Request for Information and Comments on the Implementation of Human Subjects Protection Training and Education Programs, 37460-37463 [E8-14917]
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37460
Federal Register / Vol. 73, No. 127 / Tuesday, July 1, 2008 / Notices
Dated: June 16, 2008.
John Howard,
Director, National Institute for Occupational
Safety and Health.
[FR Doc. E8–14826 Filed 6–30–08; 8:45 am]
Dated: June 16, 2008.
John Howard,
Director, National Institute for Occupational
Safety and Health.
[FR Doc. E8–14827 Filed 6–30–08; 8:45 am]
BILLING CODE 4160–17–P
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DEPARTMENT OF HEALTH AND
HUMAN SERVICES
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
National Institute for Occupational
Safety and Health; Designation of a
Class of Employees for Addition to the
Special Exposure Cohort
Request for Information and
Comments on the Implementation of
Human Subjects Protection Training
and Education Programs
Department of Health and
Human Services, Office of the Secretary,
Office of Public Health and Science,
Office for Human Research Protections.
ACTION: Notice.
AGENCY:
National Institute for
Occupational Safety and Health
(NIOSH), Department of Health and
Human Services (HHS).
AGENCY:
ACTION:
Notice.
The Department of Health and
Human Services (HHS) gives notice of a
decision to designate a class of
employees at the Nuclear Materials and
Equipment Corporation (NUMEC)
facility, Parks Township, Pennsylvania,
as an addition to the Special Exposure
Cohort (SEC) under the Energy
Employees Occupational Illness
Compensation Program Act of 2000. On
May 30, 2008, the Secretary of HHS
designated the following class of
employees as an addition to the SEC:
SUMMARY:
All Atomic Weapons Employer (AWE)
employees who worked at the Nuclear
Materials and Equipment Corporation
(NUMEC) facility in Parks Township,
Pennsylvania, from June 1, 1960, through
December 31, 1980, for a number of work
days aggregating at least 250 work days
occurring either solely under this
employment or in combination with work
days within the parameters established for
one or more other classes of employees in the
Special Exposure Cohort.
This designation will become
effective on June 29, 2008, unless
Congress provides otherwise prior to the
effective date. After this effective date,
HHS will publish a notice in the
Federal Register reporting the addition
of this class to the SEC or the result of
any provision by Congress regarding the
decision by HHS to add the class to the
SEC.
sroberts on PROD1PC70 with NOTICES
FOR FURTHER INFORMATION CONTACT:
Larry Elliott, Director, Office of
Compensation Analysis and Support,
National Institute for Occupational
Safety and Health (NIOSH), 4676
Columbia Parkway, MS C–46,
Cincinnati, OH 45226, Telephone 513–
533–6800 (this is not a toll-free
number). Information requests can also
be submitted by e-mail to
OCAS@CDC.GOV.
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SUMMARY: The Office for Human
Research Protections (OHRP), Office of
Public Health and Science is seeking
information and comments from
affected entities and individuals about
(a) Whether OHRP should issue
additional guidance recommending that
institutions engaged in human subjects
research conducted or supported by the
Department of Health and Human
Services (HHS) implement training and
education programs for certain
individuals involved in the conduct,
review, or oversight of human subjects
research, or (b) whether HHS should
develop a regulation requiring the
implementation of such training and
education programs. This request for
information and comment stems from
the 1998 report from the HHS Office of
Inspector General (OIG) recommending
that Federal requirements be enacted to
help ensure that investigators and
institutional review board (IRB)
members be adequately educated about,
and sensitized to, human subjects
protections. More recently, the
Secretary’s Advisory Committee on
Human Research Protections (SACHRP)
recommended that OHRP require
institutions to ensure that initial and
continuing training is provided for IRB
members and staff, investigators, and
certain institutional officials. The
implementation of such training and
education programs might help to
ensure that individuals involved in the
conduct or review of human subjects
research at institutions holding OHRPapproved Federalwide Assurances
(FWAs) understand and meet their
regulatory responsibilities for protecting
human subjects.
DATES: Submit written or electronic
comments by September 29, 2008.
ADDRESSES: You may submit comments
by any of the following methods:
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• E-mail:
humansubjectstraining@hhs.gov.
Include ‘‘Human Subjects Protection
Training and Education’’ in the subject
line.
• Fax: 301–402–2071.
• Mail/Hand delivery/Courier [For
paper, disk, or CD–ROM submissions]:
Michael A. Carome, M.D., Captain, U.S.
Public Health Service, OHRP, 1101
Wootton Parkway, Suite 200, Rockville,
MD 20852.
Comments received within the public
comment period, including any
personal information, will be made
available to the public upon request.
FOR FURTHER INFORMATION CONTACT:
Michael A. Carome, M.D., Captain, U.S.
Public Health Service, OHRP, 1101
Wootton Parkway, Suite 200, Rockville,
MD 20852, 240–453–6900; e-mail
Michael.Carome@hhs.gov.
SUPPLEMENTARY INFORMATION:
I. Background
Under the HHS regulations for the
protection of human subjects, found at
45 CFR part 46, institutions or
organizations that are engaged in human
subjects research that is conducted or
supported by HHS must file with OHRP
an assurance of compliance with the
human subjects protection regulations.
The assurance must be executed by an
individual authorized to act on behalf of
the institution and authorized to
assume, on behalf of the institution, the
obligations imposed by the human
subjects protection regulations [45 CFR
46.103(c)]. Thus, to fulfill his or her
regulatory responsibilities, the
institutional official must be
knowledgeable about the requirements
of the human subjects protection
regulations.
The institution’s assurance of
compliance must also designate one or
more IRBs to review research covered by
the regulations, and the institution must
ensure that each designated IRB has
sufficient staff to support the IRB’s
activities [45 CFR 46.103(b)(2)]. IRB
members must be sufficiently qualified
through experience and expertise and
diversity to promote respect for their
advice and counsel in safeguarding the
rights and welfare of human subjects.
IRB members also must have the
professional competence necessary to
review human subjects research
activities of the institution, including
the ability to ascertain the acceptability
of the proposed research in terms of
institutional commitments and
regulations, applicable law, and
standards of professional conduct and
practice; therefore, members must be
knowledgeable in those areas [45 CFR
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46.107]. Thus, to fulfill their regulatory
responsibilities, IRB members must be
informed about human subjects
protection requirements.
Investigators involved in the conduct
of human subjects research that is
conducted or supported by HHS play a
crucial role in protecting the rights and
welfare of human subjects. Investigators
have specific responsibilities under the
human subjects protection requirements
related to the conduct of IRB-approved
research. For example, no investigator
may involve a human being in research
that is conducted or supported by HHS
or covered by the institution’s assurance
unless the investigator has obtained the
legally effective informed consent of the
subject or the subject’s legally
authorized representative in accordance
with, and to the extent required by, HHS
regulations at 45 CFR 46.116. Moreover,
investigators are responsible for
providing required information to the
IRB [45 CFR 46.103(b)(5), 46.111].
Investigators are responsible for
obtaining prior approval from the IRB
for any modifications of the previously
approved research, except those
necessary to eliminate apparent
immediate hazards to subjects, and
investigators are responsible for
ensuring that progress reports and
requests for continuing review and
approval are submitted to the IRB in
accordance with the policies,
procedures, and actions of the IRB as
referenced in the institution’s OHRPapproved FWA [45 CFR 46.103(b)(4), 45
CFR 46.109(e), 45 CFR 46.115(a)(1)].
Thus, investigators need to be informed
about human subjects protection
requirements. The HHS Office of
Inspector General (OIG), in its 1998
Report, ‘‘Institutional Review Boards: A
Time for Reform,’’ called for strong
Federal action concerning education of
investigators conducting, and IRB
members reviewing, human subjects
research (https://oig.hhs.gov/oei/reports/
oei-01-97-00193.pdf). In that report, the
OIG recommended enactment of Federal
requirements that help ensure that
investigators and IRB members are
adequately educated about, and
sensitized to, human subjects
protections.
In October 2000, the National
Institutes of Health (NIH) instituted a
policy that requires education on the
protection of human research
participants for all key personnel as a
condition of funding grant applications
or contract proposals involving human
subjects research (https://
grants1.nih.gov/grants/guide/
notice-files/NOT-OD-010061.html). Key
personnel include all individuals who
are responsible for the design and
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conduct of research studies involving
human subjects.
In its 2001 report, ‘‘Ethical and Policy
Issues in Research Involving Human
Participants,’’ the National Bioethics
Advisory Committee (NBAC)
recommended that all institutions and
sponsors engaged in research involving
human participants should provide
educational programs in research ethics
to appropriate institutional officials,
investigators, IRB members, and IRB
staff (https://www.georgetown.edu/
research/nrcbl/nbac/human/
overvol1.pdf). NBAC also recommended
that the Federal Government, in
partnership with academic and
professional societies, should enhance
research ethics education related to
protecting human research subjects, as
well as stimulate development of
innovative educational programs.
In its 2002 report commissioned by
HHS, ‘‘Responsible Research: A Systems
Approach to Protecting Research
Participants,’’ the Institute of Medicine
(IOM) recommended that research
organizations should ensure that
investigators, IRB members, and other
individuals substantively involved in
research with humans are adequately
educated to perform their respective
duties (https://www.nap.edu/books/
0309084881/html/).
On March 29, 2007, SACHRP
recommended that OHRP require that
institutions ensure that initial and
continuing training is provided for IRB
members and staff, investigators, and
certain institutional officials, including
the official that signed the institution’s
FWA.
Over the past several years, OHRP has
identified serious, systemic
noncompliance with the requirements
of HHS regulations for the protection of
human subjects at a significant number
of major institutions engaged in human
subjects research conducted or
supported by HHS. In OHRP’s
experience, inadequate training and
education of individuals involved in the
conduct or review of human subjects
research has been a major root cause of
such noncompliance.
OHRP developed the FWA as a new
type of assurance in December 2000.
Initially, OHRP proposed that the FWA
include requirements for training and
education regarding human subjects
protection regulations for institutional
officials, IRB members, IRB staff,
investigators and other institutional
personnel. Following public comment
on the proposed FWA, OHRP issued a
revised version of the FWA on March
20, 2002 that strongly recommended,
rather than required, such training and
education. This decision was based, in
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37461
part, on a determination that rulemaking
would be a more appropriate
mechanism for requiring such training
and education.
In the current FWA terms of
assurance, OHRP strongly recommends
that the institutional official, human
protections administrator, and IRB
chairperson(s) designated under the
assurance complete the OHRP
Assurance Training Modules available
on the OHRP Web site at https://
137.187.172.153/CBTs/Assurance/
login.asp. Furthermore, OHRP
recommends that the institution and the
designated IRB(s) establish educational
training and oversight mechanisms
appropriate to the nature of the
institution’s research portfolio to ensure
that research investigators, IRB
members, IRB staff, and other
appropriate personnel maintain
continuing knowledge of, and comply
with, relevant ethical principles,
relevant Federal regulations, OHRP
guidance, other applicable guidance,
state and local laws, and institutional
policies for the protection of human
subjects. OHRP also recommends that
IRB members and staff complete
relevant educational training before
reviewing human subjects research; and
that research investigators complete
appropriate institutional educational
training before conducting human
subjects research.
II. Request for Information and
Comments
Based on the recommendations of the
OIG, NBAC, IOM, and SACHRP, as well
as OHRP’s own experience in
compliance activities, which has
revealed that many individuals involved
in the conduct or review of HHSsupported or conducted research at
numerous institutions had a significant
gap in knowledge about human subject
protections, OHRP is seeking comment
from affected entities and individuals
about (a) whether OHRP should issue
additional guidance recommending that
institutions engaged in human subjects
research conducted or supported by
HHS implement training and education
programs for certain individuals
involved in the conduct, review, or
oversight of human subjects research, or
(b) whether HHS should develop a
regulation requiring the implementation
of such training and education
programs. The implementation of such
training and education programs might
help to ensure that individuals involved
in the conduct or review of human
subjects research at institutions holding
OHRP-approved FWAs understand and
meet their regulatory responsibilities for
protecting human subjects.
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Federal Register / Vol. 73, No. 127 / Tuesday, July 1, 2008 / Notices
OHRP specifically seeks comment on
the following questions. Comments
should also include a reference to the
specific numbered question being
addressed:
(1) For the past 5 years OHRP has
strongly recommended through the
Terms of the FWA that:
• Institutional signatory officials,
human protections administrators, and
the IRB chairpersons personally
complete the relevant OHRP Assurance
Training Modules (see https://
137.187.172.153/CBTs/Assurance/
login.asp), or comparable training that
includes the content of these modules;
• Institutions and their designated
IRBs establish educational training and
oversight mechanisms (appropriate to
the nature and volume of its research)
to ensure that research investigators,
IRB members and staff, and other
appropriate personnel maintain
continuing knowledge of, and comply
with, the following: Relevant ethical
principles; relevant federal regulations;
written IRB procedures; OHRP
guidance; other applicable guidance,
state and local laws; and institutional
policies for the protection of human
subjects;
• IRB members and staff complete
relevant educational training before
reviewing human subjects research; and
• Research investigators complete
appropriate institutional educational
training before conducting human
subjects research.
(1a) Have institutions holding OHRPapproved FWAs routinely implemented
OHRP’s recommendations?
(1b) What, if any, are the reasons for
institutions not implementing OHRP’s
recommendations?
(1c) Has any failure of institutions to
implement OHRP’s recommendations
been a significant contributing factor to
noncompliance with the requirements
of 45 CFR part 46 and inadequate
protection of the rights and welfare of
human subjects? If so, please provide
examples.
(1d) If failure of institutions to
implement OHRP’s recommendations
has been a significant contributing
factor to noncompliance with the
requirements of 45 CFR part 46 and
inadequate protection of the rights and
welfare of human subjects, would
promulgation of a regulation requiring
institutions to implement training and
education programs for certain
individuals involved in the conduct,
review or oversight of human subjects
research be the best mechanism to
address this problem, or should
different mechanisms be used (for
example, would it be better if OHRP
instead issued additional guidance
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regarding training and education
programs)?
(1e) Even if there are no data
suggesting that failure of institutions to
implement OHRP’s recommendations
regarding education and training has
been a contributing factor in noncompliance with the requirements of 45
CFR part 46, are there other sound
reasons for developing further guidance
or a regulation regarding education and
training, and if so, what are they?
(2) If HHS decided to propose further
guidance recommending, or a regulation
requiring, that institutions implement
training and education programs for
certain individuals involved in the
conduct, review, or oversight of human
subjects research, which of the
following categories of individuals
should receive training and education
and why: IRB chairpersons; other IRB
members; IRB staff; principal
investigators; others involved in the
conduct of human subjects research
(e.g., co-investigators, study
coordinators); FWA signatory officials;
human protection administrators; or any
other category of individuals (please
specify)?
(3a) Should further guidance or a
regulation include provisions
stipulating specific content for the
training and education programs? If so,
what should the specific content
include and why (for example, should a
regulation require inclusion of any or all
of the following in the content of the
training and education programs: The
commitments and responsibilities of the
institution under the FWA; relevant
ethical principles cited in the
institution’s FWA; relevant Federal
regulations for human subjects
protection; OHRP guidance; other
applicable guidance; relevant state and
local laws; institutional policies for the
protection of human subjects; or other
content (please specify))?
(3b) Should the training and
education recommendations or
requirements differ depending upon the
nature of the individual’s involvement
in research? If so, in what manner?
(3c) Notwithstanding whether training
should be tailored according to an
individual’s role in the clinical research
process, is there a minimum level of
knowledge and skill that should be
expected of anyone working in some
aspect of the research enterprise?
(3d) How often should the content of
the materials used for this training be
updated?
(4) Should further guidance or a
regulation include provisions
stipulating that proficiency in human
subjects protection requirements be
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demonstrated in some way (please
specify)?
(5) Should further guidance or a
regulation include recommendations or
requirements for individuals to
complete some minimum amount of
training and education prior to any
involvement in the conduct, review, or
oversight of human subjects research?
(6) Should further guidance or a
regulation include recommendations or
requirements for periodic continuing
training and education? If so, should the
guidance or regulation stipulate a
specific time interval for such periodic
training and education (for example,
should the regulation require
individuals to complete continuing
training and education activities every
1, 2, or 3 years)?
(7) Should further guidance or a
regulation include recommendations or
requirements for institutions to prepare
and maintain written procedures for
ensuring implementation of the training
and education requirements?
(8) Should further guidance or a
regulation include recommendations or
requirements for institutions to prepare
and maintain written documentation
that individuals covered by the
regulation have completed the required
training and education activities?
(9) If HHS decided to propose a
regulation, what would the estimated
costs of the regulation be to institutions
in terms of infrastructure and man-hour
costs? OHRP is interested in receiving
specific information on such estimated
costs from all types and sizes of
institutions that hold OHRP-approved
FWAs. OHRP recognizes that the HHS
human subjects protection regulations
extend to a wide-range of institutions,
from very small organizations and
businesses that employ no more than a
total of 5–10 individuals, to major
academic research and health centers
that may have literally thousands of
individuals affected by any new training
and education regulation. When
providing comments regarding cost
estimates, please include a description
of assumptions that were made for
calculating cost estimated (for example,
assumptions made regarding the
number and types of individuals who
would be required to undergo training
and education, the modalities that
would be used for delivering the
training and education, the time it
would take for covered individuals to
complete initial and continuing training
and education, and how often
continuing training and education
would need to occur).
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Federal Register / Vol. 73, No. 127 / Tuesday, July 1, 2008 / Notices
Dated: June 19, 2008.
Ivor A. Pritchard,
Acting Director, Office for Human Research
Protections.
[FR Doc. E8–14917 Filed 6–30–08; 8:45 am]
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DEPARTMENT OF HEALTH AND
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Administration on Aging
Agency Information Collection
Activities; Submission for OMB
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Administration on Aging, HHS.
Notice.
AGENCY:
ACTION:
SUMMARY: The Administration on Aging
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collection of information listed below
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review and clearance under the
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Submit written comments
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FOR FURTHER INFORMATION CONTACT:
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ADDRESSES:
In
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AoA invites comments on: (1) Whether
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assumptions used; (3) ways to enhance
the quality, utility, and clarity of the
information to be collected; and (4)
ways to minimize the burden of the
collection of information on
respondents, including through the use
of automated collection techniques
when appropriate, and other forms of
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The Certification on Maintenance of
Effort for the Title III and Certification
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of Long-Term Care Ombudsman
Program Expenditures provides
statutorily required information
regarding state’s contribution to
programs funded under the Older
Americans Act and conformance with
legislative requirements, pertinent
Federal regulations and other applicable
instructions and guidelines issued by
Administration on Aging (AoA). This
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AoA estimates the burden of this
collection of information as follows: 56
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March 19, 2008 (Vol. 73, No. 54 Page
14821), the agency requested comments
on the proposed collection of
information. No comments on the
content of the collection were received.
Dated: June 26, 2008.
Josefina G. Carbonell,
Assistant Secretary for Aging.
[FR Doc. E8–14898 Filed 6–30–08; 8:45 am]
BILLING CODE 4154–01–P
DEPARTMENT OF HEALTH AND
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Services
Statement of Organization, Functions,
and Delegations of Authority
Part F of the Statement of
Organization, Functions, and
Delegations of Authority for the
Department of Health and Human
Services, Centers for Medicare &
Medicaid Services (CMS), (Federal
Register , Vol. 73, No. 46, pp. 12451–
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and updates to the functions for the
Center for Beneficiary Choices.
Part F. is described below:
• Section F. 20. (Functions) reads as
follows:
Center for Drug and Health Plan Choice
(FAE)
• Responsible for all national policies
and operations necessary for the
purchasing of Medicare Prescription
Drug (Part D) and Medicare Advantage
(Part C) health plan benefits. Designs,
implements, and manages the
procurement of prescription drug plans
(PDPs) and Medicare Advantage plans
(MA and MA–PD plans), including the
solicitation and approval of
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applications, review of benefits and
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and performance measures, review of
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management activities.
• Develops and improves all bidding
and payment policies related to the
Medicare Prescription Drug Benefit and
the Medicare Advantage (MA) program.
• Validates payments to the Part D
prescription drug and MA plans,
including routine annual risk
adjustment data validation based on
medical record review.
• Coordinates the development and
management of business requirements
for the national systems for enrollment,
payment, and contractor management
for the Prescription Drug Benefit and the
Medicare Advantage (MA) programs.
• Develops and implements the
national policy and oversees operational
implementation for all issues related to
the Retiree Drug Subsidy Program.
• Develops national policy for
eligibility, enrollment and entitlement
for Medicare Parts A, B, C, and D,
including oversight of activities related
to Part D auto-enrollment, low income
subsidy, and creditable coverage.
• Develops national policy and
oversees operational activities related to
Medicare Part A, B, C, and D claimsrelated hearings, appeals, grievances
and other beneficiary-centered dispute
resolution processes.
• Serves as the focal point for issues
related to a variety of Federal standards
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coverage, including those pertaining to
its administration of the Medigap
program, Title I of the Health Insurance
Portability and Accountability Act and
the Consolidated Omnibus Budget
Reconciliation Act.
• Works closely with the regional
Consortium for Medicare Health Plans
Operations (CMHPO) on all operational
aspects of the Part C and Part D
programs.
• Develops and implements Part C
and Part D contractor performance
monitoring programs and Part C and
Part D compliance and oversight
programs and carries out these programs
collaboratively with CMHPO.
• Develops surveys to measure
consumer experiences with their health
plans and health care providers;
manages the Consumer Assessment of
Health Care Provider and Systems
(CAHPS) survey; develops and prepares
performance measures for Part C
sponsors; analyzes and reports Health
Plan Employers Data and Information
Set data for Part C performance
measures and consumer reports; and
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Agencies
[Federal Register Volume 73, Number 127 (Tuesday, July 1, 2008)]
[Notices]
[Pages 37460-37463]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: E8-14917]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Request for Information and Comments on the Implementation of
Human Subjects Protection Training and Education Programs
AGENCY: Department of Health and Human Services, Office of the
Secretary, Office of Public Health and Science, Office for Human
Research Protections.
ACTION: Notice.
-----------------------------------------------------------------------
SUMMARY: The Office for Human Research Protections (OHRP), Office of
Public Health and Science is seeking information and comments from
affected entities and individuals about (a) Whether OHRP should issue
additional guidance recommending that institutions engaged in human
subjects research conducted or supported by the Department of Health
and Human Services (HHS) implement training and education programs for
certain individuals involved in the conduct, review, or oversight of
human subjects research, or (b) whether HHS should develop a regulation
requiring the implementation of such training and education programs.
This request for information and comment stems from the 1998 report
from the HHS Office of Inspector General (OIG) recommending that
Federal requirements be enacted to help ensure that investigators and
institutional review board (IRB) members be adequately educated about,
and sensitized to, human subjects protections. More recently, the
Secretary's Advisory Committee on Human Research Protections (SACHRP)
recommended that OHRP require institutions to ensure that initial and
continuing training is provided for IRB members and staff,
investigators, and certain institutional officials. The implementation
of such training and education programs might help to ensure that
individuals involved in the conduct or review of human subjects
research at institutions holding OHRP-approved Federalwide Assurances
(FWAs) understand and meet their regulatory responsibilities for
protecting human subjects.
DATES: Submit written or electronic comments by September 29, 2008.
ADDRESSES: You may submit comments by any of the following methods:
E-mail: humansubjectstraining@hhs.gov. Include ``Human
Subjects Protection Training and Education'' in the subject line.
Fax: 301-402-2071.
Mail/Hand delivery/Courier [For paper, disk, or CD-ROM
submissions]: Michael A. Carome, M.D., Captain, U.S. Public Health
Service, OHRP, 1101 Wootton Parkway, Suite 200, Rockville, MD 20852.
Comments received within the public comment period, including any
personal information, will be made available to the public upon
request.
FOR FURTHER INFORMATION CONTACT: Michael A. Carome, M.D., Captain,
U.S. Public Health Service, OHRP, 1101 Wootton Parkway, Suite 200,
Rockville, MD 20852, 240-453-6900; e-mail Michael.Carome@hhs.gov.
SUPPLEMENTARY INFORMATION:
I. Background
Under the HHS regulations for the protection of human subjects,
found at 45 CFR part 46, institutions or organizations that are engaged
in human subjects research that is conducted or supported by HHS must
file with OHRP an assurance of compliance with the human subjects
protection regulations. The assurance must be executed by an individual
authorized to act on behalf of the institution and authorized to
assume, on behalf of the institution, the obligations imposed by the
human subjects protection regulations [45 CFR 46.103(c)]. Thus, to
fulfill his or her regulatory responsibilities, the institutional
official must be knowledgeable about the requirements of the human
subjects protection regulations.
The institution's assurance of compliance must also designate one
or more IRBs to review research covered by the regulations, and the
institution must ensure that each designated IRB has sufficient staff
to support the IRB's activities [45 CFR 46.103(b)(2)]. IRB members must
be sufficiently qualified through experience and expertise and
diversity to promote respect for their advice and counsel in
safeguarding the rights and welfare of human subjects. IRB members also
must have the professional competence necessary to review human
subjects research activities of the institution, including the ability
to ascertain the acceptability of the proposed research in terms of
institutional commitments and regulations, applicable law, and
standards of professional conduct and practice; therefore, members must
be knowledgeable in those areas [45 CFR
[[Page 37461]]
46.107]. Thus, to fulfill their regulatory responsibilities, IRB
members must be informed about human subjects protection requirements.
Investigators involved in the conduct of human subjects research
that is conducted or supported by HHS play a crucial role in protecting
the rights and welfare of human subjects. Investigators have specific
responsibilities under the human subjects protection requirements
related to the conduct of IRB-approved research. For example, no
investigator may involve a human being in research that is conducted or
supported by HHS or covered by the institution's assurance unless the
investigator has obtained the legally effective informed consent of the
subject or the subject's legally authorized representative in
accordance with, and to the extent required by, HHS regulations at 45
CFR 46.116. Moreover, investigators are responsible for providing
required information to the IRB [45 CFR 46.103(b)(5), 46.111].
Investigators are responsible for obtaining prior approval from the IRB
for any modifications of the previously approved research, except those
necessary to eliminate apparent immediate hazards to subjects, and
investigators are responsible for ensuring that progress reports and
requests for continuing review and approval are submitted to the IRB in
accordance with the policies, procedures, and actions of the IRB as
referenced in the institution's OHRP-approved FWA [45 CFR 46.103(b)(4),
45 CFR 46.109(e), 45 CFR 46.115(a)(1)]. Thus, investigators need to be
informed about human subjects protection requirements. The HHS Office
of Inspector General (OIG), in its 1998 Report, ``Institutional Review
Boards: A Time for Reform,'' called for strong Federal action
concerning education of investigators conducting, and IRB members
reviewing, human subjects research (https://oig.hhs.gov/oei/reports/oei-
01-97-00193.pdf). In that report, the OIG recommended enactment of
Federal requirements that help ensure that investigators and IRB
members are adequately educated about, and sensitized to, human
subjects protections.
In October 2000, the National Institutes of Health (NIH) instituted
a policy that requires education on the protection of human research
participants for all key personnel as a condition of funding grant
applications or contract proposals involving human subjects research
(https://grants1.nih.gov/grants/guide/notice-files/NOT-OD-010061.html).
Key personnel include all individuals who are responsible for the
design and conduct of research studies involving human subjects.
In its 2001 report, ``Ethical and Policy Issues in Research
Involving Human Participants,'' the National Bioethics Advisory
Committee (NBAC) recommended that all institutions and sponsors engaged
in research involving human participants should provide educational
programs in research ethics to appropriate institutional officials,
investigators, IRB members, and IRB staff (https://www.georgetown.edu/
research/nrcbl/nbac/human/overvol1.pdf). NBAC also recommended that the
Federal Government, in partnership with academic and professional
societies, should enhance research ethics education related to
protecting human research subjects, as well as stimulate development of
innovative educational programs.
In its 2002 report commissioned by HHS, ``Responsible Research: A
Systems Approach to Protecting Research Participants,'' the Institute
of Medicine (IOM) recommended that research organizations should ensure
that investigators, IRB members, and other individuals substantively
involved in research with humans are adequately educated to perform
their respective duties (https://www.nap.edu/books/0309084881/html/).
On March 29, 2007, SACHRP recommended that OHRP require that
institutions ensure that initial and continuing training is provided
for IRB members and staff, investigators, and certain institutional
officials, including the official that signed the institution's FWA.
Over the past several years, OHRP has identified serious, systemic
noncompliance with the requirements of HHS regulations for the
protection of human subjects at a significant number of major
institutions engaged in human subjects research conducted or supported
by HHS. In OHRP's experience, inadequate training and education of
individuals involved in the conduct or review of human subjects
research has been a major root cause of such noncompliance.
OHRP developed the FWA as a new type of assurance in December 2000.
Initially, OHRP proposed that the FWA include requirements for training
and education regarding human subjects protection regulations for
institutional officials, IRB members, IRB staff, investigators and
other institutional personnel. Following public comment on the proposed
FWA, OHRP issued a revised version of the FWA on March 20, 2002 that
strongly recommended, rather than required, such training and
education. This decision was based, in part, on a determination that
rulemaking would be a more appropriate mechanism for requiring such
training and education.
In the current FWA terms of assurance, OHRP strongly recommends
that the institutional official, human protections administrator, and
IRB chairperson(s) designated under the assurance complete the OHRP
Assurance Training Modules available on the OHRP Web site at https://
137.187.172.153/CBTs/Assurance/login.asp. Furthermore, OHRP recommends
that the institution and the designated IRB(s) establish educational
training and oversight mechanisms appropriate to the nature of the
institution's research portfolio to ensure that research investigators,
IRB members, IRB staff, and other appropriate personnel maintain
continuing knowledge of, and comply with, relevant ethical principles,
relevant Federal regulations, OHRP guidance, other applicable guidance,
state and local laws, and institutional policies for the protection of
human subjects. OHRP also recommends that IRB members and staff
complete relevant educational training before reviewing human subjects
research; and that research investigators complete appropriate
institutional educational training before conducting human subjects
research.
II. Request for Information and Comments
Based on the recommendations of the OIG, NBAC, IOM, and SACHRP, as
well as OHRP's own experience in compliance activities, which has
revealed that many individuals involved in the conduct or review of
HHS-supported or conducted research at numerous institutions had a
significant gap in knowledge about human subject protections, OHRP is
seeking comment from affected entities and individuals about (a)
whether OHRP should issue additional guidance recommending that
institutions engaged in human subjects research conducted or supported
by HHS implement training and education programs for certain
individuals involved in the conduct, review, or oversight of human
subjects research, or (b) whether HHS should develop a regulation
requiring the implementation of such training and education programs.
The implementation of such training and education programs might help
to ensure that individuals involved in the conduct or review of human
subjects research at institutions holding OHRP-approved FWAs understand
and meet their regulatory responsibilities for protecting human
subjects.
[[Page 37462]]
OHRP specifically seeks comment on the following questions.
Comments should also include a reference to the specific numbered
question being addressed:
(1) For the past 5 years OHRP has strongly recommended through the
Terms of the FWA that:
Institutional signatory officials, human protections
administrators, and the IRB chairpersons personally complete the
relevant OHRP Assurance Training Modules (see https://137.187.172.153/
CBTs/Assurance/login.asp), or comparable training that includes the
content of these modules;
Institutions and their designated IRBs establish
educational training and oversight mechanisms (appropriate to the
nature and volume of its research) to ensure that research
investigators, IRB members and staff, and other appropriate personnel
maintain continuing knowledge of, and comply with, the following:
Relevant ethical principles; relevant federal regulations; written IRB
procedures; OHRP guidance; other applicable guidance, state and local
laws; and institutional policies for the protection of human subjects;
IRB members and staff complete relevant educational
training before reviewing human subjects research; and
Research investigators complete appropriate institutional
educational training before conducting human subjects research.
(1a) Have institutions holding OHRP-approved FWAs routinely
implemented OHRP's recommendations?
(1b) What, if any, are the reasons for institutions not
implementing OHRP's recommendations?
(1c) Has any failure of institutions to implement OHRP's
recommendations been a significant contributing factor to noncompliance
with the requirements of 45 CFR part 46 and inadequate protection of
the rights and welfare of human subjects? If so, please provide
examples.
(1d) If failure of institutions to implement OHRP's recommendations
has been a significant contributing factor to noncompliance with the
requirements of 45 CFR part 46 and inadequate protection of the rights
and welfare of human subjects, would promulgation of a regulation
requiring institutions to implement training and education programs for
certain individuals involved in the conduct, review or oversight of
human subjects research be the best mechanism to address this problem,
or should different mechanisms be used (for example, would it be better
if OHRP instead issued additional guidance regarding training and
education programs)?
(1e) Even if there are no data suggesting that failure of
institutions to implement OHRP's recommendations regarding education
and training has been a contributing factor in non-compliance with the
requirements of 45 CFR part 46, are there other sound reasons for
developing further guidance or a regulation regarding education and
training, and if so, what are they?
(2) If HHS decided to propose further guidance recommending, or a
regulation requiring, that institutions implement training and
education programs for certain individuals involved in the conduct,
review, or oversight of human subjects research, which of the following
categories of individuals should receive training and education and
why: IRB chairpersons; other IRB members; IRB staff; principal
investigators; others involved in the conduct of human subjects
research (e.g., co-investigators, study coordinators); FWA signatory
officials; human protection administrators; or any other category of
individuals (please specify)?
(3a) Should further guidance or a regulation include provisions
stipulating specific content for the training and education programs?
If so, what should the specific content include and why (for example,
should a regulation require inclusion of any or all of the following in
the content of the training and education programs: The commitments and
responsibilities of the institution under the FWA; relevant ethical
principles cited in the institution's FWA; relevant Federal regulations
for human subjects protection; OHRP guidance; other applicable
guidance; relevant state and local laws; institutional policies for the
protection of human subjects; or other content (please specify))?
(3b) Should the training and education recommendations or
requirements differ depending upon the nature of the individual's
involvement in research? If so, in what manner?
(3c) Notwithstanding whether training should be tailored according
to an individual's role in the clinical research process, is there a
minimum level of knowledge and skill that should be expected of anyone
working in some aspect of the research enterprise?
(3d) How often should the content of the materials used for this
training be updated?
(4) Should further guidance or a regulation include provisions
stipulating that proficiency in human subjects protection requirements
be demonstrated in some way (please specify)?
(5) Should further guidance or a regulation include recommendations
or requirements for individuals to complete some minimum amount of
training and education prior to any involvement in the conduct, review,
or oversight of human subjects research?
(6) Should further guidance or a regulation include recommendations
or requirements for periodic continuing training and education? If so,
should the guidance or regulation stipulate a specific time interval
for such periodic training and education (for example, should the
regulation require individuals to complete continuing training and
education activities every 1, 2, or 3 years)?
(7) Should further guidance or a regulation include recommendations
or requirements for institutions to prepare and maintain written
procedures for ensuring implementation of the training and education
requirements?
(8) Should further guidance or a regulation include recommendations
or requirements for institutions to prepare and maintain written
documentation that individuals covered by the regulation have completed
the required training and education activities?
(9) If HHS decided to propose a regulation, what would the
estimated costs of the regulation be to institutions in terms of
infrastructure and man-hour costs? OHRP is interested in receiving
specific information on such estimated costs from all types and sizes
of institutions that hold OHRP-approved FWAs. OHRP recognizes that the
HHS human subjects protection regulations extend to a wide-range of
institutions, from very small organizations and businesses that employ
no more than a total of 5-10 individuals, to major academic research
and health centers that may have literally thousands of individuals
affected by any new training and education regulation. When providing
comments regarding cost estimates, please include a description of
assumptions that were made for calculating cost estimated (for example,
assumptions made regarding the number and types of individuals who
would be required to undergo training and education, the modalities
that would be used for delivering the training and education, the time
it would take for covered individuals to complete initial and
continuing training and education, and how often continuing training
and education would need to occur).
[[Page 37463]]
Dated: June 19, 2008.
Ivor A. Pritchard,
Acting Director, Office for Human Research Protections.
[FR Doc. E8-14917 Filed 6-30-08; 8:45 am]
BILLING CODE 4150-36-P