1. Colorado Coalition for Elder Rights and Abuse Prevention (CCERAP) A Project of the Colorado Nonprofit Development Center The Aging Driver – A Colorado Perspective Presented by Ted Trujillo, Operations Director July 13, 2016

2. Colorado Division Of Motor Vehicle Driver License Section Driver License Section – Issue the document (driver license, ID) – Driving tests (vision, skills) Driver Control Section Driver Control Section – Keeper of the Record – Administer the Administrative Actions Titles and Registration Section Titles and Registration Section – Register and Title Motor Vehicle – License Plates

3. The Older Driver Defined……… Not an easy term to define, for example: Not an easy term to define, for example: In some studies “middle aged” is defined as 25-65 In some studies “middle aged” is defined as 25-65 While in another an “older driver” is over 65 While in another an “older driver” is over 65 Yet in another the “older driver” is 60 -65 Yet in another the “older driver” is 60 -65 So, in one study a driver is deemed “older” while in another they are considered “middle aged” So, in one study a driver is deemed “older” while in another they are considered “middle aged” One thing is clear…..the “system” could benefit from a clear definition! One thing is clear…..the “system” could benefit from a clear definition!

4. Drivers Over 70 Older drivers (typically those over 70 years old) are high-risk because many drivers in this age experience: Loss of mobility. Vision changes. Decreased reflexes. Hearing loss.

5. Everyone ages differently, so there is no arbitrary cut off date as to when someone should stop driving………...

6. A driver’s license signifies more than the ability to drive a car; it is a symbol of freedom and self-sufficiency. Every driver is motivated to drive for different reasons

7. So What Do We Do??

8. Colorado At A Glance……… Driver licensing is administered by the Department of Revenue (DOR), Division of Motor Vehicle (DMV) There is no mandatory age for a driver to give up their driving privilege in Colorado Colorado is a self-monitoring, voluntary reporting state – focused on medical conditions and/or functional impairment, not age There is no Medical Advisory Board (MAB), nor is there an internal medical unit with the DOR Colorado had a MAB, however it was disbanded over 25 years ago due to cost issues

9. Individuals over the age of 65 Driver licenses May not renew their driver license online (C.R.S. 42-2- 118 (1.5) (a) (I)). May renew their driver license in an office.renew May renew-by-mail every other renewal cycle (licenses or ID cards that were valid for 10 years are not eligible to renew by mail)renew-by-mail Individuals over the age of 60 wishing to obtain an identification card in lieu of a driver license may do so at no charge.identification card

10. Are the individuals who make Are individuals who make fitness State determinations immune from legal action? to drive decisions anonymous? YES NO Alaska v v Arkansas vv California v v Colorado v v District of Columbia v v Idaho v v Michigan v v Montana v v Nevada v v New Hampshirev (but examiners have limited protection from liability) Ohio v v Oregon v v South Dakota v v Vermont v v Washington v v Wyoming v v TOTAL (N=16) 8 8 0 16 States without Medical Advisory Boards

11. The myth is that the DMV has more authority than they really do. The fact is the DMV’s authority is base in existing statute and very little Is left to the discretion of the department. The Following statutes guide how the department address drivers who are medically or incompetent to drive.

12. ( 1) (a) The department shall examine every applicant for a driver's or minor driver's license. The executive director of the department, in the director's discretion, may conduct the examination in any county convenient for the applicant. The examination shall include a test of the applicant's eyesight, his or her ability to read and understand highway signs that regulate, warn, and direct traffic, and his or her knowledge of the traffic laws of this state, an actual demonstration of the applicant's ability to exercise ordinary and reasonable care and control in the operation of a motor vehicle, and such further physical and mental examination as the department finds necessary to determine the applicant's fitness to operate a motor vehicle safely upon the highways; except that an applicant seeking renewal of a driver's license by mail under section 42-2-118 need only submit the information required by that section. (b) The department, in issuing the drivers' licenses for certain types or general classes of vehicles, may waive any examination required by paragraph (a) of this subsection (1) for applicants and may certify certain employers, governmental agencies, or other appropriate organizations to train and examine all applicants for such certain types or general classes of licenses, if such training and examination is equal to the training and examination of the department. (2) Repealed. (3) (a) If the department has evidence that indicates that a licensed driver or minor driver is incompetent or otherwise not qualified to be licensed, it may, upon written notice of at least ten days to the licensee, require such driver to submit to an examination. (b) If a fatal motor vehicle accident involving one or more licensed drivers or minor drivers occurs, the department, if deemed appropriate, shall mail a written notice to all such drivers involved in the accident requiring such drivers to submit to examination. If the department has not mailed a written notice to any driver involved in a fatal accident within ninety days after the department receives notice regarding such accident, the department shall not require an examination of such driver based upon such accident. (c) Upon the conclusion of an examination required under this subsection (3), the department shall take such action as it deems appropriate and may deny, cancel, suspend, or revoke the license of such person or permit that person to retain such license subject to the restrictions under section 42-2-116. Refusal or failure of the licensee to submit to such examination shall be grounds for suspension or revocation of such person's license. Such decision of the department shall be reviewed by a court of record upon appeal to that court by the party aggrieved. (4) The department shall prepare and print rules, requirements, and regulations for the mandatory use of license examiners, and the same shall be strictly adhered to in the examination of all drivers.section 42-2-118section 42-2-116 C.R.S. 42-2-111. Examination of applicants and drivers - when required

13. C.R.S. 42-2-112. Medical Advice - Use by Department - Physician Immunity C.R.S. 42-2-112. Medical Advice - Use by Department - Physician Immunity (1) In order to determine whether any licensed driver or any applicant for a driver's license is physically or mentally able to operate a motor vehicle safely upon the highways of this state, the department is authorized, pursuant to this section and upon the adoption of rules concerning medical criteria for driver licensing, to seek and receive a written medical opinion from any physician, physician's assistant, or optometrist licensed in this state. Such written medical opinion may also be used by the department in regard to the renewal, suspension, revocation, or cancellation of drivers' licenses pursuant to this article. No written medical opinion shall be sought pursuant to this section unless the department has reason to believe that the driver or applicant is physically or mentally unable to operate a motor vehicle safely upon the highways of this state. (2) In addition to the written medical opinion sought and received pursuant to subsection (1) of this section, the department may consider a written medical opinion received from the personal physician, physician's assistant, or optometrist of an individual driver or applicant. Any written medical opinion requested by the applicant or driver from a personal physician or optometrist shall be provided to the department at the expense of the applicant or driver. Any written medical opinion required by the department shall also be at the expense of the applicant or driver. (3) No civil or criminal action shall be brought against any physician, physician's assistant, or optometrist licensed to practice in this state for providing a written medical or optometric opinion pursuant to subsection (1) or (2) of this section if such physician or optometrist acts in good faith and without malice. (4) A written medical opinion received by the department which relates to an individual applicant or driver is for the confidential use of the department in making decisions on the individual's qualifications as a driver, and the written medical opinion shall not be divulged to any person, except to the applicant or driver, or used in evidence in any trial or proceeding except in matters concerning the individual's qualifications to receive or retain a driver's license. (5) Written medical opinions received by the department pursuant to this section, in addition to other sources of information, may be used by the department in the adoption of administrative rules concerning medical criteria for driver licensing.

14. How does a driver with medical or functional impairment come to the attention of the department? Both first-time and renewal applicants must answer questions when they complete the license application. The Department accepts reports of potentially unsafe drivers from physicians, police officers, the courts and family members. Driver self reports or surrenders license Driver license staff can assess whether a driver may have a visible physical ailment or disability that may interfere with the safe operating of a motor vehicle and may require the individual provide documentation from a medical provider before the application process can continue.

15. Additional Criteria for re-examination Two (2) accidents in a three (3) years A fatal accident – Even if driver is not a fault Referred by any of the reporting resources – physician, law enforcement, court, family member

16. A driver is noticed that they have 20 days to have a re-examination of their driving skills and eye examination the driver may request a hearing with the DOR Hearings Division. The Hearing officer determines if the Department has followed the statute by appropriate notice, appropriate documentation from the appropriate entity and that the Department was not arbitrary or capricious with the action taken against the driver. If the driver is not satisfied with the decision of the Hearing Officer, they may appeal to the District Court.

17. So How Does This Work?????

18. Renewal Questions of the Driver Renewal Questions of the Driver Is your driving privilege under suspension, revocation, or denial in Colorado or any other state? During the last two years, have you had any physical, mental or emotional condition that would interfere with your ability to operate a motor vehicle safely including heart problems, diabetes, paralysis, epilepsy, seizures, lapses of consciousness, or dizziness? I have surrendered all out-of-state issued licenses in my possession.

19. How do I request a re-examination for a family member? The department can request a driver to take a re-examination based on written information received from a doctor, a law enforcement agency, a court, or and immediate family member (Form DR 2401 or letter) Can the request for re-exam be kept confidential? The request cannot be kept confidential. The driver has the right to know why he/she is being required to take a re-examination. The driver can upon proof of identification and a $9.00 fee be provided a copy of the written information used by the DMV office to request the re-examination.

20. What if the family member in question has medical issues? If the driver has medical issues the family member should contact the driver's doctor and have the doctor provide a written request for the re-examination. How is the driver notified that he/she needs to take a re-examination? The driver is notified by mail that he/she has twenty days from the date of the correspondence to take a re-examination. The letter informs the driver to contact the nearest full service driver's license office. Can re-examinations be extended if I can’t take me re-examination Re-examinations cannot be extended unless requested by a doctor. The doctor must provide, on letterhead, the reason for the extension and the length of the extension. If the extension time period is to be longer than two weeks from the original time request then the restraint will go into effect. When the driver is able to take and pass the re-examination on the first attempt, the action will be rescinded.

21. How many written notices does the Colorado DMV receive? FY 20132,306 FY 20142,610 FY 20152,471 FY 20162,366

22. So What Else Can Be Done

23. National Highway Transportation Safety Administration (NHTSA) Best Practices to Consider: National Highway Transportation Safety Administration (NHTSA) Best Practices to Consider: 64 States have Medical Advisory Boards Create a State Older Driver Safety Program Develop Resources to address issues Collect and Analyze Data on older driver crashes, injuries, and fatalities Identify and prioritize the State’s older deriver safety problems

24. Encourage and facilitate regular collaboration among agencies responsible for or impacted by older driver safety issues Coordinate older driver safety projects with other highway safety projects Increase awareness of older driver transportation options In-person license renewal should be required to be done in person after a certain age Establish a communication plan to reach medical providers Train DMV staff, including counter staff in the identification of medically at-risk drivers and the referral of those drivers for medical review A communication plan for reaching law enforcement officers with information on medically at-risk drivers Focus the communication efforts on the support of the overall policy and program

25. The purpose of my presentation today is not to say that what Colorado Is doing is right or wrong……. The purpose is to start the conversation in an effort to have an on-going dialogue around the issue of the older driver and the impact on the goal of zero deaths in Colorado. Thank you!