[Congressional Record (Bound Edition), Volume 160 (2014), Part 2]
[House]
[Pages 2845-2848]
[From the U.S. Government Publishing Office, www.gpo.gov]




     MEDICAL CERTIFICATION REQUIREMENTS FOR AIRMEN AND AIR TRAFFIC 
                CONTROLLERS RELATING TO SLEEP DISORDERS

  Mr. LoBIONDO. Mr. Speaker, I move to suspend the rules and pass the 
bill (H.R. 3578) to ensure that any new or revised requirement 
providing for the screening, testing, or treatment of an airman or an 
air traffic controller for a sleep disorder is adopted pursuant to a 
rulemaking proceeding, and for other purposes, as amended.
  The Clerk read the title of the bill.
  The text of the bill is as follows:

                               H.R. 3578

       Be it enacted by the Senate and House of Representatives of 
     the United States of America in Congress assembled,

     [SECTION 1. MEDICAL CERTIFICATION REQUIREMENTS FOR AIRMEN AND 
                   AIR TRAFFIC CONTROLLERS RELATING TO SLEEP 
                   DISORDERS.

       [(a) In General.--The Secretary of Transportation may 
     implement or enforce a requirement providing for the 
     screening, testing, or treatment (including consideration of 
     all possible treatment alternatives) of an airman or an air 
     traffic controller for a sleep disorder only if the 
     requirement is adopted pursuant to a rulemaking proceeding.
       [(b) Applicability.--Subsection (a) shall not apply to a 
     requirement that was in force before November 1, 2013.
       [(c) Definitions.--In this section, the following 
     definitions apply:
       [(1) Airman.--The term ``airman'' has the meaning given 
     that term in section 40102(a) of title 49, United States 
     Code.
       [(2) Air traffic controller.--The term ``air traffic 
     controller'' means a civilian employee of the Department of 
     Transportation described in section 2109 of title 5, United 
     States Code.
       [(3) Sleep disorder.--The term ``sleep disorder'' includes 
     obstructive sleep apnea.]

     SECTION 1. MEDICAL CERTIFICATION REQUIREMENTS FOR AIRMEN AND 
                   AIR TRAFFIC CONTROLLERS RELATING TO SLEEP 
                   DISORDERS.

       (a) In General.--The Secretary of Transportation may, 
     consistent with accepted medical standards and practices, 
     implement or enforce a requirement providing for the 
     screening, testing, or treatment (including consideration of 
     all possible treatment alternatives) of an airman or an air 
     traffic controller for a sleep disorder--
       (1) in the case of an airman, only if the requirement is 
     adopted pursuant to a rulemaking proceeding; and

[[Page 2846]]

       (2) in the case of an air traffic controller, only if the 
     Federal Aviation Administration meets its obligations 
     pursuant to chapter 71 of title 5, United States Code.
       (b) Applicability.--Subsection (a) shall not apply to a 
     requirement that was in force before November 1, 2013.
       (c) Definitions.--In this section, the following 
     definitions apply:
       (1) Airman.--The term ``airman'' has the meaning given that 
     term in section 40102(a) of title 49, United States Code.
       (2) Air traffic controller.--The term ``air traffic 
     controller'' means a civilian employee of the Department of 
     Transportation described in section 2109 of title 5, United 
     States Code.
       (3) Sleep disorder.--The term ``sleep disorder'' includes 
     obstructive sleep apnea.

  The SPEAKER pro tempore. Pursuant to the rule, the gentleman from New 
Jersey (Mr. LoBiondo) and the gentleman from Washington (Mr. Larsen) 
each will control 20 minutes.
  The Chair recognizes the gentleman from New Jersey.

                              {time}  1515


                             General Leave

  Mr. LoBIONDO. Mr. Speaker, I ask unanimous consent that all Members 
may have 5 legislative days in which to revise and extend their remarks 
and include extraneous materials for the Record on H.R. 3578.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from New Jersey?
  There was no objection.
  Mr. LoBIONDO. Mr. Speaker, I yield myself such time as I may consume.
  I rise today in support of H.R. 3578.
  Let me begin by thanking some of my colleagues--first and foremost, 
Congressman Larsen, also Congressmen Bucshon, Lipinski, and Graves--for 
their help and support in introducing this very important bill.
  Before I explain the bill, I would like to enter into the Record 
letters of support for H.R. 3578.
  Mr. Speaker, H.R. 3578 addresses the medical certification process 
for pilots and air traffic controllers as it relates only to sleep 
disorders.
  Currently, pilots and controllers are required to be medically 
certificated by the FAA at varying intervals. The duration, as well as 
the type of medical certification, depends on the type of activity they 
are seeking to perform--airline pilot, private pilot, et cetera--and 
all other factors, such as age. Regardless, pilots and controllers 
undergo a thorough medical review process, and the FAA ultimately 
decides whether or not to issue them a medical certification. Further, 
there are no certain medical conditions that the FAA automatically 
deems as disqualifying. Currently, pilots with one or more of those 
conditions, including sleep apnea, are required to seek a special 
certificate, which is issued at the sole discretion of the FAA and only 
if the applicants can prove they will not endanger public safety. 
Neither process is perfect, but it is a process that works.
  In November of 2013, the FAA announced a proposal to significantly 
and arbitrarily modify the medical requirements for airmen who might be 
at risk of having a sleep disorder, such as sleep apnea, even in the 
absence of any clinical evidence. The FAA's proposal would effectively 
assume overweight pilots have a sleep disorder based solely on their 
body mass index and would require them to prove otherwise at their own 
expense. It is a scenario of being guilty before proven innocent. The 
potential cost to these pilots could be thousands of dollars.
  The FAA proposal, announced without any input from the stakeholders, 
is neither reasonable nor effective. However, health issues can arise 
unexpectedly, which is why I have always supported reasonable, 
effective, and proactive efforts to improve aviation safety; but the 
FAA's action related to sleep disorders was carried out behind closed 
doors, with no input from stakeholders, and based upon controversial 
assumptions. While I applaud the FAA for seeking stakeholder input 
recently, it is too little, too late.
  Safety is my top priority as chairman of the Aviation Subcommittee. 
That is why the legislation we are considering today, H.R. 3578, does 
not prohibit the FAA from implementing new medical certification 
requirements for sleep disorders, but it does require the FAA, in the 
case of pilots, to conduct an open rulemaking process and, in the case 
of air traffic controllers, to use a process established under current 
Federal employment law.
  Finally, it is important to note that H.R. 3578 does not change the 
FAA's medical certification process or otherwise prevent the agency 
from responding to new medical issues in a timely manner. This 
legislation applies only to proposed changes to the medical 
certification process for sleep disorders. In addition, the rulemaking 
process required by this legislation does not apply to the enforcement 
of requirements providing for the screening, testing, or treatment of 
pilots and controllers for sleep disorders in force prior to November 
1, 2013.
  H.R. 3578 is a bipartisan bill that is supported by a wide range of 
stakeholders, and I urge my colleagues to support it.
  With that, I reserve the balance of my time.

       H.R. 3578
       Industry Supporters:
       Air Line Pilots Association
       Aircraft Owners and Pilots Association
       Airlines for America
       Allied Pilots Association
       Coalition of Airline Pilots Association
       Experimental Aircraft Association
       Federal Aviation Administration Managers Association
       General Aviation Manufacturers Association
       Helicopter Association International
       National Agricultural Aviation Association
       National Air Traffic Controllers Association
       National Air Transportation Association
       National Business Aviation Association
       NetJets Association of Shared Aircraft Pilots
       Recreational Aviation Foundation
       Southwest Airlines Pilots Association

  Mr. LARSEN of Washington. Mr. Speaker, I yield myself such time as I 
may consume.
  I rise in support of H.R. 3578.
  I want to thank Chairman LoBiondo for bringing this issue to the 
attention of the committee and for working hard to bring it to the 
floor so quickly.
  This bill would require the Federal Aviation Administration to go 
through a rulemaking process if it chooses to propose and implement new 
pilot medical certification requirements for sleep apnea.
  Under current law, in order for a pilot to be certificated, every 
pilot is screened by an aviation medical examiner to ensure he is safe 
and capable of piloting an aircraft. If a pilot is diagnosed with 
obstructive sleep apnea or with any other disqualifying medical 
condition, that pilot must obtain a ``special issuance'' medical 
certificate from the FAA to keep flying.
  Last November, the FAA abruptly announced changes to the medical 
certification process as it pertains only to sleep apnea. The new 
policy would require all airmen with a body mass index, or BMI, of 40 
or more to undergo new testing and evaluation requirements for 
obstructive sleep apnea in order to maintain their medical 
certificates.
  General aviation groups and pilot unions have raised concerns that 
the FAA's proposed policy changes could impose significant undue costs 
on thousands of airmen without an adequate opportunity for the public 
to comment on the relative safety merits of these new requirements.
  H.R. 3578 would ensure transparency and would require the FAA to 
initiate a rulemaking if it chooses to implement a new pilot medical 
certification requirement for sleep apnea. This bill would not prohibit 
the FAA from implementing new medical certification requirements, but 
the rulemaking process will provide the opportunity for all interested 
parties to comment on any proposed changes. So I urge my colleagues to 
support H.R. 3578.
  With that, I reserve the balance of my time.
  Mr. LoBIONDO. Mr. Speaker, I yield 3 minutes to the gentleman from 
Missouri (Mr. Graves), who has been a big help on this issue.
  Mr. GRAVES of Missouri. Mr. Speaker, as a general aviation pilot 
myself, I was shocked when the FAA Air Surgeon, Dr. Fred Tilton, 
announced a forthcoming guidance to require additional testing for 
pilots, as was mentioned, with the arbitrary numbers of a BMI of 40 and 
a neck size of 17 inches.

[[Page 2847]]

Not only did he indicate in December that the FAA would move forward 
with this new guidance on sleep apnea, but that it would challenge 
Congress by saying:

       If Congress passes a law to force industry consultation, we 
     will be compliant; but until they do so, we will move forward 
     with our guidance.

  Today, Congress is acting against the FAA's egregious assumption that 
these pilots pose a safety risk if untreated. When it comes to the 
general aviation community's safety record, there is simply no data or 
evidence to suggest that sleep apnea--or any other medical issue for 
that matter--is the cause behind general aviation accidents. In fact, 
most of these accidents happen as a result of weather. GA pilots know 
that, every time they get into a plane, they are taking their own lives 
into their hands as well as the lives of others. So, naturally, pilots 
are not going to knowingly put themselves into an unsafe situation.
  What is so absurd about this process is just the medical 
certification in general. The FAA requires GA pilots--or any pilot for 
that matter--to go through certification every 2 years for a third-
class medical and certification every year for a first- or a second-
class medical, but there is nothing in that process that guarantees a 
pilot's fitness to fly within that time period. It is up to the pilot 
to determine his fitness to fly himself or herself, and he or she knows 
best.
  General aviation supports 1.2 million jobs, and it contributes $150 
billion annually to the GDP. There are 223,000 general aviation 
aircraft out there serving 19,000 small and regional airports. It 
accounts for 27 million flight-hours, and it serves 166 million 
passengers every year. It is more important than most people realize, 
and adding burdensome regulations like the FAA is proposing on sleep 
apnea do nothing but discourage further participation, at least in 
general aviation.
  This rule would also have some dramatic effects on commercial 
aviation, which is also facing a pilot shortage in and of itself. Based 
on these arbitrary benchmarks, a pilot is going to be required, as was 
pointed out, to get further examinations and sleep tests, which is 
going to slow the process down that much more.
  The outcry from the pilot community, both in general aviation and in 
commercial, has led to the introduction of this bill, H.R. 3578. It 
requires the FAA to go through the normal rulemaking process, which 
allows for public comment and requires them to analyze the impact of 
the regulation. The FAA should follow the rules, plain and simple. That 
is all we are asking. They should listen to pilots and take their 
viewpoints into account.
  I want to thank Chairman LoBiondo and all of the others for 
sponsoring this piece of legislation and for joining me to make sure 
the FAA goes through the proper channels in issuing this regulation.
  Similar legislation addressing sleep apnea for truckers was passed by 
both the House and Senate last fall, and it was signed by the 
President. I hope my House colleagues will join me in supporting this 
similarly commonsense piece of legislation.
  Mr. LARSEN of Washington. Mr. Speaker, I continue to reserve the 
balance of my time.
  Mr. LoBIONDO. Mr. Speaker, I would like to yield 3 minutes to the 
gentleman from New York (Mr. Hanna).
  Mr. HANNA. I thank the gentleman from New Jersey.
  Mr. Speaker, I rise today in support of H.R. 3578, which would 
require the FAA to conduct a formal rulemaking process for sleep apnea 
certifications for pilots and air traffic controllers.
  As a member of both the Small Business Committee and the 
Transportation Committee and as a pilot, I am deeply concerned that 
complex Federal regulations and bureaucracy are hurting America's 
aviation industry.
  When deemed absolutely necessary, new FAA rules should follow a 
transparent and open process that includes strong oversight and input 
from all stakeholders. The proposed sleep apnea regulation was a broad 
administration guidance with no oversight or input. Furthermore, this 
is yet another example of the administration's regulating in search of 
a problem.
  According to the Civil Aviation Medical Association, there is no 
scientific evidence that sleep apnea has compromised aviation safety. 
According to yesterday's Washington Post, the number of small planes 
flying across this country has fallen by nearly 200,000 since 1980. The 
production of single-engine airplanes has fallen twentyfold to below 
700 per year.
  We need to ensure that any regulations help, not hinder, the aviation 
industry in growing and prospering. Across the Nation, nearly 1.2 
million workers depend on the general aviation industry. This is 
especially true in rural upstate New York. I encourage the FAA to 
ensure that we promote safety in a way that is consistent with growing 
our vital aviation industry and so that it makes sense in the real 
world.
  H.R. 3578 would require the FAA to follow a proven and transparent 
process when issuing rules, so I urge my colleagues to support this 
bill.
  Mr. LARSEN of Washington. Mr. Speaker, I continue to reserve the 
balance of my time.
  Mr. LoBIONDO. Mr. Speaker, how much time remains?
  The SPEAKER pro tempore. The gentleman from New Jersey has 11 minutes 
remaining.
  Mr. LoBIONDO. Mr. Speaker, I now yield 3 minutes to the gentleman 
from Indiana (Mr. Bucshon). I thank him for his help on this issue.
  Mr. BUCSHON. Mr. Speaker, I rise today in support of this bill.
  Less than 6 months ago, the House passed my bill, which requires the 
Department of Transportation to address the issue of sleep apnea for 
truck drivers through a rule and not guidance, potentially saving the 
industry $1 billion. Unfortunately, our Nation's pilots and air traffic 
controllers are facing a similar arbitrary guidance issued by the FAA, 
and we have brought a bill to the floor to protect them.
  As a doctor, I know firsthand that sleeping disorders are incredibly 
serious and can be very dangerous. However, I also know that you can't 
diagnose any patient by a set of arbitrary guidelines and stereotypes. 
Like any major disease, it can only be diagnosed through proper testing 
and conversation with a doctor. Issuing guidance based on nonmedical 
factors on this issue for pilots and air traffic controllers will cause 
doctors to order unnecessary tests, driving up the costs of health care 
and potentially affecting our Nation's airline travelers.
  I urge all of my colleagues to vote ``yes'' on this piece of 
legislation.
  Mr. LARSEN of Washington. Mr. Speaker, I continue to reserve the 
balance of my time.
  Mr. LoBIONDO. Mr. Speaker, I do not have any more speakers, and I am 
prepared to close when Mr. Larsen is finished.
  Mr. LARSEN of Washington. Mr. Speaker, in closing, I would like to 
again ask my colleagues to support this legislation. It is bipartisan. 
We have worked hard to get it here quickly, and we appreciate people 
supporting this.
  With that, I yield back the balance of my time.
  Mr. LoBIONDO. Mr. Speaker, in closing, I again thank my colleague Mr. 
Larsen and colleagues who were interested in this issue.
  I would like to reiterate that this bill is about transparency and 
about working with stakeholders, two areas in which the Federal 
Government desperately needs to improve. I strongly urge all of my 
colleagues to support the bill.
  I yield back the balance of my time.

  Ms. JACKSON LEE. Mr. Speaker, I rise in support of H.R. 3578, a bill 
to ensure new and revised requirements for screening, testing, or 
treatment of airman or air traffic controller sleep disorders.
  As the former chair of the House Homeland Security Committee 
Subcommittee on Transportation Security I am in strong support of this 
bill. This bill is a commonsense measure to address sleep disorder 
conditions that airmen and air traffic controllers may be experiencing.
  Under the bill the Secretary of Transportation can follow consistent 
acceptable medical standards and practices, to implement or

[[Page 2848]]

enforce actions that provide for the screening, testing, or treatment; 
including consideration of all possible treatment alternatives for 
sleep disorders.
  Sleep disorders are a serious matter that requires Congressional 
action to save lives and improve medical knowledge and best practices 
to assist those who suffer from a wide range of conditions.
  There are 40 million people, or about 5 percent of the population, in 
the United States who suffer from chronic sleep disorders. It is 
estimated that sleep disorders cost U.S. employers about $18 billion in 
productivity due to sleep loss issues.
  Further it is estimated that about 62 percent of all adults in the 
United States experience sleep problems a few nights each week.
  During any year, about 30 percent of all adults suffer from insomnia. 
In addition, only 29 percent of adults report getting the required 
amount of sleep each night.
  At least 37.9 percent of adults report unintentionally falling to 
sleep during the day once in the past month. The annual number of fatal 
car crashes associated with falling asleep at the wheel is 1,550. The 
number of non-fatal crashes associated with falling asleep is 40,000.
  Sleep disorders can occur due to medical conditions such as excessive 
drowsiness, fibromyalgia or narcolepsy and low thyroid function.
  Drowsiness in the context of sleep disorders is more serious than 
when the average person feels drowsy or sleepy during the day. We can 
usually deal with that feeling by walking around, consuming a hot 
beverage or distracting themselves with other mentally stimulating 
activity.
  The excessive drowsiness experienced as a sleep disorder is a feeling 
of abnormally needing to sleepy during the day. People experiencing 
excessive drowsiness may fall asleep in inappropriate situations or at 
inappropriate times.
  Fibromyalgia is a common syndrome that can lead to sleep disorders. 
Fibromyalgia is a syndrome in which a person has long-term, body-wide 
pain and tenderness in the joints, muscles, tendons, and other soft 
tissues. Fibromyalgia has also been linked to fatigue, sleep problems, 
headaches, depression, and anxiety.
  Narcolepsy is more widely known as a nervous system disorder that can 
cause a sufferer to fall into an uncontrolled sleep nearly 
instantaneously. The exact cause of narcolepsy is unknown.
  In some patients, narcolepsy is linked to reduced amounts of a 
protein called hypocretin, which is made in the brain. The reason why 
narcolepsy can lead to less production of this protein is unknown.
  Researchers believe that low levels of a protein called hypocretin 
may be an underlying cause of narcolepsy--a disorder that makes people 
fall asleep during the day. Pharmaceutical companies are now looking 
for drugs that will replenish the lost hypocretin.
  Emmanuel Mignot, of Stanford University Medical School, California, 
and his colleagues identified that low levels of hypocretin in patients 
with narcolepsy, their study appear in the September issue of Nature 
Medicine.
  There is no cure for narcolepsy and symptoms include an 
uncontrollable desire to sleep during in the day, sudden loss of muscle 
tone, and paralysis. Narcolepsy is diagnosable as early as ages 15 to 
25, and those affected by the disorder must find ways to cope with 
illness by changing their work and eating habits to achieve a level of 
normal behavior.
  There is far too little research that answers the hard questions 
about sleep disorders which impact airmen and air traffic controllers 
as well as millions of people in the United States.
  I ask my colleagues to join me in support of H.R. 3578.
  The SPEAKER pro tempore. The question is on the motion offered by the 
gentleman from New Jersey (Mr. LoBiondo) that the House suspend the 
rules and pass the bill, H.R. 3578, as amended.
  The question was taken.
  The SPEAKER pro tempore. In the opinion of the Chair, two-thirds 
being in the affirmative, the ayes have it.
  Mr. LoBIONDO. Mr. Speaker, I object to the vote on the ground that a 
quorum is not present and make the point of order that a quorum is not 
present.
  The SPEAKER pro tempore. Pursuant to clause 8 of rule XX, further 
proceedings on this question will be postponed.
  The point of no quorum is considered withdrawn.

                          ____________________