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I.C. DEVELOP TOOLS NEEDED TO IMPLEMENT MODEL PROGRAMS
I.C.4. Alternative Mobility Solutions
(a)Transit/Paratransit/Shared Ride Programs
(b)Volunteer Programs
(c)Private Sector Alternatives
(d)Electric Golf Carts
IC4(a). Transit/Paratransit/Shared Ride Programs
Summary:
Traditional mass transit provides a transportation alternative for the older population. Many transit agencies offer reduced fares or free rides to senior citizens. The Los Angeles County Metro Bus and Rail Systems, for example, offer fare discounts of 45 to 65 percent to senior citizen and disabled passengers on all routes. The Southeastern Pennsylvania Transit Authority (SEPTA) allows senior citizens with valid ID to ride its bus, trolley and subway lines during off-peak hours and on weekends for free.
Some seniors are unable to use mass transit even with these financial incentives in place. Some may have physical limitations which prevent them from gaining access to transit stops. Others may live in rural areas not serviced by mass transit. Paratransit and shared ride services can address these issues. These services offer more flexibility in route and schedule than traditional mass transit services, as described in the examples below.
The Southeastern Pennsylvania Transit Authority (SEPTA) offers two services to older residents of the Philadelphia area. SEPTA Senior Shared Ride is available to Philadelphia residents age 60 and older. Service is available seven days a week from 6:00 a.m. until midnight at a cost of $2.40 each way (10 percent of the full fare), or $1.95 if three or more clients are being transported. Reservations for trips may be made from 1 to 7 days in advance. Drivers will assist clients using steps, getting in and out of the vehicle, and with carrying packages; however, drivers will not enter a residence. Wheelchairs are accommodated. Companions are allowed to use the service, but must pay the same fare as the senior client. Shared-ride vans cross county lines. Clients must register for this service by completing an application and providing proof of age. SEPTA Paratransit annually provides 1.5 million door-to-door rides to Philadelphia residents unable to use public transportation. Senior citizens pay $2.40 each way and disabled persons pay $2.25 each way. Personal care attendants ride for free if registered in advance Service is available from Sunday through Thursday from 6:00 a.m. until 1:00 a.m., and twenty-four hours a day Fridays and Saturdays. Paratransit crosses county lines and goes to approximately 40 different locations outside of Philadelphia. Reservations are required 1 to 7 days in advance. An application must be completed by the client and a physician to register for paratransit service.
The Antelope Valley Transit Authority (AVTA) in California also administers a shared-ride program for seniors. The AVTA's Dial-a-Ride program provides curb-to-curb van service to seniors living in urban and rural areas of Los Angeles County. Vehicles are equipped with wheelchair lifts. Service is available seven days a week in urban areas, and Monday through Friday in rural areas. A special medical shuttle is available on Tuesday for elderly and disabled persons, and serves certain medical facilities in the Los Angeles area. Trips may be booked from 1 to 3 days in advance, but it is advised that the trip be confirmed on the day the service is requested. Same-day service is available, but clients should call at least two hours before they want to travel/ Fares range from $2.00 (Urban zone) to $5.00 (Rural 2 zone) each way. Group rates are half of the individual rate. The exact fare must be paid when boarding, as operators do not carry change, and do not accept IOU's.
The Ohio State University Medical Center publishes a directory of transportation services available to seniors living in central Ohio. Information concerning hours of operation, eligibility, locations serviced, and charges for service are given for each service provider listed. Examples of transportation services include transportation to medical centers and to senior centers (provided by the facilities themselves), curb-to-curb transportation on scheduled days to scheduled locations such as senior centers, malls, and grocery stores (by various community organizations), and reduced-fare bus service provided by Central Ohio Transit Authority.
Shasta Senior Nutrition Programs, Inc. operates a transit system for seniors in Shasta, CA. The service operates from 8:00 a.m. until 4:00 p.m., Monday through Friday, and is available to any person 60 years of age or older. Some of the vehicles in the fleet have a wheelchair lift. The suggested donation is $0.50 per trip. A 24-hour advanced notification is requested for each trip.
The Corona Dial-A-Ride program in Corona, CA offers on-demand shared-ride public transportation to any resident of the city, regardless of age. The service operates Monday through Friday 6:30 a.m. until 6:00 p.m. and Saturdays from 8:00 a.m. until 4:30 p.m. Senior citizens and disabled persons pay $0.50 per ride. Advanced notice of 24 hours is recommended. Dial-A-Ride links to RTA bus stops and Metrolink stations.
The Easy Lift organization in Santa Barbara, California operates a Dial-a-Ride service to provide door-to-door transportation for frail or cognitively impaired seniors and others unable to ride traditional mass transit lines. Easy Lift is the local Consolidated Transportation Service Agency (CTSA), and is a member of the Community Transportation Association of America (see Notebook Section IC4b). Clients pay $1.00 for each one-way trip. The actual cost to Easy Lift of transporting someone is approximately $10.00 per trip, which includes the cost for reservation staff, the driver's pay, fuel, maintenance, insurance for the vans, etc. Riders unable to use the steps to board the van will board using a wheelchair lift. Drivers may assist riders with their seat belts if requested, and will also secure tie-downs for wheelchair passengers. Reservations can be made the day of the trip, or up to two weeks in advance. Rides are booked on a first-call, first-served basis, and no priority is given based on trip purpose. Service is available from 6:00 a.m. until midnight weekdays, and 6:30 a.m. until 9:00 p.m. on weekends. During the fiscal year 1995/1996, Easy Lift scheduled over 70,000 rides for over 1,500 mobility-impaired people. The program uses a radio network to dispatch over 40 vans from approximately 12 local non-profit agencies. This "Human Service Radio Network" was established in 1988 by Easy Lift. Easy Lift is a non-profit, charitable organization that is subsidized through fundraising, grant writing, and public transit monies. The program is designed to serve individuals living independently (as opposed to those living in group homes). They will however, provide group rides at group rates, usually billed by the hour. Easy Lift also provides a "Mobility Training Program" where a mobility trainer works one-on-one with an individual to teach skills such as how to read Metropolitan Transit District (RTD) bus schedules and where to catch a bus. The trainer will also ride with a program participant on a repeated basis until he or she feels comfortable navigating fixed route bus service alone.
A 2-year project ($250,000) in Sedgewick County, KS is underway (Fall, 1998), and will provide for long-term coordination of transit services to diverse populations. In a prior demonstration project to identify transportation gaps and specific needs in a tri-county area, it was found was that there was not a need for more vehicles, but instead, a need for the development of an information management system or brokerage, that would allow for coordinated use of transit vehicles to meet the needs of customers. There is currently a lack of coordination statewide that limits the availability of transportation to elderly and disabled customers. This results in clients not getting services they need or desire, due to unavailability of transportation or funding for transportation. In addition, transportation to clients is limited (based on the trip purpose) because of system constraints. Coordinated Transit District #12 developed an information brokerage model that offers one-stop shopping with centralized intake at a coordinating center, and brings all partners and their resources together to maximize capacity. A software package is utilized to coordinate services, and includes information about clients, multiple vendors of transit services, vehicle availability, and multiple billing capabilities. Coordination of transit services and blending of funding sources and populations eliminates duplication of service, maximizes use of vehicles and staff, reduces need to purchase additional new vehicles for specialized transit needs, increases service, and serves more customers. Transit funding sources that will be filtered into the system include Medicaid, Disabled, Mentally Ill, Welfare-to-Work, Grant Resources, Older Adults, and Private Pay. This blending will allow the ability to leverage local funds with Medicaid and waivered payments with private pay/co-pay. The brokerage would mean more subsidized rides for clients who do not qualify for the other funding sources, the ability to mix funding sources and tap the strengths and capacity of all interested vendors. Through innovative coordination, rides can be provided on evenings and weekends, and for social activities, and employment. Older and disabled customers will have the opportunity to participate in social activities within the community which will increase their quality of life and reduce social isolation. Rides are available Monday through Saturday from 6:00 a.m to 10:00 p.m. and on Sunday from 8:00 a.m. to 2:00 p.m.
Project ACTION (Accessible Community Transportation in Our Nation) is a congressionally created national technical assistance program authorized under the Intermodal Surface Transportation Efficiency Act (ISTEA). The foundational work of Project ACTION is in promoting cooperation between the disability community and transportation industry. This work enables improved access to transportation for people with disabilities and the provision of accurate and practical information to help transportation operators implement the Americans with Disabilities Act (ADA). They are an enterprise of the National Easter Seal Society, "bringing transit, disability, and consumer organizations together under one cause," in cooperation with the Federal transit Administration and the U.S. Department of Transportation.
Eighty-four innovative demonstration projects and research initiatives in local communities throughout the nation have been funded. Fourteen technical assistance projects have been funded to create concrete solutions to the pressing ADA accessibility issues faced by public transit operators. Project ACTION provides training, resources and technical assistance to thousands of disability organizations,
consumers with disabilities and local transportation operators. It maintains a resource center with the most up-to-date information on transportation accessibility.
Conclusions/Preliminary Recommendations:
Paratransit or shared ride services address many of the barriers preventing the use of public transportation by older individuals. Most of these services provide door-to-door service from the passenger's home to their destination, eliminating the need to gain access to a bus stop. There are limitations to the effectiveness of these services, however. Many paratransit services offer limited hours of operation, not allowing seniors to partake of activities scheduled in the evening. Paratransit services also lack the flexibility in scheduling that many grew accustomed to when driving. Appointments usually need to be scheduled at least 24 hours in advance, and the passenger must know in advance what time a return trip is needed. This can cause problems when a medical appointment runs late, for example. The coordinated transportation brokerage model being piloted in Kansas has promise for solving many of the problems inherent in traditional paratransit programs.
For older persons who fear using public transportation because they have no experience with it, but are functionally able to use this mode of transportation, Easy Lift's "Mobility Training Program" is a good model for other transit agencies to employ.
Project ACTION appears to be a resource that should be explored by jurisdictions implementing model programs. They state that their mission becomes more compelling as transportation operators need reliable sources of information on the most cost-effective means of improving accessibility and achieving ADA compliance. Project ACTION seeks to develop working positive partnerships which allow the work of "making public transportation truly accessible a reality for all Americans." They are a networking resource for members of the transit industry as well as members of the disability community.
References:
•Antelope Valley, CA: Antelope Valley Transit Authority Dial-a-Ride program
•Central Ohio: Transportation Resource Guide
•Corona, CA: Corona Dial-a-Ride
•Los Angeles County, CA: Metro Bus and Rail
•Philadelphia, PA: Southeastern Pennsylvania Transit Authority
•Project ACTION, 700 Thirteenth Street, NW, Suite 200, Washington, DC 20005; phone: (202) 347-3066, 1-800-659-6428, fax: (202) 347-4157; email: project_action@easter-sealsdc.org; web site: www.projectaction.org.
•Shasta, CA: Senior Nutrition Program Transit System (www.tcp-ip.com/ssnp/transport.htm)
•South Santa Barbara County, CA Easy Lift (www.rain.org/~easylift/history.html)
•Transportation Needs for Sedgwick County, Kansas, August 12, 1998; Silver Haired Legislature Testimony, Transportation Brokerage/Information Management System, October 14, 1998. Marsha Gasper, Program Manager, phone: (316) 383-7298; 1-800-367-7298.
•Weaver and Robinett (1994)
IC4(b). Volunteer Programs
"Driving Decisions for Seniors" (DDS), a Eugene, Oregon-based program, provides social support and instruction on alternative transportation to local seniors (see Heckmann and Duke, 1997). This organization was founded by seniors and is run by senior volunteers. Its efforts are directed at assisting seniors facing driving restrictions, either imposed by themselves or by others, and helping current drivers prepare for the day when they can no longer drive. Among other services, DDS organizes group bus trips designed to teach seniors how to use the local mass transit system. Instruction is provided on how to plan a trip using a bus schedule, how to board a bus, transferring between routes, and treating mass transit use as a positive experience.
DDS also conducts monthly meetings at a local senior center. These meetings are designed to introduce new members to the organization in a relaxed and informal manner. Each new member is given the opportunity to tell the group about his or her specific mobility problem, and the group provides support and possible solutions.
The Michigan Department of Transportation has developed the "You Decide: Senior Driving Awareness Program" to assist older drivers in using and locating public or alternative transportation. This program is modeled after the DDS program in Oregon. As in DDS, this program also utilizes older volunteers to assist seniors in driving safely for as long as possible, and to teach those who can no longer drive safely to use alternate or mass transit. This program is presented in Section IB2 of the Notebook in greater detail.
In Wichita, KS the Central Plains Area Agency on Aging developed the Assisted Senior Transportation Volunteer Handbook as a training guide for volunteers who performed one of three types of volunteer jobs to assist frail/mobility impaired seniors using the Wichita Metropolitan Transit Authority's city bus system (as part of their 2-year demonstration project. Ref. CPAAA, 1996). The Boston Park Recreation Center became the hub for new transportation options to seniors living in southeast Wichita and the new intercounty service from Butler County. The Center is a "rest stop" for Butler County seniors who can connect with transportation services in the Wichita area. Volunteer "greeters" welcome seniors to the Boston Park Hospitality Center, where they can relax in a comfortable chair/sofa while they wait to connect with local transportation. Greeters work with the WMTA Senior Transportation Coordinator to arrange schedules for seniors who visit Boston Park, and also work with the Boston Park Neighborhood van driver to coordinate the van schedule. Volunteer "pilots" are ambassadors of the public bus system who ride with seniors and teach them how to use it. They work one-on-one with new riders of the city bus system, with the goal of assisting at least 10 new users per day, and also will be assigned to accompany a group of seniors on a "Ride the Bus Day" scheduled outing to assist riders in group as needed. The WMTA bus stops at Boston Park, making it easier for those living in the Boston Park area or using the Butler County program to take advantage of the half-price special citizen fare the system offers to seniors. Volunteer "navigators" are escorts during transportation who provide assistance to frail seniors using public transportation. Matches are made based on the residential location of the requestor and the volunteer's location. Navigators will not provide transportation, but will ride with a senior on public transportation like WMTA's Special Transportation Services.
A total of 41 seniors took advantage of the Boston Park Neighborhood Transportation Service between May 1995-September 1995. Post-measures were conducted with five older females to determine their level of satisfaction and the ease of use of the service. All indicated that the service was easy to access, friendly, affordable, and reliable, and indicated that it provided transportation needs that were not being met previously. CPAAA (1996) notes that political problems arose between county and city government agencies in the process of implementing the county/city-sponsored program, and that it is important for others who want to replicate the model to clearly define sponsors' roles and responsibilities in a written agreement prior to program implementation. Although demand for the service existed and was growing as a result of extensive publicity, there was difficulty obtaining long-term financial support. The service was discontinued when the seed money supplied from the grant ran out, and the sponsor who was expected to back the service after the project demonstration ended did not come through.
Connect-a-Ride, provided by the Jewish Council for the Aging, serves as a clearinghouse of information on alternative transportation for seniors in suburban Washington, D.C. (Montgomery County, MD and Arlington County, VA). Since program implementation in April 1996, over 650 seniors have received information and assistance to obtain transportation (Maximizing Human Potential, 1998). Free information about costs, routes and availability of both public and private transportation services is provided. Whenever possible, Connect-a-Ride also attempts to link seniors to specific programs which best address their needs. Counselors first work with the senior to identify transportation needs and resources. Then they determine whether any community-based programs are available for which the senior is eligible, and able to use. Older persons may access the agency through a local telephone call. The phone is staffed from 18 to 30 hours per week, and an answering machine is available to record other calls. These calls are returned within 24 hours. Staff spend an average of 40 minutes with each new client. Follow-up calls are made to determine whether clients were able to use the information provided, and that they were successful in making their trip.
The Columbia Association (in Howard County, MD) provides free door-to-door transportation for Columbia seniors who want to attend evening and weekend community events in Columbia (Senior Connections, 1998). This service accommodates the needs of seniors who no longer wish to drive at night. Reservations must be made three days in advance of the event.
The "Independent Transportation Network" (ITN) in Portland, ME utilizes both volunteers driving their own automobiles as well as paid drivers to transport seniors who can no longer drive. Transportation to any destination is available to all seniors, regardless of income, 24 hours a day; seven days a week. ITN is a membership organization that offers several ways that members can pay for transportation. Among these options is a program in which local merchants patronized by seniors partially subsidize rides for ITN members.
"Rec Ride Plus" in Bangor, ME utilizes volunteer drivers and dispatchers to provide low cost transportation to seniors within a 60 mile radius of Bangor. Two vans and a wheelchair-accessible bus are used to provide transportation Monday through Friday from 8:30 a.m. until 4:30 p.m.
"Volunteers in Motion" utilizes volunteers as drivers and escorts to seniors living in Brevard County, FL. In 1997, this service provided 2,900 rides to seniors living in Brevard County.
ElderNet of Lower Merion and Narberth (Pennsylvania) is a non-profit organization that was developed in 1976 by representatives of the community, and religious and governmental groups. They serve adults of all ages, including the disadvantaged and those over age 60. ElderNet is staffed by 3 professional social workers and 180 trained volunteers. Funding for the program is received from Montgomery county office on Aging, Lower Merion Township, the Borough of Narberth, community residents, businesses, churches, synagogues, and other groups. Only half of the funding is from government and foundation sources. They are an United Way donor option agency. ElderNet helps older neighbors to remain independent, and provides a variety of practical, free services. These include: (1) Immediate help - to answer questions, asses needs, and find resources to meet the needs; (2) Transportation - volunteers provide rides for medical appointments, banking, shopping, and other trips for those with low-moderate incomes who cannot use public transportation; (3) Help for the homebound - volunteers shop, do odd jobs, help complete forms and balance checkbooks, and serve as visitors, to enable homebound adults to continue to live independently in their homes; (4) Emergency help - for persons of all ages who need money for fuel, rent, food, and other one-time financial emergencies through federal and locally raised funds; (5) Community cooperation - a special Eldercare Committee of business, religious, and educational representatives meets to address the problems faced by older adults in the community; (6) Housing - using emergency funds and housing counseling, ElderNet helps homeless persons of all ages or those who are in danger of eviction, and provides information on housing options that range from rental assistance to nursing homes; (7) Telephone Reassurance - volunteers call homebound people every day, including weekends and holidays, to check on their health and security; and (8) Information - ElderNet studies issues and informs the public about programs and services for the adult community through speaking engagements, information guides, and newspaper articles. In 1997, ElderNet responded to 5,665 calls for help from 1,723 people. Their volunteers gave 7,799 hours of service and provided 1,537 escorted round trips for food, shopping, doctor's visits, or other necessary appointments.
The Community Transportation Association of America (CTAA) is an association of organizations and individuals who are "committed to improving mobility for all people." CTAA conducts research, provides technical assistance, offers educational programs, and serves as an advocate in order to make coordinated community transportation available, affordable, and accessible. It is located in Washington, DC where there are 16 full-time staff, and several part-time and consultant staff. There are no branch offices. They define community transportation as "a practical alternative that picks up where the private auto and mass transit leave off, which has evolved as an effective network of community-based agencies and coordinated services that offers the elderly access to needed services, ensures mobility for people with disabilities, and connects the poor and unemployed with jobs and training facilities."
The National Transit Resource Center of CTAA (1-800-527-8279) serves transportation providers, planners, and passengers with publications, peer support, advice, and assistance in the following areas: employment transportation; funding for transportation services, medical transportation, senior transportation, drug and alcohol testing programs, interstate passenger regulations, scheduling and dispatching systems, and vehicle procurement. Services are funded by the U.S. Department of health and Human Services and Federal Transit Administration, and are typically provided at no charge. The USDA sponsors the Community Transportation Development Fund (CTDF). The fund provides low-interest loans up to $150,000 to improve or expand transit programs in rural areas. Private carriers, nonprofits, public agencies, and community organizations are eligible for the program. Loans may be used to: acquire vehicles and provide operating expenses; purchase land for transit facilities; finance terminals, transit offices, or maintenance facilities; acquire communications equipment; or start up innovative entrepreneurial projects (e.g., owner-operator systems). These loans are intended to assist project populations of 25,000 or less whose managers do not have access to conventional financing.
CTAP, the U.S. Department of Health and Human Services Community Transportation Assistance Project, provides information and answers to questions about transportation issues, such as accessibility, coordination, funding opportunities, training, management and legislation and regulations. They offer health and social services planners and providers options for meeting client access needs. The National Transit Resource Center is CTAP's information clearinghouse. Relevant, up-to-date information on all key human services transportation issues is available through the toll-free hotline or the computer bulletin board. The Resource Center has more than 15,000 computerized entries of publications and databases on a wide range of human services and community transportation topics. Resource Center staff are knowledgeable in the latest federal regulations and pending legislation. CTAP produces a variety of publications, all targeted at
human services agencies and community transportation providers. For a list of these resources, call the Transit Hotline. TAP-Net (Technical Assistance Peer Network) allows human services agencies and transportation providers to draw upon the experience of experts nationwide. Coordination, accessibility, marketing, consumer training and more are common topics addressed by the peers. Technical assistance may be provided by telephone calls, conference workshops and presentations and on-site visits. CTAP has produced two training modules for human services transportation providers. Making Community Transportation Accessible and Coordinating Community Transportation Services contain a planning and implementation handbook as well as a facilitator guide. CTAP also conducts regional training conferences on coordination and accessibility issues. Community Solutions is CTAP's newsletter that focuses on transportation and the important role it plays in keeping communities viable and their residents independent. As states assume greater responsibility for health care and welfare, finding cost-effective community transportation solutions will become increasingly important. Community Solutions provides brief descriptions of new transportation designs and models that respond to today's challenges
Conclusions/Preliminary Recommendations:
Programs like DDS and the Boston Park Project are valuable as sources of information for seniors concerning alternative transportation. The social support and counseling provided to seniors by seniors about driving cessation is also important. Furthermore, these programs also help the senior volunteers by giving them the feeling of making a contribution to the well-being of others.
Volunteer ride programs like ITN address some of the limitations of other paratransit or shared ride services. Most notably, the use of volunteer drivers assists in holding down costs while meeting mobility needs using vehicles that are comfortable and (perceived to be) safe by older clients. Personal relationships that develop between clients and their regular drivers also increases user satisfaction with such services. These services do face some of the same problems as other shared ride programs, however, in that hours of operation are restricted and rides usually need to be scheduled at least one day in advance. Volunteer programs such as the Columbia Association provide a means for seniors to stay active in cultural community events that are usually scheduled in the evenings, and allow older drivers to restrict nighttime driving without restricting access to social events.
CTAA is a resource that should be utilized in the development and implementation of a Model Program in any jurisdiction, to help determine where gaps exist in traditional transit service, where there are community-based programs already in existence, and how to implement and creatively fund new programs.
References:
• Bangor, ME: Rec Ride Plus.
• Brevard County, FL: Volunteers in Motion• Heckmann and Duke (1997).
• Community Transportation Association of America (CTAA), 1341 G Street, NW, Suite 600, Washington, DC 20005; phone: (202) 628-1480; fax: (20) 737-9197; http://www.ctaa.org; National Transit Resource Center 1-800-527-8279.
•ElderNet of Lower Merion and Narberth, 9 South Bryn Mawr Avenue, Bryn Mawr, PA 19010, phone (610) 525-0706.
• Maximizing Human Potential, volume 6, no. 1, Summer 1998. Quarterly Newsletter of the Aging, Disability and Rehabilitation Network of the American Society on Aging.
• MDOT You Decide - Older Driver Program (based on DDS program).
• Montgomery County, MD/Arlington County, VA: Connect-a-Ride.
• Portland, ME: Independent Transportation Network.
• The Senior Connection, volume 4, Number 9, September 1998. Produced by the Howard County Department of Citizen Services/Office on Aging.
• Wichita, KS: Central Plains Area Agency on Aging Boston Park Project
IC4(c)i. Hired Drivers
Summary:
Red Top Cab in Arlington, VA has recently purchased a fleet of five wheelchair-accessible cabs for transport of elderly and disabled passengers. Red Top also offers a 10 percent discount to senior citizens.
Other taxi operators also offer fare discounts to seniors. Alexandria Yellow Cab, for example, allows seniors to purchase pre-paid coupon books, allowing them a 10 percent discount on fares with the use of the coupons. Likewise, Union Cab Company in Madison, WI allows seniors to buy $20 coupon books for rides at a 20 percent discount.
Some seniors in smaller towns may pay nonprofessional drivers for rides to and from medical appointments, etc. Driving people to destinations in exchange for payment is illegal in many towns without a taxi license, however. In 1996 a 67-year-old Oregon woman was convicted of violating one such taxicab ordinance by driving friends to medical appointments in exchange for $4.00 to $5.00 in gas money. A complaint was filed by a local cab company who was losing business to this private driver. It should be noted that the cab company charged significantly higher fares for the same trips, meaning that many seniors on fixed incomes could not afford their services.
USAA, a San Antonio, TX-based insurance company, has developed an innovative new program called "Choice Ride." The idea came about after listening to comments from its members, which often focus on changing lifestyles and the growing need for some type of safe, dependable, and fairly priced alternative transportation. After two years of research and development, Choice Ride began an 18-month field test in the Orlando, FL area on July 1, 1998 (to coincide with "Independence" Day). Choice Ride offers the convenience and privacy of a personal car, without the expense of owning the car or driving the car yourself. The service is being test marketed to members age 65 and older, and to adult members who may have parents or loved ones for whom the service may be of interest. As a door-to-door, personalized service, Choice Ride is intended to operate in suburban areas with large concentrations of USAA members. Subscribers can schedule chauffeured transportation in luxury automobiles without the worry of carrying cash for fares or tips. Choice Ride transportation is being provided by Mears Transportation Group, a recognized provider of high-quality transportation service. Transportation is available 24 hours per day, seven days per week. Subscribers call (up to one day in advance of their trip) to book a reservation to go anywhere in the four-hundred square mile service area. Three pricing plans are available for USAA members. Packages include pre-paid transportation accounts for 30, 60, or 90 rides. USAA also offers a trial program that allows a potential subscriber to "try out" Choice Ride to see if the program will accommodate their lifestyle. In addition, USAA members who sign up for Choice Ride and have an active auto policy with USAA, are eligible to receive a 90 percent premium reduction on one of their insured vehicles, if they agree not to drive that vehicle (except for emergency situations) while using Choice Ride. At the end of the test period, USAA Alliance Services Company will decide when and where to expand the program.
Conclusions/Preliminary Recommendations:
Taxis and hired drivers offer a degree of flexibility in scheduling not available with paratransit or volunteer ride services. Even with senior citizen discounts, however, the cost of these services may be out of reach for many seniors on fixed incomes. On the other hand, services like Choice Ride may actually cost less than the costs associated with owning a car. Unregulated "Gypsy" cabs as described above offer an affordable alternative, but operators of such services face stiff fines if caught.
References:
• Arlington, VA: Red Top Cab
• Alexandria, VA: Alexandria Yellow Cab
• Burkhardt, Berger, Creedon, and McGavock (1998)
• Evelyn Alexander, USAA Insurance Company. 9800 Fredericksburg Road, San Antonio, TX 78288 (1-800-535-8695)
• Madison, WI: Union Cab Company
• Media Release: Cascade Policy Institute
IC4(c)ii. Voucher Programs
Aging and disabled citizens of Baltimore are eligible for taxi vouchers funded by the Mayor of Baltimore and the Maryland Department of Transportation.
The Culver City Senior Citizens Center offers a taxi voucher program in addition to van service within a two-mile radius of the center.
Elderly residents of Berkeley, CA who cannot use public transportation can obtain reduced-cost transportation vouchers from the city's Subsidized Taxi and Van Program.
References:
• Baltimore, MD: Baltimore City Commission on Aging and Retirement Education
• Berkeley, CA: Subsidized Taxi and Voucher Program
• Culver City, CA: Culver City Senior Citizens Center
1C4(d). Electric Golf Carts
Vendors of golf carts/NEVs include Bombardier NV, Club Car, Columbia Par Car, E-Z-GO, Hyundai, Yamaha, and others. These vehicles carry from 2 to 4 adults. Most include basic safety features, such as rear-view mirrors and brake lights, and some include turn signals, windshields, wipers, headlights, safety belts, radios, etc. The base price ranges from $ 2,500 to $ 3,000.
In Florida, a golf cart operator is exempt from obtaining a driver's license, and may operate a golf cart along roadways designated for golf-cart use, and may only be operated on state roadways with a posted speed limit of 30 mi/h or less. A golf cart may cross a state road only if the location is approved by the Florida DOT. Florida permits the operation of golf carts during daylight hours, although the state, county, or municipality may allow golf carts to be operated between sunrise and sunset if the golf cart is equipped with headlights, brake lights, turn signals, and a windshield. The following equipment is required on all golf carts: "efficient brakes, reliable steering apparatus, safe tires, a rearview mirror, and red reflectorized warning devices in both the front and rear." They may be operated within a self-contained retirement community, unless the governing body of the county or municipality determines that a prohibition is necessary because of safety concerns. FDOT may also prohibit the operation of golf carts on any street or highway under its jurisdiction in the interest of safety. Although golf carts have been seen operating on sidewalks, the statute states that "no person shall drive any vehicle other than by human power upon a bicycle path, sidewalk, or sidewalk area, except upon a permanent or duly authorized temporary driveway." Golf carts may be included under a homeowner's insurance policy and do not need to be insured separately in Florida.
In Sun City, Fl (an unincorporated age-restricted community, located 16 miles south of Tampa), operation of golf carts is allowed for any purpose on county streets within the community. A brochure is given to all residents and potential residents to illustrate some of the criteria for golf cart usage in Sun City Center, and when crossing certain designated areas outside of Sun City Center.
California permits local authorities to designate certain areas of state highway for golf cart operators. Local authorities are also permitted to establish crossing zones on other streets with posted speed limits of 45 mi/h or less, adjacent to golf courses. Golf carts may not be operated on any highway unless the speed limit is 25 mi/h or less.
In Palm Desert, CA, a 5-year program was initiated in 1993 ("Golf Cart Transportation Pilot Program") to develop a convenient transportation system that is safe, environmentally sensitive, and offers zero emissions. It was designed to expand the use of golf carts to more than just transportation to golf and recreational sites, and to provide for broader use on public streets and private roads than is currently allowed for in the California Vehicle Code. Permitted users are allowed to use golf carts to travel to schools, colleges, parks, shopping, businesses, and government offices. The long-term goal is to provide full golf cart access throughout the community. New policies were designed specifying golf cart physical criteria, golf cart operator requirements, and golf cart lane design criteria. In 1997, there were more than 600 miles of golf cart lanes.
Conclusions:
The study authors concluded that the use of electronic golf carts and other NEVs holds great potential as an alternative transportation mode for seniors and other drivers with disabilities who can not, or choose not to drive regular vehicles. However, given concerns about the safe operation of vehicles in mixed traffic, state statutes need to be reviewed and revised. In addition, some decisions will need to be made regarding the functional abilities necessary for the safe operation of golf cart/NEV operators.
References:
• Mathias and Stoffle (1998)
I.C. DEVELOP TOOLS NEEDED TO IMPLEMENT MODEL PROGRAMS
I.C.5. Alternatives to Transportation
(a)Community/Social Support Activities
(b)Internet Access to Services
IC5(a). Community/Social Support Activities
The loss of freedom and mobility associated with driving cessation can impact seniors in many different ways. Many suddenly find themselves isolated from social interaction and unable to access services to allow them to continue living independently.
Marottoli et al. (1997) found an association between driving cessation and an increase in depressive symptoms in an older, noninstitutionalized sample. The loss of independence and opportunities for social interaction suffered by those without ready access to alternative forms of transportation can have a severe impact on psychological well-being. A sense of loneliness can overcome a senior who lacks access to transportation. This feeling of loneliness can also trigger depression. One study found that loneliness was a strong predictor of nursing home admissions among older persons (Wallace, Russell, Cutrona, and de la Mora, 1998). These investigators found that older individuals who attend church, experience much lower rates of nursing home admissions, compared to older persons who do not regularly attend services. They concluded that regular involvement in group activities tends to ward of the need for dependent care such as that provided by nursing homes. The study authors suggested the use of community groups are a means of bringing independent individuals together.
Providing nondriving seniors with opportunities for social interaction and the means to address day-to-day needs can prevent the onset of depression. Several organizations have put these types of services in place. In Shasta, CA, for example, the "Shasta Senior Nutrition Program" offers group lunches to those age 60 and over at four centers, located in Anderson, Burney, Lake Shasta City, and Redding. The meals are nutritionally balanced and provide one-third of the recommended dietary allowance. A donation of $2.00 or more is requested. A "Meals on Wheels Program" delivers hot meals to physically disabled or incapacitated seniors who cannot attend the congregate meals, and have no one available to cook for them. Hot meals are delivered Monday through Friday, with the exception of some holidays. Frozen dinners are available on the weekend. The "Senior Brown Bag Program" serves low-income seniors age 60+ nutritious foods that might otherwise go to waste. The meals are distributed twice a month at seven different distribution sites located throughout the Shasta County area. The recipients must be physically able to reach the distribution site. The services of the Shasta Senior Nutrition program are provided largely by volunteers, although the program is operated by a small staff.
Meals-on-Wheels of Greater San Diego home-delivers two meals per day to seniors age 60+ who are unable to prepare meals for themselves or unable to get to a grocery store. Younger disabled adults may also be eligible if they are homebound, and there are openings on a meals on wheels route. Two meals are delivered daily during the lunch hour that include a hot dinner for immediate consumption and a cold "sack" supper for later. Menus are planned by registered dietitians; both meals (together) supply two-thirds of the federal nutritional Recommended Dietary Allowance (RDA), and two-thirds of the recommended calorie intake. When necessary, meals can be prepared for people with special dietary needs. Recipients are charged on a sliding scale with a maximum charge of $5.00 per day. Meals are delivered Monday through Friday during the lunch hour. Meals on Wheels is a nationwide resource that is controlled by local community agencies. The program costs between $10 and $30 per week, depending on the older individual's income. Elders with a low income may be eligible to have the meals for free. Meals on Wheels is available on both a short-term basis (e.g., people recovering from surgery or other temporary problem) and on a continuing basis. The "Immediate Response" service ensures that meals can begin the next week day after being contacted; no one is ever put on a waiting list.
Indiana University runs two volunteer programs of benefit to seniors. The "Friends of Seniors Program" allows volunteers to provide companionship to senior citizens. The volunteer position requires 30 minutes of time on a daily basis, and volunteers must have their own transportation. Volunteers socialize and play games with seniors at an area nursing home. A meal delivery program is also provided for seniors in the Bloomington area. Another service not specifically for older adults is the "Women's Wheels " safety service that provides rides to women of the I.U. Bloomington community as an alternative to walking alone. The service is provided by two volunteers in each minivan: a driver and a navigator. Shifts are two hours in duration, from 8:00 p.m. to 10:00 p.m, and from 10:00 a.m. to 12:00 p.m.
The "Senior Support Program" in Grand Travers/Leelanau County, Michigan provides recreational activities and socialization for socially isolated citizens age 55 and older. Seniors participate in service projects, peer support activities, crafts, discussion groups, and exercise programs. The mission of the program is "to promote better physical and mental health for the frail elderly and those with emotional problems and/or developmental disabilities to help prevent premature out-of-home placements of older 'at risk' adults." The program staff includes a nurse, social worker, occupational therapist, and life skills advocates, who all have training and experience in geriatrics and mental health. Common problems of the individuals who seek their help include grief, depression, medication-related problems, exaggerated fears, difficulty adjusting to loses, and behavior problems. Outreach Counselors see adults regularly in their homes. They assist the client and family gain insight and resolve problems. Client Service Managers provide assessment, advocacy, and links to services for clients who have multiple and complex needs. There is a charge for some services, but it is established according to the person's ability to pay; no one is denied service because he or she can not pay.
Ardmore's "Care for the Elderly" provides home-based support for seniors in the Akron, OH area. They provide a variety of support options to help aging individuals stay in their own homes. They provide transportation, menu planning and meal preparation, light housekeeping, shopping, recreational activities and social support. Each senior receives an individual assessment to identify his or her needs. Referrals to other agencies are provided for any needs this program cannot meet.
"Senior Citizen Services" (SCS) of Pender County, NC provides a range of services to seniors, including home-delivered and congregate meals, transportation, and in-home assistance with activities of daily living. SCS also provides seniors with opportunities for interaction, socialization and education. The program is designed to help older adults maintain the highest level of activity, self sufficiency, and independent living.
The "Division of Long Term Care and Aging" of Snohomish County, WA provides a wide variety of services for seniors. The "Adult Day Health Program" includes social support, therapeutic activities, hot lunches, health monitoring, exercises, and more to improve the overall health and independence of seniors, and to prevent premature nursing home or hospital placement. Adult day health costs $43.07 per day; they accept Medicaid and County Respite clients, and also utilize a sliding fee scale. Case management services are also provided to assist functionally impaired seniors in obtaining the support services they need. Personal care services provide help with activities of daily living, such as assistance with baths, showers, hair washing; assistance with walking (especially outside of the home); assistance with shopping for groceries or preparing meals; and driving a person to a doctor's appointment. The "Daybreak Respite Program" operates at four different sites throughout the county. This program is designed to allow a rest break for the caregivers of seniors with limitations. Seniors participate in various structured leisure activities, allowing caregivers some time to themselves. The program costs $26.27 per day; individuals may qualify for a reduced rate if they are at a low to moderate income level. The "Retired and Senior Volunteer Program" links seniors with opportunities to donate their time to community agencies needing help. Volunteers can choose to assist in an area where they already possess skills, or use the opportunity to learn new skills. The program will assist with transportation for senior volunteers to and from the site where they are volunteering. Many other services are offered, including discount dental care, depression screening, health maintenance, legal aid, hot meals, volunteer chore services, and senior to senior peer support.
The "Philadelphia Corporation for Aging" funds several adult day care centers in the Philadelphia, PA area. These centers are community-based programs designed to meet the needs of functionally impaired older adults. They provide health and social services as well as congregate meals. They also provide a respite for the primary caregivers of impaired older adults.
The "Getting in Gear Program" in Tampa/St. Petersburg, FL provides case management services to seniors who have ceased driving. Case managers will link seniors with housekeeping, shopping, transportation, and social services with the goal of helping seniors remain independent for as long as possible.
Kennedy Health Center's "ElderCare" program provides older citizens of three New Jersey counties (Burlington, Camden, and Gloucester) with links to in-home assistance, food shopping and transportation. The goal of this program is to allow older patients to continue safely living at home for as long as possible. Kennedy has a network of 15 to 20 health centers that are located in retirement communities and area apartment buildings with a high concentration of seniors. The health centers solve the transportation problems many seniors face by bringing programs and medical services directly to them. Board-certified geriatricians are available at each facility twice per week; medical specialists including podiatrists, ophthalmologists, and ear-nose-throat physicians rotate through the centers, depending on the needs of the residents. Kennedy offers free support groups for older persons and their caregivers, with topics ranging from "Adjustment to Later Life Change" to "Chronic Pain."
"Options for Senior America" offers services to seniors living in the Northeast, Mid -Atlantic, and Southeast regions of the U.S. that include: errand service, housekeeping, hygiene, and meals. Services are available on a live-in or a live-out basis. OPTIONS is a non-medical home care organization that includes directors, managers, social workers, coordinators, and personnel who work with older persons on a daily basis. They can provide 7-day, 24-hour live-in services, or part-time and full-time live-out programs that range from 4 to 24 hours per day.
The "Dallas Lighthouse for the Blind" offers a comprehensive range of accredited rehabilitation programs for people with vision impairments. The multi-service rehabilitation agency serves nearly 1,000 people with vision disabilities each year through employment, vocational rehabilitation, information and referral, independent living rehabilitation, transitional housing and life enrichment services. Lighthouse for the Blind also operates in New Orleans (LA) and in Tampa (FL). The mission of the agency is to provide vision-disabled blind and multi-disabled blind adults and seniors with opportunities to achieve personal, social, and economic independence. They provide industrial center employment and training; vocational rehabilitation; information about and referral to other community agencies; and independent living rehabilitation. For the independent living rehabilitation component social work services provide needs assessment, intake, evaluation,
goal-oriented counseling and case management. Peer counseling services match newcomers with trained graduates of Lighthouse services. Independent living skills training gives instruction in activities of daily living such as eating, cooking, sewing, using adaptive aids and managing personal affairs. Orientation and Mobility training, learning to travel using a white cane or dog guide, is taught one-on-one by certified instructors. Students learn to travel safely and become familiar with their
environment. Support group services enable clients to adjust to and cope with their vision loss through on-campus and neighborhood group counseling. Life enrichment services enable people to experience independence during their leisure time. Therapeutic recreational services offer opportunities for social independence and enjoyment through instructional classes, fitness activities, special events and outdoor activities. Volunteer services match volunteers with vision-impaired people needing assistance in certain tasks. Volunteer opportunities may include readers, drivers, sighted escorts and shopping guides. Volunteers may also give administrative or professional services, helping the agency to serve others.
References:
• Akron, OH: Ardmore's Care for the Elderly
• Bloomington, IN: Indiana University Honors Division Volunteer Programs
• Burlington, Gloucester, and Camden County, NJ: Kennedy Health System's ElderCare Program.
• Grand Traverse and Leelanau Counties, MI: Senior Support Program
• Lighthouse for the Blind (Dallas, TX; Tampa, FL; New Orleans, LA)
• Marottoli, Mendes de Leon, Glass, et al. (1997)
• Options for Senior America: 1-800-2-OPTIONS
• Pender County, NC: Senior Citizen Services
• Philadelphia, PA: Adult Day Care Centers
• Shasta County, CA: Shasta Senior Nutrition Program; National Meals on wheels Foundation: 1- 800-999-6262
• Snohomish County, WA: Division of Long Term Care and Aging
• Tampa/St. Petersburg, FL: Getting in Gear
• Wallace, Russell, Cutrona, and de la Mora (1998)
IC5(b). Internet Access to Services
Valuable information and services for seniors who no longer drive can be found on the internet. Several World Wide Web sites cataloging services and information of interest to seniors have been developed. Furthermore, many retailers operate web sites which allow individuals to shop for groceries or other products without leaving home. This type of service could benefit seniors who no longer drive. However, according to a 1998 Department of Commerce study by the National Tele-Communications Information Administration, only 21 percent of seniors own PCs and only 8.8 percent are connected to the internet (Philadelphia Inquirer, October 18, 1998).
Microsoft created the Microsoft Senior Initiative to "bring generations and communities together by helping to provide access to technology to people of all ages." Their website at www.microsoft.com/seniors provides information to assist seniors in the following areas:
(1) Communication - writing e-mail and sending pictures via e-mail to family and friends; (2) Employability - being able to job share, telecommute, or be retrained; (3) Creativity - creating a family tree, calendar, or Web page; (4) Financial Independence - Accessing information about investments or conducting commerce over the internet; (5) Connectivity - continuing to contribute to society through a mentoring program; and (6) Learning - attending on-line seminars, researching information, or taking a virtual trip. Recently, Microsoft's Learning Pavilion was one of the 300 exhibits at the Philadelphia Corporation for Aging (PCA) "Age Expo" (10/98).
For seniors just getting started on the internet, SeniorNet is a nonprofit organization that offers 350 chat rooms and discussions on travel, gardening, and health. They are the largest on-line network and computer training program designed and taught by older adults (www.seniornet.org). Membership is $35.00 for an individual and $40.00 for a couple. Most discussion areas are accessible to non-members. A book called Young@heart Computing for Seniors (by Mary Furlong, the founder of SeniorNet and Stefan B. Lipson; McGraw-Hill, 1996, $22.95) offers basics on computer fundamentals and getting connected to the internet.
Seniors can also find guides to specialized services, health care, and housing online. One such source of this information is Senior Options (http://www.senioroptions.com). It bills itself as the "most comprehensive and complete guide to senior services on the Internet". Information on a wide range of services can be accessed on this site: housing options, home health providers, case management, legal services, etc. Searches can be conducted by geographic area to produce lists of service providers for any area of the country. Other sites geared to seniors include the SeniorCom site (www.senior.com) that provides information about retirement communities; the American Association of Retired Persons (AARP) site (www.aarp.org); ThirdAge (at www.thirdage.com) which features news and advice on health, money, romance, work, technology, family and living; the Senior Search site (at www.seniorsearch.com) which contains information about health, housing, and legal resources; and the Senior Center (at www.senior-center.com) that offers free items, bargains, and late breaking news.
At least two companies currently offer online grocery shopping. Oncart online grocery shopping allows customers to choose from thousands of grocery items (www.oncart.com). Customers are given a password for access to the system. A variety of payment options are in place for customers, and Oncart provides delivery of the order at a time and day selected by the customer.
Peapod online (www.peapod.com) offers similar service in the Boston, MA area. Members pay a $4.95 per month membership fee, and another fee for each purchase. Orders can be picked up or delivered to the home. Shoppers can choose from a variety of payment options, and can specify delivery times and instructions.
Wal Mart retail stores offer an online shopping service as well (http://www.wal-mart.com/). Orders are shipped via UPS or USPS. Payment is limited to credit card.
Conclusions/Preliminary Recommendations:
There are many services available on the internet which could benefit nondriving seniors. A major obstacle, however, is making seniors comfortable in accessing these services. Education provided by computer-literate older volunteers could facilitate seniors in gaining access to this potentially valuable source of information and assistance. One concern with many on-line shopping sites, is the requirement to supply a credit card number on-line for payment, at the time the order is placed.
References:
• Lorek, L. (October 15, 1998). "Many Sites for Seniors on Web." Sun Sentinel, South Florida.
• Microsoft Senior Initiative (Craig Spiezle, director), in The Philadelphia Inquirer, Special Advertising Section (October 18, 1998), "Microsoft Demonstrates Computer and Internet Technologies at the Age Expo."
• Oncart Online Grocery Shopping
• Peapod Online Grocery Shopping
• Senior Options
• Wal Mart Online