/policies/,/policies/clinical/,/policies/clinical/uw-health-clinical/,/policies/clinical/uw-health-clinical/administrative/,/policies/clinical/uw-health-clinical/administrative/legally-driven-care/,

/policies/clinical/uw-health-clinical/administrative/legally-driven-care/1211.policy

201706152

page

100

UWHC,UWMF,

Policies,Clinical,UW Health Clinical,Administrative,Legally Driven Care

Reporting Patients Who May Be Unsafe Drivers (1.2.11)

Reporting Patients Who May Be Unsafe Drivers (1.2.11) - Policies, Clinical, UW Health Clinical, Administrative, Legally Driven Care

1.2.11


UW HEALTH CLINICAL POLICY 1
Policy Title: Reporting Patients Who May Be Unsafe Drivers
Policy Number: 1.2.11
Category: UW Health
Type: Ambulatory and Inpatient
Effective Date: May 26, 2017

I. PURPOSE

To provide guidance on the Wisconsin law that permits a physician, physician assistant (PA), or an
advanced practice nurse prescriber (APNP) to report to the Wisconsin Department of Transportation
(WisDOT) or another state’s driver licensing agency a patient whose physical or mental condition impairs the
patient's ability to safely drive a motor vehicle and to advise of the steps necessary to make a report.

II. POLICY ELEMENTS

It is within the professional discretion of the patient’s physician, PA, or APNP to determine whether or not to
report to WisDOT or another state’s driver licensing agency patients whose physical or mental condition may
impair the patient’s ability to safely drive a motor vehicle. UW Health has no policy on whether and when
such reports should be made.

III. GENERAL INFORMATION

A. Wisconsin law provides an exception to the confidentiality of patient health care information, allowing
physicians, PAs, and APNPs who treat a patient with a physical or mental condition that, in the physician's,
PA’s, or APNP’s professional judgment, affects the patient's ability to exercise reasonable and ordinary
control over a motor vehicle, to report the patient's name and other information relevant to the condition, to
the applicable state driver licensing agency without the patient’s authorization.
B. Diagnosis of a medical condition alone is not as important as how the condition affects a patient’s ability to
function as a driver. Areas of concern may include, but not be limited to: effects of medication, reliability in
following a prescribed treatment program, behavioral and physical stability, cognitive/thinking ability,
judgment and insight, ability to stay alert, reaction time, range of motion (ability to maneuver/use arms and
legs), strength and endurance, abuse of alcohol and other drugs.
C. A physician, PA, or APNP will not be held liable for any civil damages for not reporting to the WisDOT
provided that the decision not to report was based on a good faith judgment that the physical or mental
condition of the patient does not impair the patient's ability to exercise reasonable and ordinary control over
a motor vehicle.
D. If requested by the individual who is the subject of an impaired driver report, WisDOT will provide the
individual with copies of the medical information that has been reported to WisDOT by the physician, PA, or
APNP who made the report.

IV. PROCEDURE

A. If a physician, PA, or APNP has concerns regarding a patient’s ability to safely drive a motor vehicle, the
physician, PA, or APNP may choose to discuss those concerns with the patient to determine if a report to
WisDOT or another state’s driver licensing agency is warranted.
B. If a decision is made to report, the following steps shall be taken after the treating physician, PA, or APNP
determines, using his/her professional judgment, that the patient has a physical or mental condition that
affects the patient’s ability to exercise reasonable and ordinary control over a motor vehicle. If the patient
has a driver license issued by a state other than Wisconsin, the treating physician, PA, or APNP should
follow that state’s procedure for reporting drivers:
i. Form Filing: Download the WisDOT form MV3141 (Driver Condition or Behavior Report available
on the WisDOT website at: http://wisconsindot.gov/Documents/formdocs/mv3141.pdf.
ii. Letter Reporting: Alternatively, the reporting physician, PA, or APNP may submit a letter, on
letterhead stationery, to the WisDOT. The letter should include the following information:
a. Patient/Driver name;
b. Patient/Driver date of birth;
c. Patient/Driver driver license number and state of issuance;
d. Patient/Driver address, including street, city, state, and zip code;
e. Statement regarding patient’s ability to drive at the current time. (Note that a statement the
patient is unsafe to drive will result in immediate cancellation of the patient’s driving



UW HEALTH CLINICAL POLICY 2
Policy Title: Reporting Patients Who May Be Unsafe Drivers
Policy Number: 1.2.11

privileges. A statement recommending retesting or explaining that the practitioner is
unsure whether the patient is safe to drive will result in retesting);
f. Any recommendations to WisDOT (e.g., written, road or vision retesting);
g. Physician’s, PA’s, or APNP’s signature, printed name, mailing address, telephone number
and professional license number; and
h. Date letter is signed.
iii. Filing Information: Submit the form or the letter via mail or fax to:
Wisconsin Department of Transportation Division of Motor Vehicles
Medical Review Unit
P.O.Box 7918
Madison, Wisconsin 53707-7918
Fax: 608-267-0518
C. Copies of the notification letter and any follow-up correspondence should be scanned into the patient’s
medical record. The WisDOT will notify the reporting practitioner of its final licensing decision.
D. The physician, PA, or APNP may consider whether it is appropriate to inform the patient and his/her family
when the state driver licensing agency is contacted. Discussions with the patient and family should be
documented in the medical record.
E. If the applicable state driver licensing agency does restrict driving and assistance is needed in finding
alternative transportation to and from UW Health, the patient should be referred to Patient Resources if in
the ambulatory setting or Social Work if at University Hospital, American Family Children’s Hospital, or The
American Center.
F. Emergency/Imminent Situations. When a patient or other person is presently incapacitated (regardless of
cause) and is leaving UW Health to drive, staff should offer assistance with alternate transportation. If the
person insists on driving, staff members should contact UW Police ((608) 264-2677), the Madison Police
Department ((608) 255-2345), or other appropriate law enforcement depending on his/her clinic location. If
at University Hospital or American Family Children’s Hospital, call Security at 890-5555 or if at The
American Center call Security at 440-6666. Inform law enforcement/Security of the circumstances and
share any available information about the vehicle, such as color, make, and license plate number.
Disclosure of confidential medical information should be minimized. Generally the fact of incapacity will be
sufficient.
G. Tracking and Accounting of Disclosure. The disclosure of a patient’s protected health information should be
documented using Health Link’s Quick Disclosure. See UWHC policy #6.23, Accounting of Protected Health
Information Disclosures/UWMF, Accounting of Disclosure Policy and Guidelines.

V. COORDINATION

Author: VP Business Integrity/Chief Compliance Officer
Senior Management Sponsor: SVP/Chief Administrative Officer
Reviewers: Health Information Management, UW Health Legal Department
Approval committees: UW Health Clinical Policy Committee
UW Health Clinical Policy Committee Approval: May 15, 2017

UW Health is a cohesive, united and integrated academic medical enterprise comprised of several entities.
This policy applies to facilities and programs operated by the University of Wisconsin Hospitals and Clinics
and the University of Wisconsin Medical Foundation, Inc., and to clinical facilities and programs
administered by the University of Wisconsin School of Medicine and Public Health. Each entity is
responsible for enforcement of this policy in relation to the facilities and programs that it operates.

VI. APPROVAL

Peter Newcomer, MD
Chief Clinical Officer

J.Scott McMurray, MD
Chair, UW Health Clinical Policy Committee






UW HEALTH CLINICAL POLICY 3
Policy Title: Reporting Patients Who May Be Unsafe Drivers
Policy Number: 1.2.11

VII. REFERENCES

UWHC policy #6.23, Accounting of Protected Health Information Disclosures
UWMF policy, Accounting of Disclosure Policy and Guidelines
Wis. Stats., secs. 146.82(3)(a), 448.03 (5) (b), and 441.06(7).
WisDOT website available at: http://wisconsindot.gov/Pages/dmv/license-drvs/mdcl-cncrns/med-
concerns.aspx

VIII. REVIEW DETAILS

Version: Revision
Last Full Review: May 26, 2017
Next Revision Due: May 2020
Formerly Known as: Hospital Administrative policy #4.36