[Federal Register Volume 61, Number 232 (Monday, December 2, 1996)]
[Rules and Regulations]
[Pages 63719-63720]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 96-30574]



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DEPARTMENT OF VETERANS AFFAIRS

38 CFR Part 17

RIN 2900-AH61


Community Residential Care Program and Contract Program for 
Veterans With Alcohol and Drug Dependence Disorders

AGENCY: Department of Veterans Affairs.

ACTION: Final rule.

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SUMMARY: This document updates the Department of Veterans Affairs (VA) 
regulations concerning the Community Residential Care Program and the 
Contract Program for Veterans With Alcohol and Drug Dependence 
Disorders by incorporating by reference relevant portions of the latest 
editions of the National Fire Protection Association Life Safety Code 
entitled ``NFPA 101, Life Safety Code'' and ``NFPA 101A, Guide on 
Alternative Approaches to Life Safety.'' This is intended to ensure 
that buildings used for treatment and residential services for veterans 
meet appropriate fire and safety standards. Also, this document amends 
the regulations for such programs by delegating authority to each of 
the Veterans Integrated Service Network (VISN) Directors of the 
Veterans Health Administration to grant certain equivalencies or 
variances to building standards of the Life Safety Code. Further, this 
final rule does not adopt the portion of the proposed rule concerning 
the Adult Day Health Care Program since the Adult Day Health Care 
Program and the corresponding regulations are no longer in existence.

EFFECTIVE DATE: This rule is effective January 2, 1997.
    The incorporation by reference of certain publications listed in 
the regulations is approved by the Director of the Federal Register as 
of January 2, 1997.

FOR FURTHER INFORMATION CONTACT: James R. Kelley, Director, Extended 
Care Service, for issues relating to the Community Residential Care 
Program at (202) 273-6342 (this is not a toll-free number); and Richard 
T. Suchinsky, M.D., Associate Director for Addictive Disorders and 
Psychiatric Rehabilitation, for issues relating to the Contract Program 
for Veterans With Alcohol and Drug Disorders at (202) 273-8437 (this is 
not a toll-free number), Veterans Health Administration, Department of 
Veterans Affairs, 810 Vermont Ave., NW, Washington, DC 20420.

SUPPLEMENTARY INFORMATION: On September 11, 1995, we published a 
proposed rule concerning the Adult Day Health Care Program; the 
Community Residential Care Program; and the Contract Program for 
Veterans With Alcohol and Drug Dependence Disorders (60 FR 47133). We 
proposed to update these regulations by incorporating by reference 
relevant portions of the latest editions of the National Fire 
Protection Association Life Safety Code entitled ``NFPA 101, Life 
Safety Code'' and ``NFPA 101A, Guide on Alternative Approaches to Life 
Safety.'' We also proposed changes to delegations of authority. We 
requested that comments to the proposed rule be submitted on or before 
November 13, 1995. The portion of the proposed rule concerning the 
Adult Day Health Care Program is not adopted and instead is withdrawn 
since the Adult Day Health Care Program and the corresponding 
regulations are no longer in existence (see 61 FR 21964). Based on the 
reasons stated in the proposed rule and this document, the provisions 
of the proposed rule concerning the Community Residential Care Program 
and the Contract Program for Veterans With Alcohol and Drug Dependence 
Disorders are adopted in this final rule with changes as discussed 
below.
    The Community Residential Care Program is authorized under 38 
U.S.C. 1730 and the Contract Program for Veterans With Alcohol and Drug 
Dependence Disorders is authorized under 38 U.S.C. 501 and 1720A.
    We received thirteen comments, seven of which were identical. All 
of the comments concerned the Community Residential Care Program.
    The commenters, in general, objected to any increased costs which 
may be associated with operating a residential care facility under the 
provisions of the proposed rule. For example, some commenters objected 
to the possibility that they would have to install sprinkler systems. 
One commenter asserted that his homeowner's insurance would be canceled 
if he had to install a sprinkler system. A number of commenters 
asserted that the Life Safety Code was never intended to apply to ``mom 
and pop'' operations and some commenters further asserted that small 
operations, such as those housing eight or fewer veterans, should be 
exempt from the provisions of the Life Safety Code. Some commenters 
asserted that the Life Safety Code is arbitrary in the manner in which 
increasingly stringent criteria are applied depending upon whether a 
facility has sleeping accommodations for more than three residents or 
more than 16 residents. No changes are made based on these comments 
except as discussed below.
    The Life Safety Code was intended to apply to the ``mom and pop'' 
residential care facilities and we believe that the adoption of the 
current Life Safety Code is necessary to ensure minimum levels of fire 
safety for residential care facilities participating in VA programs. 
The Life Safety Code is a national consensus code based on actual fire 
experience across the country. The code adopts standards designed to 
protect the occupants from loss of life but yet is intended to avoid 
standards which might involve significant hardship or inconvenience 
while yielding little additional increases in safety. Providing a safe 
environment is just as much a part of enhancing a veteran's life as 
other requirements of these programs.
    Although some facilities may face greater costs due to changes in 
the Life Safety Code, our belief is that the need to increase the life 
safety of veterans in participating programs takes first priority. 
However, the Life Safety Code does provide for relief in appropriate 
circumstances. In this regard, Appendix A, at A-1-4.4 provides:

    In existing buildings, it is not always practical to strictly 
apply the provisions of this Code. Physical limitations may require 
disproportionate effort or expense with little increase in public 
safety. In such cases, the authority having jurisdiction should be 
satisfied that reasonable life safety is ensured.
    In existing buildings, it is intended that any condition that 
represents a serious threat to life be mitigated by application of 
appropriate safeguards. It is not intended to require modifications 
for conditions that do not represent a significant threat to life, 
even though such conditions are not literally in compliance with the 
Code.

    It was intended that all of Appendix A be included in the material 
incorporated by reference since it consists of explanatory material 
relating to provisions incorporated by reference. Accordingly, the 
final rule incorporates by reference the provisions set forth in 
Appendix A. Also, it was intended that any equivalencies or variances 
be required to be approved by the appropriate Veterans Health 
Administration Veterans Integrated Service Networks (VISN) Director and 
this delegation is added to each of the regulatory provisions affected 
by this rule.
    Identical submissions from a number of commenters asserted that the 
technical committee that serves the National Fire Protection 
Association (NFPA) in developing the requirements of the Life Safety 
Code should include a member from the community residential program. In 
response, we note that in our view the committee is

[[Page 63720]]

well balanced and does have representation from community providers. In 
this regard, representatives of the Association of Residential 
Resources in Minnesota and the American Network of Community and 
Options are members on NFPA's technical advisory committees responsible 
for developing standards. Further, the committees also have 
representation from the VA, insurance companies, and state regulatory 
officials.
    Commenters asserted this rule might have a disproportionate effect 
and expense for small entities and that therefore a cost-benefit 
analysis should be undertaken. In our view, special consideration for 
small entities is not warranted since the rule already is designed for 
small entities and in all likelihood only small entities will conduct 
activities affected by this rule.
    The section numbers for the regulations amended by this rulemaking 
are different from those in the proposed rule because they recently 
were changed. Sections 17.51j, 17.53b, and 17.53c were changed 
respectively to sections 17.63, 17.81, and 17.82 (see 61 FR 21964).
    The Secretary hereby certifies that this final rule does 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. The rule already is designed for small entities and in all 
likelihood only small entities will conduct activities affected by this 
rule. Therefore, pursuant to 5 U.S.C. 605(b), this final rule is exempt 
from the initial and final regulatory flexibility analysis requirement 
of sections 603 and 604.

Catalog

    The Catalog of Federal Domestic Assistance Numbers are 64.015 
and 64.019.

List of Subjects in 38 CFR Part 17

    Administrative practice and procedure, Alcohol abuse, Alcoholism, 
Claims, Day care, Dental health, Drug abuse, Foreign relations, 
Government contracts, Grant program--health, Grant program--veterans, 
Health care, Health facilities, Health professions, Health records, 
Homeless, Incorporation by reference, Medical and dental schools, 
Medical devices, Medical research, Medical health programs, Nursing 
homes, Philippines, Reporting and recordkeeping requirements, 
Scholarships and fellowships, Travel and transportation expenses, 
Veterans.

    Approved: September 9, 1996.
Jesse Brown,
Secretary of Veterans Affairs.

    For the reasons set forth in the preamble, 38 CFR, part 17 is 
amended as set forth below:

PART 17--MEDICAL

    1. The authority citation for Part 17 continues to read as follows:

    Authority: 38 U.S.C. 501, 1721, unless otherwise noted.

    2. In Sec. 17.63 paragraph (a)(2) is revised to read as follows:


Sec. 17.63  Approval of community residential care facilities.

* * * * *
    (a) * * *
    (2) Meet the requirements of chapters 1-7, 22-23, and 31 and 
Appendix A of the NFPA 101, National Fire Protection Association's Life 
Safety Code (1994 edition), and NFPA 101A, Guide on Alternative 
Approaches to Life Safety (1995 edition), which are incorporated by 
reference. The institution shall provide sufficient staff to assist 
patients in the event of fire or other emergency. Incorporation by 
reference of these materials was approved by the Director of the 
Federal Register, in accordance with 5 U.S.C. 552(a) and 1 CFR part 51. 
These materials incorporated by reference are available for inspection 
at the Office of the Federal Register, Suite 700, 800 North Capitol 
Street, NW., Washington, DC, and the Department of Veterans Affairs, 
Office of Regulations Management (02D), Room 1154, 810 Vermont Avenue, 
NW., Washington, DC 20420. Copies may be obtained from the National 
Fire Protection Association, Battery March Park, Quincy, MA 02269. (For 
ordering information, call toll-free 1-800-344-3555.) Any equivalencies 
or variances to Department of Veterans Affairs requirements must be 
approved by the appropriate Veterans Health Administration Veterans 
Integrated Service Networks (VISN) Director.
* * * * *
    3. In Sec. 17.81, paragraph (a)(1)(i) is revised to read as 
follows:


Sec. 17.81  Contracts for residential treatment services for veterans 
with alcohol or drug dependence or abuse disabilities.

    (a) * * *
    (1) * * *
    (i) The building must meet the requirements of the applicable 
residential occupancy chapters (1-7, 22-23, and 31) and Appendix A of 
the NFPA 101, National Fire Protection Association's Life Safety Code 
(1994 edition) which are incorporated by reference. Incorporation by 
reference of these materials was approved by the Director of the 
Federal Register, in accordance with 5 U.S.C. 552(a) and 1 CFR part 51. 
These materials incorporated by reference are available for inspection 
at the Office of the Federal Register, Suite 700, 800 North Capitol 
Street, NW., Washington, DC, and the Department of Veterans Affairs, 
Office of Regulations Management (02D), Room 1154, 810 Vermont Avenue, 
NW., Washington, DC 20420. Copies may be obtained from the National 
Fire Protection Association, Battery March Park, Quincy, MA 02269. (For 
ordering information, call toll-free 1-800-344-3555.) Any equivalencies 
or variances to Department of Veterans Affairs requirements must be 
approved by the appropriate Veterans Health Administration Veterans 
Integrated Service Networks (VISN) Director.
* * * * *
    4. In Sec. 17.82, paragraph (a)(1)(i) is revised to read as 
follows:


Sec. 17.82  Contracts for outpatient services for veterans with alcohol 
or drug dependence or abuse disabilities.

    (a) * * *
    (1) * * *
    (i) The building must meet the requirements of the applicable 
business occupancy chapters (1-7, 26-27, and 31) and Appendix A of the 
NFPA 101, National Fire Protection Association's Life Safety Code (1994 
edition) which are incorporated by reference. Incorporation by 
reference of these materials was approved by the Director of the 
Federal Register, in accordance with 5 U.S.C. 552(a) and 1 CFR part 51. 
These materials incorporated by reference are available for inspection 
at the Office of the Federal Register, Suite 700, 800 North Capitol 
Street, NW., Washington, DC, and the Department of Veterans Affairs, 
Office of Regulations Management (02D), Room 1154, 810 Vermont Avenue, 
N.W., Washington, DC 20420. Copies may be obtained from the National 
Fire Protection Association, Battery March Park, Quincy, MA 02269. (For 
ordering information, call toll-free 1-800-344-3555.) Any equivalencies 
or variances to Department of Veterans Affairs requirements must be 
approved by the appropriate Veterans Health Administration Veterans 
Integrated Service Networks (VISN) Director.
* * * * *
[FR Doc. 96-30574 Filed 11-29-96; 8:45 am]
BILLING CODE 8320-01-P