Medical Advisory Board. reviews medical issues for licensure regarding individual drivers. medical conditions. not specified. reporting encouraged,

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1 State Reporting Regulations for Physicians Adapted from the Physician s Guide to Assessing and Counseling Older Drivers 44 and Madd.org 45 State Physician/Medical Reporting (NOTE MERGED CELLS) Mandatory, Alcoholrelated Alabama None Mandatory, Other Permissive encouraged, but conditions not Medical Advisory Board reviews individual Alaska None None Notes/Civil Immunity Civil immunity: Yes licensee should selfreport conditions that cause loss of consciousness to the DMV Arizona None encouraged, but conditions not reviews individual Civil immunity: No

2 Arkansas None California loss of consciousness Colorado None Connecticut None encouraged, but conditions not unsafe, in public s interest conditions that would affect the safe operation of a motor vehicle conditions that would affect the safe operation of a motor vehicle None development; does not review individual cases None development and reviews individual cases unsafe referred to agency called Arkansas Driver Control Civil immunity: No Mandatory includes "disorders characterized by lapses of consciousness"; specifies Alzheimer s disease Civil immunity: Yes cannot find Civil immunity: No Chapter f 2

3 Delaware loss of consciousness District of Columbia None Florida None Georgia encouraged, but encouraged, but condition not mental or physical disability that would affect the safe operation of a motor vehicle Medical would affect the safe operation of a motor vehicle reviews individual None development and reviews individual cases reviews individual Mandatory includes "losses of consciousness due to disease of the central nervous system" Title 21, Chapter Civil immunity: No Assists DMV staff with decisions on individual

4 Hawaii Hospital BAC Reporting encouraged, but reviews individual Re: mandatory BAC, "the health provider shall notify, as soon as reasonably possible, any officer present at the health care facility to investigate the accident or, if no such officer is present, the county police department in the county where the accident occurred" Idaho Illinois Indiana Hospital BAC Hospital BAC Physicians are required to report handicapping conditions Reporting encouraged, but Physicians encouraged to tell patients of their (driver s) responsibility to report loss of consciousness or would affect the safe operation of a motor vehicle None reviews individual reviews Civil immunity: No Civil immunity: No requires "hospital emergency rooms to report chemical test results of individual treated in motor vehicle crashes to Illinois State Police or law enforcement officials upon request" Civil immunity: Yes 625ILCS IC

5 individual Iowa would render the person physically or mentally incompetent to operate a motor vehicle in a safe manner Kansas Kentucky Louisiana Maine would affect the safe operation of a motor vehicle conditions that would affect the safe operation of a motor vehicle conditions not reviews individual reviews individual reviews individual reviews individual reviews C cannot find RS 40:1356 MAB reviews appeals of DMV rulings on 5

6 individual 29-A Maryland Massachusetts Michigan permitted for persons with disorders characterized by lapses of consciousness encourages by doctors, law enforcement and public of unfit encouraged to report unsafe reviews individual reviews individual Civil immunity: no Michigan has a Driver Assessment Division that reviews issues for individual Minnesota conditions not reviews individual Civil immunity: no cannot find 6

7 Mississippi Missouri Montana Nebraska Nevada loss of consciousness permitted, but any condition that could impair or limit a person s driving ability reviews individual reviews individual development and reviews individual cases Civil immunity: no , Mandatory of "epilepsy, any seizure disorder, or any other disorder characterized by lapse of consciousness" 7

8 New Hampshire New Jersey loss of consciousness New Mexico New York North Carolina unsafe North Dakota would affect the safe operation of a motor vehicle reviews individual reviews individual reviews individual development; does not review individual cases reviews individual development; does not review individual cases 263:6-B Mandatory of conditions causing "recurrent loss of consciousness" 39: VAT Article 21-B (c) 8

9 Ohio unsafe despite no advisory boards, DMV will contact consultants for difficult individual cases as needed Oklahoma Oregon Hospital BAC might impair driving would affect the safe operation of a motor vehicle would affect the safe operation of a motor vehicle reviews individual Civil immunity: no mandatory BAC only if asked; impaired driving conditions include "functional and/or cognitive impairments that are severe and cannot be corrected/controlled by surgery, meds, therapy, driving devices" no MAB - review of cases is by state health office 9

10 Pennsylvania Hospital BAC might impair driving development; does not review individual cases mandatory BAC by personnel only if requested; impaired driving conditions include neuromuscular, neuropsychiatric, cardiovascular, cerebrovascular, convulsive, and other conditions that may impair driving ability Rhode Island South Carolina would affect the safe operation of a motor vehicle reviews individual reviews individual South Dakota unsafe D no MAB, review of individual cases is performed by Dept. of Commerce and Regulation Civil immunity: no 10

11 Tennessee Texas Utah Hospital BAC Vermont ; only with patient permission Virginia unsafe Washington reviews individual reviews individual development; does not review individual cases development and reviews individual cases Civil immunity: no Civil immunity: no 11

12 West Virginia Wisconsin Wyoming would affect the safe operation of a motor vehicle reviews individual reviews individual HB 4515 just passed into law this year Civil immunity yes Appendix C: Additional Data Analysis Results Table 1: Effects of Curriculum on Physician Behavior 12

13 ** one-tailed values Variable Comparison Statistic ** Percent RI MVCs Alcohol related (correct = 40-70%) 1. pre to posttest change in correct response 2. posttest to 3 month change in correct response Z = 3.41; p <.001 Z = -1.99, p =. 02 Percent often screen for alcohol use disorders, referral for treatment 3. pre to posttest by seniority of physician change in correct response 4. posttest to 3 month by physician type change in correct response 1. pretest to 3 month change in reported screening 2. pretest to 6 month change in reported screening 3. pretest estimates of alcohol screening by physician type 4. 3 month estimates of alcohol screening by physician type 5. 6 month estimates of alcohol screening by physician type X 2 (2)= 2.23, p =. 16 X 2 (2) = 1.23, p =.26 Z = 0.14, p =.44 Z = 1.02, p =.15 F (2,71) = 2.06, p =.07 F (2,53) = 1.52, p =.11 Percent patients treated who have alcohol use disorders 1. pretest to 3 month change in estimates of alcohol use disorders 2. pretest estimates of alcohol use disorders by physician type 3. 3 month estimates of alcohol use disorders by physician type F (2,43) = 0.16, p =.43 Z = 0.28, p =.39 F (2,73) = 1.39, p =.13 F (2, 53) = 2.95, p =.06 13

14 Table 2. Medical Record Review for Alcohol screening of ED Patients Pre and Post SOS Curriculum Variable Statistic ** Percent screened for alcohol Z = 0.71; p =.24 use Total positive screens Z = 1.95, p =.03 Positive screens receiving an intervention ** one-tailed values Z = 1.74, p =.04 14