Federal Register / Vol. 75, No. 90 / Tuesday, May 11, 2010 / Proposed Rules 26167 

Emergency & Remedial Response 

Division, 290 Broadway, 19th Floor, 

New York, NY 10007. 

Such deliveries are only accepted 

during the Docket’s normal hours of 

operation, and special arrangements 

should be made for deliveries of boxed 

information. 

Instructions: Direct your comments to 

Docket ID no. EPA–HQ–SFUND–2009– 

0654. EPA’s policy is that all comments 

received will be included in the public 

docket without change and may be 

made available online at http:// 

www.regulations.gov, including any 

personal information provided, unless 

the comment includes information 

claimed to be Confidential Business 

Information (CBI) or other information 

whose disclosure is restricted by statute. 

Do not submit information that you 

consider to be CBI or otherwise 

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an ‘‘anonymous access’’ system, which 

means EPA will not know your identity 

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If you send an e-mail comment directly 

to EPA without going through http:// 

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cannot read your comment due to 

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you for clarification, EPA may not be 

able to consider your comment. 

Electronic files should avoid the use of 

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encryption, and be free of any defects or 

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Docket: 

All documents in the docket are listed 

in the http://www.regulations.gov index. 

Although listed in the index, some 

information is not publicly available, 

e.g., CBI or other information whose 

disclosure is restricted by statute. 

Certain other material, such as 

copyrighted material, will be publicly 

available only in the hard copy. Publicly 

available docket materials are available 

either electronically in http:// 

www.regulations.gov or in hard copy at: 

U.S. Environmental Protection Agency, 

Region II, Superfund Records Center, 

290 Broadway, Room 1828, (212) 637– 

4308, Hours: 9 a.m. to 5 p.m., Monday 

through Friday; and at Long Hill 

Township Free Public Library, 91 

Central Avenue, Sterling, NJ 07930, 

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Monday through Thursday, 9 a.m. to 5 

p.m., Friday and Saturday. 

FOR FURTHER INFORMATION CONTACT: 

Theresa Hwilka, Remedial Project 

Manager, U.S. Environmental Protection 

Agency, Region II, 290 Broadway, New 

York, NY 10007, (212) 637–4409, e-mail: 

hwilka.theresa@epa.gov. 

SUPPLEMENTARY INFORMATION: 

In the ‘‘Rules and Regulations’’ 

Section of today’s Federal Register, we 

are publishing a direct final Notice of 

Deletion of the Asbestos Dump 

Superfund Site without prior Notice of 

Intent to Delete because we view this as 

a noncontroversial revision and 

anticipate no adverse comment. We 

have explained our reasons for this 

deletion in the preamble to the direct 

final Notice of Deletion, and those 

reasons are incorporated herein. If we 

receive no adverse comment(s) on this 

deletion action, we will not take further 

action on this Notice of Intent to Delete. 

If we receive adverse comment(s), we 

will withdraw the direct final Notice of 

Deletion, and it will not take effect. We 

will, as appropriate, address all public 

comments in a subsequent final Notice 

of Deletion based on this Notice of 

Intent to Delete. We will not institute a 

second comment period on this Notice 

of Intent to Delete. Any parties 

interested in commenting must do so at 

this time. 

For additional information, see the 

direct final Notice of Deletion which is 

located in the Rules section of this 

Federal Register. 

List of Subjects in 40 CFR Part 300 

Environmental protection, Air 

pollution control, Chemicals, Hazardous 

waste, Hazardous substances, 

Intergovernmental relations, Penalties, 

Reporting and recordkeeping 

requirements, Superfund, Water 

pollution control, Water supply. 

Authority: 33 U.S.C. 1321(c)(2); 42 U.S.C. 

9601–9657; E.O. 12777, 56 FR 54757, 3 CFR, 

1991 Comp., p. 351; E.O. 12580, 52 FR 2923; 

3 CFR, 1987 Comp., p. 193. 

Dated: April 1, 2010. 

Judith A. Enck, 

Regional Administrator, Region 2. 

[FR Doc. 2010–10848 Filed 5–10–10; 8:45 am] 

BILLING CODE 6560–50–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Health Resources and Services 

Administration 

42 CFR Part 5 

Designation of Medically Underserved 

Populations and Health Professions 

Shortage Areas; Intent To Form 

Negotiated Rulemaking Committee 

AGENCY: Health Resources and Services 

Administration, HHS. 

ACTION: Notice of Intent To Form 

Negotiated Rulemaking Committee. 

SUMMARY: As required by Section 5602 

of Public Law 111–148, the Patient 

Protection and Affordable Care Act of 

2010, HRSA plans to establish a 

comprehensive methodology and 

criteria for Designation of Medically 

Underserved Populations (MUPs) and 

Primary Care Health Professions 

Shortage Areas (HPSAs) [under sections 

330(b)(3) and 332 of the Public Health 

Service (PHS) Act, respectively], using a 

Negotiated Rulemaking process. To do 

this, HRSA intends to establish a 

Negotiated Rulemaking Committee 

under the Federal Advisory Committee 

Act (FACA). 

Use of this Negotiated Rulemaking 

(NR) process follows two previous 

publications of Proposed Rules on 

MUP/HPSA designation for public 

comment, one in 1998 and one in 2008. 

In both cases, many public comments 

were received, and the concerns 

expressed resulted in a HRSA decision 

to reconsider and develop a new 

proposal to be published at a later date; 

no final revised rule has yet been 

adopted. It is hoped that use of the NR 

process will yield a consensus among 

technical experts and stakeholders on a 

new rule, which will then be published 

as an Interim Final Rule in accordance 

with Section 5602. 

HRSA plans that the NR Committee 

on designations will include technical 

experts on indicators of underservice/ 

shortage, data analysis, and on 

methodologies for combining multiple 

indicators, representing the public’s 

interest in assuring that the areas, 

populations and entities to be 

designated under these rules, which 

become eligible for various Federal 

programs/resources, are truly 

underserved and/or have workforce 

shortages and representatives of 

programs and other stakeholders that 

are involved in the designation process 

and/or likely to be significantly affected 

by the designation rules; and (c) a HRSA 

representative. The Committee will also 

be assisted by a neutral facilitator. 


wwoods2 on DSK1DXX6B1PROD with PROPOSALS_PART 1
26168 Federal Register / Vol. 75, No. 90 / Tuesday, May 11, 2010 / Proposed Rules 

Topics on which Public Comments 

are solicited are: 

(1) Whether HRSA has properly 

identified the key issues in this 

designation rulemaking effort; 

(2) Whether HRSA has adequately 

identified key sources of subject matter 

technical expertise relevant to defining 

underservice and shortage and 

designating underserved areas and 

populations; and 

(3) Whether we have identified 

appropriate representatives of the 

various stakeholders/interests that will 

be affected by the final designation 

rules. 

DATES: Comments, including requests to 

participate on the committee, will be 

considered if we receive them at the 

address provided below no later than 5 

p.m. June 10, 2010. 

Address and Mode of Transmission 

for Comments: You may submit 

comments in one of three ways, as listed 

below. The first is the preferred method. 

Please submit your comments in only 

one of these ways, so that no duplicates 

are received. 

1. Federal eRulemaking Portal. You 

may submit comments electronically to 

http://www.regulations.gov. Click on the 

link ‘‘Submit electronic comments on 

HRSA regulations with an open 

comment period.’’ Submit your actual 

comments as an attachment to your 

message or cover letter. (Attachments 

should be in Microsoft Word or 

WordPerfect; however, we prefer 

Microsoft Word.) 

2. By regular, express or overnight 

mail. You may mail written comments 

to the following address only: Health 

Resources and Services Administration, 

Department of Health and Human 

Services, Attention: HRSA Regulations 

Officer, Parklawn Building Rm. 14A–11, 

5600 Fishers Lane, Rockville, MD 

20857. Please allow sufficient time for 

mailed comments to be received before 

the close of the comment period. 

3. Delivery by hand (in person or by 

courier). If you prefer, you may deliver 

your written comments before the close 

of the comment period to the same 

address: Parklawn Building Room 14A– 

11, 5600 Fishers Lane, Rockville, MD 

20857. Please call in advance to 

schedule your arrival with one of our 

HRSA Regulations Office staff members 

at telephone number (301) 443–1785. 

Because of staffing and resource 

limitations, and to ensure that no 

comments are misplaced, we cannot 

accept comments by facsimile (FAX) 

transmission. 

In commenting, please refer to file 

code # HRSA–1. Comments received on 

a timely basis will be available for 

public inspection as they are received, 

beginning approximately 3 weeks after 

publication of this Notice, in Room 14– 

05 of the Health Resources and Services 

Administration’s offices at 5600 Fishers 

Lane, Rockville, MD., on Monday 

through Friday of each week from 8:30 

a.m. to 5 p.m. (phone: 301–443–1785). 

FOR FURTHER INFORMATION CONTACT: 

Director, HRSA Division of Policy 

Review and Coordination, at 301–443– 

1785. 

SUPPLEMENTARY INFORMATION: 

I. Negotiated Rulemaking Act 

The Negotiated Rulemaking Act (Pub. 

L. 101–648, 5 U.S.C. 561–570) 

establishes a seven-point framework for 

agency determinations to conduct 

negotiated rulemaking to enhance the 

rulemaking process. However, Congress 

in Public 111–148 has mandated the use 

of this process for developing a new 

MUP–HPSA designation methodology. 

In Negotiated Rulemaking (NR), 

negotiations are conducted by a 

committee, chartered under the Federal 

Advisory Committee Act (FACA) (5 

U.S.C. App. 2), with members chosen to 

represent the various interests that will 

be significantly affected by the rule. 

Each NR committee includes an agency 

representative and is assisted by a 

neutral facilitator. The goal of the 

committee is to reach consensus on the 

treatment of the major issues involved 

in the rule, including key issues of 

language. If consensus is reached, it is 

to be used as the basis of the agency’s 

proposed rule. The NR process does not 

affect otherwise applicable procedural 

requirements of FACA, the 

Administrative Procedures Act or other 

statutes. 

II. Subject and Scope of the Rule 

A. Need for the Rule 

The current Health Professional 

Shortage Area (HPSA) criteria date back 

to 1978, when they were issued under 

Section 332 of the PHS Act, as amended 

in 1976; their predecessor, the Critical 

Health Manpower Shortage Area 

(CHMSA) criteria, date back to the 1971 

legislation creating the National Health 

Service Corps. By statute, an area, 

population or facility must have a HPSA 

designation to be eligible to apply for 

placement of National Health Service 

Corps (NHSC) personnel. 

The original CHMSA criteria simply 

required that a population-to-primary 

care physician ratio threshold be 

exceeded within a rational geographic 

service area to demonstrate shortage; the 

HPSA criteria kept this basic approach 

but expanded it to allow a lower 

threshold ratio for areas with unusually 

high needs, as indicated by high 

poverty, infant mortality or fertility 

rates, overutilization, or excessive 

waiting times, and to consider 

population groups with access barriers 

within areas where the general 

population has sufficient resources. 

Facility HPSA criteria were also 

included for prisons/correctional 

institutions and for other facilities 

serving designated areas or population 

groups. 

The current Medically Underserved 

Population (MUP) criteria date back to 

1975, when they were issued to 

implement legislation enacted in 1973 

and 1974 establishing grants to support 

Health Maintenance Organizations 

(HMOs) and Community Health Centers 

(CHCs) serving medically underserved 

populations. 

The original MUP criteria, still in 

effect, employ a four-variable Index of 

Medical Underservice (IMU), with those 

variables being: percent of the 

population with incomes below the 

poverty level; primary care physicianto-population ratio; infant mortality 

rate; and percent of the population aged 

65 or over. Data on these four variables 

within a geographic service area can be 

used to compute an IMU score for the 

area; areas whose score is below an 

established threshold are identified as 

medically underserved areas (MUAs). 

There are also guidelines for applying 

the IMU to identify certain underserved 

population groups within adequately 

served areas, and additional provisions 

for designation of other underserved 

populations, including special 

provisions for migrant and homeless 

populations, and for designation in 

unique circumstances upon 

recommendation of a State Governor 

and local officials. The term MUP is 

defined to include both residents of 

geographic MUAs and population 

groups designated as MUPs through 

various means. 

Since the time that designations of 

MUPs and HPSAs were first required by 

statute in connection with the NHSC 

and Community Health Center 

programs, additional programs have also 

been required by statute to use these 

designations. These include certification 

by the Centers for Medicare and 

Medicaid Services (CMS) of Rural 

Health Clinics (RHCs) located within 

rural areas that are HPSAs or MUPs, and 

the CMS Medicare Incentive Program, 

which provides higher reimbursement 

for physician services delivered in 

HPSAs. CMS also certifies as Federally 

Qualified Health Centers (FQHCs), 

organizations that do not receive HRSA 

grants but serve an MUP and otherwise 


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meet the definition of a Health Center 

under Section 330 of the PHS Act. 

Over the years there has been an 

evolution, both in the types of requests 

for HPSA or MUP designation received, 

and in the methods for application of 

the established criteria. Beyond the 

relatively simple geographic area 

requests, such as for whole counties and 

rural subcounty areas, increasingly more 

requests have been made for urban 

neighborhood and population group 

designations. The availability of census 

data on poverty, race, and ethnicity at 

the census tract level has enabled the 

delineation of urban service areas based 

on their economic and race/ethnicity 

characteristics. Areas with 

concentrations of poor, minority and/or 

linguistically isolated populations have 

achieved area or population group 

HPSA designations based on their 

limited access to physicians adequately 

serving other parts of their metropolitan 

areas. As a result, the conceptual 

distinction between HPSA and MUP 

designations has become less apparent. 

However, while the HPSAs are 

required by statute to be updated on a 

regular basis, no such statutory 

requirement exists for MUPs, with the 

result that many MUP designations are 

now significantly outdated. It is 

important that the list of designated 

MUPs, which is used by a variety of 

Federal programs, be reasonably 

current, and that the criteria used for 

these designations reflect underservice 

indicators currently relevant and 

available (and the currently prevailing 

range of values of those indicators), 

rather than being limited to those 

indicators that were available in the 

1970s (and the range of indicator values 

then prevailing). 

For these reasons, consideration has 

been given to the development of a 

revised, more coordinated MUP and 

HPSA designation methodology and 

procedure that would, at a minimum, 

define consistently the indicators used 

for both designation types; clarify the 

distinctions between MUPs and HPSAs; 

and update both types of designation on 

a regular, simultaneous basis. Given the 

extensive numbers of comments 

received during the previous two 

attempts to do this using standard 

rulemaking procedures, Congress has 

now mandated the use of negotiated 

rulemaking. 

B. Issues and Questions To Be Resolved 

Issues that HRSA anticipates will 

require resolution through the NR 

process are outlined below. HRSA also 

invites public comment on whether 

there are other issues important to this 

rulemaking and within the scope of the 

rule. 

1. Are the objectives of the MUP 

designations and the HPSA designations 

clearly different, therefore justifying two 

separate processes? Or are the objectives 

so closely related that a single 

designation approach should be used 

both for MUPs and for HPSAs? 

2. The MUP and HPSA statutes (PHS 

Act Sec. 330(b) and 332 respectively) 

require the inclusion of factors 

indicative of health status, ability to pay 

for services, the accessibility of services, 

and the availability of health 

professionals, as well as other indicators 

of a need for health services (including 

infant mortality rates). What specific 

underservice/shortage indicators should 

be included, for either or both 

designation types, and how should they 

be defined/measured? To what extent 

should national data sources be used, 

versus State and local sources? What 

existing data sources are accurate and 

reliable enough to use, at the 

appropriate level? 

(a) What provider availability 

measures should be used? 

(b) What economic factors may 

influence access and how can they be 

measured? 

(c) What health status indicators 

should be included? 

(d) What measures of utilization 

should be included? 

(e) What demographic indicators 

should be included, if any? 

3. What methodology or 

methodologies should be used to 

incorporate/combine the impact of these 

various underservice indicators on 

access? Should indicators be combined 

in the same way or in different ways for 

use in MUP and HPSA designations? 

4. Within provider availability 

measures (such as population-toclinician ratios), which clinicians/ 

providers should be included? How do 

we define full-time-equivalents (FTEs), 

as opposed to ‘‘head counts’’? 

5. In counting the clinicians available 

within an area (or to a population 

group) for designation update purposes, 

should those clinicians placed in the 

designated area under a Federal 

program be included? 

6. How should ‘‘Rational Service 

Areas’’ or RSAs be defined for 

designation purposes? 

7. What types of Population Groups 

should be considered for designation? 

8. What is the role of Facility 

designations, which are included under 

the HPSA authority (in Sec. 332 of the 

PHS Act)? 

9. How should appropriate threshold 

levels of various underservice/shortage 

indicators incorporated in the method 

be identified to separate those areas, 

population groups and facilities found 

to qualify for designation from all 

others? 

10. How can the revised methodology 

and procedures be designed so as to 

reduce the burden of the designation 

application and update process on 

States and local entities? 

11. How should the Committee assess 

the potential impact of revised MUP/ 

HPSA methodologies, versus continued 

use of the current methods? How can 

the impact of various options and 

methodologies best be summarized and 

displayed? 

12. How can the new methodology be 

implemented in a manner that 

minimizes disruption and assures 

equity to the various areas affected? 

III. Affected Interests and Potential 

Participants 

We are proposing to include 

representatives of the following interest 

groups and/or organizations as 

negotiation participants. 

(1) Up to 3 State Primary Care Offices 

(PCOs) representing a range of States in 

terms of size, rural/urban, and different 

regions of the country, including at least 

one which is also a State Office of Rural 

Health (SORH). These PCO 

representatives would be requested to 

consult with their fellow PCOs between 

meetings. 

(2) National Organization of State 

Offices of Rural Health (NOSOHR). 

(3) Association of State and Territorial 

Health Officers (ASTHO) or National 

Academy for State Health Policy 

(NASHP). 

(4) Up to 3 State Primary Care 

Associations (PCAs) from different types 

of States. 

(5) National Association of 

Community Health Centers (NACHC). 

(6) National Association of Rural 

Health Clinics (NARHC). 

(7) National Rural Health Association. 

(8) Representatives of the Native 

American community, such as the 

National Indian Health Board (NIHB), or 

the National Council of Urban Indian 

Health (NCUIH). 

(9) Dartmouth Institute. It has 

expertise in rational service areas for 

primary care and hospital services, and 

the use of Medicare data for health 

systems analysis. 

(10) American Academy of Family 

Physicians, Robert Graham Center. It 

has expertise in health center service 

areas analysis and maintains ‘‘Health 

Landscape’’ on-line data base of health 

care data for geographical analysis. 

(11) Representatives of primary care 

providers and training programs with 

expertise on supply and demand 


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analysis and issues of underservice. 

Representatives from some of these 

groups would be asked to represent a 

larger group’s interests, including 

coordinating with sister organizations 

between NR meetings. 

(12) Representative(s) of organizations 

and institutions with expertise in 

complex data analysis, as well as 

expertise in measuring access to care 

and underservice. 

(13) Representatives of organizations 

representing State, territorial and local 

government elected officials to ensure 

their views are reflected in the process. 

Representatives from some of these 

groups would be asked to represent a 

larger group’s interests, including 

coordinating with sister organizations 

between NR meetings. 

We invite comment on this list of 

negotiation participants. The intent in 

establishing the negotiating committee 

is that all relevant types of interests are 

represented, not necessarily all parties 

with similar interests. We believe this 

proposed list of participants represents 

all types of interests likely to be affected 

by the rule to be negotiated. If 

comments suggest that other interests 

should perhaps be included, the 

procedure described in section V.C 

below will be followed. 

IV. Schedule for the Negotiation 

Public Law 111–148, the Patient 

Protection and Affordable Health Care 

Act of 2010, requires that this Notice be 

published within 45 days of enactment 

(i.e., by May 7, 2010), followed by a 30- 

day comment period (i.e., comments 

due approximately June 7, 2010). The 

Committee is to be appointed by the 

Secretary of Health and Human Services 

(HHS) within 30 days after the 

expiration of the comment period, or by 

approximately July 7, 2010. Within 10 

days thereafter, the Secretary of HHS 

will nominate her choice of a facilitator. 

The facilitator will be subject to 

consensus approval by the NR 

Committee. 

Once the Committee membership is 

selected, a Notice regarding the meeting 

schedule will be published; it is 

anticipated that the meetings will begin 

in August or September. The first day’s 

meeting will include discussion in 

detail on how the negotiations will 

proceed and how the Committee will 

function. The Committee will agree to 

ground rules for committee operation, 

will approve a facilitator, and discuss 

how best to address the principal issues 

(i.e., which issues to address first, and 

a tentative schedule for consideration of 

the rest of the issues). The Committee 

will then begin to address those issues. 

Subsequent meetings of the 

Committee will be held approximately 

monthly until all issues are resolved, 

allowing for members to report to and 

confer with their respective interest 

groups between meetings. We anticipate 

approximately six meetings, with each 

meeting lasting for 2 to 3 days. If more 

meetings are required in order to resolve 

fractious issues, or to avoid slipping the 

target date, additional face-to-face 

meetings may be scheduled (up to a 

total of two per month), or detailed 

discussions on specific issues may be 

handled with conference telephone calls 

among identified subgroups of the 

Committee. The next key action is the 

submission of a preliminary committee 

report on the Committee’s progress 

towards achieving consensus and the 

likelihood of achieving such a 

consensus by July 2011. 

If the preliminary report indicates that 

consensus is likely by July 1, 2011, 

HRSA would then help the Committee 

develop appropriate regulatory wording 

to implement the Committee’s 

decisions. The Committee would submit 

a final report to the Secretary, including 

the draft version of the interim final rule 

(as required by the legislation). The 

target date for the final report would be 

July 1, 2011. Actual publication would 

follow Departmental and Office of 

Management and Budget (OMB) review. 

If the preliminary committee report 

indicates a need for some additional 

time to achieve consensus, with 

corresponding postponement of the 

target date, the Secretary may grant a 

reasonable amount of additional time 

(such as 60 days). If the preliminary 

report indicates that the Committee has 

failed to make significant progress 

toward consensus and is unlikely to do 

so by the target date, the Secretary may 

terminate the activities of the 

Committee, and the Committee may 

submit to the Secretary a report 

specifying any areas of consensus and 

including any other information, 

recommendations or materials that the 

Committee considers appropriate. The 

Secretary will pursue publication of an 

interim-final rule by the target date, 

taking into account any areas of 

consensus, recommendations, and 

materials provided by the Committee. 

V. Formation of the Negotiated 

Committee 

A. Procedure for Establishing an 

Advisory Committee 

An agency of the Federal government 

is required to comply with the 

requirements of FACA when it 

establishes or uses a group that includes 

non-federal members as a source of 

advice. Under FACA, an advisory 

committee becomes established only 

after approval of an agreed-upon 

charter. We have prepared a draft 

charter and initiated the requisite 

consultation process. Following review 

of public comments on this Notice and 

upon successful completion of the 

approved charter, we will form the 

Committee and begin negotiations. 

B. Participants 

The total number of individuals who 

will be asked to participate in this effort 

as NR Committee members is estimated 

to be about 20, and should not exceed 

25. (A number larger than this would 

make it extremely difficult to conduct 

effective negotiations.) Each member 

will be asked to designate an Alternate 

in case the member is unable to attend 

one or more meetings, or wishes to 

share the responsibility with a close 

associate. (Alternates may attend any 

meeting with the Lead member, but in 

general the Lead member will be 

expected to do most of the talking when 

both are present.) 

One purpose of this Notice is to 

determine whether the proposed rule 

might significantly affect additional 

interests not adequately represented by 

the list of proposed participants 

included above. Each potentially 

affected organization or group of 

individuals does not necessarily need 

its own representative, since groups of 

organizations can work together to see 

that their collective interests are 

adequately represented. (See groupings 

of interest groups suggested above.) 

However, each identifiably separate 

interest must be adequately represented. 

Moreover, HRSA must be satisfied that 

the group as a whole reflects a proper 

balance and mix of the various interests. 

C. Requests for Additional 

Representation 

Persons who wish to apply for 

membership on the Committee may 

submit an application or nomination, 

which shall include the following: 

(1) The name of the applicant or 

nominee and a description of the 

interests such person shall represent; 

(2) Evidence that the applicant or 

nominee is authorized to represent 

parties related to the interests the 

person proposes to represent; 

(3) A written commitment that the 

applicant or nominee shall actively 

participate in good faith in the 

development of the rule under 

consideration; and 

(4) The reasons that the persons 

specified in the notice under Section III 

do not adequately represent the interests 


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of the person submitting the application 

or nomination. 

If, in response to this notice, 

representatives of additional interest 

groups request membership or 

representation in the negotiating group, 

HRSA will determine whether that 

representative should be added to the 

NR Committee or simply asked to 

submit its comments and concerns to us 

and to another Committee member. 

HRSA will make that decision based on 

whether the interest group: 

• Would be significantly affected by 

the rule; and 

• Is or is not already adequately 

represented on the proposed NR 

Committee. 

D. Establishing the Committee 

After reviewing any public comments 

on this Notice and any requests for 

additional representation, HRSA will 

take the final steps required to form the 

Committee. 

VI. Negotiation Procedures 

If and when this NR Committee is 

formed, the following procedures and 

guidelines will apply, unless they are 

modified as a result of comments 

received on this notice or during the 

negotiating process. 

A. Facilitator 

HRSA will use a neutral facilitator. 

The facilitator will not be involved with 

advocating for substantive aspects of the 

regulation. The facilitator’s role is to: 

• Chair negotiating sessions, assuring 

equal opportunity among the various 

members to present their points of view; 

• Help the negotiation process to run 

smoothly; and 

• Help participants define and reach 

consensus. 

B. Good Faith Negotiations 

Participants must be willing to 

negotiate in good faith, and must be 

authorized to so negotiate by the leaders 

of the organizations/groups/interests 

they represent. This may best be 

accomplished by the selection of senior 

officials of the affected organizations or 

groups as participants, and/or by the 

selection of experienced individuals in 

such organizations/groups who have 

expertise in the issues subsumed by this 

rule and who have access to such senior 

officials, allowing them to obtain 

concurrence at each stage of the NR 

process. This applies to HRSA as well, 

and HRSA will appoint an appropriate 

representative, to represent HRSA/HHS 

when the committee is appointed. 

(Representatives of components of 

HRSA and CMS which use the MUP and 

HPSA designations will also be invited 

to attend the NR meetings as resources 

on how their programs relate to the 

designations, but the HRSA/HHS 

representative will be the spokesperson 

for HRSA and HHS interests in this NR 

effort and will meet with other HHS 

component representatives between NR 

Committee meetings to maximize 

coordination.) 

C. Administrative Support 

HRSA will supply logistical, 

administrative and management 

support. HRSA will also provide 

technical support to the Committee in 

gathering and analyzing appropriate 

indicator data, methodologies and other 

information relevant to the Committee’s 

work, and conduct appropriate impact 

analyses, with contractual support from 

John Snow, Inc. (JSI). 

D. Meetings 

Meetings will typically be held in the 

DC metropolitan area or, if necessary, in 

another location, at the convenience of 

the Committee. HRSA will announce 

scheduled Committee meetings and 

agendas either in the Federal Register or 

on a committee Web site, yet to be 

established, whose location will be 

published in the Federal Register. 

Unless announced otherwise, meetings 

are open to the public. 

E. Committee Procedures 

Under the general guidance and 

direction of the facilitator, and subject 

to any applicable legal requirements, the 

members will establish at the first 

meeting the detailed procedures for 

committee meetings which they 

consider most appropriate. 

F. Defining Consensus 

The goal of the negotiating process is 

consensus. Under the Negotiated 

Rulemaking Act, consensus generally 

means that each interest group 

represented concurs in the result, unless 

the term is defined otherwise by the 

Committee. HRSA expects the 

participants to agree upon their working 

definition of this term at the first 

meeting. 

G. Failure of Advisory Committee to 

Reach Consensus 

Parties to the NR effort may withdraw 

at any time. If this happens, the 

remaining Committee members and 

HRSA will evaluate whether the 

Committee should continue. 

If the Committee is unable to reach 

consensus, HRSA will proceed to 

develop a proposed/interim final rule 

on its own, as described above. 

H. Record of Meetings 

In accordance with FACA’s 

requirements, minutes of all Committee 

meetings will be kept. The minutes will 

be placed on the Committee’s Web site 

and a copy kept in the public 

rulemaking record. 

Dated: May 6, 2010. 

Mary Wakefield, 

Administrator, Health Resources and Services 

Administration. 

Dated: May 6, 2010. 

Kathleen Sebelius, 

Secretary. 

[FR Doc. 2010–11214 Filed 5–7–10; 11:15 am] 

BILLING CODE 4165–15–P 

FEDERAL COMMUNICATIONS 

COMMISSION 

47 CFR Chapter I 

[PS Docket No. 10–93; FCC 10–63] 

Cyber Security Certification Program 

AGENCY: Federal Communications 

Commission. 

ACTION: Proposed rule. 

SUMMARY: This document seeks 

comment on whether the Commission 

should establish a voluntary program 

under which participating 

communications service providers 

would be certified by the FCC or a yet 

to be determined third party entity for 

their adherence to a set of cyber security 

objectives and/or practices. The 

Commission also seeks comment on 

other actions it should take, if any, to 

improve cyber security and to improve 

education on cyber security issues. The 

Commission’s goals in this proceeding 

are to increase the security of the 

nation’s broadband infrastructure, 

promote a culture of more vigilant cyber 

security among participants in the 

market for communications services, 

and offer end users more complete 

information about their communication 

service providers’ cyber security 

practices. 

DATES: Comments are due on or before 

July 12, 2010 and reply comments are 

due on or before September 8, 2010. 

ADDRESSES: You many submit 

comments, identified by PS Docket No. 

10–93 and/or rulemaking FCC 10–63, by 

any of the following methods: 

• Federal eRulemaking Portal: http:// 

www.regulations.gov. Follow the 

instructions for submitting comments. 

• Federal Communications 

Commission’s Web Site: http:// 

fjallfoss.fcc.gov/ecfs2/. Follow the 

instructions for submitting comments. 


wwoods2 on DSK1DXX6B1PROD with PROPOSALS_PART 1