DATA ARCHITECTURE

FORM CONTENTS

Accident Investigation 8025-2 Accident Alert AIDS Database ASRS Database Autopsy Bill Autopsy Report Bill for Tox-Box CAIS Airman Database Key Accident Tracking Info NTSB Autopsy Request NTSB Database Pilot Deviations Database Pilot/Aircrew Medical Data Tox-Box Chain of Custody Form Tox-Box Alert Tox Results Miscellaneous 72 Hour History Accident File Contents Aircraft Accident Data Transmittal Aircraft Engine Analysis FAA Pilot Records - OKC Forensic Toxicology Fatal Accident Report Human Factor Checklist NTSB Factual Report NTSB Passenger Statement NTSB Record of Visit/Conference/Phone Call NTSB Receipt of Aircraft Parts NTSB Release of Aircraft Wreckage NTSB Statement of Witness Record of Diligent Search Report of Toxicological Examination Statement of Party Representatives Aeromedical Certification 8500-8 Airman Med File AME Warning Background Check Request Background Check Results Case Summary Case Support Request Certification Recommendations Consultant Bill Consultant Data Consultant Payment Authorization Denial Letter Driving Records EIR Report EKG Eligibility Letter Field Change List File Request Legal Actions Medical Certificate More Information Request NDR Report Panel Transcript Pilot/Aircrew Medical Data Problem 8500-8 Report SITS Waiver Miscellaneous Airman Worksheet Authorization for Release of Medical Information Certificate Surrendered Memo Certification Activity Tracking form Enforcement Investigation System Screens (EIS Screens) FAA National EKG Network Database Request for Airman Medical Records (FAA 8065-2) Special Issuance (Appeals) Worksheet Special Issuance (Recertification) Worksheet Special Issuance Letters Special Medical Flight Test Report (FAA 8500-13) Aeromedical Education Program 3000-13 31501 31507 31508 AME Directory Availability / Bid Chamber Consent Form Chamber Questionnaire Consent Form Memo Course Evaluation Course Proposal Pilot Training Record Purchase Order Purchase Request Reservations Seminar Facility Bill Seminar Invitation Seminar Postcard Seminar Roster Seminar Schedule Seminar Sign-In Sheet Seminar Support Materials SF-182 Speaker Speaker Bill Technical Training Call Form Training Confirmation Form Training Confirmation Letter Training Course Worksheet Training Registration Form Travel Expense Sheets Travel Orders Travel Vouchers True Need Training Document Waiting List Schedule Miscellaneous CTTMS Reports Seminar Confirmation to AME Supply Requisition Aviation Drug Abatement Program Anti-Drug Plan Congressional Inquiries FAA ASF Hotline Final Schedule Inspection Checklist Letter of Correction Letter of Investigation List of Entities List of Laboratories Master Schedule Policy Interpretation Request for Further Action Request for Further Information Semi-Annual Report Miscellaneous Summary Report Aviation Medical Examiner Program 8500-8 8520-2D AME Designation Request AME Questionnaire AME Statistics AME Warning Basic AME Data Delinquent AMEs Designation Card Field Change List Professional Standing Request for Field Change Seminar Postcard Seminar Roster Seminar Schedule Term of Designation Letter Miscellaneous Aircraft Accident Investigation Questionnaire AME Ancillary File (AAM-410) AME Applicant - File Summary AME Designation Letter AME Program Weekly Activity Report AME Complaint AME Database Screens (AWP-300) AME Database Screens (AEA-300) AME Database Screens and File Structure AME De-Designation Postponed/Terminated Letter (Error Rate) AME De-Designation Letter (Failure to Attend Seminar) AME De-Designation Postponed/Terminated Letter (Seminar Attendance) AME De-Designation Postponed/Terminated Letter (Insufficient Exams) AME File (Regional) AME Regional Transfer Re-Designation Letter AME Seminar Warning Letter AME Status Change memo AME System Screens Applicant Letter Aviation Medical Examiner Forms Request Checklist for AME Workshops Daily Work Sheet Designation Acceptance Letter Informal Contract No-Need Letter Request For Speaker Senior AME Designation Letter Senior AME Equipment Requirement Letter Covered Positions Program 3900-7 8500-8 Airman Med File Allergy Form Allergy Questionnaire Applicant Information Applicant Medical Update Bill for Exam Employee Clearance Form Flight Surgeon's Activity Report Opinion of OWCP Claim OWCP Claim Physical Authorization Report of Investigation Request for Exam ROI Action Report Schedule of Exams STMT of Demonstrated Ability Miscellaneous Air Traffic Controller Health Program Report (Special Consideration/Disqualification) ATCS Health Program Medical Questionnaire (AEA 9430-1) Clearance Processing Sheet Diabetes Mellitus Status Report HIS System Screens Ophthalmological Evaluation for Glaucoma (FAA 8500-14) Qualification Decision Report of Eye Evaluation (FAA 8500-7) Special Medical Consultation (EA 9430-2) Employee Substance Abuse Chain of Custody Form EAP Recommended Rehab Follow-up Worksheet Letter of Medical Decertif Letter of Re-Qualification Specification of Rehab Program Substance Abuse Evaluation Successful Completion of Rehab Miscellaneous End of One Year Follow-on to Rehabilitation Letter Stating Positive Non-compliance With Rehabilitation Program Return to Duty Substance Abuse Follow-up Plan, Delinquency Occupational Health 8500-8 Auth for Exam/Treatment Chamber Consent Form Daily Clinic Patient Record Education and Screening Results Hearing Conservation PGM Form List of Physical Exams Required Manager Authorization Medical Record Transmittal National HAP Report Physical Form Quarterly HAP Report Radiologic Consultation REQ / RPT Release of Information SF52 SF600 Miscellaneous Air Traffic Status Report Form Attending Physician's Report Clinical Subsystem HIS Data Collection Form Hypertension Status Report Medical Exam Authorization Patient file - Aftercare Instructions Patient file - Medical Forms Patient file - OWCP Forms Patient file - Specifications Unsatisfactory Condition Report Research MNS/RPI Progress Report Task Forms Task Specific RPIs Resource Management Analysis of Estimate/Issue Paper/FAA BGT Analy of PGM by Subobject Class Change of Station Report Contract Status Report Cost Center Detailed TXN Listing Cost Center Funds Status Report Evaluation Follow-up Report FAA Auth ∧ Invoice for MED SVC FAA Budgetary Authorization Flt Surgeon's Monthly Activity RPT Fund Increases Summary FY Allowances FY Financial and Employment Plan Medical PGM Evaluation Monthly Activity Report Open Document Listing OPM Form 1170 Performance Appraisal Form Program/Site Evaluation Report Quarterly Review Quarterly Summary Regional Budget INC Paper SF171 SF50 SF52 SF85 SF86 Significant Activities Report Vacancies Workload Information Miscellaneous AAM Budget Status Report Biweekly Employee Data Checklist Travel Advances Outstanding

Accident Investigation

8025-2

The 8025-3 (Aircraft Accident Medical Information) form is completed at the scene of the accident. Information on the form includes the date, time, and location of the accident; the type of aircraft, make and model; the number of persons on-board; the number of fatalities; pilot information; the position of the bodies on impact; and the damage done to the seats or restraint systems. It is completed by either AAM personnel or Flight Standards personnel and submitted to the Accident Investigation Data Collector.

Accident Alert

Aviation Bulletins are read on a daily basis to keep abreast of accidents and incidents. The bulletin contains the date, time, and location of fatal and non-fatal aircraft accidents/incidents. Toxicology personnel collect this bulletin in order to prepare files for accident investigation activities. The Medical Accident Investigation section is also informed of aircraft accidents through teletype Aviation Bulletins and/or a formal notification.

AIDS Database

The Accident/Incident Database System (AIDS) contains data for general aviation accidents and incidents, air carrier incidents, and air carrier accidents. Pertinent information includes: accident/incident locations and time, pilot data including certification code and age, flight hours, aircraft data, investigation and remedial actions, fatalities and injuries, causes and factors, and weather conditions. AIDS is maintained at the FAA Aviation Standards Office in Oklahoma City.

ASRS Database

The Aviation Safety Reporting System (ASRS) is a database of ASRS forms that have been submitted voluntarily by pilots, aircrew, air traffic control employees, or any of the Armed forces agencies. The information contained in an ASRS report details all relevant data involving any flight incident in any region in the National Airspace System. The database provides a service for searching for specific information found in ASRS Reports and is maintained by the Battelle Co. of California. All information and statistics derived from the ASRS Database cannot be considered totally accurate because all information in the database is obtained on a totally voluntary basis.

Autopsy Bill

The autopsy bill is submitted by the coroner to the region along with the autopsy report. The bill contains the name and amount of the bill along with the coroner/medical examiner's name and address. The autopsy report and bill are sent at the same time.

Autopsy Report

The autopsy report is submitted by the coroner/medical examiner to the investigating office, the FAA and/or NTSB. An autopsy is performed on the pilot(s) and other pertinent personnel. AAM is interested in whether there is a medical, pharmaceutical, or human performance reason for the accident's occurrence. The autopsy report includes data on the pilot's age, sex, and any medical findings which might relate to the cause of the accident. The autopsy report and bill are sent at the same time.

Bill for Tox-Box

The bill which is received with the tox-box is sent to accounting for payment.

CAIS Airman Database

The CAIS Airman Database includes information regarding the flight certification of pilots and the medical status of those pilots. The data found in the Airman Database is supplied by the Office of Flight Safety and resides as a component of the Consolidated Database.

Key Accident Tracking Info

Key accident tracking data is taken from the 8025-3 and, in the Great Lakes Region, entered into a spread sheet. Spreadsheet data includes the date of the accident, the location, the pilot's name, and the number of passengers on-board.

NTSB Autopsy Request

The National Transportation Safety Board (NTSB) requires that an autopsy be performed when a cockpit aircrew fatality occurs. This request can either be a written request or a verbal request to the local Coroner/Medical Examiner. The NTSB Autopsy Request (Authorization), NTSB form 6120.13, is the written request. If a Flight Standards person is part of the Accident Investigation team, that person makes the request. Otherwise, any other member of the team can make the request.

NTSB Database

The NTSB Accident Records Database contains information derived from accidents investigated by the NTSB. Information contained in the database includes pilot information, accident/incident information, weather conditions, aircrew and pilot information, and aircraft information. The database is maintained in Washington, D. C.

Pilot Deviations Database

The Pilot Deviation System (PDS) contains detailed information on reported abnormal flight incidents. Information found in the PDS includes accident/incident descriptions, aircraft involved, operating phase, weather, flight plan, investigations results, and pilot information. PDS uses Dbase IV and is maintained by the Office of Safety Analysis in Washington, D.C.

Pilot/Aircrew Medical Data

Pilot and Aircrew medical information are based on the findings made as a result of the accident investigation. The accident investigation team may implications on the pilot's/aircrew's medical certification.

Tox-Box Chain of Custody Form

The tox-box is sent directly to CAMI. The tox box contains airman name, instruction sheet, and other pertinent accident data. It is accompanied with the chain-of-custody form. The chain-of-custody form records the contacts the box has made in transmission from accident site to final destination.

Tox-Box Alert

NTSB, the FAA, the Regional Flight Surgeon, Aviation Medical Examiners, or the Medical Examiner/pathologist may alert CAMI that a tox-box is coming in to be processed. CAMI can receive specimens 24 hours a day, 7 days a week. An accident file is also set up at this time to collect the accident data.

Tox Results

A copy of the toxicology report from the CAMI analysis of the tox-box is sent to the NTSB and AAI-100. The tox results include the date and location of the accident, the samples received, and substances found in the specimens. This data is also filed at CAMI. The toxicology information is used in the final NTSB Factual Report.

Miscellaneous

72 Hour History

The checklist is a list of activities performed by the pilot for the 72 hours preceding the accident. This form is used mostly for the research purposes of the accident investigation.

Accident File Contents

The Accident File Contents Form names the documents that are contained in the accident file, indicates the size of the document, and lists the number of black and white or color photos that are contained in the document. The total file size (total number of document pages) is then listed along with the total number of photographs contained in the file.

Aircraft Accident Data Transmittal

The Aircraft Accident Data Transmittal shows the NTSB and FAA organizations that have received and subsequently routed the NTSB Factual Report. The distribution list for the report is pre- printed on the form along with spaces for the recipient to initial the form and indicate the date received/routed.

Aircraft Engine Analysis

The Aircraft Engine Analysis is a narrative description of the state of the engines captured from the aircraft accident. The engines, fuel system, ignition system, lubrication system, valve and gear train are described in detail. The analysis concludes with a summary of the findings.

FAA Pilot Records - OKC

Pilot medical data is taken from his/her CAIS file and includes the pilot's age, sex, and any medical condition data which might have contributed to the cause of the accident. This data is used to determine whether there was a medical reason for the accident's occurrence.

Forensic Toxicology Fatal Accident Report

The Forensic Toxicology Fatal Accident Report lists the results of chemical analyses performed on specimens obtained from a fatal aircraft accident.

Human Factor Checklist

This is a checklist of possible factors which may have led to the accident's causation.

NTSB Factual Report

This report is a more in-depth report than the preliminary report submitted by the NTSB. he report contains information in raw form which can be used to determine human factors and protection and survival findings.

NTSB Passenger Statement

The data contained on this form is included in the NTSB final accident report. The passenger statement is taken by the NTSB for recording purposes.

NTSB Record of Visit/Conference/Phone Call

The NTSB Record of Visit/Conference/Phone Call indicates the type of interview the NTSB representative had with the witness, the date the interview occurred, and a brief summary of the witness' statement. Any conclusions or actions taken/required as a result of the information obtained from the witness are also listed on the form.

NTSB Receipt of Aircraft Parts

The NTSB Receipt of Aircraft Parts form identifies the accident, the specific aircraft parts that are being retained for further investigation, and the individual to whom the parts should be returned at the completion of the investigation.

NTSB Release of Aircraft Wreckage

The NTSB Release of Aircraft Wreckage is a release form signed by the owner of the aircraft parts that are being released into NTSB's custody.

NTSB Statement of Witness

The NTSB Statement of Witness identifies the accident an individual witnessed and then lists a narrative description of exactly what the witness saw and heard before the accident occurred and at the time the accident occurred.

Record of Diligent Search

The Record of Diligent Search is an affidavit indicating that a diligent search has been made of the airman medical records maintained in Oklahoma City to ascertain the medical certification status of the airman involved in the accident. The results of the search are stated on the form.

Report of Toxicological Examination

This report lists the specimens that were received and a discussion of toxins and drugs found therein.

Statement of Party Representatives

The Statement of Party Representatives is an acknowledgement, signed by all witnesses who have given a written statement, that their participation in an accident investigation is not at the request of a claimant or insurer. It also acknowledges that the witness has read CFR Part 831 that explains NTSB's role in an accident investigation.

Aeromedical Certification

8500-8

Form used to record the results of airmen physical examinations and report convictions for alcohol/drug related offenses. This 'form' may be processed using AMCS screens or manually.

Airman Med File

Medical file, maintained at AAM-300's Records Section, that contains an airman's medical history.

AME Warning

If the AME has made a substantial error and wrongfully certified an airman, the Airmen Certification reviewer at AAM-300 may send a letter to notify the AME of the mistake and provide guidance on proper handling. One of two letters may be sent, based on the situation: one for incorrect issuance of a Student Pilot Certificate, because the applicant is under 16 years old, and one correcting the AME for a grievous error in case handling because the applicant does not meet FAA standards.

Background Check Request

Request to Regional Security office for a background check on an airman, reviewing records of conviction.

Background Check Results

Information concerning an airman's driving records and other records of conviction, similar in nature to the NDR REPORT provided by AMC-700 to the DUI/DWI Unit.

Case Summary

Basic information taken from the coded 8500-8 which provides a summary of the current 8500-8/airman in review. This information appears on the CAIS screen supporting certification.

Case Support Request

Request for medical information and opinion on significance of an airman's alcohol/substance abuse or other psychological problem. This is achieved by sending a computer-generated report from AMC-7 to the DUI/DWI Unit that lists DUI/DWI cases in progress and summarizes their status. This report requires review by DUI/DWI personnel in order to discern cases that need attention/information "bundled" and sent to Legal to support litigation. The monthly report also provides feedback about current litigation.

Certification Recommendations

Consultant's opinion on the proper handling and disposition of an airman's application for a medical certificate. After reviewing the airman's case, the consultant will return a synopsis of the airman's condition and recommendations regarding certification, waivers and conditions. The recommendations are in letter format.

Consultant Bill

Private physician/consultant bills the FAA for services rendered in the review and disposition of airmen certification cases. Consultants are used at CAMI by General Review and Special Issuances. Consultants who participate in in-house review panels at CAMI submit an In-house Panel Review Invoice with associated documentation, such as photocopies of airline ticket invoices and hotel bills.

Consultant Data

Information describing consultants who perform independent review of aeromedical certification cases, such as name, address, specialty, phone number, etc.

Consultant Payment Authorization

Document in memo format that lists consultant bill totals by consultant and authorizes payment.

Denial Letter

Letters stating that the airman cannot be medically certified as safe to fly and reasons why. Contains request for surrender of certificate. Depending on circumstances and the amount of time that has past since the airman received the medical certificate, reviewers will send either a 602 Denial or a 609 Failure to Provide letter. The medical certificate can be revoked/denied during the first 60 days following issuance (602), but after that period, legal offices must be involved in order to remove the certificate from the airman's possession, for failing to provide information about medical conditions or drug/alcohol related convictions. The 602 DENIAL and 609 FAILURE TO PROVIDE denial letters are nested under the "DENIAL LETTER" data flow. They are stored in the airman's medical file.

Driving Records

Records maintained by the state Department or Registry of Motor Vehicles concerning traffic violations, infractions or convictions. The format and content of these records varies by state. The "DRIVING RECORDS" record is only representative of the form and content of driving records as they are provided to OAM. The descriptive information concerning the motor vehicle operator is necessary in order to ensure a match between the airman and his driving records (because DMVs provide pseudo-Social Security numbers). Presently, the data from driving records is not entered into any system, but they are reviewed and stored in the airman's medical file.

EIR Report

The Enforcement Investigative Report (EIR) reports violations of FAA regulations. The form is used by OAM and other FAA organizations to report airman violations.

EKG

A hard-copy graphic or electronic file Electrocardiogram (EKG) representing the condition of a pilot's heart. (Hard copy of international airmen are microfilmed.) Only EKGs for 1st class pilots are stored in the MUSE system. All 2nd/3rd Class EKGs requested for evaluation arrive as hard-copy and are stored in the airman's medical file. EKGs for 1st Class airmen arriving in hardcopy are sent to the EKG Unit where they are transferred into microfiche storage and discarded. The "EKG" record represented in Excelerator is based on the electronic record in the MUSE system.

Eligibility Letter

If an airmen's health has been questioned by CAMI after an AME has issued the certificate, CAMI may request more information from the airmen, bringing the validity of the certificate into question. If applications examiners determine that the airman's health is within standards and policy, the airmen is sent this letter as notification that the certificate is valid. The letter is highly structured/well-defined with some dynamic data included during composition.

Field Change List

The field change list is derived from changes in basic AME data gathered using field change forms or communication through correspondence and telephone calls. The list represents a compilation of changes in basic AME data used to update the regional AME database (if one exists) and the CAIS AME subsystem.

File Request

Routing Slip requesting the retrieval and delivery of an airman's medical file or the delivery of the slip and medical file to another applications examiner. Within AAM-300, applications examiners also use AC Form 8500-14, which contains office routing information, a summarization of the certification case, and actions recommended by the recipient review when the file is returned.

Legal Actions

Information concerning legal actions being taken against an airman for failure to provide information and/or failure to surrender a medical certificate. Two known forms/ records are received from the Aeronautical Center's Legal Office: an Informal Meeting Report and an Airman Stop Order. These occur independently and are provided as necessary. The are nested under the "LEGAL ACTIONS" data flow to conserve space in graphics mode. Both forms are stored in the airman's medical file.

Medical Certificate

Card showing that the airman is medically certified/authorized to operate an aircraft. Medical certification may be conditional. Two forms may be issued: the 8500-9 (Medical Certificate) or the 8420-2 (Medical Certificate and Student Pilot Certificate). For more information see the description of the data element "STUDENT-AIRMAN-CERT".

More Information Request

Applications examiners or FAA physicians may require: additional information about a health problem or situation (such as a misconduct), the results of specific medical tests, and/or records or medical files maintained by external medical entities. For the DUI/DWI Unit, specific types of requests include: driving records, a personal statement of drug/alcohol history, a statement concerning past treatment for drugs/alcohol, letters of recommendation from employers, doctors or clergy, psychological/psychiatric evaluations, an evaluation by substance abuse counselor, addictionologist or licensed counselor, and conviction records and reports provided by probation/parole officers, lawyers, courts and the Department of Motor Vehicles (DMV). The request is accompanied by two or more Medical Information Release Authorization (FAA form 8500-21) forms. They are completed and one is returned to OAM; the others are submitted to medical entities. The sample Information Request Letter provided to the Data Architecture team is a copy of the letter prior to being completed. As such, it does not show all the potential data elements that may be included in it.

NDR Report

Results of investigative check to see if an airman has a record of alcohol/drug related driving offenses/infractions. This is accomplished externally through the National Driver's Registry Database that comprises automobile driver's records from many, but not all, states. The report is a hard copy form completed at AMC-700 and submitted to AAM-300's DUI/DWI unit. A significant portion of the form contains redundant data that CAMI already has (it was provided to AMC-700 by CAMI). However, it is difficult to say whether the redundant data elements were taken from NDR or CAIS, though this appears to be moot. The form itself it grossly cryptic.

Panel Transcript

Transcript detailing the review and conclusions of a panel of aviation/medical experts regarding a particular Special Issuance (SI) case.

Pilot/Aircrew Medical Data

Pilot and Aircrew medical information are based on the findings made as a result of the accident investigation. The accident investigation team may implications on the pilot's/aircrew's medical certification.

Problem 8500-8 Report

CAIS report specifying which incoming 8500-8s need review because of omissions, errors or values outside of standards. The "reject sheet" and 8500-8 are matched with the appropriate airman file and sent to an applications examiner. The report specifies errors or problems and provides physical exam data from the airman's previous 8500-8.

SITS

A screen print of the SITS database's primary data screen is used to collect information supporting data entry to the Special Issuance Tracking System (SITS). SITS provides information specific to Special Issuance cases, such as follow up requirements (the submission of medical test results are regular intervals) and dates when the follow up reports were reviewed and approved.

Waiver

The actual waiver or statement of demonstrated ability (SODA). (Not the same SODA as in CP.)

Miscellaneous

Airman Worksheet

Form used to track case status (requests, transactions, dates) regarding the collection of an airman's health information and case review. Not known if this form originates from CAMI or a regional office; most likely from a regional office.

Authorization for Release of Medical Information

Statement completed by the airmen authorizing an external private-sector medical facility to release personal medical records to OAM.

Certificate Surrendered Memo

Notification from regional medical office that an airman, against whom the regional Legal Office is taking action, has surrendered a medical certificate, obviating the need for continued legal action.

Certification Activity Tracking form

Form believed to be used by a regional office to track quantitative aspects of aeromedical certification activities.

Enforcement Investigation System Screens (EIS Screens)

Computer system screens of the EIS system, used to log and track information about airmen misconduct concerning FARs.

FAA National EKG Network Database

System screens from the EKG Unit's MUSE system at CAMI.

Request for Airman Medical Records (FAA 8065-2)

Form believed to be used to request medical records from offices internal and external to OAM. For instance, a regional office may use it to request records from another regional office or CAMI. CAMI or regional offices may also use it to request medical records from external private-sector medical facilities. In this case, it is probably accompanied by a copy of the airman's "Authorization for the Release of Medical Information" form.

Special Issuance (Appeals) Worksheet

Form used to collect and summarize health information about an airman who has applied for a Special Issuance for the first time. Form is used at a level lower than presently represented in DFDs.

Special Issuance (Recertification) Worksheet

Form used to collect and summarize health information about an airman who has applied for a recertification. Form is used at a level lower than presently represented in DFDs.

Special Issuance Letters

Samples of form letters sent to airmen from the Special Issuance (Appeals) Branch to notify them of their special issuance and conditions for maintaining it.

Special Medical Flight Test Report (FAA 8500-13)

Believed to be used by General Review and Special Issuance as the basis for granting a waiver. This form may be a Statement of Demonstrated Ability (SODA). It is probably used in the regions, but may also be issued from CAMI.

Aeromedical Education Program

3000-13

AAM-120 enrolls AAM personnel in technical training courses using this form.

3150.1

The FAA 3150.1 is the blue form issued to FAA flight crews and other pilots upon completion of physiological training. The AC 3150.1 is the white training record for non-FAA pilots. The AC 3150-4 is the record for FAA pilots and aircrew.

3150.7

The 3150.7 is the Physiological Training Information and Application Form. The staff sends blank 3150.7s to the pilot. The pilot must fill this out and if training is conducted outside of CAMI, a $20 fee is required. The pilot must select from a list of facilities on the back of the form and select the option of the chamber. The form is then submitted to Accounting and then forwarded to CAMI for scheduling.

3150.8

The 3150.8 is the Global Survival Training certificate card issued to FAA Aircrew after completion of that training.

AME Directory

The AME directory is a list of all AMEs including their location and mailing address.

Availability / Bid

Seminar facility's response to a request for accommodations, stating availability of meeting space, equipment, rooms and services with associated costs.

Chamber Consent Form

The chamber consent form is returned with the pilot to airmen education. The form indicates if the pilot may be exposed to the chamber or lists reasons for access denial.

Chamber Questionnaire

The pilot must complete a questionnaire before and after exposure to the decompression chamber. If the pilot answers yes to any question, he/she must go to the clinic for a check-up. Pilots may be denied access to the chamber based on the results of the initial check-up.

Consent Form Memo

This memo explains the consent to exposure to the chamber.

Course Evaluation

Students submit course evaluations to AAM-120 upon completing a course. These evaluations provide both course evaluation feedback and notify AAM-120 officially that the course has been completed and payment may be authorized.

Course Proposal

AAM-120 prepares proposals for new courses requested by AAM personnel. These are sent to AHT-200 for approval.

Pilot Training Record

The pilot training record showing physiological and global training.

Purchase Order

Purchase Request that has been validated by Procurement to authorize expenditure of funds for a specific item or service.

Purchase Request

Standard form (FORM DOT F 4200.1) submitted to Procurement requesting expenditure of funds for specific item(s) or service(s).

Reservations

Response to seminar facility's bid, accepting the facility has the site of a seminar and specifying accommodations required.

Seminar Facility Bill

Bill submitted to AAM-400 from a seminar facility for meeting space and AV equipment costs.

Seminar Invitation

Invitation sent to AMEs within a designated geographical area to inform them of an upcoming AME seminar and their obligation to attend a seminar in the near future. The invitation contains a postcard that may be completed and returned directly to AAM-400. Prospective AMEs are selected to attend the Basic Seminar.

Seminar Postcard

Notification from AME to regional office or AAM-400 that the AME will attend a specific seminar. AAM-400 sends the AME a postcard (AC FORM 3150-12) with information about the seminar and the AME completes a portion of it regarding plans to attend and returns it to AAM-400. Prospective AMEs are selected to attend the Basic Seminar.

Seminar Roster

A copy of the pre-seminar roster is "corrected" (edit out those who didn't attend) to show the AMEs that actually attended a seminar. A copy of this roster is sent to the each AME's regional AME coordinator. The roster lists all AMEs who attended, sorted by name; however, regional AME program coordinators must scan the list to find AMEs operating within their region. The report would be more efficient if it only listed names or serial numbers of AMEs by region.

Seminar Schedule

List of AME seminars scheduled on an annual basis. The regions need this information for applicants, as well as AMEs who are delinquent in attending a seminar at least once every three years.

Seminar Sign-In Sheet

Sheet on which AMEs sign as proof of attendance at a seminar.

Seminar Support Materials

Information products generated electronically through a PC-based list, such as name tags and a roster of all AMEs scheduled to attend. AAM-400 also provides a seminar agenda and a certificate of training.

SF-182

AAM-120 enrolls AAM personnel in technical training courses using this form.

Speaker

Name, address, phone number, medical specialty, etc., of consultant/physician who might speak at an AME seminar. A contract speaker may be an AME. This data resides in both hard-copy and electronic formats.

Speaker Bill

Bill from contract speaker for services rendered under informal contract.

Technical Training Call Form

All employees must request technical training using this form. Training requests are approved by an employee's supervisor and submitted to AAM-120.

Training Confirmation Form

The form that notifies the student of enrollment confirmation. This form or a vendor-supplied notification form or letter may be used.

Training Confirmation Letter

This letter is sent by CAMI to the pilot 30 days prior to training notifying that a spot has been reserved in a class.

Training Course Worksheet

Worksheet form used in conjunction with the Course Proposal Request Form by AAM Personnel to request the development of a new course.

Training Registration Form

AAM-120 enrolls AAM personnel in technical training courses using this form.

Travel Expense Sheets

Forms used to list and submit travel expenses for reimbursement.

Travel Orders

Documentation used to indicate estimated travel expenditures prior to the actual attendance to a course.

Travel Vouchers

Documentation used to report the actual travel expenditures and are necessary in order to obtain reimbursement.

True Need Training Document

AAM Employees may only take technical training specific to their job function. These training needs are requested by employees in training calls using a true need training document to determine which employees are eligible to take courses specific to their job function.

Waiting List Schedule

Listing of pilot's names who requested physiological training through the USAF/Navy/FAA agreement. A list of pilots is compiled by AAM-420 for each military facility that participates in this agreement. Once each of these lists contains 18 names, it is immediately sent to the corresponding military facility to schedule the training.

Miscellaneous

CTTMS Reports

The Centralized Training Travel Management System (CTTMS) Reports.

Seminar Confirmation to AME

Letter sent by regional office to AME reiterating and confirming AME's intention to attend a specific seminar.

Supply Requisition

Written or telephone request to Regional Division or AAM-400 for blank forms and/or eye charts.

Aviation Drug Abatement Program

Anti-Drug Plan

The aviation entity sends the anti-drug plan to the ADAP Program Implementation Branch at HQ. The plan outlines the entity's drug testing policy and testing procedures. The key points of this plan are entered into DPTS, and the plan itself is filed in a manual file.

Congressional Inquiries

The inquiries come from the Congress. The inquiries include questions about policy, compliance of Aviation Entities, and program results.

FAA ASF Hotline

The FAA Safety Hotline is intended for use by individuals in the aviation industry having knowledge of violations of FAA regulations. Caller identities are held in confidence and are protected from disclosure under the Freedom of Information Act. As a result of this type of information, an inspection, Letter of Investigation, or referral to another FAA office may occur. The FAA Safety Hotline is administered by ASA-103 (Office of Safety Analysis) in Washington Headquarters.

Final Schedule

The FINAL SCHEDULE contains information about the individual inspections ADAP will perform on the Aviation Entities. This schedule is produced by ADAP 1.3 and contains information taken from the MASTER SCHEDULE, other investigations, and the Drug Plan Tracking System (DPTS) database. The FINAL SCHEDULE is both stored in the SCHEDULE FILE data store and is sent to ADAP 1.4.

Inspection Checklist

The checklist is completed by the ADAP personnel from HQ or Regions at the entity site. The checklist is contained on a laptop computer which is downloaded into the CEDMS system. This checklist contains information on the name of the aviation entity, the date of the inspection, and if the drug testing regulations are being fulfilled.

Letter of Correction

Letters of Correction (LOCs) are produced by the inspection team leaders after all inspections where corrections are found to be necessary. LOCs produced by the regional staff are forwarded to HQ for review and occurrence after which they are returned to the regions for signature and transmittal. Once approved they are sent to the Aviation Entities. The LOCs contain a listing of the violations which were found upon inspection of the Aviation Entity.

Letter of Investigation

The Letters of Investigation (LOIs) are generated when it's believed a rule may have been violated. In some cases, the letters are generated from the DPTS data and are sent from HQ to the entity. The LOIs can include a request for the corrected information on testing in the semi-annual report or a request for the semi-annual report if one was not sent. The LOIs inform the Aviation Entity that the ADAP considers the Entity under investigation.

List of Entities

AAM-810 generates these lists, which contain information regarding each company with an FAA-approved plan. Information contained in this list includes entity location, plan number, numbers of covered employees, etc. The list includes the names of ALL entities that are required to have a drug plan and is used to identify companies having drug plans and to develop inspection priorities.

List of Laboratories

The Substance Abuse ∧ Mental Health Services Administration (SAMHSA) sends AAM-800 a list which contains the names of laboratories which are certified to perform drug testing.

Master Schedule

A schedule of upcoming inspections performed by ADAP on the Aviation Entities. This schedule is produced by AAM-820 (Headquarters) and is used by ADAP 1.3 in the creation of the FINAL SCHEDULE, which is the actual inspection schedule including times and dates. Master schedules have information regarding scheduled inspections by weeks for the entire year. Each regional manager submits candidates (entities) to AAM-820 for scheduling inspections. AAM-820 determines the master schedule based upon the following criteria: certificate type; type of operation; geographical dispersion; complaints about the employer; date of last inspection; and the number of covered employees.

Policy Interpretation

Requested materials are sent by HQ to the Entity. These are in response to a request from the Entity or whenever major changes in the rule necessitate new guidance for the industry. Requests can include a request for a list of laboratories accredited to perform drug testing tests, guidance in performing to policy regulations, requests for memos, and information for orders and directives. These requests are sent to the Aviation Entity either in response to their requests or just on-going interpretation based on changing policy. The main purpose of sending policy interpretations is to ensure consistent policy application.

Request for Further Action

A formal letter, following a standard format, is submitted to an entity to require more action to be taken by that entity in order to fully comply with FAA Drug Policy. Examples of requests are a requirement to document the steps that have already been taken or a request for more changes to be made. These requests are sent from ADAP 1.2 to the entity based on an analysis of responses to initial letters of compliance sent by ADAP.

Request for Further Information

If an Aviation Entity has responded to a Letter of Investigation or a Letter of Correction and the information supplied was incomplete, the ADAP sends a formal letter requesting more information about the item of non-compliance. The main purpose of the letter is to obtain more information about company policy and procedures, or actions. This letter is often combined with the REQUEST FOR FURTHER ACTION letter.

Semi-Annual Report

The entity submits the semi-annual report to AAM-800. The report contains information on the number of employees tested and, if there were positive test results, for which substances.

Miscellaneous

Summary Report

Also known as an Annual Tally Report, this form is an annual report indicating drug testing and positives for all regions.

Aviation Medical Examiner Program

8500-8

Form used to record the results of a physical examination for pilots and some covered positions.

8520-2D

Form used by physician applicants to request AME designation.

AME Designation Request

Letter or phone call to Regional Flight Surgeon requesting AME status.

AME Questionnaire

Requests information used to determine an applicant's qualifications and suitability to be designated as an AME. The applicant probably returns a letter or memo responding to the list of questions.

AME Statistics

Automated reports formatted in various ways concerning AME performance, such as error rates, and demographic reports showing the ratio of AMEs to pilots geographically. In order to conserve space on the Excelerator DFDs, statistical report data elements were consolidated as a single data flow. Consequently, the AME STATISTICS record contains AME performance and demographic information.

AME Warning

If the AME has made a substantial error and wrongfully certified an airman, the Airman Certification reviewer at AAM-300 may send a letter to notify the AME of the mistake and provide guidance on proper handling. One of two letters may be sent, based on the situation: one for incorrect issuance of a Student Pilot Certificate, because the applicant is under 16 years old, and one correcting the AME for a grievous error in case handling because the applicant does not meet FAA standards.

Basic AME Data

Basic information about AMEs: name, office address, phone number, AME ID number, class authorized, last seminar attended, medical specialty, etc., used in the management of regional AMEs and in the generation of a regional directory.

Delinquent AMEs

AME program assistants and Regional Flight Surgeons must ensure that AMEs within their region meet the defined requirements. This includes attending an AME seminar at least once every three years and having a staff member attend a workshop every three years. Because of this requirement, they must know which AMEs are in violation of training requirements and therefore a potential target for termination of designation.

Designation Card

Form 8520-4 lists the designation number and signature of the physician and authorizes physician to perform examinations for airmen. The form separates into two items: an ID card for the AME and a card which is returned to AAM-400 stating whether or not the AME accepts or declines AME status.

Field Change List

The field change list is derived from changes in basic AME data gathered using field change forms or communication through correspondence and telephone calls. The list represents a compilation of changes in basic AME data used to update the regional AME database (if one exists) and the CAIS AME subsystem.

Professional Standing

Reference or endorsement of physician from the state Medical Board that licenses physicians to practice and logs instances of misconduct or improprieties committed by a physician.

Request for Field Change

Request submitted by AMEs and/or AME program assistants to change a field or fields (personal data) in the AME Records System (e.g. name, address, telephone number, etc.).

Seminar Postcard

Notification from AME to regional office or AAM-400 that the AME will attend a specific seminar. AAM-400 sends the AME a postcard (AC FORM 3150-12) with information about the seminar and the AME completes a portion of it regarding plans to attend and returns it to AAM-400. Prospective AME's are selected to attend the Basic Seminar.

Seminar Roster

A copy of the pre-seminar roster is "corrected" (edit out those who didn't attend) to show the AMEs that actually attended a seminar. A copy of this roster is sent to the each AME's regional AME coordinator. The roster lists all AMEs who attended, sorted by name; however, regional AME program coordinators must scan the list to find AMEs operating within their region. The report would be more efficient if it only listed names or serial numbers of AMEs by region.

Seminar Schedule

List of AME seminars scheduled on an annual basis. The regions need this information for applicants, as well as AMEs who are delinquent in attending a seminar at least once every three years.

Term. of Designation Letter

Letter sent to AME denying or removing AME status and requesting surrender of AME authorization and supplies.

Miscellaneous

Aircraft Accident Investigation Questionnaire

Form used by ASW-300 to enquire whether AMEs are willing to participate in aircraft accident investigations.

AME Ancillary File (AAM-410)

The ancillary AME file used to store a subset of forms and records regarding an AME at AAM-410.

AME Applicant - File Summary

Form used at a regional office to collect and summarize information relevant to the appointment of a physician to AME status, as well as track events/date (case status tracking). (Similar to AME Designation Worksheet.)

AME Designation Letter

Letter accompanying Designation Card which informs a new AME of FAA policy and the AME's responsibilities and limitations.

AME Program Weekly Activity Report

Quantitative information regarding weekly AME program activity sent from ASW-300 to the Federal Air Surgeon.

AME Complaint

Information about AME actions or status, including misconduct, impropriety, incompetence, negligence or simply discrepancies between current AME listings (AME data) and AME's address.

AME Database Screens (AWP-300)

AME database screens of Data General(?) system supporting AWP- 300. (Comparable to "AME DB.")

AME Database Screens (AEA-300)

AME database screens of system supporting the AME program at AEA- 300. (Comparable to "AME DB.")

AME Database Screens and File Structure

PC-based AME database residing at AWP-300. Includes dBase file structure. (Comparable to "AME DB.")

AME De-Designation Postponed/Terminated Letter (Error Rate)

Letter informing an AME that potential de-designation efforts against the AME have been dropped until further notice.

AME De-Designation Letter (Failure to Attend Seminar)

Letter from the regional office informing an AME that the AME has been de-designated (stripped of AME status) for failure to attend an AME seminar at least once every five years.

AME De-Designation Postponed/Terminated Letter (Seminar Attendance)

Letter informing an AME that potential de-designation efforts against the AME have been dropped until further notice.

AME De-Designation Postponed/Terminated Letter (Insufficient Exams)

Letter informing an AME that potential de-designation efforts against the AME have been dropped until further notice.

AME File (Regional)

The regional AME file used to store forms and records regarding an AME's designation, status and performance.

AME Regional Transfer Re-Designation Letter

Letter authorizing an AME who has relocated from another region to continue operating as an AME within the new region. Letter includes policy regarding AME charges, FAA policy and other stipulations.

AME Seminar Warning Letter

Letter warning an AME that the AME must attend a seminar in the near future in order to retain AME status or risk de-designation.

AME Status Change memo

Memo from Regional Office to FSDO regarding an AME's change in status. This document is similar to a "Field Change List" in that it contains information about an AME's change in status.

AME System Screens

CAIS AME subsystem screens supporting management and distribution of forms from CAMI to AMEs.

Applicant Letter

Letter accompanying AME application designation package from regional office to a private-sector physician applying for AME status.

Aviation Medical Examiner Forms Request

Form used to direct supply depot to distribute a specified quantity of forms to an AME. Form is completed in triplicate and one copy is returned to AAM-410 indicating the actual number/amount of forms shipped.

Checklist for AME Workshops

A list of tasks to be completed prior to an AME seminar. Used at ASW-300.

Daily Work Sheet

Form used by ASW-300 to record quantitative information regarding daily AME program activity.

Designation Acceptance Letter

Letter sent to new AMEs and returned to the Eastern Region office as legal acceptance of AME status. Not known why this letter is used, since this function is usually accomplished with the Designation Card.

Informal Contract

Informal contract between AAM-400 and a consultant, in which the consultant agrees to speak at a specific seminar for a specific fee.

No-Need Letter

Informs physician/applicant that there is currently an adequate number of AMEs in the area and rejects request for AME status.

Request For Speaker

Initial request to a medical expert/consultant to speak at an AME seminar to determine availability and topic.

Senior AME Designation Letter

Letter authorizing an AME to perform Class I physicals.

Senior AME Equipment Requirement Letter

Letter informing an AME applying for senior AME status of EKG network equipment requirements, which are requisite to senior AME designation.

Covered Positions Program

3900-7

This form is an ATC form that is completed by the AME and brought by the employee to his or her facility manager who provides a copy to the Center Flight Surgeon. The form states whether the employee is cleared for work as a controller, the decision on returning to work is deferred to RFS, or if further evaluation is needed.

8500-8

Form used to record the results of a physical examination for pilots and some covered positions.

Airman Med File

The medical file, if one exists, maintained by AAM-300 on an applicant for an FAA covered position who is also a pilot with medical problems. If the applicant has medical records at AAM- 300, they will be requested by the region and added to the regional employee medical file.

Allergy Form

This is a special consideration form which allows employees to take allergy medication while on the job.

Allergy Questionnaire

A questionnaire completed by either the employee or his physician. It asks questions about allergy attacks, frequency, etc.

Applicant Information

Background information about an individual applying for a covered position.

Applicant Medical Update

Medical updates personnel on the certification status of applicants. Delays can be caused by requests for military records, further medical tests, etc. If certification is pending, reasons are entered. When the individual is certified, PETS is updated, allowing personnel to proceed with hiring. Medical limitations are included.

Bill for Exam

Bill submitted to Regional Office or Clinic for services rendered such as physical examinations or medical tests. The 3930-7 form, authorizing an employee's physical exam, has a second part for billing information. The AME or AME's staff should complete this part to request payment. However, AMEs often submit their unique office invoices with the 3930-7 to provide data about services rendered and associated charges. The record representing this data flow was taken primarily from the 3930-7 billing portion.

Employee Clearance Form

The Employee Clearance Form A.K.A. Health Information System (HIS) form is used to communicate information about the employee's physical condition and decisions made by the Regional Flight Surgeon about the employee's health, abilities and reliability in performing safety-related tasks. This form was originally designed as a template to extract information from the process and enter it into the HIS system.

Flight Surgeon's Activity Report

The Flight Surgeon's Activity Report contains Regional activity statistics that measure the type and quantity of work performed in the Region. Individuals in each program area (e.g. airman certification, ATC certification) supply requested activity statistics. The clinic at CAMI also submits this report because they perform many activities typically performed by a Region. ****NOTE THAT THIS DATAFLOW EXPLODES IN TO TWO RECORDS. THE SECOND RECORD IS CALLED RFS ACTIVITY REPORT PART 2 AND CAN ONLY BE ACCESSED THROUGH THE DATA DICTIONARY FUNCTION.****

Opinion of OWCP Claim

AAM's medical opinion of an employee's OWCP injury claim.

OWCP Claim

Office of Worker's Compensation Programs OWCP claim form documenting an on the job injury.

Physical Authorization

Physical examination authorization form A.K.A. 3930-3, 3960 in clinics, or SF-44, provides external physician with approval to perform specific examinations or medical tests. The form also allows physicians to list services and costs as a means to bill the FAA. Once the form is received with its associated test results, the covered positions coordinator certifies the billing by comparing tests results with the billing information and authorizing accounting to compensate the physician.

Report of Investigation

Information concerning a covered employee's driving records and other records of conviction, similar in nature to the NDR REPORT provided by AMC-700 to the DUI/DWI Unit.

Request for Exam

A request for a physical exam of a covered employee by personnel.

ROI Action Report

Request to Regional Security Office for a background check on a covered employee reviewing records of conviction.

Schedule of Exams

The schedule of exams to be performed on covered employees.

STMT of Demonstrated Ability

The Statement of Demonstrated Ability (SODA) is a performance evaluation or test administered by an employee's manager. The form is sent to the employee's manager to have the individual observed/tested to insure he can perform his job with a medical condition that doesn't meet standards. (Color vision, high frequency hearing loss, etc.)

Miscellaneous

Air Traffic Controller Health Program Report (Special Consideration/Disqualification)

Form used to report status of covered-position employees who have requested special consideration because of a medical problem. Sample report was generated at the Salt Lake center. Not known who completes the form, how it is routed or how often.

ATCS Health Program Medical Questionnaire (AEA 9430-1)

Form used to collect information about a specific medical condition or problem affecting a covered-position employee. Form is provided to the employee who must submit it to the attending physician. How the form is returned to the regional office or center clinic is not known.

Clearance Processing Sheet

Form used at AEA-300 to collect information and perform case status tracking in support of covered-position employee medical review.

Diabetes Mellitus Status Report

Form used to collect information regarding an ATCs diabetic condition at AEA-300. Not known how the form is issued, who completes it, or how it is collected.

HIS System Screens

Computer display screens of the ASAS Health Information System (HIS).

Ophthalmological Evaluation for Glaucoma (FAA 8500-14)

Form collects information about a covered-position employee's glaucoma. The form is provided to the employee who must submit it to the attending physician. How the form is returned to the regional office or center clinic is not known.

Qualification Decision

Memo submitted by the Regional Flight Surgeon indicating the medical clearance disposition of an ATCS.

Report of Eye Evaluation (FAA 8500-7)

Form collects information about a covered-position employee's vision. Not known how the form is issued, who completes it, or how it is collected.

Special Medical Consultation (EA 9430-2)

Form used by AEA-300 to request specific medical tests from employees working in covered positions. Not known how the form is issued, who completes it, or how it is collected.

Employee Substance Abuse

Chain of Custody Form

The Drug Testing Custody and Control Form (DOT 3900-9) is completed on each individual who provides a urine sample. The purpose of this form is to provide safety and security of the specimen. It along with the urine sample is packaged and forwarded to the testing laboratory.

EAP Recommended Rehab

The EAP manager, upon notification and evaluation of disciplinary action, issues a memo or letter recommending the proper rehabilitation guidelines.

Follow-up Worksheet

A form used by the MRO, EAP, and the DPS for submission to the Departmental Drug Office. It specifies a time chart for employees' testing schedules. The form is found in the Drug Testing Guide (appendix #2 to DOT Order 3910.1b).

Letter of Medical Decertif.

If the employee holds a medical clearance, the RFS will send a letter to the employee, medically decertifying him/her, through the facility manager/appropriate officials with copies to LR, EAP, and security.

Letter of Re-Qualification

If deemed necessary, the Regional Flight Surgeon can re-qualify the employee by sending a letter of re-qualification to both the employee and the employee's manager. After the flight surgeon has reviewed the case and conducted any medical tests/evaluations, the flight surgeon will make a determination about reinstating the medical clearance and/or return-to-duty status.

Specification of Rehab Program

The employee who tests positive for drugs is informed of the steps of the rehabilitation. The employee must agree to the process and agree to the testing that will occur during the rehabilitation.

Substance Abuse Evaluation

The EAP manager provides an agency certified evaluator with background information that is required for a comprehensive evaluation. After making the evaluation, information on the level of addiction from which the employee suffers is sent to the Regional Flight Surgeon/Medical Review officer and the EAP Manager, who uses this evaluation to determine if the rehabilitation is appropriate for the employee.

Successful Completion of Rehab

After the manager and flight surgeon have determined that the employee has successfully completed rehabilitation, the manager/flight surgeon contacts the employee, congratulates him/her on his/her efforts, strongly encourages the employee to actively participate in the continued care program and to feel free to contact the manager /flight surgeon in the future. The Regional Flight Surgeon sends a congratulatory letter to the employee and destroys all rehabilitation records in accordance with the current FAA Medical Files Order 3910.8.

Miscellaneous

End of One Year Follow-on to Rehabilitation

This letter contains information for the employee to notify him/her that since one year of successful drug rehabilitation has taken place, he/she will not have to submit to regular drug urine testing.

Letter Stating Positive

The Letter Stating Positive is sent to the employee who has tested positively for an illegal drug or alcohol. This Letter asks the employee to explain the test results and to supply the MRO/RFS with any information which will prove the substance was taken for a legal medical reason.

Non-compliance With Rehabilitation Program

The letter is sent to the employee's manager informing him/her that the employee has not been following the prescribed rehabilitation plan. This is followed by the removal of the medical certification permanently for the employee.

Return to Duty Substance Abuse Follow-up Plan, Delinquency

The letter informs the employee that he/she has not been participating the in follow up to the rehabilitation program. The employee must sign the bottom of the letter stating that he/she understands that he/she must attend these follow-ons.

Occupational Health

8500-8

The 8500-8 is the physical history and examination form used for Aeromedical Certification examinations and for ATC exams. The clinic files a copy of this exam form in the medical record. For pilots with routine exams, the information is transmitted on AMCS to AAM-300. For pilots with supporting documentation, the actual 8500-8 is mailed to AAM-300 along with the other supporting documentation. When the clinic does an exam on an ATC returning to the field, the 8500-8 form is mailed to the appropriate Regional Medical Office.

Auth for Exam/Treatment

The Authorization for Examination and/or Treatment form (CA-16) authorizes an employee to receive an examination and/or treatment at the FAA's expense from a non-FAA medical facility. The facility authorized to provide the service is identified along with a description of the injury or disease. The CA-16 is the official guarantee of payment sent to private physicians when they see employees with on-the-job injuries. This form may be completed by the FAA Health Clinic, Occupational Safety, or even the employee's supervisor. In addition to the copy for the private physician, a copy goes to OWCP, and if sent from the FAA Clinic, a copy stays in the medical record.

Chamber Consent Form

The chamber consent form is returned with the pilot to airmen education. The form indicates if the pilot may be exposed to the chamber or lists reasons for access denial.

Daily Clinic Patient Record

Manual log tallying the number of different categories of visitors (such as student or FAA personnel), date, time, and reason for visit. The reasons are assigned a number in order to track activities for the RFS Activity Report.

Education and Screening Results

Screening results identify the employee who was tested and the test results (e.g. blood pressure measurements). The HAP coordinator explains the meaning of the result and recommends the appropriate follow-up action. The education function provides an explanation of the available literature regarding health awareness subjects.

Hearing Conservation PGM Form

The Hearing Conservation Program form records the job, military, and recreational history of employees who are perceived to be at risk for hearing problems. Examples of information that is recorded are previous exposures to gunfire or engine noise. The form helps to determine if hearing problems found in the physical are based on past noise exposures. Baseline hearing data is then recorded on the pre-employment physical form and maintained in the employee's file.

List of Physical Exams Required

Employees identified from the OH1 Facility Surveys to get physicals and added to the list of normally scheduled physical exams. These employees are selected based on hazardous working conditions. The list is sent from OH1 Provide Consultations to Oh4.1 Provide Physicals.

Manager Authorization

Manager authorizes performing annual physical examination.

Medical Record Transmittal

The request for records is a transmittal form (8500-16) that is sent from the FAA employee's health office to any other DOT, DOD, or other federal installation. It identifies the employee whose records must be transferred and the region/organization into which he/she is transferring. Generally, the complete file is transmitted, but in some instances, only a copy of the 8500-8 is sent for review before a controller is returned to the field; or the SF-600, Chronological Record of Medical Care, for students who have been seen at CAMI clinic while at the Aeronautical Center. This form may be used when retiring medical files, but is not mandatory.

National HAP Report

The National Health Awareness Program (HAP) Report is a compilation of the quarterly HAP reports submitted by the regions. The report summarizes the programs put on by the regions, number of participants, and the screening results.

Physical Form

At CAMI, the pre-employment physical form (78-110) is brought by the individual requiring a physical, and contains a signature authorizing the clinic to provide a physical at the FAA's expense. The form identifies the employee and contains fields for physical examination results including height, weight, and blood pressure. The form also provides spaces to describe job expectations and employee limitations. This document is the US Civil Service Commission Certificate of Medical Examination with some add-ons, including information on the employee's job requirements and conditions.

Quarterly HAP Reports

Quarterly HAP reports document the Health Awareness Program (HAP) topic(s) presented for the quarter, the number of attendees and the program findings.

Radiologic Consultation REQ / RPT

The Radiologic Consultation Request/Report authorizes an employee to have an x-ray at the FAA's expense. The form identifies the employee who is receiving the x-ray, the reason the x-ray is being done, and pertinent employee information such as age and sex.

Release of Information

The Release of Information form is used by a patient to give his or her permission for release of a copy of some of the medical records (Privacy Act Information) to a specified organization or individual. Transfer of personal medical information in almost any direction requires the patient to sign a Release of Information form to authorize it. The form is always kept in the medical record at the facility releasing the information, as they are not infrequently needed in medicolegal matters to document proper release of sensitive information.

SF52

The Request for Personnel Action (SF52) is the form used to request a personnel action such as a position change or a transfer. The form defines the action, identifies the employee, describes the employee's position, and contains the required reviews and approvals. The form is sent by the requestor to the Office of Personnel Management (OPM). OPM sends the form to the regions to notify them of an impending transfer.

SF600

The Chronological Record of Medical Care (SF600) maintains a list of employee clinic visits. Information on the form includes name, date of visit, and treatment received. This form includes answers to the OSHA questions related to asbestos, hearing, physical, biological, chemical, and radiation factors.

Miscellaneous

Air Traffic Status Report Form

This letter from the Flight Surgeon discusses the ATCS medical status of the indicated ATCS personnel.

Attending Physician's Report

This form is completed for injured employees who are filing for worker's compensation. The form is then forwarded to the Office of Worker's Compensation Program.

Clinical Subsystem

This system contains information on all contractor / employee visits to the AAM headquarters clinic. It also includes information on blood mobile drives, screening programs, and other services. It also has the potential to be used for inventory management and vendor identification.

HIS Data Collection Form

This is the form used to capture new information to be entered into the Air Traffic Control Health Information System.

Hypertension Status Report

This Air Traffic Control Specialist Health Program form discusses the specific hypertension details pertaining to ATCS personnel.

Medical Exam Authorization

The request for medical services is a form that a sick or injured employee must bring with them to the clinic in order to receive medical treatment.

Patient file - Aftercare Instructions

These are the various Aftercare Instruction forms which may be found in the patient's medical file.

Patient file - Medical Forms

These are the various additional medical forms which may be found in the patient's medical file.

Patient file - OWCP Forms

These are the various additional OWCP forms which may be found in the patient's medical file.

Patient file - Specifications

These are the various evaluation specification forms which may be found in the patient's medical file.

Unsatisfactory Condition Report

The Unsatisfactory Condition Report (FAA Form 1800-1) is widely used by the unions in filing complaints. This form is handled either by FAA Headquarters or at the regional level.

Voluntary Blood Screening Program

This HAP form is completed during voluntary blood screenings.

Research

MNS/RPI

Mission Needs Statements/Research Project Initiatives formally initiate a project. The RE∧D process, as approved by ARD, requires that all research projects have a Mission Needs Statement that provides clear justification for the research. It is expected that each MNS will have one or more Research Project Initiatives that provide documentation of the planned research and associated resource requirements. MNSs and RPIs are prepared by the FAA research sponsors. Performing organizations assist the research sponsors in preparing the RPIs. Sponsors approve the MNSs while sponsors and performing organizations are required to jointly approve the RPIs. Approved MNSs and RPIs are submitted to APM-300 for review and entry into the RE∧D document data base. APM-300 is responsible for archiving all of the RE∧D MNSs and RPIs. While RPIs are scheduled to be updated every 6 months, MNSs will be reviewed and updated at 3 year intervals.

Progress Report

Project progress reports are completed on a quarterly basis and are distributed to AAM-3, Division Managers, and sponsoring organizations. Progress reports list the need or the reason for the project, the current status, and the progress relative to the milestones. The Research committee and AAM-3 provide the review and approval.

Task Forms

Task forms provide the information needed by CAMI's Administrative area to compile the research budget. The spreadsheet or MNS/RPI contains information concerning details of project requirements including equipment, travel, supplies, and position for each approved project.

Task Specific RPIs

Task specific RPIs, a.k.a. Aeromedical Research Resume (ARR), summarize the operational problems, objectives, background, and resources associated with a research project. Information currently required on the form is generally consistent with that required on the formal RPI. Included is: project number, title, project duration, an hypothesis, set of questions, and milestones. There is an Order for Research that provides the format and contents of the RPI and directs the research process. Following review by the AAM research committee, research resumes are reviewed, approved, and signed by the CAMI Director (AAM-3). The project can then be started. The Federal Air Surgeon provides an introduction to the AAM RE∧D program book (all approved task specific RPIs) indicating overall approval for the program.

Resource Management

Analysis of Estimate/Issue Paper/FAA BGT

A summary of AAM budget requirements is sent to AVS accompanied by written justifications and supporting statistics for all new programs.

Analy of PGM by Subobject Class

The Regions submit local analyses of budget needs to ABU. ABU summarizes the Regional and CAMI budget numbers and supplies a paper copy of the summaries to AAM-120 via AVS. AAM-120 uses these numbers to determine the surplus or deficit and then adjust and generate an AAM budget.

Change of Station Report

A DAFIS monthly report which shows the expenditures associated with an individual PCS move. Report lists PCS move expenditures by person and object class.

Contract Status Report

A DAFIS monthly report which shows the status of all contracts (including previous years) which have not been closed out. Report lists contracts by program element and shows expenditures vs. obligations.

Cost Center Detailed TXN Listing

Monthly report showing all invoices that Accounting paid, obligated, or committed during the month. The report is used to prepare the Quarterly Review and reconcile CUFF reports.

Cost Center Funds Status Report

The Regional accounting offices send monthly accounting reports listing actual and budgeted expenditures for each object class or budget category. An example of an object class is overtime pay. The reports are generated by AAA from DAFIS, and are used to complete the Quarterly Review requested by the Office of Budget (ABU) and AAM-120. The reports are reviewed by AAM HQ and ABU and used as input in revising the financial plan.

Evaluation Follow-up Report

Evaluation status reports contain the follow-up actions that the Regions are taking to address the recommendations made by the evaluation team. The reports are sent to AAM-110 on a quarterly basis.

FAA Auth ∧ Invoice for MED SVC

The Regional Divisions track the invoices that they have received from AMEs in order to estimate the obligated dollars for the quarter. This information supplements the invoices-paid detail from the Cost Center Detailed Transaction Listing.

FAA Budgetary Authorization

The FAA Budgetary Authorization contains the approved budget numbers for the fiscal year. This includes personnel and budgetary authorizations.

Flt Surgeon's Monthly Activity RPT

The Flight Surgeon's Activity Report contains Regional activity statistics that measure the type and quantity of work performed in the Region. Individuals in each program area (e.g. airman certification, ATC certification) supply requested activity statistics. The clinic at CAMI also submits this report because they perform many activities typically performed by a Region. ****NOTE THAT THIS DATAFLOW EXPLODES INTO TWO RECORDS. THE SECOND RECORD IS CALLED FS ACTIVITY REPORT PART 2 AND CAN ONLY BE ACCESSED THROUGH THE DATA DICTIONARY FUNCTION.***

Fund Increases Summary

Each Regional Division and CAMI prepare an operational budget that is sent to the local division of the Office of Budget (ABU). The individual AAM budget numbers are summarized by ABU and sent to AAM-120 via AVS. Budget information is for object codes such as overtime or job-related travel.

FY Allowances

FY allowances are the dollar amounts that have been approved for each program/cost center.

FY Financial and Employment Plan

Each region, center, and AAM HQ completes a financial plan which allocates budgeted operational dollars across fiscal quarters. The plan lists planned expenditures by object class and the current format shows both quarterly and cumulative quarterly figures. The employment plan summarizes month end actual on- board figures thru the date of submission and requires on-board estimates for the remaining months. The report is used to track end-of-year (EOY) ceiling and calculate full time equivalents (FTE). Both reports are updated and submitted on a quarterly basis after completion of the quarterly review. The plan lists the object class (such as base pay) and then both the estimated dollars for the individual quarter and cumulative estimated dollars.

Medical PGM Evaluation

This report lists the recommendations and supporting discussion that resulted from the Regional program evaluation.

Monthly Activity Report

Certification division workload data such as the number of applications received for the current month, special issuance processing backlog, and correspondence received are listed in this report.

Open Document Listing

A DAFIS monthly report which shows the status of all obligating documents which have not been liquidated. Similar to the Contract Status Report but also includes travel orders.

OPM Form 1170

The Supplemental Qualification Statement Medical and Dental Officer, GS-11/15 (OPM form 1170) is submitted with the SF171 by the applicant.

Performance Appraisal Form

Sent from Human Resources (AHR) for personnel management and returned to AHR.

Program/Site Evaluation Report

Evaluation reports summarize the AAM program evaluation findings along with the recommended actions.

Quarterly Review

The Quarterly Review justifies changes to fiscal year budgeted dollars, mainly increases or transfers of dollars. Each major change, which is noted on the spreadsheet as + or - over the plan, is addressed individually in paragraph form. The primary form in the Quarterly Review is the Quarterly Status Report. It compares actual to planned expenditures, shows internal adjustments, lists requirements for the remainder of the year, and shows shortfalls/overages.

Quarterly Summary

The Office of Budget (ABU) summarizes the Quarterly Status Reports and sends the individual numbers and the summary to AVS. AVS sends the reports to AAM-120.

Regional Budget INC Paper

Narrative description of resources that the Region or Center is requesting along with the supporting justification statement.

SF171

The Application for Federal Employment (SF171) is submitted by the applicant to furnish education and work experience when applying for a position.

SF50

This is the Notification of Personnel Action form.

SF52

The Request for Personnel Action form (SF52) is used by personnel management to note requests for change in employee status, such as promotion or reassignment benefits.

SF85

The Data for Nonsensitive or Noncritical-sensitive Position form (SF85) is sent to Personnel Security to provide background information for applicants.

SF86

The Questionnaire for Sensitive Positions (For National Security) form (SF86) is used for background investigations of applicants applying for sensitive positions.

Significant Activities Report

AAM branches/divisions located at Headquarters or CAMI report the noteworthy or unusual activities that have occurred during the week to AAM-100 for compilation into an AAM-wide report. The FAS signs the report, which is forwarded to AVS. AVS receives weekly significant activities reports from each of its subordinate offices: the Office of Accident Investigation; Office of Aviation System Standards; and the Office of Aviation Medicine. The reports are intended to keep the Associate Administrator (AVS-1) abreast of important activities under his cognizance.

Vacancies

Vacancy data specifies the positions that are currently open and where these positions exist.

Workload Information

Workload information that indicates the level of Regional and Center program activity. An example of regional workload data is the number of problem airman certification cases that were received, pending, and closed in a fiscal year. An example of CAMI workload data is the total number of certification applications processed in a fiscal year. ****NOTE THAT THIS DATA FLOW EXPLODES INTO THREE RECORDS. THE SECOND AND THIRD RECORDS ARE CALLED WORKLOAD FORM PARTS 2 AND 3, AND CAN ONLY BE ACCESSED THROUGH THE DATA DICTIONARY.****

Miscellaneous

AAM Budget Status Report

The AAM Budget Status report is produced by the Regional Divisions and CAMI to report the actual dollars spent for the quarter by object class. The report is prefaced by a summary highlight statement that explains differences between actual and estimates, internal adjustments, and surplus dollars or unfunded needs. The report format is prescribed by the Office of Budget.

Biweekly Employee Data

A DAFIS monthly report which shows various employee-related data.

Checklist

Checklist of steps that need to be taken in preparation for a Regional program evaluation. Examples of steps are "choose tentative dates" and "contact manager".

Travel Advances Outstanding

A DAFIS monthly report which shows the employee's name, date of travel, and the amount outstanding.

INTERVIEW NOTES

OFFICE OF AVIATION MEDICINE DATA ARCHITECTURE PROJECT INTERVIEW NOTES Report Number: VS-ASAS-G-3793 Original Version - July 1991 Revisited - March 1992 Prepared by: U.S. Department of Transportation Research and Special Programs Administration John A. Volpe National Transportation Systems Center Cambridge, Massachusetts 02142 Prepared for: U.S. Department of Transportation Federal Aviation Administration Office of Aviation Medicine Washington, D.C. 20591 Table of Contents Section Title Page Document Control Page 1.0 INTRODUCTION . . . . . . . . . . . . . . . . . . . . .i 2.0 REFERENCING THE NOTES. . . . . . . . . . . . . . . .iii HQ HEADQUARTERS . . . . . . . . . . . . . . . . . . . HQ-1 Plans, Evaluation ∧ Management . . . . . . . . . . HQ-1 Support Division, AAM-100 Medical Specialties Division, AAM-200. . . . . . .HQ-20 CAMI CIVIL AEROMEDICAL INSTITUTE . . . . . . . . . . . . . CAMI-1 Office of the Director of CAMI, AAM-3. . . . . . CAMI-1 Aeromedical Certification. . . . . . . . . . . .CAMI-10 Division, AAM-300 Airmen Education Division, AAM-400 . . . . . . .CAMI-37 Human Resources Research . . . . . . . . . . . .CAMI-58 Division, AAM-500 Aeromedical Research Division, AAM-600 . . . . .CAMI-71 Occupational Health Division, AAM-700. . . . . .CAMI-81 REGIONS REGIONS. . . . . . . . . . . . . . . . . . . .REGIONS-1 Eastern (New York, NY) . . . . . . . . . . . .REGIONS-1 Great Lakes (Chicago, IL). . . . . . . . . . REGIONS-18 Northwest Mountain (Seattle, WA) . . . . . . REGIONS-23 Southern (Jacksonville, FL). . . . . . . . . REGIONS-37 Southwest (Ft. Worth, TX). . . . . . . . . . REGIONS-41 INDEX. . . . . . . . . . . . . . . . . . . . . . . . . . .Index-1 DOCUMENT CONTROL PAGE All pages are currently Revision 1.

1.0 INTRODUCTION

In its recently completed information systems strategy, the Office of Aviation Medicine (AAM) outlined seven long-term goals which express their Office Vision. One of the vision statements focused on program integration and the need to provide employees with the information they need to make decisions, solve problems and operate the business of aviation medicine. To support this vision AAM identified the need to complete the office-wide AAM Data Architecture Project to describe and logically model AAM data or information. The project directly addresses this need by providing AAM with improved knowledge of, control over, and access to AAM data. The AAM Data Architecture project entails the review of data that is received, processed, and distributed in Regional, Headquarters, and CAMI Divisions. The data flow, or the movement of the data from one process to another, is being developed to gain an overall understanding of how data is used by the organization. Information is then analyzed to determine the logical relationships between data elements, characteristics, and volumes. An entity-relationship modelling approach is being followed to logically organize the data and look at the natural relationships between elements. Entity-relationship models identify major objects of interest or entities, the connections or relationships between entities, and the attributes or descriptions that provide additional information about the entities. The entity-relationship model will be the basis for future physical data bases that support integrated AAM applications. AAM is a dynamic organization that continues to grow and change to provide services and support in the best possible manner. The resulting data design will be flexible enough to support the Office's changing needs. In coordination with the AAM Data Architecture Project Advocate, the AAM Automation Representative, Office of Program and Resource Management, and others at the Civil Aeromedical Institute (CAMI), AAM Regional Offices and John A. Volpe National Transportation Systems Center a cross section of AAM personnel were selected to be interviewed. The list consisted of people from each of the several program areas which AAM has a medical and/or regulatory responsibility. An extensive set of interviews with AAM personnel were used to collect the essential knowledge about information. Approximately one-quarter of the AAM staff was interviewed during the course of the interview process. The project team recognized and is sensitive to the fact that AAM personnel had been interviewed for other studies. The results of these earlier interviews and studies were used as much as possible to learn about the AAM organization and to avoid repeating the same questions. The interviews were designed to focus on data that is the input or the result of performing a function, not the function itself. The detailed analyses of the functions themselves have been left to the project teams which will perform the functional, and other requirements studies of the specific systems identified within the AAM I/S Strategic Plan. This document contains the "raw" notes from the AAM Data Architecture project interview process. No analysis is included herein. As such, please note that the comments listed herein are intended to be those of the identified individual as perceived by the Data Architecture project team members. The practical use of these notes by individuals outside of the AAM Data Architecture project team will vary. In most cases you should use them to find a general overview of the individuals responsibilities as dictated by their job position or to compare the various resources used by several individuals performing the same job. You may also find benefit in locating people who may have specific knowledge in a subject area.

2.0 REFERENCING THE NOTES

The notes are divided into three segments (Headquarters, CAMI, and Regions) and organized by division and then alphabetically by the interviewee's last name. To find a specific interview or set of interviews, refer to the index. The index contains a cross- referenced listing of all individuals, position titles, and divisions (by name and routing code). In order to cross reference the notes, some position titles have been standardized. Standardization is most obvious in the interview notes of regional personnel. To follow the position titles reference the following. Regional Administrative Officer. .Medical Administrative Officer, Program Analysis Officer Covered Position Certification SpecialistATCS Certification, Fads, ASIs Airman Certification Specialist. . . . . . . Airman Certification ADAP Manager . . . . . . .Aviation Drug Abatement Program Manager AME Program SpecialistAviation Medical Examiner Program Specialist Most of these should appear straight forward. These titles do not come from any job description standardization efforts which may currently be underway within AAM. They have been created for the sole purpose of making the following information more useful to the reader. Most other positions have common names or are unique and thus could not be or required no standardization. THIS PAGE LEFT BLANK

HEADQUARTERS

Location: Headquarters Interviewee: Curt Maloy, Program Analysis Officer Plans, Evaluation ∧ Management Support Division, AAM-100 Date: 5/24/91 Interviewer: Carol Wasserman Curt is in the process of addressing the orders, Medical Guideline Letters (MGL), and advisories to determine the information that is really available, where it is located, who has the orders and directives, and their status. Each RFS took a group of the MGL and evaluated them. It would be nice to have the text for AAM directives on-line along with the ability to update and track this data. AAM-100 is also responsible for distributing orders when they come out. Curt uses a Personal Management System (similar to WordPerfect Office). He also has AAM personnel information in a WordPerfect table. He keeps information such as phone listings, employee grade, title, and organizational zip code. He thinks Mary Reid may have similar information on-line. Curt is looking forward to the development of the budgeting system. Location: Headquarters Interviewee: Dennis McEachen, Program Specialist Plans, Evaluation ∧ Management Support Division, AAM-100 Date: 5/14/91 Interviewer: Jim Frey McEachen is involved in rulemaking, policy-making, standards development, and special projects, such as form development, issue papers, briefing papers, surveys and instructional manual revisions. His work with rulemaking and policy-making requires support from writer-editors, program analysts, technical and medical experts, and attorneys. Rulemaking involves identifying the need issue, or problem, forming a team, determining the draft language and writing a draft document. The document and supporting issue paper is presented to the "Murder Board," a high-level policy board that decides whether the agency will formally provide administrative and technical support for the project. There are 3-15 team members who are "core" people so that things don't get bogged down. Major rulemaking are usually multi-user and require considerable man-hours of work. Establishing the proper team is important. Sometimes industry gets involved. Individuals who are concerned may meet with the team and this involves recording transactions with individual representatives. Regional Flight Surgeons or the public may bring up issues. Rulemaking can affect 700,000 pilots. So, consensus is important. Rules are modified to allow latitude to accommodate groups such as the Aviation Medical Examiners, Aircraft Owners and Pilots Association, and Airline Pilots Association. The Office of the Chief Counsel plays a significant role in rulemaking as experts in litigation, rule language and interpretation. Dr. Hark confers with the FAS for medical guidance as well as the Regional Flight Surgeons and Dr. Audie Davis at CAMI. Flight Standards is usually involved, as well as the Office of Aviation Rulemaking and APO, which performs economic evaluations, such as cost/benefit analyses. APO is second in importance to legal. The rulemaking process may begin with an advanced notice of proposal, a notice of proposal or the final rule. Minutes of the early meetings are kept and used internally by the team members. The rule is published in the Federal Register, which normally generates written comments (50 - 1000+) that must be reviewed and categorized by sender and subject matter. A summary of the comments is developed that addresses the issues, proposed revisions, and recommended actions to be considered. Policy involves developing a draft that is revised by the administrators. Regional Flight Surgeons, legal and any other offices that the policy might affect have input. Policy principally concerns airman certification and ATCs, i.e. administrative matters, medical standards, and special issuances. Medical Guideline Letters (MGLs) which are issued by AAM-100 are distributed to AMEs. McEachen said that Shirlene Wilson handles production of the MGLs but that the persons responsible for composition in AAM-100 have retired. Agency orders contain policy information for federal employees, such as ATCs and AT employees and are distributed according to desired routing codes. "Policy papers," i.e. MGLs, in memo format are signed by the FAS. Their distribution depends on the agency's strategy, but will generally be distributed to the Regional Flight Surgeons and their staff and the group of employees who are affected. [There's no distinction between a Policy Paper and an MGL.] CAMI has a lot of unwritten policy, and rule-making puts policy into a regulatory format. McEachen does not have access to the RFS-BBS, but intends to get it soon. He has online searches performed through the Departmental Library, though he has not needed this service within the last year. He also uses the FAA Library and the Law Library. He has also requested information from the CAMI library and received copies of articles regarding new medical procedures in about a week. McEachen has received support from the Library of Congress through the departmental library, but this normally involves a time lag, although he can receive hard back books within 2-3 days. McEachen uses a list of specialists/consultants that is not the same as Dr.Spann's, although the lists may overlap. When seeking information, he will contact "alphabet people" from groups such as AOPA, ALPA, etc., for their comments, views and insights. He manages a "tremendous volume" of names, addresses and phone numbers using a rolodex and maintains folders on different projects. When requiring internal assistance, he goes to his manager and approaches organizations when requiring external participation. His work as a writer and liaison primarily involves consensus development and significant brain-storming. WordPerfect is McEachen's primary PC application and he has used Paradox twice in six months to display economic evaluation data. He has used Harvard Project Manager, but has difficulty with its substantial memory requirements. He has E-mail (FAA Mail) and receives a newsletter containing aviation news items via the LAN. He would like more training in PCs and applications, especially Harvard Project Manager, Paradox and spreadsheets. Location: Headquarters Interviewee: Mark Adams, Supervisory Program Analyst Plans ∧ Evaluation Branch, AAM-110 Date: 5/23/91 Interviewer: Carol Wasserman Regional Flight Surgeon (RFS) Activity Reports provide information on workloads and accomplishments for the Federal Air Surgeon (FAS). The reports are sent to the FAS and then to Mark. Today they are also used by the evaluation team (Mae and Mike). They reference the reports before going out to the Regions. Carol Mattox keeps the RFS Activity Reports on file. Mark and Carol are working on a plan to determine the appropriate information that must be collected on the reports and then will automate the reports. If the information were automated they would be able to use it for trend analysis. Monthly activity reports that are completed by the CAMI divisions are also sent to the FAS and then to Mark. They serve the same purpose as the RFS Activity Reports. Both these reports are kept for at least 2 years and are a way of providing information to the Inspector General if required. Agency direction is provided by APR. This will probably change due to the projected organizational changes. APR is charged with providing a consolidated position for the AXR Offices. All requests for information are supposed to go through APR but oftentimes Mark is asked directly for something and he may respond directly to the inquiry. Mark may receive a draft order or advisory from either APR or another Office and send the draft out to the region for input. He would then forward their comments to the requesting organization. Mark has a 5 year plan for the evaluation program. This plan is updated every year based on current year experience. A tracking system is under development to track the evaluation results and follow up activities. The evaluation program entails going out and asking questions about how and what is done in the regions. The evaluation is based on an order that describes how to do evaluations. At the end of the evaluation, the evaluators brief the RFS with their findings (for example, what they are doing that is good, what is not so good, how to fix the problems). They then brief the regional administrator on any interdivisional problems or issues. A report is then written to document findings and recommendations and sent to the regions. The regions have 45 days to fix the problem and respond to the report. Administrative people in AAM and the FAS are also briefed on the evaluation results and the response. An Action Tracking System is currently under development. It lists summary information on the evaluation, the findings, recommendations, and what the region has done to follow up. It will enable the evaluators to do an automated Delinquency report. Delinquency data is frequently requested by AAM-100. The Action Tracking System is written in Clipper. It was acquired from another agency and is being modified for AAM use. While it is probably not 100% what they need, it is better than the others that they looked at. It is taking some time to load the findings into the system. Using the system is, however, improving the evaluation program because it is enabling them to see where recommendations were unclear. Mark is also responsible for administrative activities. For example, when the office physically moved to this building he had to handle all the logistics. This activity involved telling the Logistics area AAM's requirements. All AAM directives are cleared through AAM-110. For example, CAMI does the technical work to write an order and sends it to Mark. He decides who should review it and ensures that it is typed up in the appropriate format. He sends the draft to the appropriate area (for example Airway Facilities) and receives their input. Mark then distributes it through Management Systems. They are currently working on getting an accurate inventory of AAM orders. Information that is being compiled is an inventory of the orders, when they were written, and an estimate of their useful life (i.e., when they should be reviewed and possibly updated). There is a disposition schedule that describes how long an originating document should be kept. This schedule provides a means of telling people when it is okay to throw something away. The directives and orders should also be disposed of according to this schedule. The Freedom of Information Act (FOIA) imposes some record-keeping requirements. FOIA basically states that all government information can be made available to anyone requesting the information. All written requests for information that mention FOIA must be responded to within a specified period of time and the request is handled according to FOIA procedures. The Privacy Act exempts certain types of information that Congress designated as private from FOIA. For example anyone can ask (under FOIA) if person X has a medical certificate. This is public information. They cannot ask for the contents of the medical certificate (i.e., medical conditions) because this information is legally deemed private. Individuals with a "need to know" may be able to access the data however. Anytime that anyone wants to collect any information about privacy act data, they are supposed to register this data collection under the System of Records. AAM has several systems. They have the Aviation Daily (aviation industry daily newspaper) on-line and the ability to download it into WordPerfect. Everyone in this office can access this data. They are in the process of getting a wide-area network to connect the Regional Offices, CAMI, and Headquarters. Mark will then be able to send Aviation Daily to all of AAM. This paper is one thing that helps him to do his job better. There is an internal mail system through WordPerfect Office that AAM-100 currently uses. This will be a useful AAM-wide internal mail system. This office also has the FAS Bulletin Board and FAAMAIL. Everyone in this office has a workstation with access to LOTUS 123, WordPerfect, Paradox, and Harvard Graphics. The Correspondence Mail Control System is an automated system that the secretaries use to track the status of incoming correspondence that requires action. It assigns a control number to each package that is distributed to someone in AAM and generates a cover sheet that lists who it is from, who it is sent to, subject, due date, action office, closeout date, and action. Reports are then produced on all overdue items. There are several communication protocols that everyone has access to including ProComm. The Medical Administrative Officers (MAO) are Mark's primary contact in the regions. He has a weekly telecon with them that the entire regional division is invited to attend. They discuss actions that they need to or are currently taking on different issues. Follow up information is typically sent in writing. The role of the IRM Working Group is perceived differently by different people. One view is that their responsibility is to solve technical problems encountered by AAM users in the regions. A second view (the prevailing view) looks at their role as reviewing systems development and acquisition activities and fostering and developing compatibility and standards. Mark is currently considering addressing the need expressed by the technical-problem-solving view by setting up a form on the network where people can write in problems. At specified intervals, someone will review and attempt to resolve these problems. Mark would also like to incorporate some of the drug abatement program systems into the network (the upcoming WAN) to give the regional ADAP people access to the software. Mark would also like a way to track project status and dollars for each project in the IRM plan. All requests for purchases/acquisitions of computer hardware/software are supposed to be through Mark's area. All OATS purchases are entered by Carol Mattox on the Standard Acquisition Management System (SAM). Location: Headquarters Interviewee: Mae Lapane, Program Evaluation Specialist Plans ∧ Evaluation Branch, AAM-110 Date: 5/23/91 Interviewer: Carol Wasserman The Appeals Information System (AIS) is the medical/ certification support system that used to be on the Wang VS100 at Headquarters. The AIS contained data that documented final decisions made on appeals and NTSB cases. The type of data entered included the basis for the decision, the test and abnormalities the airman had. A tracking system was later added that documented when cases were received from Oklahoma City (OKC) and the changes in case status until the appeals action was completed and the case sent back. The purpose of the system was to be able to disseminate reports to the Regional Flight Surgeons (RFS) so that they would know what the latest decisions were on certification cases and the background of the case. The goals of providing all RFSs with this data was to foster more consistent decision-making. Last year, when AAM moved to the Tariff building, the system was dismantled because data could not be entered from that location. The system was transferred to Oklahoma City where Mae believes it was the basis for the special issuance system. Data entry on this system was also a problem. The information was cumbersome to extract from the file and create reports. Action Tracking System (New system developed using Paradox - called Aviation Medicine Evaluation Tracking System (AAMET)) One of the summary reports from the system lists the recommendations and the associated actions. The region is identified, followed by the evaluation year, and each recommendation (sequentially numbered). There is one line for each recommendation. The database contains a description of the evaluation finding, recommendations, and follow up dates and actions. The system is also intended to help them determine if a problem is national or local as well as the status of the recommendations (action taken or not). When the evaluation report goes out to the field, all the information will be on the system. Formal memos will only be sent out to the regions on delinquent actions. The regions submit quarterly status reports to Mae or Mike describing what they have done with respect to the recommendations. All evaluation information is currently maintained in a folder. Location: Headquarters Interviewee: Carol Mattox, Computer Systems Analyst Plans ∧ Evaluation Branch, AAM-110 Date: 5/14/91 Interviewers: Claudia Cardile Her responsibilities include overseeing the LAN at HQ and evaluating software packages. OATS She is required to attend OIC meetings/telecons. She also processes all OATS Purchase Requests for HQ and the regions. For some of the regions and HQ she puts the Purchase Requests (PR) into SAM. Some regions can access SAM and put their own PRs into the system although she must still check over all the PRs for correctness. She reviews the requests to make sure, for example, that all the cables are ordered or the required software packages are on the order. She also checks the configuration plan for completeness and correctness. She then checks that the required signatures are all present and that it conforms with the IRM plan. She sends the PR to Mike Dunlap's office for a signature. The PR then comes back and she makes a copy for her files and sends the original to the requestor. If she finds some problem or discrepancy, she will call the requestor for clarification. Equipment She is the first contact with respect to maintenance or problems with the equipment. If there is a minor problem (such as rebooting the machine) she will take care of the problem. If there is a major problem with the LAN the contractor who installed it (PSI) will look at it. APR has a maintenance contract which takes care of the equipment. If there is a problem, she types up a memo and stores a copy of it. LAN She makes sure that the LAN is up and running. If there is a problem, people come to her for a solution. She must check on the problem. She does not complete any reports. The contractor keeps a written log of problems that is available across the network (for network administrators only). There are 9 OATS machines and 55-60 users with other types of equipment (Compaqs, Dells). The OATS machines still run Novell, WP, and Lotus. It will 2-3 years before they convert to the OATS platform. A brief list of software available on the machines is WP, Grammar Check, Lotus, Paradox, Mail Control System, WP Office, HG, and Communications - for people who need it. Aviation Daily, Utilities, and an AAM-110 Application are specific to her machine and a few others. Cost/Benefit Study When she does a PR, she puts the information on her copy of the PR. She will look at different vendors for the best price and use this information for future purchases. She keeps a copy of everything she sends out of her office. Logistics receives a copy of the PR with the vendor selected, and they then go through the same process of looking for the lowest price. CAMI She has contact with CAMI when they send a purchase request. She also receives questions about software from them. She has contact with Earl Folk about OATS matters. Miscellaneous She has no real contact with APR-110. She does have contact with APR-300 when doing PRs. APR-300 gets involved when there are any automation, maintenance, or OATS issues. APR is also in charge of the OIC meetings, setting the budget for OATS, and training. AAM automation contracts are all on-line. She is in the process of trying to revise the RFS activity report. They would like to automate this report. She will have to visit the regions and ask for their input. She gets access to the ASAS subsystems for other people. They must fill out a form and she inputs the information into the system. They then get access to the systems (HIS ∧ ISIS) She sends a hard copy to OKC requesting access. She must authorize the use of AAM databases. Location: Headquarters Interviewee: Mike Vachon, Program Evaluation Specialist Plans ∧ Evaluation Branch, AAM-110 Date: 5/14/91 Interviewer: Jim Frey Vachon is developing evaluation plans for FY92. Evaluations involve travelling to the regions and clinics and spending a week at the site while performing the evaluation. The evaluation function identifies deficiencies, ensures follow-up and resolution of problems, reports findings and amount of dollars expended for resources annually. Sites are notified by the FAS of an impending evaluation 90 days in advance. No evaluations are performed unannounced. Information provided includes: type of evaluation, length of time required, number of people to be interviewed and requests for specific types of information (personnel, training, etc.). Preparation for a site evaluation requires about a month. Workbooks are made up for each team member (4-5). These include everything a team member will need to perform their evaluation, including taking notes from interviews. The workbook is like a catalog with a table of contents, segmented by program areas, including all necessary orders and directives, information about the site (site map, regional facilities map, organizational chart, directory of personnel: titles, phone numbers, office numbers, etc), itinerary, team member responsibilities and agenda. Vachon said that the group should have training prior to the site visit, but they don't because of money and travel cost. On site, the team initially reviews the evaluation plan which includes daily assignments for each team member of the eight (8) AAM programs. Each team member provides a written report by program area at the end of the day and must verify that problems/issues are true and described to the best of their ability. Information is gathered and entered in the workbook. This includes findings, discussions/review of situation and recommendations in long-hand notes (portable computers are used for drafting close out reports for Regional Administrator). Individual reports, submitted to the team leader within two weeks, are consolidated into a final confidential report. The use of names is not used in order to provide anonymity. Two copies are sent to the Regional Flight Surgeon and Regional Administrator. One (AAM-100) copy is kept and filed and the individuals keep their individual reports. Some information is summarized for tracking purposes for follow-up reports due back for each region in order to close out all findings. The IG has access to these reports and one copy is sent to higher levels of the FAA. While on-site, Vachon attempts to combine the interview reports. An exit interview is held with the RFS upon termination of the visit, at which point, it is very important to "have the facts right." This is ensured by daily day-end meetings to review information gathered from all areas and comparing notes. Onsite visits include interviews with FAA personnel outside of OAM's purview, such as the ATC or AF Manager and staff. It is important to interview people with substantial "institutional knowledge." The final report is reviewed by Mark Adams, Curt Maloy and the Federal Air Surgeon. It requires 5-6 months to complete the evaluation process, part of which is due to a lack of clerical support. AAM-110/Evaluation staff receives monthly activity reports from Carol Mattox regarding OATS contracts and budgetary information (from Carole Kelly.) Mae Lapane handles historical weekly activity report "of everything in Aviation Medicine" for FAS signature through APR to the administrator. She receives regional activity reports through the RFS-BBS for the overall report. AAM-110 keeps a comprehensive listing of all evaluation reports from their start. Evaluations can be initiated because they are requested by a person on-site or the Federal Air Surgeon or other people within the FAA who are aware of a problem at the site. Follow up evaluations are also conducted within one year to ensure resolution of a previous problem. No sites are selected randomly. Evaluation Order/Aging spells out requirement for doing Evaluations. The evaluation team uses any GAO, IG and Risk Assessment reports in existence as a foundation for its work. IG reports are provided on a "need to know" basis. However, the relatively narrow scope of these reports does not make them particularly necessary. Team members primarily use word processing. Separate files are maintained on Vachon's PC, which is networked to provide access over the LAN to his associates. His hard-drive is segmented into directories to organize correspondence and reports. Vachon will look for information in computer files rather than hard copy and re-uses word processing documents. Vachon has access to RFS-BBS and participates in weekly telecons for direct communication. The RFS-BBS is very informal and is good for sharing medical information. Vachon has a Clipper database on his machine called the "Action Item Tracking System" that is used to log evaluation summaries and run reports. "Everything" is done in triplicate and a copy is kept in the office files as well as in personal files, because office copies tend to disappear. Vachon handles all travel arrangements (flight, hotel and ground transportation) through SATO. Hotels are generally selected based on recommendations. Location: Headquarters Interviewee: Shirlene Wilson, Management Assistant Plans ∧ Evaluation Branch, AAM-110 Date: 5/28/91 Interviewer: Carol Wasserman Shirlene works with the forms and directives and has responsibility for other of AAM's paperwork management. All AAM directives and orders are currently maintained in a cabinet. There are many of these documents although there is no current inventory or document status available. AAM-110 is aware that this is a problem and is working on a plan to catalog what's there and determine whether each document should be updated or discarded. A Directives handbook which describes how to manage the orders and directives is being updated by the Directive Management Office (DMO). Shirlene is the contact person for regional people, CAMI, and AMEs who need forms and orders. She will send them forms if they have them in stock and order them when necessary. She does not typically log requests for forms, only if they are for large numbers of forms. If a directive must be updated, the draft order is sent to AAM- 110. The draft is reviewed by the required people and comments are incorporated. The updated order with an accompanying form is then sent to Management Systems (AMS). They start the processing of the order and get it printed. The accompanying form lists instructions for distribution. The original and the order form are then returned to AAM-110 and filed. Other information that must be maintained is vital records data. Vital data is information about each order such as data written and date it should be updated or discarded. This information is not current for each order and AAM-110 is in the process of developing a plan for recording and maintaining vital records data. Shirlene also deals with Freedom of Information Act (FOIA) requests. All FOIA requests are channeled through APA. APA sends applicable requests to Shirlene. She determines the AAM organization who can respond to the request and sends them the request. They send the information to the requesting party and a copy to Shirlene. She sends a copy of what was sent to APA and completes an annual report logging AAM's role in FOIA for the year. Shirlene also maintains non-AAM forms and orders that are used by this Office. Location: Headquarters Interviewee: Carol Kelly, Financial Manager Management Support Branch, AAM-120 Date: 5/28/91 Interviewer: Carol Wasserman Carol is in the process of writing a standard operating procedure (SOP) that describes the information that she needs and how to supply it. The guidelines or SOP will ensure that all individuals both in the region and at CAMI have the same interpretation of all categories of information and provide that information in the same format. One accomplishment this year was to standardize the forms on which regional and CAMI data is collected. Program Budget information and workload data are the most important information for Carol. The reason is that Congressional OMB and other requests are focused on programs. Workload data is necessary to justify requests for additional positions and dollars. The four major areas for which budget information is submitted are: Workload, Program Budgets, Figure A object (accounting type breakdown), and contract summary. At the present time it is hard to get clear information either on current needs and their justification or on historical budget information. Budget information was typically not maintained in an easily accessible form and the information that used to be provided was not always collected in a dependable or consistent manner. The "Call for Estimates" is a set of instructions on preparing the budget. This year the "Call" was sent with a diskette (Lotus spreadsheet) that requested the regions and CAMI to plug in numbers. The regional budget preparers did not have to determine formulas or formats. The regional people get their budget together and send it to the Regional Budget Office who sends it to the National Budget Office (ABU). ABU collects and summarizes the information and sends the original breakdowns and the summaries to AVS who sends the information to Carol Kelly. AVS reviews the budget information but does not add or delete any dollars or items. The breakdowns that Carol requests are not part of ABU's call for estimates but separate AAM requirements. Carol sends her requirements to AVS and also to the regions. AVS does not send Carol a diskette of budget information. She only receives hard copies from AVS and from the regions. This office needs access to the Budget Information System (BIS) maintained by ABU. The BIS contains current obligations and expenditures. She currently has access to the Davis system (accounting system). Access to the BIS is critical. The absence of automated office-wide electronic mail makes Carol's job harder because it is not possible to send or receive files electronically. Currently information that is required the same day is sent by fax and she has to re-enter and summarize all the data. There is a standard form for budget increase papers (a justification statement). Carol is working with the regions on ensuring that the justification information that they submit for new dollars and positions meets her needs with respect to format and content. She put together a series of questions that they must answer that will give her the information that she needs. Carol provides overall AAM summary requirements to ABU. She must have clear and succinct justifications for new programs which must be supported by the appropriate statistics. It is very difficult to get the appropriate workload and activity statistics. Types of programs that she must justify, for example, are the resources required to re-open the clinics or additional ADAP positions. Statistics on different problems that people have for OWCP (workman's compensation) claims for example would help justify additional Industrial Hygiene Resources. Carol needs access to the Department of Labor OWCP claims system. Carol also needs access to the TRIMATE system for personnel and training information. The PMIS listings that they get often contain out-of-date information, particularly with respect to vacancies. AAM-120 sends a vacancy status report to Dr. Jordan. Report information must be obtained from the regions and CAMI. She works with Mary Reid to complete this report. Other input that she uses to determine overall AAM needs are reviews of rule changes and their impact and other regulatory or common requirements that may have been overlooked. She reviews the budget carefully with other Headquarters people to ensure that nothing critical is overlooked. The Budgetary Authorization report is a summary of allowances that is sent from the National Budget Office to the regional budget offices. It is up to the regional budget offices to distribute it to the regional divisions. This is why some regions said they received the report and others said they didn't. The regions and CAMI submit quarterly reports (financial plans) to AAM-110. The plans indicate how they are allocating the year's allowance. The quarterly report are by object code (objects are a specified way of breaking down budget information). The quarterly plan and actual obligations are information for the accounting system. They explain the difference between the plan and the actual expenditures. Submission of this information follows the same path as the budget. This information is also requested by the budget office on Lotus diskettes. Carol doesn't get this information on diskette and it is often difficult for her to get a copy of the quarterly reports. The Federal Air Surgeon approves the total AAM budget after it is reviewed and approved by multiple individuals. Carol is not highly involved in the research budget. The chapter 8 human factors research order documents this whole process. There is less detail required for the research budget than for the operations budget. This process is undergoing a major change at the moment. There is not necessarily any correlation between the workload data on the Regional Flight Surgeon's Activity Reports and her workload figures. It is the same thing with the monthly activity reports. Carol must be aware of is the numbers that have been submitted with respect to workload by a particular area. Her numbers must tie with theirs. It is a risk area that different groups are collecting and reporting on workload data. Location: Headquarters Interviewee: Martin "Doc" Miller, Supervisory Management Analyst Management Support Branch, AAM-120 Helen Zingman, Management Support Specialist Management Support Branch, AAM-120 Date: 5/23/91 Interviewer: Carol Wasserman The regional divisions feel that they are not getting all the training they need. The proper way to acquire nation's training is for the regions to write training proposals stating what they need and then AAM-100 would bring the proposals to AHT. This procedure is not currently followed. All Washington DC regional training information is currently maintained on-line on a Lotus spreadsheet. Data on the database includes the person's name, branch, where they are going, whether the training has been approved by AAM or AHR. The "call for training" is a request for AAM headquarters managers and his/her people to tell AAM-100 who needs training and the type of training required. This information is submitted to AHRT. The managers receive a computer printout telling them the training courses and number of slots that they are receiving. Funding for training comes from AAM and AHT-140 at the present time. Different forms need to be filled out for different types of training. A 10 part SF182 is completed for out-of-agency training (such as OPM training). This form is approved by Human Resources (AHR). Evaluations must be completed for out-of-agency training. Form 3013 is used for management training at the Center for Management Development (CMD) in Florida, the Academy or in TSI at CAMI (form 3013 must be approved by AHR prior to the training). A memo of understanding was signed between the Office for Training and Higher Education (AHT) and AAM that requires AAM to submit a monthly report on how the training funds have been used and the dollars that have been obligated. Helen is completing a training plan for the next 4 years to obtain additional funding from AHT. The next step is to send training proposals to AHD and request guidance on appropriate avenues of achieving this training. Headquarters is involved with regional training when regional needs cannot be met by the regional training people or when the training involves AHT dollars. Training needs are determined by an evaluation team, JTAs, and Telecons. Helen would like to do individual training plans for all the employees at Headquarters. She also wants to determine the training courses that are required for each Headquarters position. Location: Headquarters Interviewee: Mary Reid, Management Analyst Management Support Branch, AAM-120 Date: 5/23/91 Interviewer: Carol Wasserman Personnel deals with any issues, concerns, or regulatory changes that deal with pay, policy, employee relations, staffing, job classification, and related areas. Mary deals with the people end of the budget. Carol Kelly provides the budget expertise, Mary keeps all the vital information about who fills the positions, the number of vacancies and other employee-related data. Her major source of automated information is the PMIS listings. Mary does not have access to PMIS, she uses listings from PMIS. She would like to have access to the all included region AAM subset of PMIS data and be able to query this data. PMIS employee data is supplemented by information that is sent in from the other AAM divisions. This is mostly personnel data, what the Divisions have done to fill the position, and verifying the number of open positions. Mary also uses Federal personnel manuals and the employment laws in her work. PMIS is a monthly listing. The only thing that it doesn't show is vacancies. Vacancy data is obtained from the regional office and verified by Carol Kelly. Vacancy data from the regions is obtained informally; as Mary needs the information she requires either by phone or in writing them for it. She is asked for many types of statistics about AAM employees such as the number of employees who are eligible to retire in the next 5 years. She would like to have automation support to compile and report on these statistics. Right now she compiles them manually. If a system exists where all OPM regulations are stored, AAM needs access to it. One key personnel form is the SF52, Request for Personnel Action. The SF52 is completed by AAM requesting the action and sent to Personnel (OPM) for entry into PMIS. The Notification of Personnel Action is then an output of PMIS. Other types of reports that are completed include basic staffing reports. Location: Headquarters Interviewee: William Hark, M.D., Program Manager Medical Specialties, AAM-200 Date: 5/15/91 Interviewer: Jim Frey Hark has program control over the Employee Health Branch, Chief Psychiatrist, Biomedical and Behavioral Sciences Branch, Medical Standards and Drug Abatement. He is not involved in broad budget or personnel issues. [Hark acts as a "filter" for the Federal Air Surgeon (FAS), bringing issues to the FAS when necessary and acting as an interface between the FAS and lower levels of the organization.] In medical certification, Hark is involved in policy-making and handling individual cases. Much of this can have national prominence and provoke congressional interest. He is involved in almost all special issuance requests at the HQ level. Hark reviews documentation provided by CAMI on Special Issuance cases and plays a general trouble shooting role. Complicated cases in which processing has been mishandled or doctors simply disagree are time consuming. Congress may be "beating" on it and it can require much research and review. Hark records documents in his possession (he doesn't get files) and believes that a copy of the denial letter is kept in the "Day" file, maintained by the FAS secretary. The Day file contains all correspondence in chronological order. AAM-200 extracts relevant information into a Paradox database of cases they have reviewed. The application is not very sophisticated, but provides quick reference (screen display) to verify that cases have been received and reviewed. There is a tremendous amount of correspondence from a multitude of sources. Policy-making primarily affects pilots, but also affects ATCs. The ATCs are decentralized and they are handled by Regional Flight Surgeons. The straight-lining of RFS to the FAS led to new problems beyond the fragmentation and inconsistency of policy for ATCs. Bringing consistency to ATC policy has gotten ATC Unions involved. In determining policy, Hark must coordinate with many people and organizations. However, this process must be simply halted at some point or otherwise it will continue forever. In establishing policy, he must consider every possible effect caused by policy change. Hark plays a part in formulating policy, and can initiate change and set policy. He often needs to be apprised of the "situation" and policy. He will make recommendations, take direct actions if necessary, and interact with many organizations. Employee Health Don Watkins is the head of the Employee Health branch. Hark reviews individual cases and Dr. Watkins' decisions regarding case disposition. Problems can arise from new policy issues that are triggered by changes in politics, legislation and technology. This leads to a review of the policy or regulation to determine if it is still appropriate, leading to the development and promulgation of new policy. Watkins tracks cases. Hark reviews Employee Health program changes with Watkins. This normally involves ensuring a consistent "view" or direction of the program in concert with other FAA or government agency policy and direction and that it makes "bureaucratic sense." Much of Hark's job involves communication through individual and staff meetings, telephone conversations, memos, E-mail and the RFS-BBS. The Regional Flight Surgeons and the AAM-200 staff check the RFS-BBS daily. Hark likes the RFS because of its message handling, quick response, ability to log on from home and "improved access without phone calls." He still sends memos for a formal response. There is a tremendous volume of memos FAXed. He also participates in the RFS telecons on Tuesday and with CAMI. Hark maintains reviews and evaluates the Chief Psychiatrist's case evaluations of specific patients and employees. He participates in developing basic policy for the certification of pilots, medical clearance of employees and implementation of broad employee programs, such as alcohol and substance abuse. He is involved with problem psychiatric cases and acts as a consultant to CAMI and the Regional Flight Surgeons. His overall role is to review case decisions and form policy from a legal stand point. He is in court "constantly" and emphasizes the extreme importance of wording to insure legal and medical accuracy in all correspondence and discussions. (According to Hark, Jon Jordan is an attorney.) OAM is supported by a staff of attorneys with the general counsel who are "not as responsive as they should be" because they're "swamped." Most communication with Legal, located on the floor above, is face-to-face. The MGLs have no legal function, i.e., they are only guidance. An agency order requires compliance as does the Code of Federal Regulations. OAM has a broad need for experts/consultants at HQ. They have a wide range of concerns due to the number of branches and programs involved. Hark maintains a list of consultants/experts that overlaps with CAMI's list. Consultants help reach consensus and "keep everybody honest." He uses consultants to refer him to other experts or people at the top of their field. Journals point to authors. Files are sent out for review to consultants. The library sends a newsletter from the publisher every two weeks that reviews and summarizes 35-40 separate journal articles encompassing the entire medical field. The Departmental (DOT) Library, GW University or the National Library of Medicine provide full text of articles that are delivered by courier or electronically. Don Watkins goes online (MEDLINE) and provides print outs of citations. He gets too much sometimes. Hark also uses the Merck Manual, PDR, USPDI, Drug Evaluations, The Medical Letter, and unique texts. Hark is less involved with the Biomedical and Behavioral Science Branch. He gathers research requirements at HQ, discusses research results and connects CAMI's and HQ's research activities. He reviews research activities and reports, but provides little direct guidance. His role is mostly advisory. Drug Abatement is similar, but he has more contact (on a daily basis) with ADAP. He has to be knowledgeable about ADAP operations. His main concern is policy and direction, ensuring the proper bureaucratic sensitivity, and makes suggestions regarding program issues. Hark reviews "numbers" coming in from carriers, which are of academic interest. The associate administrator may have questions regarding these industry reports. Harks uses ADAP carrier annual reports when necessary, that show who is being tested, for what, etc. These are extremely sensitive because of possible public inference regarding substance abuse in the industry. Hark receives a "stack" of activity reports from CAMI. Most get thrown away. He receives monthly information that is "a quarter of an inch thick." He has little concern for most numbers that are only important for identifying bottle necks at CAMI. He believes the FAS also receives these reports, but does not know the extent to which he may review them. For his part, he feels he could easily call and ask for them when necessary. Hark mentioned a BBS that may be in development for Division Managers. He believes that ultimately OAM will have a LAN, an electronic document library and direct system links with CAMI so that they will be able to call up and work on each others documents. The agency's E-mail system is not implemented to a large extent at HQ. A database that summarizes cases reviewed at HQ dating back to 1981 was implemented on a WANG VS that is shared with other parts of HQ. It is just being "terminated" and there is no money to convert it to another system. OAM will lose the ability to update the database, but will still have the data. The CAMI Special Issuance database has "much less information." One problem with this database is that because of the dynamic nature of medicine, medical procedures and medical technologies, this information quickly looses value and relevance. Cases must now be tracked through the HQ paper trail. Location: Headquarters Interviewee: Steve Hecht, Administrative Officer Drug Abatement Branch, AAM-220 Date: 5/14/91 Interviewers: Claudia Cardile Action is underway to raise the Drug Abatement Branch to Division status within Aviation Medicine. Inputs Besides the plans themselves, the aviation industry is required to submit a semi-annual summary of drug test results from aviation employers. This is usually a two page report. A contractor puts the information about the employer anti-drug plans into DPTS as well as the data from the semi-annual reports of drug testing results. Both DPTS and the CEDMS are stand-alone systems at this time. The Branch would like them to be networked for greater access by people at HQ and the regions. Outputs Summaries of semi-annual reports are distributed. The Branch also does weekly activity reports which go to the HQ hierarchy and to the Department Drug Office. They make periodic reports on topics such as the drug plans and approvals, as well as special analyses of drug plans, testing results, and compliance efforts. Compliance Letters of Investigation are sent out to carriers when there are questions about their compliance status. There is a status report of how many Letters were sent out, resolved, and still pending. The data for this report is from DPTS. They will, in the future, also use the DCMIS for this purpose. The Compliance Program has standardized letters which are sent out. Compliance Inspection is trying now to set up standardized letters. If a carrier is out of compliance, the Branch can use DPTS and CEDMS to print letters saying why they are out of compliance and telling them to send information to clear up the problem. If these letters aren't answered, an investigation is opened. One trigger initiating action such an action is the semi-annual reports sent (or not sent) by aviation employers. With respect to compliance inspections, they do an inspection and the data is collected and analyzed. If an enforcement action is necessary an enforcement letter is sent. The letter is somewhat standardized except for the exact reasons listed as to why an enforcement action is necessary. For new company or entities which haven't filed a plan, a letter is sent specifying that one must be filed. The Compliance and Enforcement Data MIS contains inspection information, scheduling of inspections, and enforcement activities. The status of all these actions is recorded in the data base. AAM-220's MIS needs are documented in a study done by the Battelle Organization. Inspection A checklist is contained in the CEDMS system. The inspectors using a laptop computer with the checklist, simply write to the file while doing inspections. This data is then loaded into CEDMS. The checklist, when completed, can generate an inspection report. The inspection reports receive a number of legal on higher management reviews. before action is taken on them. Outside Contact Aviation employers call about interpretation of the rule, e.g. in unusual cases. Clarification and interpretation of the rule is often given over the phone. There are seminars and conferences set up with aviation employers to better inform them about the rule. In complex unusual cases, the Branch asks the employer to send a letter before an answer is supplied. Regions There are weekly telecons with regional anti-drug personnel, as well as frequent telephone contact as needed. HQ sometimes asks the regions to follow up on employers based in the region. When more personnel is added in the future, there will be more contact with the regions. The regions will take over more responsibilities and pass more information. They may participate in changes in employer plans, and will be heavily involved in compliance inspections and enforcement. This will mean that there will be summary reports and correspondence on related issues. He feels E-mail would be useful. The telefax is currently a vital means of communication. Procedures and Manuals The Red Book is a collection of guidance including the Rule and changes and clarifications to the Rule. The Rule is the Federal Aviation Policy. The Red Book was developed at HQ and sent to the Regions and the industry. There are also Administrative Policy and Procedures which govern the FAA and affect Personnel, Budget, Finance, and MIS. HQ's Drug Abatement Branch receives much help in administrative functions from AAM-100. There are not many internal procedures written down at this time. There is also a Compliance and Enforcement Manual which tells how to do inspections and what to do with the findings of the inspections. There is currently no systematic procedure for capturing policy interpretations to facilitate the provision of consistent answers from the industry on questions about application. Complaints Some industry employees complain to the Branch about testing procedures or results. These complaints often must be investigated and may trigger an inspection. Usually if someone calls in with a complaint, the Branch will ask that they send a letter stating the complaint in writing. Outside Contact There is contact with the Office of the Secretary of Transportation and other modes to coordinate policy throughout the Department. The National Institute for Drug Abuse has set national policy and certified labs to do Drug Testing. The FAA must follow this policy. The NIDA sends lists of labs as well as updates to the list. They also send reports on the amount of drug use in the U.S. and how well programs are controlling this use. Any reports sent out by AAM-220 must be sent through the Federal Air Surgeon. On a daily basis, perhaps 10-15 documents are sent to the FAS. Location: Headquarters Interviewee: Kathy Ladika, Program Analyst (Plans Evaluation) Drug Abatement Branch, AAM-220 Date: 5/15/91 Interviewers: Claudia Cardile The only system that Plans Evaluation inputs into is VIS. The regulations they follow are: FAR Part 121 Appendix I (the rule that is in the Red Book). They must also be familiar with Parts 61, 65, 67, and 135. These are amendments to the Rule which apply specifically to Drug Abatement. The contractor has a checklist which is used to evaluate plans. They don't access the VAX at CAMI. Notes from the Battelle Report on Drug Abatement: Data Management System - DPTS (Drug Plan Tracking System) and CEDMS (Compliance and Enforcement Data Management Subsystem) The Drug Abatement Branch accesses: VIS - Vital Information Subsystem CAIS - Comprehensive Airmen Information System EIS - Enforcement Information Subsystem AIDS - Accident/Incident Data Subsystem AES - Automated Exemption Subsystem ISIS - Integrated Safety Information Subsystem DPTS/FAATS - FAA Drug Plan Tracking System CEDMS - Compliance and Enforcement Data Management Subsystem Inputs: Regulations Anti-Drug Plan Amendments to Anti-Drug Plan Inquiries from Regulated Entities Inquiries/Complaints from Employee/Unions Congressional Requests Freedom of Information Act Requests (FOIAs) Correspondence Related to Letters of Investigation (LOIS) Reports from MROs on Positive Drug Test for Part 67 Certification Holders Semi-Annual and Annual Reports Audit Reports Data bases Outputs: Plans Correspondence and Approval Response to Congressional Inquiries Response to DOT/FAA Management Letters of Investigation (LOIs) Summary Statistics and Analysis Reports Mailings to New Regulated Entities Internal Reports/External Reports Regional Reports Audit Reports Policy Statements Docket Report - Pending Rule/Regulation/Policy Modification Freedom of Information Act Correspondences Schedules of Audits Informative Bulletins Location: Headquarters Interviewee: Irma (Sam) Hart, Nurse Practitioner Employee Health Branch, AAM-230 Date: 5/24/91 Interviewer: Carol Wasserman Health Awareness Program Sam is in charge of the National Health Awareness Program (HAP). She sends the regions the names of national organizations where they can get information on different program topics. The first year she developed the topics based on what were nationally recognized health issues (e.g., blood pressure, cholesterol). The program initially presented a topic a month. Now she works with the regional HAP coordinators to come up with broader topics that will be covered each quarter. This year's topics are: substance abuse, healthy lifestyles, cancer, and cardiovascular. The regional people can determine the areas that are most relevant to that region (for example skin cancer versus breast cancer). If there is time, the region can also do multiple topics within an area over the quarter. A quarterly program was believed to give employees more time to get the screenings and information, particularly in regions where employees are very spread out. Monthly topics also put quite a strain on the regional HAP coordinators. The coordinators send her quarterly reports on what education and screening programs they did, number of attenders and findings. This data is not submitted on a particular form. Sam is in the process of developing forms to standardize both how the coordinators collect data from program attenders and report the data to her. Sam currently compiles the information received from the regions and reports to the Federal Air Surgeon (FAS). The report includes programs run in the regions, articles published relative to the HAP topics, participants, hands-on screening done, and findings. Follow up reports are then done for the FAS to report on actions taken on those individuals for whom problems were found. Sam uses MEDLAR to search for articles relevant to the topic of the month or quarter. MEDLAR enables you to find all the recent papers and articles published by topic. The system provides a brief summary of the data and where it is published (i.e., journal name). She would like the ability to put relevant information on-line to share it with the HAP coordinators using a facility such as FAAMAIL. Sam also does education for both the HAP coordinators and employees. Videos and corresponding text were acquired through HSN to educate the nurses and physicians assistants on the different topics. Sam is in the process of putting out an order defining the program and who is responsible for implementing it. It has already been signed by Drs Hark and Jordan and will be signed by the FAA Administrator. Clinic Support Subsystem The Headquarters clinic does not do physicals but it does see FAA employees (walk-in visits) and do screenings (HAP). Employee screening data is recorded on forms and a copy is given to the employee with the results so that they can follow up with their own physicians. The data is then entered into the system. Screening or visit data is entered on the Clinic Support System (relatively new on-line system). They do not keep paper records anymore. All data is backed up daily (using FASTBACK). The system has entry screens for background patient data (the employee initially fills out an informational form). This basic identification data also has space for any pertinent information such as allergies or medications the person is taking. The system includes clinic visit data, special services (HAP or screening) data, bloodmobile data, vendor, and inventory data. While screens are available for these last two categories, they don't use them yet. The system is compatible with DBASE III. The Bloodmobile program operates as follows: a group of assigned people come down at specified times and are given posters made by Sam; they put up the poster and go around and ask people to donate blood. The names of potential donors are collected on forms which are provided to the Bloodmobile people. The names of donors are then entered on the bloodmobile screen on the Clinic Support System. This information is maintained for awards purposes. The Clinic is planning to interface the screening results obtained from equipment with the clinic support system. Much of the equipment that they use for testing is computerized (for example Body Composition, EKG, Pulmonary Functioning, and Reflectron) and maintains employee name, results, and other pertinent information. An interface would save the time of reentering the data on the clinic system. The equipment prints out the test results for employees as well as maintaining the data internally. Sam is planning to train the regional health professionals in how to use the Body Composition computer and then have them obtain the equipment. Training will occur at the National Wellness Institute conference to be held in Stevens Point, Wisconsin during July. Nationwide employee health data would be useful to Sam. Several regions have offered to use the Headquarters computer program and to supply input on regional needs and make the program useful to the clinic. Sam would then like an evaluation to determine how best to progress with a National clinic computer program. She would also like a mini-network for the clinic because they are no longer on AAM Headquarter's local network. With two nurses each using a computer to enter their patient core notes the merging has been a major problem. A nationwide clinical computer system would offer a means of reporting and evaluation of the health programs. Sam is also going to determine the cost savings of the HAP by looking at the impact of the program on sick leave and annual leave. This will be accomplished by working with AAM. Location: Headquarters Interviewee: Dr. Andrew Horne, Program Scientist Biomedical and Behavioral Sciences Branch, AAM-240 Date: 5/14/91 Interviewers: Claudia Cardile He interfaces with the FAA and the NTSB. Accidents that have medical interest come through here. He oversees the Accident Investigation Research projects at CAMI. He has done some research here, mostly putting together tables. He did one project on incapacitation in this manner. CAMI sends quarterly reports to enable him to keep in touch with what is going on there. When CAMI publishes a technical report or article, they must go through him for approval/disapproval. He sends it back to CAMI with his approval/comments. His original responsibilities were to set up the program for Accident Investigation in the regions. He does this on request from AAI and responds to major catastrophic accidents. He has contact with Dennis Shuring (Great Lakes Region) and the other Regions when there is an accident in their region with medical interests. These are mostly General Aviation accidents. The NTSB, FAA, and the manufacturer are involved in major air carrier accident. The regions send a medical report when he asks for one. The toxicology reports are sent from CAMI on a fatal accident. Annually, HQ puts together a report in the form of tables as to the number of incidents of alcohol, marijuana, etc. involved in accidents. Rulemaking When a new rule is required, it comes in as a petition for rulemaking. It is sent to those involved for comments. The comments are taken into consideration and the final decision is made on the rule. Sometimes rulemaking will not follow this path but will be considered immediately as an Advisory Circular. The updates on the Advisory Circulars in this area are done by this division. When they are written they go into a certain 'series' and are distributed to those concerned and the libraries. Depending on the subject they either go to the FAS (medical issues) or Flight Standards. Jean Watson writes the Current Issue Report for this section. Location: Headquarters Interviewee: William Shepherd, Ph.D., Supervisory Research Psychologist Biomedical and Behavioral Sciences Branch, AAM-240 Date: 5/28/91 Interviewer: Carol Wasserman Dr. Shepherd and his staff review the 9950s for consistency with the Federal Air Surgeon's (FAS) guidance and target non-compliant projects. These are discussed with Dr. Collins out at CAMI. A decision is made by Dr. Collins and Dr. Sheperd on whether they will be a part of the final research package and the final group of 9950's are then sent to the FAS for his signature. These projects then become a matter of record and are the projects that AAM is committed to working on. They are returned to CAMI with the FAS signature. The Technical Center is under a different organization and has a different mechanism for proposing and tracking research projects. There is a fair amount of informal communication between the two organizations but no accountability since the Technical Center is under AXD. All draft research reports are received by Dr. Sheperd. He directs them to the appropriate reviewers and makes sure that they are technically correct and consistent with policy. They are then returned (with comments) to CAMI. CAMI is responsible for getting them published and distributed. He believes that the responsibility for maintaining the book of 9950s will be the research committee's (and is now as well). The chair for this committee is the deputy director of CAMI. The new draft order for research describes the entire research process including documentation that must be completed and who is responsible for the process. This order will supersede the current 9950.3A order. Closing out and changing a 9950 follows the same path as getting one approved. Both require the FAS signature. There is an annual solicitation from the Federal Air Surgeon to agency operating organizations soliciting research requirements. Dr. Sheperd and the FAS receive the letter of response and put together a guidance statement that is sent to Dr. Collins. Dr. Collins then responds specifying proposed research to address these issues or explains why CAMI can't address them. The new process will require all research requests to be reviewed by the committee before they are passed to CAMI management or Principal Investigators. Quarterly status reports are now a maximum of 2 pages. They are sent from CAMI to AAM-240 and the FAA. Problem areas are discussed with the FAS. Customers do not get them. Customer contact is typically verbal and face-to-face until the final report is produced. They then meet with the customer to review the final reports and discuss how to interpret and use the data. Final reports are accompanied by Technical Report DOT Form 1700.7. The Federal Government has prepared guidelines for the protection of research subjects. The FAA (i.e., Dr. Sheperd's office) will produce an agency order prescribing methods the FAA will use to ensure that these guidelines are met. He has no outstanding information needs and does not currently use any automated systems; however, he will need future access to OAM's Research Tracking System as well as the FAA Human Factors Research database that is being developed in Superbase 4. Only data-related issue that he is aware of concerns the need for timely budget data. He is involved with the budget but not with its direct preparation. Location: Headquarters Interviewee: Jean Watson, Research Program Support Specialist Biomedical and Behavioral Sciences Branch, AAM-240 Date: 5/15/91 Interviewer: Jim Frey Watson participates in environmental research projects, fleet evaluations of commercial and commuter airlines and human factors assessments in support of flight standards. She also acts as a liaison to CAMI's research facilities, explaining to HQ personnel activities at CAMI. Watson reports to Bill Sheperd and no one reports to Watson. Biomedical and Behavioral Science research involves aging aircraft, including maintenance/inspection and human factors. Watson collects data from the industry during fleet evaluations by Flight Standards. She works in conjunction with Flight Standards and turns in her individual report to the team leader. There are normally 5-7 people on an evaluation team and the evaluation may take from 2 to 6 weeks. Watson keeps a copy of her report and Flight Standards distributes copies of the overall report. These reports detail topics such as how mechanics perform their work, what the working environment is like, etc. These reports can be very sensitive and release must be cleared. There are no summary reports. As part of the research project, HFM∧I, Watson is also involved in publishing the "handbook," which contains guidance and materials on human factors and is used by the FAA and the industry. Watson attends the HFM∧I conference twice each year and is involved in the Aging Aircraft conference, handled by the Tech Center. Watson needs current information from NIOSH and OSHA Guidelines. She relies on literature for information. She works with consultants/contractors (Galaxy Scientific) through the Tech Center and gets information or referrals to other experts. She usually calls "known" experts under contract. The Tech Center provides reports on expenditures upon request and the Budget Office (AAM-120: Annette Lyles) provides information on what's been spent, although this information is not always accurate. Watson's duty in contract management is to check for over-spending and re-program funds if necessary. Watson coordinates with Dr. Collins, CAMI director, Dr. Hordinsky and others at CAMI to provide CAMI's budget narratives to A. Lyles. Watson also provides her own budget narratives to A. Lyles. Watson receives a quarterly research projects report from CAMI. Each researcher submits a quarterly or monthly report to division managers who route it through Dr.Collins to the Research Committee. An overall research project report showing contractor activities from the contractor. Watson uses these reports to answer questions about specific research at CAMI. Questions can come from anywhere in the FAA. This can affect workload, if it's a hot topic. She can receive many phone calls and may have to write a briefing paper to OAM for the FAA Administrator or the Associate Administrator. Everything along these lines must go through doctors Jordan or Hark. Watson receives copies of CAMI technical reports that are published at the end of each project. One copy is kept in the OAM Library at the Headquarters building. Others are provided to other people through the CAMI library. When she needs to find a particular report, she uses the annual index to the reports. CAMI provides 5 copies of these reports. Watson receives reports from the industry, such as the Air Transportation Association reports. She has also used the Service Difficulty Reporting System which is used by the industry to report particular problems by aircraft and more. Watson said the system is not very useful from her perspective, needs changes and is being reformatted. Watson scores ATC 16PF tests and sends reports to the regions weekly. The tests are scored using a optical scanner. She converts the test score data into WordPerfect which she uses to format and print the test results. Watson keeps the 16PF information on a floppy disk that is locked up for security/privacy reasons. She maintains a summary sheet of people showing if they are cleared or not. She answers questions from the regions regarding ATCs. The original tests are sent to Dave Shroeder at CAMI to support research. Watson also processes FAM tests submitted by the regions. These are hand scored, but she can use the optical scanner if the work load requires it. She then calls the region with a response regarding test results. She also generates a list annually to send to the regions which is basically a quantitative activity report showing how many people were interviewed, how many cleared, etc. Watson would like access to the PETS system so that she can enter test scores into PETS and avoid having to generate a form to send to the regions. She keeps the Fads test locked up and returns completed tests to the regions, where she assumes they are kept in personnel files. Watson needs to track federal topics and activities contained in the Federal Register. (Current Contents) She also needs to know more about what systems are available. She wants access to the FAA National Plan for Aviation Human Factors (AXR-3) as well as ISN a research database for information about public and private research. She also would like access to Dialog Information Services. She has had online searches performed at the FAA library, but evidently received poor results. One search returned a large number of marginally relevant citations and she was not invited to guide the search. Watson uses WordPerfect, Paradox, Quatro, Lotus, Harvard Graphics and Harvard Project Management. She needs access to Windows and Superbase 4. She does not have OATS equipment and does not want it, because she perceives the hardware and software as bad.

CIVIL AEROMEDICAL INSTITUTE (CAMI)

Location: Civil Aeromedical Institute (CAMI) Interviewee: Minnetta Hall, Budget Analyst Office of the Director - CAMI, AAM-3 Date: 4/18/91 Interviewers: Carol Wasserman The Civil Aeromedical Institute (CAMI) operates under two major fiscal appropriations - Operations; and Research, Engineering and Development (RE∧D) - where performances and resources are controlled with an administrative financial plan. The functions that comprise each division or staff office determine the appropriation to which that organization will be assigned. The CAMI fiscal programs encompass authorized positions; hours worked, i.e., full-time equivalents (FTEs); payrolls; travel; transportation; rental; printing and reproduction services; contractual services; supplies; and equipment. These needs support medical goals, objectives, and policies applicable to the mission of FAA. In addition, the research program is planned, formulated, budgeted, and executed by task areas under the auspices of tasks established in the RE∧D Plan and is in consonance with the agency's medical goals and objectives. The lead time for identifying annual resources includes the upcoming 2 fiscal years. Tentative spending targets for the first upcoming fiscal year will tie to that which will have been approved by Congress; the second fiscal year will include new and revised budget estimates deemed necessary to accomplish medical goals and objectives. Estimates of Operations and RE∧D requirements are developed in accordance with guidelines outlined in two separate call for estimates orders. In the calls. AU-1 specifies general and uniform guidelines (applicable agencywide) that are to be used in developing the Operations and RE∧D programs. The calls also identify specific guidelines developed by the Washington Office of the Federal Air Surgeon (OAM), represented by AAM-100, for use in developing FAA medical budgets. AAM-3 submits requirements via floppy diskettes and hard copy to OAM, who in turn ensures that the requirements are considered as budgets are processed and given approval through the FAA budget system towards ultimate Congressional approval. The budget path for the annual budget year (BY) submission, depending on whether it is for the Operations or RE∧D appropriation, is: Implementing CAMI division -- AAM-6 -- AAM-3 -- AAM-100 (Annette Lyles - RE∧D); (Carol Kelly - Operations) -- APM (RE∧D); AVS (Operations) -- ABU -- OST -- OMB --- Congress At any point, a reviewing/approval office may send questions regarding the requirements back through the budget path to AAM- 100, and ultimately to AAM-3. The answers to these questions (Q∧Ss) provide data for the reviewing officials to consider when determining the resources to be approved. Final approvals at each level are known as passbacks. The CAMI fiscal programs are executed within funding levels approved by Congress in the Appropriation Act. when the applicable execution year occurs, actual obligation must tie to that year's RE∧D program, realignment between task areas is allowed within a 25% restriction. This restriction can be over- ridden and changed with a Congressional action. As the approved budget is executed during the ongoing fiscal year, quarterly reviews and financial operating plans are prepared in AAM-6 for the Operations budget in response to an ABU directive, and for the RE∧D budget through monthly procurement and financial plans developed by APM. Minnetta tracks and compiles actual FTE and dollar obligations that are reported in the reviews and plans, and also used throughout the year in daily execution of budgets. All fiscal obligations, e.g., those which are related to all PC∧B, purchase orders, travel documents, etc., are obtained from the Aeronautical Center in hard copy and through the Departmental Accounting Financial Information System (DAFIS) which can be accessed at her desk. There is sufficient detail via these means to meet her requirements related to obligations and allowances. A computerized agencywide network Budget Information System has been developed by ABU for direct input of data by FAA OPIs for accessing, updating, and reporting on financial information to the Washington ABU office. A computerized RE∧D Management and Control System (REDMACS) has also been developed by OAM that will be available for networking within OAM Washington and regional offices for updating RE∧D budge-related reports needed by APM. Interfunctional budget requirements, e.g., space, training, property management, stock and stores, etc., are managed, compiled, and reported to the Aeronautical Center OPI by other AAM-6 staff. LOTUS, Word Perfect, and Excel software are used in developing and executing ABU, OAM, and CAMI budget requirements. Location: Civil Aeromedical Institute (CAMI) Interviewee: Virginia Hicks, Supervisory Program Management Specialist Office of the Director - CAMI, AAM-3 Date: 4/18/91 Interviewers: Carol Wasserman, Claudia Cardile The Program Management Staff provides administrative support including procurement, for all CAMI divisions. In this respect, almost all reports involving more than one organization are summarized and submitted by this staff. Examples are the weekly significant activity reports, position vacancy, research tracking, training, special one-time reports, etc. These reports are in addition to the monthly status, quarterly, and end-of-the-year budget reports prepared by the staff. The staff prepares both the Operations and Research budgets for the institute for submission to Washington. In addition to these budgets, we also prepare budgets reflecting CAMI;s requirements for support from Aeronautical Center organizations, e.g. training, interfunctional equipment, telephone, procurement, logistics, and ADP. Any document, procurement requests, travel orders, etc., involving the expenditure of funds is submitted through the staff. Reasons are to assure the items are budgeted, appropriation and object class codes are correct, the document is logged for expenditure and tracking purposes, and the certification of fund availability. To expedite travel orders, we have been given the responsibility of signing numbers to travel orders before submitting to the Travel Section for processing. All requests for personnel actions are submitted for review and approval. Position descriptions are submitted through the staff office to the Classification Branch. A block of position description numbers is obtained from the Classification Branch for assignment to new position descriptions. All incentive awards, e.g. employee suggestions, performance awards, CAMI employee-of-year, and special type awards are processed by the Program Management Staff. This involves the review of awards to assure the justifications are sufficient, the preparation of necessary paperwork for payment, preparation of certificates, etc. They receive all draft directives for staffing with CAMI organizations. Comments are reviewed and summarized for a consolidated reply. A file of published directives are maintained in the staff office. Although there are files maintained by divisions, our files are considered to the official or most complete set of directives. Work orders for services such as installation of electrical outlets, painting of walls, any repair or modification to the building, etc. are submitted to the staff for review and assignment of a work order number before submitting to Dr. Collins for approval. Other types of requests for services that are reviewed and processed by the staff include telephone, office moves, pickup of excessed property and materials, key core changes, safety glasses and shoes, use and care of the permanently-assigned GSA vehicle, etc. The staff receives the shipment of equipment and supplies. Checks for shortages and assures the material is sent to the ordering office. Also maintains a central supply room for the Institute. Receiving reports for contractual services certifying payment are processed and approved by the staff. The staff also conducts personal property inventories for all of CAMI, with the exception of AAM-300. The staff is responsible for any reconciliation efforts needed for the inventories. All equipment, with the exception of AAM-300's, is received and inspected by our staff. Paperwork to input equipment into the property system is prepared and submitted to the Personal Property and Motor Fleet Section. Equipment is bar coded for inventory purposes. Location: Civil Aeromedical Institute (CAMI) Interviewee: Dr. Henry Boren, Supervisory Medical Officer for Aviation Medicine Medical Review Branch, AAM-300 Date: April 22-26, 1991 Interviewer: Jim Frey The General Review section handles all airmen who have no medical problems or are granted waivers for minor conditions that can be corrected. Receiving a waiver is not the same as receiving a Special Issuance (SI). [For more detail on the difference, see Nova Green: Special Issuance.] The General Review Branch evaluates normal applicant information and issues a Statement of Demonstrated Ability (SODA) for static defects. It also reviews and acts upon a wide variety of applications that indicate various abnormalities that do not meet the medical standards under FAR Part 67. Some of these cases may fall in a specifically disqualifying category or the General Review personnel may take an initial action such as deny request for additional information or refering to the special issuances. Some cases may fall into a category that does not meet the medical standards although the case cannot be specifically disqualified. These cases may require additional information to determine final disposition and may be assigned a general denial. Some cases are referred to an FAA selected specialist for consulting and recommendation before final disposition. Most applicants will request reconsideration and the general review personnel will re-evaluate the case. Doctors Russell and Carpenter are part of the General Review staff who provide guidance to application examiners. If the reviewer has a problem in handling an application, the reviewer provides a summary of the problem on a worksheet (file coversheet) that is routed to the doctor. The doctor will peruse the application, looking for the problem and correlating it with the note and reviewing the pilot's medical status. The doctor may write a note to the reviewer requesting more information. The file is returned to "Pending" and later delivered to a doctor once any new information is received. If an airman is denied, they are informed they need a SI. The General Review Branch is also responsible for evaluating and responding to all EKG's submitted to the Aeromedical Certification Division. Performance standards for employee evaluations are provided by the Program Support Branch. Boren receives information about operations through reports by supervisors at weekly staff meetings, the minutes of which are published. He often communicates using interoffice memos. Boren receives requests for information primarily from airmen calling about denial. AMEs and evaluating physicians also call regarding the status of certification or reconsideration. Congressional inquiries are routed from Audie Davis. AMEs and Military Flight Surgeons need policy guidance or have questions about regulatory issues. Boren as well as other staff physicians (i.e. Dr. Russell and Dr. Carpenter) take AME calls. Airmen are routed to the application reviewers. If he must speak with an airman, he will request their file first and call them back within 48 hours. Regional Flight Surgeons (RFS) and their staff will call regarding policy and procedure or may have rare certification questions. RFS telecons provide the means for an exchange of ideas. Standards are provided by FAR Part 67, general MGLs that support the standards, policy from the FAS and the AME Guide. Medical information is gathered through discussions, lectures, AME seminars, publications and the cardiology panels which are made up of specialists on the cutting edge. The doctors share journal articles and some information is received from AMEs and RFSs. Boren receives a copy of the consultant list maintained by Dr. Spann. The Branch meeting provides a forum for open discussion. This is the means for disseminating information to the staff with a question and answer session each month. Lead supervisors also bring questions to Quenton (the review supervisor) or to Boren who has an open-door policy. An airman who has been denied medical certification may ask for "reconsideration" because they believe they meet limited standards within a limited area and time. In this case they must demonstrate that they are healthy enough to operate an aircraft safely. If the airman falls into the Final Denial category, the case may be sent to SI. Other cases may be referred to the FAS for SI or final denial. Some airmen may be given a limited or unlimited medical certificate if additional information indicates that the airman meets the standards. Information about AMCD operations is received at weekly staff meeting attended by the AMCD manager and Branch Supervisors. Boren hires/contracts consultants to review special cases. He fills out a worksheet specifying that a file must go to the consultant. A transmittal is completed with a brief description of the condition and the consultant provides an opinion. No testing is performed on the airman and the consultant will not examine or meet the airman. Boren uses CAIS indirectly through his secretary who will look up any information he requires. Boren is not computer literate, but broached the idea of a system that would provide current medical knowledge, policy and procedures supporting rapid storage and retrieval. Location: Civil Aeromedical Institute (CAMI) Interviewee: Charlotte Clark, Medical Records Technician Medical Review Branch, AAM-300 Date: April 22-26, 1991 Interviewer: Jim Frey Charlotte leads a team of four people who handle incoming telephone inquiries to the certification area. These generally are inquiries regarding the status of airmen applications or other documentation/medical reports begin funneled into the certification area. Initially, the receptionists locate the airman's records on CAIS using a SSN look up and check the "date of Exam" field to determine whether the application is being (or has been) processed. AAM-300 policy allows the receptionists three minutes to resolve any inquiry and clear the telephone line. Further investigation may be required in order to respond to an inquiry. This may entail locating the airman's file (application) in order to review its contents. If an inquiry cannot be resolved immediately, the receptionist fills out a "tablet sheet" triplicate form detailing the inquiry, including basic airman information, MID number, date of inquiry and nature of inquiry. One copy is retained in order for the receptionist to respond accurately to future/repeat inquiries from the same airman. The others are placed in an out box, and are picked up several times each day by contract people who locate the airman's file and returns it to the receptionist, or pass the worksheet to the "control desk" in the records unit who attempt to locate the file. (The files are generally being reviewed in the doctor's offices.) According to Charlotte, the Records Section has no way of knowing where a file is once processing begins. If a reviewer/physician needs more information, the file is sent to the control desk, a.k.a. "pending." (This area has three different names, which confuses new employees.) Incoming mail/medical reports, etc, are matched with the file in "pending" and then returned to the original reviewer. If an incoming document is sent by express or certified mail, or FAX, a red tag is attached, giving it priority, and it is sent directly to the reviewer. Receptionists will also receive calls from FSDOs, inquiring about authorizations such as Statements of Demonstrated Ability (SODA) waivers or they may want to know if a pilot is flying illegally. A calling lawyer is turned over to Chuck Holmes, the Supervisory Medical Records Technician, immediately. Airlines may call to check pilot certification. AMEs call to determine of information they sent has been received. An AME way request guidance, and this will require "pulling" the file and turning the AME over to a reviewer or a doctor. Newspaper people may call. This requires determining their information need and turning the inquiry over to someone within the organization concerned with public relations. Calls coming from overseas are treated as priority. The receptionist informs the caller when to call back for a response. The receptionists can also receive information from people calling to report airmen who are flying illegally. In order to take action on such a report, the receptionist must get the informant's name and address (no anonymous tips). If a file can't be found, the name of the airman is added to a "phone" list, and during the day, people will mark off airman on the list as their files turn up. The phone operator's don't like to use microfiche, because it is difficult to locate looking through hundreds of them, and if it is misfiled or attached to a neighboring microfiche, it is very difficult to find. The receptionists (contractors) keep track of the number of calls received each day using hash marks. The receptionists rely on a book of Path Codes which they sometimes reference in response to inquiries. A receptionist can respond to any inquiry about an airman, but must only supply public information: date of last physical exam, class certified, and any restrictions. Location: Civil Aeromedical Institute (CAMI) Interviewee: Shirley Dark, Supervisory Program Analyst Officer Aeromedical Certification Division, AAM-300 Date: April 22-26, 1991 Interviewer: Jim Frey Manages the Program Support Branch, which includes the Records Section, Statistical functions (Leslie Downey) and on-site technical support (Dave Bohnett). The administrative functions include personnel actions (SF-52:Request for Personnel Actions), employee evaluations and appraisals, position descriptions, performance standards and training. Dark is the contracting officer representative who signs off on invoices for Personnel Services, which provides about 20 people providing on-site clerical support (control clerks, telephone receptionists, etc). The support branch includes the Records Section, the Correspondence Unit, the Mail Room and Control Clerks who match correspondence with hard-copy microfiche medical records and submit it to an application examiner. The statistical functions include publishing the "Aeromedical Certification Statistical Handbook", AC 8500-1, (see Leslie Downey/Statistical Assistant) and workload data. Dave Bohnett is a computer specialist who maintains the WANG system (about 12 users), provides support for CAIS, maintains the Special Issuance (SI) Tracking (Paradox) database running on a Compaq 386, and handles OATS implementation. Dave is also involved in site preparation for the automated 8500-8 system and performs some user training. The budget is divided by Operations (people) and Interfunctional equipment (typewriters, microfiche viewers, copiers, etc.). In order to respond to a budget call, Dark uses the previous year's budget, reviews/compares workload reports and reviews on-going and potential activities. She needs lists of all activities and proposed projects from HQ-OAM and feels there is insufficient communication between HQ and CAMI, because there are often "things in the works" of which she is not aware that could significantly affect resource allocations. Also, she said budget specifications are not shared in time and requirements may be levied at the last minute. Supervisors in CAMI's sub-units contribute to the budget process with requests for additional contracts, people, equipment and hardware. Carolyn Stewart, the division Administrative officer, assists Ms. Dark in preparing the budget. The budget is consolidated using wordprocessing and forwarded to Virginia Hicks, CAMI's Administrative officer, who may use a spreadsheet. Virginia passes her budget to Carol Kelly, formatted on diskette. Shirley receives a copy of the final budget sent to HQ, which she compares for variations in wording, since this may have been modified and can cause very important communication problems with HQ. Shirley receives the approved budget from Virginia, which shows variations in amounts allocated and supports Shirley in adjusting programs and resource allocation. The general communication of budget information between HQ and CAMI is Carol to Virginia to Shirley, providing notification of changes in the budget, which can happen at any time. In order to modify allocations, Shirley consults with Audie Davis, the division manager, branch managers, and supervisors. Invoices for contracts provided by local contracting firm shows how much of a budgeted amount has been spent and how much remains. These reports are printed by the contracting firm. AAM- 300 has a "tenant agreement" with the Aeronautical Center (AC). The AC Accounting Office handles PC∧B, overtime, travel/training, contracted services. The Accounting Office issues a monthly report showing the budget/balance/spent, which Shirley finds very helpful, but it's always at least one pay period behind. Also, the report details all of CAMI, and Shirley would like AAM-300's figures broken out. All division managers in operations receive this report. Shirley's secretary maintains a record of overtime. A list of positions printed by CPMIS at the AC is used to determine personnel costs, slot vacancies, etc. Most training is furnished by the AC. There is a training branch at the center and the management school in Florida. This is usually budgeted from AC funds. CAMI's training budget is used for: doctors to learn about new medical issues, WANG training, EKG training, OATS, and other computer training. These needs are all specific to AAM-300. Carolyn Stewart is the Training Officer. She passes training requirements to Virginia Hicks, who controls CAMI's training budget. Training records are maintained on a PC using wordprocessing. The Equipment/Supplies Budget is a lump sum for CAMI. In order to procure an item, Shirley must clear the purchase with Virginia, initiate a procurement request (PR) that Davis ∧ Dark sign and send it to Procurement (AAC-70). Procurement returns the PR with a PR Number and a copy of the order or contract generated showing the actual cost and supplier. Following receipt of the goods/services, Shirley or a member of her staff signs off and sends a copy to AAC-70 and the Accounting Office (AAC-20). The vendor bills AAC-20, which checks for receipt prior to payment. Shirley must also sign off on all contracted services rendered prior to payment which involves different paperwork. The depot maintains most office supplies and Shirley's secretary, Bridget Stephenson, uses an automated system to order supplies. Shirley is responsible for maintaining up-to-date (job) position descriptions. Shirley writes performance standards for the PDs. She also handles personnel actions (SF-52s) for recruitment, classification, change of name, retirement, resignation, etc. These are input to CPMIS at AAC-10 (Personnel). Carolyn Stewart assists in all of these personnel areas. Immediate supervisors evaluate employees annually by March. Shirley evaluates nine employees. Evaluations are sent to Personnel from Carolyn to Personnel on a dry run (only for CAMI) which ensures that the overall personnel changes conform with organizational requirements. Once feedback from AAM is received, the final appraisal forms are sent to Personnel. Employees retain a copy of their appraisal. The evaluation is input to CPMIS and the evaluation is put in the employee's "201" file at Personnel. Ratings can affect pay and promotion. Job Descriptions are written by Dark and Stewart which are often based on an outline provided by supervisor. Performance standards and PDs are kept in binders in Carolyn's office. Personnel maintains a database of generic PDs, and they can retrieve examples. Shirley likes "reusable" PDs that can be created, copied and modified. People are always calling for statistics, such as HQ-OAM, Aircraft Industry, Airline Pilots Ass'n, and health studies. The statistical area supplies the "statistical handbook" and responds to ad hoc queries. The statistical area has problems in describing to people the limitations of the data collected and the context within which it is collected. Leslie Downey, the statistical assistant, fills out a query request and submits it to Data Services Division. This can involve discussing the query over the phone with a systems analyst. The request is returned with the programmer's and computer time indicated. Data Services will generate the listings/reports or dump data to disk. All requests for data from CAIS are routed through Shirley. The RE∧D divisions do not have access to CAIS because of the Privacy Act. Location: Civil Aeromedical Institute (CAMI) Interviewee: Audie Davis, M.D., Supervisory Medical Officer for Aviation Medicine, Division Chief Aeromedical Certification Division, AAM-300 Date: April 22-26, 1991 Interviewer: Jim Frey Davis manages the division, performing evaluations, implementing changes and handling crises. He is involved in setting policy (Part 67) through the Federal Air Surgeon and the AME Guide. He is responsible for training and developing team work. Davis acts as a resource for Regional Flight Surgeons and Certification, and provides guidance to AMEs and the industry (for special cases). He participates in NTSB Hearings, court cases, depositions and sometimes appears as an expert witness, but only regarding the certification process, operations and policy. He also acts as a liaison with HQ-OAM, translating demands into operations. Davis receives quantitative monthly activity reports, showing number of applications, letters and telephone calls handled by AAM-300, which is useful because it shows the work flow and back logs which he relies on for making decisions about resource allocations. Reports that show AME performance and errors determine changes in focus of AME seminars and annual Path Code reports provided by AAC-300 (CAIS) are helpful in referring to past operations (precedent). Davis said AAM-300 needs a method to refer to actions taken on past cases. He believes he sometimes receives too much information, but what he gets is valuable in terms of guiding resource allocation. Moving information from his office into AAM-300 is generally accomplished through staff meetings with the branch chiefs or informal meetings. Processing reports (quantitative) are sent to the Federal Air Surgeon. Other information is transferred to HQ-OAM during weekly telephone conversations. Davis responds to specific requests for information, such as passing on any changes in Special Issuance (SI) certification to Dr. Hark. Davis is still involved in handling many certification cases. Davis's contact with regions is normally in coordinating workload during unusual periods and consulting Regional Flight Surgeons (RFS) before they authorize a special issuance. He normally deals with RFSs by telephone, but sometimes corresponds about current certification areas of concern, policy and procedure. He gets input regarding policy and procedure and seminar content from the RFSs. Standards are embodied in Part 67. All special issuance is "outside" of the standards. The SI criteria is established by a panel of consultants (see Joe Spann) who create policy. The Medical Guideline Letters (MGLs) are the responsibility of HQ- OAM, but they are usually not formulated without input from Davis. The recognition of a lack of an MGL or obsolete MGL often surfaces at RFS meetings. Normally, Davis will write a draft MGL that will be FAXed back and forth from HQ-OAM before it is finalized. The Federal Air Surgeon's opinions and the political climate influence MGLs. Davis said that MGLs often are produced in response to a crisis in the field, and that there should be more MGLs to clarify policy and procedure. Not much medical information affecting policy comes from AAM-500 or AAM-600. There is some clinical research, but most medical information affecting policy is derived from the panel of consultants and conferences of consultants and specialists. Davis uses the CAMI library to perform literature searches to find information about new medications and procedures. Davis has to follow the performance of AMEs and inform RFSs where problems exist and which AMEs are not performing properly. He is involved with AME seminars nationally. Davis is also involved with providing seminars for pilots and the industry and presentations to management regarding certification, drugs and alcohol. He consults airline directors regarding specific cases. Davis noted that the industry is concerned about standards and waivers and often test precedents. Davis refers to CAIS to answer inquiries, looking at Path Codes, PI number and pilot class. No one ever discusses a SI case without the file in hand. He can check CAIS for the Path Index number, call records and have the file delivered to his office. He discusses cases with Dr. Spann before talking with airline representatives. Davis also responds to congressional requests, replying to congressmen about actions taken on specific airmen, usually about 10-12 per week. Davis provides depositions. Attorneys will call to request certified copies of files, who are referred to Aeronautical Center's Legal department. He may be subpoenaed, and subpoenas are routed through Security to Legal to CAMI. Legal coordinates with Davis by telephone or FAX. Davis can provide certified copies of files and factual statements to court cases. Normally, the court expects him to appear as an expert witness, but he avoids this because of the frequency and drain on time. If he does appear as an expert witness, it is only as a representative for the FAA. Toxicological and autopsy reports are input to ASAS, but Davis is trying to transfer this responsibility to AAM-600 (see Leslie Downey/Statistical Assistant: Dr. Verano). Davis uses the AME Directory and receives quarterly reports from AAM-400. He requests reports from Nova Green's SI database on an ad hoc basis. He would like access to the library's databases, but he is unsure of the possibility or his personal ability to search it effectively. Location: Civil Aeromedical Institute (CAMI) Interviewee: Leslie Downey, Statistical Assistant Statistics ∧ Records Branch, AAM-300 Date: April 22-26, 1991 Interviewer: Jim Frey Leslie works for Shirley Dark of the Program Support Branch and produces statistical reports monthly and annually. This job requires collecting information from various sources. Some information is contained in reports provided by AAC-300 (POC Andy Burris), which is mostly workload and activity information, e.g., Aviation Medical Examiner (AME) error rates, generated by CAIS. She also collects manual activity reports from many sub-units of AAM-300. Much of her job involves consolidating information from a variety of sources, creating new information by combining data from reports, formatting reports and requesting information from many areas. Leslie does not have an education in statistics, but has 9 years of work experience in statistics. Leslie requests reports from AAC-300 using a memo to specify content, format and delivery date. Normally this is necessary to respond to a single/unique request for information. Leslie then provides the report to the individual who originally requested it on hard-copy, computer tape or PC disk. People requesting these reports are sometimes from within the FAA, e.g., the Inspector General's Office. A substantial number of the requests received are from outside the Agency, e.g., students performing studies, airline companies, etc. Annual reports are produced during the first half of January and are all stored. Leslie uses the Path Code Summary Report for reference in responding to queries. This report provides the numbers of active airmen assigned each pathology code used in medical certification. This report is also printed by age and status (pending, denied, waiver). She receives the Examination Time Period Summary broken down by region, including military and international AMEs, showing how many airmen are active. The Specific Path Code on Denied report shows every path code with totals of airmen denied by class. She also receives the Denied Airmen by Occupation and Class Applied for report. These two reports are not used by Leslie on a regular basis; however, if statistics concerning medical certification denials are required, they are both utilized. Leslie prepares the Aeromedical Certification Statistical Handbook, containing monthly activity reports provided from within AAM-300 and AME data from AAM-400. The Handbook is provided to the regions, HQ-OAM, Dr. William Collins (CAMI's director), individuals on the distribution list and anyone else requesting it. The Handbook is also used for reference in answering phone inquiries regarding medical certification statistics. The Annual Record of Physical Examinations Report, generated from 8500-8 processing on the IBM 3090, is published in July for the previous calendar year. It is distributed to HQ-OAM, Dr. William Collins, Shirley Dark and Dr. Audie Davis. This report provides complete information on all activity. It is intentionally run in July of each year, to ensure that final medical certification action has been taken in all of the previous year's cases. Leslie receives two monthly listings of AMEs, one by number and the other by name, from the Aeromedical Education Division, AAM- 400. Every October, AAC-300 prints the Path Purge Listing that is used by Charles Holmes (Records Section) to purge individual dormant files. Leslie doesn't use this report put passes it to Holmes. Leslie prepares the Monthly Backlog report is on the first day of the month for the prior month. This shows workload and activity for AAM-300. The following people provide activity reports to Leslie: Ruby Lorenz Records Section Shirley Scott ECG Section Quenton Duren Review Branch Jo Powers Data Entry Unit Debbie Licastro Correspondence Unit Sherlene Teague Special Issuance (Appeals) Nova Green Special Issuance (Recertification) Secretaries Doctor's Offices The Aeromedical Certification Processing Summary and Summary of Monthly Division Workload Processing Reports are distributed to Shirley Dark, Dr. Audie Davis, HQ-OAM and Dr. William Collins. Leslie has recently acquired an AT∧T STARLAN Network PC that is equipped with Word for Windows, Harvard Graphics, Arts and Letters, Superbase 4, Excel, etc. It is also equipped with ICOT S∧A 3270 Emulation for connectivity to the CAIS database system. She also accesses the COMPLETE system on the IBM 3090 for AME information. With this new system, viewgraphs and chars needed for presentations that were previously requested through the Audio Visuals Department can now be produced in-house. Leslie maintains an AME database of only AMEs which she uses to manage the FAA National EKG Network. Approximately 2,600 AMEs are currently transmitting on the network and the database shows which ones. She also uses the database to refer AMEs to other AMEs in their community/area who may be interested in establishing an EKG Network Group. Participation in the Network is required for all Senior AMEs. Regions send Leslie information on new Senior AMEs, including a monthly roster of all new AMEs. She also receives a monthly roster from AAM-400, which serves to double-check other rosters. Regions also forward change-of-address and other information to Leslie about AMEs. A duplicate AME database resides at the FAA EKG Network Technical Support Center (Marquette Electronics, Inc.) in Florida. This database contains data for all AMEs, including military and international. Leslie experiences great difficulty in gathering accurate information and maintaining the database. The Medical Accident System database resides on the Data General at CAMI. According to Leslie, the database fell out of use about 3 years ago, but had been in use for approximately 10 years prior. The input was values from toxicology reports, pilot information and other medical details regarding each aircraft accident. Leslie receives courtesy copies of the autopsy and toxicology reports, which she currently files. Originals of these reports are sent to the National Transportation Safety Board (NTSB). She was tasked with the update of the NAS database. However, because of limited time and the addition of other job duties, she has not updated the database in the past 3 years. A new physician, Dr. Stephen Veronneau, Manager, Aircraft Accident Research, AAM-611, has assumed the accident investigation role for CAMI, and the databases (and all accompanying hard-copy files) will become his responsibility. Leslie would like access to print reports normally run by AAC- 300, but lacks technical expertise. Location: Civil Aeromedical Institute (CAMI) Interviewee: Leslie Downey, Supervisory Medical Records Technician EKG Analysis Section, AAM-300 Shirley Scott, EKG Analysis Section, AAM-300 Date: April 22-26, 1991 Interviewer: Jim Frey The EKG Unit receives about 65,000 EKGs per year, primarily from 1st Class pilots who must have one at age 35, and then annually from age 40 on. About 500 per month of these EKGs are received as hard-copy from doctors whose initial transmissions were unsuccessful. (Upon successful transmission of an EKG, it is stored on computer and printed out (hard-copy) for review by an EKG technician. The system also prints out the airmen's previous EKG for comparison, it one exists.) Generally, ten or more minutes may pass before an EKG technician becomes aware of an EKG transmission problem or failure, and must call the doctor to request another transmission. In order to retransmit, the doctor must repeat the EKG on the patient, who, by this time, has often dressed or departed. Some doctors transmit directly to the EKG Unit, while others have arrangements with Service Bureaus that receive and "interpret" the EKG. "Interpretation" means to assess and note the airmen's physical condition based on the EKG. Information on the print out includes the airman's name, social security number, date of birth, height, weight and current medications. If the EKG has been reviewed by the service bureau, it will have been assigned appropriate pathology codes, otherwise, the EKG staff interpret the EKG and apply necessary codes. If EKG personnel are not comfortable with their ability to accurate interpret an EKG, the EKG is sent upstairs for a doctor's review, file and all. The doctor may write comments on the EKG print out. Once the EKG has been interpreted fully and accurately, the information resulting from the process is input to CAIS and the EKG system itself. The information input to CAIS is generally pathology codes, indicating a normal or abnormal condition, or a code that indicating that the EKG itself was defective (error in transmission). When this happens, the staff always contact the AME, not the Service Bureau (if applicable). If the EKG was submitted to a doctor for review, the doctor's comments must be added to the stored EKG itself. This is a process called EKG "editing", which involves selecting: the appropriate EKG, the application's Edit Mode, and any number of codes that represent standard comments normally applied by doctors to EKGs. After resolving the EKG process, the hard copy print out of the transmission is discarded. (Access to stored EKGs is by SSN and YEAR.) Hard copy EKGs sent by the AME to the EKG Unit as a substitute for transmitted EKGs are microfilmed and stored in a file cabinet by NAME and DOB. All hard-copy waiting to be microfilmed are noted on a list which is kept in a folder for one year, showing basic Airman information and the EKG's interpretation. This list is useful in tracking an EKG's location, providing interim information, and details for the CAIS system update, since they must be sent out for microfilming. After microfilming, the hard- copy is discarded. EKGs are often received by the Records Section and placed in Airmen records. This may be caused by initial receipt, or problems resulting from the circulation of EKGs and files upstairs and procedures for returning records and EKGs to their separate locations. Dr.'s requesting EKG information will send the Airmen's file to the EKG Unit with a routing slip attached, specifying the dates of the EKGs to be printed out for review, or may simply pose a question that can be answered by an EKG technician. If the EKG must be sent to the physician, it will be printed out if it is stored in the MUSE system, or the microfilm will be sent. Sometimes, the EKG personnel will check files in Regular Review for EKG hardcopy. When the file is returned from the doctor, it may be routed through the EKG Unit or the Records Section. Whoever receives the file has the responsibility of separating the contents and ensuring their return to the proper facility. For instance, if the file is returned to the EKG Unit, the personnel will return microfilm to its storage area and walk the file/application across the hall to the records section. The MUSE system provides reports on EKG traffic, such as daily totals of EKGs transmitted. EKG personnel also use hash marks to tally EKGs requiring edit, EKGs already edited (service bureaus), EKGs received as hardcopy and hard copies to be filmed. The MUSE system generated monthly reports for total EKGs by service bureau, which is used as part of their upward statistical (quantitative) reporting which is provided to Leslie Downey, the statistical assistant. This information is also used AME seminars and presentations to orient AMEs regarding the certification operations and process. The reports are maintained for two months. The service bureaus store EKG files for several months following transmission from a doctor's office and can be approached to provide hard-copy. The AME will call the service bureau to determine if a retransmission to the EKG Unit is possible. The MUSE system operates on Radal-Vadic equipment. There are four terminals available to the health technicians. One shows the workload of the MUSE system and incoming transmission by channel. It also provides information to basic AME data, which is required in order to contact AMEs if a transmission fails. The second terminal provides access to the MUSE applications for retrieving EKG files, printing hard-copy, editing EKGs and performing system maintenance. The third and fourth terminals are CAIS terminals used to update the CAIS system. Users must change terminals in order to perform the tasks described above. EKGs are usually collected (about 50) before someone will update the CAIS system. The MUSE system was implemented by Marquette Systems(?) of Florida. Marquette can be reached at 1-800-558-7070. POC is Bill Swindell (Tech Support). Bill Smith is the technician who services CAMI. Location: Civil Aeromedical Institute (CAMI) Interviewee: James Evans, Supervisory Applicant Examiner Medical Review Branch, AAM-300 Date: April 22-26, 1991 Interviewer: Jim Frey Applications are received in the mail room. They are stamped with a MID number. They then are sent to Coding where they are assigned Pathology codes. The applications are sent to data entry where much of the information is entered into CAIS. The computer compares the application's data to FAA standards for the Class applied for and will reject about 40 percent. AAC-300 prints a report of the applications listing applications with discrepancies. The reviewer will scan an application for problems and double check basic data input as well as existing files from unit if needed. If information is needed, the airman is sent a letter which may or not be a form letter. This is requested through "Typing", a.k.a. the Correspondence Unit, which generates and sends the letter. A dummy letter is put in the Pending file in the Records Section. When the airman responds, the file is pulled and given to the reviewer with the incoming correspondence. Evans receives medical and policy information from the doctors, as well as the FAS Guidelines, informal conferences and staff meetings. He uses the AME Guide, Physician's Desk Reference (PDR), Merck Manual/Medical Book and Medical Dictionary for medical information. If the reviewer is unsure about how to proceed with a case, a cover sheet is attached to the file routing it upstairs to a doctor or to a review supervisor. Standards guiding their decision making are the AME Guidelines, the doctors at CAMI and the FAS MGLs. Class I pilots must apply every 6 months. Class II pilots apply annually. Class III pilots apply every 2 years. Examiners can update CAIS with codes showing pathology or to flag airman (mark record to indicate a problem). They also obtain historical information, such as checking for the latest exam. This same information is in the file only if the current exam matched within the database. If the AME makes glaring mistakes, Evans will send the AME a letter. If the applicant has a certificate illegally, Evans sends a letter to request its return. If a "602" certificate is issued, the FAA has 60 days to question it. No time limit exists for a "609" certificate. Both CAMI and the regions handle AME errors and requests for additional information. Industry drug testing is not yet affecting Exams, and the affects it may have in the future are unknown. If an applicant is a Special Issuance (SI) case, it is given to SI. Location: Civil Aeromedical Institute (CAMI) Interviewee: Nova Green, Special Issuance Recertification Coordinator Special Issuances Branch, AAM-300 Date: April 22-26, 1991 Interviewer: Jim Frey Special Issuance (SI) processing is divided into two sections: Appeals and Recertification. Appeals handles all new SI cases, while Recertification handles the renewal of all SIs. Nova is in charge of Recertification. [SI implies a medical condition that will prevent a pilot from being certified, however, if the pilot is stable and meets certain criteria, they can be certified with stipulations.] Normally, a SI case is channeled through Regular Review to Appeals to obtain all pertinent background medical information. The complete file is sent to Dr. Spann for review and decision on new SIs. Nova handles alcohol cases. All substance abuse cases are handled by Dr. Pakul at HQ in D.C. In this case, an approved SI will be returned to Nova who writes a letter to the airman detailing the conditions of the SI with the certification included. Normally, the pilot will be in an established rehabilitation program or will have completed it already. The SI files are kept in a separate location from the Regular Review files and their contents are kept in chronological order. People with a significant medical history (e.g. cardiovascular, neurological, psychiatric, alcohol and drug) get more involved reports and the testing may be more elaborate. Nova must pay close attention to required reports, review reports and identify abnormalities or significant change from previous reports. If no change is detected, she approves SI with no changes in the airman's certification conditions. Otherwise, the case is sent to doctors for review. SI certification has several types of limitations. Examples of these include: Operational: Specify duties performed while flying (Class I excepted) or how to operate the aircraft. Vision: must wear glasses or corrective lenses. Time: set a time-limited certification. Hearing: must wear a hearing aid. Prothesis: must wear artificial limb. Standards for SI are: FAR Part 67 and Guidelines for SI (1988), published by HQ, AAM-200. This is a broad outline that specifies what information to gather, how to analyze it and what type of information to collect for follow up work. Doctors and the cardiology panels generate policy on medications and determine what follow up reports are required. HQ influences via the medical guidelines. This information is received via memos, staff meetings and word-of-mouth. Cases requiring review are given to Dr. Spann with a cover sheet. He returns the case with an opinion. Nova then sends a "scratch" letter to the Correspondence Unit who in turn generates a letter and sends it to the airman. The file is then returned to its normal place in the stacks. If further information is requested, Nova logs when the letter is sent on her calendar and checks the file when the calendar indicates it is time. If the material has not been sent by the airman, she will request it again and log a new date on her calendar. Currently, we have a pre-review position and that person contacts the airman and requests additional inquiries. This is usually done by phone. A log of these files is kept. Pilots in SI for Alcohol abuse are required to have an EKG annually. AMEs must send (label) applications and reports directly to SI or the application will go through the normal review channels. They ask the airman to have his AME forward the FAA examination directly to AAM-322 so what they can handle the re-coding first. Next, they forward the 8500-8 to be recorded on the computer. [Pathology Index (PI) numbers are assigned to pilots with a significant medical condition/problem. PI numbers are sequential unique identifiers assigned to an individual airman. Anyone with a PI number has a file that stores historical applications and medical reports. PI numbers are assigned in Regular Review for moderate risk pilots, who generally have problems with their senses (eyesight, hearing, etc.). All SI airmen have PI numbers, but they are considered high risk pilots with heart conditions, psychological or substance abuse problems. The PI number is used to locate files in the stacks.] Each examiner is given a block of unassigned PI numbers to apply to new cases. A log book is maintained to manage the distribution of PI numbers. [In the Regular Review section, a few stacks are set aside for "clear" pilots--those with no certification problems. These applications are stored in files of 200 applications each and the access point is the MID number, a sequential number assigned by the mail room upon receipt. Clear applications are kept for three years which means a healthy Class I pilot flying longer than 3 years should have 6 applications scattered in the Clear section. The MID numbers are recorded on CAIS (in chronological order(?)). Other stacks store files for individual airmen who have been assigned a PI number. These files consolidate all incoming and out-going correspondence, medical reports, etc. The access point to the file in the stacks is the PI number, also recorded on CAIS.] 'File Maintenance' is the term used to describe the actual processing of an airman's paperwork. CAIS is updated after every action and a small worksheet is completed for input to the SI Tracking system, a database kept on a COMPAQ 386 in the Special Issuance area. When a sufficient number of sheets are collected, they are input to the Paradox-based database. [According to Dave Bohnett, this database is slated for Oracle conversion and OATs compatibility. Screen prints and some documentation are available with these notes. This database duplicates basic airman information already available on CAIS, but also supports additional information required by SI. According to Nova, a LAN is slated for August 91 providing local access to CAIS and the SI database.] Currently, we are able to access to CAIS, but the SI data base is still not available. The original idea was to have each person in SI have a computer and that we be networked to each other. The reason was so that we could utilize electronic mail and other networking capabilities. The computers would also be linked to CAIS and COMPAC 386. As it turns out, we have 107AA employees and 6 contract persons and only 4 computers that have DOS/Windows. We have 1 wordprocessor with Word Perfect and 2 computer terminals that access CAIS only. Contact with regional offices is usually to request return of a "terminated" airman's certificate. This requires sending the airman's file to the Regional Desk in the Records Section, where it is copied. The copy is then sent to the Region by mail. The Regional Flight Surgeons (RFS) are authorized to issue SI and they often call for an update on policy and procedure. Sometimes they need to check to see if SI has received any reports or paperwork for the airman that they may need to certify the airman. There is some duplication of effort between the regions and SI, and interference with duplicate actions. FSDOs and regions may call to request the file for pilots involved in an accident, but they "will call just about anybody" in the records section. Location: Civil Aeromedical Institute (CAMI) Interviewee: Chuck Holmes, Records Unit Manager Statistics ∧ Records Branch, AAM-300 Date: April 22-26, 1991 Interviewer: Jim Frey Incoming correspondence is 'clocked in' with a date/time stamp and, if necessary, matched with the appropriate file. The mail room will send everything to General Review unless it is marked for Special Issuance (SI). Routine applications are bundled in quantities of 25, taken to the reviewers and placed in file drawers. The reviewers pull applications from the drawer based on date when they need more to work on. Priority applications/correspondence is delivered directly to the reviewer. The Records Section responds to requests for medical records, certified medical records and certified statements. It sends out medical records and duplicate medical certificates for pilots who have lost the original. The records are handled by 7 people, who each take a portion of them (A-C, D-F, G-K, L-N, O-P, Q-U, V-Z). A 6-digit MID number is assigned to the file and Coding may assign Pathology Index (PI) numbers that take priority over MID numbers. The 1st digit of the MID number represents the year. A portion of the General Review PI files have been converted to microfiche and all incoming documents for files maintained on fiche must be added to the fiche. They are then discarded. CAIS prints a list of incoming applications that have been flagged because of errors or values outside of FAA guidelines. All applications that are rejected by the computer are sent to the reviewers and all that are 'Clear' are filed. Any incoming correspondence is stapled to the application in the file. When a file is removed from the PI section, its contents are removed and the file cover remains in the stacks. For microfiche, the original is copied and sent to the requestor. The microfiche is 'signed out' to show that the information is being used by someone by putting a slip of paper with the master. A duplicate of the master is stored in a remote location for back-up / security reasons. Regions requesting records will be sent fiche, but any other person or organization will receive hard copy. Microfiche records can be converted back to hard copy and certified. The regions can call in requests, but requests from anyone else must be made in writing. Clerks who send out duplicate certificates have access to CAIS with basic update capability. People working the Region Desk can also update CAIS. All activities are quantified and reported upward. The date/time stamp counts pieces received. These are tallied at the end of each day and weekly reports are submitted to the supervisor. There are also monthly tallies. Chuck reports to Shirley Dark. Performance standards are based on activity. Each individual has (mostly quantitative) standards which Holmes maintains on a PC. Employee evaluations are submitted to Carolyn Stewart. Location: Civil Aeromedical Institute (CAMI) Interviewee: Tina MacMillan, Secretary to Dr. Spann Special Issuances Branch, AAM-300 Date: April 22-26, 1991 Interviewer: Jim Frey Tina proofs all incoming invoices and bills from consultants (doctors reviewing Special Issuance (SI) cases). Some include travel expenses. These must include receipts. Hotel invoices are screen for personal call expenses which are deducted, as well as "side-trip" expenses. Tina checks the per-diem and matches travel dates against all bills. She also double-checks calculations to find any arithmetic errors. For Services Rendered, she keeps copy of the bill and the consultant's report in a binder. Bills are prepared with a "Speed Memo" and forwarded to Dean Lacy, a budget analyst at CAMI, who returns the original with a signature. Lacy needs the invoices for cost and services data in order to track expenditures against budgeted funds. Tina keeps a running total in a binder to prevent exceeding budgeted funds. Tina then takes the bill to Accounting. Accounting holds the bill for 30 days and most doctors are paid within 30 days. Money for the fund is allocated quarterly. Accounting doesn't return anything to Tina. Lacy gets a report showing charges and totals, but Tina doesn't get a "run." Tina handles dictation and recruiting correspondence. She also makes hotel reservations for panel members and monitors flight schedules for pick up and departure (ground transport of physicians). Tina uses WordPerfect, Travel Lightning and a Smart system spreadsheet. She has 3270 access to CAIS which she uses to determine if a file has been sent to a consultant, a pilot's certificate rating or to check the processing status for an airman. She is authorized to update CAIS by adding or removing codes, but she rarely updates. Mostly she corrects typos and will only make changes at the request of Dr. Spann. Tina maintains a list of consultants, as well as files for each consultant that contains a "CV" or Curriculum Vita. The consultants are characterized by specialty. Only international correspondence is kept in the files. Tina maintains a log of all airmen files sent to consultants. The file is routed to Charlotte Dyer who copies and mails it and logs this transaction. The consultant returns an invoice, report, file copy, films, etc., to Charlotte. Tina needs to ensure a response from the doctor and also must watch funds budgeted for services rendered. Location: Civil Aeromedical Institute (CAMI) Interviewee: Carolyn Stewart, Administration Officer AAM-300 Date: April 22-26, 1991 Interviewer: Jim Frey Shirley's secretary (Donna Davis) handles time cards and submission to payroll. All overtime and compensation time requests are also handled by her. Carolyn handles SF-52s, training, employee evaluation, office supply ordering and position descriptions (PDs), awards, Interfunctional Budget and assists with Operational Budget. After completing a SF-52, it is sent to Personnel, but a "pending" copy is kept, and copies are sent to Virginia Hicks through Audie Davis. The original and a copy are sent to Personnel. Virginia returns a copy of her copy bearing her signature to Carolyn. (Carolyn believes that AVN has direct access to CPMIS and can request employee action without the SF- 52.) The SF-52s are filed in Carolyn's office with a sequential number assigned. A summary sheet is maintained for quick reference that shows pending items. The SF-7B Employee Record card is used for ladder positions to determine when the employee is due for time-in-grade change. Carolyn uses FARs to determine grade requirements and works closely with Personnel. Carolyn coordinates training with Virginia Hicks for 3-years in advance. The training branch sends lists of training available and Carolyn requests training by filling out a form and submitting it to Hicks. Hicks sends Carolyn a print out listing employee training which she thinks comes from AAC-17. Training is very flexible and subject to constant change. Carolyn needs software to track training and handle training requirements. Most training is conducted at the Aeronautical Center, OKC Community College or Oklahoma University. Carolyn does not apparently know which employees have received what training. She has to ask employees to list training, if she needs to know. Position descriptions (PDs) are kept in four binders (division and three branches). Carolyn uses word processing to process and store PDs on computer. The introduction of automation has often resulted in drastic changes in PDs. Carolyn needs to know Personnel policies, i.e., formal policies regarding personnel as conducted by Personnel/Human Resources (TS-23: US Civil Service Communications(?): Bureau of Policies and Standards). Carolyn uses EPAMS to print annual employee evaluations (PERs). This application saves the form as a file that can be retrieved and edited. The diskette is kept in a locked cabinet, because this information is not only private, it is quite sensitive. The evaluations are performed for a fixed time frame, but supervisors don't like this contrived arrangement, e.g., because of circumstances concerning new employees who should not be reviewed at such an early date. Supervisors keep the standards which are often both quantitative and qualitative. Carolyn maintains a list of employees and the rating submitted for each one. This list is destroyed after all PERs are submitted and cleared. She also reviews all PERs. The PERs are submitted to Personnel and the employee retains a copy. Supervisors submit awards through Carolyn to be reviewed and coordinated. When branch secretaries fill out employee forms, they come to Carolyn to get basic employee information. Bridgette Stevenson orders office supplies through the automated system which automatically deducts costs from AAM-300's budgeted funds. She also maintains the Purchase Orders. Location: Civil Aeromedical Institute (CAMI) Interviewee: Joe Spann, M.D., Supervisory Medical Officer for Aviation Medicine Special Issuances Branch, AAM-300 Date: April 22-26, 1991 Interviewer: Jim Frey Special Issuance is a mechanism whereby the Federal Air Surgeon may certify certain airmen,at his discretion, who are mandatorily denied by the Part 67 of the Federal Aviation Regulations (FAR). In Special Issuance, the Federal Air Surgeon establishes the requirements of testing individual airmen prior to Special Issuance certification and on follow-up for recertification. All third-class and limited second-class airmen can be certified by physicians within the office of Aviation Medicine, that is the Regional Flight Surgeons and SI Branch of Aeromedical Certification Division. All first-class and unlimited second-class airmen (as established by the Federal Air Surgeon's medical guidelines, December 22, 1988) will require a consultation by one or more of the Federal Air Surgeon's consultants prior to Special Issuance. Part 67 (FAR) and the 1982 amendment of 67.19 is the statutory basis for the special issuance procedure. The Medical Guidelines issued by the Federal Air Surgeon, an intra-agency memorandum delineates the method whereby the Regional Flight Surgeon and AMCD, (AAM-300), will process groups of airmen who have similar conditions in order to evaluate for special issuance and reissuance. It is noted that the individual AME cannot give special issuance nor are they authorized to reissue special issuance. The Federal Air Surgeon's cardiology panel is a unique function of the consultant specialists. This panel convenes about every 60 days to consider any cardiovascular case requiring special issuance but deal primarily with first-class and unlimited second-class applicants with cardiology problems for special issuance. Approximately one case per panel will concern a third-class applicant whose unique case might become a precedent or prototype for further special issuance decision. Over time the panel's deliberations and recommendations have established precedents based on new and existing medical knowledge and its application to individual cases. This deliberation is documented and may become policy with further feedback from the consultants to the Federal Air Surgeon There was a select panel convened only one time in late 1986 and early 1987 to discuss complaints about the SI process. By the direction of the Administrator, Admiral Engen, this panel was not primarily to review specific cases but to investigate the status of the special issuance process which obviously did include reviewing individual cases. This select panel recommended that the special issuance process be continued but with better documentation in its records whereby the decisions do not appear to be arbitrary. In fact, the panel recommended a special issuance tracking system and other record keeping that would allow an evolutionary process of decision making whereby new policies could be established by the Federal Air Surgeon allowing more liberal special issuance for the benefit of individual airmen while insuring flying safety. Because of the dynamic nature of the medical field and the evolving medical procedures and medication, special issuance policy is subject to re-evaluation which includes the old diagnoses and existing procedures as well as the new procedures and clinical entities. It is noted that AAM-300 has no in-house specialists who are practicing their specialty field other than in Aviation Medicine. MGLs may result from a panel discussion. All psychiatric cases including psychoses, personality disorders, alcoholism, and substance abuse of first- and second-class pilots are sent to Dr. Bart Pakull in Washington, DC, AAM201. In this particular area, third-class Special Issuance relies on individual psychiatric consultants and are usually processed locally. However, an occasional third-class case may be sent to Washington, DC AAM-201 for further evaluation. Dr. Spann's secretary may need Privacy Act/FOI information. After the Federal Air Surgeon's consultant activity was transferred from Washington, DC to Oklahoma City in March 1989, some of the original consultants were reluctant to participate in Oklahoma City and it became necessary to recruit well-qualified consultants in all medical specialties but particularly cardiology. AAM-320 was tested to find people with outstanding qualifications who were also interested in supporting a program in Aviation Medicine. Chairmen of Departments of Internal Medicine and Sections of Cardiology were mailed questionnaires in all the medical school in states contiguous or near to Oklahoma. From this group, I received approximately 12 replies of cardiologists with outstanding qualifications who would be willing to participate as a Federal Air Surgeon's consultant. Note that one of the considerations in this mailing was an attempt to lessen the travel costs incurred when flying consultants in from the East and West coasts. The nine Regional Flight Surgeons identify and employ consultants from their own regions which were not to be confused with the Federal Air Surgeon's consultants. We are allowed to pay our consultants $260.00/per day, a rather paltry sum when compared with private practice income. Invoices for panel participation and review of individual files are sent to us at the time the physician submits his consultation on the fire. Dr. Spann signs the invoices and his secretary (AAM-320) handles payment of the invoices. Every effort is made to expedite these repayments because of some large costs incurred in purchasing airline ticket which are carried on individual consultant's credit card. AAM-320 still does not comprehend why the airline tickets for consultant's travel cannot be purchased by the agency, i.e., the FAA as is done by General Counsel when they use the same consultants for NTSB hearings. A considerable savings could be had for the agency and U.S. Treasury in purchasing these tickets at government rates and it would certainly be helpful to consultants who have to carry this considerable sum on the individual credit cards. The more important part of the function of processing the invoices is that Dr. Spann (AAM-320) will approve or deny individual applicants for Special Issuance based on the consultant's opinion or recommendation. On a rare occasion it may be necessary to bring an individual file to a panel or other consultants if the issue is that precedent setting or unusually contentious. Spann says that Federal Air Surgeon's consultants participate because of the pleasure and satisfaction in an academic exercise. The panels provide a playing field for physicians to compare themselves with other consultants in a similar field and from a different part of country. In fact, it also provides an update and exchange of medical knowledge and information to all participants. He has been impressed to note that the exchange of information from one consultant to each other. It is Spann's belief that this is important function of the Special Issuance Branch of Aeromedical Certification Division to facilitate FAA intercourse with the medical academic community. Spann confers with people outside the area on an informal basis. A recent survey to medical schools provided 50 replies to a query regarding a heart problem. The consultant list is kept with updated CV on each consultant. The Federal Air Surgeon also maintains a copy of the curriculum vitae of each consultant (this is a recent addition to the process) and must review new appointments. Cardiology panels have been held in the Civil Aeromedical Institute in Oklahoma City starting in May 1989. To determine which consultants will participate in any given panel, a questionnaire is circulated annually, usually in December, to determine the consultant's availability, then the panels are tentatively scheduled. The consultant confirms the dates for which they are scheduled. Consultants also review individual cases that are sent to them (usually not highly litigious or controversial case). In this event, the airman's file is copied and sent to the consultant who renders an opinion and returns the case materials within 2 months. (See attached sheet: consultant's report.) Panel proceedings are tape recorded and reproduced verbatim. Additionally a stenographer takes notes in shorthand and the attending staff, Spann, Teague, Bernardini, also take notes. More recently the Federal Air Surgeon's representative, Dr. Robert Poole, is present and also makes notes regarding the decisions. The general procedure for each panel requires a preparation of an abstract of the airman's file. This is done by the Appeals' (AAM-321) Supervisor Sherlene Teague. This results in the production of a protocol and acquiring all of the necessary raw data in the form of coronary cardiac cinegram films, scintography, echocardiography, etc. At the time of the panel, the airmen's files are distributed to individual panel members. One physician then will review the protocol and the raw data in the films, etc. He will then present the case with his opinion, the films, etc. to the rest of the panel. After this presentation then the panel will vote regarding its recommendation to the Federal Air Surgeon. After reaching a decision, the applications recommended for issuance will be reviewed and signed by Dr. Audie Davis, Manager of Aeromedical Certification Division. Denials are sent to the Federal Air Surgeon in Washington, DC with appropriate working papers. The denial letter and the working papers are produced by AAM-320 and are sent to the Federal Air Surgeon. The working papers are necessary because an appealing airman's physician often attempts to contest the panel decision. After the Federal Air Surgeon has made his decision, that is confirmed the denial, this information is fed back or sent to the individual cardiologists who participated in the panel as well as on individual files that the consultant reviewed. It is noted that there have been no significant reversals in three years of panels held at CAMI. Spann maintains a list of recommendations, decisions, and precedents that have been established by the panel. This has been an informal process but involved identifying such diverse areas as: (a) What is adequate an EKG recording of a stress test? and (b) How old is a "current" coronary cardiac catheterization? The Federal Air Surgeon's consultants represent a primary source for the cutting edge of medical information, new procedures, medications, and their opinions are the driving force for evolution of the Federal Air Surgeon's issuance policy. Spann also uses the CAMI Library for obtaining medical information. In one online search performed by the librarian, he received a list of journal articles. He selected about 30 of the articles as relevant and very few were provided immediately. Many were provided within 2 weeks, but some required up to 3 months to obtain. Copies of medical journal articles are also provided by panel consultants. The consultants review Medical Guidelines for special issuance and indirectly provide recommendations to Headquarters for changes. Once an airman requires Special Issuance, he usually remains Special Issuance. The identification of an special issuance problem is usually done by an Aviation Medical Examiner, but sometimes this occurs when information comes to the CAMI Certification Division. If approved, a letter is sent to the airman, describing the conditions under which the airman will be allowed to fly. This normally involves a time limitation, instructions on how to proceed, any special tests, test dates and how to perform them. All correspondence from the airman is placed in the airman's file. All correspondence to the airman is copied and placed in the file. The file is taken to the SI section on the first floor with disposition forms attached to it and this is converted into a form letter. Retrieving an airman's SI certificate through the region is rare. Most have such short time limitations that it reduces the necessity to do this. SI's greatest interest in Accident Investigation is to determine if the pilot in command was Special Issuance and to determine if adverse changes health conditions necessitating and SI could have caused the crash. This information is a performance indicator and is fed back into the SI system. Spann provides presentations to AMEs during seminars at CAMI and in all Regions. Dr. Spann presented Special Issuances information to nine AME seminars in 1991. Additionally, he provided to military flight surgeons general information about the FAA and specifically about the Special Issuance area. Spann receives routine reports from the Special Issuance Tracking System and shares emerging patterns of SI with the industry. He feels the need to "exploit the potential of systems" to accomplish these goals and track more medical information. A nagging problem is the information vacuum left when a pilot does not re-apply for SI. Determining whether the airman is "dead, broke or ill" is an important performance indicator that SI does not receive. It costs considerably more, at least 150 times as much, to certify a Special Issuance as normal certification. Should Special Issuance airman be charged a service fee for the application process for this greatly increased cost otherwise borne entirely by taxpayers? It has been noted from a preliminary survey that less than one-half of Special Issuance third-class airmen with a cardiovascular Special Issuance are flying at the end of two years, we are concerned why an SI airman no longer flies. The determination whether an SI airman is dead, broke, or ill is an important performance indicator that SI does not routinely receive. It would be highly desirable, if possible, to implement the feedback as a condition for the original Special Issuance. Spann recognizes the value of the information that SI collects. In addition to the medical information that is used directly in the SI branch and in the Office of Aviation Medicine, we have a unique opportunity or vantage point from which to receive and review large volumes of cases that have been treated from all parts of the United States of America and from the world. For instance, this provides us an opportunity to evaluate certain types of surgical procedures for revascularization of the myocardium. At present, we are involved in the evaluations of aortic dissections as well as the risks of atrial embolization of airmen who have a trial fibrillation. Location: Civil Aeromedical Institute (CAMI) Interviewee: Sherlene Teague, Supervisor Applicant Examiner for Appeals, AAM-321 Special Issuances Branch, AAM-300 Date: April 22-26, 1991 Interviewer: Jim Frey Sherlene's section handles all cardiac cases and is tasked with acquiring all hospital records since the 'event.' Standard procedure requires a minimum 6-month recovery period after which she will ask for current tests. Incoming mail will be routed to Appeals and a clerk will match correspondence with an airman's file and deliver it to the appropriate reviewers. Sherlene handles all Class I pilots. She looks at the test results on a worksheet and if the airman is not certifiable in her opinion, she sends the file with "work up" to the doctor, who may return the file with a request for more information/tests. The file is then placed in the Pending area and if the individual responds, the file is pulled and returned to the doctor for review. Sherlene also handles all case work for the Federal Air Surgeon's cardiology panel. This entails writing airmen to request films (showing flow of blood through the heart), compiling paperwork and ensuring that the case is prepared prior to the panel convening. All Class I pilots with a cardiac problem have their certification reviewed by the panel. If there is no chance (a mandatory denial) the case is sent to Dr. Spann for review and he will issue a Final Denial with a 67.19 paragraph stating he has also received consideration for special issuance. [There are 10 mandatory reasons for a Final Denial. A Final Denial cannot be appealed. A General Denial means that the airman's condition(s) warrants denial in the opinion of consultants, but denial is not mandatory. These denials may be appealed.] A stenographer provides a transcript of the panel dictation which is included with the airman's denial. A letter is sent to the Federal Air Surgeon (FAS) for signature with a copy of the working paper (panel transcript). If the airman is certified, the films are returned to the airman immediately and is filed in Recertification, AAM-322. For 2nd Class pilots, she does the case work up and sends it to an individual consultant, most of whom are cardiologists. This includes a copy of the file, all films and a stress testing. The consultant sends back an evaluation that is routed to Dr. Spann who certifies or denies the airman. In some instances, a case may go before the cardiology panel. Special Issuance may issue waivers (Statement of Demonstrated Ability--SODA) for airman who have cardiac problems as well for things such as eyesight and hearing. Eyesight and hearing problems alone are not special issuance. The SI database, a Paradox database running on a COMPAQ 386 provides information on SI actions, such as certification status, follow ups required, etc. [See Nova Green's interview notes for more information on the SI database.] This is useful in responding to telephone inquiries. Sherlene always talks to Class I pilots, because it's urgent to get the tests in. All incoming and outgoing correspondence is kept in the airman's file. When seeking policy and procedure guidance, Sherlene goes to Dr. Spann and then Dr. Davis. Sherlene attends monthly meetings to share this information. She learns medical information from medical reports, panel transcripts and Dr. Spann. Regions call to request information about an airman's status. In the event of an accident, they will request a copy of the airman's file. Also, they may need guidance concerning tests that an airman should submit. If the (CAIS) has an "FO3" code, indicating that the region is working the case, Sherlene will send any information to the region and vice versa. Some RFSs will handle SI, while others don't, because according to the guidelines it is their prerogative. In this case, physical exams go to the Region before CAMI. Sherlene will update the SI database to show that the region is handling the case and input any results received from the region. If issued, Sherlene sends a follow-up request to the AME for tests that will be submitted with the next application (Recertification: Nova Green) and stored in the file. Location: Civil Aeromedical Institute (CAMI) Interviewee: Doug Burnett, Medical Education Program Officer, Acting Division Chief Airmen Education Division, AAM-400 Date: April 22-26, 1991 Interviewer: Jim Frey AAM-400 manages the AME and Drug Abatement seminars. This involves establishing contracts with hotels (often through corporate HQ), requesting bids, checking available space, rates and accommodations. The seminars are scheduled/planned by fiscal year, a year or two in advance. Speakers are chosen from a list of private doctors, specialists and consultants. A list of seminars is sent to the speaker, who selects one (or more?) based on time, place and preference. The presentation can deal with any medical theme, but it must be aviation oriented. The list of speakers is maintained by AAM- 400, containing basic information about the speaker (name, address, specialty, etc). Some speakers are recommended by Flight Surgeons. AAM-300 and AAM-400 assist each other in locating speakers and consultants by exchanging updated lists. After the seminar schedule is published, it is sent to all speakers, Regional Flight Surgeons and FAA people who are involved in the seminars. The AME database is used to generate a report of AMEs in the area where a seminar is scheduled who need to attend in order to maintain their AME designation. AAM-400 generates mailing labels from the database and invitations are mailed to AMEs along with a request for information about the AME's preference for accommodations. The hotel confirms accommodations with the individual AMEs. This information is used to build a list of people staying at the hotel and for making hotel reservations. The seminar agenda is created and sent to printing. Letters are sent to the speakers (informal contract) and paperwork sent/received is filed by seminar. The speaker agrees to AAM-400's terms (pay, time, date) by signing and returning an agreement. A Purchase Request is "cut" and the speaker is scheduled to receive a check. The hotel is contacted to arrange food for functions, AV equipment and other seminar support. The agenda is carried to, and distributed at, the seminar. Name tags and individualized receipts are generated by computer, as well as rosters to distribute to AMEs/MROs showing the names and addresses of people attending the seminar. AMEs/MROs pay the hotel, which is hosting the seminar, for accommodations, etc. Receipts are kept for two years. The Aeronautical Center Contracting Office selects hotels and prepares contracts for meeting space and audio-visual equipment for AME and Drug Abatement seminars. Regional Flight Surgeons, Administrators and AME coordinators sometimes call to coordinate with the seminar. The RFS usually notifies new AMEs of an upcoming seminar. AAM-400 distributes the AME performance report annually and quarterly (generated by AAC-300). The computer flags AMEs with poor performance. Location: Civil Aeromedical Institute (CAMI) Interviewee: Keith Guest, Computer Systems Analyst Airmen Education Division, AAM-400 Date: April 22-26, 1991 Interviewer: Jim Frey The AME database resides on the IBM 3090 located at the Mike Monroney Aeronautical Center (MMAC). AME database is supported by ADABAS, using NATURAL and COBOL/ADAMINT programming languages. AME application is supported by the Registry Modernization Section (AAC-322). The regions receive applications from AMEs and they process and appoint AMEs. The regions send copies of the application and show appointment through letter/correspondence. AAM-400 handles all military and international AMEs, acting as a "region" for these communities. (Military Flight Surgeons are actually AMEs.) The applications for military/international AMEs come directly to CAMI and Dick Boylan designates AMEs. Clerks perform data entry and the paperwork on all AMEs is stored in files, ordered by last name. Class IV AME files are kept separate. These AMEs do not want to be listed in the AME directory, because they do not perform public exams. Other classes include: Class I - First Class Examiner, able to certify Airline pilots (Pilots that require exam every 6 months) Class II - Second Class Examiner, able to certify transport/commercial pilots (Pilots that require exam every year) Class III - Third Class Examiner, able to certify private pilots (Pilots that require exam every two years) AMEs are classified this way both manually and in the AME database. Incoming mail generates updates to the database. All correspondence is stored in the AME file. On occasion, it is necessary to pull a file for congressional review. Only copies of the file (sometimes certified) will actually leave the office. A global monthly AME listing is printed for internal use. Four reports are generated by four access points: name, state, AME number and unmatched. The internal report(s) are used to look up AME listings and respond to inquiries from AAM-300, regions and AMEs. Other reports printed include an AME Gain/Loss report, a New AME report, a Reinstated AME list and an Inactive AME Status List, including voluntary and involuntary status. AMEs must sign designation cards annually, and this information is input to the computer, including the date the card was received and renewal/deactivation. Quarterly Performance Summary reports show AME error rates, type of error and number of exams performed. The reports are sent to the AMEs, regional AME coordinators/Flight Surgeons and are used as feedback to AMEs to correct problems and by regions to support decisions in re-designating AMEs. The reports are maintained in a file at AAM-400. A Regional Summary shows all AME activity by region. The quarterly is only printed to show AMEs due for re- appointment in the coming quarter. The Training Summary lists AMEs and seminar training by region. A copy is sent to each region and a copy is maintained by AAM- 400. These reports may be referenced in response to inquiries. Performance data is only maintained on the 3084 for one year (4 quarters) and then it is purged. Annual Performance reports are "file dumps" sorted by Region, State, County, City, and name. This is also sent to the regions and AAM-400 only keeps the most recent annual report run. AAM-400 publishes the AME Directory, prints labels on request for the regions, AME seminars and NASA. AAM-400 can also merge names with form letters for mass mailings. Information that results in an AME database update includes: changes of address, appointment, separations (de-designation), actions against an AME (put into paper file, not 3084), training information such as last seminar attended, and re-appointment cards. Actions include additional classification or Accident Investigation status. Performance data is collected via an interface with the CAIS system. Data is passed during processing. AAM-400 is currently managing the distribution of new 8500-8 forms, recording order and distribution information. Location: Civil Aeromedical Institute (CAMI) Interviewee: Janice Nakagawara, Librarian Airmen Education Division, AAM-400 Date: April 22-26, 1991 Interviewer: Jim Frey The librarian operates a library providing journals with associated indices, technical reports, books, and information ∧ referral services upon request. Requestors are primarily CAMI staff but an increasing number of requests are received from the center and regional flight surgeons, general public, private industry, and other libraries around the sate, nation, and world. Non-library housed library materials are acquired as desk references for all CAMI offices. This endeavor requires identifying, budgeting for, ordering, in processing (categorizing and classifying), distribution, and accounting to follow through on each title. Understanding the organization's goals and objectives are essential to discerning the information needs and products required to support the facility. Vendor mailing lists and publishers' advertisements are scanned for relevant materials. Blurbs are copied and routed to CAMI staff to guide in the selection of library materials. Literature searches of online bibliographic databases, cd-rom products, paper indexing sources, Federal Aviation Regulations, Advisory Circulars, etc. are conducted upon request. A journals holdings list is updated and distributed inhouse annually to assist the staff. Users may note titles of continuous interest to them for which each issue's table of contents is then routed as the issues ar received. Incoming journal issues' tables of contents are scanned and users are alerted to items in their particular field of interest. Receipt of individual journal issues is monitored using a database management system to ensure the integrity of the collection (i.e. identify nonreceipt of issues for claiming with the vendors, monitor the need for binding, assess price increases). All subscriptions have been converted to a common expiration date and the procurement is facilitated by making use of an interagency agreement through the Library of Congress Contracting Branch. This process requires coordination through AAM-6, Legal Office, Acquisitions (procurement) office, Accounting Office, Library of Congress through FEDLINK (Federal Library and Information Center Committee) and various vendors. Books are acquired based on user demands and availability of funds from the most cost and time effective source. This process requires knowledge of existing GSA contracts, publisher, vendors, available discount, acceptable payment methods per vendor/publisher, history of past service timeliness and services. No clerical support is provided the library. Thus, after determination of titles to be ordered, verification of bibliographic information, source determination and availability of funds, purchase requests must be typed. These purchase requests are forwarded to the division chief, then to AAM-6, then to AAC-66d (Aeronautical Center Library IAW). The (obsolete but still in force) directive on FAA Library Programs, then on to Acquisition for procurement. An accounting trail must also be maintained to ensure that any price changes between the purchase request and Acquisition Office's actual purchase order still meets fund availability, no errors are made between the PR and PO. Once an item is received, receiving reports must be completed and forwarded to AAM-6, the Acquisitions Office, and the Accounting Office. any discrepancies are brought to the attention of the vendor and the procurement officer and resolved. ( To the best of Janice's knowledge, the process of receipting items is not done at this level in other offices - most CAMI areas are provided this service by AAM-6). A self-service circulation system is the one used in the CAMI Library. Circulation is for two week periods with the borrower shouldering the responsibility for renewal/returns due to the nonavailability of clerical support. A dual card system is employed to facilitate the clearance process (turnover). Given the limited library user population (approximately 175 registered borrowers), overdues and circulation monitoring are of the least priority. An alert librarian, knowledgeable in the interests of library users, can retrieve any item checked out within a few hours 95% of the time. Library materials are circulated primarily to CAMI staff, AC staff, or on interlibrary loan. From AAM-300, reference question generally concern drug, drug incompatibilities, new medical procedures, and directory information. This is the most undeserved of CAMI divisions. Medical dictionaries, medical work books, EKG manuals, atlases, zip code directories, thesaurus and general dictionaries, CFRs, directories, and assorted textbooks are acquired for this division on a routine basis. Some literature searching and interlibrary loans are also provided. The library collection consists of few clinical journals. Most requests from such titles are requested on interlibrary loan. Informal reciprocity agreements are initiated and maintained by the librarian in order to obtain interlibrary loans in the least costly and most timely manner. 350-500 interlibrary loans are processed each moth with lag times ranging from a few hours (fax service) to a month (items acquired on purchase requests, form GOD, NTIS, SAE deposit accounts, or from international sources). Most interlibrary loan requests are completed within five working days. Deposit accounts are justified and documented through the library annual budget submission and are administered by the librarian. An audit trail is maintained by the librarian without intervention nor supervision by any other office. Deposit accounts are justified and documented through the library annual budget submission and are administered by the librarian. An audit trail is maintained by the librarian without intervention nor supervision by any other office. CAMI staff was introduced to online bibliographic retrieval in 1987 upon library receipt of a personal computer from AAM-300. As the credibility of both the searcher and the products are demonstrated, the demand for the service increases each day. $5000 is requested annually in the library budget submission for this service. Users are encouraged to conduct end user searches with the stipulation that the costs must be monitored by the librarian. Few users are convinced of their abilities at this point and prefer the more cost effective librarian meditated searches. Recent introduction of CD-rom products, complicated by the long term nature of our budget process, has helped to increase library users' awareness of state of the art library services. This has also been a byproduct of the recent hiring of additional researchers used to such services at universities and private industry. Currently, cd-rom services are single user access in the library to Science Citation Index, Defense Technical Information Center;s technical reports database, and the HIS (material safety data sheets) database. With the assistance of AAM-505, plans are developing for network access to these and other library services. With AAM-505, connectivity plans with the Internet for CAMI staff is also leveling at the impetus of the librarian. Future plans developed by the librarian include adding such cd-rom products as PsychLit, NTIS, GPO, CD PLUS MEDLINE, etc. as funds and documented justification of need develop. CAMI Library services as a resource library for regional and center physicians using the GratefulMed ∧ LoansomeDoc software of the National Library of Medicine. Bibliographic citations are identified by the user at his/her FAA expense from the MEDLARS database, selected for retrieval by the user and electronically transmitted to CAMI Library. The LoansomeDoc system is accessed daily by the librarian for retrieval of requests. Reprints from CAMI Library's collection are then retrieved, copied, and distributed by mail or fax as is appropriate. Those citations are not available from CAMI Library are then routed on to lenders electronically as interlibrary loans must be absorbed by the library. CAMI Library mails free copies of OAM reports in response to requests received by mail or phone at a rate of 150+ per month. Requests are received from ATC facilities, airlines, international organization, AMEs, private citizens, other government agencies, etc. Library activities are reported monthly to the division chief and include such statistics as the number of reference questions responded to, number of photocopies produced, databases accessed, interlibrary loans processed, circulation statistics, significant accomplishments, annual and sick leave taken, and continuing education courses attended as certification by the Medical Library Association requires. Knowledge of the organization's activities, necessary to the effective provision of quality, proactive library services, are not readily available to the librarian. Recent US Army Medical Library Command task and manpower analysis directives indicate one interlibrary loan requires 45 minutes to complete. This points to the fact that this library is inadequately staffed and cannot provide quality services. Location: Civil Aeromedical Institute (CAMI) Interviewee: Jannice Duskin, Computer Systems Analyst Frank Elliott, Computer Systems Programmer Robert Link, Computer Systems Analyst Dennis Rester, Computer Programmer Technical Information Systems Branch, AAM-500 Date: 4/16/91 Interviewers: Carol Wasserman, Claudia Cardile AAM-500 (Human Factors Research) is supported by a VAX cluster that is integrated with a network of PCs. Most researchers, however, use the VAX. There is a network server to run DOS applications for personnel who use a VT class terminal who do not require a PC. Personnel who utilize storage on the VAX, do not need to perform PC backups since that is taken care of through the VAX network automatically. The client/server relationship between the VAX and PCs ensures that everyone is running the same software and the same version. The TIS responds to questions and problems from the Human Resources Research Division as well as other division within CAMI. The primary goal is to make the users as self-sufficient as possible while maintaining compatibility across multiple platforms. Questions that are asked by people within the Division are typically asked informally. The Data Services Division provides some PC application software in the area of Employee Performance Appraisals and Travel which is loaded to the server for use by VAX and PC users. Activity reports that contain the programs and support provided by the section are made available to the division manager. Computer usage analyses are run fairly frequently which indicate most of the VAX disk and processor capacity is utilized. The VAX is a clustered system utilizing a VAX 6210, VAX 8350 and VAX 11/780; if one CPU falls out, the other(s) take up the work load. The Local Area Vax Cluster (LAVC) is composed of PCs, VAX 3520s, VAX 11/730, and MicroVAX II. There is a direct connection with the Radar Training Facility for mail and file transfer, independent modem capability, and Starlan access in order to communicate across all current platforms utilizing a multitude of protocols. Security is very good. Users get access only to what they need. AAM-500 does not currently access other CAMI data bases. If the regions or anyone else in CAMI need access to AAM-500 data, all they need is authorized access to the system. No specialized equipment or software is required. TIS is currently in the process of working toward CAMI- and FAA- wide mail and file transfer capability. It is also desired to have access to academia and DOD networks which could be utilized by all of CAMI for information and research exchange. Training for how to use the VAX editor and the system is all on- line. All software that they use is licensed and AAM-500 has all the manuals. TIS receives tapes from the Consolidated Personnel Management System (CPMIS) that contain ATC identification and training data. Portions of the data base are loaded from these tapes. Guidelines and standards are generally informal. With respect to data standards, the basic rule is that the name must be something recognizable and meaningful. All programs are documented internally with information such as the purpose of the routine, special modifications, purpose, date, and by whom. AAM-500 is currently taking one system at a time and converting the files to Powerhouse, a 4th generation language which utilizes a relational-like structure. Powerhouse does not have a unique or proprietary data structure which allows for easy access and utilization by a large variety of other Database systems as well as systems which cannot access proprietary data structures. The data files used to exist as extremely large flat files. These are being restructured into a relational model which will be easier to manage and access. A large part of the re- structuring effort is being contracted out. This process entails completing a statement of work which is a document that specifies requirements such as compatibility, useability, and user approval. The winning contractor then gets the file formats and layouts. The contractor is monitored closely by TIS staff members and the requiring users. The contractor provides a delivery schedule as well as status reports, interim deliverables, training, and documentation. TIS performs a market analysis which helps determine the approximate cost as well as system impact of doing the work before putting a project out to bid. There are approximately four major data bases: ATC Training and Tracking (these data bases are tied to the ATC Attrition database) ATC Attrition (contains ATC who have quit or died - this data base is tied to the CPMIS data base) CPMIS extract data (this data base is tied to the scoring data base) Scoring system (contains ATC preliminary test scores) All of these data bases are broken down into smaller relational- like files. User guides and instructions on how to use the servers and individual systems are written by TIS. User guides and instructions are written in WordPerfect. There is an informal checkout system to keep track of who has the manuals for 3rd party software. Primary PC software is as follows: WordPerfect, SPSS, Harvard Graphics/ Drawpartner (heavy users of these packages). VAX software is as follows: WordPerfect, Fortran, C, SPSS, Powerhouse, Vivid (graphics). The division owns a Software Bridge which has the capability to convert WordPerfect into Microsoft Word and vice-a-versa. In this way they are able to be compatible with OATS software and a variety of other popular software packages. There are approximately 45 individuals who use the system regularly. Users also have the capability of running more than one session at a time. The division also owns a MacIntosh FX so that surveys can be created locally and to scan text and image documents for inclusion in reports. The MacIntosh is also networked with the VAX and PCs. The division also owns an NCS 2020 scanner which is the source of the majority of data input. This scanner reads bubble sheets, pre-printed scan forms which are filled out by the regions and ATC students. It is also capable of reading scan sheets produced by the MacIntosh. Another large data source is via 9-track tape. These primarily come from the Academy but there are smaller inputs from CPMIS and occasionally from other sources. The overall data processing approach is modular to ensure that users have the needed capacity, are able to grow, and are integrated both within the department and with other areas. The main load area is shared by all PCs. There is an image backup of all work that is done plus daily incremental backups. TIS is composed of: 1 GS-334-12 Computer Systems Analyst 1 GS-334-12 Computer Systems Programmer 1 GS-334-11 Computer Systems Analyst 1 GS-334-9 Computer Programmer 1 contract Full Time Computer Programmer This staff currently supports all ADP/FIP activities within the division including, but not limited to: contracts, consulting, wiring, training, development, configuration, design, programming, acquisition, documentation, division ADP inventory, and operations. Location: Civil Aeromedical Institute (CAMI) Interviewee: Frank Elliot, Computer Systems Analyst Technical Information Systems Branch, AAM-500 Date: 4/17/91 Interviewers: Carol Wasserman, Claudia Cardile Frank is the system manager and network administrator. Primarily he works with the DEC server 250. The satellite systems connected to the network can use and share the resources as well. The system does all the software installation for the network machines. This procedure ensures consistency of the versions. VMS has facilities that handle updates/install notes (directory and files), and a history of the installations and updates. He works on the databases to make sure they are un-fragmented, backed-up, and to maintain the hardware. Reports He does monthly status reports, these are combined with Jannice's and David's for the unit. Vendor Searches He does Technical Searches for vendors to look into new technology, search for specific products, or to fix problems. He keeps his notes on file electronically and keeps a log of phone numbers. Miscellaneous Work When researchers need coding/developmental work done he or one of the other analysts does the coding or fixing of programs. They want to know what the researchers are working on in this area and their needs for upcoming future projects (including software and equipment needs). They don't have knowledge of what the other divisions are doing and feel it would be useful to have some knowledge in those areas. If they knew what resources are available in the other divisions this could help them do their job better. Security is an issue with respect to accessing the research data. There is no set policy at the CAMI with respect to the computer networks. This issue should be looked at to see if it needs to be more structured. Data Stored Tapes are kept that contain a record, log notes, and time, with respect to the tapes. Backups are done quarterly, monthly, and daily. If everything on the system were lost, at most only 8 hours of work would be lost. Data Processing Data processing development and planning occurs separately in the two research areas. AAM-500 has networked PCs attached to a mini-computer cluster. AAM-600 has individual PCs that support each research section. Location: Civil Aeromedical Institute (CAMI) Interviewee: Carol Manning, Personnel Research Psychologist Training Systems Section, AAM-524 Date: 4/16/91 Interviewers: Carol Wasserman, Claudia Cardile AAM-500 has two branches, the human factors research branch and the training and organization research branch. The human factors research branch simulates operational situations for various employees in a laboratory setting and studies the results. Carol works for the training and organization branch. This branch does evaluation research where they look at the success or utility of various programs. She develops and maintains data bases that contain background, history, and air traffic controller (ATC) test performance in selection and training programs. Statistical analyses are then run on this data. They are trying to expand the population that they work with to include pilots and airway facilities people. With respect to the ATC data base that contains the selection data and test scores, the Office of Personnel Management (OPM) administers an initial test. When Carol's area makes a special request, OPM sends a tape that contains the test information. They load selected data from this tape onto the data base contained on the VAX computer system. She would like to receive the tape of the test scores and related information regularly. They also get 16PF (psychological test) data. This data as well as medical exam data and security clearance data is used as the initial selection criteria for hiring ATC. The ATC is hired and then comes to the Academy for 9 weeks for another selection procedure. AAM-523 receives lessons and tests which are graded. AAM-500 scores the ATC tests in conjunction with the Academy to provide a double-check. The tests are received on bubble sheets. AAM-500 receives the original forms which are scanned into the VAX. The scoring results are sent to the Academy via modem and cross checked with the results generated by another unit to ensure accuracy of results. At ATC orientation the new hires are asked to complete bubble sheets with biographical information. This information is then scanned into the computer. The biographical information, academy information, and OPM data are all maintained on separate files. They are in the process of integrating this information. Supporting data such as prior experience, age at entry, race, and sex are all manually entered from a non-automated source. Analyses are done on this information to see how different breakdowns of people will perform (e.g., male versus female). They receive a fair number of short-term, informal requests for this data. When people graduate either from the Academy or other hiring programs, they go to the field facilities. Carol tracks training performance at those facilities. When training is complete at the facility, someone at the facility (e.g. a training manager, supervisor, or an administrative employee) fills out the scan form and sends it to Carol. They track all the people who are trained at the facilities. It is more difficult to identify the training results for non-academy controllers and people who left the program. CPMIS provides status information on employees which is integrated into our data base. Another problem with receiving scan forms is that they are not always sent in. There is an order that tells the training managers how they are supposed to fill out the form. It is hard to track all the people who cycle through. Air Traffic is in the process of developing FMIS through ATZ-320. This system is currently just for the Air Route Traffic Control Centers (ARTCC). It will track daily training of the ARTCC's controllers and the resulting report for each completed training phase will be sent to Carol. The FMIS system will enable them to check for errors in the data up front. There are over 300 terminals from which they receive information. It takes a long time to determine if all the forms have been turned in. Once every two years they go facility by facility to determine whether everything has been turned in and to obtain the information if it was not submitted. Field information is maintained by Carol. Dana Broach maintains Academy information. Field data consists of academy graduates plus ATCs who were hired through a special program such as the GS9 military hire program (military controllers). The biggest problem with special program hires is matching them with the CPMIS list. CPMIS is supposed to code the people from special hire programs but sometime their codes don't match AAM-24's or CPMIS writes over the old code. CPMIS information is used to complete some of the codes in the training data base and to identify people with incomplete information. Dana produces standard reports on every input (group of Academy graduates). The reports are produced approximately every month. Carol now produces reports for the en-route option, by facility and region, that tracks each phase of a controllers training since the strike and over the last three months. These reports are sent to each facility, the ATZ Division, the several divisions in the Human Resource Management Division Office, and to several Headquarters branches. Carol also produces reports in response to informal requests. Most of the work in her area is outside of AAM. She gets requests for EEO-oriented reports. The Supervisory Identification Development Program (SIDP) is the method the FAA uses to determine supervisor candidates in several occupations. Files for this program are maintained in AAM-500. Jennifer Myers is in charge of the program. The budget is submitted 2 years in advance. They write a short project description and the estimated dollars for each planned project. The year before she does a project she completes a research resume (9950) which provides a more detailed project description. The input for the 9950s is based on a request from other organizations or the Federal Air Surgeon's "Call for Research" (Note: This is not the official name). There is a "Call for Requests" which is a memo that goes to the other FAA offices. Carol may work with personnel in the other offices to develop their response to the Call for Requests. The Call then goes back to the Federal Air Surgeon. The Federal Air Surgeon develops one letter of priorities and uses the responses to the Call for Requests as justification. Researchers are encouraged to get direct money sponsorship through other sources. In this case, the researcher writes a proposal (research resume) and the sponsor says okay we'll fund it. The researcher then makes informal or formal periodic reports back to the sponsor. The research resume format changes frequently. The current format contains a hypothesis, set of questions they plan to ask, timelines, and milestones. They present the project to aviation medical people and to Dr. Sheperd and Dr. Rueley at AAM Headquarters for approval. Copies of research resumes are kept in a notebook in the Division. Worksheets containing project summary data are maintained manually and on the computer to track on-going projects. Quarterly reports are completed for each task. They are one page long and contain timelines; milestones; and original, revised, and actual completion dates; and accomplishments made during the quarter. Reports are done on the computer using WordPerfect. The individual researcher determines how each project will be conducted. He or she may consult with other researchers for advice. The research experiments are set up before Carol runs any analyses. The Monthly Activity Report is one-half page per branch. The most significant activities are noted on the report. She also keeps a phone call list that is turned in to Dr. Collins at the end of the month. One issue that Carol brought up is that better communication with other related development efforts such as FMIS would be helpful. Requests for statistical reports are submitted by the Air Traffic and Human Resource Divisions in the Regional Offices. Internal technical reports are completed according to Order 1700.8c, Standards for Preparing, Printing and Distributing FAA Formal Technical Reports. People within the Division initially review the report. People with knowledge of the area outside of the Division then review the report. A technical writer at CAMI reviews the report and then it is sent to Dr. Collins for review. After that the report is sent to Headquarters for further review. The secretaries format the technical reports. Hard copies of the reports are readily available from the library. The library is the delivery point. The reports are hard to find if you need an on-line copy. They are available from NTIS. There was no intention to make a computerized version available to the public. Carol sometimes presents statistical briefings at EEO hearings or discrimination complaints. There are no associated reporting requirements. When presentations are made at conferences or anywhere else, a short report outlining what she will be speaking about is prepared and run through a short review at CAMI or Headquarters. Carol has access to VAX electronic mail although not to FAAMAIL. She doesn't have a real need to access FAAMAIL. Location: Civil Aeromedical Institute (CAMI) Interviewee: David Nelms, Computer Systems Analyst Technical Information Systems Branch, AAM-400 Date: 4/17/91 Interviewers: Carol Wasserman, Claudia Cardile David is involved with the National Job Satisfaction Survey. His role involves sending out surveys and data sheets (bubble sheets) that are read into the computer. The data is then statistically analyzed. These surveys are sent out every two years. He is also working on the Supervisory Identification Development Program (SIDP) which identifies personnel with supervisory potential, in the ATC and Airway Facilities. Programming The programs are documented internally. There is usually a one or two page summary of instructions given to the user of the program. Monthly Reports His individual report is combined with Jannice's and Frank's and given to Dr. Schroeder. This took a good deal of time so they standardized the process within the Division by using the same word processing package and version. Miscellaneous Data Services keeps some data bases. Right now Data Services sends tapes of information such as CPMIS or the Airway Science Program, and, when requested a monthly update tape of SIDP. He would like a direct link to these data bases instead of relying on tapes. Sources of Outside Info A project that will take information for the Age 60 ruling from the NTSB, CAIS, and other DBs and maintain it as one data base in Human Factors Research is in the initial stages. Pam Delrocco is responsible for the project. Jannice is helping with the selection of hardware and David is helping with the software selection. Data from the National Training and Tracking Program comes in on the bubble scanning sheets and is maintained on a data base. Information for several data bases are obtained through the use of bubble scan sheets. Location: Civil Aeromedical Institute (CAMI) Interviewee: David Schroeder, Ph.D., Supervisory Research Psychologist for Human Resources Research Human Resources Research Division, AAM-500 Date: 4/17/91 Interviewers: Carol Wasserman, Claudia Cardile Research Process The 9950 is a brief description of the research project, containing expected start and completion dates. The 9950, along with a more detailed plan is developed for each project and is required by the research committee for each project for the entire review process. A project file is kept in the primary investigator's office and updated with research results and other letters, reports and notes that document the course of the project. Once the project has been completed, the file is reviewed and the relevant details maintained. The file is archived in the Division where the research is done. This procedure is changing to make a CAMI- based archiving facility. Following appropriate Federal guidelines, the maintenance at CAMI for the appropriate time period and are boxed for shipment to the storage facility in St. Louis. The researcher knows if the file is here or in St. Louis. With the new order, the Research Committee now reviews the entire OAM research program. Investigations are expected to conform to existing federal guidelines concerning human and animal use and to relevant performance standards. Information for the 9950 is based on the researcher's own knowledge, appropriate literature reviews, material from previous studies, and other data bases. The 9950s are prepared by the individual researcher, reviewed by the Division Manager, The OAM Research Committee, and the CAMI Director. The CAMI Director has been authorized by the FAS to approve the OAM research program. The Research Committee is comprised of the Division Manager, AAM- 240, and a Regional Flight Surgeon. Following approval, an OAM R,E,∧ D Research Program book, containing the 9950's is developed prior to the beginning of each FY. Dr. Jordan's signature in the books indicates his approval of the research program at that time. The research resume review process will occur as needed during the quarterly meetings of the research committee. In the past, studies were reviewed every year to see if they were still viable. Currently, investigators can receive approval for their research proposal for one to three years. A new book of AAM research projects is created every year. It is archived in the Division Office, the library at CAMI, and at Headquarters. They do not have a system where the information can be stored on-line. The book is of active projects. A close- out form is required to end of each project. A copy is kept in the Division, CAMI, and at Headquarters. Research direction is based upon maintaining contact with FAA operational personnel, the OAM call for research, the National Plan for Aviation Human Factors - Volumes I and II, and the FAS guidelines. Potential research projects are analyzed with respect to available resources within AAM, current project requirements, and available resources. The Research and Development (RE∧D) Plan lists current and future FFA RE∧D efforts. The RE∧D Plan contains equipment design and Human Factors research. Each year you have describe the projects that you want to initiate in the future on a form based on FAA Form 7921. The budget planning document contains a narrative task description, project areas, budgetary information, employee years, and equipment necessary for the project. There are about 2-3 pages per project. The budget is sent to Virginia Hicks' area to be put together. After the budget requirements for the two Division are compiled the budgeting information is sent to Headquarters, the FAA, the Office of the Secretary of Transportation, the OMB, and Congress. Cuts can be made at any level. The 9950 is initiated the year following approval of the research budget. These forms are completed based on what was planned in the budget plus new requirements. There has been discussion of moving the creation of the 9950 to coincide with the preparation of the budget requests. The Order for OAM Research contains all pertinent regulations regarding the care and treatment of animals. A Department of Transportation Order is in process that will contain the rules and regulations regarding the treatment of human subjects. There is an FAA Order concerning the format for the preparation of FAA Technical Reports. Investigators are encouraged to publish results of their research both in OAM Technical Reports and in the open scientific literature. Communications with the regional medical divisions is on a limited basis. It varies according to the project. The HRRD (AAM-500) conducts research on Air Traffic Control Flight Deck and Airway Facility maintenance human factors. Transfer of data between the regions and AAM-500 is basically on floppy disk. Ability to transfer data by magnetic tape and modem is also available. Activity Reporting Monthly activity reports are prepared by the individuals. They go to the secretary who puts them into the proper format for approval by the Division Manager. A copy of the reports is provided to AAM-3 and AAM-1. Quarterly research status reports are handled on the 9950 form. The fact that the 9950 is a status report is indicated by checking a different box on the form. Status information includes what was accomplished relative to the milestones; required revisions and the justification. The status report has the same distribution as the research resume. Dr. Bill Sheperd receives quarterly status reports and filters them to the users (he also coordinates the Call for Research). Location: Civil Aeromedical Institute (CAMI) Interviewee: Dennis Canfield, Ph.D., Supervisory Research Chemist Aviation Pathology ∧ Toxicology Lab, AAM-600 Date: 4/15/91 Interviewers: Carol Wasserman, Claudia Cardile Dr. Canfield identifies substances such as illegal or prescription drugs or alcohol which might be influencing aviation accidents. Any drugs that are frequently seen in accidents are potential topics for research. For example, pilots performance under a particular drug would be tested for deterioration. If he notices a problem with respect to a particular drug, he would alert the Certification area; this has not happened to date. Dr. Canfield writes his own software to analyze data base information. Programs are written in compiled BASIC. Analytical information is provided by his staff and scanned into the computer using bubble sheets. The information on the form is the results of tests performed on the specimens. Dr. Canfield is alerted of accidents by the Aviation Bulletin (a teletype at the Communications Center). Someone has to physically go and get the hardcopy Bulletin (it would be much easier if the teletype was sent directly to him in an ASCI II file). This information is then entered into the data base on the personal computer. He tracks the number of accidents that took place versus the number that they investigate. The second alert is a tox box alert. Either the NTSB field officer or the FAA field office phone or fax to tell him that a tox box is being sent. The call also provides more up-to-date information than that contained in the teletype. If Dr. Vernneau goes to the accident scene, Dr. Canfield receives additional information such as names, ages, whether there was a fire, and medications found. If this information is not obtained from someone on the scene, he does not get the medical condition. The tox box containing the specimens is typically sent by the pathologist although it could be sent by the FAA or NTSB. The shipping bill is sent to procurement and a copy is kept in the case folder. A case folder is started when he receives an alert that a tox box is being sent. Hard copies are kept of toxicology results for 2 years if the result is negative, 5 years if the results are positive. After 5 years he would like to put all results into the computer (Dell PC). Right now he has 20 years of hard copy data. Specimens are logged in. A bubble sheet of names, addresses, dates, type of aircraft, and type of specimens is filled out and scanned into the computer. This action opens a computer file for the case and assigns the case a number. Portions of the specimens are then analyzed by the staff. An analysis report is completed on the specimens and reviewed by Dr. Canfield to make sure everything looks okay. If everything is okay, the report is put in the case folder. If things are not okay, he reviews the process to see where the problem occurred (an example of a problem is inconsistent results). The analysts have 10 manuals that provide standards and step by step procedures on how to conduct specific tests. When all the test results are in the folder (e.g., alcohol, carbon monoxide, cyanide, drugs), Dr. Canfield fills out a scan card with the drugs that were found and scans the data into the PC. An interim report is printed out to verify correctness of the data, then the data base is updated. Data is always current, it is scanned in within 15 seconds of time received. The end product is a computer report on a specific case that is mailed to the NTSB regional office (of the region where the accident occurred) and to the Regional Flight Surgeon (RFS) (becomes part of the RFS report). If a positive result is found, a copy of the report is immediately faxed to AAI-100. The report contains the methodology used, sensitivity of instruments, and the drugs found. Dr. Canfield provides weekly, monthly, and quarterly activity reports to Dr. Hordinsky (AAM-600). He currently uses the CAMI library for research. He does not have access to but would find the medical records on the accident victim from the Certification data base useful to determine if the victim was on medication or had any illnesses. Deceased individuals are not covered by the Privacy Act. He would also like to be able to access NTSB's data base. Drug (molecular structure) database access is prohibitive due to the cost. Dr. Canfield is involved in workshops for flight attendants and pilots. He will occasionally run an analysis or answer a question for an airline. He publishes articles in scientific journals. The journal sends you copies of the article so that you can distribute them when asked. Before an article is submitted it goes through a technical review in the lab, 3 people at CAMI review the article and then 3 people at Headquarters (HQ) in Washington D.C. review the article. The journal also reviews it before publishing. Dr. Collins has final review. An annual report is provided to Congress (via HQ) that contains the number and types of drugs found in accidents and some statistical information. This report is provided by the computer based on data entered over the year. Dr. Canfield provides Dr. Hordinsky with the information specified by the budget area. The format changes frequently. He also completes the 9950 (Research Resume) for planned projects. Information (i.e., reason for doing research) to complete the 9950 comes from computer results or a new methodology. Research resumes are sent to Dr. Hordinsky -> Dr. Collins -> AAM-1. The Federal Air Surgeon's statement of need contains one line topics for research. He reviews this document to see if it fits what they are able to do. Dr. Canfield occasionally receives requests for research from the airline industry (verbal). He will perform some preliminary tests to see if the idea is viable. Consulting activities are mostly verbal communication. He receives requests from the NTSB, the FAA, and the RFS. He also receives calls with respect to the random drug testing program. He has some communication with the Substance Abuse Program Manager. He is called on to be an expert witness to help the FAA prove a case of whether an individual was or was not impaired. He submits a short report to the FAA prior to testimony stating his views on the case. Dr. Canfield has requested access to the FAA's electronic mail system. Location: Civil Aeromedical Institute (CAMI) Interviewee: Boyd Endecott, Chemist Toxicology and Accident Research Laboratory, AAM- 600 Date: 4/16/91 Interviewers: Carol Wasserman, Claudia Cardile Boyd was asked if he wanted to get onto the network but he didn't feel he needed access. He has access to commercial data bases and Paradox, but does not use them. They use commercial databases in conjunction with forensics such as dbase III, dbase IV, and Paradox. They also get research data through the CAMI library. His main responsibility is performing experiments in biochemistry and inhalation toxicology. Experiments Right now he is performing experiments involving the level of CO (carbon monoxide) to give 5 minute incapacitation, level of CN (cyanide) for 5 minute incapacitation, and CO and CN together for 5 minute incapacitation. The second part of the experiment were these sets of experiments for 35 minute incapacitation. When the raw data is collected, it is entered into a program written in BASIC that captures the information and stores it. This program does the analysis on the data. He records the atmosphere in the chamber, and plots the concentration of the gases using a gas chromatograph. He writes the lab conditions, settings of the equipment, the methodology, etc. into a lab notebook. All the data collected from the gas chromatograph is entered into a BASIC program. Once an experiment is finished, a report of the method and findings is made and a paper is published. There are two or three reviewers of the paper before it is sent out of the division. Reviewers are generally Mike Wayda, Dr. Hordinsky, and Dr. Collins. He completes biweekly, quarterly, and monthly status reports. The reports contain a list of who called them, consultation work, and progress on experiments. With respect to closing out a project, it usually finishes when the report or publication is written. Some of the projects closing out now are from a year or two ago. The 9950 is kept open until the report is written. The report contains information on what they did and the results of these experiments. When closing out a project, a close-out form is filled out and sent in to AAM Headquarters (HQ). Consultations They keep a log of calls received identifying the caller and how much time was spent on the call. 9950 The 9950 states the protocol or what the project will accomplish. It contains the schedule, equipment to be used, and the process which will be followed. The ideas for the 9950 come from requests from HQ and from doing their own research. At the start of a new project, a literature search is done. They go to the CAMI library and do a search on a topic. They can access other databases and literature through the modem. They have contact with the Oklahoma University library. They read scientific journals to keep up with what is going on in the outside such as the work being done in inhalation toxicology. Data Books The experimental data books contain information that describes what was done on an experiment. This includes the set-up, columns on gas chromatograph, the experiment, and experimental data published in papers. The lab books are stored in the lab office in bookcases. His area keeps records on all their own 9950s in files. HQ will send letters asking for updates on status of experiments. The regions call him when the need information on specific topics, usually AMEs call for information. Miscellaneous Some of the work they do at CAMI overlaps work done at the FAA Technical Center in Atlantic City. The work at the Technical Center is typically on a larger scale. All data collected is open to the Freedom of Information Act. Procurement Requests They initiate a procurement request (PR) when they need something for a new project. They fill out the PR and send it to the front office for a number. It then goes to the supervisor, Dr. Hordinsky, and Virginia Hicks. There is a person who handles the OATS PRs, if computer equipment is needed. These PRs must go through Security. They keep a copy of the PR and the original goes out for processing. Procurement sends a copy of the PR back when it has been processed. They store these copies in the office. They submit the budget based on money needed for equipment, people, and supplies. Budget requests are submitted 2 to 3 years ahead of time. Location: Civil Aeromedical Institute (CAMI) Interviewee: Earl Folk, Research Mathematical Technician Data Analysis Branch, AAM-600 Date: 4/18/91 Interviewers: Claudia Cardile General Responsibilities Earl's responsibilities include: General research design methodologies which involve developing randomization schemes, setting-up experiments, and working on data reduction and storage. At the present time data is stored on floppy disks, worksheets, and magnetic tape. There are 10 -14 years worth of sled impact data. We have the necessary equipment to move the Sled data to the VAX. Earl selects statistical procedures which are deemed appropriate. Then, he performs computations for research projects and documents the method used to determine the calculations, results, and conclusions. The report is given to the Principle Investigator (PI) on the project. Earl is also involved with the IRM working group (he gathers information on hardware and software in surveys). Based on a set of requirements, he helps determine the automation equipment that would be requested for AAM-600. Earl is involved in archiving data at the Institute and also works on the IRM budget. Surveys are also done to look at PC hardware and software in order to find the best purchase price. There is a network being set up connecting Virginia, Dr Collins, and Washington and will connect all division managers in AAM. There are 45 million records here (mostly in Certification) which they would like these to store using document imaging technology. Earl is on a committee with other CAMI Division representatives that is looking at this issue and proposing solutions. Earl helps people with software problems and also helps to install and run programs. He is the PC coordinator for the division and is responsible for PC maintenance. There are 3 PCs and a Hewlett Packard 100 minicomputer in his area. A bulletin board (BBS) is set-up in this area and anyone in the impact area can call files up and share data. When applicable, persons outside CAMI exchange text and data files associated with particular tasks (research projects) which is often accomplished on the BBS. He has access to FAAMAIL. Statistician When he does work as a Statistician, he frequently receives the data on spreadsheets. When he does his own research as a PI, he writes up his methods, conclusions, and the results. A copy of the report is sent to the Division Manager. If other areas ask him to do work, he writes a summary and gives it to his manager describing what work he has done and for whom. Reports He documents both his non-division and division activities for the Monthly Activity Report. Miscellaneous He is the OATS coordinator for CAMI. He occasionally accesses data bases at Wright-Patterson AFB on injuries and crash results. Earl wants to be able to access in the following systems: Medical Certification, Accident data bases, NTSB data bases, and Academy data bases. Location: Civil Aeromedical Institute (CAMI) Interviewee: Gerald Hanneman, DVM, Veterinary Medical Officer Veterinary Medicine Staff, AAM-602 Date: 4/18/91 Interviewers: Carol Wasserman, Claudia Cardile Dr. Hanneman has project-specific procedures that describe how to care for different species of animals. The Health and Human Services Department, US Public Health and other organizations have guidelines for general care of animals. These guidelines are applicable to all animal care facilities. CAMI is accredited by the American Association for Accreditation of Laboratory Animal Care (AAALAC) and uses the same books and documents for animal care as other organizations. A site visit must be done by the AAALAC every 3 years. The Department of Agriculture's Animal Welfare Act provides guidelines for the care and use of animals which does not change very often. Recently they have become more uniform in inspections and requirements. Records are kept on animal care for all animal subjects used in research. Limited paperwork is involved as they currently have only rodents. He made up some forms for dogs, cats, and other animals that aren't currently in use. The FAA has certain regulations on how long they need to keep records. They keep data up to 10 years because the time regulation changes annually. He reports any changes or additions to the original facilities or project management rule changes to AAALAC. He is available as needed for other facilities or divisions in the FAA, and has worked closely with the Department of Agriculture in areas such as animal transportation. He is on the Animal Care ∧ Use Committee which must approve the animal care and use protocol of 9950s for all projects that are doing animal based research. He doesn't have computer support but would like to keep information on a computer. He uses computers for compiling research data, manuscripts, activity status reports, and procedures. These documents are distributed internally and externally, and are used to complete the annual reports. Most reports go through Dr. Hordinsky and Dr. Collins. He uses libraries for reference on subject areas relating to animal care studies. The non-government sector has computer programs that can be used for the care of laboratory animal management although they are more appropriate for larger facilities. Location: Civil Aeromedical Institute (CAMI) Interviewee: Jerry Hordinsky, M.D., Supervisory Medical Officer for Aeromedical Research Aeromedical Research Division, AAM-600 Date: 4/16/91 Interviewers: Carol Wasserman, Claudia Cardile Research Process The current Research Working Group is transitioning to a research committee. Their purpose is to look at the current research process and put together a new draft order that will cover AAM- 500, AAM-600, AAM-240, and any OAM group initiating research. All research resumes (9950s) would go to the committee who would review the ideas and make recommendations to Dr. Collins. The research review process would be brought under CAMI's responsibility. Currently the 9950 is reviewed by an AAM committee chaired by the senior person in AAM-240 (Dr. Bill Sheperd). The scientists use their acquired technical knowledge and information obtained from the library and interested parties such as NTSB to complete the 9950s. The 9950s are placed in an annual book after they have been approved. The 9950 projects must be consistent with the FAA RE∧D Plan process. This year the Human Factors plan had to have its projects divided into 6 environments and multiple domains within each environment. This resulted in a great deal of work. Aeromedical Research was able to keep the same groupings this year. The whole RE∧D Plan format is still in flux. There is currently no standard repository for inputs to the research process. Ideas are collected from various sources such as letters, phone calls, or the Federal Air Surgeon (FAS). Inputs from various FAA areas are coordinated by Dr. Bill Sheperd. He puts out a call for research to other areas of the FAA. CAMI accepts research projects identified by this call, consistent with resources and priorities. The groups requesting the research are identified in the 9950 and are provided feedback and research identified. With respect to Regional or Headquarters contact or input into determining the research projects, a RFS is a representative on the Research Working Group and the FAS' management team provides research topics as well. There was a 9950 order that provides the protocol for writing the research resume but the new draft research order provides a more efficient process. Standardized quarterly reports have a simpler format than they used to have. Everyone at CAMI completes the same report. This report is not necessarily completed at either the Technical Center or for any work done at the Regional level. The quarterly reports go to Dr. Collins and Dr. Jordan (FAS), a repository in the library, the research committee, and to select research sponsors. Research questions from private citizens or companies often come through the Federal Air Surgeon. Regulatory requirements-related research doesn't always wait for the call for research. The principal investigator is the repository for the origin research data and status reports. Project files are individually maintained. Pilot studies are occasionally done. They may look at the feasibility of one approach versus the other. Computer Support Each research area has section-level personal computer support. They are thinking of implementing a network to address Division- wide administrative needs. Additionally, AAM-600 plans to increase the current level of PC support. AAM-600 does not have a dedicated computer support person. They try to recruit researchers with computer experience and knowledge. Other Data Base Access Access to the Certification data base could help the accident investigation, cabin safety, or vision research areas. These groups do not currently have easy access to this data. Joe Young in anthropometry cross-references national civilian and military data bases over modems. Dr. Veronneau and other investigators tap into many research-specific bulletin boards and data bases. The Privacy Act impacts human subject research (data flow, who can access). Budget The budget process is administratively centralized. The budget sheet form is distributed from Virginia Hicks. It asks what they need for FY93/94 (typically the next two years) and there are standardized guidelines for completing the form. The completed forms go to Virginia Hicks where they are compiled and then the total budget is sent to Washington D.C. The research budget in OAM is a small part of the FAA budget; therefore, it must be coordinated with this larger element and, as a consequence frequent adjustments in funding levels occur throughout the course of a typical fiscal year. Location: Civil Aeromedical Institute (CAMI) Interviewee: William Worner, Computer Program Analyst Data Analysis Staff, AAM-601 Date: 4/18/91 Interviewers: Claudia Cardile Responsibilities Bill's main responsibility is to be a troubleshooter for AAM-600. He worked with the VAX (Human Factors Research) for 6 years and has worked in this area for 6 months. There are 55 PCs in this division, and he works with the hardware and the software. He helps with software questions and does some training on new packages when needed. He is the Network administrator for the AAM-600 LAN and the CAMI-WIDE LAN. He is also responsible for 13 PCs in AAM-3 and AAM-6. He maintains the AAM-600 Electronic Bulletin Board that is used throughout CAMI to transfer data to and from outside users. As CAMI;s Assistant Site Coordinator for OATS, he is responsible for ensuring the accuracy of OATS PRs. He also tracks the status of OATs purchases and certifies all new OATS equipment. He maintains records of all OATS equipment in CAMI and sign off on all OATs receiving reports. He fixes programs, writes new programs, utilities, and writes data entry programs for the divisions' researchers and for other CAMI divisions, including AAM-3 and AAM-6. He is involved with AAM-600's computer needs including purchasing equipment and upgrades, designing networks, and determining workstation configurations. Programming He does his own programming for inventory data. When he does programming for other researchers, he documents the changes and gives the program and documentation both to Earl and to the requestor. At this time, each researcher has his/her own machine. The machines are stand-alone and there is no data sharing. When OATS comes about, they anticipate that they will share data. Troubleshooting He jots down on the calendar when he helps someone and tells Earl how much time was spent doing it. If it was a major task, it will be listed in the activity reports. Upgrades He determines the current versions, finds out the quantity and type of data currently being used, and determines what needs to be done to the data. He then tries to determine how to make the upgrade compatible with the master plan of the STARLAN. He keeps files of literature from his studies on upgrades for future use. Earl uses these files as well. If OATS equipment is involved, he handles the data on a spreadsheet. He provides a listing of required and recommended hardware and software to be included in the PR. The purchase request is done by the requestor. Bill or Earl check all ADP PRs for accuracy before initialing them. The request then goes to the front office for procurement. ADP Lab Needs With respect to case study data, their goal is to archive the data n a case-by-case basis. The ultimate goal is to put the data into a data base. The present users of the data would be the future users of the information in the data base. The labs would then be able to work together. Monthly Activity Report (MAR) Contents of the activity report include meetings he has attended, consultations, and programs worked on. He keeps a log of computer problems. Inventory He performed a hardware/software inventory of the Division to have a basis for upgrade analysis and to determine what is OATS- compatible. This information was given to Dr Hordinsky. He keeps a list of who needs new software packages. The librarian is given this list so that she can provide relevant articles and related documents. Access He feels access to the following data sources would be helpful: NTSB database, NASA, NTSB, AF bulletins boards, and Airman Certification. Location: Civil Aeromedical Institute (CAMI) Interviewee: Lita Arnold, Industrial Hygienist Clinical Operations Branch, AAM-700 Date: 4/18/91 Interviewers: Carol Wasserman, Claudia Cardile They base their policy on the standards set by OSHA. OSHA doesn't tell them what to do but does issue citations if standards are not met. The OSHA standards are a minimum and can be exceeded. The National Institute for Occupational Safety and Health (NIOSH) and other advisory groups are contacted for information. The burden is upon the employer to make sure they get the needed information. The EPA concerns at the center are addressed by a separate group. 29CFR Part 1960 is an OSHA directive that requires Federal Agencies to do inspections of facilities once a year and to be in compliance with OSHA regulations. Executive Order 12196 (February 26, 1980) also orders the FAA to comply with OSHA safety and health standards, including 1. Occupational Noise, 2. Radiation, 3. Hazard Communication, 4. Air Contaminants, 5. Hazardous Chemicals in Laboratories, and 6. Bloodborne Pathogens. Under the General Duty Clause, OSHA can cite violations for safety or health concerns for which OSHA presently lacks standards. There is a joint tenancy agreement between CAMI and the Center that requires CAMI to monitor and advise the Aeronautical Center on health and safety issues. CAMI is a microcosm - a little of everything exists here so Lita must have knowledge in many areas. There is a special budget so they can go on 24 hours notice to an emergency. A phone call starts this process. The Safety and Health Inspectors in the regions are supposed to do annual, routine inspections and send the reports to CAMI. The reports are not typically sent to CAMI. If the regions have a problem, then they call CAMI. The Industrial Hygienists are supposed to function as consultants; not do the regional inspections. The ideal situation would be to receive health and safety reports from the regions and enter the data into a data base for analysis and storage. Right now there is a manual filing system. Information is difficult to access and analyze. An Industrial Hygienist is needed for each region to provide I.H. Services and to relay information to CAMI. AAM-700 has requested 57 hygienists, 1 for every 1000-2000 people. This number includes one minimum Certified Industrial Hygienist in each region plus a minimum of one technician in each region to assist the Industrial Hygienist. There is currently no Industrial Hygiene (IH) Program Manager. Dr. Watkin (AAM-200) has an oversight role. Annual survey reports containing the number of surveys, and the number of regions and facilities visited, once were sent to Dr. Watkin. It is hard to coordinate nationwide efforts and to keep up with policy changes without a Program Manager. Lita has developed forms to gather industrial hygiene data at the Aeronautical Center. She performs surveys at the Center to make sure that work is done in compliance with OSHA health standards. The forms are based on OSHA forms. The forms document the problem found and any associated follow up. Separate forms and inspections are done for noise levels; VDT (magnetic field strength) surveys have been done; radiation from radar facilities; and indoor air quality surveys. It is her job to bring the Center into compliance with OSHA health standards. An initial Hazardous Assessments Study is done for every facility to provide a baseline. This inspection identifies low and increased risk facilities. The increased risk areas must be inspected twice annually. She goes to every facility once a year, at the invitation of the Safety Manager who has primary responsibility for safety and health of the Aeronautical Center. OSHA has guidelines for indoor air quality. For example, she received complaints from employees about the air. Lita did a survey to determine what was bothering employees, took measurements, analyzed the data and was able to resolve the situation. Lita also works with the laboratories at CAMI to make sure that they have adequate ventilation. Copies of the results of studies are supplied to the Safety and Health Manager who then forwards copies to appropriate line management personnel. Lita must provide the Safety and Health Manager with written notification of a problem situation and her recommendation. The Safety and Health Manager must follow-up on the recommendation. Lita does not have the authority to enforce the recommendation. Dr. Davis generally approves a final report on the situation. The report summarizes the findings and lists appropriate recommendations and may include attachments containing supporting data. Lita prepares a monthly activity report for Dr. Davis. She has some files on-line that document things that she has done (PC files). Material Safety Data Sheets (MSDS) give information on hazardous substances in any work material. Regulation 29CFR 1910.1200 (Hazard Communication Standard) requires that workers be informed when they are in contact with hazardous substances. Contractors are required to bring MSDS when bringing hazardous chemicals on- site. The problem is that the FAA authorizing organization may receive the MSDS from the contractor and not send them on to the industrial hygienists. It is then difficult to determine the cause of a problem if an incident should occur. The process should require that the industrial hygiene area have a MSDS on all hazardous chemicals before the contractor starts a job. Lita is trying to automate listings of MSDS. She occasionally gets NIOSH alerts that a substance is a carcinogen and can use the automated listings to determine where the substance is in use. Thus, she can alert users to the new information. The MSDS that she receives can also be out of date. Lita therefore double-checks the OSHA standard. Surveys are prompted by requests from the Safety Manager. Annual hazard assessments or calls from an employee or facility manager assist in deciding what surveys are needed. There are paper files of all surveys. There are legal requirements for retaining some of this data. For example, data on noise must be maintained for 2 years; data on asbestos must be kept for 30 years. Past data is also good to keep to show OSHA that the Aeronautical Center is meeting OSHA standards. Lita maintains regular contact with the Aeronautical Center Safety Manager. Lita produces directives for CAMI on things like how to dispose of hazardous chemicals. She also writes and reviews CAMI's safety-related standards to ensure that they are current. With respect to budgeting, Lita gives a needs assessment to Dr. Davis. With respect to regional contact, the regions sometimes send samples in for analysis. The regions may contact the industrial hygienists if they have problems with contractors or the contractor's work. They get sporadic calls for routine inspections. Mike Lenz (ALR-200) manages a Safety Management Information System (SMIS) that is used to transmit accident/illness data from the regions to Washington D.C. They would like access to this system to look for occupational health trends. There is a form that the regional Safety and Health Managers have to fill out and send into SMIS. For example if a compensation claim is filed for medical care, this data goes into SMIS. Location: Civil Aeromedical Institute (CAMI) Interviewee: Joe Beasley, Substance Abuse Control Program Manager Environmental Health Branch, AAM-700 Date: 4/17/91 Interviewers: Carol Wasserman, Claudia Cardile The Clinic provides medical care to ATC students, Aeronautical Center employees, and contractors. They also do pre-employment and courtesy drug testing. Human Resources Management does the random drug testing. He gets involved with the specimen collection and chain-of-custody aspect of random drug testing when asked. If the results come back positive, he gets involved with the Labor Relations area. Pre-employment physicals are performed when an employee needs a government drivers license, for Occupational Health needs, and occasionally a flight physical. With respect to the Drivers License physical, personnel notifies the Clinic and makes an appointment. The employee comes in and the medical record is completed (SF600) and put in the medical file. The driver license form is completed and sent to the Personnel department. The same physical form is used for the Occupational Health physical. If the results are abnormal the employee is telephoned or a letter is sent to the employee. The chart is updated with the results of the action. With respect to pre-employment drug testing, Personnel makes an appointment for the employee. The drug testing is performed in conjunction with a pre-employment physical. Both a form from personnel and a physical form are completed. A Compuchem form is also filled out - 1 copy goes to the employee, 1 copy to the medical record, and the specimen and the form are sent to Compuchem. From Compuchem he receives the results and an official chain-of-custody form. The chain-of-custody forms are kept in a separate file in his office. A copy of the results are sent to the Drug Program Manager and to the Regional Flight Surgeon in the appropriate region. The Chronological Record of Medical Care (SF600) is kept on file in the employee's folder. CA16 is the insurance claim form that is filled out for injuries. It is filed in the employees file, sent to the insurance company, and 1 copy is filed in the physician's office. Everyone who has injuries must come into the clinic with a 3900 form (request for medical services). One copy is sent back to the supervisor with the patient with notes on the treatment and one copy is retained in the employee's file. He keeps health-screening-related statistical data and compiles it in order to determine if there is a potential research project. He also provides medical back-up to research people. As Deputy Branch Manager, Joe signs procurement requests. The individual who needs the item fills out the form. Joe signs it and sends it to Administrative Services (Virginia Hicks' area). A Monthly activity report is completed for Dr. Collins. A data base with health screening program data is maintained in the Clinic. The program results are sent via modem to Washington D.C. Any changes in qualifications for maintaining pilot certification are communicated via Dr. Davis. Regional contact is informal - through phone calls or letters. The only formal contact with the Regional Flight Surgeons is generally when there is a problem with someone from their region. He communicates the results of drug tests to the Regional Drug Programs. Sometimes he is asked to do drug tests on students because they haven't been done or they have been done improperly. Joe keeps a copy of all his correspondence on floppy disk. Dr. Davis developed an Emergency Readiness Plan to ensure that they are prepared for potential disasters. Each medical person has assigned duties. Joe has access to the Federal Air Surgeon's bulletin board. He has occasional contact with the Aeromedical Certification Division. He was involved in the pilot program for the new 8500- 8 form. Clinic data is reported to Dr. Collins. A RFS activity report is sent to Washington. Location: Civil Aeromedical Institute (CAMI) Interviewee: Bill Davis, M.D., Supervisory Medical Officer for Occupational Health Occupational Health Division, AAM-700 Date: 4/18/91 Interviewers: Carol Wasserman Policy statements in this area are general statements of how their mission is interpreted for CAMI (i.e., what they are prepared to do for students, employees, contract employees, and others). His clinic's responsibilities are different from other FAA clinics because they have treatment requirements with respect to students. Others do this also. The future responsibilities of the Occupational Health area are up in the air right now. They have proposed an organizational structure and estimated staffing requirements but resources are yet to come. Their information needs may therefore be different in the near future than they are today (undoubtedly expanded). Another open question is whether industrial hygiene responsibilities will remain within Occupational Health. There is the potential that they may move out of Aviation Medicine. Budget data is organized electronically and transmitted to Virginia Hicks area. Budget information includes contracts, referrals, equipment, travel needs, and supplies. The Academy provides estimates of the number of students for input into the Clinic's budget process. A program that includes all budgetary items possible and the preparer is able to pick those that are applicable would be useful. The program would also show last year's budget. Monthly reports are compiled by the clinic, they are not prepared by each individual. Monthly reports are prepared by the environmental health area as a way to enable the two hygienists to be aware of what the other is doing. Reports also enable the group to organize what they have done and help determine what they have to do. Dr. Davis serves as an AME for the Aeromedical Center. He submits EKGs electronically to the Certification Division; exams are submitted manually. Location: Civil Aeromedical Institute (CAMI) Interviewee: Noal May, Ph.D., Industrial Hygienist Environmental Health Branch, AAM-700 Date: 4/18/91 Interviewers: Carol Wasserman, Claudia Cardile General Information Needs  Needs a computer bulletin board to transfer entire files (eliminates faxing them).  Needs a better way to identify facilities, the type of work done within these offices, individuals within the facilities. The ability to call up this data is also required.  Needs a central purchasing budget for new Regional equipment and a way to record the serial numbers, model numbers, last calibration date, and when it needs to be calibrated again. This has to be accessible to the regions. The issue here is to track the instruments that are in the regions and to ensure that they are operational. They would like the hardware people from TSC to come out and talk to them about setting up these systems.  Needs to keep up with samples taken at the facilities, get the results, and merge the results with the samples. The information should be in a data base for future analysis and comparison.  OSHA changed the asbestos standard. The impact is that they need to pull up all facilities measured in the past that don't meet the new, more stringent standard. The data needs to be stored in a data base to make future compliance easier.  Medical screening is required by OSHA. The Health Screening information that OSHA requires is contained in the Safety Management Information System (SMIS). The Industrial Hygiene area would like access to this data.  Would like to have a data base that will enable the local region to enter and access their own data but provide inquiry-only capabilities to the other regions. Training They would like to have beginners manuals as well as updated procedures and instructions for using computer systems. For example, the Safety Management Information System (SMIS) has no manual and they would like to have one. Regions They call the regions to keep in contact with what is going on out there, what they are doing, new equipment they have received, and other related topics. Dr. May has contact with OSHA, EPA, NRC, FDA, Agriculture, Public Health Services, and the US Air Force. Sometimes he calls to see if they have noted a specific problem or just to see what is new. Since he traveled in the regions for 12 years, he knows what types of problems exist and is sometimes able to talk through the situation with the Safety and Health Manager over the phone. If that does not work, he will have to travel to the region to address the situation. He has looked into issues such as food facilities, radon, asbestos, and lead in the water. He completes a report and recommendation and sends it to the Regional Flight Surgeon and to the facility with the problem. The airway facility people and the region are responsible for ensuring that the problem is fixed. He does not have the authority to enforce the recommendation. It is up to the Regional Flight Surgeon to pass the information along and make sure the problem is taken care of. Sometimes there is an issue with a local union because the safety problem affects their workers. In those situations, he will provide the union with a consultant list to verify that what he has found is true. Miscellaneous  Epidemiology - They need ways to look at this (for example, if 3 out of 4 people at a site get cancer). There needs to be a tracking system of FAA employees that would follow their movement over time.  There is currently no means of looking at occupationally related use of overall sick leave. There can be trends in the sicknesses that might indicate health hazards at one or more facilities. They keep all the information that OSHA needs on file here. The files not in priority use are kept in boxes or in a storage room. There is no index or easy way to access this data. Files are initially in the filing cabinet, then they go to the boxes, and finally to St. Louis. Reports need to be put into a data base to make them more accessible. Program Management The greatest Industrial Hygiene need is Resources. It also needs someone to do effective program management. They need someone who knows what is going on in Washington D.C. and is able to keep them informed at CAMI. There is an Executive Order which states that Industrial Hygiene and Safety people must respond to a situation within 24 hours. They then complete a trip report which states what they did, what they found, and the recommendation. It is read, reviewed, and approved by the supervisor at the facility (a person can refuse to go into a facility if they feel that it will endanger their life until something is done.) The biggest problem is with asbestos, it gets wet and falls to the floor. There needs to be a means by which they can record results on- site and directly transfer these reports. An indication must be able to made that a change was made and why. Location: Civil Aeromedical Institute (CAMI) Interviewee: Peggy Meyer, Occupational Health Nurse Clinical Operations Branch, AAM-700 Date: 4/17/91 Interviewers: Carol Wasserman, Claudia Cardile Clinic Programs The 8500 form is filled out for airman flight physicals and sent to Certification. The EKG is sent electronically to them as well. Physicals are performed for those airmen and air traffic controllers (ATC) who work at the Center. The ATC instructors from other regions must go to their region for their physicals. The Clinic keeps medical files for everyone who comes through the door. The Hearing Conservation Program services anyone in an area that has a potential to cause hearing loss. This is determined by the Industrial Hygienist. Once identified, the employee's name is place in the HCP (Hearing Conservation Program) for annual hearing examinations. Each month a list of employees names is sent to the clinic for testing. Manually, notices of appointment times are sent to the employee and their supervisor. The actual testing is performed on a computerized Tracor RA 500 audiometric system. Patient history, previous, previous tests, and work location are stored and updated during each testing. If an employee displays a hearing loss, the Industrial Hygienist is notified by the clinic nurse. The Occupational Health Program works in the same way in identification of employees, notice of appointment times are scheduled by the clinic secretary. The type of examination the employee receives is dependent on what hazardous substance the Industrial Hygienist believes the employee is exposed. The Occupational Health physical may include blood work, X-rays, hearing, vision or spirometry (lung capacity). They all include a physical examination by the clinic physician or physician's assistant. The test results are placed in their medical file. All of this is performed manually. The Occupational Health Program checks the blood-work of employees who work with paint or other hazardous substances. Data is not maintained on an automated system. If anyone at the Center is injured, they can come in for emergency help and are then referred to outside facilities for additional work. This process is not automated. The ATC students can receive primary care while they are at the Center. Their records are sent to the region when they finish the course. This process is done manually. If a contractor gets sick or has an accident, they receive emergency treatment and then refer them out. A file is kept for contractors. All employees who require a pre-employment physical can have them done at the clinic. Examples of employees requiring physicals are those who need drivers licenses, warehouse workers, pilots, and employees who transfer to the Center. Peggy is the Health Awareness Program coordinator. They have held weight loss clinics and other health screenings including blood pressure and cholesterol checks. Once a month she completes the Regional Flight Surgeon (RFS) Activity Report. The report contains all the activities she has performed in the last month. It is sent to HQ. This data is compiled manually. The clinic coordinates with the Industrial Hygienist with regard to industrial accidens. When an employee has an accident, they have the right to seek medical treatment from any medical facility. If they choose to be treated at CAMI, the staff will treat them and return them to work as soon as they are capable. If several accidents appear to have similarities, this would be brought to the attention of Industrial Hygiene. Reports Once a month clinic activity is reported to the Federal Air Surgeon. The statistics are collected from the log book kept on the counter in the clinic. Everyone requesting medical care, or medical information sign their name, date and time of visit, their class or routing number and the service they are requesting. This collected information is placed in specific category on the FAA From 1380-9 by one of the clinic nurses. The clinic secretary then types the form and forwards the form to Washington D.C. Drug Testing A student may arrive for the ATC (Air Traffic Control) screen that did not complete a required urine drug test in their regional That region will contact the clinic and make arrangements for testing while the student is in the screening program. The results are forwarded in the mail system to the requesting region. Health Awareness Program Quarterly health topics are selected by the coordinators at their meetings. The topics chosen are to be the center of the coordinators health programs in their regions. Each quarter has a designated topic on which to focus. This adds continuity from one region to the other. Each quarter the coordinator sends a report to the Health Awareness Program manager in Washington D.C. The report includes type and number of programs presented. Number of participants for programs. The name of lectures, and any publications. The third Wednesday of the month a Telecon is held. A medical file is maintained in the clinic on employees and students. A 3900 form is filled out whenever anyone comes into the clinic. A copy is given to everyone as they leave following their treatment. The 3900 form outlines any restrictions from class or work. It may contain a referral or a return date for follow-up treatment. The 3900 is a triplicate form. In regards to students, the top copy is sent with the student as outlined above. The second copy is sent to student services and the third is kept on file in the clinic. In regards to the employee, the top copy of the 3900 form is taken to the employee's supervisor. The second copy, if illness or injury is job related is sent to the Safety and Security Division. The third copy is placed in the employee's medical folder with a brief narrative note entered by one of the medical personnel of the clinic. Miscellaneous With respect to telephone inquiries, they keep a record of all the calls received (on a CAMI form). The secretary keeps this and a copy goes to Dr. Collins and to AAM Headquarters. She would like access to MEDLAR. She receives current journals to keep up with the latest health care findings.

REGIONS

Location: Eastern Region Interviewee: Carmen Alejandro, Airmen Certification Program Specialist and AME Program Specialist Aida Tizzio, Airmen Certification Program Assistant Date: 3/28/91 Interviewers: Claudia Cardile, Jim Frey Airmen If there is a violation reported either from OKC, the Hotline, an anonymous call, or from an individual, it must be verified. A violation can be 'failure to provide' or a 'disqualifying condition' (usually CAMI starts this action) or 'falsification'. Once contacted, the Region sends out a correspondence stating the charge. The response time given is 30 days. If 30 days has gone by with no response, then it is sent to legal for 'failure to provide'. The office cross-checks the EIS, if there is an existing enforcement, the file is updated. If this is a new enforcement, a file is created. When the issues have been resolved the file is purged from the EIS. If the enforcement comes from CAMI, then paperwork is sent with it, this paperwork is put in the medical file. A transmittal form is used and a copy goes in the file. If the case goes to legal, then a copy of the file is sent to legal. Copies of all the correspondence to/from the airman are kept in the medical file and the certified mail receipt is also kept in the file. CAIS is used often to gather information, all medical information from day 1 is used and stored in CAIS. This information is coded, they use a book sent from OKC to decode the information. When taking legal or security action, they request reports from security on DWI, etc. They find it difficult to get into OKC files for information. If there is an anonymous call made to the region it must be verified. The process starts with a form letter to the airman stating the allegation. If there is no answer, it is sent to legal. If the airman claims not to have been in violation and Security has no violations, then the process ends except to notify OKC to update the file. Only information that goes to Legal is reported to EIS Security will access the National Drunk Driver database and give reports to Aida. Location: Eastern Region Interviewee: Joan Kokindo, ADAP Manager Date: 3/28/91 Interviewers: Claudia Cardile, Jim Frey ADAP She is the information source person for the region concerning the ADAP program for the industry air carriers and contractors. She gives initial information and clarifying information. She helps them decide whether they need a plan (if it is a clear cut issue). If she has questions because the entity's work is too confusing or technical, she contacts AAM-220 (Jim Olavarria) the technical advisor at HQ for Drug Abatement for clarification and advice. Most of Joan's contact is on the phone. If she has a question for HQ, it is communicated over the phone. Drug Testing - the Agency's Internal Drug Testing Program Currently the internal program is managed by Human Resources (HR). It manages the Random testing and Aviation Medicine that manages the Pre-Employment, Pre-Appointment testing. If Joan has a question about Random testing she refers to the Human Resources (HR) Drug Program Coordinator (DPC). For a positive test result in either random or pre-employment testing, she prepares a packet for the Medial Review Officer (MRO) who is the Regional Flight Surgeon or the Flight Surgeon acting for him. This packet includes the positive test result, the chain of custody, and the medical file. The MRO evaluates the reason for the positive result (i.e. the employee is on medication). The MRO may contact the employee's doctor to confirm the reason for the prescription or the MRO may ask the employee to provide a copy of the prescription for the record. If the test is verified positive by the MRO, he will give his opinion and test results to the Drug Program Coordinator (DOC) in HR. The DOC will then notify the employee's division manager, the EAP manager, the Security division, and the Labor Relations branch. The information on the verified positive drug test is incorporated into the employee's medical file during the rehabilitation phases. This EAP and rehab information is kept in a sub file of the medical folder separate from general filing in a locked file cabinet. When rehabilitation is complete, all the EAP and Rehab sub-file is removed from the folder, sealed in an envelope labeled "To be opened by the Regional Flight Surgeon Only". The package is reinserted into the medical folder and returned to regular filing. Compliance and Enforcement When compliance and enforcement come into play, she will spend a majority of her time visiting air carriers, contractors and consortia; and performing C∧E inspections. Other If the ATC applicant test comes back positive, the results are verified by the MRO. If it is verified positive, the applicant is disqualified. She uses publications from HQ to verify answers to any questions for the Industry Drug Program. Her sources for information are the Advisory Circular AC# 121-30, 49 CFR Part 61 et al Nov. 1988, 49CFR Part 40 Final Rule Dec. 1989, and various amendments to the Rule. The Implementation Guidelines (Red Book) and the Question ∧ answer Book from FAA are also helpful sources. Location: Eastern Region Interviewee: Yvonne Muldrow, Covered Position Aviation Medical Program Assistant Regina Richter, Covered Position Aviation Medical Program Assistant Date: 3/29/91 Interviewers: Claudia Cardile, Jim Frey ATC Incumbents The ATC receives a yearly physical on his/her birthday (they are medically cleared until the end of the month). The authorization for the physical comes from the supervisor. If they need any test repeated, the authorization must come from this R.O. Once a year or when there are changes to the list, a list is sent out to the supervisors as to which AMEs can perform ATCs physicals. The AMEs send the bills and authorization to the R.O. This starts the process of filling out the paperwork. First is the worksheet (summary) which is kept in the medical file. The bill is paid and coded. The Facility Codes are included on the worksheet. When the 8500-8 is completed and action is decided (Qualified or Disqualified) the HIS from is completed. One copy goes to the file, one to the employee, one to the manager, and one to the manager of AEA-540. The bill goes to accounting and then the MML is updated. The Medical Assistants are the ones who decide if further review is needed. If more information on a point or clarification is needed, then a letter is sent to the ATC through the manager asking for this information. They mark on their calendar that thirty days later a response should be received. They put a copy of the letter into an accordion file which they check daily for progress in the case. When they receive information, if it is within the standards, they can then clear the ATCs. If it is not within the standards, they refer to Dr. Thieman for further clarifications. If there is no response in thirty days, a second letter is sent out, and the process of checking and waiting starts again for thirty days. ATC Transfer Personnel asks Yvonne or Regina to call the old region and make sure the ATC is medically cleared. If there are limitations, she then gets back to personnel with the results. It takes 3 or 4 days to get the medical file from the old region. They send a transmittal form with the file when they are sending a file out to another region. It has a copy which is to be returned when the file is received at the other end. Some regions don't send similar transmittals. Billing When a bill is received, they verify that the services were rendered. A copy of the bill goes into the medical file, and the bill is sent to accounting. If it is a second bill, they check with accounting to see the status of the previous bill. When there are new bills, the Medical Master Listing (MML) is updated. They don't use HIS. We don't use the HIS for billing information. They refer to the ATCS Health Program reference book from HQ when they have questions (Order 3930.3A). They would like to be able to attend some of the AME seminars for information to be better able to answer some questions. When AMEs call for guidance, the office tries to use its own resources to answer the questions before referring them to Dr. Thieman or Dr. Bauer. They keep a summary of all the vital information in the medical file including information about allergies, problems, etc. It is kept for internal use by the doctors if they refer to a case. Location: Eastern Region Interviewee: Kathy Orlando, Covered Position Program Assistant Aida Tizzio, Covered Position Program Assistant Date: 3/28/91 Interviewers: Claudia Cardile, Jim Frey ATC Applicants The process starts when they receive an application form from an AME for an ATC applicant. There is a physical application (8500- 8), lab and drug results. Security and or the Records Center in St. Louis, sends all military medical files to AEA-300 when applicable. Military files are hard to get for a FastTrack applicant, which should be processed in 90 days, it can take 6 months to a year to receive military files. HQ sends each region a list of ATCS Applicants who were cleared or not cleared on the 16PF (psychological evaluation). Sometimes the evaluations aren't coded with the correct identifier and the test must be taken again since there is no way to identify incorrectly coded evaluations. The program assistant makes a decision on fitness of each ATCS Applicant with the exception of difficult cases which are referred to the Assistant Regional Flight Surgeon. If the applicant was not fit, AEA-300 notifies AEA-14, Human Resource Management, so that he/she is taken off their list. AEA-14 sends a letter to the applicant stating why they were disqualified. No special considerations or waivers are made, they are automatically disqualified. A disqualified ATCS applicant has 15 days within receipt of his notification of disqualification to appeal through AEA-300 to the Federal Air Surgeon. If an applicant fails the psychological evaluation and passes in all other areas, then the case is referred to the flight Surgeon, (ZNY-300), Assistant Regional flight Surgeon and the Regional flight Surgeon. Each person in the office working in a specific area has copies of the MGL (guidelines) in order to reference them for questions. They keep a list of AMEs to give out information when private pilots call. They generally don't need clarification on the MGLs, but if there is a question that can't be answered, it is referred to Dr. Hark, Dr. Watkins, or Dr. Pakul's office. The Eastern Region would like the ability access on-line the results of the 16PF evaluation. They keep pending files on a calendar that is checked weekly while waiting for all the pieces of the file to come in so the evaluation can be done. They put the ATC applicant information into PETS, they can also access information that Personnel puts in the file. They don't use HIS. Applicant files are kept for 3 years and then they are purged. Fads Applicants are handled the same as ATCS applicants except that there is no lab work. The incumbents are handled like incumbent ATCS except the first year they need an EKG; once they are 30 years old they must get one every 2 years; and when they reach 50 years they receive them once a year. When a FAM is certified they notify Security and give them the HIS form. If a FAM is disqualified they notify Security and Personnel. Location: Eastern Region Interviewee: Kathy Orlando, AME Program Specialist Date: 3/28/91 Interviewers: Claudia Cardile, Jim Frey AME Certification Kathy keeps a comprehensive list of AMEs in a database on her computer (in Dbase). She generates two reports from the database, one which lists all the AMEs, the other which lists the AMEs who do physicals for covered positions. She runs these lists approximately twice a year, and she is the only one who updates her personal database. The only list of AMEs she receives from CAMI is a telephone directory which is usually out of date. She updates her database as changes come in and once a week she sends a memo to CAMI with these updates. If an AME moves, Dr. Bauer must approve/disapprove their working as an AME in the new location. Approval is based on the need in the new area. If an AME calls Dr. Bauer or the others about becoming an AME, the request must be written. An application, a list of information, and a list of training/seminars is sent when a request is made. She keeps another database of those who request information and a second data base of information on any applicant. An application is processed when a need is determined in an area. If there is a waiting list, this list is referenced an AME goes on the waiting list after all the information has been collected including references and application information. She access the AME data base in OKC. When a new AME is needed, a letter is sent to the applicant stating that he/she must attend a seminar. Seminar attendance list is checked and then designator letters are prepared and sent. Regarding complaints about AMEs, a letter is sent to the AME in question from Dr. Bauer stating the complaint. She finds the AME 'Report Card' sent from OKC useful. It tells the error rate and how many physicals were performed. If the AME needs to attend a seminar because they are at the five year time limit a letter is sent, if the next year they haven't attended a seminar, they are de-designated. If the error rate is 50% or greater a letter is sent saying they must improve and send the next 10 physicals they do to the Region to be checked. If an AME is de-designated they are asked to send back all the 8500s. If he is de-designated and is still performing physicals a letter is sent to the AME to tell him to stop. The Eastern Region would like access to the database which contains information on physicians with complaints against them and licensing problems. They would also like to be able to make AME office visits. Location: Eastern Region Interviewee: Tony Roderick, Regional Administrative Officer Date: 3/28/91 Interviewers: Claudia Cardile, Jim Frey Billing She keeps a special considerations database for covered positions which contains considerations such as diabetes and hearing problems in covered positions. She also keeps a billing procedure database which contains information about: how much was spent, when the bill was sent to accounting, when the physical was performed, and when the bill cleared through accounting. The database also contains information on all ATC, ASI Applicants, and FAM which contains: physical and lab test bills, codes for procedures performed, and how much was paid for each bill. The billing process is started when a bill is received for a physical. Usually either the physical authorization form or simply a bill is received. Right now there is a HIS sheet filled out with medical information, but this sheet is being done away with and a letter will be used to convey the information. The information from the HIS sheet is not entered into the HIS database. A copy of the authorization form/bill is put into the medical file and the original goes to accounting to be paid. When an ATC is qualified/disqualified a copy of the HIS sheet (letter in the future) is sent to the ATC, the manager, and one goes into the employee medical file kept at the region. The Washington ARTCC keeps the files it works with specifically. The New York ARTCC keeps the JFK, LaGuardia, Westchester files at the center. All the rest of the files for the seven states in the Eastern region are kept at the Region. There were approximately 6000 exams performed last year and 1700 of those were performed at the two Centers (Washington and New York). There is a worksheet form which is used to track the health and the point in the process that each file is at. The Regional office is starting an evaluation of the programs at the Region and the Centers. It will use a checklist (to be developed) to accomplish the evaluation. This action was prompted by Dr. Bauer's questions and problems seen in policy and processing information. The information collected from the evaluation will go into a report to Dr. Bauer. A copy of this report will likely go to Headquarters, the regional administrators, and management systems AEA-42. Budget The process starts with a call for the budget from AEA-43 or HQ. There are 8 to 9 different forms to fill out for the budget. These forms come in a packet when the call is made. In order to fill out the packet, the Region must coordinate with Air Traffic, Flight Standards, Security (FAM), the Budget Office (AEA-43) to do PC∧B for positions, and HQ for questions (Carol Kelly). This coordination is to project on hiring and covering positions to hire. Once the forms are finalized they are sent to Carol at HQ. This year Carol sent out a diskette containing standardized forms which are to be sent to HQ and the Budget Office. These are standardized for all regions. Tony does not receive the Budget Authorization Report. She is also in charge of sending people to training. This is started with a Training Call (Order). She then puts in all the training requirements for the Region. She puts in the number of courses they need to take, the number of people attending, the per diem, and registration. She knows if someone attends the training by the attendance lists. The TRIMATE system is used to input the training by system and not on paper, this information is used to determine the budget. The information is entered into the system, then it is approved, and then the person attends the training, and finally the system is updated. Tony feels that there is a lack of basic computer knowledge in the office. She would like them to have training and acquire the hardware, software, and systems. Procurement She uses SAM to do procurement requests. The form then goes to Procurement, a purchase order comes back, and a copy is kept after it has been signed. One copy goes back to Procurement and the other goes to the Budget Office. Performance Appraisal EPAMS - Employee Performance Appraisal Management System - is a paperless system. It will interface with CPMIS in the future. They received EPAMS from the Personnel Office to aid in the preparation of the performance standards. EPAMS gives a numerical rating at the end of the review that is printed out and a copy is given to the employee and Personnel. When EPAMS is hooked to CPMIS it will automatically give out performance awards. Other She will also be working with AISSM - Automated Information System Security Manager. This will involve: - security of all hardware; - risk assessment on data; - risk assessment on hardware, from fire, theft, water, etc.; and - physical security. An annual report will be produced and given to Security. She has the data asked for in the RFS Activity Report, but she does not feel that this is a good indicator of how her time is spent. The Eastern Region does not submit this report. Tony accesses ASAS (?), and EIR (?) only if someone needs help. Things she'd like: - Access to current AME information (right now she only has access to a book that is updated semi-annually. - Automated budget - Automated Activity Reports - Keep the information that Carol Kelly wants on-line so there would not be the middle man aspect - On-line access for Centers Location: Eastern Region Interviewee: Debbie Stouffer, Medical Billing Specialist Date: 3/28/91 Interviewers: Claudia Cardile, Jim Frey She keeps track of the billing process. - billing - procurement Billing She is responsible for any bill that is received with no supporting paperwork. The bills can be for services, physicals, drug tests, autopsies, etc. She said the authorization for autopsies comes from the NTSB, if a coroner calls for information about billing an autopsy, she tells them to send it to the NTSB since there is no set procedure for autopsy bills and authorization. Procedure: When she receives a bill, she pulls the file and sees if the bill has been received already and sent to accounting; she will then check the Medical Master Listing (MML) to see when accounting processed the bill. The MML contains the billing information about when a bill was received, when it was sent to accounting, and when accounting processed the bill. If the bill has not been received already, she will gather the necessary paperwork and then make a copy of the bill and put it into the medical file and then send the bill to accounting, she will finally update the MML. For an autopsy bill, she will make a copy and put it into the file called autopsy and then sends the bill to accounting. The Washington Center pays their own bills, she isn't involved in that process. Occasionally if a bill is sent (for specialized tests), the authorization comes with the bill in order to verify it. NY Center - Physical bills are sent to her with a copy of the worksheet. When she verifies the bill and approves it, she sends a copy of the approved bill back to the NY Center. She then updates the MML. In the case where a bill is sent to accounting and an AME claims he/she has not been paid, she checks the MML to see if the bill was processed in accounting. If so, she initiates a search for the canceled check from Kansas City (the check writing facility). A copy of the check, when found, is sent to accounting and they then give it to Debbie. She calls the AME and says that yes they were paid and then sends a copy of the check to them. She keeps one file for the clinics that bill out monthly, not for each visit. When the monthly bill comes in, she makes a copy, puts it in the file, and sends the original to accounting. Procurement Requests At the beginning of the fiscal year, she renews the maintenance contracts for medical supplies, medical equipment, subscriptions, etc. The authority for ordering comes from Tony or Dr. Bauer. She uses SAM and then prints a hard copy of the Purchase Request (PR). The PR gets approved and is given to Logistics. She keeps a copy in a manual file. She receives a hardcopy back from Logistics that has a number on it. When she receives the goods, she updates the file that it was received. If paperwork comes with the purchase, she puts it in the manual file (the file is kept in chronological order). Packing slips are compared against the order and she signs off two copies of the procurement paperwork, one goes to Logistics and one goes to accounting. She would like access to the accounting system to keep track of bills. Location: Eastern Region Interviewee: Phillip Thieman, M.D., Assistant Regional Flight Surgeon Date: 3/29/91 Interviewers: Claudia Cardile, Jim Frey Airmen Certification He deals mostly with problems that the others cannot answer. If he can't answer the questions, he refers to OKC. If letters need to be sent out for more information, he helps them word the letters. ATC Before an action is taken, the manager is usually contacted (sometimes they get information from security). The manager and doctor decide whether the ATC's performance is lacking. If no, they might take no action, if yes the ATCs may be temporarily disqualified. Current status reports go out to get more information on the problem when something comes up in the physical. Security reports are hand-carried because the information is confidential. Occupational Health (OH) OH is handled in Human Resources (HR). Eastern Region performs periodic blood screens. Dr Thieman suggested that there be an interface with HR about Occupational Health. AME Dr. Thieman answers AME questions when they call. AMEs are disciplined by Dr. Bauer or Dr. Thieman by written letter. Dr. Bauer is the only one who can de-designate an AME or permanently disqualify an ATC. Drug Testing If a positive comes out on the computer printout, then the employee is contacted privately without involving management. They determine the level of addiction and consult with EAP. EAP was already notified by the same people who notified the Region. Doctors must sign-off on the course of treatment. Questions on airmen are referred to OKC and questions on ATCs are referred to Don Watkins at HQ. He refers to the National Medical Library, Columbia Presbyterian Hospital's toxline and medline, and contacts the CAMI library. Occasionally, through a telecon or the bulletin board, he will transmit drug information to HQ or CAMI. An example of drug information is information on how a prescription drug will affect work performance. Location: Eastern Region Interviewee: Audrey Zink, Secretary Date: 3/29/91 Interviewers: Claudia Cardile, Jim Frey MGL She is on a national list for MGLs which she receives when HDQ distributes them. Upon receiving them, she distributes them to Dr. Bauer, to the other people concerned, and to the Washington D.C. and New York centers. If the copies are to be given to everyone, she makes the copies for distribution. She stores the MGLs in numerical order. When distributed by the Washington HDQ, the MGLs are received once every three months or twice every four months. When someone calls with a question, the MGL number used to answer the question is stated. She also receives FAA guidance and orders on various FAA-wide topics (administration and management). Action Notices are started at this office (e.g. Flu shot notice which is distributed throughout the FAA building and facilities). These must go through Management Systems to receive a number for distribution. Location: Great Lakes Region Interviewee: Paul Brattain, M.D., Regional Flight Surgeon Date: 5/13/91 Interviewers: Kevin Rodriguez, Claudia Cardile With respect to ATC billing of agency-required routine physical examinations, the Aviation Medical Division tells the supervisors which of the physicians have agreements to perform the exams. The agreement with the physicians to perform the routine agency- required examinations is between the Aviation Medical Division and the physician. The physician is always an AME. The exams are not performed under the umbrella of nay fee-for-service agreement as each is a unique evaluation. Billing/payment for non-routine or special medical evaluations is handled differently. There are two (2) clinics in the region where routing agency- required physical examinations are done. Currently all agency required physical examinations in the region are performed by AMEs on a fee-for-service basis either in one of the region's two (2) FAA medical clinics or in AME offices. The parts of the routine examinations not performed by a physician are generally referred to as ancillaries and are performed or overseen by nurses and physician's assistants. The authorization on Form 3930.3A is by the Regional Flight Surgeon and signed copies are in the FAA facilities for use when an employee goes to an AME for a routine examination. SF-44's are used in the two (2) FAA medical clinics where routine agency examinations are performed. Special evaluations are authorized only by the Aviation Medical Division or an FAA medical clinic. They are authorized on Forms 3930.3A but the authorization is specific for the special evaluation and is different for the authorizations in field facilities which are used to authorize routine agency-required examinations. Occupational Health The ATC Health Program and other agency-required examinations are considered to be a part of the Occupational Health Program. This part of the Occupational Health Program that are listed is mostly performed on an as-needed basis. It mostly has to do with environmental hazards and is an area where we depend heavily on the Safety and Health Officer and industrial hygienists for help. Other than agency-required certification/clearance exams mentioned above, the Occupational Health Program is not involved with routine examinations except for cases of historical asbestos exposure which are few. The other examinations that may be done under the Occupational Health Program are the result of exposure to environmental or occupational hazards and are infrequent. Suitability of fitness-for-duty examinations performed under the Occupational Health Program but these are extremely rare. Substance abuse problems including those involving PCP are handled under the Substance Abuse Program, not the PCS, problems are an additional occupational or environmental consideration under the Occupational Health Program. Health Awareness Program The Aviation Medical Division has a Health Awareness Program for the region. Health Awareness Programs in the field clinics have autonomy but the function under the umbrella of the regional program. Health Awareness activities are also conducted in the Regional Office on an ongoing basis. Records Active ATCS Health Program medical records are routinely maintained in the regional ARTCC medical clinics. Problem case files are sent to the Aviation Medical Division (and OAM Washington) for review and decision. Medication Decisions Information about the pharmacology, actions, adverse reactions and interactions of medications is readily available from many sources. With the majority of medications or groups of medications decision are not difficult. Deciding whether and ATCS should be medically cleared to perform ATCS duties or whether a pilot should be certified to fly when using a specific medication or combination of medications, particular dosage levels or uses for a medication that present differences of opinion among physicians. The thrust of this section should be directed at establishment of policy about the use of medications, especially those where there is a lack of agreement about their use. He has, on occasion, accessed Lexus-Medus. If he needs more information he will request data from AAM-300. He thinks that regions should have access to all AME and employee data in a data base to provide access to individual data when there is a transfer. This database information is under the currently being pursued by the IRM Working Group. Location: Great Lakes Region Interviewee: Dennis Shuring, Accident Investigation Coordinator Date: 5/13/91 Interviewers: Kevin Rodriguez, Claudia Cardile The information that they collect is not being used right now. Joan Morgan has put together a spreadsheet of the data collected. It contains information on the date, location, pilot, second in command, number of passengers, coroner, coroner's phone number, autopsy date, toxicology report date, 8025-2 date, and comments. The information that they gather from accidents is copied and sent to Oklahoma City (Dr. Veronneau). This data includes the post-mortem (autopsy). The autopsy report is sent to the operating district office. The 8025-2 form is completed at the scene. This report includes data on whether there was a fire, a medical problem, and proper equipment. In the future this form will be better tailored to AAM's research information needs. At this time the form is derived from a research project on seats and restraints. The post-mortem reports are not standardized since they come from many different sources. The goal in the future is to set up a facility where all autopsy for the area will be performed by one physician. The post-mortem could then be standardized. There is a Safety Order from Washington (number unknown) which states who should be contacted when there has been an accident. A telecon is set up through the Communication's Center when an accident occurs. The Flight Services Station or FSDO in the region puts together the telecon. At least one member of the Great Lakes region AI team is in on this telecon. There are four members of the AI team here. As the accident investigation progresses either the RFS or some representative from the office (a member of the AI team) is in contact with the IIC (Investigator In Charge), the NTSB, and the Local Authorities (e.g., coroner/county medical examiner, sheriff). They inform the Local Authorities of what is needed, for example, full post- mortem or specific toxicology specimens that must be collected from the pilot(s). The tox-boxes come from the FSDO office and contain containers for the specimens, the chain-of-custody sheet, and instructions on what to do. These are shipped to CAMI either by the collector or from the AI people in Great Lakes. The autopsy goes to Great Lakes along with the bill to be paid. A copy of the autopsy is made and sent to NTSB/FAA and OKC (data collection center for their records). In Great Lakes Region, a post-mortem can cost $800 or more. Every state but South Dakota () requires a post- mortem in the case of a fatal accident. There is a team of four consisting of Dennis Shuring, Joan Morgan, and two physician's assistants, who rotate being on call for accidents. . They are involved in air carrier accidents and the General Aviation accidents. If there is a VIP involved, there is much press involvement, or an Air Carrier involved then the NTSB and other agencies participate in the accident investigation as well. If this isn't the case, then the AGL AI team usually investigates. Their participation in accident investigation is mostly for the research aspect although their work may be needed for the legal side as well. The NTSB is notified as to the type of aircraft and to call the local authorities. If it is a routine accident, then they are not involved. If there is something strange about the accident (i.e., a bullet was fired) then the NTSB will ask for specific information. The NTSB is sent a copy of the autopsy. And if there is some problem with the local authorities then the NTSB will get involved to help. There is no real involvement or support from HQ. Now with Dr. Veronneau there is more support from HQ. If the accident involved an Air Carrier then the FAS is kept informed as to what is going on. The other Regions don't have any real contact with Great Lakes with respect to Accident Investigation. The 8025-2 (sometimes 8025-3 longform) data and the autopsy data is put into a spreadsheet at this time; there is no data base. The 8025-2 and autopsy are sent to Washington. At Great Lakes, they review the autopsy for problems and contact the NTSB to tell them of the findings. If they go to investigate the accident then they are the ones who fill out the 8025-2, if not, the Flight Standards fills it out. There is an Order which explains how to fill this out. It is in the process of being re-written. (Maybe 8011???) There is Order 8025.1B "Medical Investigation of Aircraft Accidents" which explains the Responsibilities of the Aviation Medicine Program. There is a section which states what the Flight Surgeon should do. The AMEs need to be better trained in order to perform the work for the regions. There used to be a program which trained AMEs in medical collection and some engineering for better understanding of what has occurred. It trained approximately 400 people before running out of money. There are approximately 150 people left from that training. The AMEs are paid a one day per diem of $50, or, if considered a consultant, $280/day. This is not enough pay to induce AMEs away from their practice to go to accidents. The ideal would be to train them, have them collect the data, and pay them a reasonable amount of money. At this time trained AMEs who can collect information at accident sites are distributed as follows in the Great Lakes Region: 1 in Ohio, 3-4 in Indiana, 1 in Illinois, 2 in Wisconsin, and 3 in Minnesota. They are not always available to go to accident scenes. There is no contact with AAI. Now that Dr. Veronneau is in charge this might change. They access the Certification (CAIS) data bases for pilot information. They would like to be like Flight Standards and have a form which collects data and then put the information into a data base. At this time they have the ability to pull up a screen from the Certification data base if they need more information. If they need a hard copy they will ask OKC for it. If there was a special issuance involved then the files are looked at closely. They are alerted that it is a special issuance by the medical certificate carried by the pilot. Human Performance is the cause of 90-95% of all aviation accidents. If they go back deep enough into the records, they can find the cause. They also talk to the families if needed. With respect to autopsy billing, the bill is attached to the autopsy and Lynn (secretary) fills out the paperwork (SF44) to pay the bill. It is then sent to accounting. With the information from the bills, they could look at costs around the country and justify the need for facilities for autopsies in the regions. When they get around to using this information, they can better justify the need for a central facility for autopsies. In 1990 there were 60-65 accidents. The number is dropping off due to the cost of fuel going up and the cost of learning to fly increasing. Public law require that an autopsy is performed on accident pilots. The authorization comes from local authorities or the NTSB has the court order the autopsies. They don't know of any data bases which they need access to. Right now they access airman data (Certification and Medical, CAIS). They support the NTSB with the accident investigation and determine probable cause. The medical aspect is mostly for research. They receive tapes of ATC conversations with pilots to help determine the causes of accidents. Location: Northwest Mountain Region Interviewee: Paula Kanesky, Regional Administrative Officer Date: 3/4/91 Interviewers: Kevin Rodriguez, Jim Frey, Carol Wasserman Budget There are two main components to the budget: PC∧B (salary, benefits, awards) and ASI/ ATCS/FAM physicals, both for applicants (except A51) and on-board employees. PC∧B information is projected based on the number of employees and is figured in conjunction with the Financial and Information Resources Division (budget branch). Physical dollars are predicted based on hiring plans and the current number of on-board safety-related employees. Northwest Mountain (ANM) estimates that 4 physicals are performed for each ATCS hired (not all ATCS who receive physicals are hired). This information is obtained from a listing assessment done by Medical and the Regional Personnel department. Medical personnel and Air Traffic are trying to cut down on the number of physicals performed by pushing to do the physical later in the process and by improving the selection process. The Western Pacific regional accounting office sends Paula a computerized report that shows exactly where ANM is with respect to the budget. The accounting report is current in terms of payroll dollars and shows the actual bills paid. It does not show committed funds (when the physical has been done and the bill is sent in, but the check has not yet been mailed). Committed funds are determined by adding up the incoming billing data that is hand-posted on cards. Individual cards are maintained for each AME that performs ATCS physicals. The AME sends in authorization forms that contain the billing information and the amount due to the AME is posted on the card. The authorization form is then sent to the regional accounting office for payment. Budget call path: ABU --> APR --> ANM-40 (regional budget office) requests information from Paula, as does the Office of Aviation Medicine. Paula receives a quarterly form from ANM-40 and submits the Quarterly Status Report to ANM-40 and to Carol Kelly, AAM-120. ANM-40 sends it to APR. APR sends the report to Carol Kelly. The quarterly report shows actual versus planned expenditures and the reasons for any discrepancies. Budget requests are submitted quarterly and annually. The budget request is used to show a need for more dollars or positions. A confirmation is sent from APR to the regional budget office, to AAM-120, and to ANM-300. Billing Most ATCS/FAM physicals are performed by contract AMEs. About 100 out of the approximately 500 AMEs in the region do ATCS/FAM physicals. Billing information is maintained in a card file. Posting cards are kept permanently. There is also a temporary card file for fiscal year expenses. Pre-signed authorization forms are sent to the Air Route Traffic Control Centers. When an Air Traffic Controller (applicant or employee) has to get a physical, the 3 part authorization form initiates the process. The ATCS manager fills out the top portion that describes what will be done. The ATCS then brings the form to the AME. The AME fills out the middle portion of the form with the results. Bills for on-board controllers, agency pilots, FAM, ASI are sent from the AME to the ARTCC. The bills are sent to the ARTCC so that the ATCS medical file (stored at the Center) can be maintained. The third part of the form is the billing information that is sent by the AME to the ARTCC. ATCS medical records are kept at the Centers. The ARTCC keeps a record of the physical and sends the bill to the regional office (Paula). The color of the authorization form differentiates whether the bill is for an on- board employee versus an applicant and the location of the employee (Green - Denver; blue - Seattle; pink - all applicants; yellow - Salt Lake City - on-board). The staff posts the billing information on the AME's card, Paula approves expenditures, and the authorization form is sent to the Western Pacific accounting office for payment. ANM forms 3930-8/9/10/11 are the Authorization and Invoice forms for physicals. The cards are used to determine the actual status of committed funds and enable Paula to respond to a doctor's inquiries if he calls to say he hasn't been paid. AMEs are paid monthly by the accounting department. Every month Paula receives a computerized report from the accounting office that shows all the bills that were paid. A pipeline fund is maintained to pay bills that are received or processed after the close of the fiscal year. The billing year is determined by date of service. Bills for autopsies are also tracked on cards. These cards are maintained separately from the ATCS physical billing system. Bills for medical specialists are maintained on separate cards as well. Information that would be extremely helpful is payment information by patient. This detail is not currently received from the accounting department. The current reports show the bills that are paid by AME, but not by the individual patient. Without the detail it is not possible to check off what actually has been paid. A Cost Center Detailed Transaction Listing (13-3F) is received from the accounting department. Blanket Purchase Authorizations (BPAs) are maintained for AMEs who do ATCS physical; medical specialists who provide additional examinations as required; coroners/pathologists; labs. The BPAs provide a contract number that is on the colored bill submitted by the AMEs. Contract requests are entered through the Standard Acquisition Management System (SAM). Logistics receives the purchase request and sets up the contract. Contracts typically get set up for 3 years. A note on the calendar is what prompts Paula to start working on a new contract. ATCS Transfer A new region requests a medical file from ANM. ANM sends a request to the Center to send the files. The request is a transmittal form. Other EIS (ASAS system) is used to find out the latest information on pilot health status from OKC. This information is good but not always current. PETS is used to track ATCS applicants. PETS CPMIS is used to find out where an employee went. ANM would be interested in finding out more about the Medical Bills Tracking System used in the Eastern Region. Training plans are sent to the Regional Human Resource office. Regional LAN system is used for local FAA mail (includes the Centers). ANM does not have office-wide FAA mail. Location: Northwest Mountain Region Interviewee: Barb Lucich-Biehl, Airmen Certification Program Specialist Date: 3/5/91 Interviewers: Kevin Rodriguez, Jim Frey, Carol Wasserman Oklahoma City (OKC) sends airman applications that need to be resolved to the Regional Office. AMEs send airman applications when there is a problem where the doctor is not authorized to issue a certificate. Barb resolves problem cases and mails the resolution and the file to OKC. The resolution of every case is either a waiver, a certificate issued or the surrender of the certificate. If more information is required from an airman a request for additional information is sent. If information is needed on an issued medical certificate, a 609 letter is sent. If the resolution is the surrender of a certificate, a confirmation is sent to the airman upon receipt of the certificate. The certificate is sent to OKC when it is received. OKC has no automated way of monitoring open cases in the Regions especially from AMEs and therefore does not know the progress on a case until it is resolved. Because of the lack of automation, there is also a lag time from when the case is resolved and OKC learns of the resolution. When a file is sent to OKC, a transmittal form is completed. A copy is sent with the file and a copy is retained for the records here. Transmittals are retained for 2.5 - 3 years and then shredded. Letters are sent return receipt requested to the airman. Files are sent usually to OKC by pouch mail. If an airman has a problem that the regional office does not want to give a permanent waiver, a time-limited certificate may be issued. It is sent to the airman by mail, return receipt requested. Those cases are followed by the RD and OKC. All information is sent to OKC upon completion. Comprehensive Airman Information System (CAIS) is accessed through the Enforcement Information Subsystem (EIS). While CAIS provides some information, questions usually cannot be answered without calling AAM-320 to get more specific information. If the airman was examined by an AME who is not in ANM region, it is very difficult to determine the AME name since only the AME designation number is on the CAIS screen and an index of AMEs by designation number does not exist. Barb works with the security department when a security check is required on an airman. A letter is sent to the Security department to request the check. They send her the written results of the check. If a psychiatric opinion is required on a case, the case is sent to Dr. Pakull in Headquarters in DC (AAM-200). A transmittal is sent with the case material. A copy of the transmittal is sent to OKC to inform them the case has been sent to HQ. The airman certification standards are the set of rules for determining whether an airman is medically certified. Since many cases are not clear-cut and the rules require clarification from OKC, the responses received are written in the margins of the notebook to record precedents. With OKC's consent, the RFS can use his judgement to modify an earlier decision with respect to whether an airman should receive a waiver or a medical certificate. Medical Guideline Letters (MGL) from the Federal Air Surgeon issue the policy on medications and other medical concerns. It is hard to determine which Letters are current and which are out- of-date. A list of outdated Letters does not exist. Barb maintains a written log of materials received and last action taken on a particular case as a way of tracking status of airman certification open cases. The airman activity portion of the Regional Flight Surgeon's activity report is difficult to fill out because there is no way of entering cases reviewed but not resolved. The report does not therefore provide a complete picture of airman activity. It is also hard to determine the information the report is requesting. Information would like to have  Narrative information from CAIS on the last action taken with respect to an airman certification case  Way of getting totals required for RFS activity report  A Tracking system or data base for airman certification cases.  Access to Dept. of Motor Vehicle (Registry) records so that she would be able to check for DUI conviction, etc. before going to Security. In this way Barb would be better able to determine the priority of the case and the rush Security needs to put on it. Accident Investigation The National Transportation Safety Board (NTSB) contacts our Communication Center. The Regional Communication Center calls or beeps ANM (Barb) right away when there is a fatal accident. Barb fills out a log sheet with the accident information. She pulls out the medical data on the pilot from CAIS and faxes a copy of the medical data to NTSB. She helps coordinate the autopsy work with NTSB by authorizing the coroner to do the autopsy. This is done verbally. NTSB sends ANM the FAA copy of the final accident report. The report is used to update the accident log. AAM-300 sends a copy of the report to the centers. The FAA copy is sent cert/RR to FSDO. The centers do the final report and send it to the region. AAM-300 Regional medical reviews final package, keeps the original of the final medical report and then forwards complete package to AAM-332 for storage. Every autopsy and toxicology bill received is also tracked using card logs. A sheet of paper lists the AMEs who are designated to go to accidents. (AMEs take a CAMI-sponsored course to get designated). AMEs are rarely used however. It would be helpful to track accident information and autopsy costs online. Occupational Health ANM has an Environmental Health and Safety Committee that holds quarterly meetings. Notes are taken at these meetings with a copy sent to all committee members and to the industrial hygiene area at CAMI and Dr. Watkin. Manual logs are maintained on the employees who are at risk for a health hazard such as asbestos. Airway facilities provides the list of employees. When physicals need to be performed (such as in the case of asbestos) and a baseline health profile is required. Letters are sent to doctors in the area in which the employees are located to see who was able to do the physicals. The doctors responded with their availability and the cost per physical. Letters were then sent to the centers authorizing employees to receive physicals. The employees then took an authorization form to a doctor who was approved. Logs are maintained of employees who received physicals (based on authorizations received from the doctors). Location: Northwest Mountain Region Interviewee: Beverly Lyons, ADAP Manager and Covered Position Certification Specialist Date: 3/4/91 Interviewers: Kevin Rodriguez, Jim Frey, Carol Wasserman ADAP Responsibilities Beverly uses a PC data base to track all Northwest Mountain aviation industry entities (135,121,sightseeing) who must submit plans. Upon request, AAM-220 sends out a list of who submitted approved plans in the ANM region. This data is used to update the data base. The original data base data came from Flight Standards and Regional ADAP Manager presentations. The regional data base is maintained so that she can keep the aviation entities informed of program updates. AAM-220 refers aviation entities in the ANM region to her if they have questions. Beverly's objective is to provide information that will help the entities comply with the ADAP rules. AAM-220 provides written material to the regions for presentation to the entities. Questions that are phoned in or are put in writing are sent to AAM-220. A copy of the questions is suspended in ANM- 300. A log is kept of all materials mailed to the entities. Each ADAP person sets the policy for his/her area. The role is undefined. Telecons are currently held between the ADAP managers and AAM-220 every other week, AAM-220 wants to make this once a month, the ADAP managers want the Telecon to be weekly. The ADAP regional person will go on the inspections once the compliance and enforcement aspect of the program is firmed up. Beverly believes that there are merits to being straight-lined to AAM-220. Information ANM Needs Access To Aviation entity plans and reports. Standard replies that are given to questions. Changes to rules, programs, requirements. A copy of all correspondence is sent to entities in ANM by AAM- 220. Applicant Drug Testing Responsibilities People who get drug tested: pre-appointment on electronic technicians when they are ready for journeyman level; pre- employment on aviation safety inspectors, federal air marshals, air traffic control specialists. A copy of the authorization NW FORM-390 for drug testing is sent to Beverly from H.R. or the supervisor in the division. A copy of the form is sent to the person being tested. The individual submits the form to a designated AME. One copy is kept by the AME, the other is sent back to be in ANM-300. If the person's name is not on the drug testing custody and control form that goes to the lab, Compuchem sends the results via modem to the regional office. The regional office matches the printout with the authorization form using the social security number. The lab notes discrepancies on the form that are not considered fatal flaws. Any fatal flaws will cancel the test and the test must be repeated. The AME is responsible for distributing the copies of the form. The appropriate hiring official is notified of all test results. Test results for the ATCS applicants go to the ANM-300 ATCS specialist for inclusion in medical records. The MRO in each region must review the custody and control forms and positive test results of each individual. Location: Northwest Mountain Region Interviewee: Danell McCaughan, AME Program Specialist Date: 3/5/91 Interviewers: Kevin Rodriguez, Jim Frey, Carol Wasserman Physicians who want to be AMEs contact AAM. Danell asks the physician to send a letter requesting to be an AME. Lists (believed to be manual) are maintained of physicians who have requested to be AMEs. A few hundred physicians apply each year. All physician applicants are given consideration. When an AME applicant letter is received, Danell completes a designation worksheet that indicates the location and number of current AMEs. The letter, the worksheet, and comments are forwarded to the Regional Flight Surgeon (RFS) who determines whether another AME is needed in that location. AAM sends the physician a letter stating that there is no need or a letter plus an application if there is a need. The physician completes the application and returns it to the regional office. A file is started on the AME upon completion of the application. The application is forwarded to the RFS for approval. A confirmation letter is then sent to the applicant and to AAM-410 in OKC. One part of the application is also sent to Oklahoma City (OKC). All AME applicants must attend a workshop and a seminar. OKC (AAM-410) sends a seminar schedule to the regions. The physician contacts the office to tell them the seminar he/she will be attending; ANM sends a letter to AAM-410 to register the physician for the class. OKC sends information regarding accommodations and an agenda to the AME. After the seminar, OKC sends a form to the regions that says who has attended seminars. A copy of this form is then put into the file of each person who attended the seminar. On the outside of the AME file, ANM marks the last date he/she attended a seminar and the location of the seminar. AMEs are assigned designation numbers. OKC sends each region a block of numbers. AMEs are assigned one of those numbers. AMEs receive certificates upon the successful completion of the seminars (are these handed out at the seminars or sent from OKC?). AME files are kept manually (contain many signed documents). The contents include the application and accompanying letter, picture, field changes (form that records changes in the AME designation, address, etc.), designations cards. Designation cards are sent to the region from OKC. The cards are signed by the AME and returned to the region for filing. The designation card is how the physician accepts the terms and conditions for becoming an AME. The designation cards are sent from OKC once a month and are signed by the AME once a year. Notes of phone conversations and copies of all correspondence are maintained in the AME file. A summary sheet is also maintained on each AME. An AME national directory is mailed to the regions annually from OKC. The regional office sends copies of the directories to the centers. Field changes are how AME directory information is updated. Copies of the field changes are sent to OKC and the Centers. AMEs who are qualified to do drug testing are listed separately. A section of the field change form is used to designate an AME for drug testing. Various letters and pieces of information are sent to the AMEs at different points in time. Equipment lists are sent before the physician becomes an AME. When an AME moves, a move letter is sent. The letter either confirms the move or defines the person as gone (didn't notify the office). An Annual report of AME performance is sent from CAMI to the Regional Offices. Quarterly reports are also sent. OKC periodically sends new regulations and forms. Most forms and letters are specific to the regional office. Things that would be nice to have Summary sheet and designation worksheet on the computer. The AME program hooked to the Centers so that a change can be made once. Other When complaints are received about AMEs from pilots, they may be sent from OKC, Centers, or the pilots directly. Information about AMEs is received by having articles being sent to the regional offices, or having seen something in a magazine the office subscribes to. Negative articles or complaints are sent directly to the RFS. He determines the next course of action. All articles and complaints are put in the AME's file. Location: Northwest Mountain Region Interviewee: Gloria Scarpelli-Norman, Covered Position Certification Specialist Date: 3/5/91 Interviewers: Kevin Rodriguez, Jim Frey, Carol Wasserman Human Resources (H.R.) starts the Air Traffic Controller (ATCS) applicant process by sending initial data on the applicants to Gloria. ANM sends H.R. and AT a list of AMEs who are designated to perform physicals. Then, they send the list to the MATES interviewer. MATES interviewers are located at the tower centers and the Flight Service Station and are the individuals who interview the ATCS applicants. The interviewer then schedules the physical. The MATES interviewer then sends Gloria a NM Form 3930 to inform her that an ATCS applicant is going out for a physical. The AME sends a bill and the completed 8500-8 form to the Regional Office. Gloria reviews the medical data, and, when the ATCS is medically cleared, enters the data in the Personnel Employment Tracking System (PETS). If a person is medically disqualified, Security is notified with a letter. HR is also notified with a letter and sent the supporting backup material. PETS is also used to record courtesy physicals that are performed for ATCSs or Federal Air Marshals (FAM) from other regions. When employees are transferring, PETS is also used to track their medical information. When an ATCS (onboard employee) is transferring into the region, HR sends NM a letter telling them where the person is transferring from. If HIS was up-to-date, Gloria could go into HIS and pull up the ATCS's medical data (other problems with the HIS are that it is cumbersome, very slow to use, and difficult to access). Gloria requests the file from the ATCS's current region, looks at the file, compares it to medical standards, and validates the information to ensure that the controller is qualified for the conditions in the local tower. Currently it takes a long time for the ATCS transfer paperwork to process. HR is not always prompt about notifying a region about an impending transfer. (HR notifies regional HR who notifies Gloria). Regions are not always prompt about transferring medical files. (In this region medical charts for ATCS are kept at the Centers). Personnel Employment Tracking System (PETS) is used by Gloria all the time. She would like to see PETS nationwide in order to look up applicants who are not from NM region. If ATCS applicants fails the course, the files are sent to St. Louis where they are archived. After three years the files are shredded. Location: Northwest Mountain Region Interviewee: Christopher Taylor, M.D., Acting Regional Flight Surgeon Date: 3/6/91 Interviewers: Kevin Rodriguez, Jim Frey, Carol Wasserman Medication decisions for ATCS are made by the Regional Flight Surgeon (RFS). ATCS medical records are maintained at the Centers. On weekdays, Dr. Taylor talks to people at the Centers and they update the ATCS records. On weekends, he often does not know the employee for whom the decision is made and no written records are maintained. It is the responsibility of the ATCS manager to keep records of decisions made. The ATCS is supposed to let the supervisor know if there are changes in medication. It is not AAM's responsibility to update the medical records. When an unusual situation occurs and more research is needed, the ATCS medical file is held at the Centers. A letter is sent to the ATCS and the supervisor when they are not cleared to work. Dr. Taylor also gets calls from airmen. He advises airmen to notify OKC if their condition changes so that their records can be updated. If he could make a notation on the airman's file it would facilitate making sure the records are updated. If it looks like there is a reason that the airman should be decertified, he gathers the appropriate data (from the airman, his medical records (online using EIS), other opinions) and contacts OKC. Dr. Taylor may contact Drs. Hark and Watkins in Washington DC (AAM-200); other RFS (e.g., Telecons, individual contact); network of local physicians; U. of Wash. School of Pharmacy for additional opinion/data. The data base at CAMI's library is a good resource for answers that are not required immediately. CAMI will respond within about 10 days with a floppy disk of articles and titles on the requested topic. NM used to access LEXUS and Gratefulmed. Access is not required. Substance Abuse Dr. Taylor maintains a notebook that lists information on employees who have tested positive for substance abuse and on employees who are self-referrals. Initial history, medications, when started rehabilitation, when completed rehabilitation, progress, follow up, dates that the person reports in, contact people is maintained. A release, signed by the individual, is filed at the Regional Office and at the Employee Assistance Program (EAP) in case either party needs to share the information. Requirement letters that are related to rehabilitation treatment and follow-up are maintained. Requirement letters are required to remove the letter of pending termination that is entered into the employee's personnel file. Requirements for rehabilitation are based on consensus between the treatment center, EAP, nurse or physician at the local center, and RFS. They have a very tight follow up program. Labor Relations is notified when the treatment is successful. The location of rehabilitation information varies by Regional Office - some store the data at EAP, others with the RFS. Occupational Health NM coordinates the occupational health (health awareness) program in the regions. NM maintains manual records of how many people attended programs and how many people succeeded. When employees have been exposed to a hazardous substance, they track who has been exposed, review the physical results and notify the employees when they are due for another physical. Employee health records are maintained at the Centers. If they get an O/H coordinator, then the programs that they run will be documented and records on the employees can be held centrally. Only employees who are exposed to health hazards and who require a medical exam (high site workers) have a medical record. AME De-designation AMEs are de-designated based on the number of errors. The quarterly/annual reports are reviewed to see who has a high error rate. Dr. Taylor talks to the staff or to the AME to put the AME on review which means that all the physicals are sent to the Office. A letter is sent to the AME telling him/her why he/she is on review and a copy is maintained in the AME's file here. If there is a need to de-designate the AME, the Office sends the AME a letter noting the steps that they have gone through and why the AME has been de-designated. The AME is then given the chance to appeal. A copy of the letter is filed in the AME's file. AMEs may also be contacted by phone or letter if the AME is doing a very low number of physicals. A high error rate or a low volume can be obtained from the quarterly and annual reports. Sometimes Dr. Taylor gets a call from a pilot with concerns about an AME. An organization is currently in the process of getting a national data base together that would list the physicians who had their licenses removed by one or more states. Now it is hard to know when a physician licensed in one state has his/her license revoked by another state. When this data base is available, Dr. Taylor would find access to it extremely helpful. Dr. Taylor also works with the legal department and security to get a court order to get access to hospital records to determine if more detail is required about an AME. With respect to the RFS Activity Report, 3 activity reports come into the Regional Office from the Centers. The activity information is consolidated at the Regional Office. The topics and questions are not clearly defined and the report is hard to fill out. Sometimes his office gets surveys where the information required has already been submitted on the Activity report. The Office can use more computer skills so that they have a broader view of the capabilities of automation. Location: Southern Region, Jacksonville Clinic Interviewee: Lanier Jones, M.D., Flight Surgeon Date: 5/16/91 Interviewer: Jim Frey Jones provides guidance to AMEs within the region. He has authority over a sub-region within the Southern Region and he handles Air Certification problems that aren't resolved at CAMI, pursues pilots who have not complied with the certification system, attends NTSB hearings and sometimes appears in court. His office has frequent contact with Air Traffic (AT), Security, Legal, Personnel, and the Florida Licensing Board, aka the state board of medical examiners. The AME program is handled by the Southern Region and there are about 100 pilots to every AME. New AMEs within the area send Airmen Certification 8500-8 data to Jones. He reviews the applications for errors and contacts the AMEs to correct AME errors. Jones also handles complaints about AMEs, requiring participation by Security and Legal. In the past, people have been sent to AME offices for exams posing as pilots to investigate the AME's behavior. It is sometimes also necessary to check arrest records. Jones also needs to know when an AME is having problems with accrediting organizations. Jones needs an AME system that provides easy access. The hard copy reports (directory and performance) provide too much and are unmanageable. Hard copy must also be aggregated manually, which requires too much time and effort. According to Jones, Joe Dinsmore of HQ-OAM is working on the role of clinics in OAM and restoring clinics to full operating status. Jones has devised a DBase IV system for managing the clinic's information. His system uses ICD (International Code for Disease) issued by Human Health and Services pathology codes, citing that it is a universal code used by hospitals and national databases. (The code used by CAMI is not ICD codes.) An important problem regarding codes is user access to codes and automated assistance in locating and selecting the correct code. Jones maintains a list of AMEs for ATCs (about 40) on the database. He uses the AME Directory for other AMEs, the FAA Directory and other government directories, but believes these should all be automated. Dr. Jones uses a PC purchased with his own money at the office. Medical files a categorized by birth month, because that is how operations are based. Jones characterized the filing system as "continuously self purging." Jones said that personnel currently type 8500-8 data using a typewriter and have even used a computer to type and print it, so using the computer to input the data for AMCS would not be difficult or present any new workload. Clinic doctors are not on the RFS-BBS. There are about 20 clinics in the planning stages and Jones says that if they are staffed, the doctors will need more responsibility in order to avoid boredom. Simply performing exams will lead to attrition. The clinic receives a personnel report containing privacy act data detailing everyone in the region, probably from the Regional Personnel Office. One problem the clinic experiences is that new employees can be on the roster for months, but the clinic is not informed. Location: Southern Region, Jacksonville Clinic Interviewee: Peggy Warren, Medical Clinic Program Assistant Date: 5/16/91 Interviewer: Jim Frey The clinic does not have a Physician's Assistant or Nurse. Peggy works as a secretary, health technician, book keeper, data entry clerk and administrative assistant. She also orders supplies and takes care of the equipment. Peggy primarily uses WordPerfect on the PC. She communicates with people using the mail, memos, will hand carry documents on site, and uses the FAX for time-critical items. E-mail is available but she has never used it, because it's simpler to place a phone call. Peggy has access to the Oklahoma City host via the regional office. She used to support HIS by the input of data daily, but no longer supports it because of the lack of time and because she never needs information from HIS, i.e., there is no benefit to supporting HIS. Peggy has read-only access to EIS, but uses it only on rare occasions. Peggy stopped using PETS in January, because it was too time consuming. She simply notifies personnel when clearing an ATC by telephone, then follows this action with hard copy notification. (Hardcopy is also required when updating PETS directly.) The clinic primary business is providing physical examinations to ATCs, maintaining 1320 files. It also handles Airmen Certification problems for the region and answers AME questions. The clinic operates the employee health program, using the standard electric sign to display information to the public, prints and distributes flyers, tests individuals and provides presentations, although presentations have not been effective because of a lack of participation. The clinic supports the Occupational Health Program by providing physical exams to individuals requiring them. It does not play a significant role in Aircraft Accident Investigation, except in that it pays the bills for autopsies (a fact that irks Peggy because it gives an unassociated office (NTSB) spending authority over a portion of the clinic's budget. The clinic maintains medical information on the 8500-8. Peggy was unfamiliar with SF-600. Peggy maintains an informal relationship with personnel in other regions performing similar duties. She has had no contact with Central or the Western Pacific regional offices. The clinic does not send any reports to Washington or CAMI. Reports are sent entirely to the regional office, where they are consolidated and forwarded upward. Reports include the monthly Flight Surgeon's Activity report, which includes number of: exams, special consideration cases, cases requiring further evaluation, autopsies, etc. Peggy performs hearing and eye tests. The results of these test are recorded on the 8500-8 during the annual exam. When lab tests are performed, the original is kept in the file and a copy is provided to the individual. A day sheet is kept for sick call which is primarily used by Dr. Jones to document the visit. The clinic maintains a Blanket Purchase Agreement (BPA) to pay AMEs. Peggy receives bills from AMEs, rubber stamps them and fills in some information to validate payment and forwards the bill to accounting. She maintains a log book, alphabetical by doctor in which she records payment. Each doctor has a page. Peggy uses SF-44B to show a "one-time" bill to accounting. Once she has submitted paperwork to accounting, she will receive nothing back. There are rarely any problems, but she will only become aware of a problem when a person calls to complain about failure to pay. Barbara Johnson from the Southern Region handles the budget. She coordinates with Peggy and Dr. Jones to accommodate their needs. Peggy will call Barbara to request funding for equipment. Medical supplies are ordered from GSA using an electronic touch tone telephone ordering system. Office supplies are provided through the ARTCC and carry no financial implications for the clinic. Location: Southwest Region Interviewee: Roel Carreon, Health Awareness Program Coordinator Date: 3/8/91 Interviewers: Kevin Rodriguez, Carol Wasserman, Jim Frey Washington HQ sent a letter to every FAA employee telling them the health topic that the health awareness program will address each month. It is up to Roel to determine what he will do each month to provide employees with information on the topic. Each region is responsible for running a program under the same topic each month. The contents and format of the program are at the regional coordinator's discretion. Roel communicates the regional monthly programs to employees using a sign and the Human Relations Committee (HRC) bulletin. He sends a note to the chairperson of the HRC to get the notice put into the bulletin. Program attendance is monitored by having people sign in when they come. The tests or procedures performed are coded and entered next to the person's names. He usually requests literature and support from an association that is involved with each month's health topic. He is maintaining a file on who was contacted and the program that was set up each month. Material is available for pickup at the time of the program and will be sent to employees unable to attend upon request. Materials are also sent to the local coordinators. He uses the computer to list what was sent and when to different FAA coordinators. The FAA coordinators at the different centers report the topics of the lectures held in the Center and how many people participated. Standard Form 600 - Health Record or Standard From 509 - Medical Record is used to record employee medical information when they visit the clinic. It lists who came and the treatment administered. He sees about 50 employees a month. He keeps the medical files for the entire time an employee is in the region. When he receives a notice (SF50 form) that an employee is going to a different region he sends the file to that region. When an employee retires or is terminated the file is sent to St. Louis. He keeps a log of where the file was sent in a notebook. Health Awareness Program Coordinators have monthly telecons. Washington HQ sends them a certain amount of information about different organizations. It is often the national branch as opposed to the local organization. He will do research and respond to employees requests for information. ATC will sometimes call him for medication information. He consults with Dr. Ziegler, references the Physicians Desk Reference as well as the medical certification standards. Roel is responsible for tracking Aviation Safety Inspector (ASI) and Federal Air Marshall (FAM) physicals. He sends letters to ASIs and Fads when they are due to have a physical. Every month he peruses his files to see which certificates will expire. With the physicals are authorization forms (3930). The FAM/ASI manager gives a form to the ASI or FAM and returns the other to Roel in the regional office. These forms are the prompts that enable him to track the physicals that are due. When the physical is completed, he sends a letter to the individual and the manager that the person is medically cleared. AMEs often send the physical to OKC instead of first sending it to him. He has to track it down, send a letter to the AME to send a copy to him. He sends the ASI physicals to OKC after reviewing them. If at the end of the month he has not yet received the flight physical, the individual is put on a delinquent file. The manager is sent a letter stating when the certificate will expire. Copies of all letters sent to the FAM/ASI and their managers are kept in the FAM/ASI files. Regions do not do special issuances on ASIs. If a special issuance is required, OKC must make the decision. All required information is sent there. A summary of ASIs and Fads are kept on index cards. Information such as the tests done, restrictions is written down. Location: Southwest Region Interviewee: Paula Harkins, Aviation Medical Program Specialist Date: 3/8/91 Interviewers: Kevin Rodriguez, Carol Wasserman, Jim Frey Most airman certification cases are sent to the regional medical office from the Civil Aeromedical Institute, CAMI, in Oklahoma City, Oklahoma. Aviation Medical Examiners (AMEs) will occasionally send airman physical examinations to region for further workup. Newly designated AMEs send their first 12 airman physical examinations to the region for review and appropriate action. FAA Aviation Security Division and FAA Flight Standards Division provides information which may warrant opening a case for investigation. Paula or the Regional Flight Surgeon may receive a telephone call or a letter from an identified or an unidentified source that would prompt further investigation. Paula may get FAA Air Traffic Control Specialist cases when the individual wants an airman medical certificate and the situation is unfamiliar. She can also get FAA Federal Air Marshall/Aviation Safety Inspector (FAM/ASI) cases from that office for the same reason. Cases are also sent from other regional medical offices on those airmen who have moved or transferred to this region. CAMI sends cases to the region after they have made several unsuccessful attempts to obtain information from airman or to retrieve an airman medical certificate, and it is felt that legal or security could help in the matter. Cases sent from CAMI are sent with cover transmittal form (FAA Form 8500-16), and a copy of the airman's medical file is provided. It is up to Paula to review the file and determine the next appropriate stop. Usually a letter is sent to airman notifying him that his case has been eligible for airman medical certification. The Airman is given the opportunity to provide the information requested or to surrender his medical certificate, as appropriate. Paula may call the airman, if appropriate. In some instances, it may be necessary to send a request to Security for concision records check or to request assistance in locating an airman before further action can be taken. In other instances, it may be necessary to send the case immediately to legal for enforcement action with no additional correspondence to airman. When a letter has been sent requesting information from the airman, upon receipt of the information and a determination has been made by the Regional Flight Surgeon that airman is medially qualified, Paula prepares a letter of reaffirmation or medical certificate as appropriate. The case is then closed an returned to CAMI. It may be necessary, however, to send the case to the Federal Air Surgeon or the FAA Chief Psychiatrist, in Washington, D.C., for review and determination of eligibility. If it is determined that airman is not qualified, a letter of denial is prepared with request for return of the certificate. If airman fails to return a certificate, Paula will initiate enforcement action as appropriate. Cases initiated in the regional medical office based upon information received from AME or other sources, are handled much the same as those cases received from CAMI. At such time, Paula requests airman's medical file from CAMI. This is usually done via telephone. Paula will call CAMI and review airman's medical file with a specialist in the Airman Certification Division at CAMI to prevent duplicate actions. If no action has been taken at CAMI, Paula will request airman's medical file to be forwarded to region. She will complete a Request for Airman Medical Records, Form, but only as a tickler for her own records. When the case is received from CAMI, it will have been sent via transmittal and copy of file is provided. In all cases, if information provided indicates that an emergency exists, or if an airman has failed to respond to our request for information or surrender his medical certificate, after discussion with the Regional Flight Surgeon, Paula initiates legal enforcement action. She summarized the action on Form 2150-5, Enforcement Investigative Report (EIR). She provides the report along with copies of airman's medical file and any related documents to legal. The report includes the Federal Aviation Regulation(s) violated and recommended action. Paula reviews the Enforcement Investigative System (EIS for any other reinforcement actions initiated against the airman, then enters the EIR into the EIS. Paula monitors EIRs by using the EIS to follow up on the status of the enforcement actions. Copies of all actions taken by legal using the EIR are usually provided by the medical office and maintain in the airman's regional medical file and enforcement file. Paula may be called upon to testify at the National Transportation Safety Board (NTSB) hearing which resulted from an EIR Action. When a certificate is retrieved by legal, any initiated EIR is closed by legal and the certificate is provided to the medical office. Upon receipt of the medical certificate, Paula will prepare a letter to the airman acknowledging receipt of the certificate, and remind him of the information needed should he wish to pursue certification, or if the airman has a known medically disqualifying condition, a simple acknowledgment will be sent to the airman. The airman is notified that his medical file will be returned to CAMI. Paula will return airman's medical file to CAMI using FAA Form 8500-16, transmittal. When an airman's medical certificate expires in the middle of enforcement action. Paula prepares a memo to Legal recommending closure of the EIR. After Legal closes the EIR, Paula will close her case and return the file to CAMI with a note on the Transmittal to flag file for appropriate action when and if airman reapplies for medical certification. Paula maintains copies of all transmittals, whether initiated by CAMI or the regional medical office, as well as any related notes pertaining to a case, for 3 years. Paula completes a monthly activity report that lists the number of cases initiated and closed, the number of certificates issued and denied, cases referred to security and legal, number of cases sent to the Federal Air Surgeon, and all other pending actions. There are approximately 150 pending cases at any one time. Guidelines for the airman certification program are provided by the Federal Air Surgeon, Medical Guidelines Letters, and CAMI. CAIS is helpful to review airman's most recent airman physical examination. Since it provides limited information, Paula will sometimes have to call CAMI to review airman's entire medical file. Although pathology codes are listed, they can be very broad. Paula gets a statistical activity report from CAMI which is used for information purposes only. Regarding the Aviation Drug Abatement Program (ADAP), all positive drug test results are reported to the Federal Air Surgeon. Those cases are usually handled at CAMI; however, if airman fails to comply with medical requests, that case my be referred to the regional medical office for further action as noted in the first paragraph of this report. Location: Southwest Region Interviewee: Hillary Perdue, ADAP Manager Date: 3/7/91 Interviewers: Kevin Rodriguez, Carol Wasserman, Jim Frey ADAP There is a red book of ADAP directives and implementation guidelines. AAM-220 sends them a supply. Upon request, Hillary sends an aviation industry entity a copy. It would be helpful to have access to the Vital Information Subsystem (VIS) to monitor the active 135 entities for compliance and submission of reports. Drug Screening It would be helpful if he had access to PETS to enable him to match applicants with their drug screen results. Drug screen results are received on a printout from Compuchem. Drug screen results are taken to the ATCS examiner. There is no way to check if they are for candidates from another region. Location: Southwest Region Interviewee: Joann Perry, Regional Administrative Officer Date: 3/7/91 Interviewers: Kevin Rodriguez, Carol Wasserman, Jim Frey Budget With respect to the budget, there is a written package and a budget request sent from R.O. Budget Office to Joann every year. She gathers information from the program areas to get the required numbers. She projects how many employees the region expects to hire and estimates the number of ATCS physicals based on Human Resource/AT recruitment plans (informal communication). Joann gets input from Flight Standards that helps her determine the drug testing cost estimates for Aviation Safety Inspectors, and input from Security to determine physical and drug screen cost estimates for Federal Air Marshals. The fee table for the AMEs is also set. Joann works the numbers up manually. The regional budget analyst who she works with has a Lotus spreadsheet. The budget is submitted to the regional budget office who submits it to APR. Joann also gives a copy of the budget to Carol Kelly in AAM-110. AAM headquarters does not send the budget request. The regional budget office and Carol Kelly both send her the dollars, number of positions, allowances, and end of year ceiling. Everything is charged back to cost center codes. When they get the budget allocation, she does a financial plan to allocate the money to the different program areas. On a monthly basis she gets a printout from the regional accounting office of what has been spent where. The key budget areas are physical exams, payments, and travel. Joann manually tracks these costs because accounting is generally behind. Vouchers (SF-44) for ATC/FAM/ASI incumbent physicals are issued and authorized by the field and then cleared through Joann before they can be paid by accounting. Joann issues SF44 for applicant physicals. One copy is sent to accounting, one copy to the doctor, and a copy is kept in the office. Travel vouchers are initiated by the person doing the travelling. She initials the travel vouchers for the SW region before RFS approval. She tracks the totals to ensure that they do not exceed the budget. Authorization for physicals (Form 3930-3 with 6 SW Region Overprints) are signed by Dr. Ziegler and sent to the FAA facilities. The facility manager then signs the authorization form to authorize the employee to get the physical. The bills for incumbents are sent back to the facility, the bills for applicants are sent to the ASW-300. One authorization overprint differentiates for an applicant exam. When an incumbent requires special testing, a letter authorizing the tests that should be done and what AAM will pay for is sent to the incumbent. The incumbent then takes the letter to his/her doctor. The letter asks the doctor to send test results and bill to the RFS. Blanket purchase agreements are maintained in separate folders. A copy of every bill that is paid through an agreement is kept in the folder. SAM is used to initiate a request for a purchase order. It prints out a request for procurement. SAM does not eliminate the paper trail. Joann must still get all the appropriate signatures, etc. Purchase requests are kept in a folder. Procurement actually issues the contract and sends a copy back to Joann. Joann holds the purchase order until she receives the product. Then she completes the receiving report on the purchase order and sends the appropriate copy to accounting and to procurement, and to logistics if purchase order is for accountable property. Joann frequently communicates with Carol Kelly and the other medical administrative officers by fax, phone, or in writing. She does not have access to FAA mail. Joann manually closes out the budget. Quarterly reviews from the accounting office indicate what the actual expenditures were versus the estimates. Because payments for the quarter come in after the report is produced, at the end of the year she has to put an obligation on the budget. Joann issues purchase orders for all small purchases. When she receives a bill from an AME, Joann fills out a voucher and sends the invoice and voucher to accounting. One copy of the voucher is sent to procurement, one to the doctor, and one copy is kept in AAM. In order to pay a bill issued against a blanket purchase order (BPA) the BPA number must be on the bill. Joann reviews the bill to make sure they have the appropriate paperwork, authorizes the bill and send it to accounting at the end of the month. Systems used are the EGATS system to request a personnel action and the TRIMATE system (national training system) to request training. One thing that takes a great deal of time is to review and comment on draft orders and to issue directives by a certain date. Southwest often does not hear the status or what happened to these orders or whether the proposed changes were implemented without followup. Location: Southwest Region Interviewee: Jenny Szatkowski, AME Program Specialist Date: 3/8/91 Interviewers: Kevin Rodriguez, Carol Wasserman, Jim Frey Jenny maintains a word perfect file of regional AMEs by state and by city within a state. Physicians contact Jenny through CAMI or direct. This action prompts her to send the physician an application form or send a letter saying that there is no need. She keeps a list of physicians who requested to be AMEs. A separate list is maintained of physicians who completed an application and were denied. If an AME is relocating and wants to continue as an AME in the new region, the physician contacts the region he is leaving and the old region provides the name and address of the RFS in the new region. When an AME leaves her region, she writes to advise them who the RFS is in the new region. An AME's designation is terminated when he leaves the region. If an AME is coming into the region from another region, she accesses the AME system at CAMI through ASAS and contacts the other region to send the file. The first 3 years an AME is designated to only do class 2 or 3 physicals (unless he was previously a military flight surgeon or Board Certified in Aerospace Medicine). The AME application form is standard throughout all the regions. Dr. Ziegler determines the need for an AME. Jenny provides him with background material such as the number of pilots, number AMEs, number exams performed, inquiries from pilots and a recommendation. Dr. Ziegler then determines if there is a need for an AME in that location. If the decision is that there is a need, an application form and a letter are sent to the doctor telling him the requirements. A file is also started on the physician. She keeps a pending designation file on all the physicians who are in process. They are tracked by state. Jenny maintains a checklist that contains all the steps that must be taken to designate an AME. Items include copies of medical diplomas, letter from state licensing board, training certificates, and references. The checklist is used to track the status of the designation process (what has been received, is still due, etc.). She also sends the doctor a list of seminar schedules and workshops. When the doctor lets her know the particular seminar he will be attending, she mails him the AME guide (sent to her from CAMI). She makes sure the latest changes to Part 67 are in the guide (CAMI mails the latest changes to Part 67 to AMEs using list on DEC data base. Jenny mails the changes to new or reinstated doctors who are not on the CAMI data base). CAMI sends her a list of the doctors who were at the seminar. After she has determined that the prospective AME is on the list, she assigns the designation number, prepares the designation letter and types the designation certificate. The physician must sign and return a copy of the designation letter. Once the acceptance letter has been received, she sends the physician an initial supply of forms. The new AME is instructed to send the first 12 physical forms to the Regional Office for review. A designation package is sent to CAMI. The package contains the completed application, designation letter, form saying whether he wants to participate in the accident investigation program. The originals of this material are maintained at the regional office; copies are sent to CAMI. The new AME also goes in the national directory. The national directory is a list of AMEs that is sent to everyone on the CAMI mailing list. Private individuals can also buy the directory from the Government Printing Office. Every time there is a change in address, status, etc. she notifies CAMI. A copy of a letter is sent to CAMI. She also sends two monthly reports to CAMI. One is a statistical report of the month's activity. The second is the actual changes that have been made to the AME data base. Seminar attendance is posted in the AME's file. A training summary from CAMI is received every quarter that lists the latest date each AME in the region attended. She highlights the ones that have the 5 years coming up (AMEs must attend a seminar every 5 years). She sends the AMEs a letter and a seminar schedule (schedules are sent to her from CAMI). Jenny keeps a running list of all the doctors to whom letters have been sent. When she gets a class list saying they have attended, they are crossed off. CAMI also sends reminders to the doctors. If additional time goes by and the AME has not attended a seminar, she sends a letter saying that their designation will be terminated if they do not attend a seminar within 30 days. Jenny creates a regional directory of local AMEs from her WordPerfect (WP) data base every 6 months. The WP data base is updated to reflect all changes to AME information, status etc. The regional directory is distributed to the FSDOs, and other local FAA centers. The regional directory is therefore more current than the annual national directory. Every month there are many changes in AME information. The current directory is updated as the change occurs, the WP data base is updated at the end of every month. Every time an AME is dropped, he is sent an initial termination letter, giving him a chance to respond. A final termination letter giving the exact date of the termination, and requesting him to return the FAA supplies, identification, and certificate is sent to the AME. This letter is coordinated with Assistant Chief Counsel. A copy is sent to CAMI. For an AME to be an Accident Investigation (A/I) AME, the AME must attend training at CAMI. Currently A/I training is not offered at CAMI due to lack of funds. They have a list of AMEs who have requested the training. This situation presents a problem for them because without the A/I training program in place, the SW region cannot revitalize the A/I program. Quarterly and annual performance summaries are sent from CAMI. The summaries list all AMEs who are to be renewed and performance data. She uses this report to determine who needs to attend seminars and who is inactive or performing poorly and should be considered to be dropped. Before an AME is terminated for a high error rate, Jenny writes him a letter saying that the error rate is too high and requests him to send the next 5 physicals to the office for review. The physicals are reviewed for administrative errors and sent back with corrections. This review provides the AME with additional training. The AME's staff is also encouraged to come to workshops. If they need to de-designate a physician, they may ask security to do a background check. They also coordinate with the legal department. Access to a national data base that tracks adverse actions against a physician would be helpful. If they become aware of an adverse action against a physician or if there is an article that implies anything improper, they write to the AME for his side of the story. If SW is aware of a problem with an individual who is transferring, they send a letter to a new region to let them know of the problem. If they want to check on a doctor in his office, the region may get the FSDOs involved. The FSDO reports its findings in written form. Records of telecons, memos, route slips are all on the computer so that the status of cases can be tracked. She does not have an AME mailing list on her computer. CAMI will produce one if she needs it. When she gets a request from someone for an AME directory, she notifies CAMI so that they can update their mailing list. Accident Investigation The Regional Administrator puts out a daily alert bulletin that lists all accidents from the previous day. If a fatal accident occurs, Jenny writes the information in a log, clips the appropriate article and prepares a file. The files are kept in chronological order. When toxicology reports are received from CAMI and autopsy reports are received from the coroners or examiners, they are copied, reviewed by Dr. Ziegler and sent to the FSDO and NTSB to inform them if there are any medical issues which could have contributed to the cause of the accident. The SW region coordinates with NTSB with respect to getting copies of the autopsy reports, etc. NTSB authorizes the autopsies although the FAA is responsible for payment of pilot autopsies. An interim report is routed to SW through NTSB or the FSDO so that Jenny can get the required information to fill out a medical report "FAA Form 8025-2 Aircraft Accident Medical Information". This report summarizes the medical information (coroner, who performed toxicology work, contributing factors to death, etc.). The medical report, other reports received, and flight history (component of interim report) are sent to CAMI. CAMI has a data base that records this data (maintained by Leslie Downey AAM- 330). It is optimal to have an AME on the accident site because then they get immediate medical feedback. Pilot medical data is obtained from CAIS. There is no access to CAMI's accident investigation data base. Location: Southwest Region Interviewee: Samye Young, Covered Position Certification Specialist Mary Schultze, Covered Position Certification Specialist Date: 3/7/91 Interviewers: Kevin Rodriguez, Carol Wasserman, Jim Frey An applicant file is created when personnel notifies SW of an applicant. AMEs send the applicant physicals to the Regional Office. Compuchem sends the drug screen results and lab results to the Regional Office (in report form). They look at whether the exam results meet the standards and determine whether the ATCS applicant is medically qualified. If additional information is required, they write to the applicant requesting the data. Copies of all correspondence is kept in the file. When an applicant is cleared or disqualified, personnel and security are notified by memo. Incumbents get physicals from the AMEs. Incumbents only get physicals annually (scheduled according to birth month). Mary reviews the physical examination application to see if the incumbent meets ATCS Medical Standards (9430.3A), not class 2 airman standards. If an oversight in the process is found, a letter is written to the controller or facility and/or the AME. when the problem is cleared, a clearance letter is sent to the controller and the facility. If an interim report on a controllers condition is required between yearly physicals, a clearance letter is sent to the controller when the report is received and cleared. A pending file of about 173 cases/month is maintained. Files of temporarily disqualified or open, diabetic, and pending are maintained in separate groups. If the ATCS has current flying time and/or makes a request for an airman medical certificate, the Regional Office issues the certificate. Memos are sent to personnel and security, with a copy to the file, after a decision has been made on applicant cases. We enter data into HIS because we received an MGL that requires all regions to input into HIS. We have never received a memo or order advising us to discontinue the practice. If someone is a pilot we use CAIS-BASIC to look at their medical records. We determine files that need to be requested or sent by maintaining the telexes that are sent to us from Personnel. Personnel calls the Medical Division and requests that a check on the medical status of a person being transferred be performed. A call is made to the appropriate Region/Facility to determine medical status, and personnel is then notified by the Medical Division. PETS is used only to enter new applicant information. A permanent card system is kept showing yearly physical examination data, facility, disqualifications, special considerations, transfers, etc. A card is started at the time the person is an applicant or transfers from another region. a notebook is maintained on when files are sent to Personnel, who then sends the files to storage in St. Louis. The notebook is maintained for at least 10 years. An applicants card is noted as to whether they are cleared or disqualified. If the applicant requests transfer of his eligibility to another region, the card is noted. Work sheets are done on each applicant and/or controller when a physical examination is received. The work sheet show what we have, what we need, what facility to which the controller is assigned. Applicant files, on those not hires, for whatever the reasons, are kept in this office for 3 years and then destroyed. Personnel sends this office a copy of the appointment letter that is sent to each applicant who is hired. At the completion of the class, a copy of the class pass/fail register is sent to the Medical Division. For those who pass, a letter is sent to them at the facility notifying them of medical status and when their next physical examination is due, with a copy of the letter to the facility manager. The files of those who fail, are purged and sent to Personnel who sends the file to storage with their OPF. They use the regional PETS system to store applicant information. PETS tells them Personnel's status with respect to an applicant. It is only used for the time that the individual is an applicant. All subsequent medical information is then stored on the HIS. When the applicant is cleared, his medical information is then entered on the HIS. HIS and PETS nationwide would be useful. Medical Guideline Letters (MGL) are used in decision-making on ATCS medical conditions. A problem with the MGL is that there is no information on what is outdated. An out-of-region file is maintained of letters from personnel requesting the region to do the physical of an employee or applicant from another region. The file is maintained so that the lab results and the drug report can be sent to the proper place. When an ATCS retires or leaves the agency, the file is purged and sent to Personnel to be sent to storage. Delinquent notice of physical examinations are sent to the Facility Manager, not the controller. When an ATCS is temporarily disqualified, a report on what he/she can or can't do is written and sent to the ATCS, mgr, Air Traffic Operations Branch, file. A monthly activity report is completed and given to Joann so that she can complete the Regional Flight Surgeons Activity Report. At the end of the month, the original physical examination and relating correspondence, of controllers who are pilots, are sent to OKC, with a copy is retained in the controllers file. Location: Southwest Region Interviewee: Tony Ziegler, M.D., Regional Flight Surgeon Date: 3/7/91 Interviewers: Kevin Rodriguez, Carol Wasserman, Jim Frey Substance Abuse Drug screens are performed for applicants and for on-board ATCS, FAM, and ASIs. 130 AMEs have written contracts to do the drug screens (along with EKGs, applicant physicals, etc.). The AMEs are sent a 3-4 page letter that itemizes what the SW region would like them to do. A training program is provided to the AME staff for the chain of custody and other program requirements. Applicant drug screening is handled entirely by the personnel department. Dr. Ziegler handles the random drug screening results and the reasonable cause results. The drug screen form is a packet with several copies. The pink copy is the Medical Review Officer (MRO) disposition form. The pink form is sent from the drug testing company (e.g., UpJohn). The form has a coded number on it, the results, and no name. The laboratory test results received by the Drug Program Coordinator (DPC) in personnel has the same identification number as the pink form. The DPC notifies Dr. Ziegler of a positive result. Now the drug test results can be identified. When the test is a positive, the results must be verified. Dr. Ziegler looks at the chain of custody form which is part of the packet sent by the DPC to make sure that there are no flaws in the process. He then calls the individual and sends a letter stating the verified positive. He also sends a copy of the test results to the individual. A release of information is mailed to the individual to be signed and returned to the RFS. He sends a letter to the manager stating that the employee is temporarily medically disqualified for duty. A written record is maintained of all activity. The Employee Assistance Program (EAP) counselor provides the initial assessment. The EAP counselor also provides reports to the national EAP and submits monthly reports to the RFS through the Human Affairs International counselor (HAI) (The HAI counselor is a specialist in substance abuse). The employee must sign an agreement contract with his manager to work with the HAI counselor. The employees file is updated based on these reports. When the person has done well in the treatment program, Dr. Ziegler issues a letter of good standing. The person can then resume his/her duties. The removal or reinstatement of personnel is done only by the Federal Air Surgeon and the Regional Flight Surgeon. A rehabilitation program is selected based on a knowledge of what is available in the area. It is a joint effort between the RFS and EAP. AMEs in the area are also solicited for their knowledge of local programs. On initial entry into the hospital, a release of information form is signed and hospital records are maintained. If a positive screen is due to medication, the name of the pharmacy and the number of the prescription are obtained and verified. The individual is then downgraded to a non-positive. The employee's manager is not informed of this process in order to protect the employee's right to privacy. The national Medical Review Officer (the Federal Air Surgeon) is informed verbally of these situations. If a paper trail is required, it can be traced through Dr. Ziegler's memos etc. Airman Certification The RFS will sometimes get a letter from a spouse or another person close to an airman stating that the individual is taking medication. It is up to Dr. Ziegler to determine if the airman is still able to fly. Information on the airman is then collected. A letter is sent to the airman to obtain additional information. OKC sends the medical records. Security may be contacted (in writing) to do a review. Dr. Ziegler determines whether the individual should be disqualified. If the decision is made to disqualify, a denial letter is sent from the RFS to tell the airman the result and the procedure to challenge. The file is then closed and sent to OKC. Other Special considerations for ATCS are handled by Dr. Ziegler. He sends a letter to the ATCS and the manager describing the medical resolution (e.g., on the appropriate medication). The letter is put in the file along with the notes that the special consideration has been granted. All ATCS physicals that have a problem that may require special considerations are reviewed by Dr. Ziegler. He sends letters to the ATCS to request additional information as required. All records for ATCS special consideration are kept in the Regional Office. Washington Headquarters is in the loop when a special consideration is denied or the RFS needs a second opinion on a case. When an ATCS appeals a denial, the Federal Air Surgeon makes the decision and communicates it in writing to the individual and to the RFS. Medical Guideline Letters are used for ATCS/airman medication guidelines. Other sources are the Federal Air Surgeon newsletter, seminars, flight surgeon training, Telecons, FAS policy meetings, and AMEs. CAMI's library is also used for support. Potentially the poison control center of the local hospital would be useful to have access to. A dial-up service on new treatments or medicines would be useful to have access to. All employee medical records are maintained at the Regional Office. If there is an environmental problem, the safety officer located in the region can do the air sampling or handle a certain number of problems. Dr. Ziegler may write the industrial hygiene area at CAMI a letter stating the environmental problem. The industrial hygiene department will write back with a recommended action. AME Decertification Correspondence from state boards, airman complaints, or other physicians sending articles are examples of how the RFS may learn about a potential problem with an AME. Information to make a de- designation decision is gathered by writing letters to the state boards, the AME, and other sources as required and through phone conversations. A file is maintained on all correspondence and actions taken. A de-designation decision is made after consultation with CAMI and the Federal Air Surgeon (An airman de- designation decision is also made after consultation with CAMI and the Federal Air Surgeon). Accident Investigation The National Transportation Systems Board (NTSB) authorizes pilot autopsies. Dr. Ziegler directs the NTSB to the local medical examiner (e.g., coroner) who signs a document to transport the body across county lines. The coroner or facility sends the autopsy report to Dr. Ziegler. He sends a copy along with his interpretation of the findings to the CAMI research division and the NTSB. He also sends the toxicology kit with the samples to CAMI.

INDEX

A AAM-3 AAM-100 AAM-110 AAM-120 AAM-200 AAM-220 AAM-230 AAM-240 AAM-300 AAM-400 AAM-500 AAM-600 AAM-700 Accident Investigation Coordinator Adams, Mark ADAP Manager Administrative Officer Administrative Officer, Regional AEA-300 Aeromedical Certification Division Aeromedical Research Division AGL-300 Airmen Certification Program Specialist Airmen Certification Program Assistant Airmen Education Division Alejandro, Carmen AME Program Specialist ANM-300 Applicant Examiner, Appeals Applicant Examiner, Special Issuance Applicant Examiner, Supervisory Arnold, Lita ASW-300 B Battelle Beasley, Joe B (Cont.) Biomedical and Behavioral Sciences Branch. Boren, Dr. Henry Brattain, Paul, M.D. Budget Analyst Burnette, Doug C CAMI Canfield, Dennis, Ph.D. Carreon, Roel Chemist Chemist, Research, Supervisory Civil Aeromedical Institute Clark, Charlotte Computer Program Analyst Computer Systems Analyst Covered Position Certification Specialist Covered Position Certification Program Assistant D Dark, Shirley Davis, Audie, M.D. Davis, Bill, M.D. Doctor Boren, Henry Brattain, Paul, M.D. Canfield, Dennis, Ph.D. Davis, Audie, M.D. Davis, Bill, M.D. Hanneman, Gerald, D.V.M. Hark, William, M.D. Hordinsky, Jerry, M.D. Horne, Andrew Jones, Lanier, M.D. May, Noal, Ph.D. Schroeder, David, Ph.D. Shepherd, William, M.D. Spann, Joe, M.D. Taylor, Christopher, M.D. Thiemann, Phillip, M.D. Ziegler, Tony, M.D. Downey Leslie Drug Abatement Branch Duskin, Jannice E Eastern Region Elliot, Frank Employee Health Branch Endicott, Boyd Evans, James F Flight Surgeon Flight Surgeon, Assistant Regional Flight Surgeon, Regional Folk, Earl G Great Lakes Region Green, Nova Guest, Keith H Hall, Minetta Hanneman, Gerald, D.V.M. Hark, William, M.D. Hart, Irma (Sam) Haskins, Paula Headquarters Health Awareness Program Coordinator Hecht, Steve Hicks, Virginia Holmes, Chuck Hordinsky, Jerry, M.D. Horne, Dr. Andrew Human Resources Research Division I Industrial Hygienist J Jacksonville Clinic Jones, Lanier, M.D. K Kanesky, Paula Kelly, Carol Kokindo, Joan L Ladika, Kathy Lapane, Mae Librarian Lucich-Biehl, Barb Lyons, Beverly M MacMillan, Tina Maloy, Curt Management Analyst Management Analyst, Supervisory Management Assistant Management Support Branch Management Support Specialist Manning, Carol Mattox, Carol May, Noal, Ph.D. McCaughan, Danell McEachen, Dennis M.D. Brattain, Paul Davis, Audie Davis, Bill Hark, William Hordinsky, Jerry Jones, Lanier Shepherd, William Spann, Joe Taylor, Christopher Thiemann, Phillip Ziegler, Tony Medical Billing Specialist Medical Clinic Program Assistant Medical Officer, Supervisory Medical Officer, Veterinary Medical Records Technician Medical Records Technician, Supervisory Medical Specialties Division Meyer, Peggy Miller, Martin "Doc" Muldrow, Yvonne N Nakagawara, Janice Nelms, David Northwest Mountain Region Nurse Practitioner O Occupational Health Division Occupational Health Nurse Office of the Director - CAMI Orlando, Kathy P Perdue, Hillary Perry, Joann Plans, Evaluation ∧ Management Support Division Plans ∧ Evaluation Branch Program Analysis Officer Program Analysis Officer, Supervisory Program Analyst, Plans Evaluation Program Analyst, Supervisory Program Evaluation Specialist Program Manager Program Manager, Substance Abuse Control Program Management Specialist Program Officer, Medical Education Program Scientist, Accident Investigation Program Specialist Psychologist, Personnel Research Psychologist, Research, Supervisory Q R Records Unit Manager Reid, Mary Research Mathematical Technician Richter, Regina Roderick, Tony S Scarpelli-Norman, Gloria Schroeder, David, Ph.D. Schultz, Mary Scott, Shirley Secretary Shepherd, William, M.D. Shuring, Dennis Southern Region, Jacksonville Clinic Southwest Region Spann, Joe, M.D. Special Issuance Recertification Coordinator Statistical Assistant Stewart, Carolyn Stouffer, Debbie Szatkowski, Jenny T Taylor, Christopher, M.D. Teague, Sherlene Thiemann, Phillip, M.D. Tizzio, Aida U V Vachon, Mike Veterinary Medical Officer W Warren, Peggy Watson, Jean Wilson, Shirlene Worner, William X Y Young, Samye Z Ziegler, Tony, M.D. Zingman, Helen Zink, Audrey