Federal Register / Vol. 75, No. 243 / Monday, December 20, 2010 / Proposed Rules 79323 

cancer to the human consumer. For the 

purpose of § 500.84(c)(1), FDA will 

assume that this Sm will correspond to 

the concentration of residue in a 

specific edible tissue that corresponds 

to a maximum lifetime risk of cancer in 

the test animals of 1 in 1 million. 

So means the concentration of a 

residue of carcinogenic concern in the 

total human diet that represents no 

significant increase in the risk of cancer 

to the human consumer. For the 

purpose of § 500.84(c)(1), FDA will 

assume that this So will correspond to 

the concentration of test compound in 

the total diet of test animals that 

corresponds to a maximum lifetime risk 

of cancer in the test animals of 1 in 1 

million. 

* * * * * 

3. Revise the introductory text of 

paragraph (c) of § 500.84 to read as 

follows: 

§ 500.84 Conditions for approval of the 

sponsored compound. 

* * * * * 

(c) For each sponsored compound that 

FDA decides should be regulated as a 

carcinogen, FDA will either analyze the 

data from the bioassays using a 

statistical extrapolation procedure as 

outlined in paragraph (c)(1) of this 

section or evaluate an alternate 

procedure proposed by the sponsor as 

provided in § 500.90. In either case, 

paragraphs (c)(2) and (c)(3) of this 

section apply. 

* * * * * 

Dated: December 15, 2010. 

Leslie Kux, 

Acting Assistant Commissioner for Policy. 

[FR Doc. 2010–31887 Filed 12–17–10; 8:45 am] 

BILLING CODE 4160–01–P 

DEPARTMENT OF VETERANS 

AFFAIRS 

38 CFR Part 63 

RIN 2900–AN73 

Health Care for Homeless Veterans 

Program 

AGENCY: Department of Veterans Affairs. 

ACTION: Proposed rule. 

SUMMARY: This proposed rule would 

establish regulations for contracting 

with community-based treatment 

facilities in the Health Care for 

Homeless Veterans (HCHV) program of 

the Department of Veterans Affairs (VA). 

It would formalize VA’s policies and 

procedures in connection with this 

program, which is designed to assist 

certain homeless veterans in obtaining 

treatment from non-VA communitybased providers. It would also clarify 

that veterans with substance use 

disorders may qualify for the program. 

DATES: Comments on the proposed rule, 

including comments on the information 

collection provisions, must be received 

on or before February 18, 2011. 

ADDRESSES: Written comments may be 

submitted through http:// 

www.Regulations.gov; by mail or hand 

delivery to the Director, Regulations 

Management (02REG), Department of 

Veterans Affairs, 810 Vermont Ave., 

NW., Room 1068, Washington, DC 

20420; or by fax to 202–273–9026. 

Comments should indicate that they are 

submitted in response to ‘‘RIN 2900– 

AN73, Health Care for Homeless 

Veterans Program.’’ Copies of comments 

received will be available for public 

inspection in the Office of Regulation 

Policy and Management, Room 1063B, 

between the hours of 8 a.m. and 4:30 

p.m., Monday through Friday (except 

holidays). Please call (202) 461–4902 

(this is not a toll-free number) for an 

appointment. In addition, during the 

comment period, comments may be 

viewed online through the Federal 

Docket Management System (FDMS) at 

http://www.Regulations.gov. 

FOR FURTHER INFORMATION CONTACT: 

Robert Hallett, Healthcare for Homeless 

Veterans Manager, c/o Bedford VA 

Medical Center, 200 Springs Road, Bldg. 

12, Bedford, MA 01730; (781) 687–3187 

(this is not a toll free number). 

SUPPLEMENTARY INFORMATION: The 

HCHV program is authorized by 38 

U.S.C. 2031, under which VA may 

provide outreach as well as ‘‘care, 

treatment, and rehabilitative services 

(directly or by contract in communitybased treatment facilities, including 

halfway houses)’’ to ‘‘veterans suffering 

from serious mental illness, including 

veterans who are homeless.’’ One of 

VA’s national priorities is a renewed 

effort to end homelessness for veterans. 

For this reason, we are proposing to 

establish regulations that are consistent 

with the current administration of this 

program. 

The primary mission of the HCHV 

program is to use outreach efforts to 

contact and engage veterans who are 

homeless and suffering from serious 

mental illness or a substance use 

disorder. Many of the veterans for 

whom the HCHV program is designed 

have not previously used VA medical 

services or been enrolled in the VA 

health care system. 

Through the HCHV program, VA 

identifies homeless veterans with 

serious mental illness and/or substance 

use disorder, usually through medical 

intervention, and offers communitybased care to those whose conditions 

are determined, clinically, to be 

managed sufficiently that the 

individuals can participate in such care. 

We have assisted homeless veterans 

with substance use disorders through 

this program because, based on our 

practical understanding and experience, 

the vast majority of homeless veterans 

have substance use disorders. Treating 

substance use as a mental disorder is 

consistent with the generally accepted 

‘‘disease model’’ of alcoholism and drug 

addiction treatment, as well as the 

modern use of medical intervention to 

treat the condition. We believe that if a 

substance use disorder is a contributing 

cause of homelessness, then that 

disorder is serious; therefore, it is 

consistent to include such veterans in a 

program designed for ‘‘veterans suffering 

from serious mental illness, including 

veterans who are homeless.’’ 38 U.S.C. 

2031(a). 

Veterans who are identified and who 

choose to participate in this form of care 

as part of their treatment plan are then 

referred by VA to an appropriate nonVA community-based provider. In some 

cases, VA will continue to actively 

medically manage the veteran’s 

condition, while in other cases a VA 

clinician may determine that a veteran 

can be sufficiently managed through 

utilization of non-medical resources, 

such as 12-step programs. 

To provide the community-based 

care, VA contracts, via the HCHV 

program, with non-VA communitybased providers, such as halfway 

houses, to provide to these veterans 

housing and mental health and/or 

substance use disorder treatment. VA 

provides per diem payments to these 

non-VA community-based providers for 

the services provided to veterans. 

Service provision within these contracts 

is typically short-term, because during 

their stay veteran-participants are 

connected with other resources 

designed to provide longer-term 

housing. These contracts, and the per 

diem payment, are governed by the 

Federal Acquisition Regulations, and 

the VA supplements thereto contained 

in the Veterans Affairs Acquisition 

Regulations at chapter 8 of title 48, CFR. 

These are the rules that specifically 

govern requirements exclusive to VA 

contracting actions. 

We propose to establish a new 38 CFR 

part 63 for the HCHV program because 

the program is unique and the proposed 

rule would not apply to therapeutic 

housing or other VA programs designed 

to end homelessness. The primary 

purposes of this rulemaking are to 

establish eligibility criteria for veterans 


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and set forth the parameters for 

selection of non-VA community-based 

providers. In addition, the proposed 

rule would clarify that HCHV contract 

residential treatment may be provided 

to homeless veterans with substance use 

disorders, which, as discussed above, 

are serious mental disorders when they 

cause or contribute to homelessness. 

Finally, we note that the proposed rule 

would be consistent with VA’s overall, 

renewed efforts to end homelessness for 

our Nation’s veterans. 

After a general description of the 

purpose and scope of the HCHV 

program in proposed § 63.1, we would 

set forth in § 63.2 a few definitions 

applicable to these regulations. 

We would define a ‘‘clinician’’ as a 

physician, physician assistant, nurse 

practitioner, psychiatrist, psychologist, 

or other independent licensed 

practitioner. This is consistent with the 

common understanding of the term and 

with the definition set forth in 38 CFR 

70.2. 

We would define ‘‘homeless’’ 

consistent with 38 U.S.C. 2002(1), 

which defines a ‘‘homeless veteran’’ as 

‘‘a veteran who is homeless (as that term 

is defined in section 103(a) of the 

McKinney-Vento Homeless Assistance 

Act (42 U.S.C. 11302(a)).’’ Under 42 

U.S.C. 11302(a), ‘‘homeless’’ means ‘‘(1) 

an individual who lacks a fixed, regular, 

and adequate nighttime residence; and 

(2) an individual who has a primary 

nighttime residence that is (A) A 

supervised publicly or privately 

operated shelter designed to provide 

temporary living accommodations 

(including welfare hotels, congregate 

shelters, and transitional housing for the 

mentally ill); (B) an institution that 

provides a temporary residence for 

individuals intended to be 

institutionalized; or (C) a public or 

private place not designed for, or 

ordinarily used as, a regular sleeping 

accommodation for human beings.’’ We 

interpret section 2002(1) to mean 

Congress intended that, for purposes of 

VA benefits for homeless veterans, we 

would define ‘‘homeless’’ consistent 

with the homeless assistance statutes 

administered by the Department of 

Health and Human Services, to include 

any future amendment of the definition 

of ‘‘homeless’’ in section 11302(a). We 

therefore propose to define ‘‘homeless’’ 

by cross-referencing section 11302(a). 

In order to be eligible for the HCHV 

program, a veteran must have a serious 

mental illness and/or a substance use 

disorder. This is a clinical 

determination made in the veteran’s 

medical record. The condition must also 

be a cause, or potential cause, of the 

veteran’s homelessness. We propose to 

define ‘‘serious mental illness’’ and 

‘‘substance use disorder’’ as diagnosed 

illnesses that actually or potentially 

contribute to a veteran’s homelessness. 

By requiring a connection between a 

clinical diagnosis and homelessness, we 

intend to address only those disorders 

that cause or contribute to a veteran’s 

homelessness. This is consistent with 

the overall purpose of 38 U.S.C. 2031, 

and the focus of the HCHV program on 

eradicating the causes of homelessness. 

We would define ‘‘non-VA 

community-based provider’’ as ‘‘a 

facility in a community that provides 

temporary, short-term housing 

(generally up to 6 months) for the 

homeless, as well as services such as 

rehabilitation services, community 

outreach, and basic mental-health 

services.’’ This definition will cover the 

types of facilities that cater to the 

population served by the HCHV 

program. Persons who need long-term 

housing, or who are homeless but do not 

require services, are not targeted by this 

program. This definition is consistent 

with the use of this term in existing 

HCHV contracts. 

We would define ‘‘participant’’ as ‘‘an 

eligible veteran under § 63.3 for whom 

VA is paying per diem to a non-VA 

community-based provider.’’ This 

definition is logical because the term 

refers to veterans who are participating 

in the program. It is also consistent with 

the use of this term in existing HCHV 

contracts. 

Under § 63.3(a), we would premise 

eligibility for per diem payments on the 

non-VA community-based provider’s 

servicing of a veteran who is homeless, 

eligible for VA medical care, and has a 

serious mental illness or substance use 

disorder that is being clinically 

managed. A finding by a VA clinician 

that a veteran’s condition is clinically 

managed generally represents the 

determination that the condition is in a 

sufficiently stable and managed state to 

allow participation in the program. We 

would generally require that the veteran 

be enrolled in the VA health care 

system, but would not so require if the 

veteran is eligible for VA health care 

under 38 CFR 17.36 regarding care 

provided to veterans enrolled in the VA 

health care system or § 17.37 regarding 

care provided to veterans who are not 

enrolled in the system. Requiring that 

the veteran’s mental illness or substance 

use disorder be clinically managed is 

also consistent with the goals of the 

HCHV Program, as well as 38 U.S.C. 

2031, because non-VA communitybased providers are generally not 

equipped to deal with veterans who 

have acute, unstable, or untreated 

mental health issues. Generally, such 

veterans who are identified through 

HCHV outreach services should be 

treated or stabilized at facilities that 

emphasize medical treatment. 

In § 63.3(b), we would establish 

certain preferences. Because per diem 

funds are not unlimited, we need to 

ensure that these funds are used first to 

assist those veterans who we believe can 

benefit the most from the HCHV 

program. We would give first preference 

to veterans who are new to the VA 

health care system as a result of VA 

outreach, or who were referred by 

community outreach programs, because 

the HCHV program was established to 

help get these hard-to-reach populations 

actively involved in the VA health care 

system. 

Proposed § 63.3(c) clarifies that 

determinations of eligibility and priority 

are made by VA and not by non-VA 

community-based providers. 

In § 63.10, we would describe our 

method of selecting non-VA 

community-based providers. Under 

proposed paragraph (a), we would 

accept applications from facilities that 

‘‘provide temporary residential 

assistance for homeless persons with 

serious mental illness, and/or substance 

use disorders, and who can provide the 

specific services and meet the standards 

identified in § 63.15 and elsewhere in 

this part.’’ This statement conforms to 

the basic definition of a non-VA 

community-based provider that we 

propose in § 63.2. 

In § 63.10(b), we would establish that 

the general principles governing the 

award of VA contracts apply to the 

award of HCHV program contracts. 

Contracts awarded through the HCHV 

program are between VA and non-VA 

community-based providers for short 

periods of time, and usually do not 

involve large amounts of money. In this 

regard, these contracts are similar to 

contracts for outpatient services made 

under 38 CFR 17.81 and 17.82. Hence, 

paragraph (b) is similar to the contract 

requirements established in those 

sections. We also note that, under 

§ 63.15(a), the safety requirements 

applicable to non-VA community-based 

providers would be identical to those 

required under § 17.81. 

Paragraph (c) would establish the 

national standards for certain contract 

terms, but would allow for local, 

contract-specific rates and contractlengths. The per diem rate, under 

paragraph (c)(1), would be established 

in individual contracts, but would have 

to be ‘‘based on local community needs, 

standards, and practices.’’ This would 

allow local VA staff to seek competitive 

contracts, and to provide per diem at a 

rate comparable to what the facility 


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would expect to receive from a private 

entity. 

Paragraph (c)(2) would prescribe 

similar provisions regarding the length 

of time for which VA may pay per diem 

based on a specific veteran. We would 

provide that contracts should generally 

not authorize the payment of per diem 

for a single veteran for a period of longer 

than 6 months; however, this term will 

ultimately be subject to the needs of 

veterans in a specific community. 

Paragraph (c)(2) would simply attempt 

to provide guidance in this regard. 

In § 63.15, we propose to establish the 

duties of, and standards applicable to, 

non-VA community-based providers. 

These standards would also be set forth 

in specific contracts. Under the Federal 

Acquisition Regulations we have 

authority to require non-VA 

community-based providers to meet 

specified standards. These duties and 

standards are consistent with current 

practice in the HCHV program, and are 

generally standard industry practice for 

the types of non-VA community-based 

providers that would be affected by this 

rulemaking. Thus, most providers 

seeking per diem contracts would 

already meet these standards. 

Adherence to these standards is 

necessary to protect the health, safety, 

and rehabilitation of this vulnerable 

population of veterans. 

Because group activities and social 

and community interaction have been 

shown to be invaluable in the 

rehabilitation of those suffering from 

serious mental illnesses or substance 

use disorders, we would require that the 

programs of non-VA community-based 

providers include structured group 

activities in § 63.15(b)(1), an 

environment conducive to social 

interaction in § 63.15(c)(2), and a 

program which includes community 

involvement in § 63.15(c)(6). 

Because most veterans who qualify for 

this program will lack their own means 

of transportation, proposed § 63.15(c)(5) 

states that a facility in an area offering 

either public transportation or nearby 

employment that requires no transit will 

receive preference over facilities in 

more remote locations. 

In order to ensure that the standards 

outlined in § 63.15 are adhered to, 

paragraph (e) would provide for 

inspections, without prior notice, of 

facilities to receive the per-diem 

payment both prior to the contract 

period and during performance. Any 

failure to meet the standards in § 63.15 

must be remedied to the satisfaction of 

the inspector before a contract may be 

awarded or renewed. 

Paperwork Reduction Act 

This proposed rule includes a 

provision, § 63.15(e)(3), which 

constitutes a collection of information 

under the Paperwork Reduction Act (44 

U.S.C. 3501–3521) that requires 

approval by the Office of Management 

and Budget (OMB). Accordingly, under 

section 3507(d) of the Act, VA has 

submitted a copy of this rulemaking to 

OMB for review. OMB assigns a control 

number for each collection of 

information it approves. Except for 

emergency approvals under 44 U.S.C. 

3507(j), VA may not conduct or sponsor, 

and a person is not required to respond 

to, a collection of information unless it 

displays a currently valid OMB control 

number. If OMB does not approve the 

collection of information as requested, 

VA will immediately remove the 

provision containing a collection of 

information or take such other action as 

is directed by OMB. 

Comments on the collection of 

information contained in this proposed 

rule should be submitted to the Office 

of Management and Budget, Attention: 

Desk Officer for the Department of 

Veterans Affairs, Office of Information 

and Regulatory Affairs, Washington, DC 

20503, with copies sent by mail or hand 

delivery to: Director, Office of 

Regulation Policy and Management 

(02REG), Department of Veterans 

Affairs, 810 Vermont Ave., NW., Room 

1068, Washington, DC 20420; fax to 

(202) 273–9026; or through http:// 

www.Regulations.gov. Comments 

should indicate that they are submitted 

in response to ‘‘RIN 2900–AN73, Health 

Care for Homeless Veterans Program.’’ 

OMB is required to make a decision 

concerning the collection of information 

contained in this proposed rule between 

30 and 60 days after publication of this 

document in the Federal Register. 

Therefore, a comment to OMB is best 

assured of having its full effect if OMB 

receives it within 30 days of 

publication. This does not affect the 

deadline for the public to comment on 

the proposed rule. 

VA considers comments by the public 

on proposed collections of information 

in— 

• Evaluating whether the proposed 

collections of information are necessary 

for the proper performance of the 

functions of VA, including whether the 

information will have practical utility; 

• Evaluating the accuracy of VA’s 

estimate of the burden of the proposed 

collections of information, including the 

validity of the methodology and 

assumptions used; 

• Enhancing the quality, usefulness, 

and clarity of the information to be 

collected; and 

• Minimizing the burden of the 

collections of information on those who 

are to respond, including through the 

use of appropriate automated, 

electronic, mechanical, or other 

technological collection techniques or 

other forms of information technology, 

e.g., permitting electronic submission of 

responses. 

The proposed amendments to title 38, 

CFR chapter I contain a collection of 

information under the Paperwork 

Reduction Act for which we are 

requesting approval by OMB. This 

collection of information is described 

immediately following this paragraph. 

Title: HCHV program. 

Summary of collection of information: 

The proposed rule at § 63.15(e)(3) 

requires the facility to keep, and provide 

to VA facility inspectors, documentary 

evidence sufficient to verify that the 

facility meets the applicable standards 

of part 63. 

Description of the need for 

information and proposed use of 

information: This information is needed 

for VA to evaluate the facilities and 

programs of non-VA community-based 

providers and determine whether the 

requirements of this part are met. 

Description of likely respondents: 

Non-VA community-based providers. 

Estimated number of respondents per 

year: Approximately 300 non-VA 

community-based providers, as, 

historically, each VA Medical Center 

awards two contracts per year. 

Estimated frequency of responses per 

year: 1. 

Estimated total annual reporting and 

recordkeeping burden: For non-VA 

community-based providers, 150 hours. 

Executive Order 12866 

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 

and safety, and other advantages; 

distributive impacts; and equity). The 

Executive Order classifies a ‘‘significant 

regulatory action,’’ requiring review by 

OMB unless OMB waives such a review, 

as any regulatory action that is likely to 

result in a rule that may: (1) Have an 

annual effect on the economy of $100 

million or more, or adversely affect in 

a material way the economy, a sector of 

the economy, productivity, competition, 

jobs, the environment, public health or 

safety, or State, local, or Tribal 

governments or communities; (2) create 


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a serious inconsistency or otherwise 

interfere with an action planned or 

taken by another agency; (3) materially 

alter the budgetary impact of 

entitlements, grants, user fees or loan 

programs or the rights and obligations of 

recipients thereof; or (4) raise novel 

legal or policy issues arising out of legal 

mandates, the President’s priorities, or 

the principles set forth in the Executive 

Order. 

The economic, interagency, economic, 

legal, and policy implications of this 

proposed rule have been examined and 

it has been determined to not be a 

significant regulatory action under 

Executive Order 12866. 

Regulatory Flexibility Act 

The Secretary hereby certifies that 

this proposed regulatory amendment 

would not have a significant economic 

impact on a substantial number of small 

entities as they are defined in the 

Regulatory Flexibility Act, 5 U.S.C. 601– 

612. This proposed amendment would 

not cause a significant economic impact 

on health care providers, suppliers, or 

similar entities since only a small 

portion of the business of affected 

entities concerns VA beneficiaries. 

Therefore, pursuant to 5 U.S.C. 605(b), 

this proposed amendment is exempt 

from the initial and final regulatory 

flexibility analysis requirements of 

sections 603 and 604. 

Unfunded Mandates 

The Unfunded Mandates Reform Act 

requires, at 2 U.S.C. 1532, that agencies 

prepare an assessment of anticipated 

costs and benefits before issuing any 

proposed rule that may result in an 

expenditure by State, local, and Tribal 

governments, in the aggregate, or by the 

private sector of $100 million or more 

(adjusted annually for inflation) in any 

given year. This proposed rule would 

have no such effect on State, local, and 

Tribal governments, or on the private 

sector. 

Catalog of Federal Domestic Assistance 

Program 

The Catalog of Federal Domestic 

Assistance numbers and titles for the 

programs affected by this document are: 

64.007, Blind Rehabilitation Centers; 

64.009, Veterans Medical Care Benefits; 

64.019, Veterans Rehabilitation Alcohol 

and Drug Dependence. 

Signing Authority 

The Secretary of Veterans Affairs, or 

designee, approved this document and 

authorized the undersigned to sign and 

submit the document to the Office of the 

Federal Register for publication 

electronically as an official document of 

the Department of Veterans Affairs. John 

R. Gingrich, Chief of Staff, Department 

of Veterans Affairs, approved this 

document on December 10, 2010, for 

publication. 

List of Subjects in 38 CFR Part 63 

Administrative practice and 

procedure, Day care, Disability benefits, 

Government contracts, Health care, 

Homeless, Housing, Individuals with 

disabilities, Low and moderate income 

housing, Public assistance programs, 

Public housing, Relocation assistance, 

Reporting and recordkeeping 

requirements, Veterans. 

Dated: December 14, 2010. 

Robert C. McFetridge, 

Director, Regulation Policy and Management, 

Office of the General Counsel, Department 

of Veterans Affairs. 

For the reasons stated in the 

preamble, VA proposes to amend 38 

CFR chapter I to add a new part 63 to 

read as follows: 

PART 63—HEALTH CARE FOR 

HOMELESS VETERANS (HCHV) 

PROGRAM 

Sec. 

63.1 Purpose and scope. 

63.2 Definitions. 

63.3 Eligible veterans. 

63.10 Selection of non-VA communitybased providers. 

63.15 Duties of, and standards applicable 

to, non-VA community-based providers. 

Authority: 38 U.S.C. 501, 2031, and as 

noted in specific sections. 

§ 63.1 Purpose and scope. 

This part implements the Health Care 

for Homeless Veterans (HCHV) Program. 

This program provides per diem 

payments to non-VA community-based 

facilities that provide housing, as well 

as care, treatment and/or rehabilitative 

services, to homeless veterans who are 

seriously mentally ill or have a 

substance use disorder. 

(Authority: 38 U.S.C. 501, 2031(a)(2)) 

§ 63.2 Definitions. 

For the purposes of this part: 

Clinician means a physician, 

physician assistant, nurse practitioner, 

psychiatrist, psychologist, or other 

independent licensed practitioner. 

Homeless has the meaning given that 

term in section 103 of the McKinneyVento Homeless Assistance Act (42 

U.S.C. 11302(a)). 

Non-VA community-based provider 

means a facility in a community that 

provides temporary, short-term housing 

(generally up to 6 months) for the 

homeless, as well as services such as 

rehabilitation services, community 

outreach, and basic mental-health 

services. 

Participant means an eligible veteran 

under § 63.3 for whom VA is paying per 

diem to a non-VA community-based 

provider. 

Serious mental illness means 

diagnosed mental illness that actually or 

potentially contributes to a veteran’s 

homelessness. 

Substance use disorder means 

alcoholism or addiction to a drug that 

actually or potentially contributes to a 

veteran’s homelessness. 

(Authority: 501, 2002, 2031) 

§ 63.3 Eligible veterans. 

(a) Eligibility. In order to serve as the 

basis for a per diem payment through 

the HCHV program, a veteran served by 

the non-VA community-based provider 

must be: 

(1) Homeless; 

(2) Enrolled in the VA health care 

system, or eligible for VA health care 

under 38 CFR 17.36 or 17.37; and 

(3) Have a serious mental illness and/ 

or substance use disorder, 

(i) That has been diagnosed by a VA 

clinician, 

(ii) Is ‘‘clinically managed’’ as 

determined by a VA clinician (clinical 

management of a condition may be 

achieved through non-medical 

intervention such as participation in a 

12-step program), and 

(iii) Impacts the veteran’s ability for 

self-care and/or management of 

financial affairs as determined by a VA 

caseworker (i.e., a clinician, social 

worker, or addiction specialist). 

(b) Priority veterans. In allocating 

HCHV program resources, VA will give 

priority to veterans, in the following 

order, who: 

(1) Are new to the VA health care 

system as a result of VA outreach 

efforts, and to those referred to VA by 

community agencies that primarily 

serve the homeless population, such as 

shelters, homeless day centers, and soup 

kitchens. 

(2) Have service-connected 

disabilities. 

(3) All other veterans. 

(c) VA will refer a veteran to a nonVA community-based provider after VA 

determines the veteran’s eligibility and 

priority. 

(Authority: 501, 2031) 

§ 63.10 Selection of non-VA communitybased providers. 

(a) Who can apply. VA may award per 

diem contracts to non-VA communitybased providers who provide temporary 

residential assistance for homeless 

persons with serious mental illness, 

and/or substance use disorders, and 


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who can provide the specific services 

and meet the standards identified in 

§ 63.15 and elsewhere in this part. 

(b) Awarding contracts. Contracts for 

services authorized under this section 

will be awarded in accordance with 

applicable VA and Federal procurement 

procedures in 48 CFR chapter 8. Such 

contracts will be awarded only after the 

quality, effectiveness and safety of the 

applicant’s program and facilities have 

been ascertained to VA’s satisfaction, 

and then only to applicants determined 

by VA to meet the requirements of this 

part. 

(c) Per diem rates and duration of 

contract periods. 

(1) Per diem rates are to be negotiated 

as a contract term between VA and the 

non-VA community-based provider; 

however, the negotiated rate must be 

based on local community needs, 

standards, and practices. 

(2) Contracts with non-VA 

community-based providers will 

establish the length of time for which 

VA may pay per diem based on an 

individual veteran; however, VA will 

not authorize the payment of per diem 

for an individual veteran for a period of 

more than 6 months absent 

extraordinary circumstances. 

(Authority: 38 U.S.C. 501, 2031) 

§ 63.15 Duties of, and standards 

applicable to, non-VA community-based 

providers. 

A non-VA community-based provider 

must meet all of the standards and 

provide the appropriate services 

identified in this section, as well as any 

additional requirements set forth in a 

specific contract. 

(a) Facility safety requirements. The 

facility must meet all applicable safety 

requirements set forth in 38 CFR 

17.81(a). 

(b) Treatment plans and therapeutic/ 

rehabilitative services. Individualized 

treatment plans are to be developed 

through a joint effort of the veteran, 

non-VA community-based provider staff 

and VA clinical staff. Therapeutic and 

rehabilitative services must be provided 

by the non-VA community-based 

provider as described in the treatment 

plan. In some cases, VA may 

complement the non-VA communitybased provider’s program with added 

treatment services such as participation 

in VA outpatient programs. Services 

provided by the non-VA communitybased provider generally should 

include, as appropriate: 

(1) Structured group activities such as 

group therapy, social skills training selfhelp group meetings or peer counseling. 

(2) Professional counseling, including 

counseling on self care skills, adaptive 

coping skills and, as appropriate, 

vocational rehabilitation counseling, in 

collaboration with VA programs and 

community resources. 

(c) Quality of life, room and board. 

(1) The non-VA community-based 

provider must provide residential room 

and board in an environment that 

promotes a lifestyle free of substance 

abuse. 

(2) The environment must be 

conducive to social interaction, 

supportive of recovery models and the 

fullest development of the resident’s 

rehabilitative potential. 

(3) Residents must be assisted in 

maintaining an acceptable level of 

personal hygiene and grooming. 

(4) Residential programs must provide 

laundry facilities. 

(5) VA will give preference to 

facilities located close to public 

transportation and/or areas that provide 

employment. 

(6) The program must promote 

community interaction, as demonstrated 

by the nature of scheduled activities or 

by information about resident 

involvement with community activities, 

volunteers, and local consumer services. 

(7) Adequate meals must be provided 

in a setting that encourages social 

interaction; nutritious snacks between 

meals and before bedtime must be 

available. 

(d) Staffing. The non-VA communitybased provider must employ sufficient 

professional staff and other personnel to 

carry out the policies and procedures of 

the program. There will be at a 

minimum, an employee on duty on the 

premises, or residing at the program and 

available for emergencies, 24 hours a 

day, 7 days a week. Staff interaction 

with residents should convey an 

attitude of genuine concern and caring. 

(e) Inspections. (1) VA must be 

permitted to conduct an initial 

inspection prior to the award of the 

contract and follow-up inspections of 

the non-VA community-based 

provider’s facility and records. At 

inspections, the non-VA communitybased provider must make available the 

documentation described in paragraph 

(e)(3) of this section. 

(2) If problems are identified as a 

result of an inspection, VA will 

establish a plan of correction and 

schedule a follow-up inspection to 

ensure that the problems are corrected. 

Contracts will not be awarded or 

renewed until noted deficiencies have 

been eliminated to the satisfaction of the 

inspector. 

(3) Non-VA community-based 

providers must keep sufficient 

documentation to support a finding that 

they comply with this section, including 

accurate records of participants’ lengths 

of stay, and these records must be made 

available at all VA inspections. 

(4) Inspections under this section may 

be conducted without prior notice. 

(f) Rights of veteran participants. The 

non-VA community-based provider 

must comply with all applicable 

patients’ rights provisions set forth in 38 

CFR 17.33. 

(g) Services and supplies. VA per 

diem payments under this part will 

include the services specified in the 

contract and any other services or 

supplies normally provided without 

extra charge to other participants in the 

non-VA community-based provider’s 

program. 

(Authority: 38 U.S.C. 501, 2031) 

(The Office of Management and Budget has 

approved the information collection 

requirement in this section under control 

number 2900–0091.) 

[FR Doc. 2010–31780 Filed 12–17–10; 8:45 am] 

BILLING CODE 8320–01–P 

ENVIRONMENTAL PROTECTION 

AGENCY 

40 CFR Part 52 

[EPA–R08–OAR–2010–0909; FRL–9240–9] 

Finding of Substantial Inadequacy of 

Implementation Plan; Call for Utah 

State Implementation Plan Revision 

AGENCY: Environmental Protection 

Agency (EPA). 

ACTION: Proposed rule; extension of the 

comment period. 

SUMMARY: EPA is extending the 

comment period for a document 

published on November 19, 2010 (75 FR 

70888). In the November 19, 2010 

document, EPA proposed a finding that 

the Utah State Implementation Plan 

(SIP) is substantially inadequate to 

attain or maintain the national ambient 

air quality standards (NAAQS) or to 

otherwise comply with the requirements 

of the Clean Air Act (CAA), based on 

Utah’s rule R307–107, which exempts 

emissions during unavoidable 

breakdowns from compliance with 

emission limitations. At the request of 

several commentors, EPA is extending 

the comment period through January 3, 

2011. 

DATES: Comments must be received on 

or before January 3, 2011. 

ADDRESSES: Submit your comments, 

identified by Docket ID No. EPA–R08– 

OAR–2010–0909, by one of the 

following methods: 

• http://www.regulations.gov. Follow 

the on-line instructions for submitting 

comments. 


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