1. Medical Qualifications for Driving
Presented by Chris Miller from PennDOT’s Driver Qualifications Section

2. PennDOT’s Medical Program
Pennsylvania regulations outline the minimum medical standards required for licensure.
The Bureau of Driver Licensing reviews medical information submitted to the Department for an applicant/license holder to ensure the minimum licensing standards are met.
PA currently has over 8.6 million licensed drivers:
Over 1.5 million drivers are 65 years of age and older.
Half of our medical cases are for drivers younger than 65 years of age.

3. Goal of PennDOT’s Bureau of Driver Licensing:
To improve the safety of Pennsylvania’s highways without unnecessarily limiting mobility.
Safety
Mobility

4. Methods for Identifying Medically Unqualified Drivers:
The Re-Examination Program
Mandatory Physician Reporting

5. Re-Examination Program:
This is a proactive approach to randomly assess driver’s medical qualifications to determine if they meet the Department’s minimum standards for the safe operation of a motor vehicle.
Every month 1,900 drivers over the age of 45 are randomly selected for a medical exam seven months prior to their license expiration date.
License will not be renewed if driver fails to comply.

6. Each driver is required to undergo both a vision screening and a physical examination.
Results from an examination within the last 12 months are acceptable.
Vision screenings are given for free at all PennDOT Driver License Centers.
If warranted by the results of the medical examination, an individual may also be required to submit additional medical information and/or successfully complete a driver’s examination.

7. Mandatory Medical Reporting:
PA law requires all physicians or licensed health care providers to report to PennDOT any patient 15 years of age or older that has a medical condition that may affect their ability to drive safely.
In 2009, over 22,000 medical reports were received.
Over 9,800 driver’s licenses were medically recalled.
Drivers wishing to surrender their driving privilege for medical reasons are entitled to one (1) free photo identification card using a DL-54A application.

8. Health care providers play a vital role in helping to protect the public from death or injury caused by drivers with medical conditions that affect their ability to drive safely.
Health care providers tell PennDOT whether persons applying for a license or those persons already possessing a license are medically fit to safely drive.

9. Other Reports regarding Medical Competency
In addition to reports from health care providers, we also get reports from a number of other sources:
Law Enforcement
Rehabilitation Centers
Crash Reports
Signed Family Reports (including concerned friends)

10. Minimum Medical Standards
The minimum standards for licensure are outlined in Chapter 83.
The minimum standards for school bus drivers are outlined in Chapter 71.
These regulations fall under the purview of the Department of Transportation, but originated and are maintained in consultation from a Medical Advisory Board.

11. PennDOT’s Medical Advisory Board
PA law requires the existence of a Medical Advisory Board and gives the Secretary of Transportation the authority to appoint members to the Board.

12. 1. One Neurologist 2. One Orthopedic Surgeon
The law also requires the Board to consist of 13 voting members comprised of the following:
1. One Neurologist One Orthopedic Surgeon
3. One Cardiologist One Optometrist
5. One Internist Department of Transportation
7. One General Practitioner Department of Justice
9. One Ophthalmologist Department of Health
11. One Psychiatrist PA State Police
13. Governor’s Council on Drug & Alcohol Abuse

13. Periodic Regulation Reviews
The Board meets semi-annually.
The Board reviews the medical standards and identifies instances where changing treatments and technology require the regulations to be updated.
The Board provides individual case reviews, as needed on a case by case basis.

14. Diabetic Regulation Updates EFFECTIVE: October 9, 2010
The Board recently promulgated changes to the regulation relating to drivers diagnosed with unstable diabetes.
unstable diabetes mellitus leading to severe hypoglycemic reactions or symptomatic hyperglycemia within the last 6 months are not qualified
Individuals who are eligible to be restored must submit follow-up exams (including an HbA1C test and vision screening) as follows:
6 months are license restoration;
12 months after previous diabetic exam;
24 months after previous diabetic exam;
48 months after previous diabetic exam.

15. School Bus Driver Diabetic Regulation Updates:
School bus drivers diagnosed with diabetes mellitus currently requiring use of insulin or other hypoglycemic medication are not qualified to drive without a waiver:
no incident of a severe hypoglycemic reaction or symptomatic hyperglycemia and the individual has been free from insulin reaction resulting in loss of consciousness, attention or awareness or the requirement of assistance from another person, for the preceding 12 months;

16. School Bus Driver Waiver continued…
driver submits to a diabetic examination every 6 months, and submits the results of the examination and the results of the HbA1C test on a form provided by the Department.
health care provider reviewing the diabetic examination shall be familiar with the individual’s past diabetic history for 24 months or have access to that history and certify that the individual is under good diabetic control;
Target HbA1C is 8% or lower.
An HbA1C higher than 8% will require more frequent diabetic examinations.

17. School Bus Driver Waiver continued…
driver must submit to an annual dilated eye examination and submit the results of the examination to PennDOT;
Individuals, upon hire to drive a school bus, shall manage their diabetes by complying with the following requirements:
Self-monitoring blood glucose 1 hour before driving, and at least every 4 hours while driving;
Maintaining a manual blood glucose monitoring log:
Carrying a source of rapidly absorbable glucose at all times while driving a school bus

18. School Bus Driver Waiver continued…
A waiver may be granted to an individual who had a disqualifying episode while under the care of a treating physician, during or concurrent with a nonrecurring transient illness, toxic ingestion or metabolic imbalance.
This waiver will only be granted if the treating physician submits written certification indicating it is a temporary condition or isolated incident not likely to recur.

19. Medical Reporting Web Site
The new diabetic standards, along with all of the other standards, can be accessed by logging on to the Medical Reporting Information Center: