Federal Register / Vol. 62, No. 172 / Friday, September 5, 1997 / Rules and Regulations 46879

(3) * * *

(xi) Well-child care. Benefits routinely

are covered for well-child care from

birth to under six years of age. These

periodic health examinations are

designed for prevention, early detection

and treatment of disease and consist of

screening procedures, immunizations

and risk counseling.

(A) The following services are covered

when required as a part of the specific

well-child care program and when

rendered by the attending pediatrician,

family physician, certified nurse

practitioner, or certified physician

assistant.

(1) Newborn examination, heredity

and metabolic screening, and newborn

circumcision.

(2) Periodic health supervision visits,

in accordance with American Academy

of Pediatrics (AAP) guidelines, intended

to promote the optimal health for

infants and children to include the

following services:

(i) History and physical examination

and mental health assessment.

(ii) Vision, hearing, and dental

screening.

(iii) Developmental appraisal to

include body measurement.

(iv) Immunizations as recommenced

by the Centers for Disease Control

(CDC).

(v) Pediatric risk assessment for lead

exposure and blood lead level test.

(vi) Tuberculosis screening.

(vii) Blood pressure screening.

(viii) Measurement of hemoglobin and

hematocrit for anemia.

(ix) Urinalysis.

(x) Health guidance and counseling,

including breastfeeding and nutrition

counseling.

(B) Additional services or visits

required because of specific findings or

because the particular circumstances of

the individual case are covered if

medically necessary and otherwise

authorized for benefits under

CHAMPUS.

(C) The Deputy Assistant Secretary of

Defense, Health Services Financing, will

determine when such services are

separately reimbursable apart from the

health supervision visit.

* * * * *

(g) * * *

(37) Preventive care. Preventive care,

such as routine, annual, or employmentrequested physical examinations;

routine screening procedures; except

that the following are not excluded:

(i) Well-child care.

(ii) Immunizations for individuals age

six and older, as recommended by the

CDC.

(iii) Rabies shots.

(iv) Tetanus shot following an

accidental injury.

(v) Rh immune globulin.

(vi) Genetic tests as specified in

paragraph (e)(3)(ii) of this section.

(vii) Immunizations and physical

examinations provided when required

in the case of dependents of active duty

military personnel who are traveling

outside the United States as a result of

an active duty member’s assignment and

such travel is being performed under

orders issued by a Uniformed Service.

(viii) Screening mammography for

asymptomatic women 40 years of age

and older, and for high risk women 35

years of age and older, when provided

under the terms and conditions

contained in the guidelines adopted by

the Deputy Assistant Secretary of

Defense, Health Services Financing.

(ix) Cancer screening Papanicolaou

(PAP) test for women who are at risk for

sexually transmissible diseases, women

who have or have had multiple sexual

partners (or if their partner has or has

had multiple sexual partners), women

who smoke cigarettes, and women 18

years of age and older when provided

under the terms and conditions

contained in the guidelines adopted by

the Deputy Assistant Secretary of

Defense, Health Services Financing.

(x) Other cancer screenings

authorized by 10 U.S.C. 1079.

(xi) Health promotion and disease

prevention visits (which may include all

of the services provided pursuant to

§ 199.18(b)(2)) may be provided in

connection with immunizations and

cancer screening examinations

authorized by paragraphs (g)(37)(ii) of

this section or (g)(37) (viii) through (x)

of this section.

* * * * *

(47) Eye and hearing examinations.

Eye and hearing examinations except as

specifically provided in paragraphs

(c)(2)(xvi) and (c)(3)(xi) of this section,

or except when rendered in connection

with medical or surgical treatment of a

covered illness or injury.

* * * * *

Dated: August 29, 1997.

L.M. Bynum,

Alternate OSD Federal Register Liaison

Officer, Department of Defense.

[FR Doc. 97–23521 Filed 9–4–97; 8:45 am]

BILLING CODE 5000–04–M

DEPARTMENT OF TRANSPORTATION

Coast Guard

33 CFR Part 117

[CGD08–97–032]

Drawbridge Operations; Kelso Bayou,

LA

AGENCY: Coast Guard, DOT.

ACTION: Notice of temporary deviation

from regulations.

SUMMARY: The Commander, Eighth

Coast Guard District has issued a

temporary deviation from the regulation

governing the operation of the SR 27

swing span drawbridge across Kelso

Bayou, mile 0.7 at Hackberry, Cameron

Parish, Louisiana. This deviation allows

the bridge to remain closed to

navigation between the hours of 3 a.m.

and 11 a.m. on September 6, 1997. This

closure is necessary to facilitate

movement of vehicular traffic for a

continuous concrete pouring operation

scheduled for that day.

DATES: The deviation is effective from 3

a.m. until 11 a.m. on September 6, 1997.

FOR FURTHER INFORMATION CONTACT:

Mr. Phil Johnson, Bridge Administration

Branch, Commander (ob), Eighth Coast

Guard District, 501 Magazine Street,

New Orleans, Louisiana 70130–3396,

telephone number (504) 589–2965.

SUPPLEMENTARY INFORMATION: The SR 27

swing span drawbridge across Kelso

Bayou, mile 0.7 at Hackberry, Cameron

Parish, Louisiana has a vertical

clearance of three feet above mean high

water in the closed to navigation

position and unlimited clearance in the

open to navigation position. Navigation

on the waterway consists primarily of

fishing vessels and recreational craft.

The Louisiana Department of

Transportation and Development has

requested a temporary deviation from

the normal operation of the bridge so

that the contractor can conduct a

continuous concrete pour operation at

the U.S. Department of Energy Storage

Site at Hackberry, Louisiana. This

operation will require that

approximately 35 cement trucks deliver

pre-mixed concrete to the site on a

perpetual traveling schedule. Delays to

vehicular traffic due to drawbridge

openings at the Kelso Bayou bridge

would jeopardize this time sensitive

procedure.

Presently, the draw is required to

open on signal during the shrimping

season, which is from about May 25

through December 22. This deviation

allows the draw to remain closed to

navigation between the hours of 3 a.m.

and 11 a.m. on September 6, 1997.
46880 Federal Register / Vol. 62, No. 172 / Friday, September 5, 1997 / Rules and Regulations

Dated: August 26, 1997.

T.W. Josiah,

Rear Admiral, U.S. Coast Guard, Commander,

Eighth Coast Guard District.

[FR Doc. 97–23518 Filed 9–4–97; 8:45 am]

BILLING CODE 4910–14–M

DEPARTMENT OF TRANSPORTATION

Coast Guard

33 CFR Part 117

[CGD08–97–033]

Drawbridge Operations; Gulf

Intracoastal Waterway, LA

AGENCY: Coast Guard, DOT.

ACTION: Notice of temporary deviation

from regulations.

SUMMARY: The Commander, Eighth

Coast Guard District has issued a

temporary deviation from the regulation

governing the operation of the SR 27

vertical lift span drawbridge across the

Gulf Intracoastal Waterway, mile 243.8,

west of Harvey Lock, at Ellender,

Calcasieu Parish, Louisiana. This

deviation allows the bridge to remain

closed to navigation between the hours

of 3 a.m. and 11 a.m. on September 6,

1997. This closure is necessary to

facilitate movement of vehicular traffic

for a continuous concrete pouring

operation scheduled for that day.

DATES: The deviation is effective from 3

a.m. until 11 a.m. on September 6, 1997.

FOR FURTHER INFORMATION CONTACT: Mr.

Phil Johnson, Bridge Administration

Branch, Commander (ob), Eighth Coast

Guard District, 501 Magazine Street,

New Orleans, Louisiana 70130–3396,

telephone number (504) 589–2965.

SUPPLEMENTARY INFORMATION: The SR 27

vertical lift span drawbridge across the

Gulf Intracoastal Waterway, mile 243.8,

west of Harvey Lock, at Ellender,

Calcasieu Parish, Louisiana has a

vertical clearance of 50 feet above mean

high water in the closed to navigation

position and 135 feet above mean high

water in the open to navigation position.

Navigation on the waterway consists of

tugs with tows, including crane barges,

commercial fishing vessels, sailing

vessels and other recreational craft. The

Louisiana Department of Transportation

and Development has requested a

temporary deviation from the normal

operation of the bridge so that the

contractor can conduct a continuous

concrete pour operation at the U.S.

Department of Energy Storage Site at

Hackberry, Louisiana. This operation

will require that approximately 35

cement trucks deliver pre-mixed

concrete to the site on a perpetual

traveling schedule. Delays to vehicular

traffic due to drawbridge openings at the

SR 27 bridge would jeopardize this time

sensitive procedure.

Presently, the draw is required to

open on signal if at least four hours’

notice is given. This deviation allows

the draw to remain closed to navigation

between the hours of 3 a.m. and 11 a.m.

on September 6, 1997.

Dated: August 26, 1997.

T.W. Josiah,

Rear Admiral, U.S. Coast Guard, Commander,

Eighth Coast Guard District.

[FR Doc. 97–23517 Filed 9–4–97; 8:45 am]

BILLING CODE 4910–14–M

ENVIRONMENTAL PROTECTION

AGENCY

40 CFR Part 52

[MO 034–1034(a); FRL–5886–3]

Approval and Promulgation of

Implementation Plans; State of

Missouri

AGENCY: Environmental Protection

Agency (EPA).

ACTION: Direct final rule.

SUMMARY: This action approves

revisions in the Missouri state rules

regarding conformity requirements in

Kansas City and St. Louis. These

changes are made to incorporate

amendments in the Federal

transportation conformity rule effective

on November 14, 1995.

DATES: This action is effective

November 4, 1997, unless, by October 6,

1997, adverse or critical comments are

received.

ADDRESSES: Copies of the documents

relevant to this action are available for

public inspection during normal

business hours at the: Environmental

Protection Agency, Air Planning and

Development Branch, 726 Minnesota

Avenue, Kansas City, Kansas 66101; and

the EPA Air & Radiation Docket and

Information Center, 401 M Street, SW.,

Washington, DC 20460.

FOR FURTHER INFORMATION CONTACT:

Christopher D. Hess at (913) 551–7213.

SUPPLEMENTARY INFORMATION:

I. Background

On November 14, 1995, the EPA

published a set of amendments to the

Federal rule on transportation

conformity contained in 40 CFR 51.390–

464 (subpart T). The state of Missouri

has adopted changes in 10 CSR 10–

2.390 (for Kansas City) and 10 CSR 10–

5.480 (for St. Louis) in order to parallel

and incorporate the Federal revisions.

These revisions were submitted to the

EPA in letters dated January 10, 1997,

and February 2, 1997, for the areas of

Kansas City and St. Louis, respectively.

These submissions were deemed

complete in letters to the state dated

February 25, 1997, and March 5, 1997.

The state provided evidence of the

lawful adoption of regulations, public

notice, and public hearing requirements.

Both state rules were submitted to

EPA for review on July 3, 1996. The

EPA requested two minor revisions in a

letter dated July 23, 1996, which the

state made prior to adoption of both

rules on July 25, 1996. The rules became

effective on December 30, 1996.

II. Analysis

The state has essentially adopted the

November 14, 1995, amendments to the

transportation conformity rule in their

entirety, while organizing the respective

rules into the established state

regulatory structure and numbering

system. Some minor differences

between the Federal and state rule exist,

such as the state’s inclusion of a

definition for ‘‘consultation’’ and

specifying the metropolitan planning

organizations in the Kansas City and St.

Louis area.

The respective rules for Kansas City

(an ozone maintenance area) and St.

Louis (an ozone and carbon monoxide

(CO) nonattainment area) are nearly

identical to one another and to the

requirements of the Federal rule, except

where the St. Louis rules include

definitions and procedures for a CO

nonattainment area, which is not

required in the Kansas City rules. For an

explanation of the specific changes in

the state’s rule to meet Federal

requirements, the reader may request

the ‘‘Technical Support Document

(TSD) for a Revision to the Missouri

State Implementation Plan (SIP),’’ dated

July 25, 1997. The revisions are

appropriate, required, and fully

approvable by the EPA.

III. Final Action

The EPA is approving revisions

submitted on January 10, 1997, and

February 2, 1997, which meet the

requirements of the transportation

conformity amendments dated

November 14, 1995. This meets the

Federal requirements set forth in 40 CFR

51, subpart T.

The EPA is publishing this action

without prior proposal because the

Agency views this as a noncontroversial

amendment and anticipates no adverse

comments. However, in a separate

document in this Federal Register

publication, the EPA is proposing to