82 FR 9402 - Information Collection Request; Submission for OMB Review
PEACE CORPS Federal Register Volume 82, Issue 23 (February 6, 2017)
Federal Register Volume 82, Issue 23 (February 6, 2017)
| Page Range | 9402-9405 | |
| FR Document | 2017-02369 |
[Federal Register Volume 82, Number 23 (Monday, February 6, 2017)] [Notices] [Pages 9402-9405] From the Federal Register Online [www.thefederalregister.org] [FR Doc No: 2017-02369] ======================================================================= ----------------------------------------------------------------------- PEACE CORPS Information Collection Request; Submission for OMB Review AGENCY: Peace Corps. ACTION: 30-day notice and request for comments. ----------------------------------------------------------------------- SUMMARY: The Peace Corps will be submitting the following information collection request to the Office of Management and Budget (OMB) for review and approval. The purpose of this notice is to allow 60 days for public comment in the Federal Register preceding submission to OMB. We are conducting this process in accordance with the Paperwork Reduction Act of 1995 (44 U.S.C. Chapter 35). DATES: Submit comments on or before March 8, 2017. ADDRESSES: Comments should be addressed to Denora Miller, FOIA/Privacy Act Officer. Denora Miller can be contacted by telephone at 202-692- 1236 or email at pcfr@peacecorps.gov. Email comments must be made in text and not in attachments. FOR FURTHER INFORMATION CONTACT: Denora Miller at Peace Corps address above. SUPPLEMENTARY INFORMATION: Title: Individual Specific Medical Evaluation Forms (15). OMB Control Number: 0420-0550. Type of Request: Revision/New. Affected Public: Individuals/Physicians. Respondents Obligation to Reply: Voluntary. Respondents: Potential and current volunteers. Burden to the Public:Asthma Evaluation Form (a) Estimated number of Applicants/physicians: 700/700. (b) Frequency of response: one time. (c) Estimated average burden per response: 75 minutes/30 minutes. (d) Estimated total reporting burden: 875 hours/350 hours. (e) Estimated annual cost to respondents: Indeterminate. General Description of Collection: When an Applicant reports on the Health History Form any history of asthma, he or she will be provided an Asthma Evaluation Form for the treating physician to complete. The Asthma Evaluation Form asks for the physician to document the Applicant's condition of asthma, including any asthma symptoms, triggers, treatments, or limitations or restrictions due to the condition. This form will be used as the basis for an individualized determination as to whether the Applicant will, with reasonable accommodation, be able to perform the essential functions of a Peace Corps Volunteer and complete a tour of service without unreasonable disruption due to health problems. This form will also be used to determine the type of accommodation that may be needed, such as placement of the Applicant within reasonable proximity to a hospital in case treatment is needed for a severe asthma attack. Diabetes Diagnosis Form (a) Estimated number of Applicants/physicians: 55/55. (b) Frequency of response: one time. (c) Estimated average burden per response: 75 minutes/30 minutes. (d) Estimated total reporting burden: 69 hours/28 hours. (e) Estimated annual cost to respondents: Indeterminate. General Description of Collection: When an Applicant reports the condition of diabetes Type 1 on the Health History Form, the Applicant will be provided a Diabetes Diagnosis Form for the treating physician to complete. In certain cases, the Applicant may also be asked to have the treating physician complete a Diabetes Diagnosis Form if the Applicant reports the condition of diabetes Type 2 on the Health History Form. The Diabetes Diagnosis Form asks the physician to document the diabetes diagnosis, etiology, possible complications, and treatment. This form will be used as the basis for an individualized determination as to whether the Applicant will, with reasonable accommodation, be able to perform the essential functions of a Peace Corps Volunteer assignment and complete a tour of service without unreasonable disruption due to health problems. This form will also be used to determine the type of accommodation that may be needed, such as placement of an Applicant who requires the use of insulin in order to ensure that adequate insulin storage facilities are available at the Applicant's site. Transfer of Care--Request for Information Form (a) Estimated number of Applicants/physicians: 1270/1270. (b) Frequency of response: One time. (c) Estimated average burden per response: 75 minutes/30 minutes. (d) Estimated total reporting burden: 1588 hours/635 hours. (e) Estimated annual cost to respondents: Indeterminate. General Description of Collection: When an Applicant reports on the Health History Form a medical condition of significant severity (other than one covered by another form), he or she may be provided the Transfer of Care--Request for Information Form for the treating physician to complete. The Transfer of Care--Request for Information Form may also be provided to an Applicant whose responses on the Health History Form indicate that the Applicant may have an unstable medical condition that requires ongoing treatment. The Transfer of Care-- Request for Information Form asks the physician to document the diagnosis, current treatment, physical limitations and the likelihood of significant progression of the condition over the next three years. This form will be used as the basis for an individualized determination as to whether the Applicant will, with reasonable accommodation, be able to perform the essential functions of a Peace Corps Volunteer assignment and complete a tour of service without unreasonable [[Page 9403]] disruption due to health problems. This form will also be used to determine the type of accommodation (e.g., avoidance of high altitudes or proximity to a hospital) that may be needed to manage the Applicant's medical condition. Mental Health Current Evaluation and Treatment Summary Form (a) Estimated number of Applicants/professional: 1221/1221. (b) Frequency of response: One time. (c) Estimated average burden per response: 105 minutes/60 minutes. (d) Estimated total reporting burden: 2137 hours/1221 hours. (e) Estimated annual cost to respondents: Indeterminate. General Description of Collection: The Mental Health Current Evaluation Form will be used when an Applicant reports on the Health History Form a history of certain serious mental health conditions, such as bipolar disorder, schizophrenia, mental health hospitalization, attempted suicide or cutting, or treatments or medications related to these conditions. In these cases, an Applicant will be provided a Mental Health Current Evaluation and Treatment Summary Form for a licensed mental health counselor, psychiatrist or psychologist to complete. The Mental Health Current Evaluation and Treatment Summary Form asks the counselor, psychiatrist or psychologist to document the dates and frequency of therapy sessions, clinical diagnoses, symptoms, course of treatment, psychotropic medications, mental health history, level of functioning, prognosis, risk of exacerbation or recurrence while overseas, recommendations for follow up and any concerns that would prevent the Applicant from completing 27 months of service without unreasonable disruption. A current mental health evaluation might be needed if information on the condition is out-dated or previous reports on the condition do not provide enough information to adequately assess the current status of the condition. This form will be used as the basis for an individualized determination as to whether the Applicant will, with reasonable accommodation, be able to perform the essential functions of a Peace Corps Volunteer and complete a tour of service without unreasonable disruption due to health problems. This form will also be used to determine the type of accommodation that may be needed, such as placement of the Applicant in a country with appropriate mental health support. Functional Abilities Evaluation Form (a) Estimated number of Applicants/professional: 300/300. (b) Frequency of response: One time. (c) Estimated average burden per response: 90 minutes/45 minutes. (d) Estimated total reporting burden: 390 hours/225 hours. (e) Estimated annual cost to respondents: Indeterminate. General Description of Collection: When an Applicant reports on the Health History Form a functional ability limitation he or she will be provided this form to determine the type of accommodation and/or placement program support (e.g., proximity to program site, support support devices) that may be needed to manage the Applicant's medical condition. This form will be used as the basis for an individualized determination as to whether the Applicant will, with reasonable accommodation, be able to perform the essential functions of a Peace Corps Volunteer assignment and complete a tour of service without unreasonable disruption due to health problems. Eating Disorder Treatment Summary Form (a) Estimated number of Applicants/physicians: 282/282. (b) Frequency of response: One time. (c) Estimated average burden per response: 105 minutes/60 minutes. (d) Estimated total reporting burden: 494 hours/282 hours. (e) Estimated annual cost to respondents: Indeterminate. General Description of Collection: The Eating Disorder Treatment Summary will be used when an Applicant reports a past or current eating disorder diagnosis in the Health History Form. In these cases the Applicant is provided an Eating Disorder Treatment Summary Form for a mental health specialist, preferably with eating disorder training, to complete. The Eating Disorder Treatment Summary Form asks the mental health specialist to document the dates and frequency of therapy sessions, clinical diagnoses, presenting problems and precipitating factors, symptoms, Applicant's weight over the past three years, relevant family history, course of treatment, psychotropic medications, mental health history inclusive of eating disorder behaviors, level of functioning, prognosis, risk of recurrence in a stressful overseas environment, recommendations for follow up, and any concerns that would prevent the Applicant from completing 27 months of service without unreasonable disruption due to the diagnosis. This form will be used as the basis for an individualized determination as to whether the Applicant will, with reasonable accommodation, be able to perform the essential functions of a Peace Corps Volunteer assignment and complete a tour of service without unreasonable disruption due to health problems. This form will also be used to determine the type of accommodation that may be needed, such as placement of the Applicant in a country with appropriate mental health support. Substance-Related and Addictive Disorders Current Evaluation Form (a) Estimated number of Applicants/specialist: 373/373. (b) Frequency of response: One time. (c) Estimated average burden per response: 165 minutes/60 minutes. (d) Estimated total reporting burden: 1026 hours/373 hours. (e) Estimated annual cost to respondents: Indeterminate. General Description of Collection: The Alcohol/Substance Abuse Current Evaluation Form is used when an Applicant reports in the Health History Form a history of substance abuse (i.e., alcohol or drug related problems such as blackouts, daily or heavy drinking patterns or the misuse of illegal or prescription drugs) and that this substance abuse affects the Applicant's daily living or that the Applicant has ongoing symptoms of substance abuse. In these cases, the Applicant is provided an Substance-Related and Addictive Disorders Current Evaluation Form for a substance abuse specialist to complete. The Substance-Related and Addictive Disorders Current Evaluation Form asks the substance abuse specialist to document the history of alcohol/ substance abuse, dates and frequency of any therapy sessions, which alcohol/substance abuse assessment tools were administered, mental health diagnoses, psychotropic medications, self harm behavior, current clinical assessment of alcohol/substance use, clinical observations, risk of recurrence in a stressful overseas environment, recommendations for follow up, and any concerns that would prevent the Applicant from completing a tour of service without unreasonable disruption due to the diagnosis. This form will be used as the basis for an individualized determination as to whether the Applicant will, with reasonable accommodation, be able to perform the essential functions of a Peace Corps Volunteer and complete a tour of service without unreasonable disruption due to health problems. This form will also be used to determine the type of accommodation that may be needed, such as placement of the Applicant in a country with appropriate sobriety support or counseling support. [[Page 9404]] Mammogram Waiver Form (a) Estimated number of Applicants: 148. (b) Frequency of response: One time. (c) Estimated average burden per response: 105 minutes. (d) Estimated total reporting burden: 259 hours. (e) Estimated annual cost to respondents: Indeterminate. General Description of Collection: The Mammogram Form is used for all Applicants who have female breasts and will be 50 years of age or older during service who wish to waive routine mammogram screening during service. If an Applicant waives routine mammogram screening during service, the Applicant's physician is asked to complete this form in order to make a general assessment of the Applicant's statistical breast cancer risk and discussed the results with the Applicant including the potential adverse health consequence of foregoing screening mammography. Cervical Cancer Screening Form (a) Estimated number of Applicants: 3600/3600. (b) Frequency of response: One time. (c) Estimated average burden per response: 40 minutes/30 minutes. (d) Estimated total reporting burden: 2400 hours/1800 hours. (e) Estimated annual cost to respondents: Indeterminate. General Description of Collection: The Cervical Cancer Screening Form is used with all Applicants with a cervix. Prior to medical clearance, female Applicants are required to submit a current cervical cancer screening examination and Pap cytology report based the American Society for Colploscopy and Cervical Pathology (ASCCP) screening time- line for their age and Pap history. This form assists the Peace Corps in determining whether an Applicant with mildly abnormal Pap history will need to be placed in a country with appropriate support. Colon Cancer Screening Form (a) Estimated number of Applicants: 575. (b) Frequency of response: One time. (c) Estimated average burden per response: 60 minutes-165 minutes. (d) Estimated total reporting burden: 575 hours-1581 hours. (e) Estimated annual cost to respondents: Indeterminate. General Description of Collection: The Colon Cancer Screening Form is used with all Applicants who are 50 years of age or older to provide the Peace Corps with the results of the Applicant's latest colon cancer screening. Any testing deemed appropriate by the American Cancer Society is accepted. The Peace Corps uses the information in the Colon Cancer Screening Form to determine if the Applicant currently has colon cancer. Additional instructions are included pertaining to abnormal test results. ECG Form (a) Estimated number of Applicants/physicians: 575/575. (b) Frequency of response: One time. (c) Estimated average burden per response: 25 minutes/15 minutes. (d) Estimated total reporting burden: 240 hours/144 hours. (e) Estimated annual cost to respondents: Indeterminate. General Description of Collection: The ECG/EKG Form is used with all Applicants who are 50 years of age or older to provide the Peace Corps with the results of an electrocardiogram. The Peace Corps uses the information in the electrocardiogram to assess whether the Applicant has any cardiac abnormalities that might affect the Applicant's service. Additional instructions are included pertaining to abnormal test results. The electrocardiogram is performed as part of the Applicant's physical examination. Reactive Tuberculin Test Evaluation Form (a) Estimated number of Applicants/physicians: 392/392. (b) Frequency of response: One time. (c) Estimated average burden per response: 75-105 minutes/30 minutes. (d) Estimated total reporting burden: 490-686 hours/196 hours. (e) Estimated annual cost to respondents: Indeterminate. General Description of Collection: The Reactive Tuberculin Test Evaluation Form is used when an Applicant reports a history of treatment for active tuberculosis or a history of a positive tuberculosis (TB) test on their Health History Form or if a positive TB test result is noted as a component of the Applicant's physical examination findings. In these cases, the Applicant is provided a Reactive Tuberculin Test Evaluation Form for the treating physician to complete. The treating physician is asked to document the type and date of a current TB test, TB test history, diagnostic tests if indicated, treatment history, risk assessment for developing active TB, current TB symptoms, and recommendations for further evaluation and treatment. In the case of a positive result on the TB test, a chest x-ray may be required, along with treatment for latent TB. Insulin Dependent Supplemental Documentation Form (a) Estimated number of Applicants/physicians: 14/14. (b) Frequency of response: One time. (c) Estimated average burden per response: 70 minutes/60 minutes. (d) Estimated total reporting burden: 16 hours/14 hours. (e) Estimated annual cost to respondents: Indeterminate. General Description of Collection: The Insulin Dependent Supplemental Documentation Form is used with Applicants who have reported on the Health History Form that they have insulin dependent diabetes. In these cases, the Applicant is provided an Insulin Dependent Supplemental Documentation Form for the treating physician to complete. The Insulin Dependent Supplemental Documentation Form asks the treating physician to document that he or she has discussed with the Applicant medication (insulin) management, including whether an insulin pump is required, as well as the care and maintenance of all required diabetes related monitors and equipment. This form assists the Peace Corps in determining whether the Applicant will be in need of insulin storage while in service and, if so, will assist the Peace Corps in determining an appropriate placement for the Applicant. Prescription for Eyeglasses Form (a) Estimated number of Applicants/physicians: 3,293/3,293. (b) Frequency of response: One time. (c) Estimated average burden per response: 60 minutes/15 minutes. (d) Estimated total reporting burden: 3,293 hours/824 hours. (e) Estimated annual cost to respondents: Indeterminate. General Description of Collection: The Prescription for Eyeglasses is used with Applicants who have reported on the Health History Form that they use corrective lenses or otherwise have uncorrected vision that is worse than 20/40. In these cases, Applicants are provided a Prescription for Eyeglasses Form for their prescriber to indicate eyeglasses frame measurements, lens instructions, type of lens, gross vision and any special instructions. This form is used in order to enable the Peace Corps to obtain replacement eyeglasses for a Volunteer during service. Required Peace Corps Immunizations Form (a) Estimated number of Applicants/physicians: 5,600. (b) Frequency of response: One time. (c) Estimated average burden per response: 60 minutes. (d) Estimated total reporting burden: 5,600 hours. (e) Estimated annual cost to respondents: Indeterminate. General Description of Collection: The Required Peace Corps Immunizations Form is used to informed Applicants of the specific vaccines and/or [[Page 9405]] documented proof of immunity required for medical clearance for the specific country of service. The form advises the Applicant that all other Center for Disease Control (CDC) recommended vaccinations will be administered after arrival in-country. This form assists the Peace Corps with establishing a baseline of the Applicant's immunization history and prepare for any additional vaccines recommended for country of service. Request for Comment: Peace Corps invites comments on whether the proposed collections of information are necessary for proper performance of the functions of the Peace Corps, including whether the information will have practical use; the accuracy of the agency's estimate of the burden of the proposed collection of information, including the validity of the information to be collected; and, ways to minimize the burden of the collection of information on those who are to respond, including through the use of automated collection techniques, when appropriate, and other forms of information technology. This notice is issued in Washington, DC on January 31, 2017. Denora Miller, FOIA/Privacy Act Officer, Management. [FR Doc. 2017-02369 Filed 2-3-17; 8:45 am] BILLING CODE 6051-01-P
![9402 Federal Register / Vol. 82, No. 23 / Monday, February 6, 2017 / Notices
Commission’s rules and regulations. ADDRESSES: Comments should be General Description of Collection:
The Commission has made appropriate addressed to Denora Miller, FOIA/ When an Applicant reports the
findings as required by the Act and the Privacy Act Officer. Denora Miller can condition of diabetes Type 1 on the
Commission’s rules and regulations in be contacted by telephone at 202–692– Health History Form, the Applicant will
10 CFR chapter I, which are set forth in 1236 or email at pcfr@peacecorps.gov. be provided a Diabetes Diagnosis Form
the license amendment. Email comments must be made in text for the treating physician to complete.
A notice of consideration of issuance and not in attachments. In certain cases, the Applicant may also
of amendment to facility operating FOR FURTHER INFORMATION CONTACT: be asked to have the treating physician
license or combined license, as Denora Miller at Peace Corps address complete a Diabetes Diagnosis Form if
applicable, proposed no significant above. the Applicant reports the condition of
hazards consideration determination, diabetes Type 2 on the Health History
SUPPLEMENTARY INFORMATION: Form. The Diabetes Diagnosis Form asks
and an opportunity for a hearing in
connection with these actions, was Title: Individual Specific Medical the physician to document the diabetes
published in the Federal Register on Evaluation Forms (15). diagnosis, etiology, possible
OMB Control Number: 0420–0550. complications, and treatment. This form
October 11, 2016 (81 FR 70175). No
Type of Request: Revision/New. will be used as the basis for an
comments were received during the 30-
Affected Public: Individuals/ individualized determination as to
day comment period.
Physicians. whether the Applicant will, with
The Commission has determined that
Respondents Obligation to Reply: reasonable accommodation, be able to
these amendments satisfy the criteria for
Voluntary. perform the essential functions of a
categorical exclusion in accordance
Respondents: Potential and current Peace Corps Volunteer assignment and
with 10 CFR 51.22. Therefore, pursuant
volunteers. complete a tour of service without
to 10 CFR 51.22(b), no environmental
Burden to the Public: unreasonable disruption due to health
impact statement or environmental • Asthma Evaluation Form
assessment need be prepared for these problems. This form will also be used to
(a) Estimated number of Applicants/ determine the type of accommodation
amendments. physicians: 700/700. that may be needed, such as placement
IV. Conclusion (b) Frequency of response: one time. of an Applicant who requires the use of
(c) Estimated average burden per insulin in order to ensure that adequate
Using the reasons set forth in the
response: 75 minutes/30 minutes. insulin storage facilities are available at
combined safety evaluation, the staff
(d) Estimated total reporting burden: the Applicant’s site.
granted the exemption and issued the
875 hours/350 hours. • Transfer of Care—Request for
amendment that the licensee requested
(e) Estimated annual cost to Information Form
on September 9, 2016. The exemption
respondents: Indeterminate. (a) Estimated number of Applicants/
and amendment were issued on General Description of Collection:
December 16, 2016, as part of a physicians: 1270/1270.
When an Applicant reports on the (b) Frequency of response: One time.
combined package to the licensee Health History Form any history of
(ADAMS Accession No. ML16327A606). (c) Estimated average burden per
asthma, he or she will be provided an response: 75 minutes/30 minutes.
Dated at Rockville, Maryland, this 31st day Asthma Evaluation Form for the treating (d) Estimated total reporting burden:
of January 2017. physician to complete. The Asthma 1588 hours/635 hours.
For the Nuclear Regulatory Commission. Evaluation Form asks for the physician (e) Estimated annual cost to
Jennifer Dixon-Herrity, to document the Applicant’s condition respondents: Indeterminate.
Chief, Licensing Branch 4, Division of New of asthma, including any asthma General Description of Collection:
Reactor Licensing, Office of New Reactors. symptoms, triggers, treatments, or When an Applicant reports on the
[FR Doc. 2017–02414 Filed 2–3–17; 8:45 am] limitations or restrictions due to the Health History Form a medical
BILLING CODE 7590–01–P
condition. This form will be used as the condition of significant severity (other
basis for an individualized than one covered by another form), he
determination as to whether the or she may be provided the Transfer of
Applicant will, with reasonable Care—Request for Information Form for
PEACE CORPS
accommodation, be able to perform the the treating physician to complete. The
Information Collection Request; essential functions of a Peace Corps Transfer of Care—Request for
Submission for OMB Review Volunteer and complete a tour of service Information Form may also be provided
without unreasonable disruption due to to an Applicant whose responses on the
AGENCY:Peace Corps. health problems. This form will also be Health History Form indicate that the
30-day notice and request for
ACTION: used to determine the type of Applicant may have an unstable
comments. accommodation that may be needed, medical condition that requires ongoing
such as placement of the Applicant treatment. The Transfer of Care—
SUMMARY: The Peace Corps will be within reasonable proximity to a Request for Information Form asks the
submitting the following information hospital in case treatment is needed for physician to document the diagnosis,
collection request to the Office of a severe asthma attack. current treatment, physical limitations
Management and Budget (OMB) for • Diabetes Diagnosis Form and the likelihood of significant
review and approval. The purpose of (a) Estimated number of Applicants/ progression of the condition over the
this notice is to allow 60 days for public next three years. This form will be used
sradovich on DSK3GMQ082PROD with NOTICES
physicians: 55/55.
comment in the Federal Register (b) Frequency of response: one time. as the basis for an individualized
preceding submission to OMB. We are (c) Estimated average burden per determination as to whether the
conducting this process in accordance response: 75 minutes/30 minutes. Applicant will, with reasonable
with the Paperwork Reduction Act of (d) Estimated total reporting burden: accommodation, be able to perform the
1995 (44 U.S.C. Chapter 35). 69 hours/28 hours. essential functions of a Peace Corps
DATES: Submit comments on or before (e) Estimated annual cost to Volunteer assignment and complete a
March 8, 2017. respondents: Indeterminate. tour of service without unreasonable
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![Federal Register / Vol. 82, No. 23 / Monday, February 6, 2017 / Notices 9405
documented proof of immunity required SUPPLEMENTARY INFORMATION: This notice is issued in Washington, DC on
for medical clearance for the specific January 31, 2017.
Title: Peace Corps Report of Physical
country of service. The form advises the Examination (PC 1790S). Denora Miller,
Applicant that all other Center for FOIA/Privacy Act Officer, Management.
OMB Control Number: 0420–0549.
Disease Control (CDC) recommended [FR Doc. 2017–02370 Filed 2–3–17; 8:45 am]
vaccinations will be administered after Type of Request: Revision. BILLING CODE 6051–01–P
arrival in-country. This form assists the Affected Public: Individuals/
Peace Corps with establishing a baseline Physicians.
of the Applicant’s immunization history Respondents Obligation to Reply: PEACE CORPS
and prepare for any additional vaccines Voluntary.
recommended for country of service. Information Collection Request;
Request for Comment: Peace Corps Respondents: Potential and current Submission for OMB Review
invites comments on whether the volunteers.
Burden to the Public: AGENCY:Peace Corps.
proposed collections of information are
necessary for proper performance of the 60-day notice and request for
ACTION:
functions of the Peace Corps, including comments.
whether the information will have SUMMARY: The Peace Corps will be
a. Estimated number 5,600/5,600.
practical use; the accuracy of the of respondents. submitting the following information
agency’s estimate of the burden of the b. Estimated average 45 min/90 min. collection request to the Office of
proposed collection of information, burden per re- Management and Budget (OMB) for
including the validity of the information sponse. review and approval. The purpose of
to be collected; and, ways to minimize c. Frequency of re- One time. this notice is to allow 60 days for public
the burden of the collection of sponse.
comment in the Federal Register
information on those who are to d. Annual reporting 4,200 hours/8,400
burden. hours. preceding submission to OMB. We are
respond, including through the use of conducting this process in accordance
automated collection techniques, when with the Paperwork Reduction Act of
appropriate, and other forms of General Description of Collection: The 1995 (44 U.S.C. Chapter 35).
information technology. information in this form will be used by
DATES: Submit comments on or before
This notice is issued in Washington, DC on the Peace Corps Office of Medical
Services to determine whether an April 7, 2017.
January 31, 2017.
Applicant will, with reasonable ADDRESSES: Comments should be
Denora Miller,
accommodation, be able to perform the addressed to Denora Miller, FOIA/
FOIA/Privacy Act Officer, Management. Privacy Act Officer. Denora Miller can
essential functions of a Peace Corps
[FR Doc. 2017–02369 Filed 2–3–17; 8:45 am] be contacted by telephone at 202–692–
Volunteer assignment and complete a
BILLING CODE 6051–01–P
tour of service without unreasonable 1236 or email at pcfr@peacecorps.gov.
disruption due to health problems and, Email comments must be made in text
if so, to establish the level of medical and not in attachments.
PEACE CORPS
and other support, if any, that may be FOR FURTHER INFORMATION CONTACT:
Information Collection Request; required to reasonably accommodate the Denora Miller at Peace Corps address
Submission for OMB Review Applicant. The information in this form above.
is also used as a baseline assessment for SUPPLEMENTARY INFORMATION:
AGENCY: Peace Corps. the Peace Corps Medical Officers Title: Global Health Service
ACTION: 30-day notice and request for overseas who are responsible for the Application.
comments. Volunteer’s medical care. Finally, the OMB Control Number: 0420–0005.
Peace Corps may use the information in Type of Request: New.
SUMMARY: The Peace Corps will be this form as a point of reference in the
submitting the following information Affected Public: Individuals.
event that, after completion of the Respondents Obligation to Reply:
collection request to the Office of Applicant’s service as a Volunteer, he or
Management and Budget (OMB) for Voluntary.
she makes a worker’s compensation Respondents: Potential Volunteers.
review and approval. The purpose of claim under the Federal Employee
this notice is to allow 30 days for public Burden to the Public:
Compensation Act (FECA). Estimated burden (hours) of the
comment in the Federal Register
Request for Comment: Peace Corps collection of information:
preceding submission to OMB. We are
invites comments on whether the a. Number of respondents: 200.
conducting this process in accordance
proposed collections of information are b. Frequency of response: One time.
with the Paperwork Reduction Act of
necessary for proper performance of the c. Completion time: 60 minutes.
1995 (44 U.S.C. Chapter 35).
functions of the Peace Corps, including d. Annual burden hours: 200 hours.
DATES: Submit comments on or before whether the information will have General Description of Collection: The
March 8, 2017. practical use; the accuracy of the Global Health Service Partnership
ADDRESSES: Comments should be agency’s estimate of the burden of the Application (hereinafter ‘‘the
addressed to Denora Miller, FOIA/ proposed collection of information, Application’’) is necessary to recruit
Privacy Act Officer. Denora Miller can including the validity of the information qualified volunteers to serve in Peace
sradovich on DSK3GMQ082PROD with NOTICES
be contacted by telephone at 202–692– to be collected; and, ways to minimize Corps Response, as Global Health
1236 or email at pcfr@peacecorps.gov. the burden of the collection of Service Partnership Volunteers to build
Email comments must be made in text information on those who are to institutional capacity and help
and not in attachments. respond, including through the use of strengthen the quality of medical and
FOR FURTHER INFORMATION CONTACT: automated collection techniques, when nursing education. Applicants are
Denora Miller at Peace Corps address appropriate, and other forms of selected based on their qualifications for
above. information technology. a specific Volunteer assignment.
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Document Created: 2017-02-04 00:25:07
Document Modified: 2017-02-04 00:25:07
| Category | Regulatory Information | |
| Collection | Federal Register | |
| sudoc Class | AE 2.7: GS 4.107: AE 2.106: | |
| Publisher | Office of the Federal Register, National Archives and Records Administration | |
| Section | Notices | |
| Action | 30-day notice and request for comments. | |
| Dates | Submit comments on or before March 8, 2017. | |
| FR Citation | 82 FR 9402 |
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