Federal Register / Vol. 76, No. 39 / Monday, February 28, 2011 / Proposed Rules 10825 

Air Act. For that reason, this proposed 

action: 

• Is not a ‘‘significant regulatory 

action’’ subject to review by the Office 

of Management and Budget under 

Executive Order 12866 (58 FR 51735, 

October 4, 1993); 

• Does not impose an information 

collection burden under the provisions 

of the Paperwork Reduction Act (44 

U.S.C. 3501 et seq.); 

• Is certified as not having a 

significant economic impact on a 

substantial number of small entities 

under the Regulatory Flexibility Act 

(5 U.S.C. 601 et seq.); 

• Does not contain any unfunded 

mandate or significantly or uniquely 

affect small governments, as described 

in the Unfunded Mandates Reform Act 

of 1995 (Pub. L. 104–4); 

• Does not have Federalism 

implications as specified in Executive 

Order 13132 (64 FR 43255, August 10, 

1999); 

• Is not an economically significant 

regulatory action based on health or 

safety risks subject to Executive Order 

13045 (62 FR 19885, April 23, 1997); 

• Is not a significant regulatory action 

subject to Executive Order 13211 (66 FR 

28355, May 22, 2001); 

• Is not subject to requirements of 

Section 12(d) of the National 

Technology Transfer and Advancement 

Act of 1995 (15 U.S.C. 272 note) because 

application of those requirements would 

be inconsistent with the Clean Air Act; 

and 

• Does not provide EPA with the 

discretionary authority to address 

disproportionate human health or 

environmental effects with practical, 

appropriate, and legally permissible 

methods under Executive Order 12898 

(59 FR 7629, February 16, 1994). 

In addition, this proposed rule does 

not have Tribal implications as 

specified by Executive Order 13175 (65 

FR 67249, November 9, 2000), because 

the SIP obligations discussed herein do 

not apply to Indian Tribes and thus will 

not impose substantial direct costs on 

Tribal governments or preempt Tribal 

law. 

Authority: 42 U.S.C. 7401 et seq. 

Dated: February 17, 2011. 

Jared Blumenfeld, 

Regional Administrator, Region IX. 

[FR Doc. 2011–4376 Filed 2–25–11; 8:45 am] 

BILLING CODE 6560–50–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

42 CFR Part 5 

Negotiated Rulemaking Committee on 

Designation of Medically Underserved 

Populations and Health Professional 

Shortage Areas; Notice of Meeting 

AGENCY: Health Resources and Services 

Administration, HHS. 

ACTION: Negotiated Rulemaking 

Committee meeting. 

SUMMARY: In accordance with section 

10(a)(2) of the Federal Advisory 

Committee Act (Pub. L. 92–463), notice 

is hereby given of the following meeting 

of the Negotiated Rulemaking 

Committee on Designation of Medically 

Underserved Populations and Health 

Professional Shortage Areas. 

DATES: Meetings will be held on March 

8, 2011, 9:30 a.m. to 6 p.m.; March 9, 

2011, 9 a.m. to 6 p.m.; and March 10, 

2011, 9 a.m. to 4 p.m. 

ADDRESSES: Meetings will be held at the 

Radisson Hotel Reagan National Airport, 

2020 Jefferson Davis Highway, 

Arlington, Virginia 22202, (703) 920– 

8600. 

FOR FURTHER INFORMATION CONTACT: For 

more information, please contact Nicole 

Patterson, Office of Shortage 

Designation, Bureau of Health 

Professions, Health Resources and 

Services Administration, Room 9A–18, 

Parklawn Building, 5600 Fishers Lane, 

Rockville, Maryland 20857, Telephone 

(301) 443–9027, E-mail: 

npatterson@hrsa.gov or visit http:// 

www.hrsa.gov/advisorycommittees/ 

shortage/. 

SUPPLEMENTARY INFORMATION: Status: 

The meeting will be open to the public. 

Purpose: The purpose of the 

Negotiated Rulemaking Committee on 

Designation of Medically Underserved 

Populations and Health Professional 

Shortage Areas (Committee) is to 

establish criteria and a comprehensive 

methodology for Designation of 

Medically Underserved Populations and 

Primary Care Health Professional 

Shortage Areas, using a Negotiated 

Rulemaking (NR) process. It is hoped 

that use of the NR process will yield 

consensus among technical experts and 

stakeholders on a new rule for 

designation of medically underserved 

populations and primary care health 

professions shortage areas, which would 

be published as an Interim Final Rule in 

accordance with Section 5602 the 

Affordable Care Act, Public Law 111– 

148. 

Agenda: The meeting will be held on 

Tuesday, March 8; Wednesday, March 

9; and Thursday, March 10. It will 

include a discussion of various 

components of a possible methodology 

for identifying areas of shortage and 

underservice, based on the 

recommendations of the Committee in 

the previous meeting. The Thursday 

meeting will also include development 

of the agenda for the next meeting. 

Members of the public will have the 

opportunity to provide comments 

during the meeting on Thursday 

afternoon, March 10. 

Requests from the public to make oral 

comments or to provide written 

comments to the Committee should be 

sent to Nicole Patterson at the contact 

address above at least 10 days prior to 

the first day of the meeting, Wednesday, 

March 8. The meeting will be open to 

the public as indicated above, with 

attendance limited to space available. 

Individuals who plan to attend and 

need special assistance, such as sign 

language interpretation or other 

reasonable accommodations, should 

notify the contact person listed above at 

least 10 days prior to the meeting. 

The Committee is working to meet the 

requirement in the Affordable Care Act 

under tight timeframes. As work has 

progressed, it has been determined that 

more time will be needed to complete 

the assignment due to its complexity, 

resulting in the Committee’s decision to 

extend planned meetings. As a result, 

the logistical challenges encountered 

with extending planned meetings and 

scheduling additional meetings 

hindered an earlier publishing of the 

meeting notice. 

Dated: February 23, 2011. 

Reva Harris, 

Acting Director, Division of Policy and 

Information Coordination. 

[FR Doc. 2011–4388 Filed 2–25–11; 8:45 am] 

BILLING CODE 4165–15–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

42 CFR Part 6 

RIN 0906–AA77 

Federal Tort Claims Act (FTCA) 

Medical Malpractice Program 

Regulations: Clarification of FTCA 

Coverage for Services Provided to 

Non-Health Center Patients 

AGENCY: Health Resources and Services 

Administration, HHS. 

ACTION: Notice of proposed rulemaking. 

SUMMARY: The Federally Supported 

Health Centers Assistance Act of 1992, 

as amended in 1995 (FSHCAA), 

provides for liability protection for 


srobinson on DSKHWCL6B1PROD with PROPOSALS
10826 Federal Register / Vol. 76, No. 39 / Monday, February 28, 2011 / Proposed Rules 

certain grantees of the Public Health 

Service and for certain individuals 

associated with these grantees. The 

Health Resources and Services 

Administration (HRSA) is the operating 

division within the Department 

responsible for administering certain 

aspects of FSHCAA. HRSA proposes 

replacing the current regulations with 

the key text and examples of activities 

that have been determined, consistent 

with provisions of the existing 

regulation, to be covered by the FTCA, 

as previously published in the Sept. 25, 

1995 Federal Register. In addition, 

HRSA proposes adding an example of 

services covered under the FTCA 

involving individual emergency care 

provided to a non-health center patient 

and updating the September 1995 

Notice immunization example to 

include events to immunize individuals 

against infectious illnesses. When 

finalized, the amended regulation will 

supersede the September 1995 Notice. 

DATES: Written comments must be 

received on or before April 29, 2011. 

Subject to consideration of the 

comments submitted, the Department 

intends to publish final regulations. 

ADDRESSES: You may submit comments, 

identified by the Regulatory Information 

Number (RIN) 0906–AA77, by any of the 

following methods: 

• Federal eRulemaking Portal: http:// 

www.regulations.gov. Follow the 

instructions for submitting comments. 

• E-mail: OQDComments@hrsa.gov. 

Include ‘‘RIN 0906–AA77’’ in the subject 

line of the message. 

• Mail: Correspondence should be 

marked ‘‘Health Center FTCA Program 

Regulation Comments’’ and mailed to: 

Office of Quality and Data, Bureau of 

Primary Health Care, Health Resources 

and Services Administration, U.S. 

Department of Health and Human 

Services, 5600 Fishers Lane, Room 15C– 

26, Rockville, Maryland 20857. 

Instructions: All submissions received 

must include the agency name and RIN 

for this rulemaking. All comments 

received will be available for public 

inspection and copying without charge 

at Parklawn Building, 5600 Fishers 

Lane, Room 15C–26, Rockville, 

Maryland 20857, weekdays (Federal 

holidays excepted) between the hours of 

8:30 a.m. and 5 p.m. 

FOR FURTHER INFORMATION CONTACT: 

Suma Nair, Director, Office of Quality 

and Data, Bureau of Primary Health 

Care, Health Resources and Services 

Administration, U.S. Department of 

Health and Human Services, 5600 

Fishers Lane, Room 15C–26, Rockville, 

Maryland 20857, Phone: (301) 594– 

0818. 

SUPPLEMENTARY INFORMATION: Section 

224(a) of the Public Health Service 

(PHS) Act (42 U.S.C. 233(a)) provides 

that the remedy against the United 

States provided under the Federal Tort 

Claims Act (FTCA) resulting from the 

performance of medical, surgical, dental 

or related functions by any 

commissioned officer or employee of 

the PHS while acting within the scope 

of his office or employment shall be 

exclusive of any other related civil 

action or proceeding. The Federally 

Supported Health Centers Assistance 

Act of 1992 (Pub. L. 102–501), as 

amended in 1995 (FSHCAA), provides 

that, subject to its provisions, certain 

entities receiving funds under section 

330 of the PHS Act, as well as any 

officers, governing board members, and 

employees, and certain contractors of 

these entities, shall be deemed for the 

purposes of medical malpractice 

liability to be employees of the PHS 

within the exclusive remedy provision 

of section 224(a) of the PHS Act. 

A final rule implementing Public Law 

102–501 was published in the Federal 

Register (60 FR 22530) on May 8, 1995, 

and added a new part 6 to 42 CFR 

chapter 1, subchapter A. This rule 

describes the eligible entities and the 

covered individuals who are or may be 

determined by the Secretary to be 

within the scope of the FTCA protection 

afforded by the Act. 

Section 6.6, also published in the May 

8, 1995 rule, describes acts and 

omissions that are covered by FSHCAA 

(covered activities or covered services). 

Subsection 6.6(d) restates the statutory 

criteria that may support a 

determination of coverage for services 

provided to individuals who are not 

patients of the covered entity. 

Subsection 6.6(e) provides examples 

of situations within the scope of 

subsection 6.6(d). Questions were 

raised, however, about the specific 

situations encompassed by 6.6(d) and 

6.6(e) and about the process for the 

Secretary to make the determinations 

provided by those subsections. 

HRSA decided that it would be 

impractical and burdensome to require 

a separate application and 

determination of coverage for certain 

situations described in the examples set 

forth in 6.6(e), as further discussed in 

the September 1995 Notice (60 FR 

49417). For those situations, the 

Department has set forth its 

determination that coverage is provided 

under 42 CFR 6.6(d) without the need 

for a separate application, so long as 

other requirements for coverage are met, 

such as a determination that the entity 

is a covered entity, a determination that 

the individual is a covered individual, 

and that the acts or omissions by those 

individuals occur within the scope of 

employment. 

HRSA proposes including the key text 

and examples of the September 1995 

Notice in 42 CFR 6.6(e), replacing the 

current regulatory text at 42 CFR 6.6(e). 

HRSA also proposes updating the 

‘‘Immunization Campaign’’ example to 

clarify that this covered situation 

includes events to immunize 

individuals against infectious illnesses 

and does not limit coverage to only 

childhood vaccinations. In addition, 

HRSA proposes adding the following 

additional new example as subsection 

6.6(e)(4) to set forth its determination of 

FTCA coverage for services to nonhealth center patients in certain 

individual emergency situations. This 

addition is expected to provide 

assurance of FTCA coverage in these 

situations and encourage reciprocal 

assistance by non-health center 

clinicians for health center patients in 

similar emergencies. 

We will consider comments on this 

proposed rule that are received within 

60 days of publication of this notice in 

the Federal Register. After the comment 

period closes, we will publish a final 

rule in the Federal Register. The 

document will include a discussion of 

any comments we receive and any 

changes. 

Federalism 

HRSA has analyzed this proposed 

rule in accordance with the principles 

set forth in Executive Order 13132. 

HRSA has determined that the proposed 

rule does not contain policies that have 

substantial direct effects on the States, 

on the relationship between the 

National Government and the States, or 

on the distribution of power and 

responsibilities among the various 

levels of government. Accordingly, 

HRSA has concluded that the proposed 

rule does not contain policies that have 

Federalism implications as defined in 

the Executive Order and, consequently, 

a Federalism summary impact statement 

is not required. 

Other Impacts 

HRSA has examined the impacts of 

the proposed rule under Executive 

Order 12866, the Regulatory Flexibility 

Act (5 U.S.C. 601–612), and the 

Unfunded Mandates Reform Act of 1995 

(Pub. L. 104–4). 

Executive Order 12866 directs 

agencies to assess all costs and benefits 

of available regulatory alternatives and, 

when regulation is necessary, to select 

regulatory approaches that maximize 

net benefits (including potential 

economic, environmental, public health 


srobinson on DSKHWCL6B1PROD with PROPOSALS
Federal Register / Vol. 76, No. 39 / Monday, February 28, 2011 / Proposed Rules 10827 

and safety, and other advantages; 

distributive impacts; and equity). HRSA 

believes that this proposed rule is not a 

significant regulatory action under the 

Executive Order. 

The Regulatory Flexibility Act 

requires agencies to analyze regulatory 

options that would minimize any 

significant impact of a rule on small 

entities. Because this proposed rule 

simply updates an existing regulation to 

add further details to the description of 

certain situations that are covered by the 

FTCA, and because such coverage is 

provided for under Federal law, HRSA 

certifies that the rule will not have a 

significant economic impact on a 

substantial number of small entities. 

Section 202(a) of the Unfunded 

Mandates Reform Act of 1995 requires 

that agencies prepare a written 

statement, which includes an 

assessment of anticipated costs and 

benefits, before proposing ‘‘any rule that 

includes any Federal mandate that may 

result in the expenditure by State, local, 

and Tribal governments, in the 

aggregate, or by the private sector, of 

$100,000,000 or more (adjusted 

annually for inflation) in any one year.’’ 

HRSA does not expect this proposed 

rule to result in any one-year 

expenditure that would meet or exceed 

this amount. 

Paperwork Reduction Act 

This rule does not contain any new 

information collection or recordkeeping 

requirements that fall under the 

purview of the Paperwork Reduction 

Act of 1995. The recordkeeping 

requirements contained in this rule are 

part of normal business practice and do 

not require the collection of new 

information or impose additional 

requirements beyond current routine 

practice. 

List of Subjects in 42 CFR Part 6 

Emergency medical services, Health 

care, Health facilities, Tort claims. 

Dated: May 27, 2010. 

Mary Wakefield, 

Administrator, Health Resources and Services 

Administration. 

Approved: January 24, 2011. 

Kathleen Sebelius, 

Secretary. 

For the reasons stated in the 

preamble, we are proposing to amend 42 

CFR part 6 as follows: 

PART 6—FEDERAL TORT CLAIMS 

ACT COVERAGE OF CERTAIN 

GRANTEES AND INDIVIDUALS 

1. The authority citation for part 6 

continues to read as follows: 

Authority: Sections 215 and 224 of the 

Public Health Service Act, 42 U.S.C. 216 and 

233. 

2. In § 6.6, revise paragraph (e) to read 

as follows: 

§ 6.6 Covered acts and omissions. 

* * * * * 

(e) For the specific activities 

described in this paragraph, when 

carried out by an entity that has been 

covered under paragraph (c) of this 

section, the Department has determined 

that coverage is provided under 

paragraph (d) of this section, without 

the need for specific application for a 

coverage determination under paragraph 

(d) of this section, if the activity or 

arrangement in question fits squarely 

within the examples of activities listed 

below; otherwise, the health center 

should seek a particularized 

determination of coverage under 

paragraph (d) of this section. 

(1) Community-Wide Interventions. (i) 

School-Based Clinics. Health center staff 

provide primary and preventive health 

care services at a facility located in a 

school or on school grounds. The health 

center has a written affiliation 

agreement with the school. 

(ii) School-Linked Clinics. Health 

center staff provide primary and 

preventive health care services, at a site 

not located on school grounds, to 

students of one or more schools. The 

health center has a written affiliation 

agreement with each school. 

(iii) Health Fairs. Health center staff 

conduct an event to attract community 

members for purposes of performing 

health assessments. Such events may be 

held in the health center, outside on its 

grounds, or elsewhere in the 

community. 

(iv) Immunization Campaigns. Health 

center staff conduct an event to 

immunize individuals against infectious 

illnesses. The event may be held at the 

health center, schools, or elsewhere in 

the community. 

(v) Migrant Camp Outreach. Health 

center staff travel to a migrant 

farmworker residence camp to conduct 

intake screening to determine those in 

need of clinic services (which may 

mean health care is provided at the time 

of such intake activity or during 

subsequent clinic staff visits to the 

camp). 

(vi) Homeless Outreach. Health center 

staff travel to a shelter for homeless 

persons, or a street location where 

homeless persons congregate, to 

conduct intake screening to determine 

those in need of clinic services (which 

may mean health care is provided at the 

time of such intake activity or during 

subsequent clinic staff visits to that 

location). 

(2) Hospital-Related Activities. 

Periodic hospital call or hospital 

emergency room coverage is required by 

the hospital as a condition for obtaining 

hospital admitting privileges. There 

must also be documentation for the 

particular health care provider that this 

coverage is a condition of employment 

at the health center. 

(3) Coverage-Related Activities. As 

part of a health center’s arrangement 

with local community providers for 

after-hours coverage of its patients, the 

health center’s providers are required by 

their employment contract to provide 

periodic or occasional cross-coverage for 

patients of these providers. 

(4) Coverage in Certain Individual 

Emergencies. A health center provider is 

providing or undertaking to provide 

covered services to a health center 

patient within the approved scope of 

project of the center, or to an individual 

who is not a patient of the health center 

under the conditions set forth in this 

rule, when the provider is then asked, 

called upon, or undertakes, at or near 

that location and as the result of a nonhealth center patient’s emergency 

situation, to temporarily treat or assist 

in treating that non-health center 

patient. In addition to any other 

documentation required for the original 

services, the health center must have 

documentation (such as employee 

manual provisions, health center 

bylaws, or an employee contract) that 

the provision of individual emergency 

treatment, when the practitioner is 

already providing or undertaking to 

provide covered services, is a condition 

of employment at the health center. 

[FR Doc. 2011–3439 Filed 2–25–11; 8:45 am] 

BILLING CODE 4160–15–P 

FEDERAL COMMUNICATIONS 

COMMISSION 

47 CFR Parts 1, 20, and 43 

[WCB: WC Docket Nos. 07–38, 09–190, 10– 

132, 11–10; FCC 11–14] 

Modernizing the FCC Form 477 Data 

Program 

AGENCY: Federal Communications 

Commission. 

ACTION: Notice of proposed rulemaking. 

SUMMARY: In this document, the 

Commission considers whether and 

how to reform the Form 477 data 

program, which serves as the 

Commission’s primary tool for 

collecting broadband and local 

telephone data. The Commission 


srobinson on DSKHWCL6B1PROD with PROPOSALS