MTO Reporting Requirements Task Force
In 2018, the Ministry of Transportation of Ontario (MTO) introduced changes to the requirements for reporting medically unfit drivers. Ontario Regulation 340/94 describes high risk conditions/impairments that are mandatory for a physician, optometrist, or nurse practitioner to report. These reports would result in licence suspension.
In surveying OPA membership and liaising with other stakeholders, several concerns were identified such as:
- The presence of certain psychiatric diagnoses as the sole basis for reporting, without consideration of qualifiers such as non-adherence to treatment recommendations, nor consideration of actual risk and functional impairment. As such, the Regulation is stigmatizing towards presence of mental illness and psychiatrists will be reporting the majority of their patient population. At the same time, the likely disruptions in therapeutic alliance could impede recovery due to non-adherence and non-attendance at follow-up appointments
- Variable interpretations of “uncontrolled substance use disorder”, with no consideration of the severity of illness
- The excessive burden of the duty to report in acute situations in which the episode is expected to resolve, with subsequent administrative burden to assist patients in appealing to reverse the suspension of one’s licence once the acute episode remits.
The OPA approached the Canadian Medical Protective Association (CMPA) for guidance and input on common case scenarios. While the CMPA was unable to provide commentary on such cases, the CMPA provided general guidance on medico-legal risks. The guidelines are available upon request to members only by emailing: firstname.lastname@example.org.
Throughout 2019, OPA worked closely with the MTO to express the above concerns.
As of September 2020, due the OPA’s advocacy and ongoing collaboration with the MTO, the following outcomes are in progress:
1. MTO is investigating whether there is opportunity for modifying the legal language of the Regulation
2. MTO is considering removing the mandatory requirement for a diagnosis to be provided on the reporting form
3. MTO has drafted an interpretive guide to assist in understanding the Regulation
MTO has also advised that modernization of the reporting system is being undertaken, which will result in an online system for reporting and liaising with the MTO. This undertaking amidst COVID-19 has further impacted progress on these matters; however, the MTO has remained welcoming of further discussions with the OPA and other stakeholders.