Before the Federal Communications Commission Washington, D.C. 20554 In the Matter of ) ) Amendment of Parts 2 and 95 of ) the Commission's Rules to Create a ) ET Docket 99-255 Wireless Medical Telemetry Service ) ) NOTICE OF PROPOSED RULE MAKING Adopted: July 14, 1999 Released: July 16, 1999 Comment Date: 45 days from date of publication in the Federal Register Reply Comment Date: 75 days from date of publication in the Federal Register By the Commission: I. INTRODUCTION 1. By this action, the Commission proposes to amend Parts 2 and 95 of the rules to allocate spectrum and to establish rules for a Wireless Medical Telemetry Service. This action is intended to allow potentially life-critical medical telemetry equipment, which currently operates on a secondary basis, unprotected from interference, to operate on a blanket licensed, interference protected basis. We believe our action will improve the reliability of this critical service. II. BACKGROUND 2. Medical telemetry equipment is used in hospitals and health care facilities to transmit patient measurement data to a nearby receiver, permitting greater patient mobility and increased comfort. Examples of medical telemetry equipment include heart, blood pressure and respiration monitors. The use of these devices allows patients to move around early in their recovery while still being monitored for adverse symptoms. With such devices, one health care worker can monitor several patients remotely, thus decreasing health care costs. 3. Currently, medical telemetry devices are allowed to operate under either Part 15 or Part 90 of the Commission's rules. Part 15 of the rules permits medical telemetry equipment to operate on an unlicensed basis on TV channels 7-13 and 14-46 (174-216 MHz and 470-668 MHz). Part 90 of the rules permits medical telemetry equipment to operate on a secondary basis to land mobile users in the 450-470 MHz band. 4. The spectrum used by medical telemetry equipment on an unlicensed or secondary basis under Parts 15 and 90 is increasingly being used more intensively by existing primary or secondary services, thereby posing an increased risk of interference to medical telemetry devices. In 1995, the Commission adopted changes to Part 90 of the rules to allow more efficient use of the spectrum for land mobile services. The Report and Order in PR Docket 92-235 established a new channeling plan for private land mobile radio (PLMR) services. This order decreased the channel spacing for PLMR services in the 450-470 MHz band from 25.0 kHz to 6.25 kHz. The transition to the smaller channels is being made in two steps. Land mobile equipment that operates in this band, which is certificated by the Commission on or after February 14, 1997, must be capable of operating on channels of 12.5 kHz or less. Land mobile equipment that operates in this band, which is certificated by the Commission on or after January 1, 2005, must be capable of operating on channels of 6.25 kHz or less. 5. Medical telemetry equipment operating under Part 90 operates on a secondary basis to PLMR services in the 450-470 MHz band on channels offset 12.5 kHz from the center frequency of the current 25.0 kHz channels ("12.5 kHz offset channels"). The maximum operating power for this equipment is substantially less than that authorized for primary users of the band. The channel separation and low-power operation minimize the possibility of interference received from, or caused to, primary users of the band. However, under the new channeling scheme, high- power primary users of the band would be able to operate on precisely the same frequencies used for medical telemetry equipment. This could possibly result in interference to medical telemetry equipment, which would cause it to be unusable at times. For this reason, on August 11, 1995, the Commission placed a freeze on the filing of applications for high power operation in the 450- 470 MHz band on the 12.5 kHz offset channels. The freeze remains in effect pending the development of a channel utilization plan that will protect low power operation on the 12.5 kHz offset channels. 6. In addition to the above-mentioned Part 90 rule changes, there have been other recent changes to the Commission's rules that could result in harmful interference to medical telemetry equipment operating under Part 15. At the direction of Congress, the Commission has provided for the introduction of digital television (DTV) stations in the TV broadcast bands. In order to accomplish this, the Commission has provided each local TV station with an additional channel that will be used to broadcast DTV during the transition. This means that there will be fewer vacant channels in every market, and that in some areas, channels that were once unused for TV broadcasting may now be used for DTV. 7. To reduce the possibility of DTV causing interference to medical telemetry equipment, the Commission adopted changes to Part 15 of the rules in 1997 to increase the number of TV frequencies where medical telemetry devices could operate on an unlicensed basis. These changes allow operation on TV channels 14-46 in addition to channels 7-13, which were the only channels where medical telemetry equipment was previously allowed to operate. The Commission also increased the maximum allowable operating power for these devices to improve reliability. 8. The transition from analog to digital television is currently under way, with the first stations commencing regular DTV broadcasting in November 1998. The Commission has created over 1600 allotments for DTV stations, a large percentage of which are on TV channels 7-46, which are also used for medical telemetry equipment operating under Part 15 of the rules. All television stations are required to commence DTV broadcasting no later than May 1, 2003. As existing stations begin DTV operation on their new channels, some low-power television stations currently operating on or adjacent to those channels may be forced to switch frequency to avoid causing harmful interference to DTV, thereby further crowding the spectrum used by medical telemetry equipment. 9. Concerns about possible interference to medical telemetry equipment by DTV operations were recently heightened. In March 1998, a TV station in Texas began test transmissions on a previously unused channel that had been assigned to it for DTV operation. The transmissions caused severe interference to the operation of medical telemetry equipment at a nearby hospital, rendering the equipment temporarily unusable. The station immediately ceased operation upon learning of the interference, and the medical telemetry equipment was changed to operate on another frequency. The Commission and the Food and Drug Administration have since taken steps to help ensure that hospitals are notified before new DTV stations come on the air to provide them with time to modify any medical telemetry equipment that operates on the same frequency. 10. The American Hospital Association's (AHA) Medical Telemetry Task Force recently submitted recommendations to the Commission for addressing the potential critical safety risks to patients from harmful interference caused to wireless medical telemetry equipment. The task force was established in response to the incidence of interference to medical telemetry equipment from a DTV station described above. Among the AHA recommendations are that specific frequencies be allocated for a medical telemetry service, and that the service be given primary status on those frequencies. III. DISCUSSION 11. Medical telemetry equipment is increasingly relied upon in hospitals to improve health care and reduce costs. Patients that require the monitoring and treatment capabilities that were formerly available only in intensive care units can be moved to general nursing units. Patient recovery is also improved because the general nursing unit offers a less stressful environment. The number of patients with chronic medical conditions is rising due to the growth in the elderly population. For these reasons, the need for monitoring patients outside of intensive care is rapidly increasing, and this need can be fulfilled with medical telemetry equipment. As we noted above, it may be difficult for this equipment to continue to operate in the bands used for DTV and the PLMR services without receiving interference. Given the importance of this equipment, we tentatively conclude that it is necessary to find additional spectrum for medical telemetry equipment. We further tentatively conclude that the spectrum should be allocated on a primary basis to ensure that medical telemetry equipment is able to function without interference from other sources. We seek comment on these tentative conclusions. A. Spectrum Allocation 1. Spectrum Requirements 12. The AHA performed a survey of 14 hospitals of various sizes in both metropolitan and suburban/rural areas to determine the amount of spectrum needed for medical telemetry equipment. The survey results identify six categories of patient medical parameters that may be measured, and indicate that up to 600 patients may need to be monitored concurrently at a single facility. In order to calculate the required spectrum, AHA assumed the transmitters would operate with a spectral efficiency of 0.8 bits per second per Hertz, which is approximately the same spectral efficiency the Commission requires in Part 90 of the rules. AHA then calculated the required spectrum for each of the six categories of parameters and determined that a total of 6.125 MHz is required to meet current patient needs. The AHA survey also indicated that the spectrum requirements for medical telemetry equipment would likely double within ten years. Therefore, AHA believes that in the long term, at least 12 MHz of spectrum is needed for medical telemetry equipment. We invite comment on this analysis, including whether the assumed spectral efficiency is reasonable, and whether more spectrally efficient technologies could be employed to reduce the amount of spectrum required. 2. Frequency Bands 13. The AHA performed an analysis of the suitability of various frequency bands, based on such factors as equipment costs, data reliability, amount of spectrum in each band and equipment power consumption. Based on its study, the AHA recommends that the following frequency bands be used for the medical telemetry service: 608-614 MHz 1385-1390 MHz 1432-1435 MHz 14. We note that other parties have expressed an interest in operating in portions of the 1300 MHz and 1400 MHz bands adjacent to the frequencies recommended by AHA. For example the Land Mobile Communications Council (LMCC) has filed a petition for rule making to allocate the 1390-1400 MHz and 1427-1432 MHz bands for private land mobile services under Part 90 of the rules. In addition, several licensees of low earth orbit ("Little Leo") satellite systems have been performing studies on the feasibility of operating satellite feeder uplinks in the 1390-1393 MHz band and downlinks in the 1429-1432 MHz band in an effort to obtain an international frequency allocation for this purpose. A discussion of the frequency bands recommended by AHA and the adjacent bands noted above follows. We request comment on the impact that a frequency allocation for medical telemetry would have on other prospective users of these bands. 15. 608-614 MHz. This band is allocated to the radio astronomy service. The allocation coincides with TV channel 37. This channel is not licensed for existing TV broadcast stations, new DTV allotments or any other licensed service. Under Part 15 of the rules, unlicensed medical telemetry equipment may operate in this band, provided it does not cause interference to radio astronomy operations. Operation in this band has several benefits for medical telemetry equipment. The band has very low background noise, since it is reserved for radio astronomy use. In addition, multiple component vendors are available with off-the-shelf parts that could be used to develop new devices for use in this band quickly. The AHA believes that medical telemetry devices operating in this band will not experience interference in the future. AHA does not envision any changes in the technical requirements that already permit operation of medical telemetry in this spectrum. However, AHA believes that the use of this spectrum for medical telemetry should be elevated to the status of a primary allocation. 16. 1385-1390 MHz and 1432-1435 MHz. These are U.S. Government bands that are being reallocated for non-government use pursuant to the Balanced Budget Act of 1997 (Balanced Budget Act). The National Telecommunications and Information Administration (NTIA) recently expressed concerns to Commission staff about the proposed reallocation of these bands to a service in which the Commission intended to assign licenses without the use of competitive bidding. Specifically, NTIA asserted that the Balanced Budget Act requires that these bands be made available through competitive bidding and that Federal agencies required to relocate from these bands are entitled to mandatory reimbursement for their relocation costs under the Strom Thurmond National Defense Authorization Act of 1998. Further, NTIA is concerned that high power government radars that will continue to operate below 1385 MHz could cause interference to medical telemetry equipment in the 1385-1390 MHz band. 17. NTIA noted the availability of spectrum in two adjacent bands being reallocated to non-government use under the Omnibus Budget Reconciliation Act of 1993 (OBRA 93). Specifically, the adjacent bands are 1390-1400 MHz and 1427-1432 MHz, which have not yet been allocated to any primary service under the Commission's rules and which the Commission is not required to auction. 18. 1390-1400 MHz. According to the NTIA's 1995 Spectrum Reallocation Final Report, this band is used by long-range air defense radars, air traffic control facilities, military test range telemetry links, tactical radio relays, and radio astronomy. NTIA recommends that airborne and space-to-earth transmissions be prohibited to protect radio astronomy operations in the 1350-1400 MHz band. In order to ease the transition of government operations out of this band, government operations will continue at 17 sites until the year 2009. 19. 1427-1432 MHz. The NTIA spectrum report states that this band is used by military tactical radio relay communications and military test range aeronautical telemetry and telecommand. NTIA recommends that airborne or space-to-earth transmissions in this band be avoided to protect radio astronomy operations in the adjacent 1400-1427 MHz band. In order to ease the transition of government operations out of the 1427-1432 MHz band, essential military airborne operations will continue at 14 sites until the year 2004. The 1427-1429 MHz band is allocated on a primary basis for use by space operations, and the 1427-1432 MHz band is allocated on a secondary basis for use by fixed and land mobile services. 20. Discussion. As stated above, we tentatively conclude that it is necessary to allocate spectrum where medical telemetry equipment can operate on a primary basis. The 608-614 MHz band appears to be suitable, because, other than radio astronomy, it is only used for medical telemetry under Part 15 of the rules. Accordingly, we propose to allocate this band to medical telemetry equipment on a co-primary basis with radio astronomy. Under this proposal, operation in this band must not cause interference to radio astronomy operations, and users will be required to coordinate their operation with radio astronomy facilities. 21. While we make no finding regarding NTIA's assertion that the 1385-1390 and 1432- 1435 MHz bands must be made available through auction, in order to expedite this proceeding we propose to identify spectrum in the 1390-1400 MHz and 1427-1432 MHz bands for medical telemetry equipment. The medical telemetry allocation would be primary to provide protection from interference, but would be non-exclusive. If an international allocation for Little Leo feeder links were made in the future, we could initiate a proceeding to domestically allocate medical telemetry on a co-primary basis with Little Leo feeder links, although medical telemetry equipment would continue to receive protection from interference. We have devised two possible options for a medical telemetry frequency allocation, which are discussed below. We seek comment on which option is more suitable, or whether any other alternative frequencies would be more suitable. 22. Option 1: 608-614 MHz / 1395-1400 MHz / 1429-1432 MHz. The 1395-1400 MHz band could be allocated for medical telemetry equipment as an alternative to the 1385-1390 band recommended by AHA. Allocating this band would provide the same amount of spectrum AHA requested in the adjacent band, and would increase the frequency separation from government radars operating below 1385 MHz, thereby reducing the risk of interference to medical telemetry equipment. Also, the 1429-1432 MHz band could be allocated as an alternative to the 1432-1435 MHz band recommended by AHA. This would provide the same amount of spectrum as requested by AHA in the adjacent band, and the frequency separation between it and the 1395- 1400 MHz band could make them more useful for two-way communications. However, this option would use the 1429-1432 MHz band that the Little Leo satellite operators are investigating for satellite feeder downlinks, as well as parts of the frequency bands requested by LMCC in their petition. Commenters should address the sharing possibilities and criteria for sharing between Little LEOs and medical telemetry under this option. 23. Option 2: 608-614 MHz / 1391-1400 MHz. A single band at 1391-1400 MHz could be allocated to medical telemetry equipment as an alternative to the upper two bands recommended by AHA. This would provide an additional 1 MHz of spectrum for medical telemetry. The larger contiguous band could provide a greater opportunity for broadband transmissions, although it may be less useful for two-way communications than two separate bands. This option would resolve the potential conflict with satellite downlinks in the 1429-1432 MHz band, but would result in 2 MHz of overlap between the proposed medical telemetry band and a possible 1390-1393 MHz satellite feeder uplink band. This option would also use parts of the frequency bands requested by LMCC in their petition. Commenters should address the sharing possibilities and criteria for sharing between Little LEOs and medical telemetry under this option. B. Service Rules 24. In this section, we propose service rules for the new Wireless Medical Telemetry Service (WMTS). These proposed service rules only apply to the WMTS and not to the current medical telemetry operations under Parts 15 and 90. The proposed rules include licensing requirements and technical standards for the equipment, as well as a frequency coordination procedure. Our proposals are based primarily upon recommendations in the AHA report submitted to the Commission. We request comment on all aspects of these proposed rules. 25. Definition. In its report, AHA proposes the following definition for medical telemetry: Wireless medical telemetry is defined as the measurement and recording of physiological parameters and other patient-related information via radiated bi- or unidirectional electromagnetic signals. 26. Our intention is to create a Wireless Medical Telemetry Service (WMTS) that will allow medical telemetry equipment to operate in hospitals and medical facilities in much the same manner as the Part 15 and Part 90 rules allow, but without the potential for interference discussed previously. Because the definition proposed by AHA appears to encompass our intention in creating this service, we propose it as the definition of the medical telemetry, and request comment. 27. Licensing. Medical telemetry equipment operating under Part 15 of the rules does not require an individual operator's license. Similarly, medical telemetry equipment operating pursuant to Part 90 does not require an individual operator's license. AHA states that, given the number and nature of devices that could be operated in a new medical telemetry service and the number of separate licenses that could co-exist in a given area, there is no basis for the administrative burden of individual licenses. AHA suggests that equipment in the WMTS could be "licensed by rule", such as is done in the Family Radio Service. We tentatively concur in AHA's assessment that there is no need to require individual operators licenses in the new WMTS. Individual licensing is generally designed to give a licensee a protected service area, and thus establishes rights among competing entities in the same service. We do not envision that operators in the WMTS will be in competition with each other as are parties in other radio services. Under our proposal, the WMTS spectrum would be shared, and there would be no mutual exclusivity between users. We therefore propose that the WMTS exist as one of the Citizen's Band services contained in Part 95 of the rules. The Commission has authority under Section 307(e) of the Communications Act to license the Citizen's Band services by rule and to define "citizen's band radio service" by rule. We seek comment on our tentative conclusion. 28. Eligibility. AHA proposes that only authorized health care professionals be eligible to operate transmitters in the WMTS. For the purpose of this service, an "authorized health care professional" would be defined as 1) a physician or other individual authorized under state or federal law to provide health care services; 2) a health care facility operated by or employing individuals authorized under state or federal law to provide health care services; or 3) any trained technician under the supervision and control of an individual or health care facility authorized under state or federal law to provide health care services. AHA suggests that we define a "health care facility" as a hospital or other establishment that offers services, facilities and beds for use beyond 24 hours in rendering medical treatment, and organizations regularly engaged in providing medical services through clinics, public health facilities and similar establishments, including government entities and agencies for their own medical activities. A health care facility would not include an ambulance or other moving vehicle. We propose the eligibility restrictions recommended by AHA to ensure that use of the allocated spectrum is limited to medical telemetry equipment. However, for the sake of clarity, we will change the term "authorized health care professional" to "authorized health care provider", and change "beyond 24 hours" to "beyond a 24 hour period". We seek comment on this proposed eligibility requirement, including whether it should be expanded to cover in-home medical uses and how it can be enforced without individual licensing. 29. Frequency coordination. AHA notes that if the WMTS were "licensed-by-rule", there would be no record of which frequencies are used by each facility or device. This could result in interference if multiple parties located close together attempt to use the same frequencies. Accordingly, AHA recommends the appointment of a frequency coordinator, who will maintain a database of all WMTS equipment in operation. The database would be used by eligible users and manufacturers to plan for specific frequency use within a geographic area, especially where numerous WMTS operations may occur. Equipment registered first in a geographic area would be entitled to protection over later-registered equipment. We preliminarily agree that AHA's proposal would assist WMTS users in avoiding interference. Accordingly, we propose that all parties using equipment in the WMTS be required to coordinate their operating frequency and other relevant technical operating parameters with a coordinator designated by the Commission. We seek comment on this proposal. 30. Specifically, we propose that the designated frequency coordinator would have responsibility to maintain an accurate engineering database of all WMTS transmitters, identified by location, operating frequency, emission type and output power. The frequency coordinator, though, would not be a decision maker as to which frequency should be used. The coordinator would notify users of potential frequency conflicts. We expect that there will be few conflicts between users of WMTS equipment due to its low operating power, and that users will be able to resolve any conflicts among themselves. The Commission would make the final decision, as necessary, in disputes between users. We propose that a single frequency coordinator be designated to handle all requests nationwide. The coordinator must be familiar with the medical telemetry user community, and must make its services available to all parties on a first-come, first-served and non-discriminatory basis. The frequency coordinator must be willing to serve a five year term, which could be renewed by the Commission. In the event that a frequency coordinator did not wish to continue at the end of its term, it would have to transfer its database to another designated entity. The Wireless Telecommunications Bureau would have delegated authority to select the coordinator, and would announce this selection by public notice. We seek comments on this proposal, including: 1) any other qualifications that a frequency coordinator must have, 2) whether a single entity or multiple entities should be designated as frequency coordinator(s), 3) how the frequency records could be maintained with multiple coordinators, and, 4) whether we should limit the fees the frequency coordinator(s) can charge. We also invite parties interested in becoming a frequency coordinator for the WMTS to file a written statement describing their qualifications. 31. The frequency coordinator would be required to maintain a database of the operating parameters submitted to it by users of the WMTS. We propose to require that the frequency coordinator make the database available to WMTS users, equipment manufacturers and the public. AHA recommends that the information submitted to the coordinator include: 1) frequency range(s) used 2) modulation scheme used 3) effective radiated power 4) number of transmitters in use at the health care facility at the time of registration 5) legal name of the authorized health care provider 6) location of transmitter (coordinates, street address, building) 7) point of contact for the authorized health care provider. We seek comment on these and any other possible information requirements. 32. AHA recommends that equipment registrations be effective for a term of five years, and may be renewed for additional five year terms. Health care providers would have to notify the frequency coordinator when a device is permanently taken out of service, unless it is replaced with one with the same technical characteristics. Health care providers would also be expected to notify the frequency coordinator of any change in location or other operating parameters. We propose to adopt these requirements, except for the more burdensome requirement that equipment registrations be renewed every five years. We seek comment on these proposals, in particular, whether an expiration date for equipment registration is necessary to ensure the database does not become "cluttered" with entries for equipment that is no longer in service if users fail to notify the coordinator of the cessation of operation. We also seek comment on who should have access to the database. 33. Permissible communications. AHA recommends that all types of information flows should be permissible in the service, including voice, data, video and telecommand, on both a unidirectional and bidirectional basis. We are concerned, however, about AHA's recommendation to allow voice and video transmissions in the WMTS. Allowing voice transmissions could encourage equipment in this service to be used as a form of wireless intercom, rather than for its intended purpose of transmitting vital patient data. Further, video transmissions could occupy a significant portion of the available spectrum for this service. Accordingly, we propose that the WMTS be used for all types of communication, except voice or video transmissions, on either a uni- or bi- directional basis. We seek comments on these proposals. 34. Technical Standards. AHA recommends that the Commission adopt only minimal technical standards for WMTS equipment. AHA states that this flexibility will encourage manufacturers to develop different applications for medical telemetry. AHA does not believe that the lack of standards will lead to inefficient uses of the band. On the contrary, it believes that allowing the industry to move forward without government standards will result in a high degree of innovation. We seek comment on this general approach, and whether the Commission should adopt more specific requirements for certain parameters (e.g. - spectral efficiency.) 35. AHA generally does not recommend a specific channelization scheme for these bands. However, it is concerned that the use of broadband technologies, such as spread spectrum, could allow a single user to monopolize a band, which could inhibit the ability of other health care facilities within an area to utilize narrowband technologies. To facilitate sharing of the spectrum, it recommends that broadband equipment operating in the 608-614 MHz band be capable of operating within one or more channels of 1.5 MHz each, up to a maximum of 6 MHz. Such equipment would operate on the minimum number of channels necessary, and must have the capability of being "throttled back" so it will occupy as little as one 1.5 MHz channel, if necessary, to allow multiple users to share that band. We are proposing these requirements, which we believe will allow the WMTS spectrum to be used efficiently. We seek comment on these proposals. 36. AHA recommends the following field strength limits for WMTS transmitters. Frequency band Maximum field strength Measurement distance Measurement bandwidth Detector function 608-614 MHz 370 mV/m 3 meters 120 +/- 20 kHz CISPR QP 1385-1390 MHz 740 mV/m 3 meters 1 MHz Average 1432-1435 MHz 740 mV/m 3 meters 1 MHz Average We note that the proposed limit in the 608-614 MHz band is approximately 5 dB higher than the current Part 15 limit for equipment operating in this band. AHA does not provide a justification as to why the limit should be increased, and we are concerned that a higher limit could result in interference to radio astronomy. Accordingly, we propose to maintain the current Part 15 limit in the 608-614 MHz band. We propose the higher limits recommended by AHA in the 1395-1400 MHz and 1429-1432 MHz bands (or in the alternatively proposed 1391-1400 MHz band) to offset the increased propagation losses at those frequencies. We request comment on the appropriateness of these proposed limits. Commenters who suggest alternatives to the frequency bands proposed in this Notice should address the issue of appropriate limits in those alternative bands. 37. AHA recommends the following out-of-band emission limits for transmitters in the WMTS. Frequency band Maximum field strength Measurement distance Measurement bandwidth Detector function 608-614 MHz 200 æV/m 3 meters 120 +/- 20 kHz CISPR QP 1385-1390 MHz 500 æV/m 3 meters 1 MHz Average 1432-1435 MHz 500 æV/m 3 meters 1 MHz Average These are the same as the current Part 15 limits for out-of-band emissions from most intentional radiators, which we believe to be effective at controlling interference. Accordingly, we are proposing AHA's recommended limits for the 608-614 MHz band, and for the 1395-1400 MHz and 1429-1432 MHz bands (or the alternatively proposed 1391-1400 MHz band). We request comment on the appropriateness of these limits. Commenters who suggest alternatives to the frequency bands proposed in this Notice should address the issue of appropriate limits in those alternative bands. 38. Protection of other existing services. As stated above, the WMTS must not cause interference to radio astronomy operations, and to certain "grandfathered" government operations. We therefore propose rules requiring the coordination of WMTS operations in the 608-614 MHz band with radio astronomy operations, similar to the requirements in Part 15. The proposed rules would also require that operation in the 1395-1400 MHz and 1429-1432 MHz bands (or the alternatively proposed 1391-1400 MHz band) must protect certain government operations. Finally, parties using WMTS equipment would need to be aware that the operation of transmitters in close proximity to medical equipment could cause interference to the operation of the medical equipment. The proposed rules would provide a warning to this effect, similar to the warning found in the Part 15 rules for medical telemetry equipment. Commenters who suggest alternatives to the frequency bands proposed in this Notice should address the need to protect other existing services. 39. Equipment authorization requirement. AHA recommends that WMTS transmitters be authorized through the Declaration of Conformity (DoC) procedure in Part 2 of the rules. AHA also recommends that the manufacturer be required to provide certain technical information to the user in addition to the other information required as part of the DoC process. DoC is a manufacturer's self-approval procedure where the equipment is tested to ensure it complies with the Commission's specified technical standards, and may then be marketed without an approval by the Commission. We believe that DoC is an appropriate authorization for WMTS equipment. The equipment is relatively low powered, and will operate in a band reserved exclusively for medical telemetry equipment, with the exception of a limited number of fixed government operations. There is therefore less concern about the equipment causing interference than would be the case if the band were shared with other services. Accordingly, we propose that medical telemetry equipment operating under the new WMTS be authorized through the DoC procedure. We also propose that laboratories accredited to perform DoC testing under Part 15 of the rules be permitted to perform DoC testing for equipment in the new WMTS, since the measurement procedures are essentially the same for both types of equipment. However, we would decline to require manufacturers to provide users certain technical information AHA recommends as part of the DoC process. We believe manufacturers would already provide this information as a routine matter, so a requirement on our part is unnecessary. We seek comments on these proposals, and whether certification would be appropriate due to the fact that new types of equipment may be developed for this service. 40. Transition Provisions. AHA believes that eventually all medical telemetry equipment should be designed to operate in the new frequency bands. AHA estimates it will take manufacturers approximately three to four years to develop and market devices for these bands. Therefore, they recommend that all equipment approved, beginning four years after adoption of final rules, should be designed to operate in the new frequency bands. AHA further recommends that equipment approved prior to that date can continue to be manufactured, marketed and operated indefinitely so that health care facilities are not forced to replace devices that are still useful. 41. While our primary goal in this proceeding is to protect the operation of medical telemetry equipment from harmful interference, we need to balance that with the goal of allowing DTV and PLMR to grow and develop without unnecessary delays. In that regard, we believe that four years is a longer transition period than necessary for requiring new equipment to operate in the new frequency bands. Equipment operating in the 608-614 MHz band is already available under the provisions of Part 15, and AHA has indicated that equipment can be rapidly developed for the other proposed bands. In order to encourage users to migrate out of the DTV and PLMR bands as quickly as possible, we propose that, beginning two years from the effective date of final rules in this proceeding, all medical telemetry equipment authorized must operate in the new frequency bands. Equipment that is already in operation in the DTV and PLMR bands as of that date may continue to be operated, but at the users' own risk. We seek comment on these proposals, including whether we should place a cutoff date on the manufacturing and importation of equipment authorized under Parts 15 and 90. 42. AHA also is concerned that the Commission may lift the freeze on high-power operation on the 12.5 kHz offset channels in the 450-470 MHz band. It states that a five year transition period starting from the adoption of rules allocating spectrum for medical telemetry equipment is necessary to avoid disastrous consequences to existing users. AHA states that a shorter transition time may be possible in parts of the band, either by relocating existing users or identifying channels which are not used by medical telemetry devices. We seek comment on AHA's 5-year proposal, and on what steps may be taken to allow an earlier lifting of the freeze in the 450-470 MHz band without causing interference to medical telemetry equipment. PROCEDURAL MATTERS 43. This is a permit-but-disclose notice and comment rule making proceeding. Ex parte presentations are permitted, except during the Sunshine Agenda period, provided they are disclosed as provided in the Commission's rules. See generally 47 C.F.R.  1.1200(a), 1.1203, and 1.1206(a). 44. Initial Regulatory Flexibility Analysis. As required by the Regulatory Flexibility Act, 5 U.S.C.  603, the Commission has prepared an Initial Regulatory Flexibility Analysis (IRFA) of the expected impact on small entities of the proposals suggested in this document. The IRFA is set forth in Appendix B. Written public comments are requested on the IRFA. These comments must be filed in accordance with the same filing deadlines as comments on the rest of the Notice, but they must have a separate and distinct heading designating them as responses to the IRFA. The Secretary will send a copy of this Notice of Proposed Rule Making, including the IRFA, to the Chief Counsel for Advocacy of the Small Business Administration in accordance with Section 603(a) of the Regulatory Flexibility Act, 5 U.S.C.  603(a). 45. Comment Dates. Pursuant to Sections 1.415 and 1.419 of the Commission's Rules, 47 C.F.R. Sections 1.415 and 1.419, interested parties may file comment on or before [45 days from date of publication in the Federal Register] and reply comments on or before [75 days from date of publication in the Federal Register]. Comments may be filed using the Commission's Electronic Comment Filing System (ECFS) or by filing paper copies. See Electronic Filing of Documents in Rulemaking Proceedings, 63 Fed. Reg. 24,121 (1998). 46. Comments filed through the ECFS can be sent as an electronic file via the Internet at . Generally, only one copy of an electronic submission must be filed. If multiple docket or rulemaking numbers appear in the caption of the proceeding, however, commenters must transmit one electronic copy of the comments to each docket or rulemaking number referenced in the caption. In completing the transmittal screen, commenters should include their full name, Postal Service mailing address, and the applicable docket or rulemaking number. Parties may also submit an electronic comment by Internet e-mail. To get filing instructions for e-mail comments, commenters should send an e-mail to ecfs@fcc.gov, and should include the following words in the body of the message, "get form ." A sample form and directions will be sent in reply. 47. Parties who choose to file by paper must file an original and four copies of each filing. If more than one docket or rulemaking number appears in the caption of this proceeding, commenters must submit two additional copies for each additional docket or rulemaking number. All filings must be sent to the Commission's Secretary, Magalie Roman Salas, Office of Secretary, Federal Communications Commission, The Portals, 445 12th Street, SW, Room TW- A325, Washington, DC 20554. 48. Parties who choose to file by paper should also submit their comments on diskette. These diskettes should be submitted to: Hugh L. Van Tuyl, Office of Engineering and Technology, Federal Communications Commission, The Portals, 445 Twelfth Street, SW, Room 7-A162, Washington, D.C. 20554. Such a submission should be on a 3.5 inch diskette formatted in an IBM compatible format using WordPerfect 5.1 for Windows or compatible software. The diskette should be accompanied by a cover letter and should be submitted in "read only" mode. The diskette should be clearly labelled with the commenter's name, proceeding (including the lead docket number, in this case ET Docket No. 99-255, type of pleading (comment or reply comment), date of submission, and the name of the electronic file on the diskette. The label should also include the following phrase "Disk Copy - Not an Original". Each diskette should contain only on party's pleadings, preferably in a single electronic file. In addition, commenters must send diskette copies to the Commission's copy contractor, International Transcription Service, Inc., 1231 20th Street, N.W., Washington, D.C. 20037. 49. Comments and reply comments will be available for public inspection during regular business in the Reference Information Center (Room CY-A257) of the Federal Communications Commission, 445 12th Street, SW, Washington, DC 20554. Copies of comments and reply comments are available through the Commission's duplicating contractor, International Transcription Service, Inc., 1231 20th Street, N.W., Washington, D.C. 20037, (202) 857-3800, TTY (202) 293-8810. 50. Alternative formats (computer diskette, large print, audio cassette and Braille) are available to persons with disabilities by contacting Martha Contee at (202) 418-0260, TTY (202) 418-2555, or at mcontee@fcc.gov. 51. IT IS ORDERED, that pursuant to Sections 4(i), 11, 301, 302, 303(e), 303(f), 303(r), 304, 307 and 332(b) of the Communications Act of 1934, as amended, 47 U.S.C. Sections 154(i), 161, 301, 302, 303(e), 303(f), 303(r), 304, 307 and 332(b), this Notice of Proposed Rule Making is hereby ADOPTED. 52. IT IS FURTHER ORDERED that the Commission's Office of Public Affairs, Reference Operations Division, SHALL SEND a copy of this Notice of Proposed Rule Making, including the Initial Regulatory Flexibility Analysis to the Chief, Counsel for Advocacy of the Small Business Administration. 53. For further information regarding this Notice of Proposed Rule Making, contact Hugh L. Van Tuyl, (202) 418-7506, Office of Engineering and Technology. FEDERAL COMMUNICATIONS COMMISSION Magalie Roman Salas Secretary Appendix A: Proposed Rules For the reasons discussed in the Notice of Proposed Rule Making, the Federal Communications Commission proposes to amend 47 CFR parts 2, 15, 90, and 95 as follows: PART 2 -- FREQUENCY ALLOCATIONS AND RADIO TREATY MATTERS; GENERAL RULES AND REGULATIONS 1. The authority citation for Part 2 continues to read as follows: AUTHORITY: Sec. 4, 302, 303, and 307 of the Communications Act of 1934, as amended, 47 U.S.C. Sections 154, 302, 303 and 307, unless otherwise noted. 2. Section 2.106, the Table of Frequency Allocations, is amended as follows: a. Remove the existing entries for 608-610 MHz, 608-614 MHz, 1350-1400 MHz, and 1429-1525 MHz. b. Add entries in numerical order for 608-610 MHz, 608-614 MHz, 1350-1395 MHz, 1395-1400 MHz, 1429-1432 MHz, 1432-1435 MHz, and 1435-1525 MHz. c. In the International Footnotes under heading I., add footnotes S5.304, S5.305, S5.306, S5.307, S5.334, S5.338, S5.339, S5.341, S5.342, and S5.343. d. Revise the text of footnotes US246, G27, and G30. e. Add footnotes USxxx, USyyy, and USzzz.  2.106 Table of Frequency Allocations * * * * * International table United States table FCC use designators Region 1 -- allocation MHz Region 2 -- allocation MHz Region 3 -- allocation MHz Government Non-Government Rule part(s) Special-use frequencies (1) (2) (3) Allocation MHz (4) Allocation MHz (5) (6) (7) 608-610 BROADCASTING S5.149 S5.296 S5.300 S5.304 S5.306 608-610 RADIO ASTRONOMY Mobile-satellite except aeronautical mobile- satellite (Earth-to- space) 608-610 FIXED MOBILE BROADCASTING RADIONAVIGATION S5.149 S5.305 S5.306 S5.307 608-610 LAND MOBILE USxxx RADIO ASTRONOMY US74 US246 608-610 LAND MOBILE USxxx RADIO ASTRONOMY US74 US246 PERSONAL (95) 610-614 BROADCASTING S5.149 S5.296 S5.300 S5.304 S5.306 610-614 RADIO ASTRONOMY Mobile-satellite except aeronautical mobile- satellite (Earth-to- space) 610-614 FIXED MOBILE BROADCASTING S5.149 S5.305 S5.306 S5.307 610-614 LAND MOBILE USxxx RADIO ASTRONOMY US74 US246 610-614 LAND MOBILE USxxx RADIO ASTRONOMY US74 US246 PERSONAL (95) * * * * * * * 1350-1395 FIXED MOBILE RADIOLOCATION S5.149 S5.338 S5.339 1350-1395 RADIOLOCATION S5.149 S5.334 S5.339 1350-1395 RADIOLOCATION S5.149 S5.339 1350-1395 FIXED MOBILE RADIOLOCATION G2 S5.149 S5.334 S5.339 US311 G27 G114 1350-1395 S5.149 S5.334 S5.339 US311 1395-1400 FIXED MOBILE RADIOLOCATION S5.149 S5.338 S5.339 1395-1400 RADIOLOCATION S5.149 S5.339 1395-1400 RADIOLOCATION S5.149 S5.339 1395-1400 LAND MOBILE USxxx S5.149 S5.339 US311 USyyy 1395-1400 LAND MOBILE USxxx S5.149 S5.339 US311 USyyy PERSONAL (95) * * * * * * * International table United States table FCC use designators Region 1 -- allocation MHz Region 2 -- allocation MHz Region 3 -- allocation MHz Government Non-Government Rule part(s) Special-use frequencies (1) (2) (3) Allocation MHz (4) Allocation MHz (5) (6) (7) 1429-1432 FIXED MOBILE except aeronautical mobile S5.341 S5.342 1429-1432 FIXED MOBILE S5.343 S5.341 1429-1432 FIXED MOBILE S5.343 S5.341 1429-1432 LAND MOBILE USxxx S5.341 USzzz 1429-1432 LAND MOBILE USxxx S5.341 USzzz PERSONAL (95) Private Land Mobile (90) 1432-1435 FIXED MOBILE except aeronautical mobile S5.341 S5.342 1432-1435 FIXED MOBILE S5.343 S5.341 1432-1435 FIXED MOBILE S5.343 S5.341 1432-1435 FIXED MOBILE S5.341 G30 1432-1435 Land Mobile (telemetry and telecommand) Fixed (telemetry) S5.341 Private Land Mobile (90) 1435-1525 FIXED MOBILE except aeronautical mobile S5.341 S5.342 1435-1525 FIXED MOBILE S5.343 S5.341 1435-1525 FIXED MOBILE S5.343 S5.341 1435-1525 MOBILE (aeronautical telemetry) US78 S5.341 1435-1525 MOBILE (aeronautical telemetry) US78 S5.341 AVIATION (87) * * * * * * * INTERNATIONAL FOOTNOTES * * * * * S5.304 Additional allocation: in the African Broadcasting Area (see Nos. S5.10 to S5.13), the band 606-614 MHz is also allocated to the radio astronomy service on a primary basis. S5.305 Additional allocation: in China, the band 606-614 MHz is also allocated to the radio astronomy service on a primary basis. S5.306 Additional allocation: in Region 1, except in the African Broadcasting Area (see Nos. S5.10 to S5.13), and in Region 3, the band 608-614 MHz is also allocated to the radio astronomy service on a secondary basis. S5.307 Additional allocation: in India, the band 608-614 MHz is also allocated to the radio astronomy service on a primary basis. * * * * * S5.334 Additional allocation: in Canada and the United States, the bands 1240-1300 MHz and 1350-1370 MHz are also allocated to the aeronautical radionavigation service on a primary basis. * * * * * S5.338 In Azerbaijan, Belarus, Mongolia, Poland, Kyrgyzstan, Slovakia, the Czech Republic, Romania, Turkmenistan and Ukraine, existing installations of the radionavigation service may continue to operate in the band 1350-1400 MHz. S5.339 The bands 1370-1400 MHz, 2640-2655 MHz, 4950-4990 MHz and 15.20-15.35 GHz are also allocated to the space research (passive) and earth exploration-satellite (passive) services on a secondary basis. * * * * * S5.341 In the bands 1400-1727 MHz, 101-120 GHz and 197-220 GHz, passive research is being conducted by some countries in a programme for the search for intentional emissions of extraterrestrial origin. S5.342 Additional allocation: in Belarus, Russia Federation and Ukraine, the band 1429- 1535 MHz is also allocated to the aeronautical mobile service on a primary basis exclusively for the purposes of aeronautical telemetry within the national territory. As of 1 April 2007, the use of the band 1452-1492 MHz is subject to agreement between the administrations concerned. S5.343 In Region 2, the use of the band 1435-1535 MHz by the aeronautical mobile service for telemetry has priority over other uses by the mobile service. * * * * * UNITED STATES (US) FOOTNOTES * * * * * US246 Except for medical telemetry equipment operating in the band 608-614 MHz, no stations shall be authorized to transmit in the following bands: 608-614 MHz, 1400-1427 MHz, 1660.5-1668.4 MHz, 2690-2700 MHz, 4990-5000 MHz, 10.68-10.70 GHz, 15.35-15.40 GHz, 23.6-24.0 GHz, 31.3-31.8 GHz, 51.4-54.25 GHz, 58.2-59.0 GHz, 64-65 GHz, 86-92 GHz, 100- 102 GHz, 105-116 GHz, 164-168 GHz, 182-185 GHz and 217-231 GHz. Medical telemetry equipment shall not cause harmful interference to radio astronomy operations in the band 608- 614 MHz and shall be coordinated under the requirements found in 47 C.F.R.  95.1119. * * * * * USxxx In the 608-614 MHz, 1395-1400 MHz, and 1429-1432 MHz bands, the land mobile service is limited to medical telemetry and telecommand operations. Additionally, the 1429- 1432 MHz band may be used on secondary basis for non-Government land mobile telemetry and telecommand and fixed telemetry. USyyy The band 1395-1400 MHz was identified for reallocation, effective January 1, 1999, for exclusive non-Government use under Title VI of the Omnibus Budget Reconciliation Act of 1993. Effective January 1, 1999, any Government operations in this band are on a non- interference basis to authorized non-Government operations and shall not hinder implementation of any non-Government operations. However, Government operations authorized as of March 22, 1995 at 17 sites identified below will be continued on a fully protected basis until January 1, 2009. Sites Lat/Long Radius Sites Lat/Long Radius Eglin AFB, FL 30 28'N/086 31'W 80 km Ft. Greely, AK 63 47'N/145 52'W 80 km Dugway PG, UT 40 11'N/112 53'W 80 Ft. Rucker, AL 31 13'N/085 49'W 80 China Lake, CA 35 41'N/117 41'W 80 Redstone, AL 34 35'N/086 35'W 80 Ft. Huachuca, AZ 31 33'N/110 18'W 80 Utah Test Range, UT 40 57'N/113 05'W 80 Cherry Point, NC 34 57'N/076 56'W 80 WSM Range, NM 32 10'N/106 21'W 80 Patuxent River, MD 38 17'N/076 25'W 80 Holloman AFB, NM 33 29'N/106 50'W 80 Aberdeen PG, MD 39 29'N/076 08'W 80 Yuma, AZ 32 29'N/114 20'W 80 Wright-Patterson AFB, OH 39 50'N/084 03'W 80 Pacific Missile Range, CA 34 07'N/119 30'W 80 Edwards AFB, CA 34 54'N/117 53'W 80 USzzz The band 1429-1432 MHz was identified for reallocation, effective January 1, 1999, for exclusive non-Government use under Title VI of the Omnibus Budget Reconciliation Act of 1993. Effective January 1, 1999, any Government operations in this band are on a non- interference basis to authorized non-Government operations and shall not hinder the implementation of any non-Government operations. However, Government operations authorized as of March 22, 1995 at 14 sites identified below will be continued on a fully protected basis until January 1, 2004. Sites Lat/Long Radius Sites Lat/Long Radius Patuxent River, MD 38 17'N/076 25'W 70 km Mountain Home AFB, ID 43 01'N/115 50'W 160 NAS Oceana, VA 36 49'N/076 02'W 100 NAS Fallon, NV 39 24'N/118 43'W 100 MCAS Cherry Point, NC 34 54'N/076 52'W 100 Nellis AFB, NV 36 14'N/115 02'W 100 Beaufort MCAS, SC 32 26'N/080 40'W 160 NAS Lemore, CA 36 18'N/119 47'W 120 NAS Cecil Field, FL 30 13'N/081 52'W 160 Yuma MCAS, AZ 32 39'N/114 35'W 160 NAS Whidbey IS., WA 48 19'N/122 24'W 70 China Lake, CA 35 29'N/117 16'W 80 Yakima Firing Ctr AAF, WA 46 40'N/120 15'W 70 MCAS Twenty Nine Palms, CA 34 15'N/116 03'W 80 GOVERNMENT (G) FOOTNOTES * * * * * G27 In the bands 225-328.6, 335.4-399.9, and 1350-1395 MHz, the fixed and mobile services are limited to the military services. G30 In the bands 138-144, 148-149.9, 150.05-150.8, 1427-1429, and 1432-1435 MHz, the fixed and mobile services are limited primarily to operations by the military services. * * * * * PART 15 -- RADIO FREQUENCY DEVICES 3. The authority citation for Part 15 continues to read as follows: AUTHORITY: 47 U.S.C. 154, 302, 303, 304, 307 and 544A. 4. Section 15.37 is amended by adding a new paragraph (h).  15.37 Transition provisions for compliance with the rules. * * * * * (h) Effective [two years from effective date of final rules], medical telemetry equipment operating under the provisions of 15.242 shall no longer be authorized. The requirements for medical telemetry equipment authorized on or after this date are found in Subpart H of Part 95 of this chapter. PART 90 -- PRIVATE LAND MOBILE RADIO SERVICES 5. The authority citation for Part 90 continues to read as follows: AUTHORITY: Secs. 4, 251-2, 303, 309, and 332, 48 Stat. 1066, 1082, as amended; 47 U.S.C. 154, 251-2, 303, 309 and 332, unless otherwise noted. 6. Section 90.203 is amended by revising paragraph (a)(1) as follows:  90.203 Certification required (a) * * * (1) Effective [two years from effective date of final rules], medical telemetry equipment operating under the provisions of 90.267(a)(5) shall no longer be authorized. The requirements for medical telemetry equipment authorized on or after this date are found in Subpart H of Part 95 of this chapter. (2)* * * * * * * * PART 95 -- PERSONAL RADIO SERVICES 7. The authority citation for Part 95 continues to read as follows: AUTHORITY: Sections 4, 303, 48 Stat. 1066, 1082, as amended; 47 U.S.C. 154, 303. 8. Section 95.401 is amended by adding a new paragraph (d) as follows:  95.401 (CB Rule 1) What are the Citizens Band Radio Services? * * * * * (d) The Wireless Medical Telemetry Service (WMTS)--a private, short distance data communication service for the transmission of patient medical information to a central monitoring location in a hospital or other medical facility. Voice and video communications are prohibited. The rules for this service are contained in subpart H of this part. 9. Section 95.601 is amended by changing the last sentence to read as follows:  95.601 Basis and purpose * * * * * The Personal Radio Services are the GMRS (General Mobile Radio Service)-subpart A, the Family Radio Service (FRS)-subpart B, the R/C (Radio Control Radio Service)-subpart C, the CB (Citizens Band Radio Service)-subpart D, the Low Power Radio Service (LPRS)-subpart G, and the Wireless Medical Telemetry Service (WMTS)-subpart H. 10. A new section 95.630 is added as follows:  95.630 WMTS transmitter frequencies WMTS transmitters may operate on the frequencies specified below. Option 1 Option 2 [ 608-614 MHz ] [ 608-614 MHz ] [ 1395-1400 MHz ] or [ 1391-1400 MHz ] [ 1429-1432 MHz ] 11. Section 95.631 is amended by adding a new paragraph (h)  95.631 Emission Types * * * * * (h) A WMTS station may transmit any emission type appropriate for communications in this service, except for video and voice. 12. Section 95.639 is amended by adding a new paragraph (f) as follows:  95.639 Maximum transmitter power * * * * * (f) The maximum field strength authorized for WMTS stations in the 608-614 MHz band is 200 mV/m, measured at 3 meters. For stations in the [1395-1400 MHz and 1429-1432 MHz] or [1391-1400 MHz] bands, the maximum field strength is 740 mV/m, measured at 3 meters. 13. Section 95.649 is revised to read as follows:  95.649 Power capability No CB, R/C, LPRS, FRS or WMTS unit shall incorporate provisions for increasing its transmitter power to any level in excess of the limits specified in  95.639. 14. Section 95.651 is revised to read as follows:  95.651 Crystal control required All transmitters used in the Personal Radio Services must be crystal controlled, except an R/C station that transmits in the 26-27 MHz frequency band, a FRS unit, a LPRS unit, or a WMTS unit. 15. A new Subpart H is added to read as follows: Subpart H -- Wireless Medical Telemetry Service (WMTS) General Provisions  95.1101 Scope This part sets out the regulations for licensed Wireless Medical Telemetry Devices operating in the 608-614 MHz, [1395-1400 MHz and 1429-1432 MHz] or [1391-1400 MHz] frequency bands.  95.1103 Definitions (a) Authorized health care provider. A physician or other individual authorized under state or federal law to provide health care services, or any other health care facility operated by or employing individuals authorized under state or federal law to provide health care services, or any trained technician operating under the supervision and control of an individual or health care facility authorized under state or federal law to provide health care services. (b) Health care facility. A health care facility includes hospitals and other establishments that offer services, facilities and beds for use beyond a 24 hour period in rendering medical treatment, and institutions and organizations regularly engaged in providing medical services through clinics, public health facilities, and similar establishments, including government entities and agencies for their own medical activities; except the term health care facility does not include an ambulance or other moving vehicle. (c) Wireless medical telemetry. The measurement and recording of physiological parameters and other patient-related information via radiated bi- or unidirectional electromagnetic signals in the [608-614 MHz, 1395-1400 MHz, and 1429-1432 MHz] or [608- 614 MHz and 1391-1400 MHz] frequency bands.  95.1105 Eligibility Authorized health care providers are authorized by rule to operate transmitters in the Wireless Medical Telemetry Service without an individual license issued by the Commission. Manufacturers of wireless medical telemetry devices and their representatives are authorized to operated wireless medical telemetry transmitters in this service solely for the purpose of demonstrating such equipment to, or installing and maintaining such equipment for, duly authorized health care providers.  95.1107 Authorized locations The operation of a wireless medical telemetry transmitter under this part is authorized anywhere within a health care facility. This authority does not extend to mobile vehicles, such as ambulances, even if those vehicles are associated with a health care facility.  95.1109 Equipment authorization requirement (a) Wireless medical telemetry devices operating under this part must be authorized under the Declaration of Conformity procedure prior to use or marketing in accordance with the provisions of Part 2, Subpart J of this chapter. (b) Each device shall be labelled with the following statement: Tested to comply with FCC requirements. Operation of this equipment requires the prior coordination with a frequency coordinator designated by the FCC for the Wireless Medical Telemetry Service.  95.1111 Frequency Coordination (a) Prior to operation, authorized health care providers who desire to use wireless medical telemetry devices must register with the designated frequency coordinator. The registration must include the following information: (1) frequency range(s) used; (2) modulation scheme used; (3) effective radiated power; (4) number of transmitters in use at the health care facility as of the date of registration; (5) legal name of the authorized health care provider; (6) location of transmitter (coordinates, street address, building); (7) point of contact for the authorized health care provider (name, title, office). (b) An authorized health care provider shall notify the frequency coordinator whenever a medical telemetry device is permanently taken out of service, unless the device is replaced with another transmitter utilizing the same technical characteristics as those reported on the effective registration. An authorized health care provider shall maintain the information contained in each registration current in all material respects, and shall notify the frequency coordinator when any change is made in the location or operating parameters previously reported which is material.  95.1113 Frequency coordinator (a) The Commission will designate a frequency coordinator to manage the usage of the frequency bands for the operation of medical telemetry devices. (b) The frequency coordinator shall review and process coordination requests submitted by authorized health care providers as required in Section 95.1111 of this part.  95.1115 General technical requirements (a) Field strength limits (1) In the 608-614 MHz band, the maximum allowable field strength is 200 mV/m, as measured at a distance of 3 meters, using measuring instrumentation with a CISPR quasi-peak detector. (2) In the [1395-1400 MHz and 1429-1432 MHz] or [1391-1400 MHz] bands, the maximum allowable field strength is 740 mV/m, as measured at a distance of 3 meters, using measuring equipment with an averaging detector and a 1 MHz measurement bandwidth. (b) Undesired emissions (1) For equipment operating in the 608-614 MHz band, out-of-band emissions are limited to 200 æV/m, as measured at a distance of 3 meters, using measuring instrumentation with a CISPR quasi-peak detector. (2) For equipment operating in the [1395-1400 MHz and 1429-1432 MHz] or [1391- 1400 MHz] bands, out-of-band emissions are limited to 500 æV/m as measured at a distance of 3 meters using measuring equipment with an averaging detector and a 1 MHz measurement bandwidth. (c) Emission types. A wireless medical telemetry device may transmit any emission type appropriate for communications in this service, except for video and voice. (d) Channel use. (1) In the [1395-1400 MHz and 1429-1432 MHz] or [1391-1400 MHz] bands, no specific channels are specified. Wireless medical telemetry devices may operate on any channel within the bands authorized for wireless medical telemetry use in this part. (2) In the 608-614 MHz band, wireless medical telemetry devices utilizing broadband technologies such as spread spectrum shall be capable of operating within one or more channels of 1.5 MHz each, up to a maximum of 6 MHz, and shall operate on the minimum number of channels necessary to avoid harmful interference to any other wireless medical telemetry devices. (3) Channel usage is on a co-primary shared basis only, and channels will not be assigned for the exclusive use of any entity. (4) Authorized health care providers, in conjunction with the equipment manufacturers, must cooperate in the selection and use of frequencies in order to reduce the potential for interference with other wireless medical telemetry devices, or other co-primary users. (e) Frequency stability. Manufacturers of wireless medical telemetry devices are responsible for ensuring frequency stability such that an emission is maintained within the band of operation under all of the manufacturer's specified conditions.  95.1117 Types of communications (a) All types of communications except voice and video are permitted, on both a unidirectional and bidirectional basis, provided that all such communications are related to the provision of medical care. (b) Operations that comply with the requirements of this part may be conducted under manual or automatic control, and on a continuous basis.  95.1119 Specific requirements for wireless medical telemetry devices operating in the 608-614 MHz band For a wireless medical telemetry device operating within the frequency range 608-614 MHz and that will be located near the radio astronomy observatories listed below, operation is not permitted until the frequency coordinator specified in 95.1113 has coordinated with, and obtain the written concurrence of, the director of the affected radio astronomy observatory before the equipment can be installed or operated (a) Within 80 kilometers of: (1) National Astronomy and Ionosphere Center, Arecibo, Puerto Rico: 18o 20' 38.28" North Latitude, 66o 45' 09.42" West Longitude. (2) National Radio Astronomy Observatory, Socorro, New Mexico: 34o 04' 43" North Latitude, 107o 37' 04" West Longitude. (3) National Radio Astronomy Observatory, Green Bank, West Virginia: 38o 26' 08'' North Latitude, 79o 49' 42'' West Longitude. (b) Within 32 kilometers of the National Radio Astronomy Observatory centered on: Very Long Baseline Array Stations Latitude (North) Longitude (West) Pie Town, NM 34o 18' 108o 07' Kitt Peak, AZ 31o 57' 111o 37' Los Alamos, NM 35o 47' 106o 15' Fort Davis, TX 30o 38' 103o 57' North Liberty, IA 41o 46' 91o 34' Brewster, WA 48o 08' 119o 41' Owens Valley, CA 37o 14' 118o 17' Saint Croix, VI 17o 46' 64o 35' Mauna Kea, HI 19o 49' 155o 28' Hancock, NH 42o 56' 71o 59' The National Science Foundation point of contact for coordination is: Spectrum Manager, Division of Astronomical Sciences, NSF Rm 1045, 4201 Wilson Blvd., Arlington, VA 22230, telephone: 703-306-1823.  95.1121 Specific requirements for wireless medical telemetry devices operating in the [1395-1400 MHz and 1429-1432 MHz] or [1391-1400 MHz] bands. Due to the critical nature of communications transmitted under this part, users shall determine whether there are any federal government radar systems whose operations could affect, or could be affected by, proposed wireless medical telemetry operations in the [1395-1400 MHz and 1429-1432 MHz] or [1391-1400 MHz] bands. The locations of government radar systems in these bands are specified in footnotes USyyy and USzzz of  2.106 of this chapter.  95.1123 Protection of medical equipment The manufacturers, installers and users of WMTS equipment are cautioned that the operation of this equipment could result in harmful interference to other nearby medical devices. APPENDIX B INITIAL REGULATORY FLEXIBILITY ANALYSIS As required by the Regulatory Flexibility Act (RFA), the Commission has prepared this present Initial Regulatory Flexibility Analysis (IRFA) of the possible significant economic impact on small entities by the policies and rules proposed in this NPRM. Written public comments are requested on this IRFA. Comments must be identified as responses to the IRFA and must be filed by the deadlines for comments provided in paragraph 45 of this NPRM. The Commission will send a copy of this NPRM, including this IRFA, to the Chief Counsel for Advocacy of the Small Business Administration. See 5 U.S.C.  603(a). In addition, the NPRM and IRFA (or summaries thereof) will be published in the Federal Register. See id. A. Need for, and Objectives of, the Proposed Rules Medical telemetry equipment currently operates on an unlicensed basis on certain unused TV channels under Part 15 of the rules, and on a secondary basis to private land mobile services in the 450-470 MHz band under Part 90 of the rules. With the transition to digital TV service, both full power and low-power TV stations may begin operating on some of the vacant channels used by medical telemetry equipment. In addition, the new channelization scheme being implemented in the 450-470 MHz band will allow high-power operation on the channels currently reserved for low- power use where medical telemetry equipment operates. Both of these changes could result in severe interference medical telemetry equipment. The proposed rules are intended to allocate new frequency bands where medical telemetry equipment can operate on a primary basis without receiving interference. B. Legal Basis The proposed action is authorized under Sections 4(i), 301, 302, 303(e), 303(f), 303(r), 304 and 307 of the Communications Act of 1934, as amended, 47 U.S.C. Sections 154(i), 301, 302, 303(e), 303(f), 303(r), 304 and 307. C. Description and Estimate of the Number of Small Entities To Which the Proposed Rules Will Apply Under the RFA, small entities may include small organizations, small businesses, and small governmental jurisdictions. 5 U.S.C.  601(6). The RFA, 5 U.S.C.  601(3), generally defines the term "small business" as having the same meaning as the term "small business concern" under the Small Business Act, 15 U.S.C.  632. A small business concern is one which: (1) is independently owned and operated; (2) is not dominant in its field of operation; and (3) satisfies any additional criteria established by the Small Business Administration ("SBA"). This standard also applies in determining whether an entity is a small business for purposes of the RFA. The Commission has not developed a definition of small entities applicable to RF Equipment Manufacturers. Therefore, the applicable definition of small entity is the definition under the SBA rules applicable to manufacturers of "Radio and Television Broadcasting and Communications Equipment." According to the SBA's regulation, an RF manufacturer must have 750 or fewer employees in order to qualify as a small business. Census Bureau data indicates that there are 858 companies in the United States that manufacture radio and television broadcasting and communications equipment, and that 778 of these firms have fewer than 750 employees and would be classified as small entities. We believe that many of the companies that manufacture RF equipment may qualify as small entities. According to the SBA's regulations, nursing homes and hospitals must have annual gross receipts of $5 million or less in order to qualify as a small business concern. 13 C.F.R.  121.201. There are approximately 11,471 nursing care firms in the nation, of which 7,953 have annual gross receipts of $5 million or less. There are approximately 3,856 hospital firms in the nation, of which 294 have gross receipts of $5 million or less. Thus, the approximate number of small confined setting entities to which the Commission's new rules will apply is 8,247. D. Description of Projected Reporting, Recordkeeping, and Other Compliance Requirements We are proposing that equipment operating in the new frequency bands be authorized through the Declaration of Conformity (DoC) procedure. DoC is a manufacturer's self-approval procedure, in which the manufacturer has the equipment tested at an accredited laboratory, and is then permitted to market the equipment without a Commission approval provided the equipment complies with the applicable technical requirements. The DoC procedure requires the manufacturer to supply a compliance statement with each product, and to retain test records. Parties operating the equipment will not be required to obtain an individual operator's license from the Commission, but they will have to register with a frequency coordinator designated by the Commission. The information submitted to the frequency coordinator will be: (1) frequency range(s) used; (2) modulation scheme used; (3) effective radiated power; (4) number of transmitters in use at the health care facility as of the date of coordination; (5) legal name of the authorized health care provider; (6) location of transmitter (coordinates, street address, building); (7) point of contact for the authorized health care provider (name, title, office). E. Steps Taken to Minimize Significant Economic Impact on Small Entities, and Significant Alternatives Considered We are proposing to allow equipment in this service to be "licensed by rule". This will eliminate the expense and delays that would result if parties were required to obtain individual operators' licenses. We are also proposing that equipment in this service be authorized through the Declaration of Conformity procedure. This will eliminate the delays in getting equipment to market that would result if manufacturers were required to obtain certification through the Commission or a designated Telecommunication Certification Body. F. Federal Rules that May Duplicate, Overlap, or Conflict With the Proposed Rule: None.