Medical Review of Drivers

1. Medical Review of Drivers

2. Medical Review To ensure the safety of motorists on Virginia's highways, drivers must meet certain requirements including vision, medical and mental standards. Overall medical review requirements are based on the Code of Virginia as well as guidance from DMV’s Medical Advisory Board.

3. Medical Advisory Board The seven members are • appointed by the Governor • licensed physicians • currently practicing in Virginia

4. DMV’s Goal To allow people to drive as long as they can drive safely.

5. Reviewing Drivers DMV is concerned about drivers with impairments in: • Level of consciousness • Vision • Judgment • Motor skills

6. Reviewing Drivers Each case evaluated on its own merits.

7. Reviewing Drivers DMV identifies drivers for review by • Driver’s license applications • Reports of impaired drivers

8. Driver’s License Application Medical questions on the DMV application include: • Vision conditions • Physical and/or mental condition that requires medication • Seizure, blackout or loss of consciousness • Condition that requires the use of special equipment to drive

9. Reports of Impaired Drivers DMV receives reports from: • Law enforcement • Physicians • Courts • DMV representatives • Relatives • Concerned citizens

10. Reports of Impaired Drivers Statutes that encourage reporting of impaired drivers: • Virginia Code § 46.2-322 • Virginia Code § 54.1-2966.1

11. Reports of Impaired Drivers HIPAA Regulations section 164.512 (j) Standard: for uses and disclosures to avert a serious threat to health or safety. It states… permitted disclosures, that a covered entity may, consistent with applicable law and standards of ethical conduct, use or disclose protected health information, if the covered entity, in good faith, believes the use or disclosure:

12. Reports of Impaired Drivers HIPAA Regulations section 164.512 (j) • Is necessary to prevent or lessen a serious and imminent threat to the health or safety of a person or the public, and • Is to a person or persons reasonably able to prevent or lessen the threat, including the target of threat

13. Reports of Impaired Drivers DMV accepts reports by • Email medreview@dmv.virginia.gov • Mail a letter or DMV report form (MED3) to: DMV Medical Review Services Post Office Box 27412 Richmond, Virginia 23269-0001 • Fax a letter or DMV report to (804) 367-1604

14. Reports of Impaired Drivers

15. Reports of Impaired Drivers Information needed • Identifying information about the driver • Reason why reporting person is concerned • Relationship to the driver • Signature of person making the report (for letters and DMV report forms) • Contact information for the reporting person

16. Medical Review DMV takes the following actions after receiving a report Step 1: Review report on impaired driver Step 2: Follow up with the person reporting a driver, if necessary Step 3: Determine the type of review to be conducted, if warranted

17. Medical Review Types of Reviews • Medical report • Vision report • Knowledge test • Road test • Driver evaluation

18. Medical Review Step 4: Notify driver of requirements • Driver is given 30 days to comply with initial requirements • Driver is given an additional 15 days to pass tests, if required, after medical/vision reports

19. Medical Review Step 5: Evaluate all information provided and test results Step 6: Determine if additional information or tests are needed Step 7: Review case with Medical Advisory Board, if necessary

20. Medical Review Step 8: Determine next action(s) • No further requirement/action needed • Impose appropriate driver’s license restriction • Require periodic medical/vision reports • Suspend driving privilege

21. Medical Review A driver may contest the action taken by DMV and request an administrative hearing. The hearing must be requested in writing. The hearing will be scheduled and conducted by the DMV Hearings Office.

22. Resources Virginia GrandDriver • An initiative of the Virginia Department for the Aging and DMV

23. Resources Virginia GrandDriver Goal Everyone stays on the road as safely as possible for as long as possible. How? By providing resources that will help drivers compensate for naturally occurring aging-related changes in driving skills.

24. Resources Virginia GrandDriver Visit www.granddriver.net • Staying safe tips • Resource links • Alternative transportation

25. Assessment Tools Driving Assessment • Objective screening • In-car and simulator performance options • Maintains doctor/patient relationship • Generally requires a physician referral

26. Assessment Tools Driving Assessments measure a person’s ability to: • Steer • Control speed • Change lanes • Negotiate intersections • Avoid road hazards • Obey the law

27. Assessment Tools Psychological Assessments • Trail Making Test, Part A & B • Mini Mental State • Clock Drawing Test • Reaction Time Studies • Screening for Geriatric Depression

28. Assessment Tools Results are confidential between patient and doctor.

29. Assessment Providers • Center for Excellence in Aging and Geriatric Health (Williamsburg) • Woodrow Wilson Rehab (Fishersville) • Glennan Center for Geriatrics and Gerontology (Norfolk) • Hampton VA Medical Center • Driver Rehab of Hampton Roads • Hunter Holmes McGuire VA Medical (Richmond) • Chippenham Johnston Willis (Richmond) • National Rehab Hospital (D.C.)

30. Assessment Providers (cont) • HealthSouth Rehab Hospital of Virginia (Richmond) • Virginia Driving Safety Laboratory (Charlottesville) • INOVA Mt. Vernon Hospital (Alexandria) • Therapy Center (Norfolk) • Driver Side Rehab (Vinton) • Deborah Bender (Winchester) • Deena Jones (Waynesboro)