Release of VA Records Relating to HIV, 14820-14822 [2017-05799]

Download as PDF 14820 Federal Register / Vol. 82, No. 55 / Thursday, March 23, 2017 / Rules and Regulations competition, employment, investment, productivity, innovation, or on the ability of U.S.-based companies to compete with foreign based companies in domestic and export markets. However, pursuant to the CRA, the DEA has submitted a copy of this interim final rule to both Houses of Congress and to the Comptroller General. List of Subjects in 21 CFR Part 1308 Administrative practice and procedure, Drug traffic control, 2. In § 1308.12, add paragraph (f)(2) to read as follows: Reporting and recordkeeping requirements. ■ For the reasons set out above, the DEA amends 21 CFR part 1308 as follows: § 1308.12 PART 1308—SCHEDULES OF CONTROLLED SUBSTANCES * Schedule II. * * (f) * * * * * 1. The authority citation for 21 CFR part 1308 continues to read as follows: ■ Authority: 21 U.S.C. 811, 812, 871(b), unless otherwise noted. (2) Dronabinol [(-)-delta-9-trans tetrahydrocannabinol] in an oral solution in a drug product approved for marketing by the U.S. Food and Drug Administration .................................................................................................................................................... * * * * MacDonald, Bridge Management Specialist, Coast Guard; telephone 504– 671–2128, email Giselle.T.MacDonald@ uscg.mil. * Dated: March 20, 2017. Chuck Rosenberg, Acting Administrator. BILLING CODE 4410–09–P DEPARTMENT OF HOMELAND SECURITY Coast Guard 33 CFR Part 117 [Docket No. USCG–2017–0100] Drawbridge Operation Regulation; Des Allemands Bayou, Des Allemands, LA Coast Guard, DHS. ACTION: Notice of deviation from drawbridge regulation. AGENCY: The Coast Guard has issued a temporary deviation from the operating schedule that governs the Burlington Northern Santa Fe Railroad swing span drawbridge across Des Allemands Bayou, mile 14.0, at Des Allemands, St. Charles and Lafourche Parishes, Louisiana. The deviation is necessary to install two open-deck spans for increased reliability of bridge operations. This deviation allows the bridge to remain in the closed-tonavigation position for two (2) separate, two-day periods. DATES: This deviation is effective from 6 a.m. on April 20, 2017 through 12 noon on April 28, 2017. ADDRESSES: The docket for this deviation, [USCG–2017–0100] is available at https://www.regulations.gov. Type the docket number in the ‘‘SEARCH’’ box and click ‘‘SEARCH’’. Click on Open Docket Folder on the line associated with this deviation. FOR FURTHER INFORMATION CONTACT: If you have questions on this temporary deviation, call or email Giselle nlaroche on DSK30NT082PROD with RULES SUMMARY: 14:46 Mar 22, 2017 Jkt 241001 end of the effective period of this temporary deviation. This deviation from the operating regulations is authorized under 33 CFR 117.35. The Burlington Northern Santa Fe Railroad Company requested a temporary deviation from the operating schedule for the swing span drawbridge across Des Allemands Bayou, mile 14.0, at Des Allemands, St. Charles and Lafourche Parishes, Louisiana. The deviation was requested to install two open-deck spans, one on each side of the existing swing span, to increase the reliability of bridge opening and closing operations. The draw currently operates under 33 CFR 117.440(b). The draw of the Burlington Northern Santa Fe Railroad Bridge, Mile 14.0, shall open on signal Monday through Friday from 7 a.m. to 3 p.m. At all other times the draw shall open on signal if at least 4 hours notice is given. For purposes of this deviation, the bridge will remain closed to navigation for two separate dates, 30 hours each, from 6 a.m. April 20, 2017 through 12 noon, April 21, 2017 and from 6 a.m., April 27, 2017 through 12 noon, April 28, 2017. During this deviation, vessels will not be allowed to pass through the bridge. The bridge has a vertical clearance of 3 feet above mean high water in the closed-to-navigation position and unlimited in the open-tonavigation position. Navigation on the waterway consists of tugs with tows, fishing vessels and recreational craft. The Coast Guard will inform the users of the waterway through our Local and Broadcast Notices to Mariners of the change in operating schedule for the bridge. The bridge will not be able to open for emergencies and there is no immediate alternate route for vessels to pass. In accordance with 33 CFR 117.35(e), the drawbridge must return to its regular operating schedule immediately at the Dated: March 17, 2017. Eric A. Washburn, Bridge Administrator, Eighth Coast Guard District. SUPPLEMENTARY INFORMATION: [FR Doc. 2017–05809 Filed 3–22–17; 8:45 am] VerDate Sep<11>2014 (7365) PO 00000 Frm 00010 Fmt 4700 Sfmt 4700 [FR Doc. 2017–05810 Filed 3–22–17; 8:45 am] BILLING CODE 9110–04–P DEPARTMENT OF VETERANS AFFAIRS 38 CFR Part 17 RIN 2900–AP73 Release of VA Records Relating to HIV Department of Veterans Affairs. Final rule. AGENCY: ACTION: The Department of Veterans Affairs (VA) is amending its medical regulations governing the release of VA medical records. Specifically, VA is eliminating the restriction on sharing a negative test result for the human immunodeficiency virus (HIV) with veterans’ outside providers. HIV testing is a common practice today in healthcare and the stigma of testing that may have been seen in the 1980s when HIV was first discovered is no longer prevalent. Continuing to protect negative HIV tests causes delays and an unnecessary burden on veterans when VA tries to share electronic medical information with the veterans’ outside providers through electronic health information exchanges. For this same reason, VA will also eliminate restrictions on negative test results of sickle cell anemia. This final rule eliminates the current barriers to electronic medical information exchange. DATES: This final rule is effective April 24, 2017. SUMMARY: E:\FR\FM\23MRR1.SGM 23MRR1 Federal Register / Vol. 82, No. 55 / Thursday, March 23, 2017 / Rules and Regulations nlaroche on DSK30NT082PROD with RULES FOR FURTHER INFORMATION CONTACT: Stephania H. Griffin, Director, Information Access and Privacy Office (10P2C), Department of Veterans Affairs, 810 Vermont Avenue NW., Washington, DC 20420; (704) 245–2492. (This is not a toll-free number.) SUPPLEMENTARY INFORMATION: In a document published in the Federal Register on August 5, 2016, VA proposed to revise its regulations that govern the release of VA medical records, specifically eliminating the restriction on protecting a negative test result for HIV and sickle cell anemia. 81 FR 51836. VA provided a 60-day comment period, which ended on October 4, 2016. We received 5 comments on the proposed rule. Section 7332 of 38 United States Code (U.S.C.) states that records of the identity, diagnosis, prognosis, or treatment of any patient or subject which are maintained in connection with the performance of any program or activity (including education, training, treatment, rehabilitation, or research) of any patient or subject relating to drug abuse, alcoholism or alcohol abuse, infection with the human immunodeficiency virus (HIV), or sickle cell anemia shall only be disclosed under certain circumstances. The intent of section 7332 is to protect the medical records of those veterans who are undergoing treatment or have a positive diagnosis for the conditions stated in this section. Due to the stigma that was associated with HIV and HIV testing at the time the regulation was first published, VA determined that the results of HIV testing should be protected regardless of the outcome of the test. Currently, HIV testing is considered part of routine health care under VA policy, similar to other types of diagnostic laboratory testing, and while oral informed consent is still required, no pre-testing counseling is required. The continued protection of negative HIV tests has posed significant obstacles to the sharing of medical information between VA and non-VA medical providers, and also places an undue burden on veterans. If VA conducts an HIV test on a veteran, VA is prevented from electronically disclosing the veteran’s medical information to the veteran’s non-VA medical provider, even if the test result is negative, unless VA first obtains a specific written authorization that meets title 38 regulatory requirements from the veteran to share the medical information. Medical information sharing is crucial to treating a veteran who has outside medical providers and VerDate Sep<11>2014 14:46 Mar 22, 2017 Jkt 241001 is significant in making certain that a veteran is not prescribed a medication that may negatively interact with other medications. Under section 7332, information about sickle cell anemia is also considered protected medical information. As with negative HIV test results, the prohibition on sharing negative test results for sickle cell anemia has posed challenges for the timely provision of medical care. This rulemaking eliminates the current restrictions on sharing with community providers negative test results of veterans for HIV and sickle cell anemia and is in line with the intent of the statute. As for positive HIV or sickle cell anemia test results, VA will continue to require a qualifying written authorization from the veteran prior to disclosure of such information. We received five comments in support of the proposed rule. All commenters agreed that the electronic exchange of negative HIV and sickle cell anemia test results between medical providers is a critical to adequately address patient care. A commenter stated ‘‘By removing the restriction on disclosure of negative test result for HIV, this proposed rule will play a significant role in ensuring that all veterans, including LGBT veterans, have access to efficient care, while also helping combat the stigma associated with HIV testing.’’ We thank the commenters for their support of the rule. Based on the rationale set forth in the Supplementary Information to the proposed rule and in this final rule, VA is adopting the proposed rule with no edits. Effect of Rulemaking Title 38 of the Code of Federal Regulations, as revised by this final rulemaking, represents VA’s implementation of its legal authority on this subject. Other than future amendments to this regulation or governing statutes, no contrary guidance or procedures are authorized. All existing or subsequent VA guidance must be read to conform with this rulemaking if possible or, if not possible, such guidance is superseded by this rulemaking. Paperwork Reduction Act This final rule contains no provisions constituting a collection of information under the Paperwork Reduction Act of 1995 (44 U.S.C. 3501–3521). Regulatory Flexibility Act The Secretary hereby certifies that this final rule will not have a significant economic impact on a substantial PO 00000 Frm 00011 Fmt 4700 Sfmt 4700 14821 number of small entities as they are defined in the Regulatory Flexibility Act, 5 U.S.C. 601–612. This final rule will impose no burden on small entities. Therefore, pursuant to 5 U.S.C. 605(b), this rulemaking would be exempt from the initial and final regulatory flexibility analysis requirements of 5 U.S.C. 603 and 604. Executive Order 12866 and 13563 Executive Orders 12866 and 13563 direct agencies to assess the costs and benefits of available regulatory alternatives and, when regulation is necessary, to select regulatory approaches that maximize net benefits (including potential economic, environmental, public health and safety effects, and other advantages; distributive impacts; and equity). Executive Order 13563 (Improving Regulation and Regulatory Review) emphasizes the importance of quantifying both costs and benefits, reducing costs, harmonizing rules, and promoting flexibility. Executive Order 12866 (Regulatory Planning and Review) defines a ‘‘significant regulatory action,’’ requiring review by the Office of Management and Budget (OMB), unless OMB waives such review, as ‘‘any regulatory action that is likely to result in a rule that may: (1) Have an annual effect on the economy of $100 million or more or adversely affect in a material way the economy, a sector of the economy, productivity, competition, jobs, the environment, public health or safety, or State, local, or tribal governments or communities; (2) Create a serious inconsistency or otherwise interfere with an action taken or planned by another agency; (3) Materially alter the budgetary impact of entitlements, grants, user fees, or loan programs or the rights and obligations of recipients thereof; or (4) Raise novel legal or policy issues arising out of legal mandates, the President’s priorities, or the principles set forth in this Executive Order.’’ The economic, interagency, budgetary, legal, and policy implications of this regulatory action have been examined, and it has been determined not to be a significant regulatory action under Executive Order 12866. VA’s impact analysis can be found as a supporting document at https://www.regulations.gov, usually within 48 hours after the rulemaking document is published. Additionally, a copy of the rulemaking and its impact analysis are available on VA’s Web site at https://www.va.gov/orpm/, by following the link for ‘‘VA Regulations Published From FY 2004 Through Fiscal Year to Date.’’ E:\FR\FM\23MRR1.SGM 23MRR1 14822 Federal Register / Vol. 82, No. 55 / Thursday, March 23, 2017 / Rules and Regulations Unfunded Mandates The Unfunded Mandates Reform Act of 1995 requires, at 2 U.S.C. 1532, that agencies prepare an assessment of anticipated costs and benefits before issuing any rule that may result in the expenditure by State, local, and tribal governments, in the aggregate, or by the private sector, of $100 million or more (adjusted annually for inflation) in any one year. This final rule will have no such effect on State, local, and tribal governments, or on the private sector. Catalog of Federal Domestic Assistance The Catalog of Federal Domestic Assistance numbers and titles for the programs affected by this document are 64.007, Blind Rehabilitation Centers; 64.008, Veterans Domiciliary Care; 64.009, Veterans Medical Care Benefits; 64.010, Veterans Nursing Home Care; 64.011, Veterans Dental Care; 64.012, Veterans Prescription Service; 64.014, Veterans State Domiciliary Care; 64.015, Veterans State Nursing Home Care; 64.018, Sharing Specialized Medical Resources; 64.019, Veterans Rehabilitation Alcohol and Drug Dependence; 64.022, Veterans Home Based Primary Care; and 64.024, VA Homeless Providers Grant and Per Diem Program. Signing Authority The Secretary of Veterans Affairs, or designee, approved this document and authorized the undersigned to sign and submit the document to the Office of the Federal Register for publication electronically as an official document of the Department of Veterans Affairs. Gina S. Farrisee, Deputy Chief of Staff, Department of Veterans Affairs, approved this document on March 16, 2017, for publication. nlaroche on DSK30NT082PROD with RULES List of Subjects in 38 CFR Part 1 Administrative practice and procedure, Archives and records, Cemeteries, Claims, Courts, Crime, Flags, Freedom of information, Government contracts, Government employees, Government property, Infants and children, Inventions and patents, Parking, Penalties, Privacy, Reporting and recordkeeping requirements, Seals and insignia, Security measures, Wages. For the reasons set out in the preamble, Department of Veterans Affairs is amending 38 CFR part 1 as follows: PART 1—GENERAL PROVISIONS 1. The authority citation for part 1 continues to read as follows: ■ VerDate Sep<11>2014 14:46 Mar 22, 2017 Jkt 241001 Authority: 38 U.S.C. 501(a), and as noted in specific sections. 2. Amend § 1.460 by revising the last sentence of the definition of ‘‘Infection with the human immunodeficiency virus (HIV)’’ and the definitions of ‘‘Patient’’ and ‘‘Treatment’’ to read as follows: include negative test results for the human immunodeficiency virus, antibodies to the virus, or sickle cell anemia, or such testing of an individual where the results are negative. * * * * * ■ 3. Revising § 1.461(a)(1)(i) to read as follows. § 1.460 § 1.461 ■ Definitions * * * * * Infection with the human immunodeficiency virus (HIV). * * * The term does not include negative results from the testing of an individual for the presence of the virus or antibodies to the virus, or such testing of an individual where the results are negative. * * * * * Patient. The term ‘‘patient’’ means any individual or subject who has been given a diagnosis or treatment for drug abuse, alcoholism or alcohol abuse, infection with the human immunodeficiency virus, or sickle cell anemia and includes any individual who, after arrest on a criminal charge, is interviewed and/or tested in connection with drug abuse, alcoholism or alcohol abuse, infection with the human immunodeficiency virus, or sickle cell anemia in order to determine that individual’s eligibility to participate in a treatment or rehabilitation program if the result of such testing is positive. The term ‘‘patient’’ includes an individual who has been diagnosed or treated for alcoholism, drug abuse, HIV infection, or sickle cell anemia for purposes of participation in a VA program or activity relating to those four conditions, including a program or activity consisting of treatment, rehabilitation, education, training, evaluation, or research. For the purpose of infection with the human immunodeficiency virus or sickle cell anemia, the term ‘‘patient’’ includes one tested positive for the disease even if no treatment is provided, offered, or requested. The term does not include a patient who has tested negative for the disease. * * * * * Treatment. The term ‘‘treatment’’ means the management and care of a patient for drug abuse, alcoholism or alcohol abuse, or the diagnosis, management and care of a patient for infection with the human immunodeficiency virus, or sickle cell anemia, or a condition which is identified as having been caused by one or more of these conditions, in order to reduce or eliminate the adverse effects upon the patient. The term does not PO 00000 Frm 00012 Fmt 4700 Sfmt 4700 Applicability. (a) * * * (1) * * * (i) Would identify a patient as an alcohol or drug abuser, an individual who tested positive for or is infected with the human immunodeficiency virus (HIV), hereafter referred to as HIV, or an individual who tested positive for or has sickle cell anemia, either directly, by reference to other publicly available information, or through verification of such an identification by another person; and * * * * * Dated: March 16, 2017. Jeffrey Martin, Office Program Manager, Office of Regulation Policy & Management, Office of the Secretary, Department of Veterans Affairs. [FR Doc. 2017–05799 Filed 3–22–17; 8:45 am] BILLING CODE 8320–01–P ENVIRONMENTAL PROTECTION AGENCY 40 CFR Part 52 [EPA–R06–OAR–2013–0167; FRL–9958–60– Region 6] Approval and Promulgation of Implementation Plans; Louisiana; Volatile Organic Compounds Rule Revision and Stage II Vapor Recovery Environmental Protection Agency (EPA). ACTION: Direct final rule. AGENCY: Under the Federal Clean Air Act (CAA or the Act) the Environmental Protection Agency (EPA) is approving the revisions submitted by the State of Louisiana controlling emissions of volatile organic compounds (VOCs) and changes to the Stage II gasoline vapor recovery rule as part of the Louisiana State Implementation Plan (SIP). DATES: This rule is effective on May 22, 2017 without further notice, unless the EPA receives relevant adverse comment by April 24, 2017. If the EPA receives such comment, the EPA will publish a timely withdrawal in the Federal Register informing the public that this rule will not take effect. ADDRESSES: Submit comments, identified by Docket No. EPA–R06– SUMMARY: E:\FR\FM\23MRR1.SGM 23MRR1

Agencies

[Federal Register Volume 82, Number 55 (Thursday, March 23, 2017)]
[Rules and Regulations]
[Pages 14820-14822]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2017-05799]


=======================================================================
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DEPARTMENT OF VETERANS AFFAIRS

38 CFR Part 17

RIN 2900-AP73


Release of VA Records Relating to HIV

AGENCY: Department of Veterans Affairs.

ACTION: Final rule.

-----------------------------------------------------------------------

SUMMARY: The Department of Veterans Affairs (VA) is amending its 
medical regulations governing the release of VA medical records. 
Specifically, VA is eliminating the restriction on sharing a negative 
test result for the human immunodeficiency virus (HIV) with veterans' 
outside providers. HIV testing is a common practice today in healthcare 
and the stigma of testing that may have been seen in the 1980s when HIV 
was first discovered is no longer prevalent. Continuing to protect 
negative HIV tests causes delays and an unnecessary burden on veterans 
when VA tries to share electronic medical information with the 
veterans' outside providers through electronic health information 
exchanges. For this same reason, VA will also eliminate restrictions on 
negative test results of sickle cell anemia. This final rule eliminates 
the current barriers to electronic medical information exchange.

DATES: This final rule is effective April 24, 2017.

[[Page 14821]]


FOR FURTHER INFORMATION CONTACT: Stephania H. Griffin, Director, 
Information Access and Privacy Office (10P2C), Department of Veterans 
Affairs, 810 Vermont Avenue NW., Washington, DC 20420; (704) 245-2492. 
(This is not a toll-free number.)

SUPPLEMENTARY INFORMATION: In a document published in the Federal 
Register on August 5, 2016, VA proposed to revise its regulations that 
govern the release of VA medical records, specifically eliminating the 
restriction on protecting a negative test result for HIV and sickle 
cell anemia. 81 FR 51836. VA provided a 60-day comment period, which 
ended on October 4, 2016. We received 5 comments on the proposed rule.
    Section 7332 of 38 United States Code (U.S.C.) states that records 
of the identity, diagnosis, prognosis, or treatment of any patient or 
subject which are maintained in connection with the performance of any 
program or activity (including education, training, treatment, 
rehabilitation, or research) of any patient or subject relating to drug 
abuse, alcoholism or alcohol abuse, infection with the human 
immunodeficiency virus (HIV), or sickle cell anemia shall only be 
disclosed under certain circumstances. The intent of section 7332 is to 
protect the medical records of those veterans who are undergoing 
treatment or have a positive diagnosis for the conditions stated in 
this section. Due to the stigma that was associated with HIV and HIV 
testing at the time the regulation was first published, VA determined 
that the results of HIV testing should be protected regardless of the 
outcome of the test. Currently, HIV testing is considered part of 
routine health care under VA policy, similar to other types of 
diagnostic laboratory testing, and while oral informed consent is still 
required, no pre-testing counseling is required.
    The continued protection of negative HIV tests has posed 
significant obstacles to the sharing of medical information between VA 
and non-VA medical providers, and also places an undue burden on 
veterans. If VA conducts an HIV test on a veteran, VA is prevented from 
electronically disclosing the veteran's medical information to the 
veteran's non-VA medical provider, even if the test result is negative, 
unless VA first obtains a specific written authorization that meets 
title 38 regulatory requirements from the veteran to share the medical 
information. Medical information sharing is crucial to treating a 
veteran who has outside medical providers and is significant in making 
certain that a veteran is not prescribed a medication that may 
negatively interact with other medications. Under section 7332, 
information about sickle cell anemia is also considered protected 
medical information. As with negative HIV test results, the prohibition 
on sharing negative test results for sickle cell anemia has posed 
challenges for the timely provision of medical care. This rulemaking 
eliminates the current restrictions on sharing with community providers 
negative test results of veterans for HIV and sickle cell anemia and is 
in line with the intent of the statute. As for positive HIV or sickle 
cell anemia test results, VA will continue to require a qualifying 
written authorization from the veteran prior to disclosure of such 
information.
    We received five comments in support of the proposed rule. All 
commenters agreed that the electronic exchange of negative HIV and 
sickle cell anemia test results between medical providers is a critical 
to adequately address patient care. A commenter stated ``By removing 
the restriction on disclosure of negative test result for HIV, this 
proposed rule will play a significant role in ensuring that all 
veterans, including LGBT veterans, have access to efficient care, while 
also helping combat the stigma associated with HIV testing.'' We thank 
the commenters for their support of the rule.
    Based on the rationale set forth in the Supplementary Information 
to the proposed rule and in this final rule, VA is adopting the 
proposed rule with no edits.

Effect of Rulemaking

    Title 38 of the Code of Federal Regulations, as revised by this 
final rulemaking, represents VA's implementation of its legal authority 
on this subject. Other than future amendments to this regulation or 
governing statutes, no contrary guidance or procedures are authorized. 
All existing or subsequent VA guidance must be read to conform with 
this rulemaking if possible or, if not possible, such guidance is 
superseded by this rulemaking.

Paperwork Reduction Act

    This final rule contains no provisions constituting a collection of 
information under the Paperwork Reduction Act of 1995 (44 U.S.C. 3501-
3521).

Regulatory Flexibility Act

    The Secretary hereby certifies that this final rule will not have a 
significant economic impact on a substantial number of small entities 
as they are defined in the Regulatory Flexibility Act, 5 U.S.C. 601-
612. This final rule will impose no burden on small entities. 
Therefore, pursuant to 5 U.S.C. 605(b), this rulemaking would be exempt 
from the initial and final regulatory flexibility analysis requirements 
of 5 U.S.C. 603 and 604.

Executive Order 12866 and 13563

    Executive Orders 12866 and 13563 direct agencies to assess the 
costs and benefits of available regulatory alternatives and, when 
regulation is necessary, to select regulatory approaches that maximize 
net benefits (including potential economic, environmental, public 
health and safety effects, and other advantages; distributive impacts; 
and equity). Executive Order 13563 (Improving Regulation and Regulatory 
Review) emphasizes the importance of quantifying both costs and 
benefits, reducing costs, harmonizing rules, and promoting flexibility. 
Executive Order 12866 (Regulatory Planning and Review) defines a 
``significant regulatory action,'' requiring review by the Office of 
Management and Budget (OMB), unless OMB waives such review, as ``any 
regulatory action that is likely to result in a rule that may: (1) Have 
an annual effect on the economy of $100 million or more or adversely 
affect in a material way the economy, a sector of the economy, 
productivity, competition, jobs, the environment, public health or 
safety, or State, local, or tribal governments or communities; (2) 
Create a serious inconsistency or otherwise interfere with an action 
taken or planned by another agency; (3) Materially alter the budgetary 
impact of entitlements, grants, user fees, or loan programs or the 
rights and obligations of recipients thereof; or (4) Raise novel legal 
or policy issues arising out of legal mandates, the President's 
priorities, or the principles set forth in this Executive Order.''
    The economic, interagency, budgetary, legal, and policy 
implications of this regulatory action have been examined, and it has 
been determined not to be a significant regulatory action under 
Executive Order 12866. VA's impact analysis can be found as a 
supporting document at https://www.regulations.gov, usually within 48 
hours after the rulemaking document is published. Additionally, a copy 
of the rulemaking and its impact analysis are available on VA's Web 
site at https://www.va.gov/orpm/, by following the link for ``VA 
Regulations Published From FY 2004 Through Fiscal Year to Date.''

[[Page 14822]]

Unfunded Mandates

    The Unfunded Mandates Reform Act of 1995 requires, at 2 U.S.C. 
1532, that agencies prepare an assessment of anticipated costs and 
benefits before issuing any rule that may result in the expenditure by 
State, local, and tribal governments, in the aggregate, or by the 
private sector, of $100 million or more (adjusted annually for 
inflation) in any one year. This final rule will have no such effect on 
State, local, and tribal governments, or on the private sector.

Catalog of Federal Domestic Assistance

    The Catalog of Federal Domestic Assistance numbers and titles for 
the programs affected by this document are 64.007, Blind Rehabilitation 
Centers; 64.008, Veterans Domiciliary Care; 64.009, Veterans Medical 
Care Benefits; 64.010, Veterans Nursing Home Care; 64.011, Veterans 
Dental Care; 64.012, Veterans Prescription Service; 64.014, Veterans 
State Domiciliary Care; 64.015, Veterans State Nursing Home Care; 
64.018, Sharing Specialized Medical Resources; 64.019, Veterans 
Rehabilitation Alcohol and Drug Dependence; 64.022, Veterans Home Based 
Primary Care; and 64.024, VA Homeless Providers Grant and Per Diem 
Program.

Signing Authority

    The Secretary of Veterans Affairs, or designee, approved this 
document and authorized the undersigned to sign and submit the document 
to the Office of the Federal Register for publication electronically as 
an official document of the Department of Veterans Affairs. Gina S. 
Farrisee, Deputy Chief of Staff, Department of Veterans Affairs, 
approved this document on March 16, 2017, for publication.

List of Subjects in 38 CFR Part 1

    Administrative practice and procedure, Archives and records, 
Cemeteries, Claims, Courts, Crime, Flags, Freedom of information, 
Government contracts, Government employees, Government property, 
Infants and children, Inventions and patents, Parking, Penalties, 
Privacy, Reporting and recordkeeping requirements, Seals and insignia, 
Security measures, Wages.

    For the reasons set out in the preamble, Department of Veterans 
Affairs is amending 38 CFR part 1 as follows:

PART 1--GENERAL PROVISIONS

0
1. The authority citation for part 1 continues to read as follows:

    Authority:  38 U.S.C. 501(a), and as noted in specific sections.

0
2. Amend Sec.  1.460 by revising the last sentence of the definition of 
``Infection with the human immunodeficiency virus (HIV)'' and the 
definitions of ``Patient'' and ``Treatment'' to read as follows:


Sec.  1.460   Definitions

* * * * *
    Infection with the human immunodeficiency virus (HIV). * * * The 
term does not include negative results from the testing of an 
individual for the presence of the virus or antibodies to the virus, or 
such testing of an individual where the results are negative.
* * * * *
    Patient. The term ``patient'' means any individual or subject who 
has been given a diagnosis or treatment for drug abuse, alcoholism or 
alcohol abuse, infection with the human immunodeficiency virus, or 
sickle cell anemia and includes any individual who, after arrest on a 
criminal charge, is interviewed and/or tested in connection with drug 
abuse, alcoholism or alcohol abuse, infection with the human 
immunodeficiency virus, or sickle cell anemia in order to determine 
that individual's eligibility to participate in a treatment or 
rehabilitation program if the result of such testing is positive. The 
term ``patient'' includes an individual who has been diagnosed or 
treated for alcoholism, drug abuse, HIV infection, or sickle cell 
anemia for purposes of participation in a VA program or activity 
relating to those four conditions, including a program or activity 
consisting of treatment, rehabilitation, education, training, 
evaluation, or research. For the purpose of infection with the human 
immunodeficiency virus or sickle cell anemia, the term ``patient'' 
includes one tested positive for the disease even if no treatment is 
provided, offered, or requested. The term does not include a patient 
who has tested negative for the disease.
* * * * *
    Treatment. The term ``treatment'' means the management and care of 
a patient for drug abuse, alcoholism or alcohol abuse, or the 
diagnosis, management and care of a patient for infection with the 
human immunodeficiency virus, or sickle cell anemia, or a condition 
which is identified as having been caused by one or more of these 
conditions, in order to reduce or eliminate the adverse effects upon 
the patient. The term does not include negative test results for the 
human immunodeficiency virus, antibodies to the virus, or sickle cell 
anemia, or such testing of an individual where the results are 
negative.
* * * * *

0
3. Revising Sec.  1.461(a)(1)(i) to read as follows.


Sec.  1.461   Applicability.

    (a) * * *
    (1) * * *
    (i) Would identify a patient as an alcohol or drug abuser, an 
individual who tested positive for or is infected with the human 
immunodeficiency virus (HIV), hereafter referred to as HIV, or an 
individual who tested positive for or has sickle cell anemia, either 
directly, by reference to other publicly available information, or 
through verification of such an identification by another person; and
* * * * *

    Dated: March 16, 2017.
Jeffrey Martin,
Office Program Manager, Office of Regulation Policy & Management, 
Office of the Secretary, Department of Veterans Affairs.
[FR Doc. 2017-05799 Filed 3-22-17; 8:45 am]
 BILLING CODE 8320-01-P
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