[Federal Register Volume 81, Number 3 (Wednesday, January 6, 2016)]
[Notices]
[Pages 459-461]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2015-33273]
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DEPARTMENT OF AGRICULTURE
Forest Service
Information Collection; Fire & Aviation Management Medical
Qualifications Program
AGENCY: Forest Service, USDA.
ACTION: Notice; request for comment.
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SUMMARY: In accordance with the Paperwork Reduction Act of 1995, the
Forest Service is seeking comments from all interested individuals and
organizations on the extension with revisions to the information
collection, Fire & Aviation Management Medical Qualifications Program.
With this extension, the Agency has changed the name of the
information collection to Fire & Aviation Management Medical
Qualifications Program.
DATES: Comments must be received in writing on or before March 9, 2015
to be assured of consideration. Comments received after that date will
be considered to the extent practicable.
ADDRESSES: Comments concerning this notice should be addressed to
Attention: Dr. Jennifer Symonds, USDA Forest Service, National
Interagency Fire Center, 3833 South Development Avenue, Boise, Idaho
83705. Comments also may be submitted via facsimile to 208-387-5735 or
by email to [email protected].
The public may inspect comments received at the National
Interagency Fire Center, during normal business hours. Visitors are
encouraged to call ahead to facilitate entry to the building.
FOR FURTHER INFORMATION CONTACT: Dr. Jennifer Symonds, Forest Service
Wildland Fire Medical Qualifications Program Manager, at 208-387-5978.
Individuals who use telecommunication devices for the deaf (TDD)
may call the Federal Relay Service (FRS) at 1-800-877-8339 twenty-four
hours a day, every day of the year, including holidays.
SUPPLEMENTARY INFORMATION:
[[Page 460]]
Title: Fire & Aviation Management Medical Qualifications Program.
OMB Number: 0596-0164.
Expiration Date of Approval: March 31, 2016.
Type of Request: Extension with revisions.
Abstract: The Protection Act of 1922 (16 U.S.C. 594) authorizes the
Forest Service to fight fires on National Forest System lands. This
information collection is an approved Forest Service collection. The
collection covers the USDA Forest Service and the Department of the
Interior, and contains the information collection activities and burden
hours for both agencies.
Wildland firefighters perform long hours of arduous labor in
adverse environmental conditions. It is imperative that these
firefighters be in sufficient physical condition to avoid injury to
themselves or their coworkers. Federal employees and private
individuals seeking employment as a firefighter with the Forest Service
or the Department of Interior complete the health capability forms.
This information collection covers the forms and burden hours
associated with the private individuals who apply for firefighter
positions with the aforementioned agencies.
Form FS-5100-30, Work Capacity Test--Informed Consent. The form is
signed by those deemed to be in sufficient health to undergo a Work
Capacity Test. The Work Capacity Test determines the level of an
individual's aerobic fitness, level of muscular strength, and muscle
endurance. The consent form is necessary to ensure the individual
taking the test is aware of the various testing levels (arduous,
moderate, and light) and the risks involved. The individual indicates
the following:
They have read the information on the form, the brochure
``Work Capacity Test'' and understand the purpose, instructions, and
risks of the test;
They have read the information, understood, and truthfully
answered the Health Screen Questionnaire; and
Test to be taken--pack test (arduous), field test
(moderate), or walk test (light).
Failure to collect this data could result in injuries or deaths
during the ``Work Capacity Test'' and while working on wildland fires.
The information provided by an applicant for Federal employment is
stored in secured official files, maintained according to Agency
regulations. The information gathered is not available from other
sources.
Estimate of Annual Burden: 5.5 Minutes.
Type of Respondents: Individuals.
Estimated Annual Number of Respondents: 20,271.
Estimated Annual Number of Responses per Respondents: 1.
Estimated Total Annual Burden on Respondents: 1,858 hours.
Form FS-5100-31, Health Screening Questionnaire. Prospective
firefighters must complete this form when seeking employment as a new
firefighter with the Forest Service or Department of the Interior. This
form collects the following information:
Name and Unit;
Medical history;
Current medical symptoms;
Other health issues; and
Cardiovascular risk factors.
The information collected pertains to an individual's health status
and health history in an effort to determine if any physical conditions
exist that might result in injury or death during fitness testing or
when fighting a wildfire. If Federal Agency officials determine, based
on the collected information, that an individual may not be physically
able to train for or take a Work Capacity Test; the agency will require
the individual to undergo a physical examination by a physician.
Failure to collect this data could result in injuries or deaths
during the ``Work Capacity Test'' and while working on wildland fires.
The information provided by an applicant for Federal employment is
stored in secured official files, maintained according to Agency
regulations. The information gathered is not available from other
sources.
Estimate of Annual Burden: 3 Minutes.
Type of Respondents: Individuals.
Estimated Annual Number of Respondents: 20,271.
Estimated Annual Number of Responses per Respondents: 1.
Estimated Total Annual Burden on Respondents: 1,014 hours.
Form FS-5100-32, Arduous Duty Medical Exam. Federal employees and
private individuals seeking employment as a firefighter with the Forest
Service will complete the form every three years (years 0, 3, 6, etc.).
The form collects the following information:
Name, Federal Employee Number (if applicable), Sex and
Date of Birth;
Address, Email Address, and Telephone Number;
Physical Activity Level and Fire Experience with Home Unit
and Forest;
Past Medical History;
Current medical symptoms; and
Other health issues.
The information collected pertains to an individual's health status
and health history in an effort to determine if any medical or physical
conditions exist that might result in injury or death during fitness
testing or when fighting a wildfire. If Federal Agency officials
determine, based on the collected information, that an individual may
not be medically or physically able to train for or take a Work
Capacity Test or meet the Medical Standards of arduous duty fire
positions, the individual may request a waiver.
The information provided by a firefighter for Federal employment is
stored in secured official files, maintained according to Agency
regulations. The information gathered is not available from other
sources.
Estimate of Annual Burden: 30 Minutes.
Type of Respondents: Individuals.
Estimated Annual Number of Respondents: 9,810.
Estimated Annual Number of Responses per Respondents: 1.
Estimated Total Annual Burden on Respondents: 4,905 hours.
Form FS-5100-33, Self-Certification Statement and Blood Pressure
Check. Federal employees and private individuals seeking employment as
a firefighter with the Forest Service will complete the form the years
in which the individual does not complete an Arduous Duty Examination.
The form collects the following information:
Name and Date of Birth;
Home Unit and Forest
Medical history;
Current medical symptoms; and
Other health issues.
The information collected pertains to an individual's health status
and health history in an effort to determine if any medical or physical
conditions exist that might result in injury or death during fitness
testing or when fighting a wildfire. If Federal Agency officials
determine, based on the collected information, that an individual may
not be medically or physically able to train for or take a Work
Capacity Test or meet the Medical Standards of arduous duty fire
positions, the individual may request a waiver.
The information provided by a firefighter for Federal employment is
stored in secured official files, maintained according to Agency
regulations. The information gathered is not available from other
sources.
Estimate of Annual Burden: 3 Minutes.
Type of Respondents: Individuals.
Estimated Annual Number of Respondents: 9,810.
Estimated Annual Number of Responses per Respondents: 1.
Estimated Total Annual Burden on Respondents: 491 hours.
[[Page 461]]
Total Estimate of Annual Burden: 41.5 Minutes.
Total Type of Respondents: Individuals.
Total Estimated Annual Number of Respondents: 20,271.
Total Estimated Annual Number of Responses per Respondents: 1.
Total Estimated Total Annual Burden on Respondents: 8,268 hours.
Comment is invited on: (1) Whether this collection of information
is necessary for the stated purposes and the proper performance of the
functions of the Agency, including whether the information will have
practical or scientific utility; (2) the accuracy of the Agency's
estimate of the burden of the collection of information, including the
validity of the methodology and assumptions used; (3) ways to enhance
the quality, utility, and clarity of the information to be collected;
and (4) ways to minimize the burden of the collection of information on
respondents, including the use of automated, electronic, mechanical, or
other technological collection techniques or other forms of information
technology.
All comments received in response to this notice, including names
and addresses when provided, will be a matter of public record.
Comments will be summarized and included in the submission request
toward Office of Management and Budget approval.
Dated: December 17, 2015.
James E. Hubbard,
Deputy Chief, State & Private Forestry.
[FR Doc. 2015-33273 Filed 1-5-16; 8:45 am]
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