Model Driver Screening and Evaluation Program
Volume III: Guidelines for Motor Vehicle Administrators


Laying the Groundwork 
for a Successful Program

Lessons learned through the most extensive pilot program implemented in this area to date1 suggest that program success will depend strongly upon various planning and organizational activities which are performed well before the driving public becomes directly affected. While problems in launching a program may be expected to differ from one jurisdiction to another, a common set of requirements can also be identified. Establishing partnerships between the DMV and other agencies and organizations with a stake in enhancing safety, mobility, and public health is an important first step. Incorporating representatives from these partners into an advisory panel to provide advice on program content and operating procedures, and preempt potential disputes where areas of overlapping jurisdiction exist among partners, should follow closely thereafter. The advisory panel will also prove invaluable in identifying technical, jurisdictional and political barriers to program success, and devising strategies to overcome them. A single administrative unit that draws upon the advice and consent of this body must also be identified within the Department to coordinate program functions and ensure that day-to-day program operations are carried out as planned.

The jurisdictional agencies whose active cooperation is essential to develop and implement an effective driver screening and evaluation program may be expected to include--though not necessarily be limited to--the Departments of Transportation, Health, and Aging. Municipal- and county-level government participation is strongly encouraged. Private health care providers, networks, and health maintenance organizations (HMOs) are key partners, with a special emphasis on the role of occupational therapists. Representatives from law enforcement and the judicial system, both potential sources of referrals into a driver screening program, should also be included. Senior advocacy and community action groups, and social service providers used and trusted by older persons will be indispensable to public information and education components. In addition, academic and professional organizations with an interest in understanding and enhancing the validity of the screening process as well as the effectiveness of the program in meeting safety and mobility goals, have important contributions to make.

Again drawing upon the model cited earlier, a standing committee or consortium with a formal structure, mission, and agenda can bring together the diverse members and stakeholders during the program planning stages. This is recommended to establish an infrastructure for communications among the various parties, and to evolve, through open discussion, a set of program objectives that all parties will endorse and support, publicly if required.

Consortium leadership will logically be exercised by a unit within the DMV that also will, upon program implementation, fulfill the central role in coordinating activities to detect and intervene with functionally impaired drivers. AAMVA Policy, consistent with provisions of the Uniform Vehicle Code and pilot implementation of Model Program components, points to the entity designated in most jurisdictions as the Medical Advisory Board (MAB) or Health Advisory Board to accomplish this function. The Director or Chief of the MAB thus chairs the advisory committee/consortium, facilitating communications and fostering consensus among its members, and serving as the primary point of contact between the consortium and the driving public. Alternately, an administrator within the DMV could successfully lead the consortium.

Without prescribing a particular administrative structure to govern their interrelation-ships, the various components--with associated personnel and locus of responsibility--that are key to an effective functional screening program may be summarized as shown in Table 1.

Table 1. 
Overview of Key Components in an Effective Screening Program
Program Function(s) Key Personnel Responsible Entity(ies)
Planning and coordination MAB Chief or Agency Administrator Jurisdictional agency
Case management Nurse (RN, LPN, or LVN) Jurisdictional agency
Functional screening (1st-tier) Specially trained license examiner (DLE) 
Health care workers with training, certification
Jurisdictional agency
Public or private sector health care or social service providers
Diagnostic assessment(2nd-tier) Medical specialists, labs, OT/CDRS Clinical and research institutions and facilities
Education and outreach re: functional decline and driving impairment OT, Certified OT Assistant, Public Relations and Customer Assistance staff Offices of Motor Vehicle agencies at all levels; Departments of Health, Public Safety and Aging; non-profit organizations
Driver counseling re: changes in driving habits, planning for driving cessation OT, Physician, Nurse, Ophthalmologist, Social Worker, specially trained staff at Senior Centers DOT, DMV, or MVA; health care and social service facilities; Area Agency on Aging
Mobility management (trip planning, alter. trans.) Specially trained staff at Senior Centers Area Agency on Aging
Training, Remediation and Adaptive equipment OT/CDRS, PT, Physician, Nurse, Optometrist, Ophthalmologist, Driving instructor Clinical/rehabilitation facilities; Driving schools

1Maryland Pilot Older Driver Study implemented in cooperation with NHTSA's Model Driver Screening and Evaluation Program project, 1998-2001.