RD387 - Mature Drivers Study - 2013 Report
Executive Summary: In January of 2013, Chairman Joe May, House Transportation Committee, and Chairman Stephen Newman, Senate Transportation Committee, called upon the Department of Motor Vehicles (DMV) to establish a stakeholders group to study “whether the Commonwealth should adopt additional objective criteria in current license renewal requirements as a means of assessing mature drivers’ continued capability to remain active, safe, independent, and mobile on the road as they age.” (*1) In addition to this charge, DMV was tasked with reviewing amendments to the federal "Highway Safety Program Guidelines: Highway Safety Program Guideline No. 13 Older Driver" issued by the U.S. Department of Transportation’s National Highway Traffic Safety Administration (NHTSA) in conjunction with current DMV data and practices. In response to the request from the transportation committee chairs and Guideline 13, DMV assembled a core team of staff to facilitate work on the study and to begin to organize the study and research the issues. For purposes of the agency’s research “mature drivers” were defined as those drivers aged 65 and older. DMV then convened an executive oversight committee and stakeholder committee to study the issues outlined in the charge letters from Delegate May and Senator Newman and Guideline 13 to better prepare the Commonwealth for the aging driving population. The executive oversight committee was led by the DMV Commissioner and included state agency leaders and leading members of state colleges and universities. The stakeholder committee was made up of over 40 participants from the medical profession, elder care industry, state agencies, state colleges and universities, law enforcement, safety and special interest groups, insurance industries, and concerned citizens. The study group was tasked with examining three main topics, driver licensing requirements, the medical review process and current outreach and education resources available for educating the public, law enforcement, medical professionals, and caregivers on how age affects driving ability. In order to review the broad topics the stakeholder group was divided into three committees: Driver Licensing, Medical Review, and Outreach and Education. While working closely with numerous stakeholders, DMV conducted extensive review of existing research and data from other states, surveyed other jurisdictions, invited leading researchers from the University of Virginia, NHTSA and TransAnalytics, LLC to present information and collected specific data from Virginia crash reports and demographics relating to mature drivers. The Driver Licensing committee explored in-person license renewal requirements, license renewal periods, the process of exchanging licenses for identification cards, graduated de-licensing, and screening tools for use in DMV customer service centers and/or medical review. The committee recommends: • Amending § 46.2-330 of the Code of Virginia to lower the statutory age for mandatory in-person license renewal for mature drivers from age 80 to age 75 • Amending § 46.2-330 of the Code of Virginia to shorten the license renewal period from eight years to five years for persons age 75 and older. Therefore, any person renewing his license at age 75 or older would have a five-year license renewal cycle • Continuing to monitor and collect data on those drivers age 85 and older and their incidences of crashes, improper actions and convictions to determine whether the license renewal period should be further shortened • Implementing the means for licensed drivers age 70 and older to exchange their driver’s licenses for special identification cards through alternative means (online, by phone, by mail) • Amending the Code of Virginia by adding a section (proposed § 46.2-943.1) to provide judges the option of requiring drivers to attend mature driver motor vehicle crash prevention courses where applicable based on the offenses committed • Supplying judges with information on the crash prevention courses for older drivers that are currently available The Medical Review committee examined DMV’s current medical review process to determine whether there is an effective process in place for identifying and addressing impaired at-risk drivers or whether any changes were warranted. The Medical Review committee studied the medical review process and considered whether there is an attainable and efficient process for referring medically impaired or at-risk drivers to DMV’s Medical Review Services (MRS), and whether all entities are aware of the process. In looking at the referral process, the committee examined whether DMV Customer Service Representatives (CSRs) are adequately trained in the identification and referral of at-risk drivers. The committee also reviewed whether DMV’s medical review forms collect the appropriate types of information needed, and whether the forms are clear and understandable. As a part of the review, the Medical Review committee also questioned whether DMV should provide confidentiality to individuals referring drivers for medical review, and whether individuals referring at-risk or impaired drivers for medical review should have immunity from civil and criminal liability when reporting in good faith. The committee recommends: • Reaching out to pharmacists and other allied health professionals to increase awareness of the medical review referral process • Continuing to obtain input from stakeholders in the medical and allied health professions on the NHTSA Diver Fitness Medical Guidelines as compared to DMV’s process, in response to Guideline 13 • Adapting NHTSA’s Table 2 Determining Driver Functional Ability by Visual Inspection into a checklist format for use by DMV CSRs in determining a customer’s functional ability to drive by visual inspection. DMV should obtain and incorporate input from committee stakeholders in the medical profession on the checklist • Expanding training to all DMV CSRs to include more training on identifying customer functionality based on observation as it relates to at-risk drivers • Continuing to obtain and incorporate medical stakeholders’ review and input on DMV’s medical reports and forms • Including a section for dementia and mild cognitive impairment into DMV’s MED 2 form • Continuing to examine and create a means for electronic submission of DMV required forms • Amending § 46.2-322 of the Code of Virginia to provide for confidentiality for persons supplying information to DMV’s MRS regarding impaired and at-risk drivers • Amending § 46.2-322 of the Code of Virginia to provide for immunity from civil and criminal liability for persons supplying information in good faith to DMV’s MRS regarding impaired and at-risk drivers as recommended by Guideline 13 The Driver’s Licensing and Medical Review committees joined together to consider screening tools, assessment tools and the role they may play in the driver’s licensing or medical review processes. The joint committee recommends: • Developing a user friendly checklist for CSRs to use to observe customers during driver’s licensing and other transactions • Implementing the use of functional capacity assessment through use of cognitive tests during the medical review process for drivers referred to medical review for cognitive issues under DMV’s current medical review statutory authority • Monitoring customers who undergo functional capacity assessments to determine if future crashes and convictions occur after they successfully complete medical review • Monitoring the outcomes as they become available for research currently underway relating to screening tools used in customer service centers (CSCs) The Outreach and Education committee was tasked with reviewing and considering recommendations regarding outreach and education programs addressing mature drivers and those drivers who are medically at-risk. Stakeholders agreed that the goal of outreach and education is to educate groups on identifying when a mature driver is at-risk and how to refer at-risk mature drivers to the DMV medical review process. Additionally, the purpose of outreach and education is to share resource information with mature drivers, their families, and caregivers, including information on the effects of aging, alternate transportation options, and driving cessation. Targeted groups to reach through outreach and education include medical and allied health professionals, law enforcement and the judiciary, DMV staff, mature drivers themselves, family and caregivers, and the general public. The committee made numerous recommendations that are addressed in detail in the report. Of those recommendations, the most critical recommendations include general and targeted recommendations: General Recommendations • Creating a coalition of stakeholder partners to create and execute a comprehensive strategic communication campaign • Leveraging the GrandDriver website as the central hub for messages and resources for mature drivers, their families and stakeholder organizations including the medical and allied health professions community, law enforcement and the judiciary • Updating and developing additional website content specifically for the medical and allied health professions community, law enforcement, the judiciary, and the general public • Linking the GrandDriver and stakeholder websites for maximum exposure and reach Targeted Outreach Recommendations • Updating and distributing communication and informational tools as well as brochures for the targeted audiences • Publishing a column about GrandDriver and the DMV medical review process in Department of Health and Department of Health Professions newsletters as well as in medical associations and other health care association publications • Seeking more proactive opportunities to attend events and inform the medical and allied health professions community about the DMV medical review process and GrandDriver resources • Reaching out to medical schools to encourage medical schools to integrate information about mature driver safety into their curricula • Highlighting and addressing mature driver issues at conferences with joint participation of DMV, law enforcement, the judiciary, and medical and allied health professionals • Enhancing training programs for DMV staff and medical and allied health professionals and developing continuing education courses for health care providers • Requesting incorporation of information in the Department of Criminal Justice Services’ law enforcement training curriculum on detecting at-risk drivers, referring these drivers for DMV medical review, and providing information to assist mature drivers • Distributing to DMV customers of a designated age information on the effects of aging on driving, the DMV medical review process and exchanging a driver’s license for a special identification card at no charge • Expanding DMV mobile operations to reach more mature drivers • Promoting the Virginia Department of Transportation’s continued efforts to improve highway design to enhance mature drivers safety • Providing information, using all communication channels, to mature drivers, their families and care givers on alternate transportation options _________________________________________ (*1) Appendix A: Charge letters from Delegate May and Senator Newman, January 9, 2013. |
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