Department of Health and Human Services July 2017 – Federal Register Recent Federal Regulation Documents

National Committee on Vital and Health Statistics: Meeting
Document Number: 2017-16036
Type: Notice
Date: 2017-07-31
Agency: Department of Health and Human Services
Developing a Framework for Regulatory Use of Real-World Evidence; Public Workshop
Document Number: 2017-16021
Type: Notice
Date: 2017-07-31
Agency: Food and Drug Administration, Department of Health and Human Services
The Food and Drug Administration (FDA, the Agency, or we) is announcing the following public workshop entitled ``Developing a Framework for Regulatory Use of Real-World Evidence.'' Convened by the Duke-Robert J. Margolis, MD, Center for Health Policy at Duke University and supported by a cooperative agreement with FDA, the purpose of the public workshop is to bring the stakeholder community together to discuss a variety of topics related to the use of real- world data (RWD) and real-world evidence (RWE) in drug development and regulatory decision making. Topics will include an update on FDA's activities to address the use of RWE in regulatory decisions and the development of a framework for tackling challenges related to RWE's regulatory acceptability. In addition, panelists will discuss opportunities to improve data development activities, study designs, and analytical methods used to create robust RWE.
Agency Information Collection Activities: Proposed Collection; Comment Request
Document Number: 2017-16016
Type: Notice
Date: 2017-07-31
Agency: Centers for Medicare & Medicaid Services, Department of Health and Human Services
The Centers for Medicare & Medicaid Services (CMS) is announcing an opportunity for the public to comment on CMS' intention to collect information from the public. Under the Paperwork Reduction Act of 1995 (the PRA), federal agencies are required to publish notice in the Federal Register concerning each proposed collection of information (including each proposed extension or reinstatement of an existing collection of information) and to allow 60 days for public comment on the proposed action. Interested persons are invited to send comments regarding our burden estimates or any other aspect of this collection of information, including the necessity and utility of the proposed information collection for the proper performance of the agency's functions, the accuracy of the estimated burden, ways to enhance the quality, utility, and clarity of the information to be collected, and the use of automated collection techniques or other forms of information technology to minimize the information collection burden.
Cardiac Troponin Assays; Public Workshop; Request for Comments
Document Number: 2017-16007
Type: Notice
Date: 2017-07-31
Agency: Food and Drug Administration, Department of Health and Human Services
The Food and Drug Administration (FDA, the Agency, or we) is announcing the following public workshop entitled ``Cardiac Troponin Assays.'' The purpose of the workshop is to discuss the development of innovative troponin assays designed to aid in the diagnosis of myocardial infarction (MI) and additional clinical uses of these assays. The workshop is intended to enhance engagement with stakeholders to facilitate device development and to discuss scientific and regulatory challenges associated with the analytical and clinical validation methods for troponin assay devices. Public input and feedback gained through this workshop may aid in the development of science-based approaches to aid in the efficient development of innovative, safe and effective, troponin diagnostic assays, which may lead to better patient care.
National Institute on Deafness and Other Communication Disorders; Notice of Meeting
Document Number: 2017-16006
Type: Notice
Date: 2017-07-31
Agency: Department of Health and Human Services, National Institutes of Health
National Heart, Lung, and Blood Institute; Notice of Closed Meetings
Document Number: 2017-16005
Type: Notice
Date: 2017-07-31
Agency: Department of Health and Human Services, National Institutes of Health
Substance Abuse and Mental Health Services Administration; Notice of Meeting
Document Number: 2017-15990
Type: Notice
Date: 2017-07-31
Agency: Department of Health and Human Services
Health Insurance MarketplaceSM
Document Number: 2017-15960
Type: Notice
Date: 2017-07-31
Agency: Centers for Medicare & Medicaid Services, Department of Health and Human Services
This notice announces the renewal of the charter of the Advisory Panel on Outreach and Education APOE (the Panel) in accordance with the Federal Advisory Committee Act. The Panel advises and makes recommendations to the Secretary of the U.S. Department of Health and Human Services (HHS) and the Administrator of the Centers for Medicare & Medicaid Services (CMS) on opportunities to enhance the effectiveness of consumer education strategies concerning the Health Insurance Marketplace\SM\, Medicare, Medicaid, and the Children's Health Insurance Program (CHIP). Additional information about the Panel is available on the Internet at: https://www.cms.gov/Regulations-and- Guidance/Guidance/FACA/APOE.html. Press inquiries are handled through the CMS Press Office at (202) 690-6145.
Notice of Delivery Area Designation for the Pamunkey Indian Tribe
Document Number: 2017-15963
Type: Notice
Date: 2017-07-28
Agency: Department of Health and Human Services, Indian Health Service
Notice is hereby given that Indian Health Service (IHS) is establishing the geographic boundaries of the Purchased/Referred Care Delivery Area (PRCDA) (formerly Contract Health Service Delivery Area or CHSDA) for the newly recognized Pamunkey Indian Tribe. The Pamunkey Indian Tribe's PRCDA is to be comprised of Caroline; Hanover; Henrico; King William; King and Queen; and New Kent Counties and the independent city of Richmond in the State of Virginia. The six counties and the one independent city listed are being designated administratively as the PRCDA for the Pamunkey Indian Tribe.
Medicaid Program; State Disproportionate Share Hospital Allotment Reductions
Document Number: 2017-15962
Type: Proposed Rule
Date: 2017-07-28
Agency: Centers for Medicare & Medicaid Services, Department of Health and Human Services
The Affordable Care Act requires aggregate reductions to state Medicaid Disproportionate Share Hospital (DSH) allotments annually beginning with fiscal year (FY) 2018. This proposed rule delineates a methodology to implement the annual allotment reductions.
Medicare, Medicaid, and Children's Health Insurance Programs: Announcement of the Extension of Temporary Moratoria on Enrollment of Part B Non-Emergency Ground Ambulance Suppliers and Home Health Agencies in Designated Geographic Locations
Document Number: 2017-15961
Type: Rule
Date: 2017-07-28
Agency: Centers for Medicare & Medicaid Services, Department of Health and Human Services
This document announces the extension of statewide temporary moratoria on the enrollment of new Medicare Part B non-emergency ground ambulance providers and suppliers and Medicare home health agencies, subunits, and branch locations in Florida, Illinois, Michigan, Texas, Pennsylvania, and New Jersey, as applicable, to prevent and combat fraud, waste, and abuse. This extension also applies to the enrollment of new non-emergency ground ambulance suppliers and home health agencies, subunits, and branch locations in Medicaid and the Children's Health Insurance Program in those states.
National Institute of Allergy and Infectious Diseases; Notice of Closed Meeting
Document Number: 2017-15955
Type: Notice
Date: 2017-07-28
Agency: Department of Health and Human Services, National Institutes of Health
National Human Genome Research Institute; Notice of Closed Meeting
Document Number: 2017-15954
Type: Notice
Date: 2017-07-28
Agency: Department of Health and Human Services, National Institutes of Health
Center for Scientific Review; Amended Notice of Meeting
Document Number: 2017-15953
Type: Notice
Date: 2017-07-28
Agency: Department of Health and Human Services, National Institutes of Health
Proposed Collection; 60-Day Comment Request: Specimen Resource Locator (National Cancer Institute)
Document Number: 2017-15952
Type: Notice
Date: 2017-07-28
Agency: Department of Health and Human Services, National Institutes of Health
In compliance with the requirement of the Paperwork Reduction Act of 1995 to provide opportunity for public comment on proposed data collection projects, the National Cancer Institute (NCI) will publish periodic summaries of propose projects to be submitted to the Office of Management and Budget (OMB) for review and approval.
Agency Information Collection Activities: Submission for OMB Review; Comment Request
Document Number: 2017-15951
Type: Notice
Date: 2017-07-28
Agency: Centers for Medicare & Medicaid Services, Department of Health and Human Services
The Centers for Medicare & Medicaid Services (CMS) is announcing an opportunity for the public to comment on CMS' intention to collect information from the public. Under the Paperwork Reduction Act of 1995 (PRA), federal agencies are required to publish notice in the Federal Register concerning each proposed collection of information, including each proposed extension or reinstatement of an existing collection of information, and to allow a second opportunity for public comment on the notice. Interested persons are invited to send comments regarding the burden estimate or any other aspect of this collection of information, including the necessity and utility of the proposed information collection for the proper performance of the agency's functions, the accuracy of the estimated burden, ways to enhance the quality, utility, and clarity of the information to be collected; and the use of automated collection techniques or other forms of information technology to minimize the information collection burden.
National Institute on Alcohol Abuse and Alcoholism; Notice of Closed Meeting
Document Number: 2017-15903
Type: Notice
Date: 2017-07-28
Agency: Department of Health and Human Services, National Institutes of Health
National Institute on Alcohol Abuse and Alcoholism; Notice of Meeting
Document Number: 2017-15902
Type: Notice
Date: 2017-07-28
Agency: Department of Health and Human Services
Medical Devices; Cardiovascular Devices; Classification of the Adjunctive Cardiovascular Status Indicator
Document Number: 2017-15901
Type: Rule
Date: 2017-07-28
Agency: Food and Drug Administration, Department of Health and Human Services
The Food and Drug Administration (FDA) is classifying the adjunctive cardiovascular status indicator into class II (special controls). The special controls that will apply to the device are identified in this order and will be part of the codified language for the adjunctive cardiovascular status indicator's classification. The Agency is classifying the device into class II (special controls) in order to provide a reasonable assurance of safety and effectiveness of the device.
Drug Products That Present Demonstrable Difficulties for Compounding Under the Federal Food, Drug, and Cosmetic Act; Establishment of a Public Docket
Document Number: 2017-15900
Type: Notice
Date: 2017-07-28
Agency: Food and Drug Administration, Department of Health and Human Services
The Food and Drug Administration (FDA or Agency) is developing a list of drug products and categories of drug products that present demonstrable difficulties for compounding (the Difficult to Compound List). The Agency previously solicited nominations for this list and received approximately 71 unique nominations. FDA is establishing a new public docket so that interested parties can nominate drug products or categories of drug products that were not previously nominated for inclusion on the Difficult to Compound List, resubmit previous nominations with additional supporting information, or submit comments.
Medical Devices; Neurological Devices; Classification of Cranial Motion Measurement Device
Document Number: 2017-15895
Type: Rule
Date: 2017-07-28
Agency: Food and Drug Administration, Department of Health and Human Services
The Food and Drug Administration (FDA or Agency) is classifying the cranial motion measurement device into class II (special controls). The special controls that will apply to the device are identified in this order and will be part of the codified language for the cranial motion measurement device's classification. The Agency is classifying the device into class II (special controls) in order to provide a reasonable assurance of safety and effectiveness of the device.
Medical Devices; Gastroenterology-Urology Devices; Classification of the Oral Removable Palatal Space Occupying Device for Weight Management and/or Weight Loss
Document Number: 2017-15894
Type: Rule
Date: 2017-07-28
Agency: Food and Drug Administration, Department of Health and Human Services
The Food and Drug Administration (FDA or Agency) is classifying the oral removable palatal space occupying device for weight management and/or weight loss into class II (special controls). The special controls that will apply to the device are identified in this order and will be part of the codified language for the oral removable palatal space occupying device for weight management and/or weight loss classification. The Agency is classifying the device into class II (special controls) in order to provide a reasonable assurance of safety and effectiveness of the device.
Medical Devices; Obstetrical and Gynecological Devices; Classification of the Closed Loop Hysteroscopic Insufflator With Cutter-Coagulator
Document Number: 2017-15892
Type: Rule
Date: 2017-07-28
Agency: Food and Drug Administration, Department of Health and Human Services
The Food and Drug Administration (FDA, Agency, or we) is classifying the closed loop hysteroscopic insufflator with cutter- coagulator into class II (special controls). The special controls that will apply to the device are identified in this order, and will be part of the codified language for the closed loop hysteroscopic insufflator with cutter-coagulator classification. The Agency is classifying the device into class II (special controls) in order to provide a reasonable assurance of safety and effectiveness of the device.
Fostering Medical Innovation: A Plan for Digital Health Devices; Software Precertification Pilot Program
Document Number: 2017-15891
Type: Notice
Date: 2017-07-28
Agency: Food and Drug Administration, Department of Health and Human Services
The Food and Drug Administration's (FDA, the Agency, or we) Center for Devices and Radiological Health (CDRH or Center) is announcing its Software Precertification Pilot Program. The program aims to evaluate a new approach toward software products, including a precertification program for the assessment of companies that perform high-quality software design and testing. This voluntary pilot program is part of FDA's ongoing efforts to develop pragmatic approaches to balance benefits and risks of digital health products. FDA intends to develop a precertification program that could replace the need for a premarket submission in some cases and allow for decreased submission content and/or faster review of marketing applications for software products in other cases. During the pilot program, FDA customers, including pilot participants, will have the opportunity to provide input on the development of the precertification program.
Agency Information Collection Activities: Proposed Collection; Comment Request
Document Number: 2017-15886
Type: Notice
Date: 2017-07-28
Agency: Agency for Healthcare Research and Quality, Department of Health and Human Services
This notice announces the intention of the Agency for Healthcare Research and Quality (AHRQ) to request that the Office of Management and Budget (OMB) approve the proposed information collection project ``Expanding the Comprehensive Unit-based Safety Program (CUSP) to Reduce Central Line-Associated Blood Stream Infections (CLABSI) and Catheter-Associated Urinary Tract Infections (CAUTI) in Intensive Care Units (ICU) with Persistently Elevated Infection Rates.''
Agency Information Collection Activities: Proposed Collection; Comment Request
Document Number: 2017-15885
Type: Notice
Date: 2017-07-28
Agency: Agency for Healthcare Research and Quality, Department of Health and Human Services
This notice announces the intention of the Agency for Healthcare Research and Quality (AHRQ) to request that the Office of Management and Budget (OMB) approve the proposed information collection project: ``The AHRQ Safety Program for Improving Surgical Care and Recovery.'' This proposed information collection was previously published in the Federal Register titled ``The AHRQ Safety Program for Enhancing Surgical Care and Recovery,'' on May 18, 2017 and allowed 60 days for public comment. AHRQ did not receive any substantive comments. The purpose of this notice is to allow an additional 30 days for public comment.
Agency Information Collection Activities: Proposed Collection; Comment Request
Document Number: 2017-15884
Type: Notice
Date: 2017-07-28
Agency: Agency for Healthcare Research and Quality, Department of Health and Human Services
This notice announces the intention of the Agency for Healthcare Research and Quality (AHRQ) to request that the Office of Management and Budget (OMB) reapprove the proposed information collection project: ``Medical Expenditure Panel SurveyInsurance Component.'' This proposed information collection was previously published in the Federal Register on April 28, 2017, and allowed 60 days for public comment. No substantive comments were received; however changes have been made to the burden estimates in Exhibit 1, resulting in an increase of 1,316 burden hours. The purpose of this notice is to allow an additional 30 days for public comment.
Agency Information Collection Activities: Proposed Collection; Comment Request
Document Number: 2017-15883
Type: Notice
Date: 2017-07-28
Agency: Agency for Healthcare Research and Quality, Department of Health and Human Services
This notice announces the intention of the Agency for Healthcare Research and Quality (AHRQ) to request that the Office of Management and Budget (OMB) approve the proposed information collection project: ``Generic Clearance for Questionnaire and Data Collection Testing, Evaluation, and Research for the Agency for Healthcare Research and Quality.'' This proposed information collection was previously published in the Federal Register on April 28, 2017, and allowed 60 days for public comment. No substantive comments were received. The purpose of this notice is to allow an additional 30 days for public comment.
Proposed Information Collection Activity; Comment Request
Document Number: 2017-15850
Type: Notice
Date: 2017-07-28
Agency: Department of Health and Human Services, Administration for Children and Families
Medicare and Medicaid Programs; CY 2018 Home Health Prospective Payment System Rate Update and Proposed CY 2019 Case-Mix Adjustment Methodology Refinements; Home Health Value-Based Purchasing Model; and Home Health Quality Reporting Requirements
Document Number: 2017-15825
Type: Proposed Rule
Date: 2017-07-28
Agency: Centers for Medicare & Medicaid Services, Department of Health and Human Services
This proposed rule updates the home health prospective payment system (HH PPS) payment rates, including the national, standardized 60- day episode payment rates, the national per-visit rates, and the non- routine medical supply (NRS) conversion factor, effective for home health episodes of care ending on or after January 1, 2018. This rule also: updates the HH PPS case-mix weights using the most current, complete data available at the time of rulemaking; implements the 3rd- year of a 3-year phase-in of a reduction to the national, standardized 60-day episode payment to account for estimated case-mix growth unrelated to increases in patient acuity (that is, nominal case-mix growth) between CY 2012 and CY 2014; and discusses our efforts to monitor the potential impacts of the rebasing adjustments that were implemented in CY 2014 through CY 2017. This rule proposes case-mix methodology refinements, as well as a change in the unit of payment from 60-day episodes of care to 30-day periods of care, to be implemented for home health services beginning on or after January 1, 2019; and finally, this rule proposes changes to the Home Health Value- Based Purchasing (HHVBP) Model and to the Home Health Quality Reporting Program (HH QRP).
Medical Devices; Immunology and Microbiology Devices; Classification of the Assayed Quality Control Material for Clinical Microbiology Assays
Document Number: 2017-15858
Type: Rule
Date: 2017-07-27
Agency: Food and Drug Administration, Department of Health and Human Services
The Food and Drug Administration (FDA, Agency, or we) is classifying the assayed quality control material for clinical microbiology assays into class II (special controls). The special controls that will apply to the device are identified in this order and will be part of the codified language for the assayed quality control material for clinical microbiology assays' classification. The Agency is classifying the device into class II (special controls) to provide a reasonable assurance of safety and effectiveness of the device.
Notice of Interest Rate on Overdue Debts
Document Number: 2017-15854
Type: Notice
Date: 2017-07-27
Agency: Department of Health and Human Services, Office of the Secretary
Submission for OMB Review; Comment Request
Document Number: 2017-15822
Type: Notice
Date: 2017-07-27
Agency: Department of Health and Human Services, Administration for Children and Families
Supplemental Evidence and Data Request on Nonsurgical Treatments for Urinary Incontinence in Adult Women: A Systematic Review Update
Document Number: 2017-15799
Type: Notice
Date: 2017-07-27
Agency: Agency for Healthcare Research and Quality, Department of Health and Human Services
The Agency for Healthcare Research and Quality (AHRQ) is seeking scientific information submissions from the public. Scientific information is being solicited to inform our review of Nonsurgical Treatments for Urinary Incontinence in Adult Women: A Systematic Review Update, which is currently being conducted by the AHRQ's Evidence-based Practice Centers (EPC) Program. Access to published and unpublished pertinent scientific information will improve the quality of this review.
Agency Information Collection Activities: Proposed Collection; Comment Request
Document Number: 2017-15798
Type: Notice
Date: 2017-07-27
Agency: Agency for Healthcare Research and Quality, Department of Health and Human Services
This notice announces the intention of the Agency for Healthcare Research and Quality (AHRQ) to request that the Office of Management and Budget (OMB) approve the proposed information collection project ``Implementation of TeamSTEPPS in Primary Care Settings (ITS- PC).'' This proposed information collection was previously published in the Federal Register on May 5, 2017 and allowed 60 days for public comment. No substantive comments were received.
Agency Information Collection Activities: Proposed Collection; Comment Request
Document Number: 2017-15796
Type: Notice
Date: 2017-07-27
Agency: Agency for Healthcare Research and Quality, Department of Health and Human Services
This notice announces the intention of the Agency for Healthcare Research and Quality (AHRQ) to request that the Office of Management and Budget (OMB) approve the proposed information collection project: ``The AHRQ Safety Program for Improving Antibiotic Use.'' This proposed information collection was previously published in the Federal Register on May 5, 2017, and allowed 60 days for public comment. AHRQ did not receive any substantive comments. The purpose of this notice is to allow an additional 30 days for public comment.
Medical Devices; Cardiovascular Devices; Classification of the Balloon Aortic Valvuloplasty Catheter
Document Number: 2017-15786
Type: Rule
Date: 2017-07-27
Agency: Food and Drug Administration, Department of Health and Human Services
The Food and Drug Administration (FDA, Agency, or we) is classifying the balloon aortic valvuloplasty catheter into class II (special controls). The special controls that will apply to the device are identified in this order and will be part of the codified language for the balloon aortic valvuloplasty catheter's classification. The Agency is classifying the device into class II (special controls) to provide a reasonable assurance of safety and effectiveness of the device.
Center for Substance Abuse Prevention; Notice of Meeting
Document Number: 2017-15784
Type: Notice
Date: 2017-07-27
Agency: Department of Health and Human Services, Substance Abuse and Mental Health Services Administration
National Institute of Nursing Research; Notice of Meeting
Document Number: 2017-15760
Type: Notice
Date: 2017-07-27
Agency: Department of Health and Human Services, National Institutes of Health
National Institute of Allergy and Infectious Diseases; Notice of Closed Meetings
Document Number: 2017-15759
Type: Notice
Date: 2017-07-27
Agency: Department of Health and Human Services, National Institutes of Health
National Institute of Allergy and Infectious Diseases; Notice of Closed Meeting
Document Number: 2017-15757
Type: Notice
Date: 2017-07-27
Agency: Department of Health and Human Services, National Institutes of Health
Office of the Commissioner; Statement of Organization, Functions, and Delegations of Authority
Document Number: 2017-15443
Type: Notice
Date: 2017-07-27
Agency: Food and Drug Administration, Department of Health and Human Services
The Food and Drug Administration (FDA), Office of the Medical Products and Tobacco (OMPT), has modified its structure. This new organizational structure was approved by the Secretary of Health and Human Services on December 22, 2016, and became effective on that date.
Sunshine Act Meeting: Board of Scientific Counselors, National Center for Health Statistics (NCHS)
Document Number: 2017-15783
Type: Notice
Date: 2017-07-26
Agency: Centers for Disease Control and Prevention, Department of Health and Human Services
A Performance Test Protocol for Closed System Transfer Devices Used During Pharmacy Compounding and Administration of Hazardous Drugs; Extension of Comment Period
Document Number: 2017-15727
Type: Notice
Date: 2017-07-26
Agency: Centers for Disease Control and Prevention, Department of Health and Human Services
On September 15, 2016 the National Institute for Occupational Safety and Health (NIOSH) of the Centers for Disease Control and Prevention (CDC), published a notice in the Federal Register [81 FR 63482] announcing a public meeting and request for public comment on a draft testing protocol. Written comments were to be received by December 7, 2016. NIOSH initially extended the public comment period to June 7, 2017 [81 FR 88687]. NIOSH extended the comment period again to August 30, 2017 [82 FR 25290]. NIOSH is extending the public comment period to close on February 28, 2018. The longer timeframe will allow companies to test the protocol with the proposed challenge agents and permit full participation in the protocol design process.
Agency Information Collection Activities: Submission for OMB Review; Comment Request
Document Number: 2017-15726
Type: Notice
Date: 2017-07-26
Agency: Centers for Medicare & Medicaid Services, Department of Health and Human Services
The Centers for Medicare & Medicaid Services (CMS) is announcing an opportunity for the public to comment on CMS' intention to collect information from the public. Under the Paperwork Reduction Act of 1995 (PRA), federal agencies are required to publish notice in the Federal Register concerning each proposed collection of information, including each proposed extension or reinstatement of an existing collection of information, and to allow a second opportunity for public comment on the notice. Interested persons are invited to send comments regarding the burden estimate or any other aspect of this collection of information, including the necessity and utility of the proposed information collection for the proper performance of the agency's functions, the accuracy of the estimated burden, ways to enhance the quality, utility, and clarity of the information to be collected; and the use of automated collection techniques or other forms of information technology to minimize the information collection burden.
Agency Forms Undergoing Paperwork Reduction Act Review
Document Number: 2017-15671
Type: Notice
Date: 2017-07-26
Agency: Centers for Disease Control and Prevention, Department of Health and Human Services
Advisory Committee on Training in Primary Care Medicine and Dentistry
Document Number: 2017-15665
Type: Notice
Date: 2017-07-26
Agency: Department of Health and Human Services, Health Resources and Services Administration
The Advisory Committee on Training in Primary Care Medicine and Dentistry (ACTPCMD) has scheduled a meeting. This meeting will be open to the public. Information about ACTPCMD and the agenda for this meeting can be found on the ACTPCMD Web site at https://www.hrsa.gov/ advisorycommittees/bhpradvisory/ACTPCMD.
Notice of Intent To Award a Single-Source Non-Competing Continuation Application To Fund Grant Number 90DN0295 University of Massachusetts for an Additional 12 Months
Document Number: 2017-15663
Type: Notice
Date: 2017-07-26
Agency: Department of Health and Human Services
The Administration for Community Living (ACL) recently announced the awarding of the University of Massachusetts-Boston to the Institute of Community Inclusion (ICI). The University of Massachusetts-Boston will maintain and advance the longitudinal study describing day and employment services nationwide for individuals with developmental disabilities.
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