DMV REPORTING: DRIVING ASSESSMENTS; DRIVING TRAINING; CAR ADAPTATION
Occupational Therapists do driving assessments at various facilities in the State of Oregon. In Oregon, the DMV is very specific about what the minimum skills are needed in order to drive. Occupational Therapists assess in three areas: visual, cognitive and physical. With that assessment the OT can say whether the person has the skills and abilities to drive. The driving assessment is not covered by Medicare and is self paid since it is not deemed "medically necessary" to drive.
The driving assessment is not an on-road test. However, it is a place to start. The Occupational Therapist should find out if the person has a valid driver's license or if the license has been suspended. The patient's doctor may have sent in the mandatory reporting form, and if so, the patient's license would automatically be suspended for a period of time. Then the person needs to take the DMV road test before they can return to driving. If the person passes the driving assessment but is not confident to get behind the wheel, they can be referred to a local driver's training school where they can get behind the wheel.
A good resource is the Oregon Driver's Education Center in Portland. Their web site is www.drivereducationcenter.com or call 503-297-4813 or Salem 503-581-3783 which offers on-road driving assessments. If the person needs modifications to their car, that is a whole specialty area.
There is also this document about Best Practices developed for therapists who submit a volunteer form to the DMV about their patients:
Change in Oregon law: OTs have civil immunity for Voluntary Reporting of Impaired Drivers
January 1, 2014, civil immunity will be extended to physicians and health care providers, including Occupational Therapists, reporting patients who are unsafe to drive under DMV's voluntary reporting program, due to the passage of HB 2195. More information can be found at: www.oregon.gov/ODOT/DMV/Pages/At-Risk_Liability.aspx
Depending on the type of information contained in the report, DMV may immediately suspend driving privileges if the person is a risk to safety. However, a driver will normally be advised that they will be given 60 days to take and pass a vision, knowledge, and drive test. In some cases, a driver may be asked to provide current medical information.
For more information contact the Driver Safety Unit at (503) 945-5083.
Keep in mind that often when health care professionals recommend that a client no longer drive, the client may not agree and will keep driving. Filing a report provides extra precautions. It is important to tell clients that you will file the report or recommend that the physician file the report. You do not have to disclose a diagnosis. Rather, it is best to describe impairments noted such as poor short-term memory, confusion, inability to follow complex commands, poor problem solving, inability to process information and respond in a timely and accurate manner, or problems with performing activities of daily living due to cognitive impairments. If the impairments are physical limitations it is appropriate to discuss adaptive driving devices and training in use with the client. If the impairment is visual performance, then a referral to an eye care professional is appropriate. Referrals for other services are appropriate for outstanding problems that may respond to remediation or medication.
Discuss the reporting system with physicians. Some physicians will want to file the report themselves while others will delegate reporting to the occupational therapists. Best practice requires that clients and their families are made aware of these processes before a driving evaluation is administered. If the evidence is derived from only cognitive assessments, then the client and family need to be educated on how these assessments correlate to driving ability and therefore, the rational for reporting to the DMV.