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MEDICAL QUALIFICATION PROGRAM FOR INDIANA’S SECTION 5311 GRANTEESIntroductionThe Model Indiana Medical Qualification Program was developed to ensure the safety of both those individuals providing public transit services and the traveling public and to establish consistent medical standards for evaluating the approximately 950 safety-sensitive employees required to hold a CDL or PPC license, and who operate rural public transportation vehicles. The Program requires all grantees to develop and adopt Indiana’s model Medical Qualification Policy and Indiana Prescription and Over-the-Counter Medication Policy. Other policies may be added to the Program as needed. Among other requirements, the Indiana Medical Qualification Program requires physical assessments for all safety-sensitive employees on a bi-annual basis and following qualifying events. The Indiana Medical Qualification Program is administered by the Indiana RTAP program, which will conduct periodic compliance assessments and collect necessary data to ensure program efficiency.Program RequirementsThe Medical Qualification Program requires the services of a Medical Determination Officer (MDO) to be responsible for carrying out all aspects of medical examination services for safety-sensitive employees utilizing the standards established by the United States Department of Transportation “Physical Qualifications for Drivers” 49 CFR Part 391; the Americans with Disabilities Act (ADA); the Indiana Medical Qualification Policy; and the Indiana Rx/OTC Medication Policy. The Medical Qualification Program requires the following physical examination services for safety-sensitive employees:Bi-Annual PhysicalsAnnual Physicals (for any employee with only a 12-month medical clearance)New Hire PhysicalsReturn to Active Status EvaluationPost-Accident EvaluationSpecial Circumstances EvaluationThe MDO providing the medical examination must provide a medical qualification determination for each participant within two business days. The MDO must consult with the participant’s treating physician to obtain additional information about the participant’s medical qualification in circumstances that clearly suggest an on-going or new condition that could impact the participant’s ability to perform a safety-sensitive function. Return to Active Status and Special Circumstance evaluations are two categories that would require the MDO to consult with a treating physician to make a fully informed medical determination. Other evaluations requiring the MDO to communicate with a treating physician will include those participants that only receive a twelve-, six-, or three-month medical clearance. Appeals ProcessThe appeals process was developed to ensure a thorough review of the employee’s health status and to increase the accuracy of the Medical Qualification Determination. This process allows individuals who have been disqualified to appeal the determination and request an objective review of their medical information. In addition, this process provides the employee the right to prove functional capability to effectively perform all safety-sensitive job functions associated with his or her position. The appeals process must be consistent for all transit operators to ensure an equivalent review of an individual’s functional ability to perform assigned safety-sensitive duties. The MDO must have a complete understanding of the physical requirements of each position within the transportation system and be able to implement the appeals process in an equivalent manner to ensure consistency with the evaluations operators are receiving during this process. RX and OTC MedicationsThe Indiana Medical Qualification Program includes a supplemental Prescription and Over-the-Counter Medications policy. This supplemental policy requires safety-sensitive employees to inform their prescribing medical practitioner of their required job duties, currently used RX/OTC medications and dietary supplements to evaluate the employee’s health condition and to determine the employee’s ability to perform safety-sensitive job functions. Furthermore, employees are required to complete a Medical Information Form that is submitted to the MDO for review and assessment. The MDO should review the RX/OTC information in relation to the individual's medical history including other medications used to determine if the employee is medically qualified to operate a public transit vehicle while using the medication. Required and Recommended Program Forms/DocumentsIn developing the Medical Qualification Program and the Supplemental RX/OTC Medications policy, several documents were produced. These forms will be necessary to ensure compliance with the Program’s requirements and include:Indiana Medical Qualification PolicyIndiana Medical Qualification Program Supplemental Policy I: Prescription and Over-the-Counter (RX/OC) MedicationsMedical Qualification Program Appeal Procedure Rx/OTC Medication Information and MDO Approval FormJob Descriptions (Driver over 15 passenger, Driver under 15 passenger, Dispatcher and Mechanic)Post-Accident Procedures and Investigation FormMedical Qualification Referral SummaryReasonable Suspicion FormConditional Offer of EmploymentAll of these documents are available on the RTAP website at or may be obtained by contacting Indiana RTAP at (800) 709-9981. Contract information for the administration of this program is as follows: Vicky Warner RTAP ManagerIndiana RTAP Program 2615 Eastwood Dr. Columbus, IN 47203. Phone: (812)-314-2946Fax: (812)-314-2924Email: vwarner@Todd Jennings Program Manager Indiana Department of Transportation 100 North Senate Ave.Indianapolis, IN 46204Phone: (317)232-1483Email: Tjennings@indot.Start-up ChecklistObtain program documents and forms to review and implement (recommendations are welcome)Establish location where physicals will be performedIdentify staff who will be performing physicals and ensure program protocols are in place (system profiles)Identify prescription and over the counter review processesIdentify the Medical Determination Officer (MDO) and/or protocols for coordinating with the programs MDO. Identify effective scheduling methods Identify record keeping procedures to ensure follow-up with applicable operators who do not meet the full two year qualification.Develop cost structure for services to be providedDevelop contract terms that include program requirement (sample contract available)Contact each transit systems with required information (location, hours, etc.)Perform physicals and medication review in accordance with Indiana MQ requirementsProvide written report within 24 hours of serviceSchedule and conduct follow-up evaluations as identifiedIndiana Public Transportation Providers (phone numbers provided upon service agreement)?Indiana Public Transit SystemsGranteeSystemAddressCity/StateZipBedfordTransit Authority of Stone City1620 L. StreetBedford,IN47421Boone CountyBoone County Transit515 CrownPoint DriveLebanon, IN46052Cass CountyCass Area Transit115 S. Sixth StreetLogansport, IN46947Clinton CountySenior Resource Center401 W. WalnutFrankfort, IN46041DeKalb CountyDeKalb County Council on Aging1800 East 7th StreetAuburn, IN46706Fayette CountyFayette County Senior Center477 Grand Ave.Connersville, IN47331Franklin CountyFranklin County Public Transportation11146 County Park RoadBrookville, IN47012Fulton CountyFulton County Council on Aging625 Pontiac StreetRochester, IN46975Hendricks Co. Sycamore Services, Inc.1001 Sycamore LaneDanville, IN46122Hamilton CountyJanus Developmental Service Inc.1555 Westfield RoadNoblesville, IN46060Hancock CountyHancock County Senior Services, Inc.312 E. Main Street, Suite AGreenfield, IN46140Harrison County Blue River ServicesP.O. Box 547Corydon, IN47112HuntingburgHuntingburg Transit System508 East Fourth StreetHuntingburg, IN47542Huntington CountyHuntington Area Transportation354 N. Jefferson StreetHuntington, IN46750Jay-Randolph-Del.LifeStream Services, Inc.1701 Pilgrim Blvd. P.O. Box 308Yorktown, IN47396Johnson CountyACCESS Johnson CountyP.O. Box 216Franklin, IN46131KIRPCArrowhead County Public Trans.115 E. 4th St., P.O. Box 127Monon, IN47959Knox CountyVincennes Van Go2009 Prospect Ave.Vincennes, IN47591Kosciusko Co.Kosciusko Area Bus Service1804 East Winona AvenueWarsaw, IN46580LaGrange CountyLaGrange County Council on AgingP.O. Box 107LaGrange, IN46761Madison CountyTransp. for Rural Areas of Madison Co.16 East Ninth StreetAnderson, IN46016MarionMarion Transportation System520 E. 6th StreetMarion, IN46952Marshall CountyRock City Rider1305 W. HarrisonPlymouth, IN46563Miami CountyMiami Co. YMCASixth & Wabash StreetPeru, IN46970MitchellMitchell Transit System407 South 6th StreetMitchell, IN47446Monroe CountyRural Transit630 W. Edgewood DriveEllettsville, IN47429New CastleNew Castle Community Transit System201 South 25th StreetNew Castle, IN47362Newton CountyNewton County Council on Aging106 E. State St., P.O. Box 140Morocco, IN47963Noble CountyNoble County Council on Aging111 Cedar StreetKendallville, IN46755Orange CountyOrange County Transit ServiceP.O. Box 267Paoli, IN47454RichmondRose View Transit & Paratransit System401 South "Q" StreetRichmond, IN47374Rush CountyRush County Senior Citizens Services504 W. 3rd StreetRushville, IN46173SeymourSeymour Transit301-309 North Chestnut StreetSeymour, IN47274SIDCFour River Resource ServiceP.O. Box 367Washington, IN47501SIRPCSoutheast Indiana Regional Planning Com.13091 Benedict DriveDillsboro, IN47018Steuben CountySteuben County Council on Aging317 W. Wayne St., Suite 1BAngola, IN46703Union CountyUnion County Transit ServiceP.O. Box 333Liberty, IN47353Wabash CountyWabash County TransitP.O. Box 447Wabash, IN46992WashingtonWashington Transit System101 NE 3rd StreetWashington, IN47501WavelandWaveland Volunteer Transportation Prog.660 N. 36th St., P.O. Box 4727Lafayette, IN47903WCIEDD - VigoWCIEDD1718 Wabash Ave.Terre Haute, IN47808Wells CountyWells County Council on Aging255 W. Water StreetBluffton, IN46714White CountyWhite County Council on AgingP.O. Box 421Monticello, IN47960Whitley CountyWhitley County Council on Aging603 W. Van BurenColumbia City, IN46725 ................
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