1 INFORMATION ABOUT THE DIAL-A-RIDE SYSTEM ELIGIBILITY The Dial-a-Ride System is a door-to-door service available to those who cannot use Public Transportation for one or more of the following reasons: a) Unable to perform daily tasks without a wheelchair or walker; b) Unable to get on or off a bus; c) Unable to walk from home/destination to the nearest bus stop; d) Unable to wait standing for more than 15 minutes; e) Unable to move in crowds (difficulty in keeping balance in a bus is not considered a transportation disadvantage since federal regulations require seats for the disabled near the entrance of all buses); f) Unable to read information signs or schedules (this does not include foreign language problems or illiteracy among otherwise able-bodied individuals); g) Unable to grasp coins, tickets or handles; h) Unable to use a bus in the performance of a life sustaining activity. The words unable and prevents mean that performing the function is absolutely impossible or causes severe or continuing pain, not discomfort, occasional pain, difficulty, or inconvenience. The following types of eligibility that may be granted are: Conditional Eligibility you are able to use the fixed route buses for some of your trips, and qualify for dial-a-ride service for other trips; Unconditional Eligibility your health condition always prevents you from using the fixed route buses and you qualify for dial-a-ride for all your trips; or Temporary Eligibility - you have a health condition or disability that temporarily prevents you from using the fixed route buses. The Humboldt Transit Authority reserves the right to conduct a re-certification process as necessary to keep our records up-to-date. Service will be provided only to persons who have been certified. Qualified Medical Professionals will be asked to assist in making the determination of certification by completing a form describing the applicant=s disability. The final decision as to whether or not the applicant qualifies for Dial-a-Ride will be made by the Humboldt Transit Authority. To help us accurately determine your eligibility for Dial-a-Ride, please fill out the application form as completely and thoroughly as possible. Once you have completed the form the Humboldt Transit Authority will determine if it will be necessary for an inperson interview.
2 INTERVIEW PROCESS If we determine that more information is needed to process your application, or that your application is incomplete we will schedule an in-person interview. At the time of your interview, we will ask you additional questions about your eligibility so we can further evaluate your travel abilities and limitations. If you know that you will need transportation to the interview, please let us know when we schedule your interview. If you are determined eligible for dial-a-ride for some trips or for all trips, we will provide you with that information in your letter of eligibility. If it is determined that you are able to use fixed route buses for some or all of your trips, we will notify you in writing of the exact reasons for this decision and provide information about how to appeal our decision. This decision will be made within 21 days of the date you complete your in-person interview or assessment. If a decision is not made within 21 days, we will provide you with dial-a-ride until a final decision is made. Complaints or comments about the system should be reported to Humboldt Transit Authority, Consuelo Espinosa, at for investigation and appropriate action. All information will be confidential. All passengers are expected to comply with vehicle rules.
3 APPLICATION FOR ADA COMPLEMENTARY PARATRANSIT SERVICE TO QUALIFY FOR DIAL-A-RIDE/LIFT SERVICE YOU MUST MEET THE FOLLOWING CRITERIA: CHECK ONE: Unable to use public transportation A resident of a convalescent home PLEASE PRINT: 1. Date of Application: 2. Name: Phone #: 3. Address: City: 4. Age: Date of Birth: 5. Agency Certifying: 6. What is your disability/medical diagnosis that prevents you from using fixed-route bus service? No longer driving is not a limitation. 7. How does your disability prevent you from using city bus service? Is this condition temporary? Yes No If yes, please list the date you expect the temporary condition to no longer exist: 8. Does your disability change from time to time because of medical treatments, medications, or other reasons? No Yes How? 9. How far can you travel without the assistance of another person? Less than 200 feet? Up to ¼ mile? Other (Please Explain)
4 10. Can you climb three 12-inch steps without assistance? Yes No How many steps can you go up or down? Number Steps 11. Can you wait outside without support for more than 10 minutes? Yes No Sometimes 12. If certified to use Dial-a-Ride or Dial-a-Lift, will you require the assistance of an attendant in order to use the system? Yes No Name of Attendant: 13. Mobility Limitations (please check all yes or no) Yes No Can travel 200 feet without assistance Yes No Can travel 3 blocks without assistance Yes No Can travel 6 blocks without assistance Yes No Can travel 9 blocks without assistance Yes No Can climb 12-inch steps without assistance. (up to 3) Yes No Can access bus using lift or ramp Yes No Can wait outside without support for 10 minutes 14. If you require the use of mobility aids. Please check all that apply: Manual Wheelchair Electric Wheelchair Electric Scooter Care Worker/Attendant Cane Walker Service Animal Oxygen Tank 15. If you use a manual wheelchair, what type of obstacles could prevent you from using a fixed-route bus equipped with lift or ramp? 16. Do you have a communication disability which necessitates the use of some type of communication aid? Yes No Sometimes If yes or sometimes, what kind of communication aid do you require? 17. Does your disability allow you to:
5 Give addresses and telephone numbers upon request? Yes No Sometimes Recognize a destination or landmark? (i.e. gas station, movie theatre, etc.)? Yes No Sometimes Deal with unexpected situations or changes in routing? Yes No Sometimes Ask for, understand and follow directions? Yes No Sometimes Make arrangements-keep appointments? Yes No Sometimes 18. List two of your most frequent destinations and how you get there now Where do you go? Address How do you get there now? Where do you go? Address How do you get there now? 19. Is there anything else you can tell us about your disability that would prevent you from using our fixed-route bus services? Please explain completely. Use the back of this page or additional sheets if necessary.
6 SIGNATURE PAGE: In order for the Humboldt Transit Authority to evaluate your request for eligibility, it may be necessary to contact a health care or rehabilitation professional for additional information about how your disability prevents you from using regular bus service. It is important that you identify one or more qualified professionals who are familiar with your particular disability and how it prevents you from using the bus system. You must include, for all professionals listed, complete telephone and address information including zips codes. Qualified professionals include: family physician independent living specialist rehabilitation specialist ophthalmologist physical therapist registered nurse occupational therapist dialysis social worker social worker psychologist (PLEASE PRINT) Family Physician (or other qualified professional) Family Physician (or other qualified professional) Professional s agency (if any) Phone# Professional s agency (if any) Phone # Address Address City State Zip City State Zip CERTIFICATION AND AUTHORIZATION: I certify that the information provided in this application is true and correct. I understand that falsification of information may result in denial of service. I authorize the professional listed above to release to Humboldt Transit Authority information about my disability and its effect on my ability to travel on the regular bus system. I understand that I may revoke this authorization at any time. Unless earlier revoked, this form will permit the professional listed to release the information described up to 60 days from the date below. Signature of applicant Date Signature of person assisting applicant Relationship to applicant Print name Address Agency Phone
7 Dear Dr. LETTER OF INTRODUCTION Re: This letter is to inform you that one of your patients is requesting certification for the ADA Complementary Paratransit/Dial-a-Ride/Dial-a-Lift Program. The ADA Complementary Paratransit/Dial-a-Ride/Dial-a-Lift Program has been established to serve the needs of persons who are unable to use the existing public transportation services offered by Redwood Transit, Eureka Transit, Arcata & Mad River Transit, and Southern Humboldt Transit. The agency certifying clients for the ADA Complementary Paratransit/Dial-a-Ride/Diala-Lift is the Humboldt Transit Authority. ADA Complementary Paratransit/Dial-a-Ride/Dial-a-Lift eligibility criteria now require that all ADA Complementary Paratransit/Dial-a-Ride/Dial-a-Lift users be certified on the basis of disability as unable to use public transportation. We are asking physicians to assist us in determining patient eligibility. The Humboldt Transit Authority will make the final determination of eligibility. The word Aunable as it relates to using the transit system means that performing the function is absolutely impossible or causes severe or continuing pain, (not discomfort, occasional pain, or difficulty.) Examples of those who would qualify to use the program are those who are: Unable to perform daily tasks without a wheelchair or walker; Unable to get on or off a bus; Unable to walk from home/destination to the nearest bus stop; Unable to wait standing for more than 10 minutes; Unable to move in crowds (difficulty in keeping balance in a bus is not considered a transportation disadvantage since federal regulations require seats for the disabled near the entrance of all buses); Unable to read information, signs, or schedules (this does not include foreign language problems or illiteracy among otherwise able-bodied individuals); Unable to grasp coins, tickets or handles; Unable to use a bus in the performance of a life sustaining activity. Eligibility may be granted on a temporary or conditional basis. Please complete the enclosed form so we can determine the eligibility of your patient. Thank you for your assistance in the completion of this certification. Please send the completed form by TO: Humboldt Transit Authority 133 V Street Eureka, CA 95501
8 PROFESSIONAL VERIFICATION Name of Applicant D.O.B. * Is D.O.B. Correct? IF THE APPLICANT IS UNFAMILIAR TO YOU, INELIGIBLE OR HAS NOT BEEN SEEN FOR MORE THAN ONE YEAR, PLEASE INDICATE UNDER ADDITIONAL COMMENTS AND RETURN BY THE DATE INDICATED IN THE COVER LETTER. If a response is not received by the date indicated, the application will be returned to the applicant. A. Has the applicant been diagnosed with significant limitations cognitive, physical, etc.? If yes, please explain. No Yes Diagnosis Onset ICD-9/DSM Temp Until When? B. Do the applicant s abilities change due to medical treatments, environment (heat, etc.)? If yes please explain. No Yes C. What is the MAXIMUM distance the applicant can either travel using a mobility aid OR ambulate unassisted. If variable, please explain. Less than 1 block 2 blocks ¼ mile ¾ mile or more 1 block 3 blocks ½ mile or more Varies: D. How many large stairs can the applicant climb or descend? If variable, please explain. none 2 4 or more 1 3 Varies: E. Without assistance, can the applicant perform the following activities? If variable, please explain. Ask for, understand and follow direction? Yes No Varies: Cope with unexpected changes in routine? Yes No Varies: Recognize landmarks? Yes No Varies: Cross busy streets? Yes No Varies: Use a telephone to make and receive calls? Yes No Varies: F. Does the applicant require an attendant to complete a trip? If yes, please explain. No Yes G. Does the applicant currently use a service animal? No Yes H. Does the applicant utilize any of the following mobility aids? does not use aid manual wheelchair braces cane motorized chair/ scooter walker other- please specify I. On average how frequently has the applicant been seen? J. Please indicate which combination of the following categories best summarizes the applicant s limitation(s): The applicant cannot ride the bus without the assistance of an attendant. The applicant cannot board the bus without a lift or ramp. The applicant cannot travel to and from the bus stop (assume not more than 6 blocks away) K. Additional comments (prognosis, overall condition, etc.): Professional Name and Title Signature Date Agency Phone Address
9 HUMBOLDT TRANSIT AUTHORITY DIAL-A-RIDE RIDER'S INFORMATION GUIDE WELCOME ADA paratransit service is a door-to-door, shared-ride transportation for individuals who are unable to use public transportation, either all of the time or some of the time, because of a disabling condition. This guide is designed to help you understand the service and responsibilities while using it. GENERAL INFORMATION The Americans with Disabilities Act (ADA) of 1990 requires all public transportation agencies like HTA to provide specialized transportation that is comparable to the public transit bus service for individuals who are unable due to a disability to ride public transit. ADA paratransit service provider is City Cab. Services are available on a prearranged basis for any trip purpose within the designated service areas. If you feel you may be eligible for ADA paratransit service you must apply through Humboldt Transit Authority Accessible Services Department, and be found eligible for the service according to ADA guidelines. ACCESSIBLE FORMATS This Rider's Information Guide is available in large print and available online at For those who have limitations seeing, hearing, speaking, remembering, moving, specially-trained Communications Assistant (CA) can relay telephone conversations by dialing 711. RECERTIFICATION OF ELIGIBILITY HTA recertifies registered clients every 3 to 5 years. A person's ADA Paratransit Eligibility letter will indicate his/her paratransit eligibility expiration date. SERVICE FOR VISITORS Visitors to the Humboldt County area can access ADA paratransit services for up to 21 days in a year. A visitor is an individual with a disability who does not reside in Humboldt County area. Visitors who present documentation that they have been ADAcertified with a disability which prevents them from using the fixed route system, in the jurisdiction in which they reside, shall be provided ADA paratransit service. For more information on Visitor Status please contact the HTA office at At the time of making your trip request with the dispatcher let the reservationist know you are visiting from another area and by which paratransit system you have been certified, if applicable. If you require paratransit service beyond the 21-day limit, you must become locally certified for ADA paratransit service.
10 SERVICE AREAS Eureka: This service area is the same as that for the Eureka Transit Service which includes Pine Hill, Myrtletown, Bayshore Mall, and Cutten (as far out as Campton Road). One ticket will be collected per trip. Arcata: This service area is the same as that for the Arcata Transit Service. One ticket will be collected per trip. Mckinleyville: The southern boundary begins at the Mad River, from the Pacific Ocean to the intersection of North Bank Road at State Highway 299. The northern boundary is U.S. Highway 101 at the Little River bridge located by the Highway Patrol scales, and to Crannell Road where it crosses Bullwinkel Creek. The eastern boundary ends at the end of Hiller Road, and the western boundary ends at the end of Gwin Road. One ticket will be collected per trip. HCAR Dial-a-Ride Service: The expanded Care-A-Van public DAR/DAL service area generally includes Old Arcata Road between Eureka and Arcata city limits; Indianola Cutoff; State Route 255 including Manila and Samoa; Elk River Road; Humboldt Hill; King Salmon; Fields Landing; Cutten; Ridgewood Heights; and College of the Redwoods. Program boundaries are generally defined to service approximately 3/4 mile from the identified roadways and/or communities. All trips must begin and/or end within the service area boundaries. The service areas are divided into twelve (12) zones, and one (1) ticket will be collected per zone. The maximum of crossing zones per trip is three (3), and no more than three (3) tickets will be collected to accomplish one (1) single trip. SERVICE DAYS AND HOURS For trips on Old Arcata Road, Manila, Samoa, Humboldt Hill, King Salmon, Fields Landing, or Cutten contact HCAR at Hours of operation are 7:00 a.m. to 7:00 p.m., Monday through Friday and 7:30 a.m. to 5:30 p.m. on Saturday. Drivers will only be able to make one stop and each time you get into the cab it will count as a separate trip and require new tickets. For your convenience, the phone number is printed on the tickets. Drivers will not wait if you are not ready or have left the requested pick-up location. All requested pick-up locations for City Cab or HCAR must be made prior to 6:45pm Monday through Friday, and 5:15pm on Saturday. Holidays observed by Dial-a-Ride are New Year s Day, Independence Day,
11 Thanksgiving Day, and Christmas Day. For trips in the Eureka, Arcata, or Mckinleyville Areas contact City Cab at Hours of operation are 6:00 a.m. to 7:00 p.m., Monday through Friday and 7:30 a.m. to 5:30 p.m. on Saturday. Reservations can be made up to 14 days in advance and seven days a week 8:00am to 5:00pm. You MUST schedule your ride 24 hours in advance, and be ready to go when the vehicle arrives. TICKETS ARE REQUIRED, $18.00 FOR A STRIP OF SIX (6) TICKETS (NO REFUNDS). MAKING A RESERVATION City Cab HCAR SCHEDULING YOUR TRIP When you call in to schedule your ride, you will need to give the following information: ~Your first and last name ~The date of your requested trip ~Your preferred pick-up and return times ~Your origin and destination addresses and phone numbers at those locations (including building name and specific drop-off and pick-up information). If a medical appointment, include the name of the doctor and the suite number. Phone number and address will be provided to personnel, as needed. ~ If you'll be traveling with an attendant, companion, or service animal. ~If you or anyone accompanying you will be traveling using a wheelchair, scooter, or other equipment. ~Any other information the driver should know to help you travel. After entering this information into the computer, the dispatcher will give you a time for pickup. The computer will be used to assist the dispatcher in making the most efficient routes so that everyone gets to where they are going on time. Since this is a shared-ride service, the driver may make other stops on the way to your drop-off point, so it is best to allow plenty of time to get to and from your destination. If you are unsure of how much time you should allot for your trip, please ask the reservation taker for suggestions when scheduling your pickup. You will need to use your "best guess" when scheduling your return time. The ADA guidelines specify that rides cannot be prioritized based on purpose of trip. Subscription Service Subscription service is limited to passengers for trips that recur weekly to the same place at the same time. ADA paratransit subscription service on a space available basis, and may prioritize service as needed. Passenger Assistance Paratransit drivers will escort passengers to and from the main door of their pickup
12 location and help passengers get on and off the vehicle. Drivers will stow small personal belongings. Passengers who need other types of help, like managing several bags or packages, finding an office inside a large medical building, filling prescriptions, etc., are advised to bring along a personal attendant. Personal Care Attendant (PCA) A personal care attendant assists the passenger with daily life functions, and may provide assistance during the ride or at the destination. If you need assistance to travel, riding with a personal care attendant is strongly encouraged. A personal care attendant is not required to pay a fare and must be picked up and dropped off at the same location as the passenger. A passenger's need for a personal care attendant must be registered with HTA's ADA paratransit service eligibility department during the eligibility determination process. If you did not indicate a need for a personal care attendant when you first applied for ADA paratransit service and now need one, you must call HTA at to request that a personal care attendant form be mailed to you. You must reserve space for your personal care attendant when scheduling a trip. Note: A family member or friend is regarded as a person accompanying the eligible rider, and not as a personal care attendant, unless the family member or friend registered is acting in the capacity of a personal care attendant. Companions A companion is someone who rides with an ADA-eligible passenger, but not as a personal care attendant. You may arrange to bring one companion along on each ride, in addition to a personal care attendant. Companions must be picked up and dropped off at the same addresses. Additional companions may be scheduled, if space is available. Companions pay the same fare as the ADA-eligible passenger. You must reserve space for your companion (including children) when scheduling a trip. TAKING A TRIP Vehicles and Operators ADA paratransit service is provided using a variety of vehicles, including taxis. City Cab's as the paratransit provider reserves the right to determine whether ADA paratransit services will be delivered using its own operators and vehicles, or using operators and vehicles of other entities (for example, taxis). You must ride in the vehicle that is sent for you. Special requests for specific vehicles and vehicle operators cannot be honored. If your pick-up and/or drop-off location is not accessible, your ADA paratransit service will need to be provided curb-to-curb.
13 Boarding Time When you call to reserve your ride, you will be given a 30-minute "pickup window" in which the vehicle will arrive. You will need to be ready at the beginning of your "pick-up window." For example, if your negotiated "ready time" is 8:00 a.m., your 30-minute "pick-up window" is 8:00 a.m. to 8:30 a.m. You will need to be ready to board at 8:00 a.m. By being ready when the vehicle arrives, you help keep everyone's trips on schedule. How Long Will the Paratransit Vehicle Wait? When the vehicle arrives within the "pick-up window," the vehicle operator will wait no more than five (5) minutes. If the vehicle arrives before your "pick-up window" starts, you may leave if you are ready. If you are not ready, the vehicle operator will wait until your "pick-up window" starts and only waite five (5) minutes. What if My Ride is Late? If your ride has not arrived within 30 minutes after your ready time, call and a dispatcher will update you on the status of your ride. Canceling a Trip The Cancel Line is open 24 hours. The minimum cancellation notice required for trips that are not needed is two (2) hours in advance of the scheduled pickup time. If your travel plans change or you will not be ready to board at your ready time," please call Shorter notice without a compelling reason could result in service interruption. Preventing No- Shows It is City Cab's goal to always connect with passengers and provide their scheduled ride. When riders do not cancel at least two (2) hours in advance or are not available to board within five (5) minutes, it is considered a "no-show." Riders can prevent no-show situations when they: Review dates, times and addresses with the reservationist to be sure information is correct Call City Cab s service provider to cancel rides as soon as the ride is no longer needed Cancel at least two (2) hours in advance of the scheduled pick-up time Are prepared to board at the starting time of the "pick-up window" and within five (5) minutes after the vehicle arrives When there are circumstances outside the rider's control, it is not considered a no show.
14 ADA Paratransit Service Trip Fares Ticket Books of 6 (six) - $18.00/book With the exception above, each one-way trip is $3.00. No fare is required for one personal care attendant. All other accompanying guests must pay the applicable fare. Vehicle operators (including taxi drivers) must collect fares upon boarding, so please have tickets ready prior to boarding. The operator cannot give change or sell ticket books. To purchase tickets, send a self addressed, stamped envelope along with a check or money order to Humboldt Transit Authority, 133 V Street, Eureka, CA Note: Trip or ticket fares are subject to change. No Refunds. Boarding with a Mobility Device ADA paratransit service vehicles are lift-equipped and will accommodate mobility devices primarily designed to assist persons with mobility disabilities, such as powered or manual wheelchairs with three (3) or more wheels and that are usable indoors and canes, crutches and walkers, provided the mobility devices can be secured and do not block the aisle or obstruct passage of other persons, and provided that they safely fit within the lift design load and platform measurements. Those who have folding wheelchairs and can transfer to a cab must use the regular cabs or mini-van instead of the Dial-a-Lift wheelchair van. You MUST schedule your ride 24 hours in advance, and be ready to go when the vehicle arrives. Drivers will only be able to make one stop and each time you get into the cab it will count as a separate trip and require new tickets. All vehicle operators are trained to operate the lift and will secure you after boarding. as - Boarding while standing on the lift is allowed, but not encouraged - Boarding while sitting on a mobility device other than a wheelchair, such a walker with a seat, is not allowed. Transporting Life-Support Equipment You may bring a respirator, portable oxygen and/or other life-support equipment as long as it does not violate laws or rules related to transportation of hazardous materials.
15 Carry on Bags Due to space limitation, customers may only carry three (3) small bags on the vehicle that they are able to manage independently without the assistance of the vehicle operator. The three carry-on items must fit within a certain space either on your lap or in front of your area. If you bring more than three (3) small bags, it will be your choice whether to board with only three bags and find alternative transportation to carry the remaining packages, or to decline the trip. If you travel with a companion, the companion is allowed a total of three small bags. A personal care attendant is not allowed to carry additional packages. Transporting Service Animals You may travel with a service animal such as a guide dog or canine companion. The use of a service animal must be identified at the time of your eligibility assessment. Please tell the reservationist when you book trips that you will be traveling with a service animal. Small pets and other non-service animals may be carried on paratransit service vehicles only in properly secured containers or carriers. You are responsible for loading and securing the containers in paratransit vehicles. Operators are not permitted to assist in carrying the animal carrier/container. Lost and Found City Cab or HCAR Paratransit services are not responsible for lost or damaged items. If you leave an item on a vehicle, call City Cab at or HCAR at If the item is located, you will be contacted by phone to make arrangements for pick-up. All lost and found items will be disposed of after 30 days. Nursing Homes/Adult Daycare/Etc. Riders picked up at these facilities should meet the drive in front of the main lobby, unless otherwise discussed prior. Drivers are not permitted to go to rooms to pick up riders. If someone other than the rider is responsible for the fare, please notify the dispatcher prior so that the fare can be collected. Drivers cannot assist riders into or out of facilities, so please have an assistant ready to help, if necessary. Riders will be dropped off in front of the main lobby.
16 PASSENGER RESPONSIBILITIES Passengers must observe the following rules and responsibilities: - Smoking is prohibited on the vehicles, and is prohibited within 40 feet from the vehicle - Parents must control children - Have the tickets or fare ready (cab fares or dial-a-ride tickets) upon boarding. Vehicle operators do not make change, or accept checks or credit cards - Seatbelts are required by passengers on vehicles - Do not distract the vehicle operator while the vehicle is in motion - Personal musical devices are allowed with head phones as long as the sound is not audible to others - Maintain appropriate, reasonable personal hygiene - Proper attire, including shirts and shoes (or appropriate foot coverings), are required on the vehicle - Bring a personal care attendant, if needed - Do not deliberately evade paying a fare - No eating or drinking is allowed on the vehicle, unless required for health reasons - No petting guide dogs or other service animals without permission from the owner - No riding under the influence of alcohol or illegal drugs - No physical abuse of another rider or the vehicle operator - Mobility devices and wheelchairs must be clean and in good working order VEHICLE OPERATOR RESPONSIBILITIES Vehicle operators will treat you with courtesy and dignity as they escort you to and from the main door (the main door is considered the lobby of a major medical facility, apartment building, etc.) of your pick-up locations and help you get on and off the vehicle. They can stow small personal belongings, push a manual wheelchair, provide directions or act as a sighted guide, but if you need other types of help, like checking you out of a care facility, filling prescriptions, managing several bags or packages, etc., please bring along a personal care attendant. Vehicle operators are not permitted to: - Operate, push or lift your electric mobility device - Transfer passengers from wheelchairs to vehicle seats - Lift or carry riders - Cross residential thresholds - Carry packages and other items - Secure child safety systems in the vehicle or children into such systems
17 SUSPENSION OF SERVICE Suspension for Excessive Missed Trips, No-Shows and Lateness Excessive missed trips are considered excessive when an individual reserves seven (7) or more trips within any month and no-shows and/or late cancels 40 percent or more of those scheduled trips. This will be considered a pattern or practice of missed trips and a violation of our No-Show/Late Cancellation policy. When you "no show" for the first leg of a trip, all later rides for the day will not automatically be canceled. It is the rider s responsibility to cancel rides (service) they no longer need. A no-show occurs when the vehicle operator arrives at the pick-up location within the 30-minute pick-up window, waits the required five (5) minutes and the customer does not board the vehicle. If a rider no-shows the first leg of a trip, any subsequent leg or a return trip will not be canceled automatically and may result in an additional no-show assessment if not cancelled as required by this policy. A late cancellation occurs when a customer cancels a trip less than two (2) hours before the scheduled trip. Customers incurring excessive missed trips may be suspended for a reasonable period. Repeated violations of No-Show Policy will result in longer suspension periods each time. However, suspensions will not be imposed for circumstances that are beyond your control. Examples of situations not within your control are: A sudden personal emergency Sudden or worsening illness Inability to get through on the cancellation phone line Late arrival of the vehicle Disruptive behavior caused by a disability In addition, subscription service will be cancelled for any customer who is suspended under the No-Show policy. Suspended subscription service customers must reapply to be considered for a new subscription. The subscription service application will not be considered until four (4) months after the end of the suspension period.
18 NO-SHOW POLICY: All No-Shows listed below occur within any 90-day period. - First No-Show: Notification will be mailed stating the date and time of the passenger s first No-Show violation. - Second No-Show: Notification will be mailed stating the dates and times of the first and second No-Show violations and warn of impending suspension should a third No-Show occur within the current 90-day time period. - Third No-Show: Notification will be mailed stating the dates and times of all three No-Shows and will notify the passenger of the one week suspension. This letter will include information on the appeal process. Humboldt Transit Authority will contact the passenger to determine the dates of the suspension period. The suspension is applicable to both standing and demand-response trips. Service Suspension for Abusive or Disruptive Behavior Service will immediately be denied on a long-term basis or indefinitely to passengers who engage in violent, seriously disruptive, or illegal conduct directed at other riders or ADA service provider staff. Such conduct includes, but is not limited to: threats or fear of physical or verbal abuse; unlawful harassment, including unwelcome verbal, nonverbal, or physical behavior having sexual or racial connotations; unauthorized use of equipment on the vehicle; voluntarily and repeatedly violating vehicle-riding rules, including smoking in the vehicle, eating or drinking without medical indication, or defacing equipment. Steps of the Suspension Process You will be provided an opportunity to explain the reason for each occurrence. Customers violating the No-Show policy will receive a notice of suspension identifying each trip that was no-showed or late cancelled and the reason(s) for the suspension. The notice will also advise the customer of the dates when the suspension begins and ends, as well as the date that the customer can start to use ADA paratransit service again. You will also receive written instructions for appealing your suspension, should you wish to appeal the decision to suspend you.
19 KEEPING ELIGIBILITY AND INFORMATION UP-TO-DATE Please call the Humboldt Transit Authority at if there is a change in the following: Your address or telephone number Your emergency contact's name or telephone number Your need for a personal care attendant Your need for subscription service When a person is registered as eligible for ADA paratransit service and does not use the service for 12 consecutive months, he or she is considered an "inactive" customer and the file is "archived." If a reservationist informs you that you are an inactive customer, you will be asked to contact the HTA office at for further information and you will also be informed of any current fare or ticket price changes. FIXED-ROUTE TRANSIT SERVICE (Eureka Transit System ETS) Services and Accessible Features ETS provides fully accessible fixed-route transit service in the greater Eureka area. ETS encourages seniors and individuals with disabilities to take advantage of the independence and flexibility that is provided by its bus system, which offers the following services and accessible features: - Reduced fare for seniors and individuals with disabilities - Trip planning - Automated stop announcements that include transfer points and major intersections, as well as announcements by vehicle operators of any requested stops announced to help orient passengers to their destinations - Priority seating for riders who have difficulty standing while the vehicle is moving - Buses with ramps or kneeling features to assist riders who use wheelchairs and other mobility devices or have difficulty getting up and down the bus steps - Reserved wheelchair securement spaces on buses
20 ADDITIONAL INFORMATION: 1. Dial-a-Ride tickets are $3.00 each and are sold in books of six for $ Once you have been certified requests for ticket purchases can be sent to: Senior Resource Eureka City Hall 1910 California Street 531 K Street Eureka, CA Eureka, CA Mckinleyville Senior Center at Azalea Hall 1620 Pickett Road Mckinleyville, CA Humboldt Transit Authority 133 V Street Eureka, CA For trip origins outside of the Dial-a-Ride/Lift service areas, the regular cab fare will be charged until the service area is reached. The Dial-a-Lift van cannot make trips outside of the service areas. PLEASE NOTE: HCAR Dial-a-Ride Vehicles are not set up to run cab meters. The only service areas covered are those as defined in the service area description section. 3. Cooridor travel between Eureka, Arcata, or Mckineyville will cost an additional ticket per zone traveled. ADA PARATRANSIT CERTIFICATION ext. 105 USEFUL PHONE NUMBERS (Area Code 707) ADA Paratransit Service Complaints: ext. 405 ADA Paratransit Ride Reservations: ADA Paratransit Cancellations: If Your Ride is Late: If You Are Delayed:
INFORMATION ABOUT THE DIAL-A-RIDE SYSTEM ELIGIBILITY The Dial-a-Ride System is a door-to-door service available to those who cannot use Public Transportation for one or more of the following reasons: Unable
130 Nestor Street Nashville, TN 37210 ADA Paratransit for the Metropolitan Transit Authority Information materials and application form for AccessRide ADA/CIVIL RIGHTS INFORMATION CONTACT: (615) 862-5950
Access Services Applying for Access > Access Services overview > Eligibility criteria > Other transportation options > How to get Access What is Access? Access Services is a public transit agency dedicated
Dear Mainstream Applicant: Thank you for your interest in Mainstream. Enclosed is an application and information about our services. Please take some time to read the information in order to familiarize
ELIGIBILITY APPLICATION Dear Customer: Thank you for inquiring about applying for Charlotte Area Transit System (CATS) Special Transportation Service (STS) eligibility. Enclosed is a copy of an Application
SPECIAL SERVICES HANDBOOK 1700 North 11th Street, Reading, PA 19604 For Information, Call The Special Services Department Phone - 610-921-2361 Fax - 610-921-0209 TDD - 610-921-1018 Toll Free 1-800-383-2278
Application for ADA Paratransit Service IMPORTANT INFORMATION FOR APPLICANTS This packet includes information and forms you need to apply for paratransit eligibility in the San Francisco Bay Area. As part
Information for VIAtrans Applicants What is VIAtrans? VIAtrans is a transportation service for persons who, because of a disability, cannot independently use regular (fixed route and schedule) VIA buses.
Non-Emergent Medical Transportation Program Guide Reservations 503-315-5544 888-315-5544 Fax: 503-315-5514 Table of Content Introduction....1 Client Eligibility....2 Scheduling a Ride....3 When to be Ready....5
The has two different forms and both forms must be completed and received by GTA either prior to the in-person interview, or brought to the interview: (1) SCAT Eligibility Questionnaire Form and (2) Professional
41 Bell Way, Greensburg, PA 15601 1-800-242-2706 APPLYING FOR GO WESTMORELAND DISABILITY TRANSPORTATION SERVICES GO Westmoreland will be utilizing the attached forms in determination of your eligibility
Town of Chapel Hill TRANSIT DEPARTMENT 6900 Millhouse Rd. Chapel Hill, NC. 27516 Dear Prospective EZ Rider Patron: Thank you for your interest in our EZ Rider Service. This service is a supplement to our
Application for ADA Paratransit Service IMPORTANT INFORMATION FOR APPLICANTS This packet includes information and forms you need to apply for paratransit eligibility in the San Francisco Bay Area. As part
Freeman Community Transit Passenger Handbook The Mission of Freeman Community Transit is to Provide Coordinated Transportation Services for all Citizens of the Hutchinson County Area and Foster Independence
Paratransit Handbook for the Clinton County Public Transit System Updated: July 16, 2015 1 This is an informational handbook regarding Clinton County Public Transit s (CCPT) policies related to Paratransit
Dear Applicant, The Americans with Disabilities Act (ADA) of 1990 is federal legislation that supports the rights of people with disabilities to participate more fully in community life. As required by
TransLink Medical Transportation Brokerage Member Program Guide Updated January 2015 TransLink 239 E. Barnett Rd, Medford, Oregon 97501 (541) 842-2060 Toll Free 1-888-518-8160 Oregon Relay Service - 711
Effingham County Public Transportation Passenger Handbook 1805 S. Banker Street Effingham, IL 62401 Dispatch Office: 1/855-755-2478 Administrative Office: 217/342-2193 Effingham County Public Transportation
BCRTA ADA Transportation Application All questions must be answered before your application will be considered. PART A. To be completed by applicant or on behalf of the applicant. PLEASE PRINT Applicant
SACRAMENTO REGIONAL TRANSIT DISTRICT AMERICANS WITH DISABILITIES ACT (ADA) FREQUENTLY ASKED QUESTIONS (FAQ) You will find answers to the most frequently asked questions about RT s ADA paratransit services
LAWRENCE TRANSIT SYSTEM 1260 Timberedge Rd. Lawrence, KS 66049 Phone: 785-312-7054 Fax: 785-312-7958 www.lawrencetransit.org T LIFT PARATRANSIT ELIGIBILITY APPLICATION Professional Verification must be
VIATRANS SERVICE CUSTOMER GUIDE VIA Metropolitan Transit P. O. Box 12489 1021 San Pedro Avenue San Antonio, Texas 78212 VIAtrans Phone: 210-362-5050 Fax: 210-362-2563 www.viainfo.net ABOUT VIA and VIATRANS
Effingham County Public Transportation Passenger Handbook 1805 S. Banker Street Effingham, IL 62401 Dispatch Office: 217/342-0859 or 1/855-755-2478 TTY 7-1-1 or 1/800-526-0844 Administrative Office: 217/342-2193
BOARD OF COUNTY COMMISSIONERS WASHINGTON COUNTY, MARYLAND ADA PARATRANSIT APPLICATION FORM WASHINGTON COUNTY TRANSIT All questions must be answered. Incomplete forms will be returned. In compliance with
IndyGo Open Door Rider Guidelines A comprehensive booklet of IndyGo s ADA paratransit service, Open Door, procedures, rules and how to ride information. Search Pages: IndyGo Updated January 2015 @IndyGoBus
Application for Door-to-Door Service The SCAT Plus service includes transportation mandated by the Americans with Disabilities Act (ADA) of 1990 and transportation mandated by the Florida Commission for
Central Illinois Public Transit Passenger Handbook The goal of Central Illinois Public Transit is to provide, safe, reliable, and timely transportation to the residents of the seven county service area;
Hancock County Public Transportation P a s s e n g e r H a n d b o o k table of contents Service Statement Passenger Bill of Rights Description of Service Service Area HCPT Public Transportation Providers
Greater Cleveland Regional Transit Authority Application For ADA Paratransit Service The Americans with Disabilities Act of 1990 (ADA) is a civil rights bill that bans discrimination against people with
ADA PHILIP MARCEL PHOTOGRAPHY COMPLEMENTARY PARATRANSIT SERVICE GUIDE w w w.go - RTS.com June 2015 Table of CONTENTS Introduction...3 What is the ADA?...3 What is Complementary Paratransit Service?...3
Dear TOPS! Applicant: Thank you for your interest in TOPS! Broward County provides shared-ride, door-to-door transportation programs for individuals who are prohibited from using the Broward County Transit
Policy Manual for RideLink Providers February 2011 Who can ride on RideLink? Any resident of Kent County over the age of 60 is eligible to ride on RideLink. All trips in RideLink will include both subscription
PARATRANSIT SERVICE Rider Handbook MACON-BIBB COUNTY TRANSIT AUTHORITY (MTA) 200 Cherry Street, Macon, GA 31201 478.803.2500 478.803.2512 October 2015 Page 1 Table of Contents Definition of Complementary
WASHINGTON COUNTY TRANSIT POLICIES AND PROCEDURES MANUAL 1. INTRODUCTION These policies and procedures are guides to assist in the governance of the Washington County Commute Express service and the Washington
DART USE ONLY 1A 1B 9A 9B Temp Duration INC / DEN / CERT Date Other Agency Access Date Status Funding Code MV Due By MV1 45 Days NEW RECERT CLIENT # E T Application for Dial-A-Ride Transportation (DART)
Ride Guide Paratransit Edition Effective March 1, 2015 Paratransit Handy Bus Monday Saturday 7:30 a.m. 4:00 p.m. (Saturday service ADA, Agency, dialysis and work only) ADA Service Reservation-based ADA
Service Procedures & Policies Alameda County Revised December 2012 Alameda County Transportation Commission 1333 Broadway, Suite 220 & 300 Oakland, CA 94612 www.alamedactc.org 1 Contents Description...1
AMERICANS WITH DISABILITIES ACT PARATRANSIT COMPLIANCE AND REASONABLE MODIFICATION PLAN Mid-Ohio Valley Transit Authority 520 Juliana Street Parkersburg, WV 26101 (304) 422-4100 www.easyriderbus.com ADOPTED:
Section 1: Entity Submitting the Plan Charles County Department of Community Services VanGO Transportation 8190 Port Tobacco Road Port Tobacco, Maryland 20677 Contact: Ms. Lisa M. Quill Chief of Housing
VTA Paratransit Appeals Process: If your eligibility for paratransit service is denied, you will receive written notification, which will include instructions for appealing the decision. If you disagree
U.S. Department of Justice Civil Rights Division Disability Rights Section An ADA Guide for Local Governments Making Community Emergency Preparedness and Response Programs Accessible to People with Disabilities
Assessment of Needs SECTION 1 GENERAL Last Name First Name Middle Initial Date of Birth Street Address: Apartment # PA City Municipality State Zip Code Telephone # SECTION 11 MEDICAL ASSISTANCE ELIGIBILITY
Eligibility Requirements for ADA Paratransit Service To request this brochure in large print, audio tape, Braille, or Spanish, please call (916) 557-4685 or TDD 557-4686 Rev. 8/25/2010 PUBLIC TRANSPORTATION
1 Effective Date: October 2012 Table of Contents LIFT Paratransit Service Rider s Guide Message from the NCTD Board of Directors... 3 Contact Information... 4 Introduction... 5 ADA Paratransit Eligibility...
2015 Transportation Guide for Older Adults A guide to transportation resources for older adults. Contents Orange County Department on Aging - Mobility Manager... 2 ORANGE COUNTY TRANSPORTATION PROVIDERS...
AMERICANS WITH DISABILITY ACT (ADA) APPLICATION The attached application must be completed by individuals who wish to apply for eligibility for the ADA Dial-a-Ride Program, door-to-door service. To Apply
First Middle Initial Last APPLICATION INSTRUCTIONS All applicants must submit a complete application which includes both forms (1) The Certification Questionnaire Form (2) The Professional Verification
Paratransit service If the local bus service can t serve someone with a disability through its regular bus system, it must provide an alternative transportation system. In Utah this service is provided
Other accessible formats available upon request. 455 North Garland Avenue Orlando, Florida 32801 www.golynx.com 0907 Table of Contents ACCESS LYNX An Overview...Page 1 Service Provider...Page 2 Eligibility...Page
Innovation in Transit GLOSSARY of Paratransit Terms January 2007 FORWARD: ABOUT PACE PARATRANSIT SERVICES Pace provides a variety of public transportation services. ADA Paratransit, which operates in the
MEDICAL ASSISTANCE TRANSPORTATION PROGRAM (MATP) Indiana County Department of Human Services- MATP 300 Indian Springs Road Suite 203 Indiana, PA 15701 PH: (724) 463-3235 or Toll free: (888) 526-6060 Extension
ADA PARATRANSIT SERVICES GUIDE Under the Americans With Disabilities Act of 1990 (ADA) January 2016 This page intentionally left blank. TABLE OF CONTENTS SERVICE AREA... 1 PVTA Member Communities:... 1
1. INTRODUCTION WASHINGTON COUNTY TRANSIT POLICIES AND PROCEDURES MANUAL These policies and procedures are guides to assist in the governance of the Washington County Commute Express Service and the Washington
Metro Bus Dial-a-Ride Service Guide Serving St. Cloud Sartell, Sauk Rapids and Waite Park, Minnesota St. Cloud Metropolitan Transit Commission 665 Franklin Ave NE, St. Cloud, MN 56304 320.251.1499 fax:
City of Tamarac Transportation Services Transportation is vital. Tamarac Para-transit maximizes independence and provides access to a full range of activities: medical appointments, grocery shopping, social
Frequently Asked Questions from Medical Practitioners How can the Facility Department help? LogistiCare maintains a Facility Services Department dedicated to handling the non-emergency medical transportation
REQUEST FOR CERTIFICATION OF AMERICANS WITH DISABILITIES ACT (ADA) DOOR-TO-DOOR ELIGIBILITY AND OTHER SPECIAL SERVICES Please be sure to complete all sections in the application. An incomplete application
Welcome to the LogistiCare seminar on arranging non-emergency medical transportation (NEMT) services for Medicaid and BadgerCare Plus members, except those residing in a nursing home, or enrolled in the
Transportation Services Guidelines Genesee County B-Line Bus Systems - Public Transportation B-Line offers transportation throughout Genesee County. Service is available Monday through Friday in Batavia
www.prairiehillstransit.org Revised December 9, 2014 Passenger Handbook Award winning Intermodal, regional building. Bus facilities in multiple towns. Comfortable, lift equipped vehicles. A traditional
COMMUNITY MOBILITY GUIDE Sedgwick County, Kansas Driver Resources Public Transportation Private Transportation September 2010 Provided by Sedgwick County Department on Aging Transportation Program Partially
Application for MetroAccess Door-to-Door Paratransit Service For People with Disabilities DO NOT MAIL OR FAX APPLICATION Transit Accessibility Center 600 5 th Street, NW Washington, DC 20001 (Between Chinatown/Gallery
TRANSPORTATION ROLES AND RESPONSIBILITIES MANCHESTER PUBLIC SCHOOLS TRANSPORTATION OFFICE: Joanne Hebert, Transportation Coordinator, Telephone 860-647-3476. This office handles all transportation requests
Paratransit Plan Proposed Updates Welcome & Call to Order Daniele Coll-Gonzalez Chief Operating Officer Rochester Genesee Regional Transportation Authority Explanation of Public Hearing Procedure Crystal
Introduction The safety of our passengers at New and Living Way Bible Church is very important. With this in mind, New and Living Way has instituted the following policies and procedures for van ministry
Member Update June 2013 Spanish Si necesita ayuda para traducir o entender este texto, por favor llame al teléfono 1-800-362-3002 (V/TTY). Russian Если вам не всё понятно в этом документе, позвоните по
Instructions Introduction The Region of Peel has several modes of transportation available to the public, including both conventional and specialized transit services. These include the City of Mississauga
Patient Safety Awareness Training for FY2015 1. The Volunteer Transportation Network (VTN) serves to provide transportation to Veterans seeking treatment at VA or VA-affiliated facilities. The following
Red Cross Patient Transport Service Frequently Asked Questions for Referring Agencies in Victoria Q1 What is the Red Cross Eligibility Criteria? Clients eligible for transport: are unable to access suitable
The Children s Guild DC Charter School Transportation Handbook Our primary objective is to ensure the safety of the students and provide a quality and dependable service to our families. We will need support
Veterans Medical Transportation Network for Senior and Disabled Veterans RTCSNV.COM WHAT IS THE VETERANS MEDICAL TRANSPORTATION NETWORK FOR SENIOR AND DISABLED VETERANS? The Regional Transportation Commission
Taxi Access Program (TAP) Customer Guide November 1, 2015 What is TAP? Pace and the City of Chicago provide an innovative program offering customers with disabilities a flexible option to Pace s ADA Paratransit
FREEDOM AREA SCHOOL DISTRICT & LAMERS BUS LINES, INC FREEDOM TERMINAL BUS RULES Updated 7/01/2015 Dear Parents and Students: It is the responsibility of the Freedom Area School District to transport approximately
APPLICATION FOR HANDI-TRANSIT SERVICE INSTRUCTIONS FOR APPLICATION 1. This application form is to be completed by the applicant (with assistance if required). Complete all questions. You are not required
A Rider s Guide 2/12/16 SW Prime Is A shared ride public transit service, not a taxi. Other riders may be picked up and dropped off during your ride. Small vehicle service for the general public that can
School Bus Service 2015/2016 INTRODUCTION: Thank you for trusting us with your child s school transportation needs. While we strive to provide your family and children with the safest and most enjoyable
TTC Wheel-Trans Service Welcome to Wheel-Trans Please review this booklet to help prepare you for a positive and safe experience when using Wheel-Trans service. If your mobility improves at any time after
1 Transportation Options for the Metro Area Table of Contents A & B Shuttle... page 3 American Ambulance Service. page 4 Bellevue Transportation Program.. page 5 Council Bluffs Shopper... page 6 Council
The Americans with Disabilities Act of 1990 (ADA) allows transit providers to suspend Paratransit service to those persons who establish a pattern or practice of missing scheduled trips resulting as No
STUDENT TRANSPORTATION REGULATION 8410-R The following students shall receive district provided transportation: Resident pupils in grades K-8 to and from school in the morning and at the end of the school
Dear Applicant, Enclosed you will find an application for a Statewide Transportation Access Pass. If approved, this pass entitles you to reduced fares offered by the Commonwealth s Regional Transit Authorities
Fitness Center Membership (Check One) RENEWING: NEW: You are new if: 1. You have not been a fitness center member before, OR 2. You have been a member in the past, but your membership has lapsed. Please
June 9, 2016 RE: Montour County Shared Ride Program and Medical Assistance Transportation Program (MATP) Dear Shared Ride/MATP Rider: The Montour County Commissioners have appointed rabbittransit as the
For Office Use Updated By (Initial Here): Mailing Address: Patient Information City, State & Zip: Primary Home Cell Permission to Leave Messages: Yes No Secondary Home Cell Permission to Leave Messages:
Customer Charter www.dublinbus.ie Contents Our commitment to you 4 Providing a quality service 4 Keeping you informed 7 Providing an accessible service 8 Paying for your journey 9 Helping the environment