Proposed Data Collection Submitted for Public Comment and Recommendations, 84149-84151 [2024-24307]
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84149
Federal Register / Vol. 89, No. 203 / Monday, October 21, 2024 / Notices
increase in synthetic opioids, including
illicitly manufactured fentanyl (IMF),
and a resurgence of stimulants,
particularly methamphetamine, into the
illegal drug supply.
Multisector collaboration is critical to
preventing overdoses and saving lives.
Two key sectors in this response are
public health and public safety, as they
are both on the front lines and both
tasked with improving community
safety and well-being. CDC
demonstrates strong commitment to
public health/public safety partnerships
through implementation of several
national programs, including the
Overdose Response Strategy (ORS).
ORS teams support public health and
public safety entities in their
jurisdictions by:
• Sharing data systems to inform
rapid and effective community overdose
prevention efforts.
• Supporting immediate, evidencebased response efforts that can directly
reduce overdose deaths.
• Designing and using promising
strategies at the intersection of public
health and public safety.
• Disseminating information to
support the implementation of
evidence-informed overdose prevention
strategies.
As the ORS is one of CDC’s flagship
overdose prevention programs, and
partnering with public safety is one of
CDC’s key overdose prevention
strategies, a greater understanding of the
impact and effectiveness of the ORS is
needed to inform program
enhancements and improvements. This
ICR focuses on a survey and a reporting
tool that ORS teams and their partners
will complete to provide critical data to
CDC for program monitoring, to inform
technical assistance and guidance
documents produced by CDC or other
partners, and to assess the extent to
which the ORS program is achieving the
goal of supporting public health and
public safety partnerships to reduce
drug overdose. It will also provide CDC
with the capacity to respond in a timely
manner to requests for information
about the program from the Department
of Health and Human Services (HHS),
the White House, Congress, and other
sources. Information collected will be
disseminated to ORS teams and to the
public via an annual Program
Evaluation Report and an ORS Annual
Report. Data from both reports will
largely be used to develop programmatic
reports, tools, and implementation
guides for the purposes of program
improvement.
CDC requests OMB approval for an
estimated 633 annual burden hours.
There is no cost to respondents other
than their time to participate.
ESTIMATED ANNUALIZED BURDEN HOURS
Number of
responses per
respondent
Average
burden per
response
(in hours)
Total
burden
(in hours)
Form name
ORS Public Health Analysts .................
ORS Annual Evaluation Survey-PHA ..
ORS Quarterly Reporting Template .....
ORS Annual Evaluation Survey-DIO ...
ORS Quarterly Reporting Template .....
ORS Annual Evaluation Survey-Public
Health Partner.
ORS Annual Evaluation Survey-Public
Safety Partner.
ORS Annual Evaluation Survey-ORS
Management/Coordination Team.
61
61
61
61
70
1
4
1
4
1
30/60
1
30/60
1
30/60
31
244
31
244
35
70
1
30/60
35
25
1
30/60
13
...............................................................
......................
..........................
....................
633
ORS Drug Intelligence Officers ............
State, territory, county and city health
department staff.
HIDTA staff ...........................................
CDCF ORS National Team Staff ..........
Total ...............................................
Jeffrey M. Zirger,
Lead, Information Collection Review Office,
Office of Public Health Ethics and
Regulations, Office of Science, Centers for
Disease Control and Prevention.
[FR Doc. 2024–24303 Filed 10–18–24; 8:45 am]
BILLING CODE 4163–18–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Disease Control and
Prevention
[60Day–25–1274; Docket No. CDC–2024–
0080]
lotter on DSK11XQN23PROD with NOTICES1
Number of
respondents
Type of respondents
Proposed Data Collection Submitted
for Public Comment and
Recommendations
VerDate Sep<11>2014
16:27 Oct 18, 2024
Jkt 265001
CDC must receive written
comments on or before December 20,
2024.
DATES:
Centers for Disease Control and
Prevention (CDC), Department of Health
and Human Services (HHS).
ACTION: Notice with comment period.
AGENCY:
The Centers for Disease
Control and Prevention (CDC), as part of
its continuing effort to reduce public
burden and maximize the utility of
government information, invites the
general public and other federal
agencies the opportunity to comment on
a continuing information collection, as
required by the Paperwork Reduction
Act of 1995. This notice invites
comment on the Million Hearts®
Hospital & Health System Recognition
Program. This program recognizes
institutions working systematically to
improve the cardiovascular health of the
population and communities they serve.
SUMMARY:
You may submit comments,
identified by Docket No. CDC–2024–
0080 by either of the following methods:
ADDRESSES:
PO 00000
Frm 00041
Fmt 4703
Sfmt 4703
• Federal eRulemaking Portal:
www.regulations.gov. Follow the
instructions for submitting comments.
• Mail: Jeffrey M. Zirger, Information
Collection Review Office, Centers for
Disease Control and Prevention, 1600
Clifton Road NE, MS H21–8, Atlanta,
Georgia 30329.
Instructions: All submissions received
must include the agency name and
Docket Number. CDC will post, without
change, all relevant comments to
www.regulations.gov.
Please note: Submit all comments
through the Federal eRulemaking portal
(www.regulations.gov) or by U.S. mail to
the address listed above.
FOR FURTHER INFORMATION CONTACT: To
request more information on the
proposed project or to obtain a copy of
the information collection plan and
instruments, contact Jeffrey M. Zirger,
Information Collection Review Office,
Centers for Disease Control and
E:\FR\FM\21OCN1.SGM
21OCN1
84150
Federal Register / Vol. 89, No. 203 / Monday, October 21, 2024 / Notices
Prevention, 1600 Clifton Road NE, MS
H21–8, Atlanta, Georgia 30329;
Telephone: 404–639–7570; Email: omb@
cdc.gov.
SUPPLEMENTARY INFORMATION: Under the
Paperwork Reduction Act of 1995 (PRA)
(44 U.S.C. 3501–3520), federal agencies
must obtain approval from the Office of
Management and Budget (OMB) for each
collection of information they conduct
or sponsor. In addition, the PRA also
requires federal agencies to provide a
60-day notice in the Federal Register
concerning each proposed collection of
information, including each new
proposed collection, each proposed
extension of existing collection of
information, and each reinstatement of
previously approved information
collection before submitting the
collection to the OMB for approval. To
comply with this requirement, we are
publishing this notice of a proposed
data collection as described below.
The OMB is particularly interested in
comments that will help:
1. Evaluate whether the proposed
collection of information is necessary
for the proper performance of the
functions of the agency, including
whether the information will have
practical utility;
2. Evaluate the accuracy of the
agency’s estimate of the burden of the
proposed collection of information,
including the validity of the
methodology and assumptions used;
3. Enhance the quality, utility, and
clarity of the information to be
collected;
4. Minimize the burden of the
collection of information on those who
are to respond, including through the
use of appropriate automated,
electronic, mechanical, or other
technological collection techniques or
other forms of information technology,
e.g., permitting electronic submissions
of responses; and
5. Assess information collection costs.
lotter on DSK11XQN23PROD with NOTICES1
Proposed Project
Million Hearts® Hospitals & Health
Systems Recognition Program (OMB
Control No. 0920–1274, Exp. 10/31/
2025)—Extension—National Center for
Chronic Disease Prevention and Health
Promotion (NCCDPHP), Centers for
Disease Control and Prevention CDC).
Background and Brief Description
Heart disease, stroke and other
cardiovascular diseases (CVDs) kill over
VerDate Sep<11>2014
16:27 Oct 18, 2024
Jkt 265001
800,000 Americans each year,
accounting for one in every three
deaths. CVD is the nation’s number one
killer among both men and women and
the leading cause of health disparities.
Million Hearts®, a national, publicprivate initiative co-led by the Centers
for Disease Control and Prevention
(CDC) and the Centers for Medicare &
Medicaid Services (CMS), was
established to address this issue.
Whether migrating towards value-based
reimbursement or simply striving for a
significant impact in reducing the
devastation of heart attacks and strokes,
clinical organizations are positioned to
improve the health of the population
they serve by implementing highimpact, evidence-based strategies.
Achieving a Million Hearts® Hospitals &
Health Systems designation signals a
commitment to not only clinical quality,
but population health overall.
Initially launched in 2020, the
Program will continue to recognize
institutions that are working to
systematically improve the
cardiovascular health of the population
and communities that they serve by
implementing strategies under the
Million Hearts® priority areas of:
Keeping People Healthy; Optimizing
Care; Improving Outcomes for Priority
Populations; and Innovating for Health.
CDC anticipates that new applicants
will range from health systems with
multiple hospitals, hospitals with and
without ambulatory medical practices,
and medical practices not affiliated with
hospitals.
Any clinical entity whose leaders
consider it eligible may apply.
Recognition can be achieved by a robust
commitment to implement specific
strategies, by implementing specific
strategies, and most importantly, by
achieving specific outcomes. Applicants
will complete the Million Hearts®
Hospitals & Health Systems Recognition
Program application, indicating the
areas in which they are committing to
implement Million Hearts® strategies;
areas in which they have implemented
key strategies; and those strategies for
which they have achieved outcomes/
results. Applicants must address a
minimum of one strategy in at least
three of the four priority areas (Keeping
People Healthy, Optimizing Care,
Improving Outcomes for Priority
Populations, and Innovating for Health)
that are outlined in the application.
PO 00000
Frm 00042
Fmt 4703
Sfmt 4703
However, they are encouraged to target
as many strategies as is appropriate for
their institution. Applicants will be
subject to a background check.
The Million Hearts® Hospitals and
Health Systems designation conveys
that the institution is committed to
preventing heart attacks and strokes by
a combination of efforts that are about
Keeping People Healthy, Optimizing
Care, Improving Outcomes for Priority
Populations and Innovating for Health.
All applicants with reported outcomes
and a select number of those who are
committing to implement or are
implementing Million Hearts®
strategies, will be asked to participate in
a semi-structured, qualitative interview.
The purpose of the interview is to
obtain in-depth contextual information
about the Million Hearts® strategies and
facilitators used to achieve improved
cardiovascular outcomes among the
applicant’s patient population.
Applicants with reported outcomes will
receive increased recognition from
Million Hearts® by having their success
stories highlighted by Million Hearts®
by placement on the Million Hearts®
website, e-newsletter. The program’s
web-based application will stay open
throughout the year and applications
will be reviewed on a quarterly basis
and recognized within six months of
acceptable review. CDC estimates that
information will be collected from up to
50 applicants per year.
The overall goal of the Million
Hearts® initiative is to prevent one
million heart attacks and strokes.
Promoting evidence-based strategies
that prevent CVD is one focus of the
initiative. CDC will use the information
collected through the Million Hearts®
Hospitals & Health Systems Recognition
Program to increase widespread
attention on successful and sustainable
implementation strategies, improve
understanding of these strategies at the
practice level, bring visibility to
organizations that commit, implement,
or have implemented Million Hearts®
strategies and motivate other hospitals
and health systems to strengthen their
efforts to address CVD.
OMB approval is requested for three
years. CDC requests OMB approval for
an estimated 149 annual burden hours.
Participation is voluntarily and there are
no costs to respondents other than their
time.
E:\FR\FM\21OCN1.SGM
21OCN1
84151
Federal Register / Vol. 89, No. 203 / Monday, October 21, 2024 / Notices
ESTIMATED ANNUALIZED BURDEN HOURS
Number of
responses per
respondent
Avg.
burden per
response
(in hrs.)
Total
burden
(in hrs.)
Form name
Medical & Health Service Manager ......
Medical & Health Service Manager ......
Recognition Program Application .........
Interview Guide ....................................
50
30
1
1
160/60
30/60
134
15
Total ...............................................
...............................................................
......................
..........................
....................
149
Jeffrey M. Zirger,
Lead, Information Collection Review Office,
Office of Public Health Ethics and
Regulations, Office of Science, Centers for
Disease Control and Prevention.
[FR Doc. 2024–24307 Filed 10–18–24; 8:45 am]
BILLING CODE 4163–18–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Disease Control and
Prevention
[30Day–25–1355]
Agency Forms Undergoing Paperwork
Reduction Act Review
lotter on DSK11XQN23PROD with NOTICES1
Number of
respondents
Type of respondents
In accordance with the Paperwork
Reduction Act of 1995, the Centers for
Disease Control and Prevention (CDC)
has submitted the information
collection request titled ‘‘Evaluation of
the Overdose Data to Action Technical
Assistance Hub’’ to the Office of
Management and Budget (OMB) for
review and approval. CDC previously
published a ‘‘Proposed Data Collection
Submitted for Public Comment and
Recommendations’’ notice on May 7,
2024, to obtain comments from the
public and affected agencies. CDC
received one non-substantive public
comment related to the previous notice.
This notice serves to allow an additional
30 days for public and affected agency
comments.
CDC will accept all comments for this
proposed information collection project.
The Office of Management and Budget
is particularly interested in comments
that:
(a) Evaluate whether the proposed
collection of information is necessary
for the proper performance of the
functions of the agency, including
whether the information will have
practical utility;
(b) Evaluate the accuracy of the
agencies estimate of the burden of the
proposed collection of information,
including the validity of the
methodology and assumptions used;
(c) Enhance the quality, utility, and
clarity of the information to be
collected;
VerDate Sep<11>2014
16:27 Oct 18, 2024
Jkt 265001
(d) Minimize the burden of the
collection of information on those who
are to respond, including, through the
use of appropriate automated,
electronic, mechanical, or other
technological collection techniques or
other forms of information technology,
e.g., permitting electronic submission of
responses; and
(e) Assess information collection
costs.
To request additional information on
the proposed project or to obtain a copy
of the information collection plan and
instruments, call (404) 639–7570.
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. Direct written
comments and/or suggestions regarding
the items contained in this notice to the
Attention: CDC Desk Officer, Office of
Management and Budget, 725 17th
Street NW, Washington, DC 20503 or by
fax to (202) 395–5806. Provide written
comments within 30 days of notice
publication.
Proposed Project
Evaluation of the Overdose Data to
Action Technical Assistance Hub (OMB
Control No. 0920–1355, Exp. 11/30/
2024)—Revision—National Center for
Injury Prevention and Control (NCIPC),
Centers for Disease Control and
Prevention (CDC).
Background and Brief Description
The Centers for Disease Control and
Prevention (CDC) requests approval of
this Revision to support the evaluation
of technical assistance (TA) provided for
the Overdose Data to Action (OD2A) in
States (OD2A–S) and OD2A: Limiting
Overdose through Collaborative Actions
in Localities (LOCAL) (OD2A: LOCAL)
programs. OD2A–S and OD2A: LOCAL
are cooperative agreements funded in
2023 to focus on comprehensive and
interdisciplinary opioid overdose
prevention efforts in 49 state health
departments, 39 localities, Puerto Rico,
PO 00000
Frm 00043
Fmt 4703
Sfmt 4703
and Washington, DC. Each program
consists of two required components—
a surveillance component and a
prevention component. OD2A recipients
implement a combination of activities
across nine State strategies and eight
local strategies within these components
to gain access to high quality and
complete data on opioid prescribing and
overdoses. The data is used to inform
prevention and response efforts in their
jurisdictions.
CDC developed and deployed a
technical assistance (TA) hub (hereafter
referred to as the OD2A TA Center) to
deliver comprehensive technical
assistance and training to support the
successful implementation and
evaluation of surveillance and
prevention activities. The OD2A TA
Center is designed to enhance the
efficiency, coordination, and
effectiveness of TA efforts by
streamlining and centralizing the
provision of overdose surveillance and
prevention TA. TA to OD2A recipients
is divided into four different levels with
multiple modes of TA delivery and
involves a wide range of TA providers
including CDC staff, internal and
external subject matter experts (SMEs)
and program partners.
The evaluation consists of web-based
surveys designed to collect process and
outcome measures about TA access,
utilization, and outcomes across all
OD2A recipient programs. The
Technical Assistance Feedback Form
will be administered to collect
immediate feedback following
individual TA encounters and group
events such as webinars and in-person
trainings. The Annual OD2A TA Survey
will be distributed twice (mid-point and
final) to assess satisfaction with overall
TA provided and the extent to which
TA supports informed implementation
of OD2A strategies. The information
obtained through this evaluation will
allow TA providers to assess OD2A
recipients’ experience and utility of
knowledge and resources gained
through individual TA support, peer-topeer sessions, and other group trainings.
To capture participants’ experiences
attending various Communities of
E:\FR\FM\21OCN1.SGM
21OCN1
]]>Agencies
[Federal Register Volume 89, Number 203 (Monday, October 21, 2024)]
[Notices]
[Pages 84149-84151]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2024-24307]
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Disease Control and Prevention
[60Day-25-1274; Docket No. CDC-2024-0080]
Proposed Data Collection Submitted for Public Comment and
Recommendations
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), as part
of its continuing effort to reduce public burden and maximize the
utility of government information, invites the general public and other
federal agencies the opportunity to comment on a continuing information
collection, as required by the Paperwork Reduction Act of 1995. This
notice invites comment on the Million Hearts[supreg] Hospital & Health
System Recognition Program. This program recognizes institutions
working systematically to improve the cardiovascular health of the
population and communities they serve.
DATES: CDC must receive written comments on or before December 20,
2024.
ADDRESSES: You may submit comments, identified by Docket No. CDC-2024-
0080 by either of the following methods:
Federal eRulemaking Portal: www.regulations.gov. Follow
the instructions for submitting comments.
Mail: Jeffrey M. Zirger, Information Collection Review
Office, Centers for Disease Control and Prevention, 1600 Clifton Road
NE, MS H21-8, Atlanta, Georgia 30329.
Instructions: All submissions received must include the agency name
and Docket Number. CDC will post, without change, all relevant comments
to www.regulations.gov.
Please note: Submit all comments through the Federal eRulemaking
portal (www.regulations.gov) or by U.S. mail to the address listed
above.
FOR FURTHER INFORMATION CONTACT: To request more information on the
proposed project or to obtain a copy of the information collection plan
and instruments, contact Jeffrey M. Zirger, Information Collection
Review Office, Centers for Disease Control and
[[Page 84150]]
Prevention, 1600 Clifton Road NE, MS H21-8, Atlanta, Georgia 30329;
Telephone: 404-639-7570; Email: [email protected].
SUPPLEMENTARY INFORMATION: Under the Paperwork Reduction Act of 1995
(PRA) (44 U.S.C. 3501-3520), federal agencies must obtain approval from
the Office of Management and Budget (OMB) for each collection of
information they conduct or sponsor. In addition, the PRA also requires
federal agencies to provide a 60-day notice in the Federal Register
concerning each proposed collection of information, including each new
proposed collection, each proposed extension of existing collection of
information, and each reinstatement of previously approved information
collection before submitting the collection to the OMB for approval. To
comply with this requirement, we are publishing this notice of a
proposed data collection as described below.
The OMB is particularly interested in comments that will help:
1. Evaluate whether the proposed collection of information is
necessary for the proper performance of the functions of the agency,
including whether the information will have practical utility;
2. Evaluate the accuracy of the agency's estimate of the burden of
the proposed collection of information, including the validity of the
methodology and assumptions used;
3. Enhance the quality, utility, and clarity of the information to
be collected;
4. Minimize the burden of the collection of information on those
who are to respond, including through the use of appropriate automated,
electronic, mechanical, or other technological collection techniques or
other forms of information technology, e.g., permitting electronic
submissions of responses; and
5. Assess information collection costs.
Proposed Project
Million Hearts[supreg] Hospitals & Health Systems Recognition
Program (OMB Control No. 0920-1274, Exp. 10/31/2025)--Extension--
National Center for Chronic Disease Prevention and Health Promotion
(NCCDPHP), Centers for Disease Control and Prevention CDC).
Background and Brief Description
Heart disease, stroke and other cardiovascular diseases (CVDs) kill
over 800,000 Americans each year, accounting for one in every three
deaths. CVD is the nation's number one killer among both men and women
and the leading cause of health disparities. Million Hearts[supreg], a
national, public-private initiative co-led by the Centers for Disease
Control and Prevention (CDC) and the Centers for Medicare & Medicaid
Services (CMS), was established to address this issue. Whether
migrating towards value-based reimbursement or simply striving for a
significant impact in reducing the devastation of heart attacks and
strokes, clinical organizations are positioned to improve the health of
the population they serve by implementing high-impact, evidence-based
strategies. Achieving a Million Hearts[supreg] Hospitals & Health
Systems designation signals a commitment to not only clinical quality,
but population health overall.
Initially launched in 2020, the Program will continue to recognize
institutions that are working to systematically improve the
cardiovascular health of the population and communities that they serve
by implementing strategies under the Million Hearts[supreg] priority
areas of: Keeping People Healthy; Optimizing Care; Improving Outcomes
for Priority Populations; and Innovating for Health. CDC anticipates
that new applicants will range from health systems with multiple
hospitals, hospitals with and without ambulatory medical practices, and
medical practices not affiliated with hospitals.
Any clinical entity whose leaders consider it eligible may apply.
Recognition can be achieved by a robust commitment to implement
specific strategies, by implementing specific strategies, and most
importantly, by achieving specific outcomes. Applicants will complete
the Million Hearts[supreg] Hospitals & Health Systems Recognition
Program application, indicating the areas in which they are committing
to implement Million Hearts[supreg] strategies; areas in which they
have implemented key strategies; and those strategies for which they
have achieved outcomes/results. Applicants must address a minimum of
one strategy in at least three of the four priority areas (Keeping
People Healthy, Optimizing Care, Improving Outcomes for Priority
Populations, and Innovating for Health) that are outlined in the
application. However, they are encouraged to target as many strategies
as is appropriate for their institution. Applicants will be subject to
a background check.
The Million Hearts[supreg] Hospitals and Health Systems designation
conveys that the institution is committed to preventing heart attacks
and strokes by a combination of efforts that are about Keeping People
Healthy, Optimizing Care, Improving Outcomes for Priority Populations
and Innovating for Health. All applicants with reported outcomes and a
select number of those who are committing to implement or are
implementing Million Hearts[supreg] strategies, will be asked to
participate in a semi-structured, qualitative interview. The purpose of
the interview is to obtain in-depth contextual information about the
Million Hearts[supreg] strategies and facilitators used to achieve
improved cardiovascular outcomes among the applicant's patient
population. Applicants with reported outcomes will receive increased
recognition from Million Hearts[supreg] by having their success stories
highlighted by Million Hearts[supreg] by placement on the Million
Hearts[supreg] website, e-newsletter. The program's web-based
application will stay open throughout the year and applications will be
reviewed on a quarterly basis and recognized within six months of
acceptable review. CDC estimates that information will be collected
from up to 50 applicants per year.
The overall goal of the Million Hearts[supreg] initiative is to
prevent one million heart attacks and strokes. Promoting evidence-based
strategies that prevent CVD is one focus of the initiative. CDC will
use the information collected through the Million Hearts[supreg]
Hospitals & Health Systems Recognition Program to increase widespread
attention on successful and sustainable implementation strategies,
improve understanding of these strategies at the practice level, bring
visibility to organizations that commit, implement, or have implemented
Million Hearts[supreg] strategies and motivate other hospitals and
health systems to strengthen their efforts to address CVD.
OMB approval is requested for three years. CDC requests OMB
approval for an estimated 149 annual burden hours. Participation is
voluntarily and there are no costs to respondents other than their
time.
[[Page 84151]]
Estimated Annualized Burden Hours
----------------------------------------------------------------------------------------------------------------
Avg. burden
Number of Number of per Total
Type of respondents Form name respondents responses per response burden (in
respondent (in hrs.) hrs.)
----------------------------------------------------------------------------------------------------------------
Medical & Health Service Manager. Recognition Program 50 1 160/60 134
Application.
Medical & Health Service Manager. Interview Guide..... 30 1 30/60 15
--------------------------------------------------------
Total........................ .................... ............ ............... ........... 149
----------------------------------------------------------------------------------------------------------------
Jeffrey M. Zirger,
Lead, Information Collection Review Office, Office of Public Health
Ethics and Regulations, Office of Science, Centers for Disease Control
and Prevention.
[FR Doc. 2024-24307 Filed 10-18-24; 8:45 am]
BILLING CODE 4163-18-P
