Medical Review of Drivers

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Medical Review of Drivers

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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
  DMVs Medical Advisory Board.

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Medical Advisory Board

• The seven members are
• appointed by the Governor
• licensed physicians
• currently practicing in Virginia

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DMVs Goal

• To allow people to drive as long as they can
  drive safely.

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Reviewing Drivers

• DMV is concerned about drivers with impairments
  in
• Level of consciousness
• Vision
• Judgment
• Motor skills

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Reviewing Drivers

• Each case evaluated on its own merits.

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Reviewing Drivers

• DMV identifies drivers for review by
• Drivers license applications
• Reports of impaired drivers

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Drivers 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

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Reports of Impaired Drivers

• DMV receives reports from
• Law enforcement
• Physicians
• Courts
• DMV representatives
• Relatives
• Concerned citizens

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Reports of Impaired Drivers

• Statutes that encourage reporting of impaired
  drivers
• Virginia Code 46.2-322
• Virginia Code 54.1-2966.1

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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

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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

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Reports of Impaired Drivers

• DMV accepts reports by
• Email
• medreview_at_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 [phone]

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Reports of Impaired Drivers
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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

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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

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Medical Review

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

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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

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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

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Medical Review

• Step 8 Determine next action(s)
• No further requirement/action needed
• Impose appropriate drivers license restriction
• Require periodic medical/vision reports
• Suspend driving privilege

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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.

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Resources

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

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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.

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Resources

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

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Assessment Tools

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

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Assessment Tools

• Driving Assessments measure a persons ability
  to
• Steer
• Control speed
• Change lanes
• Negotiate intersections
• Avoid road hazards
• Obey the law

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Assessment Tools

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

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Assessment Tools

• Results are confidential between patient and
  doctor.

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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.)

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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)