Models to Improve Transportation for Veterans, Patients and People with Disabilities

Community Transportation Association of America
CTAA's National Resource Center for Human Service Transportation Coordination released NRC Report: Transportation for America's Veterans and Their Families, which discusses improving transportation for our nation's veterans through partnerships and coordination. Examples of the work of regional ambassadors are given. The NRC also maintains a webpage "bookshelf" with veterans transportation resources.

Life-Saving Transportation

CTAA also distributed the Dialysis Report, which discusses the dire, complicated transportation demands that dialysis patients present.

The crux of the transportation challenge is that the majority of dialysis patients are covered by Medicare, which — unlike Medicaid — does not offer non-emergency transportation as a benefit. Three out of four dialysis patients in the U.S., are Medicare primary, meaning that Medicare sets the reimbursement rate and pays 80 percent of that amount ...

Indeed, in background discussions with community and public transit officials around the country for this article, a common refrain was the difficult position in which many transit operators find themselves — how to continuously add new dialysis patients to the transit schedule with no means of payment.

The situation places transportation providers between the proverbial rock and a hard place. CTAA is advocating for a funding mechanism within Medicare and for increased kidney organ donation. "Transplants can add decades to people’s lives and significantly forestall the need for dialysis, but only when the needed organs are available."

Solutions Possible to Realize Decades-Old Commitments

Association of Programs for Rural Independent Living
APRIL's Executive Director, Billy Altom, testified before the Senate Health, Education, Labor and Pensions Committee about the need for affordable, accessible and available rural transportation. Forty years after the Urban Mass Transportation Act and 20 years after the passing of the ADA, Altom argues, "minimal or nonexistent transit services in rural areas still create serious barriers to employment, accessible health care, and full participation in society for people with disabilities."

Altom sees some solutions that are working - mobility management and voucher programs. Altom praised the Easter Seals Project ACTION Mobility Management Independent Living Coaches program and he cited as an example the Center for Independent Living for Western Wisconsin Regional Mobility Management/New Freedom Program, which provided 12,000 rides last year and coordinates in seven counties with public and private transportation providers. More than 140 volunteer drivers provide the rides and the program is expanding into an 18-county area. Already weekly rides are being supplied to 130 veterans.

Partnership for Mobility Management member Denise Larson is the mobility manager for the program. She also serves on the Partnership's advisory committee.

Another Type of Coordination

American Public Human Services Association
Bridging the Divide: Leveraging New Opportunities to Integrate Health and Human Services is APHSA's new report about the value added of coordinating and aligning health and human services for clients beyond eligibility and enrollment for a "customer‐focused, one‐stop shop, 'service home'." Such coordination makes sense, according to the report, because:

Many of the same people who qualify for Medicaid, CHIP or some level of premium subsidy identified through the Exchanges also qualify for one or more human service assistance programs.

The positive impact of coordinated care and integrated case management on improving the overall health and well‐being of individuals and populations— strengthening families, achieving employment and independence, improving the well‐being of children, youth, people with disabilities, seniors and other vulnerable populations—is well documented. Better outcomes mean healthier, safer, stabilized individuals and families with a better chance of sustainable independence from government services and long‐term personal success.

The report contains case studies of what several states are doing and the impending impact of the new healthcare law.

Not Just Vehicles: Access to Long-Term Care, Food Assistance & Mobility

American Public Human Services Association
APHSA's concerns about Food and Nutrition Service (FNS) closure of Supplemental Nutrition Assistance Program (SNAP) offices include transportation barriers. It sees technology as a solution. "[I]implementation of office closures that are accompanied by the appropriate alternative methods and technology could not only avoid negative effects but can very likely on balance improve access and integrity." APSHA is also objecting to an FNS requirement for the SNAP that allows deduction from income of transportation costs for dependent care, which requires documentation of actual transportation expenses. "[T]he great variety of possible arrangements opens the door to errors, and requires an unwarranted amount of effort by the worker." APSHA would prefer either a federal standard or a state-by-state standard amount. Both of these documents are available on APSHA's homepage.

Long-Term Care Report Card

AARP
AARP issues its State Scorecard on Long-Term Services and Supports for Older Adults, People with Physical Disabilities, and Family Caregivers. The report asserts that quality of life, including engagement in the community, requires a long-term care support system where:

there is effective coordination or integration between health-related services (such as clinician services, medications, home health, and physical therapy) and supportive services (such as personal care, adult day, homemaker, transportation, and other services).

One concrete result of high quality home and community support is the cost-saving reduction of hospital readmissions. The report emphasizes that limited data to measure services such as transportation and assistance in the home means that currently the performance of programs cannot be effectively measured. A state-by-state scorecard website looks at several measures, but does not examine anything directly related to transportation.

Events

Easter Seals Project ACTION
Public Involvement in the Transportation Planning Process - webinar - October 12, 2011. This webinar will provide a guide to taking and utilizing a seat at the table for transportation planning and implementation. This event will prepare transportation advocates to offer effective input that will be heard, understood and incorporated into the over-all plan.

Transcripts from ESPA's summer webinars can now be found at its website.

Transit a Priority for People with Disabilities, Commuters and Capitol Hill

American Public Human Services Association (APHSA)
APSHA's Working for Tomorrow newsletter recommended a Minnesota policy brief. Following the link, I found a series devoted to employment of people with disabilities and the concrete changes needed to increase their employment rates. Particularly interesting is the brief about people with visual impairments and the brief about people who are deaf and blind, probably because of the prominent position of the recommendation for improved public transportation. For more information, visit the Minnesota Employment Policy Initiative.

Census Data for Transit and Transportation

National Association of Development Organizations (NADO)
NADO's current Rural Transportation newsletter includes information helpful to anyone analyzing commuter patterns. It highlights the Census Transportation Planning Products release of the 2006 - 2008 3-year American Community Survey (ACS) Data. This release shows where people are commuting to and from and how they get there, and the data is organized by where workers live, where they work, and by the flow between those places. For more information, visit http://ctpp.transportation.org/Pages/3yrdas.aspx.

National Resource Center for Human Service Transportation Coordination (NRC)
The NRC has a Census 2010 page, which links to a wonderful resource, the Transportation Research Board's Census Data for Transportation Planning.

Happenings on the Hill

National Association of Regional Councils (NARC)
NARC has updated information about the fast-moving developments on Capitol Hill and Pennsylvania Avenue regarding earmarks, the federal budget and transportation.

News Roundup: Coordination, Transportation Legislation and Technology

National Conference of State Legislatures (NCSL)
NCSL's Transportation Coordination Newsletter is a quarterly compendium of coordination developments, particularly at the state level. This issue also includes news about a volunteer driver law and resources.

NCSL's magazine has an article, Boomers on Board, which provides an overview of the demographics of the emerging boom in need and likely growth in mobility management, coordination, safety for older drivers, and land use and transportation coordination.

News

Federal Transit Administration (FTA)
FTA has a new webpage with information about each of its grant programs. Both the names and numbers of each program are supplied, with links to each program.

American Public Human Services Association (APHSA)
APHSA is closely covering the activity in Congress relating to proposals for budget cuts and human services, including transit programs.

Association for Commuter Transportation (ACT)
Act is supporting the COMMUTE Less Act (HR 260), which would actively encourage employer involvement in transit and transportation planning processes as well as "engage employers in providing commuting alternatives to employees, including carpooling, vanpooling, use of transit, and teleworking." It would also fund a national organization to house a technical assistance center, an information clearinghouse and an "information and educational program with respect to the employer investment in transportation and commuter benefit program."

Association of Programs for Rural Independent Living (APRIL)
APRIL is now offering its mentors virtual peer visits, along with the equipment to make them possible, as an alternative to in-person mentoring visits. CILs retain the choice of an in-person visit. The website has more details about the CIL mentoring program.

In a Google search to find out more about Rep. John Mica's upcoming listening tour about transportation reauthorization, there were a few transit blog posts and coverage from the Wall Street Journal. In an excellent article, Fight Looms over Transportation, the paper lays out the different positions within the Republican Party and the Administration, the shrinking value of gas tax revenue, and what is at stake for all types of infrastructure and transportation. Positions of associations, states and other stakeholders are not discussed.

Listening tour dates are available from at http://dc.streetsblog.org/2011/01/28/ti-committee-announces-field-hearing-schedule/.


Transit Wire Highlights

The Transit Wire, a transit and technology blog, links to news of what GPS means for the Lehigh and Northanpton Authority, a Pennsyvania bus system, and its customers in terms of real-time bus information and using the information about passenger loads to improve service.

Your local bus stop could soon transform from the place with exhausted faces to the place people visit whether or not they are getting on a bus. The Transit Wire led me to this neat photo-laden article about a new generation of bus stops, places with interactive media, Internet and GPS access, solar energy-produced heat and power, opportunities to leave messages, and avant garde design.

Facts & Assistance for Helping People with Disabilities

Today's American Public Human Services Association (APHSA) newsletter, Working for Tomorrow, reports "[p]eople with disabilities are much more likely than people without disabilities to consider inadequate transportation to be a problem (34 percent vs. 16 percent, respectively)— a gap of 18 percentage points." The newsletter also gives details of upcoming changes to Medicaid.

Contact Nanette Relave (202-682-0100 x241; nrelave@aphsa.org) for subscription information.

Making Service Truly Accessible

The American Bus Association and Easter Seals Project ACTION are jointly featuring the Motorcoach Operator’s ADA Pocket Guide in a two-part webinar, Using the Motorcoach Operator’s ADA Pocket Guide, starting Sept. 22. Staff from Jefferson Bus Lines will explain how their company has made its service accessible for people with disabilities.

Legislation
For information about recent legislative activities related human services programmatic and funding decisions, the American Public Human Services Association has a nice summary linked to its homepage. Information about TANF and SNAP (food stamps) is included.

Events
American Bus Association - National Rural Public and Intercity Bus Transportation Conference, on October 24-27, 2010, in Burlington, Vt. Sponsored by the Transportation Research Board, the conference will feature accessibility, rural transit policy and planning, alternative fuels, intelligent transportation systems and rural transit, regional systems, networks and coalitions, operations, safety, and security, and tribal transportation.

New online classes at the American Public Works Association include emergency preparedness and designing complete streets for all users.

We All Need to Learn about the Health Reform Law

If only due to the many dollars involved, we all need to know where a large chunk of federal and state money will be going once the provisions of the health reform law become effective.

The American Public Human Services Association (APHSA) has a short presentation that explains the effective dates of different provisions, what will happen to Medicaid, and summarizes long-term care and other provisions.

Periodic postings about the ramifications of health care reform, including its consequences for providing medical transportation, are available from the NRC Capitol Clips, a publication of the National Resource Center for Human Service Transportation Coordination (NRC).