[Federal Register Volume 65, Number 249 (Wednesday, December 27, 2000)]
[Notices]
[Pages 81902-81903]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 00-32951]
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NATIONAL SCIENCE FOUNDATION
Notice of Intent to Seek Approval to Establish an Information
Collection
AGENCY: National Science Foundation.
ACTION: Notice and request for comments.
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SUMMARY: The National Science Foundation (NSF) is announcing plans to
request clearance of this collection. In accordance with the
requirement of section 3506(c)(2)(A) of the Paperwork Reduction Act of
1995 (Pub. L. 104-13), we are providing opportunity for public comment
on this action. After obtaining and considering public comment, NSF
will prepare the submission requesting that OMB approve clearance of
this collection for no longer than 3 years.
DATES: Written comments on this notice must be received by February 26,
2001 to be assured of consideration. Comments received after that date
will be considered to the extent practicable.
FOR ADDITIONAL INFORMATION OR COMMENTS: Contact Suzanne H. Plimpton,
Reports Clearance Officer, National Science Foundation, 4201 Wilson
Boulevard, Suite 295, Arlington, VA 22230; telephone (703) 292-7556; or
send email to [email protected]. You also may obtain a copy of the data
collection instrument and instructions from Ms. Plimpton.
SUPPLEMENTARY INFORMATION:
Title of Collection: Medical Clearance Process for Deployment to
Antarctica
OMB Number: 3145-NEW.
Expiration Date of Approval: Not applicable.
Type of Request: Intent to seek approval to establish an
information collection for three years.
Abstract
A. Proposed Project
All individuals who anticipate deploying to Antarctica and to
certain regions of the Arctic under the auspices of the United States
Antarctic Program are required to take and pass a rigorous physical
examination prior to deploying. The physical examination includes a
medical history, medical examination, a dental examination and for
those persons planning to winter over in Antarctica a psychological
examination is also required. The requirement for this determination of
physical status is found in 42 U.S.C. 1870 (Authority) and 62 FR 31522,
June 10, 1997 (Source), unless otherwise noted. This part sets forth
the procedures for medical screening to determine whether candidates
for participation in the United States Antarctic [[Page216]] Program
(USAP) are physically qualified and psychologically adapted for
assignment or travel to Antarctica. Medical screening examinations are
necessary to determine the presence of any physical or psychological
conditions that would threaten the health or safety of the candidate or
other USAP participants or that could not be effectively treated by the
limited medical care capabilities in Antarctica.
(b) Presidential Memorandum No. 6646 (February 5, 1982) (available
from the National Science Foundation, Office of Polar Programs, room
755, 4201 Wilson Blvd., Arlington, VA 22230) sets forth the National
Science Foundation's overall management responsibilities for the entire
United States national program in Antarctica.
B. Use of the Information
1. Form NSF-1420, National Science Foundation--Polar Physical
Examination
(Antarctica/Arctic/Official Visitors) Medical History, will be used
by the individual to record the individual's family and personal
medical histories. It is a five-page form that includes the
individual's and the individual's emergency point-of-contact's name,
address, and telephone numbers. It contains the individual's email
address, employment affiliation and dates and locations of current and
previous polar deployments. It also includes a signed certification of
the accuracy of the information and understandings of refusal to
provide the information or providing false information. The agency's
contractor's reviewing physician and medical staff complete the
sections of the form that indicated when the documents were received
and whether or not the person qualified for polar deployment, in which
season qualified to deploy and where disqualified the reasons.
2. Form NSF-1421, Polar Physical Examination--Antarctica/Arctic,
will be used by the individuals, physician to document specific medical
examination results and the overall status of the individual's health.
It is a two-page form which also provides for the signatures of both
the patient and the examining physician, as well as contact information
about the examining physician. Finally, it contains the name, address
and telephone number of the agency's contractor that collects and
retains the information.
3. Form NSF-1422, National Science Foundation Polar Physical
Examination
(Antarctica/Arctic/Official Visitors) Medical History Interval
Screening, will only be used by individuals who are under the age of 40
and who successfully took and passed a polar examination the previous
season or not more than 24 months prior to current deployment date. It
allows the otherwise healthy individual to update his or her medical
data without having to take a physical examination every year as
opposed to those over 40 years of age who must be examined annually.
4. Form NSF-1423, Polar Dental Examination--Antarctica/Arctic/
Official Visitors, will be used by the examining dentist to document
the status of the individual's teeth and to document when the
individual was examined. It will also be used by the contractor's
reviewing dentist to document whether or not the individual is dentally
cleared to deploy to the polar regions.
5. Medical Waivers: Any individual who is determined to be not
physically qualified for polar deployment may request an administrative
waiver of the medical screening criteria. This information includes
signing a Request for Waiver that is notarized or otherwise legally
acceptable in accordance with penalty of perjury statutes, obtaining an
Employer Statement of Support. Individuals on a case-by-case basis may
also be required to submit additional medical documentation and a
letter from the individual's physician(s) regarding the individual's
medical suitability for Antarctic deployment.
6. Other information requested: In addition to the numbered forms
and other information mentioned above, the USAP medical screening
package includes the following:
--the Medical Risks for NSF-Sponsored Personnel Traveling to
Antarctica--multi-copy form
--the NSF Privacy Notice
--the NSF Medical Screening for Blood-borne Pathogens/Consent for HIV
Testing (multi-copy)
--the NSF Authorization for Treatment of Field-Team Member/Participant
Under the Age of 18 Years (multi-copy).
This should only be sent to the individuals who are under 18 years
of age.
--the Dear Doctor and Dear Dentist letters, which provide specific
laboratory and x-ray requirements, as well as other instructions.
[[Page 81903]]
7. There are two other, non-medical forms included in the mailing:
--the Personal Information Form--NSF Form Number 1424 includes a
Privacy Act Notice. This form is used to collect information on current
address and contact numbers, date and place of birth, nationality,
citizenship, social security number, passport number, emergency point
of contact information, travel dates, clothing sizes so that we may
properly outfit those individuals who deploy, work-site information and
prior deployment history.
--the Participant Notification--Important Notice for Participants in
the United States Antarctic Program. This form provides information on
the laws, of the nations through which program participants must
transit in route to Antarctica, regarding the transport, possession and
use of illegal substances and the possibility of criminal prosecution
if caught, tried and convicted.
Estimate of Burden: Public reporting burden for this collection of
information varies according to the overall health of the individual,
the amount of research required to complete the forms, the time it
takes to make an appointment, take the examination and schedule and
complete any follow-up medical, dental or psychological requirements
and the completeness of the forms submitted. The estimated time is up
to six weeks from the time the individual receives the forms until he
or she is notified by the contractor of their final clearance status.
An additional period of up to eight weeks may be required for the
individual who was disqualified to be notified of the disqualification,
to request and receive the waiver packet, to obtain employer support
and complete the waiver request, to do any follow-up testing, to return
the waiver request to the contractor plus any follow-up information,
for the contractor to get the completed packet to the National Science
Foundation, for the NSF to make and promulgate a decision.
Respondents: All individuals deploying to the Antarctic and certain
Arctic areas under the auspices of the United States Antarctic Program
must complete these forms. There are approximately 3,000 submissions
per year, with a small percentage (c.3%) under the age of 40 who
provide annual submissions but with less information.
Estimated Number of Responses per Form: Responses range from 2 to
approximately 238 responses.
Estimated Total Annual Burden on Respondents: The total annual
burden in hours, broken down by form cannot yet be measured accurately
because of the time it takes to obtain the information which depends on
the number of illnesses, surgeries, diagnoses, etc., the individual and
family members have had.
Frequency of Responses: Individuals must complete the forms
annually to be current within 12 months of their anticipated deployment
dates. Depending on individual medical status some persons may require
additional laboratory results to be current within two to six-weeks of
anticipated deployment.
Comments: Comments are invited on (a) whether the proposed
collection of information is necessary for the proper performance of
the functions of the Agency, including whether the information shall
have practical utility; (b) the accuracy of the Agency's estimate of
the burden of the proposed collection of information; (c) ways to
enhance the quality, utility, and clarity of the information on
respondents, including through the use of automated collection
techniques or other forms of information technology; and (d) ways to
minimize the burden of the collection of information on those who are
to respond, including through the use of appropriate automated,
electronic, mechanical, or other technological collection techniques or
other forms of information technology.
Dated: December 21, 2000.
Suzanne H. Plimpton,
Reports Clearance Officer.
[FR Doc. 00-32951 Filed 12-26-00; 8:45 am]
BILLING CODE 7555-01-M