[Federal Register: May 18, 2005 (Volume 70, Number 95)]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
DEPARTMENT OF TRANSPORTATION
Federal Motor Carrier Safety Administration
[Docket No. FMCSA-2005-20105]
Public Meeting To Discuss the Establishment of a National
Registry of Certified Medical Examiners
AGENCY: Federal Motor Carrier Safety Administration (FMCSA), DOT.
ACTION: Notice of public meeting.
SUMMARY: FMCSA announces a public meeting concerning a National
Registry of Certified Medical Examiners (NRCME). If established, the
NRCME would be a database of medical examiners certified by FMCSA (or a
third party) to conduct medical examinations of interstate commercial
motor vehicle (CMV) drivers and effectively determine their physical
qualifications to operate such vehicles [[Page 28597]] in interstate commerce as defined in 49 CFR 391.41. If the NRCME is
implemented, the FMCSA would only accept medical examinations conducted
by persons listed in the NRCME as proof of the physical qualifications
standards for interstate CMV drivers. The meeting is intended to
provide a general introduction to the NRCME concept and an opportunity
for discussion with subject matter experts.
DATES: The meeting will be held on June 22, 2005. The meeting will
begin at 9 a.m. and end at 1:15 p.m.
ADDRESSES: The meeting will be held at the Crystal City Marriott, 1999
Jefferson Davis Highway, Arlington, VA 22202.
FOR FURTHER INFORMATION CONTACT: For information, contact Dr. Mary D.
Gunnels, Office of Bus and Truck Standards and Operations, Physical
Qualifications Division, 202-366-4001.
Information on Services for Individuals With Disabilities
For information on facilities or services for individuals with
disabilities or to request special assistance at the meeting, contact
Ms. Margo Weeks, Axiom Resource Management, Inc., 703-379-0412, ext
Interest in certifying medical examiners to evaluate interstate
commercial motor vehicle operators dates back to 1978, when the
National Highway Traffic Safety Administration commissioned a
feasibility study on the issue. This study addressed the primary
weakness in the overall system--the lack of medical examiner
understanding of the relationship of driver physical condition to the
task of operating CMVs interstate. The study found that there were not
enough doctors to support a certified medical examiner system. Instead,
it recommended certifying a few medical examiners who would determine
fitness when there was a conflict between a driver's physician and the
motor carrier's physician.
In 1992, the Federal Motor Carrier Safety Regulations were amended
to allow physicians' assistants, advanced nurse practitioners, and
doctors of chiropractic to perform medical examinations of CMV
operators, if permitted by state license (57 FR 33278; July 28, 1992).
The number of potential medical examiners grew.
The idea of certification resurfaced during the National
Transportation Safety Board's (NTSB) January 21, 2000 public hearing in
New Orleans concerning a 1999 crash where it was determined that the
CMV operator had several life-threatening medical conditions. The NTSB
concluded that medical examiners might not have the knowledge and
information necessary to make appropriate decisions about driver
fitness. In its "Highway Accident Report, Motorcoach Run-Off-The-Road
Accident, New Orleans, Louisiana, May 9, 1999" (NTSB/HAR-01/01, PB
2001--916201, Notation 7381, August 28, 2001), the NTSB recommended (H-
01-017 through H-01-024) that the FMCSA "Develop a comprehensive
medical oversight program for interstate commercial drivers* * *" that
includes requirements to ensure "Individuals performing medical
examinations for drivers are qualified to do so and are educated about
occupational issues for drivers."
Most recently, the 107th Congress considered the issue of a
National Registry in the Senate version of the Safe, Accountable,
Flexible, and Efficient Transportation Equity Act of 2003 (S. 1072,
Sec. 4228). The legislation included language regarding the physical
examinations required of CMV operators by medical examiners who are
proficient in physical and medical examination standards and listed on
a national registry maintained by the U.S. Department of Transportation.
Development and Implementation of the NRCME
Although Congress has not yet enacted legislation to require FMCSA
to establish a registry of certified medical examiners, the Agency
seeks to provide a general introduction to the NRCME concept and to
initiate dialogue on the topic with subject matter experts. Through
this dialogue, we also anticipate developing information that would
allow us to exercise our current statutory authority under 49 U.S.C.
31316 (the Motor Carrier Safety Act of 1984) and 49 U.S.C. 31502 (the
Motor Carrier Act of 1935) to better ensure the physical qualifications
of interstate CMV drivers.
The NRCME would be used to identify medical examiners who have
demonstrated to FMCSA that they have knowledge of the driver physical
qualifications standards and all applicable advisory guidelines for use
in determining whether an individual is qualified to operate CMVs in
interstate commerce. Medical examiners listed in the NRCME would be
trained and certified by FMCSA (or a third party) as being
knowledgeable about the Federal driver physical qualifications
standards. Medical examiners are not currently required to have
specific training or demonstrate any special or unique understanding of
motor carrier operations to medically certify CMV drivers.
The delivery of program services and the ongoing operation of the
National Registry would require the participation of private sector
organizations that have relevant existing experience. These
organizations would include medical associations and societies that
provide education and training, as well as organizations that develop,
administer and analyze certification examinations. Quality management/
quality control (certification, accreditation) for the program would be
conducted using accepted existing practices in the private sector.
All interested parties are encouraged to attend, including medical
examiners, representatives of medical associations, certification and
accreditation organizations, motor carriers and drivers, state motor
carrier enforcement agencies, safety advocates and organizations. View
the following Web site for more information: http://www.nrcme.fmcsa.dot.gov.
Issued on: May 12, 2005.
Annette M. Sandberg,
[FR Doc. 05-9897 Filed 5-17-05; 8:45 am]