States have primary responsibility for BAC testing and reporting and for implementing the best practices discussed in this report. Each State should consider its own BAC testing and reporting rates and processes. If improvements are sought, each State should implement the strategies and best practices that are most appropriate to its situation.

Other organizations can and should assist States. This chapter summarizes key activities these organizations should undertake.

NHTSA

• Show States why high BAC testing and reporting rates are in their own best interest.
  
  States that set a high priority on BAC testing and reporting achieve high rates. States that see no need to test anyone not involved in a DWI investigation have considerably lower testing and reporting rates. Ordering or cajoling States to increase testing and reporting rates is far less effective than convincing them that higher rates are in their own best interest. NHTSA should articulate the case for higher testing and reporting rates clearly and convincingly to the States. State Highway Safety Offices in turn should explain the case for higher testing and reporting rates to the key organizations within the State, such as law enforcement, medical examiners and coroners, testing laboratories, prosecutors, and others.
  
  
• Establish national guidelines for testing and reporting, for example 80 percent for fatally injured drivers (achieved in 2002 by 21 States) and 60 percent for surviving drivers (eight States), as were used in the Section 410 grant criteria.
  
  Several States raised the issue of how much testing is good enough. Raising testing rates above 85 or 90 percent for fatally injured drivers may or may not be possible for a given State in a given year. If it were possible, it would be expensive and time-consuming. At some point the marginal benefit of more test results may not be worth the marginal cost of acquiring them. The same holds, probably at a lower reporting level, for surviving drivers.
  
  
• Accept PBT and other non-evidentiary BAC evidence in FARS for drivers where evidentiary BAC tests are not available or appropriate.
  
  This suggestion was discussed in Chapter V.
  
  
• Assist States to improve BAC testing and reporting:
  • Organize and fund regional BAC or FARS meetings;
  • Help States organize and fund State BAC forums;
  • Support, recognize, and reward State FARS management and staff
    
    
• Assist other organizations:
  • Coroners and medical examiners: help draft and promulgate a model best practice for testing; help provide training as needed.
  • Law enforcement: help draft and promulgate a model voluntary testing system; help provide training as needed.
  • Health and medical organizations: work cooperatively to eliminate provisions in State insurance codes or statutes that allow insurance companies to deny payment for medical treatment of intoxicated persons.

Governors Highway Safety Association (GHSA)

• Help establish BAC testing and reporting as a priority for States, through a resolution.
  The 2003 GHSA Annual Meeting adopted the following resolution:
  
  E. 19 BAC TESTING
  Improved BAC testing should be a priority for every State because BAC data will give States an accurate picture of the impaired driving problem in their State. All States are encouraged to enact mandatory BAC testing laws for dead and surviving drivers and pedestrians involved in a fatal crash or where there is a likelihood of a fatality. States are encouraged to support law enforcement officers, medical examiners, and coroners with the training and equipment they need for BAC testing and reporting. States should also develop specific procedures for the FARS analysts so they can accurately report BAC test results. State law or insurance codes that deny payment for the treatment of intoxicated persons should be repealed because such laws/codes hamper State BAC reporting efforts. States are also encouraged to convene State forums on BAC testing which would bring all the responsible agencies together to identify and overcome State BAC testing and reporting problems.
  
  GHSA should work with States, law enforcement, medical examiners and coroners to follow up on the activities discussed in the resolution.

National Association of Medical Examiners (NAME)

• Establish a “best practice” for medical examiners and coroners of testing every driver fatality for alcohol and encourage medical examiners and coroners to follow this best practice.
  
  A best practice statement could read as follows:
  "Over 12,000 drivers impaired by alcohol were involved in fatal traffic crashes in 2002. Accurate data on each driver's alcohol level are crucial to develop, implement, and evaluate measures to reduce these crashes. All medical examiners and coroners should determine the blood alcohol concentration of each driver fatality and should report this information to their State's traffic records system."
  
  
• Work with NHTSA to develop and implement training for coroners, medical examiners, and others (such as justices of the peace) who may be called upon to participate in BAC testing of fatally injured drivers.

International Association of Chiefs of Police (IACP) and National Sheriffs’ Association (NSA)

• Support voluntary BAC testing for all surviving drivers in fatal crashes through national resolutions, State and local policies, and training as needed.

National District Attorneys Association (NDAA)

• Support voluntary BAC testing for all surviving drivers in fatal crashes through national resolutions and State and local policies.

All Organizations

• Support States in eliminating provisions from State laws or insurance codes that allow insurers to deny payment for the treatment of intoxicated persons.
  
  
• Support the training and equipment that law enforcement officers, medical examiners, and coroners need for BAC testing and reporting.