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Improving the Safety of Older Road Users (2005)

Chapter: Chapter Three - Planning for Improved Older Road User Safety

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Suggested Citation:"Chapter Three - Planning for Improved Older Road User Safety." National Academies of Sciences, Engineering, and Medicine. 2005. Improving the Safety of Older Road Users. Washington, DC: The National Academies Press. doi: 10.17226/13546.
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Suggested Citation:"Chapter Three - Planning for Improved Older Road User Safety." National Academies of Sciences, Engineering, and Medicine. 2005. Improving the Safety of Older Road Users. Washington, DC: The National Academies Press. doi: 10.17226/13546.
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Suggested Citation:"Chapter Three - Planning for Improved Older Road User Safety." National Academies of Sciences, Engineering, and Medicine. 2005. Improving the Safety of Older Road Users. Washington, DC: The National Academies Press. doi: 10.17226/13546.
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Suggested Citation:"Chapter Three - Planning for Improved Older Road User Safety." National Academies of Sciences, Engineering, and Medicine. 2005. Improving the Safety of Older Road Users. Washington, DC: The National Academies Press. doi: 10.17226/13546.
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Suggested Citation:"Chapter Three - Planning for Improved Older Road User Safety." National Academies of Sciences, Engineering, and Medicine. 2005. Improving the Safety of Older Road Users. Washington, DC: The National Academies Press. doi: 10.17226/13546.
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Suggested Citation:"Chapter Three - Planning for Improved Older Road User Safety." National Academies of Sciences, Engineering, and Medicine. 2005. Improving the Safety of Older Road Users. Washington, DC: The National Academies Press. doi: 10.17226/13546.
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Suggested Citation:"Chapter Three - Planning for Improved Older Road User Safety." National Academies of Sciences, Engineering, and Medicine. 2005. Improving the Safety of Older Road Users. Washington, DC: The National Academies Press. doi: 10.17226/13546.
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Suggested Citation:"Chapter Three - Planning for Improved Older Road User Safety." National Academies of Sciences, Engineering, and Medicine. 2005. Improving the Safety of Older Road Users. Washington, DC: The National Academies Press. doi: 10.17226/13546.
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A first step in addressing the transportation safety and mobil- ity needs of older road users is the development of a strate- gic plan. The plan should articulate key issues and needs, establish goals, and specify strategies and a timetable for their implementation. A plan can also serve to bring together principal stakeholders in the process. The latter is especially important in addressing the needs of older road users, because no single agency or organization holds ownership over all potential program areas. This chapter reviews key planning initiatives for improv- ing older road user safety, focusing on the goals and recom- mendations that have helped guide and prioritize the policies and programs described in the remainder of this report. The identified planning activities are comprehensive in scope, rather than limited to just one or two program areas such as highway design or driver licensing. They are also at various stages of implementation. However, they all have in common the singular goal of improving the safety and mobility of older road users. FEDERAL GOVERNMENT INITIATIVES As noted in the literature review in chapter two, the U.S.DOT first identified a national strategic planning goal of Safe Mobil- ity, for Life in its 1997 report, Improving Transportation for a Maturing Society. The executive summary to that report states that: It is in the national interest to keep people operating their per- sonal vehicles as late in years as possible for quality of life rea- sons; yet we do not want that operation to unnecessarily endan- ger the individual or the public (U.S.DOT 1997, p. ix). The report goes on to describe three policy objectives inherent in such a goal: (1) safety, (2) individual mobility, and (3) facilitating the eventual transition to mobility alter- natives. Recommended new initiatives included an added emphasis on mobility alternatives, development of counter- measures to better protect older adults’ more fragile bodies, development of medical practice parameters and guidelines, and conducting studies to support public policy decisions in such areas as medical conditions or functional disabilities and driving safety. The 2003 U.S.DOT report, Safe Mobility for a Maturing Society: Challenges and Opportunities, further defined the 14 strategies and programs that will be needed to achieve the vision of safe mobility for life. These strategies, which were listed in chapter two, require all levels of government, the pri- vate sector, and the public to join together to help create safe transportation for all ages into the 21st century. Although some of the strategies, such as safer automobiles and better transportation services, are outside the scope of the current synthesis, others coincide with program areas reviewed in subsequent chapters of this document. With respect to plan- ning, the report emphasized that although the federal gov- ernment “can support, assist, and inform the process . . . meet- ing the mobility needs of an aging society must first and foremost be a key priority of state and local leaders.” Two specific strategies were identified for Action Item 5: Targeted state and local safe mobility action plans: 1. Encourage formation of state and local consortia to address the transportation needs of elderly people. 2. Encourage states and local communities to develop and implement safe mobility action plans. Obtaining input and leadership from community leaders and citizens representing a broad array of interest groups (social service, medical, transportation, etc.) was viewed as key to the success of this strategy. “To give safe transporta- tion the priority it warrants will require leadership, activism, and consensus building, both political and institutional” (Safe Mobility . . . 2003). In support of this approach, the DOT reached out beyond its own agency boundaries to a broad spectrum of other government agencies and professional organizations and individuals in developing its recommenda- tions. Those providing input to the document included the National Institute on Aging, CDC, Administration on Aging, AARP, AAA, AAMVA, AMA, AOTA, and representatives from the automotive industry. OTHER NATIONAL INITIATIVES AASHTO is the professional association representing state DOTs. In 1997, AASHTO produced a national SHSP focused on reducing the more than 40,000 motor vehicle deaths occur- ring annually on U.S. highways (The Strategic Highway Safety Plan 1997). Based on an analysis of crash data and the con- sensus of a specially formed committee, the plan identified 22 emphasis areas for state and local transportation depart- ments to target their efforts. One of these 22 areas was Reduc- ing Crashes Involving Older Drivers. CHAPTER THREE PLANNING FOR IMPROVED OLDER ROAD USER SAFETY

15 To assist states in achieving the goals of the SHSP, NCHRP funded a multiyear project to develop guidelines for each of the identified emphasis areas. These guidelines were published in May 2004 (Potts et al. 2004). A link to the plan is available on the AASHTO SHSP website at http://safety. transportation.org/. The guide itself represents an overall planning document for reducing older driver crashes. The identified strategies fall under five main objectives: 1. Plan for an aging population. 2. Improve the roadway/driving environment to better accommodate the special needs of older drivers. 3. Identify older drivers at increased risk of crashing and intervene. 4. Improve the driving competency of older adults in the general driving population. 5. Reduce the risk of injury and death to older drivers and passengers involved in crashes. Under the first objective, planning for an aging popula- tion, there is one key strategy identified: Establish a broad- based coalition to plan for addressing the transportation needs of older adults. The description of the strategy includes a discussion of technical, organizational, and institutional attributes for consideration in implementing the strategy, and identifies agencies that have already undertaken such plan- ning activities. These agencies and their plans are highlighted in the remainder of this chapter. Subsequent chapters iden- tify exemplary practices with respect to the other strategic areas—roadways, driver licensing, and education and public awareness. NCHRP also recently funded a small “quick response” project on this topic for the AASHTO Standing Committee on Planning. The study included a literature review and tele- phone survey of transportation planning staff in 10 state DOTs and 9 MPOs to gather information on their efforts to address the needs of older drivers in the transportation plan- ning process. The states and MPOs were chosen to represent a geographically and demographically diverse sample, as well as because of their demonstrated interest in the topic area. • States—Arizona, Florida, Maryland, Michigan, Ore- gon, Pennsylvania, Texas, Vermont, West Virginia, and Wisconsin. • MPOs—Anchorage, Atlanta, Auburn–Pelika, Charleston, Chicago, Colorado Springs, Phoenix–Mesa, Portland, and Richmond–Petersburg. The telephone survey asked respondents to rate the extent that older road user considerations influenced their trans- portation planning processes and the extent to which senior mobility was addressed in both their long- and short-range transportation plans. It also sought information on the degree to which selected traffic engineering practices, licensing pro- cedures, and alternative transportation practices had been adopted, and the extent of coordination with other agencies and organizations, including the formation of coalitions and task forces to address older road user issues. Results of the effort have been summarized in a final proj- ect report (Grimm and Horsley 2004). With respect to over- all planning for older adult safety and mobility, the authors identified Florida as the most active of the 10 states surveyed, followed by Oregon, Texas, and Wisconsin. Specific DOT program areas receiving the greatest attention were more vis- ible and easily readable road signage and driver licensing pro- grams for older driver referral, evaluation, and family inter- vention. MPO programs, on the other hand, were more focused on improving alternative transportation options, often in col- laboration with Area Agencies on Aging. The authors con- cluded that coordinated approaches, based on strong state and local collaborations and drawing from guidance at the federal level, can help other states and MPOs successfully meet the challenges of an aging population. Increasing coordination and dissemination of information between different agencies with parallel functions has had real benefits at both the state and regional level. While a blanket policy for deal- ing with the needs of elderly drivers would be unrealistic and hard to implement in the diverse conditions present in different regions of the country, some standardization and guidelines would be helpful to agencies that have only recently begun to plan for older users’ unique needs and limitations. By following the examples of state DOTs and MPOs like those surveyed, and using the most effective methods to implement coordinated strate- gies, state and regional planners guarantee that their jurisdictions will gain the maximum benefit from their efforts (Grimm and Horsley 2004). Also at the national level, AARP has continued to advo- cate greater involvement of older adults in the transportation planning process (The Policy Book . . . 2002). Citizen involve- ment is seen as especially important for creating livable com- munities where adults can age in place and not be hindered by inadequate transportation to needed goods and services. AARP recommends that states and MPOs • Implement requirements contained in federal trans- portation laws and regulations for public participation in transportation planning; • Consider the impacts of transportation planning deci- sions on the mobility of older people and people with disabilities; and • Actively promote public participation by consumers, including older people, in transportation planning activ- ities such as public transportation routing, highway and road siting and design, and investment and deploy- ment of intelligent transportation systems (The Policy Book . . . 2002).

16 STATE AND LOCAL INITIATIVES A review of the literature, coupled with Internet searches and personal communications, identified the following states or regions as currently or recently engaged in comprehensive older road user planning initiatives. In some cases, the search results have been supplemented by the DOT survey results obtained as part of the current synthesis effort. The follow- ing list contains examples of state and local older road user planning documents available on the Internet, or information on how to access them. • California Traffic Safety Among Older Adults: Recommendations for California www.eldersafety.org/oats/oats-brief-1.pdf. • Michigan Elderly Mobility and Safety Final Plan of Action http://www.semcog.org/RegPlan/ElderlyIssues/Action Plan.htm. • Oregon Report of the Older Driver Advisory Committee http://www.oregon.gov/ODOT/DMV/docs/ODAC_ Final_Recommendation_a.pdf. • Iowa Toolbox of Highway Safety Strategies http://www.iowasms.org/toolbox.htm. • Maryland Maryland Research Consortium Working Group Goals, Objectives, and Action Steps Appendix A of Model Driver Screening and Evaluation Program Vol. II Report http://www.nhtsa.dot.gov/people/injury/olddrive/model driver/volume_ii.htm. • Florida The Effects of Aging on Driving Ability http://www.hsmv.state.fl.us/ddl/atriskdriver.pdf. • Maricopa County (Arizona) Maricopa Association of Governments Regional Action Plan on Aging and Mobility http://www.mag.maricopa.gov/pdf/Elderly-Mobility- Plan.pdf. • New York State http://aging.state.ny.us/explore/project2015/report02/. • Delaware Valley (Pennsylvania and New Jersey) Getting Older and Getting Around: Aging and Mobility in the Delaware Valley http://www.dvrpc.org/publicaffairs/media/release/ p2000-02_AgingMobility.htm. Florida As noted earlier, Florida is a recognized leader in compre- hensive planning to address the safety and mobility needs of older road users. An ad hoc older driver task force was estab- lished in 1997 under the leadership of the Department of Highway Safety and Motor Vehicles, together with the Depart- ment of Elder Affairs, the Pasco–Pinellas County Area Agency on Aging, and the Florida DOT. From the beginning, the group was research driven and committed to a multi-faceted approach to accomplishing its mission of ensuring “safe mobility for Florida’s elders, which enhances dignity, quality of life, and independence throughout their life span.” In 2003, the ad hoc coalition evolved into the 30+ member, governor- appointed Florida At-Risk Driver Advisory Council. Mem- bership on the council is drawn from state agencies, the med- ical profession, senior citizen service providers, and senior citizen advocacy groups. Although the council did not immediately set out to cre- ate a strategic planning document, early on it articulated a Senior Safe Mobility Strategic Plan that included the creation of a state transportation safety resource center to serve as a clearinghouse for information on senior safety, development and evaluation of model programs, educational outreach to counties and communities, development of local coalitions and identification of local needs and resources, obtaining grant or seed money to implement model programs state- wide, and securing long-term funding support from local and state sources. More recently, the council contributed to the development of a legislatively mandated report, The Effects of Aging on Driving Ability (2004). The report summarizes many of the activities underway in Florida and incorporates recommendations by the At-Risk Driving Council in the fol- lowing areas: • Prevention, education, and early recognition of at-risk drivers; • Assessments; • Remediation, rehabilitation, and adaptation—commu- nity and the environment; and • Alternatives and accommodations for transportation. Florida’s activities span the entire range of program areas and are highlighted throughout this synthesis report. California California’s Task Force on Older Adults and Traffic Safety convened from February 2000 through June 2002. The task force was funded by grants from the California Office of Traf- fic Safety and the Automobile Club of Southern California. The 28 task force members included representatives from the California Department of Health Services, Commission on Aging, Highway Patrol, DOT, DMV, Area Agencies on Aging, university research centers, Alzheimer’s research cen- ters, emergency medical services, AAA clubs, NHTSA, and others. The specific charge given the task force was to develop recommendations that would provide direction for the Office of Traffic Safety and other state agencies on improving traf- fic safety for California’s seniors. The task force’s report, Traffic Safety Among Older Adults: Recommendations for California, was released in 2002 (Yanochko 2002).

17 The following is a list of the report’s key recommenda- tions. For each recommendation the report provides goals, action steps, and a time frame for action. It also identifies potential partners for implementing the recommendations and calls for increased funding from both public and private sources. The California Highway Patrol has assumed leader- ship for implementing the plan. • Institutionalize a statewide system for the prevention of traffic-related injuries among older adults. • Institutionalize effective and equitable driver assess- ment and licensing practices within the California DMV. • Facilitate older adult risk identification and risk reduc- tion practices. • Improve the ability of health care and service providers to assess traffic safety risk and minimize the impact of health impairments on safe mobility. • Establish roadway infrastructure and land use practices that promote safety. • Promote safer motor vehicle designs. • Expand the existing research and knowledge base about older adult traffic safety. Iowa Iowa’s older driver planning initiatives have been carried out under the auspices of the Iowa Highway Safety Management System (SMS), “a diverse partnership of highway safety prac- titioners in engineering, enforcement, education, and emer- gency services . . . dedicated to reducing the number and severity of crashes on Iowa’s roadways.” Iowa was one of the first states to formalize an SHSP, and embraced “sustain- ing safe mobility in older drivers” as one of its emphasis areas. A Toolbox of Highway Safety Strategies (2002) was later developed to provide a list of potential strategies for addressing each identified area. To further refine its plan of action for older drivers, the Iowa SMS hosted a two-day Safe Mobility Decisions for Older Drivers Forum in June 2002. The forum was convened to raise public awareness, identify key safety improvement strategies, and develop resources to help older drivers make safer mobility decisions. The 200 participants provided input to help shape Iowa’s older driver activities in eight key areas: roadways and engineering, drivers, senior services, traffic laws and enforcement, policies and legislation, vehicle design, licensing, and awareness and driver education. Participants also provided valuable feedback on some materials and ini- tiatives already in place, including an educational video and a guide for helping older adults make responsible decisions about driving. Similar forums are being held regionally across Iowa, with the motor vehicle department collaborating with local agencies on aging to host the forums. In addition, older driver safety and mobility issues have been included in the state’s safety conscious planning initiatives, both within the DOT and within individual MPOs. The Iowa SMS and a specially appointed Older Driver Task Force provide overall direction and leadership to the state’s older driver safety and mobility initiatives. Oregon Oregon’s older driver program has its bases in 1999 legislation requesting that the Oregon DOT study the effects of aging on driving ability. This led to the establishment of a 14-member Older Driver Advisory Committee, which was charged with developing recommendations for the department. The com- mittee’s report was completed in September 2000 (Report of the Older Driver . . . 2000). Members of the committee con- cluded that a multifaceted approach was needed to identify and address the issues that pose the greatest risk to public safety. Although many of the committee’s recommendations were directed toward identifying drivers at increased risk of crashing, attention was also given to the increasing avail- ability of remedial measures, funding support for alternative transportation, and improvements to the roadway. In response to the Advisory Committee’s recommenda- tion, the Oregon DOT, Driver and Motor Vehicle Services, has implemented a number of programs to improve older road user safety and mobility. These include the Medically At-Risk Driver Program, for identifying drivers with medical condi- tions and functional limitations that place them at increased risk of crashing, and the Shifting Gears in Later Years pro- gram, a broad-based education and outreach campaign to assist older adults in staying safely mobile. These initiatives are described in more detail in later sections of this report. Maryland Maryland’s older driver safety and mobility activities have been guided by the Maryland Research Consortium, a net- work of some 35 agency and organization representatives under the leadership of the Maryland MVA. The group was initially organized to support the efforts of NHTSA’s Model Driving Screening and Evaluation Program project. However, the consortium quickly assumed added responsibilities and developed a set of goals, objectives, and action steps that went beyond the immediate project and that continue to guide activities in the state. A copy of the consortium’s action plan is included as an appendix to Volume II of the Model Driver Screening and Evaluation Program final report (Staplin et al. 2003). Since its formation, the consortium has continued to meet on a regular basis to further its mission of providing Maryland’s older drivers safe mobility for life. The program has effectively integrated health, social service, and motor vehicle agency functions, enabling functionally impaired driv- ers who are identified through the DMV screening process to be linked to available rehabilitation and/or alternative trans- portation options within the community.

Michigan In Michigan, older mobility safety and planning has been led by SEMCOG, the Southeast Michigan Council of Govern- ments. In 1998, SEMCOG convened an Elderly Mobility and Safety Task Force, which examined data and hosted an Elderly Mobility and Safety Forum to aid in assessing needs and developing a plan of action. Elderly Mobility and Safety— The Michigan Approach was published in 1999, making it one of the first truly comprehensive plans (see Bruff and Evans 1999). The SEMCOG plan is also notable because of its strong emphasis on mobility. Elements of the plan include traffic engineering and driver licensing, but also alternative trans- portation, housing and land use, and health and medicine. The SEMCOG plan has since been adopted statewide in Michigan. A key promoter of the plan has been the Traffic Injury Asso- ciation, based in Oakland County. New York State As part of Project 2015, a statewide initiative by the gover- nor’s office to prepare for the impact of the state’s aging pop- ulation, the New York State DOT developed an internal plan for addressing the safety and mobility needs of its aging pop- ulation. Some two dozen policy issues were evaluated in light of (1) the impact of each on the department’s mission, (2) cost-effectiveness, (3) immediacy of need, (4) safety, and (5) risk of not addressing the issue. The three top priorities identified were • Making the state’s transportation system safer for the elderly; • Improving the mobility options for the elderly non- driver; and • Making transportation services, maintenance, and oper- ational practices more senior friendly. A total of 11 action items and anticipated results were identified to meet these priorities. The plan was published as part of the report, Project 2015: State Agencies Prepare for the Impact of an Aging New York—White Paper for Discus- sion (2002). Maricopa County The Maricopa (Arizona) Association of Governments (MAG) assembled a 30+ member Elderly Mobility Working Group to develop its Regional Action Plan on Aging and Mobility for the Phoenix area (2002). “More than 75 stakeholders par- ticipated from cities, state government, transit agencies, senior agencies, health care providers, retirement communities, faith- based groups, and educational institutions.” The group iden- tified 25 recommendations for community and agency action in four primary areas: (1) infrastructure and land use, (2) alter- 18 native transportation modes, (3) older driver competency, and (4) education and training. An Elderly Mobility Stake- holder Group was formed to oversee implementation of the strategies and to act as a forum for discussion on aging and mobility issues. MAG has now moved into the implementation phase of its Action Plan. An important area of focus has been the development of policies and design guidelines for pedes- trian areas, along with a Pedestrian Design Assistance Pro- gram that leverages federal funding to design and construct senior-friendly walking facilities. The Maricopa County Area Agency on Aging has also developed Getting Around: A Transportation and Mobility Guide for Older Adults that, among other things, contains helpful information on transi- tioning to bus, driver safety programs, Dial-A-Ride and other paratransit services, adaptive driving, and peer travel train- ing. In addition, MAG has implemented a Senior Friendly Neighborhood Grant Program that guides seniors in assess- ing the quality of the pedestrian facilities and the streets and intersections in their neighborhoods. Other programs are either underway or planned, maintaining Maricopa County as a leader in planning for the safe mobility of its senior pop- ulation (DeCindis 2004). Delaware Valley Regional Planning Commission The Delaware Valley Regional Planning Commission serves a nine-county area in New Jersey and Pennsylvania, includ- ing the city of Philadelphia. In December 1999, the commis- sion released Getting Older and Getting Around: Aging and Mobility in the Delaware Valley. The report “reviews the loca- tion and scale of the region’s current and forecasted elderly population, discusses the implications of aging on mobility, and recommends strategies to improve mobility and enhance the quality of life of the region’s elderly.” Some of the com- mission’s key recommendations include revising municipal plans and zoning regulations to encourage increased densi- ties; mixed-use communities and service clustering; expand- ing affordable housing opportunities for seniors; creating more efficient, cost-effective, and accessible transit; improving coor- dination of existing transportation services, redesigning sub- urban highways; and encouraging seniors to better plan for their future transportation needs. STATE SURVEY RESULTS A copy of the survey sent to state DOTs is contained in Appendix A. The survey had two sections—the first focused on planning and the second on engineering. It was distributed electronically to identified TRB contacts in each state, the District of Columbia, and Puerto Rico. The accompanying cover letter encouraged recipients to involve other individu- als as needed to complete the survey. Twenty-four completed

19 surveys were returned, although two included responses to the engineering questions only. Appendix B provides a state- by-state summary for the 22 state DOTs responding to the planning questions. The first set of survey questions inquired about compre- hensive strategic highway safety planning. Thirteen of the responding states (59%) reported that they had a comprehen- sive SHSP, and four others (18%) indicated that a plan was under development. Of the 13 states with a plan in place, 8 (Arizona, Connecticut, Florida, Iowa, Maryland, Michigan, Pennsylvania, and Washington) indicated that they addressed older road user safety and mobility. In addition, Missouri and New Jersey both indicated that the plans they were develop- ing would address older road users (see Table 1). It is not clear whether these efforts represent truly compre- hensive SHSPs, as recommended by AASHTO, or whether they are the state’s response to the more limited highway safety planning requirements for state 402 funding. One indi- cator of a more comprehensive plan, especially with respect to older drivers, might be participation of other agencies or organizations in the planning process, because this is a hall- mark of the AASHTO SHSP. Six of the eight states with plans addressing older road users and three of the states with plans under development indicated involvement of other agencies or organizations in their planning processes. Most often these included DMVs, state highway patrols, HSOs or traffic safety commissions, FHWA, and NHTSA. However, five states— Connecticut, Florida, Iowa, Missouri, and Pennsylvania— indicated involvement of other agencies and organizations serving older adults. Included in this list were health depart- ments, offices on aging and elder affairs, AARP, and AAA (see Appendix B). Five states identified specific goals in their plans with respect to older road users. Florida’s and Iowa’s plans have already been discussed. Washington State identified the fol- lowing strategy: “Develop a process whereby physicians can assess driving ability and notify the department of licensing if a driver is unsafe because of medical conditions and/or visual capabilities.” In Michigan, the focus is on evaluating road treatments identified as beneficial to older drivers: brighter sign legends, enlarged fonts on guide signs, brighter warning signs, and increased edge line and gore pavement markings. Missouri listed five goals for its plan in progress: 1. Expand implementation of the Older Driver Highway Design Handbook. 2. Expand and maintain roadway visibility features. 3. Provide older driver self-assessment driving tool dur- ing license renewal. 4. Educate older drivers and their caregivers about the driving risks associated with certain prescription drugs and physical conditions. 5. Investigate enhanced driver license testing procedures. The planning portion of the DOT survey also asked whether the department was engaged in other long-range planning activities to address issues of older road user safety and mobility. California noted its statewide traffic safety plan for older adults described earlier in this chapter, and both Arizona and New Jersey noted statewide efforts to promote healthy aging and safe mobility. In addition to its state level planning activities, the Iowa DOT has encouraged metropol- itan and regional planning associations to address aging driver issues as part of their safety conscious planning initia- tives. Finally, two states (Michigan and Oklahoma) indicated that their state long-range transportation plans addressed older road user issues. Several states described collaborations with other agen- cies or organizations on older road user issues. Eight of the 22 responding states (California, Florida, Iowa, Maryland, States Having a Strategic Highway Safety Plan Address Older Road Users? Collaboration with Others in Developing the Plan? Plans in Place Arizona Yes Yes Colorado No Yes Connecticut Yes Yes Florida Yes Yes Iowa Yes Yes Maryland Yes No Michigan Yes No Minnesota No No Mississippi No No New York No — Oklahoma No Yes Pennsylvania Yes (updating) Yes Washington Yes Yes Plans Under Development Georgia ? Yes Massachusetts ? Yes Missouri Yes Yes New Jersey Yes ? Note: Based on the 22 responses to the planning portion of the state DOT survey. TABLE 1 INCLUSION OF OLDER ROAD USERS IN COMPREHENSIVE STRATEGIC HIGHWAY SAFETY PLANS

Michigan, New Jersey, Texas, and Washington) (36%) had formed state-level coalitions or task forces. The coalitions of California, Florida, Iowa, Maryland, and Michigan were described earlier in this chapter, in conjunction with their statewide planning activities. New Jersey’s coalition is led by its DOT, Texas’ by its Department of Health, and Wash- ington State’s by its Traffic Safety Commission. In addition to these efforts, the New York State DOT supported its Office on Aging in developing a program to assist older dri- vers and their families, and has also collaborated with the Governor’s Traffic Safety Commission on older driver issues. Asked if they had either a formal or informal liaison with their state office on aging, 10 of the 22 responding states (Arizona, Connecticut, Florida, Iowa, Maryland, Michigan, New Jersey, New York, Pennsylvania, and Virginia) (45%) said that they did. Only Maryland’s relationship was consid- ered to be “formal.” Finally, respondents were asked to describe the extent to which MPOs in their state addressed older road user safety and mobility issues in their long-range planning, and the extent to which the MPOs involved Area Agencies on Aging in the development of their plans. These results are summarized in Table 2. Of the 22 responding states, three (Connecticut, Michi- gan, and Oklahoma) indicated that most or all of their MPOs 20 addressed older road user safety issues. Seven more states said that some MPOs did this. The remaining 55% of the responding states either noted that few or no MPOs did this or that they did not know. Results were similar with respect to MPO involvement of Area Agencies on Aging in local long-range planning. Connecticut, Florida, and Oklahoma indicated that most MPOs did this, whereas California, Geor- gia, and New York responded that some MPOs did this. GOVERNOR’S HIGHWAY SAFETY OFFICE SURVEY RESULTS One question on the survey sent to state HSOs dealt specif- ically with safety planning for older road users (see Appen- dix F, Question 1, and responses in Appendix G). All 24 jurisdictions responding to this survey noted that they had a highway safety plan, and 9 of the 24 jurisdictions, or 38%, reported that the plan addressed older road user safety and mobility. Table 3 summarizes the reported objectives or strate- gies. Six of the nine states specifically noted public informa- tion and education efforts. Iowa also noted funding for roadway improvement studies, and Massachusetts reported that it was conducting a literature review and baseline crash and injury data analysis for future planning. Tennessee was the only state to cite specific goals for reducing the number of fatal and serious injuries to drivers 65 or older. Further results from the state HSO survey are contained in chapter six. SUMMARY The U.S.DOT has articulated a clear policy supporting safe mobility for an aging road user population. However, it rec- ognizes that the necessary actions to accomplish this goal must grow from state and local initiatives—in particular, from coalitions that have joined together to develop and implement comprehensive plans to improve senior safety and mobility. A review of the literature identified six states with comprehensive plans in place—California, Florida, Iowa, Maryland, Michigan, and Oregon. In addition, regional plans were identified in Maricopa County (Arizona) and the Delaware Valley. The DOT survey provides a “snapshot” of what states are doing with regard to planning for older road user safety and mobility. Questions on the survey focused primarily on com- prehensive planning at the state and local level and on the involvement of stakeholders from both the public and private sectors in the planning process. Just over half of the 22 DOT offices responding to the planning portion of the survey indicated that older road user safety and mobility issues either had been addressed or would be addressed in their state’s strategic highway safety plan, and in one-third of the states coalitions or task forces had State Extent MPOs Address Older Road User Issues Extent AAAs Involved Arizona California Colorado Connecticut Florida Georgia Iowa Maryland Massachusetts Michigan Minnesota Mississippi Missouri New Jersey New York Oklahoma Oregon Pennsylvania Texas Virginia Washington West Virginia Some Some Unknown Most or all Some Some Unknown Unknown Unknown Most or all Few or no Few or no Few or no Few or no Some Most or all Unknown Some Few or no Few or no Unknown Some Few or no Some Unknown Most or all Most or all Some Unknown Unknown Unknown Unknown Few or no Few or no Few or no Few or no Some Most or all Unknown Few or no Few or no Few or no Unknown Unknown Notes: AAAs = Area Agencies on Aging; MPOs = metropolitan planning organizations. TABLE 2 LOCAL PLANNING FOR OLDER ROAD USERS AND INVOLVEMENT OF AREA AGENCIES ON AGING

21 been formed to address older driver safety and mobility from a broader perspective. Although collaborations with other trans- portation and safety agencies were often cited, in the absence of a coalition or task force only a few DOTs had collaborated with their state health department, department on aging, AARP, or other key stakeholders in planning for older road users. Although all 24 of the HSOs responding to the survey indicated that their states had a highway safety plan, just over one-third of the plans contained objectives or strategies intended especially to benefit older road users. It should be cautioned that because of the relatively low number of states responding to the two surveys, and because responses were more likely to be received from states active in older road user issues, these results likely overestimate the level of planning initiatives currently underway in the United States with respect to the older road user. Nevertheless, the results summarized document a wide range of activities that can serve as models for other states to draw on. Useful Web Resources “Safe Mobility for a Maturing Society: Challenges and Oppor- tunities” (U.S.DOT 2003) [Online]. Available: http://www. eyes.uab.edu/safemobility/SafeMobility.pdf. A Guide for Reducing Collisions Involving Older Drivers (Potts et al. 2004) and A Guide for Reducing Collisions Involving Pedestrians (Zegeer et al. 2004) [Online]. Avail- able: http://www.safety.transportation.org. Elderly Issues in Transportation (Grimm and Horsley 2004). Available by contacting AASHTO Standing Committee on Highway Traffic Safety. NCHRP Project Reports [Online]. Available: http://trb.org/ news/blurb_browse.asp?id=2. NCHRP Synthesis Reports [Online]. Available: http://trb. org/news/blurb_browse.asp?id=5. TCRP Project Reports [Online]. Available: http://trb.org/ news/blurb_browse.asp?id=1. Best Practices for Elderly Mobility Conference Proceedings Available from AAA Foundation for Traffic Safety. State Older Road User Goals or Objectives Included in State Highway Safety Plans Iowa Provide funding support for pavement marking visibility and signage studies. Address older road users as part of safe communities and overall enforcement/education efforts. Massachusetts Conduct literature review to establish state of the practice in the field and compiling baseline crash and injury data for an Older Driver Resource Library. Michigan Support to North American Conference on Elderly Mobility ìBest Practices from Around the World” conference held in Detroit in September 2004. Nevada Cooperative project with DMV to provide public information to specific groups including older drivers. Ohio Develop senior driver informational program. Goals in 2004 plan include reducing number of senior drivers in error involved in crashes by 2% from the FFY 2002 rate of 19.90 per 1,000 licensed senior drivers and develop a new senior driver program for Ohio motorists (age 56 and older). South Dakota Older drivers addressed by a subcommittee of the South Dakota Roadway Safety Committee. Activities include funding for PI&E efforts and for AARP Driver Safety Program instructor training. Tennessee Specific objectives include: (1) reduce the number of fatal and injury crash rates for senior drivers by 2%, (2) reduce the number of fatalities where drivers were 65 years of age and older by 1.5%, (3) continue the downward trend for senior drivers involved in alcohol-related crashes, and (4) keep our senior drivers safe and mobile as long as possible. Texas Although no specific goals are identified in its SHSP, Texas has undertaken a number of activities and projects, described throughout this report, that address older road user safety. Puerto Rico Conduct senior citizens pedestrian and impairment education program to reduce the over- involvement of seniors in traffic crashes and, in particular, pedestrian fatalities. Notes: PI&E = public information and education; SHSP = State Highway Safety Plan. TABLE 3 PLANNING FOR OLDER ROAD USERS BY GOVERNOR’S HIGHWAY SAFETY OFFICES

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TRB's National Cooperative Highway Research Program (NCHRP) Synthesis 348: Improving the Safety of Older Road Users examines programs and policies in place across the country to improve the safety and mobility of older road users. The report documents a range of strategies and related programs under way in roadway engineering, driver licensing, public information and education, and enforcement and adjudication.

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