Transcript Integrated and Continuing Transportation Services for

Mobility for Persons with Disabilities:
Examining Service and Planning
Innovations of the US New Freedom
Transportation Program
Piyushimita (Vonu) Thakuriah and Siim Sööt
University of Illinois at Chicago
Presentation made in TRANSED 2012, New Delhi, India
Session on Best practices and innovations : Policies and Legislations
Research funded by US Department of Transportation’s Federal Transit
Administration and Community Transportation Association of America
New Freedom Transportation Program
 New Freedom (NF) program: designed to go “above and
beyond” the transportation requirements of the Americans
with Disabilities Act;
 Community-based mobility solutions;
 Origins of “New Freedom Initiative (NFI)”:
 A federal initiative established in 2001 by then President George
W. Bush;
 Nationwide effort to remove barriers to community living for
people with disabilities.
 Initiative emphasizes access to assistive technologies, work,
education, and other opportunities for people with disabilities;
 Was followed up by Executive Order 13217, titled “CommunityBased Alternatives for Individuals with Disabilities” (2001).
 NF Transportation program - instituted as a stand-alone
funding program in 2005; consolidated into larger transit
program for seniors and persons with disabilities in 2012.
New Freedom Transportation Program
 Types of projects funded:
 Trip-based NF services: shuttle services, volunteer
driver services, rideshare, vanpool, route deviation;
 Information-based NF services: mobility
management, trip or itinerary planning,
ridematching, travel training;
 Capital investment NF services: vehicles, accessible
taxis, elevators, large capacity wheelchair lifts added
to vehicles, wheelchair securement added to
vehicles, accessible paths of travel, improving signage.
 Total dollar amount: FY2012 $93 million
 Match requirement for federal funds: 50%
Coordinated Human Services Transportation Plan
 NF projects should be derived from a Coordinated Human
Services Transportation Plan (CHSTP);
 A “lead agency” is required to be designated in order to lead
the planning process and is to be decided locally; lead
agencies are typically Metropolitan Planning Organizations,
Councils of Government, transit agencies, state
transportation departments (mostly for rural areas), among
others.
 Stakeholder agencies which have participated in the planning
process are termed “partner agencies”.
 CHSTP: Locally derived plan that:
 identifies transportation needs of mobility-disadvantaged
individuals, in coordination with organizations involved with
their well-being;
 provides mobility strategies;
 prioritizes transportation services for funding and
implementation.
Objectives of Paper
 Examine details of 10 transportation-based services
funded by NF program based on primary data collection
in 2009: 4 urban, 4 suburban, 2 rural to:
 Understand the Coordinated Human Services
Transportation Planning (CHSTP) process associated
with NF-funded services for seniors.
 Conduct exploratory analysis of outcomes
experienced by NF trip-based service clients.
Institutional Structure of NF-funded Services
CHSTP Planning
Organizations
Survey
Lead Agency
Partner Organization
- 18 items
Partner Organization
Survey
- 22 items
Partner Organization
NF-funded Services
Managing or
Operating
Organization
Managing or
Operating
Organization
Managing or
Operating
Organization
Program Manager
User
User
User
User
User
Survey
- 33 items
User
User
Survey
- 61 items
Findings: Service Characteristics
 Type of service: door-through-door assisted van or
personal car service; reserved curb-to-curb bus service
with point deviation; taxi service;
 Service provider category: public or non-profit;
 Service provider function: integrated social services
centers; comprehensive senior care centers; transit
operations – NF program primarily funded
supplemental services to integrated caregiving
organizations to persons with disabilities and seniors.
Findings: Use of Funds at Study Sites
 Expand volunteer driver screening, training,
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reimbursement, and secondary liability coverage;
Establish new or expand coverage of demand-response
service;
Taxi service payments or payments to taxi companies;
Travel training;
Non-emergency medical transportation;
Route deviation/curb-to-curb transit service operation.
Findings: Coordinated Planning Process I
 Lead organizations conducted extensive outreach to
organizations serving seniors;
 Lead agency perspectives:
 Appreciated feedback from non-traditional stakeholders
and concerned citizens;
 Some lead organizations felt the process was somewhat
cumbersome to set up and could be streamlined in
terms of its requirements.
 Partners involved: organizations in transportation, human
and social services, workforce development, labor and
economic development, private employers, faith-based
organizations and other organizations involved in the wellbeing of persons with disabilities, seniors and low-wage
workers.
Findings: User Profile
Employment by Age
Types of Assistive Device Needed
Oxygen
3.3%
Communicating with others
8.1%
Audible or visual singage and information
9.3%
Manuel wheelchair
8.1%
Electric scooter or wheelchair
7.0%
Assistance from another person inside the home
17.4%
Assistance from another person outside the home
25.9%
Cane, crutches, or walker
38.9%
0%
20%
40%
60%
Percent Needing Assistive Device
Household Size
Annual Household Income
Findings: Coordinated Planning Process II
 Partner organization perspective (all partner
agencies at sampled sites)
 Some but not all made financial contributions to services;
 Stated level of participation varied from high to low;
 Noted consensus among partners in assessment of
transportation gaps, strategies to address gaps and prioritization
of resources;
 Senior citizen participants: CHSTP process may be somewhat
agency-driven in these locations and might benefit from taking
input informally from private citizens;
 Viewed process as important in achieving region’s goals
regarding persons with disabilities, seniors and low-income
individuals.
 Program managers did not find the process to be particularly
useful in resolving their immediate concerns in finding the 50%
required match or the lengthy grant implementation process.
Findings: User Socio-Demographic Clusters
Results of statistical clustering: (N=271)
 Cluster 1 (Persons with disability in poor health):
Persons with disabilities likely to be unemployed, use
assistive devices, rate their health as poor, have low
levels of functional independence and live alone;
 Cluster 2 (Oldest old): “Oldest old” more likely in
better health, have higher levels of functional
independence and less assistive device usage
compared to the first and the third group;
 Cluster 3 (Young workers with disability): Younger
more likely employed but with a greater share of
impairments and need for audio and visual assistance.
Findings regarding Mobility Independence of Users
Variable
Perceived Ability
Functional
Ability
Composite
Instrumental
Activities of Daily
Living (IADL)
Description
Perceived Ability to travel independently
Composite of 6 questions measuring functional ability to
travel: (1) Can drive car; (2) Can access and board public
transport stations and stops, pay fares, understand
schedules, have no difficulty finding a place to sit, with
station crime and with bringing a service animal; (3) No
perceived difficult in using public transportation overall; (4)
Able to shop independently; (5) Do not need assistance
from another person outside home; (6) Able to sometimes
or always go outside the house, ie, not home-bound
Composite of following questions: "How often can you do
each of the following without help: (1) Use the telephone,
(2) Prepare a meal, (3) Housekeeping tasks, (4) Laundry, (5)
Manage medications, (6) Manage finances (7) Shop"
Findings regarding Mobility Independence
Disability Cluster
Variable
Perceived
Ability
Functional
Ability
Composite
IADL
Scale
(1-Never; 5=Always)
(0 – No ability in any of
the 6 functional
measures; 6 – Ability in
all 6 functional measures)
(0=Least Independent;
35=Most Independent)
1
Disabled
persons in
Poor
Health
2.9
2
Oldest
Old
2.5
3
Younger
workers
with
Disability
2.5
2.6
2.5
2.4
12.0
10.6
18.2
Components or Dimensions of Senior Mobility Needs
Two “components” explaining variation in senior mobility needs:
Principal Component Analysis
Variable Loads:
(1) no drivers’ license,
(2) difficulties in using existing
public transportation,
(3) receipt of public assistance,
(4) no vehicles in the household.
Variable Loads:
(1) living alone,
(2) difficulties in traveling
independently,
(3) perceived health,
(4) frequent medical trips
Transportation Deprivation
Component (TDC)
Construct giving extent to which
there are “hard” constraints to
travel due to lack of appropriate
transportation availability
Independence and Health
Deprivation Component (IHDC)
Extent to which individual suffers
from social isolation, health-related
mobility issues and dependence on
others to fulfill their travel needs
Implications for Senior Mobility Services
TDC
(1) Requires reliable transportation to a variety
of destinations – shopping, social etc.
(2) Needs may be served with traditional van
programs, ridesharing and Fixed-Route
services with deviations
IHDC
(1) Requires frequent and reliable medical trips
(2) Care and support in arranging the trip
(3) Assistance while undertaking the trip
(4) Needs may be served with volunteer driver
programs, other assisted door-throughdoor services, travel planning, nonemergency medical transportation
Outcomes
 95% of users reported that the service was very
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important to them;
Users reported being able to access work,
healthcare, social visits and shopping destinations
that were previously difficult to access;
Improved trip reliability;
Time savings;
Improved assistance and information;
Great deal of site-to-site variability. Some did not
consider the services to greatly improve their
mobility outcomes.
Conclusions
 NF Transportation program started as a small
program – now integrated into larger program
“Enhanced Mobility of Seniors and Individuals with
Disabilities ” - FY2013 $254.8 million;
 CHSTP – required - but needs to be streamlined
particularly for non-traditional stakeholders;
 NF program has supported transportation options as
supplemental services to integrated caregiving by
providing new funding for such services and thereby
enabling a community-based 'continuum of care‘;
 Much work ahead to matching services to client
needs – and to understanding client needs.