A geographic area will be designated as having a shortage of companion animal veterinary professional(s) if the following three criteria are met: 1. The area is a rational area for the delivery of veterinary services. 2. The ratio of resident civilian population to number of companion animal veterinarians in the area is at least 30,000:1 and the computed companion animal veterinary shortage to meet this ratio is at least 0.5. 3. Companion animal veterinarians in contiguous areas are overutilized or excessively distant from the population of the area under consideration. C. Methodology. In determining whether an area meets the criteria established by paragraphs A and B of this part, the following methodology will be used: 1. Rational Areas for the Delivery of Veterinary Services. (a) The following areas will be considered rational areas for the delivery of veterinary services: (i) A county, or a group of contiguous counties whose population centers are within 40 minutes travel time of each other. (ii) A portion of a county (or an area made up of portions of more than one county) which, because of topography, market and/or transportation patterns or other factors, has limited access to contiguous area resources, as measured generally by a travel time of greater than 40 minutes to these resources. (b) The following distances will be used as guidelines in determining distances corresponding to 40 minutes travel time: (i) Under normal conditions with primary roads available: 25 miles. (ii) In mountainous terrain or in areas with only secondary roads available: 20 miles. (iii) In flat terrain or in areas connected by interstate highways: 30 miles. 2. Determination of Number of Veterinary Livestock Units (VLU) Requiring Care. Since various types of food animals require varying amounts of veterinary care, each type of animal has been assigned a weight indicating the amount of veterinary care it requires relative to that required by a milk cow. Those weights are used to compute the number of "Veterinary Livestock Units" (VLU) for which veterinary care is required. The VLU is computed as follows: Veterinary Livestock Units (VLU)=(number of milk cows) +.2x(number of other cattle and calves) 3. Counting of Food Animal Veterinarians. The number of food animal veterinarians is determined by weighting the number of veterinarians within each of several practice categories according to the average fraction of practice time in that category which is devoted to food animal veterinary care, as follows: Number of Food Animal Veterinarians=(number of veterinarians in large animal practice, exclusively) +(number of veterinarians in bovine practice, exclusively) +(number of veterinarians in poultry practice, exclusively) +.75x(mixed practice veterinarians with greater than 50% of practice in large animal care) +.5x(mixed practice veterinarians with approximately 50% of practice in large animal care) +.25x(mixed practice veterinarians with less than 50% of practice in large animal care). 4. Counting of Companion Animal Veterinarians (that is, those who provide services for dogs, cats, horses, and any other animals maintained as companions to the owner rather than as food animals). The number of full-time equivalent companion animal veterinarians is determined by weighting the number of veterinarians within each of several practice categories by the average portion of their practice which is devoted to companion animal care by the practitioners within that category, as follows: Number of Companion Animal Veterinarians=(number of veterinarians in large animal practice, exclusively) +(number of veterinarians in equine practice, exclusively) +.75x(mixed practice veterinarians with greater than 50% of practice in small animal care) +.5x(mixed practice veterinarians with approximately 50% of practice in small animal care) +.25×(mixed practice veterinarians with less than 50% of practice in small animal care). 5. Size of Shortage Computation. The size of shortage will be computed as follows: (a) veterinarian shortage (VLU/10,000)–(number of food animal veterinarians). (b) Companion animal veterinarian shortage (resident civilian pop./ 30,000)-(number of companion animal veterinarians). 6. Contiguous Area Considerations. Veterinary professional(s) in areas contiguous to an area being considered for designation will be considered excessively distant from the population of the area or overutilized if one of the following conditions prevails in each contiguous area: (a) Veterinary professional(s) in the contiguous area are more than 60 minutes travel time from the center of the area being considered for designation (measured in accordance with paragraph C.1.(b) of this part). (b) In the case of food animal veterinary professional(s), the VLU-to-food animal veterinarian ratio in the contiguous area is in excess of 5,000: 1. (c) In the case of companion animal veterinary professional(s), the population-to-companion animal veterinarian ratio in the contiguous area is in excess of 15,000:1. C. Determination of Degree-of-Shortage. Designated areas will be assigned to degree-of-shortage groups as follows: Group 1-Areas with a food animal veterinarian shortage and no veterinarians. Group 2-Areas (not included above) with a food animal veterinarian shortage and no food animal veterinarians. Group 3-All other food animal veterinarian shortage areas. Group 4-All companion animal shortage areas (not included above) having no veterinarians. Group 5-All other companion animal shortage areas. partment of Justice to whom the authority involved has been delegated. Covered entity means an entity described in §6.3 which has been deemed by the Secretary, in accordance with §6.5, to be covered by this part. Covered individual means an individual described in §6.4. Effective date as used in §6.5 and §6.6 refers to the date of the Secretary's determination that an entity is a covered entity. Secretary means the Secretary of Health and Human Services (HHS) and any other officer or employee of the Department of HHS to whom the authority involved has been delegated. Subrecipient means an entity which receives a grant or a contract from a covered entity to provide a full range of health services on behalf of the covered entity. §6.3 Eligible entities. (a) Grantees. Entities eligible for coverage under this part are public and nonprofit private entities receiving Federal funds under any of the following grant programs: (1) Section 329 of the Act (relating to grants for migrant health centers); (2) Section 330 of the Act (relating to grants for community health centers); (3) Section 340 of the Act (relating to grants for health services for the homeless); and (4) Section 340A of the Act (relating to grants for health services for residents of public housing). (b) Subrecipients. Entities that are subrecipients of grant funds described in paragraph (a) of this section are eligible for coverage only if they provide a full range of health care services on behalf of an eligible grantee and only for those services carried out under the grant funded project. § 6.4 Covered individuals. (a) Officers and employees of a covered entity are eligible for coverage under this part. (b) Contractors of a covered entity who are physicians or other licensed or certified health care practitioners are eligible for coverage under this part if they meet the requirements of section 224(g)(5) of the Act. (c) An individual physician or other licensed or certified health care practitioner who is an officer, employee, or contractor of a covered entity will not be covered for acts or omissions occurring after receipt by the entity employing such individual of notice of a final determination by the Attorney General that he or she is no longer covered by this part, in accordance with section 224(i) of the Act. § 6.5 Deeming process for eligible entities. Eligible entities will be covered by this part only on and after the effective date of a determination by the Secretary that they meet the requirements of section 224(h) of the Act. In making such determination, the Secretary will receive such assurances and conduct such investigations as he or she deems necessary. §6.6 Covered acts and omissions. (a) Only acts and omissions occurring on and after the effective date of the Secretary's determination under §6.5 and before the later date specified in section 224(g)(3) of the Act are covered by this part. (b) Only claims for damage for personal injury, including death, resulting from the performance of medical, surgical, dental, or related functions are covered by this part. (c) With respect to covered individuals, only acts and omissions within the scope of their employment (or contract for services) are covered. If a covered individual is providing services which are not on behalf of the covered entity, such as on a volunteer basis or on behalf of a third-party (except as described in paragraph (d) of this section), whether for pay or otherwise, acts and omissions which are related to such services are not covered. (d) Only acts and omissions related to the grant-supported activity of entities are covered. Acts and omissions related to services provided to individuals who are not patients of a covered entity will be covered only if the Secretary determines that: (1) The provision of the services to such individuals benefits patients of the entity and general populations that could be served by the entity through community-wide intervention efforts within the communities served by such entity; (2) The provision of the services to such individuals facilitates the provision of services to patients of the entity; or (3) Such services are otherwise required to be provided to such individuals under an employment contract or similar arrangement between the entity and the covered individual. (e) Examples. The following are examples of situations within the scope of paragraph (d) of this section: (1) A community health center deemed to be a covered entity establishes a school-based or school-linked health program as part of its grant supported activity. Even though the students treated are not necessarily registered patients of the center, the center and its health care practitioners will be covered for services provided, if the Secretary makes the determination in paragraph (d)(1) of this section. (2) A migrant health center requires its physicians to obtain staff privileges at a community hospital. As a condition of obtaining such privileges, and thus being able to admit the center's patients to the hospital, the physicians must agree to provide occasional coverage of the hospital's emergency room. The Secretary would be authorized to determine that this coverage is necessary to facilitate the provision of services to the grantee's patients, and that it would therefore be covered by paragraph (d)(2) of this section. PART 7-DISTRIBUTION OF REFERENCE BIOLOGICAL STANDARDS AND BIOLOGICAL PREPARATIONS Sec. 7.1 Applicability. 7.2 Establishment of a user charge. 7.3 Definitions. 7.4 Schedule of charges. 7.5 Payment procedures. 7.6 Exemptions. AUTHORITY: Sec. 215, 58 Stat. 690, as amended (42 U.S.C. 216); title V of the Independent Offices Appropriation Act of 1952 (31 U.S.C. 9701); and sec. 352 of the Public Health Service Act, as amended (42 U.S.C. 263). SOURCE: 52 FR 11073, Apr. 7, 1987, unless otherwise noted. $7.1 Applicability. The provisions of this part are applicable to private entities requesting from the Centers for Disease Control (CDC) reference biological standards and biological preparations for use in their laboratories. §7.2 Establishment of a user charge. Except as otherwise provided in §7.6, a user charge shall be imposed to cover the cost to CDC of producing and distributing reference biological standards and biological preparations. $7.3 Definitions. Biological standards means a uniform and stable reference biological substance which allows measurements of relative potency to be made and described in a common currency of international and national units of activity. Biological preparations means a reference biological substance which may be used for a purpose similar to that of a standard, but which has been estab lished without a full collaborative study, or where a collaborative study has shown that it is not appropriate to establish the preparation as an international standard. $7.4 Schedule of charges. The charges imposed in §7.2 are based on the amount published in CDC's price list of available products. These charges will reflect direct costs (such as salaries and equipment), indirect costs (such as rent, telephone service, and a proportionate share of management and administrative costs), and the costs of particular ingredients. Charges may vary over time and between different biological standards or biological preparations, depending upon the cost of ingredients and the complexity of production. An up-todate schedule of charges is available from the Biological Products Branch, Center for Infectious Diseases, Centers for Disease Control, 1600 Clifton Road, Atlanta, Georgia 30333. $7.5 Payment procedures. The requester may obtain information on terms of payment and a fee schedule by writing the "Centers for Disease Control," Financial Management Office, Buckhead Facility, Room 200, Centers for Disease Control, 1600 Clifton Road, Atlanta, Georgia 30333. $7.6 Exemptions. State and local health departments, governmental institutions (e.g., State hospitals and universities), the World Health Organization, and ministries of health of foreign governments may be exempted from paying user charges, when using biological standards or biological preparations for public health purposes. 21.21 Meaning of terms. 21.22 Submission of application and evidence of qualifications. 21.23 False statements as disqualification. 21.24 Physical examinations. 21.25 Eligibility; junior assistant grade. 21.26 Eligibility; assistant grade. 21.27 Eligibility; senior assistant grade. 21.28 Age requirements, Regular Corps, senior assistant grade and below. 21.29 Eligibility; grades above senior assistant grade. 21.30 Determination of creditable years of educational and professional training and experience. 21.31 Eligibility; all grades; academic and professional education and professional training and experience. 21.32 Boards; appointment of; powers and duties. 21.55 Appointment to higher grades; candidates exceptionally qualified in specialized fields. 21.56 Reappointment. 21.57 Examination for reappointment. 21.58 Physical examination for reappoint ment. Subpart C-Involuntary Child and Spousal Support Allotments 21.70 Purpose. 21.71 Applicability and scope. 21.72 Definitions. 21.73 Policy. 21.74 Responsibilities. 21.75 Procedures. Subpart A-Definitions AUTHORITY: Sec. 215, 58 Stat. 690, as amended; 42 U.S.C. 216. § 21.1 Meaning of terms. As used in this part, the term: (a) Act means the Public Health Service Act, 58 Stat. 682, as now or hereafter amended. (b) Department means the Department of Health and Human Services. (c) Secretary means the Secretary of Health and Human Services. (d) Service means the Public Health Service. (e) Surgeon General means the Surgeon General of the Public Health Service. (f) Commissioned officer or officer, unless otherwise indicated, means either an officer of the Regular Corps or an officer of the Reserve Corps. [21 FR 9806, Dec. 12, 1956] Subpart B-Appointment AUTHORITY: Sec. 215, 58 Stat. 690, as amended; 42 U.S.C. 216; sec. 208, 58 Stat. 685, as amended; 42 U.S.C. 209. SOURCE: 21 FR 9806, Dec. 12, 1956, unless otherwise noted. PROVISIONS APPLICABLE BOTH TO REGULAR AND RESERVE CORPS § 21.21 Meaning of terms. The terms approved school, approved college, approved postgraduate school, or 190-164 D-00--3 |