# NATIONAL PARK SERVICE

**REFERENCE MANUAL**

![](media/image1.wmf){width="0.9in" height="0.6951388888888889in"}**RM
57**

**Occupational Medical Standards and Physical Fitness**

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**PART I**

**April 14, 1999**

**[Occupational Medicine, Health and Fitness]{.underline}**

**[Reference Manual]{.underline}**

I. Purpose

In order to achieve its mission to conserve park resources while
providing for the enjoyment thereof by current and future generations,
the National Park Service (NPS) requires a capable and diverse work
force. The purpose of the Service's Occupational Medicine, Health and
Fitness program is to establish and maintain a healthy, physically fit
work force through a managed program of appropriate medical surveillance
and regular physical exercise. The Health and Fitness Program is
designed to reduce the risk of illness, disease and injury, to lower
health care costs, and to improve employee morale and productivity.

For those employees holding rigorous physical duty positions having a
high potential for exposure to occupational health hazards or on-the-job
injuries, specific medical standards and/or fitness measures are applied
to eliminate or minimize these potential health risks. The Department of
the Interior has approved standards for commissioned park rangers,
GS-025, and those park ranger positions that have been designated for
enhanced law enforcement coverage.

In order to assist all employees in achieving healthier lifestyles,
which will in turn enhance individual and organizational effectiveness,
a comprehensive Occupational Medicine, Health and Fitness Program, is
hereby established. This r*eference manual* provides two distinct yet
related programs: an Occupational Medicine Program, and an Occupational
Health and Fitness Program.

This *reference manual* is issued under authority of Director's Order
57, which requires the Associate Director, Park Operations and
Education, and Associate Director, Administration to promulgate
reference manuals for the Occupational Medicine, Health and Fitness
Program. Director's Order #57 is incorporated into the Reference Manual
as section 2, below.

II. **Director's Order 57: Occupational Medicine, Health and Fitness**

This Director's Order, in conjunction with Reference Manual 57,
Occupational Medical Standards, Health and Fitness, (RM-57), is a
complete revision of the National Park Service (NPS) \"Health and
Fitness Guideline, NPS-57.\" Release No. 1 of NPS-57 is hereby
superseded; existing copies should be discarded.

**A. Background and Purpose**

In 1993 the NPS officially determined its designated law enforcement and
firefighter positions would be managed under the provisions of enhanced
annuity retirement (as authorized by 18

U.S.C. 8336(c)). The purpose of enhanced annuity retirement is to enable
agencies to field a work force capable of performing the rigorous
duties[^1] of law enforcement and firefighting.

Pursuant to 5 U.S.C. 3307, the mandatory separation age of 55 is
applicable to designated firefighter positions and the mandatory
separation age of 57 is applicable to designated law enforcement
positions*.* The mandatory separation age applies to employees in
commissioned positions regardless of appointment or series and includes
temporary, term, and seasonal appointments.

Corresponding maximum entry ages were established at age 35 for
firefighters and at age 37 for law enforcement officers to ensure
employees may meet minimum qualifications for enhanced retirement. The
maximum entry age applies to career and career conditional (permanent)
appointments. As temporary appointments are not covered by enhanced
annuity retirement, the

maximum entry age does not apply to temporary, term, or seasonal
appointments. However, as the mandatory separation age is applicable to
all appointments, no applicant may receive a temporary, term, or
seasonal appointment at or after age 57 for law enforcement positions
and at or after age 55 for designated firefighter positions.

In 1996 the Service completed a field study of the actual work of park
rangers performing primarily law enforcement duties to enable the
Department of the Interior to establish a medical standard for those
positions. The study evaluated the work of park rangers performing law
enforcement under actual conditions and circumstances and developed
proposed medical standards. The Department of the Interior, on July 2,
1998, approved (under authority contained in 5 CFR 339.202) the
resulting medical standard for commissioned park rangers.

The purpose of this Director's Order (as supplemented by the Reference
Manual 57) is to establish implementing procedures for the medical
standards and revise policy for a physical fitness program for
designated positions performing rigorous duties.

In addition to meeting requirements of law and regulation, the medical
standards will substantially improve the safety and professionalism of
employees performing law enforcement, fire fighting and other rigorous
duties. The standards are designed to ensure that employees performing
law enforcement are physically able to perform that duty and that their
performance does not constitute a threat to the health and well being of
themselves, their fellow employees, and park visitors.

The Service will achieve its public trust responsibility to provide
effective, efficient law enforcement and firefighting services by
fielding a well-trained, physically conditioned, fully capable work
force. Beyond law enforcement and firefighting services, a healthy and
physically fit work force is the key to avoiding lost work time due to
injury and illness.

Healthy, fit employees are far more productive and less costly than
employees requiring extended medical leave and rehabilitation. For these
reasons, a secondary purpose of this Director's Order is to extend and
reconstitute the Service's voluntary (optional) health and fitness
program for all employees, regardless of their job duties.

**B. Authority**

The general authority to issue this Director's Order is contained in the
NPS Organic Act (16 U.S.C. 1 through 4), and part 245 of the Department
of the Interior manual. The specific authorities and requirements
applicable to employees performing physically rigorous duties covered by
this Director's Order are found in:

###### Law

5 U.S.C. 3301. Civil service; generally

5 U.S.C. 3307. Competitive service; maximum-age entrance requirements;
exceptions

###### Regulation

5 CFR Part 300-Employment (General)

5 CFR Part 339- Medical Qualification Determinations

29 CFR Part 1910- Occupational Health and Safety

###### Office of Personnel Management Requirements (OPM)

OPM operating manual: Qualification Standards for General Schedule
Positions; Section IV, Qualification Standards, and Section VI, Medical
Requirements

***Departmental Policy***

DM-446 Law Enforcement

Department of the Interior Occupational Medicine Manual and Reference
Manual

Medical Standards, Commissioned Park Rangers, GS-025, approved July 2,
1998

## C. Operational Policies and Procedures 

**C.1** The Service will adopt appropriate medical standards and provide
opportunities for designated employees to develop and maintain their
physical fitness. The general goal is to establish, encourage, promote,
and maintain an efficient and productive work force. The more specific
goal is to ensure that all employees assigned law enforcement, fire
fighting, and other physically rigorous duties are able safely to
perform those duties.

**C.2** The Associate Director**,** Administration, and the Associate
Director, Park Operations and Education, are jointly assigned functional
authority for the Service's Occupational Medical Standards, Health and
Fitness Program. They will promulgate and periodically revise reference

manuals, training courses and materials, certifications, and other
necessary materials and

documents to implement and operate this program consistent with the
policies, procedures and authorities contained in this Director's Order.

**C.3** The Associate Director, Administration, and the Associate
Director, Park Operations and Education, will distribute and otherwise
reproduce within Reference Manual-57 medical standards approved by the
Department of the Interior for park ranger (protection) positions, and
by the OPM for firefighter and other positions. Medical standards for
other positions may be found in the OPM operating manual, "Qualification
Standards for General Schedule Positions" and/or Reference Manual-18,
Wildland Fire Management. All standards must be applied uniformly by all
managers throughout the Service.

**C.4** Servicewide consistency in the implementation and operation of
this program is vital and required. Coordination and integration of the
Occupational Medical Standards, Health and Fitness Program within
existing functional and organizational structures must take place and be
coordinated primarily at the Washington Office level by senior officials
assigned by the Associate Director, Park Operations and Education and
the Associate Director, Administration.

**C.5** In order to ensure Servicewide consistency, final Service
decisions regarding the medical and physical fitness of individuals to
perform physically rigorous operational functions and associated
training activities will be made by the Associate Director,
Administration. An appeal of a medical standards disqualification
determination must be made by an employee within 30 calendar days of
receipt of notification of disqualification. The decision of the Medical
Standards Board (MSB) will constitute the final agency decision.
Pursuant to 270 DM 771.3.5B, appeals of medical standards
disqualification determinations are processed through the procedures of
the MSB and are not subject to review by the administrative grievance
procedure. In cases appealed to the MSB, the board chairperson will
issue final Service decisions**.**

**C.6** An *applicant* who does not meet the OPM or Departmental medical
standards established for such work may not be appointed to a position
designated for enhanced law enforcement or firefighter retirement. This
applies to career, career-conditional, term, and temporary appointments.

**C.7** An *employee* who does not meet the medical standards
established for such work may not perform law enforcement or fire
fighting work, regardless of whether the duties are primary to the
position or collateral, unless the Medical Standards Board approves a
request for reasonable accommodation.

**C.8** An *employee* may not be admitted to law enforcement or
firefighting training that requires the *regular or frequent*
performance of rigorous duties unless s/he meets the medical standards
established for persons performing such duties. Any employee may be
admitted to training that requires only *occasional or incidental*
performance of rigorous duties.

**C.9** The Medical Review Officer (MRO) (who may be an employee or
contractor) will make initial (pre-hire) medical qualification
recommendations which will then be subject to approval by the Associate
Director, Administration (or designee).

**C.10** The Medical Review Officer will make post-hire (career or
temporary employees) medical qualification recommendations on a
regularly scheduled basis as defined in Reference Manuals 18 and 57. The
Associate Director, Administration (or designee) will issue medical
qualification decisions.

**C.11** Reasonable accommodation may be considered in each instance of
medical disqualification of an employee if the disqualification is the
result of disability. In the event park management is or should be aware
of an obvious or apparent disability, the employee's supervisor or
manager should seek assistance through equal opportunity professionals
and request accommodation on behalf of the employee. In the event the
disability is not obvious or apparent, the employee may request such
accommodation to the park superintendent or appropriate manager. The
superintendent will forward the request and his/her recommendation
through the regional director to the (WASO) Human Resources Program
Manager. All requests for reasonable accommodation for disability as a
result of medical disqualification must be reviewed and approved by the
Medical Standards Board *prior to implementation*.

**C.12** The Associate Director, Park Operations and Education, and
Associate Director, Administration will appoint the MSB. The MSB will
consist of: 1) the Chief, Ranger Activities Division (or designee); 2)
the Chief Law Enforcement Officer or the Program Manager for Wildland
Fire Operations, or other appropriate risk program manager; 3) a senior
Service safety manager; 4) the MRO; and 5) the Human Resources Program
Manager (or designee). The Human Resources Program Manager (or designee)
will serve as the MSB chairperson.

**C.13** The MSB chairperson will be the deciding official in reasonable
accommodation determinations and will be the spokesperson for the MSB
before any third party.

**C.14** The Service will use the Physical Efficiency Battery (PEB) of
measurements developed at the Federal Law Enforcement Training Center
(FLETC), as the mandatory physical fitness test for initial appointment
to a position whose duties are primarily law enforcement. The Service
will use the applicable Work Capacity Test Series as physical fitness
test for appointment to designated firefighting positions.

**C.15** The PEB and the Work Capacity Test Series will be threshold
tests and baseline fitness measures. The Service will generally not
place persons failing to pass the PEB or the Work Capacity Test Series
in law enforcement or firefighter training that requires the regular
performance of rigorous duties.

**C.16** For current employees performing law enforcement and**/**or
firefighting duties, the PEB and the Work Capacity Test Series will
serve to identify individuals who are potentially at high risk of injury
or disease by continuing to perform the rigorous duties of their
position. By administering the PEB and the Work Capacity Test Series,
the Service will identify employees whose physical condition may pose a
potential health or safety risk to themselves, to coworkers, or to the
public. The Service may require these employees to reduce or eliminate
that potential risk through mandatory participation in a health and
fitness program focused on positive improvement and achieving fitness
results.

**C.17** All parks and units employing park rangers or other employees
assigned law enforcement or firefighting duties may provide each such
employee 3 hours of mandatory-participation physical fitness exercise
time per workweek. Pursuant to Director's Order 18, those wildland
firefighters whose full-time duties are 100 percent arduous duty-related
(such as helitack, hotshot, engine, prescribed fire, smokejumper crews)
will normally be provided 1 hour per day for fitness training. Parks and
units may provide or make available appropriate and safe facilities and
equipment to enable each mandatory-participation employee to maintain
adequate physical conditioning to perform safely the rigorous duties
assigned. Park managers may develop on-site fitness facilities and/or
provide for employee participation in fitness facilities within a
reasonable distance to the park or office.

**C.18** The Service will continue to invest in the health and physical
well being of all its employees, regardless of job series or duties, as
authorized by 5 U.S.C. 7901 and 16 U.S.C. 1a-2(b). Service managers are
encouraged to support voluntary fitness programs to promote the physical
and mental fitness of employees under their supervision. Managers may
utilize flexible and alternative work schedules, grant annual leave or
leave without pay, disseminate information concerning community-based
programs, offer in-house fitness and health education programs, and use
other appropriate means to support employee health and fitness goals.

###### E n d D i r e c t o r ' s O r d e r

####### III. Standards and Measures

This *reference manual* addresses medical and fitness topic for those
positions covered under both *mandatory* participation fitness programs
as well as *voluntary* participation programs. Both programs address
employee health concerns and provide individual employees with
recommendations specific to their needs.

The objective of the medical standards and physical fitness program is
to achieve and maintain each employee's ability to perform their duties
safely and effectively.

**[Definitions:]{.underline}**

**Accommodation**

Accommodation means reasonable accommodation as described in 29 CFR
1613.704.

#### 

#### Arduous or hazardous positions

Positions that are dangerous or physically demanding to such a degree
that an incumbent's medical condition is necessarily an important
consideration in determining ability to perform safely and efficiently.

#### Medical condition

Health impairment which results from injury or disease, including
psychiatric disease.

#### Medical documentation

A statement from a licensed physician or other appropriate practitioner
which provides information the agency considers necessary to enable it
to make an employment decision. To be acceptable, the diagnosis or
clinical impression must be justified according to established
diagnostic criteria and the conclusions and recommendations must not be
inconsistent with generally accepted professional standards. The
determination that the diagnosis meets these criteria is made by or in
coordination with generally accepted professional standards. The
determination that the diagnosis meets these criteria is made by or in
coordination with a physician or, if appropriate, a practitioner of the
same discipline as the one who issued the statement.

**Occupational Medicine Program**

An overall system of applicant and employee medical examinations and
career-long medical surveillance. The occupational medicine program can
be used in all work-related circumstances, stressing accurate and
*consistent* application of medical findings for all individuals in
similar positions with similar duties. The occupational medicine program
has two components; one for positions having specific medical
qualification standards for physically rigorous duties and one for
positions having general medical standards.

**Medical Surveillance Program**

A system of recurring medical examinations or tests established by
written agency policy or directive to safeguard the health of employees
whose work may subject them or others to significant health or safety
risks due to occupational or environmental exposure or demands.

**Medical standard**

A written description of the medical requirements for a particular
occupation based on a determination that a certain level of fitness of
health status is required for successful performance. Medical standards
are conditions of employment and must be met prior to employment or
prior to consideration in a position when these standards apply.

### Physical requirement

A written description of job-related physical abilities which are
normally consider essential for successful performance in a specific
position.

**Occupational Fitness Program**

The Service's overall work force physical fitness program. The
occupational fitness program provides appropriate exercise equipment and
exercise facilities, individual fitness evaluations and counseling, and
individualized physical fitness development and maintenance programs for
all employees. The occupational fitness program has two components; a
mandatory program for employees in positions having mandatory physical
requirements *essential* for successful job performance, and a voluntary
program providing all employees with an opportunity to maintain general
fitness.

All incumbents of rigorous-duty positions have essential medical and
physical fitness requirements and are enrolled in the *mandatory*
fitness program, while all other employees are encouraged to participate
in the *voluntary* fitness program.

**Rigorous Position**

A position the duties of which are so rigorous that employment
opportunities should, as soon as reasonably possible, be limited
(through establishment of a maximum entry age and physical
qualifications) to physically vigorous individuals.

**Authority:**

The following excerpts of selected text from applicable laws,
regulations, and policies are provided for the reader's convenience:

**Law**

5 U.S.C. 3301. Civil Service; generally

The President may:

\(1\) Ascertain the fitness of applicants as to age, health, character,
knowledge, and ability for the employment sought;

5 U.S.C. 3307. Competitive service; maximum-age entrance requirements;
exceptions:

\(d\) The head of any agency may determine and fix the minimum and
maximum limits of age within which an original appointment may be made
to a position as a law enforcement officer or firefighter, as defined by
section 8331(20) and (21) respectively, of this title.

\(e\) The head of an agency may determine and fix the maximum age limit
for an original appointment to a position as a firefighter or law
enforcement officer, as defined by section 8401(14) or (17),
respectively, of this title.

**Regulation**

5 CFR Part 339- Medical Qualification Determinations

339.101 Coverage

This part applies to all applicants for all employees in competitive and
excepted service positions;

339.102 Purpose and Effect

\(c\) Failure to meet a properly established medical standard or
physical requirement under this part means that the individual is not
qualified for the position unless a waiver or reasonable accommodation
is indicated, as described in 339.103 and 339.204. An employee's refusal
to be examined in accordance with a proper agency order authorized under
this part is grounds for appropriate disciplinary or adverse action.

339.202 Medical standards

OPM may establish or approve medical standards for a Government-wide
occupation (i.e., an occupation common to more than one agency). An
agency may establish medical standards for positions that predominate in
that agency (i.e., where the agency has 50 percent or more of the
positions in a particular occupation). Such standards must be justified
on the basis that the duties of the position are arduous or hazardous,
or require a certain level of health status or fitness because the
nature of the positions involve a high degree of responsibility toward
the public or national security concerns. The rationale for establishing
the standard must be documented. Standards established by OPM or an
agency must be:

> Established by written directive and uniformly applied,
>
> Directly related to the actual requirements of the position, and
>
> Consistent with OPM instructions published in FPM chapter 339.

339.203 Physical requirements.

Agencies are authorized to establish physical requirements for
individual positions without OPM approval when such requirements are
considered essential for successful job performance. The

requirements must be clearly supported by the actual duties of the
position and documented in the position description.

339.205 Medical evaluation programs.

Agencies may establish periodic examination or immunization programs by
written policies or directives to safeguard the health of employees
whose work may subject them or others to significant health or safety
risks due to occupational or environmental exposure or demands. The need
for a medical evaluation program must be clearly supported by the nature
of the work. The specific positions covered must be identified and the
applicants or incumbents notified in writing of the reasons for
including the positions in the program.

842.804 Evidence.

\(a\) An agency head's determination under 802.803(a) (finding that a
position is a rigorous position) must be based solely on the official
position description of the position in question and any other official
description of duties and qualifications. The official documentation for
the position should, as soon as is reasonably possible, establish that
the primary duties of the position are so rigorous that the agency does
not allow individuals to enter the position if they are over a certain
age or if they fail to meet certain physical qualifications (that is,
physical requirements and/or medical standards), as determined by the
employing agency head based on the personnel management needs of the
agency for the positions in question.

######## Occupational Medicine Program

**Purpose**

The purpose of the Occupational Medicine Program is to provide a safe
work environment for employees by ensuring that employees meet medical
standards for their position. For employees exposed to known hazards or
required to perform rigorous duties, measures are instituted to diminish
the potential adverse effects by means of appropriate medical standards
and/or services and to ensure that they are medically fit to perform
rigorous duties.

Employees and applicants for positions covered by specific medical
standards must continually meet those medical standards.

Applicants for positions covered by validated physical fitness
requirements must meet those requirements for appointment to those
positions and must thereafter participate in fitness programs. Employees
in positions covered by validated physical fitness requirements are
encouraged to continue to meet validated physical fitness standards
after initial appointment and must participate in fitness programs.

Employees in rigorous duty positions must be physically and medically
fit and able at all times to safely perform the arduous, hazardous, and
physically demanding duties of their positions. Procedures outlined
herein may also be used to evaluate the medical capability of employees
in positions that do not have specific medical or fitness standards
safely to perform their duties.

**Positions Having Specific Medical Standards**

The OPM requires that agencies establish medical/physical qualifications
for individuals entering and retaining positions that primarily perform
rigorous (physically arduous) duties. The Service applies these
medical/physical qualifications to all positions in which rigorous
duties are assigned whether as a primary or collateral duty. This
applies whether the employee encumbering a position is in a career, term
or temporary appointment. Agencies must establish realistic standards to
ensure applicants/incumbents are physically capable of performing the
essential duties/tasks of the position safely and efficiently, without
causing risk to self or others.

Specific medical standards and a medical surveillance program are
intended to allow the Service to determine if applicants or incumbents
have any medical condition(s) that would prevent them from performing,
with or without reasonable accommodation, the essential functions of the
position without posing a significant risk to the safety and health of
self or others. The Service must determine if an employee's existing
medical condition or health status will be aggravated and/or worsened by
the physical demands and/or working conditions of the employee's job or
work conditions.

**Positions Without Specific Medical Standards**

For employees in positions without specific medical standards, the
Service seeks to:

Detect patterns of disease/injury that are work-related:

-   Provide employees with information about occupational hazards and
    present health; and

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-   Provide preventive medical health assessments and recommendations on
    a voluntary basis.

**For All Positions**

For all employees and applicants for employment, the Service seeks to:

-   Provide a consistent basis for examining and evaluating the medical
    qualifications and fitness for duty of an applicant/employee;

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-   Provide a consistent basis for evaluating requests for reasonable
    accommodation; and,

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-   Comply with the provisions of the Rehabilitation Act of 1973 and
    Amendments of 1992, the Equal Employment Opportunity Commission\'s
    (\"EEOC\") implementing regulations and 5 CFR 339, Medical
    Qualification Determinations.

The purpose of these objectives is [not]{.underline} to provide routine
preventive or diagnostic medical services. Preventive medicine services
are important and worthwhile, but are complementary to,

rather than a substitute for, job-related medical examinations. Routine
medical examinations continue to be the responsibility of the individual
employee.

####### Organization of the Occupational Medicine Program

**Rigorous Duty Medical Examinations and Qualification Determinations**

The medical examination program has two basic components. The first is a
comprehensive medical examination; where each applicant or incumbent of
a law enforcement (or firefighting) position receives a comprehensive
medical examination. Medical examinations are administered by a
qualified medical provider acceptable to the SERVICE, following the
specific examination protocol provided. The second is a medical
qualification determination made by comparing the medical condition of
the individual against the medical standards for the position.

For the first component, sufficient medical information must be obtained
to enable a professional medical-qualification decision to be rendered.
The examining physician checks all items of medical significance
necessary to accurately report sufficient medical information to fully
describe the individual's current medical condition, including reviewing
the individual's medical history. Personal physicians, medical
specialists, and treating physicians may be consulted by the examining
physician and/or the reviewing physician for more in-depth medical
information and prognosis if needed. The results and findings of the
medical examination are forwarded to the Service's designated MRO.

The MRO is a physician who has observed and studied the work of law
enforcement officers, including National Park Service rangers. The MRO
is also the expert regarding state-of-the-art medical research and
practice regarding the performance of law enforcement work. Both
knowledge of the work and knowledge of medicine are necessary in order
to make sound evaluations of an individual's ability to perform law
enforcement safely and effectively. As a recognized subject-matter
expert, the MRO is able to explain, defend, and justify the medical and
occupational basis for his/her occupational medicine conclusions.

The second component is the rendering by the MRO of a consistent
professional medical determination of the qualification of the applicant
or incumbent to perform the duties of the position safely. Information
provided to the MRO must include medical history, current medical
evaluation, and description of critical job duties, potential health
risk exposures, and any information about previous exposures to known
health risks. Consultations with personal physicians, treating
physicians, specialists, or medical professionals may be necessary. In
addition, the MRO must be informed of any potential for future exposure
to occupational illness or diseases known to the Service, that could
affect the health or safety of the individual or co-workers.

The most important characteristic of the medical review system is that
the examining physician concentrates on patient examination, and the MRO
concentrates on the relationship between the medical data (provided by
the examining physician) and the known characteristics of the job.

The MRO will be able to render a consistent medical recommendation on
all applicants and incumbents for park ranger law enforcement and/or
firefighting positions.

Specific knowledge of the tasks typically performed and the conditions
under which the tasks are performed are a crucial component necessary to
render an accurate occupational medicine opinion. As a specialist in law
enforcement occupational medicine, the MRO must be a recognized medical
expert in regard to Federal law enforcement.

For incumbents, a medical specialist's \"opinion\" or a specialized
medical test(s) may be requested by the MRO, when the MRO is uncertain
about the extent, limitations, or prognosis of

an individual\'s condition. A private physician's opinion or further
medical evaluation(s) may be voluntarily obtained by the incumbent and
submitted to the MRO for further consideration.

The Human Resources Program Manager (or designee**)**, in consultation
with the Program Manager, Ranger Activities (or designee) issues medical
disqualification determinations. Decisions will be based upon the
medical determinations of the MRO, including full consideration of any
evaluation obtained from the employee's physician, and any relevant
information that is submitted for consideration. Medical
disqualification may be appealed to the MSB chairperson.

**Employee/Applicant Responsibilities**

The NPS occupational medicine program includes mandatory
pre-placement/post conditional offer and baseline medical evaluation,
periodic medical evaluations and return to duty or fitness for duty
examinations. Participation in the occupational medicine program is
mandatory for all applicants and incumbents assigned rigorous duties.
Employees must report known prior exposures, provide complete and
accurate medical information to the examining and reviewing physicians,
and disclose any prior health issues or treatments, including mental
health issues or treatment, so that the MRO can make an informed medical
determination.

Sufficient medical information as required by the MRO must be provided
in order to render a medically sound qualification determination. In the
absence of sufficient medical information to support qualifying an
individual for a rigorous duty position, a disqualification must be
issued in the interest of public and individual safety. Withholding,
falsifying, distorting, or misrepresenting relevant medical (including
mental health) information may lead to medical disqualification and/or
disciplinary or adverse action. Falsifying an application or withholding
medical information may significantly compromise the safety of a law
enforcement officer and/or his/her fellow officers. It is the policy of
the Service that the penalty for falsification or withholding of medical
information in regard to medical examination for a rigorous duty
position is removal from Federal service (see Department of the Interior
Handbook on Charges and Penalty Selection for Disciplinary and Adverse
Actions, Table of Penalties, item 22a. "Falsification, misrepresentation
or omission of fact in connection with application for employment or
other personal history record with respect to a material fact or point
which would have adversely affected selection for appointment").

Each applicant or current employee shall report to the examining
physician and/or MRO any significant exposure (i.e., chemical,
infectious, or biological, etc.) and/or any medical condition that may
interfere with his or her ability to perform the full range of duties
required for the position. The occupational medicine program includes
mandatory preplacement/post conditional offer medical evaluation,
baseline medical evaluation, periodic medical evaluations, and return to
duty or fitness for duty examinations. Participation in the occupational
medicine program is mandatory for all applicants and incumbents of
rigorous duty (6c) positions. Employees shall voluntarily report known
prior exposures, provide complete and accurate medical information to

the examining and reviewing physicians, and disclose any prior health
issues or treatments, including mental health issues or treatment, so
that the MRO can make an informed medical determination.

####### Medical Examination Program

**Preplacement/post Conditional Medical Examinations and Baseline
Medical Examinations**

During the application process for positions with medical standards, a
medical examination must be administered prior to selection. A
preplacement/post conditional medical examination is an examination that
occurs after the applicant has accepted an offer of employment with the
condition that applicant complete the examination and receives a
satisfactory medical evaluation. The preplacement/post conditional
medical examination is required in order to assure that the applicant is
medically qualified for a rigorous-duty position.

Preplacement/preincident medical examinations are required for all
applicants and employees prior to entering into a training program,
qualifying to [perform any emergency situation]{.underline} or
hazardous-environment work (i.e., health hazard investigations, aircraft
pilot, scuba diving, rigorous rescue duties, etc.) whenever specific,
approved medical standards for such work exist.

The MRO will evaluate each medical examination against the specific
medical standard. The MRO will assess the potential effect of any
existing medical condition(s) on the applicant or employee\'s ability to
safely perform the full range of duties of the position or to work
safely in the unusual operational environment.

No one will be certified (qualified) as meeting the medical requirements
of a position if the MRO determines that the applicant has a medical
condition preventing the applicant from safely performing, with or
without reasonable accommodation, the full range of duties of the job.

A baseline medical examination is administered post-hire and is used to
establish the condition of an individual's medical health on a given
date. This data can then be compared to subsequent periodic medical
evaluation results for the purpose of determining whether the individual
has any significant health trends that may be occupationally related.

**Periodic Medical Surveillance Examinations**

In order to assure a continued acceptable level of health and medical
fitness and to ensure the performance of the full range of duties,
periodic medical evaluations are administered to all employees in
occupations/jobs having specific medical standards. All employees in
rigorous duty designated positions or assigned rigorous duties must
receive periodic medical examinations. Employees under age 40 receive
periodic medical examinations every 2 years. Employees age 40 and older
will receive periodic medical examinations annually. Examinations should
occur within 1 month of the employee's birthday.

The MRO will:

-   Determine if incumbent has developed any medical condition/s that
    would prevent him/her from performing, with or without reasonable
    accommodation, the essential functions of an enforcement job without
    posing a significant risk to the safety and health of him/herself or
    others;

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-   Determine if health status will be aggravated and/or accelerated by
    physical demands and conditions of the job;

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-   Detect changes in employee's health status that may be caused by
    harmful working conditions;

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-   Detect patterns of disease/injury that are work-related;

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-   Provide employees with information about occupational hazards and
    health maintenance advice;

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-   Comply with the Rehabilitation Act of 1973, EEOC Guidelines and 5
    CFR 339 Medical Qualifications Determinations;

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-   Provide occupationwide preventive medical health assessments and
    recommendations on an as-requested basis;

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-   Enter and regularly analyze medical information in an electronic
    medical record database and ensure that tightly restricted access to
    such records is maintained in accordance with law and regulation;

**Return to Duty and Fitness for Duty Examinations**

*Return to Duty* *Examinations* are given to an employee who has been
absent from duty due to a medical condition that the employee's
immediate supervisor (or higher-level managers) feel may threaten the
employee's ability to safely and efficiently perform the full range of
duties required.

The medical examination results will be evaluated by the MRO (by
reviewing medical reports provided by the employee\'s treating
physician, etc.), before the employee is returned to duty. The MRO will
not recommend the employee's return to the rigorous duty position if any
medical condition is present that may potentially affect the
individual\'s ability to perform all the essential functions of the job
safely. The MRO, in conjunction with supervisors and management, shall

take into account the employee\'s current duty assignment(s) and
alternative duty assignments or other programs designed to allow an
individual to gradually return to full duty.

*Fitness for Duty Examinations* may be ordered in two situations;
whenever an employee raises a medical condition as an affirmative
defense for a time and attendance, conduct, or performance

deficiency; and when management has a direct question about an
employee's continued capacity to meet the physical or medical (including
mental health) requirements of the position.

**Occupations with Medical Standards for Rigorous Duty Positions**

This section provides guidance on determining if an employee is governed
by a mandatory standard(s). Using this information proper selection of
the appropriate medical evaluation is possible.

In the NPS, some standards apply to an entire occupational series, while
others apply to some sub-grouping of a series, or actual duties
performed in a given position. In some cases what is needed is a
\"clearance for use\" such as those required for Self Contained Breather
Apparatus (SCBA).

In all these cases, determinations may be provided as a distinct
examination and clearance process or as part of an examination and
review carried out for other purposes (e.g., a comprehensive medical
surveillance program).

![](media/image5.wmf){width="0.21736111111111112in"
height="0.5611111111111111in"}

**Law Enforcement Positions**

![](media/image6.wmf){width="0.6in" height="0.5798611111111112in"}The
job requirements for law enforcement employees of the Service are by
their nature rigorous and hazardous. These job requirements are
performed under variable and unpredictable working conditions. Due to
their job requirements and working conditions, the Service has developed
an occupational safety and health program that includes medical
standards for the park ranger (protection). The Service applies
Governmentwide medical standards for criminal investigator and jailor
positions.

**Wildland Firefighter Positions**

The job requirements for wildland firefighter employees are by their
nature rigorous and hazardous. Guidelines developed by the National Fire
Protection Association (NFPA) for medical examinations (NFPA 1582 -
Medical Requirements for Firefighters, 1992; and NFPA 295 - Wildfire
Control, 1991), and by the National Wildfire Coordinating Group for
fitness (Wildland Fire Qualification Subsystem Guide - 310-1, October
1993) have been incorporated in this edition of the r*eference manual*,
pending anticipated updates or revisions.

![](media/image7.wmf){width="0.8in" height="0.3909722222222222in"}

**Diver Positions**

The job requirements for employees involved in dive operations are by
their nature arduous and hazardous.

![](media/image8.wmf){width="1.2in" height="0.4354166666666667in"}

**Pilot/Aviator Positions**

Individuals whose functions include piloting aircraft must meet the
medical standards and certification requirements of the Federal Aviation
Regulations, as presented in 14 CFR 67.

####### 

####### Occupational Medicine Program Roles and Qualifications 

**Occupational Health and Fitness Program Manager**

The Occupational Health and Fitness Programs Manager will serve as the
focal point for all aspects of the occupational health and fitness
program.

Specifically, the manager will serve as the central authority for all
program and policy determinations; the central point of contact for all
external agency issues; and as the central clearinghouse for the
occupational health and fitness program.

The Occupational Health and Fitness Program Manager, designated by the
Associate Director, Park Operations and Education, is responsible for:

1\. Implementing Reference Manual 57 and the national medical and
fitness goals.

2\. Providing general occupational medical, health and fitness
information to field offices in cooperation with central office Health
and Fitness Coordinators (HFC).

3\. Approving qualifications and protocols for HFCs.

4\. Representing the Service on the President\'s Council on Physical
Fitness and Sports.

5\. Coordinating occupational medical, health and fitness management
activities with the Department of the Interior, FLETC, and various
outside agencies, committees, and other organizations.

6\. Providing a clearinghouse on training techniques, testing, and
equipment.

**Medical Review Officer**

The MRO shall be a currently licensed doctor of medicine (M.D.) or
osteopathy (D.O.). At a minimum, the MRO should be board certified or
board eligible in the field of occupational medicine. The MRO shall be
qualified to provide professional expertise in the areas of occupational
safety and health as they relate to the program and policies established
under this program.

The MRO will provide or oversee the following advisory and consultative
services:

-   Up-to-date and complete medical and technical information regarding
    specific medical and physical conditions or medical examination
    procedures relevant to existing or proposed physical requirements or
    health related personnel management programs for employees;

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-   Review and approval of results and conclusions derived from medical
    examinations conducted by Government or contract physicians;

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-   Technical assistance (including advisory opinions in medical and
    occupational health areas, e.g., worker's compensation, disability
    retirement, medical standards, civil lawsuits, MSPB challenges, EEOC
    cases. etc.) to ensure compliance with agency policy;

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-   Expert review and analysis of medical documentation and other
    materials submitted in support of:

\(1\) medical/physical qualifications of applicants,

> \(2\) employee restoration rights under 5 U.S.C. 8151 following full
> or partial recovery from a compensable on-the-job injury, and

\(3\) requests for job accommodations or other special benefits to
health conditions.

-   Written reports on medical standards, medical policy issues, or
    individual medical documentation reviews as requested;

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-   Guidance in resolving complex medical/personnel management issues;

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-   Guidance regarding new and experimental procedures (i.e., radial
    keratotomy, surgical implants, prosthetic devices) as a means of
    satisfying medical, vision, hearing requirements, etc.;

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-   Preparation of reports summarizing findings, analysis, conclusions,
    and recommendations for use in fulfilling complex managerial
    responsibilities related to the medical evaluation and clearance
    process;

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-   Research and analysis of complex legal and medical issues through
    coordination with the Office of the Solicitor;

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-   Research and analysis of technical, scientific and medical data in
    support of policy development and program management;

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-   Assistance in the development and implementation of a comprehensive
    and cost-effective Occupational Medical Evaluation and Clearance
    Program for candidates and incumbents, including such services and
    topics as:

> Pre-employment medical evaluations
>
> Periodic medical evaluations
>
> Return-to-duty medical evaluations
>
> Preventive medicine counseling

Human Resources Program Manager (s)

The Human Resources Program Manager will notify employees and managers
of new or revised Governmentwide, agency and bureau human resources
policies and procedures that may impact safety or health. These include
drug testing, hazardous work site qualifications, and motor vehicle
operator qualifications.

Servicing personnel offices will maintain employee occupational health
records including audiograms, physical examination results, exposure
records, and physician reports, recommendations, and summaries as they
relate to occupational exposures, injuries, illnesses, return to duty,
and physical qualifications.

**Health Care Providers**

The role of the health care provider in this occupational medicine
program is that of primary provider of clinical services (including both
routine and emergency services), consultant to employees receiving
services and to the agency/program MRO, and professional data gatherer
regarding health effects of workplace exposures and the health status of
employees. Health care providers may include professionals from a
variety of professional backgrounds, including physicians, nurses, nurse
practitioners, audiologists, audiometricians, laboratory technologists,
and others in the health care arena. All health care providers,
including individual or corporate entities, who provide services for
employees are expected to do so in a manner consistent with this
r*eference manual*, the specified terms of their contracts or agreements
with the Service, and local standards for health care services.

**Examining Physician Qualification Standards/Credentials**

Many of the NPS positions for which employees will receive medical
examinations involve some aspect of exposure to chemical substances, or
because of the arduous and/or hazardous nature of the work itself. The
clinical examination services provided must be performed by or under the
supervision of a licensed physician, preferably one knowledgeable in
occupational medicine. The examining physicians, whether they serve as
individual contractors, or through a larger clinic or multi-agency
arrangement, should demonstrate that they possess necessary credentials,
including:

-   Current medical licensure in the State where services will be
    provided; and

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-   Current certification, or eligibility for certification, by the
    national board for an appropriate medical field, e.g., occupational
    medicine, preventive medicine, internal medicine, family practice;
    (certification in occupational medicine is highly preferred, though
    certification in another specialty, and additional training in
    occupational medicine, is acceptable);

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-   Possess current medical practice liability insurance (minimum
    coverage of \$1 million per occurrence and \$3 million in aggregate
    are recommended) or, if a Federal employee, the services they plan
    to provide for NPS are covered by their current position description
    and/or personnel orders (the Federal Tort Claims Act provides
    liability protection for Federal employees while performing official
    duties, including carrying out medical services);

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-   Are available to meet the specified examination needs of the covered
    employees, and are available to respond to urgent consultation or
    health care needs following exposure incidents;

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-   Have access directly, or via contract, to certified laboratory
    services for blood and urine testing (including testing for agents,
    or the biological effects of agents, such as heavy metals,
    pesticides, and polychlorinated bi-phenyls); in turn, these
    laboratories should be able to demonstrate current certification of
    program quality, such as accreditation by the College of American
    Pathologists, certification as a Medicare provider, or active
    participation in the Clinical Laboratory Improvement Program of the
    Centers for Disease Control and Prevention or the American
    Association for Clinical Chemistry;

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-   Have access directly, or via contract, to radiology services,
    including over-reads by board certified radiologists and, for any
    asbestos exposure, radiologists certified for b-readings;

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-   Use certified, regularly calibrated equipment for pulmonary function
    testing, audiometry, and electrocardiography;

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-   Have mechanisms to avoid conflict of interest, such as self
    referral, in the services they provide (employees requiring followup
    care should be referred only to their own physician, or to other
    specialists with the concurrence of the employee's own physician);

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-   Offer competitive prices for services;

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-   Are able to provide local access, or easy access arrangements, to
    services for the employees; this may involve having physicians visit
    the work site to provide services (e.g., when a sufficient number of
    examinations are to be conducted), or having employees travel
    distances that are deemed reasonable by the employees and
    management;

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-   Are available on an ongoing, timely basis to provide local clinical
    and occupational medicine consultation and guidance for management
    and employees; and

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-   Medical records MUST either be maintained by the physician or
    his/her clinic for the time periods required by regulation (e.g.,
    the period of employment plus 30 years for services related to
    occupational exposures) and available for access using normal
    release of information procedures, or forwarded to NPS for
    incorporation into the employees formal personnel folder;

For most established clinical programs, such as a Federal Occupational
Health Clinic, the above requirements will have been fully addressed and
only need to be confirmed by the NPS manager seeking to enter into a
contractual arrangement. In settings where the option of joining an
existing program does not exist, the proposed physician or clinic should
be willing to supply information that confirms their compliance with
these basic expectations. Where questions arise about local options for
clinical services, consultation may be sought with other nearby federal
agencies for their experience in securing services, or the local medical
society may be contacted for guidance on options. **Before arrangements
are finalized for local contract services, the MRO should be consulted
to confirm the appropriateness of the proposed clinical arrangements.**

### Certification of Other Clinical Staff

Other clinical staff performing services with or for the examining
physician must also be able to demonstrate their qualifications if
services are not performed under immediate supervision of the physician.
Such services specifically include audiometry and spirometry.

Consistent with 29 CFR 1910.95, audiometry are to be conducted either
with a microprocessor audiometer, or by an individual who meets one of
the following qualifications: 1) a licensed or certified audiologist,
otolaryngologist, or physician; or 2) a technician who is certified by
the Council of Accreditation in Occupational Hearing Conservation and is
responsible to an audiologist, otolaryngologist, or physician.

Consistent with applicable sections of 29 CFR 1910 related to pulmonary
function testing for occupational exposures to identified agents,
persons providing such testing are to have successfully taken a
NIOSH-approved course in spirometry.

**Certification of Laboratories**

As covered above under *Physician Qualification Standards/Credentials*,
any laboratory providing services for NPS should be able to demonstrate
current certification of program quality.

**Certification of Clinical Equipment**

As covered above under *Physician Qualification Standards/Credentials*,
only certified, regularly calibrated equipment is to be used for
pulmonary function testing, audiometry, electrocardiography, or other
machine-assisted clinical procedures.

**Referrals to Sub-Specialists**

As covered above under *Examining Physician Qualification
Standards/Credentials*, mechanisms must be in place so those clinical
providers for employees avoid conflict of interest, such as
self-referral. Employees requiring followup care for personal health
problems or preventive health services should be referred only to their
own physician, or to other specialists with the concurrence of the
employee's own physician. Referrals for conditions that relate to job
performance or safety issues are to be managed or approved by the
agency/program MRO.

**Data Systems**

As covered above under *Physician Qualification Standards/Credentials*,
any provider of clinical services for employees must have a system of
medical records in place that assures security and confidentiality, with
release of any information from an employee's record, or about an
employee's health status or clearances, only upon prior written consent
from that employee. This consent should be obtained at the time of
initial employee appointment.

####### 

####### Medical Records - Employee Medical File System 

**Management and Records Maintenance**

All information in the employee medical file (whether stored in paper,
electronic, photographic, or other means) must be considered
confidential, and must be maintained in a manner that strictly controls
access to the information, and assures the safety and integrity of those
records. These confidential records may be found in several places,
complicating the task of assuring confidentiality and security. Records
may be found in medical, personnel, dispensary, safety, or other
designated NPS offices, or in NPS, other Federal, or private health
clinics where services have been provided.

The employee medical file (EMF) is to be maintained for the period of
the employee's services with NPS, and then is to be transferred to the
National Personnel Records Center for storage or, as appropriate,
transferred to the next employing Federal agency. Some records (e.g.,
certain medical surveillance or exposure records) must be maintained for
extended periods of time (e.g., employment plus 30 years); others must
be stored, but for lesser periods. regarding exposure and medical
surveillance record storage requirements.

When medical services are provided by non-NPS personnel or programs (and
commonly in non-NPS facilities), information should be maintained in the
employees personnel folder that indicates the providers name, address,
and phone number to facilitate locating and obtaining copies of records
at a later date.

**Confidentiality/Release of Records, General**

This section covers the issue of releasing confidential client/patient
information, including conclusions or opinions directly derived from
such confidential information, to any person other than the employee
covered by those records. Applicable references include the Privacy Act
of 1974; 29 CFR 1910.20 (Access To Employee Exposure and Medical
Records); and OPM/OVT-10 Employee Medical File System Records.

Employees must be provided access to their exposure and medical records.
This access must be prompt (generally within 15 working days) and
present no unreasonable barriers for the employee. If a physician
representing the employee believes that direct employee access to

certain sensitive information could be detrimental to the employee, the
records are to be released to another health professional acceptable to
the employee.

It is the policy of the NPS that all medical confidential information
will be handled in accordance with the Privacy Act of 1974 and
subsequent amendments. At the time of their first NPS occupational
health clinical service, all employees are to receive a Privacy Act
Notice Form which outlines the specific conditions under which
information may be disclosed. Employees who already have received
clinical services, but who have not yet had the opportunity to complete
a Privacy Act form, should be offered the form at the time of their next
clinical service.

Without a signed consent from the subject employee, no confidential
information will be released to, or shared with individuals other
than: 1) authorized Occupational Safety and Health Administration (OSHA)
officials; 2) health professionals within the NPS-arranged system of
care who have a justified, programmatic need to know; and 3) other
individuals in the Department with a specific, official need to know, as
summarized in the published Departmental Manual (370 DM 293.4) or the
system of records notice for the custodian of the confidential records.
The NPS system of care may include Federal employees or contracted
health professionals who work as representatives of NPS.

**Authorization for Disclosure**

All individuals who are to receive medical examinations or other
non-emergency services (for which *any* medical or summary information
is to be forwarded to recipients other than the employee him/herself)
will be required first to *sign and date* an Authorization for
Disclosure of Information form (a consent form) before any services are
provided. The employee on the Disclosure of Information form must
specifically authorize the nature and scope of the information to be
released to the agency before the information is released. No medical
information, including summary information derived from medical records,
may be released to NPS management, or to others, without this signed
consent form.

For some NPS job categories (e.g., law enforcement), a release to the
agency of the entire medical record may be necessary. This must be noted
on the consent form for the release of the information (signed prior to
the provision of clinical services) so the employee understands that
this release will take place. In most cases, however, the release will
be more limited. For these limited releases, it is suggested that the
statement of the intent and nature of information to be disclosed
include the following language:

Summary of the occupational health-related findings from the (specify
type of) exam, including the resulting clearances, recommendations, and
suggested followup.

The OSHA has provided guidance regarding the content of this limited
information that may be appropriate to release to an employer regarding
the results of a medical evaluation. The physician's written opinion to
the employer should include:

> Whether \[or not\] the employee has any medical condition that would
> place the employee at increased risk from occupational exposure;
>
> Limitations to assigned work or use of protective equipment;
>
> A statement that the employee has been informed of the results of the
> medical examination; and, if exposures warrant,
>
> A statement that the employee has been informed of the increased risk
> of lung cancer attributable to the combined effect of smoking and
> asbestos exposure.

With this limited release, the physician's written opinion to the
employer should NOT reveal specific findings, test results, or diagnoses
unrelated to occupational exposures. For other releases (such as a copy
of the entire record, or clinical data regarding a specific diagnosis),
the disclosure form similarly should describe the specific nature of the
information to be released, so the employee is able to grant (or
withhold) informed consent to the release of information.

**Refusal to Authorize Disclosure**

If an employee chooses not to sign a consent form (which is their
right), clinical services and resultant clearances will be withheld
(e.g., to use a respirator, or to perform specified jobs, such as law
enforcement, where a clearance is required) and the employee's
supervisor will be informed so that any necessary and appropriate
personnel action may be initiated.

**HIV/AIDS**

It is important to note that a general consent form to release medical
records DOES NOT include the release of records dealing with HIV and/or
AIDS, or substance abuse diagnosis and/or treatment, unless those
subject areas are explicitly included in the signed consent by the
subject individual.

####### Request for Copies

**Surviving Spouse**

If a request for copies of records is received from the surviving spouse
of a deceased employee, the request, and a copy of the requested
information, must be sent to a departmental Freedom of Information Act
(FOIA) coordinator for review. The FOIA coordinator will release the
copy of the records after masking any information that is not pertinent
to the employee's occupational or medical health.

### Employee's Representative

If a request for copies of records is received from any individual other
than the employee or surviving spouse, that person must have been
granted power of attorney by the employee. The information may be
released if the power of attorney is unrestricted (general power of
attorney), or if it specifically covers confidential information. A
request for information release under this circumstance must be
accompanied by a signed copy of the power of attorney, a copy of which
must remain in the medical record along with a summary of which
documents were release

**Data Systems and Analysis**

The data systems in support of the DOI/NPS occupational health program
are evolving rapidly, and efforts are being made to accommodate
currently-available technology in distributing program information,
gathering pertinent program data, and conducting reviews of program
statistics and progress with addressing the DOI/NPS mission. The data
elements for the occupational health program are specified, or
indicated, throughout this r*eference manual.*

One data system currently under development is the Safety Management
Information System (SMIS), an Internet accessible accident reporting
system of the OMRPS. This system allows the local manager immediate
access to accident reports that are stored in an electronic database.
Information in the reports can be changed or corrected, as appropriate,
and then entered into the permanent accident report database for
tracking and report generation. This system will be coordinated with
other on-line databases under development by OMRPS, and will contribute
to the program management and quality assurance functions of the
national and local occupational health programs, as presented in other
sections of this r*eference manual*.

The content of this Tab will be developed further as the specific data
systems are implemented.

####### Medical Evaluations

**Preplacement/post conditional/Baseline Medical Evaluation**

(for Candidates and Employees of Positions having Medical Standards)

Schedule medical exam after successful completion of: application and
interview;

Provide candidate with authorization for medical exam, time, date, and
place.

Send examining physician appropriate exam contents and reporting forms.

Examining Physician to return report directly to MRO;

MRO will review data and recommend a finding of any of the following:

Medically Qualified;

Not Medically Qualified (Candidates not medically cleared will not be
considered further);

**[Inconclusive]{.underline}** - Results from medical exam inconclusive,
and require followup information (MRO through NPS will request
additional medical information be provided by the applicant at the
Government expense (i.e., repeat audiograms or cardiologist's review of
abnormal EKG's, etc.). No medical decision is possible until this
medical information is provided. Applicant will be provided an
additional 60 days to resubmit information directly to MRO. Failure to
submit information will result in a recommendation of Not Medically
Qualified.

Recommendations of medically qualified will be final decisions and
forwarded directly to the applicant, servicing personnel office, and
Human Resources Program Manager. Results of inconclusive will be
forwarded to applicant, servicing personnel office, and Human Resources
Program Manager, and request additional information. Results of Not
Medically Qualified will be forwarded to the Human Resources Program
Manager for final decision.

**Candidates for Admission to Training Programs**

Check records to verify successful completion of timely (medical
clearance within time schedule for individuals age) previous medical
clearance within established guidelines.

Refer to guidelines for training program i.e., some programs may involve
higher (stricter) medical standards than those already cleared for. (re.
diving, high altitude SAR etc.)

If necessary, schedule for medical exam after preliminary acceptance
into program;

Provide candidate with authorization for medical exam, time, date, and
place. Send examining physician appropriate exam contents and reporting
forms. Examining physician to return report directly to MRO.

MRO will review medical data and make a recommendation. Results will be
forwarded to NPS and communicated via letter to incumbent. Human
Resources Program Manager (or designee) must approve medical
disqualification.

Medically Qualified;

Not Medically Qualified (Candidates not medically cleared will be
disqualified and will not be considered further);

**[Inconclusive]{.underline}** - Results from medical exam inconclusive,
and require followup information (MRO through NPS will request
additional medical information be provided by the applicant at the
government expense, i.e. Repeat audiograms or cardiologist's review of
abnormal EKG's, etc. No medical decision is possible until this medical
information is provided. Applicant may be given time limit (60 days) to
provide.

**Periodic Medical Evaluations**

Schedule a medical exam for each incumbent according to the scheduled
time period for the incumbent's age group, as listed in the incumbents
guiding standard/s. Use incumbent's birth date as reference point and
schedule medical examination within 1 month of birthday.

Periodicity

Under age 40 - every 2 years

40 and above - every year

Provide incumbent with authorization for medical exam, time, date, and
place.

Send examining physician appropriate exam contents and reporting forms.

Examining physician to return report directly to MRO.

MRO will review data, and make a recommendation.

Results will be forwarded to NPS, which will review determination and
communicate via letter to incumbent.

[Acceptable:]{.underline} No significant medical issues vis-a-vis
medical standards for position;

> Medical findings relate only to personal health issues. Should consult
> with personal physician. No followup report required. All followup
> medical examinations and costs are the option and responsibility of
> employee.

[Unacceptable:]{.underline} Significant medical issues vis-a-vis medical
standard for position. Employee must have immediately be restricted from
performance of rigorous duties.

> Short-term medical issues - restrict duties to resolve or cure
> temporary medical condition or while continuing to collect medical
> information;
>
> Long-term/permanent medical condition - incumbents medically
> disqualified are subject to personnel action including, but not
> limited to:

Reconsider/appeal of medical disqualification

Accommodation of medical condition in existing position or new position

Disability retirement

Other retirement

Reassignment if available

Removal

[Inconclusive:]{.underline} Medical findings may relate to safe and
efficient job performance.

Followup medical reports must be submitted to the MRO within reasonable
time period (30-60) days. All costs are the responsibility of the
Government;

####### 

####### Medical Surveillance Examinations - Any employee, according to risk exposure

**Procedure**

Schedule a medical exam for any incumbent exposed to a listed agent.

Provide incumbent with authorization for medical exam, time, date, and
place.

Send examining physician appropriate exam contents and reporting forms.
Examining physician to return report directly to MRO, if medical
standards for the position exist. If no medical standards exist, NPS
safety managers will provide medical consultant to park managers and
medical exam results will be forwarded directly to designated medical
consultant.

MRO or medical consultant may order or request further tests and/or
Fitness For Duty Examination if warranted.

####### Return to Duty and Fitness For Duty Medical Evaluations - All employees

**Procedure**

In consultation with MRO, schedule a medical exam for any incumbent
according to criteria listed above.

Provide incumbent with authorization for medical exam, time, date, and
place.

Send examining physician appropriate exam contents and reporting forms.

Examining physician to return report directly to MRO, if medical
standards for position exist. If not, report to be sent to medical
consultant identified by NPS safety manager.

MRO or medical consultant will review data, and make a recommendation.
Results will be forwarded to appropriate NPS manager who will make a
determination and communicate via letter to incumbent.

[Acceptable]{.underline}: No adverse medical findings.

Medical findings relate to personal health. Incumbent may be advised to
consult with personal physician. No followup report required. All
followup costs are the option and responsibility of employee.

[Inconclusive:]{.underline} Medical findings may relate to safe and
efficient job performance.

Followup medical reports must be submitted to the MRO or medical
consultant within (30-60) days. Costs associated with followup reports
are responsibility of the Service.

-   [Medical findings are unacceptable]{.underline}:

> Short-term - restricts duties to resolve temporary conditions or while
> continuing to collect information;
>
> Long-term/permanent - incumbents not medically cleared are subject to
> medical disqualification and personnel action including, but not
> limited to:

Reassignment;

Appeal and Reconsideration of disqualification;

Accommodation of medical condition;

Disability Retirement

Removal

Further discussion of addressing medically disqualification may be found
below.

# Reconsideration and Reasonable Accommodation 

Medical evaluations recommendations are initially made by the MRO and
approved by the Human Resources Program Manager (or designee). Appeals
of evaluations of unacceptable may be made to the Human Resources
Program Manager within 30 calendar days of notice of disqualification.
Upon notice of unacceptable evaluation, parks/offices must immediately
remove the employee of rigorous duties. Appeals may request any of the
following:

**Reconsideration**

Applicants or employees may request a reconsideration of a medical
evaluation of unacceptable if further medical evaluations, treatment,
and/or testing conducted by medical professionals result in a medical
conclusion that the medical condition does not exist or is no longer
disqualifying. Costs that relate to further medical examination to
reconsider a long term/permanent finding of unacceptable are the
responsibility of the employee. Costs that relate to further medical
examination to clarify a finding of inconclusive or to reconsider
findings other than long term/permanent unacceptable are the
responsibility of the Service.

Reconsideration will also be provided when significant but correctable
medical conditions exist which are subsequently corrected or resolved
satisfactorily. A satisfactory medical resolution means that the
disqualifying condition has changed or no longer is present, such that
the individual is now medically capable of safely performing all duties
of the position.

Following recovery or resolution of the disqualifying medical condition,
the individual has 90 days to present medical documentation that the
condition has been corrected or is no longer present. The individual is
then eligible for consideration for entry into positions, training
programs, or assignments for which s/he now meets all medical
requirements. Documentation of full recovery or resolution of the
disqualifying medical condition must the submitted to the Human
Resources Program Manager and will be forwarded to the MRO for
evaluation and consultation.

**Reasonable Accommodation**

Accommodations may be considered in each instance of medical evaluation
finding of unacceptable of employees when there is sufficient evidence
that the full range of essential duties of the position can be performed
without endangering the health and safety of the individual or others.
If there is sufficient evidence to establish that the disqualified
employee is or could be a qualified individual with disability, the
employee's supervisor and/or manager may propose reasonable
accommodation. A qualified individual with disability is an individual
who, with or without reasonable accommodation, can perform the essential
functions of the position in question without endangering the health and
safety of the individual or others. If there is not sufficient evidence
to establish that the employee is a qualified individual with
disability, the employee is responsible for requesting and proposing the
accommodation. The superintendent will review the request and forward it
and his/her recommendation to the Human Resources Program Manager (or
designee) for consideration by the MSB. The MSB will review requests for
reasonable accommodation prior to implementation.

The Service shall make reasonable accommodation to the known physical or
mental limitations of the employee who is a qualified individual with
disability unless it can be demonstrated that the accommodation would
impose an undue hardship on program operations. Reasonable accommodation
may include, but shall not be limited to making facilities readily
accessible to and usable by individuals with handicaps, job
restructuring, part-time or modified work schedules, acquisition or
modification of equipment or devices, appropriate adjustment or
modification of examinations, the provision of readers and interpreters,
and other similar actions. In determining whether an accommodation would
impose an undue hardship on the operation of the Service factors to be
considered include the overall size of the agency\'s program with
respect to the number of employees, number and type of facilities and
size of budget, the type of agency operation, including the composition
and structure of the agency\'s work force; and the nature and the cost
of the accommodation.

### Second Opinion

If the employee is medically disqualified based upon the results of a
medical examination, s/he can request another examination, limited to
the area of concern (causing the medical evaluation finding of
unacceptable). The second examination will be conducted either by a
physician mutually acceptable to the NPS and the employee or by a
physician of the employee's choice. If a mutually acceptable physician
is used, costs for further medical examination are the responsibility of
the Service. If the employee elects to use a physician of choice, (a
physician not acceptable to the NPS due to qualifications, cost,
distance, or time considerations), the examination will be conducted on
the employee's time and at the employee's expense.

After the second medical examination, any further medical testing,
medical specialists, additional expert consultants, and other diagnostic
techniques requested or needed to rule out disqualifying conditions or
to rebut the medical findings of the first two examinations, if not
deemed necessary by the MRO, are the responsibility of the employee. The
results of the second examination will be submitted for review and
recommendation to the MRO. That recommendation will be submitted to the
Human Resources Program Manager (or designee) for decision. The employee
will be allowed 60 days from the notice of failure to meet the medical
standards, to provide this information to the agency. However, during
the period of reconsideration, the employee may not be assigned rigorous
duties of the position (for law enforcement and fire fighting positions,
duties that would qualify for primary enhanced retirement coverage).

## Appeals

Appeals of medical evaluation determinations and denials of requests for
reasonable accommodation will be made to the MSB. The MSB will be
appointed by the Associate Director, Park Operations and Education, and
Associate Director, Administration. It will consist of the Program
Manager, (Chief) Ranger Activities (or designee), the Law Enforcement
Program

Manager, a senior NPS safety manager, the MRO, and Human Resources
Program Manager (or designee). The Human Resources Program Manager (or
designee) will serve as board chairperson.

The MSB will meet regularly to review appeals of medical evaluation
determinations and requests for reasonable accommodation. The MSB will
consider the written record of the evaluation and written submission by
the employee and/or oral presentation by the employee. Oral
presentations are to be made at least cost to the Service and utilize
teleconference or video-conference in lieu of travel.

An employee has the right to be accompanied, represented and advised by
a representative of his/her choice at any stage of the appeal
proceeding. Designation or change of representative must be made in
writing to the MSB chairperson. If the employee chooses another employee
of the Department as representative, and that person is willing to
serve, permission must be granted unless such representation would: (a)
conflict with the priority needs of the Service by contributing
appreciably to neglect of the representative's duties, (b) constitute a
clear conflict of position, or conflict of interest; or (c) cause
unreasonable cost to the Government. Supervisors or managers may not
represent employees. If an employee's representative is disallowed, the
employee may request reconsideration by the Human Resources Program
Manager.

The board chairperson will be designated as the deciding official in
such determinations and spokesperson for the decisions of the Board
before any third party.

#### Medically Disqualified

In the event an employee has a medical evaluation finding of
unacceptable, long term, the employee is disqualified from holding a
rigorous duty position. It is the policy of the Service to take
appropriate action to remove the disqualified employee from the position
in a manner which is least punitive to the employee. Appropriate action
will be considered in following order:

**Reassignment -** When an employee becomes unable to perform the
essential functions of his or her position even with reasonable
accommodation due to a disability, an agency shall offer to reassign the
individual to a funded vacant position located in the same commuting
area and serviced by the same appointing authority, and at the same
grade or level, the essential functions of which the individual would be
able to perform with reasonable accommodation if necessary unless the
agency can demonstrate that the reassignment would impose an undue
hardship on the operation of its program. In the absence of a position
at the same grade or level, an offer of reassignment to a vacant
position at the highest available grade or level below the employee\'s
current grade or level shall be required, but availability of such a
vacancy shall not affect the employee\'s entitlement, if any, to
disability retirement pursuant to 5 U.S.C. 8337 or 5 U.S.C. 8451. If the
agency has already posted a notice or announcement seeking applications
for a specific vacant position at the time the agency has determined
that the nonprobationary employee is unable to perform the essential
functions of his or her position even with reasonable accommodation,
then the agency does not have an obligation under this section to offer
to reassign the individual to that position, but the agency must
consider the individual on an equal basis with those who applied for the
position.

Parks, regional offices and support offices are encouraged to utilize
each others resources to provide for reassignment of medically
disqualified employees outside local commuting areas.

**Disability Retirement -** The employee's servicing personnel office
will determine if the employee is eligible for disability retirement.
Any employee eligible for disability retirement will be counseled by a
park or central office human resources specialist who is a subject
matter expert in retirement.

**Removal.** In the event no reassignment opportunities exist with the
local commuting area, medically disqualified employees are subject to
removal from a rigorous duty position.

***End of Part 1 -- Medical Standards***

**PART II**

August 10, 1999

**[Occupational Health and Fitness Program]{.underline}**

####### Purpose

In order to manage the broad spectrum of park resources and to provide
routine and emergency services to the visiting public, the NPS employs a
diverse, multi-skilled work force. The NPS is committed to providing
good stewardship to its human resources, including assisting all
employees in attaining peak effectiveness in their jobs.

Mission success depends on high quality employee performance, which
relates directly to individual physical and mental health. The Secretary
of the Interior, in his memorandum of December 11, 1989, said that
\"engaging in a program of regular exercise reduces risk of disease,
lowers health care costs and improves employee morale and
productivity.\"

The NPS endorses health and fitness programs that effectively use our
limited resources to help achieve a healthy and fit work force. All NPS
employees are encouraged to participate in approved health and fitness
programs and to take full advantage of the physical exercise facilities
and equipment provided by the Service.

The NPS recognizes the business value of a healthy, physically fit work
force and encourages individual employees to seek the means to achieve
and maintain healthy, vigorous lives, both on and off the job. The
Service's professionally­ developed employee health and fitness program
will provide both a blueprint and vehicle for all NPS employees to
achieve healthier lifestyles, which will enhance both individual and
organizational effectiveness.

The Service recognizes that those employees who must meet mandatory
medical standards and rigorous-duty physical fitness requirements, must
have a fitness program. The Service will invest in enabling them to
attain and maintain the health and fitness levels necessary for safe and
efficient performance of their required duties. Rigorous-duty employees
must be physically capable of performing their challenging duties in a
safe and efficient manner.

####### Objectives

The NPS has the following five objectives for its health and fitness
program:

-   Develop and maintain optimal employee effectiveness and job
    performance through increased fitness and health.

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-   Reduce work time lost through illness, disability, or job
    dissatisfaction.

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-   Increase each participating employee\'s mental alertness and ability
    to absorb emotional and physical stress and reduce workplace
    tension,

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-   Promote each participating employee\'s morale and personal well
    ­being through improved health and fitness,

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-   Develop and maintain a work force capable of responding to the
    rapidly changing, increasingly difficult physical demands of
    emergency services work in parks by establishing and maintaining a
    vigorouslaw enforcement and firefighting work force as envisioned by
    Congress and demanded by the American public.

**Legal Authority**

[Director's Order #57]{.underline}

[Overall Authorities for Program]{.underline}

-   5 United States Code (USC), Section 7901, 7903 and 7904

-   5 Code of Federal Regulations (CFR), Part 792

Agencies have the authority to establish health service programs and to
use appropriated funds to establish and operate physical fitness
programs and facilities. The agency\'s program may include, but is not
limited to, physical fitness, wellness, health awareness, prevention of
illness and disease, smoking cessation, correction of alcohol and drug
abuse, medical surveillance, mental and emotional well‑being, and
adoption issues.

[Establishment of Medical and Physical Qualifications]{.underline}

-   5 CFR 339

-   DM 446, Chapter 2.1 as amended

Medical determinations pertaining to employability, including procedures
for establishing standards and physical requirements, medical evaluation
programs, the events under which medical examinations are appropriate
and how medical information may be used in making employment decisions.

[Requirement for and Payment of Medical Examinations]{.underline}

-   5 CFR 339

Specific information on obtaining medical information and requiring and
paying for medical examinations.

[Use of Duty Time for Participation in the Health and Fitness
Program]{.underline}

-   5 U.S.C. 7901

[Use of Appropriated Funds to Purchase Exercise Equipment
and]{.underline}

[Memberships in Fitness Centers]{.underline}

-   5 U.S.C. 7901

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-   16 U.S.C., Section la‑2(a)

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-   Public Law 91‑383, dated August 18, 1970

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-   Comptroller General Decision B‑227559, March 23, 1988

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-   Comptroller General Decision B‑240371, January 18, 1991

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-   Comptroller General Decision B‑243025, May 2, 1991

Agency authority to establish health service programs, including by
contract, to promote and maintain the physical and mental fitness of
employees. Included is the authority to purchase exercise equipment and,
in cases where all other resources have been considered and are
inappropriate, membership in fitness clubs.

***Important Note:*** The prohibition in 5 U.S.C. 5946 against using
appropriated funds to pay the membership dues of a Federal employee in a
society or association does [not]{.underline} prohibit a Federal agency
from using funds to purchase access for its employee to a private
fitness center\'s exercise facilities.

Several of these authorities are unique to the NPS and permit the agency
to purchase recreational equipment, facilities and services for use by
employees and their families located in isolated areas.

[Incentives]{.underline}

-   5 U.S.C. 4501

-   5 CFR 451

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-   NPS and NPS Supplements to OPM guidance/regulations

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-   Section 201 of the Federal Employee Pay Comparability Act of 1991
    (FEPCA), OPM Interim Regulations published on May 3, 1991

Incentive and award programs improve Government efficiency, economy and
effectiveness by motivating employees. Variations on the traditional
awards program may include, but are not necessarily limited to,
on‑the‑spot or fast track awards, time off awards, and honorary
recognition (plaques, trophies, etc.).

##### Office of Workmen's Compensation Programs (OWCP) Claims

-   Federal Employees Compensation Act, 5 U.S.C. 8101, et. seq., as
    amended by P.L. 93‑416

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-   20 CFR, Employee Benefits

Provisions under which employees injured as a result of participation in
the NPS Health and Fitness Program will be covered by the Federal
Employees Compensation Act (FECA). Also included are the procedures to
be followed in filing claims.

**Program Organization**

The health and fitness program for NPS employees is recognized as a
critical component of a high quality public service program. It also is
a critical component of the Service's commitment to provide the best
possible stewardship to our employees. The NPS Health and Fitness
Program contains two major components:

***[Mandatory Program]{.underline}** -* All employees who perform
rigorous and/or hazardous duties are required to participate in the NPS
physical fitness program and any associated fitness testing programs, in
order to perform satisfactorily in their position. Mandatory
participation positions include positions whose duties include
performing \"emergency services:\"

Lifeguard

SCUBA diver

Law enforcement

Search and rescue (SAR)

Wildland and structural firefighter (arduous duty positions only) and

Emergency medical services responders

***[Voluntary Program]{.underline} -*** All non‑emergency service
employees, especially employees performing physically challenging duties
or working in environmentally challenging locations, are encouraged to
[participate]{.underline} in a voluntary health and fitness program. The
Service will provide support, encouragement, information, and guidance
to all those interested in participating in such a program.

**Mandatory Fitness Program**

5 CFR 339.203 authorizes agencies to establish physical requirements for
positions with physically rigorous duties. The NPS has established the
following criteria for its *mandatory participation* health and fitness
program and fitness testing for all emergency service personnel:

-   The continual maintenance of the physical fitness level required to
    safely perform rigorous duties is a responsibility of the individual
    employee.

-   All employees who are assigned rigorous duties are *required* to
    participate in an individual fitness program.

-   Prior to beginning a physical exercise/physical fitness program and
    prior to any physical fitness testing, employees must be cleared to
    participate by the MRO via the medical examination program.

-   The assessment instrument and the acceptable fitness level for each
    emergency service (specific physical task ability) will be described
    in the appendix to this manual if and when they are developed and
    approved. Individual parks may identify and validate specific
    physical fitness measures that are accurate, task-related measures
    of specific tasks required within their park emergency operations,
    for those employees who must perform such duties with concurrence by
    the human resources program manager for the region.

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-   The basic physical fitness measurement tool for employees performing
    emergency services is the PEB of tests and the Work Capacity Test
    Series. The PEB and Work Capacity Test Series will be used as a
    basic individual fitness benchmark for all emergency services
    employees, to provide individuals with a means of assessing their
    own fitness and to provide a means of developing and measuring the
    success of individual and park fitness programs.

***NOTE*:** No personnel action may be based solely on the results of
the PEB. The PEB is not an approved, validated task standard.
Supervisors should view unsatisfactory results in the PEB as an
indication that individual performance capability may need improvement
and should logically pay closer attention to actual on-the-job
performance. Park fitness coordinators should help employees unable to
pass the PEB modify their exercise programs, provide advice on diet
modifications, rest and relaxation techniques, and other means of
encouraging and assisting employees to achieve fitness.

However, the Work Capacity Test Series tests are approved,
work-validated standards and personnel actions may be based on the
results of those tests. Persons failing those tests, at the appropriate
fitness level for identified positions, should be reassigned to other
less-arduous positions for which they meet fitness and qualification
standards.

**Continuing Implementation**

Mandatory participation in a physical fitness program has been required
for all NPS emergency services personnel since 1992. In some individual
situations, it may still be necessary to gradually phase in a regular
exercise regime in consultation with the park physical fitness
coordinator. Within 1 year of this release, every emergency services
employee (and especially every 6c-covered employee), will develop and
implement a personalized physical fitness program in consultation with
their park fitness coordinator. No matter what an individual's current
fitness level, the process of achieving fitness begins with the first
step in the exercise program.

Medical science tells us that regular participation in a logically
structured physical exercise program coupled with a good diet and
adequate rest will achieve fitness and increase longevity. For all
rigorous duty positions, individuals and supervisors must remain
cognizant that it is the extreme physical challenge(s) presented by the
duties of the position itself, not the standards of any test, that are
the true pass/fail measures of fitness.

**Law Enforcement Positions (Mandatory Participation)**

Employees nominated to attend the FLETC (to receive mandatory basic law
enforcement training) must pass both the law enforcement medical
examination/standard and the PEB ***PRIOR*** to being nominated to FLETC
training. Individuals selected for law enforcement positions must
demonstrate their ability to pass the PEB (after passing the medical
examination). Parks will again administer the PEB 1 month preceding the
start of FLETC training and must certify recent successful PEB
completion to the NPS Superintendent of law enforcement training at
FLETC before the candidate arrives there. All candidates are required to
take a medical examination and the PEB shortly after arrival at FLETC.
Failure to pass the medical examination or the PEB at that time will
result in removal from basic law enforcement training and sent back to
their original park. While attending law enforcement training, regular
physical training is provided and all trainees are encouraged to improve
their PEB scores prior to graduation. After FLETC graduation and
commissioning, all law enforcement commissioned employees are enrolled
in the mandatory physical fitness program and the medical surveillance
program. Commissioned employees are expected to maintain their physical
fitness throughout their careers in law enforcement positions.

**Other Emergency Services**

Employees in all the following emergency service positions are subject
to the provisions of the mandatory program. The basic emergency services
standard is the PEB along with the target levels developed by the FLETC.
This instrument has not been task validated but will be used as a means
of familiarizing participants with the assessment process. Ultimately,
validated physical

standards will be developed for a variety of occupations and all
affected personnel will be required to meet them according to criteria
set forth in each.

All emergency service personnel must adhere to this standard at minimum,
along with those in their individual occupations/job functions that
exceed it.

**[SCUBA Diving]{.underline}**

SCUBA Divers are subject to this chapter and Director's Order 4.

**[Structural Firefighting]{.underline}**

Structural firefighters are subject to this chapter.

**[Wildland Firefighting]{.underline}**

Wildland firefighters are subject to this chapter and Director's Order
18, Wildland Fire Management.

**[Emergency Medical Services (EMS)]{.underline}**

EMS responders who routinely respond to EMS incidents are subject to
this chapter.

**[SAR]{.underline}**

NPS SAR personnel in positions requiring arduous and/or hazardous duties
are subject to this chapter. Including but not limited to searchers,
skiers, rope handlers, litter-bearers, swimmers, climbers, cavers, dog
handlers, rappellers, field‑team leaders. Park managers and/or Incident
Commanders should identify which other local SAR positions will be
covered by this chapter. Any positions exempted from fitness
requirements should be identified ahead of time. The intent of this
section is to help ensure the safety and efficiency of the individual,
his or her co‑workers, and the operation.

**[Lifeguards]{.underline}**

Lifeguards are subject to the requirements of this chapter and
established local standards.

**[Incidental Responders]{.underline}**

Employees who assist only rarely with emergencies and who do not have
emergency response requirements in their position descriptions (i.e.,
perform emergency duties *incidentally* or as an occasional collateral
duty), are not included in the mandatory participation physical fitness
program. Although they may occasionally act in an emergency operations
role, their position's primary duties

do not require them to provide emergency services, nor to serve as
members of designated emergency teams, nor to possess special
certifications, qualifications, training, or commissions, nor to
regularly perform emergency response duties.

Although incidental responders are not required to participate in the
mandatory fitness program, it is highly recommended they take part in
the voluntary program. Park supervisors are encouraged to identify
capable employees to serve as incidental responders as a part of their
contingency planning. It is appropriate and recommended that parks have
identified incidental responders participate in the PACK test, if they
are likely to be called upon to perform an emergency function requiring
stamina, endurance, high aerobic capacity, or a function subject to high
stress. Such testing should take place regularly, not just immediately
prior to call-out. Only persons with Work Capacity Test Series scores
indicating an ability to perform arduous duties should be asked to
perform arduous tasks.

**[Critical Incident Teams Stress Management]{.underline}**

There are specialized response teams trained and ready to respond to
critical incidents involving law enforcement, search and rescue,
wildland fire, and other emergencies. These teams may have written
training standards, objectives, skill requirements, and mandatory
competencies that are unique to their role and function. Active team
members are subject to the mandatory participation physical fitness
program. In addition, team members must also meet team membership
requirements including any established, valid medical and physical
fitness standards and measures. Team managers engaged in the development
of specific, valid medical and/or physical fitness requirements will
consult with WASO/RAD concerning those requirements.

**Voluntary Fitness Program**

The voluntary physical fitness program is incentive based and
goal‑driven. [All]{.underline} non-mandatory participation employees are
encouraged to participate in this program. The personal health and
wellness benefits to be gained by participation are immense, and the
Service benefits as well. Managers are encouraged to support the program
by means of flexible and alternative work scheduling, the granting of
annual leave or leave without pay, disseminating information concerning
community‑based programs, offering in‑house fitness and health education
programs (at convenient times and locations), providing access to and
use of Government-owned physical fitness facilities, and other
appropriate means.

**Program Elements**

The NPS voluntary program must include the first two of the following
elements; the remaining three may also be included:

-   Medical and physical fitness screenings to evaluate current health
    and fitness levels and to develop baseline fitness information
    necessary to prepare individualized health fitness program.

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-   A signed liability release. A release is required for all employees
    using NPS-owned facilities or equipment to conduct physical exercise
    activities.

-   Assistance with the cost of medical screening if funds are
    available.

-   Counseling, guidance and assistance in the development and
    maintenance of personnel health and fitness plans.

-   Twice per year fitness tests.

**Liability Waivers**

Voluntary program participants must sign a liability release waiver
prior to entering the Government sponsored fitness program. Mandatory
participants are involved in the program as part of their scope of
employment, and do not need to sign a waiver.

**Health Screening for Mandatory and Voluntary Participation Programs**

Basically, physical exercise is a safe and desirable activity for most
individuals. But it is nonetheless highly advisable to have an
appropriate level of medical screening prior to starting an exercise
program or taking an exercise test. The cost of all required medical
examinations/screenings for mandatory program participants will be borne
by the Government, will take place on Government time, and will be in
compliance with the national standards and procedures set forth herein.
Park managers are authorized, but not required, to use park funds for
medical screening or physical examinations for voluntary participants.

Prior to entering either the mandatory or voluntary fitness program or
being tested for aerobic capacity or other physical conditioning,
participants must undergo the following health screening:

**Employees in Positions having Specific Medical Standards**

All employees in positions having specific medical standards, who are
required to participate in the health and fitness program must undergo
and complete the prescribed medical examination for their position and
be cleared by the MRO prior to participation in the health and fitness
program. Employees currently participating in a mandatory fitness
program at the time specific medical standards for their position are
adopted may continue to participate, but should obtain the required
medical examination as soon as practical.

**Employees in Positions without Specific Medical Standards**

Emergency services employees required to participate in the health and
fitness program and all employees volunteering to participate in the
health and fitness program must take the following health screening:

-   Employees [39 years or younger]{.underline} and *presently active\**
    in an aerobic conditioning program, [must]{.underline} take the
    Heart Disease Risk Profile (RISKO) and PAR Q evaluations (see
    Exhibits 1 & 2) prior to entering the fitness program or
    participating in any physical fitness testing.

If RISKO indicates a score of \"[Risk Moderate]{.underline}\" (31 or
less) and all answers on PAR Q are **no**, the employee may test and
participate.

If RISKO indicates a score of \"[Greater Than Average -
Dangerous]{.underline}\" (32 or higher) and/or one or more answers on
the PAR Q are yes, then the employee needs a physician\'s clearance
prior to entering the testing or fitness program.

-   Employees [39 years or younger]{.underline} but *not presently
    active*\* in an aerobics program, [must]{.underline} obtain a
    physician\'s screening for arduous duties and a medical examination
    (including blood analysis) during the 18‑month period prior to
    entering the required fitness program [and]{.underline} must take
    the RISKO and PAR Q evaluations immediately prior to any aerobics
    test.

If RISKO indicates \"[Risk Generally Average]{.underline}\" (24 or
lower) and all answers on the PAR Q are **no**, the employee may test
and participate.

If the RISKO indicates \"[Risk Moderate]{.underline}\" and/or one or
more of the answers on the PAR Q are **yes**, then the employee needs a
physician\'s clearance prior to entering the testing or fitness program.

**\**NOTE*:** For the purposes of health screening, the words *presently
active* refer to the American College of Sports Medicine\'s definition
of \"physically active.\" Under that definition, a person who is active
is someone who participates in vigorous exercise (jogging, skiing,
walking, swimming, stair climbing, etc.) for a minimum of 20 minutes per
day at least 3 days per week, and has done so far the immediate past 2
months or more.

-   Employees, [40 years or older]{.underline}, *must* obtain a medical
    examination (including blood analysis), *[and]{.underline}* obtain a
    physician\'s clearance to participate immediately prior to entering
    the required fitness program.

After being cleared to enter the program, employees in this category (4)
must take a medical examination [every 3 years.]{.underline} The NPS MRO
is authorized to require and/or permit medical examinations more often
than every three years for those in high‑risk medical categories, i.e.,

employees who have high‑blood pressure or heart trouble, who have an
inactive lifestyle, who are pregnant, or who have short or long‑term
physical/medical problems. Managers can obtain the criteria to initiate
a request for such a determination under the provisions provided in

FPM 339.

-   These required medical examinations are not intended to satisfy the
    medical examination requirement for occupations that have specific
    approved medical standards as a condition of employment. If and when
    specific medical standards are approved for a position, the medical
    examination results must be forwarded to the NPS MRO for a medical
    determination as to whether or not the applicant/employee meets
    medical standards. Through the use of a centralized MRO program,
    duplication of medical exams will be avoided.

**Medical Screening Examinations**

The health and fitness coordinator (HFC), or the supervisor, or
servicing personnel office for those smaller areas without a HFC, must
ensure required medical examinations are completed.

The HFC or program participant must inform the examining doctor of the
purpose of the examination in order to assure a proper, thorough
evaluation.

**Examination and Documentation**

-   The HFC or person to be examined must provide the examining
    physician with the standard Department of the Interior Medical
    Surveillance Program Medical History and Examination Form and a
    letter requesting a medical examination. An SF‑78 has also been
    developed for arduous and hazardous duty that covers all other
    emergency services.

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-   A blood analysis for cholesterol, LDL, triglycerides HDL, glucose,
    urea, lipids, and CBC should be requested as part of each
    examination. Voluntary screening for Lyme disease, HIV, and
    hepatitis may be conducted if an employee submits a written request
    for such test.

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-   The completed Medical History and Examination Form should be
    forwarded to an approved NPS MRO for all *mandatory* participants.
    Examining physicians may issue a clearance to participate in
    physical fitness programs or physical testing for all voluntary
    participants.

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-   Personnel and medical files and information must be handled in
    accordance with the Privacy Act standards.

**Individual Health and Fitness Programs**

**Assessment**

Once an employee has passed the health screening process, he or she is
eligible to enter a park-sponsored Individual Health and Fitness
Program. This begins with a physical fitness assessment comprised of the
fitness tests developed for the activity to be performed (PEB or Work
Capacity Test Series test) or locally developed general physical
conditioning measures.

Participants should be tested by an employee trained and certified to
administer physical fitness tests (the park HFC) twice a year. The HFC
may administer tests more often if needed for motivational or
confidence-building reasons. The results of the tests should be recorded
on a \"Fitness Test Results\" form and kept in the employee\'s fitness
file. It is the responsibility of the employee\'s supervisor to ensure
this test is completed. All fitness files must be maintained in
accordance with the Privacy Act (section 6311 of Title 5 of U.S.C.).

**Personalized Program Development**

Based on the results of the first test, the employee and the HFC should
develop and agree upon an \"Individual Health and Fitness Plan\" (IHFP)
to assist the participant in achieving higher fitness

goals. Once an interim target goal is met, the IHFP should be updated to
either a maintenance and/or improvement program. The written IHFP should
be kept in the employee\'s fitness file.

The employee, his or her supervisor, and the HFC should identify
activities to be accomplished during on-duty time. These can be physical
work‑related activities such as foot, ski, or kayak patrols; trail
clearing; and so on; or a regular program of specific physical
exercises, including such things as running, swimming, calisthenics, or
weight lifting to be included in the IHFP.

In addition to on-duty activities, the employee and HFC should identify
those fitness-related activities undertaken on off-duty time that will
result in improvements in the targeted areas.

All the fitness activities to be undertaken should be outlined on the
employee\'s IHFP.

Those employees having difficulty in meeting any of the minimum fitness
goals should be monitored and assisted by the supervisor, HFC, or other
relevant specialists. The employee is encouraged to re‑test and modify
his or her IHFP as often as necessary.

**Official Government-time Fitness Activities**

**Mandatory Participation Program**

Managers and supervisors may provide up to 3 hours per week of official
duty time, in reasonable blocks of time, for mandatory-participation
program employees to perform physical exercise. Pursuant to Director's
Order 18, those wildland firefighters whose full-time duties are 100
percent arduous duty-related (such as helitack, hotshot, engine,
prescribed fire, smokejumper crews) will normally be provided 1 hour per
day for fitness training. This Government contribution of paid time for
physical exercise is to assist the employee in meeting the fitness
requirements of the position. Fitness time may be scheduled on various
workdays throughout the workweek, as recommended by the park health and
fitness coordinator. A single long-duration activity conducted on 1 day,
such as a ski or hiking patrol, may generally count for no more than 1
hour (of the 3 hours) of fitness time that week. A good physical
conditioning regime requires various types of physical exercise to be
performed.

The Service views physical exercise time as a major investment in park
operations and in employee health. Local supervisors should expect to
get a reasonable return on that investment in terms of employee
productivity. Employees must not view fitness time as "free time" and
supervisors must not view fitness time as "wasted time."

When feasible, mandatory fitness program time should be officially
scheduled, but it is recognized that there is also a need to maintain
flexibility so exercise time does not interfere with either employee or
service responsibilities. Because emergency-services employees must be
available to respond whenever an emergency occurs, the use of portable
radios, pagers, or other means to alert exercising employees to
emergencies should be considered. Exercise programs should not be
scheduled or performed during those times when the employee\'s absence
from regular work

assignments would interfere with the performance of duties of
co‑workers. Overtime is not authorized for fitness training, and
overtime cannot be granted for work unfinished because of fitness
training. \"Unused\" fitness time may not carry forward to the next week
for any reason.

It is the responsibility of the employed to ensure that all physical
activities are performed in a satisfactory manner on duty, e.g., proper
use of equipment, environmental stressors.

*Reasonable* use of the designated exercise time toward achieving the
goals of the program should be the objective of both supervisors and
employees. Everyone should keep in mind that fitness time is regular
duty time, fully under the control of supervisors and managers, who may
direct the activities to be performed during such time. Each participant
in a mandatory participation program must specify those types of
physical training he or she will engage in while on Government time and,
if required document the use of fitness time to the satisfaction of
supervisors.

**Voluntary Participation Program**

Managers and supervisors [cannot]{.underline} authorize the use of
official duty time or administrative leave for voluntary fitness program
activities ***[except]{.underline}*** in cases of officially sponsored
and approved programs or fitness events. OPM has mandated that the
following policy apply for granting excused absences for participation
in the voluntary health and fitness activities (FPM Letter 792‑23):

-   the activity should be officially administered, such as a Federal
    Fitness Day event or an agency sponsored health screening;

-   the amount of excused absence in each instance should be a short
    period, and the activity for which excused absence is granted should
    be of a specific, fixed duration, such as annual health screenings,
    health and fitness fairs and exhibits, Federal Fitness Day, and
    health improvement activities involving a nutrition and smoking
    cessation program.

-   an excused absence should not be granted for participation in an
    activity over an extended or indefinite period; the agency official
    approving the excused absence should determine that participation in
    the activity will likely benefit the organization; and

-   the agency official approving the excused absence should ensure that
    the employee\'s absence will not interfere with the timely and
    effective performance of agency work and service to the public.

Managers and supervisors should accommodate, to the extent possible,
flexible or alternate work schedules for employees participating in the
voluntary physical fitness program. Approving annual leave for employees
taking part in officially sponsored and administered health and fitness
programs is encouraged.

**Fitness Files**

Each area should maintain a fitness file that should be kept by the HFC.
The file should contain physical test results (not medical exam
results), a copy of the IHFP, results of mandatory tests, and a record
of utilized duty time (optional). The NPS MRO is responsible for
maintaining employee

medical records pertaining to medical standards. The HFC should refer
questions and medical

information to the NPS MRO. The examining doctor should forward all
necessary medical records to the NPS MRO.

**Roles and Functions**

**Occupational Health and Fitness Program Manager**

The Occupational Health and Fitness Program Manager, Ranger Activities,
Washington Office, is the contact point for all aspects of the NPS
occupational health and fitness program.

Specifically, the manager will serve as the central authority for all
program and policy determinations; the central point of contact for all
external agency issues; and as the central clearing-house for the
Occupational Health and Fitness Program.

The Occupational Health and Fitness Program Manager, designated by the
Associate Director, Park Operations and Education, in conjunction with
the NPS FLETC Superintendent and NIFC Program Manager, is responsible
for:

-   Implementing Director's Order 57 and occupational medical and
    fitness standards and programs.

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-   Providing general medical, health and fitness information to field
    offices.

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-   Approving qualifications and protocols for HFCs.

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-   Representing the NPS on the President\'s Council on Physical Fitness
    and Sports.

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-   Coordinating occupational medical, health and fitness management
    activities with the Department of the Interior, FLETC, NFIC and
    various outside agencies, committees, and other organizations.

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-   Providing a clearing-house on training techniques and equipment.

**Regional Health and Fitness Program Managers**

Regional health and fitness program managers designated by the
respective regional directors, are responsible for:

-   Developing, implementing, and coordinating a regionwide program
    which meets the requirements of the Occupational Health and Fitness
    Program.

-   Managing the central office medical, health and fitness program,
    with an emphasis on providing assistance and technical support to
    individuals.

-   Disseminating all medical, health and fitness releases, policy
    statements, and related materials to parks and service centers.

-   Maintaining liaison with the medical, health and fitness community.

The regional office HFC should possess knowledge, skills, and abilities
commensurate with the behavioral objectives of exercise leader
certification, as defined by the American College of Sports

Medicine. In order to be qualified, a coordinator must have a working
knowledge of screening

programs, monitoring, test administration, corrective actions,
resources, advanced guidance, and safety.

**Park Health and Fitness Program Managers or Coordinators**

In general, each park must have a health and fitness program and every
participant must have access to a designated trained HFC. Therefore,
every park will need to designate a qualified employee to serve as HFC.
However, because parks vary in size, complexity, isolation, and resource
demands, some parks may not need a local designated HFC. Parks are
encouraged to cooperate with one another so the necessary HFC services
can be provided in the most cost-effective fashion. This assistance may
come from consolidating areas under one HFC, using a HFC from an
adjoining area, etc. It is recommended that parks with more than 10
employees participating in the health and fitness program designate one
or more HFCs.

Park HFCs will not replace medical professionals or professional
consultants. They are to act as an extension of such services and merely
provide a first level focal point of lay assistance to the park and/or
participating employees regarding basic fitness concerns and activities.
They should be able to identify and contact sources for further
guidance.

Park managers are responsible for the health and fitness programs within
their park areas.

The designated park HFC is responsible for:

-   Examining and determining the park\'s occupational medical, health
    and fitness program needs.

-   Developing, implementing, maintaining and/or evaluating an internal
    park occupational medical, health and fitness plan. A committee
    approach is encouraged and recommended.

-   Providing assessments and fitness testing for both voluntary and
    mandatory program participants.

-   Recommending exercise and nutrition guidance for program
    participants, including goal setting, motivation, and fitness
    educational material.

-   Maintaining individual health and fitness plans and logs for program
    participants.

**Qualifications of Park HFCs**

The key positions in the NPS Health and Fitness Program are at the park
level. The entire program rests upon the competency and dedication of
the employees designated to coordinate the program at the park level. At
a minimum, all park HFCs must attend and be certified under the physical
fitness coordinator training program offered regularly at the FLETC and
also be qualified as Work Capacity Test series Administrators..

In addition, HFCs should possess knowledge, skills, and abilities
commensurate with the behavioral objectives of exercise leader
certification, as defined by the American College of Sports Medicine.
This approximately 40-hour training may be accomplished through several
nationally recognized programs. This training should be completed
immediately before appointment whenever possible.

Nominees for these positions must:

possess an interest in health and fitness;

be able to pass the PEB, and/or PACT Test

serve as positive role models for participants;

be active in all facets of the health and fitness program;

be able to demonstrate proper fitness protocols; and

acquire and share the knowledge and information necessary to assist
employees in meeting their health and fitness goals.

It is important that managers select a park HFC who is interested in
health and fitness, but who at the same time does not give the
appearance of being a \"health zealot\" to others.

**Attaining Fitness, Overcoming Negativity**

The Health and Fitness Program is a positive incentive-filled program
designed and intended to encourage and motivate participation and
success. Parks are encouraged to provide support and helpful
encouragement to all employees in their pursuit of healthy lifestyles
and physical fitness. The program is intended to educate and stimulate
participation and the attainment of individual goals. Only in the most
severe situations should supervisors have need to resort to the
mandatory aspects of the program in order to overcome negativity and
recalcitrance.

Mandatory participants in the fitness program are required to take the
assessment instrument (PEB and/or PACK Test) as prescribed and to
participate fully in an individual fitness program designed to assist
them in attaining fitness goals. Regardless of an employee's present
physical condition, fitness can and will inevitably be attained through
regular participation in the health and fitness program.

A mandatory participant who cannot take the assessment instrument or
cannot participate in his/her individual fitness program due to physical
or medical reason(s), must inform his/her supervisor. Supervisors must
then confirm the medical basis for non-participation through medical
documentation provided by the employee and reviewed by the MRO.

Should a mandatory participant demonstrate inability physically to
perform the full range of his/her duties safely, those performance
shortcomings should be documented and may be used as the basis for
personnel actions or a Performance Improvement Plan. Personnel sanctions
are available in cases of refusal to participate in the prescribed
manner, however, the basis for this action is conduct, not performance.

***NOTE:*** Personnel actions regarding medical/physical standards MUST
be based on approved validated standards. The basis for this action will
be the medical opinion and advice of the MRO as approved by a senior NPS
official, the specific job requirements, the safety of the individual
and others, and the agency responsibility to mission accomplishment.

**Fitness Equipment and Exercise Facilities**

A clean, safe, appropriate, cost-effective location should be provided
for employees to perform physical exercise. Exercise facilities should
contain at least a minimum of fitness equipment to enable individuals to
attain and maintain fitness. Ideally, exercise facilities would be
located in or near all parks and near park employee work areas. Parks
may provide equipment and facilities directly or employees may use local
health clubs or facilities at nearby military installations, colleges,
or other institutions. The decision about which facilities will be used,
whether or not the park will invest in equipment, the type of equipment
provided, and so on is a park management decision.

Voluntary program participants may be permitted to join, at their own
expense, a group membership in a health club (if one is established for
individuals in the mandatory program). Voluntary program participants
may be permitted to use NPS-owned facilities and equipment, if
authorized by the superintendent.

Voluntary program participants, their immediate families, and any others
in the community who are authorized by the superintendent to use NPS
equipment and facilities must request in writing from the superintendent
or designee permission to use the NPS fitness facilities.

Federal procurement regulations require fitness equipment be purchased
exclusively from the GSA Purchase Schedule, section 78­I‑A. Exceptions
require agency justification, and applications for waivers must go to
GSA through the NPS procurement process.

Exercise equipment donated to the Service or acquired from other
agencies is the property of the Government. Such property is controlled
and accounted for per Federal Property Management Regulation 410 DM
114‑60 and applicable NPS guidelines and directives.

Each area with a workout center is responsible for ensuring that
adequate safety and emergency plans and procedures exist for the
facility, and that equipment is maintained in a safe condition.

Both the Public Health Service and GSA may be contacted to develop
fitness facilities in a Government‑owned or leased building. These
agencies have already established standards for the development and
maintenance of such facilities

**Health Club Memberships**

The HFC should check the possibility of using other low‑cost
alternatives to Government‑owned facilities. In areas where it is not
feasible to provide either a military or civilian exercise facility,
persons in the mandatory participation program may utilize a private
fitness center. If a health club is chosen, certain standards should be
met. The club should:

have shower and locker room facilities, aerobic training machines, and
equipment to work the major muscle groups;

provide services that are cost-effective in comparison with the
alternatives; and

be geographically desirable.

Agreements must be made in the name of the NPS and not the individual
using the membership. Procurement and contractual obligations must be in
compliance with Director's Order 62.

**Appendices**

**Physical Standards**

**PEB**

**Forms**

PARQ

RISKO

[^1]: "Rigorous position" means a position, the duties of which are so
    rigorous that employment opportunities should, as soon as reasonably
    possible, be limited (through establishment of a maximum entry age
    and physical qualifications) to young and physically vigorous
    individuals\....\" (5 C.F.R. 842.802)