Proposed Rule2026-05997
Reducing Bureaucracy and Burden for Human Services and Emergency Response Programs-Repatriation Program
Primary source
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Published
March 27, 2026
Issuing agencies
Health and Human Services DepartmentChildren and Families Administration
Abstract
The Department of Health and Human Services, Administration for Children and Families proposes to amend the Care and Treatment of Mentally Ill Nationals of the United States, Returned from Foreign Countries regulations and the Assistance for United States Citizens Returned from Foreign Countries regulations to eliminate unnecessary or obsolete regulations. The docket on https://www.regulations.gov will include a plain language summary of the NPRM.
Full Text
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<title>Federal Register, Volume 91 Issue 59 (Friday, March 27, 2026)</title>
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[Federal Register Volume 91, Number 59 (Friday, March 27, 2026)]
[Proposed Rules]
[Pages 14797-14800]
From the Federal Register Online via the Government Publishing Office [<a href="http://www.gpo.gov">www.gpo.gov</a>]
[FR Doc No: 2026-05997]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Administration for Children and Families
45 CFR Parts 211 and 212
RIN 0970-AD40
Reducing Bureaucracy and Burden for Human Services and Emergency
Response Programs--Repatriation Program
AGENCY: Office of Human Services Emergency Preparedness and Response
(OHSEPR), Administration for Children and Families (ACF), Department of
Health and Human Services (HHS).
ACTION: Notice of proposed rulemaking.
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SUMMARY: The Department of Health and Human Services, Administration
for Children and Families proposes to amend the Care and Treatment of
Mentally Ill Nationals of the United States, Returned from Foreign
Countries regulations and the Assistance for United States Citizens
Returned from Foreign Countries regulations to eliminate unnecessary or
obsolete regulations. The docket on <a href="https://www.regulations.gov">https://www.regulations.gov</a> will
include a plain language summary of the NPRM.
DATES: In order to be considered, written comments on this proposed
rule must be received on or before April 27, 2026.
ADDRESSES: You may submit written comments, identified by docket number
ACF-2026-0232 and/or RIN number 0970-AD40, by one of the following
methods:
<bullet> Federal eRulemaking Portal: Go to <a href="https://www.regulations.gov">https://www.regulations.gov</a>. Follow the instructions for submitting comments.
<bullet> Email: <a href="/cdn-cgi/l/email-protection#f7b392859290829b96839e9899b7969491d99f9f84d9909881"><span class="__cf_email__" data-cfemail="b2f6d7c0d7d5c7ded3c6dbdddcf2d3d1d49cdadac19cd5ddc4">[email protected]</span></a>. Include the docket number
ACF-2026-0232 and/or RIN number 0970-AD40 in the subject line of the
message.
Instructions: All submissions received must include the agency name
and docket number or RIN number for this rulemaking. All comments
received are a part of the public record and will be posted for public
viewing on <a href="http://www.regulations.gov">www.regulations.gov</a>, without change. Please be advised that
the substance of the comments and the identity of individuals or
entities submitting the comments will be subject to public disclosure.
FOR FURTHER INFORMATION CONTACT: Adam N. Jones, Deputy Chief of Staff,
Immediate Office of the Assistant Secretary, Administration for
Children and Families, Department of Health and Human Services,
Washington, DC 202-417-0115 or <a href="/cdn-cgi/l/email-protection#226647504745574e43564b4d4c624341440c4a4a510c454d54"><span class="__cf_email__" data-cfemail="8fcbeafdeae8fae3eefbe6e0e1cfeeece9a1e7e7fca1e8e0f9">[email protected]</span></a>.
SUPPLEMENTARY INFORMATION:
I. Statutory Authority
This proposed regulation is being issued under the authority
granted to the Secretary of Health and Human Services by 74 Stat. 308-
310 (24 U.S.C. 321-329) and Sections 1102 and 1113 of the Social
Security Act (42 U.S.C. 1302, 42 U.S.C. 1313).
II. Background
45 CFR part 211, ``Care and Treatment of Mentally Ill Nationals of
the United States, Returned from Foreign Counties'' is a comprehensive
regulatory framework established under the 74 Stat. 308-310, 42 U.S.C.
321-329. Originally published on July 19, 1974, Part 211 establishes
uniform procedures for program applications, including requirements
addressing eligibility, procedures for the care and treatment of
mentally ill repatriates, and general administrative standards. 45 CFR
part 212, ``Assistance for United States Citizens Returned from Foreign
Countries'' is a set of regulations established under the authority of
the Social Security Act (42 U.S.C. 1302, 42 U.S.C. 1313) that was
designed to implement 42 U.S.C. 1313 by providing more detailed
requirements for temporary assistance to United States (U.S.) Citizen
repatriates and their dependents.
III. Executive Summary
This NPRM proposes to rescind multiple regulations that are either
unnecessary or wholly obsolete. The proposed regulations contained in
this NPRM to be rescinded and reserved can be categorized into three
groups: those that are duplicative, those that are better suited as a
different type of sub-regulatory format, and those that are obsolete.
Duplicative regulations are those that carry no impact as the
authority and requirements stated in the regulation exist or are stated
elsewhere such as in statute, which would make these existing
regulations otherwise unnecessary.
The regulations that are better suited to a different format, i.e.
as a sub-regulatory document, are those that generally read like a
Frequently Asked Questions document or are overly prescriptive and
carry technical details that belong in programmatic instruction. ACF
proposes to rescind this category of regulations to allow for
publication in a more appropriate format following the final rule
becoming effective.
The final category are those regulations that are obsolete or
outdated This includes regulations that refer to
[[Page 14798]]
grant programs that are no longer funded, practices that are no longer
followed, or are otherwise no longer relevant.
Effective Date
ACF expects all provisions included in the proposed rule, if
finalized, to become effective 30 days from the date of publication of
the final rule.
Severability
The provisions of this NPRM, once it becomes final, are intended to
be severable, such that, in the event a court were to invalidate any
particular provision or deem it to be unenforceable, the remaining
provisions would continue to be valid. None of the provisions contained
herein are central to an overall intent of the proposed rule, nor are
any provisions dependent on the validity of other, separate provisions.
IV. Discussion of Proposed Changes
45 CFR Part 211 Care and Treatment of Mentally Ill Nationals of the
United States, Returned From Foreign Countries
Sec. 211.1 General Definitions
This Section defines the terms used in this Part. This Section is
proposed for repeal due to the fact that many of the terms that are
defined are duplicated in 24 U.S.C. 321 ``Definitions.'' There were a
few regulatory definitions that were not defined in statute, but those
terms were either commonly defined and did not need to be further
defined or were utilized only in Sections that are proposed to be
repealed.
Sec. 211.2 General
This Section specifies that ACF will consult with appropriate
agencies to ensure that any aid that is provided is provided by the
right organization. This provision is proposed for removal as the text
of the regulation is merely rephrasing and restating the language found
in the statute that authorizes the creation of the regulation, 24
U.S.C. 321-329. Thus, as the authority to consult with appropriate
agencies as well as the other statements described in this Section are
already found in statute, this Section is unnecessary and duplicate,
and therefore proposed for repeal.
Sec. 211.4 Notification to Legal Guardian, Spouse, Next of Kin, or
Interested Persons
This Section specifies that ACF will notify the next of kin and
legal guardians when repatriates with mental health needs arrive in the
United States or are transferred between states. This provision is
proposed for removal as the requirement for notifying the next of kin
and legal guardian still applies irrespective of this rule. The
recission of this rule will not hinder the ability for next of kin and
legal guardians to be notified of the repatriation of their relatives.
As such, this rule is unnecessary and thus is proposed for repeal.
Sec. 211.5 Action Under State Law; Appointment of Guardian
This Section details that ACF will act according to state law on
how to act and care for an individual who is unable to give consent,
either due to being a minor or due to their mental state, with regard
to the appointment of a guardian. As this regulation states that ACF
will follow state law, the recission of this regulation does not impact
the necessity to follow state law. In other words, by repealing this
Section, state law and the status quo will still be followed. As such,
this Section is unnecessary and is proposed to be repealed.
Sec. 211.7 Transfer and Release of Eligible Person
This Section lists the conditions under which an eligible
repatriate will be transferred and released into the care of a
relative. Furthermore, this Section details that if an individual is
unable to be released to a relative, that the individual may be
released to the appropriate state health authority. This Section is
proposed for removal as the language and authorization are found to be
duplicated in 24 U.S.C. 323 ``Care and treatment of eligible persons
until transfer and release.'' As the regulation simply mirrors the
statute, it is unnecessary and duplicate and thus proposed for repeal.
Sec. 211.8 Continuing Hospitalization
This Section details the appropriate arrangements for placement and
treatment of an eligible individual needing continued care in
furtherance of the regulations found in Sec. 211.7. Much like Sec.
211.7, this Section is also found to be duplicative of statutory
language found at 24 U.S.C. 324 ``Care and treatment of eligible
persons until transfer and release.'' As this Section also mirrors
statute, the language found in regulation is simply duplicative and
therefore not needed. Thus, this rulemaking proposes to repeal this
Section.
Sec. 211.9 Examination and Reexamination
This Section details the frequency by which an examination must be
conducted on any individual admitted to a hospital pursuant to Part
211. The language requiring that patients be examined no more than five
days after their admission and every six months thereafter is a copy of
the requirements found at 24 U.S.C. 325 ``Examination of persons
admitted.'' As this is a duplication of existing requirements, this
Section is not necessary and is proposed to be repealed.
Sec. 211.10 Termination of Hospitalization
This Section details that the process for discharge or conditional
release of a patient must comply with state laws as well as the
requirement to notify the committing court of the release. The first
component of this Section requires the hospital to release an
individual from care if they are determined to not or no longer require
hospitalization, pursuant to state laws and regulations. Thus, this
component of the rule requires hospitals to follow existing laws, which
they would be required to do irrespective of this regulation. As such,
this first component of this Section is unnecessary as it does not
carry any requirement that is not found in state specific statutes and
is proposed to be repealed.
The second component of this Section that deals with mandating the
notification to the committing court duplicates federal law in 24
U.S.C. 327 ``Notification to committing court of discharge or
conditional release.'' As this is purely duplicative, this regulation
is not needed, and the repeal will not produce any policy change.
Sec. 211.11 Request for Release From Hospitalization
This Section describes the process that must be followed when a
patient or their next of kin or legal guardian requests a release from
hospitalization. This process is described in complete detail already
at 24 U.S.C. 326 ``Release of patient.'' As the regulation merely
restates the statutory language, it is duplicative and thus
unnecessary. The repeal of this Section will not change policy for
those requesting a release from hospitalization.
Sec. 211.12 Federal Payments
This Section details the requirement that an agreement must be
established between an Administrator and a hospital as to how a
hospital or agency will be paid for services. This Section is not
needed as this describes an outdated approach which predated
government-wide regulations at 2 CFR part 200 which describe payment
methods, allowable costs, and financial management requirements. As
this
[[Page 14799]]
Section is both outdated it is proposed to be repealed provide clarity
to the public.
Sec. 211.13 Financial Responsibility of the Eligible Person;
Collections, Compromise, or Waiver of Payment
Section 211.13 details the financial responsibility for the
eligible person. This Section is proposed to be repealed as it is
duplicated in statutory language found at 24 U.S.C. 328 ``Payment for
care and treatment.'' As the requirements for who is liable and what
waiver authority of costs exist is stated in both statute and in
regulations, the regulations are not needed and are proposed to be
repealed.
Sec. 211.14 Disclosure of Information
This part details the protections against the disclosure of
information regarding individuals receiving care. This Section is
proposed to be repealed as this information is heavily expanded upon
and covered by the Health Insurance Portability and Accountability Act
of 1996 (HIPAA). This law prohibits the disclosure of patient
information without authorization, which mirrors the intent of the
regulation. As both regulations, and statute to a stronger degree,
protect patient data and information, the regulation is duplicative and
unnecessary. This repeal does not change policy with respect to
disclosure of patient information.
Sec. 211.15 Nondiscrimination
This Section details the prohibition of discrimination based on
various characteristics, which is duplicative of federal law found at
42 U.S.C. 2000d. The recission of this part is due to the existence of
other protections against discrimination which cover the topics
discussed in this Part. As such, this repeal is not intended to, nor
will enable, the discrimination of any individual based on the
characteristics described therein.
45 CFR Part 212 Assistance for United States Citizens Returned from
Foreign Countries
Much like many Sections of Part 211, this Part is found to mirror
existing statutory language. The entire Part is found to rephrase and
repeat the authorizing statute, 42 U.S.C. 1313 ``Assistance for United
States citizens returned from foreign countries.'' As the regulation is
a duplication without providing significant additional clarifying
language or detail, it is unnecessary and proposed for repeal.
V. Regulatory Process Matters
Paperwork Reduction Act
Under the Paperwork Reduction Act (44 U.S.C. 3501 et seq., as
amended) (PRA), all Departments are required to submit to the Office of
Management and Budget (OMB) for review and approval any reporting or
recordkeeping requirements inherent in a proposed or final rule. This
NPRM does not contain any information requiring OMB approval under the
PRA and, therefore, will not create any new paperwork burdens or modify
existing burdens subject to OMB review.
Executive Order 13132
Executive Order 13132 requires federal agencies to consult with
State and local government officials if they develop regulatory
policies with federalism implications. Federalism is rooted in the
belief that issues that are not national in scope or significance are
most appropriately addressed by the level of government close to the
people. This proposed rule would not have substantial direct impact on
the States, on the relationship between the federal government and the
States, or on the distribution of power and responsibilities among the
various levels of government. This NPRM would not pre-empt State law.
The changes proposed in the NPRM are removing unnecessary and obsolete
regulations from the Office of Human Services Emergency Preparedness
and Response Repatriation Program rules. Therefore, in accordance with
Section 6 of Executive Order 13132, it is determined that this action
does not have sufficient federalism implications to warrant the
preparation of a federalism summary impact statement.
Assessment of Federal Regulations and Policies on Families
Assessment of Federal Regulations and Policies on Families Section
654 of the Treasury and General Government Appropriations Act of 1999
(Pub. L. 105-277) requires federal agencies to determine whether a
policy or regulation may negatively affect family well-being. If the
agency determines a policy or regulation negatively affects family
well-being, then the agency must prepare an impact assessment
addressing seven criteria specified in the law. HHS believes it is not
necessary to prepare a family policymaking assessment because the
actions proposed in this NPRM will not have any impact on the autonomy
or integrity of the family as an institution.
VI. Regulatory Impact Analysis
We have examined the impacts of the proposed rule under Executive
Order 12866, Executive Order 13563, Executive Order 14192, the
Regulatory Flexibility Act (5 U.S.C. 601-612), and the Unfunded
Mandates Reform Act of 1995 (Pub. L. 104-4).
Executive Orders 12866 and 13563 direct us to assess all benefits
and costs of available regulatory alternatives and, when regulation is
necessary, to select regulatory approaches that maximize net benefits.
Rules are ``significant'' under Executive Order 12866 Section 3(f)(1)
if they ``have an annual effect on the economy of $100 million or more;
or adversely affect in a material way the economy, a sector of the
economy, productivity, competition, jobs, the environment, public
health or safety, or State, local or tribal governments or
communities.'' Executive Order 14192 requires that any new incremental
costs associated with significant new regulations ``shall, to the
extent permitted by law, be offset by the elimination of existing costs
associated with at least ten prior regulations.'' The Office of
Information and Regulatory Affairs (OIRA) has determined that this
proposed rule is not a significant action under Executive Order 12866
Section 3(f). This analysis indicates that the proposed rule, if
finalized would be a deregulatory action as defined by Section 3 of
Executive Order 14192.
The Regulatory Flexibility Act (RFA) requires agencies to consider
the impact of their regulatory proposals on small entities. Because
this is simply repealing obsolete and unnecessary language, we propose
to certify that the proposed rule would not have a significant economic
impact on a substantial number of small entities.
The Unfunded Mandates Reform Act of 1995 (UMRA) generally requires
that each agency conduct a cost-benefit analysis; identify and consider
a reasonable number of regulatory alternatives; and select the least
costly, most cost effective, or least burdensome alternative that
achieves the objectives of the rule before promulgating any proposed or
final rule that includes a Federal mandate that may result in
expenditures of more than $100 million (adjusted for inflation) in at
least one year by State, local, and tribal governments, in the
aggregate, or by the private sector. Each agency issuing a rule with
relevant effects over that threshold must also seek input from State,
local, and tribal governments. The current threshold after adjustment
for inflation is $193 million, using the most current (2025) Implicit
Price Deflator for
[[Page 14800]]
the Gross Domestic Product. This proposed rule would not result in an
expenditure in any year that meets or exceeds this amount.
VII. Tribal Consultation Statement
Executive Order 13175, Consultation and Coordination with Indian
Tribal Governments, requires agencies to consult with Indian Tribes
when regulations have ``substantial direct effects on one or more
Indian Tribes, on the relationship between the Federal Government and
Indian Tribes, or on the distribution of power and responsibilities
between the Federal Government and Indian Tribes.'' Similarly, ACF's
Tribal Consultation Policy says that consultation is triggered for any
legislative proposal, new rule adoption, or other policy change that
significantly affects Tribes, meaning there exists a reasonable
presumption that it has or may have substantial direct effects on one
or more Indian Tribes, on the relationship between the Federal
Government and Indian tribes, on the amount or duration of ACF program
funding, on the delivery of ACF programs or services to one or more
Indian Tribes, or on the distribution of power and responsibilities
between the Federal Government and Indian Tribes. However, as this is a
deregulatory action, per OMB M-25-36, Streamlining the Review of
Deregulatory Actions, this action presumptively does not trigger the
Tribal Consultation requirements of Executive Order 13175 nor does it
meet ACF's standard for consultation.
List of Subjects
45 CFR Part 211
Grant programs-social programs, Health care, Mental health
programs, Public assistance programs.
45 CFR Part 212
Grant programs-social programs, Public assistance programs.
For the reasons set forth in the preamble, ACF proposes to amend 45
CFR parts 211 and 212 as follows:
PART 211--CARE AND TREATMENT OF MENTALLY ILL NATIONALS OF THE
UNITED STATES, RETURNED FROM FOREIGN COUNTRIES
0
1. The authority citation for part 211 continues to read as follows:
Authority: Secs. 1-11, 74 Stat. 308-310; 24 U.S.C. 321-329.
Sec. Sec. 211.1, 211.2, 211.4, 211.5, and 211.7 through
211.15 [Removed and Reserved]
0
2. Remove and reserve Sec. Sec. 211.1, 211.2, 211.4, 211.5, 211.5, and
211.7 through 211.15.
PART 212--[REMOVED AND RESERVED]
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3. Under the authority 74 Stat. 308-310 (24 U.S.C. 321-329) and
Sections 1102 and 1113 of the Social Security Act (42 U.S.C. 1302, 42
U.S.C. 1313), remove and reserve part 212.
Robert F. Kennedy, Jr.,
Secretary, Department of Health and Human Services.
[FR Doc. 2026-05997 Filed 3-26-26; 8:45 am]
BILLING CODE 4184-PL-P
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