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NPR 7120.11A
Effective Date: September 08, 2020
Expiration Date: September 08, 2025
Printable Format (PDF)

Subject: NASA Health and Medical Technical Authority (HMTA) Implementation

Responsible Office: Office of the Chief Health & Medical Officer

| TOC | Preface | Chapter1 | Chapter2 | Chapter3 | Chapter4 | Chapter5 | AppendixA | AppendixB | AppendixC | ALL |

Chapter 3. HMTA Execution

3.1 HMTA Scope of Delegated Authority

3.1.1 The HMTA, in order to support NASA's Institutional Authority principles of independent oversight of programs and projects, delegates specific levels of decisional authority to selected individuals. All delegations are formal and traceable to the Administrator. 3.1.2 The HMTA delegated authority is comprised of: a. Level 1 (L1) - CHMO and office. b. Level 2 (L2) - Designated NASA LHIC CMO and office.

3.2 Lead HMTA Integration Centers (LHIC)

3.2.1 In order to properly align with and leverage technical resources, the HMTA is organized to take advantage of LHICs. Under such designation, the LHIC CMO serves as the HMTA L2 Decisional Authority. The LHIC CMO ensures HMTA personnel have access to qualified human system discipline expertise needed for the formulation of HMTA program and project positions, issue resolution, and adjudication of requests from relief from HMTA standards or program or project level requirements of the designated area. 3.2.2 This cross-Center collaboration promotes effective utilization of Agency expertise, avoiding duplication of resources or decisional venues used for the formulation of HMTA program and project positions, issue resolution, or adjudication of requests for relief. The NASA Centers with LHIC responsibilities, as designated by the CHMO, are: a. The Johnson Space Center for Human Space Flight activities. b. The Armstrong Flight Research Center for Aeronautics activities. c. The NASA Headquarters for all activities not delegated to individual Centers.

3.3 HMTA Delegations and Paths of Delegated Authority

3.3.1 The endpoints associated with the activities of HMTA in programs and projects are the provision for the direct management of the health and performance of flight crews in operations, and the protection of human health through the application of task-based performance standards in the integration and processing of flight vehicles. Through support for the practice of medicine, the CHMO delegates TA directly to Center CMOs as decisional integrators. Below these Center CMO's, then functions the HMTA CHPO's, who are not necessarily physicians, and serve as the direct working interface to NASA's programs and projects. This flow between physicians from L1 to L2 in HMTA is in deference to the fact that while the HMTA content is not in total medical content, there is significant direct medical practice content present in the HMTA scope, which requires decisional flow from physician to physician (See Figure 3).

Figure 3 shows the HMTA Delegations and Scope of Authority
Figure 3. HMTA Delegations and Scope of Authority

3.3.2 The LHIC CMO, as delegated from the CHMO, shall make decisions that they determine to be risk-neutral or reduce overall risk.

3.3.3 The LHIC CMO shall develop and document a Risk-Based Decision-Making process for the management of HMTA issues for programs and projects under the designated area.

3.3.4 Prior to providing programs and/or projects with an HMTA decision on positions, issue resolution, and requests from relief deemed either risk-neutral or a reduction in risk, the LHIC CMO shall inform the CHMO or their designee. This "decide and inform" philosophy is vital for an effective implementation of the HMTA.

3.3.5 For issues representing an increase in risk posture as indicated by a change in their likelihood and consequences, the LHIC CMO shall investigate, evaluate, and make a recommendation to the CHMO for decision.

3.3.6 The CHPO has authority to make decisions within the scope delegated by the LHIC CMO, according to their respective HMTA Implementation Plan. Subsequent to providing programs and/or projects with HMTA decisions, CHPOs shall inform LHIC CMO, as part of the HMTA "decide and inform" philosophy.

3.4 HMTA Implementation Plans

3.4.1 The HMTA is implemented through the application of resources and processes documented in this directive and Center HMTA Implementation Plans. Center HMTA Implementation Plans describe the effective execution of HMTA at each Center with required organizational and funding separation from programs and projects. Centers shall develop their respective HMTA Implementation Plans and obtain concurrence from the CHMO.

3.4.2 The CMO shall include the following content in their respective HMTA Implementation Plan:

a. Description of organizational structure and staffing of program and project support.

b. Description of the level of delegation of HMTA to the CMO.

c. Responsibilities and scope of delegated authority of CHPOs and other interfaces with programs or projects.

d. Description of processes for requirements management and adjudication of requests for relief.

e. Description of processes for management of formal dissents.

f. Personnel training plan.

g. If, at a designated LHIC, description of a Risk-Based Decision-Making process for management of HMTA issues.

| TOC | Preface | Chapter1 | Chapter2 | Chapter3 | Chapter4 | Chapter5 | AppendixA | AppendixB | AppendixC | ALL |
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