Updating CDC's Contraception Guidance Documents: U.S. Medical Eligibility Criteria for Contraceptive Use and U.S. Selected Practice Recommendations for Contraceptive Use, 48706-48707 [2021-18769]
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48706
Federal Register / Vol. 86, No. 166 / Tuesday, August 31, 2021 / Notices
Atlanta, GA 30341. Telephone: 770–
488–5200. Email: usmecspr@cdc.gov.
SUPPLEMENTARY INFORMATION:
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;
correction.
AGENCY:
On August 19, 2021 the
Centers for Disease Control and
Prevention (CDC) in the Department of
Health and Human Services (HHS)
published a notice 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. The
notice did not include the mailing
address to submit public comment. This
notice provides the mailing address for
the public.
DATES: The document published on
August 19, 2021 (FR 86 46703).
Comments must be received by 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: 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.
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,
khammond on DSKJM1Z7X2PROD with NOTICES
SUMMARY:
VerDate Sep<11>2014
20:08 Aug 30, 2021
Jkt 253001
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
private or proprietary information such
as Social Security numbers, medical
PO 00000
Frm 00048
Fmt 4703
Sfmt 4703
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.
Supplementary Information: 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,
E:\FR\FM\31AUN1.SGM
31AUN1
Federal Register / Vol. 86, No. 166 / Tuesday, August 31, 2021 / Notices
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.
Sandra Cashman,
Executive Secretary, Centers for Disease
Control and Prevention.
[FR Doc. 2021–18769 Filed 8–30–21; 8:45 am]
BILLING CODE 4163–18–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Administration for Children and
Families
khammond on DSKJM1Z7X2PROD with NOTICES
Submission for OMB Review;
Monitoring and Compliance for ORR
Care Provider Facilities (0970–0564)
Office of Refugee Resettlement,
Administration for Children and
Families, Department of Health and
Human Services.
ACTION: Request for public comment.
AGENCY:
The Office of Refugee
Resettlement (ORR), Administration for
Children and Families (ACF), U.S.
SUMMARY:
VerDate Sep<11>2014
20:08 Aug 30, 2021
Jkt 253001
Department of Health and Human
Services (HHS), is proposing to continue
to collect information that will allow the
Unaccompanied Children (UC) Program
to monitor its care provider facilities for
compliance with federal and state laws
and regulations, licensing and
accreditation standards, ORR policies
and procedures, and child welfare
standards. These information
collections were originally approved
under emergency approval for 6 months.
This request is to continue data
collection.
DATES: Comments due within 30 days of
publication. OMB is required to make a
decision concerning 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: ORR received several
comments on this information
collection in response to the Federal
Register Notice published on
January 21, 2021, (86 FR 6340) and has
provided responses to those comments
in its final submission to OMB. UC Path
is critical to program operations and it
is important that rollout of the new
system not be delayed. Therefore, the
below description details what will be
included in the initial launch of the UC
Path case management system and
revisions based on public comments
will be made after initial launch. ORR
plans to conduct a deliberative review
of commenters’ suggestions and
concerns and submit a request for
revisions to this information collection
request in January 2022. The upcoming
information collection request will also
include revisions based on feedback
from UC Path system users (i.e., ORR
grantee, contractor, and federal staff).
The components of this information
request include:
1. Corrective Action Report (Form M–
1): This instrument is used by ORR
Monitoring Team staff (includes federal
and contractor staff), ORR Federal Field
Specialists, and ORR Project Officers to
document care provider noncompliance with minimum standards
for the care and timely release of UC;
PO 00000
Frm 00049
Fmt 4703
Sfmt 4703
48707
federal and state laws and regulations;
licensing standards; ORR policies and
procedures; and child welfare
standards. Care providers respond to
each corrective action cited by ORR staff
by entering a detail corrective action
plan into the instrument and attaching
any relevant supporting documents.
Then, ORR staff document when each
corrective action plan is completed to
ORR’s satisfaction and enter a final
determination.
2. FFS Compliance and Safety Site
Visit Report (Form M–3A): This
instrument is used by ORR Federal
Field Specialists to document site visit
observations and interview responses.
3. Out-of-Network Site Visit Report
(Form M–3B): This instrument is used
by ORR Federal Field Specialists to
document site visit observations and
interview responses for out-of-network
providers.
Checklists for a Child-Friendly
Environment
These instruments are used by care
providers on a voluntary basis to help
ensure compliance with ORR policies
and procedures related to maintaining a
safe, child-friendly environment. ORR
may also ask care providers to complete
the checklist prior to a site visit.
4. Checklist for a Child-Friendly
Environment—Care Provider
Facility (Form M–4A)
5. Checklist for a Child-Friendly
Environment—Individual Foster
Home (Form M–4B)
Incident Reviews
These instruments are used by ORR
care provider staff to provide
information to ORR on allegations of
sexual abuse or sexual harassment that
occurred in ORR care that were
investigated by local child protective
services, state licensing, local law
enforcement, the HHS Office of the
Inspector General, and/or the Federal
Bureau of Investigation. Care providers
submit the instrument to ORR’s
Prevention of Sexual Abuse Team for
review. Incident reviews help ensure
that care providers have appropriate
protective measures in place to prevent
a similar incident from occurring again.
6. UC Incident Review (Form M–5A):
This instrument is completed for
allegations of sexual abuse or sexual
harassment that occurred in ORR care
between two children. Changed the full
name of the form from ‘‘Sexual Abuse
and Sexual Harassment UAC Incident
Review’’ to ‘‘PSA UC Incident Review.’’
7. Adult Incident Review (Form M–
5B): This instrument is completed for
allegations of sexual abuse, sexual
harassment, or inappropriate sexual
E:\FR\FM\31AUN1.SGM
31AUN1
]]>Agencies
[Federal Register Volume 86, Number 166 (Tuesday, August 31, 2021)]
[Notices]
[Pages 48706-48707]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2021-18769]
[[Page 48706]]
-----------------------------------------------------------------------
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; correction.
-----------------------------------------------------------------------
SUMMARY: On August 19, 2021 the Centers for Disease Control and
Prevention (CDC) in the Department of Health and Human Services (HHS)
published a notice 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. The notice did not include
the mailing address to submit public comment. This notice provides the
mailing address for the public.
DATES: The document published on August 19, 2021 (FR 86 46703).
Comments must be received by 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: 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.
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 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.
Supplementary Information: 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,
[[Page 48707]]
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.
Sandra Cashman,
Executive Secretary, Centers for Disease Control and Prevention.
[FR Doc. 2021-18769 Filed 8-30-21; 8:45 am]
BILLING CODE 4163-18-P
