Alberta Transportation Driver Fitness and Monitoring Mature Driver - - PowerPoint PPT Presentation

Alberta Transportation

Driver Fitness and Monitoring

Mature Driver Medical Examinations

Driver Fitness and Monitoring Section

• Alberta Transportation

– Traffic Safety Services

• Driver Programs

– Driver Fitness and Monitoring (DFM)

• DFM Roles

– Maintain complete and accurate driving record. – Determine an individual’s fitness to drive based on medical conditions. Director Secretary to the Director Manager Supervisor Reviewing Officers (7) Administrative Staff (9)

Information Used to Determine Fitness to Drive

• Medical forms completed by physicians.
• Road tests conducted by licensed driver examiners.
• Cognitive and driving assessments:

– Glenrose Rehabilitation Hospital, Foothills Hospital, DriveABLE Assessment Centers, and Occupational Therapists

• Complaints (private, police and enforcement).
• Driving record/history.

The courts have ruled that driving is a privilege and not a right. DFM gives each driver a chance for individual assessment prior to making the decision about future licensing. Our goal is to keep all Albertan’s “Safe and Mobile”.

CCMTA Medical Standards for Drivers

• Canadian Council of Motor Transport Administrators (CCMTA):

– Make decisions on administration and operational matters dealing with:

• Licensing, registration, control of motor vehicle transportation and

highway safety.

• The Medical Standards for Drivers (produced by the CCMTA) has

been developed by:

– A national committee comprised of physicians and medical experts:

• Appointed by each jurisdiction.
• Manages the medical standards and identifies and reconciles

interprovincial medical standard variance to produce a harmonized standard.

• Moved from a diagnostic model to a driver fitness model.

New CCMTA Medical Standards have been released for 2013.

Medical Review Committee (MRC)

• Files may be referred to the MRC for review and advice.
• Act as an advisory committee to the Minister with respect to:

– (i) any matters concerning the health of persons that may have a bearing on the operation of motor vehicles, and – (ii) any physical conditions that may constitute a hazard to the general public with respect to the operation of motor vehicles.

• Traffic Safety Act (TSA) Section 59

Legal Requirements

• Medical Disclosure

– A person who holds or applies for an Operator’s Licence shall immediately disclose to the Registrar a disease or disability that may be expected to interfere with the safe operation of a motor vehicle by the person.

• Operator Licensing and Vehicle Control Regulation (OLVCR)

Section16 – The physician is not legally obligated to report medically at-risk drivers to Alberta Transportation; however, they are also protected from legal action should they do so.

• Traffic Safety Act (TSA) Section 60, 60.1

Classes of Licences in Alberta

• There are 7 classes of licences in Alberta.

– Each class of licence:

• Permits the operator to drive a certain type or group of vehicles.
• Has specific requirements:

– Class 1 (Professional-Any Vehicle) – Class 2 (Professional-Bus) – Class 3 (3-axle plus) – Class 4 (Professional-Taxi, Ambulance) – Class 5 (2-axle-Cars, Light Trucks, Motor Homes or Mopeds) – Class 6 (Motorcycle & Moped) – Class 7 (Learners-2-axle & Motorcycle & Moped) – Class 8 (Photo Identification Card) http://www.servicealberta.gov.ab.ca/Drivers_Licence.cfm

The Effects of the Aging Process on Driving Ability

• Aging is associated with increased risk for a variety of medical conditions:

– Visual impairments, musculoskeletal disorders, cardiovascular disease, diabetes, cognitive impairment and dementia.

• The point at which the aging process affects an individual’s ability to drive

can be difficult to determine, therefore: – A standard frequency of medical review is established.

• For Class 1, 2, and 4 licence holders they are required to complete a satisfactory

medical: – On application – Every 5 years to age 45 – Every 2 years from age 45 to 65 – Every year after age 65

• For class 3, 5, 6 & 7 a medical review is required at age 75 and 80 and every 2

years over 80 years.

• When requested by DFM due to disclosure of a medical condition.

Driving Assessment Facilities

• Community Accessible Rehabilitation Clinics (CAR) (Calgary, AB)

– Available at:

• Peter Lougheed Centre, Sheldon M. Chumir Health Centre, South Calgary

Health Centre and Foothills Medical Centre. – Conducts pre-driving assessments for residents in Calgary and surrounding areas who:

• Had a serious injury such as a stroke, amputation, a serious fracture, or

multiple injuries.

• OR individuals at risk of admission to hospital or continuing care facility

due to a condition such as arthritis or osteoporosis. – Individuals would be referred to AMA (Calgary Main Office only) or Safety in Motion for on-road assessment if required.

• Physicians would refer to this facility if there was a concern regarding

physical or motor impairment.

Driving Assessment Facilities

• AMA (Alberta Motor Association, Calgary main office only)

– Program available in Calgary for individuals who have suffered a functional impairment without cognitive or visual deficits. – Conducts on-road assessments. – Accessed directly through Physician, Occupational Therapist, and Physical Therapist referral (referral forms are available on the AMA website).

• Safety in Motion Inc.

– Conducts on-road assessments similar to AMA.

• Main office located in Cochrane, AB.
• Can complete assessments in Calgary and surrounding areas.

Physicians would refer to these facilities if an on-road assessment is required in and around Calgary.

Driving Assessment Facilities

• Alberta Health Services (AHS) Occupational Therapy Services &

Rehabilitation Programs

– 40+ locations in Alberta http://www.albertahealthservices.ca/services.asp?pid=service&rid=7 559 – Provides assessment and treatment for patients with brain injuries, strokes, heart disease, traumatic injuries, require adaptive equipment and individuals who suffer from terminal illness such as cancer. – Assist with the identification of required equipment and therapy to allow people to be independent with activities of daily living. Physicians would refer to this type of program if there was a concern regarding cognition and motor or physical impairment.

Driving Assessment Facilities

• DriveABLE

– Available in Calgary, Edmonton, Lethbridge, Medicine Hat, Peace River, Red Deer and Wainwright. – Assessments completed are for individuals with suspected cognitive impairment (generally used for the elderly). – Two types of assessments completed at this facility:

• DriveABLE Cognitive Assessment Tool (DCAT)

– Computer based screening device used to predict actual on-road performance.

• DriveABLE On-Road Evaluation

– Behind the wheel assessment that tests drivers on their cognitive ability alone (does not test road rules). – The cost of the DriveABLE assessment is $250 (paid by the driver). Physicians would refer to this program if there was a concern regarding cognition.

Mature Driver Medical Examination

• When an individual reaches age 75 years it is a requirement, by the

Government of Alberta, to undergo a driver’s medical exam.

– This is a condition for maintaining a licence. – The driver’s medical would be completed by the treating/family physician. – The Physician may recommend a SIMARD MD test or a computer based DriveABLE assessment if there is a concern regarding cognition as it relates to the ability to drive.

• These tests are assessment tools and can be recommended by the

physician but are NOT required by the Provincial Government.

• However, if the physician recommends these tests be completed, they may

advise Driver Fitness and Monitoring based on the results.

Mature Driver Medical Examination

• The family physician has many options when completing a drivers

medical and a concern arises regarding cognition, two options are:

1) The physician can conduct an in-office screening test (Ex. SIMARD MD, Mini-Mental State Examination (MMSE) etc.)

• If the in-office cognitive screen is completed and the physician is still

unsure whether the individual is fit to drive, the physician can recommend a road test.

• If the road test is requested by the physician the Provincial Government

covers the cost of the initial test.

Mature Driver Medical Examination

2) The physician could conduct an in-office cognitive assessment and recommend further testing.

• Further testing is largely dependent on the condition.
• A referral can be made to any of the driving assessment facilities or

specialist offices. – The assessment would need to be completed prior to the completion

• f the drivers medical form.

– Results of each assessment are communicated back to the physician. – Type of testing and results can be indicated in section 8 of the driver’s medical form.

• The ultimate decision of licence suspension is made by the Registrar not

the physician.

SIMARD MD Test

• SIMARD MD stands for Screen for the Identification of the Cognitively

Impaired Medically At-Risk Drivers, A Modification of the DemTect

– The test is used by physicians to determine potential cognitive challenges that may affect an individual’s ability to drive safely. – The test consists of:

• Word list recall->repeat words in sequence;
• Number conversion->spell out numbers in words;
• Supermarket task->identify objects in a grocery store.

– The SIMARD MD test is NOT required by the Provincial Government, it is used as an assessment tool. – The test is taken at the doctors office and takes approximately 20 minutes. – The total score is out of 70:

• Score of <30 likelihood of passing an on-road assessment would be low;
• Score 31-70 referral for on-road assessment is recommended;
• Score >70 high probability of passing the on-road assessment.

SIMARD MD Test Question & Answers

• If I fail the SIMARD MD test, do I lose my licence?

– No. The test is a screening tool used to identify potential cognitive challenges. – Based on the results, your doctor may recommend further testing or a road test. – The assessment results are reviewed by the doctor with the patient and can be provided to Alberta Transportation. – The Registrar uses the physician’s report along with a variety of

• ther information to determine ability to drive safely such as:
• Medical documentation
• Driving record
• Road test results

DriveABLE Cognitive Assessment Tool (DCAT)

• Computer based cognitive assessment.
• No computer skills are required.

– A DriveABLE trained health-care professional guides the driver through the assessment. – For each aspect of the assessment, the assessor explains and demonstrates what is to be done. – The driver is provided practice on each task before the individual is tested. – There is no mouse or keyboard, the driver need only touch the screen or press a button. – The test takes 30-60 minutes to complete and is done at the DriveABLE center. – The DriveABLE test is NOT required by the Provincial Government, it is a tool physicians may use for testing cognitive abilities. – Test is scored between 1 and 99:

• 1 being least likely to fail an On-Road Evaluation;
• 99 being most likely to fail the On-Road Evaluation;
• Those in the middle range would require an On-Road Evaluation.

DriveABLE Questions & Answers

• Is DriveABLE a government test?

– DriveABLE is a private company and not affiliated with the Government of Alberta.

• I have heard of people being referred to DriveABLE for more

testing and then their licence gets pulled because they fail the

• test. Why does DriveABLE have the ability to pull a licence?

– Only the Registrar of Motor Vehicles has the authority to cancel or suspend a drivers licence. – The assessment results are reviewed by the doctor with the patient. – The Registrar uses the physician’s report along with a variety of

• ther information to determine your ability to drive safely such as:
• Medical documentation
• Driving record
• Road test results

DriveABLE Questions & Answers

• Can I ask for a standard road test instead of having to take the

DriveABLE test?

– Yes, an this is something you should discuss with your doctor. – Your doctor may recommend you take a road test as well as other testing. – Alberta Transportation may also ask you to take a road test to determine your ability to safely drive. – If the road test is ordered by the physician or Alberta Transportation, Alberta Transportation will cover the cost for the first road test.

Aging Driver Question & Answers

http://www.transportation.alberta.ca/content/docType45/Production/QARegardingA gingDrivers.pdf

Aging Driver Questions & Answers

• Is there a specific age where I have to give up my license?

– No. As long as you can safely operate a vehicle, you can renew your license at any age. Driver’s medicals are completed to determine driving safety.

• Does Alberta Transportation discourage people from driving

beyond a certain age?

– No. Our team at Alberta Transportation encourages you to drive as long as you can safely do so, regardless of your age.

• Do I have to have a medical test or road test at a certain age?

– Yes. For most license renewals (classes 5, 6, or 7) a medical report form signed by a doctor is required at:

• 75 years
• 80 Years
• Every two years after 80 years

Aging Driver Questions & Answers

• Why is testing required at certain ages?

– The age requirements are based on research that shows some medical conditions or cognitive challenges are more common at certain ages. That said, Alberta Transportation evaluates your ability to drive safely on an individual basis, regardless of your age.

• Do I have to disclose my medical conditions before I can renew

my license?

– Yes. You are legally obligated to disclose any medical conditions that may affect your ability to drive safely.

• Does my doctor have to disclose any medical conditions that

may affect my ability to drive?

– Doctors are not legally required to report. However, they are protected from legal action should they do so.

Aging Driver Questions & Answers

• Can any doctor do the medical report or is there a list of

approved doctors to go to?

– Most general practitioners and geriatric specialists do medical evaluations related to renewing a licence.

• What is involved in the medical test?

– The basic medical test looks at key areas that may affect the ability to operate a vehicle:

• Vision
• Hearing
• Cognitive abilities
• Overall health

– Your doctor may also recommend a road test or further cognitive testing before approving your medical form.

Thank You!

Driver Fitness and Monitoring Alberta Transportation 4999-98 Avenue Edmonton, AB T6B 2X3 Phone (780) 427-8230 Fax (780) 422-6612 Toll Free 310-0000 http://www.transportation.alberta.ca/