Notice of Intent

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covered by the liability insurance a
launch operator is required to purchase
when conducting a licensed launch in
the United States?
6. A government-industry risk sharing
arrangement, such as that reflected in
the CSLA and described in this Notice,
may be unusual for a commercial
industry, but it is not unique. For
example, indemnification of excess
liability is credited with enabling
commercial development of the nuclear
power industry. Do you think it is
important and appropriate for the
government to continue to support the
U.S. commercial launch industry by
having some type of liability risksharing program, such as the one
described in this Notice, and can you
state why?
7. Other governments financially
support their launch industry through
indemnification commitments. For
example, the French Government is
responsible for paying damages awarded
to victims of Arianespace launches in
excess of the insurance obtained by
Arianespace. Do you believe that the
U.S. Government should continue to
have policies and laws, such as the
CSLA risk-sharing program described in
this Notice, so that U.S. companies can
compete on similar terms against their
international competitors?
8. If you answered ‘‘yes’’ to Question
7, above, under what circumstances do
you believe the U.S. Government should
or could stop supporting the U.S.
commercial launch industry through
risk sharing? What criteria (e.g., market
share, technological success, other
considerations) would you use in
deciding that a risk-sharing arrangement
between government and industry is no
longer necessary or appropriate?
Part II
Reprinted below are the questions
presented in the first Internet public
meeting, conducted April 27–May 11.
You may answer none, some or all of
them, and then proceed to Part III.
1. Could the U.S. commercial space
transportation industry compete
effectively against non-U.S. launch
providers without the existing liability
risk-sharing regime?
2. Are the liability risk-sharing
regimes of other space-faring countries
relevant to the competitiveness of the
U.S. space transportation industry? Are
there specific elements of particular
foreign regimes that you believe provide
advantages or benefits to entities that
fall under those regimes and the ability
of non-U.S. launch providers to compete
internationally?
3. Does holding a launch operator
strictly liable for the damage or injury

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that results from its launch hinder the
commercialization of space launch
capability?
4. By treaty, the U.S. Government
accepts absolute liability for damage on
the ground or to aircraft in flight outside
of the United States when a launch
takes place from U.S. territory or
facilities. Given the Government’s
obligations in this regard, does the
existing liability risk-sharing regime
provide adequate coverage and financial
protection for the commercial space
transportation industry as well as the
Government?
5. U.S. and foreign air carriers
operating in the United States are
required to maintain insurance coverage
in certain minimum amounts covering
liability to passengers and persons and
property on the ground. For aircraft
with more than 60 seats or more than
18,000 pounds of capacity, carriers must
maintain third-party accident liability
coverage in the minimum amount of
$300,000 for any one person other than
a passenger and a total of $20 million
per involved aircraft for each
occurrence. There is no government
indemnification in the event claims
exceed that amount, nor does the U.S.
Government accept treaty-based liability
in the event of such damage. At what
stage of development and under what
circumstances should the airline
liability regime become a model for
commercial reusable launch vehicles
(RLVs) that will routinely take-off and
land?
6. The Federal Government’s current
indemnification policy does not cover
risks associated with commercial
spaceport operations that do not involve
launch vehicles. Do commercial
spaceports require a liability risksharing regime comparable to that
utilized for licensed launches and
reentries, even when there is no vehiclerelated activity taking place at the
spaceport?
7. What factors should the U.S.
Congress consider in determining
whether to continue as-is, or modify,
existing laws in terms of liability risksharing for commercial space launch
and reentry activities?
8. What suggestions do you have for
modifying the existing liability risksharing laws applicable to commercial
launch and reentry activities?
Part III
This part provides an opportunity for
you to express your views and concerns
on matters related to launch liability,
risk management and government
policies in support of the U.S.
commercial space launch industry. You
are welcome to use this opportunity to

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inform the FAA of your views regarding
U.S. commercial space transportation in
general, and the government’s role in
facilitating and supporting commercial
access to space and regulating launch
safety.
Issued in Washington, DC, on July 25,
2001.
Joseph A. Hawkins,
Acting Associate Administrator for
Commercial Space Transportation.
[FR Doc. 01–19043 Filed 7–30–01; 8:45 am]
BILLING CODE 4910–13–P

DEPARTMENT OF TRANSPORTATION
Federal Motor Carrier Safety
Administration
[Docket No. FMCSA–2001–9800]

Qualification of Drivers; Exemption
Applications; Diabetes
AGENCY: Federal Motor Carrier Safety
Administration (FMCSA), DOT.
ACTION: Notice of intent to issue
exemptions and request for comments.
SUMMARY: This notice announces the
FMCSA’s proposal to issue exemptions
to certain insulin-using diabetic drivers
of commercial motor vehicles (CMVs),
from the diabetes mellitus prohibitions
contained in the Federal Motor Carrier
Safety Regulations (FMCSRs). The
FMCSA requests comments on its
proposed exemption program, but we
are not accepting applications for
exemptions at this time. If a decision to
proceed with the exemption program is
made, the exemptions would be granted
only to those applicants who meet the
specific conditions and comply with all
the requirements of the exemption.
Exemptions would be issued for a
period of two years. After the two years,
those holding exemptions would need
to reapply for another two-year
exemption.
DATES: Comments must be received on
or before October 1, 2001.
ADDRESSES: You can mail, hand deliver,
fax, or electronically submit written
comments to the Docket Management
Facility, U.S. Department of
Transportation, Room PL–401, 400
Seventh Street, SW., Washington, DC
20590; FAX (202) 493–2251, online at
http://dmses.dot.gov/submit. Please
include the docket number that appears
in the heading of this document in your
comment. You can examine and copy
all comments from 9 a.m. to 5 p.m., e.t.,
Monday through Friday, except Federal
holidays at the docket facility. You can
also examine the docket on the Internet
at http://dms.dot.gov. If you want us to

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notify you of receipt of your comments,
please include a self-addressed,
stamped envelope or postcard, or after
submitting comments electronically,
print the acknowledgment page.
FOR FURTHER INFORMATION CONTACT: For
further information about the proposed
diabetes exemption program in this
notice, Ms. Sandra Zywokarte, Office of
Bus and Truck Standards and
Operations, (202) 366–2987; for
information about legal issues related to
this notice, Mr. Joseph Solomey, Office
of the Chief Counsel, (202) 366–1374,
FMCSA, Department of Transportation,
400 Seventh Street, SW., Washington,
DC 20590. Office hours are from 7:45
a.m. to 4:15 p.m., e.t., Monday through
Friday, except Federal holidays.
SUPPLEMENTARY INFORMATION:
Background
The motor carrier regulatory functions
of the Federal Highway Administration
(FHWA) were transferred to the recently
created Federal Motor Carrier Safety
Administration (FMCSA). The history
and delegation of authority to the
FMCSA was published in the Federal
Register on January 4, 2000 (65 FR 220).
The agency established the current
standard for diabetes in 1970 because
several risk studies indicated that
diabetic drivers had a higher rate of
accident involvement than the general
population. The diabetes requirement
provides:
A person is physically qualified to
drive a commercial motor vehicle if that
person has no established medical
history or clinical diagnosis of diabetes
mellitus currently requiring insulin for
control. 49 CFR 391.41(b)(3).
Since 1970, the agency engaged in
several activities to address the issue of
diabetes and CMV operation. On March
28, 1977, the agency published an
Advance Notice of Proposed
Rulemaking (ANPRM) to solicit
comments on the diabetes standard (42
FR 16452). The agency terminated this
rulemaking in November 1977 without
amending the standard, after
determining that the more substantive
comments and the literature cited in the
ANPRM supported the prohibition
against the operation of CMVs by
insulin-using diabetics because of
highway safety concerns. On November
25, 1987, the agency published a new
ANPRM (52 FR 45204) requesting
comments on petitions from two
individuals and the American Diabetes
Association to eliminate the blanket
prohibition against insulin-using
diabetics and grant waivers on a caseby-case basis. In September 1987, a
Conference on Diabetic Disorders and

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Commercial Drivers was held to review
the diabetes standard in light of
advances in the care of diabetics.
Conference participants (physicians,
scientists, federal officials and
representatives from the motor carrier
industry) recommended that some
drivers with diabetes could be certified
to drive depending upon insulin use
and under certain conditions (absence
of recurrent hypoglycemia, safe driving
record, etc.) (Federal Highway
Administration, Conference on Diabetic
Disorders and Commercial Drivers;
Final Report, 1988). Following this, the
agency published a Notice of Proposed
Rulemaking (55 FR 41208) requesting
comments on a proposal to revise the
diabetes standard to allow insulin-using
diabetics to operate CMVs and
sponsored a 1990 risk assessment that
estimated various levels of accidents
among diabetic drivers depending upon
the severity of hypoglycemia (Federal
Highway Administration, Insulin-using
Commercial Motor Vehicle Drivers,
1992). The estimated level of accidents
was deemed acceptable and a Notice of
Intent to Issue Waivers was published in
1992. This led to a 1993 waiver
program, based on a three-year safe
driving record while using insulin and
medical examinations by the required
specialists.
The diabetes waiver program,
originally part of a research study, was
terminated in 1996. The D.C. Circuit
Court of Appeals had found that the
initial determination that the agency’s
vision waiver program would not
adversely affect the safe operation of
CMVs was ‘‘devoid of empirical support
in the record’’ and, therefore, contrary to
law (Advocates for Highway and Auto
Safety v. Federal Highway
Administration, 28 F. 3d 1288 (D.C.
Circuit 1994)). Although the decision
initially affected only the vision waiver
program, it had a direct effect on the
diabetes program because of the similar
approach used to prequalify drivers.
Those drivers holding waivers at the
program’s termination were allowed to
continue to operate CMVs in interstate
commerce under grandfather provisions
at 49 CFR 391.64.
Feasibility Study To Qualify InsulinTreated Diabetics To Operate CMVs
On June 9, 1998, the President signed
the Transportation Equity Act for the
21st Century (TEA–21) (Pub. L. 105–
178, 112 Stat. 107). Section 4018 of the
TEA–21 directed the Secretary of
Transportation (the Secretary) to
determine if it is feasible to develop a
safe and practicable program for
allowing individuals with insulintreated diabetes mellitus (ITDM) to

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39549

operate CMVs in interstate commerce.
In making the determination, the
Secretary was directed to evaluate
research and other relevant information
on the effects of ITDM on driving
performance. TEA–21 stated that, to
accomplish this, the Secretary shall
consult the states with regard to their
programs for CMV operation by ITDM
drivers, evaluate the Department of
Transportation’s (DOT) policies in other
modes of transportation, analyze
pertinent risk data, consult with
interested groups knowledgeable about
diabetes and related issues, and assess
the possible legal consequences of
permitting ITDM individuals to operate
CMVs in interstate commerce. TEA–21
also directed the Secretary to report the
findings to Congress and, if a program
is feasible, describe the elements of a
protocol to permit individuals with
ITDM to operate CMVs. The report was
submitted to Congress on August 23,
2000, and concludes that a safe and
practicable protocol to allow some
ITDM individuals to operate CMVs is
feasible. A copy of the report is
included in the docket. The FMCSA’s
feasibility assessment included a review
of background research on the risk of
driving with diabetes. Although the
relationship between diabetes and
automobile crashes had been assessed
since 1965, the epidemiological
evidence from 1965 to 1991 produced
conflicting results. The lack of
consistent results was in many cases
caused by flawed methodology. Further,
none of the studies addressed the
operation of CMVs. With the
termination of the waiver program and
its research component, the agency
lacked clear risk assessment
information.
A literature review was conducted on
the treatment and management of ITDM.
The research results showed positive
findings. Six studies have been reported
in the literature. The two largest and
most reported studies (The Diabetes
Control and Complications Trial and the
United Kingdom Prospective Diabetes
Study Group) represented the most
extensive investigations of insulin
therapy and had similar findings. Both
showed that patients experienced
reductions in blood glucose levels and
significantly fewer microvascular
complications with intensive treatment.
However, the studies also showed
significant adverse effects from insulin
use, notably, a significantly higher rate
of hypoglycemia.
Investigation of the policies of other
DOT modal administrations regarding
ITDM showed that only the Federal
Aviation Administration (FAA) has a
well-developed program. In 1994, the

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FAA determined that selected ITDM
individuals can be considered for
special issuance of a third-class Airman
Medical Certificate under a screening,
glucose management, and monitoring
protocol. The program evolved through
a series of steps in which the agency
capitalized on its experience, reviewed
relevant research, consulted medical
experts, and considered comments from
the public and interested organizations.
As a part of its feasibility
determination, the FMCSA examined
how the states treated drivers with
ITDM. Although the states have the
option to apply the FMCSRs to the
medical qualifications for intrastate
CMV operators, they also have the
flexibility to deviate from the FMCSRs.
A few states have chosen to adopt the
federal standards and not allow ITDM
individuals to operate CMVs. Some
states have granted grandfather rights to
drivers who were already driving
intrastate, while allowing no new
drivers after a specific date. Other states
have programs whereby drivers can
apply for the opportunity to operate in
intrastate commerce. Based on several
surveys of the states and contact with
individual states, the programs of four
states (Utah, Michigan, Kentucky and
Delaware) are presented in the report as
examples of more extensive approaches.
These states have screening, operating
and monitoring protocols of varying
degrees of intensity and coverage, but
do not monitor results.
The report presents four recent risk
assessment studies (1995 to 1997) that
specifically address diabetes and the
operation of CMVs. Two of the studies
were performed in Canada, while the
other two were conducted by the Office
of Motor Carrier Safety (now the
FMCSA). The first study analyzed
insurance data for 1,307 truck drivers
and found that diabetics operating
smaller trucks had significantly higher
accident rates (diabetics operating large
combination trucks did not have higher
rates) (Dionne, G., Desjardin, D.,
LaBerge-Nadeau, C. and Moag, U.,
‘‘Medical Conditions, Risk Exposure,
and Truck Driver’s Accidents: An
Analysis with Count Data Regression
Models,’’ Accident Analysis and
Prevention, 27(3), p. 295–305; 1995).
Insulin use was not considered. The
second Canadian study used the same
database and concluded that diabetic
drivers did not have accidents that were
significantly more severe than those
without the condition (severity was
defined by injuries and fatalities). The
third study used data from the FHWA
waiver program (Federal Highway
Administration, Final Descriptive
Report: ‘‘Qualifications of Drivers-

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Vision, Diabetes, Hearing and
Epilepsy,’’ 1997). The analysis of these
data showed that the accident rate of the
diabetes waiver program drivers was
lower than the national rate. The last
study looked at 723 ITDM drivers of
large trucks and a comparison group of
1,297 drivers with commercial driver’s
licenses (Federal Highway
Administration, ‘‘A Preliminary Study
of the Risk Associated with the
Operation of Commercial Motor
Vehicles by Drivers with InsulinTreated Diabetes Mellitus,’’ 1999). After
adjustment for confounding, the results
showed no significant differences
between the two groups in accident rate
or severity. The ITDM drivers in this
study had at least 3 years experience
operating a commercial vehicle with the
condition. All of the recent studies
specifically concerned with diabetes
and CMV operation show that drivers
with that condition have a level of
safety that is the same or better than a
comparison group or the national
accident rate.
The FMCSA also assembled a panel of
physicians expert in the treatment of
diabetes. The panel was asked to
address the screening and monitoring
issues that would be associated with a
process to allow ITDM individuals to
operate CMVs. Responding with written
reports and through discussion at a
meeting in Washington, DC, the panel
expressed the opinion that advances in
the treatment of diabetes make it
possible both to control the disease and
to permit the identification of those
individuals capable of doing so. The
panel identified methods to avoid acute
complications, including hypoglycemia,
and endorsed a protocol for monitoring
glucose before and during the operation
of a CMV. The panel concluded that
from a medical standpoint a process was
feasible for permitting some individuals
with ITDM to operate CMVs.
The report concludes that a safe and
practicable protocol to allow some
ITDM individuals to operate CMVs is
feasible. The research on the treatment
and management of ITDM, combined
with the determinations of the medical
panel, indicate that the disease and its
adverse effects can be successfully
controlled and monitored. Moreover,
recent risk assessments provide
evidence that diabetic CMV operators
can perform in an acceptably safe
manner. Finally, the program operated
by the FAA and the analysis of the
agency’s diabetes waiver study program
demonstrate that it is possible to screen
and monitor ITDM individuals so that
safe performance is feasible.
The report further concludes that a
viable program protocol for allowing

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individuals with ITDM to operate CMVs
would require three components. The
first is a screening component to
identify qualified applicants. This
process would examine the applicant’s
experience and safety in operating
CMVs, the applicant’s history of
hypoglycemia, and the results of
examinations by the required medical
specialists (endocrinologists and
ophthalmologists). The second
component would provide guidelines
for managing ITDM, including supplies
to be used and the protocol for
monitoring and maintaining appropriate
blood glucose levels. The last
component would specify the process to
be used for monitoring ITDM
commercial drivers. It would address
the required medical examinations and
the schedule for their submission. It also
would indicate how glucose measures
should be taken and reviewed, and
specify how episodes of severe
hypoglycemia and accidents should be
reported. These components are based
largely on the structure of the FAA and
FHWA/FMCSA waiver programs. They
are presented in detail in the report.
Finally, the report addresses the legal
consequences of permitting ITDM
individuals to drive CMVs in interstate
commerce. It was determined that the
legal consequences of a rule (including
a regulation, policy or standard adopted
pursuant to the Administrative
Procedure Act (APA)) fall into two
categories: (1) An APA challenge to the
validity of the rule and (2) tort liability
for damages sustained in an accident
involving an ITDM driver. The
assessment concluded that these
consequences are no different from
those associated with any other rule
involving driver standards and
qualifications. For employers that hire
ITDM drivers, the rule might expose
them to new standards of responsibility
for monitoring the health of drivers who
meet federal guidelines.
Based on the research presented in
the Report to Congress, the FMCSA has
decided that evidence and precedence
indicate the appropriate form for
implementing a process would be an
exemption program. Evidence indicates
that diabetes is a chronic disease which
requires constant control, especially
ITDM, and needs, therefore, ongoing
monitoring to ensure that the disease is
under control. The evidence also
strongly suggests that the process which
guarantees an acceptable level of safety
is one that thoroughly screens ITDM
drivers who wish to operate CMVs and
periodically monitors the diseasecontrolling behavior of those
successfully screened. Experience
indicates, through the FAA and FHWA/

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FMCSA programs, such a process is best
implemented as an exemption program,
and that type of program is currently
defined and authorized in Section 4007
of TEA–21.
Authority—Waivers and Exemptions
On June 9, 1998, the agency’s waiver
authority changed with enactment of the
Transportation Equity Act for the 21st
Century (TEA–21), Public Law No. 105–
178, 112 Stat. 107. Section 4007 of
TEA–21 amended the waiver provisions
of 49 U.S.C. 31315 and 31136(e) to
change the standard for evaluating
waiver requests, to distinguish between
a waiver and an exemption, and to
establish term limits for both. Under
revised sections 31315 and 31136(e), the
FMCSA may grant a waiver for a period
of up to 3 months or an exemption for
a renewable 2-year period.
The amendments to 49 U.S.C. 31315
and 31136(e) also changed the criteria
for exempting a person from application
of a regulation. Previously an exemption
was appropriate if it was consistent with
the public interest and the safe
operation of CMVs. Now the FMCSA
may grant an exemption if it finds ‘‘such
exemption would likely achieve a level
of safety that is equivalent to, or greater
than, the level that would be achieved
absent such exemption.’’ The new
standard provides the FMCSA greater
flexibility and discretion to deal with
exemptions than the previous standard.
(See H.R. Conf. Rep. No. 105–550, at 489
(1998).)
The TEA–21 requires the FMCSA to
publish a notice in the Federal Register
for each exemption requested,
explaining that the request has been
filed, and providing the public an
opportunity to inspect the safety
analysis and any other relevant
information known to the agency, and
comment on the request. Prior to
granting a request for an exemption, the
agency must publish a notice in the
Federal Register identifying the person
or class of persons who will receive the
exemption, the provisions from which
the person will be exempt, the effective
period, and all terms and conditions of
the exemption. The terms and
conditions established by the FMCSA
must ensure that the exemption will
likely achieve a level of safety that is
equivalent to, or greater than, the level
that would be achieved by complying
with the regulation.
In addition, the agency is required to
monitor the implementation of each
exemption to ensure compliance with
its terms and conditions. If the FMCSA
denies a request for an exemption, the
agency must publish a notice in the
Federal Register identifying the person

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who was denied the exemption and the
reasons for the denial.
Generally, the duration of exemptions
issued under the authority of section
4007 is limited to two years from the
date of approval, but may be renewed.
The FMCSA is required to immediately
revoke an exemption if: (1) The person
fails to comply with the terms and
conditions of the exemption; (2) the
exemption has resulted in a lower level
of safety that was maintained before the
exemption was granted; or (3)
continuation of the exemption would
not be consistent with the goals and
objectives of the regulations issued
under the authority of 49 U.S.C. 31315
and 31136(e).
Process for Applying for an Exemption
The procedures for applying for an
exemption are at 49 CFR 381.300. The
person applying for an exemption is
required to send a written request
(which could be a typed or handwritten
letter (printed)) to the Federal Motor
Carrier Safety Administrator. The
written request must include basic
information such as the identity of the
person who would be covered by the
exemption, the name of the motor
carrier or other entity that would be
responsible for the use or operation of
CMVs during the exemption period, and
the principal place of business of the
motor carrier or other entity. Under
section 381.310, the application must
include a written statement that: (1)
Describes the event or CMV operation
for which the exemption would be used;
(2) identifies the regulation from which
the applicant is requesting relief; (3)
estimates the total number of drivers
and CMVs that would be operating
under the terms and conditions of the
exemption; and (4) explains how the
recipient of the exemption would
ensure that they achieve a level of safety
that is equivalent to, or greater than, the
level of safety that would be obtained by
complying with the regulation.
FMCSA Procedures for the Review of
Exemption Applications
Section 381.315 requires the FMCSA
to review an application for an
exemption and prepare, for the
Administrator’s signature, a Federal
Register notice requesting public
comment. After a review of the
comments received, a recommendation
will be made to the Administrator.
Notice of the Administrator’s final
decision will be published in the
Federal Register. The FMCSA would
attempt to issue a final decision within
180 days of the date it receives an
individual’s completed application.
However, if the applicant should omit

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important details or other information
necessary for the agency to conduct a
comprehensive evaluation, the FMCSA
would attempt to issue a final decision
within 180 days of the date the
additional information is received (49
CFR 381.315 and 381.320). The FMCSA
recognizes that this potential six-month
waiting period may seem burdensome.
However, the agency must carefully
evaluate each and every application for
regulatory relief from the diabetes
standard, to assess the potential safety
performance of each applicant. In
addition, the agency must prepare and
submit the candidate’s application for
public notice and comment in the
Federal Register and then evaluate
comments received before making a
final decision. The FMCSA’s overriding
concern is to ensure the safety of
interstate commercial operations. The
agency would notify all applicants in
writing once a final decision is made.
Application Information
In considering exemptions, the
FMCSA must ensure that the issuance of
diabetes exemptions would not be
contrary to the public interest and that
the exemption achieves an acceptable
level of safety. Exemptions, therefore,
would only be granted to ITDM
individuals who meet certain
conditions. These conditions, which are
based on the research literature, relevant
DOT and State exemption programs and
with substantial input from a panel of
endocrinologists, are set forth below.
Applicants for an exemption from the
ITDM prohibition would be required to
submit their applications in a letter
(there would be no application form),
include all supporting documentation,
and use the following format:
Vital Statistics
Name (First Name, Middle Initial, Last
Name):
Address (House Number and Street
Name, City, State, and Zip Code):
Telephone Number (Area Code and
Number):
Sex (Male or Female):
Date of Birth (Month, Day, Year):
Age:
Social Security Number:
State Driver’s License Number (List all
licenses held to operate a commercial
motor vehicle (CMV) during the 3year period immediately preceding
the date of application.):
Driver’s License Expiration Date:
Driver’s License Classification Code (If
not a commercial driver’s license
(CDL) classification code, specify
what vehicles may be operated under
such code):
Driver’s License Date of Issuance
(Month, Day, Year):

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Experience
Number of years driving straight trucks:
Approximate number of miles per year
driving straight trucks:
Number of years driving tractor-trailer
combinations:
Approximate number of miles per year
driving tractor-trailer combinations:
Number of years driving buses:
Approximate number of miles per year
driving buses:
Present Employment
Employer’s Name (If Applicable):
Employer’s Address:
Employer’s Telephone Number:
Type of Vehicle Operated and GVWR
(Straight Truck, Tractor-Trailer
Combination, Bus):
Commodities Transported (e.g., General
Freight, Liquids in Bulk (in cargo
tanks), Steel, Dry-Bulk, Large Heavy
Machinery, Refrigerated Products):
Estimated number of miles driven per
week:
Estimated number of daylight driving
hours per week:
Estimated number of nighttime driving
hours per week:
States in which you will drive if issued
an exemption:
In addition, the applications must
include supporting documentation
showing that the applicant:
(1) Possesses a valid intrastate CDL or
a license (non-CDL) to operate a CMV,
(2) Has operated a CMV, with a
diabetic condition controlled by the use
of insulin, for the three-year period
immediately preceding application,
(3) Has a driving record for that threeyear period that:
Contains no suspensions or
revocations of the applicant’s driver’s
license for the operation of any motor
vehicle (including their personal
vehicle);
Contains no involvement in an
accident for which the applicant
received a citation for a moving traffic
violation while operating a CMV;
Contains no involvement in an
accident for which the applicant
contributed to the cause of the accident;
and
Contains no convictions for a
disqualifying offense or more than one
serious traffic violation, as defined in 49
CFR 383.5, while operating a CMV,
(4) Has no other disqualifying
conditions including diabetes-related
complications,
(5) Has had no recurrent (two or more)
hypoglycemic reactions resulting in a
loss of consciousness or seizure within
the past five years. A period of one year
of demonstrated stability is required
following the first episode of
hypoglycemia,

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(6) Has had no recurrent
hypoglycemic reactions requiring the
assistance of another person within the
past five years. A period of one year of
demonstrated stability is required
following the first episode of
hypoglycemia,
(7) Has had no recurrent
hypoglycemic reactions resulting in
impaired cognitive function which
occurred without warning symptoms
within the past five years. A period of
one year of demonstrated stability is
required following the first episode of
hypoglycemia,
(8) Has provided a board-certified or
board-eligible endocrinologist, who is
knowledgeable about diabetes, with a
complete medical history including:
The date insulin use began;
Diabetes diagnosis and disease history;
All hospitalization records;
Consultation notes for diagnostic
examinations;
Special studies pertaining to the
diabetes;
Follow-up reports; and
Reports of any hypoglycemic insulin
reactions within the last five years,
(9) Has been examined by a boardcertified or board-eligible
endocrinologist who has conducted a
complete medical examination. The
complete medical examination must
consist of a comprehensive evaluation
of the applicant’s medical history and
current status with a report including
the following information:
Two measures of glycosylated hemoglobin,
the first 90 days prior to the last and current
measure;
Insulin dosages and types, diet utilized for
control and any significant factors such as
smoking, alcohol use, and other medications
or drugs taken; and
Examinations to detect any peripheral
neuropathy or circulatory insufficiency of the
extremities,

(10) Submits a signed statement
prepared by the examining
endocrinologist indicating the following
medical determinations:
The endocrinologist is familiar with the
applicant’s medical history for the past five
years either through actual treatment over
that time or through consultation with a
physician who has treated the applicant
during that time;
The applicant has been using insulin to
control his/her diabetes from the date of the
application back to the date the three years
of driving experience began;
The applicant has been educated in
diabetes and its management, thoroughly
informed of and understands the procedures
which must be followed to monitor and
manage his/her diabetes and what
procedures should be followed if
complications arise; and

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The applicant has the ability and has
demonstrated willingness to properly
monitor and manage his/her diabetes,

(11) Submits a separate signed
statement from an examining
ophthalmologist that the applicant has
been examined and that the applicant
does not have clinically significant
disease including unstable proliferative
diabetic retinopathy (i.e., unstable
advancing disease of blood vessels in
the retina) and meets the vision
standard at 49 CFR 391.41(b)(10).
Requirements for ITDM Individuals
Who Have Been Issued an Exemption
To Operate CMV’S
There are special conditions attached
to the issuance of any exemption for
ITDM. The following requirements
would be imposed:
(1) Individuals with ITDM shall
maintain appropriate medical supplies
for glucose management while
preparing for the operation of a CMV
and during its operation. The supplies
should include the following:
An acceptable glucose monitor with
memory;
Supplies needed to obtain adequate
blood samples and to measure blood
glucose;
Insulin to be used as necessary; and
An amount of rapidly absorbable
glucose to be used as necessary,
(2) Prior to and while driving, the
individual with ITDM shall adhere to
the following protocol for monitoring
and maintaining appropriate blood
glucose levels:
Check glucose before starting to drive
and take corrective action if necessary.
If glucose is <100 mg/dl, take glucose or
food and recheck in 30 minutes. Do not
drive if glucose is <100 mg/dl. Repeat
the process until glucose is >100 mg/dl;
While driving check glucose every
two to four hours and take appropriate
action to maintain it in the range of 100
to 400 mg/dl;
Have food available at all times when
driving. If glucose is <100 mg/dl, stop
driving and eat. Recheck in 30 minutes
and repeat procedure until glucose is
>100 mg/dl; and
If glucose is >400 mg/dl, stop driving
until glucose returns to the 100–400 mg/
dl range. If more than two hours after
last insulin injection and eating, take
additional insulin. Recheck blood
glucose in 30 minutes. Don’t resume
driving until glucose is <400 mg/dl.
Monitoring for ITDM Individuals Who
Have Been Issued an Exemption to
Operate CMV’S
In addition to the requirements for
controlling ITDM, exemption recipients
will be monitored during the period that

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Federal Register / Vol. 66, No. 147 / Tuesday, July 31, 2001 / Notices
the exemption is valid. Monitoring will
be conducted by requiring the
exemption recipients to submit the
following information to the FMCSA:
(1) Submit to a comprehensive
medical evaluation by an
endocrinologist on an annual basis. The
evaluation will include a general
physical examination and a report of
glycosylated hemoglobin concentration.
The evaluation will also involve an
assessment of the individual’s
willingness and ability to monitor and
manage the diabetic condition;
(2) Provide records of all daily glucose
measurements taken with an acceptable
device (with memory). These
measurements will be reviewed by a
specialist on a quarterly basis;
(3) Provide on an annual basis
confirmation by an ophthalmologist that
there is no proliferative diabetic
retinopathy and no clinically significant
disease that prevents the individual
from meeting the current vision
standards at 49 CFR 391.41(b)(10);
(4) Annual documentation by an
endocrinologist of ongoing education in
management of diabetes and
hypoglycemia awareness;
(5) Report, upon determination of an
endocrinologist or other physician, any
episode of severe hypoglycemia,
significant complications or inability to
manage diabetes; and
(6) Report any involvement in an
accident or any other adverse event and
whether or not they are related to an
episode of hypoglycemia.
Request for Comments
The FMCSA is requesting public
comment from all interested persons on
its intent to issue exemptions to certain
insulin-using diabetic drivers of CMVs,
from the diabetes requirement in 49 CFR
391.41(b)(3), and relevant issues
discussed in this notice. All comments
received before the close of business on
the closing date indicated above will be
considered and will be available for
examination in the docket room at the
above address. Comments received after
the closing date will be filed in the
docket and will be considered to the
extent practicable. However, the
FMCSA may issue a final notice of
intent to establish a process for
considering exemptions from the
diabetes requirement in accordance
with 49 U.S.C. 311315 and 31136(e),
and publish in the Federal Register that
decision at any time after the close of
the comment period. The FMCSA will
also continue to file in the docket
relevant information which becomes
available. Interested persons should
continue to examine the docket for new
material.

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Paper Reduction Act
Under the Paperwork Reduction Act
of 1995 (PRA) (44 U.S.C. 3501, et seq.),
Federal agencies must obtain approval
from the Office of Management and
Budget (OMB) for each collection of
information they conduct, sponsor, or
require through regulations. The
FMCSA has determined that this notice
of intent contains collection of
information requirements for the
purposes of the PRA. The proposed
exemption program, when made final,
will impact the currently-approved
information collection, ‘‘Medical
Qualification Requirements.’’ This
approval is covered by OMB Approval
No. 2126–0006 and is due to expire on
October 31, 2003. The FMCSA estimates
that approximately 200 applications for
exemption could be filed annually and
that it would take an average of 90
minutes to complete an application.
Authority: 49 U.S.C. 322, 31136 and 31315;
and 49 CFR 1.73.
Issued on: July 25, 2001.
Brian M. McLaughlin,
Acting Deputy Administrator.
[FR Doc. 01–19045 Filed 7–30–01; 8:45 am]
BILLING CODE 4910–EX–P

DEPARTMENT OF TRANSPORTATION
National Highway Traffic Safety
Administration
Reports, Forms and Record Keeping
Requirements; Agency Information
Collection Activity Under OMB Review
AGENCY: National Highway Traffic
Safety Administration, DOT.
ACTION: Notice.
SUMMARY: In compliance with the
Paperwork Reduction Act of 1995 (44
U.S.C. 3501 et seq.), this notice
announces that the Information
Collection Request (ICR) abstracted
below has been forwarded to the Office
of Management and Budget (OMB) for
review and comment. The ICR describes
the nature of the information collections
and their expected burden. The Federal
Register Notice with a 60-day comment
period was published on January 8,
2001 (66 FR 1369–1371).
DATES: Comments must be submitted on
or before August 30, 2001.
FOR FURTHER INFORMATION CONTACT:
Henrietta Spinner at the National
Highway Traffic Safety Administration,
Office of Safety Performance Standards
(NPS–20), 202–366–4802. 400 Seventh
Street, SW., Room 6240, Washington,
DC 20590.
SUPPLEMENTARY INFORMATION:

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39553

National Highway Traffic Safety
Administration
Title: 49 CFR part 537—Automotive
Fuel Economy Reports.
OMB Number: 2127–0019.
Type of Request: Extension of a
currently approved collection.
Abstract: NHTSA ensures that
automobile manufacturers comply with
49 CFR part 537—Automotive Fuel
Economy Reports. Part 537 requires that
automobile manufacturers submit
reports to NHTSA regarding their efforts
to improve automotive fuel economy.
This information assists NHTSA in
evaluating automobile manufacturers’
plans for complying with average fuel
economy standards and in preparing an
annual review of the average fuel
economy standards.
Affected Public: Business or other for
profit organizations.
Estimated Total Annual Burden:
3,474.
ADDRESSES: Send comments, within 30
days, to the Office of Information and
Regulatory Affairs, Office of
Management and Budget, 725—17th
Street, NW., Washington, DC 20503,
Attention NHTSA Desk Officer.
Comments are invited on: Whether
the proposed collection of information
is necessary for the proper performance
of the functions of the Department,
including whether the information will
have practical utility; the accuracy of
the Departments estimate of the burden
of the proposed information collection;
ways to enhance the quality, utility and
clarity of the information to be
collected; and ways to minimize the
burden of the collection of information
on respondents, including the use of
automated collection techniques or
other forms of information technology.
A Comment to OMB is most effective
if OMB receives it within 30 days of
publication.
Issued in Washington, DC, on July 25,
2001.
Herman L. Simms,
Associate Administrator for Administration.
[FR Doc. 01–18991 Filed 7–30–01; 8:45 am]
BILLING CODE 4910–59–P

DEPARTMENT OF TRANSPORTATION
National Highway Traffic Safety
Administration
Reports, Forms and Record Keeping
Requirements; Agency Information
Collection Activity Under OMB Review
AGENCY: National Highway Traffic
Safety Administration, DOT
ACTION: Notice.

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