Guidelines for Physicians & Referring Agencies

A referral is needed for the driving safety evaluation service. You may use the referral form or simply write a prescription detailing pertinent diagnoses and functional deficits, as per the following guidelines.

Suggestions to Write a Helpful Referral

• Prior to making the referral, let your patient know why s/he is being referred, what the assessment will entail and accomplish, and how much s/he can expect to pay out of pocket for this service.
• When writing the prescription/referral, it would be most helpful to list a specific reason for assessment and services. "Evaluate and treat: Diagnosis = Elderly or Frail or Debilitated" does not provide much guidance to the Driving Evaluation Clinicians (and can complicate insurance reimbursement). On the other hand, "Driving evaluation for hemianopia 2* left CVA in March 2008," "Driving evaluation for cognitive deficits relating to Alzheimer's Disease," and "Driving evaluation for determining safety risk - s/p several minor MVAs and traffic violation tickets" provide more guidance to the D.E.E.R. clinicians and are more likely to be reimbursed by insurance.

Suggested Communication of Assessment Results & Recommendations to the Client

• When applicable, family and caregivers should be informed of the recommendations.
• Counsel your patients on tips for successful and healthy aging, as well as safe driving advice.
• Encourage your patient to start planning alternative forms of transportation, in case ever needed.
• Return to driving, reinforcing any recommendation made by the D.E.E.R. clinicians.
• Limit driving with restrictions in certain geographic areas in which the client drives, conditions, time of day...
• Attend a remedial driving course to establish/maintain defensive driving skills.
• Cease driving. This is advised when a client does not demonstrate the necessary skills to resume driving, and the potential for improvement with medical interventions and retraining is poor. In this case, alternative transportation options should be reviewed with the client.

Other Considerations

• There may be a need to request for a driving evaluation through Michigan's Secretary of State's Driver Assessment and Appeal Division, Form OC88 - As provided by Section 257.320 of the Michigan Vehicle Code, the Department of State may schedule a driver assessment reexamination on a driver based on evidence of physical infirmities or disabilities, vision deficiencies, convulsive seizures, blackouts, episodes or for other reasons that my affect the person's ability to operate a motor vehicle safety. Please provide a description of an incident or pattern of behavior, or other evidence which you believe justifies an evaluation.
• There may be a need to assess the vehicle used for safety and any needed modifications or equipment to help support the client's safe transport.
• Identified patient health and functional deficiencies may warrant referrals to specialists, such as Audiologists, Opthalmologists, Psychiatrists, etc.
• Remind your patient to follow up with you after s/he has completed the D.E.E.R. Program.

Links & Additional Resources

Physician's Guide to Assessing and Counseling Older Drivers
THIS IS A MUST READ FOR PROVIDERS. These guidelines help physicians to medically assess the ability of older drivers to continue driving. This resource, developed by the AMA & the National Highway Traffic Safety Administration, includes current screening laws and regulations from all 50 states (May 2003), as well as a comprehensive list of diseases which may impair driving. http://www.ama-assn.org/ama/pub/category/10791.html (PDF Format)

AMA's Resources on Older Driver Safety

Safety Tips of Older Drivers, and Resources to Help Families Talk:

• How's My Driving? Simple Tips for Maintaining Driving Skills
  Free copes are available at Meijer Pharmacies. An electronic version is also available on the Michigan Academy of Family Physician's web site at www.mafp.com; http://www.michigan.gov/documents/ElderlyDriving_0909_84709_7.pdf
• Driving Safely While Aging Gracefully - Created by NHTSA; http://www.nhtsa.dot.gov/people/injury/olddrive/Driving%20Safely%20Aging%20Web/index.html
• Driving After you Have Had a Stroke - NHTSA published this brochure to assist families and health care professionals talk with stroke victims about their ability to drive safely. http://www.nhtsa.dot.gov/people/injury/olddrive/Stroke/images/Stroke.pdf
• We Need to Talk...Family Conversations with Older Drivers, a free brochure by The Hartford, can be downloaded in PDF formatting by accessing http://www.thehartford.com/talkwitholderdrivers/brochure.htm.

Please refer to our More Information list for interesting and helpful web link resources and brochures.

Michigan's Secretary of State's Driver Assessment and Appeal Division

The Department of State is responsible for ensuring that all drivers are able to drive safely. Under Michigan law, the department may require a reexamination if the driver:

• May have a physical or mental condition that impairs his or her ability to drive safely.
• Has been involved in three or more crashes resulting in injury or property damage during the last two years.
• Has been involved in a fatal accident.
• Has 112 or more points on his or her driver record within two years.
• Has been convicted of violating the terms, restrictions or conditions of the driver license.

Reporting A Suspected Unsafe Driver

Reporting an unsafe driver may seem drastic, but in some cases it may be the only way to handle a serious situation. Some older drivers do not realize their driving skills have deteriorated and discussing the problem with them may become difficult.

Most referrals to the department are submitted by law enforcement, but referrals are also made by health car professionals, family members, friends or concerned citizens. Any concerns about a family member or a friend whose ability to drive safely may be in question, should be submitted to the Department of State.

To refer an unsafe driver to the department, either...

• Submit a Request for Reexamination form (Form OC88) - OC-88 forms are available at any Secretary of State branch office, or may be printed from the department's web site at www.michigan .gov/sos,
  • On Form OC88, please provide a description of an incident or pattern of behavior, or other evidence which you believe justifies an evaluation. As a result, the State may schedule a driver assessment reexamination on a driver based on evidence of physical infirmities or disabilities, vision deficiencies, convulsive seizures, blackouts, episodes or for other reasons that may affect a person's ability to operate a motor vehicle safely.
• Write a letter to the department, requesting a reexamination and explaining the circumstances for the request. The letter, if used instead of form OC88, must include the following information-
  
  • The driver's full name, date of birth, current address and/or driver license number.
  • An explanation of why the driver is being referred for a driver reexamination. (The Department of State cannot process a request for a reexamination unless specific information indicating that an unsafe driving condition exists is provided.)
  • Your full name, address, telephone number and signature.

NOTE: The information provided will remain confidential to the extent permitted by law. The Department of State is unable to act upon anonymous requests for a driver reexamination.

Requests for reexamination should be mailed to:

Request for Driver Reexamination
Michigan Department of State
PO Box 30640
Lansing, MI 48909

If a professional review by the department is necessary, the driver will be notified to attend a reexamination within 30 days. The person requesting the reexamination will be mailed an acknowledgement of the request.

Reference - http://www.michigan.gov/documents/Older_Driver_2_38985_7.pdf