5. The West Virginia Bioptic Driving Program Overview and History and Chuck Huss
West Virginia’s Bioptic Driving Program
Underpinned by a 2008 Bill to Code noted below, the program (eligibility, curriculum, completion standards) are jointly agreed by the West Virginia Division of Motor Vehicles (WV DMV) and West Virginia Division of Rehabilitation Services (WV DRS) and offered only in one location: at the Division’s Rehabilitation Program’s Office Complex, Nitro, WV campus where students can either commute daily (M-Fri) or reside in a predetermined local hotel/motel as distance necessitates. Bioptic drivers are issued their own code “Class G”; whereas a standard/normally sighted driver is issued a “Class E” driver’s license. All initial screening evaluations (clinical low vision assessment, functional vision screening and behind-the-wheel screening), six-week program or training, and bioptic device are public funded in full through WV DRS, where the client agrees in writing to a goal of seeking or returning to employment.
Prior to enter to the program, the client must complete the entry requirements where only the DMV medical coordinator can approve (or deny) entry.
The medical/ visual criteria for entry is:
- Acuity 20/70 to 20/200 through carrier lens
- Visual field 120 degrees horizontally and 80 degrees vertically in same eye as above acuity
- Bioptic acuity 20/40 or better (4x or better)
- Colour vision sufficient to respond correctly to presence/changes emergency/ hazards/ markings
- No ocular diagnosis or prognosis of significant deterioration of the above
- Normal head and neck movement.
To enter the program the client must participate and provide evidence of completion of an:
- An eye exam of the above less than 6 months prior to initial screening (and provide annual results thereafter).
- Interview intake and functional vision evaluation.
- Do a steering and braking reacton time screening and on-road driver evaluation.
- Sign a release form and accept the acquisition of a driving licence is not guaranteed.
- Participate and pass score on a ‘Class G instructional permit test’.
If the client passes their Class G instructional Permit test WV DMV issues a Class G instructional permit (lasting one (1) year, if needed) allowing the student to be positioned behind the wheel when accompanied by a CDI/CDRS member of the WV DRS bioptic driving program or specially trained WV DMV driver license examiner. The capacity of the DRS to work with multiple students per class is dependent on the number of program staff available who are trained in each of the three elements including classroom instruction, passenger-in-car instruction and behind-the-wheel instruction. At the present time, WV DRS is operating this Program of screening and training with but one staff member (due to several recent retirements or job changes). In the past they have had multiple students participating per class (with as many as five full-time staff available) and low student to instructor ratios during assigned class(es).
The curriculum delivered will depend on whether the client is a new driver or has driving experience (e.g., onset of vision loss later in life). A program counsellor is available for support if needed as student (s) progress through their program of instruction.
New driver: receives 30 hours each of classroom, passenger in-car and behind the wheel (with a state certified driving instructor or driver rehab specialist/educator).
Experienced driver: can waive classroom instruction but must pass a 150-question written competency test re knowledge of the driving laws, basic driver education skill areas, basic driving knowledge.
To complete the program, the client (both new and experienced) must pass a forty (40) mile standardized Driver Performance Measurement (DPM) assessment. If a bioptic driver moves from another state to West Virginia and desires to become a WV bioptic driver, said individual must provide their driver record history from the previous five years (including any crash/ infringement), meet medical/visual eligibility, and give details and hours of participation in any prior out-of-state bioptic driving program. The client may need to do more training if their program is not equivalentto WV requirements.
Finally, after completing the bioptic driving program with the DRS, the client then must participate and pass an on-road test administered by the DMV in their DRS dual brake driver education automobile. This test is longer, more challenging and entail a greater level of acquired driving skill than the on-road test given to standard drivers without disability.
All bioptic drivers are issued with a daytime only licence initially. They can latter apply for nighttime privileges after 3 years of no at-fault accidents, no moving violations, and no driving suspensions, along with participation and satisfactory completion of additional night-time driver training and a nighttime on-road test administered by the DMV.
The WV bioptic driving program is one of the most comprehensive and well-respected programs in the USA. Currently existing programs of instruction in Canada are modelled after the WV Model. The WV model contains safeguards and checks at every stage ensuring that carefully selected clients progress through each stage. Since 2009 the Program has output 119 bioptic drivers. These drivers also have the most restrictive consequences for adverse traffic events. Any violation(s) of restrictions/conditions results in a written warning, then immediate 30-day suspension of licence per offense. Being caught again and repeat offended have progressively longer suspensions and possible loss of licensure.
21 mile vision loss onset driving
Periodically (at license renewal), DRS staff connected with the Bioptic Driving Program are also called upon to assess other visually challenged drivers, who’s acuity has dropped below the new 20/60 best corrected visual acuity cut-off (without a bioptic); via participation in what is termed a “21 mile on-road driving assessment”. Unlike the bioptic driving program that has strict medical/visual entry requirements, the WV medical guidelines for these approved drivers have no arbitrarily set visual field-testing requirements; with acuity requirements set at 20/40 for a standard unrestricted driver’s license, and up to 20/60 for a restricted driver’s licence, if approved by an optometrist or ophthalmologist. Clients below 20/60 (no bottom ‘cut off’) may still be able to hold a restricted licence (Class E) if they pass the 21-mile driver assessment and other criteria; but may have multiple restrictions applied by DMV officials e.g., an annual eye exam, no highway driving, no night driving, 30–50-mile driving radius, etc. From 2010, 116 clients have passed 21-mile criteria and retained restricted type of driving privileges. These client’s license restrictions are much more than those applied to in-state bioptic drivers. The first five (5) year review of these clients driving records revealed no moving violation or at-fault accidents or driving suspensions. During the next five (5) years, a similar driving record was accrued by such drivers, except that five (5) such drivers had their driver licenses suspended, due to lack of compliance with submission of mandatory annual eye exams.
These comprehensive testing requirements involving multidisciplinary test and review for clinical and onroad static and dynamic environments recognise each person’s agency and balances this with the rights of other road users to safe access on the road. This approach instead of arbitrary ‘cut offs’ acknowledges bioptic and low vision research be tailoring throughout from entry criteria to classroom, passenger in car, behind the wheel to restrictions/ conditions with annual reviews and final decision by the DMV. The programs are also consistent with what has been offered for decades with other disabilities but prevented for people with low vision. Studies all have weaknesses and thus cannot be used solely for public policy decision making, especially to derive ‘cut off’ when people below the consistently are able to demonstrate safe driving and licence authorities can and are able to do more take off the road those who should not be driving especially those who pass clinical ‘cut offs’.
History of the Bioptic Driving in West Virginia
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| Click photo to read: Remembering William Earl Ramsey Pioneer and Leader in Driver Rehabilitation |
In the early 1980s, William E. Ramsey, former Director of Driver Education for the West Virginia Department of Rehabilitation Services (WV DRS) started training low vison and bioptic drivers. As a disabled man himself resulting from Polio as a child he understood instinctively what the driving privilege meant. In 1983 Chuck Huss, Certified Orientation and Mobility Specialist (COMS) with work experience with low vision rehabilitation was hired by WV DRS and subsequently was permitted to assist Mr. Ramsey and Dr. Thomas Griffith et al in developing and implementing the West Virginia’s (WV) bioptic driving pilot program. Chuck applied his training of on foot low vision strategies to passenger in-car and behind the wheel, incorporating both the carrier lens and benefits of the miniature telescopic lens unit for enhanced driver safety and self-confidenc0 for select low vision individuals who wanted to explore the driving task.
Most elements researched during the WV Pilot Low Vision Driving Study (’85-’98) are employed today, except omission of psychological and visual perceptual testing. The program’s key driver assessment benchmark is the use of a DPM (Driver Performance Measurement) tool that the WV DRS contracted with the Michigan State University to develop. I’ll talk about this in another blog.
Following the success of the first three-year pilot in 1988 Chuck and others delivered their findings to the peak body for driver rehabilitation ADED (The Association for Driver Rehabilitation Specialists). Since 1986, other jurisdictions sought Chuck and Bill’s services to train staff including researchers, DMVs, low vision specialists’ optometrists/ ophthalmologists, driving instructors, school teachers, orientation and mobility, occupational therapy.
At the 1988 ADED conference two USA ophthalmologists (Dr Fonda and Dr Kenney) who attended voiced opposition to the findings of the WV bioptic driving staff & consultant team. After the conference, the WV Pilot Study continued until 1998, when an in-state directive (from above DRS) ordered to close the Program until further notice. Chuck and staff were permitted however to continue staff in-service training with other state jurisdictions throughout USA and Canada, until COVID -19 took place.
Note, during the late 1980’s and early 1990’s, several of the pilot study’s bioptic drivers instructional permits and/or drivers licences were suspended pending WV DMV administrative review.
No reasons or decisions were made, and the matter carried on for approximately ten (10) years. Then a WV Human Rights Commission Public hearing (1995) was approved; and a decision re allowance of previously licensed WV bioptic drivers rendered. All previously licensed or permitted bioptic drivers got their licenses and/ or instructional permits back (except one student, who voluntarily exited the Program without successful completion). Then on or about 1998, WV DMV modified their promulgated rules to ensure that future decisions re bioptic driver licence matters in no more than 60 days. On July 1st, 2009, the WV Bioptic Driving Program was re-implemented following the introduction and passage of a consumer led piece of legislation (WV HB 4139) that is today’s program.
Ironically, Dr Fonda who was an expert witness for the WV DMV at the WV Human Rights Hearing (1995), wrote and published an article (1989) that legal blindness (20/200 or 6/60) can be compatible with safe driving. He supported low vision driving to 20/200 yet without the bioptic. Dr Fonda reportedly would say Dr Feinbloom (the inventor of the first Galilean telescope used for driving in the USA) was taking advantage of his invention to make money off vision impaired clients. Dr Feinbloom did benefit financially from his telescopic devices used in medical and research applications. Driving was not his original intention. In 1959, to help one of his patients with distant viewing tasks, Dr. Feinboom created the first head born low powered Galilean telescope. On a follow-up visit with said patient, Dr. Feinbloom realized it had potential for visual assistance with the driving task of said client (and several hundred of his other low vision patients to follow). Currently, forty-eight (48) of fifty (50) states recognize or allow the use of bioptic lens systems for driving in the USA. Those two 92) states that do not recognize the use of bioptics for driving (namely the states of Utah and Iowa) do allow driving with sub-normal visual acuity levels down to and including 20/100 and 20/199 respectively.
Chuck Huss – the driving force behind bioptic driving program development
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| Chuck left Belinda right |
I consider Chuck Huss a strong advocate of bioptic driving rehabilitation. He has been instrumental to ensuring people with low vision for decades have been given a fair go to demonstrate they can be safe drivers. His simple philosophy is:
· Teach the student:
o Where to look
o How to look
o From what distance to look
o Then, how the telescope is going to compensate for what you need from time to time. E.g. colour of traffic lights, regulatory signs such as give way/ stop, road signs, police hand signs to stop or wave through.
· All programs must have safeguards.
· Concurrently arranged program of classroom, passenger-in-car and behind-the-wheel produce better outcomes than sequentially arranged program of instruction.
Chuck has dedicated the greater extent of his professional career to advocating for the establishment of adequate and appropriate screening measures, training strategies, and assessment techniques for those visually challenged individuals who wish to explore the driving task. Jurisdictions incorporate and have the freedom to develop and implement the type of adaptive driver training programs that best meets the needs of their constituents. So bioptic driving programs around the world will differ, just as vision standards for driving do for drivers. Chuck believes that a concurrently arranged program of classroom, passenger-in-car and behind-the-wheel produce better outcomes than sequentially arranged program of instruction. Click on this link to read a great article written by Chuck in 1997 about bioptic driving rehabilitation:
Click on this link to read a great article written by Chuck in 1997 about bioptic driving rehabilitation and others written by Chuck in addition to training material:
https://www.biopticdriversaus.com/papers
Chuck and I have co-delivered presentations to occupational therapy driving instructors in both Australia and New Zealand. Here is a link to our New Zealand conference: Part B: Bioptics Driving Role of Occupational Therapist Driving Instructors
https://www.youtube.com/watch?v=IDYELfR2MIc
Chuck is available for consultation so please reach out:
Chuck Huss, COMS
Driver Rehabilitation Specialist
Dunbar, WV 25064
TEL: (304) 767-1497 (cell)
E-MAIL: chuck_huss@hotmail.com (h)
To learn about the reasons for this blog, go to my Churchill Trust Australia webpage to read about the fellowship I was awarded being "The NRMA - ACT Road Safety Trust Churchill Fellowship to identify success factors and barriers for low vision and telescopic glasses driving" The page is here: https://www.churchilltrust.com.au/fellow/belinda-oconnor-act-2022/
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