a. The immediate and long-term responsibilities of NASA with regard to the human space flight program require that the Agency provide medical and dental care, observation, and study to astronauts, payload specialists, and other space flight participants while on active duty with NASA. This care, observation (to include health monitoring) and study will be provided, utilizing the best current guidelines for the clinical practice of medicine and dentistry, and will be comprehensive in scope as applicable to the NASA mission. It will encompass all aspects related to the mission, including certification and training, and will include all space flight mission phases (pre-, in-, and postflight). It will also provide a program of longitudinal health study, including current and retired astronauts, payload specialists, and other space flight participants.

b. The health of family members of those crewmembers who remain eligible for space flight assignment is of critical importance, and factors such as infectious disease, and stress affecting a crewmember's family may have serious adverse effects on the crewmember's health and performance, as well as the health and performance of other crewmembers. Limited outpatient medical and dental care will be provided by onsite flight medicine clinics to the crewmember's immediate family, as long as the crewmember is eligible for assignment to a space flight mission.

c. Medical and dental insurance is available for current or active duty U.S. astronauts, payload specialists, and other space flight participants. NASA will pay for health care costs of crewmembers eligible for space flight assignment not covered under the individual's insurance plan when the individual is referred by a NASA medical or dental officer, and the referral is required for space flight eligibility.

d. Subject to agreements between NASA and the International Partners, NASA will provide astronauts and payload specialists from the international community, while they are on active duty and eligible for space flight assignment in the United States, the same level of medical care, observation, and study provided to the U.S. astronauts and payload specialists.

e. Astronauts, payload specialists, and other space flight participants may voluntarily participate as subjects in biomedical research during space flight missions, provided their participation is supervised by a NASA physician and the research complies with and is in accordance with NPD 7100.8D, Protection of Human Research Subjects. All human experimental and research data records and all health information management system records compiled, pursuant to this NPD, are subject to the Privacy Act of 1974, as amended.

f. On behalf of NASA crewmembers who die in the line of duty, the Agency shall offer their spouses who remain unmarried, and their unmarried dependents under the age of 23, the option of outpatient medical and dental care on an "as available basis," at the Johnson Space Center (JSC) onsite flight medical clinics.

(a) NPD 1440.6, NASA Records Management.

(b) NPR 1441.1, Records Retention Schedules.

(c) NPD 1800.2, NASA Occupational Health Program.

(d) NPD 7100.8, Protection of Human Research Subjects.

(e) NPD 8710.1, Emergency Preparedness Program.

(f) NPR 8715.2, NASA Emergency Preparedness Plan Procedures and Guidelines.

(g) NPR 8715.3B, General Safety Program Requirements.

(h) NPD 8900.1, Medical Operations Responsibilities for Human Space Flight Programs.

(i) NPD 8900.5A, NASA Health and Medical Policy for Human Space Exploration.

(j) 5 U.S.C. 552a, Privacy Act of 1974, as amended.

(k) 14 CFR Part 1230 and 45 CFR Part 46, Protection of Human Subjects.

a. The Chief Health and Medical Officer (CHMO) is responsible for coordination and overall monitoring of this NPD, to include conducting periodic reviews of its implementation.

b. The Associate Administrator (AA), Space Operations Mission Directorate (SOMD), is responsible for ensuring that this NPD is implemented and that necessary status reports will be provided to the CHMO and include the data in support of the metrics outlined in Section 7. Measurements, below.

c. The NASA Medical Policy Board is responsible for providing policy guidance regarding this program and for any recommendations regarding changes to this NPD to the NASA Chief Medical Officer.

d. The Director, JSC, is responsible for developing and implementing an Astronaut Medical and Dental Care, Observation, and Study Program consistent with the policies set forth in this NPD.

e. Directors of other NASA Centers and other NASA officials shall provide support to this program as required.

a. METRIC: Percent of NASA Centers responding positively to survey questions.

The CHMO shall conduct an annual survey of the health care delivery systems of each Center responsible for astronaut medical care to ascertain whether appropriate Center personnel are cognizant of this NPD and an implementation plan is in place. The higher the percentage of compliance, the greater the success of the program.

b. METRIC: Percent of active duty astronauts and payload specialists with medical and dental insurance.
The AA, SOMD, and Director, Space and Life Sciences, at JSC, shall conduct an annual survey to ascertain the medical and dental insurance status of each active duty astronaut and payload specialist. The higher the percentage of active duty astronauts and payload specialists with medical and dental insurance, the greater the program success.

c. METRIC: The number of retired astronauts who receive an annual physical examination as part of the Longitudinal Study of Astronaut Health (LSAH) Program as compared to the total number of retired astronauts available, expressed as a percentage.

The CHMO will conduct an annual assessment of the LSAH to identify percentage of retired astronauts who receive an annual physical examination as compared to the total number of retired astronauts. The higher the percentage of retired astronauts receiving an annual physical examination, the more successful the program.

d. METRIC: Percent of active duty astronauts and payload specialists receiving medical care as a result of risks or errors or any other disability resulting from the performance of duty.

The CHMO will conduct an annual assessment of the LSAH to identify the percentage of space flight crewmembers receiving medical care as a result of risks, errors, or any other disability resulting from performance of duty. The lower the percentage of astronauts and payload specialists receiving medical care as a result of risks, the more successful the program.