​​​​Good morning! Thank you to Daniel Baker for that kind introduction, to Michael Amalfitano for hosting, and to Pete Bunce for inviting me today. 

GAMA and its member companies are vital safety partners to the NTSB. Whether it’s through our monthly safety meetings or your participation as parties to our investigations, we really value the close relationship between our respective organizations. And I value all we’ve achieved together. 

Safety is one of those areas where there’s always more we can do…more improvements we can make to reduce risk, prevent injuries, and save lives. That’s all the more reason why we have to pause and acknowledge our progress: There were zero deaths in commercial passenger aviation in 2020. 

In fact, in seven of the last 10 years, there have been no major commercial airline passenger fatalities. The number of accidents and the number of fatalities across the aviation industry also have decreased.

Everyone here today has contributed to making this happen. So, while the NTSB and I will always push for more — because one death is too many — know that your hard work doesn’t go unnoticed. 

I say often that the other transportation modes have a lot to learn from aviation, and I mean it. Thank you — each and every single person in this room — for your safety leadership. 

I appreciate the opportunity to say a few words and have some real dialogue this morning. Here’s what I’d like to cover before we dive into conversation: My vision for the agency, how we’ll achieve it, and how NTSB is working to make that aviation safety record even better! 

I can sum up what I hope you remember about this session in two words: Mission first. In fact, that also sums up how I hope my tenure as Chair is remembered long after my term ends. Everything I’m going to share with you today — and everything I’m doing as Chair — is in service to our safety mission. 

After my nomination and before I was confirmed, I embarked on a listening tour. I engaged with a wide variety of stakeholders, including our staff in headquarters and in the regions, to get their thoughts on where we stand as agency and where they think we need to go. 

There was plenty of positive feedback. But it wasn’t all good — and that’s what I needed to hear. We can’t chart a new course if we don’t know where we’ve been or where we’re going. 

I’m here to renew our commitment to our critical safety mission, from our investigations to our advocacy to our internal processes and procedures that enable us to fulfill that mission. Everything we do — everything — every decision we make, every action we take, must support that mission well into the future.

What, exactly, does that future look like? 

I’ll give you a couple of hints. It involves implementing our safety recommendations. And it also means that NTSB is ready for the rapid changes taking place in all modes of transportation. And no mode is changing quite as fast as aviation.

NTSB is determined to keep pace. We have to in order to serve our safety mission, the public, and each of you. Part of that means keeping up with new technologies and vehicles. We recently renamed the Major Investigations Division in the Office of Aviation Safety to reflect this. The team now known as the Air Carrier and Space Investigations Division will help lead the NTSB through the rapidly changing aviation landscape and the safety challenges that come with it. 

I’ve charged this team with two things. First: Ensure that safety leads any discussion around new aviation technology. Let me be clear: NTSB loves technology! We frequently advocate for the implementation of proven technology to improve safety on our roads, railways, waterways, and skies, including space. But advancements can also come with risk. Safety must be the focus, the core of development and implementation of new technologies — not an afterthought. 

The second thing the Division is doing is ensuring we’re prepared. This includes everything from commercial space transportation, uncrewed aircraft systems, urban air mobility, battery-powered aircraft, and clean fuel sources, like hydrogen and lithium batteries.

We all know lithium batteries have been a risk in aviation when they experience thermal runaway and uncontrolled battery overheating — not to mention the difficulty putting out a lithium battery fire, which often re-ignites even after extinguished due to stranded energy. This isn’t just a concern for aircraft components in the future, but also for transporting large lithium-ion batteries that are fueling the surge in electric vehicles. 

You may have seen that NTSB is investigating a recent crash of a Joby Aviation air taxi prototype in California. The experimental air taxi was being piloted remotely when it went down during a flight at the company’s test base on Wednesday. No injuries have been reported. 

Some might question why we’re investigating technology during testing. I’m going to give you an example from another mode since the Joby investigation is open and ongoing. 

NTSB investigated the March 18, 2018, crash of an automated test vehicle that struck and fatally injured a 49-year-old pedestrian who was walking her bike across the road. Uber ATG, now known as Aurora, had installed an automated driving system that was active for about 19 minutes before the crash. 

The operator, who was supposed to be ready to take over if an error occurred, was watching a show on her phone. The vehicle hadn’t been programmed to recognize that a pedestrian could cross a road outside a sidewalk and the tech that could’ve prevented the crash — automatic emergency braking and forward collision warning — was disabled by Uber ATG. 

Uber ATG may have attributed the collision to human error and not investigated. But it’s important that we learn when these vehicles are in testing, well before they’re deployed. And Uber ATG learned quite a bit from our investigation about safety deficiencies, poor safety culture, and lack of safety risk management, something you all understand. That’s why it’s important we’re there early.

I now want to spend a few minutes on commercial space. 

Roughly three months into my tenure, NTSB initiated a rulemaking to codify our authority to investigate certain commercial space launch and reentry accidents and mishaps, clarify our investigative process to the commercial space industry, and require reporting of accidents and mishaps to our Response Operations Center.

We already have authority under current law. In fact, the NTSB has exercised that authority, both leading and supporting numerous commercial space investigations, for nearly 30 years. 

We’ve had a memorandum of understanding in place with FAA that outlines the accidents that NTSB “shall investigate” since 1975. But commercial space flight has changed since 1975, when commercial human spaceflight wasn’t even viable. 

Over the last decade, we’ve seen tremendous growth in commercial space transportation. In 2011, there was just one FAA-permitted launch and zero reentries. In 2021, there were 54 FAA-permitted launches and six reentries. We saw people pay to be transported to the edge of space. 

Now that commercial space flight is becoming more common, we need to be ready, and the industry needs to know what to expect from us and our investigations. They need to be aware of the party process. They need to know what accidents and mishaps to report and how to do that. And they deserve a public process to weigh in on our expectations. MOUs aren’t in the public eye; rulemakings are.

If implemented, the proposed rule would enhance transportation safety by enabling us to do what we’ve been doing for nearly three decades, which is to conduct safety investigations, identify necessary corrective actions, and prevent future space transportation accidents and mishaps.

In other words, the NPRM is a prime example of a “mission first” philosophy. 

I also mentioned the future we’re working towards is one where our NTSB safety recommendations are fully implemented. I want to share a few with you now.

The first is “Enhancing the Safety of Revenue Passenger Carrying Operations Conducted Under Part 91.” Some of these operations, like hot air balloon and parachute jump flights and living history flight experiences, are exempt from certain regulations. Others have exploited loopholes in the regulations. 

I was the Member on scene for the crash of a skydiving flight in Hawaii that killed eleven people. We found that the pilot’s training was lacking, and that the operator hadn’t kept the airplane in an airworthy condition; in fact, it had been repaired after a prior crash with the wrong part. We also found that there is insufficient FAA oversight of skydiving flights more generally. 

I saw this lack of federal oversight play out again following the crash of a World War II-era B-17 at Bradley International Airport in Connecticut. We determined that the operator’s ineffective SMS, and the FAA’s lack of oversight, contributed to the accident, which killed seven people and seriously injured five others. 

We put out a report in March 2021 calling on the FAA to:

• ​Develop national safety standards or equivalent regulations for specific revenue passenger-carrying operations.
• Identify shortcomings in current regulations allowing some operators to exploit loopholes to avoid stricter oversight. 
• Require SMS for all revenue passenger-carrying operations currently conducted under Part 91. That one remains on our Most Wanted List, along with SMS for Part 135.
  

Speaking of SMS, we recommended for the first time in a recent Board meeting that the FAA and the European Union Aviation Safety Agency require organizations that design, manufacture, and maintain aircraft to establish a safety management system. 

The second safety issue I want to talk about is also on our Most Wanted List: “Install Crash-Resistant Recorders and Establish Flight Data Monitoring Programs.” 

Since 1999, the NTSB has issued one recommendation after another to the FAA about the need to require crash-resistant image and voice records on new and existing aircraft. Nearly 25 years! And for good reason: 86% of the crashes we investigate have no recording equipment installed.

A few weeks ago, I posted a safety blog on the third anniversary of an air ambulance crash in Zaleski, Ohio. The crash occurred in deteriorating weather while Survival Flight was enroute to pick up a patient for transport from one hospital to another. It’s worth noting that other operators had refused the flight given the weather conditions. All three occupants — the pilot, flight nurse, and flight paramedic — were killed in the crash. 

We found that, because the helicopter was not equipped with a video recorder, flight data recorder, or cockpit voice recorder, the accident pilot’s control inputs during the final two minutes are unknown. And, because of the lack of a video recorder, we also couldn’t conclusively determine the specific weather conditions encountered.

That crash occurred on January 29, 2019. 

Almost a year to the day, I was on scene for another helicopter crash in Calabasas, California. This one was regulated under part 135; the pilot and eight passengers, including three teens, died.

There wasn’t a flight recorder on the helicopter. We don’t know where the pilot’s attention was focused. We’ll never know what we don’t know about the safety issues on that flight…or the safety recommendations we could’ve issued to prevent a similar accident from re-occurring. 

By the way, we’ve also recommended that recorders be considered essential equipment that remains installed for the life of the helicopter so they can’t be removed, as it was in this helicopter when it was reconfigured after Island Helicopters purchased it from the State of Illinois.

The FAA, however, maintains that it’s unable to create a cost-benefit analysis for such a mandate that would satisfy OMB. The cost of a life right now, per the federal government, is $11.6 million. But speaking as the mom of a 14-year-old: her life is priceless.

Now, you might be thinking recorders are only important for investigations. They’re not. Recorders are also important for safety. 

On December 18, 2017, an Amtrak train derailed on the inaugural run of a new route in DuPont, Washington. As a result, three people were killed; 57 people on the train and eight people on the highway were injured. 

Not only was it a new route, but it was also a new locomotive. Fortunately, the cab was equipped with an inward-facing camera that provided our investigators with visual and audio recordings of the crewmember activities during the accident trip. 

Looking at the camera, we learned that the train engineer wasn’t distracted; he wasn’t well trained. In fact, he was unfamiliar with new technology on the locomotive. That recording helped Amtrak and Sound Transit make much-needed safety changes to their operations, including crewmember training.

Now, let me turn to the NTSB and talk about my vision for the agency.

We are strong agency! Our people are phenomenal, and we’re ready for the future. But, just like anything in safety, there’s always more we can do to be better.

How do we get there? I want to do three things: right-size the agency, ensure the right skills at the agency, and promote the right shared values in the agency. If we do these three things, we’ll be better positioned to serve our vital safety mission, today and tomorrow. We’ll truly be “mission first.” 

You all know what the NTSB does. 

We have approximately 400 full-time employees across the country at regional offices located in Anchorage, Alaska; Seattle, Washington; Denver, Colorado; and Ashburn, Virginia.

If you’re thinking “that’s not a lot of people to do all of that…” I’d agree! 

Now let me add this fact: we’re currently down 20 aviation investigators, which represents roughly 5% of the total agency headcount. What this means is that our people are forced to do more with less.

You’re feeling the effects as external stakeholders. Candidly, being understaffed delays our ability to conduct and close investigations. It also means we have fewer people working to address other initiatives that support our investigative efforts and inform our stakeholders. 

Know that we’re working hard to increase staffing. In my first internal address as Chair, I shared my vision that the mission comes first and challenged us to fill our vacancies quickly. How? By addressing barriers that have slowed recruiting, hiring, and maintaining a workforce for the future.

We have several aviation safety jobs posted right now. We’re hiring up to seven investigators on just one posting. So please spread the word! 

We’re at a time of tremendous growth in transportation and new ways of moving people and goods — whether it’s commercial space, urban air mobility, automated and electric vehicles, or historic investments in rail, public transit, and bicycle and pedestrian infrastructure. 

That’s why my goal isn’t just to get NTSB back to baseline in terms of headcount; we need to grow if we’re going to meet the moment. 

But it’s not just about headcount. The skills we need for our future workforce are also in flux. It starts with having the right leadership team in place.

I’ve appointed Dana Schulze as Managing Director. Along with aviation expertise, Dana is a data-driven leader. She moved our chief data scientist to the front office. Together, they’re tracking data across the agency and are looking for efficiencies, including in our hiring process. 

With me today is our new Director of the Office of Aviation Safety Tim LeBaron. Tim started with the agency as an intern in 2003 and has since led more than 300 aviation investigations. 

Tim has a great team that includes Deputy Director Dave Helson and Joe Sedor, who is now our chief technical adviser for space and advanced aerospace transportation investigations. Tim and I would be happy to brag about the team more in the discussion! 

This leads me to the third item in our strategy to future-proof NTSB, which is to promote the right shared values in the agency. 

On June 25, 2021, President Biden signed an Executive Order to advance diversity, equity, inclusion, and accessibility in the Federal workforce. I want to read one line from it: “When public servants reflect the communities they serve, the government is more effective and successful.” 

If I might suggest, when industry reflects the customers they serve, your companies are more effective and successful. Women pilots represent only 6% of the total pilot population. Mechanics, 2.6%; ground instructors, 7.8%, dispatchers, 19.7%. 

The numbers are getting better, but we can both do more to create opportunities for women in the industry. The fact is, I am only the fourth woman to serve as Chair since the NTSB was established. 

To improve safety for all communities, we must reflect the people we serve. Let me repeat: We must reflect the people we serve. 

That means reflecting a diversity of viewpoints, backgrounds, and experiences, which is why I’m looking forward to hosting a series of virtual safety summits soon. We’ll sit down with our partners and stakeholders, talk about the importance of working together to improve safety, and be open to hearing their views of our agency — especially how we can improve. 

I don’t just want people at the table who’re supportive of our work. I want to hear all views. I firmly believe it will get us to a much better result. GAMA and member companies will be invited.

Before I open it up for discussion, there’s one safety issue that I’m not sure anyone is talking about with you. And that’s the growing public health crisis on our roads.

In 2020, nearly 40,000 people died in traffic crashes. The numbers are only getting worse. The National Highway Traffic Safety Administration projects that an estimated 31,720 people died in motor vehicle crashes in the first nine months of 2021 — an increase of approximately 12%, year over year. This is the highest percentage increase during the first nine months of any year since 1975, which is when they started tracking. 

Did you know that injuries resulting from roadway incidents is the leading cause of work-related deaths?

I understand that, combined, GAMA members directly employ 175,000 people in the United States. The general aviation industry at large? Nearly a quarter-million. 

You have incredible influence on your employees in their work vehicles and in their personal vehicles. I challenge you to consider these lifesaving measures at your company:

• ​Adopt a policy that would prohibit cell phone use while driving or require the use of lockout features when using company vehicles. You are four times as likely to crash when using a cell phone while driving. Hands-free isn’t risk free. 
• Invest in driver education. It’s not just the right thing to do; it can also make good business sense. Employers are being held liable up to $25 million for employee crashes, even when employees use hands-free devices. 
• Consider screening, diagnosing, and treating drivers for obstructive sleep apnea. Fatigue is impairing.
• Educate workers about the importance of buckling up in all seating positions, including the rear seat.
• Support safer transportation options like public transit, rail, and bicycle commuting.
• And, as we talked about earlier, embrace proven, lifesaving technologies in your company-owned vehicles. Collision-avoidance technologies like automatic emergency braking and forward collision warning can help mitigate the severity of crashes or even stop them from occurring in the first place. Driver monitoring systems and speed limiters in corporate vehicles can also help. 
  

We need every strategy at our disposal to turn the tide against the public health crisis on our roads. And that includes every stakeholder. 

As the leaders of major companies who employ hundreds of thousands of people, you have the power to help us move the needle — not just in our skies, but on our roads as well.

Thank you. ​                                                            ​​