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Elderly drivers may face new test

Bill ties license renewal to mental, physical exam

By Noah Bierman
Globe Staff / September 15, 2009

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Massachusetts drivers 75 and older would have to pass a still-undefined mental and physical fitness exam to renew their licenses, under a bill released yesterday by the Legislature’s Transportation Committee.

The long-awaited proposal would address one of the most pressing issues before the Legislature, after a series of serious accidents this year involving the elderly, but it provides few specifics about the nature of the tests, who would administer them, and who would cover the cost.

Instead, it leaves that conundrum to the Registry of Motor Vehicles - an already struggling agency that has been forced to close several offices - which would be asked to come up with a system in consultation with its medical advisory board.

A possible outcome, according to the committee chairman and a Registry official who demanded anonymity, is that the agency would rely on private health care providers to make the assessment, a prospect that may not sit well with doctors.

“Physicians shouldn’t be in a position of being a policeman,’’ said Dr. Mario Motta, a Salem cardiologist and president of the Massachusetts Medical Society. “Physicians are supposed to be in a position to advocate for their patients and this is not that at all.’’

The District of Columbia appears to be the only government in the United States that requires the same degree of direct participation from a doctor for older drivers, according to a list of state requirements compiled by the Insurance Institute for Highway Safety. Washington drivers who renew licenses after age 70 must pass a vision test and present a statement from their physician certifying physical and mental competence.

In addition to opening the door to competency certifications in Massachusetts, the new bill would clarify that physicians and police officers who call the Registry to report specific suspicions of an incompetent driver would be immune from lawsuits if the reports are made in good faith. The bill would also require competency testing for any driver, regardless of age, who has three or more accidents that qualify for an insurance surcharge in the course of a year.

There has been a clamor for legislative action after several fatal crashes, including one that killed a 4-year-old girl at a crosswalk in Stoughton, several that killed older drivers’ spouses, and one last month that left a Weymouth police officer dead after he was pinned against a utility truck.

Representative Joseph F. Wagner, a Chicopee Democrat and co-chairman of the Transportation Committee, characterized the bill as a compromise that tries to provide new safeguards while stopping short of the mandatory road test demanded by some.

“That just didn’t make a lot of sense to us,’’ he said. “Giving the registrar broad authority, we provide a more comprehensive approach to the issues that we understand exist here.’’

Rachel Kaprielian, the registrar, and Governor Deval Patrick both said in written statements that they support the goals of the bill, but they declined to comment on details while the Legislature deliberates.

A Registry official, speaking on condition of anonymity for the same reason, said the agency would probably design a standard medical clearance form that could be filled out by a health care professional and mailed to the Registry as part of the renewal process. That would help the Registry in two ways: fewer drivers would crowd already overburdened offices and untrained RMV clerks would not be asked to evaluate drivers’ competence.

The tests themselves would look at a combination of health factors such as heart conditions and seizures as well as measure mental aptitude, according to the official.

The bill allows for an appeals process that could include a road test for drivers who fail to get a medical certification but believe they are still competent to drive.

Those opposed to age-based requirements, including the American Automobile Association, are already speaking out against the bill. And there is no certainty it will pass the Legislature, given the risks of alienating older residents - a potent voting bloc. Currently, there are 322,000 registered drivers between the ages of 75 and 96 in Massachusetts, out of a total of about 4.6 million licensed drivers.

But advocates for stricter rules said the effort has already gone further this year than in the past.

“When I first started pushing this bill, it was five years ago, and I couldn’t get this very committee to report out a bill for testing at age 85,’’ said Senator Brian Joyce, who supports the latest bill.

Elizabeth Dugan, a gerontologist at the University of Massachusetts at Boston and spokeswoman for Safe Roads Now, said the age seems to have been chosen arbitrarily. And the lack of details on the testing opens questions about who pays for the certification and whether a truly valid test can be applied, said Dugan, who has been active in the debate and opposes age-based testing.

“They’ve missed the mark, and it’s a lost opportunity,’’ she said.

Despite a spate of high-profile crashes in recent months, state and federal data show that elderly drivers account for fewer crashes, proportionately, than other age groups.

The state already allows doctors and law enforcement officials to refer drivers of any age with competency questions to the Registry. Those drivers - about 2,500 per year - are required to take road tests to maintain their licenses. Between January 2007 and August 2008, the state road-tested 1,007 drivers who were over the age of 75 under that provision. The majority failed.

Noah Bierman can be reached at nbierman@globe.com.