MEDICAL PROGRAM

The Strowmatt Rehabilitation Services, Inc. medical program is an Occupational Therapy TBOTE registered private practice clinic that was established to provide driver evaluation and training services to persons with medical conditions that may affect their driving capacity. These services are provided to persons with:

• traumatic brain injury
• cerebral vascular accident
• spinal cord injuries
• neuromuscular diseases

• amputation
• normal effects of aging
• psychiatric limitations
• visual disorders

• congenital conditions (muscular dystrophy, cerebral palsy, spina bifida)

Driver rehabilitation is typically the final stage of recovery that affects the client’s ability to return to work, participate in educational activities and live as independently as possible. The primary goal of these services is to determine the client’s capacity to operate a motor vehicle independently in their environment. Strowmatt Rehabilitation Services, Inc. is a Texas Department of Licensing & Regulation licensed driving school that is also a Member of the Association of Driver Rehabilitation Specialists.

In addition to driving services, the Occupational Therapists provide independent living skill evaluations and training. The staff can assess specific equipment needs including manual and power wheelchairs, as well as 3- wheel scooters. Home/work accessibility recommendations are also created to improve the independence and potential of each individual seen, including work simplification and energy conservation techniques.

REFERRAL PROCEDURE

EVALUATION PROCEDURES

• Clinical Evaluation:
This evaluation is performed by an occupational therapist with extensive experience in evaluating visual perceptual skills, visual skills (including night and glare vision), muscular strength/range of motion, reaction time, driving knowledge, cognitive processing speed, and trunk balance. Depending on the client’s diagnosis, the clinical evaluation generally lasts 1 to 2-1/2 hours. The evaluation battery is consistent with the research results that have been advocated by a number of leading universities, medical institutions and Association of Driver Rehabilitation Specialists.

All persons entering the program must possess a valid driver’s license or a learner’s permit and meet the minimum standards for motor vehicle operation as outlined by the Texas Medical Advisory Board guideline for determining driver limitation.

• Behind the Wheel Evaluation:
All behind the wheel evaluations are performed by a state certified driving instructor in a specially modified vehicle owned/leased by Strowmatt Rehabilitation Services; and, that process generally lasts up to an hour. Under special circumstances and conditions, the evaluation may be performed in the client’s own vehicle. Depending on the client’s diagnosis, the evaluation will be conducted in a car or van.

Car Evaluation

The in-car evaluation is performed in a setting consistent with the client’s prior driving skill history. The client must possess the ability to transfer him/herself in/out of the car. In many cases, the evaluation begins in a vacant parking lot and progresses to various traffic settings, depending on the client’s demonstrated skill. At the completion of the evaluation, recommendations are made in reference to adaptive equipment needs, client’s skill level with/without adaptive equipment as well as the need for additional training for licensure.

Van Evaluation

The first phase of the van evaluation process involves an assessment of methods to enter and exit the vehicle,lift operation, transfer skill, driver/passenger restraint system and primary control operation (steering, braking, and accelerating). The second phase of the evaluation process includes an evaluation of the primary control operation in traffic and the access and usage of secondary controls. Depending on the complexity of the adaptive equipment needs, the van evaluation process can take up to 10-15 hours. Upon completion of the van evaluation, equipment and training recommendations are made to achieve independent motor vehicle operation and licensure.

BEHIND THE WHEEL TRAINING

Training services are provided on an as-needed basis. In many cases, additional training/retraining will be necessary to document the client’s performance in a variety of simple to complex traffic situations. For diagnostic groups that affect cognitive functioning, training is recommended to eliminate the question of cognitive endurance and to determine consistency of behind the wheel performance. For adaptive equipment users, training is generally needed to provide the client with the opportunity to develop the appropriate skills and comfort for independent motor vehicle operation in a variety of traffic settings. When the client successfully completes the recommended behind the wheel training, he/she is accompanied to the appropriate driver license office to take the state licensure comprehensive road examination. When the client passes this road test, a record of the client’s post-injury driving capacity is on file with the state. In some cases, the client will be required to complete a written examination. Client’s that require specialized equipment or other restrictions will have these restrictions added to their driver license. For out of state clients trained in Houston, a certificate of completion will be provided to present to their local driver licensing authority. All other out of state clients will be accompanied to the appropriate licensing office.

EQUIPMENT PRESCRIPTION

Strowmatt Rehabilitation Services is acutely aware of the equipment options that are available on the market for car, truck, and van modifications. We work closely with adaptive equipment dealers and funding sources to provide the right piece of equipment that best meets the client’s needs. A prescription will be generated that will specify that client’s preferred brand (if appropriate) and the justification for equipment use. This prescription will be forwarded to the client’s physician for signature. Generally, prescriptions are not generated until the client successfully passes the DPS Comprehensive Examination. Van modification recommendations are generated at the completion of the van evaluation process.

REQUIREMENTS FOR ENTERING MEDICAL PROGRAM

• Referral/Prescription from Physician
• Client Pre-Appointment Questionnaire
• Copy of Valid Driver’s License or Learner’s Permit
• Seizure Free for six (6) months
• Funding Source in place. For private pay clients, we do NOT file insurance and payment should be made at the time services are rendered.

REFERRAL/PRESCRIPTION — This can include having the physician fill out and sign our referral form, a letter signed by the physician describing the client’s disability and recommend a driver evaluation, or it can be written on a prescription pad with the client’s name, disability, recommend driver evaluation, and physician’s signature.

CLIENT PRE-APPOINTMENT QUESTIONNAIRE — All clients are required to fill out and return our Client Pre-Appointment Questionnaire so that we can determine which vehicle and how much time is needed to better evaluate and/or train the client.

VALID LEARNER’S PERMIT OR DRIVER’S LICENSE — All clients are required to have a valid driver’s license or permit to participate in the behind the wheel portion of the evaluation. If the client is under 18 years of age and does not have a license, he/she will be required to take a classroom course to obtain a permit. If the client is 18-24 they are now required by Texas law to take a six-hour adult drivers education course provided by a TDLR-approved driving school.

FUNDING SOURCE — Accepted funding sources can include private pay, Texas Workforce Commission/Vocational Rehab Services (TWC/VRS), formerly the Department for Assistive and Rehabilitative Services (DARS), Workers Comp. and VA. TWC/VRS consumers must ensure that a purchase order is emailed or faxed to our office before the day of the service. Pre-payment of services are required for Workers Comp and VA clients. If the client is private pay, payment is required at time of service, we do NOT file insurance. We will be happy to provide you with a receipt that can be turned into your insurance company.

The length of the evaluation needed will be determined by the client’s medical diagnosis and physical abilities. For out of town clients, training can be done around the client’s home, if requested. A charge is required for mileage and food/lodging, if applicable, and determined by the State Comptroller’s office.