Reducing Bureaucracy and Burden for the Repatriation of Mentally Ill Nationals

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Administration for Children and Families

45 CFR Parts 211 and 1390

RIN 0970-AD48

Reducing Bureaucracy and Burden for the Repatriation of Mentally Ill Nationals

Office Human Services Emergency Preparedness and Response (OHSEPR), Administration for Children and Families (ACF), Department of Health and Human Services (HHS).

Notice of proposed rulemaking.

The Department of Health and Human Services, Administration for Children and Families proposes to remove the Care and Treatment of Mentally Ill Nationals of the United States, Returned from Foreign Countries regulations to streamline regulations and to renumber it under a different Part.

In order to be considered, written comments on this proposed rule must be received on or before October 5, 2026.

You may submit written comments, identified by docket number ACF-2026-0661 and/or RIN number 0970-AD48, by one of the following methods: Federal eRulemaking Portal: Go to https://www.regulations.gov. Follow the instructions for submitting comments. Email: [email protected]. Include the docket number ACF-2026-0661 and/or RIN number 0970-AD48 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 www.regulations.gov, 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. The docket on https://www.regulations.gov will include a plain language summary of the notice of proposed rulemaking (NPRM).

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 [email protected].

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).

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 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. This Part was significantly reduced by 91 FR 36542, published on June 17, 2026.

This NPRM proposes to remove the remaining sections of Part 211 and combine them into a newly created Part 1390 promulgated under the same title. This action would accomplish two tasks. First, it would consolidate the language that is currently found in Sec. Sec. 211.3 and 211.6, which no longer reads cleanly following the removal of the other sections of the Part following the publication of 91 FR 36542. This consolidation will restate the language found in these two sections into a more readable and understandable manner than the current half-century old text. Secondly, the current Part 211 exists under Chapter II of Title 45, which is called "Office of Family Assistance (Assistance Programs), Administration for Children and Families, Department of Health and Human Services." The program office that implements the regulations under current Part 211 is not the Office of Family Assistance (OFA) but rather the Office of Human Services Emergency Preparedness and Response (OHSEPR). This redesignation from Part 211 to Part 1390 would allow that to be more clearly displayed to the public.

Severability

The provisions of this NPRM, if finalized, 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.

Part 211 discusses the procedures and protections made for the care and treatment of mentally ill American nationals returned from foreign countries. This Part was heavily restructured and reduced in 2026 following ACF's intentional effort to remove duplicative and obsolete regulations. See 91 FR 36542. The initial rulemaking related to this Part resulted in the removal of 13 of the 15 sections that were initially promulgated under Part 211. While the removal of those 13 sections allowed for more clarity as to what non-duplicative requirements were in place, it did cause the remaining regulations to appear disjointed. This NPRM proposes to address this by removing and consolidating the remaining two sections into one concise, streamlined section while not changing any of the operational practice or protections for mentally ill American nationals. Furthermore, this NPRM proposes to move the regulations into the newly proposed designation of Part 1390 Subchapter J of Chapter XIII-- Administration for Children and Families, Department of Health and Human Services. This allows the public to clearly see that the regulations pertaining to the care and treatment of mentally ill nationals returned from foreign countries are overseen by OHSEPR instead of OFA.