Waynes World - July 2009
COURT ALLOWS "DIRECT OBSERVATION"
METHOD OF DRUG TESTING, AND...
PROPOSED RULES FOR
MEDICAL EXAMINERS
by Wayne Schooling
TIGHTER CONTROL OF MEDICAL EXAMINERS
Drivers who need a medical exam in the future may first have to turn to a national database of approved doctors if a proposed new rule takes effect. The FMCSA recently proposed the creation of a National Registry of Certified Medical Examiners to ensure that drivers’ physical exams are only performed by qualified doctors in a consistent manner. If finalized, the proposed rule would require eligible medical examiners to be trained by an accredited training provider and pass a test before being placed on the registry. Drivers and motor carriers would have to refer to the registry (via telephone or the internet) to find a qualified medical examiner, and examiners would need to take periodic refresher training and testing to remain on the list. Because of the added training and costs, I am sure that the day of the $25 exam will be long gone.
Under 49 CFR Part 391, all interstate commercial motor vehicle (CMV) drivers must undergo a medical exam at least every two years, but current rules do not provide much detail on who can provide the exams. The result is often inconsistency and, at times, incompetence. In 2005, a survey in Indiana found mistakes on 29% of all examination reports collected. The FMCSA believes that the enhancement of the knowledge and capabilities of medical examiners would have a clear and positive impact on both the safety of CMV operations and driver health.
Interest in certifying medical examiners dates back more than 30 years, but it took an act of Congress in 2005 to finally require development of the proposed rule, which, by Congressional deadline, is already more than two years late. The FMCSA is proposing to phase in the rule over a three-year period. Beginning two years after the rule takes effect, drivers who work for motor carriers that employ 50 or more drivers would have to have all future medical exams performed by registered examiners. Employees of smaller companies would have an additional year to comply. One major concern about the new registry is its potential effect on drivers for smaller companies in rural areas who may be unable to find a qualified examiner nearby. The FMCSA has acknowledged the concern and is asking for public input on ways to make sure examiners are accessible in rural areas and areas where the demand for certification may be low.
The FMCSA estimates that the proposed rule applies directly to about 4.4 million active interstate commercial drivers. The agency says about 40,000 certified medical examiners should be enough to perform the estimated 3 million driver medical exams per year, with each examiner conducting about 75 exams per year. Although the medical examiners will have to pay for training and testing, the FMCSA says the largest cost of the new rule would fall on drivers and motor carriers. The estimated 44,000 drivers who are screened out of the occupation due to medical issues will lose income, and motor carriers will have to replace those drivers at an estimated cost of $1,600 per driver. Other costs to the industry are expected to be low once the program is running. Information for drivers, employers and examiners about the registry program would be available through free websites (such as NTA’s), although a resource center with a toll-free phone number would also be available. On these websites, drivers and employers could find names and addresses of certified medial examiners.
The proposed rule would require that all medical examiners complete training within three years after the rule takes effect. This training would be performed by an accredited private-sector training provider (the FMCSA would develop the core curriculum and administrative requirements for the training providers). The length of the training would vary, but the agency projects that it would take just one day to teach the curriculum. The training delivery method could vary among providers and include self-paced, online training, traditional classroom-style training, or a combination of both methods. The agency anticipates providing periodic, internet-based retraining at no charge to the examiner, but examiners would have to repeat (and pay for) the complete training program at least once every 12 years.
In addition to passing the certification test, examiners would be required to pass the test again every six years. The proposed rule would also 1) require all examiners to electronically transmit to FMCSA the name and ID number for each driver examined; 2) require examiners to send copies of medical exam reports to FMCSA within 48 hours of request; 3) revise the medical card by adding a field for the doctor’s National Registry ID Number; and 4) establish procedures for removing examiners from the registry. The rule will not change the list of professionals qualified to perform medical exams, including medical doctors, doctors of osteopathy, physician assistants, advanced practice nurses, and doctors of chiropractic.
DRUG & ALCOHOL TESTING RULE UPDATES
An appeals court has upheld federal rules requiring “direct observation” of drug tests for transportation workers who either have failed or refused to take a test as a condition of employment. As the ruling on follow-up testing was issued, congressional legislation that would create a clearing-house of drug test results from truck drivers was drawing praise. A bipartisan group of senators have introduced a bill that would create a database of the drug test results of commercial truck drivers. The Safe Roads Act would authorize $5 million annually for the development and maintenance of a database for drug test results to prevent drivers who test positive from continuing to work.
~ NTA remains a name you can trust. Our website (www.ntassoc.com) is your official U.S. DOT Internet Training Site and we are administrators of a Nationally Accredited Drug and Alcohol Program. If you have any questions, call me at (562) 279-0557 or send me an e-mail to wayne@ntassoc.com. Until next month, “Drive Safe – Drive Smart!”