Grants to States for Construction or Acquisition of State Home Facilities-Update of Authorized Beds, 33192-33196 [E9-16341]
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Federal Register / Vol. 74, No. 131 / Friday, July 10, 2009 / Proposed Rules
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appropriate, for application to the
staffing needs of public employee only
Plans. However, the State has given
satisfactory assurance in its Plan that it
will meet the staffing requirements of 29
CFR 1956.10. The State has also given
satisfactory assurances of adequate State
matching funds (50%) to support the
Plan and is requesting initial Federal
funding of $1,500,000 for a total initial
program effort of $3 million.
Although the State Acts set forth the
general authority and scope for
implementing the Illinois Public
Employee Plan, the Plan is
developmental under the terms of 29
CFR 1956.2(b), in that specific rules,
regulations, and implementing
procedures must still be adopted or
revised to carry out the Plan and make
it structurally ‘‘at least as effective’’ as
Federal OSHA and fully operational.
The Plan sets forth a timetable for the
accomplishment of these and other
developmental goals within three years
of Plan approval. This timetable
addresses such general areas as the
adoption of standards and the revision
of regulations governing enforcement,
consultation, variances, contested cases,
employee access to information, and
recordkeeping. Other developmental
aspects include hiring and training of
staff, participation in OSHA’s
management information system,
development of a Field Operations
Manual and all other implementing
policies, procedures and instruction
necessary for the operation of an
effective program. The State has
extensively revised its initial State Plan
submission to address a number of
issues which were raised during the
course of Federal review of the Illinois
Plan and that required further
clarification from the State.
D. Request for Public Comment and
Opportunity To Request Hearing
Public comment on the Illinois Public
Employee Only State Plan is hereby
requested. Interested persons are invited
to submit written data, views, and
comments with respect to this proposed
initial State Plan approval. These
comments must be received on or before
August 10, 2009. Written submissions
must clearly identify the issues that are
addressed and the positions taken with
respect to each issue. The State of
Illinois will be afforded the opportunity
to respond to each submission. The
Illinois Department of Labor must also
publish appropriate notice within the
State of Illinois within 5 days of
publication of this notice, announcing
OSHA’s proposal to approve an Illinois
State Plan for Public Employees Only,
contingent on the availability of
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appropriated funds, and giving notice of
the opportunity for public comment.
Pursuant to 29 CFR 1902.39(f),
interested persons may request an
informal hearing concerning the
proposed initial State Plan approval.
Such requests also must be received on
or before August 10, 2009 and may be
submitted electronically, by facsimile,
or by regular mail, hand delivery,
express mail, messenger or courier
service, as indicated under ADDRESSES
above. Such requests must present
particularized written objections to the
proposed initial State Plan approval.
The Assistant Secretary will decide
within 30 days of the last day for filing
written views or comments and requests
for a hearing whether the objections
raised are substantial and, if so, will
publish notice of the time and place of
the scheduled hearing.
The Assistant Secretary will, within a
reasonable time after the close of the
comment period or after the certification
of the record if a hearing is held,
publish a decision in the Federal
Register. All written and oral
submissions, as well as other
information gathered by OSHA, will be
considered in any action taken. The
record of this proceeding, including
written comments and requests for
hearing, and all materials submitted in
response to this notice and at any
subsequent hearing, are available at
https://www.regulations.gov or the OSHA
Docket Office at the address above.
E. Regulatory Flexibility Act
OSHA certifies pursuant to the
Regulatory Flexibility Act of 1980 (5
U.S.C. 601 et seq.) that the proposed
initial approval of the Illinois State Plan
will not have a significant economic
impact on a substantial number of small
entities. By its own terms, the Plan will
have no effect on private sector
employment, but is limited to the State
and its political subdivisions. Moreover,
the Illinois Safety Inspection and
Education Act has been in effect since
1961 and the Illinois Health and Safety
Act has been in effect since 1936, when
the State first established a safety and
health program. Since 1985, the Illinois
program for public employees has been
in operation under the Illinois
Department of Labor with State funding
and most public sector employers in the
State, including small units of local
government, have been subject to its
terms. Compliance with State OSHA
standards is required by State law;
Federal approval of a State Plan imposes
regulatory requirements only on the
agency responsible for administering the
State Plan. Accordingly, no new
obligations would be placed on public
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sector employers as a result of Federal
approval of the Plan.
F. Federalism
Executive Order 13132, ‘‘Federalism,’’
emphasizes consultation between
Federal agencies and the States and
establishes specific review procedures
the Federal government must follow as
it carries out policies which affect state
or local governments. OSHA has
consulted extensively with Illinois
throughout the development,
submission and consideration of its
proposed State Plan. Although OSHA
has determined that the requirements
and consultation procedures provided
in Executive Order 13132 are not
applicable to initial approval decisions
under the Act, which have no effect
outside the particular State receiving the
approval, OSHA has reviewed the
Illinois initial approval decision
proposed today, and believes it is
consistent with the principles and
criteria set forth in the Executive Order.
G. Authority and Signature
This document was prepared under
the direction of Jordan Barab, Acting
Assistant Secretary of Labor for
Occupational Safety and Health. It is
issued under Section 18 of the
Occupational Safety and Health Act of
1970 (29 U.S.C. 667), 29 CFR Parts 1956
and 1902, and Secretary of Labor’s
Order No. 5–2007 (72 FR 31160).
Signed at Washington, DC, this 7th day of
July 2009.
Jordan Barab,
Acting Assistant Secretary of Labor for
Occupational Safety and Health.
[FR Doc. E9–16379 Filed 7–9–09; 8:45 am]
BILLING CODE 4510–26–P
DEPARTMENT OF VETERANS
AFFAIRS
38 CFR Part 59
RIN 2900–AM70
Grants to States for Construction or
Acquisition of State Home Facilities—
Update of Authorized Beds
Department of Veterans Affairs.
Proposed rule.
AGENCY:
ACTION:
SUMMARY: The Department of Veterans
Affairs (VA) proposes to amend its
regulations regarding grants to States for
construction or acquisition of State
homes to update the maximum number
of nursing home and domiciliary beds
designated for each State and to amend
the definition of ‘‘State’’ for purposes of
these grants to include Guam, the
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Federal Register / Vol. 74, No. 131 / Friday, July 10, 2009 / Proposed Rules
Northern Mariana Islands, and
American Samoa.
DATES: Comments must be received on
or before September 8, 2009.
ADDRESSES: Written comments may be
submitted by: Mail or hand-delivery to
Director, Regulations Management
(02REG), Department of Veterans
Affairs, 810 Vermont Avenue, NW.,
Room 1068, Washington, DC 20420; fax
to (202) 273–9026; or e-mail at https://
www.regulations.gov. Comments should
indicate that they are submitted in
response to ‘‘RIN 2900–AM70—Grants
to States for Construction or Acquisition
of State Home Facilities—Update of
Authorized Beds.’’ All comments
received will be available for public
inspection in the Office of Regulation
Policy and Management, Room 1063B,
between the hours of 8 a.m. and 4:30
p.m., Monday through Friday (except
holidays). Please call (202) 461–4902 for
an appointment. (This is not a toll-free
number.) In addition, during the
comment period, comments may be
viewed online through the Federal
Docket Management System (FDMS) at
https://www.regulations.gov.
FOR FURTHER INFORMATION CONTACT:
James F. Burris, MD, Chief Consultant,
Geriatrics and Extended Care State
Home Construction Grant Program
(114), Veterans Health Administration,
Department of Veterans Affairs, 810
Vermont Avenue, NW., Washington, DC
20420, (202) 461–6774.
SUPPLEMENTARY INFORMATION: Congress
has authorized VA to provide grants to
States for the construction or acquisition
of State home facilities for the provision
of care to veterans. See 38 U.S.C. 8131–
8138. The term ‘‘State home’’ means ‘‘a
home established by a State (other than
a possession) for veterans disabled by
age, disease, or otherwise who by reason
of such disability are incapable of
earning a living’’ and ‘‘includes such a
home which furnishes nursing home
care for veterans.’’ 38 U.S.C. 101(19).
For purposes of State home grants, the
term ‘‘State’’ means each of the several
States and Territories of the United
States, the District of Columbia, and the
Commonwealth of Puerto Rico, see 38
U.S.C. 101(20), but not possessions of
the United States, see 38 U.S.C. 101(19),
8131(2). The Department of the Interior,
which has administrative responsibility
for coordinating Federal policy in Island
groups in the Insular Area, has
identified Guam and American Samoa
as territories of the United States, and
the Northern Mariana Islands as a
Commonwealth in Political Union with
the United States, which is treated as a
U.S. territory for purposes of the State
home grant program, see
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VAOPGCCONCL 10–98. The regulatory
definition of the term ‘‘State’’ in current
38 CFR 59.2 already includes the several
States, the District of Columbia, the
Commonwealth of Puerto Rico, and the
Virgin Islands. We propose to amend
this definition to include Guam, the
Northern Mariana Islands, and
American Samoa.
Section 8134(a)(2) of title 38, U.S.C.,
mandates that VA prescribe for each
State the number of nursing home and
domiciliary beds for which grants may
be furnished, which the proposed note
to 38 CFR 59.40(a) would refer to as a
State’s ‘‘unmet need’’ number. To
compute this number, VA estimates for
each State the maximum number of
nursing home and domiciliary beds
needed by veterans in that State (which
is the maximum number of such beds
designated for each State, as shown on
the chart in proposed § 59.40(a)), and
then subtracts the number of existing
State home beds plus the number of
those beds under construction or that
would be constructed in accordance
with the State’s grant applications. In
addition, section 8134(a)(3) mandates
that VA prioritize State home grant
applications. The priorities set forth in
the law require VA to compute whether
a State applying for a grant has a great,
significant, or limited need for State
home beds. VA currently uses a State’s
‘‘unmet need’’ number to determine
whether the State has a great,
significant, or limited need for new
State home beds. See 38 CFR 59.50(e).
The Veterans Millennium Health Care
and Benefits Act (the ‘‘Act’’) (Public
Law 106–117, enacted on November 30,
1999) requires that, not less often than
every four years, VA must review and,
as necessary, revise the regulations
concerning the maximum number of
State home beds designated for each
State. 38 U.S.C. 8134(a)(4). Section
8134(a)(2) requires that these numbers
be based on the projected demand for
nursing home and domiciliary care on
November 30, 2009 (10 years after the
date of enactment of the Act) by
veterans who at such time are 65 years
of age or older and who reside in that
State. In 2001, VA originally established
the maximum number of State home
beds for each State based on the
projected demand for such beds in 2009.
See 66 FR 33845–46 (June 26, 2001). VA
now believes that Congress intended VA
to recalculate the maximum number of
beds for each State based on the
projected demand for care ten years in
the future and that this method would
be consistent with the Act’s requirement
for establishing maximum State home
bed numbers. VA thus proposes to
revise in proposed § 59.40(a) the
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33193
maximum bed numbers based on the
projected demand from veterans who, in
2020, are 65 years of age or older and
who reside in that State.
To compute the maximum number of
beds for each State in compliance with
the Act, we first estimated the total
number of veterans 65 years of age or
older residing in each State, projected to
the year 2020. We then totaled the
projected population of these veterans at
8,672,045, which would be an increase
from the 2000 projected population of
such veterans in 2009. In computing
these estimates, we considered many
factors, such as movement of these
veterans to new States, the mortality
rate of these veterans, and the fact that
the life expectancy of these veterans is
projected to be longer than before. We
then considered the projected total
demand for nursing home and
domiciliary beds in State homes. In
2000, we estimated the demand in 2009
would be for 55,299 State home beds
nationwide. We believe that this
estimated demand may also be used for
2020, despite the estimated increase in
the projected veteran population, due to
the many emerging alternatives to
institutional long-term care and
advancing technologies, such as
Telehealth, Home-Based Primary Care,
and Respite Care, and due to the fact
that veterans are choosing to stay longer
in their own homes. VA’s philosophy is
to provide extended care services in the
least restrictive environment that is safe
for the veteran, and whenever possible
in non-institutional home and
community-based settings. VA now
provides a spectrum of non-institutional
extended care services including home
telehealth, homemaker/home health
aide, skilled home care, home-based
primary care, adult day healthcare, inhome respite care, and hospice and
palliative care that were unavailable or
not widely available in 2000. VA has
been increasing the capacity to provide
these services in recent years and will
continue to do so in order to meet the
demand. Many similar services are now
available in the private sector through
Medicare/Medicaid and long-term care
insurance, and some veterans will
choose to avail themselves of those
services rather than seeking care from
VA. The non-institutional services make
it possible for many veterans who
would otherwise require nursing home
care to remain in their own homes, and
reduce the need for additional nursing
home beds. New technologic advances
that may become available over the next
decade, such as robotic assistive
devices, will also reduce the need for
additional nursing home beds. It is
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Federal Register / Vol. 74, No. 131 / Friday, July 10, 2009 / Proposed Rules
likely that these trends will offset the
growth in population and mean that no
additional nursing home beds will be
needed beyond those previously
projected. Should these assumptions
prove incorrect, VA will adjust the total
number of beds in a future revision of
this regulation. ‘‘We are specifically
interested in comments concerning this
analysis and our estimate that the
demand in 2020 for State home beds
will be for 55,299 nationwide.
We allocated the 55,299 beds based
on the percentage of veterans who in
2020 are projected to reside in each
State. Although the projected total
demand for State home beds nationwide
will remain the same in 2020, some
States will experience an increase and
other States a decrease in the maximum
number of beds that are eligible to
receive a grant from the State Veterans
Home Construction Grant program
depending on the projected population
of veterans 65 years of age or over for
each State. The table below shows the
changes in the maximum numbers of
beds for each State. We would welcome
comments regarding our projections for
individual States.
New max #
of beds
(based on
2020
projections)
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State
Old max # of beds
Alabama ........................................................................
Alaska ...........................................................................
American Samoa ..........................................................
Arizona ..........................................................................
Arkansas .......................................................................
California .......................................................................
Colorado .......................................................................
Connecticut ...................................................................
Delaware .......................................................................
DC .................................................................................
Florida ...........................................................................
Georgia .........................................................................
Guam ............................................................................
Hawaii ...........................................................................
Idaho .............................................................................
Illinois ............................................................................
Indiana ..........................................................................
Iowa ..............................................................................
Kansas ..........................................................................
Kentucky .......................................................................
Louisiana .......................................................................
Maine ............................................................................
Maryland .......................................................................
Massachusetts ..............................................................
Michigan ........................................................................
Minnesota .....................................................................
Mississippi .....................................................................
Missouri .........................................................................
Montana ........................................................................
Nebraska .......................................................................
Nevada ..........................................................................
New Hampshire ............................................................
New Jersey ...................................................................
New Mexico ..................................................................
New York ......................................................................
North Carolina ...............................................................
North Dakota .................................................................
Northern Mariana Islands .............................................
Ohio ..............................................................................
Oklahoma ......................................................................
Oregon ..........................................................................
Pennsylvania .................................................................
Puerto Rico ...................................................................
Rhode Island .................................................................
South Carolina ..............................................................
South Dakota ................................................................
Tennessee ....................................................................
Texas ............................................................................
Utah ..............................................................................
Vermont ........................................................................
Virginia ..........................................................................
Virgin Islands ................................................................
Washington ...................................................................
West Virginia .................................................................
Wisconsin ......................................................................
Wyoming .......................................................................
883 ................................................................................
79 ..................................................................................
not applicable ...............................................................
1068 ..............................................................................
557 ................................................................................
5754 ..............................................................................
717 ................................................................................
738 ................................................................................
165 ................................................................................
104 ................................................................................
4471 ..............................................................................
1202 ..............................................................................
not applicable ...............................................................
216 ................................................................................
233 ................................................................................
2271 ..............................................................................
1209 ..............................................................................
632 ................................................................................
542 ................................................................................
759 ................................................................................
785 ................................................................................
301 ................................................................................
1020 ..............................................................................
1348 ..............................................................................
1896 ..............................................................................
932 ................................................................................
500 ................................................................................
1230 ..............................................................................
198 ................................................................................
355 ................................................................................
428 ................................................................................
264 ................................................................................
1683 ..............................................................................
344 ................................................................................
3220 ..............................................................................
1454 ..............................................................................
121 ................................................................................
not applicable ...............................................................
2530 ..............................................................................
747 ................................................................................
804 ................................................................................
3173 ..............................................................................
350 ................................................................................
254 ................................................................................
750 ................................................................................
155 ................................................................................
1050 ..............................................................................
3226 ..............................................................................
304 ................................................................................
124 ................................................................................
1312 ..............................................................................
8 ....................................................................................
1215 ..............................................................................
455 ................................................................................
1070 ..............................................................................
93 ..................................................................................
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10JYP1
1007
179
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207
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1975
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394
1754
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578
518
818
638
362
1102
944
1786
1058
480
1257
281
371
649
361
992
417
2209
1900
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766
907
2336
288
157
1089
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4119
426
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¥422
773
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7
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126
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27
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61
Federal Register / Vol. 74, No. 131 / Friday, July 10, 2009 / Proposed Rules
In prioritizing applications to receive
grants, VA identifies States as having a
‘‘great’’, ‘‘significant’’, or ‘‘limited’’ need
for additional beds. ‘‘Great’’ need is
defined as a need for 2,000 or more new
beds; ‘‘significant’’ need as a need for
1,000–1,999 new beds, and ‘‘limited’’ as
a need for 999 or fewer new beds. A
State that moves into a higher priority
category as a result of the reallocation of
beds in this rule will be more likely to
receive a future grant than under the
current allocation of beds. A State that
moves into a lower priority category
will be less likely to receive a future
grant than under the current allocation
of beds. A State that remains within the
same priority category (even if the
allocation of beds to the State increases
or decreases) will have an equal
likelihood of receiving a future grant
under the new allocation as under the
current allocation.
Our decision to use the same
estimated demand for State home beds
nationwide in 2020, as that which was
projected for 2009, would not keep
States from receiving grants for
construction of new State home beds. At
this time, there are 28,823 recognized
State home beds. In addition, States are
building facilities that when recognized
will add 2,256 beds for a total of 31,079
beds. Therefore, States will soon have in
use 56 percent of the total estimated
number of State home beds needed in
2020. Of course, States will also need to
replace existing State home facilities
that become obsolete or otherwise need
replacing. We thus believe that most
States would continue to be able to
apply for State home grants if that is
what the State chooses to do.
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Unfunded Mandates
The Unfunded Mandates Reform Act
of 1995 (2 U.S.C 1532) requires that
agencies prepare an assessment of
anticipated costs and benefits before
issuing any rule that may result in an
expenditure by the State, local, or Tribal
governments, in the aggregate, or by the
private sector, of $100 million or more
(adjusted annually for inflation) in any
given year. This proposed rule would
have no such effect on State, local, or
Tribal governments, or on the private
sector.
Executive Order 12866
Executive Order 12866 directs
agencies to assess all 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, and other advantages;
distributive impacts; and equity). The
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Executive Order classifies 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 the Executive
Order. VA has examined the economic,
interagency, budgetary, legal, and policy
implications of this proposed rule and
has concluded that it does constitute a
significant regulatory action under the
Executive Order.
Paperwork Reduction Act
This document 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 proposed rule would 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. The
proposed rule would affect grants to
States and would not directly affect
small entities. Therefore, pursuant to 5
U.S.C. 605(b), this proposed rule would
be exempt from the initial and final
regulatory flexibility analyses
requirements of sections 603 and 604.
Catalog of Federal Domestic Assistance
The Catalog of Federal Domestic
Assistance program number and title for
this proposed rule is as follows: 64.005,
Grants to States for Construction of State
Home Facilities.
List of Subjects in 38 CFR Part 59
Administrative practice and
procedure, Alcohol abuse, Alcoholism,
Claims, Day care, Dental health, Drug
abuse, Foreign relations, Government
contracts, Grant programs—health,
Grant programs—veterans, Health care,
Health facilities, Health professions,
Health records, Homeless, Medical and
dental schools, Medical devices,
Medical research, Mental health
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33195
programs, Nursing homes, Reporting
and recordkeeping requirements, Travel
and transportation expenses, and
Veterans.
Approved: April 3, 2009.
John R. Gingrich,
Chief of Staff, Department of Veterans Affairs.
For the reasons stated above, the
Department of Veterans Affairs proposes
to amend 38 CFR part 59 as follows:
PART 59—GRANTS TO STATES FOR
CONSTRUCTION OR ACQUISITION OF
STATE HOMES
1. The authority citation for part 59 is
revised to read as follows:
Authority: 38 U.S.C. 101, 501, 1710, 1742,
8105, 8131–8138.
2. Amend § 59.2 by revising the
definition of ‘‘State’’ to read as follows:
§ 59.2
Definitions.
*
*
*
*
*
State means each of the several States,
the District of Columbia, the Virgin
Islands, the Commonwealth of Puerto
Rico, Guam, the Commonwealth of the
Northern Mariana Islands, and
American Samoa.
*
*
*
*
*
3. Amend § 59.40 by revising
paragraph (a) to read as follows:
§ 59.40 Maximum number of nursing home
care and domiciliary care beds for veterans
by State.
(a) Except as provided in paragraph
(b) of this section, a State may not
request a grant for a project to construct
or acquire a new State home facility, to
increase the number of beds available at
a State home facility, or to replace beds
at a State home facility if the project
would increase the total number of State
home nursing home and domiciliary
beds in that State beyond the maximum
number designated for that State, as
shown in the following chart. The
provisions of 38 U.S.C. 8134 require VA
to prescribe for each State the number
of nursing home and domiciliary beds
for which grants may be furnished (i.e.,
the unmet need). A State’s unmet need
for State home nursing home and
domiciliary beds is the number in the
following chart for that State minus the
sum of the number of nursing home and
domiciliary beds in operation at State
home facilities and the number of State
home nursing home and domiciliary
beds not yet in operation but for which
a grant has either been requested or
awarded under this part.
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State
Maximum number
of state home
nursing home &
domiciliary beds
based on 2020
projections
Alabama ..........................
Alaska .............................
American Samoa ............
Arizona ............................
Arkansas .........................
California .........................
Colorado .........................
Connecticut .....................
Delaware .........................
District of Columbia ........
Florida .............................
Georgia ...........................
Guam ..............................
Hawaii .............................
Idaho ...............................
Illinois ..............................
Indiana ............................
Iowa ................................
Kansas ............................
Kentucky .........................
Louisiana ........................
Maine ..............................
Maryland .........................
Massachusetts ................
Michigan .........................
Minnesota .......................
Mississippi ......................
Missouri ..........................
Montana ..........................
Nebraska ........................
Nevada ...........................
New Hampshire ..............
New Jersey .....................
New Mexico ....................
New York ........................
North Carolina ................
North Dakota ..................
Northern Mariana Islands
Ohio ................................
Oklahoma .......................
Oregon ............................
Pennsylvania ..................
Puerto Rico .....................
Rhode Island ..................
South Carolina ................
South Dakota ..................
Tennessee ......................
Texas ..............................
Utah ................................
Vermont ..........................
Virginia ............................
Virgin Islands ..................
Washington .....................
West Virginia ..................
Wisconsin .......................
Wyoming .........................
1,007
179
0
1,520
653
4,363
1,114
559
207
83
4,049
1,975
12
268
394
1,754
1,216
578
518
818
638
362
1,102
944
1,786
1,058
480
1,257
281
371
649
361
992
417
2,209
1,900
137
1
2,143
766
907
2,336
288
157
1,089
179
1,311
4,119
426
142
1,903
12
1,687
406
1,062
154
erowe on DSK5CLS3C1PROD with PROPOSALS-1
Note to § 59.40(a): The provisions of 38
U.S.C. 8134 require that the ‘‘unmet need’’
numbers be based on a 10-year projection of
demand for nursing home and domiciliary
care by veterans who at such time are 65
years of age or older and who reside in that
State. In determining the projected demand,
VA must take into account travel distances
for veterans and their families.
*
*
*
*
BILLING CODE 8320–01–P
ENVIRONMENTAL PROTECTION
AGENCY
40 CFR Part 52
[EPA–R09–OAR–2009–0344; FRL–8929–4]
Approval and Promulgation of Air
Quality Implementation Plans;
California
AGENCY: Environmental Protection
Agency (EPA).
ACTION: Proposed rule.
SUMMARY: EPA is proposing to approve
state implementation plan (SIP)
revisions submitted by the State of
California on June 15, 2004 and
February 3, 2009, relating to
reformulated gasoline (RFG) and diesel
fuel sold or supplied as motor vehicle
fuels in California. The revisions
relating to RFG include California Phase
3 RFG (CaRFG3) regulations, correction
of errors and streamlined requirements
for compliance with and enforcement of
the CaRFG3 standards, and an update to
the State’s predictive model to mitigate
permeation emissions associated with
the use of ethanol as a fuel additive. The
revisions relating to diesel fuel establish
test methods for determining the
aromatic hydrocarbon content in diesel
fuel and lower the maximum allowable
sulfur content for motor vehicle diesel
fuel.
DATES: Comments must be received on
or before August 10, 2009.
ADDRESSES: Submit your comments,
identified by Docket ID No. EPA–R09–
OAR–2009–0344, by one of the
following methods:
1. Federal eRulemaking Portal:
https://www.regulations.gov. Follow the
on-line instructions.
2. E-mail: buss.jeffrey@epa.gov.
NAICSs
codes a
Category
Industry .............................................................................................
Industry .............................................................................................
a North
*
[FR Doc. E9–16341 Filed 7–9–09; 8:45 am]
3. Mail or deliver: Jeffrey Buss (Air-2),
U.S. Environmental Protection Agency
Region IX, 75 Hawthorne Street, San
Francisco, CA 94105–3901.
Instructions: All comments will be
included in the public docket without
change and may be made available
online at https://www.regulations.gov,
including any personal information
provided, unless the comment includes
Confidential Business Information (CBI)
or other information whose disclosure is
restricted by statute. Information that
you consider CBI or otherwise protected
should be clearly identified as such and
should not be submitted through
https://www.regulations.gov or e-mail.
https://www.regulations.gov is an
‘‘anonymous access’’ system, and EPA
will not know your identity or contact
information unless you provide it in the
body of your comment. If you send email directly to EPA, your e-mail
address will be automatically captured
and included as part of the public
comment. If EPA cannot read your
comment due to technical difficulties
and cannot contact you for clarification,
EPA may not be able to consider your
comment.
Docket: The index to the docket for
this action is available electronically at
https://www.regulations.gov and in hard
copy at EPA Region IX, 75 Hawthorne
Street, San Francisco, California. While
all documents in the docket are listed in
the index, some information may be
publicly available only at the hard copy
location (e.g., copyrighted material), and
some may not be publicly available in
either location (e.g., CBI). To inspect the
hard copy materials, please schedule an
appointment during normal business
hours with the contact listed in the FOR
FURTHER INFORMATION CONTACT section.
FOR FURTHER INFORMATION CONTACT:
Jeffrey Buss, EPA Region IX, (415) 947–
4152, buss.jeffrey@epa.gov.
SUPPLEMENTARY INFORMATION:
Throughout this document, ‘‘we’’, ‘‘us’’
and ‘‘our’’ refer to EPA.
I. General Information
A. Does This Action Apply to Me?
Regulated categories and entities
potentially affected by this proposed
action include:
SIC codes b
324110
422710
422720
2911
5171
5172
Examples of potentially regulated parties
Petroleum refiners.
Gasoline Marketers and Distributors.
American Industry Classification System (NAICS).
Industrial Classification (SIC) system code.
b Standard
VerDate Nov<24>2008
14:43 Jul 09, 2009
Jkt 217001
PO 00000
Frm 00026
Fmt 4702
Sfmt 4702
E:\FR\FM\10JYP1.SGM
10JYP1
]]>Agencies
[Federal Register Volume 74, Number 131 (Friday, July 10, 2009)]
[Proposed Rules]
[Pages 33192-33196]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: E9-16341]
=======================================================================
-----------------------------------------------------------------------
DEPARTMENT OF VETERANS AFFAIRS
38 CFR Part 59
RIN 2900-AM70
Grants to States for Construction or Acquisition of State Home
Facilities--Update of Authorized Beds
AGENCY: Department of Veterans Affairs.
ACTION: Proposed rule.
-----------------------------------------------------------------------
SUMMARY: The Department of Veterans Affairs (VA) proposes to amend its
regulations regarding grants to States for construction or acquisition
of State homes to update the maximum number of nursing home and
domiciliary beds designated for each State and to amend the definition
of ``State'' for purposes of these grants to include Guam, the
[[Page 33193]]
Northern Mariana Islands, and American Samoa.
DATES: Comments must be received on or before September 8, 2009.
ADDRESSES: Written comments may be submitted by: Mail or hand-delivery
to Director, Regulations Management (02REG), Department of Veterans
Affairs, 810 Vermont Avenue, NW., Room 1068, Washington, DC 20420; fax
to (202) 273-9026; or e-mail at https://www.regulations.gov. Comments
should indicate that they are submitted in response to ``RIN 2900-
AM70--Grants to States for Construction or Acquisition of State Home
Facilities--Update of Authorized Beds.'' All comments received will be
available for public inspection in the Office of Regulation Policy and
Management, Room 1063B, between the hours of 8 a.m. and 4:30 p.m.,
Monday through Friday (except holidays). Please call (202) 461-4902 for
an appointment. (This is not a toll-free number.) In addition, during
the comment period, comments may be viewed online through the Federal
Docket Management System (FDMS) at https://www.regulations.gov.
FOR FURTHER INFORMATION CONTACT: James F. Burris, MD, Chief Consultant,
Geriatrics and Extended Care State Home Construction Grant Program
(114), Veterans Health Administration, Department of Veterans Affairs,
810 Vermont Avenue, NW., Washington, DC 20420, (202) 461-6774.
SUPPLEMENTARY INFORMATION: Congress has authorized VA to provide grants
to States for the construction or acquisition of State home facilities
for the provision of care to veterans. See 38 U.S.C. 8131-8138. The
term ``State home'' means ``a home established by a State (other than a
possession) for veterans disabled by age, disease, or otherwise who by
reason of such disability are incapable of earning a living'' and
``includes such a home which furnishes nursing home care for
veterans.'' 38 U.S.C. 101(19). For purposes of State home grants, the
term ``State'' means each of the several States and Territories of the
United States, the District of Columbia, and the Commonwealth of Puerto
Rico, see 38 U.S.C. 101(20), but not possessions of the United States,
see 38 U.S.C. 101(19), 8131(2). The Department of the Interior, which
has administrative responsibility for coordinating Federal policy in
Island groups in the Insular Area, has identified Guam and American
Samoa as territories of the United States, and the Northern Mariana
Islands as a Commonwealth in Political Union with the United States,
which is treated as a U.S. territory for purposes of the State home
grant program, see VAOPGCCONCL 10-98. The regulatory definition of the
term ``State'' in current 38 CFR 59.2 already includes the several
States, the District of Columbia, the Commonwealth of Puerto Rico, and
the Virgin Islands. We propose to amend this definition to include
Guam, the Northern Mariana Islands, and American Samoa.
Section 8134(a)(2) of title 38, U.S.C., mandates that VA prescribe
for each State the number of nursing home and domiciliary beds for
which grants may be furnished, which the proposed note to 38 CFR
59.40(a) would refer to as a State's ``unmet need'' number. To compute
this number, VA estimates for each State the maximum number of nursing
home and domiciliary beds needed by veterans in that State (which is
the maximum number of such beds designated for each State, as shown on
the chart in proposed Sec. 59.40(a)), and then subtracts the number of
existing State home beds plus the number of those beds under
construction or that would be constructed in accordance with the
State's grant applications. In addition, section 8134(a)(3) mandates
that VA prioritize State home grant applications. The priorities set
forth in the law require VA to compute whether a State applying for a
grant has a great, significant, or limited need for State home beds. VA
currently uses a State's ``unmet need'' number to determine whether the
State has a great, significant, or limited need for new State home
beds. See 38 CFR 59.50(e).
The Veterans Millennium Health Care and Benefits Act (the ``Act'')
(Public Law 106-117, enacted on November 30, 1999) requires that, not
less often than every four years, VA must review and, as necessary,
revise the regulations concerning the maximum number of State home beds
designated for each State. 38 U.S.C. 8134(a)(4). Section 8134(a)(2)
requires that these numbers be based on the projected demand for
nursing home and domiciliary care on November 30, 2009 (10 years after
the date of enactment of the Act) by veterans who at such time are 65
years of age or older and who reside in that State. In 2001, VA
originally established the maximum number of State home beds for each
State based on the projected demand for such beds in 2009. See 66 FR
33845-46 (June 26, 2001). VA now believes that Congress intended VA to
recalculate the maximum number of beds for each State based on the
projected demand for care ten years in the future and that this method
would be consistent with the Act's requirement for establishing maximum
State home bed numbers. VA thus proposes to revise in proposed Sec.
59.40(a) the maximum bed numbers based on the projected demand from
veterans who, in 2020, are 65 years of age or older and who reside in
that State.
To compute the maximum number of beds for each State in compliance
with the Act, we first estimated the total number of veterans 65 years
of age or older residing in each State, projected to the year 2020. We
then totaled the projected population of these veterans at 8,672,045,
which would be an increase from the 2000 projected population of such
veterans in 2009. In computing these estimates, we considered many
factors, such as movement of these veterans to new States, the
mortality rate of these veterans, and the fact that the life expectancy
of these veterans is projected to be longer than before. We then
considered the projected total demand for nursing home and domiciliary
beds in State homes. In 2000, we estimated the demand in 2009 would be
for 55,299 State home beds nationwide. We believe that this estimated
demand may also be used for 2020, despite the estimated increase in the
projected veteran population, due to the many emerging alternatives to
institutional long-term care and advancing technologies, such as
Telehealth, Home-Based Primary Care, and Respite Care, and due to the
fact that veterans are choosing to stay longer in their own homes. VA's
philosophy is to provide extended care services in the least
restrictive environment that is safe for the veteran, and whenever
possible in non-institutional home and community-based settings. VA now
provides a spectrum of non-institutional extended care services
including home telehealth, homemaker/home health aide, skilled home
care, home-based primary care, adult day healthcare, in-home respite
care, and hospice and palliative care that were unavailable or not
widely available in 2000. VA has been increasing the capacity to
provide these services in recent years and will continue to do so in
order to meet the demand. Many similar services are now available in
the private sector through Medicare/Medicaid and long-term care
insurance, and some veterans will choose to avail themselves of those
services rather than seeking care from VA. The non-institutional
services make it possible for many veterans who would otherwise require
nursing home care to remain in their own homes, and reduce the need for
additional nursing home beds. New technologic advances that may become
available over the next decade, such as robotic assistive devices, will
also reduce the need for additional nursing home beds. It is
[[Page 33194]]
likely that these trends will offset the growth in population and mean
that no additional nursing home beds will be needed beyond those
previously projected. Should these assumptions prove incorrect, VA will
adjust the total number of beds in a future revision of this
regulation. ``We are specifically interested in comments concerning
this analysis and our estimate that the demand in 2020 for State home
beds will be for 55,299 nationwide.
We allocated the 55,299 beds based on the percentage of veterans
who in 2020 are projected to reside in each State. Although the
projected total demand for State home beds nationwide will remain the
same in 2020, some States will experience an increase and other States
a decrease in the maximum number of beds that are eligible to receive a
grant from the State Veterans Home Construction Grant program depending
on the projected population of veterans 65 years of age or over for
each State. The table below shows the changes in the maximum numbers of
beds for each State. We would welcome comments regarding our
projections for individual States.
----------------------------------------------------------------------------------------------------------------
New max of beds
State Old max of beds (based on 2020 Difference (+/
projections) -)
----------------------------------------------------------------------------------------------------------------
Alabama....................................... 883............................. 1007 124
Alaska........................................ 79.............................. 179 100
American Samoa................................ not applicable.................. 0 0
Arizona....................................... 1068............................ 1520 452
Arkansas...................................... 557............................. 653 96
California.................................... 5754............................ 4363 -1391
Colorado...................................... 717............................. 1114 397
Connecticut................................... 738............................. 559 -179
Delaware...................................... 165............................. 207 42
DC............................................ 104............................. 83 -21
Florida....................................... 4471............................ 4049 -422
Georgia....................................... 1202............................ 1975 773
Guam.......................................... not applicable.................. 12 12
Hawaii........................................ 216............................. 268 52
Idaho......................................... 233............................. 394 161
Illinois...................................... 2271............................ 1754 -517
Indiana....................................... 1209............................ 1216 7
Iowa.......................................... 632............................. 578 -54
Kansas........................................ 542............................. 518 -24
Kentucky...................................... 759............................. 818 59
Louisiana..................................... 785............................. 638 -147
Maine......................................... 301............................. 362 61
Maryland...................................... 1020............................ 1102 82
Massachusetts................................. 1348............................ 944 -404
Michigan...................................... 1896............................ 1786 -110
Minnesota..................................... 932............................. 1058 126
Mississippi................................... 500............................. 480 -20
Missouri...................................... 1230............................ 1257 27
Montana....................................... 198............................. 281 83
Nebraska...................................... 355............................. 371 16
Nevada........................................ 428............................. 649 221
New Hampshire................................. 264............................. 361 97
New Jersey.................................... 1683............................ 992 -691
New Mexico.................................... 344............................. 417 73
New York...................................... 3220............................ 2209 -1011
North Carolina................................ 1454............................ 1900 446
North Dakota.................................. 121............................. 137 16
Northern Mariana Islands...................... not applicable.................. 1 1
Ohio.......................................... 2530............................ 2143 -387
Oklahoma...................................... 747............................. 766 19
Oregon........................................ 804............................. 907 103
Pennsylvania.................................. 3173............................ 2336 -837
Puerto Rico................................... 350............................. 288 -62
Rhode Island.................................. 254............................. 157 -97
South Carolina................................ 750............................. 1089 339
South Dakota.................................. 155............................. 179 24
Tennessee..................................... 1050............................ 1311 261
Texas......................................... 3226............................ 4119 893
Utah.......................................... 304............................. 426 122
Vermont....................................... 124............................. 1312 1188
Virginia...................................... 1312............................ 1903 591
Virgin Islands................................ 8............................... 12 4
Washington.................................... 1215............................ 1687 472
West Virginia................................. 455............................. 406 -49
Wisconsin..................................... 1070............................ 1062 -8
Wyoming....................................... 93.............................. 154 61
----------------------------------------------------------------------------------------------------------------
[[Page 33195]]
In prioritizing applications to receive grants, VA identifies
States as having a ``great'', ``significant'', or ``limited'' need for
additional beds. ``Great'' need is defined as a need for 2,000 or more
new beds; ``significant'' need as a need for 1,000-1,999 new beds, and
``limited'' as a need for 999 or fewer new beds. A State that moves
into a higher priority category as a result of the reallocation of beds
in this rule will be more likely to receive a future grant than under
the current allocation of beds. A State that moves into a lower
priority category will be less likely to receive a future grant than
under the current allocation of beds. A State that remains within the
same priority category (even if the allocation of beds to the State
increases or decreases) will have an equal likelihood of receiving a
future grant under the new allocation as under the current allocation.
Our decision to use the same estimated demand for State home beds
nationwide in 2020, as that which was projected for 2009, would not
keep States from receiving grants for construction of new State home
beds. At this time, there are 28,823 recognized State home beds. In
addition, States are building facilities that when recognized will add
2,256 beds for a total of 31,079 beds. Therefore, States will soon have
in use 56 percent of the total estimated number of State home beds
needed in 2020. Of course, States will also need to replace existing
State home facilities that become obsolete or otherwise need replacing.
We thus believe that most States would continue to be able to apply for
State home grants if that is what the State chooses to do.
Unfunded Mandates
The Unfunded Mandates Reform Act of 1995 (2 U.S.C 1532) requires
that agencies prepare an assessment of anticipated costs and benefits
before issuing any rule that may result in an expenditure by the State,
local, or Tribal governments, in the aggregate, or by the private
sector, of $100 million or more (adjusted annually for inflation) in
any given year. This proposed rule would have no such effect on State,
local, or Tribal governments, or on the private sector.
Executive Order 12866
Executive Order 12866 directs agencies to assess all 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,
and other advantages; distributive impacts; and equity). The Executive
Order classifies 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 the Executive
Order. VA has examined the economic, interagency, budgetary, legal, and
policy implications of this proposed rule and has concluded that it
does constitute a significant regulatory action under the Executive
Order.
Paperwork Reduction Act
This document 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 proposed rule would 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. The proposed rule would affect grants to States and
would not directly affect small entities. Therefore, pursuant to 5
U.S.C. 605(b), this proposed rule would be exempt from the initial and
final regulatory flexibility analyses requirements of sections 603 and
604.
Catalog of Federal Domestic Assistance
The Catalog of Federal Domestic Assistance program number and title
for this proposed rule is as follows: 64.005, Grants to States for
Construction of State Home Facilities.
List of Subjects in 38 CFR Part 59
Administrative practice and procedure, Alcohol abuse, Alcoholism,
Claims, Day care, Dental health, Drug abuse, Foreign relations,
Government contracts, Grant programs--health, Grant programs--veterans,
Health care, Health facilities, Health professions, Health records,
Homeless, Medical and dental schools, Medical devices, Medical
research, Mental health programs, Nursing homes, Reporting and
recordkeeping requirements, Travel and transportation expenses, and
Veterans.
Approved: April 3, 2009.
John R. Gingrich,
Chief of Staff, Department of Veterans Affairs.
For the reasons stated above, the Department of Veterans Affairs
proposes to amend 38 CFR part 59 as follows:
PART 59--GRANTS TO STATES FOR CONSTRUCTION OR ACQUISITION OF STATE
HOMES
1. The authority citation for part 59 is revised to read as
follows:
Authority: 38 U.S.C. 101, 501, 1710, 1742, 8105, 8131-8138.
2. Amend Sec. 59.2 by revising the definition of ``State'' to read
as follows:
Sec. 59.2 Definitions.
* * * * *
State means each of the several States, the District of Columbia,
the Virgin Islands, the Commonwealth of Puerto Rico, Guam, the
Commonwealth of the Northern Mariana Islands, and American Samoa.
* * * * *
3. Amend Sec. 59.40 by revising paragraph (a) to read as follows:
Sec. 59.40 Maximum number of nursing home care and domiciliary care
beds for veterans by State.
(a) Except as provided in paragraph (b) of this section, a State
may not request a grant for a project to construct or acquire a new
State home facility, to increase the number of beds available at a
State home facility, or to replace beds at a State home facility if the
project would increase the total number of State home nursing home and
domiciliary beds in that State beyond the maximum number designated for
that State, as shown in the following chart. The provisions of 38
U.S.C. 8134 require VA to prescribe for each State the number of
nursing home and domiciliary beds for which grants may be furnished
(i.e., the unmet need). A State's unmet need for State home nursing
home and domiciliary beds is the number in the following chart for that
State minus the sum of the number of nursing home and domiciliary beds
in operation at State home facilities and the number of State home
nursing home and domiciliary beds not yet in operation but for which a
grant has either been requested or awarded under this part.
[[Page 33196]]
------------------------------------------------------------------------
Maximum number of
state home
nursing home &
State domiciliary beds
based on 2020
projections
------------------------------------------------------------------------
Alabama.............................................. 1,007
Alaska............................................... 179
American Samoa....................................... 0
Arizona.............................................. 1,520
Arkansas............................................. 653
California........................................... 4,363
Colorado............................................. 1,114
Connecticut.......................................... 559
Delaware............................................. 207
District of Columbia................................. 83
Florida.............................................. 4,049
Georgia.............................................. 1,975
Guam................................................. 12
Hawaii............................................... 268
Idaho................................................ 394
Illinois............................................. 1,754
Indiana.............................................. 1,216
Iowa................................................. 578
Kansas............................................... 518
Kentucky............................................. 818
Louisiana............................................ 638
Maine................................................ 362
Maryland............................................. 1,102
Massachusetts........................................ 944
Michigan............................................. 1,786
Minnesota............................................ 1,058
Mississippi.......................................... 480
Missouri............................................. 1,257
Montana.............................................. 281
Nebraska............................................. 371
Nevada............................................... 649
New Hampshire........................................ 361
New Jersey........................................... 992
New Mexico........................................... 417
New York............................................. 2,209
North Carolina....................................... 1,900
North Dakota......................................... 137
Northern Mariana Islands............................. 1
Ohio................................................. 2,143
Oklahoma............................................. 766
Oregon............................................... 907
Pennsylvania......................................... 2,336
Puerto Rico.......................................... 288
Rhode Island......................................... 157
South Carolina....................................... 1,089
South Dakota......................................... 179
Tennessee............................................ 1,311
Texas................................................ 4,119
Utah................................................. 426
Vermont.............................................. 142
Virginia............................................. 1,903
Virgin Islands....................................... 12
Washington........................................... 1,687
West Virginia........................................ 406
Wisconsin............................................ 1,062
Wyoming.............................................. 154
------------------------------------------------------------------------
Note to Sec. 59.40(a): The provisions of 38 U.S.C. 8134 require
that the ``unmet need'' numbers be based on a 10-year projection of
demand for nursing home and domiciliary care by veterans who at such
time are 65 years of age or older and who reside in that State. In
determining the projected demand, VA must take into account travel
distances for veterans and their families.
* * * * *
[FR Doc. E9-16341 Filed 7-9-09; 8:45 am]
BILLING CODE 8320-01-P
