83_FR_56546 83 FR 56327 - Barriers to Participation in the NIOSH Coal Workers Health Surveillance Program

83 FR 56327 - Barriers to Participation in the NIOSH Coal Workers Health Surveillance Program

DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Disease Control and Prevention

Federal Register Volume 83, Issue 219 (November 13, 2018)

Page Range56327-56328
FR Document2018-24700

The Coal Workers' Health Surveillance Program (CWHSP or Program), administered by CDC's National Institute for Occupational Safety and Health (NIOSH), is seeking information from coal miners, miner advocates, unions, industry stakeholders, and other interested parties about barriers to participating in health screening offered by the Program to inform efforts to improve participation.

Federal Register, Volume 83 Issue 219 (Tuesday, November 13, 2018) 
[Federal Register Volume 83, Number 219 (Tuesday, November 13, 2018)]
[Notices]
[Pages 56327-56328]
From the Federal Register Online  [www.thefederalregister.org]
[FR Doc No: 2018-24700]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention

[Docket No. CDC-2018-0110; NIOSH-224]


Barriers to Participation in the NIOSH Coal Workers Health 
Surveillance Program

AGENCY: Centers for Disease Control and Prevention, HHS.

ACTION: Request for information.

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SUMMARY: The Coal Workers' Health Surveillance Program (CWHSP or 
Program), administered by CDC's National Institute for Occupational 
Safety and Health (NIOSH), is seeking information from coal miners, 
miner advocates, unions, industry stakeholders, and other interested 
parties about barriers to participating in health screening offered by 
the Program to inform efforts to improve participation.

DATES: Comments must be received by January 14, 2019.

ADDRESSES: Written comments: Comments may be submitted electronically, 
through the Federal eRulemaking Portal: http://www.regulations.gov, or 
by sending a hard copy to the NIOSH Docket Office, Robert A. Taft 
Laboratories, MS-C34, 1090 Tusculum Avenue, Cincinnati, OH 45226. All 
written submissions received must include the agency name (Centers for 
Disease Control and Prevention, HHS) and docket number (CDC-2018-0110; 
NIOSH-224) for this action. All relevant comments, including any 
personal information provided, will be posted without change to http://www.regulations.gov.

FOR FURTHER INFORMATION CONTACT: Cara N. Halldin, NIOSH Coal Workers' 
Health Surveillance Program, Respiratory Health Division, 1095 
Willowdale Road, MS HG900.2, Morgantown, WV 26505-2888; (304) 285-5754 
(this is not a toll-free number); [email protected].

SUPPLEMENTARY INFORMATION: 
    The NIOSH Coal Workers' Health Surveillance Program was authorized 
by the Coal Mine Health and Safety Act of 1969, as amended by the 
Federal Mine Safety and Health Act of 1977 (30 U.S.C. 801 et seq.), to 
detect dust-induced interstitial lung disease (black lung or coal 
workers' pneumoconiosis) and prevent its progression in individual 
miners, and obtain information about temporal and geographic trends 
across the population of coal miners. Through the Program, coal miners 
are offered periodic health screenings, including chest x-rays and 
spirometry examinations, at no cost to them. These screenings can 
potentially detect early signs of black lung. NIOSH has administered 
the Program since 1970. Since that time, the prevalence of radiographic 
evidence of pneumoconiosis among participating coal miners reached its 
lowest level in the late 1990s, but has steadily increased since 2000 
and is now at a 25-year high. In the Appalachian coal mining states of 
Kentucky, Virginia, and West Virginia, as many as one in five 
underground coal miners with more than 25 years' tenure are thought to 
have radiographic evidence of pneumoconiosis.\1\ Participation by coal 
miners in the CWHSP is voluntary, and about 35 percent of active coal 
miners participate in health screenings offered by the Program.\2\
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    \1\ Blackley DJ, Halldin CN, Laney AS [2018]. Continued increase 
in prevalence of coal workers' pneumoconiosis in the United States, 
1970-2017. AJPH 108(9):1220-1222.
    \2\ Id.
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    Greater participation in the Program would provide more 
opportunities for early detection of pneumoconiosis in coal miners, 
providing those with early disease the ability to take action to reduce 
the chance for progression to severe lung disease. In order to identify 
ways to improve participation in the Program, NIOSH is seeking 
information from all interested parties, especially active coal miners, 
as well as miner advocates, unions, industry stakeholders, and 
healthcare providers of screening services for the CWHSP, to learn 
about the factors that keep miners from participating in the health 
screening examinations that are available to them.
    NIOSH is particularly interested in receiving information about the 
following questions:
    1. Are coal miners aware that periodic health screenings are 
available, at no cost to them, through the Coal Workers' Health 
Surveillance Program?
    2. Is lack of convenience of the screening--for example, screening 
locations or hours of availability--a barrier to participation? If yes, 
please describe those factors that may prevent miners from accessing 
CWHSP screenings.
    3. NIOSH's mobile surveillance unit travels to different locations 
to provide free black lung screenings, including chest x-rays and 
spirometry tests.\3\ Does the mobile unit provide a useful supplement 
to services offered by approved healthcare facilities engaged by mine 
operators? If yes, please explain why mobile outreach is a useful 
supplement. If no, or if mobile outreach could be improved, please 
provide recommendations on how it could become more useful to the coal 
mining community.
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    \3\ See https://www.cdc.gov/niosh/topics/cwhsp/free-screening/wv.html.
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    4. Do coal miners receive encouragement to participate (or 
discouragement from participating) in the CWHSP screenings from others 
such as employers, unions, or co-workers? If so, please describe.
    5. Are scheduling issues, such as the need to take unpaid time off 
from work or use vacation hours or non-work hours for health 
screenings, a barrier to miners' participation in health

[[Page 56328]]

screenings? If yes, please explain the scheduling issue that is a 
barrier and provide recommendations for how it could be overcome.
    6. Does concern about the confidentiality of medical information 
pose a barrier to participation? If this is a barrier, then please 
provide recommendations or suggestions for how it can be overcome.
    7. Does concern that the early identification of dust-related lung 
disease might adversely affect a miner's career (e.g., prevent career 
advancement or the ability to get a new coal mining job) pose a barrier 
to participation? If this is a barrier, then please provide 
recommendations or suggestions for how it can be overcome.
    8. Does concern that early identification of dust-related lung 
disease might affect subsequent eligibility for compensation through 
Federal or State programs pose a barrier to participation? If this is a 
barrier, then please describe the specific compensation programs and 
how eligibility for them can be affected by early detection of dust-
related lung disease. Please also provide recommendations or 
suggestions for how this barrier could be overcome.
    9. Does concern that personal finances will require a miner to 
continue working despite early identification of dust-related lung 
disease pose a barrier to participation? If this is a barrier, please 
provide recommendations or suggestions for how it can be overcome.
    10. Are there any other barriers to participation that NIOSH should 
be aware of?
    Interested parties may participate in this activity by submitting 
written views, opinions, recommendations, and data. Comments received, 
including attachments and other supporting materials, are part of the 
public record and subject to public disclosure. Do not include any 
information in your comment or supporting materials that you do not 
wish to be disclosed. Although your name, contact information, or other 
information that identifies you in the body of your comments will be on 
public display, NIOSH will review all submissions and may choose to 
redact or withhold submissions containing private or proprietary 
information such as Social Security numbers, medical information, and/
or inappropriate language. Comments may be submitted on any topic 
related to this action. All public comments will be posted in the 
docket for this action at https://www.regulations.gov.

John J. Howard,
Director, National Institute for Occupational Safety and Health, 
Centers for Disease Control and Prevention.
[FR Doc. 2018-24700 Filed 11-9-18; 8:45 am]
 BILLING CODE 4163-19-P

Federal Register / Vol. 83, No. 219 / Tuesday, November 13, 2018 / Notices 56327 website—as legally required by FTC Safety and Health (NIOSH), is seeking pneumoconiosis.1 Participation by coal Rule 4.9(b)—we cannot redact or information from coal miners, miner miners in the CWHSP is voluntary, and remove your comment from the FTC advocates, unions, industry about 35 percent of active coal miners website, unless you submit a stakeholders, and other interested participate in health screenings offered confidentiality request that meets the parties about barriers to participating in by the Program.2 requirements for such treatment under health screening offered by the Program Greater participation in the Program FTC Rule 4.9(c), and the General to inform efforts to improve would provide more opportunities for Counsel grants that request. participation. early detection of pneumoconiosis in The FTC Act and other laws that the coal miners, providing those with early DATES: Comments must be received by disease the ability to take action to Commission administers permit the January 14, 2019. reduce the chance for progression to collection of public comments to consider and use in this proceeding as ADDRESSES: Written comments: severe lung disease. In order to identify appropriate. The Commission will Comments may be submitted ways to improve participation in the consider all timely and responsive electronically, through the Federal Program, NIOSH is seeking information public comments that it receives on or eRulemaking Portal: http:// from all interested parties, especially before December 13, 2018. For www.regulations.gov, or by sending a active coal miners, as well as miner information on the Commission’s hard copy to the NIOSH Docket Office, advocates, unions, industry privacy policy, including routine uses Robert A. Taft Laboratories, MS–C34, stakeholders, and healthcare providers permitted by the Privacy Act, see 1090 Tusculum Avenue, Cincinnati, OH of screening services for the CWHSP, to https://www.ftc.gov/site-information/ 45226. All written submissions received learn about the factors that keep miners privacy-policy. For supporting must include the agency name (Centers from participating in the health documentation and other information for Disease Control and Prevention, screening examinations that are underlying the PRA discussion in this HHS) and docket number (CDC–2018– available to them. Notice, see http://www.reginfo.gov/ 0110; NIOSH–224) for this action. All NIOSH is particularly interested in public/jsp/PRA/praDashboard.jsp. relevant comments, including any receiving information about the Comments on the information personal information provided, will be following questions: collection requirements subject to posted without change to http:// 1. Are coal miners aware that periodic review under the PRA should www.regulations.gov. health screenings are available, at no additionally be submitted to OMB. If FOR FURTHER INFORMATION CONTACT: Cara cost to them, through the Coal Workers’ sent by U.S. mail, they should be N. Halldin, NIOSH Coal Workers’ Health Surveillance Program? addressed to Office of Information and 2. Is lack of convenience of the Health Surveillance Program, Regulatory Affairs, Office of screening—for example, screening Respiratory Health Division, 1095 Management and Budget, Attention: locations or hours of availability—a Willowdale Road, MS HG900.2, Desk Officer for the Federal Trade barrier to participation? If yes, please Morgantown, WV 26505–2888; (304) Commission, New Executive Office describe those factors that may prevent 285–5754 (this is not a toll-free Building, Docket Library, Room 10102, miners from accessing CWHSP number); challdin@cdc.gov. 725 17th Street NW, Washington, DC screenings. SUPPLEMENTARY INFORMATION: 3. NIOSH’s mobile surveillance unit 20503. Comments sent to OMB by U.S. The NIOSH Coal Workers’ Health travels to different locations to provide postal mail, however, are subject to Surveillance Program was authorized by free black lung screenings, including delays due to heightened security the Coal Mine Health and Safety Act of chest x-rays and spirometry tests.3 Does precautions. Thus, comments instead 1969, as amended by the Federal Mine the mobile unit provide a useful can also be sent by email to wliberante@ Safety and Health Act of 1977 (30 U.S.C. supplement to services offered by omb.eop.gov. 801 et seq.), to detect dust-induced approved healthcare facilities engaged Heather Hippsley, interstitial lung disease (black lung or by mine operators? If yes, please explain Deputy General Counsel. coal workers’ pneumoconiosis) and why mobile outreach is a useful [FR Doc. 2018–24682 Filed 11–9–18; 8:45 am] prevent its progression in individual supplement. If no, or if mobile outreach miners, and obtain information about could be improved, please provide BILLING CODE 6750–01–P temporal and geographic trends across recommendations on how it could the population of coal miners. Through become more useful to the coal mining the Program, coal miners are offered community. DEPARTMENT OF HEALTH AND periodic health screenings, including 4. Do coal miners receive HUMAN SERVICES chest x-rays and spirometry encouragement to participate (or Centers for Disease Control and examinations, at no cost to them. These discouragement from participating) in Prevention screenings can potentially detect early the CWHSP screenings from others such signs of black lung. NIOSH has as employers, unions, or co-workers? If [Docket No. CDC–2018–0110; NIOSH–224] administered the Program since 1970. so, please describe. Since that time, the prevalence of 5. Are scheduling issues, such as the Barriers to Participation in the NIOSH radiographic evidence of need to take unpaid time off from work Coal Workers Health Surveillance pneumoconiosis among participating or use vacation hours or non-work hours Program coal miners reached its lowest level in for health screenings, a barrier to AGENCY: Centers for Disease Control and the late 1990s, but has steadily miners’ participation in health amozie on DSK3GDR082PROD with NOTICES1 Prevention, HHS. increased since 2000 and is now at a 25- ACTION: Request for information. year high. In the Appalachian coal 1 Blackley DJ, Halldin CN, Laney AS [2018]. mining states of Kentucky, Virginia, and Continued increase in prevalence of coal workers’ pneumoconiosis in the United States, 1970–2017. SUMMARY: The Coal Workers’ Health West Virginia, as many as one in five AJPH 108(9):1220–1222. Surveillance Program (CWHSP or underground coal miners with more 2 Id. Program), administered by CDC’s than 25 years’ tenure are thought to 3 See https://www.cdc.gov/niosh/topics/cwhsp/ National Institute for Occupational have radiographic evidence of free-screening/wv.html. VerDate Sep<11>2014 17:34 Nov 09, 2018 Jkt 247001 PO 00000 Frm 00054 Fmt 4703 Sfmt 4703 E:\FR\FM\13NON1.SGM 13NON1

56328 Federal Register / Vol. 83, No. 219 / Tuesday, November 13, 2018 / Notices screenings? If yes, please explain the submissions containing private or methodology for 2018, which is set forth scheduling issue that is a barrier and proprietary information such as Social in the payment notice entitled ‘‘Basic provide recommendations for how it Security numbers, medical information, Health Program; Federal Funding could be overcome. and/or inappropriate language. Methodology for Program Years 2017 6. Does concern about the Comments may be submitted on any and 2018’’ (81 FR 10091, February 29, confidentiality of medical information topic related to this action. All public 2016) (February 2016 Payment Notice). pose a barrier to participation? If this is comments will be posted in the docket The modification involves the a barrier, then please provide for this action at https:// application of a Premium Adjustment recommendations or suggestions for www.regulations.gov. Factor (PAF) that considers the how it can be overcome. premium increases in other states that John J. Howard, 7. Does concern that the early became effective after the Centers for identification of dust-related lung Director, National Institute for Occupational Medicare & Medicaid Services (CMS), Safety and Health, Centers for Disease Control disease might adversely affect a miner’s and Prevention. an operating division of the U.S. career (e.g., prevent career advancement Department of Health and Human [FR Doc. 2018–24700 Filed 11–9–18; 8:45 am] or the ability to get a new coal mining Services (HHS), discontinued payments BILLING CODE 4163–19–P job) pose a barrier to participation? If to issuers for cost-sharing reductions this is a barrier, then please provide (CSRs) provided to enrollees in recommendations or suggestions for qualified health plans (QHPs) offered on DEPARTMENT OF HEALTH AND how it can be overcome. health insurance Exchanges. HUMAN SERVICES 8. Does concern that early On July 6, 2018, pursuant to an identification of dust-related lung Centers for Medicare & Medicaid amended stipulated order issued in disease might affect subsequent Services State of New York v. U.S. Department of eligibility for compensation through Health and Human Services, 18–cv– Federal or State programs pose a barrier [CMS–2416–N] 00683 (S.D.N.Y. filed Jan. 26, 2018), to participation? If this is a barrier, then CMS issued a Draft Administrative Basic Health Program; Final please describe the specific Order on which New York and Administrative Order compensation programs and how Minnesota (the States) had an eligibility for them can be affected by AGENCY: Centers for Medicare & opportunity to comment. The States early detection of dust-related lung Medicaid Services (CMS), HHS. each submitted comments on August 6, disease. Please also provide ACTION: Notice of Final Administrative 2018. CMS considered those comments recommendations or suggestions for Order. in issuing the Final Administrative how this barrier could be overcome. Order, which adopts the HHS Revised 9. Does concern that personal finances SUMMARY: This notice serves to BHP Payment Methodology for 2018 as will require a miner to continue announce that a Final Administrative set forth in the Draft Administrative working despite early identification of Order related to the Basic Health Order. dust-related lung disease pose a barrier Program (BHP) was issued to the States to participation? If this is a barrier, of New York and Minnesota on August II. Collection of Information please provide recommendations or 24, 2018. Requirements suggestions for how it can be overcome. DATES: The Final Administrative Order This document does not impose 10. Are there any other barriers to was effective August 24, 2018. information collection requirements, participation that NIOSH should be FOR FURTHER INFORMATION CONTACT: that is, reporting, recordkeeping, or aware of? Christopher Truffer, (410) 786–1264; third-party disclosure requirements. Interested parties may participate in Meg Barry, (410) 786–1536. Consequently, review by the Office of this activity by submitting written SUPPLEMENTARY INFORMATION: Management and Budget under the views, opinions, recommendations, and authority of the Paperwork Reduction data. Comments received, including I. Background and Provisions of the Notice Act of 1995 (44 U.S.C. 3501, et seq.) is attachments and other supporting not required. materials, are part of the public record The CMS Administrator issued a and subject to public disclosure. Do not Final Administrative Order to set forth III. Addendum include any information in your the revised payment methodology that We are publishing the Final comment or supporting materials that applies to the Basic Health Program for Administrative Order as an addendum you do not wish to be disclosed. 2018 only (HHS Revised BHP Payment to this Notice. Although your name, contact Methodology). The Administrative information, or other information that Order is an agency action under 5 U.S.C. Dated: November 2, 2018. identifies you in the body of your 551(13), issued pursuant to 5 U.S.C. Seema Verma, comments will be on public display, 555(b) and (e). Administrator, Centers for Medicare & NIOSH will review all submissions and The HHS Revised BHP Payment Medicaid Services. may choose to redact or withhold Methodology modifies the existing BILLING CODE 4120–01–P amozie on DSK3GDR082PROD with NOTICES1 VerDate Sep<11>2014 17:34 Nov 09, 2018 Jkt 247001 PO 00000 Frm 00055 Fmt 4703 Sfmt 4703 E:\FR\FM\13NON1.SGM 13NON1


Document Created: 2018-11-10 03:19:09
Document Modified: 2018-11-10 03:19:09
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
ActionRequest for information.
DatesComments must be received by January 14, 2019.
ContactCara N. Halldin, NIOSH Coal Workers' Health Surveillance Program, Respiratory Health Division, 1095 Willowdale Road, MS HG900.2, Morgantown, WV 26505-2888; (304) 285-5754 (this is not a toll-free number); [email protected]
FR Citation83 FR 56327 
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