96-30574. Community Residential Care Program and Contract Program for Veterans With Alcohol and Drug Dependence Disorders  

  • [Federal Register Volume 61, Number 232 (Monday, December 2, 1996)]
    [Rules and Regulations]
    [Pages 63719-63720]
    From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
    [FR Doc No: 96-30574]
    
    
    
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    DEPARTMENT OF VETERANS AFFAIRS
    
    38 CFR Part 17
    
    RIN 2900-AH61
    
    
    Community Residential Care Program and Contract Program for 
    Veterans With Alcohol and Drug Dependence Disorders
    
    AGENCY: Department of Veterans Affairs.
    
    ACTION: Final rule.
    
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    SUMMARY: This document updates the Department of Veterans Affairs (VA) 
    regulations concerning the Community Residential Care Program and the 
    Contract Program for Veterans With Alcohol and Drug Dependence 
    Disorders by incorporating by reference relevant portions of the latest 
    editions of the National Fire Protection Association Life Safety Code 
    entitled ``NFPA 101, Life Safety Code'' and ``NFPA 101A, Guide on 
    Alternative Approaches to Life Safety.'' This is intended to ensure 
    that buildings used for treatment and residential services for veterans 
    meet appropriate fire and safety standards. Also, this document amends 
    the regulations for such programs by delegating authority to each of 
    the Veterans Integrated Service Network (VISN) Directors of the 
    Veterans Health Administration to grant certain equivalencies or 
    variances to building standards of the Life Safety Code. Further, this 
    final rule does not adopt the portion of the proposed rule concerning 
    the Adult Day Health Care Program since the Adult Day Health Care 
    Program and the corresponding regulations are no longer in existence.
    
    EFFECTIVE DATE: This rule is effective January 2, 1997.
        The incorporation by reference of certain publications listed in 
    the regulations is approved by the Director of the Federal Register as 
    of January 2, 1997.
    
    FOR FURTHER INFORMATION CONTACT: James R. Kelley, Director, Extended 
    Care Service, for issues relating to the Community Residential Care 
    Program at (202) 273-6342 (this is not a toll-free number); and Richard 
    T. Suchinsky, M.D., Associate Director for Addictive Disorders and 
    Psychiatric Rehabilitation, for issues relating to the Contract Program 
    for Veterans With Alcohol and Drug Disorders at (202) 273-8437 (this is 
    not a toll-free number), Veterans Health Administration, Department of 
    Veterans Affairs, 810 Vermont Ave., NW, Washington, DC 20420.
    
    SUPPLEMENTARY INFORMATION: On September 11, 1995, we published a 
    proposed rule concerning the Adult Day Health Care Program; the 
    Community Residential Care Program; and the Contract Program for 
    Veterans With Alcohol and Drug Dependence Disorders (60 FR 47133). We 
    proposed to update these regulations by incorporating by reference 
    relevant portions of the latest editions of the National Fire 
    Protection Association Life Safety Code entitled ``NFPA 101, Life 
    Safety Code'' and ``NFPA 101A, Guide on Alternative Approaches to Life 
    Safety.'' We also proposed changes to delegations of authority. We 
    requested that comments to the proposed rule be submitted on or before 
    November 13, 1995. The portion of the proposed rule concerning the 
    Adult Day Health Care Program is not adopted and instead is withdrawn 
    since the Adult Day Health Care Program and the corresponding 
    regulations are no longer in existence (see 61 FR 21964). Based on the 
    reasons stated in the proposed rule and this document, the provisions 
    of the proposed rule concerning the Community Residential Care Program 
    and the Contract Program for Veterans With Alcohol and Drug Dependence 
    Disorders are adopted in this final rule with changes as discussed 
    below.
        The Community Residential Care Program is authorized under 38 
    U.S.C. 1730 and the Contract Program for Veterans With Alcohol and Drug 
    Dependence Disorders is authorized under 38 U.S.C. 501 and 1720A.
        We received thirteen comments, seven of which were identical. All 
    of the comments concerned the Community Residential Care Program.
        The commenters, in general, objected to any increased costs which 
    may be associated with operating a residential care facility under the 
    provisions of the proposed rule. For example, some commenters objected 
    to the possibility that they would have to install sprinkler systems. 
    One commenter asserted that his homeowner's insurance would be canceled 
    if he had to install a sprinkler system. A number of commenters 
    asserted that the Life Safety Code was never intended to apply to ``mom 
    and pop'' operations and some commenters further asserted that small 
    operations, such as those housing eight or fewer veterans, should be 
    exempt from the provisions of the Life Safety Code. Some commenters 
    asserted that the Life Safety Code is arbitrary in the manner in which 
    increasingly stringent criteria are applied depending upon whether a 
    facility has sleeping accommodations for more than three residents or 
    more than 16 residents. No changes are made based on these comments 
    except as discussed below.
        The Life Safety Code was intended to apply to the ``mom and pop'' 
    residential care facilities and we believe that the adoption of the 
    current Life Safety Code is necessary to ensure minimum levels of fire 
    safety for residential care facilities participating in VA programs. 
    The Life Safety Code is a national consensus code based on actual fire 
    experience across the country. The code adopts standards designed to 
    protect the occupants from loss of life but yet is intended to avoid 
    standards which might involve significant hardship or inconvenience 
    while yielding little additional increases in safety. Providing a safe 
    environment is just as much a part of enhancing a veteran's life as 
    other requirements of these programs.
        Although some facilities may face greater costs due to changes in 
    the Life Safety Code, our belief is that the need to increase the life 
    safety of veterans in participating programs takes first priority. 
    However, the Life Safety Code does provide for relief in appropriate 
    circumstances. In this regard, Appendix A, at A-1-4.4 provides:
    
        In existing buildings, it is not always practical to strictly 
    apply the provisions of this Code. Physical limitations may require 
    disproportionate effort or expense with little increase in public 
    safety. In such cases, the authority having jurisdiction should be 
    satisfied that reasonable life safety is ensured.
        In existing buildings, it is intended that any condition that 
    represents a serious threat to life be mitigated by application of 
    appropriate safeguards. It is not intended to require modifications 
    for conditions that do not represent a significant threat to life, 
    even though such conditions are not literally in compliance with the 
    Code.
    
        It was intended that all of Appendix A be included in the material 
    incorporated by reference since it consists of explanatory material 
    relating to provisions incorporated by reference. Accordingly, the 
    final rule incorporates by reference the provisions set forth in 
    Appendix A. Also, it was intended that any equivalencies or variances 
    be required to be approved by the appropriate Veterans Health 
    Administration Veterans Integrated Service Networks (VISN) Director and 
    this delegation is added to each of the regulatory provisions affected 
    by this rule.
        Identical submissions from a number of commenters asserted that the 
    technical committee that serves the National Fire Protection 
    Association (NFPA) in developing the requirements of the Life Safety 
    Code should include a member from the community residential program. In 
    response, we note that in our view the committee is
    
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    well balanced and does have representation from community providers. In 
    this regard, representatives of the Association of Residential 
    Resources in Minnesota and the American Network of Community and 
    Options are members on NFPA's technical advisory committees responsible 
    for developing standards. Further, the committees also have 
    representation from the VA, insurance companies, and state regulatory 
    officials.
        Commenters asserted this rule might have a disproportionate effect 
    and expense for small entities and that therefore a cost-benefit 
    analysis should be undertaken. In our view, special consideration for 
    small entities is not warranted since the rule already is designed for 
    small entities and in all likelihood only small entities will conduct 
    activities affected by this rule.
        The section numbers for the regulations amended by this rulemaking 
    are different from those in the proposed rule because they recently 
    were changed. Sections 17.51j, 17.53b, and 17.53c were changed 
    respectively to sections 17.63, 17.81, and 17.82 (see 61 FR 21964).
        The Secretary hereby certifies that this final rule does not have a 
    significant economic impact on a substantial number of small entities 
    as they are defined in the Regulatory Flexibility Act, 5 U.S.C. 601-
    612. The rule already is designed for small entities and in all 
    likelihood only small entities will conduct activities affected by this 
    rule. Therefore, pursuant to 5 U.S.C. 605(b), this final rule is exempt 
    from the initial and final regulatory flexibility analysis requirement 
    of sections 603 and 604.
    
    Catalog
    
        The Catalog of Federal Domestic Assistance Numbers are 64.015 
    and 64.019.
    
    List of Subjects in 38 CFR Part 17
    
        Administrative practice and procedure, Alcohol abuse, Alcoholism, 
    Claims, Day care, Dental health, Drug abuse, Foreign relations, 
    Government contracts, Grant program--health, Grant program--veterans, 
    Health care, Health facilities, Health professions, Health records, 
    Homeless, Incorporation by reference, Medical and dental schools, 
    Medical devices, Medical research, Medical health programs, Nursing 
    homes, Philippines, Reporting and recordkeeping requirements, 
    Scholarships and fellowships, Travel and transportation expenses, 
    Veterans.
    
        Approved: September 9, 1996.
    Jesse Brown,
    Secretary of Veterans Affairs.
    
        For the reasons set forth in the preamble, 38 CFR, part 17 is 
    amended as set forth below:
    
    PART 17--MEDICAL
    
        1. The authority citation for Part 17 continues to read as follows:
    
        Authority: 38 U.S.C. 501, 1721, unless otherwise noted.
    
        2. In Sec. 17.63 paragraph (a)(2) is revised to read as follows:
    
    
    Sec. 17.63  Approval of community residential care facilities.
    
    * * * * *
        (a) * * *
        (2) Meet the requirements of chapters 1-7, 22-23, and 31 and 
    Appendix A of the NFPA 101, National Fire Protection Association's Life 
    Safety Code (1994 edition), and NFPA 101A, Guide on Alternative 
    Approaches to Life Safety (1995 edition), which are incorporated by 
    reference. The institution shall provide sufficient staff to assist 
    patients in the event of fire or other emergency. Incorporation by 
    reference of these materials was approved by the Director of the 
    Federal Register, in accordance with 5 U.S.C. 552(a) and 1 CFR part 51. 
    These materials incorporated by reference are available for inspection 
    at the Office of the Federal Register, Suite 700, 800 North Capitol 
    Street, NW., Washington, DC, and the Department of Veterans Affairs, 
    Office of Regulations Management (02D), Room 1154, 810 Vermont Avenue, 
    NW., Washington, DC 20420. Copies may be obtained from the National 
    Fire Protection Association, Battery March Park, Quincy, MA 02269. (For 
    ordering information, call toll-free 1-800-344-3555.) Any equivalencies 
    or variances to Department of Veterans Affairs requirements must be 
    approved by the appropriate Veterans Health Administration Veterans 
    Integrated Service Networks (VISN) Director.
    * * * * *
        3. In Sec. 17.81, paragraph (a)(1)(i) is revised to read as 
    follows:
    
    
    Sec. 17.81  Contracts for residential treatment services for veterans 
    with alcohol or drug dependence or abuse disabilities.
    
        (a) * * *
        (1) * * *
        (i) The building must meet the requirements of the applicable 
    residential occupancy chapters (1-7, 22-23, and 31) and Appendix A of 
    the NFPA 101, National Fire Protection Association's Life Safety Code 
    (1994 edition) which are incorporated by reference. Incorporation by 
    reference of these materials was approved by the Director of the 
    Federal Register, in accordance with 5 U.S.C. 552(a) and 1 CFR part 51. 
    These materials incorporated by reference are available for inspection 
    at the Office of the Federal Register, Suite 700, 800 North Capitol 
    Street, NW., Washington, DC, and the Department of Veterans Affairs, 
    Office of Regulations Management (02D), Room 1154, 810 Vermont Avenue, 
    NW., Washington, DC 20420. Copies may be obtained from the National 
    Fire Protection Association, Battery March Park, Quincy, MA 02269. (For 
    ordering information, call toll-free 1-800-344-3555.) Any equivalencies 
    or variances to Department of Veterans Affairs requirements must be 
    approved by the appropriate Veterans Health Administration Veterans 
    Integrated Service Networks (VISN) Director.
    * * * * *
        4. In Sec. 17.82, paragraph (a)(1)(i) is revised to read as 
    follows:
    
    
    Sec. 17.82  Contracts for outpatient services for veterans with alcohol 
    or drug dependence or abuse disabilities.
    
        (a) * * *
        (1) * * *
        (i) The building must meet the requirements of the applicable 
    business occupancy chapters (1-7, 26-27, and 31) and Appendix A of the 
    NFPA 101, National Fire Protection Association's Life Safety Code (1994 
    edition) which are incorporated by reference. Incorporation by 
    reference of these materials was approved by the Director of the 
    Federal Register, in accordance with 5 U.S.C. 552(a) and 1 CFR part 51. 
    These materials incorporated by reference are available for inspection 
    at the Office of the Federal Register, Suite 700, 800 North Capitol 
    Street, NW., Washington, DC, and the Department of Veterans Affairs, 
    Office of Regulations Management (02D), Room 1154, 810 Vermont Avenue, 
    N.W., Washington, DC 20420. Copies may be obtained from the National 
    Fire Protection Association, Battery March Park, Quincy, MA 02269. (For 
    ordering information, call toll-free 1-800-344-3555.) Any equivalencies 
    or variances to Department of Veterans Affairs requirements must be 
    approved by the appropriate Veterans Health Administration Veterans 
    Integrated Service Networks (VISN) Director.
    * * * * *
    [FR Doc. 96-30574 Filed 11-29-96; 8:45 am]
    BILLING CODE 8320-01-P
    
    
    

Document Information

Effective Date:
1/2/1997
Published:
12/02/1996
Department:
Veterans Affairs Department
Entry Type:
Rule
Action:
Final rule.
Document Number:
96-30574
Dates:
This rule is effective January 2, 1997.
Pages:
63719-63720 (2 pages)
RINs:
2900-AH61: Community Residential Care Program and Contract Program for Veterans With Alcohol and Drug Dependence Disorders
RIN Links:
https://www.federalregister.gov/regulations/2900-AH61/community-residential-care-program-and-contract-program-for-veterans-with-alcohol-and-drug-dependenc
PDF File:
96-30574.pdf
CFR: (3)
38 CFR 17.63
38 CFR 17.81
38 CFR 17.82