Federal Register / Vol. 86, No. 158 / Thursday, August 19, 2021 / Notices 46703 

Control Act (Act) (12 U.S.C. 1817(j)) and 

§ 225.41 of the Board’s Regulation Y (12 

CFR 225.41) to acquire shares of a bank 

or bank holding company. The factors 

that are considered in acting on the 

applications are set forth in paragraph 7 

of the Act (12 U.S.C. 1817(j)(7)). 

The public portions of the 

applications listed below, as well as 

other related filings required by the 

Board, if any, are available for 

immediate inspection at the Federal 

Reserve Bank(s) indicated below and at 

the offices of the Board of Governors. 

This information may also be obtained 

on an expedited basis, upon request, by 

contacting the appropriate Federal 

Reserve Bank and from the Board’s 

Freedom of Information Office at 

https://www.federalreserve.gov/foia/ 

request.htm. Interested persons may 

express their views in writing on the 

standards enumerated in paragraph 7 of 

the Act. 

Comments regarding each of these 

applications must be received at the 

Reserve Bank indicated or the offices of 

the Board of Governors, Ann E. 

Misback, Secretary of the Board, 20th 

Street and Constitution Avenue NW, 

Washington, DC 20551–0001, not later 

than September 3, 2021. 

A. Federal Reserve Bank of 

Minneapolis (Chris P. Wangen, 

Assistant Vice President) 90 Hennepin 

Avenue, Minneapolis, Minnesota 

55480–0291: 

1. Daniel Otten, Hayward, Minnesota; 

to retain voting shares of Minnesota 

Community Bancshares, Inc., Albert 

Lea, Minnesota, and thereby indirectly 

retain voting shares of Arcadian Bank, 

Hartland, Minnesota. 

B. Federal Reserve Bank of Kansas 

City (Jeffrey Imgarten, Assistant Vice 

President) 1 Memorial Drive, Kansas 

City, Missouri 64198–0001: 

1. Kathleen Sullivan, Cedar Rapids, 

Nebraska; to join the Sullivan Family 

Group, a group acting in concert, to 

acquire voting shares of Cedar Rapids 

State Company, and thereby indirectly 

acquire voting shares of Cedar Rapids 

State Bank, both of Cedar Rapids, 

Nebraska. 

Board of Governors of the Federal Reserve 

System, August 16, 2021. 

Michele Taylor Fennell, 

Deputy Associate Secretary of the Board. 

[FR Doc. 2021–17817 Filed 8–18–21; 8:45 am] 

BILLING CODE P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Disease Control and 

Prevention 

[Docket No. CDC–2021–0088] 

Updating CDC’s Contraception 

Guidance Documents: U.S. Medical 

Eligibility Criteria for Contraceptive 

Use and U.S. Selected Practice 

Recommendations for Contraceptive 

Use 

AGENCY: Centers for Disease Control and 

Prevention (CDC), Department of Health 

and Human Services (HHS). 

ACTION: Notice with comment period. 

SUMMARY: The Centers for Disease 

Control and Prevention (CDC) in the 

Department of Health and Human 

Services (HHS) announces the opening 

of a docket to obtain comment on CDC’s 

contraception recommendations. Two 

guidance documents, U.S. Medical 

Eligibility Criteria for Contraceptive Use 

(US MEC) and U.S. Selected Practice 

Recommendations for Contraceptive 

Use (US SPR), provide evidence-based 

recommendations to assist health care 

providers when counseling patients on 

contraceptive choice and use. Updates 

to these guidance documents typically 

occur every 5 years. As part of the 

planning process for the next update, 

CDC is requesting public comment on 

content to consider for revision or 

addition to the recommendations and 

how to improve the implementation of 

the guidance documents. This action is 

necessary to consider multiple and 

diverse perspectives and ensure that the 

documents meet the needs of U.S. 

health care providers and the persons 

they serve. 

DATES: Written comments must be 

received on or before October 18, 2021. 

ADDRESSES: You may submit comments, 

identified by Docket No. CDC–2021– 

0088 by any of the following methods: 

• Federal eRulemaking Portal: http:// 

www.regulations.gov. Follow the 

instructions for submitting comments. 

• Mail: [insert complete mailing 

address, including mailstop] 

Instructions: All submissions received 

must include the agency name and 

Docket Number. All relevant comments 

received will be posted without change 

to http://regulations.gov, including any 

personal information provided. For 

access to the docket to read background 

documents or comments received, go to 

http://www.regulations.gov. 

FOR FURTHER INFORMATION CONTACT: 

Kathryn M. Curtis, Ph.D., Division of 

Reproductive Health, Centers for 

Disease Control and Prevention, 4770 

Buford Highway NE, MS S107–2, 

Atlanta, GA 30341. Telephone: 770– 

488–5200. Email: usmecspr@cdc.gov. 

SUPPLEMENTARY INFORMATION: 

Public Participation 

Interested persons or organizations 

are invited to participate by submitting 

written views, recommendations, and 

data. CDC invites comments specifically 

on the following questions: 

1. Are there existing US MEC or US 

SPR recommendations that CDC should 

consider reviewing for possible revision, 

based on new evidence or other 

justification? Please provide references 

to new evidence and justification to 

support review of existing 

recommendations. 

2. Are there new recommendations 

that CDC should consider adding to the 

US MEC? This could include eligibility 

criteria for contraceptive use among 

people with medical conditions or 

characteristics not currently included in 

the US MEC. Please provide references 

to supporting evidence, justification, 

and impact of new recommendations. 

3. Are there new recommendations 

that CDC should consider adding to the 

US SPR? This could include clinical 

practice recommendations to address 

issues regarding initiation and use of 

specific contraceptive methods not 

currently included in the US SPR. 

Please provide references to supporting 

evidence, justification, and impact of 

new recommendations. 

4. Are there other issues that should 

be considered or suggestions to improve 

implementation of the US MEC and US 

SPR recommendations to help ensure 

equitable access to contraceptive 

services (such as better ways of 

presenting the recommendations, 

additional job aids or tools for 

providers, broader dissemination and 

implementation strategies, inclusion of 

additional partners, etc.)? Please 

provide references to supporting 

evidence or justification. 

Please note that comments received, 

including attachments and other 

supporting materials, are part of the 

public record and are subject to public 

disclosure. Comments will be posted on 

https://www.regulations.gov. Therefore, 

do not include any information in your 

comment or supporting materials that 

you consider confidential or 

inappropriate for public disclosure. If 

you include your name, contact 

information, or other information that 

identifies you in the body of your 

comments, that information will be on 

public display. CDC will review all 

submissions and may choose to redact, 

or withhold, submissions containing 


lotter on DSK11XQN23PROD with NOTICES1
46704 Federal Register / Vol. 86, No. 158 / Thursday, August 19, 2021 / Notices 

private or proprietary information such 

as Social Security numbers, medical 

information, inappropriate language, or 

duplicate/near duplicate examples of a 

mass-mail campaign. CDC will carefully 

consider all comments submitted in 

preparation of the final document. 

In 2017–2019 in the United States, 

65% of women aged 15–49 years used 

contraception; the most common 

contraceptive methods used were 

female sterilization, oral contraceptive 

pills, implants and intrauterine devices, 

and male condoms [1]. The majority 

(61%) of U.S. women aged 18–49 years 

have ongoing or potential need for 

contraceptive services [2]. Similarly, in 

2010–2016, about 60% of men aged 15– 

44 years in the United States needed 

family planning [3]. Equitable access to 

evidence-based, high quality care is 

critical to meeting the needs of persons 

seeking contraceptive services, 

improving reproductive autonomy, and 

reducing unintended pregnancy in the 

United States [2]. 

Since 2010, CDC has published 

evidence-based recommendations on 

contraception provision. These 

recommendations are intended to assist 

health care providers when they counsel 

patients about choice and use of 

contraceptive methods, with the goal of 

reducing medical barriers to 

contraception access. U.S. Medical 

Eligibility Criteria for Contraceptive Use, 

2016 (US MEC) comprises 

recommendations for the use of specific 

contraceptive methods by persons with 

certain characteristics or medical 

conditions, such as diabetes, 

hypertension, and being postpartum or 

breastfeeding [4]. U.S. Selected Practice 

Recommendations for Contraceptive 

Use, 2016 (US SPR) addresses common, 

yet sometimes complex, issues 

regarding initiation and use of specific 

contraceptive methods, such as 

examinations or tests needed before 

starting a method and management of 

side effects [5]. Both guidance 

documents are adapted from global 

guidance developed by the World 

Health Organization (WHO) and are 

based on review of the scientific 

evidence and consultation with national 

experts. CDC partners with other federal 

agencies and professional organizations 

in the development, dissemination, and 

implementation of the guidance 

documents to improve access to 

contraception and quality of family 

planning services. 

CDC is committed to ensuring that the 

US MEC and US SPR recommendations 

are reviewed and updated as new 

scientific evidence becomes available. 

Working with WHO, CDC continuously 

monitors peer-reviewed literature and 

updates recommendations as needed, 

with comprehensive reviews 

approximately every 5 years. CDC is 

currently planning for the next update 

of the US MEC and US SPR and will 

consider public comments when 

determining the scope of the guidance 

update. CDC is seeking feedback from 

health care providers, professional 

organizations, community-based 

organizations, organizations that seek to 

improve reproductive health, patient 

advocacy groups, and the public. 

The current US MEC may be found at 

the Supplementary Materials tab of the 

docket and at https://www.cdc.gov/ 

reproductivehealth/contraception/ 

mmwr/mec/summary.html. The current 

US SPR may be found at the 

Supplementary Materials tab of the 

docket and at https://www.cdc.gov/ 

reproductivehealth/contraception/ 

mmwr/spr/summary.html. 

References 

1. Daniels K, Abma JC. Current contraceptive 

status among women aged 15–49: United 

States, 2017–2019. NCHS Data Brief 

2020:388;1–8. 

2. Zapata LB, Pazol K, Curtis KM et al. Need 

for contraceptive services among women 

of reproductive age—45 jurisdictions, 

United States, 2017–2019. MMWR Morb 

Mortal Wkly Rep 2021;70:910–15. 

3. Marcell AV, Gibbs SE, Choiriyyah I et al. 

National needs of family planning among 

US men aged 15 to 44 years. Am J Public 

Health 2016:106;733–9. 

4. Curtis KM, Tepper NK, Jatlaoui TC, et al. 

U.S. medical eligibility criteria for 

contraceptive use, 2016. MMWR 

Recomm Rep 2016;65(RR–3):1–103. 

5. Curtis KM, Jatlaoui TC, Tepper NK, et al. 

U.S. selected practice recommendations 

for contraceptive use, 2016. MMWR 

Recomm Rep 2016;65(RR–4):1–66. 

Dated: August 16, 2021. 

Sandra Cashman, 

Executive Secretary, Centers for Disease 

Control and Prevention. 

[FR Doc. 2021–17818 Filed 8–18–21; 8:45 am] 

BILLING CODE 4163–18–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Administration for Children and 

Families 

Submission for OMB Review; Tribal 

Maternal, Infant, and Early Childhood 

Home Visiting Program: Guidance for 

Submitting an Annual Report to the 

Secretary (OMB #0970–0409) 

AGENCY: Office of Child Care, 

Administration for Children and 

Families, HHS. 

ACTION: Request for public comment. 

SUMMARY: The Administration for 

Children and Families (ACF), Office of 

Child Care (OCC) is requesting a 3-year 

extension of the Tribal Maternal, Infant, 

and Early Childhood Home Visiting 

(MIECHV) Program: Guidance for 

Submitting an Annual Report to the 

Secretary (OMB #0970–0409; expiration 

9/30/2021). There are minor updates to 

the annual guidance which reflects a 

change in timing for the due date of the 

final report. 

DATES: Comments due within 30 days of 

publication. OMB must make a decision 

about the collection of information 

between 30 and 60 days after 

publication of this document in the 

Federal Register. Therefore, a comment 

is best assured of having its full effect 

if OMB receives it within 30 days of 

publication. 

ADDRESSES: Written comments and 

recommendations for the proposed 

information collection should be sent 

within 30 days of publication of this 

notice to www.reginfo.gov/public/do/ 

PRAMain. Find this particular 

information collection by selecting 

‘‘Currently under 30-day Review—Open 

for Public Comments’’ or by using the 

search function. 

SUPPLEMENTARY INFORMATION: 

Description: Section 511(e)(8)(A) of Title 

V of the Social Security Act requires 

that grantees under the MIECHV 

program for states and jurisdictions 

submit an annual report to the Secretary 

of Health and Human Services regarding 

the program and activities carried out 

under the program, including such data 

and information as the Secretary shall 

require. Section 511(h)(2)(A) further 

states that the requirements for the 

MIECHV grants to tribes, tribal 

organizations, and urban Indian 

organizations are to be consistent, to the 

greatest extent practicable, with the 

requirements for grantees under the 

MIECHV program for states and 

jurisdictions. 

OCC, in collaboration with the Health 

Resources and Services Administration, 

Maternal and Child Health Bureau 

awarded grants for the Tribal MIECHV 

Program (Tribal Home Visiting) to 

support cooperative agreements to 

conduct community needs assessments; 

plan for and implement high-quality, 

culturally-relevant, evidence-based 

home visiting programs in at-risk tribal 

communities; establish, measure, and 

report on progress toward meeting 

performance measures in six 

legislatively-mandated benchmark 

areas; and conduct rigorous evaluation 

activities to build the knowledge base 

on home visiting among Native 

populations. 


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