Federal Register / Vol. 89, No. 216 / Thursday, November 7, 2024 / Notices 88349 

c. Does your operation require a 

hazmat security plan? If so, what 

elements of a security plan are 

implemented? 

d. Is there any other information you 

would like to share on this topic? 

6. Industry Process/SOPs 

a. What other companies are you 

utilizing when transporting hazardous 

materials? Can you offer a point of 

contact to gather information about this 

company’s transportation of this 

hazardous material (or materials)? 

b. What are the locations of your 

hazardous materials operations? 

c. Can you share the Standard 

Operation Procedures (SOP) for the 

handling of hazardous materials at your 

company? 

d. Are you familiar with registration 

requirements? 

e. Are you required to obtain a 

PHMSA or Federal Motor Carrier Safety 

Administration (FMCSA) registration? 

f. Who signs and prepares shipping 

papers? 

g. Do you transport any hazardous 

materials in compliance with an 

approval or special permit? 

h. Do you have any type of validation 

process that confirms compliance with 

the HMR prior to making hazardous 

material shipments? 

i. Is there any other information you 

would like to share on this topic? 

7. Carriers/Shippers/Testers/ 

Manufacturers 

a. Do you manufacture any hazardous 

material packaging? 

b. Are any other entities involved 

with the preparation, handling, or 

transportation of hazardous materials? 

c. Is there any other information you 

would like to share on this topic? 

8. Packaging 

a. Where do you purchase hazardous 

materials packaging? 

b. Is the product loaded at any 

specific temperature/pressure? 

c. What types of packaging do you 

routinely ship or receive for hazardous 

materials transportation? Including 

bulk, non-bulk, and/or cylinders. 

d. At what interval are you having the 

package tested? Who performs this 

function? Are there records? 

e. How are you closing the packages? 

Which tools or other equipment are 

used? 

f. Is there any other information you 

would like to share on this topic? 

III. Data 

The estimated reporting burdens 

associated with this information 

collection are as follows: 

OMB Control Number: None. 

Form Number: None. 

Type of Review: Regular submission. 

Affected Public: Business or other forprofit organizations. 

Estimated Number of Respondents: 

1,000. 

Estimated Number or Responses: 

1,000. 

Estimated Time per Response: 30 

minutes. Information will be collected 

on a voluntary basis to address potential 

safety issues identified by PHMSA 

investigators. 

Estimated Total Annual Burden 

Hours: 500. 

Estimated Burden Cost: $0. 

IV. Request for Comments to This 60- 

Day Supplemental Notice 

Comments are invited on: (1) whether 

the proposed collection of information 

is necessary for the proper performance 

of the functions of the agency, including 

whether the information shall have 

practical utility; (2) the accuracy of the 

agency’s estimate of the burden 

(including hours and cost) of the 

proposed collection of information; (3) 

ways to enhance the quality, utility, and 

clarity of the information to be 

collected; and (4) ways to minimize the 

burden of the collection of information 

on respondents, including through the 

use of automated collection techniques 

or other forms of information 

technology. 

Comments submitted in response to 

this 60-day supplemental notice will be 

summarized and/or included in the 

request for OMB approval of this 

information collection; they also will 

become a matter of public record. 

Issued in Washington, DC on November 4, 

2024, under authority delegated in 49 CFR 

1.97. 

Alexander Ronald Wolcott, 

Acting Chief, Regulatory Review and 

Reinvention Branch, Office of Hazardous 

Materials Safety. Pipeline and Hazardous 

Materials Safety Administration. 

[FR Doc. 2024–25875 Filed 11–6–24; 8:45 am] 

BILLING CODE 4910–60–P 

DEPARTMENT OF VETERANS 

AFFAIRS 

Notice of Request for Information on 

the Department of Veterans Affairs 

Dental Hygienist Standard of Practice 

AGENCY: Department of Veterans Affairs. 

ACTION: Request for information. 

SUMMARY: The Department of Veterans 

Affairs (VA) is requesting information to 

assist in developing a national standard 

of practice for VA Dental Hygienists. VA 

seeks comments on various topics to 

help inform VA’s development of this 

national standard of practice. 

DATES: Comments must be received on 

or before January 6, 2025. 

ADDRESSES: Comments must be 

submitted through https://

www.regulations.gov/. Except as 

provided below, comments received 

before the close of the comment period 

will be available at https://

www.regulations.gov/ for public 

viewing, inspection, or copying, 

including any personally identifiable or 

confidential business information that is 

included in a comment. We post the 

comments received before the close of 

the comment period on the following 

website as soon as possible after they 

have been received: https://

www.regulations.gov/. VA will not post 

on https://www.regulations.gov/ public 

comments that make threats to 

individuals or institutions or suggest 

that the commenter will take actions to 

harm the individual. VA encourages 

individuals not to submit duplicative 

comments. We will post acceptable 

comments from multiple unique 

commenters even if the content is 

identical or nearly identical to other 

comments. Any public comment 

received after the comment period’s 

closing date will not be considered. 

FOR FURTHER INFORMATION CONTACT: 

Ethan Kalett, Office of Regulations, 

Appeals and Policy (10BRAP), Veterans 

Health Administration, Department of 

Veterans Affairs, 810 Vermont Avenue 

NW, Washington, DC 20420, 202–461– 

0500. This is not a toll-free number. 

SUPPLEMENTARY INFORMATION: 

Authority 

Chapters 73 and 74 of 38 U.S.C. and 

38 U.S.C. 303 authorize the Secretary to 

regulate VA health care professions to 

make certain that VA’s health care 

system provides safe and effective 

health care by qualified health care 

professionals to ensure the well-being of 

those Veterans who have borne the 

battle. 

On November 12, 2020, VA published 

an interim final rule confirming that VA 

health care professionals may practice 

their health care profession consistent 

with the scope and requirements of their 

VA employment, notwithstanding any 

State license, registration, certification, 

or other requirements that unduly 

interfere with their practice. 38 CFR 

17.419; 85 FR 71838. Specifically, this 

rulemaking confirmed VA’s current 

practice of permitting VA health care 

professionals to deliver health care 

services in a State other than the health 

care professional’s State of licensure, 


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88350 Federal Register / Vol. 89, No. 216 / Thursday, November 7, 2024 / Notices 

registration, certification, or other 

requirement, and thereby, enhancing 

beneficiaries’ access to critical VA 

health care services. The rulemaking 

also confirmed VA’s authority to 

establish national standards of practice 

for its health care professionals, which 

would standardize a health care 

professional’s practice in all VA medical 

facilities, regardless of conflicting State 

laws, rules, regulations, or other 

requirements. 

The rulemaking explained that a 

national standard of practice describes 

the tasks and duties that a VA health 

care professional practicing in the 

health care profession may perform and 

may be permitted to undertake. Having 

a national standard of practice means 

that individuals from the same VA 

health care profession may perform the 

same type of tasks and duties regardless 

of the State where they are located or 

the State license, registration, 

certification, or other requirement they 

hold. We emphasized in the rulemaking 

and reiterate here that VA will 

determine, on an individual basis, that 

a health care professional has the proper 

education, training, and skills to 

perform the tasks and duties detailed in 

the national standard of practice, and 

that they will only be able to perform 

such tasks and duties after they have 

been incorporated into the individual’s 

privileges, scope of practice, or 

functional statement. The rulemaking 

explicitly did not create any such 

national standards and directed that all 

national standards of practice would be 

subsequently created through policy. 

Preemption of State Requirements 

The national standard of practice will 

preempt any State laws, rules, 

regulations, or other requirements that 

are both listed and unlisted in the 

national standard as conflicting, but that 

do conflict with the tasks and duties as 

authorized in VA’s national standard of 

practice. The term State, as applied 

here, means each of the several States, 

territories, and possessions of the 

United States and is consistent with the 

definition in 38 U.S.C. 101(20). If a State 

changes their requirements and places 

new limitations on the tasks and duties 

it permits in a manner that would be 

inconsistent with what is authorized 

under the national standard of practice, 

the national standard of practice will 

preempt such limitations and authorize 

the VA health care professional to 

continue to practice consistent with the 

tasks and duties outlined in the national 

standard of practice. 

In cases where a VA health care 

professional’s license, registration, 

certification, or other requirement 

permits a practice that is not included 

in a national standard of practice, the 

individual may continue that practice so 

long as it is permissible under Federal 

law and VA policy; is not explicitly 

restricted by the national standard of 

practice; and is approved by the VA 

medical facility. 

Need for National Standards of Practice 

It is critical that VA, the Nation’s 

largest integrated health care system, 

develop national standards of practice 

to ensure, first, that beneficiaries receive 

the same high-quality care regardless of 

where they enter the system and, 

second, that VA health care 

professionals can efficiently meet the 

needs of beneficiaries when practicing 

within the scope of their VA 

employment. National standards are 

designed to increase beneficiaries’ 

access to safe and effective health care; 

thereby, improving health outcomes. 

The importance of this initiative has 

been underscored by the Coronavirus 

Disease 2019 (COVID–19) pandemic. 

The increased need for mobility in VA’s 

workforce, including through VA’s 

Disaster Emergency Medical Personnel 

System, highlighted the importance of 

creating uniform national standards of 

practice to better support VA health care 

professionals who practice across State 

lines. Creating national standards of 

practice also promotes interoperability 

of medical data between VA and the 

Department of Defense (DoD), providing 

a complete picture of a Veteran’s health 

information and improving VA’s 

delivery of health care to the Nation’s 

Veterans. DoD has historically 

standardized practice for certain health 

care professionals, and VA has closely 

partnered with DoD to learn from their 

experience. 

Process To Develop National Standards 

of Practice 

As authorized by 38 CFR 17.419, VA 

is developing national standards of 

practice through policy. The 

overarching directive to describe 

Veterans Health Administration (VHA) 

policy on national standards of practice 

is VHA Directive 1900(3), VA National 

Standards of Practice, August 30, 2023. 

The directive is accessible on VHA’s 

publications website at https://

www.va.gov/vhapublications. As each 

individual national standard of practice 

is finalized, it is published as an 

appendix to the directive and is 

accessible at the same website. 

To develop these national standards, 

VA is using a robust, interactive process 

that adheres to the requirements of 

Executive Order (E.O.) 13132, 

Federalism, to preempt conflicting State 

laws, rules, regulations, or other 

requirements. For each health care 

occupation, a workgroup comprised of 

VA health care professionals in the 

identified occupation conducts research 

to identify internal best practices that 

may not be authorized under every State 

license, certification, or registration, but 

would enhance the practice and 

efficiency of the profession throughout 

VA. If a best practice is identified that 

is not currently authorized by every 

State, the workgroup determines what 

education, training, and skills are 

required to perform such tasks and 

duties. The workgroup then drafts a 

proposed VA national standard of 

practice using the data gathered and any 

internal stakeholder feedback received. 

The workgroup may consult with 

internal or external stakeholders at any 

point throughout the process. 

The process to develop VA national 

standards of practice includes listening 

sessions for members of the public, 

professional associations, and VA 

employees to provide comments on the 

variance between State practice acts for 

specific occupations and what should 

be included in the national standard of 

practice for that occupation. The 

listening session for dental hygienists 

was held on September 7, 2023. No 

comments were provided on the dental 

hygienists standard of practice. 

After the proposed standard is 

developed, it is first internally 

reviewed. This includes a review from 

an interdisciplinary VA workgroup 

consisting of representatives from the 

following offices: Quality Management, 

VA medical facility Chief of Staff, 

Academic Affiliates, Veterans Integrated 

Services Network (VISN) Chief Nursing 

Officer, Ethics, Workforce Management 

and Consulting, Surgery, Credentialing 

and Privileging, VISN Chief Medical 

Officer, and Electronic Health Record 

Modernization. 

After the internal review, VA provides 

the proposed national standard of 

practice to our DoD partners as an 

opportunity to flag inconsistencies with 

DoD standards. VA also engages with 

labor partners informally as part of a 

pre-decisional collaboration. Consistent 

with E.O. 13132, VA sends a letter to 

each State board and certifying 

organization or registration 

organization, as appropriate, which 

includes the proposed national standard 

and offers the recipient an opportunity 

to discuss the national standard with 

VA. After the State boards, certifying 

organizations, or registration 

organizations have received notification, 

the proposed national standard of 

practice is posted in the Federal 

Register for 60 days to obtain feedback 


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Federal Register / Vol. 89, No. 216 / Thursday, November 7, 2024 / Notices 88351 

from the public, professional 

associations, and any other interested 

parties. At the same time, the proposed 

national standard is posted to an 

internal VA site to obtain feedback from 

VA employees. Responses received 

through all vehicles—from State boards, 

professional associations, unions, VA 

employees, and any other individual or 

organization that provides comments 

through the Federal Register—will be 

reviewed. VA will make appropriate 

revisions in light of the comments, 

including those that present evidencebased practices and alternatives that 

help VA meet our mission and goals. 

VA will publish a collective response to 

all comments at https://www.va.gov/ 

standardsofpractice/. 

The national standard of practice is 

then finalized, approved, and published 

in VHA policy. Any tasks or duties 

included in the national standard will 

be properly incorporated into individual 

VA health care professionals’ privileges, 

scope of practice, or functional 

statement once it has been determined 

by their VA medical facility that the 

individual has the proper education, 

training, and skills to perform the task 

or duty. The implementation of the 

national standard of practice may be 

phased in across all VA medical 

facilities, with limited exemptions for 

health care professionals as needed. 

Format for the Proposed National 

Standard for Dental Hygienist 

The format for the proposed national 

standards of practice when there are 

State licenses is as follows. The first 

paragraph provides general information 

about the profession and what the VA 

health care professionals can do. For 

this national standard, Dental 

Hygienists perform oral prophylaxis and 

other therapeutic or preventive 

procedures for periodontal disease, 

caries control, or other dental problems. 

We reiterate that the proposed standard 

of practice does not contain an 

exhaustive list of every task and duty 

that each VA health care professional 

can perform. Rather, it is designed to 

highlight generally what tasks and 

duties the health care professionals 

perform and how they practice within 

VA. 

The second paragraph references the 

education and license, or other 

requirement, needed to practice this 

profession at VA. Qualification 

Standards for employment of health 

care professionals by VA are available 

at: https://www.va.gov/OHRM/ 

QualificationStandards/. VA follows the 

requirements outlined in its 

qualification standards even if the 

requirements conflict with or differ from 

a State requirement. The national 

standards of practice do not affect those 

requirements. For dental hygienists, VA 

requires an active, current, full, and 

unrestricted State license, and that the 

dental hygienists meet credentialing 

standards in 42 CFR part 75, Standards 

for the Accreditation of Educational 

Programs for the Credentialing of 

Radiologic Personnel. The dental 

hygienists VA qualification standards 

are available at: https://www.va.gov/ 

OHRM/QualificationStandards/HT38/ 

0682-DentalHygienist.pdf. 

The second paragraph also notes 

whether the national standard of 

practice explicitly excludes individuals 

who practice under ‘‘grandfathering’’ 

provisions. Qualification standards may 

include provisions to permit employees 

who met all the requirements prior to 

revisions of the qualification standards 

to maintain employment at VA even if 

they no longer meet the new 

qualification standards. This practice is 

referred to as grandfathering. VA dental 

hygienists have grandfathering 

provisions included within their 

qualification standards, and VA 

proposes to have those individuals 

authorized to follow the dental 

hygienists national standard of practice. 

Therefore, there would be no notation 

regarding grandfathered employees in 

the national standard of practice as they 

would be required to adhere to the same 

standard as would any other VA dental 

hygienist who meets the current 

qualification standards. 

The third paragraph establishes what 

the national standard of practice will be 

for the occupation in VA. It includes 

whether the professional can practice all 

duties covered by their license. For 

dental hygienists, VA proposes that VA 

dental hygienists can practice all duties 

covered by their license and the 

credentialing standards. VA reviewed 

State laws and practice acts for dental 

hygienists in March 2024 and did not 

identify any conflicts that impact 

practice of this profession in VA. 

This national standard of practice 

does not address training because it will 

not authorize VA dental hygienists to 

perform any tasks or duties not already 

authorized under their State license or 

certification. 

Following public and VA employee 

comments and revisions, each national 

standard of practice that is published in 

policy will also include the date for 

recertification of the standard of 

practice and a point of contact for 

questions or concerns. 

Proposed National Standard of Practice 

for Dental Hygienists 

Note: All references herein to VA and VHA 

documents incorporate by reference 

subsequent VA and VHA documents on the 

same or similar subject matter. 

1. Dental hygienists perform oral 

prophylaxis and other therapeutic or 

preventive procedures for periodontal 

disease, caries control, or other dental 

problems. 

2. Dental Hygienists in the 

Department of Veterans Affairs (VA) 

possess the education, license, and 

certification required by VA 

qualification standards, available at: 

https://www.va.gov/OHRM/ 

QualificationStandards/HT38/0682- 

dentalhygienist.pdf. 

3. VA Dental Hygienists can practice 

all duties covered by their license, and 

practice in accordance with the 

credentialing standards in 42 CFR part 

75, Standards for the Accreditation of 

Educational Programs for the 

Credentialing of Radiologic Personnel, 

available at: https://www.ecfr.gov/. VA 

reviewed State laws and practice acts 

for Dental Hygienists in March 2024 and 

did not identify any conflicts that 

impact practice of this profession in VA. 

Request for Information 

1. Is VA’s assessment of what your 

State permits and prohibits accurate? 

2. Are there any areas of variance 

between State licenses, certification, 

registration, or other requirement that 

VA should preempt that are not listed? 

3. Is there anything else you would 

like to share with us about this VA 

national standard of practice? 

Signing Authority 

Denis McDonough, Secretary of 

Veterans Affairs, approved and signed 

this document on October 22, 2024, 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. 

Luvenia Potts, 

Regulation Development Coordinator, Office 

of Regulation Policy and Management 

(00REG), Office of General Counsel, 

Department of Veterans Affairs. 

[FR Doc. 2024–25894 Filed 11–6–24; 8:45 am] 

BILLING CODE 8320–01–P 


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