SB 259 Ignition Interlock Device Deborah A. Kuhls, MD Principal Investigator dkuhls@med.unr.edu Laura K. Gryder, MA Project Director lgryder@med.unr.edu 702-671-2270 1 EXHIBIT F Senate Committee on Transportation Date: 3-30-2017 Total pages: 27 Exhibit begins with: F1 thru F27 F2
Disclosure This Project is Funded by: The Nevada Department of Public Safety Office of Traffic Safety Grant #TS-2017-UNR-UNSOM-00053 Our Data Partners: 2 F2
February 8th 2017 A man previously convicted of five DUIs is suspected of killing a 16-yearold boy. The boy was stopped at a red light at Durango Drive and Farm Road at 6:30am when David Fensch (47) plowed into him at a high rate of speed. At the time of the crash. Fensch exhibited impairment (slurred speech, inability to keep eyes open) at the scene. 3 F3
March 5th 2015 Seong Me Lee, 22, was convicted of killing two teenage girls on Boulder Highway and Russel Road in Las Vegas, NV. Lee was driving at an extremely high rate of speed when he hit the other vehicle making a Uturn. He admitted to consuming 3-4 beers two hours prior to the crash. NHP previously arrested Lee on DUI charges, unlawful open container in a vehicle, unlawful use of cell phone while driving, and possession of drug paraphernalia. He was out on bond for the previous DUI charge at the time of the crash. Lee is now serving 12-30 years 4 F4
November 12th 2016 Willie Worthams (25) is accused of killing brothers Jermaine Asher (22) and Robert Sean Roberts (23) in Las Vegas. Worthams had downed 4 shots of whiskey before he crashed into the brothers pulling out of their parking spot on the side of the road near Lake Mead and Rainbow. Worthams was racing a truck, speeding at 115 MPH, three times the posted speed limit. At the time of the crash Worthams was awaiting a court date for a previous DUI arrest. 5 F5
Background In 2014, 31% of all national fatal crashes (n=9,967) involved at least one driver with blood alcohol content (BAC) >0.08 g/dl Drivers with BACs of.08 g/dl or higher involved in fatal crashes were seven times more likely to have prior convictions for driving while impaired (DWI) than were drivers with no alcohol (7% and 1%, respectively). (NHTSA 2014) >50% of those with suspended or revoked licenses due to DUI-related charges still drive (McCartt 2003). Difficulties with enforcement of existing laws. Arguments that suspension/revocation of license interferes with ability to work and complete essential errands (particularly in regions highly dependent on motor vehicles). 6 F6
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Levels of Ignition Interlock Device (IID) Laws Permissive Partial Mandatory Decision to require IID in the hands of judges or other sentencing authorities Laws mandate interlock use for specific offenders (e.g., repeat DUI offenders) All persons convicted of a DUI offense must use an IID to drive legally 2 states 22 states 26 states Nevada *As of March 2016 Existing Nevada law states that a driver s license will be revoked for 90 days if BAC >0.08 or test positive for other illegal drug use. 8 F8
Ignition Interlock Device Enforcement by State Source: MADD 2017 F9 9
Before and After Mandatory Ignition Interlock Devices (IDD) Two years after implementation, mandatory IID laws were associated with a: 7% decrease in BAC >0.08 fatal crashes and 8% decrease in BAC 0.15 fatal crashes Equates to 1,250 (BAC >0.08) fatal crashes prevented in states that implemented mandatory IID laws from 1982-2013. When including relevant covariates (zero tolerance law, BAC 0.08 law, primary seatbelt enforcement), states with partial IID laws (e.g., Nevada) did not have a significant reduction in BAC associated crash fatalities. 1982-2013 FARS data (McGinty et al. 2016) 10 F10
Before and After Mandatory Ignition Interlock Devices (IID) cont. Mandatory IID for first time offenders The CDC estimates that a first time DUI offender has likely driven drunk 80 times before being caught. For states that adopted mandatory IID for first time offenders with BAC >0.08, fatal crashes involving drunk drivers decreased by 9% (Ullman 2015) 11 F11
National Intoxicated Driving Data 1,070 children (<15 years) died in fatal crashes. Of this, 209 child deaths occurred in alcohol-impaired driving crashes (2014 data) In 2014, $44 billion dollars in costs were due to alcohol-impaired-driving crashes. (NHTSA 2014) 12 F12
Nevada Intoxicated Driving Data 77 alcohol-related fatalities in 2016 (FARS data) 23.3% of all fatalities (preliminary data- numbers may change) Rate per 100 Million VMT of Alcohol-Impared Driving Fatalities (BAC = 0.08+) 0.4 0.35 0.3 0.25 0.35 0.33 0.29 0.35 0.2 0.15 0.34 0.33 0.33 0.37 0.33 0.11 [VALUE ] 0.14 0.16 0.1 0.08 0.05 0.37 0 2011 2012 Nevada 2013 US 2014 2015 Best State FARS 2011-2015. VMT = Vehicle Miles Traveled CDC 2014 F13 13
Nevada Alcohol-Impaired Fatalities by County Highest prevalence of alcohol-related fatalities is in Clark County, where ~70% of Nevada s population resides. When controlling for population, Esmerelda, Humboldt, and Storey are in the upper third of alcohol-related fatalities. 14 F14
Center for Traffic Safety Research: Nevada Crash-Trauma Database Years: 2005-2014 Motor Vehicle Crash data: n=18,232 15 F15
Alcohol/Drugs Suspected vs. Not Suspected 16.3% 2802 83.7% 14425 Alcohol/Drugs NOT suspected Alcohol/Drugs suspected *Data used are from CTSR s linked Nevada crash-trauma database, years 2005-2014, N=18,232 Data are not an accurate representation of injury and fatality in Nevada, as database is limited to patients with both a crash report and admitted to a trauma center F16 16
Prevalence by CDC Age Group: Alcohol/Drugs Suspected (X =176.909, p<.001) 2 600 500 456 478 372 400 325 319 300 278 247 200 149 100 49 0 15-19 years 20-24 years 25-34 years 35-44 years 45-54 years 55-64 years 65-74 years 75-84 years *Data used are from CTSR s linked Nevada crash-trauma database, years 2005-2014, N=18,232 Data are not an accurate representation of injury and fatality in Nevada, as database is limited to patients with both a crash report and admitted to a trauma center F17 85+ years 17
Gender: Alcohol/Drugs Suspected (X2=313.16, p<.001) 887 Alcohol/Drugs Suspected 1914 7197 Alcohol/Drugs NOT Suspected 7225 0 1000 2000 Female 3000 4000 5000 6000 7000 8000 Male *Data used are from CTSR s linked Nevada crash-trauma database, years 2005-2014, N=18,232 Data are not an accurate representation of injury and fatality in Nevada, as database is limited to patients with both a crash report and admitted to a trauma center F18 18
Race/Ethnicity: Alcohol/Drugs Suspected (X =75.129, p=.002) 2 100% 90% 16.7% 1838 31.5% 17.5% 593 53 160 49 39 80% 70% 60% 50% 40% 9190 2802 666 927 362 85 30% 20% 10% While American Indians have the highest within group proportion of suspected alcohol/drug use, they make up a smaller portion of the Nevada population 0% White Hispanic Black Asian Alcohol/Drugs NOT suspected American Indian Other Alcohol/Drugs suspected *Data used are from CTSR s linked Nevada crash-trauma database, years 2005-2014, N=18,232 Data are not an accurate representation of injury and fatality in Nevada, as database is limited to patients with both a crash report and admitted to a trauma center F19 19
Seatbelt Use: Alcohol/Drugs Suspected (X2=496.876, p<.001) Seatbelt Use Much Higher among those NOT suspected of drugs/alcohol 10000 9000 8000 7000 6000 5000 4000 3000 2000 1000 0 Alcohol/Drugs NOT Suspected Alcohol/Drugs Suspected No Seatbelt Yes Seatbelt *Data used are from CTSR s linked Nevada crash-trauma database, years 2005-2014, N=18,232 Data are not an accurate representation of injury and fatality in Nevada, as database is limited to patients with both a crash report and admitted to a trauma center F20 20
Speeding: Alcohol/Drugs Suspected (X2=608.89, p<.001) 8000 7076 7000 6000 5000 4000 3000 2000 Much higher proportion of NON-Speeders to Speeders 4:1 Non-Speeders to Speeders 1:1 1933 908 1000 939 0 Alcohol/Drugs NOT suspected Alcohol/Drugs suspected Speeding Not Speeding *Data used are from CTSR s linked Nevada crash-trauma database, years 2005-2014, N=18,232 Data are not an accurate representation of injury and fatality in Nevada, as database is limited to patients with both a crash report and admitted to a trauma center F21 21
Hospital Outcomes: Alcohol/Drugs Suspected Nevadans suspected of drug/alcohol use had significantly higher average injury severity (NISS*), longer hospital length of stay, longer ICU length of stay, and longer stay at the ventilator (p<.001) 12.88 14 12 10.35 10 8 6 3.94 4 *NISS is an injury scoring system (075). The NISS categories include: Minor (0-3), Moderate (4-8), Serious (9-15), Severe (16-24), Critical (25+) 4.96 1.44 2 1.95 0.67 1.05 0 NISS Hospital days Alcohol/Drugs NOT Suspected ICU days Vent days Alcohol/Drugs Suspected *Data used are from CTSR s linked Nevada crash-trauma database, years 2005-2014, N=18,232 Data are not an accurate representation of injury and fatality in Nevada, as database is limited to patients with both a crash report and admitted to a trauma center F22 22
Fatality: Alcohol/Drugs Suspected (X2=21.146, p<.001) Alcohol/Drugs suspected Alcohol/Drugs NOT suspected 1970 9742 355 118 5.7% Fatality No fatality F23 3.5% 23
Median Hospital Charges by Primary Payer: Alcohol/Drugs Suspected (p=.004) Uninsured $36,949 $30,032 State covered $25,063 Workers Comp $24,837 Self/Other $32,324 $20,286 Other Government $43,404 $25,849 Commercial/non-profit $32,481 $24,844 $27,225 Medicare $30,772 Medicaid $39,800 $27,991 $- $5,000 $10,000 $15,000 $20,000 Alcohol/Drugs suspected $25,000 $30,000 $35,000 $40,000 $45,000 Partially state covered $50,000 Alcohol/Drugs NOT suspected *Data used are from CTSR s linked Nevada crash-trauma database, years 2005-2014, N=18,232 Data are not an accurate representation of injury and fatality in Nevada, as database is limited to patients with both a crash report and admitted to a trauma center F24 24
Hospital Charges to the State of Nevada Patients injured in motor vehicle crashes (MVCs) and treated at trauma centers resulted in an annual average of $77 million in hospital charges. Average hospital charges for those suspected of alcohol/drug use: $15.7 million annually. Average annual trauma hospital charges to the State of Nevada for patients suspected of alcohol/drug use: Medicaid patients: $1.7 million. Of this, Nevada pays an average $420K each year (note: 24.7% of Medicaid charges are paid directly by the state) Uninsured patients: $5 million annually as cost to the state. The burden of hospital charges for the uninsured falls upon Nevada taxpayers. *Data used are from CTSR s linked Nevada crash-trauma database, years 2005-2014, N=18,232. Data are not an accurate representation of injury and fatality in Nevada, as database is limited to patients with both a crash report and admitted to a trauma center F25 25
Potential Impact upon Road Safety for All Nevadans Recall: >50% of those with suspended or revoked licenses due to DUI-related charges still drive (McCartt 2003). The introduction of a mandatory Ignition Interlock Device would allow offenders to drive by mandating installation of the device on their vehicle within 14 days of their arrest. This removes the ability to drive their personal vehicle while intoxicated. A suspension/revocation removes a person s legal right to drive (current NV law), but it does not remove the ability for a DUI offender to access and drive their personal vehicle while intoxicated. Currently law enforcement is needed to catch those violating their driving suspension/revocation. Recall that those arrested for DUI drove intoxicated on average 80 times before being arrested. An ignition interlock device removes the need to rely solely on law enforcement, adding a second consistent layer of protection for Nevada road users. This will prevent injuries and save lives. 26 F26
Thank you! Questions? Deborah A. Kuhls, MD Principal Investigator dkuhls@med.unr.edu Laura K. Gryder, MA Project Director lgryder@med.unr.edu 702-671-2270 27 F27