15650 Federal Register / Vol. 77, No. 52 / Friday, March 16, 2012 / Proposed Rules 

(C.) COAST GUARD SECTOR HAMPTON ROADS—COTP ZONE

Number Date Event Sponsor Location 

*******

24 ........ May 13, 2012 ........................ Ocean City Maryland Offshore Grand Prix.Offshore Performance Assn. 

Racing, LLC.

The waters of the Atlantic Ocean commencing at a point 

on the shoreline at latitude 38°25′42′′ N, longitude 

075°03′06′′ W; thence east southeast to latitude 

38°25′30′′ N, longitude 075°02′12′′ W, thence south 

southwest parallel to the Ocean City shoreline to latitude 

38°19′12′′ N, longitude 075°03′48′′ W; thence west 

northwest to the shoreline at latitude 38°19′30′′ N, longitude 075°05′00′′ W. The waters of the Atlantic Ocean 

bounded by a line drawn from a position along the 

shoreline near Ocean City, MD at latitude 38°22′25.2′′ N, 

longitude 075°03′49.4′′ W, thence easterly to latitude 

38°22′00.4′′ N, longitude 075°02′34.8′′ W, thence southwesterly to latitude 38°19′35.9′′ N, longitude 

075°03′35.4′′ W, thence westerly to a position near the 

shoreline at latitude 38°20′05′′ N, longitude 075°04′48.4′′ 

W, thence northerly along the shoreline to the point of 

origin. 

* * * * * 

Dated: February 17, 2012. 

Mark S. Ogle, 

Captain, U.S. Coast Guard, Captain of the 

Port Hampton Roads. 

[FR Doc. 2012–6380 Filed 3–15–12; 8:45 am] 

BILLING CODE 9110–04–P 

DEPARTMENT OF VETERANS 

AFFAIRS 

38 CFR Part 60 

RIN 2900–AN79 

Fisher House and Other Temporary 

Lodging 

AGENCY: Department of Veterans Affairs. 

ACTION: Proposed rule. 

SUMMARY: The Department of Veterans 

Affairs (VA) proposes to amend its 

regulations concerning Fisher House 

and other temporary lodging furnished 

by VA while a veteran is experiencing 

an episode of care at a VA medical 

facility. We intend that the proposed 

rule would update current regulations to 

better describe the application process 

for this assistance and clarify the 

distinctions between Fisher House and 

other temporary lodging provided by 

VA. The proposed rule generally reflects 

current VA policy and practice, and 

conforms to industry standards and 

expectations. 

DATES: Comments must be received by 

VA on or before May 15, 2012. 

ADDRESSES: Written comments may be 

submitted through http:// 

www.regulations.gov; by mail or hand 

delivery to the Director, Regulation 

Policy and Management (02REG), 

Department of Veterans Affairs, 810 

Vermont Ave. NW., Room 1068, 

Washington, DC 20420; or by fax to 

(202) 273–9026. Comments should 

indicate that they are submitted in 

response to ‘‘RIN 2900–AN79, Fisher 

House and Other Temporary Lodging’’. 

Copies of comments received will be 

available for public inspection in the 

Office of Regulation Policy and 

Management, Room 1063B, between the 

hours of 8 a.m. and 4:30 p.m., Monday 

through Friday (except holidays). Please 

call (202) 461–4902 (this is not a tollfree number) for an appointment. In 

addition, during the comment period, 

comments may be viewed online 

through the Federal Docket Management 

System at http://www.regulations.gov. 

FOR FURTHER INFORMATION CONTACT: 

Deborah Amdur, Chief Consultant, Care 

Management and Social Work Service 

(11SW), Veterans Health 

Administration, Department of Veterans 

Affairs, 810 Vermont Avenue NW., 

Washington, DC 20420, (202) 461–6780. 

(This is not a toll free number). 

SUPPLEMENTARY INFORMATION: Under the 

provisions of 38 U.S.C. 1708, VA ‘‘may 

furnish [certain] persons * * * with 

temporary lodging in a Fisher [H]ouse or 

other appropriate facility in connection 

with the examination, treatment, or care 

of a veteran under [chapter 17].’’ This 

authority to provide temporary lodging 

assists VA in providing appropriate 

treatment and care to veterans. 

Individuals receiving such treatment or 

care often respond better when they are 

accompanied by relatives, close friends, 

or caregivers. Thus, the provision of 

temporary lodging can be an important 

element of the veteran’s treatment. VA 

implemented its authority under section 

1708 in current 38 CFR part 60. 

However, we have determined that the 

current rules can be improved to better 

distinguish between Fisher House and 

other types of temporary lodging, and to 

describe the application process in 

greater detail. This proposed rule would 

provide such clarification, adding 

details where necessary. 

Section 60.1 Purpose and scope. 

Proposed § 60.1 would state that part 

60 applies to the use of Fisher House 

and other temporary lodging furnished 

by VA while a veteran is experiencing 

an episode of care at a VA health care 

facility. 

Section 60.2 Definitions. 

Proposed § 60.2 would set forth 

definitions applicable to part 60. For the 

purpose of receiving temporary lodging 

from VA, current regulations use the 

terms ‘‘eligible persons,’’ ‘‘a member of 

the family,’’ people who ‘‘provide the 

equivalent of family support,’’ and 

‘‘caregivers,’’ to refer to individuals 

permitted to accompany veterans during 

their episode of care. However, VA 

Form 10–0408A, the application form 

for Fisher House or other temporary 

lodging, uses the term ‘‘accompanying 

individual’’ to refer to such persons. For 

consistency of terms and to eliminate 

any ambiguity as to whether applicants 

must be related to the veteran, we 

propose to uniformly use the term 

‘‘accompanying individual.’’ We 

propose to define the term to mean ‘‘an 

individual seeking Fisher House or 

other temporary lodging, who provides 

familial support or the equivalent of 

familial support, to a veteran while the 

veteran is experiencing an episode of 

care.’’ The regulation would specifically 

explain that the term is ‘‘defined 

broadly to include relatives, close 

friends, and caregivers.’’ This proposed 

definition would therefore provide for a 

broader class of individuals permitted to 

accompany veterans during an episode 

of care. 

Current § 60.2 defines the term ‘‘C&P 

examination.’’ C&P is the acronym 


tkelley on DSK3SPTVN1PROD with PROPOSALS
Federal Register / Vol. 77, No. 52 / Friday, March 16, 2012 / Proposed Rules 15651 

commonly used to refer to VA’s 

compensation and pension programs. 

We propose to use the term 

‘‘compensation and pension 

examinations’’ instead of using the 

acronym. However, the proposed 

definition for ‘‘compensation and 

pension’’ examinations would be 

substantively identical to the definition 

in current § 60.2. 

We also propose to utilize the term 

‘‘episode of care’’ in lieu of ‘‘VA 

medical or compensation and pension 

examinations.’’ We propose to define an 

‘‘episode of care’’ as ‘‘a course of 

outpatient treatment, or a period of 

hospitalization, during which a veteran 

receives health care under 38 U.S.C. 

chapter 17, or 38 U.S.C. 8111 or 8153.’’ 

Although this would be a new term in 

part 60, it is well recognized in the 

medical community and it is generally 

accepted, used, and understood by the 

medical community and by managers 

working in the Fisher House and other 

temporary lodging programs. Further, 

using the term ‘‘episode of care’’ in our 

regulations would be clearer than 

repeatedly attempting to describe the 

types of care for which VA may provide 

lodging assistance, which is how this 

concept is set forth in the current 

regulations. 

For purposes of further clarification 

regarding the definition of ‘‘episode of 

care,’’ we propose to provide a nonexclusive list of examples of episodes of 

care. The first would be ‘‘[a]n 

appointment at a VA health care facility 

to receive health care or a compensation 

and pension examination.’’ This is 

consistent with our current regulations. 

See 38 CFR 60.1 (explaining that part 60 

‘‘sets forth requirements regarding the 

use of Fisher Houses and other 

temporary lodging by veterans receiving 

* * * [compensation and pension] 

examinations * * *.’’); see also 38 CFR 

60.3(a) (explaining that veterans with an 

appointment at a VA health care facility 

for the purpose of receiving health care 

or a compensation and pension 

examination are eligible to stay in 

temporary lodging). 

The second example would be as 

follows: ‘‘Extended outpatient 

treatment, such as treatment associated 

with organ transplant, chemotherapy, or 

radiation.’’ The use of Fisher House or 

other temporary lodging for such 

treatment is addressed in current § 60.7. 

These examples represent the most 

common episodes of care associated 

with applications for lodging, and the 

examples are consistent with current 

§ 60.3. 

The third example concerns 

hospitalizations for a critical injury or 

where death is imminent. In such cases, 

it can be helpful to the veteran to have 

friends or family present. The example 

would also include hospitalization 

‘‘where a veteran is unable to make 

medical decisions for him/herself and 

the accompanying individual is 

authorized to make such decisions on 

the veteran’s behalf.’’ In such cases, VA 

would consider an application for 

lodging by an accompanying individual 

who is authorized to make decisions for 

the veteran. We note that in most cases, 

such hospitalizations would also be 

considered hospitalizations for critical 

injury or illness. The purpose of this last 

example is to clarify that lodging may be 

provided for compassionate reasons, as 

well as logistically, medically, or legally 

necessary reasons. 

We also propose to define ‘‘Fisher 

House’’ as ‘‘a housing facility that is 

located at or near a VA health care 

facility and was constructed by and 

donated to VA by the Fisher House 

Foundation (formerly the Zachary and 

Elizabeth M. Fisher Armed Services 

Foundation).’’ This definition would be 

consistent with the definition of the 

term in current 38 CFR 60.2. However, 

we would add that the term includes ‘‘a 

facility that is treated as if it were Fisher 

House lodging under § 60.3.’’ We 

discuss this proposed addition below 

under proposed § 60.3. 

The definition of ‘‘other temporary 

lodging’’ would be slightly more 

detailed than the definition in current 

§ 60.2, but it would not be substantively 

different. The definition conforms to 

current usage and practice. 

‘‘VA’’ would be defined as ‘‘the 

Department of Veterans Affairs.’’ 

Section 60.3 Other donated temporary 

lodging. 

Proposed § 60.3 would establish that 

‘‘[w]henever VA receives, from a source 

other than the Fisher House Foundation, 

an undesignated donation of lodging to 

be used on a temporary basis, the 

lodging will be designated as if it were 

Fisher House lodging or be treated as 

other temporary lodging based upon the 

types of lodging available in the area.’’ 

Under 38 U.S.C. 8103(a)(2), the 

Secretary of Veterans Affairs (Secretary) 

may accept donations of ‘‘any facility 

* * * that the Secretary considers 

necessary for use as a medical facility.’’ 

See also 38 U.S.C. 8104(e) (authorizing 

VA to accept donations of medical 

facilities). 38 U.S.C. 8101(3) defines a 

‘‘medical facility’’ as a facility used for 

the provision of health-care services and 

including any necessary associated 

buildings. We interpret this definition of 

‘‘medical facility’’ as including lodging 

to be used on a temporary basis in 

connection with VA health care since 

the provision of temporary lodging can 

be an important element of a veteran’s 

treatment. 

Under proposed § 60.3, if the 

Secretary accepts a gift that specifies the 

terms of lodging to be provided, then 

the lodging would be used in the 

manner specified by the grantor of the 

gift. However, if no terms are specified, 

the Secretary would designate, based on 

consideration of the types of lodging 

available in the area, whether the gift 

would be treated as ‘‘other temporary 

lodging’’ or as if it were donated by the 

Fisher House Foundation. This is 

consistent with current VA practice. 

Section 60.10 Eligibility criteria for 

Fisher House or other temporary 

lodging. 

Proposed § 60.10 would set forth the 

eligibility criteria for lodging under part 

60. It would include provisions from 

several current regulations. However, 

we propose to reorganize the 

information for clarity. 

Proposed paragraph (a) would 

establish the general rule that ‘‘[w]hile 

a veteran is undergoing an episode of 

care, VA may provide either Fisher 

House or other temporary lodging, as 

appropriate, if the application meets the 

requirements of this part 60. These are 

the only types of lodging provided by 

VA under this part.’’ Proposed 

paragraph (a) is consistent with current 

§ 60.3. We would also add a new note 

to paragraph (a), which would clarify 

that ‘‘[l]odging provided for under this 

part will not be used by a person 

participating in a VA residential 

treatment program, or as a substitute for 

participation in such a program.’’ This 

note would help ensure that temporary 

lodging is properly used for its intended 

purposes, and not as an alternative to 

proper residential care. 

There are currently active duty 

servicemembers who receive care at VA 

facilities under the authority of 38 

U.S.C. 8111. Under these circumstances 

we provide lodging in the same manner 

that lodging is provided for veterans and 

their accompanying individuals. 

Servicemembers would be subject to the 

same rules as veterans and they would 

be required to meet the same eligibility 

requirements concerning episodes of 

care. 

Proposed paragraph (b) would set 

forth the general requirements for Fisher 

House and other temporary lodging. 

Further, proposed paragraph (b) would 

clarify the major distinction between 

Fisher House lodging and other 

temporary lodging. We have determined 

that current regulations lack sufficient 

clarity regarding these two different 

types of lodging. The primary 


tkelley on DSK3SPTVN1PROD with PROPOSALS
15652 Federal Register / Vol. 77, No. 52 / Friday, March 16, 2012 / Proposed Rules 

distinction is that Fisher House lodging 

is generally limited to accompanying 

individuals. It is not available for 

unaccompanied veterans. 

Also, we propose to add a note to 

paragraph (b) to clarify that ‘‘VA does 

not impose a general limit on the 

number of persons who may accompany 

a veteran, but VA may in specific cases 

provide lodging to only a specific 

number of persons due to space or 

resource limitations.’’ This is consistent 

with VA’s current general practice, 

which is to allocate lodging on a spaceavailable basis. 

Concerning the differences between 

Fisher House lodging and other 

temporary lodging provided by VA, 

proposed paragraph (b)(1) would clarify 

that Fisher House lodging is not used to 

lodge unaccompanied veterans or 

individuals in need of transitional or 

permanent housing. This distinction is 

essential to preserve the intent of the 

Fisher House Foundation, which is to 

provide support for families while a 

veteran experiences an episode of care. 

Because the purpose of Fisher House 

lodging is to provide a retreat for 

accompanying individuals from the 

medical care environment, Fisher House 

lodging is available only to 

accompanying individuals and, in 

limited circumstances of immediate 

need and no alternative temporary 

lodging, to veterans with accompanying 

individuals. 

Proposed paragraph (b)(2) would 

discuss other temporary lodging. We 

would clarify in this paragraph that for 

an accompanying individual to stay in 

other temporary lodging, the veteran 

must also be staying in temporary 

lodging. We would further specify in a 

note to this paragraph that VA may, due 

to space restrictions, impose a limit on 

the number of accompanying 

individuals. 

Proposed paragraph (c) would restate 

the requirement in current § 60.4(h) that 

the veteran be medically stable and 

capable of self-care or be accompanied 

by an individual who is able to provide 

all necessary care. The proposed rule 

would clearly state that this requirement 

applies to both Fisher House lodging 

and other temporary lodging. The 

current rule is ambiguous in this regard. 

The capacity for self-care is required 

because neither Fisher House lodging 

nor other temporary lodging is intended 

to be substitutes for, or supplements to, 

medical care. 

Proposed § 60.10(d) would restate the 

existing travel time/distance 

requirement in current § 60.5, but would 

clarify that the distance requirement 

applies to both Fisher House and other 

temporary lodging. The current rule is 

ambiguous in this regard. Proposed 

paragraph (d) would permit the travel 

time/distance requirement to be 

applicable to ‘‘the applicant,’’ allowing 

this requirement to be considered for an 

accompanying individual as well as for 

a veteran. This is current VA practice 

when considering Fisher House 

applications from non-veterans 

accompanying veterans. It would also 

clarify that VA may waive the time/ 

distance requirement under exceptional 

circumstances that apply to either the 

accompanying individual or the veteran. 

In proposed paragraph (e) we would 

prescribe special consideration for organ 

donors and their accompanying 

individuals. Specifically, regarding 

individuals who wish to donate an 

organ to a veteran, we would explain 

that ‘‘VA may provide Fisher House or 

other temporary lodging for individuals 

who must be present on site for 

evaluation, donation, and care related to 

their status as an organ donor for a 

veteran. VA may also provide Fisher 

House or other temporary lodging for 

the donor’s accompanying individuals 

at all phases of the transplant process.’’ 

This provision is based on clinical need 

pursuant to 38 U.S.C. 1710(a) regarding 

eligibility for hospital care and medical 

services and not on our temporary 

lodging authority under section 1708. 

Outcomes of transplantation are linked 

directly to the presence and competence 

of accompanying individuals who 

support the organ donor at all phases of 

the transplant process. In addition, this 

paragraph would recognize VA’s 

obligations to living donors who give 

veterans the gift of life. 

Section 60.15 Application process. 

Proposed § 60.15 would prescribe the 

application process for Fisher House or 

other temporary lodging. Under current 

§ 60.4, applications for lodging may be 

submitted by mail, telephone, facsimile, 

in person, or electronically. We intend 

to continue to provide for the same 

means of submissions. Proposed 

§ 60.15(a) would simply restate a 

portion of current § 60.4. Under 

proposed § 60.15(a), we would refer to 

VA Form 10–0408A as the application 

and provide information about where to 

obtain the form. We would also specify 

where to submit the completed form. 

This additional information is intended 

to assist applicants. We do not intend 

any changes in the current application 

process. 

In proposed paragraph (b), which is 

based upon current § 60.8 and 60.9, we 

would describe how VA processes 

applications and makes decisions to 

grant temporary lodging. However, we 

propose to add detail for purposes of 

clarification. 

Paragraph (b)(1) would state that 

applications ‘‘are generally processed in 

the order that they are received by VA, 

and temporary lodging is then granted 

on a first-come, first-served basis; 

however, in extraordinary 

circumstances, such as imminent death, 

critical injury, or organ donation 

applications may be processed out of 

order.’’ The general rule that 

applications would be processed in the 

order received would be based upon the 

last sentence of current § 60.8, which 

prescribes, ‘‘[t]emporary lodging will be 

provided on a first-come, first-served 

basis.’’ However, the proposed 

exceptions for circumstances involving 

imminent death, critical injury, or organ 

donation are new and we propose the 

exceptions because in these 

circumstances, we believe that family 

members and loved ones should be 

given every opportunity to be with the 

veteran and, likewise, that the veteran 

should be accompanied by such people. 

Proposed paragraph (b)(2) would state 

that ‘‘[t]emporary lodging is granted on 

a space-available basis, with some 

consideration given to the compatibility 

of the applicant(s) and the room(s) 

available.’’ This general rule would be 

based upon current § 60.8. The 

proposed paragraph would provide, by 

way of example, that ‘‘although VA may 

require an applicant to share a room 

with another veteran’s accompanying 

individual, VA would not do so if the 

persons affected are not the same 

gender.’’ 

Proposed paragraph (b)(3) would 

essentially restate the second sentence 

of current § 60.8. It is important that 

grants of temporary lodging at a VA 

health care facility, usually in nonutilized beds, be subject to the approval 

of the Director of the health care facility 

in order to avoid any negative impact on 

patient care. For example, a non-utilized 

bed that might not be provided to an 

accompanying individual could include 

a bed located in an intensive care unit 

or in an area of the hospital from which 

visitors are limited or barred. In 

addition, the proposed rule would add 

that ‘‘[n]on-utilized beds provided to 

accompanying individuals must be 

reassigned to VA patients when 

necessary.’’ If a patient needs to use a 

bed that was previously non-utilized 

and was provided to an accompanying 

individual, the patient would take 

priority over the accompanying 

individual and the bed would no longer 

be considered ‘‘non-utilized.’’ In such 

cases, VA would make every effort to 

relocate the accompanying individual 

into other temporary lodging. 


tkelley on DSK3SPTVN1PROD with PROPOSALS
Federal Register / Vol. 77, No. 52 / Friday, March 16, 2012 / Proposed Rules 15653 

Proposed paragraph (b)(4) would 

restate the funding limitation prescribed 

in current § 60.8, without substantive 

change. 

Proposed paragraph (b)(5) would state 

that ‘‘[s]ubject to all criteria provided in 

this part, the person responsible for 

coordinating the Fisher House and other 

temporary lodging program(s) at the VA 

health care facility of jurisdiction is 

responsible for making decisions to 

grant temporary lodging. These 

decisions are considered to be final VA 

decisions concerning individual 

medical treatment plans and the 

scheduling and use of VA lodging 

facilities, and they are not appealable to 

the Board of Veterans’ Appeals.’’ This 

general rule would be based upon 

current § 60.9, and would reflect current 

VA policy and practice. The Fisher 

House program is a unique privatepublic partnership between The Fisher 

House Foundation, Inc., and the 

Secretary of Veterans Affairs to provide 

temporary lodging for individuals who 

accompany a veteran during the 

veteran’s hospitalization for an illness, 

disease, or injury. Fisher Houses are 

given to the U.S. Government as gifts, 

and VA subsequently is responsible for 

the operation and maintenance of Fisher 

Houses. Lodging in Fisher Houses and 

other facilities is not a VA benefit, but 

rather a temporary resource made 

available to veterans on a first-come 

first-serve basis, when necessary criteria 

under the rule are met. Section 1708 

gives VA discretion to provide such 

lodging when appropriate and available, 

but does not establish a right to such 

lodging as a VA ‘‘benefit.’’ VA does not 

guarantee accommodations in VA Fisher 

Houses or in other temporary lodging 

facilities, and completion of the 

application process as described in the 

rule does not ensure temporary lodging 

would be provided. VA’s 

determinations in providing such 

lodging are based in part on medical 

judgment regarding the course of a 

veteran’s treatment and in part on 

administrative scheduling matters 

concerning the availability of space. 

These types of determinations generally 

are not subject to appellate review, nor 

could such review ordinarily be 

accompanied within the timeframes 

relevant to administering temporary 

lodging. Therefore, we do not interpret 

section 1708 as creating any benefit 

entitlement within the jurisdiction of 

the Board of Veterans’ Appeals. Rather, 

lodging decisions made under this 

proposed rule would be final VA 

decisions. 

Proposed paragraphs (b)(6) and (7) 

would reflect current practice not 

prescribed in current regulations. These 

paragraphs would explain that when VA 

cannot grant an application for one type 

of lodging, we would consider whether 

the applicant could qualify for the other 

type of lodging, regardless of any 

selection on the application. If the 

application cannot be granted for either 

type of lodging, we would send the 

application to a VA social worker to see 

if other arrangements can be made to 

assist the applicant. 

Proposed paragraph (c) would restate 

current § 60.10, without substantive 

revision. 

As indicated throughout this 

preamble, VA Form 10–0408A has been 

designated as the application form for 

Fisher House and Other Temporary 

Lodging. Current regulations do not 

refer specifically to VA Form 10–0408A. 

However, the form was approved by the 

Office of Management and Budget 

(OMB). Therefore, we intend to note in 

a parenthetical at the end of proposed 

§ 60.15 that OMB has approved the 

collection of information under control 

number 2900–0630. 

Section 60.20 Duration of Fisher 

House or other temporary lodging. 

Proposed § 60.20 would be the final 

section in part 60 and it would concern 

the duration of lodging provided by VA 

under part 60. Substantively, proposed 

paragraphs (a) and (b) would be similar 

to current § 60.7, except that the 

proposed rule would use the term 

‘‘episode of care’’ rather than describe 

specific types of medical treatment. 

Proposed § 60.20(c) would permit an 

extension of a previous period of 

lodging. The duration of a period of 

lodging would be specific to each 

situation set forth on the application 

and, therefore, would generally be 

defined by the terms of the granted 

application. However, in certain cases 

we might need to provide exceptions, 

such as when a medical emergency 

occurs during a scheduled episode of 

care or when weather changes prevent 

departure from the lodging provided by 

VA. 

Proposed paragraph (d) would 

authorize an indefinite period of lodging 

for individuals accompanying a veteran 

who is hospitalized for an indefinite 

period based on the treatment or 

rehabilitation needs of the veteran as 

determined by the veteran’s health care 

team and based on the availability of 

Fisher House lodging or of funding for 

other temporary lodging. Lodging in 

non-utilized VA hospital beds would 

not be authorized for an indefinite 

period due to the administrative and 

medical needs of VA medical facilities. 

Proposed paragraphs (e) and (f) would 

be consistent with current § 60.7. These 

paragraphs would restrict awards of 

temporary lodging to veterans who are 

unable to arrive for a scheduled 

appointment at the health care facility if 

they left their home after 8 a.m. or who 

would be unable to return home before 

7 p.m. We believe that travel before 

8 a.m. or after 7 p.m. may be more 

difficult or dangerous than travel during 

regular daylight hours. 

Effect of Rulemaking 

Title 38 of the Code of Federal 

Regulations, as proposed to be revised 

by this proposed rulemaking, would 

represent VA’s implementation of its 

exclusive legal authority on this subject. 

Other than future amendments to this 

regulation or governing statutes, no 

contrary rules or procedures would be 

authorized. All existing and subsequent 

VA guidance would be read to conform 

with this proposed rulemaking if 

possible or, if not possible, such 

guidance would be superseded by this 

rulemaking. 

Paperwork Reduction Act 

Although this document contains 

provisions constituting collections of 

information under the provisions of the 

Paperwork Reduction Act (44 U.S.C. 

3501–3521), no new or proposed revised 

collections of information are associated 

with this proposed rule. The 

information collection provisions for 

this section are approved by OMB and 

have been assigned OMB control 

number 2900–0630. 

Regulatory Flexibility Act 

The Secretary hereby certifies that 

this proposed rule would not have a 

significant economic impact on a 

substantial number of small entities as 

they are defined in the Regulatory 

Flexibility Act, 5 U.S.C. 601–612. This 

proposed rule would not cause a 

significant economic impact on health 

care providers, suppliers, or entities 

because the proposed rule would apply 

only to patients receiving care at VA 

facilities. Also, this proposed rule might 

have an insignificant impact on small 

entities involved in the lodging 

industry. However, any effect would be 

minuscule. Therefore, under 5 U.S.C. 

605(b), this proposed rule is exempt 

from the initial and final regulatory 

flexibility analyses requirements of 5 

U.S.C. 603 and 604. 

Executive Orders 12866 and 13563 

Executive Orders 12866 and 13563 

direct agencies to assess the costs and 

benefits of available regulatory 

alternatives and, when regulation is 

necessary, to select regulatory 

approaches that maximize net benefits 


tkelley on DSK3SPTVN1PROD with PROPOSALS
15654 Federal Register / Vol. 77, No. 52 / Friday, March 16, 2012 / Proposed Rules 

(including potential economic, 

environmental, public health and safety 

effects, and other advantages; 

distributive impacts; and equity). 

Executive Order 13563 (Improving 

Regulation and Regulatory Review) 

emphasizes the importance of 

quantifying both costs and benefits, 

reducing costs, harmonizing rules, and 

promoting flexibility. Executive Order 

12866 (Regulatory Planning and 

Review) classifies a ‘‘significant 

regulatory action,’’ requiring review by 

OMB, unless OMB waives such review 

as ‘‘any regulatory action that is likely 

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

annual effect on the economy of $100 

million or more or adversely affect in a 

material way the economy, a sector of 

the economy, productivity, competition, 

jobs, the environment, public health or 

safety, or State, local, or tribal 

governments or communities; (2) Create 

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.’’ 

The economic, interagency, 

budgetary, legal, and policy 

implications of this proposed rule have 

been examined and it has been 

determined not to be a significant 

regulatory action under Executive Order 

12866. 

Unfunded Mandates 

The Unfunded Mandates Reform Act 

of 1995 requires, at 2 U.S.C. 1532, that 

agencies prepare an assessment of 

anticipated costs and benefits before 

issuing any rule that may result in the 

expenditure by State, local, and tribal 

governments, in the aggregate, or by the 

private sector, of $100 million or more 

(adjusted annually for inflation) in any 

year. This proposed rule would have no 

such effect on State, local, and tribal 

governments, or on the private sector. 

Catalog of Federal Domestic Assistance 

The Catalog of Federal Domestic 

Assistance program number and title for 

this rule are as follows: 64.005, Grants 

to States for Construction of State Home 

Facilities; 64.007, Blind Rehabilitation 

Centers; 64.008, Veterans Domiciliary 

Care; 64.009, Veterans Medical Care 

Benefits; 64.010, Veterans Nursing 

Home Care; 64.014, Veterans State 

Domiciliary Care; 64.015, Veterans State 

Nursing Home Care; 64.018, Sharing 

Specialized Medical Resources; 64.019, 

Veterans Rehabilitation Alcohol and 

Drug Dependence; 64.022, Veterans 

Home Based Primary Care; and 64.024, 

VA Homeless Providers Grant and Per 

Diem Program. 

Signing Authority 

The Secretary of Veterans Affairs, or 

designee, approved this document and 

authorized the undersigned to sign and 

submit the document to the Office of the 

Federal Register for publication 

electronically as an official document of 

the Department of Veterans Affairs. John 

R. Gingrich, Chief of Staff, Department 

of Veterans Affairs, approved this 

document on March 8, 2012, for 

publication. 

List of Subjects in 38 CFR Part 60 

Health care, Health facilities, Health 

records, Reporting and recordkeeping 

requirements, Housing, Travel, 

Veterans. 

Dated: March 13, 2012. 

Robert C. McFetridge, 

Director of Regulation Policy and 

Management, Office of the General Counsel, 

Department of Veterans Affairs. 

For the reasons stated in the 

preamble, VA proposes to amend 38 

CFR part 60 as follows: 

PART 60—FISHER HOUSES AND 

OTHER TEMPORARY LODGING 

1. The authority citation for part 60 

continues to read as follows: 

Authority: 38 U.S.C. 501, 1708. 

2. Part 60 is revised to read as follows: 

Sec. 

60.1 Purpose and scope. 

60.2 Definitions. 

60.3 Other donated temporary lodging. 

60.10 Eligibility criteria for Fisher House or 

other temporary lodging. 

60.15 Application process. 

60.20 Duration of Fisher House or other 

temporary lodging. 

§ 60.1 Purpose and scope. 

This part applies to Fisher House and 

other temporary lodging furnished by 

VA while a veteran is experiencing an 

episode of care at a VA health care 

facility. 

(Authority: 38 U.S.C. 501, 1708). 

§ 60.2 Definitions. 

For the purposes of this part: 

Accompanying individual means an 

individual seeking Fisher House or 

other temporary lodging, who provides 

familial support or the equivalent of 

familial support, to a veteran while the 

veteran is experiencing an episode of 

care. This term is defined broadly to 

include relatives, close friends, and 

caregivers. 

Compensation and pension 

examination means an examination 

requested by VA’s Veterans Benefits 

Administration to be conducted at a VA 

health care facility for the purpose of 

evaluating a veteran’s claim. 

Episode of care means a course of 

outpatient treatment, or a period of 

hospitalization, during which a veteran 

receives health care under 38 U.S.C. 

chapter 17, or 38 U.S.C. 8111 or 8153. 

Examples of episodes of care include 

(but are not limited to) the following: 

(1) An appointment at a VA health 

care facility to receive health care or a 

compensation and pension examination. 

(2) Extended outpatient treatment, 

such as treatment associated with organ 

transplant, chemotherapy, or radiation. 

(3) Hospitalization for a critical injury 

or illness; where death is imminent; or 

where a veteran is unable to make 

medical decisions for him/herself and 

the accompanying individual is 

authorized to make such decisions on 

the veteran’s behalf. 

Fisher House means a housing facility 

that is located at or near a VA health 

care facility and was constructed by and 

donated to VA by the Fisher House 

Foundation (formerly the Zachary and 

Elizabeth M. Fisher Armed Services 

Foundation), or a facility that is treated 

as if it were Fisher House lodging under 

§ 60.3. 

Other temporary lodging includes: 

(1) Lodging at a temporary lodging 

facility, other than a Fisher House, 

located at a VA health care facility 

(generally referred to as a ‘‘hoptel’’); 

(2) A hotel or motel; 

(3) Non-utilized beds at a VA health 

care facility designated as lodging beds; 

and 

(4) Other donated lodging to be used 

on a temporary basis in accordance with 

38 U.S.C. 1708. 

VA means the Department of Veterans 

Affairs. 

(Authority: 38 U.S.C. 501, 1708) 

§ 60.3 Other donated temporary lodging. 

Whenever VA receives, from a source 

other than the Fisher House Foundation, 

an undesignated donation of lodging to 

be used on a temporary basis, the 

lodging will be designated as if it were 

Fisher House lodging or be treated as 

other temporary lodging based upon the 

types of lodging available in the area. If 

VA receives a gift that specifies the 

terms of the lodging provided, VA will 

use the lodging provided in the manner 

specified by the donor. 

(Authority: 38 U.S.C. 501, 1708, 8103, 8104) 


tkelley on DSK3SPTVN1PROD with PROPOSALS
Federal Register / Vol. 77, No. 52 / Friday, March 16, 2012 / Proposed Rules 15655 

§ 60.10 Eligibility criteria for Fisher House 

or other temporary lodging. 

(a) General. While a veteran is 

undergoing an episode of care, VA may 

provide either Fisher House or other 

temporary lodging, as appropriate, if the 

application meets the requirements of 

this part 60. These are the only types of 

lodging provided by VA under this part. 

Note: Lodging provided for under this 

part will not be used by a person 

participating in a VA residential 

treatment program, or as a substitute for 

participation in such a program. 

(b) Eligible persons. (1) Fisher House. 

VA may provide Fisher House lodging 

to accompanying individual(s) and, in 

limited circumstances of immediate 

need and no alternative temporary 

lodging, to a veteran with one or more 

accompanying individual(s). Fisher 

House lodging will not be used to lodge 

unaccompanied veterans or individuals 

in need of transitional or permanent 

housing. Note: VA does not impose a 

general limit on the number of persons 

who may accompany a veteran, but VA 

may in specific cases provide lodging to 

only a specific number of persons due 

to space or resource limitations. 

(2) Other temporary lodging. VA may 

provide other temporary lodging to a 

veteran or to a veteran and his or her 

accompanying individual(s). 

Accompanying individuals may not stay 

in other temporary lodging unless the 

veteran is also staying in temporary 

lodging. Note: VA does not impose a 

general limit on the number of persons 

who may accompany a veteran, but VA 

may in specific cases provide lodging to 

only a specific number of persons due 

to space or resource limitations. 

(c) Condition of the veteran. Fisher 

House or other temporary lodging will 

not be provided to a veteran unless the 

VA official reviewing the application 

determines, based on the application 

and on any necessary clinical 

information, that the veteran is: 

(1) Medically stable and capable of 

self-care; or 

(2) Accompanied by an individual 

who is able to provide all necessary 

care. 

(d) Travel time/distance requirement. 

Fisher House or other temporary lodging 

may be provided only if the applicant 

seeking lodging must travel at least 50 

miles, or for 2 hours, from his or her 

home to the VA health care facility. VA 

may waive these requirements based on 

exceptional circumstances, such as 

when the physical condition of an 

accompanying individual and/or the 

veteran, inclement weather, road 

conditions, or the mode of 

transportation, make it difficult or 

dangerous to travel to or return from the 

VA health care facility without an 

overnight stay. 

(e) Special authority for organ 

transplant cases. Notwithstanding any 

other provision of this part, VA may 

provide Fisher House or other 

temporary lodging for individuals who 

must be present on site for evaluation, 

donation, and care related to their status 

as an organ donor for a veteran. VA may 

also provide Fisher House or other 

temporary lodging for the donor’s 

accompanying individuals at all phases 

of the transplant process. 

(Authority: 38 U.S.C. 501, 1708, 1710(a)) 

§ 60.15 Application process. 

(a) Obtaining and submitting the 

application. VA Form 10–0408A is the 

application for Fisher House and other 

temporary lodging. Applications may be 

submitted by mail, telephone, facsimile, 

in person, or electronically. VA Form 

10–0408A is available from any VA 

medical center or may be obtained 

online at http://vaww4.va.gov/vaforms/ 

medical/pdf/vha-10-0408A-fill.pdf. The 

completed application must be 

submitted as follows: 

(1) For Fisher House lodging, to the 

Fisher House Manager at the VA 

medical center of jurisdiction. 

(2) For other temporary lodging, to the 

temporary lodging program coordinator 

at the VA medical center of jurisdiction. 

(b) Processing applications. (1) 

Applications are generally processed in 

the order that they are received by VA, 

and temporary lodging is then granted 

on a first come first serve basis; 

however, in extraordinary 

circumstances, such as imminent death, 

critical injury, or organ donation 

applications may be processed out of 

order. 

(2) Temporary lodging is granted on a 

space-available basis, with some 

consideration given to the compatibility 

of the applicant(s) and the room(s) 

available. For example, although VA 

may require an applicant to share a 

room with another veteran’s 

accompanying individual, VA would 

not do so if the persons affected are not 

the same gender. 

(3) Temporary lodging at a VA health 

care facility, such as non-utilized beds 

in a VA medical facility, may be made 

available only if not barred by law and 

if the Director of the medical facility 

determines that such action would not 

have a negative impact on patient care. 

Non-utilized beds provided to 

accompanying individuals must be 

reassigned to VA patients when 

necessary. 

(4) The Director of the VA Medical 

Center of jurisdiction will determine 

whether local funding is sufficient to 

allow the use of temporary lodging in 

hotels and motels. 

(5) Subject to all criteria provided in 

this part, the person responsible for 

coordinating the Fisher House and other 

temporary lodging program(s) at the VA 

health care facility of jurisdiction is 

responsible for making decisions to 

grant temporary lodging. These 

decisions are considered to be final VA 

decisions concerning individual 

medical treatment plans and the 

scheduling and use of VA lodging 

facilities, and they are not appealable to 

the Board of Veterans’ Appeals. 

(6) If VA denies an application for one 

type of lodging, such as at a Fisher 

House, the application will be 

considered for other temporary lodging 

and vice versa, if the applicant is 

eligible. 

(7) If VA denies the application for all 

types of temporary lodging, VA will 

refer the application to a VA social 

worker at the VA medical center of 

jurisdiction to determine if other 

arrangements can be made. 

(c) Costs for Fisher House and other 

temporary lodging under this part are 

borne by VA. 

(Authority: 38 U.S.C. 501, 1708) 

(The Office of Management and Budget 

has approved the information collection 

requirements in this section under OMB 

control number 2900–0630) 

§ 60.20 Duration of Fisher House or other 

temporary lodging. 

Fisher House or other temporary 

lodging may be awarded for the 

following periods: 

(a) While the veteran is undergoing an 

episode of care. 

(b) While the veteran is hospitalized, 

if the veteran is admitted to a VA 

medical facility while undergoing an 

outpatient episode of care for which 

temporary lodging was already 

provided. 

(c) As extended by the appropriate VA 

clinician or social worker based on an 

emergency situation or unforeseen 

circumstances. 

(d) For an indefinite period for 

accompanying individuals who are 

visiting veterans hospitalized for an 

indefinite period, provided that the 

accompanying individual is not using a 

VA medical facility bed. Whether a 

veteran is hospitalized for an indefinite 

period will be based upon the treatment 

or rehabilitation needs of the veteran as 

determined by the veteran’s health care 

team. 

(e) Temporary lodging may be 

furnished the night before the day of a 

scheduled appointment if, the veteran 

leaving home after 8 a.m., would be 


tkelley on DSK3SPTVN1PROD with PROPOSALS
15656 Federal Register / Vol. 77, No. 52 / Friday, March 16, 2012 / Proposed Rules 

unable to arrive at the health care 

facility by the time of the scheduled 

appointment. 

(f) Temporary lodging may be 

furnished the night of the scheduled 

appointment if, after the appointment, 

the veteran would be unable to return 

home before 7 p.m. When a veteran is 

undergoing outpatient treatment or 

procedures the veteran and 

accompanying individual(s) may be 

furnished temporary lodging for the 

duration of the episode of care subject 

to limitations described in this section. 

(Authority: 38 U.S.C. 501, 1708) 

[FR Doc. 2012–6397 Filed 3–15–12; 8:45 am] 

BILLING CODE 8320–01–P 

ENVIRONMENTAL PROTECTION 

AGENCY 

40 CFR Parts 51 and 52 

[EPA–HQ–OAR–2003–0062; FRL–9648–1] 

RIN 2060–AR30 

Implementation of the New Source 

Review (NSR) Program for Particulate 

Matter Less Than 2.5 Micrometers 

(PM2.5): Amendment to the Definition 

‘‘Regulated NSR Pollutant’’ 

Concerning Condensable Particulate 

Matter 

AGENCY: Environmental Protection 

Agency (EPA). 

ACTION: Proposed rule. 

SUMMARY: The EPA is proposing to 

revise the definition ‘‘regulated NSR 

pollutant’’ contained in two sets of 

Prevention of Significant Deterioration 

(PSD) regulations and in the EPA’s 

Emission Offset Interpretative Ruling. 

This revision would correct an 

inadvertent error made in 2008 when 

the EPA issued its final rule to 

implement the new source review (NSR) 

program for fine particles with an 

aerodynamic diameter of less than or 

equal to 2.5 micrometers (PM2.5). 

Effectively, this revision would 

reestablish the interpretation that for 

measurement of ‘‘particulate matter 

emissions’’ in the context of the PSD 

and NSR regulations there is no explicit 

requirement to include measurement of 

condensable PM. However, the 

condensable portion would continue to 

be required for emissions of particles 

with an aerodynamic diameter of less 

than or equal to 10 micrometers (PM10) 

and PM2.5. 

DATES: Comments must be received on 

or before May 15, 2012. 

Public Hearing. If anyone contacts the 

EPA requesting the opportunity to speak 

at a public hearing concerning the 

proposed regulation by March 26, 2012, 

the EPA will hold a public hearing 

approximately 30 days after publication 

in the Federal Register. Additional 

information about the hearing would be 

published in a subsequent Federal 

Register notice. 

ADDRESSES: Submit your comments, 

identified by Docket ID No. EPA–HQ– 

OAR–2003–0062, by one of the 

following methods: 

• http://www.regulations.gov. Follow 

the online instructions for submitting 

comments. 

• Email: a-and-r-docket@epa.gov. 

• Mail: Air and Radiation Docket, 

Environmental Protection Agency, Mail 

code 6102T, 1200 Pennsylvania Avenue 

NW., Washington, DC 20460. Please 

include a total of two copies. 

• Hand Delivery: EPA Docket Center, 

Public Reading Room, EPA West, Room 

3334, 1301 Constitution Ave. NW., 

Washington, DC 20460. Such deliveries 

are only accepted during the Docket’s 

normal hours of operation, and special 

arrangements should be made for 

deliveries of boxed information. 

Instructions: Direct your comments to 

the applicable docket. The EPA’s policy 

is that all comments received will be 

included in the public docket without 

change and may be made available 

online at http://www.regulations.gov, 

including any personal information 

provided, unless the comment includes 

information claimed to be confidential 

business information (CBI) or other 

information whose disclosure is 

restricted by statute. Do not submit 

information that you consider to be CBI 

or otherwise protected through 

www.regulations.gov or email. The 

www.regulations.gov Web site is an 

‘‘anonymous access’’ system, which 

means the EPA will not know your 

identity or contact information unless 

you provide it in the body of your 

comment. If you send an email 

comment directly to the EPA without 

going through www.regulations.gov, 

your email address will be 

automatically captured and included as 

part of the comment that is placed in the 

public docket and made available on the 

Internet. If you submit an electronic 

comment, the EPA recommends that 

you include your name and other 

contact information in the body of your 

comment and with any disk or CD–ROM 

you submit. If the EPA cannot read your 

comment due to technical difficulties 

and cannot contact you for clarification, 

the EPA may not be able to consider 

your comment. Electronic files should 

avoid the use of special characters, any 

form of encryption, and be free of any 

defects or viruses. 

Docket: All documents in the docket 

are listed in the www.regulations.gov 

index. Although listed in the index, 

some information is not publicly 

available, e.g., CBI or other information 

whose disclosure is restricted by statute. 

Certain other material, such as 

copyrighted material, is not placed on 

the Internet and will be publicly 

available only in hard copy form. 

Publicly available docket materials are 

available either electronically through 

www.regulations.gov or in hard copy at 

the EPA Docket Center, Public Reading 

Room, EPA West, Room 3334, 1301 

Constitution Ave. NW., Washington, DC 

20460. The Public Reading Room is 

open from 8:30 a.m. to 4:30 p.m., 

Monday through Friday, excluding legal 

holidays. The telephone number for the 

Public Reading Room is (202) 566–1742, 

and the telephone number for the Air 

Docket is (202) 566–1744. 

FOR FURTHER INFORMATION CONTACT: Mr. 

Dan deRoeck, Air Quality Policy 

Division (C504–03), U.S. Environmental 

Protection Agency, Research Triangle 

Park, NC, 27711; telephone number 

(919) 541–5593; fax number (919) 541– 

5509; or email address: 

deroeck.dan@epa.gov. 

To request a public hearing or 

information pertaining to a public 

hearing on this document, contact Ms. 

Pamela Long, Air Quality Policy 

Division, Office of Air Quality Planning 

and Standards (C504–03), 

Environmental Protection Agency, 

Research Triangle Park, North Carolina 

27711; telephone number (919) 541– 

0641; fax number (919) 541–5509; email 

address: long.pam@epa.gov. 

SUPPLEMENTARY INFORMATION: 

I. General Information 

A. Does this action apply to me? 

Entities affected by this rule include 

sources in all industry groups. The 

majority of sources potentially affected 

are expected to be in the following 

groups that emit particulate matter: 

Industry group NAICSa

Electric services ........................................................................................ 221111, 221112, 221113, 221119, 221121, 221122 

Petroleum refining .................................................................................... 32411 


tkelley on DSK3SPTVN1PROD with PROPOSALS