FMCSA Safety and Security Accomplishments

Office of Research and Analysis
Washington, DC
January 22, 2006

Medical Program Highlights

Kaye Kirby
Leader, Medical Review Board and
National Registry Initiatives

Ellison H. Wittels, MD, FACP
Senior Medical Consultant

Medical Program Activities

• Set medical standards and guidelines
• Conduct research on driver health
• Respond to inquiries and provide technical support to drivers, doctors, motor carriers and the public (substantial Congressional correspondence)
• Develop medical rulemakings (e.g., diabetes, medical CDL merger)
• Resolve conflicts among medical examiners, motor carriers, unions, and drivers
• Process medical exemptions (e.g., vision, diabetes)
• Process certificates for drivers with limb impairment (e.g., leg amputation)

Medical Standards/Regulations

• 13 Standards
  • Directly related to driving
• 9 Standards
  • Medical examiner discretion
• 4 Standards

  NO medical examiner discretion

  • Hearing
  • Vision
  • Epilepsy
  • Insulin-treated diabetes

Medical Exemptions/SPE Certificates

• Federal Vision Exemption Program
  • 1,500 active drivers
• Federal Diabetes Exemption Program
  • Seven drivers approved, dramatic increase (since SAFETEA-LU enacted)
• Skill Performance Evaluation (SPE) Certificate Program (formerly Limb Waiver Program)
  • 3,400+ active drivers

Medical Program Challenges

• Incomplete, inconsistent medical standards
• Lack of medical standards in key areas
• Number of drivers
• Medical examiner training
• Resource intensive programs

Major Initiatives: FY 2005 – 2009

• Establish Medical Review Board (MRB)
• Revise medical standards, guidelines
• Establish National Registry of Certified Medical Examiners (NRCME)
• Establish Medical Certification/CDL Merger Program
• Appoint Chief Medical Examiner
• Develop long-term program/research strategies

Medical Review Board

• Nationally recognized advisory board of medical experts
• Develop science-based medical standards and guidelines
• Chair FMCSA research panels on physical qualification standards and medical guidelines
• Advise on medical research and medical examiner training and certification
• Answer questions regarding CMV driver physical qualifications

Decision Model to Prioritize Research Panels

• Prevalence in general population (epidemiology)
• Crash risk (direct measurable risk for CMV crash)
• FMCSA priorities (e.g., statutory requirement)
• Age of guidelines
• Adequacy of guidance

Medical Panels

• Comprehensive review panels
  • 12 – 18 months
  • MRB member chairs scientific panel
• Expedited review panels
  • 3 – 6 months
  • FMCSA designates scientific panel membership
  • Specific issue updated
• Provide ongoing review cycle

Panel Schedule

National Registry of Certified Medical Examiners

• Develop comprehensive list of medical examiners who can conduct driver physical examinations
• Train, test, certify, and recertify medical examiners
• Ensure that medical examiners fully understand the medical standards in the FMCSRs and how they apply to CMV drivers
• Ensure that the list of certified medical examiners is easily accessible to drivers and motor carriers

Relationship Between MRB and the National Registry

Projected Outcomes FY 2005 – 2009

• Updated medical standards and guidelines with rulemakings
• CDL licensing action linked to medical certification process
• Institutionalized MRB with established cycle of ongoing medical standards review
• Accredited National Registry training and education program
• Reduced or eliminated need for medical exemptions and certificates

Strategy for Keeping the Public Informed . . .

• Federal Register notices
• FMCSA web site (Medical Program Page): www.fmcsa.dot.gov
• National Registry web site: www.nrcme.fmcsa.dot.gov
• MRB web site under construction
• New web sites, web-based solutions (e.g., e-mail, FAQs, on-line application process)