Frequently Asked Questions
1. Who is a readiness screening for?
The readiness screening is for an adolescent or young adult who has a known medical issue, condition, or traits that could make driving an added challenge or risk. The screening is used to begin pre-planning for the tasks of driving or community mobility. For example, most commonly a Readiness to Drive Screening is done with a young adult who has a history of developmental delays, cognitive impairment, or behavioral history that could result in unnecessary driving risk (i.e. substance abuse, criminal history, difficulties with authorities, mental health concerns).
2. Who is a potential-to-drive assessment for?
The potential to drive assessment could be for a person seeking a permit/licensure who is uncertain about safe driving ability or who could be able to drive but with some restrictions for best safety. OT/DRS’s do this assessment and make safe driving recommendations to the primary care physician and family before proceeding to behind the wheel for training. A PTD approach is very useful in cases involving impaired cognition and insight into deficits. For example, consider a young adult with low IQ or who is recovering from a Traumatic Brain Injury who is eager to drive but unaware of limitations and the older parent with moderate dementia and Alzheimer's who keeps driving despite advice to stop. These are cases in which clinical information alone may suggest and support professional recommendations for postponed driving, safety restrictions, driver retirement planning or cessation of driving (temporary or permanent). Results can be shared with physicians and the state in order to suspend or revoke a license.
3. Who is a comprehensive safe driving evaluation for?
This evaluation process is the gold standard in driving rehabilitation and may be required by a physician or the DPS. It includes the pre-screening intake, clinical assessment and behind the wheel testing (even if just at the most basic level). Often it takes an individual (client, family, or therapist) to see real on-road performance before realizing deficits and making the best action plan. It is for the permitted or licensed driver with safe driving limitations due to medical condition or other issue. If for a permitted student, this eval is to see if advancement to licensure without restrictions is appropriate (because passing a road test is not an indicator of being a safe driver in various situations). If for a licensed individual, who had a medical status change, the evaluation helps decide if the person is safe to drive again and if additional equipment, restrictions or license revocation are needed. This is required for the referring doctor and state.
4. What is an IDP?
An Individualized Driver Plan is like a school IEP or Occupational Therapy Treatment plan. Based on performance factors and client goals, a driving plan is created for a person in need. It has recommended activities, frequency, and duration. A progress check occurs as needed to update the plan.
5. What ages and conditions do you serve?
I serve teenagers, adults and elderly with a variety of needs. If I do not feel qualified or comfortable in addressing a specific issue for some reason, have a waitlist, do not take the preferred payor, or cannot travel as far or often as needed, then I will refer to someone else for assistance. I have referral relationships with multiple providers in the State and we all specialize in distinct areas of practice.
6. What locations of central Texas do you serve?
My territory is primarily the Austin Metro Area which is about 30-90 min in any direction of downtown (depending on traffic) but I can make special trips to serve outlying communities and additional cities. Travel to and from appointments taking more than 20-30 min will cost a little extra for drive time and mileage.
7. What are your hours?
All services are by appointment.
8. Where are services located?
Since I am a fully mobile provider, all service locations are pre-arranged to be in a safe and convenient place. Typically, screenings or assessments and conferences are done in quiet location such as a residence, school, library, lodge, church, clinic, hospital, or program facility. I offer driving lessons around the general living area of the driver’s home and in regions the student would need to drive. Sometimes phone calls and face-to-face computerized meetings are offered for added convenience if appropriate. If desired, a private conference space can also be rented.
9. What is required to participate?
In order to do any behind-the-wheel testing or training, a Texas driving permit or legal license is required. It cannot be expired, revoked or suspended. All clients must complete an intake process and have a pre-approved method of payment. Partial payment could be taken up front for any scheduled service. For any services being documented and billed as Occupational Therapy, a doctor script and plan of care is required. Participants must follow all recommendations for safety and be able to attend regular training sessions until discharge.
10. Are you a licensed school?
Not presently, but I have worked for a regular driving school and currently work for a TEA licensed special education and rehabilitation driving program. My OT driving rehab services and private safe driver coaching (or parent-taught lesson assistance) can count towards GDL requirements. I will discuss which route of driver training is most appropriate for students with medical conditions after an OT driver assessment and/or creation of an Individualized Driving Plan (IDP).
11. What is the cost of services?
Price of regular lessons is competitive at around $60/hour. OT driver evaluation and training can be somewhat variable but breaks down to an hourly rate typical for the average Occupational Therapy/Driving Rehab Specialist. We have major expenses to cover so most services will be in the $100-150/hour range. Some providers charge $200 or more per hour. I try to make all of my services fair and accessible to anyone in need and would be happy to discuss rate of service quotes privately. The “cost” of not getting services could be much more if an accident occurs. Additional costs may include travel time or gas milage and non-direct services.
12. How long are driving evaluations and training?
Time varies based on client factors but on average, a full and comprehensive evaluation lasts around 3 hours and training sessions each last 1.5 to 2.5 hours. Training frequency and services duration is highly variable and based on client needs. Generally a minimum of 4-12 hours is recommended for adaptive equipment needs for the experienced driver. Novice drivers generally require a minimum of 15-30 hours and those with cognitive or visual defcits can frequently take 3 or 4x longer. Duration often relates to how commited one is to the home program and attendance recommendations. Clinical assessments are around 1.5 to 2 hours. Behind the Wheel assessments can range 30 min to over an hour. Screenings are about an hour of direct intervention after doing pre-screenings ahead of time. Conference time is as long as needed. Private safe driving lessons (for either non-medical needs, passenger level training, or parent-assisted lesson coaching) are generally 1-2 hours in duration.
13. Will insurance cover this? Why not? And Why Are Services Becoming Private Pay Only?
Most insurance does not cover driving rehab as "driving" is considered an Instrumental Activity of Daily Living (IADL). Medicare also does not consider driving a medical necessity and therefore services for it are not deemed medically necessary by insurance claim reviewers (although we all disagree!). Other insurance companies are offering low fee-for-service rates for time intensive evaluations and training which could never begin to cover our basic working expenses. Equipment, Insurance, Vehicle Maintainace, Tests, and other professional expenses in this specialized field are very costly. For this reason, more and more driving rehab providers are not accepting insurance and going the private pay route to reduce out-of-pocket costs for clients. In my own past experience with attempting to take and file insurance, there were numerous times where services appeared covered and were then denied. Unfortunately, some former patients refused to pay or could not afford the bill so I had to have collections take over and take losses. As a small business, this simply does not work for profit or good customer relations. There are other reasons for my decision to be cash-based and competively priced. Insurance companies and assisting payors can delay and limit needed services. Just recently I was told by TWC to proceed with an OT evaluation as it was "approved" and then it apparently wasn't (but neither myself or the client were told). I was not paid but decided to do the right thing and not to bill the client. In order to avert the usual payer problems, all Safe Driving Rehab services are private pay. My rates are not only fair, but low considering the quality of care. In fact, I'm the lowest available in the area, yet I've been told many times I should charge more for my worth. My only response to that is "How kind. Hopefully, you will refer others and realize that I am not in this business for personal gain. I'm in it to help people, set a standard of care for others to follow, and to build safer roadways for us all". For payments, I accept cash, credit/debit/flex spending cards, or electronic transfers of funds (PayPal, Venmo) on the day of service. Clients can try to submit claims for potential insurance reimbursement on their own.
14. Do you only address driving?
No. I also address community mobility, safety, independence in living, health/and well-being. These can be direct services or supportive consultation services.