Not that anyone cares, but I'm actively addressing these items with the 4 main senators involved in the FAA Reauthorization Act of 2024, here's what I sent the senators:
Dear Senator ....,
I would like to first thank you for your efforts in passing the FAA Reauthorization Act of 2024 (The Act). As a general aviation pilot, I am grateful for your attention to enacting laws to increase the safety of the aviation industry, as well as review and improve the existing practices within the FAA to help ensure that the maximum amount of pilots are able to enjoy the ability to exercise those piloting privileges.
It is on the latter that I am writing you and specifically in regard to the medical certificate issuance and existing medical deferral process for evaluating certain mental health diagnoses and related medication use to manage such diagnoses.
I have read through the recent legislation passed on 5/16/2024 and I am encouraged to see the items addressed in sections 208, 407, 411 and 413. Most importantly, I am eager to see the outcome of the noted “working group” and “task group” to be formed under sections 411 and 413.
To make the best use of your time, my primary focus are the “Activities” outlined in Section 411. I believe many of the items being addressed in section 413 will be of less importance to applicants if the items in Section 411 are addressed, and in a timely manner. I’m outlining my view on the proposed solution (which is simple and intuitive) and supporting facts to address the existing, and already recognized, issues with how the FAA currently processes medical deferral situations involving mental health.
I want to be clear that I am in full support of making sure the skies are safe, and that we have physically and mentally fit, as well as skillful and knowledgeable, pilots up in the air. However, the existing process for medical deferral evaluation is completely inefficient and archaic given the technology available to the FAA, and the vast network of already FAA approved Airman Medical Examiners (AME), and the even more specialized and also FAA approved, Human Intervention Motivation Study (HIMS) AMEs.
For your consideration specific to Section 411 as relates to mental health and use of SSRI’s or other approved medication:
Solution:
- Allow the existing and vast network of FAA approved Human Intervention Motivation Study (HIMS) Airman Medical Examiners (AME) the authority to issue, themselves, the deferred medical certificates via standard issuance or special issuance vs. adding the additional, and unnecessary, step of sending the exact same reports and HIMS AME’s notes to the 3-5 individuals at the D.C. office currently delegated with reviewing the entirety of all initial SSRI (and other) deferrals
- This step alone would reduce the timeline for an SSRI deferral (if not most medication related deferrals) by 7-9 months and still ensure the highest level of medical scrutiny for the majority of deferral situations.
Supporting Facts:
- The FAA has already had over 85,000 pilots removed from their “review desk” and actively flying with the adoption of the BasicMed when addressing third-class medical reform
- The Basic Med operations are being further expanded to increase the allowable aircraft weight and passengers due to the reform’s success
- As already reported to Congress last year, and reported in various aviation periodicals, the FAA has shown NO difference in safety amongst pilots when comparing pilots operating under BasicMed vs. those operating under a third-class medical
- The FAA already has a network of FAA vetted and approved specialist, including:
- AMEs
- HIMS AMEs
- HIMS Psychologists
- HIMS Neuropsychologists
- The aforementioned FAA approved HIMS AMEs and HIMS specialists:
- Perform the medically required tests and evaluations with the applicant
- Provide continuity of monitoring and evaluating the applicant
- Personally interact with, observe, and medically evaluate the applicant (The FAA medical staff never meet or even speak with the applicant)
- The applicant’s HIMS AME compiles all these reports, transmits to the FAA’s OKC or D.C. office, who the review the exact same information, yet have no benefit of interacting with, observing and medically evaluating the applicant
- The deferral report, with all FAA requested items and evaluations, is required to be delivered to the FAA OKC or D.C. office within 90 days of the request
- THEREFORE it is clear that the waiting time issue and backlog is almost solely attributable to the existing practice of EVERY initial deferral being handled at the FAA medical staff level
- There are only a handful of individuals at the FAA’s D.C. office performing the “Final Review” of the AMEs report for initial mental health/SSRI related deferrals, which includes the exact same items that the HIMS AME has already reviewed
- The incidence of deferrals is increasing, and will continue to increase for the foreseeable future. Per the FAA’s own FY 2024 President’s Budget Submission
“Over time, our stakeholder base has changed. An aging general aviation pilot population has led to an increased number of medical conditions reported on applications that require monitoring, commonly from four to six health conditions. On the other end of the age spectrum, the 16-25 year-old population entering the educational system to become tomorrow’s professional pilots have a high incidence of treated mental health conditions, to include Attention Deficit Disorder/Attention-Deficit/Hyperactivity Disorder (ADD/ADHD), Major Depression and Autism Spectrum Disorder. These case files require extensive review and neuropsychological evaluations, which contributes to a backlog in medical certifications. The highly trained professionals who review these cases are logging a record number of overtime hours to keep pace and we do not anticipate this workload diminishing over time.”
This increase in deferrals will continue to create a backlog of evaluations, resulting in overworked FAA staffing, and continue to create unacceptable wait times for all levels of medical deferral certificate issuance
- Such wait times will result in the need for additional/updated “current” evaluations and tests from the FAA required specialists as already conducted evaluations required to be transmitted to the FAA within the 90 day timeline are, in some instances, over a year old by the time the FAA medical staff starts to review
- These evaluations and/or treatments, in some instances, can exceed $30,000 over the course of the wait times and depending on level of waiver required
- Statistics show that 90%-97% of all medical deferrals are ultimately approved, leading one to conclude that a contributing factor to the backlog is an issue of the FAA’s own making
For your further consideration, I pray that the noted timelines within Section 411 are worst case, and that the items, specifically under section 411, are addressed as soon as possible, and even implemented retroactively for those that are already in process as opposed to those that are newly entered into the FAA system.
Thank you for your time and consideration.
Sincerely....
References/Subject Matter
FAA Reauthorization Act of 2024 References:
SEC. 411. AEROMEDICAL INNOVATION AND MODERNIZATION WORKING GROUP.
(a) Establishment.—Not later than 180 days after the date of enactment of this Act, the Administrator shall establish a working group (in this section referred to as the “working group”) to review the medical processes, policies, and procedures of the Administration and to make recommendations to the Administrator on modernizing such processes, policies, and procedures to ensure timely and efficient certification of airmen.
(c) Activities.—In reviewing the aeromedical decision-making processes, policies, and procedures of the Administration in accordance with subsection (a), the working group, at a minimum, shall—
(1) assess the medical conditions an Aviation Medical Examiner may issue a medical certificate directly to an individual;
(2) determine the appropriateness of the list of such medical conditions as of the date of enactment of this Act;
(3) assess the special issuance process;
(8) review protocols pertaining to the Human Intervention Motivation Study of the FAA;
(10) review mental health protocols and medications approved for treating such mental health conditions, including such actions taken resulting from recommendations by the Mental Health and Aviation Medical Clearances Rulemaking Committee;
(13) assess and evaluate the user interface and information-sharing capabilities of any online medical portal administered by the FAA.
SEC. 413. MEDICAL PORTAL MODERNIZATION TASK GROUP.
(a) Establishment.—Not later than 120 days after the working group pursuant to section 411 is established, the co-chairs of such working group shall establish a medical portal modernization task group (in this section referred to as the “task group”) to evaluate the user interface and information sharing capabilities of an online medical portal administered by the FAA.
(c) Assessment; Recommendations.—The task group shall, at a minimum, assess and evaluate the capabilities of any such medical portal and provide recommendations to improve the following:
(2) The status of an airman’s medical application and the disclosure of how long an airman can expect to wait for a final determination to be issued by the Administrator.
(3) The disclosure of the name and contact information of the Administrator’s representative managing an airman’s case so that an Aviation Medical Examiner has a point of contact within the Administration who is familiar with an airman’s application.
