82_FR_21908 82 FR 21819 - Nerve Agents and Certain Insecticides (Organophosphorus and/or Carbamate) Countermeasures

82 FR 21819 - Nerve Agents and Certain Insecticides (Organophosphorus and/or Carbamate) Countermeasures

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Federal Register Volume 82, Issue 89 (May 10, 2017)

Page Range21819-21825
FR Document2017-09455

The Secretary is issuing a declaration pursuant to section 319F-3 of the Public Health Service Act to provide liability protections consistent with that authority for medical countermeasures against nerve agents and organophosphorus insecticides that result in organophosphorus poisoning and carbamate insecticides that result in carbamate poisoning.

Federal Register, Volume 82 Issue 89 (Wednesday, May 10, 2017)
[Federal Register Volume 82, Number 89 (Wednesday, May 10, 2017)]
[Notices]
[Pages 21819-21825]
From the Federal Register Online  [www.thefederalregister.org]
[FR Doc No: 2017-09455]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES


Nerve Agents and Certain Insecticides (Organophosphorus and/or 
Carbamate) Countermeasures

AGENCY: Department of Health and Human Services, Office of the 
Secretary.

ACTION: Notice.

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SUMMARY: The Secretary is issuing a declaration pursuant to section 
319F-3 of the Public Health Service Act to

[[Page 21820]]

provide liability protections consistent with that authority for 
medical countermeasures against nerve agents and organophosphorus 
insecticides that result in organophosphorus poisoning and carbamate 
insecticides that result in carbamate poisoning.

DATES: The declaration is effective as of April 11, 2017.

FOR FURTHER INFORMATION CONTACT: George W. Korch Jr., Ph.D., Acting 
Assistant Secretary for Preparedness and Response, Office of the 
Secretary, Department of Health and Human Services, 200 Independence 
Avenue SW., Washington, DC 20201, Telephone (202) 205-2882 (this is not 
a toll-free number).

SUPPLEMENTARY INFORMATION:

Background

    The Public Readiness and Emergency Preparedness Act (PREP Act) 
authorizes the Secretary of the U.S. Department of Health and Human 
Services to issue a declaration to provide liability immunity to 
certain individuals and entities (Covered Persons) against any claim of 
loss caused by, arising out of, relating to, or resulting from the 
administration or use of medical countermeasures (Covered 
Countermeasures), except for claims that meet the PREP Act's definition 
of willful misconduct. Using this authority, the Secretary is issuing 
this declaration for medical countermeasures against nerve agents and 
organophosphorus insecticides that result in organophosphorus poisoning 
and carbamate insecticides that result in carbamate poisoning. The 
purpose of issuing this declaration is to strengthen preparedness 
against these threats that pose an ongoing credible risk of a future 
public health emergency and does not indicate a change in threat 
information.
    The declaration is published in full. We explain both the 
substantive and format changes in this supplementary section.
    The PREP Act was enacted on December 30, 2005 as Public Law 109-
148, Division C, Section 2. It amended the Public Health Service 
(``PHS'') Act, adding section 319F-3, which addresses liability 
immunity, and section 319F-4, which creates a compensation program. 
These sections are codified in the U.S. Code as 42 U.S.C. 247d-6d and 
42 U.S.C. 247d-6e, respectively. The Pandemic and All-Hazards 
Preparedness Reauthorization Act (PAHPRA), Public Law 113-5, was 
enacted on March 13, 2013. Among other things, PAHPRA added sections 
564A and 564B to the Federal Food, Drug & Cosmetic (FD&C) Act to 
provide new emergency authorities for dispensing approved products in 
emergencies and products held for emergency use. PAHPRA accordingly 
amended the definitions of Covered Countermeasures and qualified 
pandemic and epidemic products in section 319F-3 of the Public Health 
Service Act (the PREP Act provisions), so that products made available 
under these new FD&C Act authorities could be covered under PREP Act 
declarations. PAHPRA also extended the definition of qualified pandemic 
and epidemic products to include products or technologies intended to 
enhance the use or effect of a drug, biological product, or device used 
against the pandemic or epidemic or against adverse events from these 
products.
    Unless otherwise noted, all statutory citations below are to the 
U.S. Code.

Section I, Determination of Public Health Emergency or Credible Risk of 
Future Public Health Emergency

    Before issuing a declaration under the PREP Act, the Secretary is 
required to determine that a disease or other health condition or 
threat to health constitutes a public health emergency or that there is 
a credible risk that the disease, condition, or threat may in the 
future constitute such an emergency.\1\ This determination is separate 
and apart from a declaration issued by the Secretary under section 319 
of the PHS Act \2\ that a disease or disorder presents a public health 
emergency or that, a public health emergency, including significant 
outbreaks of infectious diseases or bioterrorist attacks, otherwise 
exists, or other declarations or determinations made under other 
authorities of the Secretary. The declaration states in section I the 
Secretary's determination that there is a credible risk that the 
release of nerve agents or organophosphorus insecticides and the 
resulting organophosphorus poisoning or the release of carbamate 
insecticides and the resulting carbamate poisoning may, in the future, 
constitute a public health emergency.
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    \1\ 42 U.S.C. 247d-6d(b)(1).
    \2\ 42 U.S.C. 247d.
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Section II, Factors Considered

    In deciding whether and under what circumstances to issue a 
declaration with respect to a Covered Countermeasure, the Secretary 
must consider the desirability of encouraging the design, development, 
clinical testing or investigation, manufacture, labeling, distribution, 
formulation, packaging, marketing, promotion, sale, purchase, donation, 
dispensing, prescribing, administration, licensing, and use of the 
countermeasure.\3\ The declaration states these considerations in 
section II.
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    \3\ 42 U.S.C. 247d-6d(b)(6).
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Section III, Recommended Activities

    The Secretary must recommend the activities for which the PREP 
Act's liability immunity is in effect. These activities may include, 
under conditions as the Secretary may specify, the manufacture, 
testing, development, distribution, administration, or use of one or 
more Covered Countermeasures (Recommended Activities).\4\ The 
declaration states the Recommended Activities in section III.
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    \4\ 42 U.S.C. 247d-6d(b)(1).
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Section IV, Liability Immunity

    The Secretary must also state that liability protections available 
under the PREP Act are in effect with respect to the Recommended 
Activities.\5\ These liability protections provide that, ``[s]ubject to 
other provisions of [the PREP Act], a covered person shall be immune 
from suit and liability under Federal and State law with respect to all 
claims for loss caused by, arising out of, relating to, or resulting 
from the administration to or use by an individual of a covered 
countermeasure if a declaration . . . has been issued with respect to 
such countermeasure.'' \6\ The declaration includes the statement that 
liability immunity is in effect for Recommended Activities in section 
IV.
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    \5\ 42 U.S.C. 247d-6d(b)(1).
    \6\ 42 U.S.C. 247d-6d(a)(1).
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Section V, Covered Persons

    The PREP Act's liability immunity applies to Covered Persons with 
respect to administration or use of a Covered Countermeasure. The term 
``Covered Persons'' has a specific meaning, and is defined in the PREP 
Act to include manufacturers, distributors, program planners, and 
qualified persons, and their officials, agents, and employees, and the 
United States.\7\ The PREP Act further defines the terms 
``manufacturer,'' ``distributor,'' ``program planner,'' and ``qualified 
person'' as described below.\8\
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    \7\ 42 U.S.C. 247d-6d(i)(2).
    \8\ 42 U.S.C. 247d-6d(i).
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    A manufacturer includes a contractor or subcontractor of a 
manufacturer; a supplier or licenser of any product, intellectual 
property, service, research tool or component or other article used in 
the design, development, clinical testing, investigation or 
manufacturing of a Covered Countermeasure; and any or all of the 
parents, subsidiaries,

[[Page 21821]]

affiliates, successors, and assigns of a manufacturer; \9\
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    \9\ 42 U.S.C. 247d-6d(i)(4).
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    A distributor means a person or entity engaged in the distribution 
of drugs, biologics, or devices, including but not limited to: 
Manufacturers; repackers; common carriers; contract carriers; air 
carriers; own-label distributors; private-label distributors; jobbers; 
brokers; warehouses and wholesale drug warehouses; independent 
wholesale drug traders; and, retail pharmacies; \10\
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    \10\ 42 U.S.C. 247d-6d(i)(3).
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    A program planner means a state or local government, including a 
Native American Tribe; a person employed by the state or local 
government; or other person who supervises or administers a program 
with respect to the administration, dispensing, distribution, 
provision, or use of a Covered Countermeasure, including a person who 
establishes requirements, provides policy guidance, or supplies 
technical or scientific advice or assistance or provides a facility to 
administer or use a Covered Countermeasure in accordance with the 
Secretary's declaration.\11\ Under this definition, a private sector 
employer or community group or other person can be a program planner 
when it carries out the described activities.
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    \11\ 42 U.S.C. 247d-6d(i)(6).
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    A qualified person means a licensed health professional or other 
individual who is authorized to prescribe, administer, or dispense 
Covered Countermeasures under the law of the state in which the 
countermeasure was prescribed, administered, or dispensed; or, a person 
within a category of persons identified as qualified in the Secretary's 
declaration.\12\ Under this definition, the Secretary can describe in 
the declaration other qualified persons, such as volunteers, who are 
Covered Persons. Section V describes other qualified persons covered by 
this declaration.
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    \12\ 42 U.S.C. 247d-6d(i)(8).
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    The PREP Act also defines the word ``person'' as used in the Act: A 
person includes an individual, partnership, corporation, association, 
entity, or public or private corporation, including a federal, state, 
or local government agency or department.\13\
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    \13\ 42 U.S.C. 247d-6d(i)(5).
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    The declaration lists Covered Persons in section V to include 
manufacturers, distributors, program planners, qualified persons, and 
their officials, agents, and employees, as those terms are defined in 
the PREP Act, and the United States.
    The declaration also lists in section V Additional Covered Persons 
to include: (a) Any person authorized in accordance with the public 
health and medical emergency response of the Authority Having 
Jurisdiction, . . . to prescribe, administer, deliver, distribute or 
dispense the Covered Countermeasures, and their officials, agents, 
employees, contractors and volunteers, following a declaration of an 
emergency; (b) any person authorized to prescribe, administer, or 
dispense the Covered Countermeasures or who is otherwise authorized to 
perform an activity under an Emergency Use Authorization in accordance 
with section 564 of the FD&C Act; and, (c) any person authorized to 
prescribe, administer, or dispense Covered Countermeasures in 
accordance with Section 564A of the FD&C Act.

Section VI, Covered Countermeasures

    As noted above, section III describes the Secretary's Recommended 
Activities for which liability immunity is in effect. This section 
identifies the countermeasures for which the Secretary has recommended 
such activities. The PREP Act states that a Covered Countermeasure must 
be a ``qualified pandemic or epidemic product,'' or a ``security 
countermeasure,'' as described immediately below; or a drug, biological 
product or device authorized for emergency use in accordance with 
section 564, 564A, or 564B of the FD&C Act.\14\
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    \14\ 42 U.S.C. 247d-6d(i)(1). Sections 564, 564A, and 564B of 
the FD&C Act may be found at 21 U.S.C. 360bbb-3, 360bbb-3a, and 
360bbb-3b.
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    A qualified pandemic or epidemic product means a drug or device, as 
defined in the FD&C Act or a biological product, as defined in the PHS 
Act \15\ that is: (i) Manufactured, used, designed, developed, 
modified, licensed or procured to diagnose, mitigate, prevent, treat, 
or cure a pandemic or epidemic or limit the harm such a pandemic or 
epidemic might otherwise cause; (ii) manufactured, used, designed, 
developed, modified, licensed, or procured to diagnose, mitigate, 
prevent, treat, or cure a serious or life-threatening disease or 
condition caused by such a drug, biological product or device; (iii) 
or, a product or technology intended to enhance the use or effect of 
such a drug, biological product, or device.\16\
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    \15\ 21 U.S.C. 321(g)(1), (h); 42 U.S.C. 262(i).
    \16\ 42 U.S.C. 247d-6d(i)(1)(A), (i)(7).
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    A security countermeasure is a drug or device, as defined in the 
FD&C Act or a biological product, as defined in the PHS Act \17\ that: 
(i)(a) The Secretary determines to be a priority to diagnose, mitigate, 
prevent or treat harm from any biological, chemical, radiological, or 
nuclear agent identified as a material threat by the Secretary of 
Homeland Security, or (b) to diagnose, mitigate, prevent, or treat harm 
from a condition that may result in adverse health consequences or 
death and may be caused by administering a drug, biological product, or 
device against such an agent; and (ii) is determined by the Secretary 
of Health and Human Services to be a necessary countermeasure to 
protect public health.\18\
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    \17\ 21 U.S.C. 321(g)(1), (h);42 U.S.C. 262(i).
    \18\ 42 U.S.C. 247d-6d(i)(1)(B),(c)(1)(B).
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    To be a Covered Countermeasure, qualified pandemic or epidemic 
products and security countermeasures also must be approved or cleared 
under the FD&C Act; \19\ licensed under the PHS Act; \20\ authorized 
for emergency use under sections 564, 564A, or 564B of the FD&C 
Act.\21\ A qualified pandemic or epidemic product also may be a Covered 
Countermeasure when it is exempted under the FD&C Act for use as an 
investigational drug or device \22\ that is the object of research for 
possible use for diagnosis, mitigation, prevention, treatment, cure or 
limit harm of a pandemic or epidemic or serious or life-threatening 
condition caused by such a drug or device. A security countermeasure 
also may be a Covered Countermeasure if it may reasonably be determined 
to qualify for approval or licensing within ten years after the 
Department's determination that procurement of the countermeasure is 
appropriate.
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    \19\ 21 U.S.C. 301 et seq.
    \20\ 42 U.S.C. 262.
    \21\ 21 U.S.C. 360bbb-3, 360bbb-3a, 360bbb-3b.
    \22\ 21 U.S.C. 355(i), 360j(g).
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    The declaration describes the Covered Countermeasures in Section VI 
as: Any antidote; any other drug; all components and constituent 
materials of these antidotes and other drugs; all devices and their 
constituent components used in the administration of these antidotes 
and other drugs; any diagnostic; or any other device to identify, 
prevent, or treat organophosphorus or carbamate poisoning or adverse 
events from such countermeasures.
    The declaration also includes in section VI a statement referencing 
the statutory definitions of Covered Countermeasures to make clear that 
these statutory definitions limit the scope of Covered Countermeasures.

Section VII, Limitations on Distribution

    The Secretary may specify that liability immunity is in effect only 
to Covered Countermeasures obtained

[[Page 21822]]

through a particular means of distribution.\23\
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    \23\ 42 U.S.C. 247d-6d(a)(5), (b)(2)(E).
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    The declaration states in section VII that liability immunity is 
afforded to Covered Persons for Recommended Activities related to: (a) 
Present or future Federal contracts, cooperative agreements, grants, 
other transactions, interagency agreements, or memoranda of 
understanding or other Federal agreements or activities directly 
conducted by the Federal Government; or (b) Activities authorized in 
accordance with the public health and medical response of the Authority 
Having Jurisdiction to prescribe, administer, deliver, distribute, or 
dispense the Covered Countermeasures to respond to an event covered by 
a declared emergency, including authorized activities that occur as 
part of the response before the formal declaration of an emergency. The 
declaration also provides in section VII definitions for ``Authority 
Having Jurisdiction'' and ``Declaration of an Emergency:''
    i. The Authority Having Jurisdiction means the public agency or its 
delegate that has legal responsibility and authority for responding to 
an incident, based on political or geographical (e.g., city, county, 
Tribal, State, or Federal boundary lines) or functional (e.g., law 
enforcement, public health) range or sphere of authority.
    ii. A declaration of emergency means any declaration by any 
authorized local, regional, State, or Federal official of an emergency 
specific to events that indicate an immediate need to administer and 
use the Covered Countermeasures, with the exception of a Federal 
declaration in support of an Emergency Use Authorization under section 
564 of the FD&C Act unless such declaration specifies otherwise;
    Subsection (b) is intended to cover distribution, dispensing, 
administration, or use of the covered countermeasure under a formal 
government-authorized response to circumstances at any time those 
activities occur to respond to an event that gives rise to a declared 
emergency. Subsection (b) is not intended to be limited to cover those 
activities only after an emergency is formally declared and includes 
authorized activities that occur as part of the response before the 
formal declaration of an emergency. The Secretary recognizes that in 
emergency circumstances, distribution, dispensing, administration, or 
use of countermeasures may need to be expedient and may occur prior to 
a formal declaration of an emergency. This concern is particularly 
critical for the countermeasures covered by this declaration, where the 
Covered Countermeasures may need to be administered within minutes of 
exposure to a nerve agent to save lives. Thus, the Secretary is 
clarifying that coverage under subsection (b) is intended to cover any 
distribution, dispensing, administration, or use in accordance with the 
Authority Having Jurisdiction at any time that those activities address 
the emergency circumstances that gave rise to the declared emergency 
even if the activities occur prior to the declaration itself.
    For governmental program planners only, liability immunity is 
afforded only to the extent they obtain Covered Countermeasures through 
voluntary means, such as (1) donation; (2) commercial sale; (3) 
deployment of Covered Countermeasures from Federal stockpiles; or (4) 
deployment of donated, purchased, or otherwise voluntarily obtained 
Covered Countermeasures from State, local, or private stockpiles. This 
limitation on distribution is intended to deter program planners that 
are government entities from seizing privately held stockpiles of 
Covered Countermeasures. It does not apply to any other Covered 
Persons, including other program planners who are not government 
entities.

Section VIII, Category of Disease, Health Condition, or Threat

    The Secretary must identify, for each Covered Countermeasure, the 
categories of diseases, health conditions, or threats to health for 
which the Secretary recommends the administration or use of the 
countermeasure.\24\ The declaration states in section VIII that the 
category of disease, health condition, or threat for which the 
Secretary recommends administration or use of the countermeasures is 
organophosphorus or carbamate poisoning.
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    \24\ 42 U.S.C. 247d-6d(b)(2)(A).
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Section IX, Administration of Covered Countermeasures

    The PREP Act does not explicitly define the term ``administration'' 
but does assign the Secretary the responsibility to provide relevant 
conditions in the declaration. The declaration defines administration 
in section IX as: Administration of a Covered Countermeasure means 
physical provision of the countermeasures to recipients, or activities 
and decisions directly relating to public and private delivery, 
distribution and dispensing of the countermeasures to recipients; 
management and operation of countermeasure programs; or management and 
operation of locations for purpose of distributing and dispensing 
countermeasures.
    This definition of ``administration'' is intended to extend only to 
physical provision of a countermeasure to a recipient, such as 
vaccination or handing drugs to patients, and to activities related to 
management and operation of programs and locations for providing 
countermeasures to recipients, such as decisions and actions involving 
security and queuing, but only insofar as those activities directly 
relate to the countermeasure activities. Claims for which Covered 
Persons are provided immunity under the Act are losses caused by, 
arising out of, relating to, or resulting from the administration to or 
use by an individual of a Covered Countermeasure consistent with the 
terms of a declaration issued under the Act.\25\ Under the Secretary's 
definition, these liability claims are precluded if the claims allege 
an injury caused by physical provision of a countermeasure to a 
recipient, or if the claims are directly due to conditions of delivery, 
distribution, dispensing, or management and operation of countermeasure 
programs at distribution and dispensing sites.
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    \25\ 42 U.S.C. 247d-6d(a).
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    Thus, it is the Secretary's interpretation that, when a declaration 
is in effect, the Act precludes, for example, liability claims alleging 
negligence by a manufacturer in creating a vaccine, or negligence by a 
health care provider in prescribing the wrong dose, absent willful 
misconduct. Likewise, the Act precludes a liability claim relating to 
the management and operation of a countermeasure distribution program 
or site, such as a slip-and-fall injury or vehicle collision by a 
recipient receiving a countermeasure at a retail store serving as an 
administration or dispensing location that alleges, for example, lax 
security or chaotic crowd control. However, a liability claim alleging 
an injury occurring at the site that was not directly related to the 
countermeasure activities is not covered, such as a slip and fall with 
no direct connection to the countermeasure's administration or use. In 
each case, whether immunity is applicable will depend on the particular 
facts and circumstances.

[[Page 21823]]

Section X, Population

    The Secretary must identify, for each Covered Countermeasure 
specified in a declaration, the population or populations of 
individuals for which liability immunity is in effect with respect to 
administration or use of the countermeasure.\26\ This section explains 
which individuals should use the countermeasure or to whom the 
countermeasure should be administered--in short, those who should be 
vaccinated or take a drug or other countermeasure. The declaration 
provides in section X that the population includes any individual who 
uses or who is administered a Covered Countermeasure in accordance with 
the declaration.
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    \26\ 42 U.S.C. 247d-6d(b)(2)(C).
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    In addition, the PREP Act specifies that liability immunity is 
afforded: (1) To manufacturers and distributors without regard to 
whether the countermeasure is used by or administered to this 
population; and (2) to program planners and qualified persons when the 
countermeasure is either used by or administered to this population or 
the program planner or qualified person reasonably could have believed 
the recipient was in this population.\27\ We included these statutory 
conditions in the declaration section X for clarity.
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    \27\ 42 U.S.C. 247d-6d(a)(4).
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Section XI, Geographic Area

    The Secretary must identify, for each Covered Countermeasure 
specified in the declaration, the geographic area or areas for which 
liability immunity is in effect with respect to administration or use 
of the countermeasure, including, as appropriate, whether the 
declaration applies only to individuals physically present in the area 
or, in addition, applies to individuals who have a described connection 
to the area.\28\ The declaration states in section XI that there are no 
limitations on geographic area.
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    \28\ 42 U.S.C. 247d-6d(b)(2)(D).
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    In addition, the PREP Act specifies that liability immunity is 
afforded: (1) To manufacturers and distributors without regard to 
whether the countermeasure is used by or administered to individuals in 
the geographic areas; and (2) to program planners and qualified persons 
when the countermeasure is either used or administered in the 
geographic areas or the program planner or qualified person reasonably 
could have believed the countermeasure was used or administered in the 
areas.\29\ We included these statutory conditions in the declaration 
section XI for clarity.
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    \29\ 42 U.S.C. 247d-6d(a)(4).
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Section XII, Effective Time Period

    The Secretary must identify, for each Covered Countermeasure, the 
period or periods during which liability immunity is in effect, 
designated by dates, milestones, or other description of events, 
including factors specified in the PREP Act.\30\
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    \30\ 42 U.S.C. 246d-6d(b)(2)(B), (b)(6).
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    The declaration states in section XII when liability immunity takes 
effect for different means of distribution within that time period.

Section XIII, Additional Time Period of Coverage

    The Secretary must specify a date after the ending date of the 
effective period of the declaration that is reasonable for 
manufacturers to arrange for disposition of the Covered Countermeasure, 
including return of the product to the manufacturer, and for other 
Covered Persons to take appropriate actions to limit administration or 
use of the Covered Countermeasure.\31\ In addition, the PREP Act 
specifies that for Covered Countermeasures that are subject to a 
declaration at the time they are obtained for the Strategic National 
Stockpile under 42 U.S.C. 247d-6b(a), the effective period of the 
declaration extends through the time the countermeasure is used or 
administered pursuant to a distribution or release from the Stockpile. 
Liability immunity under the provisions of the PREP Act and the 
conditions of the declaration continues during these additional time 
periods. Thus, liability immunity is afforded during the ``Effective 
Time Period,'' described under section XII of the declaration, plus the 
``Additional Time Period of Coverage'' described under section XIII of 
the declaration.
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    \31\ 42 U.S.C. 247d-6d(b)(3).
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    The declaration states in section XIII that the additional time 
period is twelve (12) months and also states that extended coverage 
applies to any products obtained for the Strategic National Stockpile 
during the effective period of the declaration. We included the 
statutory provision for clarity.

Section XIV, Countermeasures Injury Compensation Program

    Section 319F-4 of the PREP Act authorizes a Countermeasures Injury 
Compensation Program (CICP) to provide benefits to eligible individuals 
who sustain a serious physical injury or die as a direct result of the 
administration or use of a Covered Countermeasure.\32\ Compensation 
under the CICP for an injury directly caused by a Covered 
Countermeasure is based on the requirements set forth in this 
declaration, the administrative rules for the Program,\33\ and the 
statute.\34\ To show direct causation between a Covered Countermeasure 
and a serious physical injury, the statute requires ``compelling, 
reliable, valid, medical and scientific evidence.'' \35\ The 
administrative rules for the Program further explain the necessary 
requirements for eligibility under the CICP. Please note that, by 
statute, requirements for compensation under the CICP may not always 
align with the requirements for liability immunity provided under the 
PREP Act. The declaration explains in section XIV, ``Countermeasures 
Injury Compensation Program'' the types of injury and standard of 
evidence needed to be considered for compensation under the CICP. 
Further, the administrative rules for the CICP specify if 
countermeasures are administered or used outside the United States, 
only otherwise eligible individuals at American embassies, military 
installations abroad (such as military bases, ships, and camps) or at 
North Atlantic Treaty Organization (NATO) installations (subject to the 
NATO Status of Forces Agreement) where American servicemen and 
servicewomen are stationed may be considered for CICP benefits. Other 
individuals outside the United States may not be eligible for CICP 
benefits.
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    \32\ 42 U.S.C. 247d-6e.
    \33\ 42 CFR part 110.
    \34\ 42 U.S.C. 247d-6e.
    \35\ 42 U.S.C. 247d-6e(b)(4).
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Section XV, Amendments

    The Secretary may amend any portion of a declaration through 
publication in the Federal Register.\36\ The declaration states in 
section XV that any amendments to this declaration will be published in 
the Federal Register.
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    \36\ 42 U.S.C. 247d-6d(b)(4).
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Declaration

Declaration for Public Readiness and Emergency Preparedness Act 
Coverage for Nerve Agents and Certain Insecticides (Organophosphorus 
and/or Carbamate) Countermeasures

I. Determination of Public Health Emergency or Credible Risk of Future 
Public Health Emergency

42 U.S.C. 247d-6d(b)(1)

    I have determined that there is a credible risk that the release of 
nerve agents or organophosphorus insecticides and the resulting 
organophosphorus

[[Page 21824]]

poisoning or release of carbamate insecticides and the resulting 
carbamate poisoning may, in the future, constitute a public health 
emergency.

II. Factors Considered

42 U.S.C. 247d-6d(b)(6)

    I have considered the desirability of encouraging the design, 
development, clinical testing or investigation, manufacture, labeling, 
distribution, formulation, packaging, marketing, promotion, sale, 
purchase, donation, dispensing, prescribing, administration, licensing, 
and use of the Covered Countermeasures.

III. Recommended Activities

42 U.S.C. 247d-6d(b)(1)

    I recommend, under the conditions stated in this declaration, the 
manufacture, testing, development, distribution, administration, or use 
of the Covered Countermeasures.

IV. Liability Immunity

42 U.S.C. 247d-6d(a), 247d-6d(b)(1)

    Liability immunity as prescribed in the PREP Act and conditions 
stated in this declaration is in effect for the Recommended Activities 
described in section III.

V. Covered Persons

42 U.S.C. 247d-6d(i)(2), (3), (4), (6), (8)(A) and (B)

    Covered Persons who are afforded liability immunity under this 
declaration are ``manufacturers,'' ``distributors,'' ``program 
planners,'' ``qualified persons,'' and their officials, agents, and 
employees, as those terms are defined in the PREP Act, and the United 
States.
    In addition, I have determined that the following additional 
persons are qualified persons: (a) Any person authorized in accordance 
with the public health and medical emergency response of the Authority 
Having Jurisdiction, as described in section VII below, to prescribe, 
administer, deliver, distribute or dispense the Covered 
Countermeasures, and their officials, agents, employees, contractors 
and volunteers, following a declaration of an emergency; (b) Any person 
authorized to prescribe, administer, or dispense the Covered 
Countermeasures or who is otherwise authorized to perform an activity 
under an Emergency Use Authorization in accordance with section 564 of 
the FD&C Act; (c) Any person authorized to prescribe, administer, or 
dispense Covered Countermeasures in accordance with Section 564A of the 
FD&C Act.

VI. Covered Countermeasures

42 U.S.C. 247d-6b(c)(1)(B), 42 U.S.C. 247d-6d(i)(1) and (7)

    Covered Countermeasures are: Any antidote; any other drug; all 
components and constituent materials of these antidotes and other 
drugs; all devices and their constituent components used in the 
administration of these antidotes and other drugs; any diagnostic; or 
any other device to identify, prevent, or treat organophosphorus or 
carbamate poisoning or adverse events from such countermeasures.
    Covered Countermeasures must be ``qualified pandemic or epidemic 
products,'' or ``security countermeasures,'' or drugs, biological 
products, or devices authorized for investigational or emergency use, 
as those terms are defined in the PREP Act, the FD&C Act, and the 
Public Health Service Act.

VII. Limitations on Distribution

42 U.S.C. 247d-6d(a)(5) and (b)(2)(E)

    I have determined that liability immunity is afforded to Covered 
Persons only for Recommended Activities involving Covered 
Countermeasures that are related to:
    (a) Present or future Federal contracts, cooperative agreements, 
grants, other transactions, interagency agreements, memoranda of 
understanding, or other Federal agreements, or activities directly 
conducted by the Federal Government; or
    (b) Activities authorized in accordance with the public health and 
medical response of the Authority Having Jurisdiction to prescribe, 
administer, deliver, distribute or dispense the Covered Countermeasures 
to respond to an event covered by a declared emergency, including 
authorized activities that occur as part of the response before the 
formal declaration of an emergency.
    i. The Authority Having Jurisdiction means the public agency or its 
delegate that has legal responsibility and authority for responding to 
an incident, based on political or geographical (e.g., city, county, 
Tribal, State, or Federal boundary lines) or functional (e.g., law 
enforcement, public health) range or sphere of authority.
    ii. A declaration of emergency means any declaration by any 
authorized local, regional, State, or Federal official of an emergency 
specific to events that indicate an immediate need to administer and 
use the Covered Countermeasures, with the exception of a Federal 
declaration in support of an Emergency Use Authorization under section 
564 of the FD&C Act unless such declaration specifies otherwise;
    I have also determined that for governmental program planners only, 
liability immunity is afforded only to the extent such program planners 
obtain Covered Countermeasures through voluntary means, such as (1) 
donation; (2) commercial sale; (3) deployment of Covered 
Countermeasures from Federal stockpiles; or (4) deployment of donated, 
purchased, or otherwise voluntarily obtained Covered Countermeasures 
from State, local, or private stockpiles.

VIII. Category of Disease, Health Condition, or Threat

42 U.S.C. 247d-6d(b)(2)(A)

    The category of disease, health condition, or threat for which I 
recommend the administration or use of the Covered Countermeasures is 
organophosphorus or carbamate poisoning.

IX. Administration of Covered Countermeasures

42 U.S.C. 247d-6d(a)(2)(B)

    Administration of the Covered Countermeasure means physical 
provision of the countermeasures to recipients, or activities and 
decisions directly relating to public and private delivery, 
distribution and dispensing of the countermeasures to recipients, 
management and operation of countermeasure programs, or management and 
operation of locations for purpose of distributing and dispensing 
countermeasures.

X. Population

42 U.S.C. 247d-6d(a)(4), 247d-6d(b)(2)(C)

    The populations of individuals include any individual who uses or 
is administered the Covered Countermeasures in accordance with this 
declaration.
    Liability immunity is afforded to manufacturers and distributors 
without regard to whether the countermeasure is used by or administered 
to this population; liability immunity is afforded to program planners 
and qualified persons when the countermeasure is used by or 
administered to this population or the program planner or qualified 
person reasonably could have believed the recipient was in this 
population.

[[Page 21825]]

XI. Geographic Area

42 U.S.C. 247d-6d(a)(4), 247d-6d(b)(2)(D)

    Liability immunity is afforded for the administration or use of a 
Covered Countermeasure without geographic limitation.
    Liability immunity is afforded to manufacturers and distributors 
without regard to whether the countermeasure is used by or administered 
in these geographic areas; liability immunity is afforded to program 
planners and qualified persons when the countermeasure is used by or 
administered in these geographic areas, or the program planner or 
qualified person reasonably could have believed the recipient was in 
these geographic areas.

XII. Effective Time Period

42 U.S.C. 247d-6d(b)(2)(B)

    Liability immunity for Covered Countermeasures obtained through 
means of distribution other than in accordance with the public health 
and medical response of the Authority Having Jurisdiction extends 
through December 31, 2022.
    Liability immunity for Covered Countermeasures administered and 
used in accordance with the public health and medical response of the 
Authority Having Jurisdiction begins on the date the response to an 
event covered by an emergency declaration begins, including authorized 
activities that occur as part of the response before the formal 
declaration of an emergency, and lasts through (1) the final day the 
emergency declaration is in effect or (2) December 31, 2022, whichever 
occurs first.

XIII. Additional Time Period of Coverage

42 U.S.C. 247d-6d(b)(3)(A), (B) and (C)

    I have determined that an additional twelve (12) months of 
liability protection is reasonable to allow for the manufacturer(s) to 
arrange for disposition of the Covered Countermeasure, including return 
of the Covered Countermeasures to the manufacturer, and for Covered 
Persons to take such other actions as are appropriate to limit the 
administration or use of the Covered Countermeasures.
    Covered Countermeasures obtained for the Strategic National 
Stockpile (``SNS'') during the effective period of this declaration for 
Covered Countermeasures obtained through means of distribution other 
than in accordance with the public health and medical response of the 
Authority Having Jurisdiction are covered through the date of 
administration or use pursuant to a distribution or release from the 
SNS.

XIV. Countermeasures Injury Compensation Program

42 U.S.C. 247d-6e

    The PREP Act authorizes a Countermeasures Injury Compensation 
Program (``CICP'') to provide benefits to certain individuals or 
estates of individuals who sustain a serious physical covered injury as 
the direct result of the administration or use of a Covered 
Countermeasure and/or benefits to certain survivors of individuals who 
die as a direct result of the administration or use of the Covered 
Countermeasure. The causal connection between the countermeasure and 
the serious physical injury must be supported by compelling, reliable, 
valid, medical and scientific evidence in order for the individual to 
be considered for compensation. The CICP is administered by the Health 
Resources and Services Administration (``HRSA''), within the Department 
of Health and Human Services. Information about the CICP is available 
at the toll free number 1-855-266-2427 or http://www.hrsa.gov/cicp/.

XV. Amendments

42 U.S.C. 247d-6d(b)(4)

    Any amendments to this declaration will be published in the Federal 
Register.

    Authority: 42 U.S.C. 247d-6d.

    Dated: May 4, 2017.
Thomas E. Price,
Secretary.
[FR Doc. 2017-09455 Filed 5-9-17; 8:45 am]
BILLING CODE 4150-03-P



                                                                               Federal Register / Vol. 82, No. 89 / Wednesday, May 10, 2017 / Notices                                                   21819

                                                  name and contact information to be                      I. Background                                         II. Potential Modifications to the FDA
                                                  made publicly available, you can                                                                              Blueprint
                                                  provide this information on the cover                      On July 12, 2012, FDA approved an
                                                                                                          ER/LA Opioid Analgesics REMS,                            FDA is considering modifications to
                                                  sheet and not in the body of your                                                                             the existing Blueprint in light of
                                                  comments and you must identify this                     including an FDA-created ‘‘Blueprint for
                                                                                                                                                                recommendations from the May 2016
                                                  information as ‘‘confidential.’’ Any                    Prescriber Education for Extended-
                                                                                                                                                                Advisory Committee meeting. The draft
                                                  information marked as ‘‘confidential’’                  Release and Long-Acting (ER/LA)
                                                                                                                                                                revisions to the Blueprint being made
                                                  will not be disclosed except in                         Opioid Analgesics.’’ The goal of the                  available pursuant to this notice would
                                                  accordance with 21 CFR 10.20 and other                  REMS is to reduce serious adverse                     broaden the Blueprint to include
                                                  applicable disclosure law. For more                     outcomes resulting from inappropriate                 information on pain management,
                                                  information about FDA’s posting of                      prescribing, misuse, and abuse of ER/LA               including the principles of acute and
                                                  comments to public dockets, see 80 FR                   opioid analgesics while maintaining                   chronic pain management; non-
                                                  56469, September 18, 2015, or access                    patient access to pain medications.                   pharmacologic treatments for pain; and
                                                  the information at: https://www.gpo.gov/                   The ER/LA Opioid Analgesics REMS                   pharmacologic treatments for pain (both
                                                  fdsys/pkg/FR-2015-09-18/pdf/2015-                       requires that training in the form of                 non-opioid analgesic and opioid
                                                  23389.pdf.                                              accredited continuing education be                    analgesic). FDA intends to consider
                                                     Docket: For access to the docket to                  made available to health care providers               public input as it considers
                                                  read background documents or the                        who prescribe ER/LA opioid analgesics.                modifications to the ER/LA Opioid
                                                  electronic and written/paper comments                   The accredited continuing education                   Analgesics REMS.
                                                  received, go to https://                                must include all elements of the FDA                  III. May 2017 Public Workshop
                                                  www.regulations.gov and insert the                      Blueprint, which includes a basic
                                                                                                                                                                   On April 18, 2017, FDA published a
                                                  docket number, found in brackets in the                 outline and the core messages related to
                                                                                                                                                                notice announcing a public workshop
                                                  heading of this document, into the                      ER/LA opioid analgesics. FDA
                                                                                                                                                                scheduled for May 9–10, 2017, to seek
                                                  ‘‘Search’’ box and follow the prompts                   developed the Blueprint following
                                                                                                                                                                input on issues and challenges
                                                  and/or go to the Division of Dockets                    extensive input from stakeholders and                 associated with Federal efforts to
                                                  Management, 5630 Fishers Lane, Rm.                      sought input on a draft version on                    support training on pain management
                                                  1061, Rockville, MD 20852.                              November 7, 2011 (76 FR 68766), before                and the safe prescribing, dispensing,
                                                     Submit written requests for single                   approving it in 2012 as part of the ER/               and patient use of opioids (safe use of
                                                  copies of the draft revised Blueprint to                LA Opioid Analgesics REMS.                            opioids) for health care providers.
                                                  the Division of Drug Information, Center                   On May 3–4, 2016, FDA convened a                   Through the public workshop, FDA
                                                  for Drug Evaluation and Research, Food                  joint meeting of the Drug Safety and                  hopes to obtain additional insight from
                                                  and Drug Administration, 10001 New                      Risk Management Advisory Committee                    a variety of stakeholders on how best to
                                                  Hampshire Ave., Hillandale Building,                    and the Anesthetic and Analgesic Drug                 ensure that health care providers receive
                                                  4th Floor, Silver Spring, MD 20993–                     Products Advisory Committee to discuss                training in pain management and the
                                                  0002. Send one self-addressed adhesive                  whether this REMS assures safe use of                 safe use of opioids. The draft revisions
                                                  label to assist that office in processing               these products; whether or not it is                  to the Blueprint being made available at
                                                  your requests. See the SUPPLEMENTARY                    unduly burdensome to patient access to                https://www.fda.gov/Drugs/NewsEvents/
                                                  INFORMATION section for electronic                      the drugs; and whether it (to the extent              ucm553931.htm are intended to provide
                                                  access to the draft revised Blueprint.                  practicable) minimizes the burden to the              important context for the public
                                                                                                          health care delivery system (March 14,                workshop’s discussion. However, the
                                                  FOR FURTHER INFORMATION CONTACT:                                                                              Blueprint itself will not be a discussion
                                                                                                          2016, 81 FR 13372). FDA also sought
                                                  Janelle Derbis, Center for Drug                         input on possible modifications to the                topic at the workshop. FDA intends to
                                                  Evaluation and Research (HFD–1), Food                   ER/LA Opioid Analgesic REMS,                          consider any comments submitted to
                                                  and Drug Administration 20 North                        including expansion of the scope and                  this docket as it considers possible
                                                  Michigan Ave., Suite 510, Chicago, IL                   content of prescriber training and                    modifications to the ER/LA Opioid
                                                  60602, 312–596–6516.                                    expansion of the REMS program to                      Analgesics REMS.
                                                  SUPPLEMENTARY INFORMATION:      FDA is                  include immediate release (IR) opioid                   Dated: May 4, 2017.
                                                  announcing the availability of draft                    analgesics. Advisory Committee                        Anna K. Abram,
                                                  revisions to the ‘‘FDA Blueprint for                    members were in favor of modifying the                Deputy Commissioner for Policy, Planning,
                                                  Prescriber Education for Extended-                      REMS program to include the IR opioid                 Legislation, and Analysis.
                                                  Release and Long-Acting Opioid                          analgesics as well as broadening the                  [FR Doc. 2017–09442 Filed 5–9–17; 8:45 am]
                                                  Analgesics’’ (draft revisions to the                    training program to include pain                      BILLING CODE 4164–01–P
                                                  Blueprint). In addition to seeking                      management. The majority of the
                                                  comment on the draft revisions to the                   members were in favor of a requirement
                                                  Blueprint, FDA expects the draft                        for all prescribers to complete training.             DEPARTMENT OF HEALTH AND
                                                  revisions to create important context for               Many of the members recommended                       HUMAN SERVICES
                                                  discussions at a public workshop on                     that the required training program be
                                                  issues and challenges associated with                   implemented through mechanisms                        Nerve Agents and Certain Insecticides
                                                  Federal efforts to support training on                  outside the FDA REMS authority. The                   (Organophosphorus and/or
                                                  pain management and the safe                            majority of members also stated that                  Carbamate) Countermeasures
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                                                  prescribing, dispensing, and patient use                other health care providers involved in               AGENCY: Department of Health and
                                                  of opioids (safe use of opioids) for                    the management of pain should be                      Human Services, Office of the Secretary.
                                                  health care providers. That workshop,                   included as a target audience for                     ACTION: Notice.
                                                  which is scheduled for May 9–10, 2017,                  education, though they did not specify
                                                  was previously announced in the                         that the training should be mandatory                 SUMMARY:  The Secretary is issuing a
                                                  Federal Register on April 18, 2017 (82                  for non-prescribing health care                       declaration pursuant to section 319F–3
                                                  FR 18300).                                              providers.                                            of the Public Health Service Act to


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                                                  21820                        Federal Register / Vol. 82, No. 89 / Wednesday, May 10, 2017 / Notices

                                                  provide liability protections consistent                new emergency authorities for                            administration, licensing, and use of the
                                                  with that authority for medical                         dispensing approved products in                          countermeasure.3 The declaration states
                                                  countermeasures against nerve agents                    emergencies and products held for                        these considerations in section II.
                                                  and organophosphorus insecticides that                  emergency use. PAHPRA accordingly
                                                                                                                                                                   Section III, Recommended Activities
                                                  result in organophosphorus poisoning                    amended the definitions of Covered
                                                  and carbamate insecticides that result in               Countermeasures and qualified                               The Secretary must recommend the
                                                  carbamate poisoning.                                    pandemic and epidemic products in                        activities for which the PREP Act’s
                                                  DATES: The declaration is effective as of               section 319F–3 of the Public Health                      liability immunity is in effect. These
                                                  April 11, 2017.                                         Service Act (the PREP Act provisions),                   activities may include, under conditions
                                                  FOR FURTHER INFORMATION CONTACT:                        so that products made available under                    as the Secretary may specify, the
                                                  George W. Korch Jr., Ph.D., Acting                      these new FD&C Act authorities could                     manufacture, testing, development,
                                                  Assistant Secretary for Preparedness                    be covered under PREP Act                                distribution, administration, or use of
                                                  and Response, Office of the Secretary,                  declarations. PAHPRA also extended                       one or more Covered Countermeasures
                                                  Department of Health and Human                          the definition of qualified pandemic and                 (Recommended Activities).4 The
                                                  Services, 200 Independence Avenue                       epidemic products to include products                    declaration states the Recommended
                                                  SW., Washington, DC 20201, Telephone                    or technologies intended to enhance the                  Activities in section III.
                                                  (202) 205–2882 (this is not a toll-free                 use or effect of a drug, biological
                                                                                                          product, or device used against the                      Section IV, Liability Immunity
                                                  number).
                                                                                                          pandemic or epidemic or against                             The Secretary must also state that
                                                  SUPPLEMENTARY INFORMATION:                              adverse events from these products.                      liability protections available under the
                                                  Background                                                 Unless otherwise noted, all statutory
                                                                                                                                                                   PREP Act are in effect with respect to
                                                                                                          citations below are to the U.S. Code.
                                                     The Public Readiness and Emergency                                                                            the Recommended Activities.5 These
                                                  Preparedness Act (PREP Act) authorizes                  Section I, Determination of Public                       liability protections provide that,
                                                  the Secretary of the U.S. Department of                 Health Emergency or Credible Risk of                     ‘‘[s]ubject to other provisions of [the
                                                  Health and Human Services to issue a                    Future Public Health Emergency                           PREP Act], a covered person shall be
                                                  declaration to provide liability                           Before issuing a declaration under the                immune from suit and liability under
                                                  immunity to certain individuals and                     PREP Act, the Secretary is required to                   Federal and State law with respect to all
                                                  entities (Covered Persons) against any                  determine that a disease or other health                 claims for loss caused by, arising out of,
                                                  claim of loss caused by, arising out of,                condition or threat to health constitutes                relating to, or resulting from the
                                                  relating to, or resulting from the                      a public health emergency or that there                  administration to or use by an
                                                  administration or use of medical                        is a credible risk that the disease,                     individual of a covered countermeasure
                                                  countermeasures (Covered                                condition, or threat may in the future                   if a declaration . . . has been issued
                                                  Countermeasures), except for claims                     constitute such an emergency.1 This                      with respect to such countermeasure.’’ 6
                                                  that meet the PREP Act’s definition of                  determination is separate and apart from                 The declaration includes the statement
                                                  willful misconduct. Using this                          a declaration issued by the Secretary                    that liability immunity is in effect for
                                                  authority, the Secretary is issuing this                under section 319 of the PHS Act 2 that                  Recommended Activities in section IV.
                                                  declaration for medical                                 a disease or disorder presents a public                  Section V, Covered Persons
                                                  countermeasures against nerve agents                    health emergency or that, a public
                                                  and organophosphorus insecticides that                  health emergency, including significant                     The PREP Act’s liability immunity
                                                  result in organophosphorus poisoning                    outbreaks of infectious diseases or                      applies to Covered Persons with respect
                                                  and carbamate insecticides that result in               bioterrorist attacks, otherwise exists, or               to administration or use of a Covered
                                                  carbamate poisoning. The purpose of                     other declarations or determinations                     Countermeasure. The term ‘‘Covered
                                                  issuing this declaration is to strengthen               made under other authorities of the                      Persons’’ has a specific meaning, and is
                                                  preparedness against these threats that                 Secretary. The declaration states in                     defined in the PREP Act to include
                                                  pose an ongoing credible risk of a future               section I the Secretary’s determination                  manufacturers, distributors, program
                                                  public health emergency and does not                    that there is a credible risk that the                   planners, and qualified persons, and
                                                  indicate a change in threat information.                release of nerve agents or                               their officials, agents, and employees,
                                                     The declaration is published in full.                organophosphorus insecticides and the                    and the United States.7 The PREP Act
                                                  We explain both the substantive and                     resulting organophosphorus poisoning                     further defines the terms
                                                  format changes in this supplementary                    or the release of carbamate insecticides                 ‘‘manufacturer,’’ ‘‘distributor,’’
                                                  section.                                                and the resulting carbamate poisoning                    ‘‘program planner,’’ and ‘‘qualified
                                                     The PREP Act was enacted on                          may, in the future, constitute a public                  person’’ as described below.8
                                                  December 30, 2005 as Public Law 109–                    health emergency.                                           A manufacturer includes a contractor
                                                  148, Division C, Section 2. It amended                                                                           or subcontractor of a manufacturer; a
                                                  the Public Health Service (‘‘PHS’’) Act,                Section II, Factors Considered
                                                                                                                                                                   supplier or licenser of any product,
                                                  adding section 319F–3, which addresses                    In deciding whether and under what                     intellectual property, service, research
                                                  liability immunity, and section 319F–4,                 circumstances to issue a declaration                     tool or component or other article used
                                                  which creates a compensation program.                   with respect to a Covered                                in the design, development, clinical
                                                  These sections are codified in the U.S.                 Countermeasure, the Secretary must                       testing, investigation or manufacturing
                                                  Code as 42 U.S.C. 247d–6d and 42                        consider the desirability of encouraging                 of a Covered Countermeasure; and any
                                                  U.S.C. 247d–6e, respectively. The
jstallworth on DSK7TPTVN1PROD with NOTICES




                                                                                                          the design, development, clinical testing                or all of the parents, subsidiaries,
                                                  Pandemic and All-Hazards                                or investigation, manufacture, labeling,
                                                  Preparedness Reauthorization Act                        distribution, formulation, packaging,                      3 42 U.S.C. 247d–6d(b)(6).
                                                  (PAHPRA), Public Law 113–5, was                         marketing, promotion, sale, purchase,                      4 42 U.S.C. 247d–6d(b)(1).
                                                  enacted on March 13, 2013. Among                        donation, dispensing, prescribing,                         5 42 U.S.C. 247d–6d(b)(1).
                                                  other things, PAHPRA added sections                                                                                6 42 U.S.C. 247d–6d(a)(1).

                                                  564A and 564B to the Federal Food,                       1 42   U.S.C. 247d–6d(b)(1).                              7 42 U.S.C. 247d–6d(i)(2).

                                                  Drug & Cosmetic (FD&C) Act to provide                    2 42   U.S.C. 247d.                                       8 42 U.S.C. 247d–6d(i).




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                                                                                  Federal Register / Vol. 82, No. 89 / Wednesday, May 10, 2017 / Notices                                                21821

                                                  affiliates, successors, and assigns of a                with the public health and medical                    biological, chemical, radiological, or
                                                  manufacturer; 9                                         emergency response of the Authority                   nuclear agent identified as a material
                                                     A distributor means a person or entity               Having Jurisdiction, . . . to prescribe,              threat by the Secretary of Homeland
                                                  engaged in the distribution of drugs,                   administer, deliver, distribute or                    Security, or (b) to diagnose, mitigate,
                                                  biologics, or devices, including but not                dispense the Covered Countermeasures,                 prevent, or treat harm from a condition
                                                  limited to: Manufacturers; repackers;                   and their officials, agents, employees,               that may result in adverse health
                                                  common carriers; contract carriers; air                 contractors and volunteers, following a               consequences or death and may be
                                                  carriers; own-label distributors; private-              declaration of an emergency; (b) any                  caused by administering a drug,
                                                  label distributors; jobbers; brokers;                   person authorized to prescribe,                       biological product, or device against
                                                  warehouses and wholesale drug                           administer, or dispense the Covered                   such an agent; and (ii) is determined by
                                                  warehouses; independent wholesale                       Countermeasures or who is otherwise                   the Secretary of Health and Human
                                                  drug traders; and, retail pharmacies; 10                authorized to perform an activity under               Services to be a necessary
                                                     A program planner means a state or                   an Emergency Use Authorization in                     countermeasure to protect public
                                                  local government, including a Native                    accordance with section 564 of the                    health.18
                                                  American Tribe; a person employed by                    FD&C Act; and, (c) any person                            To be a Covered Countermeasure,
                                                  the state or local government; or other                 authorized to prescribe, administer, or               qualified pandemic or epidemic
                                                  person who supervises or administers a                  dispense Covered Countermeasures in                   products and security countermeasures
                                                  program with respect to the                             accordance with Section 564A of the                   also must be approved or cleared under
                                                  administration, dispensing, distribution,               FD&C Act.                                             the FD&C Act; 19 licensed under the PHS
                                                  provision, or use of a Covered                          Section VI, Covered Countermeasures                   Act; 20 authorized for emergency use
                                                  Countermeasure, including a person                                                                            under sections 564, 564A, or 564B of the
                                                  who establishes requirements, provides                     As noted above, section III describes
                                                                                                                                                                FD&C Act.21 A qualified pandemic or
                                                  policy guidance, or supplies technical                  the Secretary’s Recommended Activities
                                                                                                          for which liability immunity is in effect.            epidemic product also may be a Covered
                                                  or scientific advice or assistance or                                                                         Countermeasure when it is exempted
                                                  provides a facility to administer or use                This section identifies the
                                                                                                          countermeasures for which the                         under the FD&C Act for use as an
                                                  a Covered Countermeasure in                                                                                   investigational drug or device 22 that is
                                                  accordance with the Secretary’s                         Secretary has recommended such
                                                                                                          activities. The PREP Act states that a                the object of research for possible use
                                                  declaration.11 Under this definition, a                                                                       for diagnosis, mitigation, prevention,
                                                  private sector employer or community                    Covered Countermeasure must be a
                                                                                                          ‘‘qualified pandemic or epidemic                      treatment, cure or limit harm of a
                                                  group or other person can be a program                                                                        pandemic or epidemic or serious or life-
                                                  planner when it carries out the                         product,’’ or a ‘‘security
                                                                                                          countermeasure,’’ as described                        threatening condition caused by such a
                                                  described activities.                                                                                         drug or device. A security
                                                     A qualified person means a licensed                  immediately below; or a drug, biological
                                                                                                          product or device authorized for                      countermeasure also may be a Covered
                                                  health professional or other individual                                                                       Countermeasure if it may reasonably be
                                                  who is authorized to prescribe,                         emergency use in accordance with
                                                                                                          section 564, 564A, or 564B of the FD&C                determined to qualify for approval or
                                                  administer, or dispense Covered                                                                               licensing within ten years after the
                                                  Countermeasures under the law of the                    Act.14
                                                                                                             A qualified pandemic or epidemic                   Department’s determination that
                                                  state in which the countermeasure was                                                                         procurement of the countermeasure is
                                                  prescribed, administered, or dispensed;                 product means a drug or device, as
                                                                                                          defined in the FD&C Act or a biological               appropriate.
                                                  or, a person within a category of persons
                                                                                                          product, as defined in the PHS Act 15                    The declaration describes the Covered
                                                  identified as qualified in the Secretary’s
                                                                                                          that is: (i) Manufactured, used,                      Countermeasures in Section VI as: Any
                                                  declaration.12 Under this definition, the
                                                                                                          designed, developed, modified, licensed               antidote; any other drug; all components
                                                  Secretary can describe in the declaration
                                                                                                          or procured to diagnose, mitigate,                    and constituent materials of these
                                                  other qualified persons, such as
                                                                                                          prevent, treat, or cure a pandemic or                 antidotes and other drugs; all devices
                                                  volunteers, who are Covered Persons.
                                                                                                          epidemic or limit the harm such a                     and their constituent components used
                                                  Section V describes other qualified
                                                                                                          pandemic or epidemic might otherwise                  in the administration of these antidotes
                                                  persons covered by this declaration.
                                                                                                          cause; (ii) manufactured, used,                       and other drugs; any diagnostic; or any
                                                     The PREP Act also defines the word
                                                                                                          designed, developed, modified,                        other device to identify, prevent, or treat
                                                  ‘‘person’’ as used in the Act: A person
                                                                                                          licensed, or procured to diagnose,                    organophosphorus or carbamate
                                                  includes an individual, partnership,
                                                                                                          mitigate, prevent, treat, or cure a serious           poisoning or adverse events from such
                                                  corporation, association, entity, or
                                                                                                          or life-threatening disease or condition              countermeasures.
                                                  public or private corporation, including
                                                                                                          caused by such a drug, biological                        The declaration also includes in
                                                  a federal, state, or local government
                                                                                                          product or device; (iii) or, a product or             section VI a statement referencing the
                                                  agency or department.13
                                                                                                          technology intended to enhance the use                statutory definitions of Covered
                                                     The declaration lists Covered Persons
                                                                                                          or effect of such a drug, biological                  Countermeasures to make clear that
                                                  in section V to include manufacturers,
                                                                                                          product, or device.16                                 these statutory definitions limit the
                                                  distributors, program planners, qualified                  A security countermeasure is a drug
                                                  persons, and their officials, agents, and                                                                     scope of Covered Countermeasures.
                                                                                                          or device, as defined in the FD&C Act
                                                  employees, as those terms are defined in                or a biological product, as defined in the            Section VII, Limitations on Distribution
                                                  the PREP Act, and the United States.                    PHS Act 17 that: (i)(a) The Secretary
                                                     The declaration also lists in section V                                                                       The Secretary may specify that
                                                                                                          determines to be a priority to diagnose,
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                                                  Additional Covered Persons to include:                                                                        liability immunity is in effect only to
                                                                                                          mitigate, prevent or treat harm from any              Covered Countermeasures obtained
                                                  (a) Any person authorized in accordance
                                                                                                            14 42 U.S.C. 247d–6d(i)(1). Sections 564, 564A,
                                                    9 42 U.S.C. 247d–6d(i)(4).                                                                                    18 42 U.S.C. 247d–6d(i)(1)(B),(c)(1)(B).
                                                                                                          and 564B of the FD&C Act may be found at 21
                                                    10 42 U.S.C. 247d–6d(i)(3).                                                                                   19 21 U.S.C. 301 et seq.
                                                                                                          U.S.C. 360bbb–3, 360bbb–3a, and 360bbb–3b.
                                                    11 42 U.S.C. 247d–6d(i)(6).                             15 21 U.S.C. 321(g)(1), (h); 42 U.S.C. 262(i).        20 42 U.S.C. 262.
                                                    12 42 U.S.C. 247d–6d(i)(8).                             16 42 U.S.C. 247d–6d(i)(1)(A), (i)(7).                21 21 U.S.C. 360bbb–3, 360bbb–3a, 360bbb–3b.
                                                    13 42 U.S.C. 247d–6d(i)(5).                             17 21 U.S.C. 321(g)(1), (h);42 U.S.C. 262(i).         22 21 U.S.C. 355(i), 360j(g).




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                                                  21822                            Federal Register / Vol. 82, No. 89 / Wednesday, May 10, 2017 / Notices

                                                  through a particular means of                              This concern is particularly critical for             to public and private delivery,
                                                  distribution.23                                            the countermeasures covered by this                   distribution and dispensing of the
                                                     The declaration states in section VII                   declaration, where the Covered                        countermeasures to recipients;
                                                  that liability immunity is afforded to                     Countermeasures may need to be                        management and operation of
                                                  Covered Persons for Recommended                            administered within minutes of                        countermeasure programs; or
                                                  Activities related to: (a) Present or                      exposure to a nerve agent to save lives.              management and operation of locations
                                                  future Federal contracts, cooperative                      Thus, the Secretary is clarifying that                for purpose of distributing and
                                                  agreements, grants, other transactions,                    coverage under subsection (b) is                      dispensing countermeasures.
                                                  interagency agreements, or memoranda                       intended to cover any distribution,
                                                  of understanding or other Federal                          dispensing, administration, or use in                    This definition of ‘‘administration’’ is
                                                  agreements or activities directly                          accordance with the Authority Having                  intended to extend only to physical
                                                  conducted by the Federal Government;                       Jurisdiction at any time that those                   provision of a countermeasure to a
                                                  or (b) Activities authorized in                            activities address the emergency                      recipient, such as vaccination or
                                                  accordance with the public health and                      circumstances that gave rise to the                   handing drugs to patients, and to
                                                  medical response of the Authority                          declared emergency even if the                        activities related to management and
                                                  Having Jurisdiction to prescribe,                          activities occur prior to the declaration             operation of programs and locations for
                                                  administer, deliver, distribute, or                        itself.                                               providing countermeasures to
                                                  dispense the Covered Countermeasures                          For governmental program planners                  recipients, such as decisions and actions
                                                  to respond to an event covered by a                        only, liability immunity is afforded only             involving security and queuing, but
                                                  declared emergency, including                              to the extent they obtain Covered                     only insofar as those activities directly
                                                  authorized activities that occur as part                   Countermeasures through voluntary                     relate to the countermeasure activities.
                                                  of the response before the formal                          means, such as (1) donation; (2)                      Claims for which Covered Persons are
                                                  declaration of an emergency. The                           commercial sale; (3) deployment of                    provided immunity under the Act are
                                                  declaration also provides in section VII                   Covered Countermeasures from Federal                  losses caused by, arising out of, relating
                                                  definitions for ‘‘Authority Having                         stockpiles; or (4) deployment of                      to, or resulting from the administration
                                                  Jurisdiction’’ and ‘‘Declaration of an                     donated, purchased, or otherwise                      to or use by an individual of a Covered
                                                  Emergency:’’                                               voluntarily obtained Covered                          Countermeasure consistent with the
                                                     i. The Authority Having Jurisdiction                    Countermeasures from State, local, or                 terms of a declaration issued under the
                                                  means the public agency or its delegate                    private stockpiles. This limitation on                Act.25 Under the Secretary’s definition,
                                                  that has legal responsibility and                          distribution is intended to deter
                                                                                                                                                                   these liability claims are precluded if
                                                  authority for responding to an incident,                   program planners that are government
                                                  based on political or geographical (e.g.,                                                                        the claims allege an injury caused by
                                                                                                             entities from seizing privately held
                                                  city, county, Tribal, State, or Federal                                                                          physical provision of a countermeasure
                                                                                                             stockpiles of Covered Countermeasures.
                                                  boundary lines) or functional (e.g., law                                                                         to a recipient, or if the claims are
                                                                                                             It does not apply to any other Covered
                                                  enforcement, public health) range or                                                                             directly due to conditions of delivery,
                                                                                                             Persons, including other program
                                                  sphere of authority.                                       planners who are not government                       distribution, dispensing, or management
                                                     ii. A declaration of emergency means                    entities.                                             and operation of countermeasure
                                                  any declaration by any authorized local,                                                                         programs at distribution and dispensing
                                                  regional, State, or Federal official of an                 Section VIII, Category of Disease,                    sites.
                                                  emergency specific to events that                          Health Condition, or Threat
                                                                                                                                                                      Thus, it is the Secretary’s
                                                  indicate an immediate need to                                The Secretary must identify, for each               interpretation that, when a declaration
                                                  administer and use the Covered                             Covered Countermeasure, the categories                is in effect, the Act precludes, for
                                                  Countermeasures, with the exception of                     of diseases, health conditions, or threats            example, liability claims alleging
                                                  a Federal declaration in support of an                     to health for which the Secretary                     negligence by a manufacturer in creating
                                                  Emergency Use Authorization under                          recommends the administration or use                  a vaccine, or negligence by a health care
                                                  section 564 of the FD&C Act unless such                    of the countermeasure.24 The                          provider in prescribing the wrong dose,
                                                  declaration specifies otherwise;                           declaration states in section VIII that the           absent willful misconduct. Likewise, the
                                                     Subsection (b) is intended to cover                     category of disease, health condition, or             Act precludes a liability claim relating
                                                  distribution, dispensing, administration,                  threat for which the Secretary                        to the management and operation of a
                                                  or use of the covered countermeasure                       recommends administration or use of                   countermeasure distribution program or
                                                  under a formal government-authorized                       the countermeasures is                                site, such as a slip-and-fall injury or
                                                  response to circumstances at any time                      organophosphorus or carbamate
                                                  those activities occur to respond to an                                                                          vehicle collision by a recipient receiving
                                                                                                             poisoning.                                            a countermeasure at a retail store
                                                  event that gives rise to a declared
                                                  emergency. Subsection (b) is not                           Section IX, Administration of Covered                 serving as an administration or
                                                  intended to be limited to cover those                      Countermeasures                                       dispensing location that alleges, for
                                                  activities only after an emergency is                        The PREP Act does not explicitly                    example, lax security or chaotic crowd
                                                  formally declared and includes                             define the term ‘‘administration’’ but                control. However, a liability claim
                                                  authorized activities that occur as part                   does assign the Secretary the                         alleging an injury occurring at the site
                                                  of the response before the formal                          responsibility to provide relevant                    that was not directly related to the
                                                  declaration of an emergency. The                           conditions in the declaration. The                    countermeasure activities is not
                                                  Secretary recognizes that in emergency                     declaration defines administration in                 covered, such as a slip and fall with no
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                                                  circumstances, distribution, dispensing,                   section IX as: Administration of a                    direct connection to the
                                                  administration, or use of                                  Covered Countermeasure means                          countermeasure’s administration or use.
                                                  countermeasures may need to be                             physical provision of the                             In each case, whether immunity is
                                                  expedient and may occur prior to a                         countermeasures to recipients, or                     applicable will depend on the particular
                                                  formal declaration of an emergency.                        activities and decisions directly relating            facts and circumstances.

                                                    23 42   U.S.C. 247d–6d(a)(5), (b)(2)(E).                  24 42   U.S.C. 247d–6d(b)(2)(A).                       25 42   U.S.C. 247d–6d(a).



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                                                                               Federal Register / Vol. 82, No. 89 / Wednesday, May 10, 2017 / Notices                                               21823

                                                  Section X, Population                                   included these statutory conditions in                   Countermeasure.32 Compensation under
                                                     The Secretary must identify, for each                the declaration section XI for clarity.                  the CICP for an injury directly caused by
                                                  Covered Countermeasure specified in a                                                                            a Covered Countermeasure is based on
                                                                                                          Section XII, Effective Time Period
                                                  declaration, the population or                                                                                   the requirements set forth in this
                                                                                                             The Secretary must identify, for each                 declaration, the administrative rules for
                                                  populations of individuals for which
                                                                                                          Covered Countermeasure, the period or                    the Program,33 and the statute.34 To
                                                  liability immunity is in effect with
                                                  respect to administration or use of the                 periods during which liability immunity                  show direct causation between a
                                                  countermeasure.26 This section explains                 is in effect, designated by dates,                       Covered Countermeasure and a serious
                                                  which individuals should use the                        milestones, or other description of                      physical injury, the statute requires
                                                  countermeasure or to whom the                           events, including factors specified in the               ‘‘compelling, reliable, valid, medical
                                                  countermeasure should be                                PREP Act.30                                              and scientific evidence.’’ 35 The
                                                                                                             The declaration states in section XII                 administrative rules for the Program
                                                  administered—in short, those who
                                                                                                          when liability immunity takes effect for                 further explain the necessary
                                                  should be vaccinated or take a drug or
                                                  other countermeasure. The declaration                   different means of distribution within                   requirements for eligibility under the
                                                  provides in section X that the                          that time period.                                        CICP. Please note that, by statute,
                                                  population includes any individual who                  Section XIII, Additional Time Period of                  requirements for compensation under
                                                  uses or who is administered a Covered                   Coverage                                                 the CICP may not always align with the
                                                  Countermeasure in accordance with the                                                                            requirements for liability immunity
                                                                                                             The Secretary must specify a date                     provided under the PREP Act. The
                                                  declaration.                                            after the ending date of the effective
                                                     In addition, the PREP Act specifies                                                                           declaration explains in section XIV,
                                                                                                          period of the declaration that is                        ‘‘Countermeasures Injury Compensation
                                                  that liability immunity is afforded: (1)
                                                                                                          reasonable for manufacturers to arrange                  Program’’ the types of injury and
                                                  To manufacturers and distributors
                                                                                                          for disposition of the Covered                           standard of evidence needed to be
                                                  without regard to whether the
                                                  countermeasure is used by or                            Countermeasure, including return of the                  considered for compensation under the
                                                  administered to this population; and (2)                product to the manufacturer, and for                     CICP. Further, the administrative rules
                                                  to program planners and qualified                       other Covered Persons to take                            for the CICP specify if countermeasures
                                                  persons when the countermeasure is                      appropriate actions to limit                             are administered or used outside the
                                                  either used by or administered to this                  administration or use of the Covered                     United States, only otherwise eligible
                                                  population or the program planner or                    Countermeasure.31 In addition, the                       individuals at American embassies,
                                                  qualified person reasonably could have                  PREP Act specifies that for Covered                      military installations abroad (such as
                                                  believed the recipient was in this                      Countermeasures that are subject to a                    military bases, ships, and camps) or at
                                                  population.27 We included these                         declaration at the time they are obtained                North Atlantic Treaty Organization
                                                  statutory conditions in the declaration                 for the Strategic National Stockpile                     (NATO) installations (subject to the
                                                  section X for clarity.                                  under 42 U.S.C. 247d–6b(a), the                          NATO Status of Forces Agreement)
                                                                                                          effective period of the declaration                      where American servicemen and
                                                  Section XI, Geographic Area                             extends through the time the                             servicewomen are stationed may be
                                                     The Secretary must identify, for each                countermeasure is used or administered                   considered for CICP benefits. Other
                                                  Covered Countermeasure specified in                     pursuant to a distribution or release                    individuals outside the United States
                                                  the declaration, the geographic area or                 from the Stockpile. Liability immunity                   may not be eligible for CICP benefits.
                                                  areas for which liability immunity is in                under the provisions of the PREP Act
                                                  effect with respect to administration or                and the conditions of the declaration                    Section XV, Amendments
                                                  use of the countermeasure, including, as                continues during these additional time                     The Secretary may amend any portion
                                                  appropriate, whether the declaration                    periods. Thus, liability immunity is                     of a declaration through publication in
                                                  applies only to individuals physically                  afforded during the ‘‘Effective Time                     the Federal Register.36 The declaration
                                                  present in the area or, in addition,                    Period,’’ described under section XII of                 states in section XV that any
                                                  applies to individuals who have a                       the declaration, plus the ‘‘Additional                   amendments to this declaration will be
                                                  described connection to the area.28 The                 Time Period of Coverage’’ described                      published in the Federal Register.
                                                  declaration states in section XI that                   under section XIII of the declaration.
                                                                                                             The declaration states in section XIII                Declaration
                                                  there are no limitations on geographic
                                                  area.                                                   that the additional time period is twelve                Declaration for Public Readiness and
                                                    In addition, the PREP Act specifies                   (12) months and also states that                         Emergency Preparedness Act Coverage
                                                  that liability immunity is afforded: (1)                extended coverage applies to any                         for Nerve Agents and Certain
                                                  To manufacturers and distributors                       products obtained for the Strategic                      Insecticides (Organophosphorus and/or
                                                  without regard to whether the                           National Stockpile during the effective                  Carbamate) Countermeasures
                                                  countermeasure is used by or                            period of the declaration. We included                   I. Determination of Public Health
                                                  administered to individuals in the                      the statutory provision for clarity.                     Emergency or Credible Risk of Future
                                                  geographic areas; and (2) to program                                                                             Public Health Emergency
                                                                                                          Section XIV, Countermeasures Injury
                                                  planners and qualified persons when
                                                                                                          Compensation Program                                     42 U.S.C. 247d–6d(b)(1)
                                                  the countermeasure is either used or
                                                  administered in the geographic areas or                   Section 319F–4 of the PREP Act                           I have determined that there is a
                                                  the program planner or qualified person                 authorizes a Countermeasures Injury                      credible risk that the release of nerve
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                                                  reasonably could have believed the                      Compensation Program (CICP) to                           agents or organophosphorus insecticides
                                                  countermeasure was used or                              provide benefits to eligible individuals                 and the resulting organophosphorus
                                                  administered in the areas.29 We                         who sustain a serious physical injury or
                                                                                                          die as a direct result of the                              32 42 U.S.C. 247d–6e.
                                                    26 42 U.S.C. 247d–6d(b)(2)(C).                        administration or use of a Covered                         33 42 CFR part 110.
                                                    27 42 U.S.C. 247d–6d(a)(4).                                                                                      34 42 U.S.C. 247d–6e.
                                                    28 42 U.S.C. 247d–6d(b)(2)(D).                         30 42   U.S.C. 246d–6d(b)(2)(B), (b)(6).                  35 42 U.S.C. 247d–6e(b)(4).
                                                    29 42 U.S.C. 247d–6d(a)(4).                            31 42   U.S.C. 247d–6d(b)(3).                             36 42 U.S.C. 247d–6d(b)(4).




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                                                  21824                        Federal Register / Vol. 82, No. 89 / Wednesday, May 10, 2017 / Notices

                                                  poisoning or release of carbamate                       VI. Covered Countermeasures                           section 564 of the FD&C Act unless such
                                                  insecticides and the resulting carbamate                                                                      declaration specifies otherwise;
                                                                                                          42 U.S.C. 247d–6b(c)(1)(B), 42 U.S.C.
                                                  poisoning may, in the future, constitute                                                                         I have also determined that for
                                                                                                          247d–6d(i)(1) and (7)
                                                  a public health emergency.                                                                                    governmental program planners only,
                                                                                                             Covered Countermeasures are: Any
                                                  II. Factors Considered                                  antidote; any other drug; all components              liability immunity is afforded only to
                                                                                                          and constituent materials of these                    the extent such program planners obtain
                                                  42 U.S.C. 247d–6d(b)(6)
                                                                                                          antidotes and other drugs; all devices                Covered Countermeasures through
                                                     I have considered the desirability of                                                                      voluntary means, such as (1) donation;
                                                  encouraging the design, development,                    and their constituent components used
                                                                                                          in the administration of these antidotes              (2) commercial sale; (3) deployment of
                                                  clinical testing or investigation,                                                                            Covered Countermeasures from Federal
                                                  manufacture, labeling, distribution,                    and other drugs; any diagnostic; or any
                                                                                                          other device to identify, prevent, or treat           stockpiles; or (4) deployment of
                                                  formulation, packaging, marketing,                                                                            donated, purchased, or otherwise
                                                  promotion, sale, purchase, donation,                    organophosphorus or carbamate
                                                                                                          poisoning or adverse events from such                 voluntarily obtained Covered
                                                  dispensing, prescribing, administration,
                                                                                                          countermeasures.                                      Countermeasures from State, local, or
                                                  licensing, and use of the Covered
                                                                                                             Covered Countermeasures must be                    private stockpiles.
                                                  Countermeasures.
                                                                                                          ‘‘qualified pandemic or epidemic
                                                  III. Recommended Activities                             products,’’ or ‘‘security                             VIII. Category of Disease, Health
                                                                                                          countermeasures,’’ or drugs, biological               Condition, or Threat
                                                  42 U.S.C. 247d–6d(b)(1)
                                                                                                          products, or devices authorized for                   42 U.S.C. 247d–6d(b)(2)(A)
                                                    I recommend, under the conditions                     investigational or emergency use, as
                                                  stated in this declaration, the                         those terms are defined in the PREP Act,                The category of disease, health
                                                  manufacture, testing, development,                      the FD&C Act, and the Public Health                   condition, or threat for which I
                                                  distribution, administration, or use of                 Service Act.                                          recommend the administration or use of
                                                  the Covered Countermeasures.                                                                                  the Covered Countermeasures is
                                                                                                          VII. Limitations on Distribution
                                                  IV. Liability Immunity                                                                                        organophosphorus or carbamate
                                                                                                          42 U.S.C. 247d–6d(a)(5) and (b)(2)(E)                 poisoning.
                                                  42 U.S.C. 247d–6d(a), 247d–6d(b)(1)
                                                                                                             I have determined that liability                   IX. Administration of Covered
                                                    Liability immunity as prescribed in                   immunity is afforded to Covered
                                                  the PREP Act and conditions stated in                                                                         Countermeasures
                                                                                                          Persons only for Recommended
                                                  this declaration is in effect for the                   Activities involving Covered                          42 U.S.C. 247d–6d(a)(2)(B)
                                                  Recommended Activities described in                     Countermeasures that are related to:
                                                  section III.                                               (a) Present or future Federal contracts,             Administration of the Covered
                                                                                                          cooperative agreements, grants, other                 Countermeasure means physical
                                                  V. Covered Persons
                                                                                                          transactions, interagency agreements,                 provision of the countermeasures to
                                                  42 U.S.C. 247d–6d(i)(2), (3), (4), (6),                 memoranda of understanding, or other                  recipients, or activities and decisions
                                                  (8)(A) and (B)                                          Federal agreements, or activities directly            directly relating to public and private
                                                     Covered Persons who are afforded                     conducted by the Federal Government;                  delivery, distribution and dispensing of
                                                  liability immunity under this                           or                                                    the countermeasures to recipients,
                                                  declaration are ‘‘manufacturers,’’                         (b) Activities authorized in                       management and operation of
                                                  ‘‘distributors,’’ ‘‘program planners,’’                 accordance with the public health and                 countermeasure programs, or
                                                  ‘‘qualified persons,’’ and their officials,             medical response of the Authority                     management and operation of locations
                                                  agents, and employees, as those terms                   Having Jurisdiction to prescribe,                     for purpose of distributing and
                                                  are defined in the PREP Act, and the                    administer, deliver, distribute or                    dispensing countermeasures.
                                                  United States.                                          dispense the Covered Countermeasures
                                                     In addition, I have determined that                  to respond to an event covered by a                   X. Population
                                                  the following additional persons are                    declared emergency, including                         42 U.S.C. 247d–6d(a)(4), 247d–
                                                  qualified persons: (a) Any person                       authorized activities that occur as part              6d(b)(2)(C)
                                                  authorized in accordance with the                       of the response before the formal
                                                  public health and medical emergency                     declaration of an emergency.                             The populations of individuals
                                                  response of the Authority Having                           i. The Authority Having Jurisdiction               include any individual who uses or is
                                                  Jurisdiction, as described in section VII               means the public agency or its delegate               administered the Covered
                                                  below, to prescribe, administer, deliver,               that has legal responsibility and                     Countermeasures in accordance with
                                                  distribute or dispense the Covered                      authority for responding to an incident,              this declaration.
                                                  Countermeasures, and their officials,                   based on political or geographical (e.g.,
                                                                                                                                                                   Liability immunity is afforded to
                                                  agents, employees, contractors and                      city, county, Tribal, State, or Federal
                                                  volunteers, following a declaration of an               boundary lines) or functional (e.g., law              manufacturers and distributors without
                                                  emergency; (b) Any person authorized                    enforcement, public health) range or                  regard to whether the countermeasure is
                                                  to prescribe, administer, or dispense the               sphere of authority.                                  used by or administered to this
                                                  Covered Countermeasures or who is                          ii. A declaration of emergency means               population; liability immunity is
                                                  otherwise authorized to perform an                      any declaration by any authorized local,              afforded to program planners and
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                                                  activity under an Emergency Use                         regional, State, or Federal official of an            qualified persons when the
                                                  Authorization in accordance with                        emergency specific to events that                     countermeasure is used by or
                                                  section 564 of the FD&C Act; (c) Any                    indicate an immediate need to                         administered to this population or the
                                                  person authorized to prescribe,                         administer and use the Covered                        program planner or qualified person
                                                  administer, or dispense Covered                         Countermeasures, with the exception of                reasonably could have believed the
                                                  Countermeasures in accordance with                      a Federal declaration in support of an                recipient was in this population.
                                                  Section 564A of the FD&C Act.                           Emergency Use Authorization under


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                                                                               Federal Register / Vol. 82, No. 89 / Wednesday, May 10, 2017 / Notices                                                   21825

                                                  XI. Geographic Area                                     Having Jurisdiction are covered through               property such as patentable material,
                                                                                                          the date of administration or use                     and personal information concerning
                                                  42 U.S.C. 247d–6d(a)(4), 247d–
                                                                                                          pursuant to a distribution or release                 individuals associated with the grant
                                                  6d(b)(2)(D)
                                                                                                          from the SNS.                                         applications, the disclosure of which
                                                     Liability immunity is afforded for the                                                                     would constitute a clearly unwarranted
                                                  administration or use of a Covered                      XIV. Countermeasures Injury
                                                                                                          Compensation Program                                  invasion of personal privacy.
                                                  Countermeasure without geographic
                                                                                                                                                                  Name of Committee: National Institute of
                                                  limitation.                                             42 U.S.C. 247d–6e                                     Child Health and Human Development
                                                     Liability immunity is afforded to                                                                          Special Emphasis Panel; Learning Disabilities
                                                                                                            The PREP Act authorizes a
                                                  manufacturers and distributors without                                                                        Research Centers.
                                                                                                          Countermeasures Injury Compensation
                                                  regard to whether the countermeasure is                                                                         Date: June 22–23, 2017.
                                                                                                          Program (‘‘CICP’’) to provide benefits to
                                                  used by or administered in these                                                                                Time: 7:00 a.m. to 6:00 p.m.
                                                                                                          certain individuals or estates of
                                                  geographic areas; liability immunity is                                                                         Agenda: To review and evaluate grant
                                                                                                          individuals who sustain a serious                     applications.
                                                  afforded to program planners and
                                                                                                          physical covered injury as the direct                   Place: Beacon Hotel and Corporate
                                                  qualified persons when the
                                                                                                          result of the administration or use of a              Quarters, 1615 Rhode Island Avenue NW.,
                                                  countermeasure is used by or
                                                                                                          Covered Countermeasure and/or                         Washington, DC 20036
                                                  administered in these geographic areas,
                                                                                                          benefits to certain survivors of                        Contact Person: Marita R. Hopmann, Ph.D.,
                                                  or the program planner or qualified                                                                           Scientific Review Officer, Division of
                                                                                                          individuals who die as a direct result of
                                                  person reasonably could have believed                                                                         Scientific Review, Eunice Kennedy Shriver
                                                                                                          the administration or use of the Covered
                                                  the recipient was in these geographic                                                                         National Institute of Child Health & Human
                                                                                                          Countermeasure. The causal connection
                                                  areas.                                                                                                        Development, 6710B Rockledge Drive,
                                                                                                          between the countermeasure and the
                                                                                                                                                                Bethesda, MD 20892, Phone: 301–435–6911,
                                                  XII. Effective Time Period                              serious physical injury must be                       Email: HopmannM@mail.nih.gov.
                                                                                                          supported by compelling, reliable, valid,
                                                  42 U.S.C. 247d–6d(b)(2)(B)                                                                                      Name of Committee: National Institute of
                                                                                                          medical and scientific evidence in order              Child Health and Human Development Initial
                                                     Liability immunity for Covered                       for the individual to be considered for               Review Group; Developmental Biology
                                                  Countermeasures obtained through                        compensation. The CICP is                             Subcommittee.
                                                  means of distribution other than in                     administered by the Health Resources                    Date: July 24, 2017.
                                                  accordance with the public health and                   and Services Administration (‘‘HRSA’’),                 Time: 8:00 a.m. to 5:30 p.m.
                                                  medical response of the Authority                       within the Department of Health and                     Agenda: To review and evaluate grant
                                                  Having Jurisdiction extends through                     Human Services. Information about the                 applications.
                                                  December 31, 2022.                                      CICP is available at the toll free number               Place: Embassy Suites, Chevy Chase, MD.
                                                     Liability immunity for Covered                                                                               Contact Person: Cathy J. Wedeen, Ph.D.,
                                                                                                          1–855–266–2427 or http://
                                                  Countermeasures administered and                                                                              Scientific Review Officer, Division of
                                                                                                          www.hrsa.gov/cicp/.                                   Scientific Review, Eunice Kennedy Shriver
                                                  used in accordance with the public
                                                                                                          XV. Amendments                                        National Institute of Child Health and
                                                  health and medical response of the                                                                            Human Development, 6710B Rockledge
                                                  Authority Having Jurisdiction begins on                 42 U.S.C. 247d–6d(b)(4)                               Drive, Bethesda, MD 20892, 301–435–6878,
                                                  the date the response to an event                                                                             wedeenc@mail.nih.gov.
                                                                                                            Any amendments to this declaration
                                                  covered by an emergency declaration                                                                           (Catalogue of Federal Domestic Assistance
                                                                                                          will be published in the Federal
                                                  begins, including authorized activities                                                                       Program Nos. 93.864, Population Research;
                                                                                                          Register.
                                                  that occur as part of the response before                                                                     93.865, Research for Mothers and Children;
                                                  the formal declaration of an emergency,                   Authority: 42 U.S.C. 247d–6d.                       93.929, Center for Medical Rehabilitation
                                                  and lasts through (1) the final day the                   Dated: May 4, 2017.                                 Research; 93.209, Contraception and
                                                  emergency declaration is in effect or (2)               Thomas E. Price,                                      Infertility Loan Repayment Program, National
                                                  December 31, 2022, whichever occurs                                                                           Institutes of Health, HHS)
                                                                                                          Secretary.
                                                  first.                                                  [FR Doc. 2017–09455 Filed 5–9–17; 8:45 am]              Dated: May 4, 2017.
                                                  XIII. Additional Time Period of                         BILLING CODE 4150–03–P                                Michelle Trout,
                                                  Coverage                                                                                                      Program Analyst, Office of Federal Advisory
                                                                                                                                                                Committee Policy.
                                                  42 U.S.C. 247d–6d(b)(3)(A), (B) and (C)                 DEPARTMENT OF HEALTH AND                              [FR Doc. 2017–09413 Filed 5–9–17; 8:45 am]
                                                     I have determined that an additional                 HUMAN SERVICES                                        BILLING CODE 4140–01–P
                                                  twelve (12) months of liability
                                                  protection is reasonable to allow for the               National Institutes of Health
                                                  manufacturer(s) to arrange for                                                                                DEPARTMENT OF HEALTH AND
                                                                                                          Eunice Kennedy Shriver National                       HUMAN SERVICES
                                                  disposition of the Covered
                                                                                                          Institute of Child Health & Human
                                                  Countermeasure, including return of the
                                                                                                          Development; Notice of Closed                         National Institutes of Health
                                                  Covered Countermeasures to the
                                                                                                          Meetings
                                                  manufacturer, and for Covered Persons
                                                                                                                                                                Center for Scientific Review; Notice of
                                                  to take such other actions as are                         Pursuant to section 10(d) of the                    Closed Meetings
                                                  appropriate to limit the administration                 Federal Advisory Committee Act, as
                                                  or use of the Covered Countermeasures.                  amended (5 U.S.C. App.), notice is                      Pursuant to section 10(d) of the
                                                     Covered Countermeasures obtained
jstallworth on DSK7TPTVN1PROD with NOTICES




                                                                                                          hereby given of the following meetings.               Federal Advisory Committee Act, as
                                                  for the Strategic National Stockpile                      The meetings will be closed to the                  amended (5 U.S.C. App.), notice is
                                                  (‘‘SNS’’) during the effective period of                public in accordance with the                         hereby given of the following meetings.
                                                  this declaration for Covered                            provisions set forth in sections                        The meetings will be closed to the
                                                  Countermeasures obtained through                        552b(c)(4) and 552b(c)(6), Title 5 U.S.C.,            public in accordance with the
                                                  means of distribution other than in                     as amended. The grant applications and                provisions set forth in sections
                                                  accordance with the public health and                   the discussions could disclose                        552b(c)(4) and 552b(c)(6), Title 5 U.S.C.,
                                                  medical response of the Authority                       confidential trade secrets or commercial              as amended. The grant applications and


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Document Created: 2017-05-10 00:00:51
Document Modified: 2017-05-10 00:00:51
CategoryRegulatory Information
CollectionFederal Register
sudoc ClassAE 2.7:
GS 4.107:
AE 2.106:
PublisherOffice of the Federal Register, National Archives and Records Administration
SectionNotices
ActionNotice.
DatesThe declaration is effective as of April 11, 2017.
ContactGeorge W. Korch Jr., Ph.D., Acting Assistant Secretary for Preparedness and Response, Office of the Secretary, Department of Health and Human Services, 200 Independence Avenue SW., Washington, DC 20201, Telephone (202) 205-2882 (this is not a toll-free number).
FR Citation82 FR 21819 

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