Updating CDC's Contraception Guidance Documents: U.S. Medical Eligibility Criteria for Contraceptive Use and U.S. Selected Practice Recommendations for Contraceptive Use, 46703-46704 [2021-17818]

Download as PDF Federal Register / Vol. 86, No. 158 / Thursday, August 19, 2021 / Notices lotter on DSK11XQN23PROD with NOTICES1 Control Act (Act) (12 U.S.C. 1817(j)) and § 225.41 of the Board’s Regulation Y (12 CFR 225.41) to acquire shares of a bank or bank holding company. The factors that are considered in acting on the applications are set forth in paragraph 7 of the Act (12 U.S.C. 1817(j)(7)). The public portions of the applications listed below, as well as other related filings required by the Board, if any, are available for immediate inspection at the Federal Reserve Bank(s) indicated below and at the offices of the Board of Governors. This information may also be obtained on an expedited basis, upon request, by contacting the appropriate Federal Reserve Bank and from the Board’s Freedom of Information Office at https://www.federalreserve.gov/foia/ request.htm. Interested persons may express their views in writing on the standards enumerated in paragraph 7 of the Act. Comments regarding each of these applications must be received at the Reserve Bank indicated or the offices of the Board of Governors, Ann E. Misback, Secretary of the Board, 20th Street and Constitution Avenue NW, Washington, DC 20551–0001, not later than September 3, 2021. A. Federal Reserve Bank of Minneapolis (Chris P. Wangen, Assistant Vice President) 90 Hennepin Avenue, Minneapolis, Minnesota 55480–0291: 1. Daniel Otten, Hayward, Minnesota; to retain voting shares of Minnesota Community Bancshares, Inc., Albert Lea, Minnesota, and thereby indirectly retain voting shares of Arcadian Bank, Hartland, Minnesota. B. Federal Reserve Bank of Kansas City (Jeffrey Imgarten, Assistant Vice President) 1 Memorial Drive, Kansas City, Missouri 64198–0001: 1. Kathleen Sullivan, Cedar Rapids, Nebraska; to join the Sullivan Family Group, a group acting in concert, to acquire voting shares of Cedar Rapids State Company, and thereby indirectly acquire voting shares of Cedar Rapids State Bank, both of Cedar Rapids, Nebraska. Board of Governors of the Federal Reserve System, August 16, 2021. Michele Taylor Fennell, Deputy Associate Secretary of the Board. [FR Doc. 2021–17817 Filed 8–18–21; 8:45 am] BILLING CODE P VerDate Sep<11>2014 17:28 Aug 18, 2021 Jkt 253001 DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention [Docket No. CDC–2021–0088] Updating CDC’s Contraception Guidance Documents: U.S. Medical Eligibility Criteria for Contraceptive Use and U.S. Selected Practice Recommendations for Contraceptive Use Centers for Disease Control and Prevention (CDC), Department of Health and Human Services (HHS). ACTION: Notice with comment period. AGENCY: SUMMARY: The Centers for Disease Control and Prevention (CDC) in the Department of Health and Human Services (HHS) announces the opening of a docket to obtain comment on CDC’s contraception recommendations. Two guidance documents, U.S. Medical Eligibility Criteria for Contraceptive Use (US MEC) and U.S. Selected Practice Recommendations for Contraceptive Use (US SPR), provide evidence-based recommendations to assist health care providers when counseling patients on contraceptive choice and use. Updates to these guidance documents typically occur every 5 years. As part of the planning process for the next update, CDC is requesting public comment on content to consider for revision or addition to the recommendations and how to improve the implementation of the guidance documents. This action is necessary to consider multiple and diverse perspectives and ensure that the documents meet the needs of U.S. health care providers and the persons they serve. DATES: Written comments must be received on or before October 18, 2021. ADDRESSES: You may submit comments, identified by Docket No. CDC–2021– 0088 by any of the following methods: • Federal eRulemaking Portal: https:// www.regulations.gov. Follow the instructions for submitting comments. • Mail: [insert complete mailing address, including mailstop] Instructions: All submissions received must include the agency name and Docket Number. All relevant comments received will be posted without change to https://regulations.gov, including any personal information provided. For access to the docket to read background documents or comments received, go to https://www.regulations.gov. FOR FURTHER INFORMATION CONTACT: Kathryn M. Curtis, Ph.D., Division of Reproductive Health, Centers for PO 00000 Frm 00031 Fmt 4703 Sfmt 4703 46703 Disease Control and Prevention, 4770 Buford Highway NE, MS S107–2, Atlanta, GA 30341. Telephone: 770– 488–5200. Email: usmecspr@cdc.gov. SUPPLEMENTARY INFORMATION: Public Participation Interested persons or organizations are invited to participate by submitting written views, recommendations, and data. CDC invites comments specifically on the following questions: 1. Are there existing US MEC or US SPR recommendations that CDC should consider reviewing for possible revision, based on new evidence or other justification? Please provide references to new evidence and justification to support review of existing recommendations. 2. Are there new recommendations that CDC should consider adding to the US MEC? This could include eligibility criteria for contraceptive use among people with medical conditions or characteristics not currently included in the US MEC. Please provide references to supporting evidence, justification, and impact of new recommendations. 3. Are there new recommendations that CDC should consider adding to the US SPR? This could include clinical practice recommendations to address issues regarding initiation and use of specific contraceptive methods not currently included in the US SPR. Please provide references to supporting evidence, justification, and impact of new recommendations. 4. Are there other issues that should be considered or suggestions to improve implementation of the US MEC and US SPR recommendations to help ensure equitable access to contraceptive services (such as better ways of presenting the recommendations, additional job aids or tools for providers, broader dissemination and implementation strategies, inclusion of additional partners, etc.)? Please provide references to supporting evidence or justification. Please note that comments received, including attachments and other supporting materials, are part of the public record and are subject to public disclosure. Comments will be posted on https://www.regulations.gov. Therefore, do not include any information in your comment or supporting materials that you consider confidential or inappropriate for public disclosure. If you include your name, contact information, or other information that identifies you in the body of your comments, that information will be on public display. CDC will review all submissions and may choose to redact, or withhold, submissions containing E:\FR\FM\19AUN1.SGM 19AUN1 lotter on DSK11XQN23PROD with NOTICES1 46704 Federal Register / Vol. 86, No. 158 / Thursday, August 19, 2021 / Notices private or proprietary information such as Social Security numbers, medical information, inappropriate language, or duplicate/near duplicate examples of a mass-mail campaign. CDC will carefully consider all comments submitted in preparation of the final document. In 2017–2019 in the United States, 65% of women aged 15–49 years used contraception; the most common contraceptive methods used were female sterilization, oral contraceptive pills, implants and intrauterine devices, and male condoms [1]. The majority (61%) of U.S. women aged 18–49 years have ongoing or potential need for contraceptive services [2]. Similarly, in 2010–2016, about 60% of men aged 15– 44 years in the United States needed family planning [3]. Equitable access to evidence-based, high quality care is critical to meeting the needs of persons seeking contraceptive services, improving reproductive autonomy, and reducing unintended pregnancy in the United States [2]. Since 2010, CDC has published evidence-based recommendations on contraception provision. These recommendations are intended to assist health care providers when they counsel patients about choice and use of contraceptive methods, with the goal of reducing medical barriers to contraception access. U.S. Medical Eligibility Criteria for Contraceptive Use, 2016 (US MEC) comprises recommendations for the use of specific contraceptive methods by persons with certain characteristics or medical conditions, such as diabetes, hypertension, and being postpartum or breastfeeding [4]. U.S. Selected Practice Recommendations for Contraceptive Use, 2016 (US SPR) addresses common, yet sometimes complex, issues regarding initiation and use of specific contraceptive methods, such as examinations or tests needed before starting a method and management of side effects [5]. Both guidance documents are adapted from global guidance developed by the World Health Organization (WHO) and are based on review of the scientific evidence and consultation with national experts. CDC partners with other federal agencies and professional organizations in the development, dissemination, and implementation of the guidance documents to improve access to contraception and quality of family planning services. CDC is committed to ensuring that the US MEC and US SPR recommendations are reviewed and updated as new scientific evidence becomes available. Working with WHO, CDC continuously monitors peer-reviewed literature and VerDate Sep<11>2014 17:28 Aug 18, 2021 Jkt 253001 updates recommendations as needed, with comprehensive reviews approximately every 5 years. CDC is currently planning for the next update of the US MEC and US SPR and will consider public comments when determining the scope of the guidance update. CDC is seeking feedback from health care providers, professional organizations, community-based organizations, organizations that seek to improve reproductive health, patient advocacy groups, and the public. The current US MEC may be found at the Supplementary Materials tab of the docket and at https://www.cdc.gov/ reproductivehealth/contraception/ mmwr/mec/summary.html. The current US SPR may be found at the Supplementary Materials tab of the docket and at https://www.cdc.gov/ reproductivehealth/contraception/ mmwr/spr/summary.html. References 1. Daniels K, Abma JC. Current contraceptive status among women aged 15–49: United States, 2017–2019. NCHS Data Brief 2020:388;1–8. 2. Zapata LB, Pazol K, Curtis KM et al. Need for contraceptive services among women of reproductive age—45 jurisdictions, United States, 2017–2019. MMWR Morb Mortal Wkly Rep 2021;70:910–15. 3. Marcell AV, Gibbs SE, Choiriyyah I et al. National needs of family planning among US men aged 15 to 44 years. Am J Public Health 2016:106;733–9. 4. Curtis KM, Tepper NK, Jatlaoui TC, et al. U.S. medical eligibility criteria for contraceptive use, 2016. MMWR Recomm Rep 2016;65(RR–3):1–103. 5. Curtis KM, Jatlaoui TC, Tepper NK, et al. U.S. selected practice recommendations for contraceptive use, 2016. MMWR Recomm Rep 2016;65(RR–4):1–66. Dated: August 16, 2021. Sandra Cashman, Executive Secretary, Centers for Disease Control and Prevention. [FR Doc. 2021–17818 Filed 8–18–21; 8:45 am] BILLING CODE 4163–18–P DEPARTMENT OF HEALTH AND HUMAN SERVICES Administration for Children and Families Submission for OMB Review; Tribal Maternal, Infant, and Early Childhood Home Visiting Program: Guidance for Submitting an Annual Report to the Secretary (OMB #0970–0409) Office of Child Care, Administration for Children and Families, HHS. ACTION: Request for public comment. AGENCY: PO 00000 Frm 00032 Fmt 4703 Sfmt 4703 SUMMARY: The Administration for Children and Families (ACF), Office of Child Care (OCC) is requesting a 3-year extension of the Tribal Maternal, Infant, and Early Childhood Home Visiting (MIECHV) Program: Guidance for Submitting an Annual Report to the Secretary (OMB #0970–0409; expiration 9/30/2021). There are minor updates to the annual guidance which reflects a change in timing for the due date of the final report. DATES: Comments due within 30 days of publication. OMB must make a decision about the collection of information between 30 and 60 days after publication of this document in the Federal Register. Therefore, a comment is best assured of having its full effect if OMB receives it within 30 days of publication. ADDRESSES: Written comments and recommendations for the proposed information collection should be sent within 30 days of publication of this notice to www.reginfo.gov/public/do/ PRAMain. Find this particular information collection by selecting ‘‘Currently under 30-day Review—Open for Public Comments’’ or by using the search function. SUPPLEMENTARY INFORMATION: Description: Section 511(e)(8)(A) of Title V of the Social Security Act requires that grantees under the MIECHV program for states and jurisdictions submit an annual report to the Secretary of Health and Human Services regarding the program and activities carried out under the program, including such data and information as the Secretary shall require. Section 511(h)(2)(A) further states that the requirements for the MIECHV grants to tribes, tribal organizations, and urban Indian organizations are to be consistent, to the greatest extent practicable, with the requirements for grantees under the MIECHV program for states and jurisdictions. OCC, in collaboration with the Health Resources and Services Administration, Maternal and Child Health Bureau awarded grants for the Tribal MIECHV Program (Tribal Home Visiting) to support cooperative agreements to conduct community needs assessments; plan for and implement high-quality, culturally-relevant, evidence-based home visiting programs in at-risk tribal communities; establish, measure, and report on progress toward meeting performance measures in six legislatively-mandated benchmark areas; and conduct rigorous evaluation activities to build the knowledge base on home visiting among Native populations. E:\FR\FM\19AUN1.SGM 19AUN1

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[Federal Register Volume 86, Number 158 (Thursday, August 19, 2021)]
[Notices]
[Pages 46703-46704]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2021-17818]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention

[Docket No. CDC-2021-0088]


Updating CDC's Contraception Guidance Documents: U.S. Medical 
Eligibility Criteria for Contraceptive Use and U.S. Selected Practice 
Recommendations for Contraceptive Use

AGENCY: Centers for Disease Control and Prevention (CDC), Department of 
Health and Human Services (HHS).

ACTION: Notice with comment period.

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

SUMMARY: The Centers for Disease Control and Prevention (CDC) in the 
Department of Health and Human Services (HHS) announces the opening of 
a docket to obtain comment on CDC's contraception recommendations. Two 
guidance documents, U.S. Medical Eligibility Criteria for Contraceptive 
Use (US MEC) and U.S. Selected Practice Recommendations for 
Contraceptive Use (US SPR), provide evidence-based recommendations to 
assist health care providers when counseling patients on contraceptive 
choice and use. Updates to these guidance documents typically occur 
every 5 years. As part of the planning process for the next update, CDC 
is requesting public comment on content to consider for revision or 
addition to the recommendations and how to improve the implementation 
of the guidance documents. This action is necessary to consider 
multiple and diverse perspectives and ensure that the documents meet 
the needs of U.S. health care providers and the persons they serve.

DATES: Written comments must be received on or before October 18, 2021.

ADDRESSES: You may submit comments, identified by Docket No. CDC-2021-
0088 by any of the following methods:
     Federal eRulemaking Portal: https://www.regulations.gov. 
Follow the instructions for submitting comments.
     Mail: [insert complete mailing address, including 
mailstop]
    Instructions: All submissions received must include the agency name 
and Docket Number. All relevant comments received will be posted 
without change to https://regulations.gov, including any personal 
information provided. For access to the docket to read background 
documents or comments received, go to https://www.regulations.gov.

FOR FURTHER INFORMATION CONTACT: Kathryn M. Curtis, Ph.D., Division of 
Reproductive Health, Centers for Disease Control and Prevention, 4770 
Buford Highway NE, MS S107-2, Atlanta, GA 30341. Telephone: 770-488-
5200. Email: [email protected].

SUPPLEMENTARY INFORMATION:

Public Participation

    Interested persons or organizations are invited to participate by 
submitting written views, recommendations, and data. CDC invites 
comments specifically on the following questions:
    1. Are there existing US MEC or US SPR recommendations that CDC 
should consider reviewing for possible revision, based on new evidence 
or other justification? Please provide references to new evidence and 
justification to support review of existing recommendations.
    2. Are there new recommendations that CDC should consider adding to 
the US MEC? This could include eligibility criteria for contraceptive 
use among people with medical conditions or characteristics not 
currently included in the US MEC. Please provide references to 
supporting evidence, justification, and impact of new recommendations.
    3. Are there new recommendations that CDC should consider adding to 
the US SPR? This could include clinical practice recommendations to 
address issues regarding initiation and use of specific contraceptive 
methods not currently included in the US SPR. Please provide references 
to supporting evidence, justification, and impact of new 
recommendations.
    4. Are there other issues that should be considered or suggestions 
to improve implementation of the US MEC and US SPR recommendations to 
help ensure equitable access to contraceptive services (such as better 
ways of presenting the recommendations, additional job aids or tools 
for providers, broader dissemination and implementation strategies, 
inclusion of additional partners, etc.)? Please provide references to 
supporting evidence or justification.
    Please note that comments received, including attachments and other 
supporting materials, are part of the public record and are subject to 
public disclosure. Comments will be posted on https://www.regulations.gov. Therefore, do not include any information in your 
comment or supporting materials that you consider confidential or 
inappropriate for public disclosure. If you include your name, contact 
information, or other information that identifies you in the body of 
your comments, that information will be on public display. CDC will 
review all submissions and may choose to redact, or withhold, 
submissions containing

[[Page 46704]]

private or proprietary information such as Social Security numbers, 
medical information, inappropriate language, or duplicate/near 
duplicate examples of a mass-mail campaign. CDC will carefully consider 
all comments submitted in preparation of the final document.
    In 2017-2019 in the United States, 65% of women aged 15-49 years 
used contraception; the most common contraceptive methods used were 
female sterilization, oral contraceptive pills, implants and 
intrauterine devices, and male condoms [1]. The majority (61%) of U.S. 
women aged 18-49 years have ongoing or potential need for contraceptive 
services [2]. Similarly, in 2010-2016, about 60% of men aged 15-44 
years in the United States needed family planning [3]. Equitable access 
to evidence-based, high quality care is critical to meeting the needs 
of persons seeking contraceptive services, improving reproductive 
autonomy, and reducing unintended pregnancy in the United States [2].
    Since 2010, CDC has published evidence-based recommendations on 
contraception provision. These recommendations are intended to assist 
health care providers when they counsel patients about choice and use 
of contraceptive methods, with the goal of reducing medical barriers to 
contraception access. U.S. Medical Eligibility Criteria for 
Contraceptive Use, 2016 (US MEC) comprises recommendations for the use 
of specific contraceptive methods by persons with certain 
characteristics or medical conditions, such as diabetes, hypertension, 
and being postpartum or breastfeeding [4]. U.S. Selected Practice 
Recommendations for Contraceptive Use, 2016 (US SPR) addresses common, 
yet sometimes complex, issues regarding initiation and use of specific 
contraceptive methods, such as examinations or tests needed before 
starting a method and management of side effects [5]. Both guidance 
documents are adapted from global guidance developed by the World 
Health Organization (WHO) and are based on review of the scientific 
evidence and consultation with national experts. CDC partners with 
other federal agencies and professional organizations in the 
development, dissemination, and implementation of the guidance 
documents to improve access to contraception and quality of family 
planning services.
    CDC is committed to ensuring that the US MEC and US SPR 
recommendations are reviewed and updated as new scientific evidence 
becomes available. Working with WHO, CDC continuously monitors peer-
reviewed literature and updates recommendations as needed, with 
comprehensive reviews approximately every 5 years. CDC is currently 
planning for the next update of the US MEC and US SPR and will consider 
public comments when determining the scope of the guidance update. CDC 
is seeking feedback from health care providers, professional 
organizations, community-based organizations, organizations that seek 
to improve reproductive health, patient advocacy groups, and the 
public.
    The current US MEC may be found at the Supplementary Materials tab 
of the docket and at https://www.cdc.gov/reproductivehealth/contraception/mmwr/mec/summary.html. The current US SPR may be found at 
the Supplementary Materials tab of the docket and at https://www.cdc.gov/reproductivehealth/contraception/mmwr/spr/summary.html.

References

1. Daniels K, Abma JC. Current contraceptive status among women aged 
15-49: United States, 2017-2019. NCHS Data Brief 2020:388;1-8.
2. Zapata LB, Pazol K, Curtis KM et al. Need for contraceptive 
services among women of reproductive age--45 jurisdictions, United 
States, 2017-2019. MMWR Morb Mortal Wkly Rep 2021;70:910-15.
3. Marcell AV, Gibbs SE, Choiriyyah I et al. National needs of 
family planning among US men aged 15 to 44 years. Am J Public Health 
2016:106;733-9.
4. Curtis KM, Tepper NK, Jatlaoui TC, et al. U.S. medical 
eligibility criteria for contraceptive use, 2016. MMWR Recomm Rep 
2016;65(RR-3):1-103.
5. Curtis KM, Jatlaoui TC, Tepper NK, et al. U.S. selected practice 
recommendations for contraceptive use, 2016. MMWR Recomm Rep 
2016;65(RR-4):1-66.

    Dated: August 16, 2021.
Sandra Cashman,
Executive Secretary, Centers for Disease Control and Prevention.
[FR Doc. 2021-17818 Filed 8-18-21; 8:45 am]
BILLING CODE 4163-18-P

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