Piyushimita (Vonu) Thakuriah and Siim Sööt University of Illinois at Chicago

1. Mobility for Persons with Disabilities: Examining Service and PlanningInnovations of the US New Freedom Transportation Program Piyushimita (Vonu) Thakuriah and Siim Sööt University of Illinois at Chicago Presentation made in TRANSED 2012, New Delhi, India Session on Best practices and innovations : Policies and Legislations Research funded by US Department of Transportation’s Federal Transit Administration and Community Transportation Association of America

2. New Freedom Transportation Program • New Freedom (NF) program: designed to go “above and beyond” the transportation requirements of the Americans with Disabilities Act; • Community-based mobility solutions; • Origins of “New Freedom Initiative (NFI)”: • A federal initiative established in 2001 by then President George W. Bush; • Nationwide effort to remove barriers to community living for people with disabilities. • Initiative emphasizes access to assistive technologies, work, education, and other opportunities for people with disabilities; • Was followed up by Executive Order 13217, titled “Community-Based Alternatives for Individuals with Disabilities” (2001). • NF Transportation program - instituted as a stand-alone funding program in 2005; consolidated into larger transit program for seniors and persons with disabilities in 2012.

3. New Freedom Transportation Program • Types of projects funded: • Trip-based NF services: shuttle services, volunteer driver services, rideshare, vanpool, route deviation; • Information-based NF services: mobility management, trip or itinerary planning, ridematching, travel training; • Capital investment NF services: vehicles, accessible taxis, elevators, large capacity wheelchair lifts added to vehicles, wheelchair securement added to vehicles, accessible paths of travel, improving signage. • Total dollar amount: FY2012 $93 million • Match requirement for federal funds: 50%

4. Coordinated Human Services Transportation Plan • NF projects should be derived from a Coordinated Human Services Transportation Plan (CHSTP); • A “lead agency” is required to be designated in order to lead the planning process and is to be decided locally; lead agencies are typically Metropolitan Planning Organizations, Councils of Government, transit agencies, state transportation departments (mostly for rural areas), among others. • Stakeholder agencies which have participated in the planning process are termed “partner agencies”. • CHSTP: Locally derived plan that: • identifies transportation needs of mobility-disadvantaged individuals, in coordination with organizations involved with their well-being; • provides mobility strategies; • prioritizes transportation services for funding and implementation.

5. Objectives of Paper • Examine details of 10 transportation-based services funded by NF program based on primary data collection in 2009: 4 urban, 4 suburban, 2 rural to: • Understand the Coordinated Human Services Transportation Planning (CHSTP) process associated with NF-funded services for seniors. • Conduct exploratory analysis of outcomes experienced by NF trip-based service clients.

6. Institutional Structure of NF-funded Services CHSTP Organizations CHSTP Planning Survey - 18 items Lead Agency Partner Organization Partner Organization Survey - 22 items Partner Organization NF-funded Services Managing or Operating Organization Managing or Operating Organization Program Manager Managing or Operating Organization Survey - 33 items Survey - 61 items User User User User User User User

7. Findings: Service Characteristics • Type of service: door-through-door assisted van or personal car service; reserved curb-to-curb bus service with point deviation; taxi service; • Service provider category: public or non-profit; • Service provider function: integrated social services centers; comprehensive senior care centers; transit operations – NF program primarily funded supplemental services to integrated caregiving organizations to persons with disabilitiesand seniors.

8. Findings: Use of Funds at Study Sites • Expand volunteer driver screening, training, reimbursement, and secondary liability coverage; • Establish new or expand coverage of demand-response service; • Taxi service payments or payments to taxi companies; • Travel training; • Non-emergency medicaltransportation; • Route deviation/curb-to-curb transit service operation.

9. Findings: Coordinated Planning Process I • Lead organizations conducted extensive outreach to organizations serving seniors; • Lead agency perspectives: • Appreciated feedback from non-traditional stakeholders and concerned citizens; • Some lead organizations felt the process was somewhat cumbersome to set up and could be streamlined in terms of its requirements. • Partners involved: organizations in transportation, human and social services, workforce development, labor and economic development, private employers, faith-based organizations and other organizations involved in the well-being of persons with disabilities, seniors and low-wage workers.

10. Findings: User Profile Types of Assistive Device Needed Employment by Age Annual Household Income Household Size

11. Findings: Coordinated Planning Process II • Partner organization perspective (all partner agencies at sampled sites) • Some but not all made financial contributions to services; • Stated level of participation varied from high to low; • Noted consensus among partners in assessment of transportation gaps, strategies to address gaps and prioritization of resources; • Senior citizen participants: CHSTP process may be somewhat agency-driven in these locations and might benefit from taking input informally from private citizens; • Viewed process as important in achieving region’s goals regarding persons with disabilities, seniors and low-income individuals. • Program managers did not find the process to be particularly useful in resolving their immediate concerns in finding the 50% required match or the lengthy grant implementation process.

12. Findings: User Socio-Demographic Clusters • Cluster 1 (Persons with disability in poor health): Persons with disabilities likely to be unemployed, use assistive devices, rate their health as poor, have low levels of functional independence and live alone; • Cluster 2 (Oldest old): “Oldest old” more likely in better health, have higher levels of functional independence and less assistive device usage compared to the first and the third group; • Cluster 3 (Young workers with disability): Younger more likely employed but with a greater share of impairments and need for audio and visual assistance. Results of statistical clustering: (N=271)

13. Findings regarding Mobility Independence of Users

14. Findings regarding Mobility Independence

15. Components or Dimensions of Senior Mobility Needs Two “components” explaining variation in senior mobility needs: Principal Component Analysis Variable Loads: no drivers’ license, difficulties in using existing public transportation, receipt of public assistance, no vehicles in the household. Variable Loads: living alone, difficulties in traveling independently, perceived health, frequent medical trips Transportation Deprivation Component (TDC) Construct giving extent to which there are “hard” constraints to travel due to lack of appropriate transportation availability Independence and Health Deprivation Component (IHDC) Extent to which individual suffers from social isolation, health-related mobility issues and dependence on others to fulfill their travel needs

16. Implications for Senior Mobility Services Requires reliable transportation to a variety of destinations – shopping, social etc. Needs may be served with traditional van programs, ridesharing and Fixed-Route services with deviations TDC Requires frequent and reliable medical trips Care and support in arranging the trip Assistance while undertaking the trip Needs may be served with volunteer driver programs, other assisted door-through-door services, travel planning, non-emergency medical transportation IHDC

17. Outcomes • 95% of users reported that the service was very important to them; • Users reported being able to access work, healthcare, social visits and shopping destinations that were previously difficult to access; • Improved trip reliability; • Time savings; • Improved assistance and information; • Great deal of site-to-site variability. Some did not consider the services to greatly improve their mobility outcomes.

18. Conclusions • NF Transportation program started as a small program – now integrated into larger program “Enhanced Mobility of Seniors and Individuals with Disabilities ” - FY2013 $254.8 million; • CHSTP – required - but needs to be streamlined particularly for non-traditional stakeholders; • NF program has supported transportation options as supplemental services to integrated caregiving by providing new funding for such services and thereby enabling a community-based 'continuum of care‘; • Much work ahead to matching services to client needs – and to understanding client needs.