[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]
[[Page 63719]]
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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