MEETING WITH EXPERTS
Ranks 8, 17, and 22: Use of External, Non-Medical Triggers for Medical Reviews
Use of external, nonmedical triggers for medical reviews was weighted 7.26, placing it 7th in importance among the 16 components listed in the middle column of the RVA. The four components evaluated in this area included: (1) law enforcement/courts, (2) family, (3) social services, and (4) the general public.
Reports by law enforcement are a credible source of informationthe officer was there, saw what happened, and asked the driver questions that possibly provided information about medical conditions. All meeting attendees were in agreement that referrals by law enforcement are important in the identification of at-risk drivers.
Jurisdictions reported varying figures estimating referrals that come from law enforcement, ranging from “very few” to “the majority.” One jurisdiction reported it receives as many as 40 to 50 a week. These are not crashes; these are observations. Law enforcement officers make referrals after they see a driver almost hit another car (or perform some other unsafe maneuver), follow the driver, make a stop, and then find out that the driver has poor physical health, or admits to being disoriented, etc. One jurisdiction said 35 percent of its referrals come from law enforcement. Reports come in as a “request for re-exam” as opposed to a ticket. Thirty percent of the law enforcement referrals are for conditions including drivers who blacked out, are confused, or are dazed. When an officer requests an exam, the DMV temporarily suspends the license (and an investigator physically takes the license away) until the MAB can review the case. Several meeting attendees stated that in their jurisdictions, they do not immediately suspend a license when a police report is received.
Timeliness of law enforcement reporting is important. In some jurisdictions, the police officer’s supervisor must sign off on the law enforcement request for reexamination, which slows down the process and can be problematic when an emergency suspension should have been placed on a driver after the observed event/behavior (e.g., for the dazed, confused, blacked-out conditions).
Law enforcement officers have requested feedback from DMVs regarding the outcomes of police reports to DMVs. One MAB physician said communication between the DMV and the police is importantif law enforcement refers drivers to the DMV, law enforcement deserves to know which drivers are reentering the driving public.
Comments regarding reporting by family members centered on confidentiality issues. Many meeting attendees thought a person should have the right to know who the “accuser” is, so the DMV should not accept anonymous reports or allow reports to remain confidential. In a jurisdiction that favors anonymous/confidential reporting, it was stated that on average, family members have struggled with these decisions for well over a year before they report the driver. When family members begin the struggle with the decision to contact the DMV, the driver is already having some problems. There could be severe consequences to family members for reporting their loved ones if the reports cannot be kept confidential.
Several attendees said investigations could weed out the cases reported anonymously that are not valid. One attendee said that unless a DMV has the resources to put into investigating reports that are not signed, anonymous reports should not be accepted. Although some anonymous reports are legitimate (and would not have been submitted if not confidential for fear of retaliation by the driver), many are submitted by “bad family members” such as angry spouses/ex-spouses trying to get back at each other or greedy children trying to get possession of a parent’s car or get them off of the road for other ulterior motives. Investigations to validate claims received a weight in the RVA that placed in the bottom half of the components in terms of importance (rank = 43); however, meeting attendees said follow-up of reporting sources was important. Funding for this activity is a barrier in some jurisdictions.
One attendee responded that her State has a very liberal open-records law, and consequently confidentiality is fraught with problems. In that jurisdiction, drivers can make their Driver Condition and Behavior Reports confidential but have to “jump through a couple of extra hoops” to do that. If an action begins with a confidential Driver Condition and Behavior Report, it can get thrown out if the case goes through a judicial review process, because the DMV, by law, cannot release the information.
Reports by social services agencies did not receive much discussion; however, social workers in a continuing-care retirement community concerned about drivers in that community, are considered an important referral source by at least one jurisdiction present at the meeting.