Effectiveness of Behavioral Highway Safety Countermeasures (2008)

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18 Final decisions as to whether a state may choose to imple- ment a given countermeasure—or not—often will depend on the cost of implementation versus the expected benefit from implementation. Expected benefits are covered in the previ- ous chapter. This chapter will address the issue of cost of implementation. Cost may be thought of as falling into four general areas: political capital, resource allocation, user pay, and direct cost. Benefit/cost ratios typically are based on the direct cost to the state highway safety office (SHO) of implementing a given countermeasure. However, direct cost is not the only cost. Very often direct cost is not even the most significant cost or consideration when selecting a given countermeasure for implementation. Political Capital Each state will make an assessment of what is doable—and not doable—each year in their highway safety plan. This de- termination becomes a judgment call that can only be made at the state level. Is a mandatory motorcycle helmet law pos- sible given the current legislature? How about a primary seat belt law or an upgrade to the graduated licensing law? What can realistically be accomplished and what initiatives should be given priority? In general, most SHOs work toward a priori- tized and limited set of objectives for each legislative session, rather than pursuing an omnibus list of possible new legisla- tive initiatives. Direct costs associated with passing and implementing leg- islation, although generally modest, are nonetheless real, and need to be considered as a bill moves forward and passage appears likely. For instance, Oregon estimated that adminis- trative costs associated with implementing their new GDL law were $150,000. They also estimated that the crash reduction benefit to the state of Oregon was nearly $11 million, resulting in a benefit/cost ratio of 73/1. That is, there was a $73 savings for every dollar invested. Benefit/cost ratios of this magnitude would be expected from most of the proven legal and regula- tory countermeasures, although such ratios are rarely the de- ciding factor on whether to pass such legislation. Political capital also refers to the tolerance and acceptance of the general public for highway safety initiatives. The general population has come to expect holiday crackdowns on drunk driving, speed, and aggressive driving. Would they welcome automated speed enforcement? How about automated speed enforcement around school zones? Political capital is a real, yet largely nonquantifiable, cost. Most of the law and policy countermeasures listed as Proven and considered effective in the previous section cost little in terms of dollars and their benefit/cost ratios are enormous. Yet, they may require a large amount of political capital and, as such, may be out of reach at this time in some states. Resource Allocation States that have prioritized speeding as the number one enforcement issue will not be spending much time on red- light running. There are only so many officers and overtime hours that an enforcement agency can fill. Similarly, if the SHO is inundating media outlets with child safety messages, these same outlets will not also be receptive to a drunk driv- ing campaign at the same time. Or, if SHO staff have been tasked with community outreach, it is not likely that they will also be available for the development of other programs. Sim- ilarly, if sister state agencies and nonprofit organizations are being asked to focus on one campaign, they may not be able to assist in other areas as well. Many of the resources available to a state office are neither renewable nor expandable. They are fixed and, once deployed, will not be available for some other effort in any specified time period. The “cost” of deploying these resources in pursuit of one goal is the potential for missing the opportunity to pursue some other goal. Although these costs are real, like political costs, they are difficult to quantify. Such costs are C H A P T E R 6 Estimation of Cost to Implement Countermeasures

minimized by deploying these nonrenewable resources in pursuit of those countermeasures that will produce the great- est reduction in highway loss. A common phrase is: If I can save one life, it will all be worth it. Perhaps, but SHOs do not have this luxury. If they deploy a measure that saves one life rather than deploying a measure that could have saved three lives, using the same time and money, then they have, in effect, killed two people. User Pay A large proportion of the cost, and—not incidentally—the benefit, for implementing highway safety initiatives is borne by the client or the user of that initiative. Such costs are quan- tifiable, yet they rarely enter into consideration of whether to implement a selected countermeasure. Parents, not the state, are the ones who most often purchase a child restraint, booster seat, or bike helmet. Convicted drunk drivers are the ones who most often pay for their alcohol assessment, rehabilita- tion, or vehicle interlock. Only a small proportion of the costs for both child safety and alcohol sanctioning programs are borne by the state. As such, these programs need only mar- ginal effectiveness in order to be very cost effective. Another source of user pay is the fines that violators pay when convicted of speeding, red-light running, and other violations. Fines that are collected typically go to the state, county, or municipal General Fund. Fees collected are often used to support the court and the rest of the adjudication sys- tem. We do not have a tradition of counting General Fund revenue as an offset for the cost of countermeasure imple- mentation. In fact, our tradition is the opposite. We attempt to build a wall between the revenue generated from ticket writ- ing and the agency performing the service. We do not want the public to feel that the police will profit from writing a ticket. What is the benefit/cost ratio from writing tickets? It may be quite large, particularly if the ticket writing results in more revenue to the General Fund than the agency and adjudica- tion costs associated with the activity. Either way, it is not a number that we generally include in our benefit/cost ratios, nor is it one that we are likely to include in such calculations in the foreseeable future. Automated speed enforcement and red-light running cameras are a clear exception. Here, we want to know the implementation and operation costs of the systems and we want to know that the fines generated will cover these costs. The expectation is that these systems will be at least revenue neutral. That is, they will generate a sufficient amount of fine revenue to cover their implementation and maintenance costs. If successful, and if they reduce crashes, their benefit/ cost ratio will be very large. A Government Accountability Office (GAO) report (2003), found that photo enforcement program revenues were lower than program costs in three jurisdictions, while revenues in two other jurisdictions ex- ceeded program costs. It seems likely that both technologies, automated speed and red-light running, are now sufficiently developed such that a jurisdiction can implement either one as revenue neutral and/or with excess revenue devoted to some worthwhile purpose such as education. Automated speed enforcement and red-light running have one additional important feature that sets them apart from officer-dependent ticket writing. The fine is assessed against the vehicle, not against the driver. Thus, no drivers will have their drivers license suspended or insurance increased if their vehicle is photographed violating the law. While this effect is not necessarily desirable from a general deterrence point of view, it is an important distinction that has made such pro- grams acceptable in some communities. Direct Cost Last, but not least, is the issue of direct cost. That is, coun- termeasures that consume real dollars from highway safety, enforcement, or other budgets and need to be weighed against benefits to justify the expenditures. Surprisingly, there are relatively few Proven countermeasures that fall into this cate- gory. With regard to the countermeasures discussed through- out the remainder of this chapter, cost estimates are drawn from original documents that documented their effectiveness (and costs) and from experience with ongoing programs. These estimates are clearly imprecise and, as such, need to be viewed as only a starting point for planning purposes. Actual cost estimates for a given program implemented in a given state and in a given year have often come primarily from the grants awarded by the states. The following subsections are intended only to outline costs that have been reported in the past, based on existing research reports. School Pedestrian Training for Children Most of the available “programs in a box” that are oriented toward a particular grade level are low cost and easy to im- plement. Per-student costs for school pedestrian training materials range from less than one dollar to two dollars. Statewide coverage for a first-year K-6 program might cost $500,000 to $800,000 for a “typical” state with 600 fatalities. As was suggested earlier, estimated savings from such a program would be $450,046, suggesting that the effort would have a negative return on investment. However, most of the costs outlined are first-year costs which, if amortized over several years, would bring subsequent year costs down to a much lower level. Moreover, the program could be targeted to only those urban areas that have a substantial child pedes- trian safety problem, further reducing implementation costs and providing the potential for a positive benefit/cost ratio. 19

Booster Seat Promotions It is likely that a comprehensive booster seat program would involve a large number of entities and activities such as the following: a community coalition of agencies and orga- nizations to promote booster seat use; a citizen advisory group of parents and caregivers to provide feedback on campaign messages and materials; development of strategies to ensure community involvement; community education; newspaper articles; organization and group newsletter articles; a booster seat website; tip sheets, brochures, and flyers in multiple lan- guages; a telephone information line for parents; resource kits for preschools and health care providers; radio and TV public service announcements; educational programs to address barriers to booster set use; discount booster seat coupons ($10 off); car seat training program and in-services for health care providers, child care providers and educators, law en- forcement, EMS personnel, and advocates. Direct costs for such an effort, for the typical 600-fatality state, could range from a low of $300,000 (assuming substan- tial donated time and effort from cooperating agencies) to as much as $800,000 (assuming paid media and coupons to low- income families). As indicated, estimated savings from such a program would be $6,140,394 suggesting that the effort would have a benefit/cost ratio (i.e., return on investment) ranging from 8/1 to 20/1. That is, a return of $8 to $20 would be expected from each dollar invested. Sobriety Checkpoints The most recent documented, comprehensive statewide sobriety checkpoint program was implemented in Connecticut in 2003 (Zwicker, Chaudhary, Maloney et al., 2007). The state used paid media in support of a statewide program of sobri- ety checkpoints. Costs for this program were approximately $1.25 per resident of the state. So, if a typical 600-fatality state had a population of 5 million people, then the program might cost $6.25 million (about $7 million, adjusted for inflation). As computed earlier, estimated savings from such a program would be $107,569,717, resulting in a benefit/cost ratio of 15/1. That is, a return of $15 would be expected from each dollar invested. Short, High-Visibility Belt Law Enforcement A comprehensive Click It or Ticket (CIOT) Program has generally included paid media ($300,000 to $500,000); at least one law enforcement liaison to recruit enforcement agency participation ($100,000 per year, minimum); plus enforce- ment grants to police agencies (possibly $200,000 to $500,000 for an average-size state). Total costs should range from about $600,000 to just over $1 million. As computed earlier, estimated savings from such a program would be $27,274,673 suggesting that the effort would have a benefit/cost return on investment of 27/1 to 45/1. That is, a return of $27 to $45 would be expected from each dollar invested. Mass Media Supporting Alcohol Enforcement Eight mass media studies that showed positive effects were reviewed by the Task Force on Community Preventive Ser- vices, a group supported by the Centers for Disease Control and Prevention (CDC). Cost information was provided for two of these mass media programs. Based on 1997 U.S. dollars, a Victoria, Australia, campaign cost $403,174 per month in its first 23 months for advertisement development, support- ing media, media placement, and concept research. Estimated savings from medical costs, productivity losses, pain and suf- fering, and property damage were $8,324,532 per month, with $3,214,096 of this being for averted medical costs. Thus, the benefit/cost ratio, as computed from this Australian pro- gram, would be approximately 20/1. In the United States, a six-month campaign was conducted in Kansas. It used paid media (in Wichita) and public service announcements (in Kansas City). Total costs were estimated to be $454,000, and $322,660 in these two cites, respectively. Included were costs for planning and evaluation, message production, and media scheduling. Total savings from averted costs of insurance administration, premature funerals, legal and court expenses, medical payments, property damage, re- habilitation, and employers’ losses were estimated at $3,431,305 for the Wichita campaign, and $3,676,399 for Kansas City. The benefit/cost ratio, as computed from these numbers, would be approximately 8/1 for Wichita and 11/1 for Kansas City. Community Programs Including Age-Twenty-One Enforcement Massachusetts conducted comprehensive safety programs in six communities beginning in 1988. Each community im- plemented age-21 minimum drinking age (MDA) enforcement as part of a broader endeavor including efforts to reduce speeding and increase seat belt use. Costs in 1988 dollars were approximately $1 per person per year. Funds were used to pay for a coordinator, added police enforcement, other program activities, and the purchase of materials. In addition, each community included substantial voluntary efforts. What would such a program cost today? It is estimated that approximately $2 to $3 per person would be required and, as computed earlier, estimated savings from such a program would be nearly $10 million. Here, the costs of such an effort would be roughly equal to the savings. 20

States wishing to pursue such a comprehensive community effort should consider primarily targeting communities that have an identified under-age drinking problem. Such pro- grams are routinely implemented, for instance, in college towns and vacation destinations frequented by young per- sons. In this way, the program effort and resources are con- centrated in communities that would benefit most from an effective program. Individual Meetings, Group Meetings, and Warning Letters Benefit/cost evaluations of individual meetings, group meetings, and warning letters have been reported in studies conducted by the California DMV. These studies suggested that all three approaches may be cost effective, although the warning letter consistently provides a higher benefit/cost ratio than the other two approaches. Although the warning letter produces the smallest reduction in crashes (4% versus 5% for group meetings and 8% for individual meetings) it can be implemented at the lowest cost. It is estimated that a warning letter program can be imple- mented at a cost of approximately $2 per letter. The typical 600-fatality state might issue approximately 200,000 speeding tickets per year. Thus, if a warning letter was sent to every violator, the cost of the program would be approximately $400,000. The benefit (see Appendix B) is estimated at $7,251,743 for a benefit/cost ratio of approximately 36/1. The cost of a group meeting program is estimated at approximately $30 per attendee, and the cost of an individual meeting is estimated at $100. Thus, neither of these two approaches would be particularly cost effective if applied to every speed violator. Likely because of these higher costs, states have generally re- served these intensive interventions for multiple offenders. 21