
[Federal Register Volume 76, Number 87 (Thursday, May 5, 2011)]
[Notices]
[Pages 25769-25773]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2011-11012]


-----------------------------------------------------------------------

DEPARTMENT OF TRANSPORTATION

Federal Motor Carrier Safety Administration

[Docket No. FMCSA-2011-0103]


Qualification of Drivers; Exemption Applications; Diabetes 
Mellitus

AGENCY: Federal Motor Carrier Safety Administration (FMCSA).

ACTION: Notice of applications for exemption from the diabetes mellitus 
standard; request for comments.

-----------------------------------------------------------------------

SUMMARY: FMCSA announces receipt of applications from 24 individuals 
for exemption from the prohibition against persons with insulin-treated 
diabetes mellitus (ITDM) operating commercial motor vehicles (CMVs) in 
interstate commerce. If granted, the exemptions would enable these 
individuals with ITDM to operate CMVs in interstate commerce.

DATES: Comments must be received on or before June 6, 2011.

ADDRESSES: You may submit comments bearing the Federal Docket 
Management System (FDMS) Docket No. FMCSA-2011-0103 using any of the 
following methods:
     Federal eRulemaking Portal: Go to http://www.regulations.gov. Follow the on-line instructions for submitting 
comments.
     Mail: Docket Management Facility; U.S. Department of 
Transportation, 1200 New Jersey Avenue, SE., West Building Ground 
Floor, Room W12-140, Washington, DC 20590-0001.
     Hand Delivery: West Building Ground Floor, Room W12-140, 
1200 New Jersey Avenue, SE., Washington, DC, between 9 a.m. and 5 p.m., 
Monday through Friday, except Federal Holidays.
     Fax: 1-202-493-2251.
    Instructions: Each submission must include the Agency name and the 
docket numbers for this notice. Note that all comments received will be 
posted without change to http://www.regulations.gov, including any 
personal information provided. Please see the Privacy Act heading below 
for further information.
    Docket: For access to the docket to read background documents or 
comments, go to http://www.regulations.gov at any time or Room W12-140 
on the ground level of the West Building, 1200 New Jersey Avenue, SE., 
Washington, DC, between 9 a.m. and 5 p.m., Monday through Friday, 
except Federal holidays. The Federal Docket Management System (FDMS) is 
available 24 hours each day, 365 days each year. If you want 
acknowledgment that we received your comments, please include a self-
addressed, stamped envelope or postcard or print the acknowledgement 
page that appears after submitting comments on-line.
    Privacy Act: Anyone may search the electronic form of all comments 
received into any of our dockets by the name of the individual 
submitting the comment (or of the person signing the comment, if 
submitted on behalf of an association, business, labor union, etc.). 
You may review DOT's Privacy Act Statement for the FDMS published in 
the Federal Register on January 17, 2008 (73 FR 3316), or you may visit 
http://edocket.access.gpo.gov/2008/pdf/E8-785.pdf.

FOR FURTHER INFORMATION CONTACT: Dr. Mary D. Gunnels, Director, Medical 
Programs, (202) 366-4001, fmcsamedical@dot.gov, FMCSA, Department of 
Transportation, 1200 New Jersey Avenue, SE., Room W64-224, Washington, 
DC 20590-0001. Office hours are from 8:30 a.m. to 5 p.m., Monday 
through Friday, except Federal holidays.

SUPPLEMENTARY INFORMATION:

Background

    Under 49 U.S.C. 31136(e) and 31315, FMCSA may grant an exemption 
from the Federal Motor Carrier Safety

[[Page 25770]]

Regulations for a 2-year period if it finds ``such exemption would 
likely achieve a level of safety that is equivalent to, or greater 
than, the level that would be achieved absent such exemption.'' The 
statute also allows the Agency to renew exemptions at the end of the 2-
year period. The 24 individuals listed in this notice have recently 
requested such an exemption from the diabetes prohibition in 49 CFR 
391.41(b)(3), which applies to drivers of CMVs in interstate commerce. 
Accordingly, the Agency will evaluate the qualifications of each 
applicant to determine whether granting the exemption will achieve the 
required level of safety mandated by the statutes.

Qualifications of Applicants

Alfonso L. Abeyta

    Mr. Abeyta, age 57, has had ITDM since 2006. His endocrinologist 
examined him in 2010 and certified that he has had no severe 
hypoglycemic reactions resulting in loss of consciousness, requiring 
the assistance of another person, or resulting in impaired cognitive 
function that occurred without warning in the past 12 months and no 
recurrent (2 or more) severe hypoglycemic episodes in the last 5 years. 
His endocrinologist certifies that Mr. Abeyta understands diabetes 
management and monitoring, has stable control of his diabetes using 
insulin, and is able to drive a CMV safely. Mr. Abeyta meets the 
requirements of the vision standard at 49 CFR 391.41(b)(10). His 
optometrist examined him in 2010 and certified that he does not have 
diabetic retinopathy. He holds a Class A Commercial Driver's License 
(CDL) from Texas.

Perfecto Aquino

    Mr. Aquino, 50, has had ITDM since 2008. His endocrinologist 
examined him in 2010 and certified that he has had no severe 
hypoglycemic reactions resulting in loss of consciousness, requiring 
the assistance of another person, or resulting in impaired cognitive 
function that occurred without warning in the past 12 months and no 
recurrent (2 or more) severe hypoglycemic episodes in the last 5 years. 
His endocrinologist certifies that Mr. Aquino understands diabetes 
management and monitoring, has stable control of his diabetes using 
insulin, and is able to drive a CMV safely. Mr. Aquino meets the 
requirements of the vision standard at 49 CFR 391.41(b)(10). His 
ophthalmologist examined him in 2010 and certified that he has stable 
nonproliferative diabetic retinopathy. He holds a Class A CDL from 
Illinois.

James C. Ayotte

    Mr. Ayotte, 50, has had ITDM since 1977. His endocrinologist 
examined him in 2010 and certified that he has had no severe 
hypoglycemic reactions resulting in loss of consciousness, requiring 
the assistance of another person, or resulting in impaired cognitive 
function that occurred without warning in the past 12 months and no 
recurrent (2 or more) severe hypoglycemic episodes in the last 5 years. 
His endocrinologist certifies that Mr. Ayotte understands diabetes 
management and monitoring, has stable control of his diabetes using 
insulin, and is able to drive a CMV safely. Mr. Ayotte meets the 
requirements of the vision standard at 49 CFR 391.41(b)(10). His 
optometrist examined him in 2011 and certified that he does not have 
diabetic retinopathy. He holds a Class D operator's license from South 
Carolina.

John C. Beason

    Mr. Beason, 62, has had ITDM since 2010. His endocrinologist 
examined him in 2010 and certified that he has had no severe 
hypoglycemic reactions resulting in loss of consciousness, requiring 
the assistance of another person, or resulting in impaired cognitive 
function that occurred without warning in the past 12 months and no 
recurrent (2 or more) severe hypoglycemic episodes in the last 5 years. 
His endocrinologist certifies that Mr. Beason understands diabetes 
management and monitoring, has stable control of his diabetes using 
insulin, and is able to drive a CMV safely. Mr. Beason meets the 
requirements of the vision standard at 49 CFR 391.41(b)(10). His 
ophthalmologist examined him in 2010 and certified that he has stable 
nonproliferative diabetic retinopathy. He holds a Class A CDL from 
Tennessee.

Charles A. Best

    Mr. Best, 27, has had ITDM since 2010. His endocrinologist examined 
him in 2010 and certified that he has had no severe hypoglycemic 
reactions resulting in loss of consciousness, requiring the assistance 
of another person, or resulting in impaired cognitive function that 
occurred without warning in the past 12 months and no recurrent (2 or 
more) severe hypoglycemic episodes in the last 5 years. His 
endocrinologist certifies that Mr. Best understands diabetes management 
and monitoring, has stable control of his diabetes using insulin, and 
is able to drive a CMV safely. Mr. Best meets the requirements of the 
vision standard at 49 CFR 391.41(b)(10). His optometrist examined him 
in 2010 and certified that he does not have diabetic retinopathy. He 
holds a Class A CDL from Ohio.

Gregory E. Bichsel, II

    Mr. Bichsel, 42, has had ITDM since 2010. His endocrinologist 
examined him in 2011 and certified that he has had no severe 
hypoglycemic reactions resulting in loss of consciousness, requiring 
the assistance of another person, or resulting in impaired cognitive 
function that occurred without warning in the past 12 months and no 
recurrent (2 or more) severe hypoglycemic episodes in the last 5 years. 
His endocrinologist certifies that Mr. Bichsel understands diabetes 
management and monitoring, has stable control of his diabetes using 
insulin, and is able to drive a CMV safely. Mr. Bichsel meets the 
requirements of the vision standard at 49 CFR 391.41(b)(10). His 
optometrist examined him in 2011 and certified that he does not have 
diabetic retinopathy. He holds a Class A CDL from Montana.

Raymond D. Dubose

    Mr. Dubose, 53, has had ITDM since 2010. His endocrinologist 
examined him in 2011 and certified that he has had no severe 
hypoglycemic reactions resulting in loss of consciousness, requiring 
the assistance of another person, or resulting in impaired cognitive 
function that occurred without warning in the past 12 months and no 
recurrent (2 or more) severe hypoglycemic episodes in the last 5 years. 
His endocrinologist certifies that Mr. Dubose understands diabetes 
management and monitoring, has stable control of his diabetes using 
insulin, and is able to drive a CMV safely. Mr. Dubose meets the 
requirements of the vision standard at 49 CFR 391.41(b)(10). His 
optometrist examined him in 2011 and certified that he does not have 
diabetic retinopathy. He holds a Class B CDL from Georgia.

Adam Errickson

    Mr. Errickson, 21, has had ITDM since 1998. His endocrinologist 
examined him in 2011 and certified that he has had no severe 
hypoglycemic reactions resulting in loss of consciousness, requiring 
the assistance of another person, or resulting in impaired cognitive 
function that occurred without warning in the past 12 months and no 
recurrent (2 or more) severe hypoglycemic episodes in the last 5 years. 
His endocrinologist certifies that Mr. Errickson understands diabetes 
management and monitoring, has stable control of his diabetes using 
insulin, and is able to drive a CMV safely. Mr. Errickson meets the 
requirements of the vision standard at 49 CFR 391.41(b)(10). His 
optometrist examined him in 2011 and certified that

[[Page 25771]]

he does not have diabetic retinopathy. He holds a Class D operator's 
license from New Jersey.

Jon M. Greiner

    Mr. Greiner, 58, has had ITDM since 2003. His endocrinologist 
examined him in 2011 and certified that he has had no severe 
hypoglycemic reactions resulting in loss of consciousness, requiring 
the assistance of another person, or resulting in impaired cognitive 
function that occurred without warning in the past 12 months and no 
recurrent (2 or more) severe hypoglycemic episodes in the last 5 years. 
His endocrinologist certifies that Mr. Greiner understands diabetes 
management and monitoring, has stable control of his diabetes using 
insulin, and is able to drive a CMV safely. Mr. Greiner meets the 
requirements of the vision standard at 49 CFR 391.41(b)(10). His 
ophthalmologist examined him in 2011 and certified that he does not 
have diabetic retinopathy. He holds a Class D operator's license from 
Minnesota.

Gregory M. Hoyt

    Mr. Hoyt, 38, has had ITDM since 2003. His endocrinologist examined 
him in 2011 and certified that he has had no severe hypoglycemic 
reactions resulting in loss of consciousness, requiring the assistance 
of another person, or resulting in impaired cognitive function that 
occurred without warning in the past 12 months and no recurrent (2 or 
more) severe hypoglycemic episodes in the last 5 years. His 
endocrinologist certifies that Mr. Hoyt understands diabetes management 
and monitoring, has stable control of his diabetes using insulin, and 
is able to drive a CMV safely. Mr. Hoyt meets the requirements of the 
vision standard at 49 CFR 391.41(b)(10). His ophthalmologist examined 
him in 2010 and certified that he does not have diabetic retinopathy. 
He holds a Class D operator's license from Vermont.

Robert E. Jackson

    Mr. Jackson, 44, has had ITDM since 2002. His endocrinologist 
examined him in 2010 and certified that he has had no severe 
hypoglycemic reactions resulting in loss of consciousness, requiring 
the assistance of another person, or resulting in impaired cognitive 
function that occurred without warning in the past 12 months and no 
recurrent (2 or more) severe hypoglycemic episodes in the last 5 years. 
His endocrinologist certifies that Mr. Jackson understands diabetes 
management and monitoring, has stable control of his diabetes using 
insulin, and is able to drive a CMV safely. Mr. Jackson meets the 
requirements of the vision standard at 49 CFR 391.41(b)(10). His 
ophthalmologist examined him in 2010 and certified that he does not 
have diabetic retinopathy. He holds a Class C operator's license from 
North Carolina.

Kimm D. Jacobson

    Mr. Jacobson, 56, has had ITDM since 2006. His endocrinologist 
examined him in 2010 and certified that he has had no severe 
hypoglycemic reactions resulting in loss of consciousness, requiring 
the assistance of another person, or resulting in impaired cognitive 
function that occurred without warning in the past 12 months and no 
recurrent (2 or more) severe hypoglycemic episodes in the last 5 years. 
His endocrinologist certifies that Mr. Jacobson understands diabetes 
management and monitoring, has stable control of his diabetes using 
insulin, and is able to drive a CMV safely. Mr. Jacobson meets the 
requirements of the vision standard at 49 CFR 391.41(b)(10). His 
optometrist examined him in 2010 and certified that he does not have 
diabetic retinopathy. He holds a Class A CDL from Minnesota.

Daryl D. Jibben

    Mr. Jibben, 54, has had ITDM since 2000. His endocrinologist 
examined him in 2011 and certified that he has had no severe 
hypoglycemic reactions resulting in loss of consciousness, requiring 
the assistance of another person, or resulting in impaired cognitive 
function that occurred without warning in the past 12 months and no 
recurrent (2 or more) severe hypoglycemic episodes in the last 5 years. 
His endocrinologist certifies that Mr. Jibben understands diabetes 
management and monitoring, has stable control of his diabetes using 
insulin, and is able to drive a CMV safely. Mr. Jibben meets the 
requirements of the vision standard at 49 CFR 391.41(b)(10). His 
optometrist examined him in 2011 and certified that he does not have 
diabetic retinopathy. He holds a Class A CDL from Minnesota.

Jimmy G. Lee, Jr.

    Mr. Lee, 29, has had ITDM since 2009. His endocrinologist examined 
him in 2010 and certified that he has had no severe hypoglycemic 
reactions resulting in loss of consciousness, requiring the assistance 
of another person, or resulting in impaired cognitive function that 
occurred without warning in the past 12 months and no recurrent (2 or 
more) severe hypoglycemic episodes in the last 5 years. His 
endocrinologist certifies that Mr. Lee understands diabetes management 
and monitoring, has stable control of his diabetes using insulin, and 
is able to drive a CMV safely. Mr. Lee meets the requirements of the 
vision standard at 49 CFR 391.41(b)(10). His optometrist examined him 
in 2010 and certified that he does not have diabetic retinopathy. He 
holds a Class A CDL from North Carolina.

Daniel S. May

    Mr. May, 22, has had ITDM since 2010. His endocrinologist examined 
him in 2011 and certified that he has had no severe hypoglycemic 
reactions resulting in loss of consciousness, requiring the assistance 
of another person, or resulting in impaired cognitive function that 
occurred without warning in the past 12 months and no recurrent (2 or 
more) severe hypoglycemic episodes in the last 5 years. His 
endocrinologist certifies that Mr. May understands diabetes management 
and monitoring, has stable control of his diabetes using insulin, and 
is able to drive a CMV safely. Mr. May meets the requirements of the 
vision standard at 49 CFR 391.41(b)(10). His optometrist examined him 
in 2011 and certified that he does not have diabetic retinopathy. He 
holds a Class A CDL from Iowa.

Gerald D. McElya

    Mr. McElya, 51, has had ITDM since 2010. His endocrinologist 
examined him in 2011 and certified that he has had no severe 
hypoglycemic reactions resulting in loss of consciousness, requiring 
the assistance of another person, or resulting in impaired cognitive 
function that occurred without warning in the past 12 months and no 
recurrent (2 or more) severe hypoglycemic episodes in the last 5 years. 
His endocrinologist certifies that Mr. McElya understands diabetes 
management and monitoring, has stable control of his diabetes using 
insulin, and is able to drive a CMV safely. Mr. McElya meets the 
requirements of the vision standard at 49 CFR 391.41(b)(10). His 
ophthalmologist examined him in 2010 and certified that he does not 
have diabetic retinopathy. He holds a Class A CDL from Texas.

Michael L. Moore

    Mr. Moore, 45, has had ITDM since 2010. His endocrinologist 
examined him in 2011 and certified that he has had no severe 
hypoglycemic reactions resulting in loss of consciousness, requiring 
the assistance of another person, or resulting in impaired cognitive 
function that occurred without warning in the past 12 months and no 
recurrent (2 or more) severe hypoglycemic episodes in the last 5 years. 
His endocrinologist certifies that Mr. Moore understands

[[Page 25772]]

diabetes management and monitoring, has stable control of his diabetes 
using insulin, and is able to drive a CMV safely. Mr. Moore meets the 
requirements of the vision standard at 49 CFR 391.41(b)(10). His 
ophthalmologist examined him in 2011 and certified that he does not 
have diabetic retinopathy. He holds a Class A CDL from California.

Stacey W. Nelson

    Mr. Nelson, 34, has had ITDM since 2007. His endocrinologist 
examined him in 2011 and certified that he has had no severe 
hypoglycemic reactions resulting in loss of consciousness, requiring 
the assistance of another person, or resulting in impaired cognitive 
function that occurred without warning in the past 12 months and no 
recurrent (2 or more) severe hypoglycemic episodes in the last 5 years. 
His endocrinologist certifies that Mr. Nelson understands diabetes 
management and monitoring, has stable control of his diabetes using 
insulin, and is able to drive a CMV safely. Mr. Nelson meets the 
requirements of the vision standard at 49 CFR 391.41(b)(10). His 
ophthalmologist examined him in 2011 and certified that he has stable 
proliferative and nonproliferative diabetic retinopathy in both eyes. 
He holds a Class A CDL from Nebraska.

Ervin W. Ponto

    Mr. Ponto, 61, has had ITDM since 2008. His endocrinologist 
examined him in 2010 and certified that he has had no severe 
hypoglycemic reactions resulting in loss of consciousness, requiring 
the assistance of another person, or resulting in impaired cognitive 
function that occurred without warning in the past 12 months and no 
recurrent (2 or more) severe hypoglycemic episodes in the last 5 years. 
His endocrinologist certifies that Mr. Ponto understands diabetes 
management and monitoring, has stable control of his diabetes using 
insulin, and is able to drive a CMV safely. Mr. Ponto meets the 
requirements of the vision standard at 49 CFR 391.41(b)(10). His 
ophthalmologist examined him in 2010 and certified that he does not 
have diabetic retinopathy. He holds a Class A CDL from Minnesota.

Donald B. Ramaley

    Mr. Ramaley, 69, has had ITDM since 2009. His endocrinologist 
examined him in 2011 and certified that he has had no severe 
hypoglycemic reactions resulting in loss of consciousness, requiring 
the assistance of another person, or resulting in impaired cognitive 
function that occurred without warning in the past 12 months and no 
recurrent (2 or more) severe hypoglycemic episodes in the last 5 years. 
His endocrinologist certifies that Mr. Ramaley understands diabetes 
management and monitoring, has stable control of his diabetes using 
insulin, and is able to drive a CMV safely. Mr. Ramaley meets the 
requirements of the vision standard at 49 CFR 391.41(b)(10). His 
ophthalmologist examined him in 2011 and certified that he does not 
have diabetic retinopathy. He holds a Class B CDL from Pennsylvania.

Bart H. Rideout

    Mr. Rideout, 51, has had ITDM since 2010. His endocrinologist 
examined him in 2010 and certified that he has had no severe 
hypoglycemic reactions resulting in loss of consciousness, requiring 
the assistance of another person, or resulting in impaired cognitive 
function that occurred without warning in the past 12 months and no 
recurrent (2 or more) severe hypoglycemic episodes in the last 5 years. 
His endocrinologist certifies that Mr. Rideout understands diabetes 
management and monitoring, has stable control of his diabetes using 
insulin, and is able to drive a CMV safely. Mr. Rideout meets the 
requirements of the vision standard at 49 CFR 391.41(b)(10). His 
optometrist examined him in 2010 and certified that he does not have 
diabetic retinopathy. He holds a Class A CDL from Connecticut.

Floyd M. Tyler

    Mr. Tyler, 72, has had ITDM since 2010. His endocrinologist 
examined him in 2011 and certified that he has had no severe 
hypoglycemic reactions resulting in loss of consciousness, requiring 
the assistance of another person, or resulting in impaired cognitive 
function that occurred without warning in the past 12 months and no 
recurrent (2 or more) severe hypoglycemic episodes in the last 5 years. 
His endocrinologist certifies that Mr. Tyler understands diabetes 
management and monitoring, has stable control of his diabetes using 
insulin, and is able to drive a CMV safely. Mr. Tyler meets the 
requirements of the vision standard at 49 CFR 391.41(b)(10). His 
ophthalmologist examined him in 2010 and certified that he has stable 
nonproliferative diabetic retinopathy. He holds a Class A CDL from 
Pennsylvania.

Richard G. Wunderlich

    Mr. Wunderlich, 61, has had ITDM since 2009. His endocrinologist 
examined him in 2010 and certified that he has had no severe 
hypoglycemic reactions resulting in loss of consciousness, requiring 
the assistance of another person, or resulting in impaired cognitive 
function that occurred without warning in the past 12 months and no 
recurrent (2 or more) severe hypoglycemic episodes in the last 5 years. 
His endocrinologist certifies that Mr. Wunderlich understands diabetes 
management and monitoring, has stable control of his diabetes using 
insulin, and is able to drive a CMV safely. Mr. Wunderlich meets the 
requirements of the vision standard at 49 CFR 391.41(b)(10). His 
optometrist examined him in 2011 and certified that he does not have 
diabetic retinopathy. He holds a Class A CDL from Minnesota.

Mathew E. Yeates

    Mr. Yeates, 32, has had ITDM since 2008. His endocrinologist 
examined him in 2010 and certified that he has had no severe 
hypoglycemic reactions resulting in loss of consciousness, requiring 
the assistance of another person, or resulting in impaired cognitive 
function that occurred without warning in the past 12 months and no 
recurrent (2 or more) severe hypoglycemic episodes in the last 5 years. 
His endocrinologist certifies that Mr. Yeates understands diabetes 
management and monitoring, has stable control of his diabetes using 
insulin, and is able to drive a CMV safely. Mr. Yeates meets the 
requirements of the vision standard at 49 CFR 391.41(b)(10). His 
optometrist examined him in 2010 and certified that he does not have 
diabetic retinopathy. He holds a Class D operator's license from Utah.

Request for Comments

    In accordance with 49 U.S.C. 31136(e) and 31315, FMCSA requests 
public comment from all interested persons on the exemption petitions 
described in this notice.
    We will consider all comments received before the close of business 
on the closing date indicated in the date section of the notice.
    FMCSA notes that section 4129 of the Safe, Accountable, Flexible 
and Efficient Transportation Equity Act: A Legacy for Users requires 
the Secretary to revise its diabetes exemption program established on 
September 3, 2003 (68 FR 52441)\1\. The revision must provide for 
individual assessment of drivers with diabetes mellitus, and be 
consistent with the criteria described in section

[[Page 25773]]

4018 of the Transportation Equity Act for the 21st Century (49 U.S.C. 
31305).
---------------------------------------------------------------------------

    \1\ Section 4129(a) refers to the 2003 notice as a ``final 
rule.'' However, the 2003 notice did not issue a ``final rule'' but 
did establish the procedures and standards for issuing exemptions 
for drivers with ITDM.
---------------------------------------------------------------------------

    Section 4129 requires: (1) Elimination of the requirement for 3 
years of experience operating CMVs while being treated with insulin; 
and (2) establishment of a specified minimum period of insulin use to 
demonstrate stable control of diabetes before being allowed to operate 
a CMV.
    In response to section 4129, FMCSA made immediate revisions to the 
diabetes exemption program established by the September 3, 2003 notice. 
FMCSA discontinued use of the 3-year driving experience and fulfilled 
the requirements of section 4129 while continuing to ensure that 
operation of CMVs by drivers with ITDM will achieve the requisite level 
of safety required of all exemptions granted under 49 USC. 31136 (e).
    Section 4129(d) also directed FMCSA to ensure that drivers of CMVs 
with ITDM are not held to a higher standard than other drivers, with 
the exception of limited operating, monitoring and medical requirements 
that are deemed medically necessary.
    The FMCSA concluded that all of the operating, monitoring and 
medical requirements set out in the September 3, 2003 notice, except as 
modified, were in compliance with section 4129(d). Therefore, all of 
the requirements set out in the September 3, 2003 notice, except as 
modified by the notice in the Federal Register on November 8, 2005 (70 
FR 67777), remain in effect.

    Issued on: April 21, 2011.
Larry W. Minor,
Associate Administrator for Policy.
[FR Doc. 2011-11012 Filed 5-4-11; 8:45 am]
BILLING CODE 4910-EX-P


