Past Three Years

Placing Control In Our Hands: Year Three Report - Introduction

As part of our transportation initiative APRIL has received a major grant to demonstrate the effectiveness of a voucher model to provide transportation for people with disabilities living in rural areas. The grant is funded by RSA (U. S. Department of Education) for $1,494,218 over a five-year period (2001-2006). Linda Gonzales serves as Project Director, Dr. Tom Seekins (RTC: Rural) and Dr. Devva Kasnitz are Co-Principal Investigators and Dr. Dennis Stombaugh is our Project Manager. The following report highlights our progress during our third year of funding (October 1, 2003 to September 30, 2004).

Project Goals and Objectives

The goal of our project is to demonstrate the effectiveness of a voucher model to provide employment related transportation for people with disabilities who live in rural areas. It is projected that each of the ten demonstration sites will provide up to 40,000 miles of transportation to approximately 50 individuals for vocational and related independent living trips.

Objectives for the third year of this project included the following:

Develop operational strategies and resource materials and provide ongoing technical assistance to the ten sites.
Implement the voucher model at each of the ten sites and evaluate the effectiveness of the model.

The voucher model is described in the annual reports for years one and two.

Target Population

The consumer population served reflects the wide diversity in our sites located in rural Alaska, Georgia, Illinois, Kansas, Massachusetts, Minnesota, Montana, New Mexico, Pennsylvania and Utah. Fifty-two percent are male and they have an average age of 41 years. Riders reported the following disability diagnoses:

Physical/Mobility = 14%
Hearing Impairment = 1%
Mental/Emotional = 20%
Visual Impairment = 9%
Cognitive Impairment = 8%
Other = 20%
Multiple responses = 28%

Sixty-four percent of our consumers are white, 8% are black and 25% are American Indian, Alaskan Native or Native Hawaiian. At the time of enrollment 32% were employed part-time and 14% were employed full-time while 15% were in a paid internship, in school or in a training program. Thirty-eight percent lived in a single person household. Seventy-one percent of our consumers had household incomes below $10,000 and another 23% had household incomes between $10,000 and $20,000 and only 10% had medical insurance from their employer and 29% had no medical insurance. Eighty-one percent are or have been a VR client. Fifty-three percent of the consumer households did not own a vehicle.

Summary for Years one, two, and three

During the first year of the project ten sites were selected to provide diversity in location, population density, geography, minority populations, disability groups served and transportation availability and service. This ensured that our experiences and replication materials could be applied widely across the United States. Site coordinators were also trained and training materials, data collection forms and site management spreadsheets and check books were prepared and distributed.

During the second year the sites transitioned from the initial start-up phase to full operation with additional consumers participating. Eligibility criteria and policies and procedures were developed to establish priorities based on community values and local needs. Data collection continued and many sites were visited to evaluate the program’s effectiveness and to determine how effectiveness varied with community characteristics. During the first two years 56 of the 378 people participating in the project obtained employment (37 full-time and 19 part-time jobs).

During the third year of this five year grant all the sites have been in full operation. During this period 104 new consumers were added and the sites modified and adjusted program procedures to operate more effectively. Data collection and analysis continued and all remaining sites were visited by project staff. The project provided over 32,000 rides (346,832 miles) to 224 consumers during this fiscal year. Both program strengths and concerns were identified. Specific improvements that could be made in program operation were defined.

Project Outcomes

Employment. During this reporting period an additional 61 consumers obtained employment (28 full-time and 33 part-time jobs). For the first three years of this project 117 people have obtained employment (65 full time and 52 part time jobs). The number of new jobs obtained this year was higher than during the first two years especially at sites where strong working relationships with VR have been developed. A similar number of consumers who were employed when they enrolled in the program or who obtained jobs in previous years reported that the program has either helped them maintain their current job or improve their employment (found a better job, were able to increase the number of hours worked or a more rewarding job with their original employer).

Placing Control In Our Hands: Year Two Report - Introduction

Linda Gonzales serves as Project Director, Dr. Tom Seekins (RTC: Rural) and Dr. Devva Kasnitz are Co-Principal Investigators and Dr. Dennis Stombaugh is our Project Manager. The following report highlights our progress at the end of our second year (October 1 2002 - September 30, 2003).

Overview and Project Objectives

Objectives for the second year of this project included the following:

Develop operational strategies and resource materials and provide ongoing technical assistance to the sites.
Implement the voucher model at each of the ten sites and evaluate the effectiveness of the model.

During the current reporting period sites have transitioned from the initial start-up phase to full operation. During this period additional consumers were added, the eligibility criteria were refined and policies and procedures were developed to establish priorities based on community values and local needs. Data collection analysis continued and site visits were conducted to evaluate the program's effectiveness and to determine how effectiveness varied with community characteristics.

Year One Summary

During the first year of the Traveler's Cheque Project ten sites were selected to obtain ten very diverse communities so that the results and replication materials developed as a result of this grant could be applied widely across the United States. Diversity in location, population density, geography, minority populations, disability groups served, transportation availability and transportation experience was emphasized. Training materials for site coordinators, data collection forms, data and ride management spreadsheets as well as the cheque books ( vouchers and transaction registers) were prepared and distributed. The Community Transportation Coordinators (CTC's, site managers) were also trained. During the first year the project was initiated at all ten sites and was in operation for two to four months at each site. At the end of the first year we had 173 consumers who had made 4100 trips covering 53,520 miles. Of these 173 consumers 31 people obtained jobs (20 full-time and 11 part-time) as a result of the project.

Target Population and Gegraphical Area Served

The consumer population served by this project is quite diverse and reflects the wide diversity in our sites which serve rural areas located in Alaska, Georgia, Illinois, Kansas, Massachusetts, Minnesota, Montana, New Mexico, Pennsylvania and Utah. Fifty-two percent are male and they have an average age of 40 years. Riders reported the following disability diagnoses:

Physical/Mobility = 13%
Hearing Impairment = 1%
Mental/Emotional = 19%
Visual Impairment = 9%
Cognitive Impairment = 6%
Other = 17%
Multiple responses = 34%

Sixty-one percent of our consumers are white, 9% are black and 26% are American Indian, Alaskan Native or Native Hawaiian. At the time of enrollment 30% were employed part-time and 15% were employed full-time while 15% were in a paid internship, in school or in a training program. Thirty-eight percent lived in a single person household.

Seventy-two percent of our consumers had household incomes below $10,000 and another 22% had household incomes between $10,000 and $20,000 and only 10% had medical insurance from their employer and 31% had no medical insurance. Seventy-eight percent are or have been a VR client. Fifty-six percent of the consumer households did not own a vehicle.

Project Outcomes: Employment

During this reporting period an additional 25 consumers obtained jobs (17 full-time and 8 part-time). For the first two years of this project 56 people have obtained employment ( 37 full-time and 19 part-time jobs). A similar number of consumers who were employed when they enrolled in the program have reported that the Traveler's Cheque Program has either helped them maintain their current job or improve their employment (found a better job, were able to increase the number of hours worked or moved to a more rewarding job with their original employer).

Project Outcomes: Transportation Provided

Rides provided. The ten sites served 378 consumers during the second year of operation and have provided transportation to people with disabilities during the first and second year as follows:

Number of rides = 33,653
Miles provided = 357,987
Average miles per trip = 10.6
Voucher reimbursement = $146,943.24
Average cost per mile = $0.41
Average cost per trip = $4.37

During the first year of the project each site was only in operation for two to four months. During the second year each site had a full twelve months of operation. The following table shows the performance criteria for both years.

Performance Criteria

Number of consumers
Year One 173
Year Two 378
Miles provided
Year One 53,520
Year Two 357,987
Trips provided
Year One 4100
Year Two 33,653
Payments to providers
Year One $19,710
Year Two $146,943
Average cost per trip
Year One $4.81
Year Two $4.37
Average cost per mile
Year One $0.37
Year Two $0.41
Average miles per trip
Year One 13.1
Year Two 10.6

Trip Purposes

Most of the rides provided were for transportation to and from work (85%). The remaining 15% were provided for MEDICAL, SHOPPING, and SCHOOL purposes when these trips were documented as necessary to maintain, seek or prepare for employment.

Site Considerations

The average length of each trip varies by site and ranges from a low of 3.0 miles in Kansas, where most transportation has been for work trips in town to 37.0 miles in Utah where only three small towns are located in a very mountainous, largely uninhabited region covering over 5000 square miles (population density = 5 people per square mile). In Kansas over 99% of the trips were for work. In Utah 60 percent of the trips have been for school and 34% of the trips have been for work. In Utah the only educational opportunities are in Price and consumers are willing to travel the 50 or 60 miles each way using volunteer drivers to increase their educational opportunities.

Picture of an accessible van at the Kansas Site
Accessible van at the Kansas Site

Significant variations between sites also occurred in terms of the cost to provide trips. In Kansas many consumers used the vouchers to make the existing demand-response transit more affordable and with the large number of short trips that were provided average costs were only $0.30 per mile and the average per trip cost was only 90 cents. In Utah which used only volunteer drivers at 34.5 cents per mile the average per trip cost was $12.77 due to the long distances involved.

New Voucher Site (CIL) in Price, Utah

Use of Higher Cost Providers (Taxis)

In other states, where rates with higher cost providers were negotiated and utilized, the costs per mile and the costs per trip were higher as well. In Massachusetts and Pennsylvania the average costs per mile were 89.5 cents and 73.9 cents respectively. In Massachusetts where trip lengths were frequently substantial (remote areas of Cape Cod) the average cost per trip was $15.02. Only four sites (Georgia, Illinois, Massachusetts and Pennsylvania) have used higher cost providers (primarily taxi). Both Georgia and Pennsylvania limited the use of taxi providers to short distance trips in cases where volunteers were not available. Both Pennsylvania and Georgia are considering severely reducing taxi providers or eliminating the use of higher cost providers to increase the number of consumers who can be served with the limited resources available. Massachusetts will also be reducing its dependence on higher cost providers. Illinois has only used taxi providers in a few very limited cases where other options were not feasible. For the project as a whole, only 4% of the miles have been provided by the higher cost providers. Most sites either chose not to use taxi providers or appropriate taxi providers simply did not exist.

Rural Area served by PA Site

Sites With Existing Transit

Three sites (Kansas, Minnesota and New Mexico) have existing, small rural transit systems available and have included them in the voucher program. The vouchers have been used to make the transit system affordable for very low income individuals, to provide night service to employment sites or to enable consumers to use volunteer drivers on evenings and weekends when transit was not available. For example, the rural transit operator in New Mexico has been providing rides to our Traveler's Cheque consumers from the Zuni reservation to the local employer (Wal-Mart) located 40 miles from the reservation on evenings and weekends for 34.5 cents per mile. The cooperation and responsiveness of rural transit providers has been outstanding.

Before the Traveler's Cheque Program, many consumers in Kansas and Minnesota could not afford the local transit service. We met with over 20 consumers in Kansas and Minnesota who were forced to walk, bike or miss work during extremely difficult travel conditions due to affordability issues. As a result of the voucher program, one young man was able to afford to ride the bus to his part-time job (1.5 hours on Saturday and 1.5 hours on Sunday). Without the voucher project he would have been forced to relinquish his job. He expressed how significant his part-time job (3 hours per week) was to his self-esteem and his ability to participate in his community.

View from Zuni Pueblo Site (New Mexico)

Voucher Site in Marshall, MN

New Transit Options Developed

One of the sites, BAIN Inc., in Bainbridge, GA serves a county in which over 10% of the county's population has a visual impairment. Our site has teamed with other local human service agencies and with the county government to secure several new, accessible vans which will be pooled and used to provide a coordinated, rural transit system for the county. The new transit cooperative will be participating and cooperating with the Traveler's Cheque Program and should help the citizens of this unique rural southern county with their transportation needs.

Voucher site in Bainbridge, GA.

Funds Available Limit Service

When this project was originally proposed it was anticipated that we would be able to assist 50 consumers at each site with 40,000 miles of transportation each year. This was based on the assumption that each site would have approximately $12,000 to $14,000 available for each full year of operation and that the average cost would be approximately 34.5 cents per mile. It was also assumed, based on two pilot studies, that 20 to 40% of the vouchers might not be submitted for payment (volunteers would refuse to take payment for the rides they provided).

We are finding that nearly 100% of the vouchers are being submitted for payment by the providers and the funds will probably only support thirty to forty consumers at each site. The number of consumers who can be enrolled does vary by site and depends primarily on the average distances required per trip and also on the rate of reimbursement. When higher cost providers are used the number of miles and the number of consumers who can be enrolled decreases. Our average cost per mile has been 41.0 cents.

We had also anticipated that many consumers could be transitioned to other transportation options as their employment status improved. The goal was to then enroll new consumers as current consumers transitioned to other options. Each of our sites has had some success stories in moving consumers to other options, but in most cases other affordable, reliable and safe alternatives are difficult to locate in our rural communities.

While sites had carry-over funds available from the initial start up year during year two, during the third year of the project they will have fewer dollars available. We are working closely with the sites to help them prioritize rides, seek efficient low-cost providers and seek supplemental funds.

Advocacy

One of the most important aspects of this demonstration project is to use the visibility and influence of APRIL's national status as an advocate for increased options in rural transportation. Having a major project on rural transportation funded by RSA has helped increase our credibility with other federal agencies such as the Administration on Developmental Disabilities (ADD) at HHS and the Federal Transit Administration (FTA) at DOT.

Project staff members were involved in a series of regional dialogues on accessible transportation sponsored by FTA and held during the FY 2003 fiscal year in Anchorage, Alaska, Kansas City, Missouri, Dallas, Texas, and Louisville, Kentucky. Every dialogue included break-out discussion groups of people interested in rural accessible transportation and it was our role to be sure that rural issues were voiced. In many instances, rural issues emerged as the top recommendations to FTA on accessible transportation.

In addition to the regional dialogues noted above, a special one day dialogue on rural transportation was held in Washington DC in conjunction with FTA's celebration of ADA week in late July. Project Staff took the lead in planning and presenting this dialogue that produced a National Action Plan for Rural Accessible Transportation. Project Director/APRIL Executive Director Linda Gonzales was presented with a plaque of appreciation from the FTA for her work in the area of rural accessible transportation.

Once again, Project Staff participated in the 2003 National Summit on Accessible Transportation sponsored by National Easter Seal's Project Action.

The Administration of Developmental Disabilities funded several projects around the country to address rural accessible transportation and three of those projects funded have sought out the help and consultation of Project Staff in designing their products, and/or planning and participating in their conferences. These collaborations include the University of North Dakota at Minot, Center on People with Disabilities, whose project is titled the Great Plains Rural Initiative on Transportation. GRIT is designing and piloting software to be used with transportation voucher programs. The Commonwealth of Massachusetts Transportation Project is testing the application of using palm pilots for arranging transportation for people with cognitive impairments. Project Manager Dennis Stombaugh attended their conference on transportation for people with disabilities and presented a report on the effectiveness of the voucher program. Project staff also worked with the Indiana Governor's Council on People with Disabilities to organize and present a National Summit on Rural Transportation to be held in Indianapolis in late October, 2003.

Project Staff presented the APRIL Transportation Voucher Program in a well-attended workshop at the 2003 National Conference on Independent Living in Washington DC in June. We have held several meetings with congressional staff members who are writing the Reauthorization of TEA-21.

Project Director Linda Gonzales was featured in an article in the Rural Monitor (Rural Technical Assistance Center) discussing the transportation issues encountered by people with disabilities living in rural America. (Volume 10, #2, Fall 2003)

Project Replication

One of the objectives of this project is to evaluate which policies and procedures are most appropriate for different local communities. A second objective is to develop materials that will enable diverse communities throughout the country to replicate the Traveler's Cheque Program. We will be developing a "replication kit" which will include the following items:

Policy and program guidelines that are sensitive to local community values
Training manuals for
Sponsoring organizations
Community Transportation Coordinators
Bookkeepers
Providers
Consumers
Record keeping strategies and spreadsheets
Voucher printing guidelines and procedures

Products of the Project

The following products are currently available from APRIL in electronic formats:

Training manual
Brochures
Rider Forms
Trip diaries and satisfaction questionnaires
Enrollment forms and Individual Transportation Plan forms
Sample vouchers and check registers
Excel workbooks to record and manage consumer trip data

For additional information please contact the APRIL office.

Placing Control In Our Hands: Year One Report - Introduction

Overview and Project Objectives

Objectives for the initial period of this project included the following:

Select ten sites to provide diversity in geographical location, disability population served, availability of transportation resources and population density.
Develop operational strategies and resource materials and provide ongoing technical assistance to the sites.
Implement the voucher model at each of the ten sites and evaluate the effectiveness of the model.

Target Population and Geographic Area Served

The target population is individuals with disabilities in rural areas throughout the United States. Four sites were pre-selected and a request for proposals was widely distributed to select an additional six sites. Fifty excellent proposals were received and the ten sites were selected to achieve as much diversity as possible. TABLE I lists the ten sites and highlights important characteristics for each site.

Table I: Ten Demonstration Sites and Their Characteristics.

Site

Homer, Alaska
Low population density; experience with a transportation voucher program.

BAIN, Inc. Bainbridge, Georgia
No transportation experience; 10% of county population has a visual impairment; large black minority population.

DSNWK
Hays, Kansas
Transportation provider is the lead organization; transportation experience; very large rural service area.

Southern Illinois CIL
Carbondale, Illinois
Large rural service area; high unemployment; large black minority population.

South East CIL
Fall River, Mass.
High population density, but many remote rural areas; partnership of three CIL's

Southwestern CIL
Marshall, Minnesota
Very large, very rural area; upper Midwest; no transportation available.

Salish and Kootenai Tribes
Pablo, Montana
Section 121 VR program; high unemployment (49%); limited transportation experience.

Zuni Entrepreneurial Enterprises
Zuni, New Mexico
Section 121 VR program; high unemployment (67%); transportation experience.

CIL of Central Pennsylvania
Camp Hill, Pennsylvania
Rural area; several counties; transportation experience.

Active Re-Entry
Price, Utah
Very rural area with population density of 5 people per square mile; no transportation experience.

Program Operation: Roles and Responsabilities

At each site, five major participants in the Traveler's Cheque Program each play a major role. The five participants include the sponsoring organization, the community transportation coordinator (CTC), the bookkeeper, the transportation providers and the consumers. Each has significant roles and responsibilities as follows:

Sponsoring organization:

Establishes eligibility criteria and mileage allocation policies.
Ensures that the organization has appropriate liability insurance.
Develops mechanisms to pay transportation providers in a timely manner.
Community Transportation Coordinator (site program manager)
Establishes a Transportation Interest Network, which includes local providers, service organizations, consumers, and other community leaders to provide coordination and advocacy.
Locates and negotiates rates and the acceptance of the vouchers with public and private transportation providers. Also assists consumers in locating volunteer drivers who are reimbursed at a rate of 34.5 cents per mile.
Locates and works with consumers to establish an Individual Transportation Plan, makes mileage allocations to each consumer and trains consumers to use the vouchers (traveler's cheques) effectively.
Coordinates and communicates with all participants in the program and with the national site (APRIL).

Bookkeeper

Records all trips and associated data and makes payments to providers.
Invoices APRIL for reimbursements and transmits data forms for record keeping.
Providers
May be individual volunteers (paid at 34.5 cents per mile) or may be any public or private provider willing to accept the vouchers at the rate negotiated with the Community Transportation Coordinator.
Public and private providers should be able to document appropriate insurance coverage.
Accept vouchers, provide transportation and submit the vouchers to the site for payment.

Consumers

Work with the CTC to complete all forms and develop an Individual Transportation Plan.
Carefully select providers and consider safety and insurance coverage when using individual volunteers.
Pay providers with the Traveler's Cheques and submit the duplicate vouchers to the bookkeeper.
Maintain an accurate mileage balance.

To implement the program effectively at all ten sites and to adequately document the program's effectiveness we have developed the following tools, forms and reporting documents:

The initial training manual for the sites and CTC's
The vouchers and cheque registers. These are very similar to a duplicate checkbook. The consumer fills in the date, mileage, and provider, circles the trip purpose and signs the cheque. The checkbook is also available in a large print version.
A three-day trip diary and a satisfaction questionnaire that are used to help assess the transportation needs of each consumer. The trip diary records both the trips actually taken and the trips desired by the consumer.
An enrollment form and a form used to develop the Individual Transportation Plan.
An Excel workbook for each site to maintain records and to collect and analyze data.

Project Outcomes

As of September 30, 2002, each of the ten sites has been in operation between two and four months depending on individual site constraints and the methods chosen to implement the program. TABLE II provides average values for all ten sites and shows the range of data for a number of variables. The very large ranges in the performance criteria were due to the fact that some sites were one to two months ahead of the other sites in program implementation.

Tabble II. Performance Criteria at Each Site as of September 30, 2002.

Performance Criteria

Number of consumers
Site Average 17.3
Range 2 - 50

Miles allocated to consumers
Site Average 21,054 mi
Range 1,710 mi - 81,356 mi

Miles provided
Site Average 5,352 mi
Range 470 mi - 16,584 mi

Trips provided
Site Average 410
Range 64 - 1,091

Payments to providers
Site Average $1,971
Range $162 - $6,199

Average cost per trip,
Site Average $4.81
Range $1.13 - $8.87

Average cost per mile
Site Average $0.37
Range $0.23 - $0.72

Average miles per trip
Site Average 13.1 mi
Range 3.1 mi - 25.7 mi

The purpose of each trip was categorized by the consumer as WORK, MEDICAL, SOCIAL/RELIGIOUS, SCHOOL, or SHOPPING. TABLE III indicates that most of the trips were for transportation to work (73%). Trips for other purposes were all used, but at much lower percentages.

Table III: Trip Purposes. 4097 total trips were provided.

Purpose

Work:
73 Percent

Medical:
6 Percent

Social Religious
9 Percent

School
5 Percent

Shopping
8 Percent

An analysis of consumer demographic data did not quantify a "typical consumer"; rather it indicated a very large diversity in the population served. Of the 174 consumers enrolled in the Traveler's Cheque Program on September 30, 2002, 54% were male, the average age was 48 and 40% reported multiple disability diagnoses. Sixty-seven percent were white, 12% were black and 18% were American Indian, Alaskan Native, or Native Hawaiian. At the time of enrollment 41% of the consumers were employed either full time (23%) or part time (17%). Twenty-three percent of the consumers reported that they were unemployed and 6% indicated that they were retired. Annual household income was reported to be below $10,000 by 64% of the consumers and only 11% reported that they had medical insurance from their employer. Fifty-six percent of the consumers were VR clients and another 31% were VR clients in the past. In 59% of the households no one owned a vehicle.

At the ten sites 31 consumers were able to obtain employment (20 full-time and 11 part-time) as a result of the Traveler's Cheque Program. Anecdotally a similar number of consumers either improved their employment options or were able to maintain their current positions due to the Traveler's Cheque Program. For example, two young women who required a lift-equipped van to transport them, found jobs and are currently successfully employed and using the Traveler's Cheque Program for transportation. Each plans to purchase her own lift-equipped vehicles in the near future. One of the young women is taking driver's education classes in order to drive her own vehicle.

In another case, a 56 year-old male with a brain injury and severe diabetes was able to live independently in his home and pay for transportation to and from kidney dialysis, shop for his own groceries and go on an occasional fishing trip to the Ohio River with his fishing buddies. Without the Traveler's Cheque Program, this gentleman would have had no alternative but to reside in a nursing home.

Three OVR/BVS consumers were referred to the project because they needed transportation to a job on Saturday. Previously, each consumer was receiving para-transit through a fixed route provider. However, the Saturday route was eliminated, and there were no affordable transportation options to their jobs on Saturday. The voucher program was able to serve these three individuals, and they were able to maintain their employment due to the availability of the voucher program.

Another person who is using the service is a woman in her sixties who had to give up going to church because there was no transportation available on weekends. This program has provided the option for her to become involved again in the life of her congregation, both through church services and additional ministries she participates in and she has expressed her extreme satisfaction for this development in her life.

Project Replication

Policy and program guidelines that are sensitive to local community values
Training manuals for
Sponsoring organizations
Community Transportation Coordinators
Bookkeepers
Providers
Consumers
Record keeping strategies and spreadsheets
Voucher printing guidelines and procedures

Products of the Project

The following products are currently available from APRIL in electronic formats:

Training manual
Brochures
Rider Forms
Trip diaries and satisfaction questionnaires
Enrollment forms and Individual Transportation Plan forms
Sample vouchers and check registers
Excel workbooks to record and manage consumer trip data

For additional information please contact the APRIL office.