Federal Register / Vol. 87, No. 48 / Friday, March 11, 2022 / Notices 14011 

with permission of the institution at 

which the student is enrolled; (2) is to 

be uncompensated; and (3) will not 

displace any employee. Form A–384 

establishes the responsibility of 

students, their institutions, and the FCC 

as a precondition to accepting 

individuals as unpaid volunteers. 

One such precondition now included 

on Form A–384, for which the FCC 

previously received Emergency 

approval, is the requirement that 

students comply with regulations and 

policies pertaining to COVID–19 

vaccination requirements for Federal 

workers. On September 9, 2021, the 

President issued Executive Order (E.O.) 

14043, ‘‘Requiring Coronavirus Disease 

2019 Vaccination for Federal 

Employees,’’ requiring all Federal 

employees, as defined by 5 U.S.C. 2105, 

to be vaccinated against COVID–19, 

with exceptions only as required by law. 

Although the vaccination requirement is 

currently the subject of a nationwide 

injunction, the FCC will continue to 

develop and implement health and 

safety protocols to ensure and maintain 

the safety of all occupants during 

standard operations and public health 

emergencies or similar health and safety 

incidents, such as a pandemic. As 

relevant here, this includes requiring 

unpaid employees to report their 

vaccination status. 

Federal Communications Commission. 

Marlene Dortch, 

Secretary, Office of the Secretary. 

[FR Doc. 2022–05155 Filed 3–10–22; 8:45 am] 

BILLING CODE 6712–01–P 

FEDERAL MARITIME COMMISSION 

Sunshine Act Meetings 

TIME AND DATE: March 16, 2022; 10:00 

a.m. 

PLACE: This meeting will be held by 

video-conference only. 

STATUS: Part of the meeting will be open 

to the public and available to view, 

streamed live, accessible from 

www.fmc.gov. The rest of the meeting 

will be closed to the public. 

MATTERS TO BE CONSIDERED: 

Portions Open to the Public: 

1. Commissioner Sola, Update on Fact 

Finding 30: COVID–19 Impact on 

Cruise Industry 

2. Staff Briefing on Ongoing 

Enforcement Activities 

Portions Closed to the Public: 

1. Staff Briefing on Ongoing 

Enforcement Activities 

2. Area Representative Regional Activity 

Updates 

CONTACT PERSON FOR MORE INFORMATION: 

William Cody, Secretary, (202) 523– 

5725. 

William Cody, 

Secretary. 

[FR Doc. 2022–05261 Filed 3–9–22; 11:15 am] 

BILLING CODE 6730–02–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Agency for Healthcare Research and 

Quality 

Supplemental Evidence and Data 

Request on Postpartum Care for 

Women Up to One Year After 

Pregnancy 

AGENCY: Agency for Healthcare Research 

and Quality (AHRQ), HHS. 

ACTION: Request for supplemental 

evidence and data submissions. 

SUMMARY: The Agency for Healthcare 

Research and Quality (AHRQ) is seeking 

scientific information submissions from 

the public. Scientific information is 

being solicited to inform our review on 

Postpartum Care for Women Up to One 

Year After Pregnancy, which is 

currently being conducted by the 

AHRQ’s Evidence-based Practice 

Centers (EPC) Program. Access to 

published and unpublished pertinent 

scientific information will improve the 

quality of this review. 

DATES: Submission Deadline on or 

before April 11, 2022. 

ADDRESSES: 

Email submissions: epc@

ahrq.hhs.gov. 

Print submissions: 

Mailing Address: Center for Evidence 

and Practice Improvement, Agency for 

Healthcare Research and Quality, Attn: 

EPC SEADs Coordinator, 5600 Fishers 

Lane, Mail Stop 06E53A, Rockville, MD 

20857. 

Shipping Address (FedEx, UPS, etc.): 

Center for Evidence and Practice 

Improvement, Agency for Healthcare 

Research and Quality, ATTN: EPC 

SEADs Coordinator, 5600 Fishers Lane, 

Mail Stop 06E77D, Rockville, MD 

20857. 

FOR FURTHER INFORMATION CONTACT: 

Jenae Benns, Telephone: 301–427–1496 

or Email: epc@ahrq.hhs.gov. 

SUPPLEMENTARY INFORMATION: The 

Agency for Healthcare Research and 

Quality has commissioned the 

Evidence-based Practice Centers (EPC) 

Program to complete a review of the 

evidence for Postpartum Care for 

Women Up to One Year After 

Pregnancy. AHRQ is conducting this 

technical brief pursuant to Section 902 

of the Public Health Service Act, 42 

U.S.C. 299a. 

The EPC Program is dedicated to 

identifying as many studies as possible 

that are relevant to the questions for 

each of its reviews. In order to do so, we 

are supplementing the usual manual 

and electronic database searches of the 

literature by requesting information 

from the public (e.g., details of studies 

conducted). We are looking for studies 

that report on Postpartum Care for 

Women Up to One Year After 

Pregnancy, including those that describe 

adverse events. The entire research 

protocol is available online at: https://

effectivehealthcare.ahrq.gov/products/ 

postpartum-care-one-year/protocol. 

This is to notify the public that the 

EPC Program would find the following 

information on Postpartum Care for 

Women Up to One Year After Pregnancy 

helpful: 

D A list of completed studies that 

your organization has sponsored for this 

indication. In the list, please indicate 

whether results are available on 

ClinicalTrials.gov along with the 

ClinicalTrials.gov trial number. 

D For completed studies that do not 

have results on ClinicalTrials.gov, a 

summary, including the following 

elements: Study number, study period, 

design, methodology, indication and 

diagnosis, proper use instructions, 

inclusion and exclusion criteria, 

primary and secondary outcomes, 

baseline characteristics, number of 

patients screened/eligible/enrolled/lost 

to follow-up/withdrawn/analyzed, 

effectiveness/efficacy, and safety results. 

D A list of ongoing studies that your 

organization has sponsored for this 

indication. In the list, please provide the 

ClinicalTrials.gov trial number or, if the 

trial is not registered, the protocol for 

the study including a study number, the 

study period, design, methodology, 

indication and diagnosis, proper use 

instructions, inclusion and exclusion 

criteria, and primary and secondary 

outcomes. 

D Description of whether the above 

studies constitute ALL Phase II and 

above clinical trials sponsored by your 

organization for this indication and an 

index outlining the relevant information 

in each submitted file. 

Your contribution is very beneficial to 

the Program. Materials submitted must 

be publicly available or able to be made 

public. Materials that are considered 

confidential; marketing materials; study 

types not included in the review; or 

information on indications not included 

in the review cannot be used by the EPC 

Program. This is a voluntary request for 

information, and all costs for complying 


lotter on DSK11XQN23PROD with NOTICES1
14012 Federal Register / Vol. 87, No. 48 / Friday, March 11, 2022 / Notices 

with this request must be borne by the 

submitter. 

The draft of this review will be posted 

on AHRQ’s EPC Program website and 

available for public comment for a 

period of 4 weeks. If you would like to 

be notified when the draft is posted, 

please sign up for the email list at: 

https://www.effectivehealthcare.

ahrq.gov/email-updates. 

The systematic review will answer the 

following questions. This information is 

provided as background. AHRQ is not 

requesting that the public provide 

answers to these questions. 

Key Questions (KQ) 

KQ 1: What healthcare delivery 

strategies affect postpartum healthcare 

utilization and improve maternal 

outcomes within 1 year postpartum? 

a. Do the healthcare delivery 

strategies affect postpartum healthcare 

utilization and improve maternal 

outcomes within 3 months postpartum? 

Does this relationship differ by timing of 

outcomes, specifically within 6 days 

postpartum, between 1 to 6 weeks 

postpartum, and between 6 weeks and 

3 months postpartum? 

b. Do the healthcare delivery 

strategies affect postpartum healthcare 

utilization and improve maternal 

outcomes between 3 months and 1 year 

postpartum? 

KQ 2: Does extension of health 

insurance coverage or improvements in 

access to healthcare affect postpartum 

healthcare utilization and improve 

maternal outcomes within 1 year 

postpartum? 

PICOTSD (Populations, Interventions, 

Comparators, Outcomes, Timing, 

Settings, and Design) 

Key Question 1 (Strategies for 

Healthcare Delivery) 

Populations 

• Individuals (of any age) who are in 

the postpartum period (defined as 

within 1 year after giving birth). 

Æ For this review, ‘‘giving birth’’ is 

defined as a live birth, intrauterine 

fetal death (IUFD)/stillbirth, or 

induced abortion that occurred at 

20 or more weeks of gestation (i.e., 

the duration of gestation that is 

commonly considered to denote the 

viability of the fetus). 

• Eligible populations 

Æ Healthy individuals (general 

population) 

Æ Individuals at increased risk of 

postpartum complications due to 

pregnancy-related conditions (e.g., 

hypertensive disorders of 

pregnancy, gestational diabetes) 

Æ Individuals at increased risk of 

postpartum complications due to 

incident or newly diagnosed 

conditions postpartum (e.g., 

postpartum hypertension, 

postpartum depression, new-onset 

diabetes) 

• Exclude: 

Æ Individuals with specific health 

conditions not typically managed 

by providers of pregnancy and 

postpartum care, (e.g., multiple 

sclerosis, HIV, cancer, substance 

use disorders other than tobacco). 

Æ Individuals with diagnosed chronic 

conditions—pre-existing (nongestational) diabetes, cardiac 

disease/risk factors (e.g., 

cardiomyopathy, pre-existing [nongestational] hypertension), mood 

disorders (e.g., major depression, 

anxiety), stress urinary 

incontinence, and dyspareunia. 

Content of Interventions Provided 

(note that these are not the interventions 

being compared in the review). 

Categories of interventions include 

components of the ACOG Postpartum 

Care Plan: 18

• Counseling, support, and education 

regarding 

Æ Infant care and feeding 

Æ Reproductive life planning and 

contraception 

Æ Adverse pregnancy outcomes 

associated with cardiometabolic 

disease 

Æ Risks and behaviors associated with 

poor postpartum health 

• Screening or prevention of: 

Æ Pregnancy complications 

Æ Common chronic health conditions 

(e.g., hypertension, diabetes) 

Æ Mental health conditions (e.g., 

depression, anxiety) 

Æ Common gynecologic problems 

(e.g., sexually transmitted 

infections, cervical cancer) 

Æ Common postpartum problems 

(e.g., stress urinary incontinence, 

dyspareunia) 

• Exclude: 

Æ Treatments for acute or emergency 

postpartum conditions (e.g., for 

mastitis, urinary tract infections, 

other infections) 

Æ Treatments or other interventions 

for conditions unrelated to 

pregnancy (e.g., HIV, 

schizophrenia) 

Æ Treatments or other interventions 

for acute conditions during 

pregnancy or occurring around the 

time of giving birth (e.g., for 

postpartum hemorrhage, 

preeclampsia with severe features) 

Æ Treatments or other interventions 

directed at the infant (e.g., wellchild visits, otitis media, colic) 

Æ Referral-only interventions (e.g., 

lactation consultants for specific 

lactation problems) 

Delivery Strategies 

• Where healthcare is delivered—e.g., 

hospital, clinic, home visit, 

community health center, birth 

center, virtual care/telehealth, 

Women Infants and Children (WIC) 

program office/site 

• How healthcare is delivered—e.g., 

dedicated postpartum care visit, as 

part of well-child visit, group visit 

• When healthcare is delivered—e.g., 

timing before giving birth, after 

giving birth, or at postpartum visits 

• Who provides healthcare/support 

Æ Predominantly health system-based 

care—e.g., OB/GYN, midwife, 

pediatrician, family physician, 

internist, physician assistant, nurse 

practitioner, nurse, lactation 

consultant (when integrated as part 

of the care), clinical psychologist or 

other mental health professional 

Æ Predominantly community-based 

care—e.g., doula support, 

community health worker, lay 

support, social worker/support, 

peer support, case manager 

• Healthcare coordination and 

management of care—e.g., patient 

navigators, creation and 

implementation of post-birth care 

plans, strategies for continuity of 

care/care transitions, strategies to 

facilitate access to appointments/ 

scheduling, postpartum specialty 

care clinics, multidisciplinary care 

models (e.g., maternal and child 

health centers, maternity care 

homes), evidence-based care 

protocols, incentives for care 

completion 

• Information and communication 

technology—e.g., bidirectional 

telemedicine, virtual televisits, 

phone visits, bidirectional texting, 

real-time chat-bots, smartphone or 

computer applications designed to 

enhance provision of postpartum 

healthcare 

Æ Exclude: Social media or support 

groups (without provider 

involvement), web or device 

applications aimed at general 

health maintenance 

• Interventions targeted at healthcare 

providers or systems—e.g., 

interventions to improve guidelineadherent care, clinical decision 

support tools, interventions to help 

reduce healthcare inequities (e.g., 

promoting respectful care) 

• Exclude: 

Æ Referral-only interventions (e.g., 

lactation consultants for specific 

lactation problems) 


lotter on DSK11XQN23PROD with NOTICES1
Federal Register / Vol. 87, No. 48 / Friday, March 11, 2022 / Notices 14013 

Æ Treatments for specific ailments or 

conditions (e.g., pelvic floor 

physical therapy, urinary 

incontinence treatment, 

contraception, pain treatment, 

cognitive behavioral therapy) 

Æ Insurance extension (which is 

covered in KQ 2) 

Comparator Delivery Strategies 

• Standard delivery strategy 

• Alternative delivery strategy 

Outcomes (* and bold font denotes 

important outcomes that will be used 

when developing Strength of Evidence 

tables) 

• Intermediate and healthcare 

utilization outcomes 

Æ Attendance at postpartum visits * 

Æ Unplanned care utilization (e.g., 

unplanned readmissions, 

emergency room visits) * 

Æ Adherence to condition-specific 

screening/testing (e.g., blood 

pressure monitoring, glucose 

tolerance testing) or treatment * 

Æ Transition to primary care provider 

for long-term care * 

• Clinical outcomes (as appropriate, 

outcomes include incidence, 

prevalence/continuation, severity, 

and resolution) 

Æ Maternal mortality * 

Æ Symptoms or diagnosis of mental 

health conditions (e.g., anxiety, 

depression, substance use) * 

Æ Patient-reported outcomes 

D Quality of life (using validated 

measures) * 

D Perceived stress * 

D Pain 

D Sleep quality 

D Fatigue 

D Sexual well-being and satisfaction 

D Awareness of risk factors for longterm ill health 

Æ Physical health/medical outcomes 

D Postpartum onset of preeclampsia 

or hypertension 

D Infections (e.g., mastitis, wound 

infections) 

D Severe maternal morbidity 

Æ Cardiovascular disorders (e.g., 

cardiomyopathy) 

Æ Cerebrovascular disorders (e.g., 

stroke) 

Æ Bleeding 

Æ Venous thromboembolism 

Æ Other 

Æ Interpregnancy interval 

Æ Unintended pregnancies 

Æ Contraceptive initiation and 

continuation 

Æ Breastfeeding intention, initiation, 

duration, and exclusivity 

Æ Reduction in health inequities (e.g., 

by race, ethnicity, geography, 

disability status) 

• Harms 

Æ Health inequities * 

Æ Perceived discrimination * 

Æ Over-utilization of healthcare 

Æ Patient burden regarding 

postpartum care 

Potential Effect Modifiers 

• Patient-level factors 

Æ Age 

Æ Race/ethnicity 

Æ Gender identity 

Æ Sexual identity 

Æ Physical disability status 

Æ Socioeconomic status 

Æ Immigration status 

Æ Barriers to transportation to 

healthcare facility 

Æ Paid family leave policies (e.g., 

presence versus absence, different 

durations of leave) 

Æ Access to internet (for virtual care/ 

telehealth questions) 

Æ Substance use/substance use 

disorder 

Æ Type of insurance coverage 

(insured versus uninsured, private 

versus public [e.g., Medicaid], 

insurance coverage of postpartum 

care, Medicaid insurance coverage 

extension or expansion) 

Æ Presence versus absence of 

disorders of pregnancy (e.g., 

hypertensive, cardiovascular, 

gestational diabetes mellitus) or 

peripartum complications that 

increase risk of postpartum 

complications 

Æ Preterm versus term delivery 

Æ Live birth versus stillbirth/ 

spontaneous abortion/induced 

abortion 

Æ Number of infants (singleton versus 

twins/triplets, etc.) 

Æ Presence versus absence of a 

supportive partner 

Æ Infant health (e.g., neonatal 

intensive care unit [NICU] 

admission, congenital anomalies) 

• Setting factors 

Æ Country (U.S. versus other highincome countries) 

Æ Geographic location (urban versus 

suburban versus rural) 

Æ Different levels of neighborhood 

vulnerability (e.g., social 

vulnerability index) 

Æ Volume of facility/hospital (high 

versus low) 

Æ Type of facility/hospital (private 

versus public) 

Æ Racial/ethnic concordance between 

provider and patient 

Æ Language concordance between 

provider and patient 

Timing 

• Delivery strategy and comparator 

delivery strategy: Antenatal or 

postpartum (or both) 

Æ If the service is delivered 

antenatally, the strategy must be 

aimed at postpartum health (not 

just that the outcome was measured 

during the postpartum period). 

• Outcome measurement: For KQ 1a: 

Within 3 months after giving birth. 

For KQ 1b: 3 months to 1 year after 

giving birth (except interpregnancy 

interval, unintended pregnancies, 

and chronic diseases [e.g., diabetes, 

hypertension], which can be later) 

Settings 

• High-income countries (as classified 

by the World Bank—see https://

datahelpdesk.worldbank.org/ 

knowledgebase/articles/906519- 

world-bank-country-and-lendinggroups) 

• Outpatient care 

• Exclude: Institutionalized settings 

(e.g., prisons) 

Design 

• Randomized controlled trials (N ≥10 

participants per group) 

• Nonrandomized comparative studies, 

longitudinal (prospective or 

retrospective) (N ≥30 participants 

per group) 

• Case-control studies (N ≥30 

participants per group) 

• Exclude: Single-group 

(noncomparative) studies, 

comparative cross-sectional studies 

(without a discernable time-period 

between implementation of strategy 

for intervention and measurement 

of outcomes), qualitative studies 

Key Question 2 (Extension of Healthcare 

or Insurance Coverage) 

Populations 

• Individuals (of any age) who are in 

the postpartum period (defined as 

within 1 year after giving birth). 

Æ For this review, ‘‘giving birth’’ is 

defined as a live birth, intrauterine 

fetal death (IUFD)/stillbirth, or 

induced abortion that occurred at 

20 or more weeks of gestation (i.e., 

the duration of gestation that is 

commonly considered to denote the 

viability of the fetus). 

• Eligible populations 

Æ Healthy individuals (general 

population) 

Æ Individuals at increased risk of 

postpartum complications due to 

pregnancy-related conditions (e.g., 

hypertensive disorders of 

pregnancy, gestational diabetes) 

Æ Individuals at increased risk of 

postpartum complications due to 

incident or newly diagnosed 

conditions postpartum (e.g., 

postpartum hypertension, 


lotter on DSK11XQN23PROD with NOTICES1
14014 Federal Register / Vol. 87, No. 48 / Friday, March 11, 2022 / Notices 

postpartum depression, new-onset 

diabetes) 

• Exclude: 

Æ Individuals with specific health 

conditions not typically managed 

by providers of pregnancy and 

postpartum care, (e.g., multiple 

sclerosis, HIV, cancer, substance 

use disorders other than tobacco). 

Æ Individuals with diagnosed chronic 

conditions—pre-existing (nongestational) diabetes, cardiac 

disease/risk factors (e.g., 

cardiomyopathy, pre-existing [nongestational] hypertension), mood 

disorders (e.g., major depression, 

anxiety), stress urinary 

incontinence, and dyspareunia. 

Interventions 

• More comprehensive insurance 

coverage 

• Extended duration of insurance 

coverage 

• More continuous insurance coverage 

• Better/more continuous access to care 

as the result of a targeted program 

at the state, system, or provider 

level (e.g., Medicaid expansion) 

Comparators 

• Less comprehensive level of or no 

insurance coverage 

• Less continuous insurance coverage 

• Worse, less continuous, or no access 

to healthcare 

Outcomes (* and bold font denotes 

important outcomes that will be used 

when developing Strength of Evidence 

tables) 

• Intermediate and healthcare 

utilization outcomes 

Æ Attendance at postpartum visits * 

Æ Unplanned care utilization (e.g., 

readmissions, emergency room 

visits) * 

Æ Adherence to condition-specific 

screening/testing (e.g., blood 

pressure monitoring, glucose 

tolerance testing) or treatment * 

Æ Transition to primary care provider 

for long-term care * 

• Clinical outcomes (as appropriate, 

outcomes include incidence, 

prevalence/continuation, severity, 

and resolution) 

Æ Maternal mortality * 

Æ Symptoms or diagnosis of mental 

health conditions (e.g., anxiety, 

depression, substance use) * 

Æ Patient-reported outcomes 

D Quality of life (using validated 

measures) * 

D Perceived stress * 

D Pain 

D Sleep quality 

D Fatigue 

D Sexual well-being and satisfaction 

D Awareness of risk factors for longterm ill health 

Æ Physical health/medical outcomes 

D Postpartum onset of preeclampsia 

or hypertension 

D Infections (e.g., mastitis, wound 

infections) 

D Severe maternal morbidity 

Æ Cardiovascular disorders (e.g., 

cardiomyopathy) 

Æ Cerebrovascular disorders (e.g., 

stroke) 

Æ Bleeding 

Æ Venous thromboembolism 

Æ Other 

Æ Interpregnancy interval 

Æ Unintended pregnancies 

Æ Contraceptive initiation and 

continuation 

Æ Breastfeeding intention, initiation, 

duration, and exclusivity 

Æ Reduction in health inequities (e.g., 

by race, ethnicity, geography, 

disability status) 

• Harms 

Æ Health inequities * 

Æ Perceived discrimination * 

Æ Over-utilization of healthcare 

Æ Patient burden regarding 

postpartum care 

Potential Effect Modifiers 

• Patient-level factors 

Æ Age 

Æ Race/ethnicity 

Æ Gender identity 

Æ Sexual identity 

Æ Physical disability status 

Æ Socioeconomic status 

Æ Immigration status 

Æ Barriers to transportation to 

healthcare facility 

Æ Paid family leave policies (e.g., 

presence versus absence, different 

durations of leave) 

Æ Substance use/substance use 

disorder 

Æ Type of insurance coverage 

(insured versus uninsured, private 

versus public [e.g., Medicaid], 

insurance coverage of postpartum 

care, Medicaid insurance coverage 

extension or expansion) 

Æ Presence versus absence of 

disorders of pregnancy (e.g., 

hypertensive, cardiovascular, 

gestational diabetes mellitus) or 

peripartum complications that 

increase risk of postpartum 

complications 

Æ Preterm versus term delivery 

Æ Live birth versus stillbirth/ 

spontaneous abortion/induced 

abortion 

Æ Number of infants (singleton versus 

twins/triplets, etc.) 

Æ Presence versus absence of a 

supportive partner 

Æ Infant health (e.g., neonatal 

intensive care unit [NICU] 

admission, congenital anomalies) 

• Setting factors 

Æ Geographic location (urban versus 

suburban versus rural) 

Æ Different levels of neighborhood 

vulnerability (e.g., social 

vulnerability index) 

Æ Volume of facility/hospital (high 

versus low) 

Æ Type of facility/hospital (private 

versus public) 

Æ Racial/ethnic concordance between 

provider and patient 

Æ Language concordance between 

provider and patient 

Timing 

• Interventions and Comparators: 

Within 1 year after giving birth 

• Outcome measurement: Up to 1 year 

after giving birth (except 

interpregnancy interval, unintended 

pregnancies, and chronic diseases 

[e.g., diabetes, hypertension], which 

can be later) 

Settings 

• U.S. only 

• Outpatient care 

• Exclude: Institutionalized settings 

(e.g., prisons) 

Design 

• Randomized controlled trials (N 

≥10 participants per group) 

• Nonrandomized comparative 

studies, longitudinal (prospective or 

retrospective) or cross-sectional (N 

≥30 participants per group) 

• Case-control studies (N ≥30 

participants per group) 

• Exclude: Single-group 

(noncomparative) studies, 

comparative cross-sectional studies 

(without a discernable time-period 

between intervention and 

measurement of outcomes), 

qualitative studies 

Dated: March 7, 2022. 

Marquita Cullom, 

Associate Director. 

[FR Doc. 2022–05141 Filed 3–10–22; 8:45 am] 

BILLING CODE 4160–90–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Agency for Healthcare Research and 

Quality 

Patient Safety Organizations: 

Voluntary Relinquishment for the 

QCMetrix PSO 

AGENCY: Agency for Healthcare Research 

and Quality (AHRQ), Department of 

Health and Human Services (HHS). 

ACTION: Notice of delisting. 


lotter on DSK11XQN23PROD with NOTICES1