Supplemental Transportation Programs For Seniors

Transcription

1 Supplemental Transportation Programs For Seniors Photo by Stewart Smith Photography By The Beverly Foundation Pasadena, California In partnership with AAA Foundation for Traffic Safety 1440 New York Avenue, N.W., Suite 201 Washington, DC / June 2001 (Second printing - May 2002) 1

2 Acknowledgements The authors of this report are grateful to the managers of the 370 supplemental transportation programs (STPs) who responded to our initial national inquiry and to the 236 programs that returned questionnaires. These responses form the basis for the findings presented in this report. Several national organizations also contributed important information to this report. These include: the AAA Foundation for Traffic Safety and AAA-Affiliated Motor Clubs; Shepherds' Centers of America; the Retired and Senior Volunteer Program Director s Association; the National Association of State Units on Aging; and Grantmakers in Aging. The staff, volunteers, board members, drivers, and riders of the 11 programs ( STAR Award winners) that were selected as models of excellence were especially helpful in the preparation of program reviews and case studies. These programs include: Area IV Agency on Aging (Twin Falls, Idaho) Gadabout Transportation Services, Inc. (Ithaca, New York) Gold Country Telecare, Inc. (Grass Valley, California) Independent Transportation Network (Westbrook, Maine) Jefferson County Service Organization (Oskaloosa, Kansas) Lauderhill Transportation Program (Lauderhill, Florida) Ride Connection, Inc. (Portland, Maine) San Felipe Elderly Transportation Program (San Felipe, New Mexico) Shepherd's Escort Transportation (Kalamazoo, Michigan) Transportation Reimbursement and Information Program (Riverside, CA) West Austin Caregivers (Austin, Texas) The project also benefited from the participation of a panel of experts on transportation and aging who reviewed the program profiles and provided critical input used in selecting the programs of excellence. These panel members included: Merry Banks from the California State Automobile Association; James Birren from the Center on Aging, University of California, Los Angeles; John Eberhard from the US Department of Transportation; Edgar Rivas from the National Hispanic Council on Aging; and David Willis from the AAA Foundation for Traffic Safety. A final note of appreciation to the staff and friends of STPs throughout the United States is in order. By developing innovative ways to provide transportation to seniors, these caregivers are providing critical transportation services that allow seniors to remain mobile. Not only do existing STPs provide transportation for seniors in many communities, they also provide useful models for program developers, and hope that better transportation alternatives are around the corner in other communities. 2

3 Table of Contents Foreword...4 Executive Summary...5 Introduction...7 Project Methods...9 Results...11 History...11 Location...13 Organization...13 Transportation Services...14 Finances...16 Risk Management...17 Problems and Solutions...17 What do STPs Contribute?...19 Criteria for Senior-Friendly Transportation...19 Program Observations...19 Conclusion...21 Appendix A One-Page Profiles of 11 Award Winners...23 Gadabout Transportation Services, Inc. (Ithaca, New York)...25 Gold Country Telecare, Inc. (Grass Valley, California)...26 Independent Transportation Network (Westbrook, Maine)...27 Lauderhill Transportation Program (Lauderhill, Florida)...28 Ride Connection, Inc. (Portland, Oregon)...29 Transportation Reimbursement and Information Program (Riverside, California)...30 Area IV Agency on Aging (Twin Falls, Idaho)...31 Jefferson County Service Organization (Oskaloosa, Kansas)...32 San Felipe Elderly Transportation Program (San Felipe, New Mexico)...33 Shepherd's Escort Transportation (Kalamazoo, Michigan)...34 West Austin Caregivers (Austin, Texas)...35 Appendix B Program Reviews...37 Area IV Agency on Aging (Twin Falls, Idaho)...39 Jefferson County Service Organization (Oskaloosa, Kansas)...43 San Felipe Elderly Transportation Program (San Felipe, New Mexico)...47 Shepherd's Escort Transportation (Kalamazoo, Michigan)...51 West Austin Caregivers (Austin, Texas)...55 Appendix C Case Studies...59 Gadabout Transportation Services, Inc. (Ithaca, New York)...61 Gold Country Telecare, Inc. (Grass Valley, California)...69 Independent Transportation Network (Westbrook, Maine)...77 Lauderhill Transportation Program (Lauderhill, Florida)...83 Ride Connection, Inc. (Portland, Oregon)...89 Transportation Reimbursement and Information Program (Riverside, California)

4 Foreword This report summarizes the purposes, activities, and outcomes of a project on supplemental transportation programs for seniors. Funding from the AAA Foundation for Traffic Safety, a philanthropic foundation in Washington DC, made the project possible. The Beverly Foundation, a private foundation in Pasadena, California, matched the AAA Foundation s contribution in cash and in kind. Drs. Helen Kerschner and Rhonda Aizenberg conducted the project with assistance from Audrey Gomez and Leonard Smith. 4

5 Executive Summary The Supplemental Transportation Program for Seniors project was initiated in 2000 by the AAA Foundation for Traffic Safety, a philanthropic foundation in Washington DC, and the Beverly Foundation, a private foundation in Pasadena, California. It was designed as a ninemonth effort to gather information about community-based transportation programs for seniors in the United States. The aim was to describe and evaluate these programs and disseminate findings to interested organizations and groups. Preliminary research by the two Foundations revealed that many older Americans could not access ordinary forms of public transportation. They could not walk to a bus stop, get into a van, go to a physician s office without an escort, or afford a taxi. However, the study also found that many communities throughout the country were tackling this problem by organizing grassroots and community-based informal transportation services for seniors. These programs were more flexible than traditional transportation alternatives and were highly responsive to individual needs. Subsequently, in 2000, the two organizations set up this project to gather information and study the effectiveness of community-based transportation programs for seniors in the United States. Initial discussions with the staff of such programs revealed that many programs were not informal but, in fact, were fairly sophisticated in their structure and operations. Project staff recognized the value of including these programs and coined the term supplemental transportation programs, or STPs, to encompass both formal and informal programs. The project team sent preliminary surveys to STP program administrators who had been identified through membership lists or internal networks of participating national organizations. Within three months, preliminary surveys from 370 senior transportation programs around the country were received. Project staff then sent each respondent a detailed written questionnaire asking about the program's history, affiliations, service relationships, service delivery performance, finances, risk management activities, problems, and unique features. As an incentive, survey respondents were informed that programs of excellence would win cash awards. Of the 370 programs sent questionnaires, 236 responded a response rate of 64 percent. Profiles were developed for the 236 programs that completed and returned the survey. The table below shows characteristics of the 236 STPs. Location Organization 33% rural, 19% urban, 10% suburban, 36% mixed, 2% not specified 82% nonprofit, 72% part of an umbrella organization Rider targeting 43% target seniors only, 42% target seniors and disabled, 12% target seniors and others, 11% target everyone Trip Purpose Availability 45% provide rides to medical appointments only, 44% for any purpose, 30% for essential trips, 29% for social and recreation activities, 7% for religious events 54% daytime only, 40% weekdays only 5

6 Service Escorts 45% provide (or can provide) escort services Vehicles 45% use passenger vehicles, 46% vans, 27% buses, 6% taxis Rider Fees 67% no fees, 21% flat rate fee, 11% mileage rate, 9% sliding fee Drivers 39% volunteers only, 36% paid only, 22% volunteer and paid Funding 67% grant funding, 43% fees/donations from riders, 19% taxes Problems 43% drivers, 42% finances, 15% vehicles, 8% marketing, 6% operations A short list of programs was chosen for the final round in the STAR (Senior Transportation Action Response) Program Awards. Project staff and a panel of five experts in transportation and aging services reviewed the profiles and other program information and selected 11 programs of excellence. They considered performance patterns, geographic location, sponsorship, size, and financing, and the panel made a deliberate effort to select programs that varied on these criteria. Consequently, although these eleven programs were selected, other excellent programs could have been selected under different judging criteria. One-page summaries of these eleven winning programs are in Appendix A. Five of these winners received an award of $1,000 and were the subject of a program review. Project staff gathered information through teleconferences with program staff and by reviewing archival and secondary resources. The five STAR Award winners had innovative programs that were relatively small and informal. For the most part, they were sponsored by community-based organizations. Program reviews for these five STPs are in Appendix B. 1. Area IV Agency on Aging (Twin Falls, Idaho) 2. Jefferson County Service Organization (Oskaloosa, Kansas) 3. San Felipe Elderly Transportation Program (San Felipe, New Mexico) 4. Shepherd's Escort Transportation (Kalamazoo, Michigan) 5. West Austin Caregivers (Austin, Texas) The other six programs received $1,500 awards and were the subjects of case studies. These STAR Award winners had budgets ranging from $220,000 to over $5.6 million. Each provided extensive and complex services, and had what might be called formalized management systems. Project staff conducted site visits and had one-on-one and group discussions with program administrators, staff members, and volunteers. Project staff also reviewed archival documents and other secondary information about the programs. Case studies were more intensive than the program reviews, so the case study descriptions are especially rich in detail about the background, structure, and operations of the programs (See Appendix C). 1. Gadabout Transportation Services, Inc. (Ithaca, New York) 2. Gold Country Telecare, Inc. (Grass Valley, California) 3. Independent Transportation Network (Westbrook, Maine) 4. Lauderhill Transportation Program (Lauderhill, Florida) 5. Ride Connection, Inc. (Portland, Oregon) 6. Transportation Reimbursement and Information Program (Riverside, California) 6

7 Introduction The AAA Foundation for Traffic Safety is a philanthropic foundation in Washington, DC and the Beverly Foundation is a private foundation in Pasadena, California. Availability of safe transportation options for seniors is central to the mission of both organizations. The two Foundations joined forces when it became apparent that many seniors who wanted or needed to stop driving lacked information and/or alternatives. It is easier to get unsafe older drivers off the road if senior-friendly transportation options are available. Together the Beverly Foundation and the AAA Foundation for Traffic Safety are well positioned to study alternative transportation program for seniors, disseminate the information to interested parties, and participate in sustained efforts to solve problems. This final report emanated from a project begun in It was designed as a nine-month effort to gather information about community-based transportation programs for seniors in the United States. The aim was to describe and evaluate programs and disseminate findings to interested organizations and groups across the country. Due to the tremendous interest among program providers and community leaders who received surveys, the project scope was expanded to include a STAR (Senior Transportation Action Response) Awards program to identify and recognize models of excellence. One project goal was to understand organizational structures of programs that provided mobility alternatives for seniors. Initial discussions with the staff of community-based transportation programs indicated that many of these programs for seniors were not informal but in fact were fairly sophisticated in terms of their structure and operations. Recognizing the diversity of these transportation programs for seniors, the phrase supplemental transportation programs or STPs was coined to encompass both formal and informal programs. Transportation and senior service experts have tended to assume that public and paratransit (transportation for people with disabilities regardless of age) meet the transportation needs of seniors who do not drive. This project asked seniors and their caregivers to identify transportation problems and to suggest possible solutions to these problems. In the course of the study, it became clear that many seniors could not or were not comfortable using standard types of transportation. Walking to a bus stop, getting into a van, going to a physician s office without an escort, or taking a taxi were not considered realistic options. However, the study also found that many communities were tackling this problem by organizing grassroots and community-based transportation services for seniors. There was considerable variation in how these programs were structured and operated, but flexibility and responsiveness to individual needs were common themes. These programs thrived by providing realistic options that allowed seniors to stop driving without losing their mobility. Small community groups or nonprofit organizations such as churches and interfaith organizations launched most of the identified STPs. Some programs are independent and others are part of larger umbrella organizations. Within these two organization types, four STP service models emerged: 1. Sole-service programs: Provide only transportation 2. Multi-service programs: Provide a menu of services, including transportation 7

8 3. Contract programs: Contract with outside transportation providers 4. Coordinating programs: Coordinate transportation for several organizations. There is considerable overlap across these four STP service models in terms of budgets, target customers, clients, drivers, purpose of rides, modes of transportation, sources of income, numbers of rides provided, and riders served. Project staff recognized the importance of five criteria for senior-friendly transportation: availability, accessibility, acceptability, affordability, and adaptability. They called them the Five A s of senior-friendly transportation. The Five A s of Senior-friendly Transportation Availability: Transportation exists and is available when needed (e.g., evenings, weekdays, weekends). Accessibility: Transportation can be reached and used (e.g., bus stairs are negotiable, seats are high enough, vehicle comes to the door, transit stops are reachable). Acceptability: Deals with standards including cleanliness and safety (e.g., the transporting vehicle is clean, transit stops are in safe areas, drivers are courteous and helpful). Affordability: Deals with costs (e.g., fees are affordable, vouchers or coupons are available to defray out-of-pocket expenses). Adaptability: Transportation can be modified or adjusted to meet special needs (e.g., the vehicle can accommodate a wheelchair, trip chaining is possible, escorts can be provided). 8

9 Project Methods The project began on April 1, The project team decided that working through national organizations with memberships or internal networks would be the most efficient way to promote the project and identify existing STPs (see box below for a list of participating organizations). A media release and preliminary survey were produced and sent to STP administrators. As an incentive for project administrators to complete and return the preliminary survey, they were offered a free AAA Foundation video called The Older and Wiser Driver. The media release also mentioned an upcoming random drawing for programs that returned the survey, and cash awards and publicity for those selected as programs of excellence. During a three-month period, 370 STPs sent back preliminary surveys. Respondents who sent back surveys were then sent a detailed questionnaire asking about the program's history, affiliations, service relationships, service delivery performance, finances, risk management activities, problems, and unique features. Of the 370 programs sent questionnaires, 236 responded a response rate of 64 percent. Questionnaire responses were entered into a Statistical Package for the Social Sciences (SPSS) database. Project staff then developed profiles of the 236 programs that completed and returned the surveys. These profiles included the program s contact information, organizational status and type, affiliations and service relationships, service delivery components, financial information, risk management and marketing approaches, problems, and unique features. Project staff reviewed these profiles and selected a short list of programs to be considered for the Participating National Organizations AAA Foundation for Traffic Safety and AAA-Affiliated Motor Clubs Automobile Club of Southern California California State Automobile Association Auto Club South Shepherds Center of America (110 member organizations) Retired and Senior Volunteer Program - Directors Association National Association of State Units on Aging (52 member organizations and 535 Area Agencies on Aging) Grantmakers in Aging (55 member organizations) final STAR (Senior Transportation Action Response) Program Awards. At this point, project staff and a panel of five experts in transportation and aging services reviewed the profiles and other program information and selected 11 winners. Criteria for selecting these programs included performance patterns, geographic location, sponsorship, size, and financing. The panel made a deliberate effort to select programs that varied on these criteria. Two groups emerged from the 11 winners. The first group of five smaller program winners each received an award of $1,000 and was the subject of a program review. The second group of winners consisted of six of the bigger programs. Each received an award of $1,500 and was the subject of a detailed case study. 9

10 To complete the case studies, project staff made site visits to each of the six winning programs. They held one-on-one and group discussions with the program administrators, dispatchers, reservation agents, volunteer and paid drivers, riders, and board members. They also reviewed any archival documents and other secondary information about the programs. Teleconferences with the program staff were held before and after the site visits. The case studies described the start-up history of the program, its physical location, purpose and organizational structure, operations, marketing, risk management efforts, budget and funding, problems and solutions, the keys to its success, and the possibility of its replication. The aim of the case studies was to provide guidance and suggestions to organizations interested in enhancing or starting a supplemental transportation program. Also, the STAR award winners can point to the award and use the case studies in their community outreach efforts and funding applications. The reviews of the five programs in the second group were less intensive than the case studies. They gave a shorter account of the background, structure, and operations of the selected programs. Project staff gathered this information via teleconferences with program staff and by reviewing archival and secondary resources. The five program reviews addressed the history of the program s start-up, sponsorship and external relationships, operations and management, funding and budget, and special program features. General advice about establishing and building successful STPs is also provided. 10

11 Results These results are based on a mailed survey of 236 respondents who were associated with supplemental transportation programs for seniors. The mail questionnaire included a series of closed-ended and open-ended questions on a broad range of structural, operational, and performance issues, including: History and Background Location Organization Structure and Relationships Transportation Services Finances Risk Management Problems and Solutions Sponsors and Contributors Advice for Transportation Leaders The table below shows characteristics of the 236 STPs. Location Organization 33% rural, 19% urban, 10% suburban, 36% mixed, 2% not specified 82% nonprofit, 72% part of an umbrella organization Rider Targeting 43% target seniors only, 42% target seniors and disabled, 12% target seniors and others, 11% target everyone Trip Purpose Availability 45% provide rides to medical appointments only, 44% for any purpose, 30% for essential trips, 29% social and recreation activities, 7% for religious events 54% daytime only, 40% weekdays only Service Escorts 45% provide escort services Vehicles 45% use passenger vehicles, 46% vans, 27% buses, 6% taxis Rider Fees 67% no fee, 21% flat rate fee, 11% mileage rate, 9% sliding fee Drivers 39% volunteers only, 36% paid only, 22% volunteer and paid Funding 67% grant funding, 43% fees/donations from riders, 19% taxes Problems 43% drivers, 42% finances, 15% vehicles, 8% marketing, 6% operations History Year Started Figure 1 shows that many of the programs have been in existence for a long time. In fact, half had been established by the mid-1980s. Reason Started Many respondents said their programs began as gap fillers or rescue measures to address serious deficits in local transportation systems. Virtually all respondents shared the fundamental belief that transportation is critical for seniors to maintain their independence when driving is not a safe or sensible option. Typical comments about why programs were started include: Seniors had no transportation options. To provide transportation to medical appointments so...seniors would be able to maintain 11

12 their independence and thus be able to stay in their homes longer. Figure 1 Year Started for 236 Supplemental Transportation Programs Unknown The program was started to help low income seniors to remain independent and self-sufficient in their homes......without transportation no other services could be accessed. To provide safe and dependable transportation to seniors who lack their own transportation or are remote from conventional forms of public transit. To provide public transportation and rescue senior transit present 57 Number of Programs 92 The program began... to provide frail, isolated elderly people living in the community with transportation, with escorts if necessary... In some cases, empirical data were collected to demonstrate program need and in other cases data collection was initiated based on local concerns. For instance: Figure 2 Number of STPs in Sample by State CA 22 OR 5 WA 5 NV 5 ID 1 AZ 8 UT 1 MT 5 WY NM 1 CO 1 ND SD NE 3 TX 7 KS 7 OK 7 MN 4 IA 4 MO 6 AR 2 LA 7 WI 10 IL 9 MS IN 8 TN 1 MI 6 AL 2 KY 1 OH 5 GA 1 WV 3 SC 1 PA 6 VA 7 NC 7 NY 49 VT ME 2 NH MA 3 RI CT NJ 1 4 DE MD 2 1 AK FL 4 HI 2 12

13 A United Way survey showed that rural transportation for seniors was a big demand. Surveys done with senior citizens indicated priority need... The program was implemented after the Senior Advisory Board...implemented survey and focus groups to determine needs for senior citizens... The need had been clearly established in research for pilot grant. Location State Distribution Figure 2 shows the states represented in this sample of STPs. Rural/Urban Status Figure 3 shows that one-third (33%) of respondents considered their areas to be rural; 19% urban; 10% suburban; 36% serve a mix of areas, and 2% did not respond. Organization Type The vast majority of programs are operated by nonprofit organizations (82%). Only 2% are for profit and the rest are hybrids. Results from another question indicate that 72% are part of larger umbrella organizations. Figure 4 Sources of Funding for STPs Respondents from 42 states answered the survey, with the top two states being New York (49 programs) and California (22). Figure 3 Program Service Area Government Nonprofit Church 29% 45% 62% Suburban 10% Urban 19% Unknown 2% Mixed 36% Business Unknown 3% 12% Funding Sources As Figure 4 shows, the majority of programs in this sample of STPs are supported by government agencies (62%), followed by nonprofit organizations (45%), churches (29%), and businesses (12%). Rural 33% Service Relationships Figure 5 shows service relationships of these STPs. Aging-related services are involved in 13

14 77% of programs, followed by social services (53%), health services (48%) and a local transportation system (34%). As the percentages indicate, there is considerable overlap in sources of support and service relationships. Aging-related Services Figure 5 STP Service Relationships 77% Transportation Services Trip Purpose Figure 6 shows the types of trips allowed by the sampled programs. About 45% of the programs offer rides for medical appointments only, a similar proportion (44%) provide rides for any purpose, 30% for essential trips, 29% for social activities, and 7% for religious events. Availability Rides are available only during daytime hours in 54% of the surveyed programs and only on weekdays for 40% of the programs. Social Services Health Services 48% 53% Figure 7 Accessibility of Programs Local Transportation 34% Door-to-Door 81% Unknown 4% Curb-to-Curb 19% Figure 6 Purpose of Trips Varied Route Fixed Route 11% 11% Medical Appointments 45% Unknown 3% Any Purpose 44% Essential Trips Social Activities 30% 29% Accessibility Four out of five programs (81%) provide doorto-door service, although close to one-fifth (19%) provide curb-to-curb service, 11% have a varied route and 11% follow a fixed route. Religious Events Other Purposes 7% 4% Adaptability About 60% of the programs provide single passenger service and nearly half (45%) offer escort services. 14

15 Figure 8 Ridership People Using STPs Figure 9 Reservation Policies Seniors Seniors & People with Disabilities 42% 42% 2+ Days Notice 18% Unknown 7% Same Day 26% Seniors and Others General Public 12% 11% Unknown 2% 2 Days Notice 16% 24 Hrs. Notice 33% Ridership Figure 8 shows that about 42% of the programs target senior riders only, 42% target seniors and people with disabilities, 12% target seniors and others, and only 11% target the general public. Of programs with valid responses, the median number of riders served annually is 300 and the median number of rides provided is 3,852. This translates to 12 rides annually per rider. Volunteer & Paid 22% Figure 10 Types of Drivers Unknown 3% Volunteer Only 39% Reservation Policies Figure 9 shows that about 26% of the programs allow same-day service, 33% require reservations 24 hours in advance, 16% require two-day advance reservations, and 18% require that reservations be made more than two days in advance. Types of Drivers Figure 10 shows that about 39% of the programs use volunteer drivers only, 36% use paid drivers only, and 22% use both volunteer and paid drivers. Of programs with volunteer drivers only, the range is from 1 to 600 drivers and the median Paid Only 36% number of drivers is 30. Of programs that use only paid drivers, the range is from 1 to 400 drivers and the median number of drivers is 5. Programs that use a mix of paid and volunteer drivers have between 2 and 800 drivers and the 15

16 median is 23 drivers; most drivers are volunteers (median of 12 volunteers and 4 paid). There is great variability in the age of drivers. Some programs have primarily young adult drivers, others have middle aged and older adults, and still others (about 14%) have only senior drivers. Auto Van Bus Other Taxi Figure 11 Types of Vehicles 6% 13% 30% 50% 50% Types of Vehicles Figure 11 shows that 50% of all programs use passenger vehicles, 50% use vans, 30% use buses, 13% use other vehicles, and 6% use taxis. The number of passenger vehicles ranges from one to 400 (median of 15 per program), the number of vans ranges from one to 408 (median of three), the number of buses ranges from one to 42 (median of two), and the number of taxis ranges from one to 80 (median of two). largest budget of about $62,000,000. The median budget for umbrella organizations is $1,850,000. Grant Funding Grants provide funds for about two-thirds (67%) of the programs. For programs receiving grants, on average, grants account for 61% of the funding for these programs. Only 11% rely exclusively on grants. Grants are awarded by city, county, and state aging and transportation departments, county mental health departments, general funds, United Way, HUD (block grants), city governments, politicians, economic development associations, Lions clubs, lottery funds, ministerial associations, county employees, private supporters, friends, families, and local trusts. Rider Fees Figure 12 shows that 69% of the programs require no rider fees (although donations are often accepted), 21% provide service for a flat rate, 11% have a mileage rate, and 9% have sliding fees. Forty-three percent of the programs reported that at least part of their funding comes from rider fees and donations. On average, rider fees accounted for about 10% of the funding. No Rider Fees Figure 12 Types of Program Fees 69% Finances Budget Annual budgets for these programs range from zero to $9,800,000, but the median annual budget is only about $50,000. Many of the programs are part of larger umbrella organizations with the Flat Fee Mileage Rate Sliding Fees 11% 9% 21% 16

17 Tax Revenue Nearly one-fifth (19%) of the programs received funding from tax revenues, and these revenues accounted for about 36% of funding. Specific sources include property taxes, cigarette taxes, gas taxes, and the general revenue fund. Risk Management Driver and Vehicle Screening Close to four-fifths (79%) of the programs say they conduct driver screenings. Most often this includes checking references, criminal records, driver records, and insurance coverage. Some programs fingerprint drivers; others conduct random drug testing prior to and/or during employment. If the driver uses a personal vehicle, some programs conduct vehicle inspections; others conduct road tests to evaluate driving skills. tend to assume that the outside provider will have sufficient coverage. At least one program indicated that they had attempted to reduce their liability by requiring drivers to identify their own volunteer riders. Problems and Solutions Figure 13 shows the distribution of difficult problems faced by STPs in the sample. Drivers (43%) and finances (42%) were by far the most common problems. Driver problems generally involved recruitment and retention of volunteer and paid drivers. Financial problems typically related to insufficient funding (and often to the constraints this places on mileage reimbursement for volunteers) and the high cost of vehicle purchases, maintenance, repairs, and insurance. Vehicles was the third most common problem Driver Training Three out of five programs (62%) provide driver training. Sometimes this includes the AARP or AAA driver improvement program or instruction in vehicle maintenance and/or alcohol/drug prevention. More often, though, it involves training in first aid, CPR, and HIV/AIDS and/or other blood borne pathogens. Some programs provide sensitivity training so that drivers will know how to interact with seniors and frail populations. Instruction may also be provided on proper lifting and transferring techniques and how to transport wheelchairs. Figure 13 Problems Faced by Programs Drivers Financial Vehicles Marketing Operations 8% 6% 15% 43% 42% Insurance Four out of five (80%) programs report that drivers and riders are covered by insurance, a similar proportion (78%) report that vehicles are insured. Most programs maintain their own insurance coverage or are covered by their umbrella organization's policy (e.g., Red Cross, church, parish council, hospital) or by the city, town or county. Sometimes they rely exclusively on their drivers personal insurance. Those programs that contract for transportation services Insurance Riders Evaluation Legal Other 4% 3% 1% 0% 12% 17

18 (15%), specifically insufficient numbers, breakdowns, lack of replacements, and inability to accommodate wheel chairs and other special individual needs. Next was marketing and lack of public awareness (8%), followed by operations (6%), limited hours of operation, too much paperwork, and the reliance on manual as opposed to computerized record keeping. Other factors included insurance (4%), difficulties with obtaining coverage; riders (3%), changing reservations and expecting preferential treatment or single passenger rides; evaluation (1%); and legal issues (0.4%). Friends/ Associates Figure 14 Advertising Methods 73% Figure 15 How People Find Out About Programs Word of Mouth Other Promotional Methods Unpaid Advertising Paid Advertising Unknown 3% 19% 47% 57% 79% Program Enhancement Respondents were asked, What one thing could be done to enhance or expand the existing program? Responses were surprisingly consistent and emphasized fundamental changes. Most notably expanding hours of operation (to evenings and weekends), broadening the service area (especially to accommodate inter-county rides and increased penetration in rural communities), enhancing compensation for volunteers and paid drivers, hiring additional staff (drivers, fundraiser, marketing specialist, administrative staff, volunteer coordinator, escorts, dispatcher), and acquiring additional vehicles (especially vans and vehicles that are wheel-chair accessible). Social Service or Medical Newspaper Articles Newsletter 55% 67% 72% Marketing In terms of specific advertising methods, Figure 14 shows that 73% rely on friends and associates to disseminate information about the program, 72% rely on social service or medical personnel, 67% use newspaper articles, 55% use newsletters, and 36% use TV and radio. TV/Radio Other Unknown 5% 36% 34% Figure 15 shows how respondents believed people heard about the programs. Nearly four out of five (79%) reported word-of-mouth recommendations, 57% said other promotional methods, 47% said unpaid advertising, and 19% mentioned paid advertising. 18

19 Sustainability Respondents were presented with five ways to promote sustainability of informal/supplemental transportation programs and were asked to select the top two. Responses highlighted the importance of financial solvency and for programs to reflect community values and needs. Specific responses were as follows: eliminate dependency on short term financial support such as grants (50%); align with the values/needs of the community (45%); create broad community acceptance of the program (43%); develop links with reputable organizations in the community (36%); and prepare a line of leadership succession (10%). What do STPs Contribute? Rationale and Expectations Respondents were presented with 20 phrases describing possible contributions of supplemental transportation programs. When asked to identify the top four phrases describing why their program was created, the leading responses were: link people with health services (61%); get people where they need to go (60%); provide service (36%); and provide userfriendly service (34%). Less than 8% wanted to reduce collision risk for seniors and an even smaller percentage (less than 3%) to make the community safer. When asked to select the top four phrases that best described what they wanted as their program s contributions in the future, the leading responses were: get people where they need to go (36%); keep people involved (34%); provide transportation options (33%); and develop organization partnerships (29%). Again, reducing the risk of collision for seniors and making the community safer were selected by only 10% and 9% of respondents, respectively. Criteria for Senior-Friendly Transportation The Five A's Respondents were presented with a list of The Five A s criteria for senior-friendly transportation and were asked to identify the two most adhered to by their program. The Five A s were defined as follows: availability (provides a needed option); acceptability (meets expectations of users); accessibility (has user friendly design); affordability (accommodates financial circumstances of users); and adaptability (can be modified to meet individual needs). The choices were availability (67%), affordability (56%), accessibility (32%), adaptability (30%), and acceptability (12%). Program Observations Comments to Transportation Leaders Program providers were asked what they would say if they could tell transportation leaders in the United States one thing about their program and its contribution to seniors. There was considerable agreement in their responses. Comments consistently emphasized the impact that programs had on meeting the transportation needs of seniors and on the integral connection that existed between transportation and access to other services, independence, and the ability to continue to live in the community. People need affordable, reliable door-to-door service. The impact on their lives for something as simple as a ride to a doctor's is something words can't describe. When we have to reject someone because we don't have funding, many just do not go. We are really their life link. A cherished dream of all older people is to maintain their quality of life by continuing to live independently in their own homes for as 19

20 long as possible...volunteers provide doorthrough-door transportation for older adults who are no longer able to drive. Affordable transportation allows our elderly to remain in their homes and communities, thus preventing or delaying the need for unnecessary costly institutionalization and fosters neighborhood stabilization. Existing bus programs use buses for transportation. Public schools...head Start, Salvation Army, VOA, etc., are an untapped resource to be utilized during down time to transport the public for needed services. This could be accomplished legislatively or by using incentives Faith-based community organizations work! Volunteers are working from their hearts to meet the needs and make a difference in their communities. Support for these initiatives is crucial because it builds stronger-connected communities which I think saves money in the end. It (transportation) is the single most important need today. It (transportation) keeps them (seniors) in their own homes, paying taxes....more funding (with less reporting requirements) should be available... Transportation is a vital link to other services and needed goods... Transportation by far is the highest need of the elderly it ought to be funded much more adequately. We see an increasing need for 1:1 transportation. 20

21 Conclusion This is the first published report on the topic of supplemental transportation programs for seniors. Professionals from 236 programs nationwide provided detailed information about their programs. STPs take many forms; community groups and nonprofit organizations such as churches and interfaith organizations often provide the spark. Most are either operated by small, independent organizations or larger service agencies. Some provide service in urban areas, others in rural areas, and still others serve a mix of areas. Some programs are targeted specifically to seniors and others serve a more varied clientele. Some programs pay their drivers, others use volunteer drivers, and still others do both. Some provide rides for specific needs (e.g., medical appointments) and others provide rides for any purpose. Some provide escorts and others do not. Some require no rider fees but accept donations; others are fee-based, receive tax support, and/or receive grant funding. Finally, there is wide variation in budget sizes and number of rides provided annually. Recognizing gaps and deficiencies in transportation for seniors, leaders in communities across the country have begun using innovative methods to meet the transportation needs of seniors. In some communities STPs add an important transportation option for seniors and in other communities STPs provide the only way for seniors to get around. The STP approach gives professionals, older people, and their families a reason to hope that communities can develop viable transportation solutions for seniors. As the population ages and transportation demand increases, it is likely that more communities will experiment with STPs. Disseminating results is the final project activity. This information is free and will be sent to professionals and community leaders who have been identified as sharing an interest in supplemental transportation programs for seniors. Project findings will also be disseminated through the networks and web sites of the Beverly Foundation and AAAFTS and through other national and community organizations. The Beverly Foundation and AAAFTS will send out the executive summary of the report in response to inquiries and requests for general information and will disseminate the case studies and program reviews to national organizations and to conference and meeting participants. Finally, staff will prepare articles highlighting project findings and will organize workshops aimed at professional audiences in the fields of aging and transportation. This study has increased awareness about STPs and has added to the body of knowledge about senior transportation. The study also underscores the need for additional research, demonstration projects, and education. The Beverly Foundation is planning a series of projects in 2001 that will continue indexing and studying STPs in selected states and regions. In addition, the Foundation plans to prepare and disseminate information, including a how to manual on STP resources and best practices from the STAR Search winning programs. Some readers of this report may find the most interesting and useful information in the three appendices. Appendix A has one-page descriptions of each of the STAR Search winners. Appendices B and C provide a fuller explanation of the obstacles, strategies, and successes of the 11 STAR Search winners. 21

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23 Appendix A One-Page Profiles of 11 Award Winners Group 1 comprised the six STAR Award winners that were selected for case studies. They had budgets of $220,000 to over $5.6 million, provided extensive and complex services, and had what might be called formalized management systems. Each award winner in this category received a contribution of $1,500. The selected programs were: 1. Gadabout Transportation Services, Inc. (Ithaca, New York) 2. Gold Country Telecare, Inc. (Grass Valley, California) 3. Independent Transportation Network (Westbrook, Maine) 4. Lauderhill Transportation Program (Lauderhill, Florida) 5. Ride Connection, Inc. (Portland, Oregon) 6. Transportation Reimbursement and Information Program (Riverside, California) Group 2 comprised the five STAR Award winners that were selected for program reviews. These innovative STPs were relatively small and less formalized. For the most part, they were sponsored by community-based organizations. Each award winner in this category received a contribution of $1,000. The selected programs were: 1. Area IV Agency on Aging (Twin Falls, Idaho) 2. Jefferson County Service Organization (Oskaloosa, Kansas) 3. San Felipe Elderly Transportation Program (San Felipe, New Mexico) 4. Shepherd s Escort Transportation (Kalamazoo, Michigan) 5. West Austin Caregivers (Austin, Texas) One of the incentives for returning the preliminary survey was the random drawing with three prizes of $500. The project team randomly selected three programs from among the 370 who had returned the survey. These are: Davis Community Transportation in Davis, California; Shepherd s Center of Greensboro (North Carolina); and Mastick Senior Center in Alameda, California. The following section contains summary profiles of all 11 of the STAR Award programs. The profiles provide a snapshot of the organizational and operational characteristics of these programs. Summary information is included on backgrounds, relationships, transportation services, finances, risk management activities, marketing strategies, most difficult problems, and unique features. The entire program reviews and case studies are available in Appendix A and B, respectively. 23

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25 GADABOUT TRANSPORTATION SERVICES, INC. 737 Willow Avenue Ithaca, New York Tel: ; Fax: Contact: Judith E. Willis Year Started: 1976 Organization Status: Nonprofit Type of Program: Independent organization that offers a sole-service program of transportation Affiliations: Not applicable Service Relationships: TCAT (public transit), County Office on Aging, Challenge Industries (sheltered workshop), Cornell University Transit, Department of Mental Health, Tompkins Department of Social Services Area Served: Mix of urban and rural Vehicle Type and Number: 20 buses (17 with wheelchair lifts) Number of Drivers: 40 volunteers, 11 paid Riders Targeted: Seniors and disabled Rider Reservations: Must schedule 24 hours in advance Purpose of Rides: Any purpose Availability of Transport: Weekdays (weekend contract to provide ADA services), daytime Type of Service: Door-to-door Ridership Fee Structure: Flat rate Escort Availability: Escorts are available sometimes Annual Number of Riders Served: 1,500-2,000 Annual Number of Rides: 40,000 (one-way) Use of Technology: Computers used for billing, trip recording, and record keeping Transportation Program Budget: $626,000 Umbrella Organization Budget: None Funding Sources: Tax revenue, rider fees Major Areas of Expense: Salaries, vehicle repair and maintenance, fuel and insurance Driver Screening: Valid CDL-C license with passenger endorsement, driver record check, eye reflex coordination test, behind the wheel road test Driver Training: 8-hour defensive driver training program Insurance for Vehicles: Large umbrella policy through local broker Insurance for Drivers: Large umbrella policy through local broker Marketing Strategies: Newspaper articles, TV and radio, social services and medical personnel Methods: Unpaid advertising, referrals from local agencies, word of mouth Most Difficult Problems: Driver recruitment and retention, availability of vehicles Unique Features: Program was originally under the auspices of the American Red Cross; staff of the Office for Aging helped to write the original grant proposal to Section16(b)2 New York State Department of Transportation; arrangement exists with Tompkins County Department of Social Services to help provide escorts under the work experience program. 25

26 GOLD COUNTRY TELECARE, INC. Gold Care P.O. Box 2161 Grass Valley, CA Tel: ; Fax Contact: Don Martin Year Started: 1974 Organization Status: Nonprofit Type of Program: Independent organization that provides transportation only Affiliations: Nevada County Department of Transportation, CALTRANS Service Relationships: Gold Country Community/Senior Center, FREED, Sierra Services for the Blind, Del Oro Caregiver Res. Center, Abbey Physical Therapy-Rehab Center, Bowman-Solinsky Warm Water Pool, Sierra Nevada Memorial Hospital, Music in the Mountains, Lutz Adult Daycare Svcs, Gambo Health Care, PRIDE Industries, Neighborhood Center of the Arts Area Served: Rural Vehicle Type and Number: 8 minivans, 3 vans, 2 buses, 1 sedan Number of Drivers: 8 volunteers, 20 paid drivers Riders Targeted: Seniors and disabled Rider Reservations: Schedule at least 1 day in advance Purpose of Rides: Any purpose Availability of Transport: Every day (including weekends), daytime and evenings Type of Service: Door-to-door Ridership Fee Structure: Mileage rate, flat rate, vouchers available Escort Availability: Does not provide escorts Annual Number of Riders Served: 1,267 Annual Number of Rides: 28,236 (one-way) Use of Technology: Office 2000, Word, Excel, Access, and Publisher Transportation Program Budget: $810,583 Umbrella Organization Budget: Not applicable Funding Sources: Grants, rider fees, fundraising, in-kind services Major Areas of Expense: Personnel, vehicles, facility Driver Screening: Valid California B-P license, criminal and DMV record checks, liability insurance verification (for volunteers), pre-employment and ongoing random drug testing Driver Training: Paratransit driving procedures and policies, ride along, sensitivity training, monthly safety meetings Insurance for Vehicles: Nonprofits United Insurance Pool (up to $5 million) Insurance for Drivers: Nonprofits United Insurance Pool (up to $5 million) Marketing Strategies: Newspaper, newsletter, friends and associates, social service or medical personnel, participation on nonprofit boards, and community activities Methods: Pay for some advertising, word of mouth, community outreach Most Difficult Problems: Constantly need more vehicles and operating revenue Unique Features: Began as a church volunteer meal service and evolved into a paratransit program for seniors and disabled persons in rural, off-road, mountainous areas. 26

27 INDEPENDENT TRANSPORTATION NETWORK (ITN) 90 Bridge Street Westbrook, Maine Tel: ; Fax Contact: Katherine Freund Year Started: 1996 Organization Status: Nonprofit Type of Program: Social entrepreneur (public/private partnership) senior transit service Affiliations: Federal Transit Administration, AARP, Transportation Research Board Service Relationships: Local transportation system, aging services, social services, health services, adult children, businesses Area Served: Mix of urban and rural Vehicle Type and Number: 135 volunteer vehicles, 7 automobiles owned by ITN Number of Drivers: 135 volunteers, 10 paid Riders Targeted: Seniors and the visually impaired Rider Reservations: Same day service available Purpose of Rides: Any purpose Availability of Transport: Every day (including weekends), 24-hours a day Type of Service: Door-to-door Ridership Fee Structure: Membership fee; mileage and flat rate; if more than two stops, mileage plus hourly rate Escort Availability: Does not provide escort Annual Number of Riders Served: 1,000+ Annual Number of Rides: 20,000 Use of Technology: Access database adapted for dispatching; geographic information system used for routing and dispatching Transportation Program Budget: $540,931 Umbrella Organization Budget: $738,073 Funding Sources: Grants, rider fees, membership dues, charitable gifts, merchant participation Major Areas of Expense: Not available Driver Screening: Valid driver license, DMV and insurance check, criminal history check, road test, personal references, vehicle check Driver Training: In-service training Insurance for Vehicles: ITN vehicles insured for $3 million; personal insurance is primary for volunteers Insurance for Drivers: $5,000 medical coverage; personal insurance is primary for volunteers Marketing Strategies: Newspaper, TV and radio, newsletter, friends and associates, social service and medical personnel, Internet Methods: Word of mouth, media, doctors, social workers, customers, Agency on Aging Most Difficult Problems: Technology, labor issues Unique Features: Membership organization that uses a geographic information system for routing and dispatching; offers innovative payment programs. 27