Agency Use of MEDMAC Recommendations 11 th Meeting

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Agency Use of MEDMAC Recommendations 11 th Meeting of MEDMAC April 4 -5, 2017

Agency Use of MEDMAC Recommendations 11 th Meeting of MEDMAC April 4 -5, 2017

Overview • Summary of MEDMAC tasks • Focus on specific categories of tasks and

Overview • Summary of MEDMAC tasks • Focus on specific categories of tasks and recommendations – Medical and physical evaluation guidelines – Statute and regulation – Designated Medical Examiner • Outcomes

Summary of Tasks • MEDMAC has addressed 24 tasks since the inaugural meeting in

Summary of Tasks • MEDMAC has addressed 24 tasks since the inaugural meeting in 2011 – 19 tasks closed with recommendation – 1 task closed without recommendation (rolled into another task – 3 tasks remain open (one with interim recommendations) – 1 task not started – 1 non-task associated recommendation

Tasks Related to the Medical and Physical Evaluation Guidelines • Surge in medical appeals

Tasks Related to the Medical and Physical Evaluation Guidelines • Surge in medical appeals in 2011 • Highlighted need for improved clarity and specificity – How are medical conditions evaluated? – What criteria are considered for a waiver? • Triggered delays in application process • Risk of inconsistency in the evaluation process

Tasks Related to the Medical and Physical Evaluation Guidelines MEDMAC assigned 5 tasks on

Tasks Related to the Medical and Physical Evaluation Guidelines MEDMAC assigned 5 tasks on the issue • Task 11 -01 - Revising NVIC 04 -08 – Open; recommendations as “draft NVIC” • Task 11 -02 - Top Medical Conditions – Closed w/o recommendation; rolled into Task 1 • Task 14 -09 – Medications • Task 14 -10 – Impaired Color Vision • Task 15 -11 – The General Medical Exam

Tasks Related to the Medical and Physical Evaluation Guidelines Agency Use of Recommendations •

Tasks Related to the Medical and Physical Evaluation Guidelines Agency Use of Recommendations • Majority incorporated into policy – Changes 1 and 2, Draft Manual • Not incorporated at this time – Those requiring changes to the statute or regulation (prohibited meds, conditions) – Those requiring further study (Condition specific table of limitations and restrictions)

Tasks Related to the Statute and the Regulation MEDMAC assigned 3 tasks on sufficiency:

Tasks Related to the Statute and the Regulation MEDMAC assigned 3 tasks on sufficiency: • Task 11 -03 – Review of SNPRM for 46 CFR 10 C • Task 13 -07 – Review of relevant statutes • Task 14 -08 – Review of relevant regulation – Recommended prohibition for certain medications – Recommended requirement to report changes in condition/medication – Did not recommend list of prohibited conditions or additional physical fitness standard

Tasks Related to the Statute and the Regulation • Task 15 -13 – Occupational

Tasks Related to the Statute and the Regulation • Task 15 -13 – Occupational Health Risk Analysis – Open, pending review of MERPAC input • Agency use of MEDMAC recommendations – Recommendations for Task 11 -03 considered and many incorporated into 46 CFR part 10 subpart C – Recommendations for Tasks 13 -07 and 14 -08 – being considered for future action

Tasks Related to the DME Program • Task 11 -06 – Designated Medical Examiner

Tasks Related to the DME Program • Task 11 -06 – Designated Medical Examiner Program • Task 16 -18 – DME Training Content, Part A • Task 16 -19 – DME Training Content, Part B Agency considering the recommendations and most are being incorporated into development of the pilot program.

Outcomes • Better specificity and clarity in the guidance • Reduction in net application

Outcomes • Better specificity and clarity in the guidance • Reduction in net application processing time – Regulated community has necessary information to understand the evaluation process and submit best information • Reduction in medical appeals – Regulated community has better understanding of why and when they may be denied medical certification

Next Steps Looking forward to considering and incorporating other MEDMAC recommendations • DME pilot

Next Steps Looking forward to considering and incorporating other MEDMAC recommendations • DME pilot program; full DME program • Mariner health education (5 Tasks) • Occupational health risk analysis • Form review and revision – recurrent task • Mariner medical database • Other topics as the need arises