31712 Federal Register / Vol. 83, No. 131 / Monday, July 9, 2018 / Proposed Rules 

also be viewed online through the 

Federal Docket Management System 

(FDMS) at http://www.regulations.gov. 

FOR FURTHER INFORMATION CONTACT: 

Michael Shores, Director, Office of 

Regulation Policy and Management, 

Office of the Secretary, Department of 

Veterans Affairs, 810 Vermont Avenue 

NW, Washington DC, 20420; (202) 461– 

4921. 

SUPPLEMENTARY INFORMATION: Section 

1710 of title 38 United States Code 

(U.S.C.) requires VA to ‘‘furnish hospital 

care and medical services which the 

Secretary determines to be needed’’ for 

eligible veterans. In 1999, VA 

promulgated 38 CFR 17.38, establishing 

the Department’s medical benefits 

package for veterans enrolled in VA’s 

health care system. 64 FR 54207 (Oct. 6, 

1999). The regulation describes the 

types of medical care and services 

available for such veterans. Care 

referred to in the medical benefits 

package is provided to individuals only 

if it is determined by appropriate 

healthcare professionals that the care is 

needed to promote, preserve, or restore 

the health of the individual and is in 

accord with generally accepted 

standards of medical practice. 38 CFR 

17.38(b). Paragraph (c) of that section 

provides a list of medical services the 

medical benefits package does not 

include. Paragraph (c)(4) explicitly 

excludes ‘‘gender alterations’’ from the 

medical benefits package. 

On May 9, 2016, VA received a 

Petition for Rulemaking petitioning VA 

to amend its medical regulations by 

removing the exclusion of ‘‘gender 

alterations’’ from its medical benefits 

package. The petition asks VA to 

remove 38 CFR 17.38(c)(4), allowing VA 

to provide gender alteration surgeries. 

As part of its ongoing consideration of 

the petition, VA now seeks public 

comment on the petition and on 

whether ‘‘gender alterations’’ should be 

included in the medical benefits 

package. On February 22, 2018, the 

Department of Defense issued a report 

that considered the efficacy of gender 

alteration surgery as treatment for 

gender dysphoria. That report noted 

considerable scientific uncertainty and 

overall lack of high quality scientific 

evidence demonstrating the extent to 

which transition-related treatments such 

as sex reassignment surgery remedy the 

multifaceted mental health problems 

associated with gender dysphoria. 

Commenters are specifically invited 

to address the following questions: 

What evidence is available about the 

safety and effectiveness of gender 

alterations for the treatment of gender 

dysphoria and how reliable is that 

evidence? 

Given the challenge of the high rates 

of Veteran suicide, what does the 

evidence, including peer-reviewed 

evidence, suggest about the impact of 

gender alterations on the rates of suicide 

and suicide ideation among those 

suffering from gender dysphoria? 

Given that any addition to the 

medical benefits package will have an 

associated cost and burden on existing 

specialists, especially urological and 

vascular surgeons and other highly 

trained specialists who are already in 

shorty supply nationwide, what is the 

potential impact of adding ‘‘gender 

alterations’’ on Veterans’ access to care, 

particularly for Veterans facing lifethreatening medical conditions waiting 

to see surgical specialists? 

We are providing a 60-day period 

from the date of publication of this 

Federal Register Notice for the public to 

submit comments on this subject. VA 

will consider the comments received, 

and then determine whether to propose 

a regulatory change in response to the 

Petition for Rulemaking. VA will 

announce any action it takes in the 

Federal Register. 

Signing Authority 

The Secretary of Veterans Affairs, or 

designee, approved this document and 

authorized the undersigned to sign and 

submit the document to the Office of the 

Federal Register for publication 

electronically as an official document of 

the Department of Veterans Affairs. 

Jacquelyn Hayes-Byrd, Acting Chief of 

Staff, Department of Veterans Affairs, 

approved this document on June 19, 

2018, for publication. 

Michael Shores, 

Director, Office of Regulation Policy & 

Management, Office of the Secretary, 

Department of Veterans Affairs. 

[FR Doc. 2018–14629 Filed 7–6–18; 8:45 am] 

BILLING CODE 8320–01–P 

POSTAL SERVICE 

39 CFR Part 111 

New Mailing Standards for Mailpieces 

Containing Liquids 

AGENCY: Postal ServiceTM. 

ACTION: Proposed rule. 

SUMMARY: The Postal Service is 

proposing to revise Mailing Standards 

of the United States Postal Service, 

Domestic Mail Manual (DMM) section 

601.3.4 to provide for more rigorous 

packaging requirements for mailpieces 

containing liquids. 

DATES: Submit comments on or before 

August 8, 2018. 

ADDRESSES: Mail or deliver written 

comments to the manager, Product 

Classification, U.S. Postal Service, 475 

L’Enfant Plaza SW, Room 4446, 

Washington, DC 20260–5015. If sending 

comments by email, include the name 

and address of the commenter and send 

to ProductClassification@usps.gov with 

a subject line of ‘‘New Standards for 

Liquids’’. Faxed comments are not 

accepted. You may inspect and 

photocopy all written comments, by 

appointment only, at USPS 

Headquarters Library, 475 L’Enfant 

Plaza SW, 11th Floor North, 

Washington, DC 20260. These records 

are available for review Monday through 

Friday, 9 a.m.–4 p.m., by calling 202– 

268–2906. 

FOR FURTHER INFORMATION CONTACT: 

Direct questions to Wm. Kevin Gunther 

at wkgunther@uspis.gov or phone at 

(202) 268–7208, or Michelle Lassiter at 

michelle.d.lassiter@usps.gov or phone at 

(202) 268–2914. 

SUPPLEMENTARY INFORMATION: The Postal 

Service and United States Postal 

Inspection Service (USPIS) have 

observed an increased frequency of 

incidents involving containers of liquids 

rupturing while in Postal Service 

networks. A typical result of these 

incidents is damage to surrounding 

mailpieces and to Postal Service 

equipment. 

When responding to incidents 

involving liquid spills, Postal Service 

employees frequently note that 

mailpieces containing liquids are often 

not marked on the outer mailing 

container as required by DMM 601.3.4. 

Many of these leaking mailpieces 

contain plastic primary receptacles. 

Mailers often do not consider plastic 

primary receptacles to be breakable, and 

therefore do not cushion these primary 

receptacles with absorbent material or 

include secondary containers, as 

specified by DMM 601.3.4. 

The Postal Service and USPIS have 

also observed that spills of nonhazardous materials in relatively small 

quantities can result in damage to 

surrounding mailpieces and cause 

temporary equipment shutdowns. This 

is especially true with viscous or oily 

substances, such as oils and lotions. 

These materials are often mailed by 

First-Class Package Service®. When 

ruptured, they will frequently leak onto 

other lightweight mailpieces containing 

photographs and documents. 

This proposed revision would require 

mailers of all liquids in nonmetal 

containers, regardless of volume, to 

provide triple packaging, including 


sradovich on DSK3GMQ082PROD with PROPOSALS
Federal Register / Vol. 83, No. 131 / Monday, July 9, 2018 / Proposed Rules 31713 

1Petition of the United States Postal Service for 

the Initiation of a Proceeding to Consider Proposed 

Changes in Analytical Principles (Proposal Six), 

June 26, 2018 (Petition). The Postal Service filed a 

non-public library reference with Proposal Six. 

Library Reference USPS–RM2018–9/NP1, 

Nonpublic Material Relating to Proposal Six, June 

26, 2018; Notice of Filing of USPS–RM2018–9/NP1 

and Application for Nonpublic Treatment, June 26, 

2018. 

absorbent cushioning materials, sealed 

secondary packaging, and a strong outer 

mailing container. The Postal Service is 

also adding language to encourage the 

use of locking rings when mailing metal 

containers with friction-top closures 

(push-down tops). 

The Postal Service believes these new 

mailing standards will prevent spills in 

general and reduce the frequency of 

incidents in which ruptured containers 

of liquid cause significant damage to 

surrounding mailpieces. The Postal 

Service anticipates that this proposed 

revision will result in decreased cost 

and time related to spill response, mail 

decontamination, site cleanup, and 

provide for an improved customer 

experience. 

If this proposed rule is adopted, the 

Postal Service will revise and align the 

language referencing the packaging of 

nonhazardous liquids located in DMM 

601.3.4 and add clarifying language 

regarding the use of orientation arrows. 

The Postal Service will also publish an 

appropriate amendment to 39 CFR part 

111 to reflect these changes. Finally, if 

the proposed rule is adopted, the Postal 

Service will also make corresponding 

revisions to Publication 52, Hazardous, 

Restricted, and Perishable Mail, section 

451 to align both publications with 

regard to the packaging of liquids in its 

networks. 

Although exempt from the notice and 

comment requirements of the 

Administrative Procedure Act (5 U.S.C. 

553(b), (c)) regarding proposed 

rulemaking by 39 U.S.C. 410(a), the 

Postal Service invites public comments 

on the following proposed revisions to 

Mailing Standards of the United States 

Postal Service, Domestic Mail Manual 

(DMM), incorporated by reference in the 

Code of Federal Regulations (see 39 CFR 

111.1). 

List of Subjects in 39 CFR Part 111 

Administrative practice and 

procedure, Incorporation by reference, 

Postal Service. 

Accordingly, for the reasons stated in 

the preamble, the Postal Service 

proposes that 39 CFR parts 111 and 113 

be amended as follows: 

PART 111—[AMENDED] 

■ 1. The authority citation for 39 CFR 

part 111 continues to read as follows: 

Authority: 5 U.S.C. 552(a); 13 U.S.C. 301– 

307; 18 U.S.C. 1692–1737; 39 U.S.C. 101, 

401, 403, 404, 414, 416, 3001–3011, 3201– 

3219, 3403–3406, 3621, 3622, 3626, 3632, 

3633, and 5001. 

■ 2. Revise the following sections of 

Mailing Standards of the United States 

Postal Service, Domestic Mail Manual 

(DMM), as follows: 

Mailing Standards of the United States 

Postal Service, Domestic Mail Manual 

(DMM) 

* * * * * 

600 Basic Standards for All Mailing 

Services 

601 Mailability 

* * * * * 

3.0 Packaging 

* * * * * 

3.4 Liquids 

[Revise the introductory paragraph of 

3.4 to read as follows:] 

Mailers must mark the outer container 

of a mailpiece containing liquid to 

indicate the nature of the contents, and 

include orientation arrows in 

accordance with Publication 52, section 

226. Mailers must package and mail 

liquids under the following conditions: 

[Revise 601.3.4a to read as follows:] 

a. Use screw-on caps with a minimum 

of one and one-half turns, soldering, 

clips, or similar means to close primary 

containers containing liquids. Do not 

use containers with friction-top closures 

(push-down tops) except as provided in 

3.4d. 

[Renumber the current 601.3.4b 

through 601.3.4d as the new 601.3.4c 

through 601.3.4e and add a new 

601.3.4b to read as follows:] 

b. The use of locking rings or similar 

devices is encouraged when mailing 

containers with friction-top closures 

(push-down tops). 

* * * * * 

[Revise renumbered 601.3.4d to read 

as follows:] 

d. All nonmetal containers of liquids, 

including plastic containers, and metal 

containers with friction top closures, 

without regard to volume, must be 

triple-packaged according to the 

following requirements: 

1. Cushion the primary container(s) 

with absorbent material capable of 

absorbing all of the liquid in the 

container(s) in case of breakage; 

2. Place the primary container inside 

another sealed, leakproof container 

(secondary container), such as a 

watertight can or plastic bag; and 

3. Use a strong and securely sealed 

outer mailing container durable enough 

to protect the contents and durable 

enough to withstand normal processing 

in Postal Service networks. 

* * * * * 

Ruth Stevenson, 

Attorney, Federal Compliance. 

[FR Doc. 2018–14382 Filed 7–6–18; 8:45 am] 

BILLING CODE 7710–12–P 

POSTAL REGULATORY COMMISSION 

39 CFR Part 3050 

[Docket No. RM2018–9; Order No. 4692] 

Periodic Reporting 

AGENCY: Postal Regulatory Commission. 

ACTION: Notice of proposed rulemaking. 

SUMMARY: The Commission is 

acknowledging a recent filing requesting 

the Commission initiate an informal 

rulemaking proceeding to consider 

changes to an analytical method for use 

in periodic reporting (Proposal Six). 

This document informs the public of the 

filing, invites public comment, and 

takes other administrative steps. 

DATES: Comments are due: August 15, 

2018. 

ADDRESSES: Submit comments 

electronically via the Commission’s 

Filing Online system at http://

www.prc.gov. Those who cannot submit 

comments electronically should contact 

the person identified in the FOR FURTHER

INFORMATION CONTACT section by 

telephone for advice on filing 

alternatives. 

FOR FURTHER INFORMATION CONTACT: 

David A. Trissell, General Counsel, at 

202–789–6820. 

SUPPLEMENTARY INFORMATION: 

Table of Contents 

I. Introduction 

II. Proposal Six 

III. Notice and Comment 

IV. Ordering Paragraphs 

I. Introduction 

On June 26, 2018, the Postal Service 

filed a petition pursuant to 39 CFR 

3050.11, requesting that the 

Commission initiate a rulemaking 

proceeding to consider changes to 

analytical principles relating to periodic 

reports.1 The Petition identifies the 


sradovich on DSK3GMQ082PROD with PROPOSALS