The complete 3rd Class Medical Reform law text.

[cnoe]

SEC. 2307. MEDICAL CERTIFICATION OF CERTAIN SMALL AIRCRAFT PILOTS.

(a) In General.—Not later than 180 days after the date of enactment of this Act, the Administrator of the Federal Aviation Administration shall issue or revise regulations to ensure that an individual may operate as pilot in command of a covered aircraft if—

(1) the individual possesses a valid driver's license issued by a State, territory, or possession of the United States and complies with all medical requirements or restrictions associated with that license;

(2) the individual holds a medical certificate issued by the Federal Aviation Administration on the date of enactment of this Act, held such a certificate at any point during the 10-year period preceding such date of enactment, or obtains such a certificate after such date of enactment;

(3) the most recent medical certificate issued by the Federal Aviation Administration to the individual—

(A) indicates whether the certificate is first, second, or third class;

(B) may include authorization for special issuance;

(C) may be expired;

(D) cannot have been revoked or suspended; and

(E) cannot have been withdrawn;

(4) the most recent application for airman medical certification submitted to the Federal Aviation Administration by the individual cannot have been completed and denied;

(5) the individual has completed a medical education course described in subsection (c) during the 24 calendar months before acting as pilot in command of a covered aircraft and demonstrates proof of completion of the course;

(6) the individual, when serving as a pilot in command, is under the care and treatment of a physician if the individual has been diagnosed with any medical condition that may impact the ability of the individual to fly;

(7) the individual has received a comprehensive medical examination from a State-licensed physician during the previous 48 months and—

(A) prior to the examination, the individual—

(i) completed the individual's section of the checklist described in subsection (b); and

(ii) provided the completed checklist to the physician performing the examination; and

(B) the physician conducted the comprehensive medical examination in accordance with the checklist described in subsection (b), checking each item specified during the examination and addressing, as medically appropriate, every medical condition listed, and any medications the individual is taking; and

(8) the individual is operating in accordance with the following conditions:

(A) The covered aircraft is carrying not more than 5 passengers.

(B) The individual is operating the covered aircraft under visual flight rules or instrument flight rules.

(C) The flight, including each portion of that flight, is not carried out—

(i) for compensation or hire, including that no passenger or property on the flight is being carried for compensation or hire;

(ii) at an altitude that is more than 18,000 feet above mean sea level;

(iii) outside the United States, unless authorized by the country in which the flight is conducted; or

(iv) at an indicated air speed exceeding 250 knots.

(b) Comprehensive Medical Examination.—

(1) IN GENERAL.—Not later than 180 days after the date of enactment of this Act, the Administrator shall develop a checklist for an individual to complete and provide to the physician performing the comprehensive medical examination required in subsection (a)(7).

(2) REQUIREMENTS.—The checklist shall contain—

(A) a section, for the individual to complete that contains—

(i) boxes 3 through 13 and boxes 16 through 19 of the Federal Aviation Administration Form 8500–8 (3–99); and

(ii) a signature line for the individual to affirm that—

(I) the answers provided by the individual on that checklist, including the individual's answers regarding medical history, are true and complete;

(II) the individual understands that he or she is prohibited under Federal Aviation Administration regulations from acting as pilot in command, or any other capacity as a required flight crew member, if he or she knows or has reason to know of any medical deficiency or medically disqualifying condition that would make the individual unable to operate the aircraft in a safe manner; and

(III) the individual is aware of the regulations pertaining to the prohibition on operations during medical deficiency and has no medically disqualifying conditions in accordance with applicable law;

(B) a section with instructions for the individual to provide the completed checklist to the physician performing the comprehensive medical examination required in subsection (a)(7); and

(C) a section, for the physician to complete, that instructs the physician—

(i) to perform a clinical examination of—

(I) head, face, neck, and scalp;

(II) nose, sinuses, mouth, and throat;

(III) ears, general (internal and external canals), and eardrums (perforation);

(IV) eyes (general), ophthalmoscopic, pupils (equality and reaction), and ocular motility (associated parallel movement, nystagmus);

(V) lungs and chest (not including breast examination);

(VI) heart (precordial activity, rhythm, sounds, and murmurs);

(VII) vascular system (pulse, amplitude, and character, and arms, legs, and others);

(VIII) abdomen and viscera (including hernia);

(IX) anus (not including digital examination);

(X) skin;

(XI) G–U system (not including pelvic examination);

(XII) upper and lower extremities (strength and range of motion);

(XIII) spine and other musculoskeletal;

(XIV) identifying body marks, scars, and tattoos (size and location);

(XV) lymphatics;

(XVI) neurologic (tendon reflexes, equilibrium, senses, cranial nerves, and coordination, etc.);

(XVII) psychiatric (appearance, behavior, mood, communication, and memory);

(XVIII) general systemic;

(XIX) hearing;

(XX) vision (distant, near, and intermediate vision, field of vision, color vision, and ocular alignment);

(XXI) blood pressure and pulse; and

(XXII) anything else the physician, in his or her medical judgment, considers necessary;

(ii) to exercise medical discretion to address, as medically appropriate, any medical conditions identified, and to exercise medical discretion in determining whether any medical tests are warranted as part of the comprehensive medical examination;

(iii) to discuss all drugs the individual reports taking (prescription and nonprescription) and their potential to interfere with the safe operation of an aircraft or motor vehicle;

(iv) to sign the checklist, stating: “I certify that I discussed all items on this checklist with the individual during my examination, discussed any medications the individual is taking that could interfere with their ability to safely operate an aircraft or motor vehicle, and performed an examination that included all of the items on this checklist. I certify that I am not aware of any medical condition that, as presently treated, could interfere with the individual's ability to safely operate an aircraft.”; and

(v) to provide the date the comprehensive medical examination was completed, and the physician's full name, address, telephone number, and State medical license number.

(3) LOGBOOK.—The completed checklist shall be retained in the individual's logbook and made available on request.

(c) Medical Education Course Requirements.—The medical education course described in this subsection shall—

(1) be available on the Internet free of charge;

(2) be developed and periodically updated in coordination with representatives of relevant nonprofit and not-for-profit general aviation stakeholder groups;

(3) educate pilots on conducting medical self-assessments;

(4) advise pilots on identifying warning signs of potential serious medical conditions;

(5) identify risk mitigation strategies for medical conditions;

(6) increase awareness of the impacts of potentially impairing over-the-counter and prescription drug medications;

(7) encourage regular medical examinations and consultations with primary care physicians;

(8) inform pilots of the regulations pertaining to the prohibition on operations during medical deficiency and medically disqualifying conditions;

(9) provide the checklist developed by the Federal Aviation Administration in accordance with subsection (b); and

(10) upon successful completion of the course, electronically provide to the individual and transmit to the Federal Aviation Administration—

(A) a certification of completion of the medical education course, which shall be printed and retained in the individual's logbook and made available upon request, and shall contain the individual's name, address, and airman certificate number;

(B) subject to subsection (d), a release authorizing the National Driver Register through a designated State Department of Motor Vehicles to furnish to the Federal Aviation Administration information pertaining to the individual's driving record;

(C) a certification by the individual that the individual is under the care and treatment of a physician if the individual has been diagnosed with any medical condition that may impact the ability of the individual to fly, as required under subsection (a)(6);

(D) a form that includes—

(i) the name, address, telephone number, and airman certificate number of the individual;

(ii) the name, address, telephone number, and State medical license number of the physician performing the comprehensive medical examination required in subsection (a)(7);

(iii) the date of the comprehensive medical examination required in subsection (a)(7); and

(iv) a certification by the individual that the checklist described in subsection (b) was followed and signed by the physician in the comprehensive medical examination required in subsection (a)(7); and

(E) a statement, which shall be printed, and signed by the individual certifying that the individual understands the existing prohibition on operations during medical deficiency by stating: “I understand that I cannot act as pilot in command, or any other capacity as a required flight crew member, if I know or have reason to know of any medical condition that would make me unable to operate the aircraft in a safe manner.”.

(d) National Driver Register.—The authorization under subsection (c)(10)(B) shall be an authorization for a single access to the information contained in the National Driver Register.

(e) Special Issuance Process.—

(1) IN GENERAL.—An individual who has qualified for the third-class medical certificate exemption under subsection (a) and is seeking to serve as a pilot in command of a covered aircraft shall be required to have completed the process for obtaining an Authorization for Special Issuance of a Medical Certificate for each of the following:

(A) A mental health disorder, limited to an established medical history or clinical diagnosis of—

(i) personality disorder that is severe enough to have repeatedly manifested itself by overt acts;

(ii) psychosis, defined as a case in which an individual—

(I) has manifested delusions, hallucinations, grossly bizarre or disorganized behavior, or other commonly accepted symptoms of psychosis; or

(II) may reasonably be expected to manifest delusions, hallucinations, grossly bizarre or disorganized behavior, or other commonly accepted symptoms of psychosis;

(iii) bipolar disorder; or

(iv) substance dependence within the previous 2 years, as defined in section 67.307(a)(4) of title 14, Code of Federal Regulations.

(B) A neurological disorder, limited to an established medical history or clinical diagnosis of any of the following:

(i) Epilepsy.

(ii) Disturbance of consciousness without satisfactory medical explanation of the cause.

(iii) A transient loss of control of nervous system functions without satisfactory medical explanation of the cause.

(C) A cardiovascular condition, limited to a one-time special issuance for each diagnosis of the following:

(i) Myocardial infraction.

(ii) Coronary heart disease that has required treatment.

(iii) Cardiac valve replacement.

(iv) Heart replacement.

(2) SPECIAL RULE FOR CARDIOVASCULAR CONDITIONS.—In the case of an individual with a cardiovascular condition, the process for obtaining an Authorization for Special Issuance of a Medical Certificate shall be satisfied with the successful completion of an appropriate clinical evaluation without a mandatory wait period.

(3) SPECIAL RULE FOR MENTAL HEALTH CONDITIONS.—

(A) IN GENERAL.—In the case of an individual with a clinically diagnosed mental health condition, the third-class medical certificate exemption under subsection (a) shall not apply if—

(i) in the judgment of the individual's State-licensed medical specialist, the condition—

(I) renders the individual unable to safely perform the duties or exercise the airman privileges described in subsection (a)(8); or

(II) may reasonably be expected to make the individual unable to perform the duties or exercise the privileges described in subsection (a)(8); or

(ii) the individual's driver's license is revoked by the issuing agency as a result of a clinically diagnosed mental health condition.

(B) CERTIFICATION.—Subject to subparagraph (A), an individual clinically diagnosed with a mental health condition shall certify every 2 years, in conjunction with the certification under subsection (c)(10)(C), that the individual is under the care of a State-licensed medical specialist for that mental health condition.

(4) SPECIAL RULE FOR NEUROLOGICAL CONDITIONS.—

(A) IN GENERAL.—In the case of an individual with a clinically diagnosed neurological condition, the third-class medical certificate exemption under subsection (a) shall not apply if—

(i) in the judgment of the individual's State-licensed medical specialist, the condition—

(I) renders the individual unable to safely perform the duties or exercise the airman privileges described in subsection (a)(8); or

(II) may reasonably be expected to make the individual unable to perform the duties or exercise the privileges described in subsection (a)(8); or

(ii) the individual's driver's license is revoked by the issuing agency as a result of a clinically diagnosed neurological condition.

(B) CERTIFICATION.—Subject to subparagraph (A), an individual clinically diagnosed with a neurological condition shall certify every 2 years, in conjunction with the certification under subsection (c)(10)(C), that the individual is under the care of a State-licensed medical specialist for that neurological condition.

(f) Identification Of Additional Medical Conditions For CACI Program.—

(1) IN GENERAL.—Not later than 180 days after the date of enactment of this Act, the Administrator shall review and identify additional medical conditions that could be added to the program known as the Conditions AMEs Can Issue (CACI) program.

(2) CONSULTATIONS.—In carrying out paragraph (1), the Administrator shall consult with aviation, medical, and union stakeholders.

(3) REPORT REQUIRED.—Not later than 180 days after the date of enactment of this Act, the Administrator shall submit to the appropriate committees of Congress a report listing the medical conditions that have been added to the CACI program under paragraph (1).

(g) Expedited Authorization For Special Issuance Of A Medical Certificate.—

(1) IN GENERAL.—The Administrator shall implement procedures to expedite the process for obtaining an Authorization for Special Issuance of a Medical Certificate under section 67.401 of title 14, Code of Federal Regulations.

(2) CONSULTATIONS.—In carrying out paragraph (1), the Administrator shall consult with aviation, medical, and union stakeholders.

(3) REPORT REQUIRED.—Not later than 1 year after the date of enactment of this Act, the Administrator shall submit to the appropriate committees of Congress a report describing how the procedures implemented under paragraph (1) will streamline the process for obtaining an Authorization for Special Issuance of a Medical Certificate and reduce the amount of time needed to review and decide special issuance cases.

(h) Report Required.—Not later than 5 years after the date of enactment of this Act, the Administrator, in coordination with the National Transportation Safety Board, shall submit to the appropriate committees of Congress a report that describes the effect of the regulations issued or revised under subsection (a) and includes statistics with respect to changes in small aircraft activity and safety incidents.

(i) Prohibition On Enforcement Actions.—Beginning on the date that is 1 year after the date of enactment of this Act, the Administrator may not take an enforcement action for not holding a valid third-class medical certificate against a pilot of a covered aircraft for a flight if the pilot and the flight meet, through a good faith effort, the applicable requirements under subsection (a), except paragraph (5) of that subsection, unless the Administrator has published final regulations in the Federal Register under that subsection.

(j) Covered Aircraft Defined.—In this section, the term “covered aircraft” means an aircraft that—

(1) is authorized under Federal law to carry not more than 6 occupants; and

(2) has a maximum certificated takeoff weight of not more than 6,000 pounds.

(k) Operations Covered.—The provisions and requirements covered in this section do not apply to pilots who elect to operate under the medical requirements under subsection (b) or subsection (c) of section 61.23 of title 14, Code of Federal Regulations.

(l) Authority To Require Additional Information.—

(1) IN GENERAL.—If the Administrator receives credible or urgent information, including from the National Driver Register or the Administrator's Safety Hotline, that reflects on an individual's ability to safely operate a covered aircraft under the third-class medical certificate exemption in subsection (a), the Administrator may require the individual to provide additional information or history so that the Administrator may determine whether the individual is safe to continue operating a covered aircraft.

(2) USE OF INFORMATION.—The Administrator may use credible or urgent information received under paragraph (1) to request an individual to provide additional information or to take actions under section 44709(b) of title 49, United States Code.

[ArtVandelay]

I read through this, I'm not a lawyer, but I don't see where it says someone with a special issuance cannot use this, as was discussed in another thread?

[M20S Driver]

47 minutes ago, teejayevans said:

I read through this, I'm not a lawyer, but I don't see where it says someone with a special issuance cannot use this, as was discussed in another thread?

I was looking for the same info.  My understanding is that if you have or had a valid special issuance in the past 10 years, you qualify.  if it was revoked, then it does not qualify you. This was covered in AOPA's QA section.

[DXB]

I initially thought the final bill was incredibly stupid, but I've given it some thought and changed my mind.  Doing away with the 3rd class medical charade altogether would have made more sense, but this is progress.

As an MD, I think the detailed exam that physicians are asked to sign off in the new language is ridiculous.  A meaningful ophthalmoscopic or otoscopic exam from a non-specialist? Yeah right. GU exam??  Anal exam?? "So doc...what exactly are you looking for on my anus that might suddenly incapacitate me while operating an aircraft?"   Some primary MDs will cringe at this form and but sign it off anyway, assuming it's for an established patient with whom they have a good rapport. At the low end of medicine, some will make a side business of signing these off for a few hundred bucks a pop with minimal effort spent. If you really have a serious problem that would have legitimately kept you from getting a medical, you will now be able to find someone to sign off if you search hard enough (kinda like narcotic scripts).  But I think there are a tiny number of people with truly relevant medical problems who are itching to fly, and these people are likely undeterred by not having a medical under the old or new system. 

The bottom line is that, if you are one of the folks who gets pointlessly tortured for 3rd class renewals (for instance Mr. Ropers below), the new system does provide real relief, and so I applaud AOPA.  For the rest of us, it goes from a predictable, structured inconvenience with your AME every two years to a less structured imposition on an MD of some kind every 4 years.  Note any licensed physician can sign it off.  For friends I know to be of generally sound physical and mental health, I'd be willing to do it as a favor...even without actually satisfying the mandate to look up their butts (don't tell the FAA ).

 

[flyboy0681]

I'm not so sure of this provision, which your doctor must examine:  (IX) anus (not including digital examination);

[DXB]

1 hour ago, flyboy0681 said:

I'm not so sure of this provision, which your doctor must examine:  (IX) anus (not including digital examination);

Hidden line items will get you every time.  It should have more accurately been called the "2016 FAA Budget Extension and Universal Pilot Anal Exam Act."  

[Piloto]

2 hours ago, flyboy0681 said:

I'm not so sure of this provision, which your doctor must examine:  (IX) anus (not including digital examination);

I think this is more related to an hemorrhoids condition. Since your a seated when flying an hemorrhoids condition can be painful during turbulence. You can check yourself when bathing for it. I had mine removed when I was 25. Never came back. The surgery is quick but the recovery pain and bleeding last for about a week.

José

[sleepingsquirrel]

The Anus is the pilots most important indicator of safe operations! Just do something remotely stupid in an airplane and see what happens to it. 
It sometimes is the best indicator of something bad about to happen if a pilot just learns to recognize it.

Many seat covers have been replaced because of its ability to chew a hole or let loose.

[flyboy0681]

58 minutes ago, Piloto said:

I think this is more related to an hemorrhoids condition. Since your a seated when flying an hemorrhoids condition can be painful during turbulence. You can check yourself when bathing for it. I had mine removed when I was 25. Never came back. The surgery is quick but the recovery pain and bleeding last for about a week.

José

José, do the letters TMI mean anything to you?

[Jeff_S]

I find it incredibly entertaining that we all zoomed in on the anal check up. I was going to say something funny but y'all beat me to the punch.

One thing I noted, though, is the act only gives the FAA 180 days to get the process defined. I thought the FAQs said they had a full year. Did I read that wrong?

[Piloto]

19 minutes ago, flyboy0681 said:

José, do the letters TMI mean anything to you?

If you suffer from TMI (Too Much Incontinence) there are plenty of products in the market.

[Hank]

48 minutes ago, Jeff_S said:

I find it incredibly entertaining that we all zoomed in on the anal check up. I was going to say something funny but y'all beat me to the punch.

One thing I noted, though, is the act only gives the FAA 180 days to get the process defined. I thought the FAQs said they had a full year. Did I read that wrong?

The Feds have 180 days to write the regs. But they have a history of missing deadlines, so the Bill was written that after one year, if the new regs aren't issued yet, we can fly under the Law as written and passed, and the Feds cannot take action against anyone for doing so. The old Medical regs are supposed to go away in 180 days; if they don't, they effectively disappear after a year while waiting on the new regs to appear. What will the new regs say? That's anyone's guess, but the Bill tells them what it must contain. I think if they try to go overboard, they will get reined in. Time will tell . . . . . . .

[carusoam]

Would the Feds be writing the rules themselves, or will they be hiring knowledgable people like AOPA, NBAA, and EAA to do that for them as a contracted project?

it probably takes a hundred experienced people to get this done in two years.  Probably not linear math to get it done in less than that....

Who is writing the part 23 update?

Thinking out loud,

-a-

 

[201er]

Wait, so basically now instead of getting a 3rd class medical every 5 years, I have to get an anal probe every 4 years and take online classes every 2? How is this an advantage to everyone who doesn't have medical difficulties? 

[Hank]

3 minutes ago, 201er said:

Wait, so basically now instead of getting a 3rd class medical every 5 years, I have to get an anal probe every 4 years and take online classes every 2? How is this an advantage to everyone who doesn't have medical difficulties? 

Once you hit age 40, the "every five years" bit becomes "every two years" anyway. So you really aren't losing much now, but are gaining much later. Besides, the whole anus thing specifically says "without digital examination," which is a reference to the doc pushing a digit into the anus [digit = Latin for finger], not anything to do with electrons and color monitors instead of wiggly needle-thingys.

Not quite what we were hoping for, but still an improvement. Huge? You be the judge. Those with an SI, especially those whom the FAA requires repetitive, medically-unnecessary testing per their own doctors, will certainly think so.

[1964-M20E]

I would have preferred a much simpler version but lever it to the politicians to make things more complicated than they need to be.

However,  maybe someone can back me up on this but it appears that if the FAA drags their feet on the specific regulations like they normally do we end up with the basic law above with no additional 3rd class medical regulations.  It may be the way to go so that the FAA doesn't introduce more useless regulations.

[Marauder]

Wait, so basically now instead of getting a 3rd class medical every 5 years, I have to get an anal probe every 4 years and take online classes every 2? How is this an advantage to everyone who doesn't have medical difficulties? 

Mike -- think of it this way, you are taking one up the anus for the rest of us who have been getting it up the anus for years.

One day you will look back at this and be happy about this change. It ain't perfect but it sure beats the current process.

Sent from my iPad using Tapatalk

[flyboy0681]

10 hours ago, Hank said:

Besides, the whole anus thing specifically says "without digital examination," which is a reference to the doc pushing a digit into the anus [digit = Latin for finger], not anything to do with electrons and color monitors instead of wiggly needle-thingys.

 

FWIW, the all important prostate check can only be done one way...

[TWinter]

For us older farts it will be a pleasure not having to go every two years. If you maintain any level of good health it is more a feeling of just something I don't have to work into my schedule every two years and the worries of " what if ".

My personal example is I get the "White Coat Syndrome". I am fairly healthy and try to exercise and eat sensible. However, even though I try to stay healthy and have never needed to go to a doctor or a hospital visit for anything other than requirements for job physicals, insurance physicals when I was younger and now my FAA exams. I will go occasionally for a spring time visit to a nurse practitioner for a spring allergy shot (not always necessary, but get one to just help the watery eyes and occasional sneeze feeling to help when everything is blooming or I mow..never happened when I lived on the coast, just since I've lived in the middle of farm country).

I'm a creature of habit and don't like change or evasion of my private space. When I go for ANY physical I get very apprehensive. My blood pressure elevates, my pulse quickens etc. When I am at home and check BP and pulse everything is very normal. My other half is a Respiratory Therapist so I know the readings are accurate. I've even been known to bring a BP log with me for my FAA physicals to prove what my BP and pulse normally run. I always passed with my FAA doctor, but I always get nervious and think what if he is not happy with that BP and I'm over stressed that day and over the FAA limit on this particular visit? I'm always very close. My flying could end, have to sell my plane..OMG, the pressure!!

Some will say, why not BP meds. To me BP pills are just a temporary relief and only fool the BP cuff. Why take a pill when my normal BP and pulse are very good. If I can I'd rather maintain it with exercise and diet..so far so good, except when that white coat comes in the office. I think I'm healthy and feel good. Put a white doctors coat and stethoscope on and watch out.

It's also nice now knowing I have a choice of who I want to sign-off on off on it. I will probably continue to go to my current MD that has done my FAA physicals, but choices are good. It's good to know that of the several doctors that are friends of mine and were not FAA docs I now have the option to get the physical with someone I know. It wilI certainly make me feel less stressed, result BP and pulse closer to normal .I think the fear that some have expressed of some doctors not wanting to take on the liability of signing off has been over-concern. 

If all continues and my health maintains I figure only have to endure 11 more physicals if I am able to fly until I reach 100 yrs old.   I can handle that!!

Good job AOPA!

Just my .02 and past experience..

-Tom

 

[Hank]

37 minutes ago, flyboy0681 said:

FWIW, the all important prostate check can only be done one way...

True, but our "mediCal exams" don't require investigating our prostates, only a visual anus inspection. Poor doctors. . . .  

[amillet]

I no longer have a prostate (radical prostatectomy in 1999). For some reason my GP insists on performing the digital exam anyway.  I accuse him of being deviant.

[flyboy0681]

40 minutes ago, TWinter said:

For us older farts it will be a pleasure not having to go every two years.

Imagine how ATP's feel, having to go every six months!

[Guitarmaster]

40 minutes ago, TWinter said: For us older farts it will be a pleasure not having to go every two years.

Imagine how ATP's feel, having to go every six months!

Yep. An EKG every 6 months as well. Just doing my part to keep the skies safe! You're welcome.

[Marauder]

40 minutes ago, TWinter said: For us older farts it will be a pleasure not having to go every two years.

Imagine how ATP's feel, having to go every six months!

How do you know they don't enjoy it?

Sent from my iPad using Tapatalk

[Piloto]

I am kind lost on all this. Isn't the anus connected to the rectum and not the prostate? Isn't the prostate status determined by a PSA test? At medical school how they train the finger to know what they are touching. Do they get a bunch of old guys with prostate problems and penetrate them to train the finger. Watch out here comes the Harvard med kids to check you out. Why can't they use an ultrasound analyzer?

José