Federal Register / Vol. 86, No. 138 / Thursday, July 22, 2021 / Notices 38717 

1Order Suspending the Right to Introduce Certain 

Persons from Countries Where a Quarantinable 

Communicable Disease Exists, 85 FR 65806 (Oct. 

16, 2020). The October Order replaced the Order 

Suspending Introduction of Certain Persons from 

Countries Where a Communicable Disease Exists, 

issued on March 20, 2020. 85 FR 17060 (Mar. 26, 

2020); Extension of Order Under Sections 362 and 

365 of the Public Health Service Act; Order 

Suspending Introduction of Certain Persons From 

Countries Where a Communicable Disease Exists, 

Continued 

EXHIBIT 2—ESTIMATED ANNUALIZED COST BURDEN—Continued 

Form name Number of 

respondents 

Total burden 

hours 

Average 

hourly wage 

rate 

Total cost 

burden 

Electronic Health Record (EHR) Extracts 

Initial data pull for 10% of hospitals that do not confer rights to their NHSN 

data (once at baseline for ICU and non-ICU cohorts, 800 units total) ........ 27 135 ∧ 35.17 4,747.95 

Initial data pull for hospital onset bacteremia (including MSSA) and MRSApositive clinical cultures (not available in NHSN) (once at baseline for ICU 

and non-ICU cohorts, 800 units total) .......................................................... 267 935 ∧ 35.17 32,866.37 

Initial data pull for 10% of units that submit point prevalence survey data 

(once at baseline for ICU and non-ICU cohorts, 800 units total) ................ 27 14 ∧ 35.17 474.80 

Initial data pull for 20% of surgical settings that do not confer rights to 

NHSN data (once at baseline for Surgical cohort, 300 settings total) ........ 20 10 ∧ 35.17 351.70 

Initial data pull (once at baseline for LTC cohort, 300 facilities total) ............. 100 500 ∧ 35.17 17,585.00 

Quarterly data (quarterly during 18 months of implementation for ICU and 

non-ICU cohorts, 1,100 units total) .............................................................. 267 801 ∧ 35.17 28,171.17 

Quarterly data collection of monthly data for 20% of hospitals that do not 

confer rights to their NHSN data (quarterly during 18 months of implementation for surgical cohorts, 300 units total) ............................................ 20 60 ∧ 35.17 2,110.20 

Monthly data (monthly per facility during 18 months of implementation for 

LTC cohort, 100 facilities total) .................................................................... 100 900 ∧ 35.17 31,653.00 

Total .......................................................................................................... 13,429 11,552 ........................ 540,325.83 

* This is an average of the average hourly wage rate for physician, nurse, nurse practitioner, physician’s assistant, and nurse’s aide from the 

May 2019 National Occupational Employment and Wage Estimates, United States, U.S. Bureau of Labor Statistics (https://www.bls.gov/oes/current/oes_nat.htm#00-0000). ∧This is an average of the average hourly wage rate for nurse and IT specialist from the May 2019 National Occupational Employment and 

Wage Estimates, United States, U.S. Bureau of Labor Statistics (https://www.bls.gov/oes/current/oes_nat.htm#00-0000). 

Request for Comments 

In accordance with the Paperwork 

Reduction Act, 44 U.S.C. 3501–3520, 

comments on AHRQ’s information 

collection are requested with regard to 

any of the following: (a) Whether the 

proposed collection of information is 

necessary for the proper performance of 

AHRQ’s health care research and health 

care information dissemination 

functions, including whether the 

information will have practical utility; 

(b) the accuracy of AHRQ’s estimate of 

burden (including hours and costs) of 

the proposed collection(s) of 

information; (c) ways to enhance the 

quality, utility and clarity of the 

information to be collected; and (d) 

ways to minimize the burden of the 

collection of information upon the 

respondents, including the use of 

automated collection techniques or 

other forms of information technology. 

Comments submitted in response to 

this notice will be summarized and 

included in the Agency’s subsequent 

request for OMB approval of the 

proposed information collection. All 

comments will become a matter of 

public record. 

Dated: July 19, 2021. 

Marquita Cullom, 

Associate Director. 

[FR Doc. 2021–15621 Filed 7–21–21; 8:45 am] 

BILLING CODE 4160–90–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Disease Control and 

Prevention 

Public Health Determination Regarding 

an Exception for Unaccompanied 

Noncitizen Children From the Order 

Suspending the Right To Introduce 

Certain Persons From Countries 

Where a Quarantinable Communicable 

Disease Exists 

AGENCY: Centers for Disease Control and 

Prevention (CDC), Department of Health 

and Human Services (HHS). 

ACTION: Notice. 

SUMMARY: The Centers for Disease 

Control and Prevention (CDC), a 

component of the Department of Health 

and Human Services (HHS), announces 

an Order excepting unaccompanied 

noncitizen children (UC) from the Order 

Suspending the Right to Introduce 

Certain Persons from Countries Where a 

Quarantinable Communicable Disease 

Exists, issued on October 13, 2020 

(October Order). CDC finds that, at this 

time, there is appropriate infrastructure 

in place to protect the children, 

caregivers, and local communities from 

elevated risk of COVID–19 transmission 

as a result of the introduction of UC, 

and U.S. healthcare resources are not 

significantly impacted by providing UC 

necessary care. CDC believes the 

COVID–19-related public health 

concerns associated with UC 

introduction can be adequately 

addressed without the UC being subject 

to the October Order, thereby permitting 

the government to better address the 

humanitarian challenges for these 

children. Therefore, CDC is fully 

excepting UC from the October Order, 

and the Notice regarding the temporary 

exception of UC published February 17, 

2021 is hereby superseded. 

DATES: This Order went into effect July 

16, 2021. 

FOR FURTHER INFORMATION CONTACT: 

Tiffany Brown, Deputy Chief of Staff, 

Centers for Disease Control and 

Prevention, 1600 Clifton Road NE, MS 

H21–10, Atlanta, GA 30329. Phone: 

404–639–7000. Email: cdcregulations@

cdc.gov. 

SUPPLEMENTARY INFORMATION: As part of 

government efforts to mitigate the 

introduction, transmission, and spread 

of COVID–19, CDC issued the October 

Order,1 suspending the right to 


lotter on DSK11XQN23PROD with NOTICES1
38718 Federal Register / Vol. 86, No. 138 / Thursday, July 22, 2021 / Notices 

85 FR 22424 (Apr. 22, 2020); Amendment and 

Extension of Order Under Sections 362 and 365 of 

the Public Health Service Act; Order Suspending 

Introduction of Certain Persons from Countries 

Where a Communicable Disease Exists, 85 FR 31503 

(May 26, 2020). 

2See 85 FR 65806, 65807. 

3Notice of Temporary Exception from Expulsion 

of Unaccompanied Noncitizen Children 

Encountered in the United States Pending 

Forthcoming Public Health Determination, 86 FR 

9942 (Feb. 17, 2021). 

4CDC’s understanding is that this class of 

individuals is similar to or the same as those 

individuals who would be considered 

‘‘unaccompanied alien children’’ (see 6 U.S.C. 279) 

for purposes of HHS ORR custody, were DHS to 

make the necessary immigration determinations 

under Title 8 of the U.S. Code. 

5Notice of Temporary Exception from Expulsion 

of Unaccompanied Noncitizen Children 

Encountered in the United States Pending 

Forthcoming Public Health Determination, 86 FR 

9942 (Feb. 17, 2021). 

6Order Suspending the Right to Introduce Certain 

Persons from Countries Where a Quarantinable 

Communicable Disease Exists, 85 FR 65806 (Oct. 

16, 2020). The October Order replaced the Order 

Suspending Introduction of Certain Persons from 

Countries Where a Communicable Disease Exists, 

issued on March 20, 2020, extended on April 20, 

2020, and amended May 19, 2020. Notice of Order 

Under Sections 362 and 365 of the Public Health 

Service Act Suspending Introduction of Certain 

Persons from Countries Where a Communicable 

Disease Exists, 85 FR 17060 (Mar. 26, 2020); 

Extension of Order Under Sections 362 and 365 of 

the Public Health Service Act; Order Suspending 

Introduction of Certain Persons From Countries 

Where a Communicable Disease Exists, 85 FR 22424 

(Apr. 22, 2020); Amendment and Extension of 

Order Under Sections 362 and 365 of the Public 

Health Service Act; Order Suspending Introduction 

of Certain Persons from Countries Where a 

Communicable Disease Exists, 85 FR 31503 (May 

26, 2020). 

7 ‘‘Suspension of the right to introduce’’ means to 

cause the temporary cessation of the effect of any 

law, rule, decree, or order pursuant to which a 

person might otherwise have the right to be 

introduced or seek introduction into the United 

States. 42 CFR 71.40(b)(5). 

8Quarantinable communicable diseases are any 

of the communicable diseases listed in Executive 

Order, as provided under § 361 of the Public Health 

Service Act (42 U.S.C. 264). 42 CFR 71.1. The list 

of quarantinable communicable diseases currently 

includes cholera, diphtheria, infectious 

tuberculosis, plague, smallpox, yellow fever, viral 

hemorrhagic fevers (Lassa, Marburg, Ebola, 

Crimean-Congo, South American, and others not yet 

isolated or named), severe acute respiratory 

syndromes (including Middle East respiratory 

syndrome and COVID–19), and influenza caused by 

novel or reemergent influenza viruses that are 

causing, or have the potential to cause, a pandemic. 

See Exec. Order 13295, 68 FR 17255 (Apr. 4, 2003), 

as amended by Exec. Order 13375, 70 FR 17299 

(Apr. 1, 2005) and Exec. Order 13674, 79 FR 45671 

(July 31, 2014). 

9This Order is using the term ‘‘covered 

noncitizens’’ to have the same meaning as ‘‘covered 

aliens’’ in the October Order. See October Order, 85 

FR 65806, 65807 (defining ‘‘covered aliens’’ as 

‘‘persons traveling from Canada or Mexico 

(regardless of their country of origin) who would 

otherwise be introduced into a congregate setting in 

a land or coastal Port of Entry (POE) or Border 

Patrol station at or near the United States borders 

with Canada or Mexico,’’ subject to certain 

exceptions. These persons ‘‘would typically be 

aliens seeking to enter the United States at POEs 

who do not have proper travel documents, aliens 

whose entry is otherwise contrary to law, and aliens 

who are apprehended near the border seeking to 

unlawfully enter the United States between 

POEs.’’). 

10When U.S. Customs and Border Protection 

(CBP) or the U.S. Department of Homeland Security 

(DHS) partner agencies encounter noncitizens off 

the coast closely adjacent to the land borders, it 

transfers the noncitizens for processing in POE or 

Border Patrol stations closest to the encounter. 

Absent the October Order, such noncitizens would 

be held in the same congregate settings and holding 

facilities as any encounters along the land border, 

resulting in similar public health concerns related 

to the introduction, transmission, and spread of 

COVID–19. 

11Notice of Temporary Exception from Expulsion 

of Unaccompanied Noncitizen Children 

Encountered in the United States Pending 

Forthcoming Public Health Determination, 86 FR 

9942 (Feb. 17, 2021). 

12CDC’s understanding is that this class of 

individuals is similar to or the same as those 

individuals who would be considered 

‘‘unaccompanied alien children’’ (see 6 U.S.C. 279) 

for purposes of HHS ORR custody, were DHS to 

make the necessary immigration determinations 

under Title 8 of the U.S. Code. 

introduce certain persons into the 

United States (U.S.) from countries or 

places where a quarantinable 

communicable disease exists to protect 

the public’s health from an increase in 

risk of the introduction of COVID–19. 

The Order applied specifically to certain 

noncitizens as defined 2 who would 

otherwise be introduced into a 

congregate setting in land or coastal 

ports of entry (POE) or Border Patrol 

stations at or near the U.S. borders with 

Canada and Mexico. On February 17, 

2021,3 CDC published a notice 

announcing the temporary exception 

from expulsion of unaccompanied 

noncitizen children 4 (UC) encountered 

in the United States from the October 

Order.5

As detailed in the Order, CDC has 

reviewed the current situation with 

regards to the COVID–19 public health 

emergency and UC in immigrations 

facilities and has concluded that it is 

appropriate to fully except UC from the 

October Order given the measures in 

place to prevent and mitigate 

transmission of COVID–19 in this 

population. CDC finds that the robust 

network UC care facilities operated by 

the Office of Refugee Resettlement 

(ORR), a component of HHS, the testing 

and medical care available therein, as 

well as COVID–19 mitigation protocols 

including vaccination for personnel and 

eligible UC, result in very low 

likelihood that processing UC in 

accordance with existing immigration 

procedures under Title 8 of the U.S. 

Code will result in undue strain on the 

U.S. healthcare system or healthcare 

resources. Moreover, UC released to a 

vetted sponsor or placed in a permanent 

ORR shelter do not pose a significant 

level of risk for COVID–19 spread into 

the community because they are 

released after having undergone testing, 

quarantine and/or isolation, and 

vaccination when possible, and their 

sponsors are provided with appropriate 

medical and public health direction. 

A copy of the Order is provided 

below, and a copy of the signed Order 

can be found at https://www.cdc.gov/ 

coronavirus/2019-ncov/more/pdf/Notice

UnaccompaniedChildren.pdf. 

U.S. DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Disease Control and 

Prevention (CDC) 

Order Under Sections 362 & 365 of the 

Public Health Service Act (42 U.S.C. 

265, 268) and 42 CFR 71.40 

Public Health Determination Regarding 

an Exception for Unaccompanied 

Noncitizen Children From the Order 

Suspending the right to Introduce 

Certain Persons From Countries Where 

a Quarantinable Communicable Disease 

Exists 

As part of U.S. government efforts to 

mitigate the introduction, transmission, 

and spread of COVID–19, CDC issued an 

Order on March 20, 2020 (March Order), 

later replaced on October 13, 2020 

(October Order),6 suspending the right 

to introduce 7 certain persons into the 

United States from countries or places 

where a quarantinable communicable 

disease 8 exists in order to protect the 

public health from an increase in risk of 

the introduction of COVID–19. The 

Orders applied specifically to covered 

noncitizens 9 who would otherwise be 

introduced into a congregate setting in 

land or coastal ports of entry (POE) or 

Border Patrol stations at or near the U.S. 

borders 10 with Canada and Mexico. On 

February 17, 2021, CDC published a 

notice 11 (February Notice) announcing 

the temporary exception of 

unaccompanied noncitizen children 

from the October Order; the February 

Notice stated that CDC would complete 

a public health assessment and publish 

an additional notice or a modified 

Order. As explained below, CDC has 

concluded that it is appropriate to 

except unaccompanied noncitizen 

children 12 (UC) from the October Order 

given the measures in place to prevent 

and mitigate transmission of COVID–19 

in this population. 

Under the March and October Orders, 

UC were included as part of the covered 

noncitizens for whom the right of 

introduction into the United States was 

suspended; however, UC largely have 

been excepted from the application of 

the Order, first pursuant to judicial 


lotter on DSK11XQN23PROD with NOTICES1
Federal Register / Vol. 86, No. 138 / Thursday, July 22, 2021 / Notices 38719 

13 Dkt. No. 80, P.J.E.S. v. Mayorkas et al., No. 

1:20–cv–02245 (D.D.C. Nov. 18, 2020). 

14See 8 U.S.C. 1232; Stipulated Settlement 

Agreement, Flores v. Reno, No. CV 85–cv–4544 

(C.D. Cal. Jan. 17, 1997). 

15 8 U.S.C. 1232(b)(3). 

16EIS are intended to be a temporary measure 

providing a standard of care consistent with the 

best interest of children during an emergency 

situation. When fully operational with appropriate 

staffing and basic medical resources, EIS provide a 

safer, less crowded environment where UC are 

cared for, processed as quickly as possible, and are 

either released to a sponsor or transferred to an 

appropriate ORR facility for longer-term care. When 

no longer necessary, EIS facilities are demobilized. 

17HHS Executive Leadership Information Brief 

(internal document). Published July 12, 2021. 18For comparison, on March 29, 2021, nearly 

5,500 UC were in CBP custody, with 3,540 of those 

UC in custody for longer than 72 hours; as of March 

31, 2021, the average time in CBP custody for UC 

was 131 hours. 19Specifically, ORR currently uses the following 

COVID–19 protocols for UC at EIS: UC are tested 

for COVID–19 by CBP prior to being transported to 

an EIS and then are also tested upon arrival to EIS. 

UC are required to quarantine for the first 7 days 

after admission to an EIS and can be released from 

quarantine on the morning of day 8 if they remain 

asymptomatic and had a negative COVID–19 test in 

the 48 hours prior. In addition to testing at 

admission and during quarantine, UC are routinely 

tested during their stay at EIS (e.g., every three 

days), and any UC that develops symptoms 

consistent with COVID–19 infection is immediately 

tested. UC who test positive for COVID–19 are 

required to be isolated for 10 days from the date the 

positive test was collected, or 10 days from the date 

of symptom onset if asymptomatic. Contact tracing 

is conducted whenever anyone tests positive for 

COVID–19; UC exposed to COVID–19 are 

quarantined for seven days, tested on the 5th, 6th, 

or 7th day of their quarantine, and are released 

upon receiving a negative test result. ORR has also 

issued similar COVID–19 guidance to licensed 

facilities. 

20 In ORR facilities where the risk of transmission 

is moderate to high, public health officials working 

collaboratively with ORR facilities can determine 

the appropriateness of offering screening and repeat 

testing of randomly selected asymptomatic staff and 

children at the facility, as feasible, to identify cases 

and prevent secondary transmission. 

21Additional criteria (e.g., continued symptom 

monitoring and correct and consistent wearing of 

masks) should be met by ORR as outlined on CDC’s 

website. See Science Brief: Options to Reduce 

Quarantine for Contacts of Persons with SARS– 

CoV–2 Infection Using Symptom Monitoring and 

Diagnostic Testing, Centers for Disease Control and 

Prevention, https://www.cdc.gov/coronavirus/2019- 

ncov/more/scientific-brief-options-to-reducequarantine.html (last updated Dec. 2, 2020). 

action,13 and later under the February 

Notice. As a result, since November 18, 

2020, UC have generally been processed 

under regular immigration processes 

under Title 8 of the U.S. Code and 

therefore referred from U.S. Customs 

and Border Protection (CBP), an agency 

within the U.S. Department of 

Homeland Security (DHS), to the Office 

of Refugee Resettlement (ORR) within 

the U.S. Department of Health and 

Human Services’ (HHS) Administration 

for Children and Families (ACF) for care 

and custody, according to the usual 

legal framework governing such 

referrals.14 Pursuant to these 

requirements, UC encountered in the 

United States by CBP generally are 

transferred to ORR within 72 hours of 

intake at a POE or Border Patrol 

station.15 Upon transfer to ORR custody, 

UC are transported to facilities that 

operate under cooperative agreements or 

contracts with HHS and must meet ORR 

requirements to ensure a high level of 

quality, child-focused care by 

appropriately trained staff. ORR 

operates 210 facilities in 22 states. At 

these facilities, case managers work to 

identify and ultimately place UC with 

vetted sponsors (usually family 

members within the United States). 

Beginning in mid-2020, the United 

States began experiencing an increase in 

the number of UC arriving daily at the 

southern border. By February 2021, due 

to the record numbers of transfers to 

ORR, UC being held in CBP custody 

awaiting ORR transfer increased due to 

a lack of available space in ORR 

facilities. ORR and other government 

agencies responded to the influx of UC 

by rapidly expanding capacity and 

developing robust, safe COVID–19 

protocols in consultation with CDC. 

In conjunction with the Federal 

Emergency Management Agency 

(FEMA) and with the assistance of the 

Department of Defense, HHS and ORR 

opened temporary intake facilities along 

the U.S. southern border and in the 

interior to add capacity. A total of 14 

Emergency Intake Sites (EIS) 16 were 

opened across the United States. CDC 

assisted ORR by sending medical 

epidemiologists and other public health 

professionals to provide technical 

assistance on COVID–19 mitigation 

protocols. ORR now has a capacity of 

over 20,000 beds; currently, over 15,100 

children are in its care. ORR has 

successfully processed and discharged 

over 55,000 UC since January 20, 2021. 

The successful efforts to expand 

capacity for UC have resulted in 

sufficient capacity at ORR sites—both 

along the border and in the interior— 

significantly reducing the length of time 

that UC remain in CBP custody. As of 

July 13, 2021, the current average time 

a UC remained in CBP custody before 

transferring to ORR custody was 26 

hours, and four UC have been in CBP 

custody for over 72 hours.17 This 

represents a substantial improvement 

from early 2021.18 While the number of 

UC encountered may remain at elevated 

levels, expanded ORR capacity and 

improved processing methods have 

resulted in UC remaining in CBP 

custody for shorter periods of time. 

The processes in place at the EIS and 

at ORR’s regular facilities afford 

sufficient resources and time to identify 

SARS–CoV–2 cases and implement 

environmental controls to attenuate the 

risk of COVID–19 infection and 

spread.19 With CDC’s assistance and 

guidance, ORR also has implemented 

COVID–19 testing regimes for UC in its 

care and continues to practice other 

mitigation measures to further prevent 

and curtail any transmission of the 

SARS–CoV–2 virus among UC in its 

care. These strategies include universal 

and proper wearing of masks, physical 

distancing, frequent hand washing, 

cleaning and disinfection, improved 

ventilation, staff vaccination, and 

cohorting UC according to their COVID– 

19 test status. Per CDC recommendation, 

ORR conducts serial testing of staff to 

allow early detection of a possible 

outbreak.20 ORR contract staff working 

in facilities serving UC are encouraged 

to receive the COVID–19 vaccine.21 As 

advised by CDC, ORR restricts 

movement of unvaccinated personnel 

between facilities to reduce potential 

outbreaks resulting from transfer of 

unvaccinated staff between shelters. 

These measures help reduce the spread 

of COVID–19 among UC prior to being 

introduced into U.S. communities. 

In addition to the mitigation measures 

at EIS and ORR facilities outlined above, 

following FDA expansion of the 

emergency use authorization for the 

Pfizer-BioNTech COVID–19 vaccine for 

adolescents 12 to 15 years of age, CDC 

provided updated recommendations to 

ORR regarding the vaccination of UC 

ages 12 and older. ORR subsequently 

approved the administration of COVID– 

19 vaccine for age-eligible children. 

Under ORR care, children ages 12 and 

over are offered a COVID–19 vaccine as 

soon as possible, as long as there are no 

contraindications and vaccination does 

not delay unification of UC with 

sponsors. Of the total population of UC 

in ORR care, approximately 90% are 

eligible for vaccination and, as of July 

12, 2021, ORR has administered at least 

one dose of the COVID–19 vaccine to 

10,124 UC. CDC considers these 

vaccination efforts to be a critical risk 

reduction measure that supports 

excepting UC from the October Order. 

Although 8,435 UC have tested 

positive for COVID–19 while at ORR 

shelters during the period of March 24, 

2020 to July 8, 2021, 8,081 of those UC 

testing positive have successfully 

completed medical isolation, with few 

requiring medical treatment. Similarly, 

6,590 COVID–19 cases have been 

reported among 14 EIS as of July 7, 

2021; however only 14 (0.5%) of the UC 

in this group have required 

hospitalization (including two severe 


lotter on DSK11XQN23PROD with NOTICES1
38720 Federal Register / Vol. 86, No. 138 / Thursday, July 22, 2021 / Notices 

22This situation could change based on an 

increased influx of UC, changes in COVID–19 

infection dynamics among UC, or unforeseen 

reductions in housing capacity. 23See 86 FR 9942. 24 42 U.S.C. 268; 42 CFR 71.40(d). 

1Title XXXIII of the PHS Act is codified at 42 

U.S.C. 300mm to 300mm–61. Those portions of the 

James Zadroga 9/11 Health and Compensation Act 

of 2010 found in Titles II and III of Public Law 111– 

347 do not pertain to the WTC Health Program and 

are codified elsewhere. 

2The List of WTC-Related Health Conditions is 

established in 42 U.S.C. 300mm–22(a)(3)–(4) and 

300mm–32(b); additional conditions may be added 

through rulemaking and the complete list is 

provided in WTC Health Program regulations at 42 

CFR 88.15. 

3 42 U.S.C. 300mm–51(a). 

cases requiring intensive care). These 

numbers indicate that the risk of 

overburdening the local healthcare 

systems by UC presenting with severe 

COVID–19 disease remains low. Based 

on the robust network of ORR care 

facilities and the testing and medical 

care available therein, as well as 

COVID–19 mitigation protocols 

including vaccination for personnel and 

eligible UC, there is very low likelihood 

that processing UC in accordance with 

existing Title 8 procedures will result in 

undue strain on the U.S. healthcare 

system or healthcare resources. 

Moreover, UC released to a vetted 

sponsor or placed in a permanent ORR 

shelter do not pose a significant level of 

risk for COVID–19 spread into the 

community because they are released 

after having undergone testing, 

quarantine and/or isolation, and 

vaccination when possible, and their 

sponsors are provided with appropriate 

medical and public health direction. 

CDC thus finds that, at this time,22

there is appropriate infrastructure in 

place to protect the children, caregivers, 

and local communities from elevated 

risk of COVID–19 transmission as a 

result of the introduction of UC, and 

U.S. healthcare resources are not 

significantly impacted by providing UC 

necessary care. CDC believes the 

COVID–19-related public health 

concerns associated with UC 

introduction can be adequately 

addressed without UC being subject to 

the October Order, thereby permitting 

the government to better address the 

humanitarian challenges for these 

children. Based on the foregoing, CDC is 

fully excepting UC from the October 

Order,23 and the February Notice is 

hereby superseded. This Order shall be 

immediately effective. I consulted with 

DHS and other federal departments as 

needed before I issued this Order and 

requested that DHS continue to aid in 

the enforcement of this Order because 

CDC does not have the capability, 

resources, or personnel needed to do 

so.24

This Order is not a rule subject to 

notice and comment under the 

Administrative Procedure Act (APA). 

Even if it were, notice and comment and 

a delay in effective date are not required 

because there is good cause to dispense 

with prior public notice and the 

opportunity to comment on this Order 

and a delayed effective date. Given the 

public health emergency caused by 

COVID–19 and the highly unpredictable 

nature of its transmission and spread, it 

would be impracticable and contrary to 

public health practices and the public 

interest to delay the issuing and 

effective date of this Order with respect 

to UC. In addition, because this Order 

concerns the ongoing discussions with 

Canada and Mexico on how best to 

control COVID–19 transmission over 

our shared borders, it directly 

‘‘involve[s] . . . a . . . foreign affairs 

function of the United States.’’ 5 U.S.C. 

553(a)(1). Notice and comment and a 

delay in effective date would not be 

required for that reason as well. 

Authority 

The authority for this Order is 

Sections 362 and 365 of the Public 

Health Service Act (42 U.S.C. 265, 268) 

and 42 CFR 71.40. 

Dated: July 19,2021. 

Sherri Berger, 

Chief of Staff, Centers for Disease Control 

and Prevention. 

[FR Doc. 2021–15699 Filed 7–20–21; 4:15 pm] 

BILLING CODE 4163–18–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Disease Control and 

Prevention 

[Docket No. CDC–2021–0071; NIOSH–341] 

World Trade Center Health Program; 

Request for Information 

AGENCY: Centers for Disease Control and 

Prevention, HHS. 

ACTION: Request for information. 

SUMMARY: The National Institute for 

Occupational Safety and Health 

(NIOSH), within the Centers for Disease 

Control and Prevention (CDC), is 

soliciting public comment on the scope 

of an upcoming funding announcement 

for FY2022 regarding the World Trade 

Center (WTC) Health Program’s research 

priorities involving WTC survivors. The 

WTC Health Program’s research 

program helps answer critical questions 

about potential 9/11-related physical 

and mental health conditions as well as 

diagnosing and treating health 

conditions on the List of WTC-Related 

Health Conditions. 

DATES: Comments must be received by 

August 23, 2021. 

ADDRESSES: Comments may be 

submitted through either of the 

following two methods: 

• Federal eRulemaking Portal: http:// 

www.regulations.gov (follow the 

instructions for submitting comments), 

or 

• By Mail: NIOSH Docket Office, 

Robert A. Taft Laboratories, MS C–34, 

1090 Tusculum Avenue, Cincinnati, 

Ohio 45226–1998. 

Instructions: All written submissions 

received in response to this notice must 

include the agency name (Centers for 

Disease Control and Prevention, HHS) 

and docket number (CDC–2021–0071; 

NIOSH–341) for this action. All relevant 

comments, including any personal 

information provided, will be posted 

without change to http:// 

www.regulations.gov. 

FOR FURTHER INFORMATION CONTACT: 

Rachel Weiss, Program Analyst, 1090 

Tusculum Avenue, MS: C–48, 

Cincinnati, OH 45226; telephone (855) 

818–1629 (this is a toll-free number); 

email NIOSHregs@cdc.gov. 

SUPPLEMENTARY INFORMATION: Title I of 

the James Zadroga 9/11 Health and 

Compensation Act of 2010 (Pub. L. 111– 

347, as amended by Pub. L. 114–113 

and Pub. L. 116–59), added Title XXXIII 

to the Public Health Service (PHS) Act,1

establishing the WTC Health Program 

within the Department of Health and 

Human Services (HHS). The WTC 

Health Program provides medical 

monitoring and treatment benefits for 

health conditions on the List of WTCRelated Health Conditions (List) 2 to 

eligible firefighters and related 

personnel, law enforcement officers, 

and rescue, recovery, and cleanup 

workers who responded to the 

September 11, 2001, terrorist attacks in 

New York City, at the Pentagon, and in 

Shanksville, Pennsylvania (responders). 

The Program also provides benefits to 

eligible persons who were present in the 

dust or dust cloud on September 11, 

2001, or who worked, resided, or 

attended school, childcare, or adult 

daycare in the New York City disaster 

area (survivors). 

The Zadroga Act also requires that the 

Program establish a research program on 

health conditions resulting from the 

September 11, 2001, terrorist attacks, 

addressing the following topics: 3

• Physical and mental health 

conditions that may be related to the 

September 11, 2001, terrorist attacks; 


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