DAR File No. 44166

Public Safety, Driver License

Rule R708-7

Functional Ability in Driving: Guidelines for Physicians

Notice of Proposed Rule

(Amendment)

DAR File No.: 44166
Filed: 10/30/2019 11:34:36 AM

RULE ANALYSIS

Purpose of the rule or reason for the change:

The purpose of this rule change is to incorporate changes to the "Functional Ability in Driving: Guidelines and Standards for Health Care Professionals" as recommended by the Medical Advisory Board to the Driver License Division (Division), and to specify the manner in which the "Functional Ability in Driving: Guidelines and Standards for Health Care Professionals" are made available to health care providers and members of the public.

Summary of the rule or change:

The Medical Advisory Board (Board) recommended changes to the Functional Ability Guidelines and Standards which included modifying the titles of some of the categories the�Division will follow including,�epilepsy which will be known as seizures and psychiatric or emotional conditions which will be known as mental health.� The Board recommended removing the hearing and balance category, this condition can be addressed in other areas monitored by a healthcare professional.� These changes required the administrative rule be amended to reflect the recommendations made by the Board and adopted by the Division.� In addition, the amendment proposes that the Functional Ability Guidelines and Standards would stop being mass printed for the purpose of distribution to Health Care Providers but instead be provided in a digital format to allow for timely, up-to-date revisions.� Printed copies of the guidelines will be made available for purchase at Driver License offices.

Statutory or constitutional authorization for this rule:

• Section 53-3-224
• Section 53-3-303
• Section 53-3-304
• 49 CFR 391.43

This rule or change incorporates by reference the following material:

• Updates Functional Ability in Driving: Guidelines and Standards for Health Care Professionals, published by Utah Driver License Division, 01/01/2019

Anticipated cost or savings to:

the state budget:

There is no anticipated cost or savings to the state budget as a result of this rule amendment. The Division has previously had the "Functional Ability in Driving: Guidelines and Standards for Health Care Professionals" printed by Utah Correctional Industries. The last printing of the guidelines occurred in 2015 and cost approximately $340, which was transferred from the Utah Driver License Division to Utah Correctional Industries. Due to the fact that the guidelines will no longer be printed in bulk, the cost for printing will no longer need to be deducted from the Division's budget and transferred to Utah Correctional Industries' budget. The Division will still be able to provide an individual a hard copy of the guidelines if requested; however, they will no longer print the guidelines in bulk.

local governments:

There is not an anticipated cost or savings to local governments because this rule amendment removes the text regarding one of the medical categories for which a medical report form was previously required, and specifies that the "Functional Ability in Driving: Guidelines and Standards for Health Care Professionals" will no longer be printed for distribution. This rule change will not have an impact on local governments.

small businesses:

There is not an anticipated cost or savings to small businesses because this rule amendment removes the text regarding one of the medical categories for which a medical report form was previously required, and specifies that the "Functional Ability in Driving: Guidelines and Standards for Health Care Professionals" will no longer be printed for distribution. The guidelines are made available to health care providers and members of the public via the Division's website. The guidelines were previously printed by Utah Correctional Industries and not a small business.

persons other than small businesses, businesses, or local governmental entities:

There is an anticipated savings to persons other than small businesses, businesses, or local government entities because a person requesting a hard copy of "Functional Ability in Driving: Guidelines and Standards for Health Care Professionals" will no longer be required to pay a $5 fee to obtain a copy. The guidelines have been published to the Division's website for several years; however, prior to this rule change, if a member of the public requested a hard copy of the guidelines, they had the option to obtain a hard copy for a $5 fee. The language requiring payment of the $5 fee for a copy has been removed from this rule. The Division is unable to determine how many individuals have paid the $5 fee for a hard copy of the guidelines in the past because the information is not available; however, the Division anticipates the number would be relatively low due to the fact that most individuals would have accessed the information through the Division's website. Health care providers were not charged a $5 fee for a copy of the guidelines.

Compliance costs for affected persons:

There are no direct compliance costs by affected persons to the Division. A driver may have costs for an office visit, testing, or the time needed for the health care professional to complete the necessary forms.

Comments by the department head on the fiscal impact the rule may have on businesses:

There are no non-small businesses that will be impacted by this rule amendment. This rule amendment removes the text regarding one of the medical categories for which a medical report form was previously required, and specifies that "Functional Ability in Driving: Guidelines And Standards for Health Care Professionals" will no longer be printed for distribution. Health care providers and members of the public are able to view the guidelines via the Division's website. The guidelines were previously printed for the Division by Utah Correctional Industries, and not a small or non-small business.

Jess L. Anderson, Commissioner

The full text of this rule may be inspected, during regular business hours, at the Office of Administrative Rules, or at:

Public Safety
Driver License
CALVIN L RAMPTON COMPLEX
4501 S 2700 W 3RD FL
SALT LAKE CITY, UT 84119-5595

Direct questions regarding this rule to:

• Kim Gibb at the above address, by phone at 801-556-8198, by FAX at 801-964-4482, or by Internet E-mail at kgibb@utah.gov
• Tara Zamora at the above address, by phone at 801-964-4483, by FAX at 801-964-4482, or by Internet E-mail at tarazamora@utah.gov

Interested persons may present their views on this rule by submitting written comments to the address above no later than 5:00 p.m. on:

12/16/2019

This rule may become effective on:

12/24/2019

Authorized by:

Chris Caras, Director

Appendix 1: Regulatory Impact Summary Table*

Fiscal Costs	FY 2020	FY 2021	FY 2022
State Government	$0	$0	$0
Local Government	$0	$0	$0
Small Businesses	$0	$0	$0
Non-Small Businesses	$0	$0	$0
Other Person	$0	$0	$0
Total Fiscal Costs:	$0	$0	$0
Fiscal Benefits
State Government	$0	$0	$0
Local Government	$0	$0	$0
Small Businesses	$0	$0	$0
Non-Small Businesses	$0	$0	$0
Other Persons	$0	$0	$0
Total Fiscal Benefits:	$0	$0	$0
Net Fiscal Benefits:	$0	$0	$0

 

*This table only includes fiscal impacts that could be measured. If there are inestimable fiscal impacts, they will not be included in this table. Inestimable impacts for State Government, Local Government, Small Businesses and Other Persons are described in the narrative. Inestimable impacts for Non - Small Businesses are described in Appendix 2.

 

Appendix 2: Regulatory Impact to Non - Small Businesses

There are no non-small businesses that will be impacted by this rule amendment. This rule amendment removes the text regarding one of the medical categories for which a medical report form was previously required, and specifies the manner in which the "Functional Ability in Driving: Guidelines and Standards for Health Care Professionals" are be made available to health care providers and members of the public.

 

The head of department of Public Safety, Commissioner Jess Anderson, has reviewed and approved this fiscal analysis.

 

 

R708. Public Safety, Driver License.

R708-7. Functional Ability in Driving: Guidelines for Physicians.

R708-7-1. Purpose.

The purpose of this rule is to establish standards and guidelines to assist health care professionals in determining who may be impaired, the responsibilities of the health care professionals, and the driver's responsibilities regarding their health as it relates to highway safety.

 

R708-7-2. Authority.

This rule is authorized by Sections 53-3-224, 53-3-303, 53-3-304, and 49 CFR 391.43.

 

R708-7-3. Definitions.

(1) "Board" means the Driver License Medical Advisory Board created in Section 53-3-303.

(2) "Division" means the Driver License Division.

(3) "Health care professional" means a physician or surgeon licensed to practice medicine in the state, or when recommended by the Medical Advisory Board, may include other health care professionals licensed to conduct physical examinations in this state.

(4) "Impaired person" means a person who has a mental, emotional, or nonstable physical disability or disease that may impair the person's ability to exercise reasonable and ordinary control at all times over a motor vehicle while driving on the highway. It does not include a person having a nonprogressive or stable physical impairment that is objectively observable and that may be evaluated by a functional driving examination.

 

R708-7-4. Health and Driving.

(1) Every driver operating a vehicle is individually responsible for their health when driving. Each applicant for a Utah driver license shall be required to answer personal health questions related to driving safety in accordance with recommendations made by the Driver License Medical Advisory Board pursuant to the provisions of Section 53-3-303(8). If the applicant experiences a significant health problem, the applicant is required to take a [medical report ]form furnished by the division to a health care professional who provides all requested information, including a safety assessment level that reflects the applicant's medical condition.

(2) The health care professional will be expected to discuss the applicant's health as it may affect driving abilities and to make special recommendations in unusual circumstances. Based upon a completed safety assessment, the division may deny driving privileges or issue a license with or without limitations in accordance with the standards described in this rule and lists, tables, and charts incorporated herein. Health care professionals have a responsibility to help reduce unsafe highway driving conditions by carefully applying these guidelines and standards, and by counseling with their patients about driving under medical constraints.

 

R708-7-5. Driver's Responsibilities.

(1) The 1979 Utah State Legislature has defined driver operating responsibilities in Section 53-3-303, related to physical, mental or emotional impairments of drivers. Drivers are:

(a) responsible to refrain from driving if there is uncertainty caused from having a physical, mental or emotional impairment which may affect driving safety;

(b) expected to seek competent medical evaluation and advice about the significance of any impairment that relates to driving vehicles safely; and

(c) responsible for reporting a "physical, mental or emotional impairment which may affect driving safety" to the Driver License Division in a timely manner.

 

R708-7-6. Health Care Professional's Responsibilities.

(1) Pursuant to Section 53-3-303, health care professionals shall:

(a) make reports to the division respecting impairments which may affect driving safety when requested by their patients. Nevertheless, the final responsibility for issuing a driver license remains with the director of the division;

(b) counsel their patients about how their condition affects safe driving. For example, if medication is prescribed for a patient which may cause changes in alertness or coordination, the health care professional shall advise the patient about how the medication can affect safe driving, and when it would be safe to operate a vehicle. Or, if a patient's visual acuity drops, the patient should similarly be advised, at least until corrective action has been taken to improve vision; and

(c) in accordance with Section 53-3-303(14)(b), be responsible for making available to their patients without reservation, their recommendations and appropriate information related to driving safety and responsibilities, whether defined by published guidelines or not.

 

R708-7-7. Driver License Medical Advisory Board.

(1) The Driver License Medical Advisory Board, as per Section 53-3-303, shall advise the director of the division and recommend written functional ability and safety assessment guidelines and standards for determining the physical, mental and emotional capabilities of applicants for licenses, appropriate to various driving abilities.

(2) In case of uncertainty of interpretation of these guidelines and standards, or in special circumstances, applicants may request a review of any division decision by a panel of board members. All of the actions of the director and board are subject to judicial review.

(3) In accordance with Section 53-3-303(8), the board shall administer the functional ability and safety assessment guidelines, which are intended to minimize such conflicts as the individual's desire to drive and the community's desire for highway safety.

 

R708-7-8. Persons Authorized to Complete Functional Ability Evaluation Medical Report Form.

(1) Physicians and surgeons licensed to practice medicine may complete the entire Functional Ability Evaluation Medical Report form.

(2) Nurse practitioners and physician assistants, and in accordance with 49 CFR 391.43, physician assistants, advanced practice nurses, doctors of chiropractic and other health care professionals, may perform physical examinations and report their findings on the Functional Ability Evaluation Medical Report form provided that:

(a) they are licensed by the state as health care professionals;

(b) the physical examination does not require advanced or complex diagnosis or treatment; and

(c) in the event that advanced or complex medical diagnostic analysis is required, the licensed health care professional, consistent with sound medical practices, will be expected to promptly refer the patient to the appropriate physician, surgeon or doctor of osteopathy for further evaluation and for completion of the functional ability evaluations certifications report in those categories.

 

R708-7-9. Safety Assessment Level Categories.

Functional ability of a driver to operate a vehicle safely may be affected by a wide range of physical, mental or emotional impairments. To simplify reporting and to make possible a comparison of relative risks and limitations, the Medical Advisory Board has adopted physical, emotional and behavioral safety assessment levels as defined in [12]11 separate categories, with multiple levels under each category.

 

R708-7-10. Use of the Safety Assessment Level.

(1) Health care professionals who evaluate their patients' health status for purposes of the patient obtaining a Utah driver license, shall report safety assessment levels on forms provided by the division.

(2) In assessing patient health and completing these report forms, health care professionals shall apply the standards and related information contained in the following lists, charts, and tables, which standards and guidelines are referred to in , [a booklet entitled, ]"Functional Ability in Driving: Guidelines And Standards for Health Care Professionals." Specific categories are:

(a) "Category A" - diabetes and other metabolic conditions; narrative listing and table;

(b) "Category B" - cardiovascular; narrative listing and table;

(c) "Category C" - pulmonary; narrative listing and table;

(d) "Category D" - neurologic; narrative listing and table;

(e) "Category E" - [epilepsy]seizures and other episodic conditions; narrative listing and table;

(f) "Category F" - learning, memory and communications; narrative listing and table;

(g) "Category G" - [psychiatric or emotional conditions]mental health; narrative listing and table;

(h) "Category H" - alcohol and other drugs; narrative listing and table;

(i) "Category I" - visual acuity; narrative listing and table;

(j) "Category J" - musculoskeletal abnormality or chronic medical debility; narrative listing and table; and

(k) "Category K" - alertness or sleep disorders; narrative listing and table;[and

(L) "Category L" - hearing and balance; narrative listing and table.]

(3) [Copies of t]These guidelines are [printed in a booklet and distributed by the division in addition to being ]published on the Driver License Division webpage. [These booklets may be obtained at no cost for health care professionals or $5 per booklet for all other individuals. ] A [Copies]copy may be obtained in person at any Division office or by written request to the Driver License Division Medical Section at P.O. Box 144501, Salt Lake City, Utah 84114-4501.

(4) Report forms completed by a health care professional and received by the division are to be used as a screening tool in assessing an individual's ability to safely operate a motor vehicle.

(a) Some safety assessment levels as identified in the "Functional Ability in Driving: Guidelines And Standards for Health Care Professionals", may result in the division requesting an individual to complete a driver review, which may include a driving skills test in order to demonstrate the ability to safely operate a motor vehicle before determining whether the individual will maintain the privilege to drive. In some cases when a privilege to drive is granted, driving restrictions may be required in order to ensure public safety.

(b) A health care professional may also request that the division evaluate an individual's driving skill level at the health care professional's discretion.

(5) The division shall notify an individual that their privilege to drive is denied upon receipt of the following:

(a) a medical report that is completed in the categories A, B, C, D, E, F, G, H, J, or K, [or L, ]for which the driver is assessed at a level "8" in accordance with the "Functional Ability in Driving: Guidelines And Standards for Health Care Professionals", or other documentation which indicates that the health care professional recommends that the individual does not drive; or

(b) a medical report that is completed in the category I for which the driver is assessed at a level "10" in accordance with the "Functional Ability in Driving: Guidelines And Standards for Health Care Professionals", or other documentation which indicates that the health care professional recommends that the individual does not drive.

(6) Upon receipt of a notice of denial of the privilege to drive, an individual may request a review of the division's decision by a panel of board members. All of the actions of the director and board are subject to judicial review.

 

KEY: administrative procedures, health care professionals, physicians

Date of Enactment or Last Substantive Amendment: [March 10, 2015]2019

Notice of Continuation: January 8, 2017

Authorizing, and Implemented or Interpreted Law: 53-3-224; 53-3-303; 53-3-304; 49 CFR 391.43