Addressing the rapid rate of change in the DOT-regulated world

Transcription

1 DOT Regulations Addressing the rapid rate of change in the DOT-regulated world Health care trends affecting today s commercial vehicle drivers and their companies June 2016

2 Today there is a heightened awareness around the need for commercial driver safety. The result is that more regulations are being put into place and both companies and drivers operating under the direction of the Department of Transportation (DOT) are experiencing numerous changes today. 6M Concentra has been a leading provider of occupational health for nearly four decades. We have performed more than 6 million DOT exams in the U.S. since To protect the company, the public, and the more than 3 million commercial drivers on the road1, employers must be vigilant about their drivers health. As the country s largest DOT exam provider, Concentra has a finger on the pulse of the DOT industry and the regulatory changes that are impacting DOT-regulated employers and drivers. This paper identifies some health-related trends we are seeing in the transportation industry as well as predictions we are making regarding future trends. It also details how we can support your company and your employees through education, consultation, and an array of health services that can help you navigate the rapid changes of the DOT-regulated world. 3,978 large trucks and buses were involved in fatal crashes in The number of large truck or bus injury crashes increased 55% between 2009 and Trend #1: Stricter DOT physical exam regulations As awareness increases about how driver health can impact on-the-road safety, DOT physical regulations have grown stricter. All drivers and physical providers were required to use new forms as of April 20, The catalyst was a high-profile tour bus crash, in which the driver was found unqualified to operate a commercial motor vehicle. Today s DOT physical regulations, put into place by the Federal Motor Carrier Safety Administration (FMCSA), carry a number of new requirements. Certified medical examiners performing physical examinations of commercial vehicle drivers must now use a newly developed Medical Examination Report (MER) as well as a new Medical Examiner's Certificate (MEC). Medical examiners must report results of all commercial drivers' physical examinations (including the results of examinations where the driver was found not qualified) to the FMCSA s National Registry. The results are then electronically transmitted from the FMCSA s registry to the state driver s licensing agencies. Once the information is in the registry, it becomes harder for forge MECs/driver cards. In fact, beginning in June 2018, drivers will no longer be required to carry a card or submit it to the state where he or she is licensed. The electronic registry will verify their certification. 2

3 Because the registry will track the drivers exam results and the medical exam provider, another likely outcome will be a reduction in doctor shopping to find a provider who will unethically qualify the driver. While you are no doubt aware of the changes described above, we find that many employers and drivers are often surprised by some of the new DOT physical requirements. For example: The forms cannot be altered in any way, such as adding a logo or additional sections Drivers are required to get a new physical after every limited certification has expired Concentra has also instituted a rule that, if the driver does not complete an exam for any reason even because he or she forgot to bring his eyeglasses he or she will be required to take an entirely new exam. Concentra s medical experts can provide your company and your drivers with guidance in understanding the new DOT exam regulations and expediting the DOT physical examination process. We can also assist you in developing DOT policies to help keep your drivers compliant with the new regulations. 24 hrs By 2018, DOT exam data must be transmitted to the registry within 24 hours. Concentra began doing so in Learn more about Concentra DOT physicals. Trend #2: A slow shift toward getting and keeping drivers healthy According to a 2016 report, industry estimates for the shortage of truck drivers range from about 50,000 to 1 million and the American Trucking Associations trucking companies will need to hire 89,000 new drivers annually to eradicate the shortage.3 There are various reasons for this prediction. The commercial driver workforce is aging and nearing retirement, with an average driver age of 49.4 Additionally, the transportation industry is known for high turnover as drivers move from company to company to increase their incomes. Meanwhile, because the driver workforce is not being replaced at a rate equivalent to its depletion, driver demand continues to rise. Exacerbating this shortage is the fact that the commercial driving population is inherently less healthy than that of non-commercial drivers, due to the nature of the demands of the job long, sedentary hours and limited access to healthy food or exercise options. However, as the workforce continues to age, more companies are taking an interest in getting and keeping their drivers healthy. 3

4 We strongly encourage employers to make proactive health initiatives a priority in order to keep drivers on the road and productive and to reduce the risk of costly accidents. To support your efforts to improve driver health, Concentra can provide a comprehensive health program designed for companies with commercial drivers. Our program focuses on education and preventive care, as well as interventional methods such as substance abuse programs. Learn more 20% Up to 20% of all large truck crashes are due to drowsy or fatigued driving, which accounts for almost 9,000 fatalities and up to 220,000 serious injuries.10 Trend # 3: A continued reluctance to invest in driver health Although driver health is becoming a priority for some transportation companies, the overwhelming majority are still reluctant to invest in health programming. For many employers and drivers, this reluctance is driven by economic necessity. After all, most truck fleets consist of 200 trucks or less, and even more have fewer than 25.5 Naturally, a small company must operate on thin profit margins that directly correlate to time spent on the road not in a medical clinic, a gym, or a health food store. Downtime equals lost income and lost profits. Though studies have proven the bottom-line benefits to companies that invest in health and wellness programs with one reporting revealing that every dollar invested in intervention yielded $6 in health care savings6 the return on investment is not immediate. The result is that health care is simply not a high priority for most companies, or for drivers, who make an average of $40,000 to $73,000 per year.7 What s more, 38% of long-haul truck drivers have no health insurance.8 This becomes a problem when the majority of commercial drivers are unhealthy, given recent data concerning the ties between driver health and safety on the road. Concentra can help you institute a health and wellness program that can help you reduce health care costs and realize a faster ROI from your wellness program. Learn more 4

5 Trend #4: Increase in sleep apnea monitoring Sleep apnea, a sleep disorder in which breathing repeatedly stops and starts, is a dangerous condition that affects more than 18 million adults in the United States.9 The FMCSA estimates that almost one-third of commercial drivers suffer from sleep apnea.10 There is a growing awareness in the medical community of the dangers of sleep apnea, which can lead to heart disease, stroke, and diabetes if left untreated. In addition to those health risks, the condition invariably causes extreme fatigue. As you might imagine, this is a problem for commercial drivers. Research shows that commercial drivers who operate vehicles such as tow trucks, tractor-trailers, and buses are more likely to drive drowsy. 11 Because of this, more employers are taking an interest in monitoring drivers who have or exhibit symptoms of sleep apnea. This cannot be over-emphasized: if an employer is aware that a driver has sleep apnea and chooses not to address it, they are putting the company, the driver, and the public at risk. For this reason, the transportation industry is in the beginning stages of developing regulations around sleep apnea for workers in safety-related positions. 5X drivers with untreated sleep apnea are five times as likely to get into preventable crashes as drivers without the condition.12 The good news is that sleep apnea, while a chronic condition, is manageable. In fact, treating sleep apnea pays enormous returns in terms of lower health care costs, increased productivity and fewer crashes. Once drivers seek treatment, they are typically cleared to continue driving. Diagnosing sleep apnea can be costly. A recent survey found that costs to drivers referred for a sleep test exceeded $1000, even for those who had insurance. 13 A thorough exam and diagnosis can also cause drivers to lose a week of work. Nevertheless, employers should make sleep apnea screening and monitoring a priority in order to protect their company and their drivers. Some of our transportation clients have already taken steps to protect their drivers by monitoring sleep information remotely and even doing periodic checks on individual drivers via electronic data transmission. Concentra can screen your drivers for risk factors related to sleep apnea. If we suspect the driver has the condition, we will refer him or her to a primary care physician for testing. We always recommend that the driver seek a board-certified sleep specialist, who can verify the diagnosis with a sleep test. 5

6 Looking to the future While the trends we ve discussed are happening today, we also predict several scenarios that could impact the transportation industry in the future. These include increases in: Commercial transportation demand for both truck transport and drivers Weight limits Use of longer trucks Use of driver data for remote monitoring for conditions like sleep apnea New technology that facilitates vehicle-to-vehicle communication may lead to another potential change in the industry: the use of autonomous or semiautonomous vehicles. This could result in the use of driverless trucks that are grouped closely together in a train-like formation to increase fuel efficiency. Meanwhile, in response to the issue of an aging driver workforce, there is talk of decreasing the driving age for commercial drivers to 18. We strongly oppose this, as the risk of motor vehicle crashes is higher among 16- to 19-year-olds than among any other age group. In fact, per mile driven, drivers ages 16 to 19 are nearly three times more likely than drivers aged 20 and older to be in a fatal crash. 14 As the industry continues to change, new regulations concerning driver health and safety will be added. As this occurs, we hope this will spur employers and drivers to invest in health and wellness to protect both the drivers and the public at large. How Concentra can help Concentra works with employers to develop comprehensive, customized health and wellness plans for their drivers. We understand the challenges that are unique to your industry, and we can develop a plan that works within your needs and budget. We can also provide policy guidance to your company to support internal and regulatory compliance in your driver health program. At Concentra, you and your drivers can also have the assurance of knowing that our clinicians are highly trained and always up-to-date on the latest DOT-related rules and changes. We work with our clients to help them understand FMCSA requirements and ensure drivers are prepared for their exam. Our expertise can help you reduce costs by avoiding delays or downtime due to mistakes, such as altered DOT forms. Learn more about how Concentra can help you can take proactive steps to get and keep drivers healthy and keep the wheels on the road. 1 Truck Driver Shortage Analysis, American Trucking Associations, 2015: (ATA) Truck Driver Shortage Analysis for American Trucking... 2 Large Truck and Bus Crash Facts 2014, Federal Motor Carrier Safety Administration, April 2015: 3 The Current State of the Driver Shortage in 2016, Cerasis, May 2016: 4 Truck Driver Shortage Analysis, American Trucking Associations, 2015: (ATA) Truck Driver Shortage Analysis for American Trucking... 5 Growing a Small Fleet, Truckinginfo, October 2013: 6 What s the Hard Return on Employee Wellness Programs?, Harvard Business Review, December 2010: 7 Truck drivers wanted. Pay: $73,000, CNN Money, October 2015: 8 National Survey of Long-Haul Truck Driver Health and Injury, Federal Motor Carrier Safety Administration, January 2014: Long-Haul%20Truck%20Driver%20Health%20and%20Injury.pdf 9 National Sleep Foundation: 10 Get On the Road to Better Health, Federal Motor Carrier Safety Administration: 11 Drowsy Driving: Asleep at the Wheel, Centers for Disease Control and Prevention: 12 Truck drivers who fail to adhere to sleep apnea treatment have higher crash rate, Harvard T.H. Chan School of Medicine, March 2016.: 13 Sleep apnea research: Truck operators must spend average of $1,200 for testing when apnea suspected, Overdrive, May 2016: 14 Teen Drivers: Get the Facts, Centers for Disease Control and Prevention: June