[Federal Register Volume 87, Number 120 (Thursday, June 23, 2022)]
[Notices]
[Pages 37518-37520]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2022-13374]



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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Administration for Children and Families


Request for Information: Forced Labor in Healthcare Supply Chains

AGENCY: Office on Trafficking in Persons (OTIP), Administration for 
Children and Families (ACF), U.S. Department of Health and Human 
Services (HHS).

ACTION: Notice of Request for Information.

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SUMMARY: The Office on Trafficking in Persons (OTIP) requests 
information on forced labor, a form of human trafficking, in healthcare 
supply chains including monitoring, training, and research efforts. 
This request for information (RFI) is part of OTIP's ongoing efforts to 
seek public comments to inform implementation of Executive Order 14001 
(A Sustainable Public Health Supply Chain), the National Strategy for a 
Resilient Public Health Supply Chain, and other related efforts on 
forced labor.

DATES: Comments on this notice must be received by midnight Eastern 
Daylight Time (EDT) 30 days after posting. OTIP will not respond 
individually to responders but will consider all comments submitted by 
the deadline.

ADDRESSES: Please submit all responses via email to 
[email protected] with ``RFI: Forced Labor in Healthcare 
Supply Chains'' in the subject. Submissions can include attachments of 
or links to any supporting documentation (e.g., research, training 
materials, policies, data). Please provide your contact information, 
including the organization name, for possible follow-up from OTIP.

FOR FURTHER INFORMATION CONTACT: Alyssa Wheeler, Policy Analyst, Office 
on Trafficking in Persons, Email: [email protected].

SUPPLEMENTARY INFORMATION:

I. Background

    OTIP is responsible for the development of anti-trafficking 
strategies, policies, and programs to prevent human trafficking, build 
health and human service capacity to respond to human trafficking, 
increase victim identification and access to services, and strengthen 
health and well-being outcomes of trafficking survivors. OTIP funds the 
National Human Trafficking Hotline, where an analysis of 32,000 cases 
reported into the hotline identified healthcare services as one of 25 
industries impacted by human trafficking.\1\ OTIP programs also include 
grants to community-based organizations to fund comprehensive case 
management services for survivors of human trafficking, training and 
technical assistance for health and human service organizations to 
build capacity to respond to human trafficking, and research and policy 
guidance. OTIP serves as the secretariat for the HHS Task Force to 
Prevent Human Trafficking.\2\
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    \1\ The Typology of Modern Slavery report analyzing data from 
the National Human Trafficking Hotline is available at https://polarisproject.org/wp-content/uploads/2019/09/Polaris-Typology-of-Modern-Slavery-1.pdf.
    \2\ Press release for the HHS Task Force to Prevent Human 
Trafficking is available at https://www.hhs.gov/about/news/2022/01/31/secretary-becerra-announces-new-hhs-task-force-to-prevent-human-trafficking.html.
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    In July 2021, HHS published the National Strategy for a Resilient 
Public Health Supply Chain in response to Executive Order 14001 on a 
sustainable public health supply chain.\3\ \4\ \5\ The strategy 
incorporates learnings from experiences of significant disruptions to 
public health supply chains during the COVID-19 pandemic. It reinforces 
a commitment to an ethical, equitable, and environmentally sustainable 
public health supply chain. This includes a call to ``having processes 
in place to identify and mitigate sourcing risks such as child labor, 
forced labor, and human trafficking.'' The strategy recognizes the 
impact of production scarcity, decrease in qualified labor, 
insufficient technical skills, and other domestic and international 
factors as increasing risk of forced labor. For example, Objective 1.4 
incorporates efforts on forced labor while combatting unfair trade.
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    \3\ The National Strategy for a Resilient Public Health Supply 
Chain is available at https://www.phe.gov/Preparedness/legal/Documents/National-Strategy-for-Resilient-Public-Health-Supply-Chain.pdf.
    \4\ Executive Order 14001 is available at https://www.federalregister.gov/documents/2021/01/26/2021-01865/a-sustainable-public-health-supply-chain.
    \5\ More information on mitigating labor trafficking in public 
health supply chains is available at https://www.acf.hhs.gov/blog/2021/10/mitigating-labor-trafficking-public-health-supply-chains.
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    As part of this response, the Procurement and Supply Chains 
Committee of the Senior Policy Operating Group under the President's 
Interagency Taskforce to Monitor and Combat Trafficking in Persons 
established a subgroup on Forced Labor in Global Supply Chains. This 
subgroup is coordinating relevant federal efforts on corporate 
accountability and compliance, including with the healthcare industry.
    Public comments responding to this RFI may inform OTIP, HHS, and 
federal interagency efforts on trainings, policy guidance, resources, 
and coordination on data and due diligence tailored to healthcare 
organizations, procurement professionals, and suppliers.

II. Definitions

    The term ``forced labor'' is defined for U.S. enforcement purposes 
in two separate sections of the United States Code. First, the criminal 
statutes of Title 18 encompass the range of activities involved in 
obtaining the labor or services of a person including (1) force, 
threats of force, physical restraint, or threats of physical restraint; 
(2) serious harm, threats of serious harm; (3) abuse or threatened 
abuse of the legal process; (4) or by a ``scheme, plan or pattern'' 
designed to cause fear of serious harm or physical restraint (18 U.S.C. 
1589). Once a person's labor is obtained by such means, the person's 
previous consent or effort to obtain employment with the trafficker 
does not preclude the person from being considered a victim, or the 
government from prosecuting the offender. Title 18 also defines forced 
labor as occurring when an individual or entity ``knowingly benefits, 
financially or by receiving anything of value, from participating in a 
venture which has engaged in providing or obtaining labor or services 
by prohibited means, knowing or in reckless disregard of the fact that 
the venture has engaged in providing or obtaining labor or services by 
such prohibited means.'' \6\
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    \6\ Additional text on 18 U.S.C. 1589 is available at https://uscode.house.gov/view.xhtml?hl=false&edition=prelim&req=granuleid%3AUSC-2000-title18-section1589#=0.
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    Second, the customs-related statute of Title 19 defines forced 
labor in connection with the prohibition on the importation of goods 
mined, produced, or manufactured wholly or in part by convict labor, 
forced labor, and/or indentured labor (19 U.S.C. 1307). In this 
context, forced and/or indentured labor includes children and is 
defined as ``all work or service which is exacted from any person under 
the menace of any penalty for its nonperformance and for which the 
worker does not offer himself voluntarily.'' \7\
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    \7\ Additional text on 19 U.S.C. 1307 is available at https://uscode.house.gov/view.xhtml?req=(title:19%20section:1307%20edition:prelim).
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    Forced labor is also referenced in connection to human trafficking 
protections codified in Title 22, specifically in forms of labor 
trafficking (22 U.S.C. 7102). Labor trafficking, one type of ``severe 
forms of trafficking in persons,'' means ``the recruitment, harboring, 
transportation, provision, or

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obtaining of a person for labor or services, through the use of force, 
fraud, or coercion for the purpose of subjection to involuntary 
servitude, peonage, debt bondage, or slavery.'' \8\
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    \8\ Additional text on 22 U.S.C. 7102 is available at https://www.govinfo.gov/content/pkg/USCODE-2011-title22/html/USCODE-2011-title22-chap78.htm.
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    Pursuant to concepts set out in the National Strategy for a 
Resilient Public Health Supply Chain, healthcare supply chains include 
the ``finished product . . . raw materials, equipment, and ancillary 
supplies needed to make and use that product'' (e.g., drugs, biological 
products, medical devices, personal protective equipment). For the 
purposes of the RFI, healthcare supply chains also include nutrition-
related procurement and the acquisition of services, including delivery 
of clinical services (e.g., nursing) and ancillary services (e.g., 
food, custodial, and laundry services).
    For purposes of this RFI, ``healthcare product'' will mean any item 
sourced or produced in the healthcare supply chain, and ``healthcare 
services'' will refer to any services procured by an organization in 
the healthcare sector, including clinical and support services.

III. Request for Comments

    OTIP is interested in all the questions listed below, but 
respondents are welcome to address as many or as few as they choose and 
to address additional areas of interest not listed.

A. Information on Monitoring Forced Labor in the Procurement of 
Healthcare Services

     Does your organization or another organization have 
established standard operating procedures for preventing, identifying, 
reporting, and addressing suspected forced labor or unfair labor 
practices by staffing agencies or other subcontractors providing 
workforce personnel?
     What are your current reporting mechanisms in procuring 
clinical services and services in general? Would it be feasible to 
incorporate measures on forced labor in those mechanisms?
     How can service contracting practices be strengthened in 
the healthcare sector?
     Are there mechanisms in place for individuals delivering 
clinical or supporting services in the healthcare sector to report 
abuse, fraud, or forced labor? If so, what are those practices and 
mechanisms? What protections from retaliation are in place for 
individuals reporting? Are these mechanisms being successfully 
utilized?
     What steps does your organization take to investigate and, 
if needed, remediate forced labor violations?
     Are there any barriers in federal policies, programs, and 
systems that make it challenging to monitor and address forced labor 
risks in healthcare services procurement? If so, what are those 
barriers?

B. Information on Monitoring Forced Labor in the Procurement of 
Healthcare Products

     Does your organization or another organization have 
established standard operating procedures for preventing, identifying, 
reporting, and addressing suspected forced labor or unfair labor 
practices by potential suppliers or contractors for healthcare 
products?
     What are your current due diligence and reporting 
mechanisms in procuring healthcare products in general? Would it be 
feasible to incorporate measures on forced labor in those mechanisms?
     How can supply chain transparency practices be 
strengthened to combat forced labor in the healthcare products?
     Are there practices and mechanisms in place for 
procurement professionals, administrators, contractors, and/or anyone 
else who might become aware of forced labor risks in procurement of 
goods to report abuse, fraud, or forced labor? If so, what are those 
practices and mechanisms? What protections from retaliation are in 
place for individuals reporting? Are these mechanisms being 
successfully utilized?
     What steps does your organization take to investigate and, 
if needed, remediate forced labor violations?
     Are there any barriers in federal policies, programs, and 
systems that make it challenging to monitor and address forced labor 
risks in healthcare product procurement? If so, what are those 
barriers?

C. Information on Training and Public Awareness on Forced Labor in 
Healthcare Supply Chains

     Do you think healthcare procurement professionals and 
suppliers are aware of forced labor in supply chains (e.g., production 
of personal protective equipment, medical equipment) or in the 
workforce (e.g., patient care services, ancillary support services)?
     What resources currently exist to help healthcare 
procurement professionals and suppliers prevent, identify, report, and 
address forced labor in supply chains? Please provide links to 
resources or information on organizations developing resources.
     What trainings, information sharing, or information 
collection efforts have successfully integrated content on forced labor 
in the acquisition of healthcare products and services?
     What are the gaps in training, technical assistance, and 
awareness on identifying, monitoring, and addressing forced labor in 
healthcare supply chains?

D. Information on Research and Data on Forced Labor in Healthcare 
Supply Chains

     Who do you consider a subject matter expert on forced 
labor in healthcare supply chains and/or in supply chains more broadly? 
Please provide the name, affiliation, and email for any individuals you 
list.
     Do you currently rely on research, data, or information on 
forced labor in healthcare supply chains to inform your organization's 
practices to prevent, monitor, and respond to concerns? If so, what 
type of information and where do you access that information?
     What research, data, or information would be helpful to 
inform and/or strengthen due diligence processes for healthcare 
procurement professionals and suppliers?
     What diversity, equity, and inclusion considerations 
should inform understanding of how forced labor occurs in healthcare 
supply chains from both the administrative and workforce perspectives?
    This RFI is for planning purposes only and should not be construed 
as a policy, solicitation for applications, or as an obligation on the 
part of the Government to provide support for any ideas identified in 
response to it. OTIP will use the information submitted in response to 
this RFI at its discretion and will not provide comments to any 
responder's submission. However, responses to the RFI may be reflected 
in future solicitation(s), policies, or publications. Respondents will 
not be identified in any published reports. Respondents are advised 
that the Government is under no obligation to acknowledge receipt of 
the information received or provide feedback to respondents with 
respect to any information submitted. No proprietary, classified, 
confidential, or sensitive information should be included in your 
response, unless marked as Business Confidential Information (BCI). 
Materials submitted may be made public.
    Material submitted by members of the public that is properly marked 
as BCI with a valid statutory basis will not be disclosed publicly. For 
any comments that contain BCI, the file name of the business 
confidential version should begin with the characters `BCI'. Any

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page containing BCI must be clearly marked `BUSINESS CONFIDENTIAL' on 
the top of that page, and the submission should clearly indicate, via 
brackets, highlighting, or other means, the specific information that 
is business confidential. A filer requesting business confidential 
treatment must certify that the information is business confidential 
and that they would not customarily release it to the public. Filers of 
comments containing BCI also must submit a public version of their 
comments. The file name of the public version should begin with the 
character `P'.

    Dated: June 16, 2022.
Roshelle M. Brooks,
Office of the Executive Secretariat, Administration for Children and 
Families.
[FR Doc. 2022-13374 Filed 6-22-22; 8:45 am]
BILLING CODE 4184-47-P