[Federal Register Volume 83, Number 201 (Wednesday, October 17, 2018)]
[Notices]
[Pages 52454-52455]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2018-22522]
[[Page 52454]]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Disease Control and Prevention
[Docket No. CDC-2018-0094; NIOSH-321]
Implementation of Section 2695 (42 U.S.C. 300ff-131) Public Law
111-87: Infectious Diseases and Circumstances Relevant to Notification
Requirements: Definition of Emergency Response Employee
AGENCY: Centers for Disease Control and Prevention, HHS.
ACTION: Notice and request for comment.
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SUMMARY: The Centers for Disease Control and Prevention (CDC), within
the Department of Health and Human Services (HHS), is adding a
definition of the term ``emergency response employees'' to the
definitions section of the document entitled ``Implementation of
Section 2695 (42 U.S.C. 300ff-131) Public Law 111-87: Infectious
Diseases and Circumstances Relevant to Notification Requirements,''
which contains a list of potentially life-threatening infectious
diseases to which emergency response employees may be exposed and
companion guidelines published by the National Institute for
Occupational Safety and Health (NIOSH), pursuant to the Ryan White HIV/
AIDS Treatment Extension Act of 2009.
DATES: Comments must be received by December 17, 2018.
ADDRESSES:
Written comments: You may submit comments by any of the following
methods:
Federal eRulemaking Portal: http://www.regulations.gov.
Follow the instructions for submitting comments to the docket.
Mail: NIOSH Docket Office, Robert A. Taft Laboratories,
MS-C34, 1090 Tusculum Avenue, Cincinnati, OH 45226.
Instructions: All submissions received must include the agency name
(Centers for Disease Control and Prevention, HHS) and docket number
(CDC-2018-0094; NIOSH-321) for this action. All relevant comments,
including any personal information provided, will be posted without
change to http://www.regulations.gov. For detailed instructions on
submitting public comments, see the ``Public Participation'' heading of
the SUPPLEMENTARY INFORMATION section of this document.
FOR FURTHER INFORMATION CONTACT: Rachel Weiss, Office of the Director,
NIOSH; 1090 Tusculum Avenue, MS:C-48, Cincinnati, OH 45226; telephone
(855) 818-1629 (this is a toll-free number); email [email protected].
SUPPLEMENTARY INFORMATION:
I. Public Participation
Interested parties may participate in this activity by submitting
written views, opinions, recommendations, and data. Comments received,
including attachments and other supporting materials, are part of the
public record and subject to public disclosure. Do not include any
information in your comment or supporting materials that you do not
wish to be disclosed. Although your name, contact information, or other
information that identifies you in the body of your comments will be on
public display, NIOSH will review all submissions and may choose (but
is not required) to redact or withhold submissions containing private
or proprietary information such as Social Security numbers, medical
information, and/or inappropriate language. You may submit comments on
any topic related to this action. All public comments will be posted in
the docket for this action at https://www.regulations.gov.
II. Statutory Authority
The Ryan White Comprehensive AIDS Resources Emergency (CARE) Act of
1990 (Pub. L. 101-381) was reauthorized in 1996, 2000, 2006, and 2009.
The most recent reauthorization, the Ryan White HIV/AIDS Treatment
Extension Act of 2009 (Pub. L. 111-87), amended the Public Health
Service Act (PHS Act, 42 U.S.C. 201-300ii) and requires the HHS
Secretary to establish the following: A list of potentially life-
threatening infectious diseases, including emerging infectious
diseases, to which emergency response employees (ERE) may be exposed in
responding to emergencies; guidelines describing circumstances in which
EREs may be exposed to these diseases, taking into account the
conditions under which emergency response is provided; and guidelines
describing the manner in which medical facilities should make
determinations about exposures.
In a Federal Register notice published on July 14, 2010, the HHS
Secretary delegated this responsibility to the CDC Director.\1\ The CDC
Director further assigned the responsibility to the NIOSH Director and
formally re-delegated the authority to develop the list and guidelines
to NIOSH on August 27, 2018.\2\
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\1\ 75 FR 40842.
\2\ 83 FR 50379 (October 4, 2018).
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III. Background
On November 2, 2011, CDC published a notice in the Federal Register
entitled Implementation of Section 2695 (42 U.S.C. 300ff-131) Public
Law 111-87: Infectious Diseases and Circumstances Relevant to
Notification Requirements.\3\ The notice included ``a list of
potentially life-threatening infectious diseases, including emerging
infectious diseases, to which EREs may be exposed in responding to
emergencies . . .; guidelines describing circumstances in which
employees may be exposed to these diseases; and guidelines describing
the manner in which medical facilities should make determinations about
exposures.'' The list and guidelines published in that notice did not
include a definition for ``emergency response employee.''
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\3\ 76 FR 67736.
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Upon reconsideration following additional requests to clarify the
meaning of ``emergency response employee,'' NIOSH is adding a
definition of the term ``emergency response employee'' to the
definitions section of the list and guidelines. ``Emergency response
employee'' means:
firefighters, law enforcement officers, paramedics, emergency
medical technicians, funeral service practitioners, and other
individuals (including employees of legally organized and recognized
volunteer organizations, without regard to whether such employees
receive nominal compensation) who, in the course of professional
duties, respond to emergencies in the geographic area involved.
The definition effectively identifies those employees who may be
exposed to a potentially life-threatening infectious disease while
attending to, treating, assisting or transporting a victim of an
emergency taken to a medical facility as a result of the emergency (see
42 U.S.C. 300ff-133(a)). The definition's reference to ``other
individuals'' provides NIOSH with discretion in determining whether
additional categories of EREs may be included in the future. By
including this definition, all interested parties, including those
responsible for reporting when an ERE has been exposed to a potentially
life-threatening infectious disease, ERE employers, medical facilities,
state public health officers, the EREs themselves, and the public will
know which individuals and entities fall within the scope of the
notification procedures and guidelines.
This definition was originally included in the Ryan White CARE Act
of 1990 and amended by the Ryan White CARE Act Amendments of 1996 (Pub.
L. 104-146), and, therefore, codified in the
[[Page 52455]]
PHS Act. The notification provisions, including the definition of
``emergency response employee,'' were then removed from the Ryan White
HIV/AIDS Treatment Modernization Act of 2006 and the PHS Act.\4\ The
term ``emergency response employee,'' however, continued to be used in
a different part of the statutes pertaining to responsibilities
assigned to the Health Resources and Services Administration (HRSA).\5\
When Congress reinstated the notification provisions in Part G of the
Ryan White HIV/AIDS Treatment Extension Act of 2009, a definition of
ERE was not included.
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\4\ The notification provisions now included in Part G were
formerly found in Part E, which was deleted because the intent of
the 2006 reauthorization was, in part, to eliminate programs ``which
had never been funded or re-examined in the last two
reauthorizations.'' Congress then ``deleted definitions which were
no longer relevant (e.g., designated officer of emergency response
employees, emergency, emergency response employee, employer of
emergency response employees, and exposed),'' which were located in
Part D of the original statute. See H.R. REP. NO. 109-695, at 12
(2006).
\5\ 42 U.S.C. 300ff-62.
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NIOSH has interpreted the legislative history and the development
of the Ryan White CARE Act of 1990 and subsequent reauthorizations to
indicate that Congress's failure to restore the original definition of
ERE was unintentional and merely an oversight. Including the original
statutory definition in the NIOSH list and guidelines would allow the
notification provisions to be implemented as Congress originally
intended.
Including the definition of ``emergency response employee'' in the
definitions section of the list and guidelines is within NIOSH's
authority, pursuant to the August 27, 2018 re-delegation for the sec.
2695 duties. Implicit in this directive is the need to identify the
types of EREs who transport or serve victims of emergencies taken to
medical facilities, in order to improve the notification system
allowing EREs to receive timely diagnosis and post-exposure medical
treatment for infectious disease exposures. NIOSH therefore has the
authority to include the definition of ``emergency response employees''
in the list and guidelines.
After consideration of public comment submitted to the docket for
this action, NIOSH will update the guidelines and list with the ERE
definition and re-publish them on the NIOSH Ryan White HIV/AIDS
Treatment Extension Act of 2009 topic page, at https://www.cdc.gov/niosh/topics/ryanwhite/.
John J. Howard,
Director, National Institute for Occupational Safety and Health,
Centers for Disease Control and Prevention.
[FR Doc. 2018-22522 Filed 10-16-18; 8:45 am]
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