Privacy Act USDA/FS-27 YCC Enrollee Medical Records

PA_USDA_FS_27.doc

Youth Conservation Corps Application and Medical History

Privacy Act USDA/FS-27 YCC Enrollee Medical Records

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[DOCID:agri_001-50]                         


 USDA/FS-27

Federal Register:  Vol. 40, No. 167, pg 38945, August 27, 1975

System name:  Youth Conservation Corps (YCC) Enrollee Medical 
      Records, USDA/FS.

     System location:  Forest Service Office responsible for 
   administration of the YCC camp. Addresses of these offices are the 
   same as listed under 36 CFR 200.2 subpart A.
     Categories of individuals covered by the system:  Current and 
   former YCC enrollees.
     Categories of records in the system:  Medical History Forms, 
   Accident Injury and Medical Treatment Forms, and Parental Permission 
   portion of the application forms.
     Authority for maintenance of the system:  16 U.S.C. 1703
     Routine uses of records maintained in the system, including 
   categories of users and the purposes of such uses:  (1) Disclosure to 
   a Federal, State or local agency maintaining civil, criminal or other 
   relevant enforcement information or other pertinent information, such 
   as current licenses, if necessary to obtain information relevant to 
   an agency decision concerning the hiring or retention of an employee, 
   the issuance of a security clearance, the letting of a contract, or 
   the issuance of a license, grant or other benefits. (2) Disclosure to 
   a Federal agency, in response to its request in connection with the 
   hiring or retention of an employee, the issuance of a security 
   clearance, the reporting of an investigation of an employee, the 
   letting of a contract, or the issuance of a license, grant, or other 
   benefit by the requesting agency, to the extent that the information 
   is relevant and necessary to the requesting agency's decision on the 
   matter. Disclosure may be made to a congressional office from the 
   record of an individual in response to an inquiry from the 
   congressional office made at the request of that individual.
     Policies and practices for storing, retrieving, accessing, 
   retaining, and disposing of records in the system: 
     Storage:  Maintained in file folders.
     Retrievability:  Indexed by name of enrollee.
     Safeguards:  Stored in metal filing cabinets in locked office.
     Retention and disposal:  Manual records are maintained for 3 years. 
   Everything is then destroyed, except accident forms and medical 
   treatment forms. These are retained permanently or until such time as 
   enrollee may submit a claim.
     System manager(s) and address:  Director, Staff of Manpower and 
   Youth Conservation Programs, U.S. Department of Agriculture, Forest 
   Service, Washington, DC 20250.
     Notification procedure:  Any individual may request information 
   regarding this system of records, or information as to whether the 
   system contains records pertaining to him from the Forest Service 
   organizational unit where the YCC camp was located. The addresses for 
   these offices are in 36 CFR 200.2, subpart A. A request for 
   information pertaining to an individual should contain name, address, 
   dates when work was performed, program under which enrolled, and 
   location where work was performed.
     Record access procedures:  Use same procedures as for requesting 
   Notification.
     Contesting record procedures:  Use same procedures as for 
   requesting Notification.
     Record source categories:  Information in this system comes 
   primarily from the individual himself, medical doctor, and camp 
   official compiling accident or injury information.


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