18138 Federal Register / Vol. 75, No. 68 / Friday, April 9, 2010 / Proposed Rules 

to that state, we anticipate that safety 

benefits of the proposal would be 

correspondingly higher than expected 

for aviation operations in the 

continental National Airspace System 

(NAS). 

Environmental Analysis 

FAA Order 1050.1E identifies FAA 

actions that are categorically excluded 

from preparation of an environmental 

assessment or environmental impact 

statement under the National 

Environmental Policy Act in the 

absence of extraordinary circumstances. 

The FAA has determined this proposed 

rulemaking action qualifies for the 

categorical exclusion identified in 

paragraph 312(f) and involves no 

extraordinary circumstances. 

Regulations That Significantly Affect 

Energy Supply, Distribution, or Use 

The FAA has analyzed this proposal 

under Executive Order 13211, Actions 

Concerning Regulations that 

Significantly Affect Energy Supply, 

Distribution, or Use (May 18, 2001). We 

have determined that it is not a 

‘‘significant regulatory action’’ under the 

executive order because it is not a 

‘‘significant regulatory action’’ under 

Executive Order 12866, and it is not 

likely to have a significant adverse effect 

on the supply, distribution, or use of 

energy. 

Additional Information 

Comments Invited: 

The FAA invites interested persons to 

participate in this rulemaking by 

submitting written comments, data, or 

views. We also invite comments relating 

to the economic, environmental, energy, 

or federalism impacts that might result 

from adopting the proposals in this 

document. The most helpful comments 

reference a specific portion of the 

proposal, explain the reason for any 

recommended change, and include 

supporting data. To ensure the docket 

does not contain duplicate comments, 

please send only one copy of written 

comments, or if you are filing comments 

electronically, please submit your 

comments only one time. 

We will file in the docket all 

comments we receive, as well as a 

report summarizing each substantive 

public contact with FAA personnel 

concerning this proposed rulemaking. 

Before acting on this proposal, we will 

consider all comments we receive on or 

before the closing date for comments. 

We will consider comments filed after 

the comment period has closed if it is 

possible to do so without incurring 

expense or delay. We may change this 

proposal in light of the comments we 

receive. 

Proprietary or Confidential Business 

Information: 

Do not file in the docket information 

that you consider to be proprietary or 

confidential business information. Send 

or deliver this information directly to 

the person identified in the FOR FURTHER

INFORMATION CONTACT section of this 

document. You must mark the 

information that you consider 

proprietary or confidential. If you send 

the information on a disk or CD–ROM, 

mark the outside of the disk or CD–ROM 

and also identify electronically within 

the disk or CD–ROM the specific 

information that is proprietary or 

confidential. 

Under 14 CFR 11.35(b), when we are 

aware of proprietary information filed 

with a comment, we do not place it in 

the docket. We hold it in a separate file 

to which the public does not have 

access, and we place a note in the 

docket that we have received it. If we 

receive a request to examine or copy 

this information, we treat it as any other 

request under the Freedom of 

Information Act (5 U.S.C. 552). We 

process such a request under the DOT 

procedures found in 49 CFR part 7. 

Availability of Rulemaking 

Documents: 

You can get an electronic copy of 

rulemaking documents using the 

Internet by— 

1. Searching the Federal eRulemaking 

Portal (http://www.regulations.gov): 

2. Visiting the FAA’s Regulations and 

Policies web page at http:// 

www.faa.gov/regulations_policies: or 

3. Accessing the Government Printing 

Office’s web page at http:// 

www.gpoaccess.gov/fr/index.html. 

You can also get a copy by sending a 

request to the Federal Aviation 

Administration, Office of Rulemaking, 

ARM–1, 800 Independence Avenue, 

SW., Washington, DC 20591, or by 

calling (202) 267–9680. Make sure to 

identify the docket number or notice 

number of this rulemaking. 

You may access all documents the 

FAA considered in developing this 

proposed rule, including economic 

analyses and technical reports, from the 

Internet through the Federal 

eRulemaking Portal referenced in 

paragraph (1). 

List of Subjects in 14 CFR Part 21 

Aircraft, Aviation safety, Exports, 

Imports, Reporting and recordkeeping 

requirements. 

The Proposed Amendment 

In consideration of the foregoing, the 

Federal Aviation Administration 

proposes to amend Chapter I of Title 14, 

Code of Federal Regulations, as follows: 

PART 21—CERTIFICATION 

PROCEDURES FOR PRODUCTS, 

ARTICLES, AND PARTS 

1. The authority citation for part 21 

continues to read as follows: 

Authority: 42 U.S.C. 7572; 49 U.S.C. 

106(g), 40105, 40113, 44701–44702, 44704, 

44707, 44709, 44711, 44713, 44715, 45303. 

2. Amend § 21.35 by revising 

paragraph (b)(2) to read as follows: 

§ 21.35 Flight tests. 

* * * * * 

(b) * * * 

(2) For aircraft to be certificated under 

this subchapter, except gliders and 

except reciprocating engine powered 

airplanes of 6,000 lbs. or less maximum 

certificated weight that are to be 

certificated under part 23 of this 

chapter, to determine whether there is 

reasonable assurance that the aircraft, its 

components, and its equipment are 

reliable and function properly. 

* * * * * 

Issued in Washington, DC, on April 2, 

2010. 

Kalene C. Yanamura, 

Acting Director, Aircraft Certification Service. 

[FR Doc. 2010–8130 Filed 4–8–10; 8:45 am] 

BILLING CODE 4910–13–P 

DEPARTMENT OF DEFENSE 

Office of the Secretary 

32 CFR Part 108 

[Docket ID: DOD–2009–OS–0036; RIN 0790– 

AI52] 

Health Care Eligibility Under the 

Secretarial Designee Program and 

Related Special Authorities 

AGENCY: Department of Defense (DoD). 

ACTION: Proposed rule. 

SUMMARY: This proposed action would 

establish policies and assign 

responsibilities for health care eligibility 

under the Secretarial Designee Program. 

It would also implement the 

requirement where the United States 

would receive reimbursement for 

inpatient health care provided in the 

United States to foreign military or 

diplomatic personnel or their 

dependents, except in certain cases 

covered by Reciprocal Health Care 

Agreements (RHCAs) between the 

Department of Defense and a foreign 

country. 


srobinson on DSKHWCL6B1PROD with PROPOSALS
Federal Register / Vol. 75, No. 68 / Friday, April 9, 2010 / Proposed Rules 18139 

1Copies available on the Internet at http:// 

www.dtic.mil/whs/directives/corres/pdf/ 

300005p.pdf. 

2Copies available on the Internet at http:// 

www.dtic.mil/whs/directives/corres/pdf/ 

220502p.pdf. 

3Copies available on the Internet at http:// 

www.dtic.mil/whs/directives/corres/html/ 

231008.htm. 

4Copies available on the Internet at http:// 

www.dtic.mil/whs/directives/corres/pdf/ 

100013p.pdf. 

DATES: Comments must be received by 

June 8, 2010. 

ADDRESSES: You may submit comments, 

identified by docket number and/or RIN 

number and title, by any of the 

following methods: 

• Federal Rulemaking Portal: http:// 

www.regulations.gov. Follow the 

instructions for submitting comments. 

• Mail: Federal Docket Management 

System Office, 1160 Defense Pentagon, 

OSD Mailroom 3C843, Washington, DC 

20301–1160. 

Instructions: All submissions received 

must include the agency name and 

docket number or Regulatory 

Information Number (RIN) for this 

Federal Register document. The general 

policy for comments and other 

submissions from members of the public 

is to make these submissions available 

for public viewing on the Internet at 

http://www.regulations.gov as they are 

received without change, including any 

personal identifiers or contact 

information. 

FOR FURTHER INFORMATION CONTACT: Col 

Michael Skidmore, (703) 614–4157. 

SUPPLEMENTARY INFORMATION: 

Executive Order 12866, ‘‘Regulatory 

Planning and Review’’ 

It has been certified that 32 CFR part 

108 does not: 

(1) Have an annual effect on the 

economy of $100 million or more or 

adversely affect in a material way the 

economy; a section of the economy; 

productivity; competition; jobs; the 

environment; public health or safety; or 

State, local, or tribunal governments or 

communities; 

(2) Create a serious inconsistency or 

otherwise interfere with an action taken 

or planned 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 this Executive Order. 

Sec. 202, Public Law 104–4, ‘‘Unfunded 

Mandates Reform Act’’ 

It has been certified that 32 CFR part 

108 does not contain a Federal mandate 

that may result in the expenditure by 

State, local and tribunal governments, in 

aggregate, or by the private sector, of 

$100 million or more in any one year. 

Public Law 96–354, ‘‘Regulatory 

Flexibility Act’’ (5 U.S.C. 601) 

It has been certified that 32 CFR part 

108 is not subject to the Regulatory 

Flexibility Act (5 U.S.C. 601) because it 

would not, if promulgated, have a 

significant economic impact on a 

substantial number of small entities. 

Public Law 96–511, ‘‘Paperwork 

Reduction Act’’ (44 U.S.C. Chapter 35) 

It has been certified that 32 CFR part 

108 does not impose reporting or 

recordkeeping requirements under the 

Paperwork Reduction Act of 1995. 

Executive Order 13132, ‘‘Federalism’’ 

It has been certified that 32 CFR part 

108 does not have federalism 

implications, as set forth in Executive 

Order 13132. This rule does not have 

substantial direct effects on: 

(1) The States; 

(2) The relationship between the 

National Government and the States; or 

(3) The distribution of power and 

responsibilities among the various 

levels of Government. 

List of Subjects in 32 CFR Part 108 

Diplomatic personnel, Health care, 

Military personnel. 

Accordingly, 32 CFR part 108 is 

proposed to be added to read as follows. 

PART 108—HEALTH CARE 

ELIGIBILITY UNDER THE 

SECRETARIAL DESIGNEE PROGRAM 

AND RELATED SPECIAL 

AUTHORITIES 

Sec. 

108.1 Purpose. 

108.2 Applicability. 

108.3 Definition. 

108.4 Policy. 

108.5 Eligible senior officials of the U.S. 

Government. 

108.6 Responsibilities. 

Authority: 10 U.S.C. 1074(c); 10 U.S.C. 

2559. 

§ 108.1 Purpose. 

This part: 

(a) Establishes policy and assigns 

responsibilities under 10 U.S.C. 1074(c) 

for health care eligibility under the 

Secretarial Designee Program. 

(b) Implements the requirement of 10 

U.S.C. 2559 that the United States 

receive reimbursement for inpatient 

health care provided in the United 

States to foreign military or diplomatic 

personnel or their dependents, except in 

certain cases covered by Reciprocal 

Health Care Agreements (RHCAs) 

between the Department of Defense and 

a foreign country. 

§ 108.2 Applicability. 

This part: 

(a) Applies to the Office of the 

Secretary of Defense, the Military 

Departments, the Office of the Chairman 

of the Joint Chiefs of Staff and the Joint 

Staff, the Combatant Commands, the 

Office of the Inspector General of the 

Department of Defense, the Defense 

Agencies, the DoD Field Activities, and 

all other organizational entities in the 

Department of Defense (hereafter 

referred to collectively as the ‘‘DoD 

Components’’). 

(b) Does not apply to health care 

services provided to coalition forces in 

operational settings, or to allied forces 

in overseas training exercises and 

similar activities. Also, does not apply 

to health care services provided to 

foreign nationals overseas under DoD 

Instruction 3000.05 1, DoD Instruction 

2205.2 2, or DoD Instruction 2310.08E 3. 

§ 108.3 Definition. 

Secretarial Designee Program. The 

program established under 10 U.S.C. 

1074(c) to create by regulation an 

eligibility for health care services in 

military medical treatment facilities 

(MTFs) as well as dental treatment 

facilities for individuals who have no 

such eligibility under 10 U.S.C. chapter 

55. 

§ 108.4 Policy. 

It is DoD policy that: 

(a) General Policy. The use of 

regulatory authority to establish DoD 

health care eligibility for individuals 

without a specific statutory entitlement 

or eligibility shall be used very 

sparingly, and only when it serves a 

compelling DoD mission interest. When 

used, it shall be on a reimbursable basis, 

unless non-reimbursable care is 

authorized by this part or 

reimbursement is waived by the Under 

Secretary of Defense (Personnel & 

Readiness) (USD(P&R)) or the 

Secretaries of the Military Departments 

when they are the approving authority. 

(b) Foreign Military Personnel and 

Their Dependents—(1) MTF Care in the 

United States. Foreign military 

personnel in the United States under the 

sponsorship or invitation of the 

Department of Defense, and their 

dependents approved by the 

Department of Defense to accompany 

them, are eligible for space-available 

care as provided in DoD Instruction 

1000.13.4 Consistent with 10 U.S.C. 


srobinson on DSKHWCL6B1PROD with PROPOSALS
18140 Federal Register / Vol. 75, No. 68 / Friday, April 9, 2010 / Proposed Rules 

5Copies available on the Internet at http:// 

www.dtic.mil/whs/directives/corres/pdf/ 

605501p.pdf. 

6Copies available at OASD (Health Affairs/TMA 

FHP&RP), 1200 Defense Pentagon, Room 3E1073, 

Washington, DC 20301–1200. 

2559, in cases in which reimbursement 

is required by DoDI 1000.13, a RHCA 

may provide a waiver of reimbursement 

for inpatient and/or outpatient care in 

the United States in a military medical 

treatment facility for military personnel 

from a foreign country and their 

dependents, if comparable care is made 

available to at least a comparable 

number of U.S. military personnel and 

their dependents in that foreign country. 

RHCAs may have durations of up to 4 

years, provided that there is a 

revalidation every 2 years of continuing 

compliance with the requirements for 

comparable care and comparable 

numbers. A disparity of 25 percent or 

less in the number of foreign personnel 

and dependents above U.S. personnel 

and dependents shall be considered 

within the range of comparable 

numbers. 

(2) Non-MTF Care in the United 

States. Foreign military personnel in the 

United States under the sponsorship or 

invitation of the Department of Defense, 

and their dependents approved by the 

Department of Defense to accompany 

them, are not eligible for DoD payment 

for outpatient or inpatient care received 

from non-DoD providers, except for 

such personnel covered by the North 

Atlantic Treaty Organization Status of 

Forces Agreement (SOFA) or the 

Partnership for Peace SOFA and 

authorized care under the TRICARE 

Standard program according to § 199.3 

of this title, outpatient care may be 

provided as specified therein. 

(c) Foreign Diplomatic or Other Senior 

Foreign Officials. Foreign diplomatic or 

other senior foreign officials and the 

dependents of such officials may be 

provided inpatient or outpatient 

services in MTFs only in compelling 

circumstances, including both medical 

circumstances and mission interests, 

and through case-by-case approval. 

(1) In the United States, the approval 

authority is the USD(P&R). The 

authority to waive reimbursement for 

care provided in the United States, to 

the extent allowed by law, is the 

USD(P&R) or the Secretaries of the 

Military Departments when they are the 

approving authority. 

(2) Requests from the State 

Department or other agency of the U.S. 

Government will be considered on a 

reimbursable basis. 

(3) Under 10 U.S.C. 2559, 

reimbursement to the United States for 

care provided in the United States on an 

inpatient basis to foreign diplomatic 

personnel or their dependents is 

required. 

(d) Other Foreign Nationals. Other 

foreign nationals (other than those 

described in paragraphs (b) and (c) of 

this section) may be designated as 

eligible for space-available care in MTFs 

only in extraordinary circumstances. 

(1) The authority to waive 

reimbursement for care provided in the 

United States, to the extent allowed by 

law, is the USD(P&R) or the Secretaries 

of the Military Departments when they 

are the approving authority. Waiver 

requests will only be considered based 

on a direct and compelling relationship 

to a priority DoD mission objective. 

(2) Requests from the State 

Department or other agency of the U.S. 

Government will be considered on a 

reimbursable basis. Such requests must 

be supported by the U.S. Ambassador to 

the country involved and the 

Geographical Combatant Commander 

for that area of responsibility and must 

be premised on critically important 

interests of the United States. 

(e) Invited Persons Accompanying the 

Overseas Force. The Secretaries of the 

Military Departments and the USD(P&R) 

may designate as eligible for spaceavailable care from the Military Health 

System outside the United States those 

persons invited by the Department of 

Defense to accompany or visit the 

military force in overseas locations or 

invited to participate in DoD-sponsored 

morale, welfare, and recreation 

activities. This authority is limited to 

health care needs arising in the course 

of the invited activities. Separate 

approval is needed to continue health 

care initiated under this paragraph in 

MTFs in the United States. 

(1) In the case of employees or 

affiliates of news organizations, all care 

provided under the authority of 

introductory paragraph (e) of this 

section is reimbursable. For other 

individuals designated as eligible under 

this paragraph (e), the designation may 

provide, to the extent allowed by law, 

for outpatient care on a nonreimbursable basis, and establish a caseby-case authority for waiver of 

reimbursement for inpatient care. 

(2) This paragraph (e) does not apply 

to employees of the Executive Branch of 

the United States or personnel affiliated 

with contractors of the United States. 

(f) U.S. Nationals Overseas. Health 

care for U.S. nationals overseas is not 

authorized, except as otherwise 

provided in this part. 

(g) U.S. Government Civilian 

Employees and Contractor Personnel. 

(1) Civilian employees of the 

Department of Defense and other 

government agencies, and employees of 

DoD contractors, and the dependents of 

such personnel are eligible for MTF care 

to the extent provided in DoD 

Instruction 1000.13. 

(2) Occupational health care services 

provided to DoD employees under 5 

U.S.C. 7901, authorities cited in DoD 

Instruction 6055.1,5 or under other 

authorities except 10 U.S.C. 1074(c) are 

not affected by this part. The Secretaries 

of the Military Departments and the 

USD(P&R) may designate DoD civilian 

employees, applicants for employment, 

and personnel performing services for 

the Department of Defense under 

Federal contracts as eligible for 

occupational health care services 

required by the Department of Defense 

as a condition of employment or 

involvement in any particular 

assignment, duty, or undertaking. 

(3) Any health care services provided 

by the Military Health System to 

employees of DoD non-appropriated 

fund instrumentalities shall be on a 

reimbursable basis. 

(4) In the case of DoD civilian 

employees forward deployed in support 

of U.S. military personnel engaged in 

hostilities, eligibility for MTF care (in 

addition to all eligibility for programs 

administered by the Department of 

Labor Office of Workers’ Compensation 

Programs (OWCP)) is as follows: 

(i) Consistent with Policy Guidance 

for Provision of Medical Care to DoD 

civilian Employees Injured or Wounded 

While Forward Deployed in Support of 

Hostilities,6 DoD civilian employees 

who become ill, contract diseases, or are 

injured or wounded while so deployed 

are eligible for medical evacuation or 

health care treatment and services in 

MTFs at the same level and scope 

provided to military personnel, all on a 

non-reimbursable basis. 

(ii) DoD civilian employees who, 

subsequent to such deployment, 

identify OWCP-compensable conditions 

are eligible for MTF care for such 

conditions, all on a non-reimbursable 

basis. 

(iii) USD(P&R) may, under compelling 

circumstances, approve additional 

eligibility for care in MTFs for other 

U.S. Government civilian employees 

who become ill or injured while so 

deployed, or other DoD civilian 

employees overseas. 

(5) Contractor Personnel Authorized 

to Accompany U.S. Armed Forces. In 

the case of contractor personnel 

authorized to accompany U.S. Armed 

Forces in deployed settings under DoD 


srobinson on DSKHWCL6B1PROD with PROPOSALS
Federal Register / Vol. 75, No. 68 / Friday, April 9, 2010 / Proposed Rules 18141 

7Copies available on the Internet at http:// 

www.dtic.mil/whs/directives/corres/pdf/ 

302041p.pdf. 

8Copies available on the Internet at http:// 

www.dtic.mil/whs/directives/corres/pdf/ 

321602p.pdf. 

9Copies available on the Internet at http:// 

www.dtic.mil/whs/directives/corres/pdf/ 

600011p.pdf. 

10Copies available on the Internet at http:// 

www.dtic.mil/whs/directives/corres/pdf/ 

512402p.pdf. 

11Copies available on the Internet at http:// 

www.dtic.mil/whs/directives/corres/html/ 

553003.htm. 

Instruction 3020.417, MTF care may be 

provided as stated in DoD Instruction 

3020.41. 

(h) Health Care. The Secretaries of the 

Military Departments and the USD(P&R) 

may designate emergency patients as 

eligible for emergency health care from 

MTFs in the United States emergency 

patients pursuant to arrangements with 

local health authorities or in other 

appropriate circumstances. Such care 

shall be on a reimbursable basis, unless 

waived by the USD(P&R) or the 

Secretaries of the Military Departments 

when they are the approving authority. 

(i) Research Subject Volunteers. 

Research subjects are eligible for health 

care services from MTFs to the extent 

DoD Components are required by DoD 

Directive 3216.02 8 to establish 

procedures to protect subjects from 

medical expenses that are a direct result 

of participation in the research. Such 

care is on a non-reimbursable basis and 

limited to research injuries (unless the 

volunteer is otherwise an eligible health 

care beneficiary). 

(j) Continuity of Care Extensions of 

Eligibility. The Secretaries of the 

Military Departments and the USD(P&R) 

may establish temporary eligibility on a 

space-available basis for former 

members and former dependents of 

members of the seven Uniformed 

Services for a limited period of time, not 

to exceed 6 months, or in the case of 

pregnancy, the completion of the 

pregnancy, after statutory eligibility 

expires when appropriate to allow 

completion or appropriate transition of 

a course of treatment begun prior to 

such expiration. In the case of a 

pregnancy covered by this paragraph, 

the designation of eligibility may 

include initial health care for the 

newborn infant. Care under this 

paragraph is authorized on a nonreimbursable basis. 

(k) Members of the Armed Forces. The 

Secretaries of the Military Departments 

and the USD(P&R) may establish 

eligibility not specifically provided by 

statute for critical mission-related health 

care services for designated members of 

the Armed Forces, such as Reserve 

Component members not in a present 

duty status. This authority includes 

payment for health care services in 

private facilities to the extent authorized 

by 10 U.S.C. 1074(c). Care under this 

paragraph is non-reimbursable. 

(l) Certain Senior Officials of the U.S. 

Government. The officials and others 

listed in § 108.5 part are designated as 

eligible for space-available inpatient and 

outpatient health care services from the 

Military Health System on a 

reimbursable basis. 

(m) Nonmedical Attendants. The 

Secretaries of the Military Departments 

and the USD(P&R) may designate as 

eligible for space available MTF care 

persons designated as nonmedical 

attendants as defined by 37 U.S.C. 

411k(b). Costs of medical care rendered 

are reimbursable unless reimbursement 

is waived by the Secretary of the 

Military Department concerned or 

USD(P&R). This authority is limited to 

health care needs arising while 

designated as a nonmedical attendant. 

(n) Patient Movement. Provisions of 

this part concerning inpatient care shall 

also apply to requests for patient 

movement through the medical 

evacuation system under DoD 

Instruction 6000.11.9 Aeromedical 

evacuation transportation assets are 

reserved for those individuals 

designated as Secretarial Designees who 

need transportation to attain necessary 

health care. 

(o) Other Individuals Entitled to DoD 

Identification (ID) Card. Other 

individuals entitled to a DoD ID card 

under DoD Instruction 1000.13 are 

eligible for space-available MTF health 

care to the extent provided in DoD 

Instruction 1000.13. 

(p) Reciprocity among Military 

Departments. Subject to the capabilities 

of the professional staff, the availability 

of space and facilities, and any other 

limitation imposed by the approving 

authority, all Services will provide 

medical treatment to individuals that 

have been granted Secretarial designee 

status by any of the Secretaries of the 

Military Departments. Each agreement 

must identify the specific MTF or 

geographical region in which medical 

care is requested, requiring close 

coordination among service program 

managers. Secretarial designee status 

may have durations of up to two years. 

§ 108.5 Eligible senior officials of the U.S. 

Government. 

(a) The following individuals are 

Secretarial Designees for space-available 

care in MTFs on a reimbursable basis: 

(1) The President and the Vice 

President. 

(2) Members of Congress. 

(3) Members of the Cabinet. 

(4) Officials of the Department of 

Defense appointed by the President and 

confirmed by the Senate. 

(5) Article III Federal Judges. (Article 

III courts are: The Supreme Court of the 

United States, U.S. Courts of Appeal, 

U.S. District Courts, U.S. Court of 

International Trade, United States 

Foreign Intelligence Surveillance Court, 

United States Foreign Intelligence 

Surveillance Court of Review.) 

(6) Judges of the U.S. Court of Appeals 

for the Armed Forces. 

(7) Assistants to the President. 

(8) Director of the White House 

Military Office. 

(9) Former Presidents of the United 

States and their spouses, widows, and 

minor children. 

(b) [Reserved] 

§ 108.6 Responsibilities. 

(a) The USD(P&R) shall evaluate 

requests for and where appropriate, 

grant exceptions to policy established 

by this part and DoDD 5124.02,10

including waiver of reimbursement, to 

the extent allowed by law. 

(b) The USD(P)) shall evaluate 

requests and determine DoD mission 

interest for Secretarial Designee Status 

and RHCAs to identify those agreements 

that would be in the best interest of the 

Department of Defense and approve 

negotiations of RHCAs by the Assistant 

Secretary of Defense (Health Affairs) 

(ASD(HA)). 

(c) The USD(C)) shall, in coordination 

with ASD(HA), establish appropriate 

reimbursement rates, including 

appropriate interagency rates and rates 

applicable to students in International 

Military Education and Training 

programs. 

(d) The Under Secretary of Defense for 

Acquisition, Technology, and Logistics 

shall evaluate requests for Exception to 

the Transportation Policy. The authority 

to grant such a exception is by 

USD(P&R) or the Secretary of the 

Military Department concerned. 

(e) The ASD(HA), under the authority, 

direction, and control of the USD(P&R), 

shall, following approval of the USD(P) 

and USD (P&R) and in coordination 

with USD(P) and the GC, DoD, and in 

accordance with DoD Directive 

5530.3,11 begin negotiations, negotiate, 

and have the authority to sign RHCAs. 

(f) The Secretaries of the Military 

Departments shall: 

(1) Issue, revise, or modify as 

appropriate, regulations to comply with 

this part. 

(2) Appoint a Military Department 

representative who will administer the 


srobinson on DSKHWCL6B1PROD with PROPOSALS
18142 Federal Register / Vol. 75, No. 68 / Friday, April 9, 2010 / Proposed Rules 

Secretarial Designee Program within the 

Military Department and coordinate 

with other DoD Components in its 

effective operation. 

(3) Where and when appropriate, the 

Military Department concerned shall 

coordinate with U.S. Transportation 

Command/Global Patient Movement 

Requirements Center. 

(4) Provide written quarterly reports 

to the USD(P&R) and USD(C) reflecting 

the number of individuals designated as 

Secretarial Designees within their 

Military Departments, the reasons for 

such designation, the expected duration 

of such designation, the costs and 

sources of funding authorizing the 

support of such designee status for each 

designee. 

(5) Create a Patient Category code to 

identify Secretarial Designees treated at 

MTFs. 

(6) Provide an annual consolidated 

list reflecting the number of Secretarial 

Designees within their departments, 

reasons for such designation, location 

where designee is receiving treatment, 

the costs and sources of funding, nature 

and duration of treatment and 

expiration date of designee status to 

USD(P&R), USD(C), and ASD(HA). 

(i) In cases where the USD(P&R) 

designates an individual as a Secretarial 

Designee, the Military Department 

concerned shall include this individual 

on any lists provided to USD(P&R) and 

USD(C) for reporting purposes. 

(ii) Annually consolidate Secretarial 

Designee patient costs and forward 

those data to ASD(HA) and USD(C), 

along with a report of collection for 

reimbursable costs. 

(g) The Commanders of the 

Geographic Combatant Commands 

(GCCs) shall: 

(1) Refer requests to waive 

reimbursement through the Chairman of 

the Joint Chiefs of Staff to the 

USD(P&R). 

(2) Refer requests for Secretarial 

Designee status for medical care in the 

United States through the Chairman of 

the Joint Chiefs of Staff to USD(P&R). 

(3) Through the Chairman of the Joint 

Chiefs of Staff, provide written quarterly 

reports to the USD(P&R) and USD(C) 

reflecting the number of individuals 

designated as Secretarial Designees 

within their geographic area of 

responsibility, the reasons for such 

designation, the expected duration of 

such designation, the costs and sources 

of funding authorizing the support of 

such designee status for each designee. 

(4) Use existing approved Patient 

Category code(s) to identify Secretarial 

Designees treated at MTFs within their 

geographic area of responsibility. 

(5) Provide for an accounting and 

collection system for reimbursement of 

medical costs within their geographic 

area of responsibility. 

(6) Provide an annual consolidated 

list reflecting the number of Secretarial 

Designees within their respective 

geographic areas of responsibility, 

reasons for such designation, location 

where designee is receiving treatment, 

nature and duration of treatment, and 

expiration date of designee status 

through the Chairman of the Joint Chiefs 

of Staff to USD(P&R), USD(C), and 

ASD(HA). 

(h) Commander, United States 

Transportation Command shall: 

(1) Coordinate patient movement with 

all concerned Military Departments. 

(2) Upon request of the Military 

Department concerned or Commanders 

of the GCCs, determine availability of 

DoD transportation assets, or when cost 

effective, coordinate with civilian 

ambulance authorities, to effect 

transportation of Secretarial Designee as 

appropriate. 

(3) Ensure the Global Patient 

Movement Requirements Center, as the 

regulating agency, will consistently 

serve as the single point of contact for 

patient movement for Secretarial 

Designee patients using DoD assets 

upon request. 

(4) Annually consolidate Secretarial 

Designee patient listing who utilized the 

DoD patient movement system and 

forward to ASD(HA) and USD(C). 

Dated: April 6, 2010. 

Mitchell S. Bryman, 

Alternate OSD Federal Register Liaison 

Officer, Department of Defense. 

[FR Doc. 2010–8161 Filed 4–8–10; 8:45 am] 

BILLING CODE 5001–06–P 

ENVIRONMENTAL PROTECTION 

AGENCY 

40 CFR Part 52 

[EPA–R06–OAR–2006–0988; FRL–9135–5] 

Approval and Promulgation of Air 

Quality Implementation Plans; Texas; 

Control of Air Pollution From Motor 

Vehicles 

AGENCY: Environmental Protection 

Agency (EPA). 

ACTION: Proposed rule. 

SUMMARY: The EPA is proposing to 

approve revisions to the Texas State 

Implementation Plan (SIP) that amend 

Title 30 of the Texas Administrative 

Code (TAC), Chapter 114, Control of Air 

Pollution from Motor Vehicles. The 

State submitted these revisions on May 

15, 2006, October 10, 2006, January 17, 

2008, and February 28, 2008. These 

revisions establish the Rebate Grant 

Process and the Texas Clean School Bus 

Program under the Texas Emissions 

Reduction Plan (TERP), further amend 

the TERP, and amend the Locally 

Enforced Motor Vehicle Idling 

Limitations. The EPA is proposing to 

approve these SIP revisions because 

they allow for clarity and consistency of 

the SIP requirements. The EPA is 

proposing to approve these revisions 

pursuant to section 110 of the Federal 

Clean Air Act (CAA). 

DATES: Written comments must be 

received on or before May 10, 2010. 

ADDRESSES: Comments may be mailed to 

Mr. Guy Donaldson, Chief, Air Planning 

Section (6PD–L), Environmental 

Protection Agency, 1445 Ross Avenue, 

Suite 1200, Dallas, Texas 75202–2733. 

Comments may also be submitted 

electronically or through hand delivery/ 

courier by following the detailed 

instructions in the ADDRESSES section of 

the direct final rule located in the rules 

section of this Federal Register. 

FOR FURTHER INFORMATION CONTACT: Ms. 

Dayana Medina, Air Planning Section 

(6PD–L), Multimedia Planning and 

Permitting Division, U.S. Environmental 

Protection Agency, Region 6, 1445 Ross 

Avenue, Suite 700, Dallas, Texas 75202– 

2733, telephone (214) 665–7241; fax 

number 214–665–7263; e-mail address 

medina.dayana@epa.gov. 

SUPPLEMENTARY INFORMATION: In the 

final rules section of this Federal 

Register, EPA is approving the State’s 

SIP submittal as a direct final rule 

without prior proposal because the 

Agency views this as a noncontroversial 

submittal and anticipates no adverse 

comments. A detailed rationale for the 

approval is set forth in the direct final 

rule. If no relevant adverse comments 

are received in response to this action, 

no further activity is contemplated. If 

EPA receives adverse comments, the 

direct final rule will be withdrawn and 

all public comments received will be 

addressed in a subsequent final rule 

based on this proposed rule. EPA will 

not institute a second comment period. 

Any parties interested in commenting 

on this action should do so at this time. 

Please note that if EPA receives adverse 

comment on an amendment, paragraph, 

or section of this rule and if that 

provision may be severed from the 

remainder of the rule, EPA may adopt 

as final those provisions of the rule that 

are not the subject of an adverse 

comment. 

For additional information, see the 

direct final rule, which is located in the 

rules section of this Federal Register. 


srobinson on DSKHWCL6B1PROD with PROPOSALS