81_FR_62623 81 FR 62448 - Medical Review Board Task Report on Insulin Treated Diabetes Mellitus and Commercial Motor Vehicle Drivers

81 FR 62448 - Medical Review Board Task Report on Insulin Treated Diabetes Mellitus and Commercial Motor Vehicle Drivers

DEPARTMENT OF TRANSPORTATION
Federal Motor Carrier Safety Administration

Federal Register Volume 81, Issue 175 (September 9, 2016)

Page Range62448-62450
FR Document2016-21724

In May 2015, FMCSA published a notice of proposed rulemaking (NPRM) in the Federal Register to allow drivers with stable, well- controlled insulin-treated diabetes mellitus (ITDM) to be qualified to operate commercial motor vehicles (CMVs) in interstate commerce. The comment period closed on July 6, 2015 and the Agency received over 1,250 comments. In that same month, FMCSA requested the Medical Review Board (MRB) to provide the Agency with advice by reviewing and analyzing the comments and providing recommendations to FMCSA for its consideration. The Agency announces the availability of the MRB's report and requests comments on the MRB recommendations. The Final MRB Task 15-01 Report is posted in the docket at FMCSA-2005-23151.

Federal Register, Volume 81 Issue 175 (Friday, September 9, 2016) 
[Federal Register Volume 81, Number 175 (Friday, September 9, 2016)]
[Proposed Rules]
[Pages 62448-62450]
From the Federal Register Online  [www.thefederalregister.org]
[FR Doc No: 2016-21724]


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DEPARTMENT OF TRANSPORTATION

Federal Motor Carrier Safety Administration

49 CFR Part 391

[Docket No. FMCSA-2005-23151]
RIN 2126-AA95


Medical Review Board Task Report on Insulin Treated Diabetes 
Mellitus and Commercial Motor Vehicle Drivers

AGENCY: Federal Motor Carrier Safety Administration (FMCSA), DOT.

ACTION: Notice of availability; request for comments.

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SUMMARY: In May 2015, FMCSA published a notice of proposed rulemaking 
(NPRM) in the Federal Register to allow drivers with stable, well-
controlled insulin-treated diabetes mellitus (ITDM) to be qualified to 
operate commercial motor vehicles (CMVs) in interstate commerce. The 
comment period closed on July 6, 2015 and the Agency received over 
1,250 comments. In that same month, FMCSA requested the Medical Review 
Board (MRB) to provide the Agency with advice by reviewing and 
analyzing the comments and providing recommendations to FMCSA for its 
consideration. The Agency announces the availability of the MRB's 
report and requests comments on the MRB recommendations. The Final MRB 
Task 15-01 Report is posted in the docket at FMCSA-2005-23151.

DATES: Comments must be received on or before November 8, 2016.

ADDRESSES: You may submit comments bearing the Federal Docket 
Management System (FDMS) Docket No. FMCSA-2005-23151 using any of the 
following methods:
     Federal eRulemaking Portal: Go to www.regulations.gov. 
Follow the on-line instructions for submitting comments.
     Mail: Docket Management Facility; U.S. Department of 
Transportation, Room W12-140, 1200 New Jersey Avenue SE., Washington, 
DC 20590-0001.
     Hand Delivery or Courier: West Building Ground Floor, Room 
W12-140, 1200 New Jersey Avenue SE., Washington, DC, between 9 a.m. and 
5 p.m., ET, Monday through Friday, except Federal Holidays.
     Fax: 1-202-493-2251.
    Each submission must include FMCSA and docket number FMCSA-2005-
23151. Note that DOT posts all comments received without change to 
www.regulations.gov, including any personal information included in a 
comment. Please see the Privacy Act heading below.
    Docket: For access to the docket to read background documents or 
comments, go to www.regulations.gov at any time or visit Room W12-140 
on the ground level of the West Building, 1200 New Jersey Avenue SE., 
Washington, DC, between 9 a.m. and 5 p.m., ET, Monday through Friday, 
except Federal holidays. The on-line FDMS is available 24 hours each 
day, 365 days each year. If you want acknowledgment that we received 
your comments, please include a self-addressed, stamped envelope or 
postcard or print the acknowledgement page that appears after 
submitting comments on-line.
    Privacy Act: In accordance with 5 U.S.C. 553(c), DOT solicits 
comments from the public to better inform its rulemaking process. DOT 
posts these comments, without edit, including any personal information 
the commenter provides, to www.regulations.gov, as described in the 
system of records notice (DOT/ALL-14 FDMS), which can be reviewed at 
www.dot.gov/privacy.

FOR FURTHER INFORMATION CONTACT: Ms. Christine A. Hydock, 1200 New 
Jersey Ave. SE., Washington, DC 20590, or by phone at (202) 366-4001 or 
by email at FMCSAMedical@dot.gov. If you have questions on viewing or 
submitting material to the docket, contact Docket Services, telephone 
(202) 366-9826.

SUPPLEMENTARY INFORMATION:

I. Public Participation and Request for Comments

    FMCSA encourages you to participate by submitting comments and 
related materials.

Submitting Comments

    If you submit a comment, please include the docket number for this 
notice (FMCSA-2005-23151), indicate the specific section of this 
document to which each comment applies, and provide a reason for each 
suggestion or recommendation. You may submit your comments and material 
online or by fax, mail, or hand delivery, but please use only one of 
these means. FMCSA recommends that you include your name and a mailing 
address, an email address, or a phone number in the body of your 
document so that FMCSA can contact you if there are questions regarding 
your submission.
    To submit your comment online, go to http://www.regulations.gov, 
put the

[[Page 62449]]

docket number, FMCSA-2005-23151, in the keyword box, and click 
``Search.'' When the new screen appears, click on the ``Comment Now!'' 
button and type your comment into the text box on the following screen. 
Choose whether you are submitting your comment as an individual or on 
behalf of a third party and then submit. If you submit your comments by 
mail or hand delivery, submit them in an unbound format, no larger than 
8\1/2\ by 11 inches, suitable for copying and electronic filing. If you 
submit comments by mail and would like to know that they reached the 
facility, please enclose a stamped, self-addressed postcard or 
envelope.
    FMCSA will consider these comments, in addition to the comments 
submitted in response to the NPRM, in determining how to proceed with 
this rulemaking.

Viewing Comments and Documents

    To view comments, as well as any documents mentioned in this notice 
as being available in the docket, go to http://www.regulations.gov. 
Insert the docket number, FMCSA-2005-23151, in the keyword box, and 
click ``Search.'' Next, click the ``Open Docket Folder'' button and 
choose the document to review. If you do not have access to the 
Internet, you may view the docket online by visiting the Docket 
Management Facility in Room W12-140 on the ground floor of the DOT West 
Building, 1200 New Jersey Avenue SE., Washington, DC 20590, between 9 
a.m. and 5 p.m., E.T., Monday through Friday, except Federal holidays.

II. Background

    Diabetes mellitus is a disease manifested by the body's inability 
to maintain normal function of insulin, a substance that controls 
glycemic levels in the blood. Diabetes presents a major health 
challenge, particularly those who drive CMVs in interstate commerce. 
Under 49 CFR 391.41(b)(3), a person is physically qualified to drive a 
commercial motor vehicle if that person has no established medical 
history or clinical diagnosis of diabetes mellitus currently requiring 
insulin for control. Since 2003, FMCSA has maintained an exemption 
program for individuals that use insulin to treat their diabetes 
mellitus, that allows them to drive in interstate commerce if their 
diabetes is stable and they meet criteria of the program. 68 FR 52441 
(Sept. 3, 2003), as revised, 70 FR 67777 (Nov. 8, 2005).
    In May 2015, FMCSA issued an NPRM in the Federal Register to allow 
drivers with stable, well-controlled ITDM to be qualified to operate 
CMVs in interstate commerce. The NPRM would enable individuals with 
ITDM to obtain a Medical Examiner's Certificate (MEC) from a Certified 
Medical Examiner (CME) at least annually in order to operate in 
interstate commerce as long as evidence is presented by the treating 
clinician who prescribes insulin documenting that the driver's 
condition is stable and well-controlled. The comment period on the NPRM 
closed on July 6, 2015, and the Agency received more than 1,250 
comments.

MRB Tasking

    The MRB was established to provide FMCSA with medical advice and 
recommendations on medical standards and guidelines for the physical 
qualifications of operators of CMVs, medical examiner education, and 
medical research. 49 U.S.C. 31149(a)(1). The MRB, in view of its 
statutory creation and advisory function, is chartered by the 
Department of Transportation as an advisory committee under the 
provisions of the Federal Advisory Committee Act. 5 U.S.C. App. See 
http://www.facadatabase.gov/committee/committee.aspx?cid=2084&aid=47. 
See also Announcement of Establishment of the Federal Motor Carrier 
Safety Administration Medical Review Board, 70 FR 57642 (Oct. 3, 2005). 
The members of the MRB are appointed by the Secretary to reflect 
expertise in a variety of medical specialties relevant to the driver 
fitness requirements of FMCSA. 49 U.S.C. 31149(a)(2).
    In an effort to assist in the development of the final rule, on 
July 15, 2015, FMCSA requested advice from the MRB for the Agency to 
consider. Specifically, FMCSA asked the members to review and analyze 
all comments from medical professionals and associations, and identify 
factors the Agency should consider when making a decision about the 
next steps in the diabetes rulemaking. A public meeting to discuss this 
matter was held by the MRB on July 21 and 22, 2015. The Agency received 
the MRB's final report on September 1, 2015. Details of the meeting, 
including the original task, final report and supporting materials used 
by the MRB are posted on the Agency's public Web site: https://www.fmcsa.dot.gov/medical-review-board-mrb-meeting-topics.

MRB Final Report

    The MRB's final report is available in the docket for this 
rulemaking (in addition to being available on the Agency's public Web 
site). The final report contains a number of detailed recommendations 
for FMCSA to consider as it develops a final rule. The Agency believes 
that public comment on the recommendations will assist it in evaluating 
the advice it has received from the MRB. Comments must be limited to 
addressing the recommendations in the MRB final report. A summary of 
the report's major recommendations is set out below:
    The MRB recommended that ITDM drivers be medically disqualified 
unless they meet the following requirements demonstrating their stable, 
well-controlled ITDM:
    1. The driver must provide an FMCSA Drivers With Insulin Treated 
Diabetes Mellitus Assessment Form (set out in the recommendations) to a 
medical examiner that has been completed and signed by the treating 
clinician. The treating clinician must be a Doctor of Medicine, a 
Doctor of Osteopathy, a Nurse Practitioner or a Physician's Assistant 
who prescribed insulin to the driver and is knowledgeable regarding the 
treatment of diabetes.
    2. The driver must receive a complete ophthalmology or optometry 
exam, including dilated retinal exam, at least every 2 years 
documenting the presence or absence of retinopathy/macular edema and 
the degree of retinopathy and/or macular edema if present (using the 
International Classification of Diabetic Retinopathy and Diabetic 
Macular Edema).
    The MRB recommended that medical examiners be allowed to certify an 
ITDM driver as medically qualified for a time period of no longer than 
1 year only if the driver has not experienced any of the 8 
disqualifying factors below (which the MRB believes should be listed in 
49 CFR 391.46):
    1. Any episode of severe hypoglycemia within the previous 6 months.
    2. Blood sugar less than 60 milligrams per deciliter (mg/dL) 
demonstrated in current glucose logs.
    3. Hypoglycemia appearing in the absence of warning symptoms (i.e., 
hypoglycemic unawareness).
    4. An episode of severe hypoglycemia, blood sugar less than 60 mg/
dl, or hypoglycemic unawareness within the previous 6 months; the 
driver should be medically disqualified and must remain disqualified 
for at least 6 months.
    5. Uncontrolled diabetes, as evidenced by Hemoglobin A1c (HbA1c) 
level greater than 10 percent. A driver could be reinstated when HbA1c 
level is less than or equal to 10 percent.
    6. Stage 3 or 4 diabetic retinopathy; a driver should be 
permanently disqualified.
    7. Signs of target organ damage; a driver should be disqualified 
until the

[[Page 62450]]

matter is resolved by treatment, if possible.
    8. Inadequate record of self-monitoring of blood glucose; a driver 
should be disqualified for inadequate records until the driver can 
demonstrate adequate evidence of glucose records (minimum 1 month).
    In addition, the MRB stated that, if a driver is medically 
disqualified due to not meeting the ITDM criteria listed above, the 
driver should remain disqualified for at least 6 months.

Comments Requested

    Comments are requested on any and all of the recommendations 
provided in the advisory final report from the Medical Review Board but 
only on those recommendations. To the extent possible, comments should 
include supporting materials, such as, for example, data analyses, 
studies, reports, or journal articles. FMCSA will consider these 
comments, in addition to the comments submitted in response to the 
NPRM, in determining how to proceed with this rulemaking.

    Issued on: August 30, 2016.
Larry W. Minor,
Associate Administrator for Policy.
[FR Doc. 2016-21724 Filed 9-8-16; 8:45 am]
BILLING CODE 4910-EX-P

62448 Federal Register / Vol. 81, No. 175 / Friday, September 9, 2016 / Proposed Rules GSAR clause 552.212–4 Alternate I, and (End of Clause) Each submission must include therefore all provisions of clause 552.212–4 [FR Doc. 2016–21610 Filed 9–8–16; 8:45 am] FMCSA and docket number FMCSA– Alternate I that apply to ‘‘materials’’ also 2005–23151. Note that DOT posts all BILLING CODE 6820–61–P apply to order-level materials. The ordering comments received without change to activity shall follow procedures under the www.regulations.gov, including any Federal Travel Regulation and FAR Part 31 when order-level materials include travel. personal information included in a DEPARTMENT OF TRANSPORTATION comment. Please see the Privacy Act (3) Order-level materials shall only be acquired in direct support of an order and Federal Motor Carrier Safety heading below. not as the primary basis. Docket: For access to the docket to Administration (4) The cumulative value of order-level read background documents or materials awarded under an FSS order shall comments, go to www.regulations.gov at 49 CFR Part 391 not exceed 33 percent of the total value of the any time or visit Room W12–140 on the order. [Docket No. FMCSA–2005–23151] ground level of the West Building, 1200 (5) All order-level materials shall be placed New Jersey Avenue SE., Washington, under the Order-Level Materials SIN. RIN 2126–AA95 DC, between 9 a.m. and 5 p.m., ET, (6) Prior to the placement of an order that Monday through Friday, except Federal includes order-level materials, the ordering Medical Review Board Task Report on holidays. The on-line FDMS is available activity shall follow procedures in FAR Insulin Treated Diabetes Mellitus and 8.404(h). 24 hours each day, 365 days each year. Commercial Motor Vehicle Drivers (7) To support the price reasonableness of If you want acknowledgment that we order-level materials, the contractor AGENCY: Federal Motor Carrier Safety received your comments, please include proposing order-level materials as part of a Administration (FMCSA), DOT. a self-addressed, stamped envelope or solution shall submit a minimum of three ACTION: Notice of availability; request postcard or print the acknowledgement quotes obtained by the contractor for each for comments. page that appears after submitting order-level material above the micro- comments on-line. purchase threshold. One of these three quotes SUMMARY: In May 2015, FMCSA Privacy Act: In accordance with 5 may include materials furnished by the published a notice of proposed U.S.C. 553(c), DOT solicits comments contractor under FAR 52.212–4 Alternate I from the public to better inform its rulemaking (NPRM) in the Federal (i)(1)(ii)(A) If the contractor cannot obtain rulemaking process. DOT posts these three quotes, the contractor shall provide the Register to allow drivers with stable, well-controlled insulin-treated diabetes comments, without edit, including any rationale for why they cannot obtain three quotes to support the contracting officer’s mellitus (ITDM) to be qualified to personal information the commenter determination in (d)(7) of this section. operate commercial motor vehicles provides, to www.regulations.gov, as (8) The ordering activity contracting officer (CMVs) in interstate commerce. The described in the system of records must make a determination that prices for all comment period closed on July 6, 2015 notice (DOT/ALL–14 FDMS), which can order-level materials are determined fair and and the Agency received over 1,250 be reviewed at www.dot.gov/privacy. reasonable. The ordering activity contracting comments. In that same month, FMCSA FOR FURTHER INFORMATION CONTACT: Ms. officer may base their determination on a requested the Medical Review Board Christine A. Hydock, 1200 New Jersey comparison of the quotes received in Ave. SE., Washington, DC 20590, or by (MRB) to provide the Agency with response to the task or delivery order phone at (202) 366–4001 or by email at solicitation or other relevant pricing advice by reviewing and analyzing the comments and providing FMCSAMedical@dot.gov. If you have information available. (9) Prior to an increase in the ceiling price recommendations to FMCSA for its questions on viewing or submitting of order-level materials above the micro- consideration. The Agency announces material to the docket, contact Docket purchase threshold, the ordering activity the availability of the MRB’s report and Services, telephone (202) 366–9826. contracting officer shall— requests comments on the MRB SUPPLEMENTARY INFORMATION: (i) Conduct an analysis of pricing and other recommendations. The Final MRB Task relevant factors to determine if the action is I. Public Participation and Request for 15–01 Report is posted in the docket at Comments in the best interest of the Government and FMCSA–2005–23151. obtain the approval at the levels described in FMCSA encourages you to participate FAR 8.405–6(d); or DATES: Comments must be received on by submitting comments and related (ii) Follow the procedures at FAR 8.405– or before November 8, 2016. materials. 6 for a change that modifies the general scope ADDRESSES: You may submit comments of the order. bearing the Federal Docket Management Submitting Comments (10) In accordance with GSAR clause System (FDMS) Docket No. FMCSA– If you submit a comment, please 552.215–71 Examination of Records by GSA, 2005–23151 using any of the following include the docket number for this GSA has the authority to examine the methods: notice (FMCSA–2005–23151), indicate contractor’s records for compliance with the pricing provisions in FAR clause 52.212–4 • Federal eRulemaking Portal: Go to the specific section of this document to Alternate I, to include examination of any www.regulations.gov. Follow the on-line which each comment applies, and books, documents, papers, and records instructions for submitting comments. provide a reason for each suggestion or involving transactions related to the contract • Mail: Docket Management Facility; recommendation. You may submit your for overbillings, billing errors, and U.S. Department of Transportation, comments and material online or by fax, compliance with the IFF and the Sales Room W12–140, 1200 New Jersey mail, or hand delivery, but please use Reporting clauses of the contract. Avenue SE., Washington, DC 20590– only one of these means. FMCSA (11) Order-level materials are exempt from 0001. ehiers on DSK5VPTVN1PROD with PROPOSALS recommends that you include your the following clauses: • Hand Delivery or Courier: West name and a mailing address, an email (i) 552.216–70 Economic Price Building Ground Floor, Room W12–140, address, or a phone number in the body Adjustment—FSS Multiple Award Schedule Contracts. 1200 New Jersey Avenue SE., of your document so that FMCSA can (ii) 552.238–71 Submission and Washington, DC, between 9 a.m. and 5 contact you if there are questions Distribution of Authorized FSS Schedule p.m., ET, Monday through Friday, regarding your submission. Pricelists. except Federal Holidays. To submit your comment online, go to (iii) 552.238–75 Price Reductions. • Fax: 1–202–493–2251. http://www.regulations.gov, put the VerDate Sep<11>2014 15:27 Sep 08, 2016 Jkt 238001 PO 00000 Frm 00030 Fmt 4702 Sfmt 4702 E:\FR\FM\09SEP1.SGM 09SEP1

Federal Register / Vol. 81, No. 175 / Friday, September 9, 2016 / Proposed Rules 62449 docket number, FMCSA–2005–23151, in would enable individuals with ITDM to Agency believes that public comment the keyword box, and click ‘‘Search.’’ obtain a Medical Examiner’s Certificate on the recommendations will assist it in When the new screen appears, click on (MEC) from a Certified Medical evaluating the advice it has received the ‘‘Comment Now!’’ button and type Examiner (CME) at least annually in from the MRB. Comments must be your comment into the text box on the order to operate in interstate commerce limited to addressing the following screen. Choose whether you as long as evidence is presented by the recommendations in the MRB final are submitting your comment as an treating clinician who prescribes insulin report. A summary of the report’s major individual or on behalf of a third party documenting that the driver’s condition recommendations is set out below: and then submit. If you submit your is stable and well-controlled. The The MRB recommended that ITDM comments by mail or hand delivery, comment period on the NPRM closed on drivers be medically disqualified unless submit them in an unbound format, no July 6, 2015, and the Agency received they meet the following requirements larger than 81⁄2 by 11 inches, suitable for more than 1,250 comments. demonstrating their stable, well- copying and electronic filing. If you controlled ITDM: MRB Tasking submit comments by mail and would 1. The driver must provide an FMCSA like to know that they reached the The MRB was established to provide Drivers With Insulin Treated Diabetes facility, please enclose a stamped, self- FMCSA with medical advice and Mellitus Assessment Form (set out in the addressed postcard or envelope. recommendations on medical standards recommendations) to a medical FMCSA will consider these and guidelines for the physical examiner that has been completed and comments, in addition to the comments qualifications of operators of CMVs, signed by the treating clinician. The submitted in response to the NPRM, in medical examiner education, and treating clinician must be a Doctor of determining how to proceed with this medical research. 49 U.S.C. 31149(a)(1). Medicine, a Doctor of Osteopathy, a rulemaking. The MRB, in view of its statutory Nurse Practitioner or a Physician’s creation and advisory function, is Assistant who prescribed insulin to the Viewing Comments and Documents chartered by the Department of driver and is knowledgeable regarding To view comments, as well as any Transportation as an advisory the treatment of diabetes. documents mentioned in this notice as committee under the provisions of the 2. The driver must receive a complete being available in the docket, go to Federal Advisory Committee Act. 5 http://www.regulations.gov. Insert the ophthalmology or optometry exam, U.S.C. App. See http:// docket number, FMCSA–2005–23151, in including dilated retinal exam, at least www.facadatabase.gov/committee/ the keyword box, and click ‘‘Search.’’ every 2 years documenting the presence committee.aspx?cid=2084&aid=47. See Next, click the ‘‘Open Docket Folder’’ or absence of retinopathy/macular also Announcement of Establishment of button and choose the document to edema and the degree of retinopathy the Federal Motor Carrier Safety review. If you do not have access to the and/or macular edema if present (using Administration Medical Review Board, Internet, you may view the docket 70 FR 57642 (Oct. 3, 2005). The the International Classification of online by visiting the Docket members of the MRB are appointed by Diabetic Retinopathy and Diabetic Management Facility in Room W12–140 the Secretary to reflect expertise in a Macular Edema). on the ground floor of the DOT West variety of medical specialties relevant to The MRB recommended that medical Building, 1200 New Jersey Avenue SE., the driver fitness requirements of examiners be allowed to certify an Washington, DC 20590, between 9 a.m. FMCSA. 49 U.S.C. 31149(a)(2). ITDM driver as medically qualified for and 5 p.m., E.T., Monday through In an effort to assist in the a time period of no longer than 1 year Friday, except Federal holidays. development of the final rule, on July only if the driver has not experienced 15, 2015, FMCSA requested advice from any of the 8 disqualifying factors below II. Background the MRB for the Agency to consider. (which the MRB believes should be Diabetes mellitus is a disease Specifically, FMCSA asked the members listed in 49 CFR 391.46): manifested by the body’s inability to to review and analyze all comments 1. Any episode of severe maintain normal function of insulin, a from medical professionals and hypoglycemia within the previous 6 substance that controls glycemic levels associations, and identify factors the months. in the blood. Diabetes presents a major Agency should consider when making a 2. Blood sugar less than 60 milligrams health challenge, particularly those who decision about the next steps in the per deciliter (mg/dL) demonstrated in drive CMVs in interstate commerce. diabetes rulemaking. A public meeting current glucose logs. Under 49 CFR 391.41(b)(3), a person is to discuss this matter was held by the 3. Hypoglycemia appearing in the physically qualified to drive a MRB on July 21 and 22, 2015. The absence of warning symptoms (i.e., commercial motor vehicle if that person Agency received the MRB’s final report hypoglycemic unawareness). has no established medical history or on September 1, 2015. Details of the 4. An episode of severe hypoglycemia, clinical diagnosis of diabetes mellitus meeting, including the original task, blood sugar less than 60 mg/dl, or currently requiring insulin for control. final report and supporting materials hypoglycemic unawareness within the Since 2003, FMCSA has maintained an used by the MRB are posted on the previous 6 months; the driver should be exemption program for individuals that Agency’s public Web site: https:// medically disqualified and must remain use insulin to treat their diabetes www.fmcsa.dot.gov/medical-review- disqualified for at least 6 months. mellitus, that allows them to drive in board-mrb-meeting-topics. 5. Uncontrolled diabetes, as interstate commerce if their diabetes is evidenced by Hemoglobin A1c (HbA1c) MRB Final Report level greater than 10 percent. A driver ehiers on DSK5VPTVN1PROD with PROPOSALS stable and they meet criteria of the program. 68 FR 52441 (Sept. 3, 2003), as The MRB’s final report is available in could be reinstated when HbA1c level is revised, 70 FR 67777 (Nov. 8, 2005). the docket for this rulemaking (in less than or equal to 10 percent. In May 2015, FMCSA issued an addition to being available on the 6. Stage 3 or 4 diabetic retinopathy; a NPRM in the Federal Register to allow Agency’s public Web site). The final driver should be permanently drivers with stable, well-controlled report contains a number of detailed disqualified. ITDM to be qualified to operate CMVs recommendations for FMCSA to 7. Signs of target organ damage; a in interstate commerce. The NPRM consider as it develops a final rule. The driver should be disqualified until the VerDate Sep<11>2014 15:27 Sep 08, 2016 Jkt 238001 PO 00000 Frm 00031 Fmt 4702 Sfmt 4702 E:\FR\FM\09SEP1.SGM 09SEP1

62450 Federal Register / Vol. 81, No. 175 / Friday, September 9, 2016 / Proposed Rules matter is resolved by treatment, if below) must be received by 11:59 p.m. (b) Genetics and taxonomy; possible. Eastern time on the closing date. We (c) Historical and current range, 8. Inadequate record of self- must receive requests for public including distribution patterns; monitoring of blood glucose; a driver hearings, in writing, at the address (d) Historical and current population should be disqualified for inadequate shown in FOR FURTHER INFORMATION levels, and current and projected trends; records until the driver can demonstrate CONTACT by October 24, 2016 and adequate evidence of glucose records ADDRESSES: You may submit comments (e) Past and ongoing conservation (minimum 1 month). by one of the following methods: (1) measures for the species, its habitat, or In addition, the MRB stated that, if a Electronically: Go to the Federal both. driver is medically disqualified due to eRulemaking Portal: http:// (2) Factors that may affect the not meeting the ITDM criteria listed www.regulations.gov. In the Search box, continued existence of the species, above, the driver should remain enter FWS–R2–ES–2016–0099, which is which may include habitat modification disqualified for at least 6 months. the docket number for this rulemaking. or destruction, overutilization, disease, Then click on the Search button. On the Comments Requested predation, the inadequacy of existing resulting page, in the Search panel on Comments are requested on any and regulatory mechanisms, or other natural the left side of the screen, under the all of the recommendations provided in or manmade factors. Document Type heading, click on the the advisory final report from the Proposed Rules link to locate this (3) Biological, commercial trade, or Medical Review Board but only on those document. You may submit a comment other relevant data concerning any recommendations. To the extent by clicking on ‘‘Comment Now!’’ threats (or lack thereof) to this species possible, comments should include (2) By hard copy: Submit by U.S. mail and existing regulations that may be supporting materials, such as, for or hand-delivery to: Public Comments addressing those threats. example, data analyses, studies, reports, Processing, Attn: FWS–R2–ES–2016– Please include sufficient information or journal articles. FMCSA will consider 0099, U.S. Fish and Wildlife Service, with your submission (such as scientific these comments, in addition to the MS: BPHC, 5275 Leesburg Pike, Falls journal articles or other publications) to comments submitted in response to the Church, VA 22041–3803. allow us to verify any scientific or NPRM, in determining how to proceed We request that you send comments commercial information you include. with this rulemaking. only by the methods described above. Please note that submissions merely We will post all comments on http:// stating support for or opposition to the Issued on: August 30, 2016. www.regulations.gov. This generally action under consideration without Larry W. Minor, means that we will post any personal providing supporting information, Associate Administrator for Policy. information you provide us (see Public although noted, will not be considered [FR Doc. 2016–21724 Filed 9–8–16; 8:45 am] Comments, below, for more in making a determination, as section BILLING CODE 4910–EX–P information). 4(b)(1)(A) of the Act (16 U.S.C. 1531 et FOR FURTHER INFORMATION CONTACT: seq.) directs that determinations as to Adam Zerrenner, Field Supervisor, U.S. whether any species is an endangered or DEPARTMENT OF THE INTERIOR Fish and Wildlife Service, Austin threatened species must be made Ecological Services Field Office, 10711 ‘‘solely on the basis of the best scientific Fish and Wildlife Service Burnet Rd., Suite 200, Austin, TX and commercial data available.’’ 78758; telephone 512–490–0057; or You may submit your comments and 50 CFR Part 17 facsimile 512–490–0974. Persons who materials concerning this proposed rule [Docket No. FWS–R2–ES–2016–0099; use a telecommunications device for the by one of the methods listed above in 4500030113] deaf (TDD) may call the Federal ADDRESSES. We request that you send Information Relay Service (FIRS) at comments only by the methods RIN 1018–BA74 800–877–8339. described in ADDRESSES. Endangered and Threatened Wildlife SUPPLEMENTARY INFORMATION: If you submit information via http:// and Plants; Endangered Species www.regulations.gov, your entire Information Requested Status for Guadalupe Fescue submission—including any personal Public Comments identifying information—will be posted AGENCY: Fish and Wildlife Service, We intend that any final action on the Web site. If your submission is Interior. resulting from this proposed rule will be made via a hardcopy that includes ACTION: Proposed rule. based on the best available scientific personal identifying information, you and commercial data and will be as may request at the top of your document SUMMARY: We, the U.S. Fish and accurate and as effective as possible. that we withhold this information from Wildlife Service (Service), propose to Therefore, we request comments or public review. However, we cannot list Festuca ligulata (Guadalupe fescue), information from other concerned guarantee that we will be able to do so. a plant species from the Chihuahuan governmental agencies, Native We will post all hardcopy submissions Desert of west Texas and Mexico, as an American tribes, the scientific on http://www.regulations.gov. endangered species under the community, industry, or any other Comments and materials we receive, Endangered Species Act of 1973, as interested parties concerning this as well as supporting documentation we amended (Act). If we finalize this rule used in preparing this proposed rule, ehiers on DSK5VPTVN1PROD with PROPOSALS proposed rule. We particularly seek as proposed, it would extend the Act’s comments concerning: will be available for public inspection protections to this species. (1) Guadalupe fescue’s biology, range, on http://www.regulations.gov, or by DATES: We will accept comments and population trends, including: appointment, during normal business received or postmarked on or before (a) Biological or ecological hours, at the U.S. Fish and Wildlife November 8, 2016. Comments submitted requirements of the species, including Service, Austin Ecological Services electronically using the Federal habitat requirements for soils, Field Office (see FOR FURTHER eRulemaking Portal (see ADDRESSES, reproduction, and associated species; INFORMATION CONTACT). VerDate Sep<11>2014 15:27 Sep 08, 2016 Jkt 238001 PO 00000 Frm 00032 Fmt 4702 Sfmt 4702 E:\FR\FM\09SEP1.SGM 09SEP1


Document Created: 2018-02-09 13:15:16
Document Modified: 2018-02-09 13:15:16
CategoryRegulatory Information
CollectionFederal Register
sudoc ClassAE 2.7:
GS 4.107:
AE 2.106:
PublisherOffice of the Federal Register, National Archives and Records Administration
SectionProposed Rules
ActionNotice of availability; request for comments.
DatesComments must be received on or before November 8, 2016.
ContactMs. Christine A. Hydock, 1200 New Jersey Ave. SE., Washington, DC 20590, or by phone at (202) 366-4001 or by email at [email protected] If you have questions on viewing or submitting material to the docket, contact Docket Services, telephone (202) 366-9826.
FR Citation81 FR 62448 
RIN Number2126-AA95
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