46856 Federal Register / Vol. 86, No. 159 / Friday, August 20, 2021 / Notices 

A 60-day notice published in the 

Federal Register on April 20, 2021, vol. 

86, No. 74, pp. 20499–20500. No public 

comments were received in response to 

the ICR. 

Need and Proposed Use of the 

Information: HRSA uses the 

documentation submitted in core 

medical services waiver requests to 

determine if the grant applicant or 

recipient meets the statutory 

requirements for waiver eligibility 

outlined in Sections 2604(c), 2612(b), 

and 2651(c) of the Public Health Service 

Act. 

Likely Respondents: HRSA expects 

responses from RWHAP Parts A, B, and 

C grant applicants and recipients. The 

number of grant recipients requesting 

waivers has fluctuated annually and has 

ranged from 15 to 22 per year since the 

waiver process was implemented in FY 

2007. 

Given the changes in the health care 

environment, HRSA anticipates 

receiving possibly up to 22 applications 

in a given year. 

Burden Statement: Burden in this 

context means the time expended by 

persons to generate, maintain, retain, 

disclose or provide the information 

requested. This includes the time 

needed to review instructions; to 

develop, acquire, install, and utilize 

technology and systems for the purpose 

of collecting, validating, and verifying 

information, processing and 

maintaining information, and disclosing 

and providing information; to train 

personnel and to be able to respond to 

a collection of information; to search 

data sources; to complete and review 

the collection of information; and to 

transmit or otherwise disclose the 

information. The total annual burden 

hours estimated for this ICR are 

summarized in the table below. 

TOTAL ESTIMATED ANNUALIZED BURDEN HOURS

Form name Number of 

respondents 

Number of 

responses per 

respondent 

Total 

responses 

Average 

burden per 

response 

(in hours) 

Total burden 

hours 

Waiver Request ................................................................... 22 1 22 4 88 

22 ........................ 22 ........................ 88 

HRSA notes that this proposed 

process represents a decrease in burden 

when compared to the current policy 

outlined in PN 13–07 due in part to the 

elimination of the requirement to 

prepare and submit a narrative and 

multiple documents. HRSA specifically 

requests comments on (1) the necessity 

and utility of the proposed information 

collection for the proper performance of 

the agency’s functions, (2) the accuracy 

of the estimated burden, (3) ways to 

enhance the quality, utility, and clarity 

of the information to be collected, and 

(4) the use of automated collection 

techniques or other forms of information 

technology to minimize the information 

collection burden. 

Maria G. Button, 

Director, Executive Secretariat. 

[FR Doc. 2021–17834 Filed 8–19–21; 8:45 am] 

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DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Health Resources and Services 

Administration 

Updated HRSA-Supported Women’s 

Preventive Services Guidelines: WellWomen Preventive Visits, Counseling 

for Sexually Transmitted Infections, 

and Breastfeeding Services and 

Supplies 

AGENCY: Health Resources and Services 

Administration (HRSA), Department of 

Health and Human Services (HHS). 

ACTION: Notice. 

SUMMARY: This notice seeks comments 

on an updated draft recommendation for 

Well-Woman Preventive Visits, 

Counseling for Sexually Transmitted 

Infections, and Breastfeeding Services 

and Supplies, as part of the HRSAsupported Women’s Preventive Services 

Guidelines. This updated draft 

recommendation has been developed 

through a national cooperative 

agreement, the Women’s Preventive 

Services Initiative (WPSI), by the 

American College of Obstetricians and 

Gynecologists (ACOG). Under the Public 

Health Service Act, as added by the 

Patient Protection and Affordable Care 

Act, non-grandfathered group health 

plans and non-grandfathered group and 

individual health insurance issuers 

must include coverage, without cost 

sharing, for certain preventive services 

under that section, including those 

provided for in the HRSA-supported 

Women’s Preventive Services 

Guidelines (Guidelines). 

DATES: Members of the public are 

invited to provide written comments no 

later than September 20, 2021. All 

comments received on or before this 

date will be reviewed and considered by 

the WPSI Multidisciplinary Steering 

Committee. 

ADDRESSES: Members of the public 

interested in providing comments on 

the draft recommendation statements 

can do so by accessing the initiative’s 

web page at https://www.womens

preventivehealth.org/. 

FOR FURTHER INFORMATION CONTACT: 

Kimberly Sherman, HRSA, Maternal 

and Child Health Bureau, telephone 

(301) 443–8283, email: wellwomancare@

hrsa.gov. 

SUPPLEMENTARY INFORMATION: The 

HRSA-supported Women’s Preventive 

Services Guidelines were originally 

established in 2011 based on a study 

and recommendations by the Institute of 

Medicine, now known as the National 

Academy of Medicine, commissioned 

by HHS. Since then, there have been 

advancements in science and gaps 

identified in these guidelines, including 

a greater emphasis on practice-based 

clinical considerations. In March 2016, 

HRSA awarded a 5-year cooperative 

agreement to convene a coalition 

representing clinicians, academics, and 

consumer-focused health professional 

organizations to conduct a rigorous 

review of current scientific evidence 

and recommend updates to existing 

guidelines. The ACOG was awarded the 

cooperative agreement and formed the 

WPSI, which consists of an Advisory 

Panel and two expert committees; the 

Multidisciplinary Steering Committee 

(MSC) and the Dissemination and 

Implementation Steering Committee, to 

improve adult women’s health across 

the lifespan by engaging a coalition of 

health professional organizations to 

review evidence and recommend 

updates to the HRSA-supported 

Women’s Preventive Services 

Guidelines. HRSA would then decide 

whether or not to support, in whole or 


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Federal Register / Vol. 86, No. 159 / Friday, August 20, 2021 / Notices 46857 

in part, the recommended updates to the 

Guidelines. 

In March 2021, ACOG was awarded a 

subsequent cooperative agreement to 

further review and recommend updates 

to the Guidelines. As the award 

recipient, starting on March 1, 2021, 

ACOG has engaged in a process to 

consider and review new information 

developed by a multidisciplinary group 

of women’s health professional 

organizations. Following 

recommendations by ACOG, HRSA will 

decide whether to support, in whole or 

in part, the recommended updates to the 

guidelines. 

As part of this cooperative agreement, 

ACOG is required to base its 

recommended updates to the Guidelines 

on review and synthesis of existing 

clinical guidelines and new scientific 

evidence. The National Academy of 

Medicine standards for establishing 

foundations for and rating strengths of 

recommendations, articulation of 

recommendations, as well as external 

reviews are to be met in developing 

these guidelines. Additionally, 

processes are to be incorporated to 

assure opportunity for public input and 

transparency, including participation by 

patients and consumers, in the 

development of the updated Guideline 

recommendations. 

This notice solicits comments from 

the public on the draft recommendation 

statements for the Well-Woman 

Preventive Visits, Counseling for 

Sexually Transmitted Infections, and 

Breastfeeding Services and Supplies. 

The updated draft clinical 

recommendation statements are 

provided below: 

Well Woman Preventive Visits 

The MSC has updated the clinical 

recommendation statement to reflect 

that recommended services may be 

completed at a single visit or as part of 

a series of preventive health visits that 

take place over time to obtain the 

necessary services. Well Women Visits 

have also been further defined to 

include pre-pregnancy, prenatal, and 

interpregnancy visits. 

‘‘The WPSI recommends that women 

receive at least one preventive care visit per 

year beginning in adolescence and 

continuing across the lifespan to ensure the 

provision of all recommended preventive 

services. These services may be completed at 

a single visit or as part of a series of visits 

that take place over time to obtain all 

necessary services depending on a woman’s 

age, health status, reproductive health needs, 

pregnancy status, and risk factors. Well 

women visits include pre-pregnancy, 

prenatal, and interpregnancy visits. The 

primary purpose of well-woman visits is the 

delivery and coordination of all 

recommended preventive services as 

determined by age and risk factors.’’ 

Counseling for Sexually Transmitted 

Infections 

The MSC has made minor updates to 

the counseling for sexually transmitted 

infections statement to include a review 

of a women’s sexual history, and 

modified the risk factor list by stating 

that risk factors are ‘‘not limited to’’ the 

areas indicated. 

‘‘The WPSI recommends directed 

behavioral counseling by a health care 

provider or other appropriately trained 

individual for sexually active adolescent and 

adult women at an increased risk for sexually 

transmitted infections (STIs). 

The WPSI recommends that health care 

providers review a woman’s sexual history 

and risk factors to help identify those at an 

increased risk of STIs. Risk factors include 

but are not limited to age younger than 25 

years, a recent history of an STI, a new sex 

partner, multiple partners, a partner with 

concurrent partners, a partner with an STI, 

and a lack of or inconsistent condom use. For 

adolescents and women not identified as 

high risk, counseling to reduce the risk of 

STIs should be considered, as determined by 

clinical judgment.’’ 

Breastfeeding Services and Supplies 

The MSC has updated the clinical 

recommendation to include consultative 

services that will optimize successful 

initiation and maintenance of 

breastfeeding. 

‘‘The WPSI recommends comprehensive 

lactation support services (including 

consultation, counseling, education, and 

breastfeeding equipment and supplies) 

during the antenatal, perinatal, and 

postpartum periods to optimize the 

successful initiation and maintenance of 

breastfeeding.’’ 

Members of the public can view each 

complete updated draft 

recommendation statement by accessing 

the initiative’s web page at https://

www.womenspreventivehealth.org/. 

Diana Espinosa, 

Acting Administrator. 

[FR Doc. 2021–17826 Filed 8–19–21; 8:45 am] 

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DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

National Institutes of Health 

National Institute on Aging; Notice of 

Closed Meetings 

Pursuant to section 10(d) of the 

Federal Advisory Committee Act, as 

amended, notice is hereby given of the 

following meetings. 

The meetings will be closed to the 

public in accordance with the 

provisions set forth in sections 

552b(c)(4) and 552b(c)(6), Title 5 U.S.C., 

as amended. The grant applications and 

the discussions could disclose 

confidential trade secrets or commercial 

property such as patentable material, 

and personal information concerning 

individuals associated with the grant 

applications, the disclosure of which 

would constitute a clearly unwarranted 

invasion of personal privacy. 

Name of Committee: National Institute on 

Aging Special Emphasis Panel; Aging and 

Metabolic Plasticity of Adipose Tissue. 

Date: October 19, 2021. 

Time: 12:00 p.m. to 5:30 p.m. 

Agenda: To review and evaluate grant 

applications. 

Place: National Institute on Aging, 

Gateway Building, 7201 Wisconsin Avenue, 

Bethesda, MD 20892 (Video Meeting). 

Contact Person: Joshua Jin-Hyouk Park, 

Ph.D., Scientific Review Officer, Scientific 

Review Branch, National Institute on Aging, 

National Institutes of Health, Gateway 

Building 2W200, 7201 Wisconsin Avenue, 

Bethesda, MD 20892, (301) 496–6208, 

joshua.park4@nih.gov. 

Name of Committee: National Institute on 

Aging Special Emphasis Panel; MOST4 

Osteoarthritis Study. 

Date: October 27, 2021. 

Time: 12:00 p.m. to 5:30 p.m. 

Agenda: To review and evaluate grant 

applications. 

Place: National Institute on Aging, 

Gateway Building, 7201 Wisconsin Avenue, 

Bethesda, MD 20892 (Video Meeting). 

Contact Person: Joshua Jin-Hyouk Park, 

Ph.D., Scientific Review Officer, Scientific 

Review Branch, National Institute on Aging, 

National Institutes of Health, Gateway 

Building 2W200, 7201 Wisconsin Avenue, 

Bethesda, MD 20892, (301) 496–6208, 

joshua.park4@nih.gov. 

Name of Committee: National Institute on 

Aging Special Emphasis Panel; Neurogenesis 

Dynamics in AD and ADRD. 

Date: November 9–10, 2021. 

Time: 11:00 a.m. to 5:30 p.m. 

Agenda: To review and evaluate grant 

applications. 

Place: National Institute on Aging, 

Gateway Building, 7201 Wisconsin Avenue, 

Bethesda, MD 20892 (Video Meeting). 

Contact Person: Joshua Jin-Hyouk Park, 

Ph.D., Scientific Review Officer, Scientific 

Review Branch, National Institute on Aging, 

National Institutes of Health, Gateway 

Building 2W200, 7201 Wisconsin Avenue, 

Bethesda, MD 20892, (301) 496–6208, 

joshua.park4@nih.gov. 

(Catalogue of Federal Domestic Assistance 

Program Nos. 93.866, Aging Research, 

National Institutes of Health, HHS) 

Dated: August 17, 2021. 

Miguelina Perez, 

Program Analyst, Office of Federal Advisory 

Committee Policy. 

[FR Doc. 2021–17877 Filed 8–19–21; 8:45 am] 

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khammond on DSKJM1Z7X2PROD with NOTICES