Yielding to Transportation Needs

Getting around is central to life in America. On a daily basis, we travel to work, school, medical appointments, the grocery store, movie theaters, sporting events, piano lessons and church. For many people, mobility is only as difficult as finding the keys to the car. But for a significant number of Americans without access to a car because of old age, disability or poverty, getting around can be an ordeal. Although some can use the subway, bus or rail, they aren’t avaliable for everyone, including rural populations and people hampered by a physical impairment.

As baby boomers age, more Americans will begin to look for alternatives to cars and public transportation. States will face fiscal and logistical challenges to finding ways to keep a significantly older population mobile.

The Growing Need
To understand the potential crisis, it is important to understand the demographics. In 2000, the U.S. Census Bureau counted 35 million people age 65 and older, up 3 million from a decade before. By 2025, that number is expected increase by 80 percent—to 62 million. Common age-related impairments—such as frailty, loss of vision and slower response times—can make it difficult to walk or drive. An AARP survey found that 25 percent of people age 75 and older had not driven in at least a month, and a U.S. Department of Transportation survey found that 50 percent of non-drivers stay at home on any given day because they lack transportation.

Poverty and physical disability also can limit mobility. For those living at or below the poverty line, the costs to purchase, insure and maintain a car are often prohibitive.  Nearly 37 million people in the United States live in poverty, and it’s estimated that 90 percent of people on public assistance do not own a car. And approximately 30 percent of Americans with disabilities—nearly 6.3 million people—have difficulty using transportation.

Fortunately, many federal, state and local public and private programs provide special transit services for disadvantaged communities. A 2003 U.S. Government Accountability Office (GAO) report identified 62 federal programs that fund transportation services for those needing them. Hundreds of other programs are available through state and local government agencies, nonprofit organizations and private companies.

States dedicate lots of money to special transportation needs. Most contribute matching funds for federally sponsored transportation initiatives. Prominent examples include nonemergency transportation programs under Medicaid, the Capital Assistance Program for Elderly Persons and Persons with Disabilities, the Vocational Rehabilitation Program, and the Job Access and Reverse Commute program. Many states have also created their own independent special-needs transportation programs or support local initiatives. Although exact figures are unknown, the GAO estimates that states spend several hundred million dollars on special transportation services each year.

Transportation Programs a Jumble
No single law or bill created transportation programs for disadvantaged people and no single agency administers such programs. Laws evolved piecemeal as part of federal, state and local legislation, and federal, state, regional, county and city governmental agencies all work within the special needs transportation service system. Programs serve rural and urban communities, indigent populations, veterans, people with disabilities, senior citizens and Medicaid recipients. They provide transportation for employment, trips to the doctor, the dentist and the pharmacy, child care, recreation, education and other activities. Multiple agencies, with distinct constituencies and different goals, administer these services. The jumble can be difficult for people using the systems. Those who fit more than one eligibility category or require transportation for various reasons might need to talk to several different agencies or organizations. And for states, providing services through numerous programs is expensive and inefficient.

The list of problems with special transportation programs is long, and they all inconvenience the customer and cost the state money. Services are duplicated or they overlap. Schedules are inconsistent and overall service is often poor. Some services are overused and others not fully used. And there’s variation in safety standards.

Is Coordination a Solution?
Since the 1970s, many public agencies and private organizations have touted coordination as a potential solution to the special transportation muddle. In theory, coordination promises two main benefits—improved customer service and cost savings. It should make the system easier to use and recognize that people might not fit into a single category. Coordination can save money by eliminating duplication and pooling existing resources.

A New Old Idea
Although the tendency is to dismiss coordination as an old, vague and under-used concept, it’s an idea that has gained momentum lately. In 2004, President Bush issued an executive order to promote federal coordination. That same year, the Federal Transit Administration provided $1.575 million for state coordination programs. The Safe Accountable Flexible Efficient Transportation Equity Act: A Legacy for Users (SAFETEA-LU)—the current transportation reauthorization bill—contains several incentives for state and local coordination. The federal United We Ride program—staffed by the departments of Transportation, Labor, Health and Human Services, and Education—provides national information about coordination strategies and activity. It’s this federal encouragement that may help continue to push coordination onto the national agenda.

All 50 states and the District of Columbia are trying to coordinate activities at some level. Laws in 21 states specifically coordinate special transportation services, and statutes in 34 states contain coordination requirements or authorizations. Specific efforts vary. They may include better planning and communication between agencies through the development of a coordinating body or committee. California, Florida, Idaho, Illinois, Iowa, Kentucky, Maryland, Minnesota, Missouri, North Carolina, Vermont and Washington have each established a comprehensive coordination authority.

In other examples, agencies organized “brokerage” arrangements that make a single agency the point of contact for all special needs transportation. Coordination has included sharing vehicles and resources, jointly purchasing fleets and supplies, and adopting similar standards that allow agencies to work together. States have coordinated services for a single population or targeted jurisdiction and they have coordinated statewide programs across multiple populations and communities.

Happier Customers
Washington Representative Dennis Flannigan, who sponsored special transportation legislation, says his state’s coordination efforts have been very successful. “Other states should do this,” he says.

At the top of the list for Flannigan is improved customer service. His bill reauthorizes the state’s Agency Council on Coordinated Transportation and requires the council to address barriers to a statewide program. The council must also certify that local plans developed with regional planning organizations meet federal requirements.

“Many people have special needs,” says Flannigan. “We needed to do something. Now, people who might have been stuck are out and about.”

Florida has proof that coordinating efforts saves money. The state passed a law in 1979 requiring a single entity in each county to coordinate transportation services for disadvantaged communities. “It’s a common sense approach to doing business,” says Lisa Bacot, executive director of Florida’s Commission for the Transportation Disadvantaged, which oversees the program. “In 1995, Florida spent $105 million on non-emergency medical transportation. In the last fiscal year, we spent just $73 million. So in the last 12 years with this program, our trips have doubled, but the money we spend has decreased 35 percent,” says Bacot. “You can’t argue with those numbers.”

Other states have reported similar successes. Twenty-three transit agencies in Iowa coordinate transportation with 45 school districts, leading to an estimated savings of more than $1 million. A Georgia non-emergency medical transportation brokerage program cut administration costs nearly in half. Oregon officials estimate that the state saves $11 million annually through a brokerage system. A brokerage system approved by Kentucky lawmakers increased the number of special transportation trips in the state from 10,271 in 1998 to more than 2.3 million in 2003.

Caution!
Despite the apparent successes, legislators should be cautious when coordinating special transportation programs. Although the concept of coordination seems easy enough, in practice it can be tricky.

In Kentucky, for example, a 2004 audit concluded that its coordination program had not always improved customer satisfaction or reduced costs. Giving customers more choices made it more difficult to coordinate services. Additionally, while Kentucky’s law created incentives for brokers and transportation service providers to reduce costs, the audit found that the program offered few incentives to guarantee good customer service.

Several legislative audits of Florida’s coordination program found that it had succeeded in improving the coordination of transportation services to disadvantaged populations. But the audits identified problems with monitoring transportation providers and reporting performance and questioned whether services were being provided statewide. Florida Senator Lee Constantine sponsored legislation to address some of these concerns. He says the new law strengthened the commission’s coordination powers and helps it provide better transportation services in the state. “The commission is now better equipped,” he says. “Many Floridians depend on this program to get from place to place.” 

In other states where legislatures require agencies to coordinate transportation services, it is difficult to determine whether coordination improved after the legislature passed the law. Missouri, for example, established both a coordinating council on special transportation and an interagency committee on special transportation. However, neither body remains in operation.

The lesson from Florida, Kentucky, Missouri and elsewhere isn’t necessarily that coordination is problematic; it’s that coordination should be approached cautiously and with effective oversight. “It’s a great program,” says Florida’s Bacot. “It really sells to all parties. It puts money back in the system and helps riders that have no other way to get around.”

Need Not Going Away
As the number of people needing transportation assistance continues to grow, the number of legislators who see coordination as a potential solution will likely increase. In 2007, legislatures in eight states considered coordination-related legislation. It’s a figure that’s likely to climb in 2008.

“I’ve been around people with special needs for a while,” says Washington’s Flannigan. “Many couldn’t get out. This has helped and that’s what’s important.”