; Request for Comments

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-27

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2012-N-0882] Generic Drug User Fee Amendments of 2012; Public Meeting; Request for Comments AGENCY: Food and Drug Administration, HHS. ACTION: Notice of public meeting; request for comments. SUMMARY: The Food and Drug...

  5. 78 FR 27113 - Generic Drug User Fee Amendments of 2012; Regulatory Science Initiatives Public Hearing; Request...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-09

    .... FDA-2013-N-0402] Generic Drug User Fee Amendments of 2012; Regulatory Science Initiatives Public... public meeting that will provide an overview of the current status of the regulatory science initiatives... societies, and other interested stakeholders-- as it fulfills its statutory requirement under the Generic...

  6. 78 FR 72016 - User Fees for Processing Installment Agreements and Offers in Compromise

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-02

    ... regulations affect taxpayers who wish to pay their federal tax liabilities through installment agreements and... to pay $43 for any new installment agreement, including a direct debit installment agreement. The... do not have the means to pay the user fee, even at the reduced rate. The commenter stated that low...

  7. Automating Document Delivery: A Conference Report.

    ERIC Educational Resources Information Center

    Ensor, Pat

    1992-01-01

    Describes presentations made at a forum on automation, interlibrary loan (ILL), and document delivery sponsored by the Houston Area Library Consortium. Highlights include access versus ownership; software for ILL; fee-based services; automated management systems for ILL; and electronic mail and online systems for end-user-generated ILL requests.…

  8. 78 FR 28917 - Self-Regulatory Organizations; NYSE Arca, Inc.; Notice of Filing and Immediate Effectiveness of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-16

    ... Change Establishing Non- Display Usage Fees and Amending the Professional End-User Fees for NYSE Arca... Proposed Rule Change The Exchange proposes to establish non-display usage fees and to amend the... Proposed Rule Change 1. Purpose The Exchange proposes to establish non-display usage fees and to amend the...

  9. 78 FR 46980 - Prescription Drug User Fee Rates for Fiscal Year 2014

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-02

    ... 116.333 The FY 2014 application fee is estimated by dividing the average number of full applications... dividing the adjusted total fee revenue to be derived from establishments ($252,342,667) by the estimated... use this number for its FY 2014 estimate. The FY 2014 product fee rate is determined by dividing the...

  10. 14 CFR Appendix B to Subpart 1214... - Occupancy Fee Schedule

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... occupancy fee will be zero. For a postponed or cancelled shared flight, the occupancy fee will be computed... which is less than zero, the occupancy fee will be reset to zero. For a postponed or cancelled shared flight one year or less, but more than six months before launch, the user shall reimburse NASA an...

  11. Immediate and sustained effects of user fee exemption on healthcare utilization among children under five in Burkina Faso: A controlled interrupted time-series analysis.

    PubMed

    Zombré, David; De Allegri, Manuela; Ridde, Valéry

    2017-04-01

    Little is known about the long-term effects of user fee exemption policies on health care use in developing countries. We examined the association between user fee exemption and health care use among children under five in Burkina Faso. We also examined how factors related to characteristics of health facilities and their environment moderate this association. We used a multilevel controlled interrupted time-series design to examine the strength of effect and long term effects of user fee exemption policy on the rate of health service utilization in children under five between January 2004 and December 2014. The initiation of the intervention more than doubled the utilization rate with an immediate 132.596% increase in intervention facilities (IRR: 2.326; 95% CI: 1.980 to 2.672). The effect of the intervention was 32.766% higher in facilities with higher workforce density (IRR: 1.328; 95% CI (1.209-1.446)) and during the rainy season (IRR:1.2001; 95% CI: 1.0953-1.3149), but not significant in facilities with higher dispersed populations (IRR: 1.075; 95% CI: (0.942-1.207)). Although the intervention effect was substantially significant immediately following its inception, the pace of growth, while positive over a first phase, decelerated to stabilize itself three years and 7 months later before starting to decrease slowly towards the end of the study period. This study provides additional evidence to support user fee exemption policies complemented by improvements in health care quality. Future work should include an assessment of the impact of user fee exemption on infant morbidity and mortality and better discuss factors that could explain the slowdown in this upward trend of utilization rates three and a half years after the intervention onset. Copyright © 2017. Published by Elsevier Ltd.

  12. Tracking implementation and (un)intended consequences: a process evaluation of an innovative peripheral health facility financing mechanism in Kenya

    PubMed Central

    Waweru, Evelyn; Goodman, Catherine; Kedenge, Sarah; Tsofa, Benjamin; Molyneux, Sassy

    2016-01-01

    In many African countries, user fees have failed to achieve intended access and quality of care improvements. Subsequent user fee reduction or elimination policies have often been poorly planned, without alternative sources of income for facilities. We describe early implementation of an innovative national health financing intervention in Kenya; the health sector services fund (HSSF). In HSSF, central funds are credited directly into a facility’s bank account quarterly, and facility funds are managed by health facility management committees (HFMCs) including community representatives. HSSF is therefore a finance mechanism with potential to increase access to funds for peripheral facilities, support user fee reduction and improve equity in access. We conducted a process evaluation of HSSF implementation based on a theory of change underpinning the intervention. Methods included interviews at national, district and facility levels, facility record reviews, a structured exit survey and a document review. We found impressive achievements: HSSF funds were reaching facilities; funds were being overseen and used in a way that strengthened transparency and community involvement; and health workers’ motivation and patient satisfaction improved. Challenges or unintended outcomes included: complex and centralized accounting requirements undermining efficiency; interactions between HSSF and user fees leading to difficulties in accessing crucial user fee funds; and some relationship problems between key players. Although user fees charged had not increased, national reduction policies were still not being adhered to. Finance mechanisms can have a strong positive impact on peripheral facilities, and HFMCs can play a valuable role in managing facilities. Although fiduciary oversight is essential, mechanisms should allow for local decision-making and ensure that unmanageable paperwork is avoided. There are also limits to what can be achieved with relatively small funds in contexts of enormous need. Process evaluations tracking (un)intended consequences of interventions can contribute to regional financing and decentralization debates. PMID:25920355

  13. The effect of user fee exemption on the utilization of maternal health care at mission health facilities in Malawi.

    PubMed

    Manthalu, Gerald; Yi, Deokhee; Farrar, Shelley; Nkhoma, Dominic

    2016-11-01

    The Government of Malawi has signed contracts called service level agreements (SLAs) with mission health facilities in order to exempt their catchment populations from paying user fees. Government in turn reimburses the facilities for the services that they provide. SLAs started in 2006 with 28 out of 165 mission health facilities and increased to 74 in 2015. Most SLAs cover only maternal, neonatal and in some cases child health services due to limited resources. This study evaluated the effect of user fee exemption on the utilization of maternal health services. The difference-in-differences approach was combined with propensity score matching to evaluate the causal effect of user fee exemption. The gradual uptake of the policy provided a natural experiment with treated and control health facilities. A second control group, patients seeking non-maternal health care at CHAM health facilities with SLAs, was used to check the robustness of the results obtained using the primary control group. Health facility level panel data for 142 mission health facilities from 2003 to 2010 were used. User fee exemption led to a 15% (P <  0.01) increase in the mean proportion of women who made at least one antenatal care (ANC) visit during pregnancy, a 12% (P < 0.05) increase in average ANC visits and an 11% (P < 0.05) increase in the mean proportion of pregnant women who delivered at the facilities. No effects were found for the proportion of pregnant women who made the first ANC visit in the first trimester and the proportion of women who made postpartum care visits. We conclude that user fee exemption is an important policy for increasing maternal health care utilization. For certain maternal services, however, other determinants may be more important. © The Author 2016. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

  14. Tracking implementation and (un)intended consequences: a process evaluation of an innovative peripheral health facility financing mechanism in Kenya.

    PubMed

    Waweru, Evelyn; Goodman, Catherine; Kedenge, Sarah; Tsofa, Benjamin; Molyneux, Sassy

    2016-03-01

    In many African countries, user fees have failed to achieve intended access and quality of care improvements. Subsequent user fee reduction or elimination policies have often been poorly planned, without alternative sources of income for facilities. We describe early implementation of an innovative national health financing intervention in Kenya; the health sector services fund (HSSF). In HSSF, central funds are credited directly into a facility's bank account quarterly, and facility funds are managed by health facility management committees (HFMCs) including community representatives. HSSF is therefore a finance mechanism with potential to increase access to funds for peripheral facilities, support user fee reduction and improve equity in access. We conducted a process evaluation of HSSF implementation based on a theory of change underpinning the intervention. Methods included interviews at national, district and facility levels, facility record reviews, a structured exit survey and a document review. We found impressive achievements: HSSF funds were reaching facilities; funds were being overseen and used in a way that strengthened transparency and community involvement; and health workers' motivation and patient satisfaction improved. Challenges or unintended outcomes included: complex and centralized accounting requirements undermining efficiency; interactions between HSSF and user fees leading to difficulties in accessing crucial user fee funds; and some relationship problems between key players. Although user fees charged had not increased, national reduction policies were still not being adhered to. Finance mechanisms can have a strong positive impact on peripheral facilities, and HFMCs can play a valuable role in managing facilities. Although fiduciary oversight is essential, mechanisms should allow for local decision-making and ensure that unmanageable paperwork is avoided. There are also limits to what can be achieved with relatively small funds in contexts of enormous need. Process evaluations tracking (un)intended consequences of interventions can contribute to regional financing and decentralization debates. © The Author 2015. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

  15. The experience of Ghana in implementing a user fee exemption policy to provide free delivery care.

    PubMed

    Witter, Sophie; Arhinful, Daniel Kojo; Kusi, Anthony; Zakariah-Akoto, Sawudatu

    2007-11-01

    In resource-poor countries, the high cost of user fees for deliveries limits access to skilled attendance, and contributes to maternal and neonatal mortality and the impoverishment of vulnerable households. A growing number of countries are experimenting with different approaches to tackling financial barriers to maternal health care. This paper describes an innovative scheme introduced in Ghana in 2003 to exempt all pregnant women from payments for delivery, in which public, mission and private providers could claim back lost user fee revenues, according to an agreed tariff. The paper presents part of the findings of an evaluation of the policy based on interviews with 65 key informants in the health system at national, regional, district and facility level, including policymakers, managers and providers. The exemption mechanism was well accepted and appropriate, but there were important problems with disbursing and sustaining the funding, and with budgeting and management. Staff workloads increased as more women attended, and levels of compensation for services and staff were important to the scheme's acceptance. At the end of 2005, a national health insurance scheme, intended to include full maternal health care cover, was starting up in Ghana, and it was not yet clear how the exemptions scheme would fit into it.

  16. Does charging different user fees for primary and secondary care affect first-contacts with primary healthcare? A systematic review

    PubMed Central

    Hone, Thomas; Lee, John Tayu; Majeed, Azeem; Conteh, Lesong; Millett, Christopher

    2017-01-01

    Abstract Policy-makers are increasingly considering charging users different fees between primary and secondary care (differential user charges) to encourage utilisation of primary health care in health systems with limited gate keeping. A systematic review was conducted to evaluate the impact of introducing differential user charges on service utilisation. We reviewed studies published in MEDLINE, EMBASE, the Cochrane library, EconLIT, HMIC, and WHO library databases from January 1990 until June 2015. We extracted data from the studies meeting defined eligibility criteria and assessed study quality using an established checklist. We synthesized evidence narratively. Eight studies from six countries met our eligibility criteria. The overall study quality was low, with diversity in populations, interventions, settings, and methods. Five studies examined the introduction of or increase in user charges for secondary care, with four showing decreased secondary care utilisation, and three showing increased primary care utilisation. One study identified an increase in primary care utilisation after primary care user charges were reduced. The introduction of a non-referral charge in secondary care was associated with lower primary care utilisation in one study. One study compared user charges across insurance plans, associating higher charges in secondary care with higher utilisation in both primary and secondary care. Overall, the impact of introducing differential user-charges on primary care utilisation remains uncertain. Further research is required to understand their impact as a demand side intervention, including implications for health system costs and on utilisation among low-income patients. PMID:28453713

  17. 77 FR 65321 - Importation, Exportation, and Transportation of Wildlife; User Fee Exemption Program for Low-Risk...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-26

    ... DEPARTMENT OF THE INTERIOR Fish and Wildlife Service 50 CFR Part 14 [Docket No. FWS-HQ-LE-2012... Wildlife; User Fee Exemption Program for Low-Risk Importations and Exportations AGENCY: Fish and Wildlife... parts and products. To address this issue, the Service is implementing a program that exempts certain...

  18. 78 FR 15019 - Food and Drug Administration Prescription Drug User Fee Act V Benefit-Risk Plan; Request for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-08

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2013-N-0196] Food and Drug Administration Prescription Drug User Fee Act V Benefit-Risk Plan; Request for Comments AGENCY: Food and Drug Administration, HHS. ACTION: Notice, request for comments. SUMMARY: The Food and...

  19. 75 FR 20616 - Information Collection Request to Office of Management and Budget; OMB Control Numbers: 1625-0007...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-20

    ... Liquid Chemicals Proposed for Bulk Water Movement; (2) 1625-0074, Direct User Fees for Inspection or... of Intent and Operations Manual; and (5) 1625-0102, National Response Resource Inventory. Before...: The estimated burden has increased from 78 hours to 600 hours a year. 2. Title: Direct User Fees for...

  20. 75 FR 39551 - Collection of Information Under Review by Office of Management and Budget; OMB Control Numbers...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-09

    ... Liquid Chemicals Proposed for Bulk Water Movement; (2) 1625-0074, Direct User Fees for Inspection or... of Intent and Operations Manual; and (5) 1625-0102, National Response Resource Inventory. Our ICRs...: Direct User Fees for Inspection or Examination of U.S. and Foreign Commercial Vessels. OMB Control Number...

  1. 78 FR 65349 - Collection of Information Under Review by Office of Management and Budget

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-31

    ... following collections of information: 1625-0074, Direct User Fees for Inspection or Examination of U.S. and... Manual. Our ICRs describe the information we seek to collect from the public. Review and comments by OIRA... User Fees for Inspection or Examination of U.S. and Foreign Commercial Vessels. OMB Control Number...

  2. It's Not the Principle, It's the Money of the Thing.

    ERIC Educational Resources Information Center

    Budd, John M.

    1989-01-01

    Asserts that, although many arguments in favor of user fees for library services are based on economics, little economic benefit is actually gained by levying charges for some services. A microeconomics model that has been used to demonstrate the benefits of user fees is critiqued, and the issue of accountability is discussed. (23 references) (CLB)

  3. 76 FR 67522 - Self-Regulatory Organizations; NYSE Arca, Inc.; Notice of Filing of Proposed Rule Change...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-01

    ... Potential ``Users'' of Its Co-Location Services To Include Any Market Participant That Requests To Receive Co-Location Services Directly From the Exchange and Amending Its Fee Schedule To Establish a Fee for... scope of potential ``Users'' of its co-location services to include any market participant that requests...

  4. 76 FR 67526 - Self-Regulatory Organizations; NYSE Arca, Inc.; Notice of Filing of Proposed Rule Change...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-01

    ..., order routing and market data delivery services to their customers while the User is co-located in the... Potential ``Users'' of Its Co-Location Services To Include Any Market Participant That Requests To Receive Co-Location Services Directly From the Exchange and Amending Its Fee Schedule To Establish a Fee for...

  5. 76 FR 79242 - Self-Regulatory Organizations; NYSE Arca, Inc.; Order Approving a Proposed Rule Change Expanding...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-21

    ..., order routing and market data delivery services to their customers while the User is co-located in the... Potential ``Users'' of Its Co-Location Services To Include Any Market Participant that Requests to Receive Co-Location Services Directly From the Exchange and Amending Its Fee Schedule To Establish a Fee for...

  6. 76 FR 45826 - Medical Device User Fee Rates for Fiscal Year 2012

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-01

    ... paper check: All paper checks must be in U.S. currency from a U.S. bank and made payable to the Food and... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2011-N-0542] Medical Device User Fee Rates for Fiscal Year 2012 AGENCY: Food and Drug Administration, HHS. ACTION...

  7. 76 FR 45814 - Animal Generic Drug User Fee Rates and Payment Procedures for Fiscal Year 2012

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-01

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2011-N-0547] Animal Generic Drug User Fee Rates and Payment Procedures for Fiscal Year 2012 AGENCY: Food and Drug Administration, HHS. ACTION: Notice. SUMMARY: The Food and Drug Administration (FDA) is announcing the rates and...

  8. 78 FR 28669 - Self-Regulatory Organizations; BATS Exchange, Inc.; Notice of Filing and Immediate Effectiveness...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-15

    ... ``Options Pricing'' section of its fee schedule effective immediately, in order to (i) increase fees for any...'') thresholds. The Exchange offers a bulk-quoting interface which allows Users \\6\\ of BATS Options to submit and... receipt. The bulk-quoting application for BATS Options is a particularly useful feature for Users that...

  9. NBS (National Bureau of Standards) calibration services users guide: Fee schedule

    NASA Astrophysics Data System (ADS)

    1987-04-01

    The physical measurement services of the National Bureau of Standards are designed to help the makers and users of precision instruments achieve the highest possible levels of measurement quality and productivity. The hundreds of individual services found listed in the Fee Schedule constitute the highest-order calibration services available in the United States. These services directly link a customer's precision equipment or transfer standards to national measurement standards. These services are offered to public and private organizations and individuals alike. The Fee Schedule is a supplement to NBS Special Publication 250, Calibration Services Users Guide. These documents are designed to make the task of selecting and ordering an appropriate calibration service as quick and easy as possible.

  10. Techniques for assessing the socio-economic effects of vehicle mileage fees.

    DOT National Transportation Integrated Search

    2008-06-01

    The purpose of this study was to develop tools for assessing the distributional effects of alternative highway user fees for light vehicles : in Oregon. The analysis focused on a change from the current gasoline tax to a VMT fee structure for collect...

  11. Long-term pavement performance information management system : pavement performance database user reference guide

    DOT National Transportation Integrated Search

    1995-02-01

    This paper (1) summarizes the most relevant current experience and practice regarding permits (provisions, administrative requirements) and highway use pricing mechanisms (use taxes, permit fees, tolls) of importance for truck size and weight (TS&W) ...

  12. 77 FR 67820 - Privacy Act of 1974; Report of a New System of Records; Food and Drug Administration User Fee System

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-14

    ..., timely account disablement/deletion, configuration management, maintenance, system and information... paper or CD-ROM submissions): Division of Dockets Management (HFA-305), Food and Drug Administration... document, into the ``Search'' box and follow the prompts and/or go to the Division of Dockets Management...

  13. 77 FR 6164 - Self-Regulatory Organizations; The NASDAQ Stock Market LLC; Notice of Filing and Immediate...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-07

    ... to systems operated by NASDAQ, including the Nasdaq Market Center, the FINRA/NASDAQ Trade Reporting... front-end system for low volume users. NASDAQ proposes to increase the monthly fee assessed for greater... using any facility or system that NASDAQ operates or controls, and it does not unfairly discriminate...

  14. Application of system dynamics for developing financially self-sustaining management policies for water and wastewater systems.

    PubMed

    Rehan, R; Knight, M A; Haas, C T; Unger, A J A

    2011-10-15

    Recently enacted regulations in Canada and elsewhere require water utilities to be financially self-sustaining over the long-term. This implies full cost recovery for providing water and wastewater services to users. This study proposes a new approach to help water utilities plan to meet the requirements of the new regulations. A causal loop diagram is developed for a financially self-sustaining water utility which frames water and wastewater network management as a complex system with multiple interconnections and feedback loops. The novel System Dynamics approach is used to develop a demonstration model for water and wastewater network management. This is the first known application of System Dynamics to water and wastewater network management. The network simulated is that of a typical Canadian water utility that has under invested in maintenance. Model results show that with no proactive rehabilitation strategy the utility will need to substantially increase its user fees to achieve financial sustainability. This increase is further exacerbated when price elasticity of water demand is considered. When the utility pursues proactive rehabilitation, financial sustainability is achieved with lower user fees. Having demonstrated the significance of feedback loops for financial management of water and wastewater networks, the paper makes the case for a more complete utility model that considers the complexity of the system by incorporating all feedback loops. Crown Copyright © 2011. Published by Elsevier Ltd. All rights reserved.

  15. 76 FR 72619 - User Fee To Take the Registered Tax Return Preparer Competency Examination

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-25

    ..., 2011)), provide that only attorneys, certified public accountants, enrolled agents, and registered tax... Fee To Take the Registered Tax Return Preparer Competency Examination AGENCY: Internal Revenue Service... regulations. The final regulations redesignate rules pertaining to fees for obtaining a preparer tax...

  16. AdaNET research project

    NASA Technical Reports Server (NTRS)

    Digman, R. Michael

    1988-01-01

    The components necessary for the success of the commercialization of an Ada Technology Transition Network are reported in detail. The organizational plan presents the planned structure for services development and technical transition of AdaNET services to potential user communities. The Business Plan is the operational plan for the AdaNET service as a commercial venture. The Technical Plan is the plan from which the AdaNET can be designed including detailed requirements analysis. Also contained is an analysis of user fees and charges, and a proposed user fee schedule.

  17. 76 FR 40964 - Self-Regulatory Organizations; C2 Options Exchange, Incorporated; Notice of Filing and Immediate...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-12

    ... Schedule to extend a fee waiver related to the PULSe workstation and to adopt a limited fee waiver for new users of the PULSe workstation. The text of the proposed rule change is available on the Exchange's Web... is to extend a fee waiver related to the PULSe workstation and to adopt a limited fee waiver for new...

  18. 78 FR 3900 - Generic Drug User Fee-Active Pharmaceutical Ingredient and Finished Dosage Form Facility Fee...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-17

    ... facility fee, we divide the $132,945,000 by the total number of facilities (758) which gives us a domestic... domestic API facility fee, we divide the $23,415,000 by the total number of facilities (885) which gives us..., Attention: Government Lockbox 979108, 1005 Convention Plaza, St. Louis, MO 63101. (Note: This U.S. Bank...

  19. Potential revenues from a new day-use fee

    Treesearch

    Stephen D. Reiling; Hsiang-tai Cheng

    1995-01-01

    The Corps of Engineers will be implementing a new user fee at day-use areas during the next two years. This paper presents the procedures used to estimate the revenue that the new fee would generate at six Corps projects located across the U.S. The results suggest that revenues will fall well short of the naive projection calculated on the assumption that the new fee...

  20. 9 CFR 130.11 - User fees for inspecting and approving import/export facilities and establishments.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... hourly user fee rate in § 130.30(2) applies to biosecurity level two laboratories. (b) [Reserved] [65 FR... approval) Per year $537.00 $553.00 $570.00 $587.00 $604.00 Inspection for approval of biosecurity level three labs (all inspections related to approving the laboratory for handling one defined set of...

  1. 75 FR 33761 - Notice of a New Fee Site; Federal Lands Recreation Enhancement Act (Title VIII, Pub. L. 108-447)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-15

    ... $5.00 daily user fee or accept the $20 annual user vehicle sticker at the Beck Road Trailhead based... Beck Road Trailhead on the Chequamegon-Nicolet National Forest will provide a much needed trailhead... communities of Drummond, Barnes, Cable, Delta, and Iron River. The funds collected at the Beck Road Trailhead...

  2. 78 FR 32067 - User Fees for 2013 Crop Cotton Classification Services to Growers

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-29

    ... Fees for 2013 Crop Cotton Classification Services to Growers AGENCY: Agricultural Marketing Service... cotton producers for 2013 crop cotton classification services at $2.20 per bale--the same level as in 2012. Revenues resulting from this cotton classing fee and existing reserves are sufficient to cover...

  3. Health care utilisation under the 30-Baht Scheme among the urban poor in Mitrapap slum, Khon Kaen, Thailand: a cross-sectional study

    PubMed Central

    Coronini-Cronberg, Sophie; Laohasiriwong, Wongsa; Gericke, Christian A

    2007-01-01

    Background In 2001, the Government of Thailand introduced a universal coverage scheme with the aim of ensuring equitable health care access for even the poorest citizens. For a flat user fee of 30 Baht per consultation, or for free for those falling into exemption categories, every scheme participant may access registered health services. The exemption categories include children under 12 years of age, senior citizens aged 60 years and over, the very poor, and volunteer health workers. The functioning of these exemption mechanisms and the effect of the scheme on health service utilisation among the poor is controversial. Methods This cross-sectional study investigated the prevalence of 30-Baht Scheme registration and subsequent self-reported health service utilisation among an urban poor population in the Teparuk community within the Mitrapap slum in Khon Kaen city, northeastern Thailand. Furthermore, the effectiveness of the exemption mechanisms in reaching the very poor and the elderly was examined. Factors for users' choice of health facilities were identified. Results Overall, the proportion of the Teparuk community enrolled with the 30-Baht Scheme was high at 86%, with over one quarter of these exempted from paying the consultation fee. User fee exemption was significantly more frequent among households with an above-poverty-line income (64.7%) compared to those below the poverty line (35.3%), χ2 (df) = 5.251 (1); p-value = 0.018. In addition, one third of respondents over 60 years of age were found to be still paying user fees. Self-reported use of registered medical facilities in case of illness was stated to be predominantly due to the service being available through the scheme, with service quality not a chief consideration. Overall consumer satisfaction was high, especially among those not required to pay the 30 Baht user fee. Conclusion Whilst the 30-Baht Scheme seems to cover most of the poor population of Mitrapap slum in Khon Kaen, the user fee exemption mechanism only works partially with regard to reaching the poorest and exempting senior citizens. Service utilisation and satisfaction are highest amongst those who are fee-exempt. Service quality was not an important factor influencing choice of health facility. Ways should be sought to improve the effectiveness of the current exemption mechanisms. PMID:17883874

  4. FEDIX: The on-line database retrieval service of government information for colleges, universities, and other organizations. User`s guide, Version 4.0/Release 2.1

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Not Available

    FEDIX is an on-line information service that links the higher education community and the federal government to facilitate research, education, and services. The system provides accurate, timely federal agency information to colleges, universities, and other research organizations. There are no registration fees or access charges. Participating agencies include DOE, FAA, NASA, ONR, AFOSR, NSF, NSA, DOE, DOEd, HUD, and AID. This guide is intended to help users access and utilize FEDIX.

  5. 78 FR 66746 - Medical Device User Fee and Modernization Act; Notice to Public of Web Site Location of Fiscal...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-06

    ...] Medical Device User Fee and Modernization Act; Notice to Public of Web Site Location of Fiscal Year 2014... and Drug Administration (FDA or the Agency) is announcing the Web site location where the Agency will... documents, FDA has committed to updating its Web site in a timely manner to reflect the Agency's review of...

  6. User-fee-removal improves equity of children's health care utilization and reduces families' financial burden: evidence from Jamaica.

    PubMed

    Li, Zhihui; Li, Mingqiang; Fink, Günther; Bourne, Paul; Bärnighausen, Till; Atun, Rifat

    2017-06-01

    The impact of user-fee policies on the equity of health care utilization and households' financial burdens has remained largely unexplored in Latin American and the Caribbean, as well as in upper-middle-income countries. This paper assesses the short- and long-term impacts of Jamaica's user-fee-removal for children in 2007. This study utilizes 14 rounds of data from the Jamaica Survey of Living Conditions (JSLC) for the periods 1996 to 2012. JSLC is a national household survey, which collects data on health care utilization and among other purposes for planning. Interrupted time series (ITS) analysis was used to examine the immediate impact of the user-fee-removal policy on children's health care utilization and households' financial burdens, as well as the impact in the medium- to long-term. Immediately following the implementation of user-fee-removal, the odds of seeking for health care if the children fell ill in the past 4 weeks increased by 97% (odds ratio 2.0, 95% confidence interval (CI) 1.1 to 3.5, P  = 0.018). In the short-term (2007-2008), health care utilization increased at a faster rate among children not in poverty than children in poverty; while this gap narrowed after 2008. There was minimal difference in health care utilization across wealth groups in the medium- to long-term. The household's financial burden (health expenditure as a share of household's non-food expenditures) reduced by 6 percentage points (95% CI: -11 to -1, P  = 0.020) right after the policy was implemented and kept at a low level. The difference in financial burden between children in poverty and children not in poverty shrunk rapidly after 2007 and remained small in subsequent years. User-fee-removal had a positive impact on promoting health care utilization among children and reducing their household health expenditures in Jamaica. The short-term and the medium- to long-term results have different indications: In the short-term, the policy deteriorated the equity of access to health care for children, while the equity status improved fast in the medium- to long-term.

  7. Does charging different user fees for primary and secondary care affect first-contacts with primary healthcare? A systematic review.

    PubMed

    Hone, Thomas; Lee, John Tayu; Majeed, Azeem; Conteh, Lesong; Millett, Christopher

    2017-06-01

    Policy-makers are increasingly considering charging users different fees between primary and secondary care (differential user charges) to encourage utilisation of primary health care in health systems with limited gate keeping. A systematic review was conducted to evaluate the impact of introducing differential user charges on service utilisation. We reviewed studies published in MEDLINE, EMBASE, the Cochrane library, EconLIT, HMIC, and WHO library databases from January 1990 until June 2015. We extracted data from the studies meeting defined eligibility criteria and assessed study quality using an established checklist. We synthesized evidence narratively. Eight studies from six countries met our eligibility criteria. The overall study quality was low, with diversity in populations, interventions, settings, and methods. Five studies examined the introduction of or increase in user charges for secondary care, with four showing decreased secondary care utilisation, and three showing increased primary care utilisation. One study identified an increase in primary care utilisation after primary care user charges were reduced. The introduction of a non-referral charge in secondary care was associated with lower primary care utilisation in one study. One study compared user charges across insurance plans, associating higher charges in secondary care with higher utilisation in both primary and secondary care. Overall, the impact of introducing differential user-charges on primary care utilisation remains uncertain. Further research is required to understand their impact as a demand side intervention, including implications for health system costs and on utilisation among low-income patients. © The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  8. 77 FR 65199 - Generic Drug User Fee-Backlog Fee Rate for Fiscal Year 2013

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-25

    ... payment to ensure that your backlog fee is fully paid. The account information is as follows: New York... INFORMATION CONTACT: David Miller, Office of Financial Management (HFA-100), Food and Drug Administration, 1350 Piccard Dr., PI50, rm. 210J, Rockville, MD 20850, 301-796-7103. SUPPLEMENTARY INFORMATION: I...

  9. 76 FR 39788 - Regulations Governing Fees for Services

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-07

    ... DEPARTMENT OF TRANSPORTATION Surface Transportation Board 49 CFR Part 1002 [Docket No. EP 542 (Sub... governing user fees for services performed, 49 CFR 1002.2(f), Part V, by lowering the fee for sub-item 56(iv... complaint to the Board. For example, over the past 10 years, our Rail Consumer and Public Assistance unit...

  10. 49 CFR 360.5 - Updating user fees.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... determined by the cost study in Regulations Governing Fees For Service, 1 I.C.C. 2d 60 (1984), or subsequent... material in the Federal Register or FMCSA Register. (This rounding procedures excludes copying, printing... determined by the cost study in Regulations Governing Fees For Service, 1 I.C.C. 2d 60 (1984), or subsequent...

  11. 8 CFR 286.2 - Fee for arrival of passengers aboard commercial aircraft or commercial vessels.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... SECURITY IMMIGRATION REGULATIONS IMMIGRATION USER FEE § 286.2 Fee for arrival of passengers aboard..., per individual is charged and collected by the Commissioner for the immigration inspection of each... Act, per individual, is charged and collected by the Commissioner for the immigration inspection at a...

  12. Health Care Payments in Vietnam: Patients' Quagmire of Caring for Health versus Economic Destitution.

    PubMed

    Pekerti, Andre; Vuong, Quan-Hoang; Ho, Tung Manh; Vuong, Thu-Trang

    2017-09-25

    In the last three decades many developing and middle-income nations' health care systems have been financed via out-of-pocket payments by individuals. User fees charges, however, may not be the best approach or thenmost equitable approach to finance and/or reform health services in developing nations. This study investigates the status of Vietnam's current health system as a result of implementing user fees policies. A recent mandate by the government to increase the universal cover to 100% attempts to tackle inadequate insurance cover, one of the four major factors contributing to the high and increasing probability of destitution for Vietnamese patients (the other three being: non-residency, long stay in hospital, and high cost of treatment). Empirical results however suggest that this may be catastrophic for low-income earners: if insurance cover reimbursement decreases below 50% of actual health expenditures, the probability of Vietnamese falling into destitution will rise further. Our findings provide policy implications and directions to improve Vietnam's health care system, in particular by ensuring the utilization of health services and financial protection for the people.

  13. Rural health care in Vietnam and China: conflict between market reforms and social need.

    PubMed

    Huong, Dang Boi; Phuong, Nguyen Khanh; Bales, Sarah; Jiaying, Chen; Lucas, Henry; Segall, Malcolm

    2007-01-01

    China and Vietnam have adopted market reforms in the health sector in the context of market economic reforms. Vietnam has developed a large private health sector, while in China commercialization has occurred mainly in the formal public sector, where user fees are now the main source of facility finance. As a result, the integrity of China's planned health service has been disrupted, especially in poor rural areas. In Vietnam the government has been an important financer of public health facilities and the pre-reform health service is largely intact, although user fees finance an increasing share of facility expenditure. Over-servicing of patients to generate revenue occurs in both countries, but more seriously in China. In both countries government health expenditure has declined as a share of total health expenditure and total government expenditure, while out-of-pocket health spending has become the main form of health finance. This has particularly affected the rural poor, deterring them from accessing health care. Assistance for the poor to meet public-sector user fees is more beneficial and widespread in Vietnam than China. China is now criticizing the degree of commercialization of its health system and considers its health reforms "basically unsuccessful." Market reforms that stimulate growth in the economy are not appropriate to reform of social sectors such as health.

  14. Resource Sharing in Times of Retrenchment.

    ERIC Educational Resources Information Center

    Sloan, Bernard G.

    1992-01-01

    Discusses the impact of decreases in revenues on the resource-sharing activities of ILLINET Online and the Illinois Library Computer Systems Organization (ILCSO). Strategies for successfully coping with fiscal crises are suggested, including reducing levels of service and initiating user fees for interlibrary loans and faxing photocopied journal…

  15. Colorado mileage-based user fee study.

    DOT National Transportation Integrated Search

    2013-12-01

    The Transportation Research Board, Government Accountability Office, and Colorado Transportation : Finance and Implementation Panel (CTFIP) suggested that Colorado pursue fees based on actual travel : as an alternative to the fuel tax. Revenues from ...

  16. 9 CFR 130.6 - User fees for inspection of live animals at land border ports along the United States-Mexico border.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... animals at land border ports along the United States-Mexico border. 130.6 Section 130.6 Animals and Animal... User fees for inspection of live animals at land border ports along the United States-Mexico border. (a... importation into or entry into the United States through a land border port along the United States-Mexico...

  17. 78 FR 46977 - Generic Drug User Fee-Abbreviated New Drug Application, Prior Approval Supplement, Drug Master...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-02

    ... costs to total FDA costs of the review of human generic drug activities for the first 3 of the preceding... review of human generic drug activities. Since the first year of the Generic Drug User Fee Program has... activities other than PC&B (see section 744B(c)(1)(C) of the FD&C Act). Table 3 of this document provides the...

  18. 15 CFR Appendix A to Part 950 - Schedule of User Fees for Access to NOAA Environmental Data

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ....00 2.00 Online In-Situ Digital Data 6.00 6.00 Data Poster 18.00 18.00 Shipping Service for orders... * 11.00 Additional National Geophysical Data Center (NGDC) User Fees: Mini Poster 1.00 1.00 Icosahedron... 7,665.00 8,032.00 Data Poster * 18.00 High Definition Geomagnetic Model * 19,997.00 * Reflects a new...

  19. 9 CFR 130.6 - User fees for inspection of live animals at land border ports along the United States-Mexico border.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... animals at land border ports along the United States-Mexico border. 130.6 Section 130.6 Animals and Animal... User fees for inspection of live animals at land border ports along the United States-Mexico border. (a... importation into or entry into the United States through a land border port along the United States-Mexico...

  20. 9 CFR 130.6 - User fees for inspection of live animals at land border ports along the United States-Mexico border.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... animals at land border ports along the United States-Mexico border. 130.6 Section 130.6 Animals and Animal... User fees for inspection of live animals at land border ports along the United States-Mexico border. (a... importation into or entry into the United States through a land border port along the United States-Mexico...

  1. 9 CFR 130.6 - User fees for inspection of live animals at land border ports along the United States-Mexico border.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... animals at land border ports along the United States-Mexico border. 130.6 Section 130.6 Animals and Animal... User fees for inspection of live animals at land border ports along the United States-Mexico border. (a... importation into or entry into the United States through a land border port along the United States-Mexico...

  2. 9 CFR 130.6 - User fees for inspection of live animals at land border ports along the United States-Mexico border.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... animals at land border ports along the United States-Mexico border. 130.6 Section 130.6 Animals and Animal... User fees for inspection of live animals at land border ports along the United States-Mexico border. (a... importation into or entry into the United States through a land border port along the United States-Mexico...

  3. National Practitioner Data Bank; change in user fee and elimination of diskette queries--HRSA. Withdrawal.

    PubMed

    1998-02-13

    National Practitioner Data Bank; Change in User Fee and Elimination of Diskette Queries notice, document 98-2637, pages 5811-5812, Volume 63, Number 23, in the issue of Wednesday, February 4, 1998, was published in error and is withdrawn from publication. The correct version of the notice was published on Thursday, January 29, 1998, Document No. 98-2116, Volume 63, Number 19, page 4460.

  4. 76 FR 79233 - Self-Regulatory Organizations; NYSE Amex LLC; Order Approving a Proposed Rule Change Expanding...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-21

    ... Potential ``Users'' of Its Co-Location Services To Include Any Market Participant that Requests To Receive Co-Location Services Directly from the Exchange and Amending Its Fee Schedule To Establish a Fee for... co-location services, and to amend its Fee Schedule. The proposed rule change was published for...

  5. 7 CFR 504.2 - Fees for deposit and requisition of microbial cultures.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 6 2010-01-01 2010-01-01 false Fees for deposit and requisition of microbial cultures... cultures. (a) Depositors of microbial cultures must pay a one-time $500 user fee for each culture deposited on or after November 1, 1983. (b) For cultures deposited on or after November 1, 1983, requesters...

  6. 75 FR 81110 - Schedule of Fees for Access to NOAA Environmental Data, Information, and Related Products and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-27

    ... Related Products and Services AGENCY: National Environmental Satellite, Data and Information Service..., information, and related products and services to users. NESDIS is revising the fee schedule to ensure that... related products and services. NESDIS is authorized under 15 U.S.C. 1534 to assess fees, up to fair market...

  7. 8 CFR 286.8 - Establishment of pilot programs for the charging of a land border fee for inspection services.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... DEPARTMENT OF HOMELAND SECURITY IMMIGRATION REGULATIONS IMMIGRATION USER FEE § 286.8 Establishment of pilot... charge fees for immigration inspection services to be collected by the Commissioner. Individual ports-of... inspection services and to recover the cost of: (a) Hiring additional immigration inspectors, including all...

  8. Use of performance measurement to include air quality and energy into mileage-based user fees.

    DOT National Transportation Integrated Search

    2012-03-01

    Road pricing is an increasingly popular tool for achieving a number of transportation policy related goals and objectives. Addressing environmental concerns is a common goal of road pricing systems in Europe but is less common in the U.S., and framew...

  9. The Computer Catalog: A Democratic or Authoritarian Technology?

    ERIC Educational Resources Information Center

    Adams, Judith A.

    1988-01-01

    Discussion of consequences of library automation argues that technology should be used to augment access to information. Online public access catalogs are considered in this context, along with several related issues such as system incompatibility, invasion of privacy, barriers to database access and manipulation, and user fees, which contribute…

  10. 49 CFR 360.5 - Updating user fees.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... determined by the cost study in Regulations Governing Fees For Service, 1 I.C.C. 2d 60 (1984), or subsequent... material in the Federal Register or FMCSA Register. (This rounding procedures excludes copying, printing...

  11. 49 CFR 360.5 - Updating user fees.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... determined by the cost study in Regulations Governing Fees For Service, 1 I.C.C. 2d 60 (1984), or subsequent... material in the Federal Register or FMCSA Register. (This rounding procedures excludes copying, printing...

  12. 49 CFR 360.5 - Updating user fees.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... determined by the cost study in Regulations Governing Fees For Service, 1 I.C.C. 2d 60 (1984), or subsequent... material in the Federal Register or FMCSA Register. (This rounding procedures excludes copying, printing...

  13. 40 CFR 700.45 - Fee payments.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... shall be in United States currency and shall be paid by money order, bank draft, wire transfer, Pay.gov... Finance Center, Toxic Substances Control Act User Fees, P.O. Box 979073, St. Louis, MO 63197-9000. (3...

  14. Why Did Abolishing Fees Not Increase Public School Enrollment in Kenya? Africa Growth Initiative. Working Paper 4

    ERIC Educational Resources Information Center

    Bold, Tessa; Kimenyi, Mwangi S.; Mwabu, Germano; Sandefur, Justin

    2013-01-01

    A large empirical literature has shown that user fees significantly deter public service utilization in developing countries. While most of these results reflect partial equilibrium analysis, we find that the nationwide abolition of public school fees in Kenya in 2003 led to no increase in net public enrollment rates, but rather a dramatic shift…

  15. 49 CFR 1002.3 - Updating user fees.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... Services, 1 I.C.C.2d 60 (1984) or subsequent cost studies. The base period for measuring changes shall be... material in the Federal Register. (e) All updated fees shall be rounded downward in the following manner...

  16. Fees for Library Service: They Are not Inevitable!

    ERIC Educational Resources Information Center

    Kranich, Nancy

    1980-01-01

    The interests of libraries and users are best served when library services are provided without fee. Policy makers must be convinced that library services are a combination of public and merit goods deserving governmental funding. (RAA)

  17. Ethical considerations related to participation and partnership: an investigation of stakeholders' perceptions of an action-research project on user fee removal for the poorest in Burkina Faso.

    PubMed

    Hunt, Matthew R; Gogognon, Patrick; Ridde, Valéry

    2014-02-20

    Healthcare user fees present an important barrier for accessing services for the poorest (indigents) in Burkina Faso and selective removal of fees has been incorporated in national healthcare planning. However, establishing fair, effective and sustainable mechanisms for the removal of user fees presents important challenges. A participatory action-research project was conducted in Ouargaye, Burkina Faso, to test mechanisms for identifying those who are indigents, and funding and implementing user fee removal. In this paper, we explore stakeholder perceptions of ethical considerations relating to participation and partnership arising in the action-research. We conducted 39 in-depth interviews to examine ethical issues associated with the action-research. Respondents included 14 individuals identified as indigent through the community selection process, seven members of village selection committees, six local healthcare professionals, five members of the management committees of local health clinics, five members of the research team, and four regional or national policy-makers. Using constant comparative techniques, we carried out an inductive thematic analysis of the collected data. The Ouargaye project involved a participatory model, included both implementation and research components, and focused on a vulnerable group within small, rural communities. Stakeholder perceptions and experiences relating to the participatory approach and reliance on multiple partnerships in the project were associated with a range of ethical considerations related to 1) seeking common ground through communication and collaboration, 2) community participation and risk of stigmatization, 3) impacts of local funding of the user fee removal, 4) efforts to promote fairness in the selection of the indigents, and 5) power relations and the development of partnerships. This investigation of the Ouargaye project serves to illuminate the distinctive ethical terrain of a participatory public health action-research project. In carrying out such projects, careful attention and effort is needed to establish and maintain respectful relationships amongst those involved, acknowledge and address differences of power and position, and evaluate burdens and risks for individuals and groups.

  18. Ethical considerations related to participation and partnership: an investigation of stakeholders’ perceptions of an action-research project on user fee removal for the poorest in Burkina Faso

    PubMed Central

    2014-01-01

    Background Healthcare user fees present an important barrier for accessing services for the poorest (indigents) in Burkina Faso and selective removal of fees has been incorporated in national healthcare planning. However, establishing fair, effective and sustainable mechanisms for the removal of user fees presents important challenges. A participatory action-research project was conducted in Ouargaye, Burkina Faso, to test mechanisms for identifying those who are indigents, and funding and implementing user fee removal. In this paper, we explore stakeholder perceptions of ethical considerations relating to participation and partnership arising in the action-research. Methods We conducted 39 in-depth interviews to examine ethical issues associated with the action-research. Respondents included 14 individuals identified as indigent through the community selection process, seven members of village selection committees, six local healthcare professionals, five members of the management committees of local health clinics, five members of the research team, and four regional or national policy-makers. Using constant comparative techniques, we carried out an inductive thematic analysis of the collected data. Results The Ouargaye project involved a participatory model, included both implementation and research components, and focused on a vulnerable group within small, rural communities. Stakeholder perceptions and experiences relating to the participatory approach and reliance on multiple partnerships in the project were associated with a range of ethical considerations related to 1) seeking common ground through communication and collaboration, 2) community participation and risk of stigmatization, 3) impacts of local funding of the user fee removal, 4) efforts to promote fairness in the selection of the indigents, and 5) power relations and the development of partnerships. Conclusions This investigation of the Ouargaye project serves to illuminate the distinctive ethical terrain of a participatory public health action-research project. In carrying out such projects, careful attention and effort is needed to establish and maintain respectful relationships amongst those involved, acknowledge and address differences of power and position, and evaluate burdens and risks for individuals and groups. PMID:24555854

  19. Two-Level Verification of Data Integrity for Data Storage in Cloud Computing

    NASA Astrophysics Data System (ADS)

    Xu, Guangwei; Chen, Chunlin; Wang, Hongya; Zang, Zhuping; Pang, Mugen; Jiang, Ping

    Data storage in cloud computing can save capital expenditure and relive burden of storage management for users. As the lose or corruption of files stored may happen, many researchers focus on the verification of data integrity. However, massive users often bring large numbers of verifying tasks for the auditor. Moreover, users also need to pay extra fee for these verifying tasks beyond storage fee. Therefore, we propose a two-level verification of data integrity to alleviate these problems. The key idea is to routinely verify the data integrity by users and arbitrate the challenge between the user and cloud provider by the auditor according to the MACs and ϕ values. The extensive performance simulations show that the proposed scheme obviously decreases auditor's verifying tasks and the ratio of wrong arbitration.

  20. Removing user fees in the health sector: a review of policy processes in six sub-Saharan African countries.

    PubMed

    Meessen, Bruno; Hercot, David; Noirhomme, Mathieu; Ridde, Valéry; Tibouti, Abdelmajid; Tashobya, Christine Kirunga; Gilson, Lucy

    2011-11-01

    In recent years, governments of several low-income countries have taken decisive action by removing fully or partially user fees in the health sector. In this study, we review recent reforms in six sub-Saharan African countries: Burkina Faso, Burundi, Ghana, Liberia, Senegal and Uganda. The review describes the processes and strategies through which user fee removal reforms have been implemented and tries to assess them by referring to a good practice hypotheses framework. The analysis shows that African leaders are willing to take strong action to remove financial barriers met by vulnerable groups, especially pregnant women and children. However, due to a lack of consultation and the often unexpected timing of the decision taken by the political authorities, there was insufficient preparation for user fee removal in several countries. This lack of preparation resulted in poor design of the reform and weaknesses in the processes of policy formulation and implementation. Our assessment is that there is now a window of opportunity in many African countries for policy action to address barriers to accessing health care. Mobilizing sufficient financial resources and obtaining long-term commitment are obviously crucial requirements, but design details, the formulation process and implementation plan also need careful thought. We contend that national policy-makers and international agencies could better collaborate in this respect.

  1. Costs and financing of improvements in the quality of maternal health services through the Bamako Initiative in Nigeria.

    PubMed

    Ogunbekun, I; Adeyi, O; Wouters, A; Morrow, R H

    1996-12-01

    This paper reports on a study to assess the quality of maternal health care in public health facilities in Nigeria and to identify the resource implications of making the necessary quality improvements. Drawing upon unifying themes from quality assurance, basic microeconomics and the Bamako Initiative, locally defined norms were used to estimate resource requirements for improving the quality of maternal health care. Wide gaps existed between what is required (the norm) and what was available in terms of fixed and variable resources required for the delivery of maternal health services in public facilities implementing the Bamako Initiative in the Local Government Areas studied. Given such constraints, it was highly unlikely that technically acceptable standards of care could be met without additional resource inputs to meet the norm. This is part of the cost of doing business and merits serious policy dialogue. Revenue generation from health services was poor and appeared to be more related to inadequate supply of essential drugs and consumables than to the use of uneconomic fee scales. It is likely that user fees will be necessary to supplement scarce government budgets, especially to fund the most critical variable inputs associated with quality improvements. However, any user fee system, especially one that raises fees to patients, will have to be accompanied by immediate and visible quality improvements. Without such quality improvements, cost recovery will result in even lower utilization and attempts to generate new revenues are unlikely to succeed.

  2. 76 FR 56201 - Prescription Drug User Fee Act; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-12

    ... PDUFA expires in September 2012. At that time, new legislation will be required for FDA to collect... and upgrade its information technology systems. At the same time, FDA committed to complete reviews in...\\ Since PDUFA was enacted, the median approval time of original NDAs and BLAs has been reduced by about 50...

  3. 75 FR 45632 - Animal Drug User Fee Rates and Payment Procedures for Fiscal Year 2011

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-03

    ... available to you after you submit a cover sheet. Click the ``Pay Now'' button.) On your check, bank draft... 2011, FDA is assuming that the number of applications that will pay fees in FY 2011 will equal the... applications subject to the criteria set forth is section 512(d)(4) of the act which pay half of the full fee...

  4. Data distribution satellite

    NASA Technical Reports Server (NTRS)

    Price, Kent M.; Jorasch, Ronald E.; Wiskerchen, Michael J.

    1991-01-01

    A description is given of a data distribution satellite (DDS) system. The DDS would operate in conjunction with the tracking and data relay satellite system to give ground-based users real time, two-way access to instruments in space and space-gathered data. The scope of work includes the following: (1) user requirements are derived; (2) communication scenarios are synthesized; (3) system design constraints and projected technology availability are identified; (4) DDS communications payload configuration is derived, and the satellite is designed; (5) requirements for earth terminals and network control are given; (6) system costs are estimated, both life cycle costs and user fees; and (7) technology developments are recommended, and a technology development plan is given. The most important results obtained are as follows: (1) a satellite designed for launch in 2007 is feasible and has 10 Gb/s capacity, 5.5 kW power, and 2000 kg mass; (2) DDS features include on-board baseband switching, use of Ku- and Ka-bands, multiple optical intersatellite links; and (3) system user costs are competitive with projected terrestrial communication costs.

  5. Potential benefits of mileage-based user fees to the freight industry and industry concerns.

    DOT National Transportation Integrated Search

    2012-08-01

    The concept of funding surface transportation infrastructure through fees charged on miles driven has been : receiving growing attention from transportation professionals and researchers in recent years. Highway funding in : the United States has tra...

  6. SUPPORTING CONGRESSIONAL OVERSIGHT: Framework for Considering Budgetary Implications of Selected GAO Work

    DTIC Science & Technology

    2001-03-01

    Certain State Taxes 95 Increase Nuclear Waste Disposal Fees 97 Recover Federal Investment in Successfully Commercialized Technologies 99 Revise the...Motor Fuels 154 Index Excise Tax Bases for Inflation 156 Increase Highway User Fees on Heavy Trucks 158 Impose Pollution Fees and Taxes 160 Appendix...Were Shared 284 Require Corporate Tax Document Matching 286 Improve Administration of the Tax Deduction for Real Estate Taxes 287 Increase Collection

  7. Exploring health facilities' experiences in implementing the free health-care policy (FHCP) in Nepal: how did organizational factors influence the implementation of the user-fee abolition policy?

    PubMed

    Sato, Midori; Gilson, Lucy

    2015-12-01

    This article presents an Asian experience of abolishing health-care user fees: Nepal's universal free health-care policy, implemented in 2008. Based on doctoral fieldwork between August 2008 and April 2009, the paper analyses primary-care facilities' and central and district health systems' experiences with the policy. It makes a unique contribution to existing evidence because it explicitly applies organizational theory within a carefully designed, rigorous, multiple case-study analysis to deepen our understanding of the organizational and 'people' factors in the successful removal of user fees. The cases were two pairs of primary-care facilities in one district, paired for comparison of the facilities' experiences with the policy in relation to its effects on health care utilization. Data collection methods included document reviews; key informant interviews at district and central levels; in-depth, semi-structured interviews and group interviews at case facilities. (Data on indicators of utilization and quality changes over time were also collected and will be published separately). Using key elements of Nadler and Tushman's 'Organizational Congruence' model, a degree-of-fit analysis tested the study's initial propositions and yielded generalizations for contexts in and outside Nepal. The study found that Nepal's key implementation challenges were similar to Africa's: insufficient or delayed inputs of drugs and compensation; insufficient workforce and the resulting reduced quality of services that hampered facilities' relationships with their clients and health providers' attitudes. However, the Nepalese case facilities with (1) good intra- and inter-facility relationships, (2) adequate staffing, (3) well-oriented providers and (4) previously trained, better-informed and skilled health management committees experienced higher utilization and better-quality indicators over time. Through its detailed analysis of Nepal's experience in removing user fees, the study highlights the importance of addressing the 'people' and 'organizational' factors in health-policy development and implementation. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2015; all rights reserved.

  8. User fees, self-selection and the poor in Bangladesh.

    PubMed

    Thomas, S; Killingsworth, J R; Acharya, S

    1998-03-01

    The widespread uncontrolled introduction of user fees in any developing country is likely to have a disastrous impact on poorer patients. Furthermore, traditional targeting schemes aimed at their exemption are often expensive, difficult to administer and ineffective at reaching those in greatest need. This research study examines how user fees can raise revenue and target poorer patients, under the right market conditions, without resorting to costly targeting schemes. The authors draw their findings from case studies of cost recovery in the health and population sectors in Bangladesh. The mechanism suggested in the paper is to use self-selection. It is argued that under certain market conditions poorer patients will choose the health-care option that is appropriate to their means. They will thus identify themselves as poor without having to be selected or tested by an independent authority. This self-selection allows the relevant authorities to cross-subsidize their market choice by over-charging the non-poor in other segments of the market.

  9. EFFECT OF FEES ON WATER SERVICE CUTOFFS AND PAYMENT DELINQUENCIES

    EPA Science Inventory

    A study was conducted to determine whether increased water and sewer user fees have generated increases in payment delinquencies and service cutoff rates and whether they have created other problems such as increased health hazards. Another objective was to examine the varied use...

  10. Enhancing Kentucky's transportation funding capacity : a review of six innovative financing options.

    DOT National Transportation Integrated Search

    2005-06-01

    Kentucky faces several challenges in meeting the funding needs for its transportation infrastructure. The state currently relies on a revenue stream based on road user taxes and fees. However, the structure of these taxes and fees are such that reven...

  11. 19 CFR 24.22 - Fees for certain services.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... following address: U.S. Customs and Border Protection, Attn: DTOPS Program Administrator, 6650 Telecom Drive... address: U.S. Customs and Border Protection, Attn: DTOPS Program Administrator, 6650 Telecom Drive, Suite....S. Customs and Border Protection, Revenue Division, Attn: User Fee Team, 6650 Telecom Drive, Suite...

  12. 19 CFR 24.22 - Fees for certain services.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... following address: U.S. Customs and Border Protection, Attn: DTOPS Program Administrator, 6650 Telecom Drive... address: U.S. Customs and Border Protection, Attn: DTOPS Program Administrator, 6650 Telecom Drive, Suite....S. Customs and Border Protection, Revenue Division, Attn: User Fee Team, 6650 Telecom Drive, Suite...

  13. 77 FR 1101 - Self-Regulatory Organizations; C2 Options Exchange, Incorporated; Notice of Filing and Immediate...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-01-09

    ... Login ID and FIX Login ID to $500 per month for regular access and $1000 per month for Sponsored User... a FIX fee of $1200 for a minimum of two monthly login IDs (so, $600 for one), or a fee of $2,400 for... to increase the fees charged for a CMI Login ID and FIX Login ID to $500 per month for regular access...

  14. The Prescription Drug User Fee Act: Cause for Concern?

    PubMed

    Gabay, Michael

    2018-04-01

    The Prescription Drug User Fee Act (PDUFA) was originally enacted into law in 1992. PDUFA provides the Food and Drug Administration (FDA) with needed revenue in the form of various fees paid by drug and biologic manufacturers. The FDA utilizes this revenue to streamline the review and approval process for medications. Since the enactment of PDUFA, the median approval time for priority new drug applications and biologics license applications has reduced significantly. The FDA views PDUFA as a successful program that provides a consistent revenue stream to the agency, improves access to medications for patients, and allows industry to have a more predictable product review timeline. However, critics of PDUFA cite concerns including the potential for a lack of FDA independence and medication safety issues involving drugs approved after the existence of PDUFA.

  15. User fees across ecosystem boundaries: Are SCUBA divers willing to pay for terrestrial biodiversity conservation?

    PubMed

    Roberts, Michaela; Hanley, Nick; Cresswell, Will

    2017-09-15

    While ecological links between ecosystems have been long recognised, management rarely crosses ecosystem boundaries. Coral reefs are susceptible to damage through terrestrial run-off, and failing to account for this within management threatens reef protection. In order to quantify the extent to that coral reef users are willing to support management actions to improve ecosystem quality, we conducted a choice experiment with SCUBA divers on the island of Bonaire, Caribbean Netherlands. Specifically, we estimated their willingness to pay to reduce terrestrial overgrazing as a means to improve reef health. Willingness to pay was estimated using the multinomial, random parameter and latent class logit models. Willingness to pay for improvements to reef quality was positive for the majority of respondents. Estimates from the latent class model determined willingness to pay for reef improvements of between $31.17 - $413.18/year, dependent on class membership. This represents a significant source of funding for terrestrial conservation, and illustrates the potential for user fees to be applied across ecosystem boundaries. We argue that such across-ecosystem-boundary funding mechanisms are an important avenue for future investigation in many connected systems. Copyright © 2017 Elsevier Ltd. All rights reserved.

  16. 32 CFR 204.6 - Collections.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 32 National Defense 2 2014-07-01 2014-07-01 false Collections. 204.6 Section 204.6 National Defense Department of Defense (Continued) OFFICE OF THE SECRETARY OF DEFENSE (CONTINUED) MISCELLANEOUS USER FEES § 204.6 Collections. (a) Collections of fees will be made in advance or simultaneously with...

  17. 44 CFR 5.43 - Waiver or reduction of fees.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Waiver or reduction of fees. 5.43 Section 5.43 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY... requester's and/or intended user's identity and qualifications, expertise in the subject area and ability...

  18. 78 FR 40527 - Self-Regulatory Organizations; The NASDAQ Stock Market LLC; Notice of Filing and Immediate...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-05

    ... users using the Co-Lo Console \\4\\ on or after July 1, 2013 through August 31, 2013. The reduced fee... reduction in co-location cabinet fees). \\4\\ The ``Co-Lo Console'' is NASDAQ's web-based ordering tool, and...

  19. Parental Participation Fees in School Expenses in Israel

    ERIC Educational Resources Information Center

    Shaked, Haim

    2016-01-01

    Purpose: Many countries throughout the world provide all children with free education. However, sometimes there are user charges in publically funded schools worldwide. The purpose of this paper is to explore parental participation fees in school expenses in Israel, depicting the current situation and analyzing its implications.…

  20. Inequities in accessibility to and utilisation of maternal health services in Ghana after user-fee exemption: a descriptive study.

    PubMed

    Ganle, John K; Parker, Michael; Fitzpatrick, Raymond; Otupiri, Easmon

    2014-11-01

    Inequities in accessibility to, and utilisation of maternal healthcare services impede progress towards attainment of the maternal health-related Millennium Development Goals. The objective of this study is to examine the extent to which maternal health services are utilised in Ghana, and whether inequities in accessibility to and utilization of services have been eliminated following the implementation of a user-fee exemption policy, that aims to reduce financial barriers to access, reduce inequities in access, and improve access to and use of birthing services. We analyzed data from the 2007 Ghana Maternal Health Survey for inequities in access to and utilization of maternal health services. In measuring the inequities, frequency tables and cross-tabulations were used to compare rates of service utilization by region, residence and selected socio-demographic variables. Findings show marginal increases in accessibility to and utilisation of skilled antenatal, delivery and postnatal care services following the policy implementation (2003-2007). However, large gradients of inequities exist between geographic regions, urban and rural areas, and different socio-demographic, religious and ethnic groupings. More urban women (40%) than rural, 53% more women in the highest wealth quintile than women in the lowest, 38% more women in the best performing region (Central Region) than the worst (Upper East Region), and 48% more women with at least secondary education than those with no formal education, accessed and used all components of skilled maternal health services in the five years preceding the survey. Our findings raise questions about the potential equity and distributional benefits of Ghana's user-fee exemption policy, and the role of non-financial barriers or considerations. Exempting user-fees for maternal health services is a promising policy option for improving access to maternal health care, but might be insufficient on its own to secure equitable access to maternal health services in Ghana. Ensuring equity in access will require moving beyond user-fee exemption to addressing wider issues of supply and demand factors and the social determinants of health, including redistributing healthcare resources and services, and redressing the positional vulnerability of women in their communities.

  1. Who Can Afford Health Care? Evaluating the Socio-Economic Conditions and the Ability to Contribute to Health Care in a Post-Conflict Area in DR Congo

    PubMed Central

    Gerstl, Sibylle; Sauter, Justin; Kasanda, Joseph; Kinzelbach, Alfred

    2013-01-01

    Introduction The Democratic Republic of the Congo is today one of the poorest countries in the world; the health status of the population ranks among the worst in Sub-Saharan Africa. Public health services charge user fees and drug prices. Since 2008, north-eastern Congo is facing a guerrilla war. Malteser International is assisting with free health care for internally displaced persons as well as the general population. Before the incursion the health system was based on user fees. The aim of this study was to determine the socio-economic conditions of the population and to assess their ability to contribute to health care. Methodology Heads of 552 randomly selected households in 23 clusters in two health zones were interviewed using a standardised questionnaire. Findings The demographic description and socio-economic conditions of the study population were homogenous. Major source of income was agriculture (57%); 47% of the households earned less than US$ 5.5/week. Ninety-two percent of the interviewed households estimated that they would be able to contribute to consultation fees (maximum amount of US$ 0.27) and 79% to the drug prices (maximum amount of US$ 1.10). Six percent opted for free consultations and 19% for free drugs. Conclusions Living conditions were very basic; the estimated income of the study population was low. Almost half of the population perceived their current living situation as fairly good/good. More than 90% of the study population estimated to be able to contribute to consultation fees and 80% to drug prices. As a result Malteser International suggested introducing flat-rates for health care services. Once the project ends, the population will have to pay again for their health service. One solution would be the introduction of a health care financing system with the goal to reach universal coverage to health care. PMID:24204819

  2. Removing financial barriers to access reproductive, maternal and newborn health services: the challenges and policy implications for human resources for health

    PubMed Central

    2013-01-01

    Background The last decade has seen widespread retreat from user fees with the intention to reduce financial constraints to users in accessing health care and in particular improving access to reproductive, maternal and newborn health services. This has had important benefits in reducing financial barriers to access in a number of settings. If the policies work as intended, service utilization rates increase. However this increases workloads for health staff and at the same time, the loss of user fee revenues can imply that health workers lose bonuses or allowances, or that it becomes more difficult to ensure uninterrupted supplies of health care inputs. This research aimed to assess how policies reducing demand-side barriers to access to health care have affected service delivery with a particular focus on human resources for health. Methods We undertook case studies in five countries (Ghana, Nepal, Sierra Leone, Zambia and Zimbabwe). In each we reviewed financing and HRH policies, considered the impact financing policy change had made on health service utilization rates, analysed the distribution of health staff and their actual and potential workloads, and compared remuneration terms in the public sectors. Results We question a number of common assumptions about the financing and human resource inter-relationships. The impact of fee removal on utilization levels is mostly not sustained or supported by all the evidence. Shortages of human resources for health at the national level are not universal; maldistribution within countries is the greater problem. Low salaries are not universal; most of the countries pay health workers well by national benchmarks. Conclusions The interconnectedness between user fee policy and HRH situations proves difficult to assess. Many policies have been changing over the relevant period, some clearly and others possibly in response to problems identified associated with financing policy change. Other relevant variables have also changed. However, as is now well-recognised in the user fee literature, co-ordination of health financing and human resource policies is essential. This appears less well recognised in the human resources literature. This coordination involves considering user charges, resource availability at health facility level, health worker pay, terms and conditions, and recruitment in tandem. All these policies need to be effectively monitored in their processes as well as outcomes, but sufficient data are not collected for this purpose. PMID:24053731

  3. Removing financial barriers to access reproductive, maternal and newborn health services: the challenges and policy implications for human resources for health.

    PubMed

    McPake, Barbara; Witter, Sophie; Ensor, Tim; Fustukian, Suzanne; Newlands, David; Martineau, Tim; Chirwa, Yotamu

    2013-09-22

    The last decade has seen widespread retreat from user fees with the intention to reduce financial constraints to users in accessing health care and in particular improving access to reproductive, maternal and newborn health services. This has had important benefits in reducing financial barriers to access in a number of settings. If the policies work as intended, service utilization rates increase. However this increases workloads for health staff and at the same time, the loss of user fee revenues can imply that health workers lose bonuses or allowances, or that it becomes more difficult to ensure uninterrupted supplies of health care inputs.This research aimed to assess how policies reducing demand-side barriers to access to health care have affected service delivery with a particular focus on human resources for health. We undertook case studies in five countries (Ghana, Nepal, Sierra Leone, Zambia and Zimbabwe). In each we reviewed financing and HRH policies, considered the impact financing policy change had made on health service utilization rates, analysed the distribution of health staff and their actual and potential workloads, and compared remuneration terms in the public sectors. We question a number of common assumptions about the financing and human resource inter-relationships. The impact of fee removal on utilization levels is mostly not sustained or supported by all the evidence. Shortages of human resources for health at the national level are not universal; maldistribution within countries is the greater problem. Low salaries are not universal; most of the countries pay health workers well by national benchmarks. The interconnectedness between user fee policy and HRH situations proves difficult to assess. Many policies have been changing over the relevant period, some clearly and others possibly in response to problems identified associated with financing policy change. Other relevant variables have also changed.However, as is now well-recognised in the user fee literature, co-ordination of health financing and human resource policies is essential. This appears less well recognised in the human resources literature. This coordination involves considering user charges, resource availability at health facility level, health worker pay, terms and conditions, and recruitment in tandem. All these policies need to be effectively monitored in their processes as well as outcomes, but sufficient data are not collected for this purpose.

  4. Funding conservation through use and potentials for price discrimination among scuba divers at Sipadan, Malaysia.

    PubMed

    Emang, Diana; Lundhede, Thomas Hedemark; Thorsen, Bo Jellesmark

    2016-11-01

    The protected coral reefs off the coast of Malaysia receive numerous tourists, while also being as fishing grounds. These joint environmental pressures raise the need for additional costly conservation measures. It is natural to consider the potential for expanding the 'user pays' principle, already implemented in the form of various user fees. This study explores the potential for price discrimination among scuba divers at Sipadan in Malaysia. The study applies a choice experiment to estimate scuba divers willingness to pay higher user fees for avoiding decreases of or getting improvements in environmental and recreational aspects of the diving experience. We investigate how sensitivity to fee size and hence willingness to pay vary with suitable selected characteristics of divers. We find potentials for a third degree price discrimination strategy exploiting higher willingness to pay among foreign divers (45%), male divers (16%) and people who has visited Sipadan several times (25%). Thus, revised pricing structures could significantly increase funds for the preservation of Sipadan. Copyright © 2016 Elsevier Ltd. All rights reserved.

  5. 76 FR 6475 - Agency Information Collection Activities; Submission for Office of Management and Budget Review...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-04

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2010-N-0603... Request; Animal Drug User Fees and Fee Waivers and Reductions AGENCY: Food and Drug Administration, HHS. ACTION: Notice. SUMMARY: The Food and Drug Administration (FDA) is announcing that a proposed collection...

  6. Pay for Play: Fees for Cocurricular Activities.

    ERIC Educational Resources Information Center

    Pepe, Thomas J.; Tufts, Alice L.

    1984-01-01

    As school budgets face serious problems, one area under examination is the cocurricular activities section of the school budget. Many districts are charging user fees to students participating in school sports, band, drama, and even elective courses. Since no direct reference is made to education in the United States Constitution, education is a…

  7. 75 FR 17281 - Changes in Hourly Fee Rates for Science and Technology Laboratory Services-Fiscal Years 2010-2012

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-06

    ..., residue chemistry, proximate analysis for composition, and biomolecular (DNA-based) testing. A user fee... provide greater clarity of reported test analyses and laboratory determinations. DATES: Effective April 7... analyses and laboratory determinations provided by AMS laboratory services apply only to the submitted...

  8. 75 FR 47820 - Generic Drug User Fee; Public Meeting; Request for Comments

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-09

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2010-N-0381... fee program. The number of human generic drug applications awaiting FDA action and the median review... needed for presentations, FDA reserves the right to terminate the meeting early. If you need special...

  9. 42 CFR 422.6 - Cost-sharing in enrollment-related costs.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... counseling and assistance program) and section 1860D-1(c) of the Act (relating to dissemination of enrollment...—(1) Timing of collection. CMS collects the fees over 9 consecutive months beginning with January of... under title XVIII. (f) Assessment methodology. (1) The amount of the applicable portion of the user fee...

  10. 42 CFR 422.6 - Cost-sharing in enrollment-related costs.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... counseling and assistance program) and section 1860D-1(c) of the Act (relating to dissemination of enrollment...—(1) Timing of collection. CMS collects the fees over 9 consecutive months beginning with January of... under title XVIII. (f) Assessment methodology. (1) The amount of the applicable portion of the user fee...

  11. 42 CFR 422.6 - Cost-sharing in enrollment-related costs.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... counseling and assistance program) and section 1860D-1(c) of the Act (relating to dissemination of enrollment...—(1) Timing of collection. CMS collects the fees over 9 consecutive months beginning with January of... under title XVIII. (f) Assessment methodology. (1) The amount of the applicable portion of the user fee...

  12. Fee Based Document Delivery by a National Library: Publishing in the New Millennium.

    ERIC Educational Resources Information Center

    Smith, Malcolm D.

    1996-01-01

    An overview of the development of document supply relationships between libraries and publishers, based on the British Library's Document Supply Centre, reveals four areas leading to fee based (copyright) document delivery: libraries as markets for publishers; making users aware of what is published; making publications more accessible; and the…

  13. 8 CFR 286.3 - Exceptions.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 8 Aliens and Nationality 1 2010-01-01 2010-01-01 false Exceptions. 286.3 Section 286.3 Aliens and Nationality DEPARTMENT OF HOMELAND SECURITY IMMIGRATION REGULATIONS IMMIGRATION USER FEE § 286.3 Exceptions. The fees set forth in §§ 286.2(a) and 286.2(b) shall not be charged or collected from passengers who...

  14. The effect of user fees on the utilization of family planning services. A clinical study.

    PubMed

    Bailey, W; Wynter, H H; Lee, A; Oliver, P; Jackson, J

    1994-06-01

    A new fee structure was introduced to the Advanced Training and Research in Fertility Management Unit in 1992. The study looked at the effect of the new fees on attendance and the choice of contraceptive methods through an examination of clinical records and a questionnaire survey. There was a decline in attendance of roughly 28 per cent between 1992 and 1993. The decline affected mainly new clients and those who accepted injectables. A reduction in the price of injectables is suggested since the fee for this short-term method is more in line with those charged for long-term and permanent methods.

  15. Curing over-use by prescribing fees: an evaluation of the effect of user fees' implementation on healthcare use in the Czech Republic.

    PubMed

    Kalousova, Lucie

    2015-05-01

    In 2008, the Czech Republic instituted a new policy that requires most patients to pay a small fee for some inpatient and outpatient healthcare services. Using the Survey of Health Aging and Retirement in Europe, this article examines the changes in healthcare utilization of Czechs 50 years and older following the new fee requirement by constructing difference-in-differences regression models focusing on four outcome measures: any visits to primary care physician, any hospitalization, number of visits to the primary care physician and number of nights hospitalized. For this population, I find that the likelihood of having any primary care visit decreased after the policy was instituted. The likelihood of reporting any hospitalization was not significantly changed. The predicted number of primary care visits per person declined, but the predicted number of nights spent in a hospital did not. I find only mixed evidence of greater effect of the user fees on some subpopulations compared with others. Those 65 or older reduced their use more than those between 50 and 64, and so did those who consider their health to be good, and the less educated. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2014; all rights reserved.

  16. Improving Management of Military Construction Planning and Design

    DTIC Science & Technology

    1991-10-01

    waterfront facilities and operations and its transportation systems, owns and operates JFK Airport . The Port Authority has an extremely capable and...restructured, and many projects are being deferred until the economic picture brightens. Airline user fees are the principal source of income for the JFK ... Airport . This "downsizing" has caused major schedule readjustment and sequencing of designs to ensure compatibility with existing facilities. In managing

  17. 78 FR 53055 - Regulations Governing Fees for Services Performed in Connection With Licensing and Related...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-28

    ... the unchanged salary costs from the 2012 User Fee Update decision; no change in the publication cost levels of that decision; plus increase changes to two of the three Board overhead cost factors (the other overhead factor remains unchanged from its 2012 level), resulting from the mechanical application of the...

  18. 76 FR 5830 - FBI Records Management Division; National Name Check Program Section; New User Fees Schedule

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-02

    ... study employed the same Activity Based Cost (ABC) accounting method detailed in the Final Rule establishing the process for setting fees (75 FR 24796 (May 6, 2010)). The ABC methodology is consistent with widely accepted accounting principles and complies with the provisions of 31 U.S.C. 9701 and other...

  19. 77 FR 44158 - Fees for Services Performed in Connection With Licensing and Related Services-2012 Update

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-27

    ... AGENCY: Surface Transportation Board, DOT. ACTION: Final rules. SUMMARY: The Board adopts its 2012 user... result of no wage & salary increases given in January 2012, no change to publication costs from their... 1002.3(d). The fee changes adopted here, reflect a combination of the unchanged wage and salary costs...

  20. 76 FR 46628 - Regulations Governing Fees for Services Performed in Connection With Licensing and Related...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-03

    ... Services--2011 Update AGENCY: Surface Transportation Board. ACTION: Final rule. SUMMARY: The Board adopts... decreased costs, resulting from a freeze on wage and salary increases in 2011, coupled with changes to the... adopted here reflect a combination of the unchanged wage and salary costs from the 2010 User Fee Update...

  1. 77 FR 45624 - Animal Drug User Fee Rates and Payment Procedures for Fiscal Year 2013

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-01

    ... cumulative amount by which fees collected fell below amounts appropriated for FY 2009 through FY 2012. Table... collections have fallen substantially below the amounts appropriated each year and in aggregate. The only... currently estimates to have available at the end of FY 2013. It begins with the balance available at the end...

  2. 77 FR 75014 - Schedule of Fees for Access to NOAA Environmental Data, Information, and Related Products and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-19

    ... Related Products and Services AGENCY: National Environmental Satellite, Data and Information Service..., information, and related products and services to users. NESDIS is revising the fee schedule that has been in... environmental data, information, and related products and services. NESDIS is authorized under 15 U.S.C. 1534 to...

  3. --No Title--

    Science.gov Websites

    ("DOE"). The user is granted the right, without any fee or cost, to use, copy, modify, alter all copies of the data. Further, the user of this data agrees to credit NREL in any publications or following obligations on the User. The names DOE/NREL may not be used in any advertising or publicity to

  4. Completeness assessment of type II active pharmaceutical ingredient drug master files under generic drug user fee amendment: review metrics and common incomplete items.

    PubMed

    Zhang, Huyi; Li, Haitao; Song, Wei; Shen, Diandian; Skanchy, David; Shen, Kun; Lionberger, Robert A; Rosencrance, Susan M; Yu, Lawrence X

    2014-09-01

    Under the Generic Drug User Fee Amendments (GDUFA) of 2012, Type II active pharmaceutical ingredient (API) drug master files (DMFs) must pay a user fee and pass a Completeness Assessment (CA) before they can be referenced in an Abbreviated New Drug Application (ANDA), ANDA amendment, or ANDA prior approval supplement (PAS). During the first year of GDUFA implementation, from October 1, 2012 to September 30, 2013, approximately 1,500 Type II API DMFs received at least one cycle of CA review and more than 1,100 Type II DMFs were deemed complete and published on FDA's "Available for Reference List". The data from CA reviews were analyzed for factors that influenced the CA review process and metrics, as well as the areas of DMF submissions which most frequently led to an incomplete CA status. The metrics analysis revealed that electronic DMFs appear to improve the completeness of submission and shorten both the review and response times. Utilizing the CA checklist to compile and proactively update the DMFs improves the chance for the DMFs to pass the CA in the first cycle. However, given that the majority of DMFs require at least two cycles of CA before being deemed complete, it is recommended that DMF fees are paid 6 months in advance of the ANDA submissions in order to avoid negatively impacting the filling status of the ANDAs.

  5. Reimagining cost recovery in Pakistan's irrigation system through willingness-to-pay estimates for irrigation water from a discrete choice experiment

    NASA Astrophysics Data System (ADS)

    Bell, Andrew Reid; Shah, M. Azeem Ali; Ward, Patrick S.

    2014-08-01

    It is widely argued that farmers are unwilling to pay adequate fees for surface water irrigation to recover the costs associated with maintenance and improvement of delivery systems. In this paper, we use a discrete choice experiment to study farmer preferences for irrigation characteristics along two branch canals in Punjab Province in eastern Pakistan. We find that farmers are generally willing to pay well in excess of current surface water irrigation costs for increased surface water reliability and that the amount that farmers are willing to pay is an increasing function of their existing surface water supply as well as location along the main canal branch. This explicit translation of implicit willingness-to-pay (WTP) for water (via expenditure on groundwater pumping) to WTP for reliable surface water demonstrates the potential for greatly enhanced cost recovery in the Indus Basin Irrigation System via appropriate setting of water user fees, driven by the higher WTP of those currently receiving reliable supplies.

  6. Reimagining cost recovery in Pakistan's irrigation system through willingness-to-pay estimates for irrigation water from a discrete choice experiment

    PubMed Central

    Bell, Andrew Reid; Shah, M Azeem Ali; Ward, Patrick S

    2014-01-01

    It is widely argued that farmers are unwilling to pay adequate fees for surface water irrigation to recover the costs associated with maintenance and improvement of delivery systems. In this paper, we use a discrete choice experiment to study farmer preferences for irrigation characteristics along two branch canals in Punjab Province in eastern Pakistan. We find that farmers are generally willing to pay well in excess of current surface water irrigation costs for increased surface water reliability and that the amount that farmers are willing to pay is an increasing function of their existing surface water supply as well as location along the main canal branch. This explicit translation of implicit willingness-to-pay (WTP) for water (via expenditure on groundwater pumping) to WTP for reliable surface water demonstrates the potential for greatly enhanced cost recovery in the Indus Basin Irrigation System via appropriate setting of water user fees, driven by the higher WTP of those currently receiving reliable supplies. PMID:25552779

  7. Education and the Market: Which Parts of the Neo Liberal Solution Are Correct? Innocenti Occasional Papers. Special Subseries "Fiscal Policy and the Poor," Economic Policy Series.

    ERIC Educational Resources Information Center

    Colclough, Christopher

    This paper examines the argument that education systems in development countries should be financed more directly by private households. It finds that cost-recovery policies are likely to be harmful to efficiency and equity if significant resources were to be generated by these means. User fees at primary and secondary levels would increase…

  8. 77 FR 67410 - Self-Regulatory Organizations; The National Securities Clearing Corporation; Notice of Filing and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-09

    ... transmission, and the settlement of such payments, with regard to investor accounts held on an omnibus account... payment of 12b-1 fees \\6\\ with regard to investor accounts held in Omnibus, and (v) establish the fees that NSCC will charge users of the Service with regard to investor accounts held in Omnibus. \\6\\ This...

  9. 36 CFR 222.51 - National Forests in 16 Western States.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... fee for 1988 and subsequent grazing fee years represents the economic value of the use of the land to the user and is the product of multiplying the base fair market value of $1.23 by the result of the annual Forage Value Index, added to the sum of the Beef Cattle Price Index minus the Prices Paid Index...

  10. 36 CFR 222.51 - National Forests in 16 Western States.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... fee for 1988 and subsequent grazing fee years represents the economic value of the use of the land to the user and is the product of multiplying the base fair market value of $1.23 by the result of the annual Forage Value Index, added to the sum of the Beef Cattle Price Index minus the Prices Paid Index...

  11. 36 CFR 222.51 - National Forests in 16 Western States.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... fee for 1988 and subsequent grazing fee years represents the economic value of the use of the land to the user and is the product of multiplying the base fair market value of $1.23 by the result of the annual Forage Value Index, added to the sum of the Beef Cattle Price Index minus the Prices Paid Index...

  12. 36 CFR 222.51 - National Forests in 16 Western States.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... fee for 1988 and subsequent grazing fee years represents the economic value of the use of the land to the user and is the product of multiplying the base fair market value of $1.23 by the result of the annual Forage Value Index, added to the sum of the Beef Cattle Price Index minus the Prices Paid Index...

  13. 36 CFR 222.51 - National Forests in 16 Western States.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... fee for 1988 and subsequent grazing fee years represents the economic value of the use of the land to the user and is the product of multiplying the base fair market value of $1.23 by the result of the annual Forage Value Index, added to the sum of the Beef Cattle Price Index minus the Prices Paid Index...

  14. Fee-for-Service Health Care Expenditures: Evidence of Selection Effects among Subscribers Who Choose HMOs. Health Insurance Experiment Series.

    ERIC Educational Resources Information Center

    Buchanan, Joan; Cretin, Shan

    Although competition among health plans has been encouraged as a means to control health care expenditures, some fee-for-service (FFS) insurers attribute part of their increased average expenditures to favorable selection of low users into newly offered health maintenance organization (HMO) plans. To test this hypothesis, the health care…

  15. 77 FR 45639 - Prescription Drug User Fee Rates for Fiscal Year 2013

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-01

    ... compensation and benefits (PC&B) paid per full-time equivalent position (FTE) at FDA for the first 3 of the 4... preceding FY 2013. The 3 year average is 2.17 percent. Table 1--FDA Personnel Compensation and Benefits (PC... 108.25 122.3 The FY 2013 application fee is estimated by dividing the average number of full...

  16. 77 FR 65198 - Generic Drug User Fee-Abbreviated New Drug Application, Prior Approval Supplement, and Drug...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-25

    ... FY 2013 is 1,160. The FY 2013 application fee is estimated by dividing the number of full application... in FY 2013. Dividing the DMF revenue of $14,940,000 by the estimated number of first-referenced DMFs..., Attention: Government Lockbox 979108, 1005 Convention Plaza, St. Louis, MO 63101. (Note: This U.S. Bank...

  17. 76 FR 53503 - Self-Regulatory Organizations; NASDAQ OMX BX, Inc.; Notice of Filing and Immediate Effectiveness...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-26

    ... Establish and Adopt Fees for the New BX Pre-Trade Risk Management Service August 19, 2011. Pursuant to... Change The Exchange proposes to establish and adopt fees for the new BX Pre-Trade Risk Management service.... * * * * * 7016. [Reserved] BX Pre-Trade Risk Management (a) Users of BX Pre-trade Risk Management (``PRM'') will...

  18. Curing over-use by prescribing fees: an evaluation of the effect of user fees’ implementation on healthcare use in the Czech Republic

    PubMed Central

    Kalousova, Lucie

    2015-01-01

    In 2008, the Czech Republic instituted a new policy that requires most patients to pay a small fee for some inpatient and outpatient healthcare services. Using the Survey of Health Aging and Retirement in Europe, this article examines the changes in healthcare utilization of Czechs 50 years and older following the new fee requirement by constructing difference-in-differences regression models focusing on four outcome measures: any visits to primary care physician, any hospitalization, number of visits to the primary care physician and number of nights hospitalized. For this population, I find that the likelihood of having any primary care visit decreased after the policy was instituted. The likelihood of reporting any hospitalization was not significantly changed. The predicted number of primary care visits per person declined, but the predicted number of nights spent in a hospital did not. I find only mixed evidence of greater effect of the user fees on some subpopulations compared with others. Those 65 or older reduced their use more than those between 50 and 64, and so did those who consider their health to be good, and the less educated. PMID:24790063

  19. nevada_50mwind

    Science.gov Websites

    of Energy ("DOE"). The user is granted the right, without any fee or cost, to use, copy notice appears in all copies of the data. Further, the user of this data agrees to credit NREL in any impose the following obligations on the User. The names DOE/NREL may not be used in any advertising or

  20. RISK REDUCTION WITH A FUZZY EXPERT EXPLORATION TOOL

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Robert S. Balch; Ron Broadhead

    2005-03-01

    Incomplete or sparse data such as geologic or formation characteristics introduce a high level of risk for oil exploration and development projects. ''Expert'' systems developed and used in several disciplines and industries have demonstrated beneficial results when working with sparse data. State-of-the-art expert exploration tools, relying on a database, and computer maps generated by neural networks and user inputs, have been developed through the use of ''fuzzy'' logic, a mathematical treatment of imprecise or non-explicit parameters and values. Oil prospecting risk has been reduced with the use of these properly verified and validated ''Fuzzy Expert Exploration (FEE) Tools.'' Through themore » course of this project, FEE Tools and supporting software were developed for two producing formations in southeast New Mexico. Tools of this type can be beneficial in many regions of the U.S. by enabling risk reduction in oil and gas prospecting as well as decreased prospecting and development costs. In today's oil industry environment, many smaller exploration companies lack the resources of a pool of expert exploration personnel. Downsizing, volatile oil prices, and scarcity of domestic exploration funds have also affected larger companies, and will, with time, affect the end users of oil industry products in the U.S. as reserves are depleted. The FEE Tools benefit a diverse group in the U.S., allowing a more efficient use of scarce funds, and potentially reducing dependence on foreign oil and providing lower product prices for consumers.« less

  1. The effects of fee bundling on dental utilization.

    PubMed Central

    Porter, J; Coyte, P C; Barnsley, J; Croxford, R

    1999-01-01

    OBJECTIVE: To examine dental utilization following an adjustment to the provincial fee schedule in which preventive maintenance (recall) services were bundled at lower fees. DATA SOURCES/STUDY SETTING: Blue Cross dental insurance claims for claimants associated with four major Ontario employers using a common insurance plan over the period 1987-1990. STUDY DESIGN: This before-and-after design analyzes the dental claims experience over a four-year period for 4,455 individuals 18 years of age and older one year prior to the bundling of services, one year concurrent with the change, and two years after the introduction of bundling. The dependent variable is the annual adjusted payment per user. DATA COLLECTION/EXTRACTION METHODS: The analysis was based on all claims submitted by adult users for services received at recall visits and who reported at least one visit of this type between 1987 and 1990. In these data, 26,177 services were provided by 1,214 dentists and represent 41 percent of all adult service claims submitted over the four years of observation. PRINCIPAL FINDINGS: Real per capita payment for adult recall services decreased by 0.3 percent in the year bundling was implemented (1988), but by the end of the study period such payments had increased 4.8 percent relative to pre-bundling levels. Multiple regression analysis assessed the role of patient and provider variables in the upward trend of per capita payments. The following variables were significant in explaining 37 percent of the variation in utilization over the period of observation: subscriber employment location; ever having received periodontal scaling or ever having received restorative services; regular user; dentist's school of graduation; and interactions involving year, service type, and regular user status. CONCLUSIONS: The volume and intensity of services received by adult patients increased when fee constraints were imposed on dentists. Future efforts to contain dental expenditures through fee schedule design will need to take this into consideration. Issues for future dental services research include provider billing practices, utilization among frequent attenders, and outcomes evaluation particularly with regard to periodontal care and replacement of restorations. PMID:10536976

  2. US Astronomers Access to SIMBAD in Strasbourg

    NASA Technical Reports Server (NTRS)

    Oliversen, Ronald (Technical Monitor); Eichhorn, Guenther

    2004-01-01

    During the last year the US SIMBAD Gateway Project continued to provide services like user registration to the US users of the SIMBAD database in France. Currently there are over 4500 US users registered. We also provided user support by answering questions from users and handling requests for lost passwords when still necessary. Even though almost all users now access SIMBAD without a password, based on hostnames/IP addresses, there are still some users that need individual passwords. We continued to maintain the mirror copy of the SIMBAD database on a server at SAO. This allows much faster access for the US users. During the past year we again moved this mirror to a faster server to improve access for the US users. We again supported a demonstration of the SIMBAD database at the meeting of the American Astronomical Society in January. We provided support for the demonstration activities at the SIMBAD booth. We paid part of the fee for the SIMBAD demonstration. We continued to improve the cross-linking between the SIMBAD project and the Astrophysics Data System. This cross-linking between these systems is very much appreciated by the users of both the SIMBAD database and the ADS Abstract Service. The mirror of the SIMBAD database at SA0 makes this connection faster for the US astronomers. We exchange information between the ADS and SIMBAD on a daily basis. During the last year we also installed a mirror copy of the Vizier system from the CDS, in addition to the SIMBAD mirror.

  3. Studying complex interventions: reflections from the FEMHealth project on evaluating fee exemption policies in West Africa and Morocco.

    PubMed

    Marchal, Bruno; Van Belle, Sara; De Brouwere, Vincent; Witter, Sophie

    2013-11-08

    The importance of complexity in health care policy-making and interventions, as well as research and evaluation is now widely acknowledged, but conceptual confusion reigns and few applications of complexity concepts in research design have been published. Taking user fee exemption policies as an entry point, we explore the methodological consequences of 'complexity' for health policy research and evaluation. We first discuss the difference between simple, complicated and complex and introduce key concepts of complex adaptive systems theory. We then apply these to fee exemption policies. We describe how the FEMHealth research project attempts to address the challenges of complexity in its evaluation of fee exemption policies for maternal care. We present how the development of a programme theory for fee exemption policies was used to structure the overall design. This allowed for structured discussions on the hypotheses held by the researchers and helped to structure, integrate and monitor the sub-studies. We then show how the choice of data collection methods and tools for each sub-study was informed by the overall design. Applying key concepts from complexity theory proved useful in broadening our view on fee exemption policies and in developing the overall research design. However, we encountered a number of challenges, including maintaining adaptiveness of the design during the evaluation, and ensuring cohesion in the disciplinary diversity of the research teams. Whether the programme theory can fulfil its claimed potential to help making sense of the findings is yet to be tested. Experience from other studies allows for some moderate optimism. However, the biggest challenge complexity throws at health system researchers may be to deal with the unknown unknowns and the consequence that complex issues can only be understood in retrospect. From a complexity theory point of view, only plausible explanations can be developed, not predictive theories. Yet here, theory-driven approaches may help.

  4. FEDIX: The on-line database retrieval service of government information for colleges, universities, and other organizations. User`s guide: Version 4.0/Release 2.0

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Not Available

    FEDIX is an on-line information service that links the higher education community and the federal government to facilitate research, education, and services. The system provides accurate and timely federal agency information to colleges, universities, and other research organizations. There are no registration fees and no access charges for using FEDIX. Agencies participating in the FEDIX system include: Department of Energy (DOE), Federal Aviation Administration (FAA), National Aeronautics and Space Administration (NASA), Office of Naval Research (ONR), Air Force Office of Scientific Research (AFOSR), National Science Foundation (NSF), National Security Agency (NSA), Department of Commerce (DOC), Department of Education (DOEd), Departmentmore » of Housing and Urban Development (HUD), and Agency for International Development (AID). Additional government agencies are expected to join FEDIX in the near future. This guide is intended to help users access and utilize the FEDIX system. Because the system is frequently updated, however, some menus and tables used as examples in this text may not exactly match those displayed on the live system.« less

  5. 32 CFR 204.4 - Responsibilities.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 32 National Defense 2 2014-07-01 2014-07-01 false Responsibilities. 204.4 Section 204.4 National Defense Department of Defense (Continued) OFFICE OF THE SECRETARY OF DEFENSE (CONTINUED) MISCELLANEOUS USER FEES § 204.4 Responsibilities. (a) The USD(C) shall develop and monitor policies governing user...

  6. Video Recordings in Public Libraries.

    ERIC Educational Resources Information Center

    Doyle, Stephen

    1984-01-01

    Reports on development and operation of public library collection of video recordings, describes results of user survey conducted over 6-month period, and offers brief guidelines. Potential users, censorship and copyright, organization of collection, fees, damage and loss, funding, purchasing and promotion, formats, processing and cataloging,…

  7. Database in Artificial Intelligence.

    ERIC Educational Resources Information Center

    Wilkinson, Julia

    1986-01-01

    Describes a specialist bibliographic database of literature in the field of artificial intelligence created by the Turing Institute (Glasgow, Scotland) using the BRS/Search information retrieval software. The subscription method for end-users--i.e., annual fee entitles user to unlimited access to database, document provision, and printed awareness…

  8. User Fees in General Practice: Willingness to Pay and Potential Substitution Patterns-Results from a Danish GP Patient Survey.

    PubMed

    Kronborg, Christian; Pedersen, Line Bjørnskov; Fournaise, Anders; Kronborg, Christel Nøhr

    2017-10-01

    Increases in public expenditures to general practitioner (GP) services and specialist care have spurred debate over whether to implement user fees for healthcare services such as GP consultations in Denmark. The objective of this study was to examine Danish patients' attitudes towards user fees and their willingness to pay (WTP) for a consultation, and to investigate how user charges may impact patients' behaviour. A questionnaire survey was conducted in a GP clinic. A total of 343 individual persons answered the questionnaire. One hundred and seventy (50%) persons were not willing to pay for a consultation. Among patients reporting positive WTP values, the mean WTP was 137 (standard deviation 140) Danish kroner (DKK). Patients who were 65 years old or older were more likely to be willing to pay for a GP consultation than patients under the age of 65 years. Furthermore, patients with a personal annual income of more than 200,000 DKK were more likely to be willing to pay for a consultation than other income groups. With respect to patients with a positive WTP value, their own assessment of the seriousness of the consultation and their self-assessed health influenced the amount they would be willing to pay. Finally, we observed a stated willingness to substitute GP consultations with alternatives that are free of charge. About half of the patients with an appointment for a GP consultation are willing to pay for the consultation. User charges may potentially influence the patients' behaviour. ClinicalTrials.gov NCT01784731.

  9. 76 FR 66723 - Food Safety Modernization Act Domestic and Foreign Facility Reinspections, Recall, and Importer...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-27

    ...The Food and Drug Administration (FDA) is extending the comment period to November 30, 2011, for the notice entitled, ``Food Safety Modernization Act Domestic and Foreign Facility Reinspections, Recall, and Importer Reinspection User Fee Rates for Fiscal Year 2012'' that appeared in the Federal Register of August 1, 2011 (76 FR 45820). In that document, FDA announced the establishment of a docket to obtain comments that would be considered in establishing the fee rates for fiscal year (FY) 2013. In particular, the Agency provided the current FY 2012 fees and requested public comments to the document and intends to consider such comments, as well as experience and additional data gained in implementing these fees in FY 2012, in establishing the fee rates for FY 2013. The Agency is taking this action in response to requests for an extension to allow interested persons additional time to submit comments.

  10. 75 FR 45636 - Animal Generic Drug User Fee Rates and Payment Procedures for Fiscal Year 2011

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-03

    ... . (The Pay.gov payment option is available to you after you submit a cover sheet. Click the ``Pay Now... that the number of applications that will pay fees in FY 2011 will equal 30 percent less than the... average receipts of 14.4 per year over the latest 5 years, including our FY 2010 estimate. Applying a 30...

  11. Development of a site analysis tool for distributed wind projects

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Shaw, Shawn

    The Cadmus Group, Inc., in collaboration with the National Renewable Energy Laboratory (NREL) and Encraft, was awarded a grant from the Department of Energy (DOE) to develop a site analysis tool for distributed wind technologies. As the principal investigator for this project, Mr. Shawn Shaw was responsible for overall project management, direction, and technical approach. The product resulting from this project is the Distributed Wind Site Analysis Tool (DSAT), a software tool for analyzing proposed sites for distributed wind technology (DWT) systems. This user-friendly tool supports the long-term growth and stability of the DWT market by providing reliable, realistic estimatesmore » of site and system energy output and feasibility. DSAT-which is accessible online and requires no purchase or download of software-is available in two account types; Standard: This free account allows the user to analyze a limited number of sites and to produce a system performance report for each; and Professional: For a small annual fee users can analyze an unlimited number of sites, produce system performance reports, and generate other customizable reports containing key information such as visual influence and wind resources. The tool’s interactive maps allow users to create site models that incorporate the obstructions and terrain types present. Users can generate site reports immediately after entering the requisite site information. Ideally, this tool also educates users regarding good site selection and effective evaluation practices.« less

  12. No effect of user fee exemption on perceived quality of delivery care in Burkina Faso: a case-control study.

    PubMed

    Philibert, Aline; Ridde, Valéry; Bado, Aristide; Fournier, Pierre

    2014-03-11

    Although many developing countries have developed user fee exemption policies to move towards universal health coverage as a priority, very few studies have attempted to measure the quality of care. The present paper aims at assessing whether women's satisfaction with delivery care is maintained with a total fee exemption in Burkina Faso. A quasi-experimental design with both intervention and control groups was carried out. Six health centres were selected in rural health districts with limited resources. In the intervention group, delivery care is free of charge at health centres while in the control district women have to pay 900 West African CFA francs (U$2). A total of 870 women who delivered at the health centre were interviewed at home after their visit over a 60-day range. A series of principal component analyses (PCA) were carried out to identify the dimension of patients' satisfaction. Women's satisfaction loaded satisfactorily on a three-dimension principal component analysis (PCA): 1-provider-patient interaction; 2-nursing care services; 3-environment. Women in both the intervention and control groups were satisfied or very satisfied in 90% of cases (in 31 of 34 items). For each dimension, average satisfaction was similar between the two groups, even after controlling for socio-demographic factors (p = 0.436, p = 0.506, p = 0.310, respectively). The effects of total fee exemption on satisfaction were similar for any women without reinforcing inequalities between very poor and wealthy women (p ≥ 0.05). Although the wealthiest women were more dissatisfied with the delivery environment (p = 0.017), the poorest were more highly satisfied with nursing care services (p = 0.009). Contrary to our expectations, total fee exemption at the point of service did not seem to have a negative impact on quality of care, and women's perceptions remained very positive. This paper shows that the policy of completely abolishing user fees with organized implementation is certainly a way for developing countries to engage in universal coverage while maintaining the quality of care.

  13. Electric and Hybrid Electric Vehicle Technologies

    DTIC Science & Technology

    1998-06-30

    participants; car sharing logistics; liability issues; billing and col- lecting user fees; service and maintenance support; data acquisition; and...driven on the freeway, and their circumstances had changed. Among the challenges facing station-car and car - sharing programs that use EVs rather than...funding; selection and training of users; many different types of participants; car sharing logistics; liability issues; billing and collecting user

  14. Unit Costing of Health Extension Worker Activities in Ethiopia: A Model for Managers at the District and Health Facility Level

    PubMed Central

    Canavan, Maureen E.; Linnander, Erika; Ahmed, Shirin; Mohammed, Halima; Bradley, Elizabeth H.

    2018-01-01

    Background: Over the last decade, Ethiopia has made impressive national improvements in health outcomes, including reductions in maternal, neonatal, infant, and child mortality attributed in large part to their Health Extension Program (HEP). As this program continues to evolve and improve, understanding the unit cost of health extension worker (HEW) services is fundamental to planning for future growth and ensuring adequate financial support to deliver effective primary care throughout the country. Methods: We sought to examine and report the data needed to generate a HEW fee schedule that would allow for full cost recovery for HEW services. Using HEW activity data and estimates from national studies and local systems we were able to estimate salary costs and the average time spent by an HEW per patient/community encounter for each type of services associated with specific users. Using this information, we created separate fee schedules for activities in urban and rural settings with two estimates of non-salary multipliers to calculate the total cost for HEW services. Results: In the urban areas, the HEW fees for full cost recovery of the provision of services (including salary, supplies, and overhead costs) ranged from 55.1 birr to 209.1 birr per encounter. The rural HEW fees ranged from 19.6 birr to 219.4 birr. Conclusion: Efforts to support health system strengthening in low-income settings have often neglected to generate adequate, actionable data on the costs of primary care services. In this study, we have combined time-motion and available financial data to generate a fee schedule that allows for full cost recovery of the provision of services through billable health education and service encounters provided by Ethiopian HEWs. This may be useful in other country settings where managers seek to make evidence-informed planning and resource allocation decisions to address high burden of disease within the context of weak administrative data systems and severe financial constraints. PMID:29764103

  15. 76 FR 27114 - Self-Regulatory Organizations; NYSE Arca, Inc.; Notice of Filing and Immediate Effectiveness of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-10

    ... CRD Processing Fee, the NASD Annual System Processing Fee, and the NYSE Arca Transfer/Re-license... Fees, the NASD Annual System Processing Fee, and the NYSE Arca Transfer/Re-license Individual Fee. Fees... Options Regulatory Surveillance Authority (``ORSA'') national market system plan and in doing so shares...

  16. Trucking industry response in a changing world of tolling and rising fuel prices

    DOT National Transportation Integrated Search

    2007-12-01

    Direct user fees based options are gaining further momentum all across the United States and particularly in the state of TX. The success of such ventures or projects requires a clear assessment of demand for toll roads among the potential user group...

  17. Impact of user fees on maternal health service utilization and related health outcomes: a systematic review.

    PubMed

    Dzakpasu, Susie; Powell-Jackson, Timothy; Campbell, Oona M R

    2014-03-01

    To assess the evidence of the impact of user fees on maternal health service utilization and related health outcomes in low- and middle-income countries, as well as their impact on inequalities in these outcomes. Studies were identified by modifying a search strategy from a related systematic review. Primary studies of any design were included if they reported the effect of fee changes on maternal health service utilization, related health outcomes and inequalities in these outcomes. For each study, data were systematically extracted and a quality assessment conducted. Due to the heterogeneity of study methods, results were examined narratively. Twenty studies were included. Designs and analytic approaches comprised: two interrupted time series, eight repeated cross-sectional, nine before-and-after without comparison groups and one before-and-after in three groups. Overall, the quality of studies was poor. Few studies addressed potential sources of bias, such as secular trends over time, and even basic tests of statistical significance were often not reported. Consistency in the direction of effects provided some evidence of an increase in facility delivery in particular after fees were removed, as well as possible increases in the number of managed delivery complications. There was little evidence of the effect on health outcomes or inequality in accessing care and, where available, the direction of effect varied. Despite the global momentum to abolish user fees for maternal and child health services, robust evidence quantifying impact remains scant. Improved methods for evaluating and reporting on these interventions are recommended, including better descriptions of the interventions and context, looking at a range of outcome measures, and adopting robust analytical methods that allow for adjustment of underlying and seasonal trends, reporting immediate as well as longer-term (e.g. at 6 months and 1 year) effects and using comparison groups where possible.

  18. Do client fees help or hurt?

    PubMed

    Barnett, B

    1998-01-01

    This article discusses the impact of client fees for family planning (FP) services on cost recovery and level of user services in developing countries. The UN Population Fund reports that developing country governments currently pay 75% of the costs of FP programs. Donors contribute 15%, and clients pay 10%. Current pressures are on FP services to broaden and improve their scope, while user demand is increasing. Program managers should consider the program's need for funds and the clients' willingness to pay. Clients are willing to pay about 1% of their income for contraception. A study of sterilization acceptance in Mexico finds that the average monthly case load declined by 10% after the 1st price increase from $43 to $55 and declined by 58% after the 2nd price increase to $60. Fewer low-income clients requested sterilization. A CEMOPLAF study in Ecuador finds that in three price increase situations the number of clients seeking services declined, but the economic mix of clients remained about the same. The decline was 20% in the group with a 20% price increase and 26% in the 40% increase group. In setting fees, the first need is to determine unit costs. The Futures Group International recommends considering political, regulatory, and institutional constraints for charging fees; priorities for revenue use; protection for poor clients; and monitoring of money collection and expenditure. Management Sciences for Health emphasizes consideration of the reasons for collection of fees, client affordability, and client perception of quality issues. Sliding scales can be used to protect poor clients. Charging fees for laboratory services can subsidize poor clients. A Bangladesh program operated a restaurant and catering service in order to subsidize FP services. Colombia's PROFAMILIA sells medical and surgical services and a social marketing program in order to expand clinics.

  19. Analyzing the influence of institutions on health policy development in Uganda: a case study of the decision to abolish user fees.

    PubMed

    Moat, K A; Abelson, J

    2011-12-01

    During the 2001 election campaign, President Yoweri Museveni announced he was abolishing user fees for health services in Uganda. No analysis has been carried out to explain how he was able to initiate such an important policy decision without encountering any immediate barriers. To explain this outcome through in-depth policy analysis driven by the application of key analytical frameworks. An explanatory case study informed by analytical frameworks from the institutionalism literature was undertaken. Multiple data sources were used including: academic literature, key government documents, grey literature, and a variety of print media. According to the analytical frameworks employed, several formal institutional constraints existed that would have reduced the prospects for the abolition of user fees. However, prevalent informal institutions such as "Big Man" presidentialism and clientelism that were both 'competing' and 'complementary' can be used to explain the policy outcome. The analysis suggests that these factors trumped the impact of more formal institutional structures in the Ugandan context. Consideration should be given to the interactions between formal and informal institutions in the analysis of health policy processes in Uganda, as they provide a more nuanced understanding of how each set of factors influence policy outcomes.

  20. The Differential Impact of User-Fee Exemption Compared to Conditional Cash Transfers on Safe Deliveries in Nepal.

    PubMed

    Pradhan, Elina; Fan, Victoria Y

    2017-08-01

    To assess the differential impact of a copayment exemption compared to a cash incentive on increasing skilled birth attendance (i.e., birth attended by a skilled health worker) in Nepal. This study used data on 8,785 children born between July 2005 and December 2008, obtained from the nationally representative Demographic and Health Surveys, 2006 and 2011. Twenty-five districts received both the policy interventions, and the remaining 50 control districts received only the cash incentive. We employed a difference-in-differences model to compare children born in districts with both interventions to those in districts with conditional cash transfers only. Average marginal effects of the difference-in-difference coefficient on skilled birth attendance measures are estimated. Skilled birth attendance in districts with both interventions was no higher on average than in districts with only the cash incentive. In areas with adequate road networks, however, significantly higher skilled birth attendance was observed in districts with both interventions compared to those with only the cash incentive. The added incentive of the user-fee exemption did not significantly increase skilled birth attendance relative to the presence of the cash incentive. User-fee exemptions may not be effective in areas with inadequate road infrastructure. © Health Research and Educational Trust.

  1. Implementation of Fee-Free Maternal Health-Care Policy in Ghana: Perspectives of Users of Antenatal and Delivery Care Services From Public Health-Care Facilities in Accra.

    PubMed

    Anafi, Patricia; Mprah, Wisdom K; Jackson, Allen M; Jacobson, Janelle J; Torres, Christopher M; Crow, Brent M; O'Rourke, Kathleen M

    2018-01-01

    In 2008, the government of Ghana implemented a national user fee maternal care exemption policy through the National Health Insurance Scheme to improve financial access to maternal health services and reduce maternal as well as perinatal deaths. Although evidence shows that there has been some success with this initiative, there are still issues relating to cost of care to beneficiaries of the initiative. A qualitative study, comprising 12 focus group discussions and 6 interviews, was conducted with 90 women in six selected urban neighborhoods in Accra, Ghana, to examine users' perspectives regarding the implementation of this policy initiative. Findings showed that direct cost of delivery care services was entirely free, but costs related to antenatal care services and indirect costs related to delivery care still limit the use of hospital-based midwifery and obstetric care. There was also misunderstanding about the initiative due to misinformation created by the government through the media.We recommend that issues related to both direct and indirect costs of antenatal and delivery care provided in public health-care facilities must be addressed to eliminate some of the lingering barriers relating to cost hindering the smooth operation and sustainability of the maternal care fee exemption policy.

  2. A Proposal for User Fees for In-House Video-Cassette Dubbing of Commercial Educational Films

    ERIC Educational Resources Information Center

    Seymour, Jim

    1973-01-01

    A proposal for one possible route to determining an equitable basis for school districts and other end-users of educational films to produce in-house video copies of those films, while not violating the rights of the holders of copyrights on the films. (Author)

  3. Poverty, user fees and ability to pay for health care for children with suspected dengue in rural Cambodia

    PubMed Central

    Khun, Sokrin; Manderson, Lenore

    2008-01-01

    User fees were introduced in public health facilities in Cambodia in 1997 in order to inject funds into the health system to enhance the quality of services. Because of inadequate health insurance, a social safety net scheme was introduced to ensure that all people were able to attend the health facilities. However, continuing high rates of hospitalization and mortality from dengue fever among infants and children reflect the difficulties that women continue to face in finding sufficient cash in cases of medical emergency, resulting in delays in diagnosis and treatment. In this article, drawing on in-depth interviews conducted with mothers of children infected with dengue in eastern Cambodia, we illustrate the profound economic consequences for households when a child is ill. The direct costs for health care and medical services, and added indirect costs, deterred poor women from presenting with sick children. Those who eventually sought care often had to finance health spending through out-of-pocket payments and loans, or sold property, goods or labour to meet the costs. Costs were often catastrophic, exacerbating the extreme poverty of those least able to afford it. PMID:18439268

  4. Poverty, user fees and ability to pay for health care for children with suspected dengue in rural Cambodia.

    PubMed

    Khun, Sokrin; Manderson, Lenore

    2008-04-25

    User fees were introduced in public health facilities in Cambodia in 1997 in order to inject funds into the health system to enhance the quality of services. Because of inadequate health insurance, a social safety net scheme was introduced to ensure that all people were able to attend the health facilities. However, continuing high rates of hospitalization and mortality from dengue fever among infants and children reflect the difficulties that women continue to face in finding sufficient cash in cases of medical emergency, resulting in delays in diagnosis and treatment. In this article, drawing on in-depth interviews conducted with mothers of children infected with dengue in eastern Cambodia, we illustrate the profound economic consequences for households when a child is ill. The direct costs for health care and medical services, and added indirect costs, deterred poor women from presenting with sick children. Those who eventually sought care often had to finance health spending through out-of-pocket payments and loans, or sold property, goods or labour to meet the costs. Costs were often catastrophic, exacerbating the extreme poverty of those least able to afford it.

  5. Circumventing 'free care' and 'shouting louder': using a health systems approach to study eye health system sustainability in government and mission facilities of north-west Tanzania.

    PubMed

    Palmer, Jennifer J; Gilbert, Alice; Choy, Michelle; Blanchet, Karl

    2016-09-09

    Little is known about the contributions of faith-based organisations (FBOs) to health systems in Africa. In the specialist area of eye health, international and domestic Christian FBOs have been important contributors as service providers and donors, but they are also commonly critiqued as having developed eye health systems parallel to government structures which are unsustainable. In this study, we use a health systems approach (quarterly interviews, a participatory sustainability analysis exercise and a social network analysis) to describe the strategies used by eye care practitioners in four hospitals of north-west Tanzania to navigate the government, church mission and donor rules that govern eye services delivery there. Practitioners in this region felt eye care was systemically neglected by government and therefore was 'all under the NGOs', but support from international donors was also precarious. Practitioners therefore adopted four main strategies to improve the sustainability of their services: (1) maintain 'sustainability funds' to retain financial autonomy over income; (2) avoid granting government user fee exemptions to elderly patients who are the majority of service users; (3) expand or contract outreach services as financial circumstances change; and (4) access peer support for problem-solving and advocacy. Mission-based eye teams had greater freedom to increase their income from user fees by not implementing government policies for 'free care'. Teams in all hospitals, however, found similar strategies to manage their programmes even when their management structures were unique, suggesting the importance of informal rules shared through a peer network in governing eye care in this pluralistic health system. Health systems research can generate new evidence on the social dynamics that cross public and private sectors within a local health system. In this area of Tanzania, Christian FBOs' investments are important, not only in terms of the population health outcomes achieved by teams they support, but also in the diversity of organisational models they contribute to in the wider eye health system, which facilitates innovation.

  6. Are all-terrain vehicle riders willing to pay trail user fees to ride on public lands in the USA?

    Treesearch

    Stephanie A. Snyder; Robert A. Smail

    2009-01-01

    Some public lands in the USA offer opportunities for all-terrain vehicle (ATV) riding, but few charge trail use fees. In a case study in the US state of Wisconsin, the contingent valuation method was used to examine riders' willingness to pay (WTP) to ride on public lands. Information on riders' habits, preferences and responses to a dichotomous choice WTP...

  7. Direct facility funding as a response to user fee reduction: implementation and perceived impact among Kenyan health centres and dispensaries

    PubMed Central

    Opwora, Antony; Kabare, Margaret; Molyneux, Sassy; Goodman, Catherine

    2010-01-01

    There is increasing pressure for reduction of user fees, but this can have adverse effects by decreasing facility-level funds. To address this, direct facility funding (DFF) was piloted in Coast Province, Kenya, with health facility committees (HFCs) responsible for managing the funds. We evaluated the implementation and perceived impact 2.5 years after DFF introduction. Quantitative data collection at 30 public health centres and dispensaries included a structured interview with the in-charge, record reviews and exit interviews. In addition, in-depth interviews were conducted with the in-charge and HFC members at 12 facilities, and with district staff and other stakeholders. DFF procedures were well established: HFCs met regularly and accounting procedures were broadly followed. DFF made an important contribution to facility cash income, accounting for 47% in health centres and 62% in dispensaries. The main items of expenditure were wages for support staff (32%), travel (21%), and construction and maintenance (18%). DFF was perceived to have a highly positive impact through funding support staff such as cleaners and patient attendants, outreach activities, renovations, patient referrals and increasing HFC activity. This was perceived to have improved health worker motivation, utilization and quality of care. A number of problems were identified. HFC training was reportedly inadequate, and no DFF documentation was available at facility level, leading to confusion. Charging user fees above those specified in the national policy remained common, and understanding of DFF among the broader community was very limited. Finally, relationships between HFCs and health workers were sometimes characterized by mistrust and resentment. Relatively small increases in funding may significantly affect facility performance when the funds are managed at the periphery. Kenya plans to scale up DFF nationwide. Our findings indicate this is warranted, but should include improved training and documentation, greater emphasis on community engagement, and insistence on user fee adherence. PMID:20211967

  8. Direct facility funding as a response to user fee reduction: implementation and perceived impact among Kenyan health centres and dispensaries.

    PubMed

    Opwora, Antony; Kabare, Margaret; Molyneux, Sassy; Goodman, Catherine

    2010-09-01

    There is increasing pressure for reduction of user fees, but this can have adverse effects by decreasing facility-level funds. To address this, direct facility funding (DFF) was piloted in Coast Province, Kenya, with health facility committees (HFCs) responsible for managing the funds. We evaluated the implementation and perceived impact 2.5 years after DFF introduction. Quantitative data collection at 30 public health centres and dispensaries included a structured interview with the in-charge, record reviews and exit interviews. In addition, in-depth interviews were conducted with the in-charge and HFC members at 12 facilities, and with district staff and other stakeholders. DFF procedures were well established: HFCs met regularly and accounting procedures were broadly followed. DFF made an important contribution to facility cash income, accounting for 47% in health centres and 62% in dispensaries. The main items of expenditure were wages for support staff (32%), travel (21%), and construction and maintenance (18%). DFF was perceived to have a highly positive impact through funding support staff such as cleaners and patient attendants, outreach activities, renovations, patient referrals and increasing HFC activity. This was perceived to have improved health worker motivation, utilization and quality of care. A number of problems were identified. HFC training was reportedly inadequate, and no DFF documentation was available at facility level, leading to confusion. Charging user fees above those specified in the national policy remained common, and understanding of DFF among the broader community was very limited. Finally, relationships between HFCs and health workers were sometimes characterized by mistrust and resentment. Relatively small increases in funding may significantly affect facility performance when the funds are managed at the periphery. Kenya plans to scale up DFF nationwide. Our findings indicate this is warranted, but should include improved training and documentation, greater emphasis on community engagement, and insistence on user fee adherence.

  9. Who benefits from free institutional delivery? evidence from a cross sectional survey of North Central and Southwestern Nigeria.

    PubMed

    Ajayi, Anthony I; Akpan, Wilson

    2017-09-02

    The reasons for low utilisation of maternal health services in settings where the user-fee removal policy has been implemented continue to generate scholarly debates. Evidence of whether user-fee removal benefits the poor women in underserved settings is scanty and inconsistent. This article examines use of maternal health care services in the context of free maternal healthcare and profiles the beneficiaries of user-fee removal. The study adopted a descriptive design. A three-stage cluster sampling method was used to select a representative sample of 1227 women who gave birth between 2011 and 2015. Questionnaires were administered using a face-to-face interview approach and data generated were analysed using descriptive and inferential statistics. The analysis shows that the use of maternal healthcare services has improved considerably in North Central and Southwestern Nigeria. While socioeconomic and geographical inequality in the use of maternal healthcare services appear to be disappearing in Southwestern Nigeria, it appears to be widening in North Central Nigeria. The findings indicate that 33.6% of women reported to have benefitted from the free child-delivery programme; however, substantial variation exists across the two regions. The proportion of beneficiaries of user-fee removal policy was highest in urban areas (35.9%), among women belonging to the middle income category (38.3%), among women who gave birth in primary health centres (63.1%) and among women who resided in communities where there was availability of health facilities (37.2%). The study concludes that low coverage of the free maternal health programme, especially among women of low socioeconomic status residing in underserved settings is among the reasons for persistent poor maternal health outcomes in the context of free maternal healthcare. A model towards improving maternal health in underserved settings, especially in North Central Nigeria, would entail provisioning of health facilities as well as focusing on implementing equitable maternal health policies.

  10. Willingness to Pay for Drug Rehabilitation: Implications for Cost Recovery October 14, 2007

    PubMed Central

    Bishai, D.; Sindelar, J.; Ricketts, E. P.; Huettner, S.; Cornelius, L.; Lloyd, J. J.; Havens, J. R.; Latkin, C. A.; Strathdee, S. A.

    2008-01-01

    Objectives This study estimates the value that clients place on methadone maintenance and how this value varies with the effectiveness of treatment and availability of case management. We provide the first estimate of the price elasticity of the demand for drug treatment. Methods We interviewed 241 heroin users who had been referred to, but had not yet entered, methadone maintenance treatment in Baltimore, Maryland. We asked each subject to state a preference among three hypothetical treatment programs that varied across 3 domains: weekly fee paid by the client out-of-pocket ($5 to $100), presence/absence of case management, and time spent heroin-free (3 to 24 months). Each subject was asked to complete 18 orthogonal comparisons. Subsequently each subject was asked if they likely would enroll in their preferred choice among the set of three. We computed the expected willingness to pay (WTP) as the probability of enrollment times the fee considered in each choice considered from a multivariate logistic model that controlled for product attributes. We also estimated the price elasticity of demand. Results The median expected fee subjects were willing to pay for a program that offered 3 months of heroin-free time was $7.30 per week, rising to $17.11 per week for programs that offered 24 months of heroin-free time. The availability of case management increased median WTP by $5.64 per week. The price elasticity was −0.39 (SE 0.042). Conclusions Clients will pay more for higher rates of treatment success and for the presence of case management. Clients are willing to pay for drug treatment but the median willingness to pay falls short of the estimated program costs of $82 per week. Thus a combined approach of user fees and subsidization may be the optimal financing strategy for the drug treatment system. PMID:18207264

  11. A Study to Improve the Brazilian Air Force’s Material Management System

    DTIC Science & Technology

    1991-12-01

    of Technology, in June 1990. Permanent Address: Base A6rea de Sio Paulo Instituto de Logistica da Aerongutica 07181 Guarulhos Sio Paulo Brazil 160 Vita...orders instead of more frequent smaller ones, and transportation from vendor to depot, which includes international fees in most cases, would be...optimized by the same reason. The transportation from depots to final users would not be affected, since only changes of depots and changes of material

  12. US HealthLink: a national information resource for health care professionals.

    PubMed

    Yasnoff, W A

    1992-06-01

    US HealthLink is a new, comprehensive online medical information system designed specifically for health care professionals. Available to individuals for a fixed fee, it includes literature, news, diagnostic decision support, drug interactions, electronic mail, and bulletin boards. It also provides user-specific current awareness via clipping service, and fax delivery of both clipping and electronic mail information. US HealthLink can now be utilized to access a wide variety of medical information sources inexpensively.

  13. 75 FR 61252 - Proposed Information Collection (Create Payment Request for the VA Funding Fee Payment System (VA...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-04

    ... Payment Request for the VA Funding Fee Payment System (VA FFPS); A Computer Generated Funding Fee Receipt... Payment Request for the VA Funding Fee Payment System (VA FFPS); A Computer Generated Funding Fee Receipt... information through the Federal Docket Management System (FDMS) at http://www.Regulations.gov or to Nancy J...

  14. 75 FR 61859 - Proposed Information Collection (Create Payment Request for the VA Funding Fee Payment System (VA...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-06

    ... Payment Request for the VA Funding Fee Payment System (VA FFPS); A Computer Generated Funding Fee Receipt... Payment Request for the VA Funding Fee Payment System (VA FFPS); A Computer Generated Funding Fee Receipt... information through the Federal Docket Management System (FDMS) at http://www.Regulations.gov or to Nancy J...

  15. Perinatal mortality among infants born during health user-fees (Cash & Carry) and the national health insurance scheme (NHIS) eras in Ghana: a cross-sectional study.

    PubMed

    Ibrahim, Abdallah; Maya, Ernest T; Donkor, Ernestina; Agyepong, Irene A; Adanu, Richard M

    2016-12-08

    This research determined the rates of perinatal mortality among infants delivered under Ghana's national health insurance scheme (NHIS) compared to infants delivered under the previous "Cash and Carry" system in Northern Region, especially as the country takes stock of its progress toward meeting the Millennium Development Goals (MDG) 4 and 5. The labor and maternity wards delivery records of infants delivered before and after the implementation of the NHIS in Northern Region were examined. Records of available daily deliveries during the two health systems were extracted. Fisher's exact tests of non-random association were used to examine the bivariate association between categorical independent variables and perinatal mortality. On average, 8% of infants delivered during the health user-fee (Cash & Carry) died compared to about 4% infant deaths during the NHIS delivery fee exemption period in Northern Region, Ghana. There were no remarkable difference in the rate of infant deaths among mothers in almost all age categories in both the Cash and Carry and the NHIS periods except in mothers age 35 years and older. Infants born to multiparous mothers were significantly more likely to die than those born to first time mothers. There were more twin deaths during the Cash and Carry system (p = 0.001) compared to the NHIS system. Deliveries by caesarean section increased from an average of 14% in the "Cash and Carry" era to an average of 20% in the NHIS era. The overall rate of perinatal mortality declined by half (50%) in infants born during the NHIS era compared to the Cash and Carry era. However, caesarean deliveries increased during the NHIS era. These findings suggest that pregnant women in the Northern Region of Ghana were able to access the opportunity to utilize the NHIS for antenatal visits and possibly utilized skilled care at delivery at no cost or very minimal cost to them, which therefore improved Ghana's progress towards meeting the MDG 4, (reducing under-five deaths by two-thirds).

  16. 77 FR 7109 - Establishment of User Fees for Filovirus Testing of Nonhuman Primate Liver Samples

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-10

    ... assay (ELISA) or other appropriate methodology. Each specimen will be held for six months. After six... loss of the only commercially available antigen-detection ELISA filovirus testing facility. Currently... current methodology (ELISA) used to test NHP liver samples. This cost determines the amount of the user...

  17. 78 FR 32581 - Tobacco Products, User Fees, Requirements for the Submission of Data Needed To Calculate User...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-31

    .... DATES: Submit either electronic or written comments on the proposed rule by August 14, 2013. Submit... Budget (OMB) (see the ``Paperwork Reduction Act of 1995'' section of this document). Electronic Submissions Submit electronic comments in the following way: Federal eRulemaking Portal: http://www...

  18. mx_yuc_50mwind

    Science.gov Websites

    data is not suitable for micro-siting potential development projects. This shapefile was generated from ;). The user is granted the right, without any fee or cost, to use, copy, modify, alter, enhance and the data. Further, the user of this data agrees to credit NREL in any publications or software that

  19. hi_90mwindspeed_off

    Science.gov Websites

    WGS 84. The shapefile was generated from the raster dataset and then projected to Geographic Decimal "). The user is granted the right, without any fee or cost, to use, copy, modify, alter, enhance copies of the data. Further, the user of this data agrees to credit NREL in any publications or software

  20. PR_VI_50mwind

    Science.gov Websites

    -siting potential development projects. This shapefile was generated from a raster dataset with a 200 m of Energy ("DOE"). The user is granted the right, without any fee or cost, to use, copy notice appears in all copies of the data. Further, the user of this data agrees to credit NREL in any

  1. do_50mwind

    Science.gov Websites

    is not suitable for micro-siting potential development projects. This shapefile was generated from a "). The user is granted the right, without any fee or cost, to use, copy, modify, alter, enhance copies of the data. Further, the user of this data agrees to credit NREL in any publications or software

  2. UserTesting.com: A Tool for Usability Testing of Online Resources

    ERIC Educational Resources Information Center

    Koundinya, Vikram; Klink, Jenna; Widhalm, Melissa

    2017-01-01

    Extension educators are increasingly using online resources in their program design and delivery. Usability testing is essential for ensuring that these resources are relevant and useful to learners. On the basis of our experiences with iteratively developing products using a testing service called UserTesting, we promote the use of fee-based…

  3. 75 FR 78806 - Agency Information Collection (Create Payment Request for the VA Funding Fee Payment System (VA...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-16

    ... Payment Request for the VA Funding Fee Payment System (VA FFPS); a Computer Generated Funding Fee Receipt.... 2900-0474.'' SUPPLEMENTARY INFORMATION: Title: Create Payment Request for the VA Funding Fee Payment System (VA FFPS); a Computer Generated Funding Fee Receipt, VA Form 26-8986. OMB Control Number: 2900...

  4. University multi-user facility survey-2010.

    PubMed

    Riley, Melissa B

    2011-12-01

    Multi-user facilities serve as a resource for many universities. In 2010, a survey was conducted investigating possible changes and successful characteristics of multi-user facilities, as well as identifying problems in facilities. Over 300 surveys were e-mailed to persons identified from university websites as being involved with multi-user facilities. Complete responses were received from 36 facilities with an average of 20 years of operation. Facilities were associated with specific departments (22%), colleges (22%), and university research centers (8.3%) or were not affiliated with any department or college within the university (47%). The five most important factors to succeed as a multi-user facility were: 1) maintaining an experienced, professional staff in an open atmosphere; 2) university-level support providing partial funding; 3) broad client base; 4) instrument training programs; and 5) an effective leader and engaged strategic advisory group. The most significant problems were: 1) inadequate university financial support and commitment; 2) problems recovering full service costs from university subsidies and user fees; 3) availability of funds to repair and upgrade equipment; 4) inability to retain highly qualified staff; and 5) unqualified users dirtying/damaging equipment. Further information related to these issues and to fee structure was solicited. Overall, there appeared to be a decline in university support for facilities and more emphasis on securing income by serving clients outside of the institution and by obtaining grants from entities outside of the university.

  5. 78 FR 59771 - Proposed Information Collection (Create Payment Request for the VA Funding Fee Payment System (VA...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-27

    ... Payment Request for the VA Funding Fee Payment System (VA FFPS); a Computer Generated Funding Fee Receipt.... Title: Create Payment Request for the VA Funding Fee Payment System (VA FFPS); A Computer Generated Funding Fee Receipt, VA Form 26-8986. OMB Control Number: 2900-0474. Type of Review: Revision of a...

  6. Primary Care Physicians' Experience with Electronic Medical Records: Barriers to Implementation in a Fee-for-Service Environment

    PubMed Central

    Ludwick, D. A.; Doucette, John

    2009-01-01

    Our aging population has exacerbated strong and divergent trends between health human resource supply and demand. One way to mitigate future inequities is through the adoption of health information technology (HIT). Our previous research showed a number of risks and mitigating factors which affected HIT implementation success. We confirmed these findings through semistructured interviews with nine Alberta clinics. Sociotechnical factors significantly affected physicians' implementation success. Physicians reported that the time constraints limited their willingness to investigate, procure, and implement an EMR. The combination of antiquated exam room design, complex HIT user interfaces, insufficient physician computer skills, and the urgency in patient encounters precipitated by a fee-for-service remuneration model and long waitlists compromised the quantity, if not the quality, of the information exchange. Alternative remuneration and access to services plans might be considered to drive prudent behavior during physician office system implementation. PMID:19081787

  7. 76 FR 67506 - Self-Regulatory Organizations; NYSE Amex LLC; Notice of Filing of Proposed Rule Change Expanding...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-01

    ... Potential ``Users'' of Its Co-Location Services To Include Any Market Participant That Requests To Receive Co-Location Services Directly From the Exchange and Amending Its Price List To Establish a Fee for... scope of potential ``Users'' of its co-location services to include any market participant that requests...

  8. 76 FR 79249 - Self-Regulatory Organizations; NYSE Amex LLC; Order Approving a Proposed Rule Change Expanding...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-21

    ... market data delivery services to their customers while the User is co-located in the Exchange's data... Potential ``Users'' of Its Co-Location Services To Include Any Market Participant That Requests To Receive Co-Location Services Directly From the Exchange and Amending Its Price List To Establish a Fee for...

  9. 77 FR 6971 - Establishment of User Fees for Filovirus Testing of Nonhuman Primate Liver Samples

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-10

    ... (ELISA) or other appropriate methodology. Each specimen will be held for six months. After six months.../CDC's analysis of costs to the Government is based on the current methodology (ELISA) used to test NHP... different methodology or changes in the availability of ELISA reagents will affect the amount of the user...

  10. neweng_wpc50_poly

    Science.gov Websites

    development projects. This shapefile was generated from a raster dataset with a 200 m resolution, in a UTM Energy ("DOE"). The user is granted the right, without any fee or cost, to use, copy, modify appears in all copies of the data. Further, the user of this data agrees to credit NREL in any

  11. CT_50m_Wind

    Science.gov Websites

    development projects. This shapefile was generated from a raster dataset with a 200 m resolution, in a UTM Energy ("DOE"). The user is granted the right, without any fee or cost, to use, copy, modify appears in all copies of the data. Further, the user of this data agrees to credit NREL in any

  12. RI_50m_Wind

    Science.gov Websites

    development projects. This shapefile was generated from a raster dataset with a 200 m resolution, in a UTM Energy ("DOE"). The user is granted the right, without any fee or cost, to use, copy, modify appears in all copies of the data. Further, the user of this data agrees to credit NREL in any

  13. pacific_coast_90mwindspeed_off

    Science.gov Websites

    UTM zone 11, datum WGS 84. The shapefile was generated from these raster datasets and then projected of Energy ("DOE"). The user is granted the right, without any fee or cost, to use, copy notice appears in all copies of the data. Further, the user of this data agrees to credit NREL in any

  14. NH_50m_Wind

    Science.gov Websites

    development projects. This shapefile was generated from a raster dataset with a 200 m resolution, in a UTM Energy ("DOE"). The user is granted the right, without any fee or cost, to use, copy, modify appears in all copies of the data. Further, the user of this data agrees to credit NREL in any

  15. ga_50m_wind

    Science.gov Websites

    development projects. This shapefile was generated from a raster dataset with a 200 m resolution, in a UTM Energy ("DOE"). The user is granted the right, without any fee or cost, to use, copy, modify appears in all copies of the data. Further, the user of this data agrees to credit NREL in any

  16. MA_50m_Wind

    Science.gov Websites

    development projects. This shapefile was generated from a raster dataset with a 200 m resolution, in a UTM Energy ("DOE"). The user is granted the right, without any fee or cost, to use, copy, modify appears in all copies of the data. Further, the user of this data agrees to credit NREL in any

  17. IA_50m_Wind

    Science.gov Websites

    development projects. This shapefile was generated from a raster dataset with a 200 m resolution, in a UTM Energy ("DOE"). The user is granted the right, without any fee or cost, to use, copy, modify appears in all copies of the data. Further, the user of this data agrees to credit NREL in any

  18. Data Use Disclaimer Agreement | Energy Analysis | NREL

    Science.gov Websites

    Energy, LLC ("ALLIANCE") for the U.S. Department of Energy ("DOE"). Access to and use user is granted the right, without any fee or cost, to use, copy, modify, alter, enhance and distribute Tool. Further, the user agrees to credit DOE/NREL/ALLIANCE in any publication that results from the use

  19. Cost consideration as a factor affecting recreation site decisions

    Treesearch

    Allan Marsinko; John Dwyer; Herb Schroeder

    2001-01-01

    Because they are charged with providing opportunities for all potential site users, it is important that managers at public sites understand the characteristics and behaviors of different user groups. Recreationists who are sensitive to cost may be more sensitive to certain changes in policies, such as fees and other charges, than those who are not sensitive to costs....

  20. Rhode Island | Midmarket Solar Policies in the United States | Solar

    Science.gov Websites

    . The cost of the impact study fee ranges from $500 to $10,000 for midsized systems. Eligible Systems Type of Interconnection Residential systems ≤25 kW No impact study fee Residential systems >25 kW $100 impact study fee Nonresidential systems ≤100 kW $500 impact study fee Nonresidential systems 100

  1. Frequent Questions about e-Manifest

    EPA Pesticide Factsheets

    Frequently Asked Questions (FAQ) about e-Manifest covering these areas: scope, generators, receivers, manifest preparation & brokers, federal and state implementation, fee obligations, record retention, data policy, data correction, and user registration.

  2. COMPARISON OF MEDICAL COSTS AND CARE OF APPENDECTOMY PATIENTS BETWEEN FEE-FOR-SERVICE AND SET FEE FOR DIAGNOSIS-RELATED GROUP SYSTEMS IN 20 CHINESE HOSPITALS.

    PubMed

    Zhang, Yin-hua; He, Guo-ping; Liu, Jing-wei

    2016-09-01

    The objective of this study was to compare the fee-for-service and set fee for diagnosis-related group systems with regard to quality of medical care and cost to appendectomy patients. We conducted a retrospective study of 208 inpatients (from 20 hospitals) who undergone appendectomy in Changsha, China during 2013. Data were obtained from databases of medical insurance information systems directly connected to the hospital information systems. We collected and compared patient ages, length of study, and total medical costs for impatient appendectomies between patients using fee-for-service and set fee for diagnosisrelated group systems. One hundred thirty-three patients used the fee for service system and 75 used the set fee diagnosis related group system. For those using the diagnosis-related group system, the mean length of hospitalization (6.2 days) and mean number of prescribed antimicrobials (2.4) per patient were significantly lower than those of the patients who used the fee-for-service system (7.3 days and 3.0, respectively; p = 0.018; p < 0.05) and were accompanied by lower medical costs and cost of antimicrobials (RMB 2,518 versus RMB 4,484 and RMB476 versus RMB1,108, respectively; p = 0.000, p = 0.000). There were no significant differences in post-surgical complications between the two systems. The diagnosis-related group system had significantly medical costs for appendectomy compared to the fee-for-service system, without sacrificing quality of medical care.

  3. Health fee exemptions: controversies and misunderstandings around a research programme. Researchers and the public debate

    PubMed Central

    2015-01-01

    Our research programme on fee exemption policies in Burkina Faso, Mali and Niger involved sensitive topics with strong ideological and political connotations for the decision-makers, for health-workers, and for users. Thus we were confronted with reluctance, criticism, pressures and accusations. Our frank description of the shortcomings of these policies, based on rigorous research, and never polemical or accusatory, surprises political leaders and health managers, who are accustomed to official data, censored evaluations and discourse of justification. This reflexive paper aims to react to some misunderstandings that arose regularly: "By focusing on the problems, you will discourage the aid donors". "By focusing on the problems, you are playing into the hands of the opponents of fee exemption". "You should focus on what works and not on what doesn't work". "The comments and behaviour you report are not representative". "What you say is not new, we already knew about it". Double discourse prevails in aid-dependent countries. The official discourse is mostly sterilized and far removed from reality. It protects the routine of the local bureaucracies. But the private 'speak' is quite different, and everyone knows the everyday ruses, tricks and arrangements within the health system. Anthropologists collect the private speak and transmit it to the public sphere through their analyses in order to provide a serious account of a reality, and creating the conditions for an expert debate and a public debate. The national conference on fee exemption held in Niamey in 2012 was a success in this perspective: healthcare personnel spoke for the first time in a public setting about the numerous problems associated with the fee exemption policy, and they largely confirmed and even supplemented the results of our research. It is difficult to see how the healthcare system can be improved and better quality of service provided without starting from a rigorous diagnosis of these usually concealed realities. Such diagnosis gives arguments to reformers within the health system to make change happen. PMID:26559243

  4. The human resource implications of improving financial risk protection for mothers and newborns in Zimbabwe

    PubMed Central

    2013-01-01

    Background A paradigm shift in global health policy on user fees has been evident in the last decade with a growing consensus that user fees undermine equitable access to essential health care in many low and middle income countries. Changes to fees have major implications for human resources for health (HRH), though the linkages are rarely explicitly examined. This study aimed to examine the inter-linkages in Zimbabwe in order to generate lessons for HRH and fee policies, with particular respect to reproductive, maternal and newborn health (RMNH). Methods The study used secondary data and small-scale qualitative fieldwork (key informant interview and focus group discussions) at national level and in one district in 2011. Results The past decades have seen a shift in the burden of payments onto households. Implementation of the complex rules on exemptions is patchy and confused. RMNH services are seen as hard for families to afford, even in the absence of complications. Human resources are constrained in managing current demand and any growth in demand by high external and internal migration, and low remuneration, amongst other factors. We find that nurses and midwives are evenly distributed across the country (at least in the public sector), though doctors are not. This means that for four provinces, there are not enough doctors to provide more complex care, and only three provinces could provide cover in the event of all deliveries taking place in facilities. Conclusions This analysis suggests that there is a strong case for reducing the financial burden on clients of RMNH services and also a pressing need to improve the terms and conditions of key health staff. Numbers need to grow, and distribution is also a challenge, suggesting the need for differentiated policies in relation to rural areas, especially for doctors and specialists. The management of user fees should also be reviewed, particularly for non-Ministry facilities, which do not retain their revenues, and receive limited investment in return from the municipalities and district councils. Overall public investment in health needs to grow. PMID:23714143

  5. The human resource implications of improving financial risk protection for mothers and newborns in Zimbabwe.

    PubMed

    Chirwa, Yotamu; Witter, Sophie; Munjoma, Malvern; Mashange, Wilson; Ensor, Tim; McPake, Barbara; Munyati, Shungu

    2013-05-28

    A paradigm shift in global health policy on user fees has been evident in the last decade with a growing consensus that user fees undermine equitable access to essential health care in many low and middle income countries. Changes to fees have major implications for human resources for health (HRH), though the linkages are rarely explicitly examined. This study aimed to examine the inter-linkages in Zimbabwe in order to generate lessons for HRH and fee policies, with particular respect to reproductive, maternal and newborn health (RMNH). The study used secondary data and small-scale qualitative fieldwork (key informant interview and focus group discussions) at national level and in one district in 2011. The past decades have seen a shift in the burden of payments onto households. Implementation of the complex rules on exemptions is patchy and confused. RMNH services are seen as hard for families to afford, even in the absence of complications. Human resources are constrained in managing current demand and any growth in demand by high external and internal migration, and low remuneration, amongst other factors. We find that nurses and midwives are evenly distributed across the country (at least in the public sector), though doctors are not. This means that for four provinces, there are not enough doctors to provide more complex care, and only three provinces could provide cover in the event of all deliveries taking place in facilities. This analysis suggests that there is a strong case for reducing the financial burden on clients of RMNH services and also a pressing need to improve the terms and conditions of key health staff. Numbers need to grow, and distribution is also a challenge, suggesting the need for differentiated policies in relation to rural areas, especially for doctors and specialists. The management of user fees should also be reviewed, particularly for non-Ministry facilities, which do not retain their revenues, and receive limited investment in return from the municipalities and district councils. Overall public investment in health needs to grow.

  6. 75 FR 33704 - Loan Guaranty: Elimination of Redundant Regulations

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-15

    ... budgetary impact of entitlements, grants, user fees, or loan programs or the rights and obligations of..., Handicapped, Housing, Indians, Individuals with disabilities, Loan programs--housing and community development...

  7. 7 CFR 504.5 - Address.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... USER FEES § 504.5 Address. Deposits of and requests for microbial patent cultures should be directed to the Curator, ARS Patent Culture Collection, Northern Regional Research Center, USDA-ARS, 1815 N...

  8. Public Parks in Hong Kong: Characteristics of Physical Activity Areas and Their Users

    PubMed Central

    Chow, Bik C.; McKenzie, Thomas L.; Sit, Cindy H. P.

    2016-01-01

    Public parks, salient locations for engaging populations in health promoting physical activity, are especially important in high-density cities. We used the System for Observing Physical Activity in Communities (SOPARC) to conduct the first-ever surveillance study of nine public parks in Hong Kong (288 observation sessions during 36 weekdays and 36 weekend days) and observed 28,585 visitors in 262 diverse areas/facilities. Parks were widely used throughout the day on weekdays and weekend days and across summer and autumn; visitor rates were among the highest seen in 24 SOPARC studies. In contrast to other studies where teens and children dominated park use, most visitors (71%) were adults and seniors. More males (61%) than females used the parks, and they dominated areas designed for sports. Over 60% of visitors were observed engaging in moderate-to-vigorous physical activity, a rate higher than other SOPARC studies. Facilities with user fees were less accessible than non-fee areas, but they provided relatively more supervised and organized activities. Assessing parks by age, gender, and physical activity can provide useful information relative to population health. This study not only provides information useful to local administrators for planning and programming park facilities relative to physical activity, but it also provides a baseline for comparison by other high-density cities. PMID:27367709

  9. Airport and Airway Costs: Allocation and Recovery in the 1980’s.

    DTIC Science & Technology

    1987-02-01

    1997 [8]. 3*X S.% Volume 4, FAA Cost Recovery Options [9). Volume 5, Econometric Cost Functions for FAA Cost Allocation Model [10]. Volume 6, Users...and relative price elasticities ( Ramsey pricing technique). User fees based on the Ramsey pricing tend to be less burdensome on users and minimize...full discussion of the Ramsey pricing techniques is provided in Allocation of Federal Airport and Airway Costs for FY 1985 [6]. -12- In step 5

  10. 77 FR 35355 - User Fee Schedule for Trade Promotion Services

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-13

    ... or distributors, manufacturers, licensees, franchisees or strategic partners. The U.S. exporter..., manufacturers, licensees, franchisees or strategic partners. The U.S. exporter identifies the type of firm it...

  11. 26 CFR 300.0 - User fees; in general.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... the enrollment of an enrolled agent. (7) Enrolling an enrolled actuary. (8) Renewing the enrollment of an enrolled actuary. (9) Taking the special enrollment examination to become an enrolled retirement...

  12. 26 CFR 300.0 - User fees; in general.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... the enrollment of an enrolled agent. (7) Enrolling an enrolled actuary. (8) Renewing the enrollment of an enrolled actuary. (9) Taking the special enrollment examination to become an enrolled retirement...

  13. 26 CFR 300.0 - User fees; in general.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... the enrollment of an enrolled agent. (7) Enrolling an enrolled actuary. (8) Renewing the enrollment of an enrolled actuary. (9) Taking the special enrollment examination to become an enrolled retirement...

  14. 29 CFR 1610.14 - Waiver of user charges.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... directors and the librarian are hereby authorized to collect fees where applicable in accordance with § 1610...). District directors, field directors, area directors, local directors and the librarian are hereby...

  15. Uptake of evidence in policy development: the case of user fees for health care in public health facilities in Uganda.

    PubMed

    Nabyonga-Orem, Juliet; Ssengooba, Freddie; Mijumbi, Rhona; Tashobya, Christine Kirunga; Marchal, Bruno; Criel, Bart

    2014-12-18

    Several countries in Sub Saharan Africa have abolished user fees for health care but the extent to which such a policy decision is guided by evidence needs further exploration. We explored the barriers and facilitating factors to uptake of evidence in the process of user fee abolition in Uganda and how the context and stakeholders involved shaped the uptake of evidence. This study builds on previous work in Uganda that led to the development of a middle range theory (MRT) outlining the main facilitating factors for knowledge translation (KT). Application of the MRT to the case of abolition of user fees contributes to its refining. Employing a theory-driven inquiry and case study approach given the need for in-depth investigation, we reviewed documents and conducted interviews with 32 purposefully selected key informants. We assessed whether evidence was available, had or had not been considered in policy development and the reasons why and; assessed how the actors and the context shaped the uptake of evidence. Symbolic, conceptual and instrumental uses of evidence were manifest. Different actors were influenced by different types of evidence. While technocrats in the ministry of health (MoH) relied on formal research, politicians relied on community complaints. The capacity of the MoH to lead the KT process was weak and the partnerships for KT were informal. The political window and alignment of the evidence with overall government discourse enhanced uptake of evidence. Stakeholders were divided, seemed to be polarized for various reasons and had varying levels of support and influence impacting the uptake of evidence. Evidence will be taken up in policy development in instances where the MoH leads the KT process, there are partnerships for KT in place, and the overall government policy and the political situation can be expected to play a role. Different actors will be influenced by different types of evidence and their level of support and influence will impact the uptake of evidence. In addition, the extent to which a policy issue is contested and, whether stakeholders share similar opinions and preferences will impact the uptake of evidence.

  16. 77 FR 62283 - Self-Regulatory Organizations; The NASDAQ Stock Market LLC; Notice of Filing and Immediate...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-12

    ... using a Nasdaq Workstation or Weblink ACT 2.0 user account. Member firms subscribing to the ACT Reject... Workstation and Weblink ACT 2.0 user account selected for subscription to the ACT Reject Scan service. Nasdaq..., per month. Use of the ACT Reject Scan service is voluntary and the subscription fee will be imposed on...

  17. 76 FR 35498 - Self-Regulatory Organizations; The NASDAQ Stock Market LLC; Notice of Filing and Immediate...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-17

    ... handling of a large volume of customer and proprietary order flow. Given the portability of order flow from... public customers. For BONO SM data, the proposed per-user fees are $5 per Professional user; and $1 per... to attract order flow to that exchange. The Exchange believes that the continued availability of BONO...

  18. 76 FR 67520 - Self-Regulatory Organizations; NYSE Amex LLC; Notice of Filing of Proposed Rule Change Expanding...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-01

    ... delivery services to their customers while the User is co-located in the Exchange's data center.\\7\\ As is... Potential ``Users'' of Its Co-Location Services To Include Any Market Participant That Requests To Receive Co-Location Services Directly From the Exchange and Amending Its Price List To Establish a Fee for...

  19. Data Use Disclaimer Agreement | Energy Analysis | NREL

    Science.gov Websites

    ;). Access to and use of this Tool shall impose the following obligations on the user, as set forth in this Agreement. The user is granted the right, without any fee or cost, to use, copy, modify, alter, enhance and the use of this Tool. The names DOE/NREL/ALLIANCE, however, may not be used in any advertising or

  20. 48 CFR 2452.216-70 - Estimated cost, base fee and award fee.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 48 Federal Acquisition Regulations System 6 2013-10-01 2013-10-01 false Estimated cost, base fee... Provisions and Clauses 2452.216-70 Estimated cost, base fee and award fee. As prescribed in 2416.406(e)(1), insert the following clause in all cost-plus-award-fee contracts: Estimated Cost, Base Fee and Award Fee...

  1. 48 CFR 2452.216-70 - Estimated cost, base fee and award fee.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 48 Federal Acquisition Regulations System 6 2012-10-01 2012-10-01 false Estimated cost, base fee... Provisions and Clauses 2452.216-70 Estimated cost, base fee and award fee. As prescribed in 2416.406(e)(1), insert the following clause in all cost-plus-award-fee contracts: Estimated Cost, Base Fee and Award Fee...

  2. 48 CFR 452.216-71 - Base Fee and Award Fee Proposal.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 48 Federal Acquisition Regulations System 4 2011-10-01 2011-10-01 false Base Fee and Award Fee... Base Fee and Award Fee Proposal. As prescribed in 416.470, insert the following provision: Base Fee and Award Proposal (FEB 1988) For the purpose of this solicitation, offerors shall propose a base fee of...

  3. 48 CFR 1552.216-75 - Base fee and award fee proposal.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 48 Federal Acquisition Regulations System 6 2013-10-01 2013-10-01 false Base fee and award fee... 1552.216-75 Base fee and award fee proposal. As prescribed in 1516.405(b), insert the following clause: Base Fee and Award Fee Proposal (FEB 1999) For the purpose of this solicitation, offerors shall propose...

  4. 48 CFR 1552.216-75 - Base fee and award fee proposal.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 48 Federal Acquisition Regulations System 6 2012-10-01 2012-10-01 false Base fee and award fee... 1552.216-75 Base fee and award fee proposal. As prescribed in 1516.405(b), insert the following clause: Base Fee and Award Fee Proposal (FEB 1999) For the purpose of this solicitation, offerors shall propose...

  5. 48 CFR 1552.216-75 - Base fee and award fee proposal.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 6 2010-10-01 2010-10-01 true Base fee and award fee... 1552.216-75 Base fee and award fee proposal. As prescribed in 1516.405(b), insert the following clause: Base Fee and Award Fee Proposal (FEB 1999) For the purpose of this solicitation, offerors shall propose...

  6. 48 CFR 452.216-71 - Base Fee and Award Fee Proposal.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 4 2010-10-01 2010-10-01 false Base Fee and Award Fee... Base Fee and Award Fee Proposal. As prescribed in 416.470, insert the following provision: Base Fee and Award Proposal (FEB 1988) For the purpose of this solicitation, offerors shall propose a base fee of...

  7. 48 CFR 950.7009 - Fees.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Fees. 950.7009 Section 950.7009 Federal Acquisition Regulations System DEPARTMENT OF ENERGY CONTRACT MANAGEMENT EXTRAORDINARY CONTRACTUAL ACTIONS AND THE SAFETY ACT Nuclear Indemnification of DOE Contractors 950.7009 Fees. No fee will...

  8. 77 FR 38866 - Self-Regulatory Organizations; Financial Industry Regulatory Authority, Inc.; Notice of Filing...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-29

    ... supra note 6. System Processing Fee Under Section 4(b)(6) of Schedule A, FINRA currently charges an annual $30 system processing fee for each member's registered individuals. FINRA is proposing to increase the system processing fee to $45. This fee has not been increased since January 2000.\\11\\ Since 2000...

  9. American Autoimmune Related Diseases Association

    MedlinePlus

    ... Policy Contact Us Who We Help Patients ARNet Research Survey AD Knowledge Base Autoimmune Disease List Common Thread ... Planned Giving Shop AARDA Volunteer Take Action ARNet Research Survey Voter Voice Prescription Drug User Fee Act (PDUFA) ...

  10. 26 CFR 300.0 - User fees; in general.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... the enrollment of an enrolled agent. (7) Enrolling an enrolled actuary. (8) Renewing the enrollment of an enrolled actuary. (9) Applying for a preparer tax identification number. [T.D. 8589, 60 FR 8299...

  11. 48 CFR 215.404-74 - Fee requirements for cost-plus-award-fee contracts.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 3 2010-10-01 2010-10-01 false Fee requirements for cost... NEGOTIATION Contract Pricing 215.404-74 Fee requirements for cost-plus-award-fee contracts. In developing a fee objective for cost-plus-award-fee contracts, the contracting officer shall— (a) Follow the...

  12. 75 FR 47701 - Electronic System for Travel Authorization (ESTA): Travel Promotion Fee and Fee for Use of the...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-09

    ...; CBP Dec. No. 10-25] RIN 1651-AA83 Electronic System for Travel Authorization (ESTA): Travel Promotion... congressionally mandated fee of $14.00, which is the sum of two amounts: a $10 travel promotion fee for an approved ESTA statutorily set by the Travel Promotion Act and a $4.00 operational fee for the use of ESTA...

  13. Financing blood transfusion services in sub-Saharan Africa: a role for user fees?

    PubMed

    Hensher, M; Jefferys, E

    2000-09-01

    The provision of a secure and safe blood supply has taken on new importance in sub-Saharan Africa with the onset of the AIDS epidemic. Blood transfusion services capable of providing safe blood are not cheap, however, and there has been some debate on the desirability and sustainability of different financing mechanisms for blood transfusion services. This paper examines patterns of financing blood transfusion in three countries--Côte d'Ivoire, Zimbabwe and Mozambique. It goes on to consider the conceptual options for financing safe blood, and to examine in detail the possible role of user fees for blood transfusion in Africa, developing a simple model of their likely burden to patients based on data from Côte d'Ivoire. The model indicates that, at best, there can only be a limited role for user fees in the financing of safe blood transfusion services, due mainly to the relatively high cost of producing a unit of safe blood. Charging individuals for the blood they receive is likely to be administratively complex and costly, could realistically recover only a fraction of the production costs involved, and is further complicated by the fact that the main recipients of blood transfusion in sub-Saharan Africa are children and pregnant women. If cost-recovery for safe blood is to be attempted, the most viable option appears to be that of charging a collective fee, levied upon all inpatients, not just on those who receive blood. Such a mechanism is not without problems, not least in its failure to offer incentives for more appropriate blood use, and it is still likely to recover only a portion of the costs of producing safe blood. Whether or not cost-recovery is instituted, there will remain an important role for public funding of blood transfusion services, and, by implication, an important role for foreign donor support.

  14. Mountain Biking at Tsali: An Assessment of Users, Preferences, Conflicts, and Management Alternatives

    Treesearch

    J. Michael Bowker; Donald B.K. English

    2002-01-01

    Tsali Recreation Area is part of the Cheoah Ranger District of the Nantahala National Forest. Overlooking the Great Smoky Mountains, it is one of the premier mountain biking sites in the Eastern United States. The results of a 13-month on-site survey of 1,359 Tsali visitors examine the demographics, behavior, current trip profile, and attitudes toward user fees,...

  15. 75 FR 12555 - Prescription Drug User Fee Act; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-16

    ... negotiations with the regulated industry on PDUFA reauthorization, we publish a notice in the Federal Register...)(2)) of the FD&C Act requires that before FDA begins negotiations with the regulated industry on...

  16. 19 CFR 112.42 - Application for identification card.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    .../4″ × 11/4″ color photographs of the applicant. The fingerprints of the applicant shall also be... inform the applicant of the current Federal Bureau of Investigation user fee for conducting fingerprint...

  17. 19 CFR 112.42 - Application for identification card.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    .../4″ × 11/4″ color photographs of the applicant. The fingerprints of the applicant shall also be... inform the applicant of the current Federal Bureau of Investigation user fee for conducting fingerprint...

  18. 19 CFR 112.42 - Application for identification card.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    .../4″ × 11/4″ color photographs of the applicant. The fingerprints of the applicant shall also be... inform the applicant of the current Federal Bureau of Investigation user fee for conducting fingerprint...

  19. 19 CFR 112.42 - Application for identification card.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    .../4″ × 11/4″ color photographs of the applicant. The fingerprints of the applicant shall also be... inform the applicant of the current Federal Bureau of Investigation user fee for conducting fingerprint...

  20. 19 CFR 112.42 - Application for identification card.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    .../4″ × 11/4″ color photographs of the applicant. The fingerprints of the applicant shall also be... inform the applicant of the current Federal Bureau of Investigation user fee for conducting fingerprint...

  1. The national free delivery policy in Nepal: early evidence of its effects on health facilities.

    PubMed

    Witter, Sophie; Khadka, Sunil; Nath, Hom; Tiwari, Suresh

    2011-11-01

    Nepal faces the challenge of high levels of poverty, difficult access to health facilities and poor, though improving, health indicators. In response, in the past 5 years it has been experimenting with a range of approaches to removing user fees. Access to health care is now enshrined as a constitutional right for all. This article examines the latest policy, which was introduced in January 2009: free delivery care across the country. The study objective was to understand the effects of the policy on health facilities. Study methods included structured forms to retrieve financial and activity data from national, district and facility records (comparing 10 months before implementation with 10 months after). These were supplemented by semi-structured interviews with key informants at different levels of the health system. Findings include that utilization of services (at the facilities visited) continues to rise, with caesareans proportionate to the general growth in deliveries. Funds for the free delivery policy ('Aama') are found to be adequate to cover the main costs of services, with some surplus which can be invested in staff and in improving services. The system for reimbursing facilities is operating without undue delay and there is satisfaction with the flexibility of use of resources which it allows and the additional incentives for staff. The main concerns relate to wider systemic issues-in particular, understaffing in some key posts and areas, and dwindling general revenues for the facilities, especially through loss of wider user fee revenues. This may explain the ongoing charges for patients, which both facilities and patients report. It will be challenging to build on the gains of the past few years and sustain them, at the same time as merging the separate free care funding streams.

  2. 48 CFR 216.405-2 - Cost-plus-award-fee contracts.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 3 2010-10-01 2010-10-01 false Cost-plus-award-fee... Contracts 216.405-2 Cost-plus-award-fee contracts. (b) Application. The cost-plus-award-fee (CPAF) contract... avoid— (1) Establishing cost-plus-fixed-fee contracts when the criteria for cost-plus-fixed-fee...

  3. The Future Revisited.

    ERIC Educational Resources Information Center

    Mason, Marilyn Gell

    1996-01-01

    Reviews earlier predictions about technological change in libraries, finds that providing equal access to information remains the library's mission, and forecasts the future. Topics include ownership versus access, electronic resources, information infrastructure, users, levels of service fees, circulation, librarians as "information…

  4. 9 CFR 130.4 - User fees for processing import permit applications.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ..., vectors, or germ plasm (embryos or semen) or to transport organisms or vectors1 Initial permit Per... Transit Permit (Animals, Animal Semen, Animal Embryos, Birds, Poultry, or Hatching Eggs).” 2 Permits to...

  5. 9 CFR 130.4 - User fees for processing import permit applications.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ..., vectors, or germ plasm (embryos or semen) or to transport organisms or vectors1 Initial permit Per... Transit Permit (Animals, Animal Semen, Animal Embryos, Birds, Poultry, or Hatching Eggs).” 2 Permits to...

  6. 9 CFR 130.4 - User fees for processing import permit applications.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ..., vectors, or germ plasm (embryos or semen) or to transport organisms or vectors1 Initial permit Per... Transit Permit (Animals, Animal Semen, Animal Embryos, Birds, Poultry, or Hatching Eggs).” 2 Permits to...

  7. 9 CFR 130.4 - User fees for processing import permit applications.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ..., vectors, or germ plasm (embryos or semen) or to transport organisms or vectors1 Initial permit Per... Transit Permit (Animals, Animal Semen, Animal Embryos, Birds, Poultry, or Hatching Eggs).” 2 Permits to...

  8. 9 CFR 130.4 - User fees for processing import permit applications.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ..., vectors, or germ plasm (embryos or semen) or to transport organisms or vectors1 Initial permit Per... Transit Permit (Animals, Animal Semen, Animal Embryos, Birds, Poultry, or Hatching Eggs).” 2 Permits to...

  9. 76 FR 4119 - Generic Drug User Fee; Notice of Public Meeting; Reopening of the Comment Period

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-24

    ... opportunity for all interested parties to provide information and share views on the matter. DATES: Submit.... The requesters represent manufacturers of active pharmaceutical ingredients who did not previously...

  10. Health financing to promote access in low income settings-how much do we know?

    PubMed

    Palmer, Natasha; Mueller, Dirk H; Gilson, Lucy; Mills, Anne; Haines, Andy

    In this article we outline research since 1995 on the impact of various financing strategies on access to health services or health outcomes in low income countries. The limited evidence available suggests, in general, that user fees deterred utilisation. Prepayment or insurance schemes offered potential for improving access, but are very limited in scope. Conditional cash payments showed promise for improving uptake of interventions, but could also create a perverse incentive. The largely African origin of the reports of user fees, and the evidence from Latin America on conditional cash transfers, demonstrate the importance of the context in which studies are done. There is a need for improved quality of research in this area. Larger scale, upfront funding for evaluation of health financing initiatives is necessary to ensure an evidence base that corresponds to the importance of this issue for achieving development goals.

  11. How User Fees Influence Contraception in Low and Middle Income Countries: A Systematic Review

    PubMed Central

    Korachais, Catherine; Macouillard, Elodie; Meessen, Bruno

    2016-01-01

    Accessible and quality reproductive health services are critical for low‐ and middle‐income countries (LMICs). After a decade of waning investment in family planning, interest and funding are growing once again. This article assesses whether introducing, removing, or changing user fees for contraception has an effect on contraceptive use. We conducted a search of 14 international databases. We included randomized controlled trials, interrupted‐time series analyses, controlled before‐and‐after study designs, and cohort studies that reported contraception‐related variables as an outcome and a change in the price of contraceptives as an intervention. Four studies were eligible but none was at low risk of bias overall. Most of these, as well as other studies not included in the present research, found that demand for contraception was not cost‐sensitive. We could draw no robust summary of evidence, strongly suggesting that further research in this area is needed. PMID:27859370

  12. Supplementary physicians' fees: a sustainable system?

    PubMed

    Calcoen, Piet; van de Ven, Wynand P M M

    2018-01-25

    In Belgium and France, physicians can charge a supplementary fee on top of the tariff set by the mandatory basic health insurance scheme. In both countries, the supplementary fee system is under pressure because of financial sustainability concerns and a lack of added value for the patient. Expenditure on supplementary fees is increasing much faster than total health expenditure. So far, measures taken to curb this trend have not been successful. For certain categories of physicians, supplementary fees represent one-third of total income. For patients, however, the added value of supplementary fees is not that clear. Supplementary fees can buy comfort and access to physicians who refuse to treat patients who are not willing to pay supplementary fees. Perceived quality of care plays an important role in patients' willingness to pay supplementary fees. Today, there is no evidence that physicians who charge supplementary fees provide better quality of care than physicians who do not. However, linking supplementary fees to objectively proven quality of care and limiting access to top quality care to patients able and willing to pay supplementary fees might not be socially acceptable in many countries. Our conclusion is that supplementary physicians' fees are not sustainable.

  13. 48 CFR 853.236-70 - VA Form 10-6298, Architect-Engineer Fee Proposal.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 48 Federal Acquisition Regulations System 5 2014-10-01 2014-10-01 false VA Form 10-6298, Architect-Engineer Fee Proposal. 853.236-70 Section 853.236-70 Federal Acquisition Regulations System DEPARTMENT OF...-Engineer Fee Proposal. VA Form 10-6298, Architect-Engineer Fee Proposal, shall be used as prescribed in 836...

  14. 48 CFR 853.236-70 - VA Form 10-6298, Architect-Engineer Fee Proposal.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false VA Form 10-6298, Architect-Engineer Fee Proposal. 853.236-70 Section 853.236-70 Federal Acquisition Regulations System DEPARTMENT OF...-Engineer Fee Proposal. VA Form 10-6298, Architect-Engineer Fee Proposal, shall be used as prescribed in 836...

  15. Increasing Open Source Software Integration on the Department of Defense Unclassified Desktop

    DTIC Science & Technology

    2008-06-01

    free and legal access to the source code grants the user or operating agency considerable power and control . Commercial, off-the-shelf (COTS...COMMAND, CONTROL AND COMMUNICATIONS (C-3)) from the NAVAL POSTGRADUATE SCHOOL June 2008 Author: Steven A. Schearer Approved...Network. This fee also entitles users to unlimited web support with a two-business-day turnaround time. The retail price for a one year, basic

  16. Prioritized service system behavior

    NASA Astrophysics Data System (ADS)

    Oliver, Huw

    2001-07-01

    Internet technology is becoming the infrastructure of the future for any information that can be transmitted digitally, including voice, audio, video and data services of all kinds. The trend to integrate voice and data traffic observed in the Internet is expected to continue until the full integration of all media types is achieved. At the same time it is obvious that the business model employed for current Internet usage is not sustainable for the creation of an infrastructure suitable to support a diverse and ever-increasing range of application services. Currently the Internet provides only a single class of best-effort service and prices are mainly built on flat-fee, access based schemes. We propose the use of pricing mechanisms for controlling demand for scarce resources, in order to improve the economic efficiency of the system. Standard results in economic theory suggest that increasing the value of the network services to the users is beneficial to both the users and the network operator (since he can charge them more and get back a bigger percentage of their surplus). Using pricing mechanisms helps in that respect. When demand is high, prices are being raised and hence deter the users with low valuation for the service to use it. This leaves resources to be available for the users that value them more, and hence are ready to pay more.

  17. 48 CFR 915.404-4-71-6 - Fee base.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 48 Federal Acquisition Regulations System 5 2012-10-01 2012-10-01 false Fee base. 915.404-4-71-6... CONTRACT TYPES CONTRACTING BY NEGOTIATION Contract Pricing 915.404-4-71-6 Fee base. (a) The fee base shown... estimate of cost to which a percentage factor is applied to determine maximum fee allowances. The fee base...

  18. 48 CFR 915.404-4-71-6 - Fee base.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 48 Federal Acquisition Regulations System 5 2013-10-01 2013-10-01 false Fee base. 915.404-4-71-6... CONTRACT TYPES CONTRACTING BY NEGOTIATION Contract Pricing 915.404-4-71-6 Fee base. (a) The fee base shown... estimate of cost to which a percentage factor is applied to determine maximum fee allowances. The fee base...

  19. 48 CFR 915.404-4-71-6 - Fee base.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 48 Federal Acquisition Regulations System 5 2011-10-01 2011-10-01 false Fee base. 915.404-4-71-6... CONTRACT TYPES CONTRACTING BY NEGOTIATION Contract Pricing 915.404-4-71-6 Fee base. (a) The fee base shown... estimate of cost to which a percentage factor is applied to determine maximum fee allowances. The fee base...

  20. 48 CFR 915.404-4-71-6 - Fee base.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Fee base. 915.404-4-71-6... CONTRACT TYPES CONTRACTING BY NEGOTIATION Contract Pricing 915.404-4-71-6 Fee base. (a) The fee base shown... estimate of cost to which a percentage factor is applied to determine maximum fee allowances. The fee base...

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