Alberta Transportation Driver Fitness and Monitoring
Mature Driver Medical Examinations
Driver Fitness and Monitoring Section • Alberta Transportation Director – Traffic Safety Services • Driver Programs Secretary to – Driver Fitness and the Director Monitoring (DFM) • DFM Roles Manager – Maintain complete and accurate driving record. – Determine an Supervisor Reviewing individual’s fitness to Officers (7) drive based on medical conditions. 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 of 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.
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