[Federal Register Volume 85, Number 109 (Friday, June 5, 2020)]
[Rules and Regulations]
[Pages 34522-34524]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2020-12359]
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DEPARTMENT OF VETERANS AFFAIRS
38 CFR Part 71
RIN 2900-AQ96
Home Visits in Program of Comprehensive Assistance for Family
Caregivers During COVID-19 National Emergency
AGENCY: Department of Veterans Affairs
ACTION: Interim final rule.
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SUMMARY: The Department of Veterans Affairs (VA) is revising its
regulations that govern VA's Program of Comprehensive Assistance for
Family Caregivers (PCAFC) to relax the requirement for in-person home
visits during the National Emergency related to Coronavirus Disease-
2019 (COVID-19). This change is required to ensure the safety and well-
being of veterans, caregivers, and VA clinical staff.
DATES:
Effective Date: This rule is effective on June 5, 2020.
Comment Date: Comments must be received on or before July 6, 2020.
ADDRESSES: Written comments may be submitted through http://www.Regulations.gov; by mail or hand-delivery to the Director, Office
of Regulation Policy and Management (00REG), Department of Veterans
Affairs, 810 Vermont Avenue NW, Room 1064, Washington, DC 20420; or by
fax to (202) 273-9026. Comments should indicate that they are submitted
in response to ``RIN 2900-AQ96, Home Visits in Program of Comprehensive
Assistance for Family Caregivers During COVID-19 National Emergency.''
Copies of comments received will be available for public inspection in
the Office of Regulation Policy and Management, Room 1064, between the
hours of 8:00 a.m. and 4:30 p.m. Monday through Friday (except
holidays). Please call (202) 461-4902 for an appointment. (This is not
a toll-free number.) In
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addition, during the comment period, comments may be viewed online
through the Federal Docket Management System at http://www.Regulations.gov.
FOR FURTHER INFORMATION CONTACT: Elyse Kaplan, National Deputy
Director, Caregiver Support Program, Care Management and Social Work,
10P4C, Veterans Health Administration, Department of Veterans Affairs,
810 Vermont Ave. NW, Washington, DC 20420, (202) 461-7337. (This is not
a toll-free number.)
SUPPLEMENTARY INFORMATION: Title I of Public Law 111-163, Caregivers
and Veterans Omnibus Health Services Act of 2010 (hereinafter referred
to as ``the Caregivers Act''), established section 1720G(a) of title 38
of the United States Code (U.S.C.), which required VA to establish a
Program of Comprehensive Assistance for Family Caregivers (PCAFC) for
eligible veterans who have a serious injury incurred or aggravated in
the line of duty on or after September 11, 2001. The Caregivers Act
also required VA to establish a Program of General Caregiver Support
Services (PGCSS), pursuant to 38 U.S.C. 1720G(b), which is available to
caregivers of covered veterans of all eras of military service. VA
implemented PCAFC and PGCSS through its regulations in part 71 of title
38 of the Code of Federal Regulations (CFR). Through PCAFC, VA provides
Family Caregivers of eligible veterans (as those terms are defined in
38 CFR 71.15) certain benefits, such as training, respite care,
counseling, technical support, beneficiary travel (to attend required
caregiver training and for an eligible veteran's medical appointments),
a monthly stipend payment, and access to health care (if qualified)
through the Civilian Health and Medical Program of the Department of
Veterans Affairs (CHAMPVA). 38 U.S.C. 1720G(a)(3), 38 CFR 71.40. This
interim final rule relates to PCAFC.
VA is adding a new Sec. 71.60 to title 38, CFR, to provide
flexibility in the mode by which VA conducts PCAFC home visits for the
duration of the National Emergency related to COVID-19 declared by the
President on March 13, 2020 (the COVID-19 National Emergency). COVID-19
is a new disease that causes respiratory illness in people and can
spread from person to person. Many individuals and communities across
the country have taken steps to reduce the spread of COVID-19,
including isolating individuals diagnosed with the disease and
implementing physical distancing measures. The priority goal in the VA
response to COVID-19 is the protection of veterans, their caregivers,
and VA staff. To reduce the risk of exposure to and transmission of
COVID-19 to individuals involved in PCAFC, as well as members of their
households and others with whom they come into contact who may be
affected, VA is relaxing PCAFC home visit requirements as set forth in
this interim final rule. This is especially important given the
vulnerable population of veterans served by PCAFC. Pursuant to Sec.
71.60, VA will have flexibility to conduct home visits through means
other than in-person visits, including videoconference or other
available telehealth modalities. Section 71.60 will only apply to home
visits under part 71 and will not apply to other parts of title 38,
CFR.
This interim final rule has an immediate impact on the mode by
which VA completes the initial home-care assessments required by 38 CFR
71.25(e). Section 71.25(e) sets forth the requirement for an initial
home-care assessment prior to approval and designation of a Family
Caregiver under PCAFC. Section 71.25(e) currently requires ``a VA
clinician or a clinical team [to] visit the eligible veteran's home to
assess the caregiver's completion of training and competence to provide
personal care services at the eligible veteran's home, and to measure
the eligible veteran's well being.'' Pursuant to Sec. 71.60, a VA
clinician or clinical team is no longer required to conduct an in-
person visit in the eligible veteran's home to satisfy this requirement
for the duration the COVID-19 National Emergency.
Section 71.60 may also impact the home visit requirements proposed
by VA on March 6, 2020 in RIN 2900-AQ48, Program of Comprehensive
Assistance for Family Caregivers Improvements and Amendments Under the
VA MISSION Act of 2018. 85 FR 13356. The proposed rule references a
home visit in proposed Sec. 71.25(e) with respect to the initial home-
care assessment, specifies that reassessments under proposed Sec.
71.30 may include a visit to the eligible veteran's home, and proposes
to require an annual home visit in proposed Sec. 71.40(b)(2) for
purposes of wellness contacts. For the duration of the COVID-19
National Emergency, Sec. 71.60 will authorize VA to complete these
home visits through means other than an in-person visit to the eligible
veteran's home, such as videoconference or other available telehealth
modalities.
Administrative Procedure Act
The Secretary of Veterans Affairs finds that there is good cause
under the provisions of 5 U.S.C. 553(b)(B), to publish this interim
final rule without prior notice and the opportunity for public comment,
and under 5 U.S.C. 553(d), to dispense with the delayed effective date
ordinarily prescribed by the Administrative Procedure Act (APA).
Pursuant to section 553(b)(B) of the APA, general notice and the
opportunity for public comment are not required with respect to a
rulemaking when an ``agency for good cause finds (and incorporates the
finding and a brief statement of reasons therefor in the rules issued)
that notice and public procedure thereon are impracticable,
unnecessary, or contrary to the public interest.'' The Secretary finds
that it is contrary to the public interest to delay issuance of this
rule for the purpose of soliciting prior public comment because there
is an immediate and pressing public health risk for veterans,
caregivers, and clinical staff involved in PCAFC home visits, as well
as members of their households and others with whom they come into
contact who may be affected. Mandating an in-person visit to an
eligible veteran's home through PCAFC could increase the risk of
exposure to and transmission of COVID-19, and it is critical that VA
have immediate flexibility to conduct home visits through other means.
For these reasons, the Secretary has concluded that ordinary notice and
comment procedures would be impracticable and contrary to the public
interest and is accordingly issuing this rule as an interim final rule.
The Secretary will consider and address comments that are received
within 30 days after the date that this interim final rule is published
in the Federal Register and address them in a subsequent Federal
Register document announcing a final rule incorporating any changes
made in response to the public comments.
The APA also requires a 30-day delayed effective date, except for
``(1) a substantive rule which grants or recognizes an exemption or
relieves a restriction; (2) interpretative rules and statements of
policy; or (3) as otherwise provided by the agency for good cause found
and published with the rule.'' 5 U.S.C. 553(d). For the reasons stated
above, the Secretary finds that there is also good cause for this
interim rule to be effective immediately upon publication. It is in the
public interest for VA to have flexibility to utilize alternative
modalities to conduct required home visits during the COVID-19 National
Emergency, and this will be facilitated by an immediate effective date.
Additionally, this rule relieves a
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restriction by expanding the modes by which the home visits can be
completed. Instead of requiring such visits to be completed through in-
person visits to the eligible veteran's home, for the duration of the
COVID-19 National Emergency, PCAFC home visits can be completed through
other means, including videoconference or other available telehealth
modalities. By relieving a restriction and because any delay in
implementation of Sec. 71.60 would be contrary to the public interest
under 5 U.S.C. 553(d)(1) and (3), respectively, this interim final rule
is exempt from the APA's delayed effective date requirement.
Paperwork Reduction Act
This interim final rule contains no provisions constituting a
collection of information under the Paperwork Reduction Act of 1995 (44
U.S.C. 3501-3521).
Regulatory Flexibility Act
The Secretary hereby certifies that this interim final rule will
not have a significant economic impact on a substantial number of small
entities as they are defined in the Regulatory Flexibility Act (5
U.S.C. 601-612). This interim final rule provides flexibility in the
modes by which VA conducts PCAFC home visits for the duration of the
National Emergency related to COVID-19 and does not affect small
businesses. Therefore, pursuant to 5 U.S.C. 605(b), the initial and
final regulatory flexibility analysis requirements of 5 U.S.C. 603 and
604 do not apply.
Executive Orders 12866, 13563 and 13771
Executive Orders 12866 and 13563 direct agencies to assess the
costs and benefits of available regulatory alternatives and, when
regulation is necessary, to select regulatory approaches that maximize
net benefits (including potential economic, environmental, public
health and safety effects, and other advantages; distributive impacts;
and equity). Executive Order 13563 (Improving Regulation and Regulatory
Review) emphasizes the importance of quantifying both costs and
benefits, reducing costs, harmonizing rules, and promoting flexibility.
The Office of Information and Regulatory Affairs has determined that
this rule is not a significant regulatory action under Executive Order
12866.
VA's impact analysis can be found as a supporting document at
http://www.regulations.gov, usually within 48 hours after the
rulemaking document is published. Additionally, a copy of the
rulemaking and its impact analysis are available on VA's website at
http://www.va.gov/orpm/, by following the link for ``VA Regulations
Published From FY 2004 Through Fiscal Year to Date.''
This interim final rule is considered an E.O. 13771 deregulatory
action. Details on the estimated cost savings of this interim final
rule can be found in the rule's economic analysis.
Unfunded Mandates
The Unfunded Mandates Reform Act of 1995 requires, at 2 U.S.C.
1532, that agencies prepare an assessment of anticipated costs and
benefits before issuing any rule that may result in the expenditure by
State, local, and tribal governments, in the aggregate, or by the
private sector, of $100 million or more (adjusted annually for
inflation) in any one year. This interim final rule will have no such
effect on State, local, and tribal governments, or on the private
sector.
Congressional Review Act
Pursuant to the Congressional Review Act (5 U.S.C. 801 et seq.),
the Office of Information and Regulatory Affairs designated this rule
as not a major rule, as defined by 5 U.S.C. 804(2).
Catalog of Federal Domestic Assistance
The Catalog of Federal Domestic Assistance numbers and titles for
the programs affected by this document are 64.009, Veterans Medical
Care Benefits.
List of Subjects in 38 CFR Part 71
Administrative practice and procedure, Caregivers program, Claims,
Health care, Health facilities, Health professions, Mental health
programs, Travel and transportation expenses, Veterans.
Signing Authority
The Secretary of Veterans Affairs, or designee, approved this
document and authorized the undersigned to sign and submit the document
to the Office of the Federal Register for publication electronically as
an official document of the Department of Veterans Affairs. Brooks D.
Tucker, Acting Chief of Staff, Department of Veterans Affairs, approved
this document on June 3, 2020, for publication.
Consuela Benjamin,
Regulation Development Coordinator, Office of Regulation Policy &
Management, Office of the Secretary, Department of Veterans Affairs.
For the reasons stated in the preamble, the Department of Veterans
Affairs amends 38 CFR part 71 as follows:
PART 71--CAREGIVERS BENEFITS AND CERTAIN MEDICAL BENEFITS OFFERED
TO FAMILY MEMBERS OF VETERANS
0
1. The authority citation for part 71 continues to read as follows:
Authority: 38 U.S.C. 501, 1720G, unless otherwise noted.
0
2. Add Sec. 71.60 to read as follows:
Sec. 71.60 Home Visits During COVID-19 National Emergency.
Notwithstanding the requirements in this part, for the duration of
the National Emergency related to COVID-19 declared by the President on
March 13, 2020, VA may complete visits to the eligible veteran's home
under this part through videoconference or other available telehealth
modalities.
[FR Doc. 2020-12359 Filed 6-4-20; 8:45 am]
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