White House Conference on Aging: Policy Committee Listening Session – Transportation – January 8, 2004 The Role of the State Motor Vehicle Department Robert Raleigh, MD Director, Medical Advisory Board & Driver Safety Research Maryland Motor Vehicle Administration

Background for role of State Motor Vehicle Department About 13% of Drivers today are age 65 to 90 + In just 6 yrs (2011) the First Baby Boomer turns age 65 In 2 Decades about 25% of all Drivers will be age 65 to 90 + Age does not determine a safe driver, but functional capability does. Research in the last 7 yrs has validated a few capability tests that are useful. Independent Activities of Daily Living (IADL) will motivate many older drivers to request the DMV for a license. (restricted or unrestricted) A multidiscipline team will be required to handle this crisis effectively. Team members vary depending on type of case. Example: MAB nurse case mgr., MAB doctor, an AOTA member with CDRS, ADED member with CDRS, driver’s doctor (Dx & RX), Certified Vendors for equipment to aid in driving, Certified Professional Driving Schools, Social Service Agencies, etc. White House Conference on Aging — Listening Session: Transportation

More Facts re: WHY the DMV will have a Key Role 1- Medical Issues of aging and driving are important, and 37 (75%) of our 50 states currently have Medical Advisory Boards (MAB), not all, are equally prepared. But there is 6 yrs to prepare before the older driver increase begins. The state DMV are primarily the only agency that has a regular close contact with all drivers. An important mission of the MAB & DMV is Keeping Older Drivers on the Road as long as they may be safe personally and also from a Public Health Perspective. An 82 yr old male driver, post stroke, with persistent weakness of right arm & leg. No other adverse symptoms or signs were present. More treatment was indicated with a spinner knob on the steering wheel and a left footed gas pedal. Following his training with adaptive equipment, a 10 mile radius of his home was determined as the geographic area that would allow for safe independent living. He passed the test and for the next three years they were able to care for themselves. At that point they decided to sell their home and live in an Assisted Living facility. White House Conference on Aging — Listening Session: Transportation

More on DMV / MAB value in Keeping Older Drivers mobile & independent 1.Previous case illustrates keeping social service costs minimal and postpones in this case for 3 years the need for alternate transportation. 2.Safe mobility and independence keep seniors from boredom & depression. 3.With 75% of states having an MAB there is a foundation for an easier transition to the concept of how to keep seniors driving safely. 4.MAB referrals generally show more functional decline than the average license renewal driver. Therefore a license renewal program is early intervention and should have a less complex job in keeping drivers on the road safely. 5. When the crisis begins, there will be a need for more Occupational Therapist and Driver Educators with CDRS to meet the Challenge. White House Conference on Aging — Listening Session: Transportation

Glossary AOTA American Occupational Therapy Association CDRS Certified Driver Rehab Specialist ADED Association for Driver Rehab Specialist PT Physical Therapist DMV Department of Motor Vehicles MAB Medical Advisory Board