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 20005 202/638-5944 www.aaafoundation.org June 2001
(Second printing - May 2002) 1

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 Directors 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.

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) ..........97

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 Foundations contribution in cash and in kind. Drs. Helen Kerschner and Rhonda Aizenberg conducted the project with assistance from Audrey Gomez and Leonard Smith.

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 physicians 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

33% rural, 19% urban, 10% suburban, 36% mixed, 2% not specified Organization 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 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 Availability 54% daytime only, 40% weekdays only

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

mal. 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)

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 infor-

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 2000. 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 physicians 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

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 As of senior-friendly transportation.

The Five As 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).

Project Methods
The project began on April 1, 2000. 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 programs 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.

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 programs 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.

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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 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

The table below shows characteristics of the 236 STPs. Location 33% rural, 19% urban, 10% suburban, 36% mixed, 2% not specified Organization 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 45% provide rides to medical appointments only, 44% for any purpose, 30% for essential trips, 29% social and recreation activities, 7% for religious events Availability 54% daytime only, 40% weekdays only

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
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their independence and thus be able to stay in their homes longer.

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 The program began... to provide frail, isolated elderly people living in the community with transportation, with escorts if necessary...

Figure 1 Year Started for 236 Supplemental Transportation Programs

Unknown 1937 1969 1970 1979 1980 1989 1990 present Number of Programs 57 92 9 8 70

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

WA 5 OR 5 MT 5 ID 1 WY NV 5 CA 22 NE 3 CO 1 KS 7 OK 7 IA 4 ND MN 4 SD WI 10 MI 6 IL 9 IN 8 OH 5 KY 1 TN 1 AR 2 MS TX 7 AK LA 7 AL 2 GA 1 SC 1 VT NY 49 PA 6 WV 3 VA 7 NC 7 ME 2 NH MA 3 RI CT NJ 1 4 DE MD 1 2

UT 1

MO 6

AZ 8

NM 1

FL 4

HI 2

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 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.

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.

Location
State Distribution Figure 2 shows the states represented in this sample of STPs. Respondents from 42 states answered the survey, with the top two states being New York (49 programs) and California (22).

Figure 4 Sources of Funding for STPs

Government Nonprofit 45% 29% 12% 3%

62%

Figure 3 Program Service Area

Unknown 2% Suburban 10% Urban 19% Mixed 36%

Church Business Unknown

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%). Service Relationships Figure 5 shows service relationships of these STPs. Aging-related services are involved in

Rural 33%

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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.

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.

Figure 5 STP Service Relationships

Aging-related Services Social Services Health Services Local Transportation Unknown 4% 34% 53% 48% 77%

Figure 7 Accessibility of Programs

Door-to-Door Curb-to-Curb Varied Route Fixed Route 45% 44% 30% 29% 7% 4% Unknown 19% 11% 11% 3%

81%

Figure 6 Purpose of Trips

Medical Appointments Any Purpose Essential Trips Social Activities Religious Events Other Purposes

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. Adaptability About 60% of the programs provide single passenger service and nearly half (45%) offer escort services.

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Figure 8 Ridership People Using STPs

Seniors Seniors & People with Disabilities Seniors and Others General Public Unknown 2% 12% 11% 42%

Figure 9 Reservation Policies

Unknown 7% 2+ Days Notice 18% Same Day 26%

42%

2 Days Notice 16% 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. 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%

24 Hrs. Notice 33%

Figure 10 Types of Drivers

Unknown 3% Volunteer & Paid 22% Volunteer Only 39%

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

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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.

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.

Figure 11 Types of Vehicles

Auto Van Bus Other Taxi 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).

Figure 12 Types of Program Fees

No Rider Fees Flat Fee 21% 11% 9%

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

Mileage Rate Sliding Fees

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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.

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 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. 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. 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 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

Figure 13 Problems Faced by Programs

Drivers Financial Vehicles Marketing Operations Insurance Riders Evaluation Legal Other 8% 6% 4% 3% 1% 0% 12% 15% 43% 42%

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(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%). 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 commu-

Figure 15 How People Find Out About Programs

Word of Mouth Other Promotional Methods Unpaid Advertising Paid Advertising Unknown 3% 19%

79%

57%

47%

Figure 14 Advertising Methods

Friends/ Associates Social Service or Medical Newspaper Articles Newsletter TV/Radio Other Unknown 5% 36% 34% 55% 73% 72% 67%

nities), 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). 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. 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.

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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%).

Criteria for Senior-Friendly Transportation

The Five A's Respondents were presented with a list of The Five As criteria for senior-friendly transportation and were asked to identify the two most adhered to by their program. The Five As 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%).

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 programs 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.

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

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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.

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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.

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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. Shepherds 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; Shepherds 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.

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24

GADABOUT TRANSPORTATION SERVICES, INC.

737 Willow Avenue Ithaca, New York 14850 Tel: 607 273-1878; Fax: 607 277-9551 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.

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GOLD COUNTRY TELECARE, INC.

Gold Care P.O. Box 2161 Grass Valley, CA 95945 Tel: 530 274-8264; Fax 530 272-1349 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.
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INDEPENDENT TRANSPORTATION NETWORK (ITN)

90 Bridge Street Westbrook, Maine 04092 Tel: 207 854-0505; Fax 207 854-1026 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.
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LAUDERDALE TRANSPORTATION PROGRAM

1176 NW 42 Way Lauderhill, Florida 33313 Tel: 954 321-2453; Fax: 954 321-2460 Contact: Tina Hahamovitch Year Started: 1982 Organization Status: City government Type of Program: Intergenerational transportation program located in a community center Affiliations: None Service Relationships: Senior Center, Health and Social Services, Optimist Club, Boys and Girls Clubs, Smart Charter School Area Served: Suburban Vehicle Type and Number: 5 bubble-top vans (wheelchair accessible), two 45-passenger buses Number of Drivers: 5 paid drivers Riders Targeted: Seniors, disabled, and children Rider Reservations: 2 weeks in advance for medical trips; 24 hours in advance for other trips Purpose of Rides: Essential trips, religious events, medical and grocery shopping, child activities Availability of Transport: Every day (including weekends), daytime and evenings Type of Service: Door-to-door (seniors) and pick up at specific sites (children) Ridership Fee Structure: Flat rate Escort Availability: Does not provide escorts Annual Number of Riders Served: 775 seniors; 1,244 children Annual Number of Rides: 19,054 (one-way) for seniors; 6,742 (one-way) for children Use of Technology: Route Logic software for scheduling; currently converting to Paralogic, which organizes scheduling by priority, time and mileage Transportation Program Budget: $226,497 Umbrella Organization Budget: $4,031,909 Funding Sources: Tax revenue (city sales tax), rider fees Major Areas of Expense: Salaries, vehicles, operating costs Driver Screening: Driver history and background checks, valid CDL class B license with passenger endorsement, experience with air brakes, alcohol/drug test, medical exam Driver Training: 2-week training by lead driver, 1-week observation while driving Insurance for Vehicles: Self-insurance by city Insurance for Drivers: Self-insurance by city Marketing Strategies: Newspaper, radio, newsletter, social services, distribution of flyers/ brochures Methods: Free advertisements, city newspaper, word of mouth Most Difficult Problems: Financial - finding revenue sources Unique Features: Intergenerational transportation program for seniors and children.

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RIDE CONNECTION, INC.

2145 NW Overton Portland, Oregon 97210 Tel: 503 413-8924; Fax: 503 413-8927 Contact: Elaine Wells Year Started: 1988 Organization Status: Nonprofit Type of Program: Coordinates transportation with a network of outside providers Affiliations: State Department of Transportation, Tri-Met Service Relationships: Clackamas Senior Transportation Consortium, Red Cross, Comm. Svcs, Inc., Edwards Center, Evergreen Hillsboro Health and Rehabilitation, Tualatin Valley Centers, Tuality Valley Healthcare, Albertina Keer Centers, Ecumenical Ministries, Friendly House, Hollywood Senior Center, Ikoi No Kai, Independent Living Residences, Project Linkage, Mittleman Jewish Community Center, NW Pilot Project, NW Portland Ministries, Portland Impact, Providence ElderPlace, YWCA Area Served: Mix of urban and rural Vehicle Type and Number: 200 personal automobiles, 5 taxi cab companies, 13 accessible minivans, 42 minibuses with wheelchair lifts Number of Drivers: 500 volunteers, 100 paid Riders Targeted: Seniors, disabled and general public Rider Reservations: Same day requests accepted if openings exist Purpose of Rides: Any purpose Availability of Transport: Weekdays, daytime (weekends and evenings according to availability) Type of Service: Door-to-door Ridership Fee Structure: No rider fees (donations accepted) Escort Availability: Escorts can be provided Annual Number of Riders Served: 7,000 Annual Number of Rides: 198,000 (one-way) Use of Technology: PASS Lite for scheduling and dispatching, Microsoft Access Transportation Program Budget: $5.6 million Umbrella Organization Budget: Not applicable Funding Sources: OR DOT, Tri-Met Major Areas of Expense: Contracted services, vehicles Driver Screening: Valid license, DMV and national criminal record checks, fingerprinting, FTA drug and alcohol test, medical exam Driver Training: Vehicle orientation, wheelchair securement training, mobility awareness and assistance training, defensive driving Insurance for Vehicles: Commercial general liability; personal insurance for volunteers Insurance for Drivers: Commercial general liability; personal insurance for volunteers Marketing Strategies: Articles in newspaper, program newsletter, Web site Methods: Free advertising, word of mouth Most Difficult Problems: Financial - demand outstrips resources Unique Features: Provides technical, advocacy, and financial support to participating providers.
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TRANSPORTATION REIMBURSEMENT AND INFORMATION PROGRAM (T.R.I.P.)

6296 Rivercrest Drive, Suite K Riverside, California 92507 Tel: 909 697-4697; Fax: 909 697-4698 Contact: Richard Smith Year Started: 1993 Organization Status: Nonprofit Type of Program: Social assistance transportation program with volunteer drivers/escorts Affiliations: Transportation Commission, County Office on Aging, Sunline Transit Agency, Valley Transit Agency Service Relationships: County Office on Aging, County Department of Social Services, numerous providers of in-home services Area Served: Mix of urban and rural Vehicle Type and Number: 1,000 personal automobiles Number of Drivers: 1,000 volunteer drivers Riders Targeted: Seniors and disabled Rider Reservations: Same day and same hour service available Purpose of Rides: Any purpose with some services determined by case management Availability of Transport: Every day (including weekends) Type of Service: Door-to-door Ridership Fee Structure: No rider fees Escort Availability: Drivers also function as escorts Annual Number of Riders Served: 722 Annual Number of Rides: 31,039 (one-way) Use of Technology: TRIP TRAK (developed in partnership with Images Software) creates a database for tracking background characteristics and travel patterns of drivers and riders Transportation Program Budget: $395,000 Umbrella Organization Budget: $465,000 Funding Sources: Grants, tax revenue, private contributions Major Areas of Expense: Travel reimbursement, information and referral, salaries Driver Screening: DMV and background checks Driver Training: Orientation supported by written materials Insurance for Vehicles: Nonprofit Insurance Alliance of California (NIAC) Insurance for Drivers: Nonprofit Insurance Alliance of California (NIAC) Marketing Strategies: Referrals by social workers, medical professionals and in-home service providers Methods: Articles in newspaper, newsletter, agency partnerships, program video Most Difficult Problems: Drivers - recruitment and liability risk Unique Features: The majority of funding for TRIP is from tax revenue; volunteer drivers also serve as escorts.

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AREA IV AGENCY ON AGING SENIOR TRANSPORTATION PROGRAM

College of Southern Idaho P.O. Box 1238 Twin Falls, Idaho 83303-1238 Tel: 208 736-2122; Fax 208 736-2126 Contact: Lynn D. Hughes Year Started: 1982 Organization Status: Nonprofit Type of Program: Coordinates contracts with outside providers Affiliations: College of Southern Idaho, Magic Valley Checker Cab, Valley Vista Care Services, Ageless Senior Citizens, Inc., Senior Companion Program, Senior Assisted Service, Silver and Gold Senior Center Service Relationships: Public Transportation Advisory Council, Idaho Committee on Aging, Area IV Development Assoc., Dept. of Health and Welfare, Vocational Rehab, Rehab Workshop, Commission on the Blind Area Served: Mix of urban and rural Vehicle Type and Number: 75 automobiles, 2 taxis, 2 vans, 3 buses Number of Drivers: 61 volunteers, 8 paid Riders Targeted: Seniors and disabled Rider Reservations: Same day service available Purpose of Rides: Any purpose Availability of Transport: Every day (including weekends) for taxi service, weekdays for other modes Type of Service: Door-to-door, curb-to-curb Ridership Fee Structure: Flat rate, mileage rate Escort Availability: Escorts can be provided Annual Number of Riders Served: 640 Annual Number of Rides: 28,600 (one-way) Use of Technology: None Transportation Program Budget: $78,000 Umbrella Organization Budget: $21 million Funding Sources: Idaho Department of Transportation, Idaho Senior Service Act Major Areas of Expense: Administration, equipment, labor Driver Screening: Background check and driver record check (1 carrier) Driver Training: Passenger assistance, safety and sensitivity, CPR, first aid, defensive driving Insurance for Vehicles: Contracted providers carry insurance Insurance for Drivers: Contracted providers carry insurance Marketing Strategies: TV and radio, newsletter, friends and associates, social service or medical personnel Methods: Advertise but do not pay, word of mouth, public announcements Most Difficult Problems: Rural nature of the service area Unique Features: Coordinates contractual arrangements with six transportation providers.

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JEFFERSON COUNTY SERVICE ORGANIZATION

610 Delaware Street Oskaloosa, Kansas 66066 Tel: 785 863-2637; Fax 785 863-3460 Contact: Lynn Luck Year Started: 1975 Organization Status: Nonprofit Type of Program: Service organization that offers transportation Affiliations: Kansas Department of Transportation, Area Agency on Aging, United Way Service Relationships: Jayhawks Area Agency on Aging, Jefferson County Health Department Area Served: Rural Vehicle Type and Number: 2 automobiles, 8 vans Number of Drivers: 3 volunteers, 19 paid drivers Riders Targeted: General public Rider Reservations: Same day service available Purpose of Rides: Any purpose Availability of Transport: Weekdays (special appointments on weekends) Type of Service: Door-to-door Ridership Fee Structure: Sliding scale, donations Escort Availability: Escorts can be provided Annual Number of Riders Served: 650 seniors Annual Number of Rides: 8,250 (one-way) - 87 percent of rides are for seniors Use of Technology: None Transportation Program Budget: $81,000 Umbrella Organization Budget: $110,497 Funding Sources: Kansas Department of Transportation, rider fees, county property tax, United Way, Area Agency on Aging Major Areas of Expense: Driver wages, fuel, insurance Driver Screening: Driver record check by insurance company, drug testing Driver Training: First aid, CPR, attendance at statewide safety program encouraged Insurance for Vehicles: Liability and collision Insurance for Drivers: Liability and collision Marketing Strategies: Newspaper, friends and associates, social service or medical personnel Methods: Paid advertising, word of mouth, brochures Most Difficult Problems: Marketing - there are no local television or radio stations and only a weekly newspaper Unique Features: Sole provider of transportation in the county - no public or paratransit system is available; drivers are highly compassionate and provide hands-on assistance to riders.

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SAN FELIPE ELDERLY TRANSPORTATION PROGRAM

P.O. Box 4352 San Felipe, New Mexico 87001 Tel: 505 867-2349; Fax: 505 771-8685 Contact: Emily Velasquez Year Started: 1985 Organization Status: Nonprofit Type of Program: Transportation program operated through senior center Affiliations: Federal, state, county, tribal, Office of Indian Affairs, NMICOA, 19 Pueblos, Apache Tribe Service Relationships: All Indian, state, county, BIA, HIS, state and community health representatives Area Served: Rural Vehicle Type and Number: 2 vans, 1 minivan (staff vehicles if necessary) Number of Drivers: 1 volunteer, 2 paid (plus staff if necessary) Riders Targeted: Seniors and disabled Rider Reservations: Same day for local service, 2 days in advance for metro appointments Purpose of Rides: Any purpose Availability of Transport: Weekdays only, daytime and evening Type of Service: Door-to-door Ridership Fee Structure: No rider fees Escort Availability: Escorts can be provided Annual Number of Riders Served: 90 Annual Number of Rides: 34,000 (one-way) Use of Technology: Cell phones are used Transportation Program Budget: $19,325 Umbrella Organization Budget: $133,073 Funding Sources: Administration on Aging, state general funds Major Areas of Expense: Gas, maintenance, salaries, insurance Driver Screening: Valid driver license, driving record check, native Driver Training: Must be trainable, with previous driving experience Insurance for Vehicles: General liability coverage for drivers, staff and occupants Insurance for Drivers: General liability coverage for drivers, staff and occupants Marketing Strategies: Program newsletter, social service and medical personnel, memos, posters Methods: Meetings, word of mouth Most Difficult Problems: Financial, drivers, vehicles, operations, insurance Unique Features: The San Felipe Pueblo Casino contributed to the program by purchasing a van; the San Felipe Pueblo supports the program by providing inexpensive gasoline; there is strong support by the Tribal Government, population of elders at large, and local and outside community resources.

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SHEPHERDS CENTER ESCORT TRANSPORT

1833 S. Burdick Street Kalamazoo, Michigan 49001 Tel: 616 383-1122; Fax: 616 344-6170 Contact: Joanne DeKoekkoek Year Started: 1991 Organization Status: Nonprofit Type of Program: Interfaith organization that provides escort transportation Affiliations: 42 churches in Kalamazoo County Service Relationships: Senior services, Catholic Family Services, Family Independence Association, Bronson/Borgess Hospitals, Visiting Nurses Association, home health care providers, senior centers, adult day care programs Area Served: Mix of urban, rural, and suburban Vehicle Type and Number: 120 personal automobiles Number of Drivers: 120 volunteers Riders Targeted: Seniors Rider Reservations: Scheduling more than 2 days in advance Purpose of Rides: Medical appointments only Availability of Transport: Weekdays only (Monday through Thursday), daytime Type of Service: Door-to-door Ridership Fee Structure: Donations accepted Escort Availability: Escorts always provided Annual Number of Riders Served: 258 Annual Number of Rides provided: 4,162 (one-way) Use of Technology: None Transportation Program Budget: $9,000 Umbrella Organization Budget: $53,325 Funding Sources: Donations Major Areas of Expense: Insurance, volunteer recognition Driver Screening: Valid driver license and insurance, driver record check through state police Driver Training: AAA Foundation video, RN instructs on dealing with frail elderly Insurance for Vehicles: Corporation Insurance Management Association (CIMA) Insurance for Drivers: Corporation Insurance Management Association (CIMA) Marketing Strategies: Articles in newspaper, TV and radio, program newsletter, social service or medical personnel, card left with physician when client brought to office by volunteer Methods: Advertise but do not pay, word of mouth Most Difficult Problems: Ride requests exceed driver availability Unique Features: Riders and drivers often form strong emotional ties; donation envelope and program newsletter sent to local physicians to facilitate contributions.

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WEST AUSTIN CAREGIVERS

2601 Exposition Blvd. Room 205 Austin, Texas 78703 Tel: 512 472-6339; Fax: 512 472-7158 Contact: Jean Barrett-Teel Year Started: 1985 Organization Status: Nonprofit Type of Program: Interfaith organization that provides transportation by volunteers Affiliations: 13 sponsoring congregations, 6 caregiver groups in Austin Metropolitan Area Service Relationships: Congregations, local hospital, home health and aging services, senior housing projects Area Served: Urban Vehicle Type and Number: 85 personal automobiles Number of Drivers: 85 volunteers Riders Targeted: Seniors Rider Reservations: Schedule 2 days in advance, same day if available Purpose of Rides: Any purpose Availability of Transport: Every day (including weekends) Type of Service: Door-to- (and through) door, curb-to-curb Ridership Fee Structure: No rider fees (donations accepted) Escort Availability: Escorts can be provided (driver can accompany as requested) Annual Number of Riders Served: 326 Annual Number of Rides: 3,285 (one-way) Use of Technology: FileMaker Pro for scheduling Transportation Program Budget: $36,000 Umbrella Organization Budget: None Funding Sources: Grants (Junior League, foundations), sponsor pledges, congregations, individual donations, interest income Major Areas of Expense: Payroll, insurance, phone, and copier Driver Screening: Contracted with United Way for background checks Driver Training: Aging process, transporting clients with special needs, The Older and Wiser Driver video (AAA Foundation), 55 Alive encouraged Insurance for Vehicles: $1,000,000 policy on volunteers Insurance for Drivers: Liability and accident Marketing Strategies: Newspaper articles, program newsletter, social service and medical personnel, congregations, local universities Methods: Word of mouth, volunteer fairs, congregational sponsors, presentations to community organizations Most Difficult Problems: Limited financial resources, volunteer driver recruitment Unique Features: Established a service agreement with the Junior League to provide volunteers; an ad hoc group called Partners in Caregiving helps West Austin Caregivers and six other similar groups in Austin collaborate and provide mutual assistance.
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Appendix B Five Program Reviews

The project team completed program reviews of five programs. These programs were relatively small and less formal than the case study programs. For the most part, they were sponsored by community-based organizations. They are: 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) Each program review contains information on the programs background and history, on the location and availability of its transportation options, its staffing, transportation services, funding and budget, and strengths and weaknesses, and advice for other communities that may be setting up or enhancing STPs.

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STP Review

AREA IV AGENCY ON AGING SENIOR TRANSPORTATION PROGRAM

College of Southern Idaho P.O. Box 1238 Twin Falls, Idaho 83303-1238 Tel: 208 736-2122; Fax: 208 736-2126 Contact: Lynn D. Hughes General Background The Senior Transportation Program is organized by the Area IV Agency on Aging (AAA), located in Twin Falls, Idaho. The city of Twin Falls sits on a high-desert elevation of 3,745 feet above sea level with the Snake River Canyon at the northern edge and distant mountains rimming the horizons in most directions. Twin Falls has long been an agricultural center, and many of its largest employers are involved in growing and processing food. Its largest employer, the College of Southern Idaho, is the umbrella organization for the AAA. The AAA serves the eight south-central counties in the state: Twin Falls, Gooding, Minidoka, Cassia, Blaine, Lincoln, Camas, and Jerome. These counties have a combined population of 158,710, 13 percent of whom are aged 65 and above. History The AAA established the Senior Transportation Program in 1982 in response to the urging of the Idaho Commission on Aging and the availability of funding through the Older Americans Act. Transportation Services The Senior Transportation Program provides transportation services to seniors through contractual arrangements with outside providers. From 1982 to 1999, the program had a contract with Trans IV who provided rides in wheelchairaccessible buses. Trans IV also subcontracted with several local senior centers that owned vans to provide transportation services in their respec39

tive areas. Since then, the program has evolved and, in 2000, it selected six new providers. Each meets a different community need, and together they provide a broad range of transportation services. While the Senior Transportation Program offers transportation, AAA provides other programs: congregate and home-delivered meals, an older workers program, adult protection (fraud prevention, education about elder abuse), homemaker services, ombudsman services, care coordination, senior companions, foster grandparents, and information and assistance. The Deputy Director of the AAA manages the Senior Transportation Program. He allocates about 35 percent of his time to developing proposals for transportation funding and overseeing the programs contracts. Program Elements All seniors and disabled residents in the eightcounty area of Region IV (south-central Idaho) are eligible for rides through the Senior Transportation Program. Rides. An estimated 640 riders receive 28,600 one-way rides annually. The average cost per one-way ride is $2.80. Survey data indicate that the Senior Transportation Program provides the only means of transportation for as many as 42 percent of its users. The other 58 percent have access to other forms of transportation, including friends and family.

Carriers. The Senior Transportation Program contracts with the following six providers to supply transportation services: 1. Senior Assisted ServiceVolunteer drivers provide rides for any purpose in south-central Idaho and for medical purposes to Boise and Salt Lake City. Drivers use their own vehicles and are reimbursed $0.26 per mile. No fees are required from riders, but donations are accepted. 2. Senior Companion ProgramVolunteer drivers provide rides in south-central Idaho and are reimbursed $0.26 per mile. 3. Magic Valley Checker CabA commercial taxi service provides rides in Twin Falls for $1 per ride plus $0.80 per mile beyond eight miles. 4. Ageless Senior Citizens, Inc.Rides are provided between the two cities of Kimberly and Hansen for any purpose and to Twin Falls primarily for medical purposes. A fee of $1 is charged per ride plus $0.50 per mile beyond eight miles. 5. Silver and Gold Senior CenterRides are provided within the city of Eden for $1 plus $0.50 per mile beyond 20 miles. 6. Valley Vista Care ServicesRides are provided in the cities of Burley and Rupert for $1 plus $1.65 per mile beyond 20 miles. Vehicles. Collectively, the six carriers have a fleet of 75 automobiles, two taxis, two vans, and three buses. Scheduling. The Magic Valley Checker Cab operates at any time on short notice with the exception of holidays. The other carriers provide service from 6 a.m. to 6 p.m. Monday through Friday and require 24-hours notice. Reservations are made directly with the service provider. In most cases, the riders make their own reservations, but caregivers make 18% of reservations. There is very little seasonal variation in rider reservations.

Drivers. A total of eight paid drivers and 61 volunteer drivers are part of the Senior Transportation Program. Marketing. The Senior Transportation Program is promoted on TV and radio. Advertising is not paid for, and word of mouth referrals are common. The program distributes an annual report and a newsletter. Information is spread by friends and associates and by social service and medical personnel. Risk Management. One of the six carriers conducts driver background and motor vehicle record checks. All drivers are required to participate in driver training. Two days of training are given on passenger assistance, safety, and driver sensitivity. A one-day defensive driving program is offered, which includes first aid and CPR instruction. The commercial carriers are responsible for their own insurance coverage. The Senior Companion Program and Senior Assisted Service are covered through the College of Southern Idaho, and the Silver and Gold Senior Center is covered by ICRIMP through the city. To date, the Senior Transportation Program has been collision-free, and no rider has been injured. Funding and Budget The annual budget for the Senior Transportation Program is approximately $78,000. This includes $8,000 in administrative costs. The remaining $70,000 is distributed to the contracting organizations to reimburse them for providing transportation services for the program. The Idaho Department of Transportation provides funding for 80 percent of the programs costs. The Idaho Senior Services Act provides a 20 percent match. The College of Southern Idaho, the umbrella organization, is very supportive of the Senior Transportation Program and its widespread visibility across the eight-county region. The College provides in-kind support in the form of office space, telephones, and maintenance

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expenses and handles the programs contracts and audits. Strengths and Weaknesses A key strength of the program is the wide range of its different kinds of transportation that it makes available. Rides are provided in taxis, buses, vans, and private automobiles. There is even the possibility for riders to request curb-tocurb, door-to-door, and even door-through-door service, and escorts are available through the Senior Companion Program and Senior Assisted Service. In the past, some of the drivers and dispatchers were reported to be uncaringand insensitive.There also were occasions where riders were left behind because they were not ready when their pick-up rides arrived. Changes have been made in the AAAs contracts with its providers to address these problems, which appear to have been solved.

Advice from Experience Advice to other communities that might be starting a similar program would include the need for sensitivity, flexibility, and openness to change. According to the programs staff: To be successful, it is necessary to be sensitive to the needs, characteristics and feelings of the people who are being served. There is nothing more important than customer satisfaction. Without it, the service is a failure. Older people need and are entitled to respect! Dont be afraid of change. If you become aware of problems and have done your homework, you need the gumption to make improvements. Its too easy to get stuck in tradition.

Area IV Agency on Aging Senior Transportation Program Budget

Annual Expenditures Office Operations* $ 8,000 Vehicle Operations $ 69,654 Magic Valley Checker Cab 49,700 Senior Assisted Services 10,724 Senior Companion Program 910 Ageless Senior Citizens, Inc. 3,850 Silver and Gold Senior Center 720 Valley Vista Care Services 3,750 Other $ 0 Total $77,654 Income for 2000 $77,654 Idaho Dept. of Transportation (Federal) 80% Idaho Senior Services Act (Local Match) 20%

Total

100%

*Includes administrative and office related salaries, benefits, taxes, supplies, etc. **Includes all contract expenses with the six service providers.

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STP Review

JEFFERSON COUNTY SERVICE ORGANIZATION

610 Delaware Street Oskaloosa, Kansas 66066 Tel: 785 863-2637 Fax: 785 863-3460 Contact: Lynn Luck General Background Jefferson County Service Organization is located in Jefferson County, Kansas, just north of the University of Kansas. The county is comprises eight major communities. Total population is estimated at 18,243, with 13.5 percent (or 2,448 people) aged 65 or older and 2.1 percent (or 383 people) aged 85 or older. The county is geographically rural, and over 17 percent of its residents are farm workers. Per capita income exceeds $20,000. History Jefferson County Service Organization is a 501(c)(3) nonprofit. It was established in 1975, when a group of eight leaders from the eight communities in the county recognized a serious gap in available transportation and joined together to obtain funding for a van to provide rides to residents throughout the county. They submitted a request for funding to the Kansas Department of Transportation, which provided funding for 80 percent of the cost of the vehicle. The remaining 20 percent was funded from a county property tax. Transportation Services No other public or paratransit system is available in the county. As a result, Jefferson County Service Organization is the only organized transportation alternative for community-based residents as well as for the residents of nursing homes. In fact, it is the sole transportation provider for the three local nursing homes and provides patients with rides to medical appointments as well as to recreational outings. The program is promoted via newspaper articles, through friends and associates, and through social service and medical referrals. The majority of people who obtain transportation from the Service Organization use it for all their transportation needs. Although about 40 percent still drive, their driving is limited to the immediate area. Rides are obtained for longer-distance travel required for medical appointments. About 30 percent of riders have family members who live nearby, but work constraints make it difficult or impossible for these relatives to provide the seniors with transportation. In fact, about 70 percent of employed residents of the area commute outside the county for work so are not in the neighborhood during the workday. The programs staff includes an Executive Director, who allocates about 50 percent of his/her time to the transportation program; seven reservation agents each giving three-quarters of their time; 19 part-time paid drivers (who collectively work an average of 640 hours a month); and three volunteer drivers (who contribute an average of 15 hours of driving time per month). Program Elements Anyone living in the county can obtain transportation through the Jefferson County Service Organization. However, 85 percent of the riders are seniors and most are age 75 and older. Rides. About 8,250 one-way rides are provided annually. There are 650 seniors who use the program, and they account for 87 percent (or 7,098) of all rides. Door-to-door service is provided. The average cost per one-way ride is $9.71. No

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rider fees are required for medical and shopping trips, although donations are accepted. The average donation per round trip is $3.00. Riders pay $0.35 per mile plus the drivers wages for pleasure trips. Most rides are for medical purposes and in most cases (80 percent) involve an intercounty commute. The average round trip ride is approximately 60 miles. Vehicles. The program has a fleet of eight vans and two automobiles. Most of the vehicles are small and were selected because they are more economical than larger vehicles to operate when transporting single or few passengers. The vehicles are distributed across the eight communities in the county. Scheduling. Each of the eight communities has its own reservationist who schedules rides and its own drivers who live in the immediate area. Should the demand for rides exceed local resources (vehicles or drivers), a central coordinator is available to help to find an available driver and vehicle from a neighboring community within the county. Rides can be scheduled the same day as needed and are normally available for any purpose on weekdays and for special appointments on weekends (depending on how many drivers are available). Most of the time the actual user schedules the ride, but caregivers make about 20% of requests. Drivers. The vans are driven by 19 part-time paid drivers. All but three of the drivers are retired and continue to work because they enjoy being involved and are familiar with the people they transport. They are paid $6.00 per hour. In addition, three volunteer drivers are available to provide rides in their personal vehicles. Escorts. Since most of the rides involve long distances, drivers almost always stay with passengers until they are ready to return home. In fact, drivers typically help riders to schedule and record their next medical appointments before leaving their physicians offices and also help

them with their shopping and with carrying their grocery packages. Risk Management. The programs insurance company screens drivers to ensure that their driving record is clean. Potential drivers are also required to be drug tested by the state prior to employment and are subject to random urine testing while employed. At the onset of their employment, they are encouraged to attend an annual statewide safety program where they are given first aid and CPR training. Vehicles in the fleet are covered by liability and collision insurance. To date, no major collision has occurred, although a few minor crashes have been reported. Funding and Budget The total annual budget for the transportation program is $81,000. The total budget for the Jefferson County Service Organization is $110,497, which covers the costs of the other programs the organization runs including a commodities program for low-income residents and seniors; information and outreach for seniors, especially regarding government subsidized programs; and advocacy. Funding for purchasing vehicles for the transportation program continues to come from the State Department of Transportation (80 percent) and the county (20 percent matching funds). Operating expenses for the transportation program are covered by grants from the Kansas Department of Transportation and the Jayhawks Area Agency on Aging, from rider fees, from a county property tax, and from the United Way. Strengths and Weaknesses According to the programs staff, the drivers are what distinguish the program. Drivers are perceived as being truly compassionate and go beyond merely providing transportation to and from appointments. They provide hands-on assistance and often help riders to plan and coordinate their medical and other personal needs

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(for example, by helping them to schedule follow-up appointments and to organize their medications). The program has faced major obstacles in marketing and in expansion. A state grant was awarded to expand the programs services to transport ex-welfare recipients to their workplaces as part of the Welfare to Work Program. A fixed-route service was established, but usage was very low and the program was eliminated. The absence of a major media outlet makes it difficult to promote the program countywide, and the program needs to develop contacts with local media channels. Advice from Experience Advice to other communities that might be starting a similar program would include the importance of verifying the need for the program,

obtaining long-term funding, and ensuring that the programs capacity can meet the demand for service. According to the staff: It is critical to evaluate the true need for the program in order to avoid unnecessary duplication in services. When planning a new program and purchasing equipment, it is essential to ensure that funds can be obtained to sustain it. People want and need quick-response transportation. They dont want, and health problems often make it impossible for them, to wait long intervals for transportation to arrive. Thus, a sufficient number of drivers and vehicles need to be available to provide a timely service.

Jefferson County Service Organization Budget

Annual Expenditures Office Operations* Vehicle Operations Driver Salaries Maintenance/Repair Purchase/Lease Fuel/Oil Insurance/Bonding Driver Screening Other Total $21,738 $58,041 36,816 6,000 0 9,250 5,750 225 $ 300 $80,079 *Includes administrative and office related salaries, benefits, taxes, supplies, rent, etc. Sources of Funding Income for 2000 $80,079 Kansas Department of Transportation 30% Rider Fees/Donations 21% United Way 20% County Property Tax 20% Area Agency on Aging 9% Total 100%

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STP Review

SAN FELIPE ELDERLY TRANSPORTATION PROGRAM

P.O. Box 4352 San Felipe Pueblo, New Mexico 87001 Tel: 505 867-2349 Fax: 505 771-8685 Contact: Emily Velasquez General Background The San Felipe Pueblo Elderly program runs this transportation program. The San Felipe Pueblo, or village, is about 30 miles from Albuquerque, New Mexico. Its location on the banks of the Rio Grande against a backdrop of mountains and mesas places it in a picturesque yet rural area with no public transportation system and no private taxi services. Of the 3,222 residents on the Pueblo, 11 percent are aged 60 and older. History In the late 1970s and early 1980s, San Felipes Elderly Program was part of the Seven Pueblos Elderly Program in Sandoval County. In 1985, the San Felipe Tribe learned that they qualified for their own program because there were more than 60 elderly people living on the Pueblo. Thus, the San Felipe Elderly Program was born. Funds for the program came exclusively from the Older Americans Act. The creation of a senior center and an elderly program on the Pueblo made it possible to identify the transportation problems faced by seniors, to understand their transportation needs, and to develop a transportation program. Transportation Services In the 1980s, the elderly on the Pueblo took an active role in advocating for health and social service programs, and in encouraging the development of the Pueblos Elderly Transportation Program. Transportation was identified as the greatest problem in a 1985 needs assessment. At that time, 98% indicated that they lacked adequate transportation and had to rely on family and friends to get around, and 92% said they had no close friends outside their family. A large number indicated that they could not depend on their family members because of high unemployment, low income, and a lack of available vehicles. The problem was compounded by the fact that public and private transportation systems were not available on the Pueblo and that very few elderly owned or drove a car. Although the Pueblo had a rather out-dated 12-passenger van, it was evident that there were limited transportation options in the community and that reliable transportation was a critical need. Program Elements The Pueblos Elderly Program was and is the primary sponsor of the San Felipe Elderly Transportation Program. This sponsorship came about because of the outcome of the needs assessment and the availability of capital funds for the purchase of a van. The program is limited to seniors and people with disabilities. Primary funding is provided through the Older Americans Act. The program serves the majority of elderly on the Pueblo. Rides. Program estimates show that it serves 90 seniors and provides 130 rides a day, 5 days a week, 52-weeks a year. The estimated cost per ride is $1.45. There is no fee for the service. For many seniors, it is the only transportation available. Thus, the program provides them with rides for essential trips, annual religious events, social activities, shopping, and any other purpose if time permits. On several occasions, the seniors have raised funds for travel to Juarez, Mexico and to the Grand Canyon. This first visit of

47

most seniors to locations far beyond the Pueblo has provided them with the opportunity to play an important role as village elders who can tell their grandchildren about their distant travel experiences. Vehicles. Vans were selected as the mode of transportation because the state allocated funds for vans and because a greater number of seniors can be transported in a van than in a car. Currently, the fleet consists of two vans and one minivan. The San Felipe Pueblo Casino purchased one of these vans. The availability of a dependable van not only meets the essential transportation needs of the elderly but, according to the director, The van also enables our seniors to take trips that expose them to the world. In the past they were isolated and now they can be involved. At times, the staffs vehicles also are used. The San Felipe Tribe provides gasoline at an inexpensive price. Scheduling. Transportation is provided throughout the day and, in some instances, in the evenings. It is available on the same day that appointments are made; however, for longer trips into Albuquerque or Santa Fe, appointments must be scheduled two days in advance. The program uses cellular phones for communication. Drivers. The Pueblo recruits volunteers and has two paid drivers. When drivers are not available, staff of the Elderly Program volunteer to drive the van. Recruitment of both volunteer and paid drivers has always been a major problem because of the rural location of the Pueblo and the limited availability of drivers within the Tribe. Escorts. Upon request, escorts can be provided to riders. Marketing. Information about the program is published in the Elderly Program newsletter as well as on posters and memos that are distrib-

uted throughout the Pueblo. In addition, the program relies on announcements at Pueblo meetings, staff of social services and medical programs telling their patients about the program, and word of mouth to advertise the programs existence. Risk Management. Driver screening includes ascertaining that the driver has a valid current license and a clean driving record. The San Felipe Elderly Program provides insurance for the vans, drivers, and occupants. Because of liability concerns, the program decided not to provide rides to people outside the Pueblo. Funding and Budget Prior to 1985, the San Felipe Tribe was very reluctant to accept state money. The availability of State Capital Outlay funds prompted the Elderly Program to apply for monies to purchase a van. The programs staff, especially the director, conducted a vigorous advocacy campaign and prepared the necessary funding applications. Initial funding for the operation of the program was provided from the Older Americans Act. Since its start-up, the programs major outlays (the purchase and operation of vans and the payment of drivers and insurance) have been funded through the Older Americans Act, Title VI funds; the State Funds for Capital Outlays; the United Way; the San Felipe employees of Levi Strauss; the American Indian Society; Casino Hollywood (the Pueblos casino); and the Tribe itself. Strengths and Weaknesses Because many seniors have difficulty entering and exiting the larger vans, program staff would like to obtain another minivan or station wagon. The State has indicated that the program needs a handicapped van. While capital funding may be available, the program has always had difficulty securing funds for operations and insurance. Presently, the Elderly Program budget cannot cover any additional expenses.

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Advice from Experience Program staff highlight the importance of developing community support and involvement and of ensuring that there is adequate funding to cover operating expenses before incurring vehicle and capital expenses. Indian villages are very different. They are generally located in rural areas and people dont have many transportation options. Reliable transportation is not only critical to the independence of elderly people, it often is essential to their survival.

" Getting the elderly involved in advocating for their own elderly center and transportation program created the opportunity to apply for and secure state funds. It also made it possible for women to attend the Tribal Council. Securing capital funds for the purchase of vans is the easy part. It is very difficult to get money to cover maintenance and driver salaries. Before trying to expand a program, it is important to consider the operating costs.

San Felipe Elderly Transportation Program Budget

Annual Expenditures Office Operations* Vehicle Operations Driver Salaries Maintenance/Repair Purchase/Lease Fuel/Oil Insurance/Bonding Driver Screening Other Total $ 108,799 $ 24,274 17,714 500 0 3,012 3,048 0 $ 0 $ 132,073 Sources of Funding Income for 2000 State of New Mexico Title VI $132,073 47% 53%

Total

100%

*Includes administrative and office related salaries, benefits, taxes, supplies, rent, etc.

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STP Review

SHEPHERDS CENTER ESCORT TRANSPORTATION

1833 So. Burdick Street Kalamazoo, Michigan 49001 Tel: 616 383-1122; Fax: 616 344-6170 Contact: Joanne DeKoekkoek General Background Shepherds Center Escort Transportation is located in Kalamazoo, Michigan, about midway between Chicago and Detroit. Although it was the manufacturing domain for Checker cabs and the Roamer automobile, Kalamazoo also has the distinction of being the site of the first outdoor pedestrian shopping mall in the United States. In 1994, the county of Kalamazoo comprised an estimated total population of 228,800, of which about 20 percent were 55 years and above. Median income for all households in 1990 exceeded $32,000. History The idea for Shepherds Center Escort Transportation grew out of a community senior interfaith exposition held in 1987. About 350 people attended and discussed what they considered to be the greatest needs in the community. Transportation was identified as one of the most pressing problems. The void was identified not just in moving people from one place to the next, but specifically in escort transportation. One of the participants, a local ministers wife, had heard about Shepherds Centers of America and their development of interfaith groups around the country. Led by her efforts, the Shepherds Center of Kalamazoo was established in 1989. A Steering Committee was organized to create a transportation program, which was formed in 1991. The program received a start-up grant of $20,000 from a local foundation. There were 12 coordinators, one from each of 12 participating churches. Within each church, five or six members were identified who would be volunteer drivers. Rides were provided to local seniors for any purpose, three days a week, from Tuesday through Thursday. Currently, an eight-member Escort Transportation Committee oversees the program. Community support continues to be high. Fortytwo congregations provide in-kind and/or financial assistance. Even local public and paratransit providers are supportive, for they recognize the importance of providing escort services. Service relationships are maintained with senior services, senior centers, adult day care programs, Bronson/Borgess Hospitals, Catholic Family Services, Family Independence Association, the Visiting Nurses Association and home health care providers. Transportation Services According to some standards, Kalamazoo may be considered transportation-rich. It offers both public and paratransit, including a fixedroute bus system; a taxi service; the CARAVAN program operated by the Department of Health and Human Services, which uses vehicles equipped with a wheelchair lift to provide roundtrip service to work, school or medical appointments ($5.00 fare); a van service operated by the local senior services agency, which provides rides primarily to medical appointments ($5.00 round trip fare); and Metro Van, which also is handicapped-accessible. However, none of these alternatives provide escort service and all are fee-based.

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Program Elements Escort Transportation is available to all adults age 60 and above in Kalamazoo County. Due to excess demand, rides are usually restricted to medical trips (for personal needs or to visit a loved one in a hospital or nursing home). Rides. The program serves 258 riders with 4,162 one-way trips annually, for a per-ride cost of $2.17. There are no rider fees, although donations are accepted. (The suggested round-trip donation is $5.00.) Most riders have no family in close proximity. Where relatives exist, they usually work and are unavailable to provide transportation. The majority of riders simply have no other means of getting around. Because of health and functional limitations, public transportation is unacceptable and paratransit is less than desirable. Scheduling. Riders make 70% of their own reservations. Caregivers, including children, visiting nurses and social workers made 30% of the reservations. Reservations must be scheduled more than 2 days in advance. The service is available Monday through Thursday from 8:00 am to 4:00 p.m. Since many of the drivers are older, nighttime rides are avoided. A different person coordinates the program each day of the week. The coordinator calls the main office for the list of riders and consults the listing of available drivers for that day. The coordinator telephones the drivers who then contact riders directly. The driver provides the rider with his or her first name (they are advised to not release their last name for confidentiality purposes), type of vehicle to expect, and time of pick-up. Drivers. Currently, 120 volunteer drivers participate and provide rides in their personal vehicles. Escorts. Drivers are available to escort riders and often stay with them until they are ready to return home. Marketing. The program is promoted through

newspaper articles, TV and radio, a program newsletter and social service or medical personnel referrals. Also, a card is left with the physician each time a client is brought to their office by a volunteer from the Shepherds Center. Program brochures are distributed for posting at physician offices, churches and senior agencies. Risk Management. Drivers are required to show proof of a current drivers license and automobile insurance. State police check all driver records and driver training is offered. During this time an educational video, The Older and Wiser Driver, developed by the AAA Foundation for Traffic Safety, is viewed and a registered nurse provides instruction on how to deal with the frail elderly. A volunteer insurance policy, purchased with the Corporation Insurance Management Association (CIMA), provides special coverage for drivers. The policy covers expenses that are not included in the volunteer drivers personal automobile insurance policy. To date, no accident claims have been submitted. Funding and Budget The programs current annual budget is $9,000. Fundraising efforts have been stepped-up recently. A grant application was submitted to fund an Assistant Director position to help oversee the transportation program and other Shepherds Center activities. The transportation program is self-supporting and covers expenses through rider contributions as well as through donations from the general public and participating congregations. A donation envelope along with a newsletter is sent to physicians three times a year to facilitate contributions. A local church provides space as an in-kind donation. The total budget for the Shepherds Center is $53,325. Strengths and Weaknesses According to program staff, the escort component of the program is its primary strength. Riders are comforted and relieved to know that there will be a friendly face and helping hand available in the waiting room when they com-

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plete a medical appointment or needed medical treatment. Strong emotional relationships often develop between drivers and riders. An identified weakness relates to the absence of mileage reimbursement. Long distance rides are often necessary and, because of escalating gasoline prices, many drivers have become reluctant to make these trips. This has required a special effort to match drivers with riders living in very close proximity. Also, more drivers are being recruited to provide one-way rides to adult day care programs, which may be far distances, but do not require them to remain with the passengers.

Advice from Experience Suggestions about starting new programs focus on the importance of obtaining community support, involving volunteers, and having specific job responsibilities and guidelines. According to staff: Make sure that there is a need for the program and that it is worthwhile. Know how you will inform the community about the service and its merits. Dont be afraid to talk to other transportation providers in the community since they are all overburdened. Since the greatest satisfaction a person can receive is giving to others, drivers often say they benefit more than the people they transport However, make sure that guidelines exist for drivers and coordinators.

Shepherds Center Escort Transportation Budget

Annual Expenditures Office Operations* Vehicle Operations Driver Salaries Maintenance/Repair Purchase/Lease Fuel/Oil Insurance/Bonding Driver Screening Other Total $ 9,000 $ 0 0 0 0 0 0 0 $ 0 $ 9,000 Sources of Funding Income for 2000 Rider donations and contributions $9,000 100%

Total

100%

*Includes administrative and office related salaries, benefits, taxes, supplies, rent, etc.

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STP Review

WEST AUSTIN CAREGIVERS

2601 Exposition Boulevard, Room 205 Austin, Texas 78703 Telephone: 512 472-6339; Fax: 512 472-7158 Contact: Jean Barrett-Teel General Background Austin, Texas in Travis County is located in the central part of the state, 200 miles from Dallas and 160 miles from Houston. There are 654,255 residents; 8% are aged 65 and older. Austin, the capital of Texas, has a per capita income of over $29,000. West Austin Caregivers is located near the University of Texas campus and the State Capital complex. History In 1984, the Austin Metropolitan Ministries identified a need for support care for older congregants. A local university student undertook a project called the Caregiver Program, targeting West Austin or old Austin, based on 1980 census tracts. West Austin Caregivers was incorporated as a 501 (c)(3) in 1985 to provide volunteer support services for older adults. Initial assessment identified transportation as the greatest need. During the first year volunteers and two halftime paid employees served 50 clients. Only essential rides were provided, and in addition to transportation, the program also delivered meals. Transportation Services The Austin mass transit system offers, for a fee, Special Transit Service to seniors and the disabled. Meals on Wheels and Moreof Austin provides personalized medical transportation by volunteers to their enrolled clients. The Austin Parks and Recreation Department offers van service to seniors. Medicaid patients have limited access to transportation for medical appointments. These programs all offer curb-to-curb service and many elderly find it difficult to access and utilize them. The West Austin Caregivers program provides personalized transportation to medical appointments, grocery shopping, community activities, and personal or business errands. The levels of transportation service are: Curb-to-Curb client waits at curb, goes to vehicle on own; Door-to-Doorvolunteer goes to door for client, escorts to entrance of destination and returns for client; and Door-through-Door volunteer goes to door for client, escorts client into destination and waits. Referrals come from sponsoring congregations, local hospital, home health and aging services personnel, and senior housing projects. In 1999, the West Austin Caregivers employed two staff totaling 50 hours per week, five volunteer office staff, and 125 volunteers (85 drivers) who provided services to 326 clients. Program Elements Clients of the program are age 60 and above and live within the service boundaries. They need and use the organizations transportation program for a variety of reasons: 1) forfeiture of a drivers license; 2) inability to pay for taxi service; 3) lack of suitability or reliability of public transportation; 4) lack of immediate family living nearby, or able to provide help; and (5) one or more physical or mental disabilities. Transportation is provided to clients in vehicles owned by volunteer drivers. Rides. The program services 326 riders with a total of 3,285 one-way rides each year. This translates into an annual average of 39 trips per driver and 11 trips per rider. The average cost per ride is $9.44.

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Vehicles. Volunteers use their own vehicles to drive clients. The caregiver drivers serve as companions for the clients while providing transportation and this personalizes the service. Scheduling. Clients call in requests to volunteer receptionists. Volunteers or staff record requests on client cards and a master calendar. The matching process then includes the following considerations: (1) availability of volunteers date of last drive, preferred days and times for service, commute time, type of vehicle and other personal preferences; and (2) client needs type of vehicle required, level of assistance requested and other special needs. Drivers are called, faxed or e-mailed weekly by volunteers or staff and offered various opportunities to drive. When volunteer drivers agree to an assignment, the information is appropriately logged. Volunteer drivers are responsible for calling clients to introduce themselves and to confirm the reservation. The scheduling process is a manual system that currently is being adapted to a computer database program, using Filemaker Pro. Drivers. The sponsoring congregations help recruit volunteers. In addition, partnerships are developed with community organizations (The Junior League of Austin and the Retired Senior Volunteer Program) to provide volunteer opportunities for members. A number of volunteers have come from local universities, the State Legislature and corporations after they learned about West Austin Caregivers through its web site, which is linked to several volunteer recruitment sites. Other friend-raisingactivities include community volunteer/health fairs and presentations, public service announcements, event coverage by local media, and word of mouth via clients and current volunteers. There are no minimum time requirements for volunteers. Their involvement can range from once a month to several trips per week. This flexibility has helped develop a satisfied, long-standing group of volunteer drivers.

Risk Management. Drivers are screened via application, interview and a background check. West Austin Caregivers has a $1 million liability insurance policy covering volunteers. Training is provided on the aging process, special considerations of transporting clients with limitations, and the social and emotional well being of older adults. A protocol for emergencies is established. The staff is always open to client feedback about their sense of personal safety. Some drivers are retirees and, when their driving capabilities become risky, they are offered other volunteer positions, such as friendly visitors. Funding and Budget The 1999 budget was $36,000. The largest share of funding comes from grants and sponsoring congregations. Other funding sources include contributions generated by fundraisers and private donations. Clients currently provide a small percentage of donation revenue. Office space is provided in-kind by one of the sponsors. Strengths and Weaknesses Volunteer recruitment presents the greatest problem since it takes special people who are willing to accommodate to the requirements of providing transportation to older adults. For example: (1) driving a personal vehicle; (2) committing to a specific time; (3) providing a direct, point-topoint ride; and (4) providing physical or emotional assistance to someone else when needed. Several solutions have been tried to increase the volunteer pool. One has been to recruit drivers who are available only on the weekend and then to encourage clients to schedule their non-essential requests on Saturdays and Sundays. Another has been to break out round-trip requests into two one-way rides that can be provided by different volunteers. Also, volunteers with full time jobs who can take an hour or so to drop off or pick up clients have been recruited.

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Advice from Experience Program staff say that it is critical to believe in the importance of transportation, to be connected to local and regional funding sources, and to remember family and friends when looking for financial and volunteer support. If you lose your transportation, you lose your last link to independence. West Austin Caregivers is a transportation lifeline. If a program does not have access to on-going funding, it may have difficulties trying to run the program and to raise funds at the same time. Many of the individuals who help develop the program make commitments that last a lifetime. The student who originated the idea of West Austin Caregivers is now starting the eighth caregiver group in another town. Often, family caregivers also find a way to give something back to the community.

The involvement of family caregivers is evidenced in the following letter: Dear caregivers: Enclosed is my volunteer application. I am well acquainted with this organization as my mother used your services for years for some time. You were a great help when she had to give up driving and I could not take her to appointments at special times. For this, I will always be thankful. Since my mother passed away in June, I am trying hard to help others in some small way. My only talent is driving a car. I speak only English, I cant cook, know no heavy conversations, but do try to be sociable. Not much of a blue ribbon person, am I. I do have two afternoons a week off where I could be used in some way. If you can find a place for me, great. If not, I will wait until maybe sometime in the future you can find a slot for me. According to the program director, this volunteers name is now on the transportation request calendar every week!

West Austin Caregivers Budget

Annual Expenditures Office Operations* Vehicle Operations Driver Salaries Maintenance/Repair Purchase/Lease Fuel/Oil Insurance/Bonding Driver Screening Other Total $ 33,320 $ 2,680 0 0 0 0 2,430 250 $ 0 $ 36,000 Sources of Funding Income for 1999 Grants Church ssponsors Contributions Interest & Dividends Special Funding $55,887 40% 35% 17% 6% 2%

Total

100%

*Includes administrative and office related salaries, benefits, taxes, supplies, rent, etc.

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Appendix C Six Case Studies

The project team conducted in-depth case studies of six of theSTAR Award winners. These programs had budgets ranging from $220,000 to over $5.6 million, they provided extensive and complex services, and they had what might be called formal management systems. These programs are: 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) Each case study includes detailed information on the programs location, the availability of its transportation options, its purpose, history, organizational relationships, transportation services, staffing, service relationships, rider eligibility, marketing efforts, risk management efforts, and budget and funding sources. The case studies also highlight various problems that these programs have encountered as well as the ways that were found to solve them and the key reasons for each programs success and the likelihood that this success can be replicated.

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STP Case Study

GADABOUT TRANSPORTATION SERVICES, INC.

737 Willow Avenue Ithaca, New York 14850 Tel: 607 273-1878; Fax: 607 277-9551 Contact: Judith E. Willis, Executive Director The following letter was sent to Gadabout from a grateful rider. Enclosed please find my payment for transportation to and from the hospital yesterday. I am very grateful for all the services you have offered me. I have spoken to a reporter from the Ithaca Journal and have suggested that they should assign a reporter to spend a day traveling with one of your buses for a day. I was told they have written up Gadabout several times. I would suggest that you put pressure on the Editor. Even I, as a rider, did not recognize the extent of services and the complexities of the delivery of these services to the elderly and disabled. sient, with a high turnover in students and teachers. Long-term residents account for only about one-third of the population. Transportation Options TCAT (Tompkins Consolidated Area Transit) is the fixed-route transit provider that covers the city, Cornell and I.C. campuses, and Tompkins Countys rural routes. In 2000, TCAT provided 8 million rider trips. There also is a taxi service, which provides about 400,000 rider trips per year, and an Airline Limousine, which covers Tompkins County, Syracuse, and Elmira airports. Life-equipped transportation is provided only by Bangs Ambulance locally (at high ambulance rates) and by a company called Tender Loving Care (TLC), which is located in Syracuse, also at prohibitively high rates.

The Environment
Location Gadabout is located in Ithaca, New York. The community of Ithaca is located in Tompkins County, which has a total population of 97,656 (9.5% are aged 65 or older), and a median household income of $34,000. Ithaca accounts for one-third of all residents and one-fourth of all seniors in the county. In addition to being home to Cornell University and Ithaca College (I.C.), Ithacas other major employers include the Corning and Borg-Warner companies. Given that Ithaca is an education center, its population is relatively tran-

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Emergency transportation for individuals is partially supplied by the Red Cross and Friends in Service Help (FISH), a small volunteer transportation service in the community that provides rides to anyone in the community for medical appointments only. Volunteer drivers use their personal vehicles.

Program Purpose
Gadabout is a private nonprofit agency that provides transportation in Tompkins County, New York for people aged 60 and over and for people with disabilities. The need for transportation is a high priority for the elderly and disabled in the county. Gadabout has answered this need by providing them with transportation to medical facilities, nutrition programs, grocery shopping, work, and volunteer and organizational activities. Gadabouts priority is to serve non-ambulatory clients. Since these trips take more time than other trips, able-bodied senior citizens are encouraged to use the countys TCAT public bus service whenever possible. The goals of Gadabout are set forth in Articles of Incorporation and By-Laws, adopted by the Gadabout Board of Directors in March 1981. As stated in this document, the primary purpose of the program is to develop, administer, and evaluate a voluntary transportation system for elderly and handicapped residents of Tompkins County. History The idea for Gadabout was triggered by passage of a 1974 amendment to the Urban Mass Transportation Act of 1964, Section 16(b)(2), which authorized grants of federal funds to private, nonprofit organizations for the purchase of vehicles and other equipment for transportation of the elderly and handicapped. In 1994, representatives from the Tompkins County Chapter of the American Red Cross, the Office for the Aging, Church Community Action,

Developmental Disabilities, Ithacare, Ellis Hollow Apartments, Lakeside Nursing Home, and the Senior Citizens Council formed a committee. Over a two-year period, the committee organized, raised funds, and filed an application for funds to purchase vehicles. By November of 1976, Gadabout had been officially organized, and the first 14-passenger bus had arrived. In 1977, upon the closing of the Groton Community Service Center, funds from the Centers liquidation were earmarked for a Gadabout bus that would serve the Northeast area of the county. The Groton/Dryden Gadabout was started in 1980. At its inception, Gadabout was an appropriate undertaking for its sponsor, the Red Cross, since the Red Cross had a great deal of experience in using volunteers in existing programs. The relationship was administrative in nature and involved no direct support from the Red Cross, even though Gadabout was considered to be one of its programs. In June of 1981, Gadabout officially became an independent nonprofit agency called Gadabout Transportation Services, Inc. Gadabout had always been financially independent and had a community-based coalition of supporters. Thus, the move to incorporate Gadabout as an entity separate from the Red Cross just meant that it had to find more adequate office and parking space, arrange for proper vehicle insurance and radio communication, and assume complete administrative responsibility for the service. By December of 1981, the newly incorporated Gadabout Service had successfully established itself and completed its first half-year of independent operation.

Organizational Features
The Model A supplemental transportation program for seniors can be operated either by an independent organization or be part of a larger umbrella

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organization. Within these two organization models, there are four models for providing transportation services: Sole-service Programs - provide only transportation Multi-service Programs - provide a menu of services, including transportation Contract Programs - contract with outside transportation providers Coordinating Programs - coordinate transportation for several organizations. Organizational Relationships Gadabout is an independent organization that offers a sole-service program of transportation. A 20-member Board of Directors is responsible for policy guidance and oversight. Members serve one to three-year terms. The by-laws provide for the representation of participating organizations, volunteers, and consumers (riders). Participating organizations are defined as those that have made substantial contributions to the program, in most cases housing providers or caregivers whose clients benefit directly from the services of Gadabout. Minutes of the monthly Board meetings are available to the public in the Gadabout office. TCAT contracts with Gadabout to provide its ADA paratransit service. Furthermore, TCAT passes on local county funding and State Transit Operating Assistance (STOA) to Gadabout on a permile, per-passenger basis. Gadabout leases space from TCAT for its office, dispatch and parking of its vehicles. In 1989, the TCAT and its partners (including Gadabout, which is represented on the TCAT Board) decided to build a shared facility that was opened in 1991, and the lease of

space was arranged at that time. TCAT also maintains Gadabouts vehicles at a mutually agreed rate. The chart below shows Gadabouts present organizational structure. The Board of Directors is the policy-making body. The Executive Director of Gadabout Transportation Services, Inc. works under the supervision of the Board of Directors and is responsible for supervising and hiring the other staff members. The volunteers are recruited and supervised by the Executive Director and the Groton Coordinator but work under the guidance of other staff members.

Program Operations
Transportation Services Gadabout provides a demand-response service. It is available to anyone in Tompkins County who is aged 60 or older or is disabled. In 1999, Gadabout provided 49,000 one-way rides a year on a fleet of 20 buses, all of which are radioequipped to communicate with the Gadabout Ithaca base station. Seventeen of the buses are equipped with wheelchair lifts. Rides are available Monday through Friday. Groups can use Gadabout vehicles on weekends and evenings. Transportation is available for any purpose. However, most rides are for medical purposes,

Gadabout Transportation Services, Inc. Board of Directors

Executive Director

Financial Director

Scheduler/ Dispatcher

Staff Drivers and Program Volunteers

Groton/ Dryden Coordinator

Office Assistant

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followed by shopping and attending to personal business. Many senior riders continue to drive and are especially likely to request rides during the winter months due to inclement weather. Program Staffing Gadabouts office staff consists of seven paid employees and a cadre of volunteers. The paid staff includes an Executive Director, a Financial Director, a Scheduler/Dispatcher, an Operations Support Coordinator, an Administrative Assistant, a Data Manager and an Office Assistant. There are five full-time and six part-time drivers. Service Relationships In 1985, an evening Gadabout service for Cornell disabled students was arranged through an American with Disabilities Act contract with TCAT and with help from Cornell student volunteers and Cornell University (CU) Transit. CU Transit pays for the operating cost of basing a van at the Cornell campus with trained student volunteers. Gadabout also contracts with Challenge Industries (which operates sheltered workshops (for people with disabilities) and the Department of Mental Health to transport daycare clients to the Skylight Club. Gadabout also has an agreement with the Retired Seniors Volunteer Program (RSVP) to transport volunteers to their jobsites and another agreement with Longview Senior Day Care to bring their participants to and from the center. Gadabout also handles requests from five long-term care nursing homes. Paid and Volunteer Drivers In 1999, 45 volunteer drivers and 11 paid drivers were involved in providing Gadabouts transportation services. According to the programs staff, the volunteer drivers are the foundation of the program, and without them, the whole nature of the serviceits warmth and personal caringwould be of a much lower quality and Gadabout would be a very different program. Since 1987, the number of volunteer drivers has increased to

45 active volunteers. They range in age from 20 to 70. Some are college professors and others have little education. Drivers contribute anywhere from an occasional half-day to four or five days per week; the average is about 20 hours of service per month, usually in five-hour shifts. Many drivers have been with the program for a long time. (Staff members say that it is difficult to find professional drivers.) Volunteers Although Gadabout relies on volunteer drivers, it also employs drivers in order to provide dependable transportation during early mornings and other periods when volunteers are usually unavailable. Several efforts have been made to find volunteers to serve as escorts. A trial program was organized with the Tompkins County Department of Social Services to provide escorts under the countys work experience program. An effort also has been made to find and train volunteers to serve as escorts and to help with wheelchair service and grocery routes. However, it has been difficult to find volunteers to fill this role. Transportation Scheduling Requests for rides are accepted days and even weeks in advance. At a minimum, they must be received by 12:00 noon of the day preceding the needed ride. When contacting Gadabout, callers are asked the following questions: whether they have physical difficulties, if they use a special or regular wheelchair, if they need to be transported in a lift-equipped vehicle, whether they need multiple stops, if an escort will be with them, and whether they can use the TCAT bus service. They also are asked the date, time, and destination of the requested ride. Staff members prepare the ride schedules for the following day by hand each day. New and outstanding request forms are reviewed and then organized according to the times when riders need to be picked up and returned. If there are competing requests for rides at the same time, a priority system is used. First priority is assigned to medical and dental

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appointments, followed by nutritional programs (including grocery shopping), followed by volunteer work, then social and personal errands. The final schedule is written and photocopied for the office staff and for each driver. Riders contact Gadabout after 3:00 p.m. of the day preceding their ride to learn the time at which they will be picked up. Marketing Efforts Gadabout has not developed formal marketing strategies, but is publicized by the Office for Aging, senior citizen groups, the Cayuga Medical Center, doctors offices, senior residential units, Challenge Industries, and staff working at facilities for people with development disabilities. Risk Management The driving records of all volunteers are screened before they are eligible to drive for Gadabout. In order to be licensed as a driver, volunteers are also required to pass a thorough physical, which includes eyesight and hearing tests, a behind-the-wheel road test, and a written commercial driver test consisting of around 100 questions. Once a driver is hired, he or she has to take yearly and bi-annual driver tests and be available for continual training. Apprentice drivers work with seasoned volunteer drivers on their first few trips to learn the procedures.

Financial Considerations
The Gadabout Budget Gadabouts total annual budget is $641,884. Until 1986, the exclusive source of Gadabouts funds from the county was federal revenue-sharing funds. In 1986, the county experienced the first round of revenue-sharing cutbacks, but the reduction in federal support was made up by local tax revenue. The States support for the program is limited to state transit operating assistance (per mile, per trip), and help with the purchase of vehicles (see below).

UMTA Funding Most of the 20 Gadabout buses have been purchased through grants under the 5310 program, formerly Section 16(b)(2), of the Federal Urban Mass Transit Act (UMTA). Through this program, the state provides 80 percent of the vehicles cost and the community must provide the additional 20 percent. The application process takes about a year and requires that the applying program demonstrate organizational capability, fiscal soundness, and the ability to manage and finance the ongoing operation of the vehicles that will be acquired. Vehicles purchased with Federal Section 5310 program funds are monitored by New York State Department of Transportation for five years. Quarterly reports must be filed indicating the number of passengers carried, the number and purpose of all rides, and a breakdown of passengers in categories (for example, the elderly, the disabled, the ambulatory, or those in wheelchairs). Mileage, maintenance, and repairs also are recorded. While the Federal Section 5310 program helps programs to purchase vehicles, there are no government programs that help to fund the operation of the vehicles. These funds must be raised locally from municipalities, rider donations, groups and agencies using the vehicles, and annual fundraising events. For the first 15 years, there was the Gadabout Chicken Barbecue. Now the local grain and pet store holds a Wild Bird Food Sale to benefit Gadabout, and program staff solicit support via an annual Friends of Gadabout letter. Rider Fees Gadabout has evolved from being a donation program to a fee-based program. Until the mid1990s, riders were not required to pay a fee. To help to cover the costs of the service, donations were encouraged with suggested amounts for different trip lengths. In 1993, Gadabout provided an estimated 38,000 trips, which resulted in $22,000 in donations or an average contribution of $0.58 per door-to-door ride. In 1994, a set fee system was introduced because additional rev-

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enue was needed to cover the cost of providing the service and because the program had to charge fees in order to receive public funding. The fee structure has remained unchanged since it was first introduced. Trips within the city of Ithaca cost a minimum of $1.00 each way. Trips outside the city are a minimum of $1.50 each way. In 1999, revenues from fees amounted to $46,132. The program has refrained from introducing a more complicated fee structure because it would be harder for the drivers to determine and collect the fares. Service Fees On weekends and evenings Gadabout vehicles are available for group use. Organizations are charged on a per-mile basis and must use a qualified Gadabout volunteer as the driver. Also, groups such as Challenge Industries as well as several nursing homes have a contract with Gadabout to provide transportation for their residents.

identified special licensing locations where these volunteers could take oral tests. Today, both are volunteer drivers. Driver Training Gadabouts riders are getting older, so the client part of the driver training is essential to providing an appropriate service. It is important for drivers to appreciate that most people who use the service have special needs. Although a drivers sensitivity program has not yet been initiated, there have been discussions about how it might be focused. Service Limitations Gadabout is currently unable to provide transportation services evenings or on weekends, except for groups. Although many older people do not go out in the evenings, there does seem to be a demand. Consequently, the program staff is exploring ways to extend Gadabouts service hours.

Problems and Solutions

Advocacy for Funding and Recognition Like other small transportation agencies, Gadabout relies on State funds for some of its capital and operating expenses. According to Gadabouts staff, the New York State DOT has a poor understanding of the special needs of seniors and people with disabilities. Gadabout has joined a rural transportation advisory committee (RTAP) to discuss statewide issues and the needs of small systems. Volunteer Recruitment Due to difficulties recruiting volunteers staff provide help to prospective volunteers who wish to qualify as drivers, especially with regard to licensing. One retiree wanted to volunteer but said he had trouble with tests. Another wanted to be a volunteer but could not read. The staff arranged for both people to be coached and for audiotapes to be made of the manual. They also

Keys to Success and Replication

Gadabout has experienced success over time in changing from a sponsored to an independent organization and from a donation to a fee-based program and in developing a working relationship with the county transportation system. Therefore, it has several key features that would enable it to be replicated not only other rural communities but in urban communities as well, such as sponsorship and community links, volunteer drivers, and manual scheduling. Initial Sponsorship Sponsorship by a well-established organization in the community can be important in the startup phase. However, as an STP develops and wants to become independent, the type of relationship that exists with the sponsor and the community will determine the complexity and viability of the separation.

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Volunteer Driver Staff believe the volunteer drivers are the foundation of the program. Without them, the whole nature of the service its warmth and personal caring would be of a much lower quality. Using volunteer drivers in an STP can have a positive impact on the type of service that it provides. Manual Scheduling Gadabouts reservations and schedules are not computerized and are very labor-intensive. Fortunately, there is great attention to detail, and emphasis on recording ride requests correctly, which translates into good transportation service. While computerization might result in greater efficiency and integration, some are concerned that this would result in inflexibility and less personal interactions with riders.

Conclusion
Transportation planners and community leaders often concentrate exclusively on the availability of transportation services. However, a 1999 study by the Beverly Foundation identified not one, but 5 As of Senior Friendly Transportation availability, accessibility, affordability, acceptability, and adaptability. By attending to all five As supplemental transportation programs for seniors can fill the gap in transportation services for seniors. Gadabout meets the needs for senior-friendly transportation in several ways. It is available to anyone aged 60 and over for any purpose, although it does not offer evening and weekend transportation and appointments need to be made one day in advance. It is affordable to riders because it charges only nominal fees for its services. It is acceptable in terms of rider satisfaction with services. It is accessible; most Gadabout vehicles are equipped with wheelchair lifts and meet ADA specifications. And it is adaptable as escorted transportation is available upon request.

Observation of Staff
It is difficult for a small program that is primarily for older and disabled people to be seen as a player in public transportation (in New York state). One reason there isnt much support for these kinds of programs is that people who want to work in the big league want to work with the real transit people, and the guys see us as a bunch of little ladies who run small human service agency programs. The Federal Section 5310 program, which provides capital funds for vehicles to agencies such as Gadabout, is the only public transportation program that does not receive state funds to match federal grants. All other federal-aided transit programs receive state matching funds. The Section 5310 program is at the back of the bus in New York State.

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STP Case Study

GOLD COUNTRY TELECARE, INC.

13076 Ridge Road P.O. Box 2161 Grass Valley, CA 95945 Tel: 530 274-8264; Fax: 530 272-1349 Contact: Don Martin, Executive Director Elizabeth is 87 years young by her description. In 1999 she broke her hip and several ribs and wondered, How am I going to get around? A friend suggested that she call Telecare, but she thought it would be too much to ask for help. Fortunately she did call and started using Telecare to go to doctors appointments, the senior center, shopping, and bingo. In her own words, Im on a limited income and couldnt afford to go anywhere if it wasnt for Telecare and the vouchers. Id be stuck at home. Nowhere in the whole wide world could I get service like this! For many seniors like Elizabeth, Telecare is the lifeline that enables them to remain independent in the community. Many of the seniors who use Telecare have low incomes, do not drive, have no nearby relatives, and are unable to use the public transportation system. try roads. An estimated 89,590 people live in Nevada County. About 20 percent of the residents are aged 65 or older. Many of the elderly have low incomes and live in rented rooms or shacks. Transportation Options Telecare serves Western Nevada County and the city of Truckee (in the northeast section of the county). It is the sole provider of paratransit services in Western Nevada County. Public transportation options in Western Nevada County include the Gold Country Stage (a fixed-route public transportation service) and two local private taxi services. In Truckee, residents have the option of using the local Dial-A-Ride service (which is not operated by Telecare). Telecare riders are encouraged to use public transportation, but many individuals live off the fixed

The Environment
Location Telecare is located in Grass Valley, California, which was the heart of the California Gold Rush in the 1850s. Nestled in the rural foothills of the Sierra Nevada Mountains, Grass Valley is centrally located near many popular places. It is 1.5 hours from Reno, Nevada; 2 hours from Lake Tahoe; 1 hour from Sacramento; and 2.5 hours from San Francisco. It is located in Nevada County, which boasts beautiful rivers, lakes, forests, and scenic coun-

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route and/or cannot get to bus pick-up points. Also, due to the geographic terrain of the county, the available fixed-route public transportation system is unable to pick up a majority of Telecare riders due to unpaved roads, steep hills, or rough, uneven topography. Private taxis serve those who can afford to pay for them and who do not need specially equipped vehicles.

Telecare began to devote its resources exclusively to transportation. It expanded its service area outside of Western Nevada County to the city of Truckee and, more recently in September 2000, earned the county contract to operate the Dial-ARide program in Western Nevada County. It is now the sole provider of paratransit and already has saved the county $87,000. This figure is expected to double next year. In addition to providing transportation for essential purposes, Telecare now has the capability to transport riders to enrichment programs, shopping, church, and recreational and social events. Transportation also is available for special seasonal activities including the Fall Color Run, the Christmas Lights Run, the Spring Wildflower Run, and Music in the Mountains.

Program Purpose
The mission of Telecare is to provide transportation for Nevada County seniors and people with disabilities, enabling them to maintain their independence and participate in the community. It provides specialized paratransit services seven days a week using professional and volunteer drivers. Both demand response and subscription (rides that occur on the same day/same time on a regular basis) services are offered. Rides are available to medical appointments, health services, support groups, enrichment programs, church, shopping, and out-of-town medical services. History Telecare began in 1974 as a volunteer meal service under the auspices of Grace Lutheran Church in Grass Valley. Shortly after its inception, Telecare began to provide transportation for seniors. It used volunteer drivers and provided rides exclusively for medical appointments. In 1977, Telecare became independent from the church and was incorporated as a private nonprofit agency. During the following year, it introduced an information and assistance program for seniors. Beginning in the mid-1980s, Telecare began to hire professional drivers. In the late 1990s, Telecares Board of Directors was recomposed, and the organizations focus on quality transportation service was enhanced. As a result, the information and assistance program was transferred to the local senior center, and

Organizational Features
The Model Supplemental transportation programs for seniors can be independent organizations or can be operated as part of larger umbrella organizations. Within these two organization types, there are four models for providing transportation services: Sole-service Programs - provide only transportation Multi-service Programs - provide a menu of services, including transportation Contract Programs - contract with outside transportation providers Coordinating Programs - coordinate transportation for several organizations. Organizational Relationships Telecare is an independent organization that offers a sole service program. Its transportation program and organization are one and the same. The members of the organization are the volunteer Board of Directors. They consist of eight

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people representing a diverse cross-section of the local community. Collectively, they offer a wide range of experience in transportation, health care, senior and social services, finances, and city government. Telecares bylaws require that at least one member of the Board is eligible for and uses Telecares services.

at that destination for a short time. When no other pickups are scheduled, the driver will ride around the block and wait for the dispatcher to tell him or her return for the rider. Telecare believes that this indicates to riders that they are paying for a professional service. Program Staffing Telecares functions are divided among six divisions: Executive, Development, Program, Fiscal, Support, and Service. Staffing within these divisions is as follows: Executive Division. The Executive Division reports to the Board and is responsible for managing the agency. The present Executive Director has a long history in the transportation field and was previously employed as a Telecare driver supervisor. Development Division. The Development Director acquires funding, manages volunteer recruitment, marketing, public relations, and assists the Director. Program Division. The Dispatch Supervisor oversees the drivers and dispatch personnel and coordinates the drivers schedules. Two Dispatch Operators handle client intake and requests for rides and maintain communication with drivers while they are transporting passengers. The Statistics Coordinator organizes the in-house statistical tracking system and prepares the programs statistics. Fiscal Division. The Financial Manager is responsible for maintaining and tracking all fiscal operations. Support Division. The Program Assistant performs administrative duties and provides support to other divisions. Service Division. The Service Division consists of 20 paid and eight volunteer drivers. Volunteers are mostly retirees and work for

Program Operations
Transportation Services In 1999-2000, Telecare provided transportation to 1,267 riders. Over half (53 percent) were subscription passengers. Most riders live in rural, outlying areas of the county and are on fixed or low incomes. During 1999-2000, Telecare recorded 28,236 boardings. Ridership levels varied throughout the year, with declines occurring in December and January when family members tend to be visiting for the holidays and adverse weather makes travel less desirable. During the current fiscal year (2000-2001), ridership and boardings are expected to increase significantly as a result of Telecares new Dial-ARide contract with the county. An estimated 72,000 one-way rides are expected, with the average cost per ride estimated at $10.11. Door-to-door service is available Monday to Friday from 6:00 a.m.-10:30 p.m.; Saturday from 8:00 a.m.-8:00 p.m.; and Sunday from 8:00 a.m.5:00 p.m. Potential riders must make a reservation at least one day and as much as 30 days in advance. Riders are advised to allow a 30-minute window of time on each pick-up and return request to account for unexpected weather or traffic conditions. Telecares vehicle fleet consists of 13 wheelchair-accessible vehicles (eight minivans, three vans, and two buses) and one sedan. When a Telecare vehicle drops off a rider at a destination, the driver normally does not wait, even if the passenger will only be staying

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Telecare part-time. Due to the countys contract requirements, paid drivers provide only intracounty transportation. Volunteer drivers provide some local runs and all out-of-county trips using their own vehicle or an agency vehicle. Service Relationships Telecare has established service relationships with several agencies and organizations in the community. Demand response service is provided to clients of the Gold Country Community/Senior Center, FREED (Foundation of Resources for Equality and Employment for the Disabled, an Independent Living Resource Center that helps people with disabilities reach their goals for independent living), the Sierra Services for the Blind, the Del Oro Caregiver Resource Center, the Abbey Physical TherapyRehab Center, the Bowman-Solinsky Warm Water Pool, the Sierra Nevada Memorial Hospital, and Music in the Mountains. Subscription services are provided to Lutz Adult Day Care Services (Telecare provides 32 percent of their transportation), Gambo Health Care (several patients are transported three times a week to and from this facility for dialysis treatment), PRIDE Industries (disabled individuals are transported to and from home and work), and the Neighborhood Center of the Arts (transportation is provided for adults with developmental disabilities to and from this facility for arts and community integration). Rider Eligibility The programs rider eligibility requirements are simple; seniors aged 60 years and older and people with disabilities can use the service. Because Telecare receives funding from the county, it must comply with the Federal Americans with Disabilities Act (ADA). It must give first priority for service to people with disabilities who live inside the ADA corridor (three-quarters of a mile on either side of the fixed-route public transportation system). People who live outside the ADA corridor often need to be bumped or are turned down.

Non-passengers (usually caregivers) make about 25% of ride requests. When a person calls, they reach the dispatch office. The operator tells new callers about the service. If they want to reserve a ride, the person is asked their name, address, phone number, age, date, time, and the destination of prospective ride. The operator also asks about the ambulatory/special needs status of the person who will be taking the ride, for example, whether it will be necessary to transport any special equipment such as a wheelchair, walker, or oxygen and/or if they will be accompanied by an escort. The operator records all of this information by writing it down manually and then passes it on to the scheduler who enters the data in an Excel spreadsheet and completes the actual ride scheduling. Prior to the service date, a staff member calls the passenger to confirm the ride. During the initial contact, the operator advises callers with disabilities that they will be sent a form to complete and submit to the county to determine their ADA eligibility status. In the interim, those under the age of 60 who are waiting for the county to approve their eligibility for ADA transit services can receive rides from Telecare. Clients of the Lutz Adult Day Care Center who are on the subscription transportation program are required to complete a form indicating whether the driver can leave them alone when they are taken home or whether, if no one is at home, they should be dropped off at a neighbors home (within three blocks) or be returned to the center. Marketing Efforts Friends and service partners are actively involved in promoting Telecare throughout the community. The programs Executive and Development Directors also promote the program through fundraising mailings, media releases, public speaking forums, and networking. Telecare is listed in the Yellow Pages under three separate headings: (1) Senior Citizens Services

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and Organizations, (2) Disabled Persons Access, Equipment, and Services, and (3) Dial-A-Ride. A program newsletter is printed four times a year and distributed to approximately 200 individuals and organizations. Finally, the Telecare name is prominently displayed on the programs vehicles. Since the vehicles are on the road seven days a week, they serve as a very noticeable mobile billboard. Risk Management Paid drivers are required to have a clean DMV and no criminal record. In addition, they must submit to a pre-employment drug test and ongoing random drug testing thereafter set up through the Nevada County Personnel Department. Drivers must have a valid California B-P license allowing them to drive a bus with passengers. There are three driver instructors on staff who are certified by Non-Profits United Insurance to provide in-house training the procedures and policies of paratransit driving. The training consists of 20 hours of classroom instruction, a ride along, and meetings with the individuals and agencies that use Telecare. The classroom phase covers procedures for lifting and transferring riders and securing wheelchairs, state and federal regulations, and sensitivity training to facilitate effective interactions with frail elderly people and riders with Alzheimers. Volunteer drivers are required to meet screening and training requirements too. They must have a valid California driver license, a clean driving record, and motor vehicle insurance meeting minimum state requirements ($50K/$100K). They also must comply with federal drug-free workplace requirements, attend a new driver orientation session, participate in a ride along with a Telecare transportation assistant or trainer, and attend quarterly driver in-service safety training meetings.

Telecare maintains a $5 million insurance policy on all its vehicles and drivers through the NonProfits United Insurance Pool (NPUIP). Since its inception, Telecare has earned the annual Excellence in Safety Award from the NPUIP and has consistently received satisfactory ratings on site inspections by the California Highway Patrol (CHP). The CHP inspects driver records, vehicles, and vehicle records for maintenance, safety, and proper certifications. Telecare surveys riders twice a year to obtain input on driver performance. According to program staff, Input from riders, whether solicited or unsolicited, is one of the best ways to identify potential driver problems.

Financial Considerations
The Telecare Budget Telecares annual budget for 2000-2001 is over $810,000. The bulk of this money comes from the California Department of Transportation. Funding Sources Initial funding for Telecare was provided by the sponsoring church and by donations to cover operating expenses. Once Telecare became an incorporated nonprofit agency in 1977, fundraising, grants, and special events added to the funding stream. Today, funding for Telecare comes mainly from grants and donations. The California Department of Transportation (Section 5310, which provides vehicle acquisition funds), the Area IV Agency on Aging, and the United Way have provided grants. Telecare also receives funding from Western Nevada County to operate the Dial-A-Ride program in the county. In November 2000, Telecare received a one-year grant from Catholic Healthcare West for a new pilot project called T.H.E. (Transportation for Health and Enrichment) VAN PROGRAM. This grant covers the costs of transporting 24 low-

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income seniors for a month to various health services in the community and for a midday lunch at the local senior center. Through its volunteers, Telecare also receives inkind services. In the last fiscal year, volunteers donated 10,412 hours of service, equal to an estimated in-kind contribution of $72,884. Rider Fees Rider fees cover about 12% of Telecares budget. One-way fares for intra-county service are $2.00 for one to four miles, $3.00 for four to seven miles, and $5.00 for seven to 10 miles. Longer rides to destinations outside of the county are available for a higher flat rate. Telecare offers a transportation voucher program funded by the Area IV Agency on Aging to assist low-income seniors. To be eligible, riders must be at least 60 years old. For a $2.00 donation, a person receives a booklet of 20 vouchers. Each voucher is worth $1.00. The person can use vouchers to cover up to 50 percent of the fare for any transportation purpose, including medical appointments outside of Nevada County. Mileage Reimbursement Volunteer drivers receive a reimbursement of $0.32 a mile. There is no limit on monthly mileage. Drivers are required to keep track of their daily miles on a mileage form, which they submit at least monthly.

ferent direction leave and those of us who were in sync needed to stay and help the program grow. Telecare started to build solid and supportive relationships throughout the community. Staff and Board members met with various community groups, local businesses, and nonprofit agencies. Membership of the Board changed, and the Board started to hold annual retreats to develop short and long-term goals and objectives for the organization. Added emphasis was placed on hiring good staff members who would be dedicated to the program and would be effective team players. Nonprofit Philosophy Before Telecare received the Dial-A-Ride contract for Western Nevada County, there were two paratransit providers in the area: Telecare and a private, for profit company. As part of its Dial-aRide contract, Telecare was required to absorb drivers from the other company. However, this presented significant problems during the transition period. Many drivers from the other company were not accustomed to working for a nonprofit agency and had to be educated about the importance of meeting clients needs rather than making a profit. Over time, most of these drivers began to understand the difference and started responding in a positive way to the ideas behind a nonprofit organization.

Problems and Solutions

Community Support In the mid-1990s, Telecares Board of Directors was giving serious thought to closing the organization. As one Board member described the situation, What happened is that we (the Board members) sat down and realized that all of us didnt have the same goals and we werent all heading in the same direction. We decided that we needed to let those who were going in a dif-

Keys to Success and Replication

The experience of Telecare highlights the significance not only of establishing initial support for a program but also of ensuring that the program continues to receive internal and external support and that it responds to the changing needs of the community.

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Conclusion
Transportation planners and community leaders often concentrate exclusively on the availability of transportation services. However, a 1999 study by the Beverly Foundation identified not one, but 5 As of Senior Friendly Transportation availability, accessibility, affordability, acceptability, and adaptability. By attending to all five As, supplemental transportation programs for seniors can fill the gap in transportation services for seniors. Telecare meets the needs for senior-friendly transportation in several ways. It is available on

weekdays and weekends, during the daytime and evening, and riders can use it for trips of any purpose. It is accessible by offering door-todoor service. It is affordable to both riders and drivers as riders can purchase vouchers to cover up to half of the trip expense and the program reimburses volunteer drivers for their mileage. It is acceptable in that it is responsive to the preferences of seniors and places a premium on the courteousness and responsiveness of its drivers. It is adaptable in meeting riders needs and provides a range of different vehicles that can accommodate a riders special equipment requirements.

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STP Case Study

INDEPENDENT TRANSPORTATION NETWORK (ITN)

90 Bridge Street Westbrook, Maine 04092 Tel: 207 834-0505; Fax: 207 854-1026 Contact: Katherine Freund

20 Reasons to Use ITN (Written by a riders family who wanted to encourage her to stop driving.) The car is always warm when you get in. You always get to ride in the front seat. You get to talk to someone. You can order the driver around. You can sleep while you drive. You dont have to worry about parking. You never have to ask someone to fix a flat tire. You dont owe any money if theres an accident. You dont have to buy insurance. You dont have to vacuum or wash your car. You dont have to pay for parking tickets. You dont ever have to drive in snow or ice or bad weather. You can drink alcohol with dinner when you go out. You dont have to drive at night. You are delivered door-to-door and never have to walk. You never get lost. The drivers sometimes turn into friends. You get your packages carried into the house. You get escorted to the door. You arrive at your destination relaxed.

The Environment
Location The Independent Transportation Network (ITN) is located in Westbrook, Maine. Westbrook is located near the southern coast, west of Portland, Maines largest city. It is 50 miles north of the Maine/New Hampshire border. The population of greater Portland is approximately 277,202. About 14 percent (or 37,968 people) are aged 65 or older, and close to half of the elderly (or 17,878 people) are at least 75 years old.

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Transportation Options The Greater Portland METRO, the South Portland Bus Service, the Regional Transportation Program (RTP), and ITN are several of the specialized transportation services in the community. The Greater Portland Transit District, or METRO, is a scheduled, handicapaccessible, public bus system that serves the Greater Portland Area, Westbrook, and some of South Portland. The South Portland Bus Service is a scheduled, handicap-accessible, public bus system that serves the Greater South Portland Area and Portland. Its service area originates in Cumberland County but will take people to locations outside the county if necessary. RTP is a nonprofit, scheduled and on-demand, curb-tocurb, senior bus service that serves Cumberland County. Several taxi services also are available, which charge on a per mile basis with an initial pick-up fee.

feasibility study; from the American Association for Retired Persons (AARP) for a study of volunteerism in ITN; and from the Federal Transit Administration (FTA) for its operational costs. Later, the TRB provided additional funding to study innovative payment plans and the use of intelligent transportation system (ITS) technology to make senior transportation more efficient.

Organizational Features
The Model Supplemental transportation programs for seniors can be independent organizations or can be operated as part of larger umbrella organizations. Within these two organization types, there are four models for providing transportation services: Sole-service Programs - provide only transportation Multi-service Programs - provide a menu of services, including transportation Contract Programs - contract with outside transportation providers Coordinating Programs - coordinate transportation for several organizations. Organizational Relationships ITN is a nonprofit independent organization. It is not currently working under any other umbrella organization, although it has created the National Endowment for Transportation for Seniors, which will eventually subsume ITN. The ITN Board of Directors makes policy and funding decisions and the Council of Advisors provides advice on national development efforts. ITN identifies itself as having five types of relationships: with volunteers, customer-members, non-customer members, businesses, and the adult children of customers. Volunteers are an integral component of ITN and comprise a large share of the drivers in the program. The bulk of ITN customers are members aged 65 or older or

Program Purpose
ITN is a nonprofit, on-demand, door-to-door, senior transit service. Rides are booked by customers in advance or when needed and are paid for through prepaid accounts. ITN provides transportation for people who have the means to meet essential and other transportation needs but may not have the capacity to drive and may not want to trouble family members or friends for help. ITN provides rides in automobiles driven by both paid and volunteer drivers. History From inception, ITN was conceived as a model for a national solution to the problem of keeping Americas aging population mobile. Its creator designed ITN within the conceptual framework of national policies on education and alternative transportation. In 1992, she began writing funding proposals to turn what had been a graduateschool project into a working transportation service. In 1996-97, ITN received funding from the Transportation Research Board (TRB) for a

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who are visually impaired. ITN has developed innovative relationships with local businesses and with the adult children of customers (often their caregivers) who benefit from the program and are willing to help to pay for rides. ITN has raised additional revenue through these relationships.

Dispatchers, a Business and Community Development Director, a Volunteer Coordinator, a Finance Director, and a Receptionist Clerk. Staff members are responsible for organizing and implementing the day-to-day operations of ITN and for maintaining an active grant-writing, research, and national development agenda. Rider Eligibility To use ITNs services, an individual must be aged 65 or older or visually impaired, must become a member of ITN, and must live within the ITN service area. Annual membership is $20. For this fee, members receive access to the service, a bi-monthly newsletter, and a yearly gift certificate on their birthday. Members are required to sign an informed consent form that allows ITN to use demographic and ride information for transportation research. There are essentially three ways in which rides are planned: (1) standing transportation appointments; (2) one-day advance reservations; and (3) same-day ride reservations. Almost all rides (97 percent) are scheduled at least 24 hours in advance. There is a discount for advance scheduling. The scheduling and dispatching process is as follows. First, the member calls the service to schedule the ride. Second, the reservation is entered into the system. Third, the dispatcher arranges a schedule. Fourth, the dispatcher assigns the schedule to the drivers (paid drivers receive a written schedule, while volunteer drivers receive the information over the telephone). Marketing ITNs marketing approach identifies members of the community who benefit when older people have mobility and then builds a program to create a voluntary revenue stream around that relationship. ITN has devised many innovative payment plans using this approach including the Gift Certificates from Adult Children plan and the Merchant Participation plan.

Program Operations
Transportation Services The ITN service area stretches from Kennebunk, north to South Freeport and east/west in a 15mile radius of Portland and a 15-mile radius of Saco/Biddeford. While Portland is a highly developed area with many public transportation options, the majority of the service area is made up of small, rural communities that have little or no public transit. Many residents live far from their town or city center and are not within comfortable walking distance of necessary health facilities, social services, grocery stores, and pharmacies. ITN is available seven days a week, 24 hours a day. Rides are provided in private automobiles by 135 volunteer and 10 paid drivers. According to staff, the drivers (paid and volunteer) are not difficult to recruit; there is virtually no difference in responsibility between the volunteers and the paid drivers, and they tend to stay with the program once they are involved. Volunteer drivers use their personal vehicles, and paid drivers use the seven automobiles owned by ITN. The vehicles are unmarked, except for a small placard with a logo that is placed in the window. Over 1,000 people are transported annually by ITN. Together they receive over 20,000 rides, or an average of 20 rides per customer, each year. Volunteers provide about 30 percent of the rides. Program Staffing Staff includes a President and Executive Director, a Research Assistant, a Director of Information Systems, an Operation Manager,

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ITN has also developed the Ride & Shop program, where merchants help to pay for rides for their customers; the Ride Services program, where private contracts are established with local merchants and organizations (for example, churches, assisted living facilities and businesses); and Healthy Miles, a similar program developed for health care providers. Many of these innovative payment programs were developed through the research grants that ITN received from TRB. ITN also has been the subject of various articles in the general media as well as in professional publications. Information on the program is also available on the Internet (www.itninc.org). Risk Management All paid and volunteer drivers are screened by ITN. Drivers are screened for criminal history, a valid driver license, driving record, and vehicle inspection and insurance. The volunteer coordinator also checks personal references and conducts a short road test. As part of the in-service training, new drivers are required to drive with an experienced driver for one day before they are allowed to transport passengers. They also receive training on how to help people with functional limitations and special needs and on procedures for lifting and transferring riders with wheelchairs. Drivers cannot be asked to lift more than 25lbs. The inservice training also covers information on mileage reimbursement. ITN has received a grant to expand its driver training activities. All ITN vehicles are insured with a $3 million policy (with a $500 deductible) to cover bodily injury, property damage, uninsured motorist, and collision. Medical coverage is $5,000 per person. Personal insurance is primary for volunteer drivers. ITNs insurance is activated if the volunteers coverage is not adequate.

Technology ITN has adapted an ACCESS database for entering requests and dispatching rides. A variety of user groups, such as dispatchers, marketing and financial staff, recruiters, researchers, and customers are able to use this systems features. The system allows a sample of people to be abstracted for research and analysis. Recently, it was used to determine outcomes for a study related to customer independence and selfreliance. Currently, the entire system, including its website, is being built into an Internet application using an SQL server as a database. When complete, the ITN Application Service Provider (ASP) model will be Internet based, for example with information available on ITNs communitybased solution for such programs as rideshare, monthly statements, merchant participation, and payments from adult children. ITN also has developed a new geographic information system (GIS) software package for dispatching and routing. The program was developed in collaboration with Environmental Systems Research Institute, Inc. (ESRI) in Redlands, California. The ITN program is capable of determining ridesharing arrangements and vehicle routing; dispatching volunteer before paid drivers; and calculating trip times, fares, and monthly statements.

Financial Considerations
ITN Budget ITNs annual budget exceeds $540,000. A substantial percentage of the budget comes from grants for pilot development. According to its Executive Director, ITN is attempting to develop tools for any community to use to support an economically sustainable senior transit service The purpose of this approach is to liberate senior transit from its dependence on operating subsidy from tax dollars and to liberate volunteer community transit services for seniors from the crushing burden of perpetually inadequate resources to meet the demand for service.

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FTA Support In 1997, ITN was awarded the first $700,000 of a $1.2 million grant from the FTA to set up a three-phase demonstration project that would create a model that could be replicated across the country. The goal was to develop a national, non-profit, community-based, economically sustainable, transportation solution for older people. The project has four objectives: (1) to create a sustainable model; (2) to address the needs of rural seniors; (3) to incorporate efficiencies of technology; and (4) to develop the tools and methodology for replicating this approach. ITN is still operating under this funding and is working toward this goal. The shaded areas in the chart below show the project elements to be addressed with the second part of the FTA deployment award ($500,000), which began in 1999. Rider Fees ITN derives additional funds from membership and rider fees. Rather than pay for rides when they happen, each member pays annual dues of $20.00 and makes an advance deposit of $20.00 to cover rides for the first month. (This advance should cover about three to four rides.) Service charges are tallied per mile, however no money is exchanged during rides. Members maintain a positive balance, their rides are debited from their accounts, and they receive a monthly statement. The average fare is $7 per ride. Riders actually pay only a percentage of the cost of their rides; the organization and community business associates subsidize the remaining balance. Also, for those who might have difficulty paying the entire fee, ITN has established a Roads Scholars program, which is supported by community groups and individuals. Mileage Reimbursement. At the end of each day, drivers submit a report on their occupied and unoccupied miles. (Occupied miles are when at least one passenger is present in the vehicle, and

unoccupied miles refer to times when no passengers are present.) Volunteer mileage reimbursement is tracked through the database. Volunteer drivers are reimbursed at a rate of $0.25 per mile for occupied miles. Many volunteers donate their mileage reimbursement back to ITN. For unoccupied miles, volunteers receive a credit in the transportation service. They may store this credit for themselves, for when they get older; or the mileage may be assigned to their family, friends, or others who need assistance. Ridership/Revenue Growth The chart below illustrates changes in ITNs ridership and revenue levels from 1997-2000. The data show that, since its inception, ITNs ridership and revenue have both grown significantly. The increase was especially rapid from 19992000, particularly in the case of revenue. In the near future, ITN will separate the Portland model from the national development effort. The entity that ITN created to explore and develop the national program is the National Endowment for Transportation for Seniors. It will take with it the functions of research, software development, policy analysis, national replication, and national fundraising. The remaining organization will have one primary goal: to complete the economically sustainable model. The ITN has moved from its former incubator home, over the Southern Maine Agency on Aging in Portland, to its own facility located in Westbrook, tripling its facility space.

Problems and Solutions

ITNs experience during the past six years has been one of growth and development of services, initiation of innovative research activities, and efforts to establish itself as a national model for senior transportation. Its greatest problem has been the development of a solid base of funding.

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Financial Vulnerability Supply versus demand has been the biggest challenge faced by ITN. As it adds new members almost daily, the demand for transportation services continues to grow. Since rider fees pay only a portion of the actual cost for operation, ITN relies on outside funding sources. Thus, ITN must continually develop innovative funding options to maintain its operations. Innovative programs such as Ride & Shop, Healthy Miles, and Ride Services have been developed to promote the organization as well as to provide financial resources. To date, efforts to expand funding have been successful. However, as demand for its service grows, ITN must find new ways to meet the needs of new members without draining current financial resources. Service Delivery One of the major problems faced by STPs involves trip dispatching and routing and the tracking of rides and costs. ITNs new GIS software package uses state-of-the-art logistics capabilities to dispatch and route rides and to track costs. The program will allow ITN to increase efficiency and reduce operating costs.

conceived as a focus for research, policy analysis, education, and fundraising for alternative transportation for seniors. ITN Technology The GIS software is the most important technology developed by the ITN. Beyond the usual functions of routing and dispatching, the ITN software incorporates payment plans and billing functions. It is expected to provide a model for other STPs and will be available on the Internet.

Conclusion
Transportation planners and community leaders often concentrate exclusively on the availability of transportation services. However, a 1999 study by the Beverly Foundation identified not one, but 5 As of Senior Friendly Transportation availability, accessibility, affordability, acceptability, and adaptability. By attending to all five As supplemental transportation programs for seniors can fill the gap in transportation services for seniors. ITN meets the needs for senior-friendly transportation in several ways. It is available to all seniors in the service area if they become members of the organization. It is accessible because seniors are picked up at their homes and are taken to any destination they choose within the service area. ITN does not discriminate on the basis of income. It is affordable because of its innovative payment programs (such as Ride & Shop, Rideshare, Road Scholarship, and gift certificates). It is acceptable to seniors because it offers a transportation alternative that closely resembles private transportation. Riders are helped to and from an automobile and are provided with a courteous service that caters to their needs. ITN is adaptable because its service is customized to the needs of seniors.

Keys to Success and Replication

ITN has the unique feature of being a transportation program for seniors who have the means to meet essential and other transportation needs. STPs across the country could benefit from emulating some of ITNs procedures. According to its Executive Director, Since five out of six of todays seniors have the good fortune to be above the poverty level, ITNs system of reasonable fare payment combined with voluntary community support has the potential to bring mobility and independence to many seniors. National Endowment for Transportation for Seniors (NETS). NETS, the latest concept to emerge from ITN, will be the umbrella organization under which ITN operates in the future. It is

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STP Case Study

LAUDERHILL TRANSPORTATION PROGRAM

1176 NW 42 Way Lauderhill, Florida 33313 Tel: 954 321-2453; Fax: 954 321-2460 Contact: Tina Hahamovitch Ruth Listerheim, an 86-year-old resident of Lauderhill, lost her husband four years ago. When he died, she did not feel comfortable driving any more, so she gave her car to her grandson. Ruth says she felt isolated and depressed. She was no longer independent. Her family did not live in the area and, therefore, could not give her much help. She could not afford taxicabs and hesitated to call on her neighbors to take her to medical appointments and grocery shopping. Ruth did not want to impose. Everyday living had become a real struggle. Since joining the Lauderhill Transportation Program, she says her life has improved. For example, when she had cataract surgery, the drivers picked her up and took her home, and she was able to get to her follow-up appointments without any problems. She also says she uses the program to go grocery shopping, banking, socializing, trips to local shopping malls, the flea market, or even to the beach. Having transportation has made life much easier for Ruth Listerheim than it was four years ago. are at least aged 75. In recent years, there have been major shifts in the population. Many residents have lived in the community for 20 or 30 years and have aged in place. As a consequence, much of the senior population has become very elderly and frail and live on limited incomes. Many live in condominiums, are homebound, have no families, and are in need of major services. Younger seniors and individuals with children are beginning to buy condominiums from those who have inherited them from a deceased parent. Transportation Options Broward County has a fixed-route bus system. The county also provides a demand-system paratransit program called TOPS for qualified residents. Applicants for TOPS must have their physicians complete a form outlining their dis-

The Environment
Location The city of Lauderhill, Florida is located in Broward County, about 10 miles west of Fort Lauderdale. It is almost a Z shape and is 7 1/2 miles tip to tip. According to the 1990 census, the city had an estimated population of 51,000. Of that total, about one-quarter are aged 60 and above and over 10 percent

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abilities and explaining why they cannot use the regular county bus system. TOPS picks applicants up, brings them to its location, interviews them, and tests their ability to walk up and down stairs as well as around the building. Applicants also are tested to see if they can learn to use the regular fixed-route transit. If qualified for the TOPS paratransit service, applicants are assigned to one of several providers. The fee for using TOPS is $2.00 each way. Although residents can use taxis or private drivers, these services are expensive and most elders either are unable or unwilling to spend the money.

Act (ADA) and those who no longer drive because of visual or physical impairments. Over time, it has become clear that many seniors who use the service cannot access other transportation options. They cannot walk to the bus stop, cannot wait in the sun and heat, and cannot get on the bus, let alone transfer from one bus to another. At the time that the transportation program was started, the senior community in Lauderhill was very powerful. A senior center had just opened and the director realized from talking with members that there was a need for senior transportation. Many seniors had recently stopped driving. Funding did not seem to be a major issue as there was considerable support from the newly created Department of Social Services and from the city administration.

Program Purpose
The Lauderhill Transportation Program serves seniors and children. It provides demandresponse, door-to-door transportation for older adult residents of Lauderhill. The program provides transportation for medical appointments, grocery shopping, banking, church, and trips that are conducted in conjunction with the senior center. Nonresidents who are members of the senior center are allowed to travel with the program on organized trips but must get to the senior center on their own. The Lauderhill Program is especially important because many of the seniors who use it cannot access the fixed-route bus system yet do not qualify for the TOPS program. History The program was started in 1982. Its purpose was to provide medical transportation to seniors who fell through the cracks because they were unable to get to the fixed-route service. It transported riders in a van at no charge. The city was divided into quadrants with each quadrant having its own day for service. While the program was run economically, people often had long waits in the doctors office because the program did not have a demand-response capability. Today, the program serves all seniors including: those who are disabled, yet do not meet the disability requirements of the Americans Disability

Organizational Features
The Model Supplemental transportation programs for seniors can be independent organizations or can be operated as part of larger umbrella organizations. Within these two organization types, there are four models for providing transportation services: Sole-service Programs - provide only transportation Multi-service Programs - provide a menu of services, including transportation Contract Programs - contract with outside transportation providers Coordinating Programs - coordinate transportation for several organizations. Organizational Relationships The Lauderhill Transportation Program only provides transportation; however, it is part of a larger organization. It was originally established by

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the Social Services Department, that now is a division of the Parks and Leisure Services Department. In addition to transportation, the Parks and Leisure Services Department is responsible for 12 parks. The Department also maintains all medians in the city and coordinates all sports programs, special events, after-school activities, and social services. The Lauderhill Transportation Program is physically located within the Lauderhill Community Center. The center offers daily programs to seniors and children and hosts community meetings in the evenings. In addition to the demand-response transportation that the program provides to seniors, it also transports children to: summer camp; school-out programs; holiday camps at Christmas and Easter; Optimist Club sports programs, such as football, basketball, and soccer; track and field clubs; swim team events; after-school programs; and kiddie co-operatives. It also handles special transportation requests by city departments and park-and-ride shuttles for special events. The program also has service relationships with the Boys and Girls Clubs and Smart Charter School. While the program itself might be described as intergenerational, the services that are provided do not tend to integrate the generations. There is no advisory committee for the Lauderhill Transportation Program, nor is there an advocacy group. According to the Director, seniors are the best advocates for the program. The Area Agency on Aging (even though they could be seen as a competitor) and the Mental Health Association also are considered advocates.

Program Operations
Transportation Services When the program started, it had one brokendown, roach-infested vehicle.According to staff, the transportation was not comfortable. The vans were not air-conditioned, and people had to climb over a hump to reach the back seats. Today the program has seven vehicles: two 10passenger vans with tie downs for two wheelchairs; one 14-passenger vehicle; two 20-passenger vehicles; and two 45-passenger vehicles. In addition to being able to serve people with disabilities and active older adults, the programs fleet allows it to accommodate large groups as well as individual riders. There are 775 registered senior riders in the program, who receive 19,054 one-way rides annually. The program also includes 1,244 children who annually receive 6,742 one-way rides. The service area includes locations within and beyond the borders of the community. Lauderhill has very few medical offices and shopping centers, so it is frequently necessary for residents to travel to neighboring communities. According to the scheduling staff, the programs door-to-door demand service is almost like a taxi service. Most transportation takes place on weekdays. However, senior trips also take place on weekends and in the evenings. Reservations for trips to the senior center are based on the booking deadlines for the trip destination. The program requests that reservations for medical transport be made two weeks in advance. Other requests can be made the day before. The program does not take same-day requests unless they are for medical emergencies, which are confirmed with the doctor. Trip scheduling is simple. For example: Ms. Jones calls the program; she is asked for her social security number; she is scheduled for a ride 30 minutes in advance of her appointment;

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the appointment is put into the computerized scheduling system; the route schedules are prepared for the drivers; and drivers are assigned to the various routes. Program Staffing In 1988, the programs staff consisted of volunteers and one transportation aide. Today, the programs staff includes one full-time transportation coordinator, one part-time scheduler, one part-time dispatcher, one full-time driver, and four part-time drivers. The program budgets for 240 driver hours per week. Due to hiring freezes, the part-time scheduler position is currently vacant. Rider Eligibility Senior riders must be aged 60 or over and must be residents of Lauderhill. The process for registering new riders is as follows: a senior calls to request transportation; one of the schedulers provides a short verbal history of the program and tells the caller about procedures for arranging transportation; an appointment is made for an interview; the senior is picked up for the interview and returned home at no charge if they have no other transportation; the senior is asked for an ID to prove his or her age and place of residence; a registration form is completed with their name and emergency information; brochures are provided that explain how to make an appointment; and vouchers are made available for transportation. Risk Management Riders must sign a hold harmlessform in order to utilize the program. Insurance is provided by the city, which is self-insured. Insurance company personnel are available to answer seniors questions and address any concerns. The program has had two accidents that have needed to be resolved by an insurance company. In order to be hired, drivers must have a commercial class B driver license with a P (passenger) endorsement and have experience with air

brakes. The commercial driver license (CDL) requirements make it difficult for the program to get qualified drivers, so the program must hire many part-time staff. At the same time, it has been difficult to keep part-time staff because they receive no paid benefits. Before any driver is hired, his or her DMV and background records are checked. Drivers receive behind-the-wheel training, part of which is adjusted to reflect past driving experiences. The training lasts two weeks, during which time a trainee rides with an experienced driver to learn routes, rules, and procedures for transporting elderly and disabled people and for managing wheelchair lifts. CPR and first aid instruction are also provided, and Fire Department staff members train the drivers in the use of extinguishers and on how to get passengers out of the vehicles in an emergency. After two weeks, new drivers are evaluated and, if need be, are given an additional week of training. Ongoing training includes safety workshops to provide updated information. Technology The Lauderhill Program is currently using a computerized program called Route Logic for trip scheduling. However, the staff is in the process of changing to Paralogic, which organizes scheduling by priority, time, and mileage. Paralogic is used by many transit and paratransit systems throughout the country, and it is expected to make scheduling easier.

Financial Considerations
The Lauderhill Program Budget The Lauderhill Transportation Program has an annual budget of $226,497, with most of its funding coming from the city. The budget for the Parks and Leisure Services Department is $4,031,909.

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City Tax Support In the early years of the Lauderhill Transportation Program, vehicles were purchased through UMPTA (Urban Mass Para Transit Authority). Additional funding for the programs capital and operating expenses came from city tax dollars. Today, the UMPTA option no longer exists, and funding for the programs capital and operating expenses comes from the citys budget. Fully 86 percent of the programs budget is funded by the city. The city of Lauderhill recently applied for county funds to set up a community shuttle that will serve as a feeder line into the main county lines. When the community shuttle starts, it will be supported by county funds and city tax dollars. The county encouraged cities to apply to fund the shuttle because the feeder lines will enable them to streamline their fixed route systems. City residents will be able to transfer across city boundaries via the county service. For Lauderhills seniors who are able to walk to the local bus stop, the new feeder line will be a great asset. They will have more flexibility in the choosing when to travel. Those who are unable to walk to the bus stop will be able to use the Lauderhill Transportation Program for door-todoor service. Rider Fees Transportation fees also fund the program. When rider fees were first initiated, a one-way ride for a senior was $0.50. Recently, the fee was increased to $1.00. There is a $3.00 charge for senior mini-trips to, for example, the beach, restaurants, and malls. When seniors need transportation to volunteer, they ride free; aides and caregivers also travel free. Friends must pay the usual fee. Senior residents can purchase Trip Passes for $10.00, to cover 10 one-way rides. Because they are on limited incomes, most seniors purchase one pass at a time. However, they are encouraged to purchase an extra pass because drivers

cannot accept cash and cannot provide transportation to someone without a pass. The program attempts to schedule shared rides whenever possible. Buses usually are not filled to capacity when transporting seniors to medical appointments, but they are filled when transporting children to and from their activities. Consequently, the average cost per ride for seniors is $9 compared to $2 for childrens trips.

Problems and Solutions

Political and Economic Vulnerability The Lauderhill Transportation Program has been supported by public funds for many years. The population it serves has grown considerably in recent years as has its funding and the number of vehicles available for service. Also, because of the reorganization of services within the community, its target audience has been expanded to include children as well as seniors. However, as the county and city leadership reevaluates the communitys needs and develops plans for expanding transportation services, it is imperative that they recognize the value of the Lauderhill Transportation Program. The message must be conveyed that there are seniors who are unable to use public transit and require the more personalized services that this program offers. At-risk Seniors Many seniors have serious physical or cognitive limitations that preclude them from using even the specialized services offered by Lauderhill Transportation Program. Some of their basic needs are going unmet. To help solve this problem and to create a link between seniors and youth, the programs staff members are working with the Mental Health Association to develop an intergenerational community service program. The plan is for teenagers to shop on weekends for seniors and to be transported in the programs buses. The goal is not only to meet the physical

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needs of seniors but also to provide them with some emotional nourishment.

Keys to Success and Replication

The Lauderhill Transportation Program has a long history of providing transportation to seniors in the community and has the unique characteristic of being an intergenerational program. As a government agency, many of its features may be difficult for nonprofit organizations to replicate. However, its approach to community support and program marketing are notable. Community Support Strong community ties and good relationships with funding sources are critical elements for the survival of any STP. This is especially important for a government-sponsored program such as the Lauderhill Transportation Program, where the host agency has other constituencies and there are other programs that provide rides to seniors. However, existing public and paratransit alternatives do not meet the needs of all seniors in the community and are unable to adequately address their quality of lifeissues, let alone their travel needs. Program Marketing No STP can thrive if potential users are not aware that it exists. Conveying information about the program often requires more than responding to telephone inquiries, distributing fliers, or printing advertisements. In the case of

the Lauderhill Transportation Program, it has been necessary for drivers to visit condominiums that contain large concentrations of seniors so that they can personally promote and explain the program.

Conclusion
Transportation planners and community leaders often concentrate exclusively on the availability of transportation services. However, a 1999 study by the Beverly Foundation identified not one, but 5 As of Senior Friendly Transportation availability, accessibility, affordability, acceptability, and adaptability. By attending to all five As supplemental transportation programs for seniors can fill the gap in transportation services for seniors. The Lauderhill Transportation Program meets the needs for senior-friendlytransportation in several ways. It is available to senior residents who make reservations two weeks in advance for medical appointments and one day in advance for other purposes. It also is available to nonresidents involved in trips sponsored by the senior center. It is accessible because it provides doorto-door service and because the programs vans meet ADA requirements. It is affordable since riders pay only a nominal fee. It is acceptable because it transports seniors in vans, which they have indicated they often prefer to cars since they can socialize with more fellow passengers. It is adaptable in that same-day service is possible in the case of emergencies.

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STP Case Study

RIDE CONNECTION, INC.

2145 NW Overton Portland, OR 97210 Tel: 503 413-8924 Fax: 503 413-8927 Contact: Elaine Wells, Executive Director Charles and Ashild Zumwald have been married for 68 years. When health problems forced Ashild to move to a care center facility, it was not close to their home. Charles no longer drove, there was no nearby public transit route, and he could not afford daily taxicab rides. Fortunately, he found out about Ride Connection and has been using this service ever since. Because of Ride Connection, Charles is able to visit his wife every day. His daily visits have helped both him and Ashild adjust to her residential relocation. A 1998 Oregon Department of Transportation study estimated that 11 percent of households in the state have at least one individual with mobility impairments. Extrapolating from this figure, the number of disabled residents that live in Ride Connections service area totals 51,000. Statewide, of those with mobility impairments, 76 percent report finding it difficult to use fixedroute services, and 44 percent report having difficulty getting access to the kind of transportation that they need. Transportation Options Tri-County Metropolitan Transportation District (Tri-Met) is a municipal corporation that provides public transportation for much of the three counties in the Portland, Oregon metropolitan area. Tri-Met operates a 33-mile Metropolitan Area Express (MAX) light rail line, 101 bus

The Environment
Location Ride Connection, Inc., is located in Portland, Oregon. It coordinates paratransit services in Clackamas, Multnomah, and Washington Counties. About 42% of the states residents live within this tricounty metropolitan area in Northwest Oregon. Multnomah County is the most urban and heavily populated, with a population of 633,224, followed by Washington County, the most rural, with 409,305 residents. Clackamas County has 338,251 residents. About 11 percent of the population (153,031 people) in the tri-county area is aged 65 years or older. Roughly 55,800 households in metropolitan Portland provide care to an older family member. This number is projected to rise to 68,805 by 2010.

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routes, and a LIFT paratransit program that services seniors and the disabled. Because of the Americans with Disabilities Act (ADA), priority for the LIFT program is given to people who live within the ADA corridor (in other words, within three-quarters of a mile of the fixed-route system).

highlighted the importance of coordinating existing transportation services provided by local social service agencies and of supporting volunteer programs to supplement the transit systems special needs service. In response, Tri-Met commissioned a study that was conducted by Crain and Associates from California. The study supported the citizens group recommendations and suggested a nonprofit organization be developed to coordinate existing services. Several factors influenced this conclusion: the desire to serve people with special needs with a more adaptable and accessible service than traditional mass transit; the opportunity to make cost savings by using volunteers and collaborative techniques; the reduction of administrative responsibilities in working with a large network of community agencies; and a nonprofit agency would be eligible for funding not commonly available to public agencies (through foundations, corporations, businesses, and individuals). Tri-Met hired a consultant to design the program. The program was founded in 1986 under the auspices of Tri-Met. A request for proposals was released to identify organizations that were interested in participating in the network. Initially, six organizations were included. In 1988, the program was incorporated as a private nonprofit organization under the name of Volunteer Transportation, Inc. The consultant was hired as the agencys first Executive Director. In 1999, the organization was renamed Ride Connection, Inc.

Program Purpose
Ride Connection, Inc., comprises a network of transportation providers that receive public funding to complement the ADA service provided by Tri-Met. These providers offer rides primarily to the elderly and people with disabilities, but some programs (in rural Washington County) also transport young people and others who lack transportation options. Rides are available for medical appointments, social service needs, shopping, employment, volunteer work, and recreation. Ride Connection promotes the stability and growth of its providers by offering them technical support, advocacy, and resource development. It coordinates system-wide driver screening and safety programs and supplies operational and capital funding to the providers. In addition to coordinating direct transportation services, Ride Connection provides travel training to promote the use of public transportation by seniors, people with disabilities, and people with low incomes. History Studies of the communitys needs were partially responsible for the creation of Ride Connection. A study prepared in 1977 for what was then the Urban Mass Transportation Authority (now the Federal Transit Administration) provided initial evidence on unmet transportation needs among elderly people and people with disabilities. Subsequently, in 1985, Tri-Met invited a citizens group to provide input and recommendations about how to meet this need. The group

Organizational Features
The Model Supplemental transportation programs for seniors can be independent organizations or can be operated as part of larger umbrella organizations. Within these two organization types, there are four models for providing transportation services:

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 Sole-service Programs - provide only transportation Multi-service Programs - provide a menu of services, including transportation Contract Programs - contract with outside transportation providers Coordinating Programs - coordinate transportation for several organizations. Organizational Relationships Ride Connection is a 501(c)(3) private nonprofit organization governed by a Board of Directors. According to its bylaws, the Board must consist of a minimum of seven and a maximum of 15 members. Each county that is served has more than one representative on the Board. Since a major goal of the organization is to broaden its financial base by developing new funding sources, people with fundraising and development expertise are recruited for the Board. Other attractive characteristics for board members are transportation expertise and knowledge about needs of seniors and the people with disabilities. Ride Connection has also established four advisory committees comprised of staff, Board members, service providers, and representatives from other organizations. These include: The Fund Development and Marketing Committee, which provides counsel on resource development and marketing strategies. The Vehicle Procurement Committee, which gives advice on vehicle procurement as part of the vehicle loan and vehicle-sharing programs offered to network providers. The Quality Improvement Committee, which acts as an advisory committee to the Board on safety and training issues. The Peer Review Committee, which reviews motor vehicle collision and violation reports for

drivers who are part of the network and makes recommendations to the Board on continued driver eligibility and training.

Program Operations
Transportation Services Ride Connection includes providers that serve a mix of urban and rural areas. Collectively, they involve about 500 volunteer drivers (mostly retirees) and 100 paid drivers. Drivers use personal or agency vehicles to transport riders. Because volunteers are less enthusiastic about driving during rush hour, paid drivers provide most early-morning and late-afternoon rides. In 1999, Ride Connection programs provided a total of 198,000 rides to 7,000 different riders. There was some seasonal variation in requests for rides, with less demand in winter months. Due to a lack of drivers and vehicles, at least 20 percent of rider requests go unmet. Collectively, Ride Connection providers have a fleet of over 200 volunteer-owned passenger vehicles, 13 accessible minivans, and 42 minibuses with wheelchair lifts. Taxis are also available through the five participating cab companies. Most of the providers can provide an escort when needed. Usually, the escort is a different person from the driver. Program Staffing Ride Connection has a full-time Executive Director and 11 full-time and part-time employees. Specific jobs include Administrative Manager, Program Development Manager, Volunteer Recruitment Manager, Contract Manager, Fiscal Manager, Fiscal Assistant, Lead Dispatcher, Dispatcher, Program Records Clerk, Driver Training Coordinator, and Clerical Assistant.

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Service Relationships Currently, 32 providers belong to the Ride Connection network. Providers sign a contract with Ride Connection and are required to comply with specific operating standards and procedures. In return, they have immediate access to technical support on a range of operational issues, including driver screening criteria, training policies, and safety programs. Ride Connection also helps them with fund development, advocacy, marketing, and networking. Rider Eligibility Ride Connection provides rides to individuals who reside in the tri-county service area, who are aged 60 and over with no other viable transportation, who are unable to use public transit in the maintenance of life-sustaining activities, and who are unable to access public transit. Eligibility information is self-reported and is not verified by the organization or its providers. In the case of rural Washington County, rides also are available to the general public, for example to parents and children for school or after-school activities and to low-income residents for rides to their jobs. When the general population uses the service, they usually need rides to and from public transit stations. Callers must request rides directly with service providers. If the person contacts Ride Connection, the operator asks where the caller is located and gives a referral to the closest provider(s). When callers register with the provider, they provide their name, address, major cross street, telephone number, and an emergency contact name and phone number. They are asked about their health and mobility, including whether they use a walker, wheelchair, cane, or scooter. In addition, they are asked whether they will have an escort riding with them. Information on race/ethnicity, date of birth, number of household members, and annual income is optional and is collected to meet the requirements by some of Ride Connections funding agencies.

After the caller is registered, he or she may request a ride at any time. Although different providers have different procedures, callers are encouraged to make reservations as far in advance as possible; same-day requests are accepted if openings exist. When requests are made, callers provide their name, address, a telephone number at their destination, their doctor or therapists name (if applicable), the appointment time and date, and their expected return time. A scheduler reviews the request and matches it with a vehicle and driver. The caller is then contacted to confirm that the ride will be available. In rural Washington County where there is a central dispatch office, the software program called PASS Lite, created by Trapeze, is used for scheduling and dispatching. Ride Connection uses Microsoft Access for its system-wide database. There are plans to centralize all scheduling and dispatching for providers in the future and to standardize databases and reports using PASS software. Marketing Efforts Sources of advertising include a website, newspaper articles, and a program newsletter that Ride Connection publishes four times a year. Individual providers also produce newsletters and flyers that they distribute independently. Risk Management Ride Connection has developed an Operations Manual containing policies, procedures, and guidelines for screening and training both paid and volunteer staff. The manual aims to ensure the safety of riders and to protect the organization from legal actions involving negligent hiring practices. To be a paid or volunteer driver, applicants must be at least 23 years of age with at least five years of driving experience. They must show proof of a valid drivers license and have an excellent driving history as evidenced by a certi-

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fied court report of the DMV driving record. Their driving record must not include more than two moving violations or preventable collisions (or a combination of the two) during the previous three years. Drivers may not have an uncontrolled chronic illness, such as epilepsy, diabetes, or a heart or respiratory problem, and may not have an alcohol or drug problem. When requested, they must provide a physicians statement qualifying them as physically able to drive and must pass a drugs screening test. Ride Connection obtains an Oregon Criminal Record Check with a 10-year history for each applicant. If the criminal record check is acceptable, the applicant provides his or her fingerprints, which are then subjected to a National Criminal Record Check. A provisional acceptance for employment is granted pending acceptable results from the National Criminal Record Check. If the driver will be using his or her own personal vehicle, proof of insurance must be verified. Applicants who are approved to drive are enrolled in the DMV flag system, which alerts Ride Connection when a driver has been involved in a collision and/or moving violation. Ride Connection notifies providers when a driver is no longer eligible to drive. When more than two moving violations or collisions are reported, the case may be referred to Ride Connections Peer Review Committee. Prior to transporting riders in an agency vehicle, all volunteers and employees are required to complete vehicle orientation and wheelchair securement training. Also, regardless of whether they will be using a personal or an agency vehicle, they must take an on-road driving test. Within six months of their initial driving assignment, they must complete a series of more extensive training sessions. First, they must complete a Mobility Awareness and Assistance Program, which lasts for four hours and emphasizes spe-

cial needs transportation. The program offers a basic explanation of some of the physical and physiological disabilities and impairments that may affect riders and provides tips on how to communicate and interact with people. It also provides training on how to deal with exposure to blood-borne pathogens. Drivers must repeat this program every three years. Second, drivers must complete a DMV-approved classroom defensive driving course. If the applicant is younger than 55 years old, there is an option of enrolling in a four-hour or eight-hour program. The longer program is required of drivers who are 55 years of age or older; it emphasizes the changes that accompany the aging process and the impact these changes can have on driving. Both programs review basic defensive driving principles and traffic safety laws, including any recent changes in laws. Drivers under the age of 70 must repeat the defensive driving training every three years, and those aged 70 and over must repeat it every two years. Drivers also are required to comply with vehicle inspection and maintenance procedures. Daily pre-trip inspections are mandatory for agency vehicles and are recommended for personal vehicles. All vehicles, including personal vehicles, must contain a body blood precaution kit. Inspections for agency vehicles must be documented and kept on file.

Financial Considerations
The Ride Connection Budget The total annual budget for Ride Connection exceeds $5.6 million. Fully 58 percent of its budget is allocated to its providers. An additional 21.6 percent covers expenses for purchasing vehicles for the vehicle-loan program. Ride Connection incurs no rental costs due to the inkind contribution of office space by Legacy Health System.

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Core Funding Ride Connection receives the majority of its grant revenues from the State of Oregon through its Department of Transportation, Public Transit Division, and from Tri-Met. Capital funding for 90 percent of the cost of vehicle purchases comes from the Oregon Department of Transportation (Section 5310), and the provider is required to obtain 10 percent of matching funds from the county. Rider Fees Other than in rural Washington County, there are no required rider fees. Donations are accepted, and Ride Connection returns these donations to the transporting provider. Some riders do not provide a donation and among those who do make a donation, the average is under $0.50 a ride. In rural Washington County, where eligibility is extended to the general community, the fee structure for one-way rides is $0.50 for riders over the age of 12 and $0.25 for young children. Mileage Reimbursement Volunteer drivers record time and mileage and submit monthly reports for reimbursement. The reimbursement rate is $0.325 a mile.

lion) for the next two years. Ride Connection was awarded $2.4 million of this amount. Before receiving the funds, Ride Connection must develop strategic plans to show how the additional money will be used. These plans will be critical when the time comes to go back to the legislature and prove that the increased funding was put to good use. System-wide Coordination There are wide differences in resources, capabilities, and needs of the 32 providers, which presents challenges in terms of standardizing and integrating their activities and procedures. Ride Connection has made it a priority to be responsive to individual providers, yet at the same time it has systematized and coordinated many key activities. For example, it has developed and implemented model screening, training, and performance policies and methods. It has begun to centralize scheduling and dispatching and has begun to coordinate monitoring and reporting systems. This has increased the programs efficiency and effectiveness and has reduced redundancy and costs. For customers, the result has been an affordable service, improved safety and security, and access to transportation that can cross community boundaries.

Keys to Success and Replication Problems and Solutions

Political and Economic Vulnerability Historically, financial support to meet the special transportation needs of seniors and people with disabilities has been lacking in Oregon. To educate legislators and gain their support for increased state funding, Ride Connection participated in a coordinated advocacy network during the past legislative session. The network commissioned a study that demonstrated that an estimated $54 million was needed to provide special transportation statewide. As a result, funding was increased to $19 million (up from $12 milThe success of Ride Connection highlights the benefits of coordinating transportation services within a community and of centralizing the administrative functions of several providers. It also emphasizes the importance of understanding the needs of riders and the capabilities of the providers. The important role of volunteers in delivering services and the importance of driver screening and performance standards are underscored by the Ride Connection success. Driver Standards It is essential to have documented screening, training, and performance standards that apply

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both to paid and volunteer drivers. This not only safeguards the drivers but also reduces the risk for riders and other road users. It is especially important when transporting seniors since their increased frailty makes them more vulnerable to complications in the event of being injured in a collision. Having risk management measures in place demonstrates that the organization is responsible and is taking steps to minimize its exposure to risk and liability. Future Rider Needs A collaborative effort is underway for special transportation planning in the tri-county area. The regions Area Agencies on Aging, Tri-Met, and the Special Transportation Fund Advisory Committee are coordinating a broad-based effort to create a regional transportation services plan for the elderly and disabled. An Elderly Disabled Transportation Plan Steering Committee has been set up, comprised of 25 representatives from senior and disability advocacy groups, agencies, advisory committees, service providers and clients, including Ride Connection. Over the next year, the Steering Committee will produce a vision statement for elderly and disabled transportation; assess the need for transportation over the next decade; formulate a service, capital, finance, and implementation plan; and look at issues of coordination within the region.

Conclusion
Transportation planners and community leaders often concentrate exclusively on the availability of transportation services. However, a 1999 study by the Beverly Foundation identified not one, but 5 As of Senior Friendly Transportation availability, accessibility, affordability, acceptability, and adaptability. By attending to all five As supplemental transportation programs for seniors can fill the gap in transportation services for seniors. Ride Connection meets the needs for seniorfriendly transportation in several ways. Providers are available on weekdays and some weekends. It is accessible, as door-to-door transportation is provided. It is affordable, as no fee is required and volunteer drivers are reimbursed for mileage. It is acceptable to the clientele, as drivers are expected to comply with vehicle inspection and maintenance standards and are trained to be sensitive to the needs of riders. It is adaptable by being able to accommodate special equipment and provide escorts. The story of the birth and development of Ride Connection is one of evolution and collaboration, of identifying needs and filling them, and of recognizing opportunity and building on it.

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STP Case Study

TRANSPORTATION REIMBURSEMENT AND INFORMATION PROGRAM (T.R.I.P.)

6296 Rivercrest Drive, Suite K Riverside, CA 92507 Tel: 909 697-4697 Fax: 909 697-4698 Contact: Richard Smith, Executive Director

Ida Butler lives in Sun City, California. She is 79, has a limited income, and lives alone. Her husband died about 10 years ago, and she has no family in the area. Ida has had heart trouble for the past five years. Three years ago she had to give up driving when she could no longer afford to maintain her car. She has become so frail that it is nearly impossible for her to use normal public transportation. Before Ida started using T.R.I.P., she found it difficult to ask neighbors to drive her around. However, now that she has some money from T.R.I.P. to reimburse them for their gas expenses, she has been able to find a great driver and finds it much easier to ask for help. She says she can get to the grocery store, the pharmacy, and even the senior center when she needs to, but she says she tries to plan her trips to coincide with trips that her driver is making anyway. About once a month, Ida sends a $5.00 bill in the mail to T.R.I.P. with a note saying she wants to do what she can to help support the program because it has meant so much to her quality of life.

is considered a rural area. The county of Riverside is the fourth largest in California, stretching nearly 200 miles long and comprising over 7,200 square miles of fertile river valleys, low deserts, mountains, foothills, and rolling plains. While the countys history is linked to the agriculture industry, in recent years, commerce, construction, manufacturing, and tourism have resulted in dramatic population growth. Between 1980 and 1990, the number of residents grew by over 76 percent, making Riverside the fastestgrowing county in California. In 1999, it had an estimated population of 1,530,653, of whom 12.5 percent (or over 191,000 people) were aged 65 or older.

The Environment
Location T.R.I.P. is located in Riverside, California. The city of Riverside is about 60 miles from Los Angeles in a valley at the base of the Box Springs Mountains. Despite its proximity to Los Angeles, it

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Transportation Options The transportation options in Riverside County include: the Riverside Transit Agency in West Riverside County (fixed-route and Dial-A-Ride), the SunLine Transit Agency in the Coachella Valley (SunBus, SunDial, and SunLink to the West County), and supplemental transit programs, including T.R.I.P. According to several participants in the T.R.I.P. program, it is impossible for many older people to use the countys fixed-route system and even the Dial-A-Ride program for two reasons: the services are difficult to access, and they do not provide escorts.

Getting the program started took commitment and advocacy from many organizations. Initially, there was a feeling within the community and the government that good neighbors provide rides without being reimbursed. Some residents were fearful that people would rip offa reimbursement program. In addition, there was an ongoing struggle within the county concerning how the pot of transportation money that was available should be divided among fixed rail, bus transportation, specialized programs, and new programs. In 1993, a committee of the Board of Supervisors voted to fund senior transportation through the Riverside County Office on Aging. The following year, the senior transportation effort was transferred to an existing nonprofit organization (the Partnership to Preserve Independent Living for Seniors and Persons with Disabilities), and a new program called T.R.I.P was established.

Program Purpose
T.R.I.P. targets those who are truly deprived of transportation frail seniors and people with disabilities who have no other form of transport available and who would be homebound and unable to access health services or otherwise provide for their daily needs. T.R.I.P. provides transportation for seniors for local errands such as grocery shopping, doctor visits, and personal appointments by volunteer drivers. Local travel in Riverside County can often mean trips as far as 50 miles from West Riverside County and the Coachella Valley or over 100 miles from Blythe. Riders receive money from T.R.I.P. to reimburse their drivers for their mileage. T.R.I.P. also provides seniors with information and referrals to other public and specialized transportation services throughout Riverside County. History The T.R.I.P. program is an outgrowth of a community planning effort. In the 1980s, interested parties were invited to a meeting to assess consumer needs in the county; specialized transportation was identified as an unmet need. When the idea of the program was presented in public hearings throughout the county, it received consistent support.

Organizational Features
The Model A supplemental transportation program for seniors can be operated either by an independent organization or be part of a larger umbrella organization. Within these two organization models, there are four models for providing transportation services: Sole-service Programs - provide only transportation Multi-service Programs - provide a menu of services, including transportation Contract Programs - contract with outside transportation providers Coordinating Programs - coordinate transportation for several organizations.

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Organizational Relationships T.R.I.P. is located within the nonprofit 501(c)(3) organization, The Partnership to Preserve Independent Living for Seniors and Persons with Disabilities. The Partnership was incorporated in 1989, and was originally called the Senior and Disabled Citizens Coalition. Created by the County Office on Aging, the Coalition was an active supporter of the Americans With Disabilities Act and was involved in gaining support for the bill prior to its passage into law. The Coalition had close ties not only with the aging community but also with transportation providers in the county. When the nonprofit decided to provide funding for the volunteer driver reimbursement program, it also provided a convenient home for the newly formed T.R.I.P. In addition to T.R.I.P., the Partnership to Preserve Independent Living is home to Vital Connections (a web portal that presents education, information, and resource links); Health Education Video Program (a video production service); and Meeting the Challenges Quarterly (a free publication for seniors and people with disabilities).

and returns the form; if an application is not returned within 30 days, T.R.I.P. makes a followup call to determine why the application has not been returned and assists the senior as needed in completing the form; the completed application is reviewed by the T.R.I.P. eligibility review committee; for eligible seniors, T.R.I.P. provides information and/or counseling to help the senior to locate a volunteer driver; the senior and driver make transportation arrangements; the senior submits a request for reimbursement to T.R.I.P. on a monthly basis; T.R.I.P. sends a check for mileage reimbursement to the senior; and (10) the senior reimburses the driver for mileage. Program Staffing Staff include the Executive Director of the Partnership (who allocates 20 hours per week to T.R.I.P.), an Administrative Coordinator (25 hours per week), and a Clerical-Data Entry Assistant (18 hours per week). The staff is augmented by sub-contractors one to handle accounting functions and to prepare reimbursements for riders, and another (with the County Office on Agings Senior HelpLink Information and Referral service) to identify and screen potential riders. Service Relationships T.R.I.P. is described as a partnership between the nonprofit and government sectors. When it was founded, not only was T.R.I.P provided with an established umbrella under which to operate but it was also provided with immediate and close ties to other agencies in both the aging and transportation fields. This partnership approach provides T.R.I.P. with a critical service relationship. When T.R.I.P. was first created, it developed a contractual relationship with the Riverside County Office of Agings Senior HelpLink Program. HelpLink provides callers with information about available transportation options in the county and conducts initial screening and referral services for T.R.I.P.

Program Operations
Transportation Services T.R.I.P. serves a mix of urban and rural residents. In 1999, using their own vehicles, about 1,000 volunteer drivers provided 31,039 (one-way) rides to 722 riders. Because the transportation agreement is made between the rider and driver, same-day service, even same-hour service, is possible. While the program is described as providing door-to-door transportation, many drivers act as escorts and even assist riders with activities of daily living. The T.R.I.P. program typically works in the following manner: a senior is referred to T.R.I.P. by a social service provider; a T.R.I.P. application form is sent to the senior; the senior completes

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Rider Eligibility As a social assistance transportation program, T.R.I.P. uses case reviews to determine peoples eligibility for the program. Organizations that specialize in providing services to the elderly conduct a preliminary screening interview with the applicant and, based on the results, make a referral to T.R.I.P. Then, after the senior has completed an application, a committee reviews the information to determine whether the senior is eligible for the program. HelpLink provides most referrals to T.R.I.P. and, because HelpLink is part of a state network, an 800 number is available. When callers contact HelpLink, they are asked several questions to explore their service needs. A number of questions relate to transportation: Can you drive your car for your everyday needs? Can anyone in your home drive you? Can you ride the bus? Can you use Dial-A-Ride or other specialized transportation? HelpLink receives 70,000 calls a year, about 10 percent of which have a transportation-related question or problem. Of these calls, around four percent are ultimately referred to T.R.I.P. When people are referred to T.R.I.P, they are mailed a 35-item application form. The application is designed to find out about the persons health status and ability to use other kinds of transportation. Questions relate to their drivers license and vehicle ownership, the availability of family members to provide rides, their use of buses and other transportation services during the previous year, how far they live from the nearest bus stop, their reasons for being unable to use other transportation, whether they have health difficulties, whether they need recurring medical treatments or therapy, proximity to their doctors office, their ability to shop for groceries and other personal needs, their potential use of T.R.I.P. in the event of them being eligible, the persons ability to find a volunteer escort/driver,

and the name of the escort and/or driver and his or her relationship to the applicant. Completed applications are examined by an eligibility review committee comprised of two members of the Partnership board, a representative from a funding agency, and a representative from the disability community. The committee meets every two weeks and reviews around six to 12 applications. About one-third of the applicants are denied eligibility because the committee determines that they are capable of using other transportation options (such as Dial-ARide). Those who are approved are considered to be truly transportation-needy. Most of the people who apply and are approved live independently in the community. However, several reside in nursing homes. Nursing home residents may qualify if their facilitys van does not travel to locations where they need to go. For example, one rider had to travel 20 miles for medical treatment and was unable to get there in the facility van. The T.R.I.P. eligibility review committee approved her for these medical trips only. Marketing Efforts Due to its tough eligibility requirements, it could be said that seniors market themselves to T.R.I.P rather than the other way around. Social workers, health care providers, and other professionals in aging and social service organizations are aware of T.R.I.P. and provide referrals to the program. HelpLink provides additional marketingof the program, but, even in this case, their intake specialists refer callers to other transportation options whenever possible. Risk Management Personal background and DMV checks are used to screen volunteer drivers. Once approved, each driver/escort is provided with a manual that addresses the special needsof seniors and gives tips on how to be sensitive to individuals

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capabilities. There are tentative plans to have the Red Cross provide emergency medical training and for the American Automobile Association to run a refresher program for T.R.I.P.s volunteer drivers. The Nonprofit Insurance Alliance of California provides insurance for T.R.I.P.s vehicles and drivers. When the question of who should select the drivers was first discussed, some people were concerned that, if the program were to recruit the drivers, then it would be liable if an accident occurred. For this reason, T.R.I.P. has a policy of not providing riders with direct referrals to volunteer drivers. However, the rider-oriented driver recruitment program also serves to empower seniors by letting them recruit their own drivers.

SunTrip program of SunLine Transit Agency in the Coachella Valley. Other Funding T.R.I.P. is also funded by the SunLine Transit Agency. T.R.I.P. and SunLine have a Memorandum of Understanding (MOU) through which the SunTrip program provides T.R.I.P. with county transportation funds, and T.R.I.P. provides what are called complementarytransportation services for seniors in the Coachella Valley. Other funding for T.R.I.P. comes from the Riverside County Office on Aging and the city of Blythe. The program also receives charitable contributions from businesses and individuals. Although T.R.I.P. has had difficulty obtaining foundation funding, the Executive Director of T.R.I.P. commented, I heard the head of one foundation say, We think about funding buildings and programs, but we dont give much thought to how people are going to get there and use them. Mileage Reimbursement Riders who are approved to participate in the T.R.I.P. program pay no fees but are required to submit requests for mileage reimbursement on a monthly basis. T.R.I.P. reimburses them for mileage at a rate of $0.28 per mile. An eligible rider can be reimbursed for up to 300 miles ($84 per month). Calculations are based on round-trip mileage. The average round-trip is 40 miles or $11.20 per trip. People can arrange to make several different trips in one ride, but they will not be reimbursed for the additional stops. While rides are reimbursed for many purposes (such as grocery shopping, general shopping, and personal appointments), 50 percent of the reimbursed trips are for medical services. T.R.I.P. has a unique approach in that it reimburses riders rather than drivers. The rider receives the reimbursement check and then distributes the reimbursement to his or her volunteer

Financial Considerations
The T.R.I.P. Budget T.R.I.P. is the largest of the Partnerships programs. Its budget of $395,000 is approximately 85 percent of the Partnerships budget. The bulk of the budget comes from sales tax and the rest from county agencies and contributions. Tax Support In 1988, when voters in Riverside County passed Measure A (a half-cent sales tax for transportation), the Riverside County Transportation Commission (RCTC) was empowered to use a portion of these revenues to provide seniors, people with disabilities, and the truly needy with transportation assistance. Currently, 60 percent of the T.R.I.P. budget is funded through RCTC with Measure A revenues. T.R.I.P. uses its Measure A funds to provide mileage reimbursement to volunteer drivers. According to one county supervisor, providing Measure A funds to T.R.I.P. reflected the attitude in Riverside County that transportation is a way to maximize the options for delivering social services. The RCTC determines the allocation of funds for other county transportation services and programs as well. Measure A funds also support the cooperative

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driver(s). According to the programs Executive Director, it is organized that way to empower seniors to help themselves. Driver Recruitment T.R.I.P. also has a unique method for recruiting drivers in that it encourages riders to locate their own volunteer drivers. The burden of recruiting someone is on the rider, not the program. However, T.R.I.P. has developed audiotapes and videotapes that provide tips to its clients on how to solicit assistance from neighbors, friends, and other potential drivers.

adopt its current rider/driver recruitment model. However, recent discussions with its insurance provider have reduced concerns about liability to the point that T.R.I.P. is now gearing up to supplement its team of volunteer drivers by developing its own driver recruitment program. Financial Resource Development Although at first glance it might seem that public funding ensures the sustainability of T.R.I.P., the fact is that it must apply annually for the funds that it receives from the county. Also, these funds are not allocated directly to T.R.I.P. but flow through a government transportation agency. Thus, T.R.I.P. must constantly present its case to the public sector. This vulnerability and the need for additional support to expand its program have led T.R.I.P. to begin exploring other potential funding sources.

Problems and Solutions

Rider/Driver Eligibility In its early years, the criteria for participation by riders and drivers were loosely defined. As a result, many riders who used the service had other transportation options, and many drivers who were reimbursed for mileage were actually the riders family members. In 1996, the Partnership decided to develop tighter eligibility criteria for both riders and drivers in order to ensure that TRIP continued to receive public funds. In 1996-97, the mission and objectives of the program were reevaluated, new and more rigorous eligibility criteria were established, and an eligibility review committee was created. As a result, 75 percent of the people then enrolled in the program were subsequently ruled to be ineligible. Since that time, 635 people have been added to the program, and a computerized tracking program called TRIP TRAK has been developed to monitor the administration of the eligibility criteria and to identify any possible cases of reimbursement fraud. Volunteer Recruitment and Liability Initially, T.R.I.P. supporters and partners were concerned about the organizations potential liability if drivers were recruited directly by T.R.I.P. and were involved in a collision or in any misconduct with a rider. This led T.R.I.P. to

Keys to Success and Replication

The success of T.R.I.P., its ability to overcome obstacles, and continued efforts to develop innovative methods of partnerships and funding hint at the exciting potential of replicating the T.R.I.P. model. T.R.I.P. experience underscores the importance of three key issues: community support, service eligibility, and driver recruitment. Community Support Community support is critical to any program that is funded with public money. To gain that support, it is essential that there be a clear need for services and that its mission is seen as complementary to rather than competitive with existing services. Service Eligibility Programs that receive public funds and/or that provide reimbursement for mileage must have a high level of accountability and, by necessity, need to develop and apply stringent eligibility requirements for their riders as well as their drivers.

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Driver Recruitment Volunteer transportation programs that require riders to recruit their own drivers may inhibit many seniors from using these programs, especially if they have few or no family or friends. Multiple methods may be necessary to ensure that potential riders are matched with drivers. Programs may need to take a more active and innovative role in recruiting drivers and to forge service partnerships with community groups and organizations that can add to their driver pool.

rtation availability, accessibility, affordability, acceptability, and adaptability. By attending to all five As, supplemental transportation programs for seniors fill the gap in transportation services that many seniors experience in communities throughout the country. T.R.I.P. meets the needs for seniorfriendlytransportation in several ways. It is available the same day and even the same hour for any purpose. It is accessible in that it provides door-to-door as well as escort services. It is affordable to both riders and drivers since riders do not pay fees and drivers are reimbursed for mileage. It is acceptable in terms of its rider satisfaction with volunteer drivers and transportation in private automobiles. It is adaptable because, when special equipment is needed, it can link riders with other programs that can accommodate wheelchairs or other assistive devices.

Conclusion
Transportation planners and community leaders often concentrate exclusively on the availability of transportation services. However, in a 1999 study of the transportation needs of seniors and their lay caregivers, the Beverly Foundation identified 5 As of Senior Friendly Transpo-

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