Coordinated Transportation Retreat Florida Commission for the Transportation Disadvantaged April 11, 2012

Coordinated Transportation Retreat
Florida Commission for the Transportation Disadvantaged
April 11, 2012
Jo Ann Hutchinson, United We Ride Ambassador
National Resource Center for Human Service Transportation Coordination
Presentation Outline
 History & Role of the National Resource Center for Human Services
Transportation Coordination
 Coordination at the National Level
 Trends That Will Impact Transportation Coordination
 Strategies to Address Trends
 Coordinated Planning
 Why States Look to Florida as a Coordination Model
 How the NRC Can Help
Thank You for Your Service to Floridians!
National Resource Center for
Human Service Transportation Coordination
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NRC was created in SAFETEA-LU (Federal Transportation Act) in 2005. Prior to the
NRC, the United We Ride Initiative was created by Executive Order by President
George Bush and resulted in the statutory creation of the NRC to create national
emphasis on coordination.
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Basic Purpose: Provide states and communities with the support they need to
improve and coordinate their public and human service transportation.
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Goal: To help states and communities across the country to better coordinate
community transportation, making them more livable, especially for human
service program customers.
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How: Cooperative Agreement between Federal Transit Administration and
Community Transportation Association of America
National Resource Center for
Human Service Transportation Coordination
Collaborates with the Federal Transit Administration (FTA) and the Coordinating Council on
Access & Mobility (CCAM)
– Provides technical assistance to CCAM
– Meets with individual members of the CCAM
– Provides support to CCAM meetings
Research
Technical Assistance (TA) & Training
Strategic Partnerships with National Consortium and Other TA Centers
Ambassador Program - Ten ambassadors serve all states/territories across the
country and are assigned to a FTA region. Region IV includes the States of
Florida, Alabama, Georgia, Kentucky, Mississippi, North Carolina, South
Carolina, Tennessee and Puerto Rico.
Federal Interagency Coordination Council
on Access and Mobility
Presidential Executive Order established in 2004, under the
direction of Department of Transportation, created the
Interagency Transportation Coordinating Council on Access
and Mobility (CCAM).
The Council works to promote interagency cooperation and
establishes mechanisms to minimize duplication and overlap
of Federal transportation programs (estimated at 80
programs).
Federal Interagency Coordination Council
on Access and Mobility
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Secretaries of Transportation
Health and Human Services
Education
Labor
Veterans Affairs
Agriculture
Housing and Urban Development
Interior
The Attorney General
The Commissioner of Social Security
And any other department the Secretary of Transportation designates.
Florida Has Led Other States to
Starting Their Coordination Journey
Florida saw this picture long before “coordination was cool’’ !
Medicaid
Program
Development
Disabilities
Family
Assistance
Temporary
Assistance for
Needy Families
Substance Abuse
Mental Health
United Methodist
Church
Clayton School
District
Medicare &
Medicaid Svcs
HHS
Health
Resources
& Services
Head
Start
Children
& Families
Health
Care
Rural Transit
Operators
Office of the
Secretary
Family
Ride Inc
Assistant
Secretary
Planning
Evaluation
Child
Care
Bureau
Soc. Services
Block Grant
ABC’s Transit
Aging
Education
Community
Services
Centers for
Independent Living
State Governors
&
Cabinet Secretaries
Disability
Rehab and
Research
Rehabilitation
Services
Administration
Federal
Agencies
&
Grant
$
Education
Office of Special
Education Programs
Office of Disability
Employment Policy
Employment
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Shopping
Local
Government
Labor
Recreation
Employment
Training
Agency
Medicaid
Transportation
Urbanized
Grant Program
Office of the
Secretary
National Highway
Traffic Safety
Administration
Federal Transit
Administration
Elderly
&
Disability
Program
Blue Top Taxi
Independence
Easter Shows
Early Learning
Center
Rural Grant
Program
Metro Access
Departmental
Office of
Civil Rights
Assistant Secretary
for Transportation
Policy
Job Access
Reverse Commute
Program
DART
Coordination Is…
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The efficient & effective use of limited transportation resources for getting people
to work, health care and other daily activities
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Working with transit providers, veterans organizations, human service agencies,
private institutions, businesses, volunteers and political leaders to broaden
transportation options.
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Keeping people mobile and independent in their own homes
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Encouraging greater use of available transportation resources
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Increasing overall health and well-being
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Reducing overall costs to society (health care, unemployment, etc.)
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Creating cost-sharing arrangements between human service agencies and
transportation communities
The National Conference of State Legislatures Reports…
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44,000 levels of government are involved in providing or funding transportation.
Each has its own laws and regulations to carry out their multitude of
responsibilities.
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In addition, thousands of non-profit agencies, private companies and individuals
are involved with providing transportation services to a wide audience of
customers and users.
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Coordinating councils are implemented in recognition of the complex governing
structures that have arisen over time to meet the needs of various populations for
transportation services, which has resulted in a lack of consistency in approaches,
an overlap of services in some places, and unconnected services in others.
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Close to thirty states now have coordinating councils statutorily created or by a
governor’s executive order or initiative. In Florida, a separate state commission
implements a statewide coordination scheme.
Trends Impacting
Transportation Coordination
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Planning for the next reauthorization of SAFETEA-LU (Federal Transportation Act)
continues to be debated with continued emphasis and expansion for coordination
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FTA programs allow for use of human service transportation programs as local
match and funding of mobility management functions as another way to improve
coordination options
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Veterans transportation needs are rising and new federal funds (applications due
April 19) are being made available to create access for veterans and their families
in a coordinated concept
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Medicare for older adults is limited to emergency transportation but plans are
proposed to create a non-emergency provision due to the growth in seniors,
dialysis transportation and more
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The Coordinating Council on Access & Mobility (CCAM) is working on major
coordination policies amongst all the federal agencies to improve coordination at
the State and local levels
Trends Impacting
Transportation Coordination
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The creation of the NRC managed by CTAA is expected to continue to help states
and communities identify and implement ways to work together.
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Unemployment is high creating the need for the unemployed and the
underemployed to identify other forms of mobility.
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More people are in poverty than in recent years due to the economy resulting in
more mobility needs for health care, employment, training, etc.
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A crisis in kidney disease and dialysis treatment has increased 900 percent. The
three-weekly-for-four-hours treatment will create enormous transportation
challenges especially for the return trip. Coordinated mobility is the key to solve
these challenges. (New)
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The nation's population of those 65 and older will double between 2000 and 2030,
according to the U.S. Administration on Aging. That adds up to one out of every
five Americans — 72.1 million people.
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Older Americans desire to “age in place” remaining in their homes. 79% of seniors
live in suburban (56%) or rural (23%) communities.
Trends Impacting
Transportation Coordination
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By 2015, more than 15.5 million Americans 65 and older will live in communities
where public transportation service is poor or non-existent. That number will grow
rapidly as the baby boom generation “ages in place” in suburbs and exurbs with
few mobility options for those who do not drive.
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Many older adults are returning to work either as paid employees or volunteers
and many will need mobility options. Since the start of the recession in 2007,
employment for people over 55 has grown by 3.9 million even though payrolls
have fallen by 4.2 million. (New)
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More than one-third (36 percent) of the 915,000 grandparents ages 60 and older
who are caring for their grandchildren, were in the labor force in 2010 (2011
analysis of American Community Survey).
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Without access to affordable travel options, seniors who no longer drive make 15
percent fewer trips to the doctor, 59 percent fewer trips to shop or eat out and 65
percent fewer trips to visit friends and family, than drivers of the same age. As the
cost of owning and fueling a vehicle rises, many older Americans who can still
drive nonetheless will be looking for lower-cost options
Trends Impacting
Transportation Coordination
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AARP reports that older adults predominantly travel in their personal vehicles, but
transit use by people age 65+, as a share of all trips they take, has increased by a
remarkable 40% between 2001 and 2009. In 2009, older adults took more than 1
billion trips on public transportation.
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Most Americans are going to live for a number of years after they cease driving, so
the challenge to meet the special transportation needs of these frail older people
(85+) continues.
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Specialized transportation is the only feasible mode for frail older persons, other
than getting rides from others. They will often need travel escorts and door-todoor and door-through door assistance so that they can continue to live
independently in their own homes and connected to their communities.
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Lost mobility jeopardizes not only the physical and emotional health of the
individual who may feel a sense of loss and dependency but also the quality of
their community.
Trends Impacting
Transportation Coordination
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As the Baby Boom Generation turns 65 that began in 2011, this generation
continues to age and grow, it will demand a level of mobility and an active lifestyle
that far outpaces any of America’s previous generations. This aging population will
both create and face significant transportation challenges, including a
transportation system that lacks many features that would accommodate the level
of mobility and safety older Americans desire and expect.
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Transportation innovations are needed to accommodate the Baby Boom
Generation’s need for improved safety and mobility will benefit users of all ages.
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For older Americans, as well as the population in general, the ability to travel
represents freedom, activity and choice. Older Americans prize their mobility and
active lifestyles and want to maintain them as long as possible.
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Few communities have started to think long term about how to plan and redesign
services for aging Baby Boomers as they move out of the workforce and into
retirement.
Trends Impacting
Transportation Coordination
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Dwindling budgets in a tight economy have pushed communities to cut spending
on delivering meals to the homebound and shuttling folks who can no longer drive
to grocery stores and doctor's offices.
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Six years ago, the National Association of Area Agencies on Aging said less than
half of cities it surveyed were preparing to deal with the needs of older folks. It
said the results "should serve as a wake-up call for communities to begin planning
now.“ Five years later, a survey was done and found little had changed. There was
still an identified need for transportation.
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Over 50 million people in the U.S. have some type of disability often limiting their
mobility – The unemployment rate is 30% or higher with 79% of this population
citing transportation as a major barrier. (New)
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Veterans who serve our country in the past, present or in the future need access
to health care, employment, training and other activities.
Trends Impacting
Transportation Coordination
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By 2014, at least 1.2 million riders will be eligible for Medicaid Non-emergency
transportation in Florida
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States are moving toward managed care models
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Some states without a statewide coordinated network are choosing to hire brokers
(usually on a regional level) to manage their NEMT transportation programs
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State budgets are expected to continue to see the adverse effects of the recession
with severely depressed state revenues and higher demand for human services
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States are having to do more with less and State staffing is not increasing
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More persons are unemployed qualifying for Medicaid
Trends Impacting
Transportation Coordination
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The 2014 Affordable Health Care Act will bring on new members never before
eligible for Medicaid
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The new Medicaid population will be mainly adults who have not had insurance:
– No preventative care
– Chronic untreated conditions
– High utilization in the first years
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States are turning to Managed Care Organizations (MCO) to manage
transportation as well as the medical care
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Managed Care Organizations often utilize brokers to manage their transportation
needs
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States have been using alternative delivery systems to provide health care through
HMO’s and Managed Care
Strategies to Address Trends
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Leadership is the key to success and including all the partners in the TD program is
critical for successful outcomes (Nothing About Us Without Us)
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Strengthen the coordinated transportation infrastructure by implementing new, cost
effective and creative ways to provide these needed services, including, but not
limited to:
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Expanded bus routes, flex routes, accessible taxis, purchasing more energy efficient
vehicles, installing stops or facilities that better accommodate older or physically
challenged passengers; and additional non-traditional and private sector approaches
to transit, including formal and informal ridesharing, donated vehicle programs,
volunteer programs and taxi services.
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Partner with others to offer training to help older people drive more safely, installing
more road signs that are easier to read and other ways to allow older people the
ability to continue driving
Strategies to Address Trends
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Emphasize cost-effectiveness in everything you do – we all can do better!
Continue documenting your performance relating to trips and purposes and
educate elected officials and others with results
Advocate in a united way at all levels with partners at the local, state and
federal levels
Reach out to nontraditional partners: health maintenance organizations, local
and national foundations, veteran’s organizations, faith based community,
volunteer programs, local business leaders and anyone who has a desire to
improve mobility
Assist industry leaders like CTAA and other partners to educate Congress to
create a Medicare transportation provision (other than ambulances)
Assist CTAA and other partners to create mobility options for America’s
veterans and their families
SPREAD THE WORD: Transportation investments lead to decreased costs for
healthcare, unemployment related costs and higher emergency transportation
costs.
Strategies to Address Trends
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Increase funding support to address the growing needs (TD Trust Fund, Voluntary
Donations to the TD Trust Fund, Public Transit Trust Fund, etc.)
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Consider funding and incentives for coordinators and operators who engage in
innovative coordination practices
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Ensuring that state departments of transportation retain their authority to “flex” a
portion of highway funds for transit projects and programs;
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Including a “complete streets” policy to ensure that streets and intersections
around transit stops are safe and inviting for seniors & other passengers
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Promote regional coordination initiatives at both the delivery level and the
planning level. Partnerships among the CTC’s could be enhanced as well as Local
Coordinating Boards and Planning agencies
Strategies to Address Trends
Consider FTA Funding that is available to implement mobility management
activities. Such activities can include:
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Support for short term management activities to plan and implement coordinated
services (Development of Coordinated Plans)
The operation of transportation brokerages to coordinate providers, funding
agencies and customers (Mobility Managers)
Customer-oriented travel navigator systems and neighborhood travel coordination
activities such as coordinating individualized travel training and trip planning
activities for customers; (Travel Training)
The development and operation of one-stop transportation traveler call centers to
coordinate transportation information on all travel modes
Operational planning for the acquisition of intelligent transportation technologies
to help plan and operate coordinated systems
The support of State and local coordination policy bodies and councils
Match requirements vary from 50/50 (operating programs) or 80/20 (capital
program funds) Among other sources, match can be used from nontransportation contracts (i.e. Medicaid, Aging, TANF, etc) to stretch available
dollars
Coordination is Required
for FTA Funding
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Requirements under SAFETEA-LU (Transportation Bill) in order to receive FTA
Section 5310, 5316 and 5317 funds
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Section 5310 – Elderly and Individuals with Disabilities Program: Provides for the
purchase of vehicles to transport elderly persons or persons with disabilities.
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Section 5316 – Job Access and Reverse Commute: Designed to transport welfare
recipients and low income individuals to and from jobs and reverse commute
activities
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Section 5317 – New Freedom Program: Provides improved public transportation
services, and alternatives to public transportation, for people with disabilities,
beyond those required by the Americans with Disabilities Act of 1990 (ADA)
Why Other States Look to Florida
 It’s working and you have a track record
 You have had a continued commitment for coordination since 1979
 There is a coordinated transportation infrastructure in place in all 67 counties that
serves as the gatekeeper for limited tax dollars
 There is dedicated funding with the TD Trust Fund
 Legislative support continues
 Local elected official continue to provide financial and other support
 Local Coordinating Boards continue to oversee CTC operations and perform other
needed tasks at the local level
 Planning agencies continue to provide needed support including developing the
required coordinated human service transportation plan in order to receive
available FTA funds
 The Medicaid agency continues to support coordination and is committed to
ensure those funds are used in the most cost effective manner
 Medicaid agency works with the Commission to eliminate barriers
The Message That Began in 1979 Is The Same But Is
More Important Than Ever:
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Coordination Brings People Together: Resulting in Increased Mobility, Cost Savings
in Other Social Services and Improved Lives
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Coordination Maximizes Limited Resources
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Coordination Ensures Accountability for Millions of Tax Dollars
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Coordination Improves Efficiencies for Participating Human Service Agencies
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Coordination Provides a Return on the Investment
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And More Important – Coordination Improves the Quality of Life for Floridians
Closing Thoughts:
• Coordination is not a “one time” event or process
• Coordination can be best achieved through the continued efforts of
elected officials, experienced transportation and planning entities, health
care organizations, veterans organizations, transportation and human
service agencies, advocates and others
• Coordination is more achievable today due to available technical
assistance resources and flexibility in program funding
• Coordination is not always easy but it is achievable through trust,
teamwork and cooperation
• Coordination is a journey - not necessarily a destination
Ambassador Assistance is Available
• A Clearinghouse of Information on Coordination and Available Resources
• A Facilitator at the State, Regional or Local Level
• A Mediator
• A Problem Solver
• Someone Who Cares!
Ambassador Contact Information
Jo Ann Hutchinson, United We Ride Ambassador-Region 4
National Resource Center for Human Service Transportation
Coordination (NRC)
Toll Free: 800.891.0590, Ext. 730
Email: [email protected]
Blog:
www.nrctransportation.org
Twitter: @4Coordination
Any Questions
Thank You & United We Ride!