[Federal Register Volume 81, Number 225 (Tuesday, November 22, 2016)]
[Notices]
[Page 83922]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2016-28044]



[[Page 83922]]

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DEPARTMENT OF STATE

[Public Notice 9789]


30-Day Notice of Proposed Information Collection: Self 
Certification and Ability To Perform in Emergencies (ESCAPE) Program

ACTION: Notice of request for public comment and submission to OMB of 
proposed collection of information.

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SUMMARY: The Department of State has submitted the information 
collection described below to the Office of Management and Budget (OMB) 
for approval. In accordance with the Paperwork Reduction Act of 1995 we 
are requesting comments on this collection from all interested 
individuals and organizations. The purpose of this Notice is to allow 
30 days for public comment.

DATES: Submit comments directly to the Office of Management and Budget 
(OMB) up to December 22, 2016.

ADDRESSES: Direct comments to the Department of State Desk Officer in 
the Office of Information and Regulatory Affairs at the Office of 
Management and Budget (OMB). You may submit comments by the following 
methods:
     Email: [email protected]. You must include the 
DS form number, information collection title, and the OMB control 
number in the subject line of your message.
     Fax: 202-395-5806. Attention: Desk Officer for Department 
of State.

FOR FURTHER INFORMATION CONTACT: Direct requests for additional 
information regarding the collection listed in this notice, including 
requests for copies of the proposed collection instrument and 
supporting documents, to Joan F. Grew, who may be reached on 703-875-
5412 or at [email protected].

SUPPLEMENTARY INFORMATION: 
     Title of Information Collection: Self Certification and 
Ability To Perform in Emergencies (ESCAPE) Program.
     OMB Control Number: 1405-0224.
     Type of Request: Revision of a Currently Approved 
Collection.
     Originating Office: Bureau of Medical Services (MED).
     Form Number: DS-6570.
     Respondents: Non-federal individuals being considered for 
contracted assignments at ESCAPE-designated posts.
     Estimated Number of Respondents: 200.
     Estimated Number of Responses: 200.
     Average Time per Response: 30 minutes.
     Total Estimated Burden Time: 100 annual hours.
     Frequency: One time per deployment to ESCAPE post.
     Obligation to Respond: Required to obtain a benefit.
    We are soliciting public comments to permit the Department to:
     Evaluate whether the proposed information collection is 
necessary for the proper functions of the Department.
     Evaluate the accuracy of our estimate of the time and cost 
burden for this proposed collection, including the validity of the 
methodology and assumptions used.
     Enhance the quality, utility, and clarity of the 
information to be collected.
     Minimize the reporting burden on those who are to respond, 
including the use of automated collection techniques or other forms of 
information technology.

    Please note that comments submitted in response to this Notice are 
public record. Before including any detailed personal information, you 
should be aware that your comments as submitted, including your 
personal information, will be available for public review.

Abstract of Proposed Collection

    The goal of the ``Self Certification and Ability To Perform In 
Emergencies'' (ESCAPE) program is to ensure that non-federal 
individuals who are being considered for a contracted position at a 
designated post are capable of the unique, potentially challenging and 
life threatening conditions at ESCAPE posts. These individuals are 
required to review with a medical provider the pre-deployment 
acknowledgement form (DS-6570) and then affirm that they understand the 
physical rigors and security conditions at these posts and can perform 
any specified emergency functions. Medical information is collected 
from medical providers and respondents during this review. The 
Department of State is requesting approval of this Information 
Collection so non-federal individuals who will be selected for 
assignments can provide completed pre-deployment medical information. 
This Collection is allowed under the Foreign Service Act of 1980 (22 
U.S.C. 3901) and the Basic Authorities Act of 1956 (22 U.S.C. 2651).

Methodology

    The information collected will be collected using a form (DS-6570) 
during a medical review between a non-federal individual and his/her 
medical provider. The individual will submit the completed form, signed 
by both the individual and provider, to the Bureau of Medical Services 
at the U.S. Department of States.

Behzad Shahbazian,
Director of Clinical Services, Bureau of Medical Services, Department 
of State.
[FR Doc. 2016-28044 Filed 11-21-16; 8:45 am]
 BILLING CODE 4710-36-P