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Changes to Medical Reporting of Drivers Gives OTs New Reporting Authority

March 01, 2018
Effective July 1, 2018, occupational therapists will have new authority and responsibility, under the Highway Traffic Act, 1990 to report potentially unsafe drivers directly to the Ministry of Transportation.

In 2015, the Highway Traffic Act, 1990 was amended. The amendments gave the Ministry of Transportation the ability to grant authority for medical reporting to additional health practitioners, to revise the nature of the conditions that must be reported, and to introduce the authority for “discretionary” reports. These amendments are outlined in Section 203 and 204 of the Highway Traffic Act, 1990.

On February 23, 2018, the new regulations relating to the medical reporting requirements for drivers were published (Ontario Regulation 38/18: Drivers’ Licences Amending O. Reg. 340/94).

Highlights of the regulations include:

1. Discretionary Reporting - Occupational therapists have been granted authority and responsibility for discretionary reporting of potentially unsafe drivers

Highway Traffic Act, 1990, Section 203

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Discretionary reports

(2) A prescribed person may report to the Registrar a person who is at least 16 years old who, in the opinion of the prescribed person, has or appears to have a medical condition, functional impairment or visual impairment that may make it dangerous for the person to operate a motor vehicle. 2015, c. 14, s. 55.

Authority to make discretionary report prevails over duty of confidentiality

(3) The authority to make a report under subsection (2) prevails over any duty of confidentiality imposed on the prescribed person by or under any other Act or by a standard of practice or rule of professional conduct that would otherwise preclude him or her from providing the information described in that subsection to the Registrar. 2015, c. 14, s. 55.

Required to meet the person

(4) Subsections (1) and (2) only apply if the prescribed person actually met the reported person for an examination or for the provision of medical or other services, or in the circumstances prescribed by regulation. 2015, c. 14, s. 55.

Authority to make discretionary report is not a duty

(5) Subsections (2) and (3) do not impose a duty on a prescribed person to report to the Registrar. 2015, c. 14, s. 55.

2. New List of Conditions for Reporting – The list defines the high risk medical conditions, functional impairments and visual impairments to be used for mandatory and discretionary reports (O. Reg. 38/18).

Ontario Regulation 38/18: Drivers' Licenses, Section 14.1

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(3) For the purposes of subsection 203 (1) of the Act, the following are the prescribed medical conditions, functional impairments and visual impairments that a prescribed person under subsection (1) shall report:

1. Cognitive impairment: a disorder resulting in cognitive impairment that,

i affects attention, judgment and problem solving, planning and sequencing, memory, insight, reaction time or visuospatial perception, and
ii results in substantial limitation of the person’s ability to perform activities of daily living.

2. Sudden incapacitation: a disorder that has a moderate or high risk of sudden incapacitation, or that has resulted in sudden incapacitation and that has a moderate or high risk of recurrence.

3. Motor or sensory impairment: a condition or disorder resulting in severe motor impairment that affects co-ordination, muscle strength and control, flexibility, motor planning, touch or positional sense.

4. Visual impairment:

i A best corrected visual acuity that is below 20/50 with both eyes open and examined together.
ii A visual field that is less than 120 continuous degrees along the horizontal meridian, or less than 15 continuous degrees above and below fixation, or less than 60 degrees to either side of the vertical midline, including hemianopia.
iii Diplopia that is within 40 degrees of fixation point (in all directions) of primary position, that cannot be corrected using prism lenses or patching.

5. Substance use disorder: a diagnosis of an uncontrolled substance use disorder, excluding caffeine and nicotine, and the person is non-compliant with treatment recommendations.

6. Psychiatric illness: a condition or disorder that currently involves acute psychosis or severe abnormalities of perception such as those present in schizophrenia or in other psychotic disorders, bipolar disorders, trauma or stressor-related disorders, dissociative disorders or neurocognitive disorders, or the person has a suicidal plan involving a vehicle or an intent to use a vehicle to harm others.

3. New Medical Reporting Form – A new medical reporting form for use by physicians, nurse practitioners and occupational therapists for both mandatory and discretionary reporting has been approved and will be online as of July 1, 2018.

We know occupational therapists will have lots of questions about how these new rules will impact their practice. In preparation for July 1, 2018, the College will be working with key stakeholders to develop guidelines to clarify reporting expectations and assist occupational therapists with the implementation of the new medical reporting rules.

Stay tuned for more information. If you have any questions, please contact Kara Ronald, Deputy Registrar, at kronald@coto.org.