July 19, 2007 Draft 3
The Astronaut Health Care System Review Committee was formed after NASA Administrator Michael Griffin directed the agency's Chief Health and Medical Officer, Dr. Richard Williams, in a February 7, 2007, memo to conduct a review of the medical and mental health services available to NASA astronauts at the Johnson Space Center. Eight committee members were selected from a pool of nominees provided by the senior medical officers of other federal agencies. The committee was chaired by Air Force Col. Richard Bachmann, commander of the U.S. Air Force School of Aerospace Medicine.
NASA is grateful to the review committee for the considerable time and effort it spent developing the report. There are many thoughtful recommendations included in the report. NASA takes these recommendations very seriously. They will be carefully studied and evaluated by NASA's senior management and by the NASA Medical Policy Board. This review was one of two studies begun in the wake of former astronaut Lisa Nowak's arrest. The other was an internal Johnson Space Center assessment of health practices, including behavioral health, for the astronaut corps. The reviews are being released concurrently.
1. Review committee recommendations already being adopted:
2. The Next Steps: Some of the findings in the report, including those related to "heavy use of alcohol by astronauts in the immediate preflight period," will require additional review by NASA. The committee did not provide NASA with specific details of the alleged incidents. As a result, NASA must independently determine the facts of the reported incidents.
3. Alcohol Use and Space Flight: NASA has an alcohol use policy for agency aircraft flight that historically has been applied to space flight. As a result of the report, NASA has adopted an interim space flight alcohol use policy based on the agency's T-38 aircraft policy. This interim policy prohibits alcohol consumption within the12 hours prior to flight and astronauts will neither be under the influence nor the effects of alcohol at the time of launch. All astronauts will be educated on the policy. NASA will undertake a comprehensive review of alcohol use policies relating to aircraft use and space flight. NASA officials will be investigating the allegations of alcohol use by astronauts in the immediate pre-flight period.
4. Fear of Retaliation: Administrator Griffin and NASA senior leaders believe they have an affirmative obligation to encourage all employees to bring safety issues of any type up the chain of command, and to protect those employees from retaliation. NASA employees have the option of anonymously reporting safety issues if they have concerns. The goal is to guarantee that all potential issues will be given serious consideration and that retaliation will be prevented or deterred.
5. Culture Change Progress: Dissenting opinions freely expressed and seriously considered in the space shuttle program's Flight Readiness Review during the past two years seem to be tangible evidence of cultural change at NASA. The administrator and deputy administrator have reaffirmed that the willingness, freedom and responsibility to bring safety issues to the attention of NASA management, free of retaliation, also extends to the astronaut corps, flight medicine, and life sciences.
6. Performance Reviews: The committee received reports that "required supervisory evaluations and performance appraisals for astronauts were often not done for years and, when done, were often perfunctory and did not satisfy the intent, particularly with respect to evaluative and mentoring opportunities." The report also suggests that astronauts may be seeking performance feedback beyond the current annual review processes. While procedures are, in fact, in place for regular performance appraisals, the concerns of the committee regarding how effectively these procedures are carried out will be thoroughly reviewed by NASA management.
7. Code of Conduct: The report recommends NASA establish an astronaut code of conduct. NASA will implement the recommendation.
8. Behavioral Health Evaluations for all Astronauts: NASA medical and behavioral health experts have recommended that behavioral health assessments be conducted for all astronauts in conjunction with annual flight physicals. NASA medical authorities will implement annual behavioral health evaluations for all astronauts eligible for flight assignment.
9. Astronaut Health Care: NASA's goal for the future is to provide the best possible health care for our astronauts. We asked this committee to review our procedures in the aftermath of the Lisa Nowak arrest as part of an effort to improve astronaut health care. The committee report will help us do just that.
10. Mitigating the Risk: The report notes that "initial screening and recurrent psychological evaluation are not intended to, nor can they, predict a disorder of conduct or 'act of passion.' However, they can identify persons at increased risk, allowing proactive interventions which may mitigate the risk." NASA shares this view.