Two weeks ago, there was a minor accident in Cleveland involving a White County school bus. No one was injured, and no students were on the bus.

But the accident raised questions about how local school systems monitor the health of their bus drivers.

According to the Cleveland Police Department, bus driver Paula Massey lost consciousness at the wheel on March 11. She had just left White County Middle School at about 10 a.m. and was attempting to turn left onto Old Blairsville Highway when she blacked out.

The bus drifted across the road into a ditch, causing slight damage to the right front bumper. According to the police report, Massey told first responders that she had no memory of what happened after she left the middle school.

When asked if she had a history of seizures, Massey reportedly stated that she did have a seizure last July.

According to Georgia law, after a person has had a seizure they are supposed to refrain from driving their car until they have been seizure-free for at least six months. But the rules are much stricter for bus drivers.

"It’s very clear, under the rules for carrying human cargo, that if you have a seizure disorder you are (permanently) disqualified from driving (a commercial vehicle)," said Dr. Edward Galaid, a Gainesville physician who specializes in occupational medicine.

But because school systems have policies for screening bus drivers, such incidents are rare.

"We’ve never had any driver have a seizure or anything like that," said Gordon Higgins, spokesman for the Hall County school system.

Paul Shaw, superintendent of the White County school system, said the March 11 incident was a first for the county. "We’ve never had anything like this happen before," he said. "We were very fortunate (that no children were on the bus)."

It’s impossible to predict or prevent every medical crisis, but school systems in Northeast Georgia try to minimize the likelihood of a problem by requiring every bus driver to have an annual physical, typically during the two weeks before school begins in August.

"The Department of Transportation requires physicals every two years (for truck drivers). But in Hall, bus drivers have exams every year. We go above and beyond," said Dr. David Hocker, an occupational medicine physician who is under contract to provide physicals for the Gainesville and Hall school systems.

Though trucker safety is important, Hocker said even more caution is warranted for school bus drivers.

"You’re not hauling chickens or bricks. You’re hauling children," he said.

Hocker said though bus drivers are not federally regulated, the exam he performs almost is identical to the one for commercial truck drivers.

"We look for uncontrolled hypertension, diabetes, vision changes, musculoskeletal problems," he said.

Hocker said the two biggest disqualifying ailments are seizure disorders and insulin-dependent diabetes. Type 2 diabetes is allowed as long as it’s controlled with medication.

Galaid, who examines bus drivers for local private schools and for Gainesville’s Red Rabbit transit system, said he conducts a thorough neurological evaluation as well. But the basic neuro tests, which check for things such as balance, cannot tell him whether a patient has had a seizure in the past or predict whether they’ll have one in the future.

"So the medical history is just as important as the physical exam," he said.

Patients are asked to fill out an extensive form listing their past and current illnesses and symptoms. The assumption is that the person will disclose all relevant information.

"We trust that the patient is telling the truth. Most people are pretty forthcoming," Galaid said.

But doctors can’t know whether the patient is withholding certain details. And in the current economy, some employees may be reluctant to reveal a problem, fearing they might lose their job.

Galaid acknowledged that possibility. "We don’t put them through lie-detector tests," he said.

Brenda Jarrard, a bus driver with Hall County schools for 17 years, said she always has answered the questions truthfully. "And I’m hoping that most bus drivers are honest," she said.

Jarrard said she’s required to inform her supervisor about any prescription drugs she takes, and she knows she may be required to undergo random screenings for illicit drugs several times a year.

"If I know I have to take anything (that might cause drowsiness), I won’t take it after 7 p.m.," she said.

That’s because Jarrard has to get up at 4:45 a.m. in order to make it to Riverbend Elementary for her first route of the day. She then delivers students to North Hall Middle and high schools.

Jarrard said she’s never had any health issues that might affect her driving.

"It’s not physically demanding. The buses all have power steering, and they don’t have stick shifts anymore," she said.

Though it might seem distracting to steer a large vehicle through traffic with dozens of rowdy kids on board, Jarrard takes it in stride.

"It’s not stressful," she said. "My kids are really good."

But if a driver has reason to believe he or she might be impaired, Galaid said remaining silent could be dangerous.

"All employees have a responsibility to show up fit to perform their job," he said. "If they have concerns about their fitness, they need to inform their employer."

Though all local school systems require their drivers to get annual physicals, their policies vary on who is allowed to perform the exams.

In the Hall system, drivers have no choice in the matter. "They send us a letter, telling us the date and time (of the exam appointment) and where to go," said Jarrard.

In the Gainesville system, assistant transportation director Jerry Castleberry said bus drivers can go to the doctor hired by the system, at no charge. "Or they can go to another physician to get that DOT form filled out, at their own expense," he said. "But very few do that."

Forsyth County schools spokeswoman Jennifer Caracciolo said her district contracts with a clinic operated by Northeast Georgia Health System because no other local provider can handle the volume of physicals on 320 drivers in a two-month period.

Lumpkin County schools superintendent Dewey Moye said his system also contracts with a Dahlonega affiliate of Northeast Georgia Health System.

Habersham County schools superintendent Robert Costley said he contracts with doctors at Habersham Medical Center for physicals.

Dawson County schools superintendent Nicky Gilleland said his system contracts with a local physician who practices general medicine.

In White County, Shaw said his small system cannot afford to contract with a specific clinic. "Each driver goes to their own physician, and he signs a form verifying that they are fit to drive the bus," Shaw said.

Hocker said in an ideal world, all drivers would be examined by a doctor who specializes in occupational medicine.

"You really need to have someone who’s well-versed in DOT rules before doing a physical like that," he said.