Federal Register / Vol. 75, No. 124 / Tuesday, June 29, 2010 / Notices 37463 

FOR FURTHER INFORMATION CONTACT: John 

Maounis, Captain John Smith 

Chesapeake National Historic Trail, 

National Park Service, 410 Severn 

Avenue, Suite 314, Annapolis, MD 

21403, 410–260–2473. 

Dated: May 13, 2010. 

John Maounis, 

Superintendent, Captain John Smith 

Chesapeake National Historic Trail. 

[FR Doc. 2010–15725 Filed 6–28–10; 8:45 am] 

BILLING CODE P 

DEPARTMENT OF THE INTERIOR 

National Park Service 

Official Trail Marker for the StarSpangled Banner National Historic 

Trail 

AGENCY: National Parks Service, 

Interior. 

ACTION: Official Insignia, Designation. 

Authority: National Trails System Act, 16 

U.S.C. 124(a) and 1246(c) and Protection of 

Official Badges, insignia, etc. in 18 U.S.C. 

701. 

SUMMARY: This notice issues the official 

trail marker insignia of the StarSpangled Banner National Historic 

Trail. The insignia for this trail was 

completed in August 2008 after the Trail 

was designated. It first came into public 

use in 2008. The National Park Service 

uses this insignia to mark the Trail’s 

route. This publication accomplishes 

the official designation of the insignia in 

use by the National Park Service. 

SUPPLEMENTARY INFORMATION: The 

primary author of this document is John 

Maounis, Superintendent, StarSpangled Banner National Historic 

Trail. The insignia depicted below is 

prescribed as the official trail marker for 

the Star-Spangled Banner National 

Historic Trail, administered by the 

National Park Service, Chesapeake Bay 

Office, Annapolis, Maryland. 

Authorization for use of this trail marker 

is controlled by the administrator of the 

Trail. 

In making this prescription, notice is 

hereby given that whoever 

manufactures, sells or possesses these 

insignia or any colorable imitation 

thereof, or photographs or prints or in 

any other manner makes or executes any 

engraving, photograph or print, or 

impression in the likeness of this 

insignia, or any colorable imitation 

thereof, without written authorization 

from the United States Department of 

the Interior is subject to the penalty 

provisions of section 701 of Title 18 of 

the United States Code. 

FOR FURTHER INFORMATION CONTACT: John 

Maounis, Star-Spangled Banner 

National Historic Trail, National Park 

Service, 410 Severn Avenue, Suite 314, 

Annapolis, MD 21403, 410–260–2473. 

Dated: May 13, 2010. 

John Maounis, 

Superintendent, Star-Spangled Banner 

National Historic Trail. 

[FR Doc. 2010–15727 Filed 6–28–10; 8:45 am] 

BILLING CODE P 

INTERNATIONAL TRADE 

COMMISSION 

[USITC SE–10–023] 

Government in the Sunshine Act 

Meeting Notice 

AGENCY HOLDING THE MEETING: United 

States International Trade Commission. 

TIME AND DATE: July 1, 2010 at 10 a.m. 

PLACE: Room 101, 500 E Street, SW., 

Washington, DC 20436, Telephone: 

(202) 205–2000. 

STATUS: Open to the public. 

Matters To Be Considered 

1. Agenda for future meetings: None. 

2. Minutes. 

3. Ratification List. 

4. Inv. Nos. 701–TA–466 and 731– 

TA–1162 (Final)(Wire Decking from 

China)—briefing and vote. (The 

Commission is currently scheduled to 

transmit its determinations and 

Commissioners’ opinions to the 

Secretary of Commerce on or before July 

26, 2010.) 

5. Outstanding action jackets: None. 

In accordance with Commission 

policy, subject matter listed above, not 

disposed of at the scheduled meeting, 

may be carried over to the agenda of the 

following meeting. 

By order of the Commission: 

Issued: June 24, 2010. 

William R. Bishop, 

Hearings and Meetings Coordinator. 

[FR Doc. 2010–15804 Filed 6–25–10; 11:15 am] 

BILLING CODE 7020–02–P 

DEPARTMENT OF JUSTICE 

Drug Enforcement Administration 

[Docket No. DEA–337N] 

Dispensing of Controlled Substances 

to Residents at Long Term Care 

Facilities 

AGENCY: Drug Enforcement 

Administration (DEA), Department of 

Justice. 

ACTION: Notice; solicitation of 

information. 


emcdonald on DSK2BSOYB1PROD with NOTICES4EN29JN10.063</GPH>
37464 Federal Register / Vol. 75, No. 124 / Tuesday, June 29, 2010 / Notices 

SUMMARY: To analyze ongoing issues 

related to the dispensing of controlled 

substances to residents residing at long 

term care facilities (LTCFs), DEA is 

soliciting information on this subject 

from practitioners, pharmacists, LTCFs, 

nurses, residents and family of residents 

in long term care facilities, State 

regulatory agencies, and other interested 

members of the public. Specifically, 

DEA is exploring whether—while 

adhering to the framework of the 

Controlled Substances Act—any further 

revisions to the DEA regulations are 

feasible and warranted toward the goal 

of making it easier for residents of 

LTCFs to receive controlled substance 

medications. This notice recites the 

pertinent statutory considerations and 

contains a series of questions designed 

to elicit public comment that will assist 

DEA in making this evaluation. 

DATES: Written comments must be 

postmarked and electronic comments 

must be submitted on or before August 

30, 2010. Commenters should be aware 

that the electronic Federal Docket 

Management System will not accept 

comments after midnight Eastern Time 

on the last day of the comment period. 

ADDRESSES: To ensure proper handling 

of comments, please reference ‘‘Docket 

No. DEA–337’’ on all written and 

electronic correspondence. Written 

comments being sent via regular or 

express mail should be sent to the Drug 

Enforcement Administration, Attention: 

DEA Federal Register Representative/ 

ODL, 8701 Morrissette Drive, 

Springfield, VA 22152. Comments may 

be sent to DEA by sending an electronic 

message to 

dea.diversion.policy@usdoj.gov. DEA 

will accept attachments to electronic 

comments in Microsoft Word, 

WordPerfect, Adobe PDF, or Excel file 

formats only. DEA will not accept any 

file formats other than those specifically 

listed here. 

Please note that DEA is requesting 

that electronic comments be submitted 

before midnight Eastern Time on the 

day the comment period closes because 

http://www.regulations.gov terminates 

the public’s ability to submit comments 

at midnight Eastern Time on the day the 

comment period closes. Commenters in 

time zones other than Eastern Time may 

want to consider this so that their 

electronic comments are received. All 

comments sent via regular or express 

mail will be considered timely if 

postmarked on the day the comment 

period closes. 

FOR FURTHER INFORMATION CONTACT: 

Mark W. Caverly, Chief, Liaison and 

Policy Section, Office of Diversion 

Control, Drug Enforcement 

Administration, 8701 Morrissette Drive, 

Springfield, VA 22152; telephone: (202) 

307–7297. 

SUPPLEMENTARY INFORMATION: 

Posting of Public Comments: Please 

note that all comments received are 

considered part of the public record and 

made available for public inspection 

online at http://www.regulations.gov 

and in the Drug Enforcement 

Administration’s public docket. Such 

information includes personal 

identifying information (such as your 

name, address, etc.) voluntarily 

submitted by the commenter. 

If you want to submit personal 

identifying information (such as your 

name, address, etc.) as part of your 

comment, but do not want it to be 

posted online or made available in the 

public docket, you must include the 

phrase ‘‘PERSONAL IDENTIFYING 

INFORMATION’’ in the first paragraph 

of your comment. You must also place 

all the personal identifying information 

you do not want posted online or made 

available in the public docket in the first 

paragraph of your comment and identify 

what information you want redacted. 

If you want to submit confidential 

business information as part of your 

comment, but do not want it to be 

posted online or made available in the 

public docket, you must include the 

phrase ‘‘CONFIDENTIAL BUSINESS 

INFORMATION’’ in the first paragraph 

of your comment. You must also 

prominently identify confidential 

business information to be redacted 

within the comment. If a comment has 

so much confidential business 

information that it cannot be effectively 

redacted, all or part of that comment 

may not be posted online or made 

available in the public docket. 

Personal identifying information and 

confidential business information 

identified and located as set forth above 

will be redacted and the comment, in 

redacted form, will be posted online and 

placed in the Drug Enforcement 

Administration’s public docket file. 

Please note that the Freedom of 

Information Act applies to all comments 

received. If you wish to inspect the 

agency’s public docket file in person by 

appointment, please see the FOR

FURTHER INFORMATION CONTACT

paragraph. 

Background 

In enacting the Controlled Substances 

Act (CSA) in 1970, Congress recognized 

at the outset of the Act that while 

‘‘[m]any of the drugs included with [the 

Act] have a useful and legitimate 

medical purpose and are necessary to 

maintain the health and general welfare 

of the American people, * * * [t]he 

illegal * * * distribution, and 

possession and improper use of 

controlled substances have a substantial 

and detrimental impact on the health 

and general welfare of the American 

people.’’ 21 U.S.C. 801. To minimize the 

likelihood that pharmaceutical 

controlled substances would be diverted 

into illicit channels, Congress 

established under the CSA a ‘‘closed 

system of drug distribution’’ for 

legitimate handlers of controlled 

substances. This system is comprised of 

a series of statutory provisions designed 

to ensure that all persons in the 

legitimate distribution chain are 

registered and keep records with respect 

to all transfers of controlled substances. 

Another key element of the CSA 

regulatory scheme is the requirement 

(first established under Federal law in 

1914) that controlled substances only be 

dispensed for a legitimate medical 

purpose by DEA-registered practitioners 

acting in the usual course of their 

professional practice. 

As the agency responsible for 

enforcing the CSA and administering 

the regulatory provisions of the Act, 

DEA has continually sought to 

reevaluate the regulations within the 

statutory framework. That is, any DEA 

regulation must maintain the statutory 

requirements of the CSA. Also, 

whenever DEA is evaluating whether to 

revise the regulations, the agency must 

take into account the dual aims of 

facilitating the delivery of controlled 

substance medications to patients for 

legitimate medical purposes and 

safeguarding against the diversion of 

these drugs into illicit channels. 

Controlled Substances 

DEA regulates controlled substances 

which account for between 10 percent 

and 11 percent of all prescriptions 

written in the United States. Controlled 

substances are drugs and other 

substances that have a potential for 

abuse and psychological and physical 

dependence; these include opioids, 

stimulants, depressants, hallucinogens, 

anabolic steroids, and drugs that are 

immediate precursors of these classes of 

substances. The CSA and implementing 

regulations at 21 CFR 1308 list 

controlled substances and place them in 

five schedules based on whether they 

have an accepted medical use in the 

United States and their relative abuse 

potential and likelihood of causing 

dependence when abused. The degree of 

restriction under the CSA depends upon 

the schedule of a given controlled 

substance. The intent of the statute and 

regulations is to protect the public 

health and safety by ensuring that there 

is a sufficient supply of controlled 


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Federal Register / Vol. 75, No. 124 / Tuesday, June 29, 2010 / Notices 37465 

substances for medical, scientific, and 

other legitimate purposes while 

preventing and deterring the diversion 

of controlled substances to illegal 

purposes. 

Schedule I substances have a high 

potential for abuse and have no 

accepted medical use in treatment in the 

United States. 21 U.S.C. 812(b)(1). These 

substances may only be used for 

research, chemical analysis, or 

manufacture of other drugs. Schedule II 

controlled substances have accepted 

medical use in treatment in the United 

States while having a high potential for 

abuse and having the greatest potential 

for physical and psychological 

dependence of the FDA-approved 

pharmaceutical controlled substances. 

21 U.S.C. 812(b)(2). For this reason, 

Schedule II controlled substances are 

subject to the highest levels of controls 

among FDA-approved controlled 

substances. Examples of schedule II 

narcotics include morphine, codeine, 

and opium. Some common brand names 

include hydromorphone (Dilaudid®), 

methadone (Dolophine®), meperidine 

(Demerol®), oxycodone (OxyContin®), 

and fentanyl (Sublimaze® or 

Duragesic®). Schedule II narcotics are 

commonly prescribed for the treatment 

of moderate to severe pain. 

Controlled substances in Schedules 

III–V have an accepted medical use in 

the United States and have a lower 

dependence and abuse potential than 

Schedule II substances. 21 U.S.C. 

812(b)(3), (4), (5). Thus, the statutory 

and regulatory restrictions on Schedule 

III–V substances, while significant, are 

not as extensive as those for Schedule 

II substances. Examples of schedule III 

narcotics include combination products 

containing less than 15 milligrams of 

hydrocodone per dosage unit (Vicodin®, 

Lorcet®, and Lortab®) and products 

containing not more than 90 milligrams 

of codeine per dosage unit (i.e., Tylenol 

with codeine®). Schedule III narcotics 

are commonly prescribed for moderate 

pain. Substances in this schedule have 

a lower potential for abuse relative to 

substances in Schedule II. 

Examples of Schedule IV substances 

include propoxyphene (Darvon® and 

Darvocet-N 100®), alprazolam (Xanax®), 

clonazepam (Klonopin®), and triazolam 

(Halcion®). Examples of Schedule V 

substances are cough preparations 

containing not more than 200 

milligrams of codeine per 100 milliliters 

or per 100 grams (Robitussin AC®, and 

Phenergan with Codeine®). 

Long Term Care Facilities 

With specific regard to nursing homes 

and other Long Term Care Facilities 

(LTCFs), DEA has made a number of 

revisions to the regulations over the 

years to make it easier for residents of 

these facilities to receive controlled 

substance medications, including the 

following: 

• For schedule II controlled 

substances, a practitioner or a 

practitioner’s agent may fax to a 

pharmacy a prescription written by the 

practitioner for a LTCF resident. 21 CFR 

1306.11(f). This accommodation 

obviates the need to physically deliver 

a hard copy of the original written 

prescription to the pharmacy. It should 

be noted that allowance for faxing 

prescriptions for schedule II controlled 

substances is not permissible as a 

general rule in non-LTCF settings. 

• Pharmacies may install at a LTCF 

(but in no other setting) an automated 

dispensing system (ADS). 21 CFR 

1301.27. As with all dispensing of 

controlled substances by pharmacies, 

such dispensing must still be pursuant 

to valid prescription, but these 

machines can alleviate certain burdens 

in the LTCF setting by placing the 

supply of controlled substances directly 

on site for convenient dispensing to a 

resident. Once a pharmacy receives a 

valid prescription issued by the 

practitioner, the pharmacy initiates the 

release of the prescribed drugs from the 

automated dispensing system at the 

LTCF by remotely entering a code. 

Thereafter, a practitioner or authorized 

nurse at the LTCF enters another code 

that completes release of the drugs from 

the machine. In this manner, 

pharmacies may, in their discretion, 

dispense small amounts of the drugs 

(e.g., daily doses) rather than the entire 

amount indicated on the prescription at 

one time. The automated dispensing 

systems may be used in both emergency 

and nonemergency situations. The 

automated dispensing systems thereby 

provide at least two benefits: (1) They 

allow for immediate dispensing of 

controlled substances in emergency 

situations and (2) they help to prevent 

accumulation of unused medications at 

the LTCF. 

• The regulations make a special 

allowance in the LTCF setting for partial 

filling by pharmacists of prescriptions 

for schedule II controlled substances. 21 

CFR 1306.13(b). Under this provision, 

where the patient is a resident of a LTCF 

(or is terminally ill), such partial filling 

may occur as long as the amount 

dispensed does not exceed the total 

prescribed and occurs within 60 days of 

the date that the prescription was 

written. This lessens the extent to which 

LTCFs accumulate unused controlled 

substances. 

• Although the CSA prohibits the 

refilling of prescriptions for schedule II 

controlled substances (21 U.S.C. 829(a)), 

DEA has issued a regulation that allows 

practitioners to issue multiple 

sequential prescriptions authorizing a 

patient to receive up to a 90-day supply 

for these substances. 21 CFR 1306.12. 

This accommodation applies to all 

practitioners, not just those with 

patients in LTCFs, but it can be 

particularly useful in the LTCF setting 

where physicians sometimes visit the 

residents only once every 30 or 60 days. 

• To facilitate the dispensing of 

controlled substances in emergencies, 

DEA has allowed pharmacies to place in 

LTCFs ‘‘emergency kits’’ that are 

routinely stocked with commonly 

dispensed controlled substances (45 FR 

24128, April 9, 1980). These kits are 

considered extensions of the pharmacy 

and are controlled under the pharmacy’s 

DEA registration. Again, the same 

requirement of a valid prescription 

delivered to the pharmacy prior to 

dispensing applies with respect to these 

kits; however, they provide an 

immediate supply of the drugs in 

emergencies and eliminate the need to 

wait for a delivery from the pharmacy 

in such circumstances. 

DEA is continuing to evaluate 

whether further regulatory changes are 

warranted for the LTCF setting and is 

seeking public comment on this topic. 

As indicated, the dispensing of 

controlled substances to residents of 

LTCFs—as with the dispensing of 

controlled substances to patients in any 

other setting—must take place in 

accordance with the CSA. Thus, in 

order to consider what types of 

controlled substance dispensing 

practices might be permissible in a 

LTCF setting, and whether any revisions 

to the DEA regulations might be 

warranted to accommodate such 

practices, the provisions of the CSA 

governing the dispensing of controlled 

substances must be considered. The 

following is a brief summary of these 

provisions, which have remained 

consistent since the enactment of the 

CSA in 1970. 

The registration requirement—As set 

forth in 21 U.S.C. 822(a), every person 

who dispenses any controlled substance 

must obtain a DEA registration issued in 

accordance with the agency regulations. 

The regulations governing registration 

are set forth in 21 CFR Part 1301. 

Persons registered with DEA are 

authorized to dispense controlled 

substances only to the extent authorized 

by their registration and in conformity 

with the CSA. 21 U.S.C. 822(b). In 

addition, to be eligible under the CSA 

to obtain a registration to dispense 

controlled substances, a practitioner— 

which could be an individual (such as 


emcdonald on DSK2BSOYB1PROD with NOTICES4
37466 Federal Register / Vol. 75, No. 124 / Tuesday, June 29, 2010 / Notices 

1As stated above, DEA has recently issued 

regulations allowing for the electronic prescribing 

a physician), an institution (such as a 

hospital), or a pharmacy—must be 

licensed or otherwise authorized to 

dispense controlled substances under 

the laws of the State in which the 

practitioner practices. 21 U.S.C. 802(21), 

823(f), 824(a)(3). 

The recordkeeping requirement—As 

set forth in 21 U.S.C. 827(a), every 

registrant authorized to dispense 

controlled substances must maintain, on 

a current basis, a complete and accurate 

record of each such substance 

dispensed. 

The prescription requirement—The 

requirement of a prescription is set forth 

in 21 U.S.C. 829. For schedule II 

controlled substances, this provision 

states, in pertinent part: 

Except when dispensed directly by a 

practitioner, other than a pharmacist, to an 

ultimate user, no controlled substance in 

schedule II, which is a prescription drug 

* * *, may be dispensed without the written 

prescription of a practitioner, except that in 

emergency situations * * *, such drug may 

be dispensed upon oral prescription in 

accordance with [21 U.S.C. 353(b)]. 

21 U.S.C. 829(a). 

For schedule III and IV controlled 

substances, the pertinent part of the 

statute states: 

Except when dispensed directly by a 

practitioner, other than a pharmacist, to an 

ultimate user, no controlled substance in 

schedule III or IV, which is a prescription 

drug * * * may be dispensed without a 

written or oral prescription in conformity 

with [21 U.S.C. 353(b)]. 

21 U.S.C. 829(b). 

Prescriptions are required to contain 

specific information including: patient 

name and address; drug name, strength, 

dosage form, quantity prescribed, 

directions for use; and name, address, 

and DEA number of the issuing 

practitioner. 21 CFR 1306.05(a). All 

prescriptions for controlled substances 

must be dated as of, and signed on, the 

day when issued. 

Two aspects of these statutory 

provisions bear emphasis here. First, in 

those situations in which a controlled 

substance is not dispensed directly by a 

practitioner (e.g., it is dispensed by a 

pharmacy), the dispensing must be 

pursuant to a prescription issued by a 

practitioner. Second, the prescription 

must be issued in writing by the 

practitioner if the drug is a schedule II 

controlled substance (except in an 

emergency, in which an oral 

prescription issued by the practitioner is 

permitted); whereas the prescription 

may be issued in writing or orally by the 

practitioner if the drug is a schedule III 

or IV controlled substance. 

The requirement of a legitimate 

medical purpose in the usual course of 

professional practice—As the United 

States Supreme Court explained in 

United States v. Moore, 423 U.S. 122, 

136–138 (1975), implicit in the CSA is 

the requirement that every prescription 

for a controlled substance must be 

issued for a legitimate medical purpose 

by an individual practitioner acting in 

the usual course of his professional 

practice. As the Supreme Court stated in 

Moore, id., this implicit requirement of 

the CSA is made explicit in a provision 

of the DEA regulations, 21 CFR 

1306.04(a), which states: 

A prescription for a controlled substance to 

be effective must be issued for a legitimate 

medical purpose by an individual 

practitioner acting in the usual course of his 

professional practice. The responsibility for 

the proper prescribing and dispensing of 

controlled substances is upon the prescribing 

practitioner, but a corresponding 

responsibility rests with the pharmacist who 

fills the prescription. An order purporting to 

be a prescription issued not in the usual 

course of professional treatment or in 

legitimate and authorized research is not a 

prescription within the meaning and intent 

of [21 U.S.C. 829] and the person knowingly 

filling such a purported prescription, as well 

as the person issuing it, shall be subject to 

the penalties provided for violations of the 

provisions of law relating to controlled 

substances. 

The Moore decision also makes clear 

that, under the CSA, the requirement of 

a legitimate medical purpose in the 

usual course of professional practice is 

tied to the concept of registration. The 

Supreme Court stated, with respect to 

the prescribing and dispensing of 

controlled substances, ‘‘only the lawful 

acts of registrants are exempted’’ from 

the CSA’s general prohibition on 

dispensing controlled substances. Id. at 

131 (emphasis added). Further, the 

Court stated that the CSA was intended 

‘‘to limit a registered physician’s 

dispensing authority to the course of his 

‘professional practice’ ’’ and that the 

registration of a practitioner ‘‘is limited 

to the dispensing and use of drugs ‘in 

the course of professional practice 

* * *.’ ’’ Id. at 140–141. 

The foregoing aspects of the CSA, 

viewed collectively, can be reiterated as 

setting forth the following principles: 

• To lawfully dispense a controlled 

substance to a patient, the dispenser 

must be in one of the following two 

categories: (1) A practitioner authorized 

to dispense controlled substances 

directly to patients (such as a physician 

or a hospital) or (2) a pharmacy or other 

entity authorized to dispense controlled 

substances pursuant to a prescription 

issued by a practitioner. 

• For either of the foregoing two 

categories of dispensers, the dispenser 

must be licensed or otherwise 

authorized under State law to engage in 

such activity and also have a DEA 

registration authorizing such activity. 

• Because controlled substances may 

only be dispensed for a legitimate 

medical purpose by a practitioner acting 

in the usual course of professional 

practice, and only a DEA-registered 

practitioner may make the 

determination there is such a legitimate 

medical purpose for a given instance of 

dispensing, a DEA registrant may not 

delegate to a subordinate the medical 

decision making that must underlie 

each instance of dispensing. 

Accordingly, to be consistent with the 

CSA, any type of arrangement under 

which controlled substances would be 

dispensed to patients who reside in 

LTCFs must adhere to the foregoing 

principles. 

Note Regarding Electronic Prescribing of 

Controlled Substances 

DEA revised its regulations effective 

June 1, 2010 to provide practitioners 

with the option of writing prescriptions 

for controlled substances electronically. 

75 FR 16236, March 31, 2010. The 

regulations also permit pharmacies to 

receive, dispense, and archive these 

electronic prescriptions. This rule 

provides another tool for practitioners to 

use when prescribing a controlled 

substance for their patients, including 

those who reside in a LTCF. This rule 

allows a practitioner to use a computer, 

laptop or personal digital assistant 

(PDA) to send a prescription to a 

pharmacy from a remote location 

instantaneously. The basic framework of 

the CSA outlined above remains in 

effect with respect to the issuance of 

electronic prescriptions. 

Note Regarding Authority of Agents of 

Individual Practitioners 

While a prescription for a controlled 

substance must always be issued by a 

DEA-registered practitioner (rather than 

the agent of a practitioner), an agent 

may, under certain circumstances, be 

involved in the transmission of the 

prescription to the pharmacy. The 

general statutory requirements, as 

implemented through regulations, are 

described below. 

The CSA provides that—except in 

emergency situations—a controlled 

substance in schedule II may only be 

dispensed by a pharmacy pursuant to a 

written prescription signed by a 

practitioner. 21 U.S.C. 829(a). The 

written prescription generally must be 

directly, physically provided to the 

pharmacist.1 Where the patient is a 


emcdonald on DSK2BSOYB1PROD with NOTICES4
Federal Register / Vol. 75, No. 124 / Tuesday, June 29, 2010 / Notices 37467 

of controlled substances. Where a practitioner 

issues an electronic prescription in accordance with 

these regulations, such a prescription constitutes a 

written prescription within the meaning of the CSA. 

When such an electronic prescription is used, the 

prescription information is conveyed electronically 

from the practitioner to the pharmacy, rather than 

through the delivery to the pharmacy of a hard copy 

of the prescription that was signed by the 

practitioner. 

resident of a LTCF, and the drug being 

dispensed is a schedule II controlled 

substance, the DEA regulations permit 

an individual practitioner, or his agent 

where a valid agency relationship exists, 

to transmit by facsimile to the pharmacy 

a written prescription that has been 

issued and signed by the practitioner. 21 

CFR 1306.11(f). 

As indicated, the CSA contains an 

exception that allows practitioners to 

issue oral prescriptions for schedule II 

controlled substances in an emergency. 

21 U.S.C. 829(a). In this context, 

Congress assigned to the Secretary of 

HHS, in consultation with the Attorney 

General, responsibility for defining the 

term ‘‘emergency’’ by regulation. The 

Secretary delegated this responsibility 

to the Food and Drug Administration, 

which set forth the definition of 

‘‘emergency’’ in 21 CFR 290.10. 

Assuming the situation constitutes a 

bona fide emergency within the 

meaning of the FDA regulation, and a 

practitioner determines that such 

emergency warrants the dispensing of a 

schedule II controlled substance, a 

pharmacy may dispense the medication 

upon receiving oral authorization from 

the practitioner in accordance with 21 

CFR 1306.11(d). That regulation 

requires, among other things, that the 

quantity prescribed and dispensed be 

limited to the amount adequate to treat 

the patient during the emergency 

period, and that the practitioner follow 

up within 7 days with a written 

prescription to the dispensing 

pharmacy. 21 CFR 1306.11(d). The 

regulation further requires the pharmacy 

to make a reasonable effort to determine 

that the oral authorization came from 

the practitioner, which may include a 

callback to the practitioner using his 

phone number as listed in the telephone 

directory. 

For controlled substances in 

schedules III–V, the CSA provides that 

a pharmacy may dispense pursuant to a 

‘‘written or oral prescription.’’ 21 U.S.C. 

829(b). Where an oral prescription is 

permitted by the CSA, the DEA 

regulations also provide that a 

practitioner may transmit to the 

pharmacy a facsimile of a written, 

manually signed prescription in lieu of 

an oral prescription. 21 CFR 1306.21(a). 

As a result, a prescription issued by a 

practitioner for substance in schedules 

III–V may be transmitted to a pharmacy 

in the following ways: (1) By delivery to 

the pharmacy of the original, written 

prescription signed by the practitioner; 

(2) by the practitioner or his agent 

(where a valid agency relationship 

exists) faxing the written prescription 

signed by the practitioner; or (3) by the 

practitioner or his agent (where a valid 

agency relationship exists) orally 

transmitting the prescription to a 

pharmacy, where it is promptly reduced 

to writing by the pharmacist prior to 

dispensing. 21 CFR 1306.21(a) and 

1306.03(b). 

As previously discussed, the CSA 

does not permit the prescribing 

practitioner to delegate to an agent or 

any other person the practitioner’s 

authority to issue a prescription for a 

controlled substance. Thus, the 

determination of a legitimate medical 

purpose must be made by the 

practitioner acting in the usual course of 

their professional practice; the 

determination may not be made by the 

agent. Likewise, the required elements 

of the prescription (set forth in 21 CFR 

Part 1306) must be specified by the 

prescribing practitioner—not the agent. 

The pharmacist who fills a prescription 

for a controlled substance has a 

corresponding responsibility to ensure 

that these requirements have been met. 

21 CFR 1306.04(a), 1306.05(a). 

Other Considerations Regarding State 

Licensure 

As indicated, to be eligible for a DEA 

registration, a practitioner must be 

licensed or otherwise authorized by the 

State in which he practices to carry out 

the specific activity for which he seeks 

a registration. This typically entails a 

determination by the applicable State 

regulatory body that the practitioner 

meets certain qualifications. For 

example, to practice medicine, States 

generally require that a physician obtain 

a medical license issued by the State 

medical board, which typically requires 

the physician to demonstrate the 

completion of certain education and 

training, to pass an examination 

demonstrating competency to practice 

medicine, and to undergo a background 

check to verify professional 

competence, ethics, and character. To 

operate a hospital, States generally 

require, at a minimum, that the facility 

obtain a license from the State public 

health department, which typically 

requires the facility to demonstrate that 

it has appropriate levels of qualified 

healthcare professional staff 

(physicians, nurses, etc.) and facilities 

to provide a proper standard of hospital 

service to the community. As part of the 

licensure process, States may also 

require that the hospital demonstrate 

specific qualifications to provide 

particular types of services. In addition, 

some States may require hospitals to 

obtain accreditation and/or certification 

from public and private agencies. To 

operate a pharmacy, States generally 

require the pharmacy to obtain a license 

from the State board of pharmacy, 

which also typically requires a showing 

of properly qualified staff and facilities. 

Thus, by requiring practitioners to 

obtain a State license or other State 

authorization as a prerequisite to 

obtaining a DEA registration, the CSA 

ensures that controlled substances are 

only dispensed by those persons who 

have appropriate professional 

qualifications and who follow 

professional standards. 

Accordingly, to remain consistent 

with the CSA, if a LTCF were to be 

eligible to obtain a DEA registration, it 

would need to have the requisite State 

license or other State authorization that 

is commensurate with the extent of the 

qualifications of its staff and with its 

ability to adhere to applicable 

professional standards for dispensing 

controlled substances to patients. 

Distinctions Between LTCFs and 

Hospitals 

An important distinction between 

LTCFs and hospitals is that States 

authorize hospitals to have independent 

controlled substances authority and 

accordingly hospitals may register with 

DEA. This means, among other things, 

that hospitals are authorized to maintain 

common stocks of controlled substances 

for immediate dispensing or 

administration pursuant to a 

practitioner’s medication order and are 

subject to DEA regulatory oversight and 

inspection. LTCFs, on the other hand, 

typically have no independent State 

controlled substances authority and 

accordingly are not eligible to become 

DEA registrants, as explained above. 

This means they may not maintain 

common stocks of controlled 

substances. Therefore, any prescribed 

controlled substance medication in a 

LTCF is deemed, for CSA purposes, to 

be possessed by the resident and not the 

facility. A further consequence of their 

lack of DEA registration is that LTCFs 

are not subject to direct DEA regulatory 

oversight and inspection, security and 

recordkeeping requirements, or 

administrative action (suspension or 

revocation of registration). 

There are a variety of reasons that 

States may currently treat LTCFs 

differently than hospitals. For example, 

although LTCFs provide care for 

residents, the nature of their practice is 

not the same as that of a hospital. LTCF 


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2 If a physician wrote all the elements of a 

prescription specified in 21 CFR 1306.05(a) on a 

patient’s chart, including the signature on the date 

when issued, this would be considered a valid 

‘‘prescription’’ within the meaning of the CSA and 

DEA regulations, and such document containing all 

the required elements could be delivered to a 

pharmacy for dispensing in accordance with 21 

U.S.C. 829. 

residents typically reside in these 

facilities for long periods of time and 

have health issues and disorders that 

require long-term medical attention. 

Generally, they do not receive daily care 

from an on-site physician; and, indeed, 

many facilities do not employ a 

physician as part of their staff 24 hours 

a day. Likewise, the extent to which 

registered nurses (rather than licensed 

practical nurses or nursing assistants) 

are involved in resident care is generally 

less in LTCFs than in hospitals. Also, in 

contrast to the length of stays of 

residents of LTCFs, patients in hospitals 

are typically there for short periods of 

time and are regularly monitored by 

their attending physician or hospital 

staff physicians. 

Note Regarding Chart Orders 

As explained above, because a DEAregistered hospital is a ‘‘practitioner’’ 

within the meaning of the CSA, it is 

permissible under the Act for such a 

hospital to dispense controlled 

substances directly to patients without a 

prescription. 21 U.S.C. 829(a), (b). 

Because of this, in a hospital setting, a 

hospital may dispense a controlled 

substance, for immediate administration 

to a patient, pursuant to an order for 

medication made by a physician (or 

other individual practitioner) who is an 

employee or agent of the hospital. 21 

CFR 1306.11(c). This may occur, for 

example, through the issuance of a 

‘‘chart order’’ by a hospital physician. In 

this context, the term ‘‘chart order’’ 

should be distinguished from the term 

‘‘prescription.’’ A prescription—unlike a 

chart order—must contain all the 

information specified in 21 CFR 1306.05 

(including, among other things, the 

signature of the physician).2

It bears emphasis that regardless of 

whether the controlled substance is 

dispensed by a pharmacy pursuant to a 

prescription or hospital pursuant to a 

chart order, the person who issues the 

prescription or order must be authorized 

under the CSA to make the medical 

determination, while acting in the usual 

course of professional practice, that 

there is a legitimate medical purpose for 

the drugs to be dispensed to the patient. 

The CSA ensures this condition is 

satisfied by allowing only those 

practitioners who have obtained the 

requisite State licensure and DEA 

registration to make such medical 

determination and issue the 

corresponding prescription or chart 

order. Another point worth noting is 

that, in the hospital setting, where a 

physician issues a chart order for a 

controlled substance, the physician, as 

well as the nursing staff and hospital 

pharmacy staff who take certain steps in 

carrying out the order, are all acting as 

employees or agents of the DEAregistered hospital and thus are 

collectively viewed as the ‘‘practitioner’’ 

within the meaning of the CSA. The 

physician who issues the chart order is 

doing so under the hospital’s DEA 

registration number in accordance with 

the requirements of 21 CFR 1301.22(c). 

The hospital is, therefore, responsible 

for ensuring that all such persons are 

acting in accordance with the CSA and 

DEA regulations, and any failure to do 

so may result in criminal or civil 

liability on the part of the hospital or 

loss of the hospital’s DEA registration. 

These legal consequences are part of the 

fabric of the CSA that promotes 

compliance with the Act. 

As indicated, most LTCFs are not 

licensed by the State as hospitals or 

other practitioners authorized to 

dispense controlled substances directly 

to patients, and thus they are not 

eligible under the CSA for registration 

as practitioners. 

Other Federal Regulations Governing 

Long Term Care Facilities 

For purposes of the CSA, DEA defines 

the term ‘‘long term care facility’’ (LTCF) 

as ‘‘a nursing home, retirement care, 

mental care, or other facility or 

institution which provides extended 

health care to resident patients.’’ 21 CFR 

1300.01(b)(25). The Secretary of Health 

and Human Services (HHS) applies 

more specific definitions for purposes of 

defining facilities eligible to participate 

in Medicare and Medicaid. 42 CFR 

483.5. 

HHS establishes requirements deemed 

necessary for the health and safety of 

individuals to whom services are 

furnished in nursing facilities 

participating in Medicare and Medicaid. 

42 CFR 483.1. For example, basic 

resident rights and obligations are 

outlined along with certain basic 

responsibilities of the facility. Some of 

these responsibilities include facility 

organization such as requiring a medical 

director (42 CFR 483.5(b)(2)(iii)) and 

maintaining a quality assessment and 

assurance committee consisting of a 

physician, the director of nursing 

services and three others. 42 CFR 

483.75(o). The facility must operate and 

provide services in compliance with all 

applicable Federal, State and local laws 

and professional standards. 42 CFR 

483.75(b). 

Other HHS requirements for LTCFs 

establish a level of care. For example, 

the facility must perform periodic 

assessments of a resident’s needs (42 

CFR 483.20(b), (c)) and must establish 

and follow nursing services standards. 

42 CFR 483.30. Among requirements for 

physician care are: 

• The facility must have physician 

orders for the resident’s immediate care 

at the time each resident is admitted. 42 

CFR 483.20(a). 

• Each resident must remain under 

the care of a physician and there must 

be physician supervision when their 

attending physician is unavailable. 42 

CFR 483.40(a). 

• The facility must provide or arrange 

for the provision of physician services 

24 hours a day, in case of an emergency. 

42 CFR 483.40(d). 

• The facility must provide or obtain 

laboratory services only when ordered 

by the attending physician. 42 CFR 

483.75(j)(2)(i). 

• A physician may not delegate a task 

when the regulations specify that the 

physician must perform it personally, or 

when the delegation is prohibited under 

State law or by the facility’s own 

policies. 42 CFR 483.40(e)(2). 

A few of the requirements with 

respect to medications are that: 

• The facility must employ or obtain 

the services of a licensed pharmacist to 

establish a system of records of receipt 

and disposition of all controlled drugs 

and, among other responsibilities, to 

review the drug regimen of each 

resident at least monthly. 42 CFR 

483.60(b), (c). 

• The facility must establish minimal 

requirements for quality of care, 

including that a resident’s drug regimen 

must be free from unnecessary drugs as 

defined in 42 CFR 483.25(l). 

• The facility must also provide 

separately locked, permanently affixed 

compartments for storage of controlled 

drugs listed in Schedule II and other 

drugs subject to abuse unless the facility 

uses single unit package drug 

distribution systems in which the 

quantity stored is minimal and a 

missing dose can be readily detected. 42 

CFR 483.60(e)(2). 

• Among the standards required for 

the provision of hospice-related 

inpatient care in a participating 

Medicare/Medicaid facility is the 

hospice’s responsibility to provide 

‘‘drugs necessary for the palliation of 

pain and symptoms associated with the 

terminal illness and related conditions.’’ 

42 CFR 418.112(c)(6). 

As an element of certification and 

enforcement, HHS utilizes different 


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Federal Register / Vol. 75, No. 124 / Tuesday, June 29, 2010 / Notices 37469 

‘‘surveys’’ of a given facility. These 

various surveys gather periodic, 

resident-centered information about the 

quality of service furnished in a facility 

to determine compliance with the 

requirements for participation in 

Medicare and Medicaid. 42 CFR 

488.301. 

Solicitation of Information 

Within the foregoing statutory 

framework, DEA is hereby seeking input 

from interested members of the public 

regarding the types of lawful controlled 

substance dispensing practices currently 

taking place in the LTCF setting or 

which might take place if appropriate 

amendments to the DEA regulations 

were issued that comported with the 

CSA. Along similar lines, DEA is 

seeking comment on the types of 

controlled substance licensing 

authorities that States currently provide 

to LTCFs, or which States might be 

willing to provide in the future. To 

facilitate the gathering of relevant 

information, DEA has specific questions 

that appear below. These questions are 

separated into general issues. 

Commenters are encouraged to reference 

the question number enumerated below 

in their response. 

A. Definitions 

The terminology used to describe and 

classify facilities that DEA considers to 

be LTCFs varies between agencies and 

from State to State. 

1. The definitions of facilities for 

Medicare reimbursement purposes are 

different in many respects from the 

terms used in DEA regulations. The 

DEA regulations define a LTCF as ‘‘a 

nursing home, retirement care, mental 

care or other facility or institution 

which provides extended health care to 

resident patients.’’ How do State 

regulators/licensing authorities define 

facilities that DEA would consider 

LTCFs? 

2. Are all LTCFs Medicare/Medicaid 

facilities? If not, what differentiates a 

facility that is not a Medicare/Medicaid 

facility from one that is? 

3. What does the term ‘‘prescription’’ 

mean as used in a LTCF? 

4. What does the term ‘‘chart order’’ 

mean as used in a LTCF? 

5. What does the term ‘‘standing 

order’’ mean as used in a LTCF? 

B. Scope 

6. For how many residents does your 

LTCF provide care? Of those, what 

percentage require controlled substance 

medications? 

7. Approximately what percentage of 

those residents requiring controlled 

substance medications receive such 

medications on a daily basis? Further, of 

those who receive controlled substances 

on a daily basis, what percentage 

receive Schedule II controlled 

substances? 

8. When a person comes to a LTCF, 

does the person bring their own alreadydispensed medications? 

9. What, if any, State requirements 

impact a person’s ability to bring 

medication into a LTCF? 

10. If a person arrives at the facility 

without any medication information, 

how does the facility obtain any needed 

medications? 

11. If a person is moving from an 

acute care facility to a LTCF, what 

factors impact the acute care 

practitioner’s ability and willingness to 

provide written prescriptions to the 

person? 

12. If a person arrives at a facility 

without medication and without 

prescriptions, what steps does the 

facility take to assess the person’s 

medication needs? 

13. What are the current practices for 

obtaining controlled substance 

prescriptions for residents at a LTCF? 

How do these practices differ between 

Schedule II controlled substances and 

Schedule III–V controlled substances? 

How do these practices differ between 

an emergency situation and a nonemergency situation? 

14. What types of emergency 

situations arise at a LTCF that would 

necessitate the use of controlled 

substances? 

15. What are the standard operating 

procedures to address emergencies? 

What are the procedures in a LTCF for 

obtaining controlled substance 

medications for residents in an 

emergency situation? Is the process 

different for Schedule II as opposed to 

Schedule III–V controlled substances? 

16. Has your facility experienced 

delays in obtaining controlled substance 

medications for residents? If so, why 

have these delays occurred? At what 

steps in the prescribing process have 

these delays occurred? Please specify 

whether the delay was with a Schedule 

II controlled substance or with a 

substance in Schedule III through V. 

17. Have any residents at your facility 

experienced problems caused by delays 

in obtaining prescriptions for controlled 

substances? If so, what was the reason 

for the delay? How often have such 

problems occurred? Did the delays 

occur with Schedule II controlled 

substances or with substances in 

Schedule III through V? 

18. Does your facility send residents 

to the hospital to receive controlled 

substance medications because they 

were unable to receive the medications 

at your facility in a timely manner? If so, 

how many times did this occur in the 

last 12 months? 

C. Communication 

19. How often are practitioners 

contacted by LTCFs regarding requests 

for changes in residents’ medications 

generally? How often does this occur for 

controlled substance prescriptions 

specifically? 

20. How does communication 

currently occur among the practitioner, 

the LTCF and the pharmacy, e.g. phone, 

fax, other? Do you expect the new DEA 

regulations providing the option of 

electronic prescriptions will be used by 

practitioners and pharmacies in your 

LTCF setting? If so, do you anticipate 

that the use of electronic prescriptions 

will alleviate delays you may have 

experienced in providing controlled 

substances to residents? 

21. Does the LTCF or practitioner 

communicate other information to the 

pharmacy, such as changes in the 

resident’s practitioner or the change in 

status of a resident? 

22. Would practitioners have any 

interest in designating certain persons at 

LTCFs as their agents solely for the 

purpose of communicating controlled 

substance prescription information to 

the pharmacy, understanding that the 

agent would be working under the 

prescriber’s DEA registration and that 

the prescriber would be responsible for 

the agent’s actions, which must be 

consistent with the CSA? 

D. Pharmacy Service 

23. Would your LTCF be amenable to 

having a pharmacy on site as an integral 

element of the LTCF? If so, would you 

seek to have the pharmacy operate 

under a registration granted to the LTCF 

or operate independently at the LTCF 

under its own pharmacy registration? 

24. Does your State allow pharmacies 

to install and operate automated 

dispensing systems at LTCFs? If not, is 

your State considering allowing them to 

do so? 

E. Chart Orders 

Additional information about the 

current use of chart orders for other than 

controlled substances would be helpful. 

25. In current practice, when must a 

practitioner acknowledge a chart order 

by signing it? Do State laws/regulations, 

HHS regulations, or other standards (e.g. 

Joint Commission) define the time 

period within which the practitioner 

must sign the chart order for any care 

setting (hospital, clinic, or LTCF)? 

26. Currently, are chart orders (in 

hospitals or in LTCFs for non-controlled 

substances) required to have an 


emcdonald on DSK2BSOYB1PROD with NOTICES4
37470 Federal Register / Vol. 75, No. 124 / Tuesday, June 29, 2010 / Notices 

‘‘expiration’’ date, at which time they 

must be either reauthorized or closed? 

LTCFs differ from hospitals in that 

residents in LTCFs by definition stay for 

a longer period. Because of this, should 

chart orders in LTCFs ‘‘expire’’ at some 

time after issuance? If so, what time 

period would be appropriate? 

27. If certain persons at the LTCF 

were designated to act as agents of 

individual practitioners (to the extent 

authorized by the CSA) to communicate 

controlled substance information from 

the individual practitioner to the 

pharmacy, how would this change 

current practices at your facility for 

obtaining controlled substance 

medications for residents? What 

safeguards should be required? 

F. State Regulatory Authorities 

28. What authority does your State 

currently give LTCFs for handling and 

managing controlled substances? Which 

agency is responsible for such 

authority? 

29. What controlled substance 

activities, if any, are authorized, e.g. 

prescribing, administering, or 

dispensing? In what schedules? How 

many LTCFs apply for any such 

authorization and how many receive 

such authorization? 

30. What State requirements are there 

pertaining to the storage of controlled 

substances at LTCFs? 

31. Is your State considering giving/ 

increasing LTCFs’ authority to handle/ 

dispense controlled substances? If so, is 

your State considering creating a new 

type of registration just for LTCFs or 

would your State consider allowing 

LTCFs to register as institutional 

practitioners like hospitals? 

32. What changes in State pharmacy 

and LTCF laws/regulations would be 

necessary for pharmacies to operate in 

LTCFs under a registration granted to 

the LTCF or to operate independently at 

the LTCF under its own pharmacy 

registration? 

33. Do State laws or regulations 

specify or limit access to emergency kits 

or to controlled substances in LTCFs? 

34. Do State inspectors check the 

records and stock of emergency kits? If 

so, how often? 

G. Certification/Accreditation 

To be eligible for Medicare or 

Medicaid reimbursement, nursing 

facilities and skilled nursing facilities 

must be inspected by State officials for 

compliance with HHS requirements. 

HHS regulations, for instance, impose 

staffing requirements and requirements 

regarding the safekeeping of drugs. 

35. How often do State regulators 

inspect LTCFs? What is the legal 

requirement in your State for frequency 

of inspection, and what is the actual 

timing? 

36. Has your LTCF sought 

accreditation by the Joint Commission 

or other non-governmental accrediting 

organization? What do LTCFs see as the 

advantages and disadvantages of seeking 

such accreditation? 

H. Staff 

37. Does the Medical Director of your 

facility also serve as Medical Director 

for other locations or facilities? If so, for 

how many? 

38. Is the Medical Director of your 

facility also an attending physician? 

39. Is your Medical Director registered 

with DEA as a practitioner? 

40. If your LTCF is a Medicare or 

Medicaid approved facility, what 

barriers, if any, has your facility faced 

in assuring the provision of physician 

services 24 hours a day in case of an 

emergency? 

41. As a LTCF, does your facility have 

a physician on site during regular 

business hours? 

42. How does your facility 

communicate with a resident’s 

practitioner? 

43. How frequently is a physician on 

site at your facility? Do most physicians 

treat multiple residents at a single 

facility? 

44. Does your facility have a 

registered nurse on duty for more than 

8 hours a day, 7 days a week? Less? 

45. When a registered nurse is not on 

duty at your facility, how are 

procedures relating to medications 

different? 

46. What are the State education and 

continuing education requirements for 

licensed nurses other than registered 

nurses (LPNs, etc)? Does the State 

require a criminal background check 

prior to licensing? 

47. What role do nurses’ aides have in 

helping residents get their medications? 

48. What are the State education and 

continuing education requirements for 

nurses’ aides? Does your State license 

nurses’ aides? 

49. What personnel/job descriptions 

have access to emergency kits in your 

facility? 

50. What personnel/job descriptions 

have access to controlled substance 

storage in your facility? Are temporary 

employees or volunteers given access? 

51. What personnel/job descriptions 

have authority to contact the pharmacy 

to relay a noncontrolled substance 

prescription/drug order for a resident? 

I. Emergency Kits 

52. Does your facility have an 

emergency kit that contains controlled 

substances? If so, what controlled 

substances does your emergency kit 

contain? 

53. If your facility has an emergency 

kit that contains controlled substances, 

how are those controlled substances 

procured and dispensed? 

54. What are the current controlled 

substance inventory protocols for any 

emergency kit and/or automated 

dispensing system at your LTCF? 

55. What records document receipt 

and dispensing of controlled substances 

to and from this kit? 

56. How often in the last two years 

have controlled substances been lost or 

stolen from an emergency kit at your 

facility? 

Please submit written comments no 

later than August 30, 2010 using the 

address information provided at the 

beginning of this document. 

Dated: June 24, 2010 

Joseph T. Rannazzisi, 

Deputy Assistant Administrator, Office of 

Diversion Control. 

[FR Doc. 2010–15757 Filed 6–28–10; 8:45 am] 

BILLING CODE 4410–09–P 

NATIONAL CREDIT UNION 

ADMINISTRATION 

Sunshine Act; Notice of Agency 

Meeting 

TIME AND DATE: 11 a.m., Wednesday, 

June 30, 2010. 

PLACE: Board Room, 7th Floor, Room 

7047, 1775 Duke Street, Alexandria, VA 

22314–3428. 

STATUS: Closed. 

Matter To Be Considered 

1. Consideration of Supervisory 

Activities. Closed pursuant to 

Exemptions (8), (9)(A)(ii) and (9)(B). 

FOR FURTHER INFORMATION CONTACT: 

Mary Rupp, Secretary of the Board, 

Telephone: 703–518–6304. 

Board Secretary, 

Mary Rupp. 

[FR Doc. 2010–15957 Filed 6–25–10; 4:15 pm] 

BILLING CODE P 

NATIONAL TRANSPORTATION 

SAFETY BOARD 

Sunshine Act Meeting 

TIME AND DATE: 9:30 a.m., Tuesday, July 

13, 2010. 

PLACE: NTSB Conference Center, 429 

L’Enfant Plaza SW., Washington, DC 

20594. 

STATUS: The ONE item is open to the 

public. 


emcdonald on DSK2BSOYB1PROD with NOTICES4