MV PICCS Intervention: In-Person License Renewal for Drivers Aged 70+

At a glance

Requiring older adult drivers to appear in person for license renewal helps examiners identify impairments that might interfere with safe driving.


Drivers aged 70 and above have higher fatal crash rates per mile traveled than most other age groups.12 With advancing age, older adults experience reduced physical and cognitive capabilities and increased use of drowsiness-inducing medications, both of which can influence crash risk.1 Changes in driving habits, such as increased driving on local roads with more traffic, and fragility as a result of advancing age put older adult drivers at an increased risk for injury or death.1

One of the interventions in MV PICCS is to require that all drivers over age 70 renew their driver's licenses in person at a department of motor vehicles instead of using mail-in or online renewal. Requiring older adult drivers to appear in person for license renewal helps examiners identify impairments that might interfere with safe driving, an opportunity particularly helpful for older adult drivers whose driving abilities might change between renewals.13

Effectiveness and use

Evidence from several sources suggests that potential driving impairment can be identified through the renewal process. According to a 1995 survey of license examiners, in-person renewals allow for observations of and interactions with older adult drivers that can identify potential impairment.3 In an examination of drivers reported as potentially medically unfit to drive during 2001–2005 in Missouri, approximately one quarter were identified by license office staff.4 Office staff noted concerns including balance issues and confusion.4 A study of Iowa drivers age 70 and older who were renewing their licenses during 2006–2008 found that drivers who were referred for additional testing were older and had more prescription medications and mobility limitations than drivers who were not referred by licensing staff for additional testing.5

A study using 1985–2000 state-level crash data from the Fatality Analysis Reporting System (FARS) found that in-person license renewal reduced fatalities among drivers aged 85 and above.6 Another study using 1986–2011 FARS data found lower fatal crash involvement rates for drivers aged 85 and above in states requiring in-person license renewal.7 However, it is unknown whether the reduction in fatal crashes was due to the removal of unsafe older adult drivers through in-person license renewal or the drivers themselves retiring prematurely from driving instead of renewing their licenses.7

Policies designed to identify unsafe older drivers are acceptable to both staff and older adult drivers.8 One study investigated driver licensing policies (such as in-person renewal, shorter renewal intervals, and vision tests) in four states with relevant policies through discussions with state-level licensing staff and older adult drivers who recently completed the in-person renewal process. Both staff and older adult drivers were supportive of the policies because they believed the policies had a positive impact on the safety of older adult drivers.8

An in-person license renewal requirement for older adults is accompanied by shorter renewal cycles and a vision test in many states.19 A few states also require written or road tests.1

State legislation

You can visit the license renewal procedures state laws webpage on the Insurance Institute for Highway Safety's website for up-to-date information on in-person license renewal policies, requirements, and laws by state.29

Cost and time to implement

Costs to driver licensing agencies will vary based on the frequency and requirements of in-person license renewals and the number of older adult drivers in the state.1 Frequent in-person license renewals increase staff workload and administrative costs compared with mail or online renewals.1 Further requirements of vision tests and any subsequent screenings and assessments will incur additional costs.1

Shortening the renewal interval can be implemented in a few months, but it will be several years before the new requirement applies to all drivers.1 The requirement does not apply to an individual until their current valid license expires.1

Other issues and resources

Stopping driving can impact older adults health, limit social interactions, and reduce their ability to get around.10 CDC has developed a planning tool called MyMobility Plan to help older adults plan for future mobility changes that might increase their risk for motor vehicle crashes and falls. Adult children or caregivers can also use this planning tool to help older parents, relatives, or friends.10

You can read NHTSA's Countermeasures that Work: A Highway Safety Countermeasure Guide for State Highway Safety Offices to learn more about the topics above and other issues related to in-person license renewal, such as age discrimination and road test or medical report requirements.1

You can read the RAND Corporation's final reports for MV PICCS 1.0/2.0 and MV PICCS 3.0 for more information about how effectiveness and costs were incorporated into the MV PICCS tool for this intervention.


In 1903, Missouri and Massachusetts were the first states to require and issue driver's licenses, but no states required a test for a driver's license until 1908, when Rhode Island was the first state to require a driver's license examination.11 By 1959, all states required a driver's license examination.11

In 2019, 83% of adults aged 70 and older had a driver's license; this is an increase from 73% in 1997.2 During this time, the number of licensed drivers 70 and older increased 70%.2 As older adults are an increasingly large proportion of the population and are keeping their licenses longer, the safety of older adult drivers is a timely issue.2


The MV PICCS tool and supporting materials are no longer being updated. The tool is based on 2015 data; intervention descriptions were updated in 2022.
  1. Venkatraman, V., Richard, C. M., Magee, K., & Johnson, K. (2023). Countermeasures that work: A highway safety countermeasures guide for State Highway Safety Offices. (Report No. DOT HS 813 490). Washington, DC: National Highway Traffic Safety Administration.
  2. Insurance Institute for Highway Safety, & Highway Loss Data Institute. (2021). Older adults. Accessed on 1/27/2022.
  3. Cobb, R. W., & Coughlin, J. F. (1998). Regulating older drivers: How are the states coping? Journal of Aging & Social Policy, 9(4), 71–87.
  4. Meuser, T. M., Carr, D. B., & Ulfarsson, G. F. (2009). Motor-vehicle crash history and licensing outcomes for older drivers reported as medically impaired in Missouri. Accident Analysis & Prevention, 41(2), 246-252.
  5. Braitman, K. A., Chaudhary, N. K., & McCartt, A. T. (2010). Restricted licensing among older drivers in Iowa. Journal of Safety Reseach, 41(6), 481–486.
  6. Morrisey, M. A., & Grabowski, D. C. (2005). State motor vehicle laws and older drivers. Health Economics, 14(4), 407–419.
  7. Tefft, B. C. (2014). Driver license renewal policies and fatal crash involvement rates of older drivers, United States, 1986–2011. Injury Epidemiology, 1(1), 25.
  8. Thomas III, F. D., Blomberg, R. D., Knodler, M., & Matthew R.E. Romoser, M. R. E. (2013). Licensing procedures for older drivers. (Report No. DOT HS 811 833). Washington, DC: National Highway Traffic Safety Administration
  9. Insurance Institute for Highway Safety, & Highway Loss Data Institute. (2022). License renewal procedures by state. Accessed on 1/27/2022.
  10. Centers for Disease Control and Prevention. (2020). MyMobility Plan. Accessed on 8/20/21.
  11. Federal Highway Administration. (2018). Highway statistics summary to 1995, Section III: Driver licensing, Year of first driver license law and examination (Table DL-230). Accessed on 2/7/2022.