 I would like to welcome next Essie Wagner with NHTSA, a wonderful person. I hope you all get a chance to meet with her today. She has a lot of experience and just a good friend. Really, my topic today, when I was asked to talk about, is national perspectives on safety and how it works. And I was like, well, how about we just talk about what I do more often. And that's really try to translate research into something useful. Before I go on though, I do want to note Iowa's leadership on all of these traffic safety issues. People like Kim, people like Tom, have been out there doing work internationally and really making Iowa look great in the rest of the world. You know, creating the flexible license renewal policies. That's a national model. Other states are saying, wow, you can do that. You can go out and give people licenses just for their local areas. Okay, we'll do that. You know, adopting the roadway design guidelines. Those are things that even, you know, Australia says, wow, Iowa's doing that. Okay, we can do it too. You're really, you're fostering an environment where you have creative people doing creative things to help the rest of the community. And you're not, you're exporting the ideas, but you're not exporting the people. And so I think that's really to be commended. So thank you for that. Before I go on into talking about older driver stuff, I need to introduce NHTSA, which is the National Highway Traffic Safety Administration. I don't know if you're familiar with us. We're the people who, our mission is to save lives and prevent injuries on, from crashes on our nation's roads. It's a pretty straightforward kind of thing. It's very easy to understand it and to get behind it. I mean, how can you be against saving lives? You can't. And we get a progress report every day when we open up the newspaper. Go, no, not this one. And we go out every day and we're trying to do better. We're trying to save those lives. We're also responsible for vehicle safety standards, things like getting the airbags into cars all those years ago. We're responsible for cafe standards of corporate average fuel economy. We did the cars program, you know, cash for clunkers as everybody knows it as. And we also manage the FARS database, which is the Vitality Analysis Reporting System and a lot of the other crash databases. So things that you probably use in your daily work are things that we have a hand in. So with regard to older drivers, we've had a program in place for 20 years now, mostly with research. A lot of that research was done here in Iowa at the old Iowa driving simulator, and what eventually grew up to be NADS, as well as other researchers along and around in the state here. The reason that we got behind doing this kind of research is because we were sort of looking into the crystal ball of the future saying, oh gosh, those baby boomers. In 20 years, they're going to be older drivers. We have to do something to address this issue. We have to get them off the road. Oh my gosh, what are we going to do? And then through doing our research, we realized that's not going to be effective and get a lot of people hating us. And by the way, it's not necessarily going to be the right thing to do. There are so many people who are capable of driving safely. So why don't we try to focus on the people who are at risk? So that was sort of where the research led us in the way. So we had these population pressures. We also have, in addition to the baby boomers changing, we saw that older people were living longer and they're living healthier lives. So they're going to be out there on the roads. So we had that. We also saw there were some pressures, as we call it, from exposure. They're out there driving more, particularly the baby boomers. The women are going to be driving so much more than the earlier cohorts, like the older drivers, where the women were sitting in the passenger seat and the men were in the driver's seat. Baby boomers, oh, we're not doing that. We're going to be driving ourselves. So we had to make sure that we were addressing those kinds of issues. And then the last pressure that we have to address is that frailty pressure. There's nothing really that we can do to change the individual's ability to recover or withstand the crash forces. So we have to make the vehicle itself safer, and we have to make sure that that crash doesn't happen in the first place. So those are the kinds of things that shaped us and shaped our thinking when we decided to set our program, our program goal, as to hold the line on fatalities. We knew that there were going to be things that were going to be pushing those numbers up, but we decided that we had to make sure that they stayed at least level and hopefully would go down. We'll see in, I guess it's 13 months whether or not all our hard work has really been effective when the baby boomers do start turning 65. But we'll get there. We'll get there. Now in 2001, I said part of what I do is translate research. We did all this research, research, research. And I translate that into something useful. And it's really harder than you would think. It's like, well, OK, I can take that report and take it off the shelf and say, OK, everybody do this. And then I think people hear me is really not easy. What we decided to do is look to other people that have a common mission with us. So for the older driver program, we looked at partners such as the American Medical Association, where we developed the Physician's Guide for Assessing and Counseling Older Drivers. What we saw is we want to help physicians counsel their patients. And physicians were already identified as being important, legitimate, and listened to sources for good traffic safety information. But they had no idea what to say. And so what we did together is we came up with this guide. We're about to come out later on. It'll be early next year for a revised version of the Physician's Guide, if you're familiar with that. We've also established partnerships with the American Association on Aging and the American Occupational Therapy Association. Different people who have common mission to save lives and to educate their users on how to help people save lives and to continue staying out there and being active and involved in the community, but doing it safely. So the important thing to remember is that we always, always, always have a foundation in research. Research tells us where to go. We can't, like, oh, yeah, let's go ahead and do a program on X. And no, we can't do that. We have to have some evidence basis for what we're doing. There's a lot of what Dan was talking about there. One of the programs, one of the projects, and this is what Kim alluded to, that we worked together on forever, was this right here, the Driver Fitness Medical Guidelines, which just came out. It says September, but it was October 2nd. I know, because I was jumping up and down when this came out. We started working with AMBA, which is the American Association of Motor Vehicle Administrators. We've been working with them for years anyhow, because licensing has something to do with traffic safety, we think. We've always thought that. Also, at the same time, our research was suggesting that our, it's not necessarily age, that it's abilities. It's functionality that makes a person safe or unsafe. I mean, we have, we know there are people at age 50 that have early stage dementia. We also know that there are people who are in their 80s who are running marathons. So we know it's not age, we know it's function. So, yeah, six years ago we started this project. And we, it's sort of like courting cats. Getting the physicians to understand licensing, getting licensing to understand what the doctors were having to say, and we came up with an evidence-based guide for making licensing decisions. It's really a very useful tool. It has information on how you have to, as a DMV administrator, how you have to comply with the Americans with Disabilities Act. It sounds really benign, but it's really critically important. I'm sure you understand completely. You don't want to have people arguing with you over what you're doing. You want to actually have to show them, have to have them demonstrate that they are safe as drivers. Seems reasonable in terms of that. And we learned through the process that those are the ways that we have to do it. It has information for the driver licensing administrators on making outreach and communications with the other people, people with the MS, people with diabetes, people with dementia. Do outreach for those individuals. These are the things that we expect of you also for their physicians. So if you make a referral to us, this is what we're going to need to have from you. The other thing that it includes is sort of the dissenting opinions. You know, you try to come to consensus on these things. But sometimes people just aren't going to come to an agreement on why you think you should be doing something. And in particular, this has an appendix in here describing the dissent from the American Diabetes Association saying they think it should be this way, then the DMV people say no, and the DMV and the physician people say, no, it should be this way. This sort of tells you as a DMV people what to expect if you decide to make these recommended changes. So that it gives you a whole picture of you could just say, yes, I can do this, I can change the world, but it's really not easy to do. I'll give you those steps. And of course, just having this out on somebody's shelf is not going to save one life. What we have to do and what we're going to do in the coming years is promote the use and encourage states like Iowa and all the others as well to go ahead and adopt this. To, yes, say, okay, there is evidence for making this kind of policy change and let's go ahead and do it. So similar efforts have gone through, we've gone through similar efforts, excuse me, to develop activities on transitioning from driving. That was something that was talked about earlier. We call it transitioning. Some people call it driving retirement. What I really like to think of it is just moving over into the passenger seat because most of your trips, four older people are gonna be in cars. They're not gonna be jumping on the paratransit because in places around here there's not necessarily gonna be the paratransit. They're gonna get a ride from the neighbor. They're gonna get a ride from the adult child, most likely the daughter. As I said earlier, when we started out this business, we really were saying, well, how are we gonna get them off the road? And no, it's not gonna work. Through our research, through our activities and partnerships, we came to realize that now we have to do this this way. Most people are gonna be fine and safe for most of their lives, really. It's just when you get to the end, when the functional abilities change, when functional abilities deteriorate, that you have to make those transitions, make those decisions to stop driving. And so we worked with the American Society on Aging to develop the Driving Transitions Education. It's really for geriatric social workers or anybody who works with older people or their families one-on-one on making, how do you go through the process? As you just say, okay, your driving career's over. Sorry, give me the keys. No, it's not gonna work that way. It tells you how to go through. Okay, let's look at the driving. Where do they go? What do they need to do? Where do they feel their most value in driving? And how do you make sure that they maintain that value? So it's a very, I love this education tool. I have a couple of copies here as well. So if you do have questions about it afterwards, please do let me know. And again, it's that whole research background that helped us get the credibility to make these basic simple recommendations. Now that we've gotten these tools out, our aim is really to go into some of the harder issues. Where our future has us going is gonna be more into this transitions world and more into the dementia world. Because one, there's really probably inadequate research in those areas. But there's also, those are the areas that are the thorniest. Things that the families and judiciary and licensing have the most challenges facing. They don't understand how to do it. So it's easy. I don't think it's ever gonna be easy, particularly with dementia. Cause there are good days and bad days and there are days where people just, they suddenly drop off the cliff for cognitive function. And since driver licensing only sees people but every year, if they're on a short cycle, that's 364 other days that this person could be out there driving. And that can't rest on the shoulders of licensing. It needs to rest on the shoulders of families. It needs to go on to physicians and other social services people as well as on law enforcement as our last resort. They need to understand how to act and how to change the behavior of that individual as putting others at risk. Now, in terms of going forward with today's work, I want you to think about where are the gaps? Cause these are the ways that we go about things and it's on the national level too. Where are the gaps? What are we missing? What do we do? What's being done elsewhere that we can sort of tweak and make our own? Those are all good. And then like I said, our predictions are gonna either come true or we're going to have to change things around when the baby boomers do start turning 65 next year. But so, just what we have to do is first is to look to the evidence. And that's based on this stuff that's in the back chapters of this guide that we have, the medical guidelines. There's a lot in there. It says, okay, what other things can we research? Where's the evidence? Kind of dicey, kind of dodgy. See what you can do to make that better. Look where others aren't necessarily looking. What other rocks can you pull up? In terms of older drivers, I mean vision, we all know it's important, but there's not really any evidence that says what vision is important, what level of vision is unsafe and what is safe. It astounds me to realize that. Parkinson's disease is another issue that we need to look at a little more closely. The next thing I really want you to do, in particular today is make connections. I think everybody has said this, all the speakers this morning, talk to other people. We're stronger and we make better decisions when we have other voices involved. And for example, with the driver, we would never have been able to come up with as good a quality report if we hadn't had some of those really challenging people from Canada. We'll talk about, they were, oh gosh, I love them to death, but oh, they were fun. And lastly, as I make something useful, person. I want you to encourage theft and the law enforcement people can go like that. Just don't go reinventing the wheel. Don't do something that's exactly like what they're doing over in Missouri or Canada or something. At the same time that they're doing it, look at what they're doing, get the results and say, okay, now it's mine. I'm gonna make this an Iowa thing or wherever it is that you're actually from. Take it back, but, you know, feeding is good. And the academics will say, oh no, no, this is actually implementation, so you get to steal. And besides, it's easier. So with that, I do want to thank you and thank you for your time and I look forward to a productive meeting. Thank you. Thank you.