update: federal motor carrier safety administration (fmcsa) women in buses council american bus...
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Update: Federal Motor Carrier Safety Administration (FMCSA)
Women in Buses CouncilAmerican Bus Association
September 17, 2014
Elaine Papp, RN, MSN, COHN-S, FAAOHNChief, Medical Programs Division
Agenda
Overview of FMCSA Medical Programs and Medical Certification Requirements
National Registry of Certified Medical Examiners Medical Exemptions Online tools
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FMCSA Mission
The Federal Motor Carrier Safety Administration is focused on reducing crashes, injuries, and fatalities involving large trucks and buses.
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Interstate or Intrastate
Defined by transportation of goods: Interstate commerce, transports people or goods across a state
line Example -- Federal Express driver
Intrastate commerce, transports people or goods within the state Example -- A gravel truck driver -- gravel from a quarry within a state to
businesses in the same state
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Truck and Bus Driver Statistics
3.5 million active interstate drivers 3 million CDL holders
Approx. 539,033 active interstate motor carriers
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U.S. Department of Transportation (DOT)Interstate Traffic Crash Statistics 2012
Persons Large Truck
Crashes
Bus Crashes
Large Truck
and Bus Crashes
All Vehicle Crashes
Fatalities 3,464 250 3,702 30,800
Injuries 73,000 12,000 85,000 1,634,000
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Medical Program Activities Rulemaking/Guidance Development Research
Medical Review Board Medical Expert Panels Evidence Reports
Compliance Assistance Medical Exemptions/Variances
Vision, Diabetes, Hearing, Seizure Skill Performance Evaluation (SPE) Agency has requested public comment on exemption
applications for seizure conditions and hearing loss 7
Purpose of the Medical Certification Examination
Determine a driver's physical qualification to operate a commercial motor vehicle (CMV) Interstate commerce 49 CFR 391.41-49
Med Cert/CDL Rule Driver must provide MEC to SDLA to
obtain or maintain commercial driver’s license
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Medical Examiner Responsibilities
Knowledgeable about: Physical and mental demands of CMV driver job duties FMCSA regulations, including guidance
Use of medical protocols Make medical determinations based on FMCSA
regulations and advisory criteria
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National Registry Background New regulation - Published April 20, 2012 Requires medical examiners:
Complete training Pass a test Periodic training and testing Maintain licensure Report completed CMV driver examinations monthly
Compliance Date – May 21, 2014 All CMV drivers must use a ME on the National Registry Medical certificates issued prior to May 21, 2014 are valid until
the expiration date11
National Registry Statistics
As of September 15, 2014■ 57,924 ME - registered but haven’t taken test
35,483 ME – passed test, not yet certified 34,819 ME – certified on registry
■ National Registry is working Finding ME fraud
■ Be sure to check the National Registry for your ME’s certification
■ If ME not certified – driver needs a different ME
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Regulations and Advisory Criteria
Regulations Mandatory
Advisory Criteria Assist the Medical Examiner in making individual
determination of physical fitness for driving
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Medical Exemption Programs
Federal Diabetes Exemption Program Federal Vision Exemption Program Hearing Exemptions Seizure Exemptions Skill Performance Evaluation Certificate Program
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Federal Diabetes Exemption Program
Exemptions for drivers who have insulin-dependent diabetes mellitus
Drivers submit application Medical information showing their diabetes is under control
To maintain exemption, drivers submit quarterly monitoring reports
Diabetes exemption application can be found at:https://www.fmcsa.dot.gov/rules-regulations/topics/medical/exemptions.htm or call (703) 448-3094
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Federal Vision Exemption Program One eye does not meet the minimum vision requirements Better eye must meet the minimum vision standard Drivers submit application
Medical information showing driver is able to meet all other physical requirements
Experience driving with vision deficiency Crash/violation history Vision exemption application can be found at
https://www.fmcsa.dot.gov/rules-regulations/topics/medical/exemptions.htm or call (703) 448-3094
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Federal Hearing Exemption Program
Driver must perceive forced whisper in better ear at not less than 5 feet with or without hearing aid or no hearing loss in better in greater than 40 decibels at 500, 1,000 and 2,000 Hz with or without hearing aid
Driver may apply for an exemption by contacting the Medical Programs Division at FMCSA (202) 366-4001
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Federal Seizure Exemption Program Disqualified from operating in interstate commerce 49 CFR 391.41(b)(8) May be considered for exemption based on number of
years: Since last seizure, stable on anti-seizure medication, medical
history Exemption determinations are based on a case-by-case
review Driver may apply for an exemption by contacting the
Medical Programs Division at FMCSA (202) 366-4001
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Skill Performance Evaluation (SPE)
Driver with loss or fixed limb impairment Evaluation of driving skills Driver completes application process including
Assessment and evaluation by an Orthopedic Surgeon or Physiatrist
Medical examination certification that designates he is otherwise qualified except for completion of the SPE
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OSA
Congressional action Public Law 113-45
■ Signed into law October 2013 Requires Agency to develop regulation on
OSA before issuing new guidance
■ What does the Agency say about OSA?
OSA Included in respiratory dysfunction
regulation 49 CFR 391.41(b)(5) Advisory criteria
Respiratory dysfunction MRB/MCSAC Recommendations to
Agency Two-pronged approach
Interim - guidance Long-term - rulemaking
Agency has not taken action on MRB/MCSC recommendations
OSA
■ Focus for ME Use medical protocols/standards of clinical
care to determine physical qualification■ Like all other medical conditions
Consider the actual risk of sudden or gradual incapacitation
Undiagnosed OSA with risk factors■ Consider issuing short-term medical card for
testing and treatment Driver diagnosed and successfully treated
■ Demonstrated compliance with treatment Letter from treating clinician CPAP recorder printout Dental device tracking printout or other
Online Tools
You may access the following on the the FMCSA website: Evidence Reports Medical Expert Panel Reports Medical Review Board (MRB) Recommendations Medical Examiner’s Handbook (pdf version)
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Contact InformationFederal Motor Carrier SafetyAdministration, Medical Programs DivisionU.S. Department of TransportationWashington, D.C.
E-mail: [email protected]: (202) 366-4001Fax: (202) 366-8842
Medical Programswww.fmcsa.dot.gov/rules-regulations/topics/medical/medical.htm
National Registry Websitewww.nationalregistry.fmcsa.dot.gov
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