The government has been exploring the challenges and benefits of human services transportation since the 1980s. Human services transportation has been a top priority of many agencies since President Bush released Executive Order 13330 in February 2002. In order to expand and improve service for all Americans, a complementary goal of many human services transportation initiatives, including the latest USDOT initiative, the MSAA, is to achieve a more efficient use of Federal transportation dollars. In support of MSAA, this report summarizes the Phase Two (Foundation Research) effort.
There are many past and ongoing human services transportation, coordination, and technology initiatives such as the 2002 Presidential Executive Order, the Federal Interagency Coordinating Council, and the UWR program that have been created as a result of the GAO's and other organization's research findings. In addition to these initiatives, several non-profit organizations such as the CTAA and ESPA have created technical assistance opportunities for both transportation providers and users. Some of these efforts focus specifically on the role of technology in achieving increased mobility, accessibility, and coordination.
New capabilities and opportunities are being created in both the transportation and health and human services communities through the use of emerging technologies and innovative services. Pioneering public transportation agencies are using Intelligent Transportation Systems (ITS) to provide centralized coordination of community transportation providers, one stop shopping, and service brokering through integrated automatic vehicle location systems, advanced communications, and universal benefit cards. Others are providing on-vehicle audio annunciation, accessible traveler information, and flexible routing to assist passengers with disabilities in using conventional transit services. In the rehabilitation community, innovative AT such as personal GPS and personal display assistants (PDA) use mobile communications to provide real-time assistance to those with cognitive disabilities, accessible pedestrian signals, and "talking" bus stops and signs are also being developed. However, the two communities are often unaware of the research, new approaches, and advances that each is making, and neither may have direct communication with the disability community at large. The USDOT is now bringing them together to provide a coordinated effort to apply technological solutions to the barriers to accessibility and mobility for persons with disabilities.
The foundation of this MSAA initiative is built around the notions of service coordination and technology integration. The definition of the transportation-disadvantaged, according to the GAO report, includes " people who are unable to provide their own transportation as a result of a disability, an age-related condition, or an income constraint."  TCRP Report 49, Using Public Transportation to Reduce the Economic, Social, and Human Costs of Personal Immobility (1999) uses a more generic definition for the transportation disadvantaged: "Those people whose range of travel alternative is limited, especially in the availability of easy-to-use and inexpensive options for trip-making."
This key relationship is what the FTA and the FHWA hope to expand on as they work toward the ultimate goal of the MSAA initiative, which is
[t]o develop the architecture/design of a replicable, scalable traveler management coordination center, which will enhance service accessibility and operations efficiency and provide a one-stop customer-based travel information and trip planning services. 
Phase 2 of the MSAA initiative is titled "Foundation Research." The purpose of this phase is to:
- Integrate knowledge from the transportation and human services communities on needs, gaps, barriers, past and current innovations, and emerging opportunities so that program resources can be allocated to focus on the correct targets.
- Establish the baseline so that measurable performance can be defined and gauged.
- Develop the information inventory so that subsequent program activities can build upon existing knowledge and systems.
- Identify concurrent activities and initiatives by public sectors so that related efforts can be effectively integrated and/or coordinated.
Section 1 of the report will discuss the scope of the human services transportation system, highlight what has been done to date (research, coordinating council, technical assistance), and address the current state of the practice.
The goal of the MSAA initiative is driven by growing inefficiencies within the human services transportation system: resources and service areas are limited and service is fragmented or not coordinated. These factors make the service delivery process challenging. The inefficiencies and challenges within the human services transportation system were well summarized in a June 2003 report to Congress released by the U.S. Government Accountability Office (formerly the General Accounting Office or GAO) titled "Transportation Disadvantaged Populations," which highlighted the following statistics:
- 62 Federal programs fund transportation services.
- 29 of these programs spent at least $2.4 billion on these services in fiscal year 2001. 
These programs typically fund transportation services for persons classified as transportation disadvantaged; section 2 of this document discusses the definition of "transportation disadvantaged" in great detail. The GAO provided a brief definition in their 2003 report: "persons who lack the ability to provide their own transportation or have difficulty accessing whatever conventional public transportation may be available."  Currently, there are 15.5 million people in the U.S. who could be considered transportation disadvantaged,  with nearly 100 million more who are at risk for becoming transportation disadvantaged . The confusing array of transportation programs, funding sources, user groups, and destinations have been shown in a popular USDOT depiction, seen in Figure 1-1.
1.2 What Has Been Done?
The notions of improved service coordination and technology existed prior to the well-publicized GAO report of 2003. Prior to and since this report, there have been many efforts made to document the problems which exist within human services transportation and the solutions that may relieve them. Many organizations, both governmental and non-governmental, have conducted studies and technology deployments with respect to human services transportation systems; these efforts have resulted in numerous workshops, technology demonstrations, and a presidential executive order. These various activities have focused on institutional issues, such as coordination, technology opportunities, such as intelligent transportation system (ITS) demonstrations, and technical assistance and training availability, such as that offered by non-profits. These past efforts are summarized below.
The GAO's research on human services transportation improvement has focused largely on the topic of coordination. The GAO has published five major reports related to coordination – three of these are focused on the levels of coordination that exist at the Federal level. Each report updates the information in the previous study. The latest study, which was published in 2004, focuses on the efforts that are currently in place to enhance mobility for seniors.
Hindrances to Coordinating Transportation of People Participating in Federally Funded Grant Programs. 
The 1977 study was the GAO's first study on human services transportation coordination. This report did not endorse coordination or document the benefits of coordination, nor did it recommend the best processes for achieving coordination. The purpose of this 1977 study was to:
- Identify Federal programs that provide transportation.
- Identify restrictions that prevent or confuse Federal, State, and local coordination efforts.
- Highlight successful examples of coordination.
In 1977, the GAO had identified 114 Federal programs with transportation benefits, although at this time, these programs "did not distinguish among rural areas, small urban areas, and urban areas."  The main hindrances that inhibited coordination efforts at that time still remain today:
- Concerns among agencies that coordination reduces the quality of service provided to clients.
- Concerns about accountability and bookkeeping.
- Concerns regarding perceived or real incompatibility in the transportation needs of various client groups.
- Concerns over availability of continuous funding.
Some of the hindrances the GAO identified in 1977 have been improved upon by the Federal government. Most notably, the GAO identified the "lack of a concerted Federal effort to coordinate transportation." Since the publication of this report, the Federal government has developed programs such as the Coordinating Council on Access and Mobility (CCAM) and UWR initiative, which specifically address the need for human services transportation coordination.
Although this report did not recommend ways to eliminate the documented hindrances, the GAO recognized elements of successful coordination examples, including the role of strong local leadership and the need for Federal program regulations that offer coordination guidance.
Transportation Coordination: Benefits and Barriers Exist, and Planning Efforts Progress Slowly. 
This study was released in October 1999 as a report to Congressional Committees. The study was conducted by the Resources, Community, and Economic Develop Division of the GAO and was produced at the request of the U.S. Senate Committee on Banking, Housing and Urban Affairs and the U.S. House of Representatives Committee on Transportation Infrastructure. These Congressional Committees requested the GAO to review:
- The benefits and incentives to human services transportation coordination.
- The Department of Health and Human Services' (HHS) and the FTA's efforts to identify barriers to transportation coordination.
- The HHS' and FTA's efforts to enhance transportation coordination through State and local transportation planning. 
In this report, GAO documented the estimated total Federal expenditures that relate to transportation. These expenditures were tracked and documented for HHS and FTA under the Department of Transportation (DOT.) For Fiscal Year (FY) 1998, HHS spent between $2 billion and $3.5 billion. During the same period, FTA spent in excess of $4 billion.
The report briefly summarized successful examples of human services transportation coordination in terms of methods and benefits, which had previously been documented by the CTAA. The focus of this document was on the efforts (as of 1999) of the FTA and HHS to strengthen interagency coordination. At that time, the main method to improve human services transportation coordination was through a Coordinating Council. The Council was initially formed in 1986 and has existed since that time.
As of 1999, the Council had been directed by congressional committees (such as those that requested the GAO report) to advance coordination through joint planning guidelines. In 1997, the Council developed planning guidelines; these were still under development in 1999 when this particular study was published (the Coordinating Council did publish its coordinated transportation planning guidelines at the end of 2000). The GAO report documented the overall consensus of FTA and HHS: specifically, that the Coordinating Council needed strengthening. The GAO report also recommended that the Coordinating Council produce an annual report to the Secretaries of HHS and DOT to achieve additional accountability. As of 2003, the strategic plan was final and guidelines for coordinating transportation services were complete, although the GAO found in its subsequent 2003 report that the goals and objectives in this plan were "generally not measurable," nor were they linked to the activities in the Coordinating Council's action plan.
Transportation Disadvantaged Populations: Some Coordination Efforts Among Programs Providing Transportation Services, but Obstacles Persist. 
Like the 1999 report, the June 2003 report on human services transportation also focused on coordination and was preceded by GAO testimony to the House of Representatives Committee on Transportation and Infrastructure and the Committee on Education and the Workforce (in May of 2003). Both the testimony and the report were conducted to:
- Identify the Federal programs that provide/fund transportation services to transportation disadvantaged individuals and the spending/obligations of each program.
- Assess the extent of coordination among various programs.
- Identify any obstacles to coordination and potential ways to overcome such obstacles. 
This testimony and subsequent report were assembled using data GAO gathered through in-depth interviews with pertinent Federal agencies, advocacy organizations, and industry representatives as well as by conducting five case studies (in Arizona, Florida, New York, South Dakota, and Wisconsin) and a literature review. This report publicized the now-familiar statistics that we included in Section 1.1:
- 62 Federal programs fund transportation services.
- 29 of these programs spent at least $2.4 billion on these services in fiscal year 2001.  This was a clarification of initial findings that were publicized in the 1999 GAO report related to resources spent on human services transportation.
Using the five case studies, several coordination efforts were identified and documented; these results included examples of consolidation, cost savings, and sharing vehicles and/or information. Despite these examples, there were still instances of "overlapping, fragmented, or confusing services among programs that did not coordinate."  The GAO recommended including additional Federal agencies on the Coordinating Council (only 2 of the 62 programs that fund services were represented). Lastly, the report identified three types of obstacles that prevented coordination from occurring:
- Reluctance to share vehicles and fund coordination activities due to concerns about possible adverse effects on clients.
- Differences in eligibility requirements, safety standards, and other programmatic requirements that can limit providers' ability to share transportation resources.
- Lack of leadership and commitment to coordinate. 
As we will illustrate in later sections of this document, many of these obstacles still exist today despite the fact that the GAO included potential mitigation strategies for these obstacles, including harmonization of standards, expansion of interagency forums, and provision of incentives or mandates.
Transportation-Disadvantaged Populations: Federal Agencies Are Taking Steps to Assist States and Local Agencies in Coordinating Transportation Services. 
The GAO document cited above was researched between November 2003 and February 2004 and published at the request of the U.S. House of Representatives Committee on Transportation and Infrastructure (Subcommittee on Highways, Transit, and Pipelines) on February 24, 2004. The purpose of the document was to follow-up on the GAO's June 2003 report on coordination as well as to:
- Determine whether the Departments of Labor, Education, Transportation, and Health and Human Services and the Coordinating Council had taken steps to address GAO recommendations from June 2003.
- Identify actions taken by the four Federal departments relative to the options outlined by the GAO for improving coordination. 
Overall, this report documented that, while coordination of Federal programs had improved at the State and local level, some of the recommendations made in the June 2003 report had yet to be carried out. As of the publication of this memo, the Departments of Labor (DOL) and Education (DOEd) had been invited to join the Coordinating Council; additionally, the guidance and technical assistance efforts of the HHS, DOT, and DOL had been improved and expanded, especially related to the HHS' Medicaid program and the DOL's Workforce Investment Act. In addition, all four departments launched the "United We Ride" (UWR) initiative, which is discussed in detail in this section. While positive, these efforts were all in early stages of implementation; therefore, the GAO indicated that long-term success could be measured by the sustainability of these changes. Finally, the FTA specifically included coordination-related performance goals in its strategic plan.
Despite these positive changes, there were still some instances where GAO recommendations had not yet been implemented. As of the publication of the memo, the DOEd had not begun "developing guidance on coordination for its programs."  While many agencies within the four Federal departments had linked their web sites to the main web site of the Coordinating Council, many had not yet completed this task. While FTA took steps to include coordination in its strategic plan, other agencies and departments had not incorporated coordination-related elements.
This document stressed the long-term commitment of resources as a key for making coordination efforts successful.
Transportation-Disadvantaged Seniors: Efforts to Enhance Senior Mobility Could Benefit from Additional Guidance and Information. 
The U.S. Senate Special Committee on Aging asked the GAO to conduct a study related to older adults who are transportation disadvantaged. This study identifies:
- Federal programs that address senior mobility issues.
- The extent to which these programs meet senior mobility needs.
- Program practices that enhance senior mobility and the cost-effectiveness of service delivery.
- Obstacles to addressing senior mobility needs and strategies for overcoming those obstacles. 
The GAO conducted research as part of this effort from November 2003 until August 2004. The report identified 15 programs that addressed the mobility issues of disadvantaged seniors. While the data are of limited extent, the national data did identify three needs which are typically not met; these include trips to multiple destinations or for purposes that involve carrying packages; trips to life-enhancing activities, such as cultural events; and travel in rural and suburban areas. 
The report also highlighted the work that local transportation providers have done to enhance the mobility of the senior populations while enhancing the cost-effectiveness of service delivery. These efforts ranged from leveraging existing funds to improving customer service. Finally, a helpful table summarized the obstacles, strategies, and trade-offs of meeting the transportation needs of transportation-disadvantaged seniors. The table can be seen in the report summary, which is available on-line. 
1.2.2 Coordinating Council on Access and Mobility, United We Ride, and the New Freedom Initiative
Coordinating Council on Access and Mobility (CCAM)
The CCAM was created in 1986. As of today, this council is known as the Federal Interagency Coordinating Council on Access and Mobility. This new council was established by Presidential Executive Order 13330 in February 2004, which focused on Human Service Transportation Coordination.
The 11 members on the council are from HHS, Department of the Interior, Department of Veteran's Affairs, the National Council on Disability, DOL, Department of Housing and Urban Development, DOEd, DOT, the Social Security Administration, Department of Agriculture, and the Department of Justice. It is chaired by the Secretary of Transportation (the USDOT is the lead agency on both the Coordinating Council and the UWR initiative). The focus of the council is to carry out an Action Plan that is designed to implement the goals of the Executive Order:
- Education and Outreach: to develop an education plan for coordinated human service transportation resulting in enhanced customer access at the local level for individuals with disabilities, older adults, and individuals with lower incomes.
- Consolidated Access: to simplify access to transportation services and to enhance customer service through the development of a comprehensive and coordinated transportation system.
- Regulatory Barriers: to reduce restrictive and duplicative laws, regulations, and programs related to human service transportation at the Federal level.
- Coordinated Planning: to ensure comprehensive planning for the coordination of human service transportation for individuals with disabilities, older adults, and persons with lower incomes.
- Cost Allocation: to standardize cost allocation processes.
- Useful Practices: to document successful strategies in coordinating human service transportation at the Federal, State, Tribal, and local levels. 
The Council has specific deliverables related to these goals, many of which, including the Useful Practices database, have already been completed. The Council meets regularly to assign commitments to deliverables. To complete these deliverables, action plans have been developed for each Department. The Federal Interagency Council recently submitted (in May 2005) their response to Presidential Executive Order 13330. This report summarized the actions taken with respect to each deliverable recommended by the Executive Order. The Council's five recommendations emphasized coordination-based solutions which strengthen existing transportation services:
- Coordinated transportation planning (e.g., mechanisms that require participation in "a community transportation planning process for human service transportation programs" ).
- Vehicle sharing (among federally funded programs).
- Cost allocation (where statutorily permitted).
- Reporting and evaluation (to permit cross agency analysis of the effectiveness, efficiency and progress made by those agencies working towards improved coordination).
- Consolidated access transportation demonstration program – this program will demonstrate the use of a single transportation system, financed through a consolidated Federal stream, that is designed to meet the needs of transportation disadvantaged populations.
United We Ride
UWR is an FTA initiative which was unveiled in June 2003. It has been utilized by the Council to help achieve the goals of Executive Order 13330. The initiative includes five elements:
- A Framework for Action self-assessment tool.
- State leadership awards.
- A National Leadership Forum on Human Service Transportation Coordination.
- State coordination grants (released in November 2004).
- A technical assistance program known as "Help Along the Way."
Before the UWR initiative began, the USDOT ITS Joint Program Office (JPO) sponsored a series of workshops. These workshops were organized by the DOT, HHS and DOL to bring State-level personnel together to discuss the Federal initiatives related to human service transportation coordination and related ITS or IT strategies which had helped achieve coordinated systems. The workshops included time for State roundtable meetings, where States could work on their own action plans for furthering coordination initiatives. Four workshops were held between March and September 2003. After the UWR initiative was publicized, an additional six workshops were held during 2004. The results of these workshops are discussed in detail in the next section.
New Freedom Initiative
Lastly, another government initiative was created in 2001 to help increase the mobility of certain transportation-disadvantaged individuals. President Bush's New Freedom Initiative was announced in 2001. The goal of this initiative was "to promote the full participation of people with disabilities in all areas of society by increasing access to assistive and universally designed technologies, expanding educational and employment opportunities, and promoting increased access into daily community life."  This initiative secured $120 million from FY 2002 to FY 2004 for:
- Competitive grants to provide additional transportation services for Americans with disabilities, increasing their access to the job market.
- A pilot program to demonstrate innovative solutions for transportation problems that prevent many people with disabilities from living more independently. 
Transportation Research Board/Transit Cooperative Research Program
TCRP is a publicly funded organization (through the Transportation Equity Act for the 21st Century, or TEA-21) operating under the FTA. TCRP carries out numerous research efforts related to the improved mobility, environmental, and energy objectives of public transportation systems. These research efforts include solving operational problems, discussing useful technologies from related industries, and finding additional means "for the public transportation industry to innovate.
Three TCRP reports focus specifically on coordination, while the remaining documents focus on technology and communications solutions that improve individual mobility.
Brief summaries of relevant documents are included below.
- TCRP Report 91: Economic Benefits of Coordinating Human Services Transportation and Transit Services, 2003.
This report takes a high-level approach to defining coordination of transit services and documenting the expected benefits of that coordination. It emphasizes the use of coordination as a technique for improved resource management while acknowledging the political elements that can influence the level of success it achieves. It notes that coordination requires resource sharing: power, responsibility, management, and funding.
The benefits are presented not only in economic terms such as efficiency, productivity, and funding, but also in customer service terms, such as mobility, service availability, and system management. In discussing both the benefits and the strategies for achieving them, the report highlights several case studies from all over the U.S. The key recommendations from this report are as follows:
- Shifting paratransit riders to fixed route services and allowing non-transit agencies to provide ADA (Americans with Disabilities Act) paratransit services.
- Encouraging partnering arrangements that expand transportation services into areas of little or no service availability.
- Coordinating the transportation functions of multiple human services agencies.
- Generating additional income for transit providers through service provision to human services agency clients. 
- TCRP Report 101: Toolkit for Rural Community Coordinated Transportation Services, 2004.
Like TCRP Report 91, this document again defines coordination and highlights its benefits. It also identifies the parties that need to be involved in coordination efforts for those efforts to be successful.
This document is intended to provide the resources necessary for agencies or providers that are moving towards or are already setting up coordinated systems in the rural environment. It includes "information, instructions, and examples of lessons learned [both positive and negative experiences] from actual implementation experiences." 
- TCRP Report 105: Strategies to Increase Coordination of Transportation Services for the Transportation Disadvantaged, 2004.
This report focuses on strategies for initiating or improving transportation service coordination at the local or regional level from the perspective of providing service to transportation disadvantaged users. Although the purpose of the report was to address customer service from both the public and private transportation service perspectives, in actuality it provided a perspective that was almost exclusively focused on public-sector services. The report discussed the "trends" in human service transportation coordination, included case studies of organizations that had recently implemented or undertaken coordination activities (there were 22 in this report), identified funding sources for potential efforts, and documented coordination challenges and lessons learned.
- The need for strong leadership or a "local champion."
- The need for a lead agency.
- Using Federal programs as a catalyst (for example, the Job Access Reverse Commute [JARC] program and the ADA).
- State-level coordination programs and State-level incentive funding.
- The need for adequate planning and program evaluation.
- The need for considering coordination at the regional level.
- Identifying and using non-traditional funding sources.
- Using technology as a support tool.
- Coordination challenges and lessons learned.
- Coordination efforts are difficult to sustain.
- Trust among partners can be a big obstacle.
- Phased or incremental approaches tend to work best.
- Additional time and effort is required during the planning stages to ensure future growth and sustainability.
- TCRP Synthesis 37: Communicating with Persons with Disabilities in a Multimodal Transit Environment, 2001.
This synthesis effort reviewed existing North American literature that had been published (as of 2001) on technologies that assist transit agencies in communicating with disabled travelers, including seniors and those with sensory, vision, hearing, and cognition impairments. The synthesis also uses data from a TCRP survey of transit agencies, conducted as part of the research for the paper, on practical solutions that were currently in use.
The report discussed:
- Advanced technologies (e.g., Smart cards).
- Visual technologies (e.g., light emitting diodes, or LED).
- Auditory technologies (e.g., talking signs).
- Tactile technologies (e.g., detectable warnings).
- Geographic information systems.
- Passenger training programs.
- Staff sensitivity training for transit personnel.
The key item identified in the synthesis research "indicated that the most successful approach was to implement communication techniques and technologies with universal benefits to all passengers and to ensure that the specific needs of those individuals with disabilities were incorporated as part of the process."  This finding has translated into the approach FTA and FHWA are utilizing with the current MSAA initiative.
- TCRP Report 76: Guidebook for Selecting Technology Systems for Small Urban and Rural Public Transportation Operators, 2002.
This report was designed to act as a resource for public transportation operators; therefore, it is an easy-to-use booklet which documents the process by which a technology deployment should be undertaken:
- Provider self-assessment: technology review team formulation, problem definition, and needs assessment.
- Matching needs and technologies: technology tables, descriptions, and solutions by user need.
- Functionality and costs: identifying products, vendors, and users; previewing products; and identifying costs.
- Financing solutions: funding sources, both traditional and alternative.
- Implementation: developing an implementation plan, executing a technology procurement, and selecting a bid.
In addition to acting as a "how-to" guide for technology implementations, the report also emphasized the need for transportation providers to stay abreast of emerging technologies and business practices. It specifically referenced mobile data devices, public data networks, the Internet, and Application Service Providers as technologies that were beginning to show benefits to transportation operations and management. Lastly, the guidebook included lists of key transit technologies, vendors, and vendor contact information in the Appendices.
- TCRP Synthesis 57: Computer-Aided Scheduling and Dispatch in Demand-Responsive Transit Services, 2004.
This synthesis utilized a literature review and a survey of public transit agencies which provided demand-responsive transit (DRT) services to create a single storehouse of information related to computer-aided scheduling and dispatch (CASD). The synthesis compares transit agency expectations of the CASD with vendors' views on system capabilities. It also documents the reasons for unsuccessful technology implementations while highlighting methods for improving the procurement and implementation of these types of systems. The synthesis results are broken out into several categories:
- DRT management planning.
- Software procurement.
- Software implementation.
- Evaluation of computerized DRT systems.
- Associated technologies, including mobile data terminals, automatic vehicle location systems, etc.
One of the key recommendations of this study was the need for transit agencies to incorporate the use of technical simulation models and mathematical routing and scheduling algorithms into their CASD system design. The research summarized by this TCRP synthesis study seemed to indicate that users who had utilized these tools had improved CASD system performance.
1.2.3 Other Efforts
Many other organizations have contributed to improving mobility for all Americans, whether through advocating increased coordination in human services transportation systems or advocating the use of transportation in general. This is not an all-inclusive list; rather, it is meant to highlight the more extensive efforts.
American Public Transportation Association
In 2004, the American Public Transportation Association (APTA) hosted a conference titled "Linking Technology with Mobility for Seniors and People with Disabilities." This conference specifically focused on how current and future technologies can help improve mobility. It included presentations by transit authorities, technology providers, and government agencies and included information on specific ITS applications, best practices, lessons learned (in implementation, funding, etc.) and funding sources. The best practices presented came from all over the world: North and South America, Europe, and Asia. Many of the presentations specifically focused on improving mobility and accessibility.
APTA has also published several documents related to mobility and technology. Some focus on specific demographics or technologies, as indicated by titles such as "Transit Services for Seniors" and "Smart Cards and U.S. Public Transportation." These documents can be found on APTA's web site. In addition, APTA's Monograph Series comprises documents that publicize the benefits of transit. Two of these publications focus specifically on mobility:
- "Mobility for the Aging Population."
- "Mobility for America's Small Urban and Rural Communities."
APTA's September 2002 publication titled "The Benefits of Public Transportation" also documents the specific benefits for all service areas (metropolitan, small urban, and rural), populations, and programs (human services, education, seniors, and the disabled). This document highlighted ridership figures that indicated public transportation is crucial to many individuals: of current (2002) transit riders, more than 20 percent would not have made the trip without transit, and nearly 70 percent did not have access to cars at the time they made their trip. Even more critical, nearly 94 percent of public assistance recipients rely on public transportation. 
Finally, a more recent APTA-sponsored report titled "Aging Americans: Stranded Without Options" specifically discusses the changing age demographic in the U.S. It highlights the lack of adequate transportation choices for the increasingly aging population and discusses the need for additional research on mobility among older Americans. The Surface Transportation Policy Project authored the report, which was co-sponsored by the American Association of Retired Persons (AARP). It was released in April of 2004 and can also be found on the APTA web site.
The National Transit Institute (NTI) has also done significant work related to coordination and mobility. NTI's Transit Program Management and Compliance series offers courses including "Compliance with ADA Paratransit Eligibility" and "Paratransit Scheduling and Dispatch Fundamentals." The NTI Advanced Technologies series offers courses related to "Complying with the FTA's Policy on ITS Architecture Consistency," providing "Flexible Community Transit Services," and the applications, costs, and benefits of ITS for transit.
The NTI Management Development course series offers a course titled "Coordinated Mobility: A Unified Transportation Management Solution." This course is designed for transit providers, brokerage personnel, State agencies, human service professions, and metropolitan planning organization (MPO) or council of government (COG) personnel. It is designed to help all personnel who provide transportation services become familiar the characteristics of the changing customer base, including people with disabilities, low-income individuals, and seniors. The specific goals of this course are as follows:
- Identify ways to forge partnerships with community players to coordinate multimodal transportation options around the needs of the customer.
- Develop an understanding of the customer travel needs of today.
- Create awareness of the opportunities.
- Present elements of mobility management and planning techniques.
- Identify and promote the benefits of mobility management for communities.
- Identify funding resources.
CTAA and the National Consortium on the Coordination of Human Services Transportation
The CTAA provides transportation assistance, especially in rural areas and especially for individuals who are transportation disadvantaged. The organization's technical assistance efforts are discussed in more detail in Section 1.4. CTAA oversees the operation of the National Consortium on the Coordination of Human Services Transportation, which "includes representatives from associations and organizations with interest in transit and human service issues."  The members include user groups (i.e., advocacy organizations), CTAA, Easter Seals Project ACTION, the Association of MPOs, APTA, the American Public Works Association (APWA), the National Conference of State Legislatures (NCSL), and others. This Consortium produces projects based on research related to the coordination of both human services and mobility services. Their latest report was released in 2005 and was titled "Coordinated Human Service Transportation: State Legislative Approaches." This report was prepared by the National Conference of State Legislatures and was funded by FTA.
This document recognizes the importance of personal mobility and how the needs of the transportation disadvantaged are becoming increasingly important as the population grows. The purpose of the report was to document the coordination efforts and their success in all 50 States and the District of Columbia. It also provided nine recommendations based on these activities. In general, the report found that:
- 34 States have statutes with coordination requirements or authorizations for human services transportation.
- 21 States have statutes that specifically require coordination of human service transportation programs.
- 2 States have consolidated specialized transportation services through legislative action.
- 45 States, the District of Columbia, and the Virgin Islands have applied for Federal aid to improve coordination.
- 12 States have State agency reports or task forces that have provided recommendations for future coordination. 
The report is careful to highlight the fact that coordination through legislation may not be the optimal solution for many of the specialized transportation concerns. The recommendations focus on the various approaches State legislatures undertake; these can be utilized to serve multiple disadvantaged populations, extend the applicability of mandates and statutes, and incorporate measures of effectiveness (MOE) to track the effects of the policies.
1.3 Current State of the Practice
Current efforts to improve and increase the mobility and accessibility of human services transportation, and thus transportation for all Americans, have overwhelmingly focused on technology and service coordination. Recently completed and current efforts are discussed below.
1.3.1 United We Ride – Workshop Results and Follow-on
In November 2000, the USDOT Joint Program Office began to work with HHS and DOL to conduct research and increase awareness within these agencies of the capabilities and benefits offered by technology to enhance human services transportation coordination and how information technology and ITS strategies might be applied to these types of transportation services, especially in rural areas. The research team working on this task determined that "regional coordination workshops would provide the best venue for highlighting what ITS strategies could offer."  These workshops are discussed briefly in Section 1.2.2, as some of the workshops were held in conjunction with the UWR initiative. The workshops began in spring of 2003 and were suspended after the announcement of the UWR initiative. The workshops resumed in the fall of 2004 and were completed by December 2004. The first round of workshops was hosted by FTA regional administrators and HHS regional directors. They were held in the following locations:
- FTA Region I: March 20, 2003, Boston.
- FTA Region III: June 25, 2003, Philadelphia.
- FTA Region VI: June 18-19, 2003, Dallas.
- FTA Region X: September 11, 2003, Seattle.
The first round of workshops was organized by a planning team that included Federal and State agency representatives along with an SAIC consultant team. The workshops included presentations on HHS programs such as the Administration on Aging (AoA), Centers for Medicaid and Medicare Services (CMS), and Temporary Assistance for Needy Families (TANF) programs. The workshops also provided participants with an ITS overview and best practices (i.e., local innovative practices.) Finally, the workshops left time for State attendees to meet with each other, along with a facilitator and note taker, to discuss their action plan for building a more coordinated human services transportation system within their States. The level of existing coordination in each State varied greatly, but the notes which were taken during the breakout sessions were intended to help State teams document their progress. States could then reference these notes and workshop activities as a springboard for continuing coordination efforts. Technology solutions were highlighted more prominently in some regions, specifically those that have established coordination programs in place and are at various stages of implementing ITS solutions.
The second round of workshops was updated to include the coordination issues addressed by the UWR initiative. These workshops were held in the following locations:
- FTA Region II, October 28, 2004, New York City.
- FTA Region IV, October 14-15, 2004, Atlanta.
- FTA Region V, November 15, 2004, Chicago.
- FTA Region VII, December 1-2, 2004, Kansas City.
- FTA Region VIII, December 9-10, 2004, Denver.
- FTA Region IX, November 8-9, 2004, San Francisco.
Like the first set of workshops, a regional planning team planned each workshop's content, but, unlike the first round, the content was tailored to the needs of each region. The second phase also utilized the services of a professional facilitator to ensure the optimal use of time and content. Each workshop included an overview of the UWR initiative and an overview of ITS. Some of the six regions included program overviews (similar to those included in the first round of workshops), but others did not. Time was allotted for State teams to collaborate on their coordination efforts, but this phase utilized the UWR Framework for Action to complete this task.
Again, some States have coordinated more than others, and some have used technology more than others to help build more coordinated systems. It seems that no two States have taken the same route to building coordinated systems or increasing awareness among legislators and constituents on coordination activities and issues. As the SAIC team reviewed the State notes from these workshops, they learned that, in this round of workshops, many States focused only on coordination issues, while only a few focused on the linkage between coordination issues and how technology could be used to help overcome these issues or assist current activities.
Despite the differing focus of the two sets of workshops, the SAIC team identified many common concerns:
- The perception of a need to have some type of mandated coordination at the State level, and possibly the Federal level, whether by executive order or legislative action.
- The importance of having all of the right people engaged in the coordination effort.
- The recognition by several States that, while many transportation disadvantaged communities are the focus of coordination efforts, the mobility and accessibility needs of all persons should be addressed in States' vision statements for the future.
- The need to make more resources and more flexible funding available at both the Federal and State levels.
- The problems with data availability and reliability – the workshops highlighted how technology can be used to improve record keeping and data collection and reporting efforts as well as how technology can enhance coordination and improve transportation operations.
- The need to define and showcase success stories.
- The need to educate stakeholders about coordination options and benefits.
The UWR initiative, the Coordinating Council on Access and Mobility, and the MSAA initiative have all begun to address many of these considerations.
1.3.2 Oak Ridge National Laboratory: Human Services Transportation – A Cross-Cutting Study. ITS Applications for Coordinating and Improving Transportation Options for The Elderly, Disabled or Poor.
The draft version of this report was released on April 14, 2005. The purpose of this document is to highlight technologies that service public transportation options for the elderly, poor, or disabled. We have included a summary of this effort because it is recognized that serving these three communities may have a positive impact on other transportation disadvantaged populations, thereby benefiting all persons. The cross-cutting study only considered technologies that have been deployed and are therefore already proven. The report highlighted six practices and four additional examples of specific technology applications. The practices highlighted how technology was used to assist in information dissemination, payment options, safety and security,  and system flexibility. The six best practices sites included (descriptions of the best practices sites will be included in section 3.4):
- Wheels of Wellness in Philadelphia, PA – coordination through brokerage.
- Cape Cod Regional Transit Authority (CCRTA) in Cape Cod, MA.
- Flint Mass Transportation Authority (MTA) in Flint, MI – coordination with decentralization.
- Ventura County Transportation Commission (VCTC), Ventura, CA – coordination of public/private, cross-jurisdictional data integration.
- TriMet in Portland, OR – coordination of accessibility on all modes.
- Client Referral, Ridership and Financial Tracking (CRRAFT) in New Mexico – Statewide coordination of client information among agencies.
The specific technology applications examined by the cross-cutting study included:
- Reach Your Destination Early (RYDE) in Kearney, NE – goal setting using ITS architecture.
- OmniLink in Prince William County, VA – fixed route flex service aids all users.
- Municipal Railway in San Francisco, CA – remote infrared audible signals (RIAS).
- Suburban Mobility Authority for Regional Transportation (SMART) in Detroit, MI – shared resources.
The report also highlighted the key lessons learned from these examples during planning and deployment activities. These lessons focused on implementation, provider personnel, data standardization, and measures of success. Overall, the lessons learned indicated:
- A need for technologies to be phased in incrementally, allowing problems to be worked through as they are encountered.
- A need for adequate staff, operator, driver, and user training; this will help reduce employee apprehension and convince them to work with and use the technology as opposed to ignoring it or working against it. This ties in with the need for good marketing of the technology, both to users and employees.
- A need for regular meetings between system providers, policy makers, subcontractors, special interest user groups, and agency managers so that problems and ideas can be shared and a consensus can be reached during system design; this will help ensure maximum functionality in the system.
- A need for identification of all data uses: much of the data collected by ITS can be used in multiple places by multiple parties, so the databases that collect data should be centralized and user friendly to allow the data to be easily mined and reused.
- A need for continued assessment of the system: some benefits are not apparent immediately. In addition, some benefits are not apparent to individuals, but rather to the whole system. The agency or provider who implements the technology should also continually seek measures of effectiveness for technology deployments. System effectiveness and/or success can be measured technically, politically, and among consumers.
- A need for minimal system modifications if a vendor-supplied software is used. Multiple modifications may reduce the effectiveness while increasing the cost, maintenance, and training required to support the system.
Finally, the report emphasized that while there are many successful examples of technology implementations across the country, "[t]here is no single technology or configuration that will be appropriate for all areas [of population density, geographic setting, and population composition.]." 
1.3.3 Technology Solutions for Persons with Disabilities
FTA released a report in draft form in October 2004 that summarized research conducted between May 2002 and October 2004. The report was prepared for the FTA in support of the MSAA initiative and specifically supports the basic Phase 2 Foundation Research portion of the initiative. The report is based on a literature review and is designed to provide a single source of information for "planning the implementation of currently available technologies, and for identifying appropriate technologies for deployment under different service scenarios."  It mainly considers ITS, but also includes a brief discussion of AT.
This report also highlights how transit technologies can assist providers in accessing various trip elements encountered during a typical trip – these mirror the trip components that will be discussed in Section 2. Much of the information collected during the literature review is presented in tabular format: technology solutions versus disability categories, such as hearing, vision, cognitive, and physical disabilities, and technology solutions versus actions that are part of trip elements. The report also provides a brief discussion of many currently available commercial off-the-shelf (COTS) products and developmental technologies and how they serve all disability areas and trip elements. The report discusses the maturity level and future potential of the technologies, costing information, and ability to stand alone or work with other existing or developmental technologies.
There is also a discussion of many technologies, both ITS and assistive, in Section 3.0 of this document.
1.3.4 Technical Assistance Efforts: CTAA, Easter Seals Project ACTION, and Others
There are various technical assistance efforts relative to both coordination and technology. These efforts are targeted to States and communities that are working to improve and coordinate existing transportation resources. Currently, there are two main technical assistance efforts that specifically address the coordination of human services transportation.
Community Transportation Association of America
CTAA's main on-line method of providing technical assistance is through its "Information Station," which connects users with community transportation resources and information related to coordination; employment; and medical, rural, senior, and accessible transportation.  CTAA also sponsors or administers other technical assistance efforts related to the coordination of human services transportation, including:
- The National Consortium on the Coordination of Human Services Transportation, which was previously discussed in Section 1.2.4.
- "United We Ride – Help Along the Way" – This technical assistance program builds on the work of the Community Transportation Assistance Program (CTAP), the Rural Transportation Assistance Program (RTAP), ESPA, and other stakeholders to provide hands-on assistance to States and communities in the development and delivery of coordinated human service transportation programs.
- CTAA, through CTAP, provides technical assistance to organizations and agencies (at the State and local levels) with questions about providing transportation services to older adults, individuals with low incomes, children and families, and people with disabilities. CTAP is funded by HHS, as many of the technical assistance efforts help people access health care, child care, employment, and other social services.
- The National Job Links Employment Transportation Initiative – Also known as "Joblinks," this program is jointly funded by USDOT and DOL. Joblinks is a national peer-to-peer network that "links local agencies with experienced practitioners familiar with human services and workforce development environments and knowledgeable about special client transportation needs.
- Rural Passenger Transportation Technical Assistance Program (RPTTAP) – Created by USDA in 1988 and administered by CTAA, the RPTTAP provides technical assistance for small communities of less than 50,000 people. The focus of the program is economic development: helping small and emerging businesses and stimulating economic development through new and improved public transportation. 
- Tribal Passenger Transportation Assistance Program – The program is designed to help Native American tribes enhance economic growth and development by improving transportation services. Technical assistance is limited to planning and may support transit service improvements and expansion, system start-up, facility development, development of marketing plans and materials, transportation coordination, training and other public transit problem solving activities. 
Easter Seals Project ACTION
While CTAA focuses on all community transportation in urban and rural environments, ESPA concentrates on assisting the disability and transportation disadvantaged communities in working toward providing universal access to transportation services for people with disabilities. ESPA offers technical assistance in meeting ADA requirements in a variety of formats, including a hotline, web site, publications clearinghouse, newsletter, and training.
There are other technical assistance efforts which relate to specific environments and topic areas. We will highlight a few of these.
- ITS Peer-to-Peer Program: The Federal Highway Administration (FHWA) oversees this program. The Peer-to-Peer program is essentially a network of USDOT-approved ITS professionals who have worked extensively within ITS systems as planners, implementers, or operators in both urban and rural areas. The assistance the network provides is mainly short-term and comes in the form of telephone consultations, document reviews, presentations, and, occasionally, site visits. It serves urban and rural environments and highway, transit, and motor carrier modes.
- Multi-State Technical Assistance Program (MTAP): The American Association of Highway and Transportation Officials (AASHTO) administers this program geared towards State-level public transportation agencies. The purpose of the program is to provide these agencies with a forum to educate one another about Federal transit regulations, grant program management, and other technical issues related to the daily operation of public transportation. MTAP has annual meetings, a peer-to-peer program, and conference call and e-mail communication among its 44 members.
- National Rural Transit Assistance Program (RTAP): As its name suggests, RTAP provides outreach and training to organizations involved in rural transit, especially State-level RTAPs (each State hosts its own RTAP). Although established by FTA, the program is administered by the American Public Works Association (APWA) in a consortium arrangement with the CTAA.
1.4 Final Report Layout
The remainder of the document is organized according to the following topic areas.
- Section 2 Issues, Needs, Barriers, and Gaps.
- Section 2 compares the mobility and accessibility needs with the current level of transportation service that is available; in doing so, it will point out the unmet needs and gaps that have been noted by transportation consumers. It will discuss, from the service provision perspective, the issues and hurdles that have compromised service providers' and program administrators' ability to eliminate gaps.
- Section 3 Linking Technologies with Accessibility and Mobility.
- Section 3 builds on the materials presented in the previous sections in order to demonstrate how various technologies – and human factors – may be used to enhance access and mobility for persons who are transportation disadvantaged.
- Section 4 Foundation Research Discussion Groups.
- Section 4 addresses the five discussion groups and major themes and priorities of each group.
- Section 5 Preliminary Architecture.
- Section 6 Synthesized Findings and Next Steps.
- U.S. General Accounting Office, Transportation-Disadvantaged Populations, GAO-03-697, June 2003.
- U.S. General Accounting Office, Transportation-Disadvantaged Populations, GAO-03-697, (Washington D.C., June 2003), pp. 3-4.
- R. Wallace, P. Hughes-Cromwick, H. Mull, and S. Khasnabis, "Access to Healthcare and Non-emergency Transportation: Two Missing Links," (presented to the Transportation Research Board,) January 2005.
- George W. Bush, "The President's New Freedom Initiative for People with Disabilities: The 2004 Progress Report," March 2004,
- "How Information Technology (IT) and Intelligent Transportation Systems (ITS) Can Enhance Coordination Efforts," from USDOT/HHS United We Ride Regional Coordination Workshop presentation (2004).
- U.S. General Accounting Office., Hindrances to Coordinating Transportation of People Participating in Federally Funded Grant Programs, CED-77-19, October 1977.
- U.S. General Accounting Office., Transportation Coordination: Benefits and Barriers Exist, and Planning Efforts Progress Slowly, GAO/RCED-00-1, October 1999.
- General Accounting Office, Transportation Disadvantaged Populations: Some Coordination Efforts Among Programs Providing Transportation Services, but Obstacles Persist, GAO-03-697, June 2003.
- U.S. General Accounting Office, Transportation Disadvantaged Populations: Some Coordination Efforts Among Programs Providing Transportation Services, but Obstacles Persist, GAO-03-697, June 2003.
- U.S. General Accounting Office, Transportation-Disadvantaged Populations: Federal Agencies Are Taking Steps to Assist States and Local Agencies in Coordinating Transportation Services, GAO-04-420R, February 2004.
- U.S. General Accounting Office, "Transportation-Disadvantaged Seniors, Efforts to Enhance Senior Mobility Could Benefit from Additional Guidance and Information," GAO-04-971, August 2004.
- GAO, GAO-04-971, August 2004.
- GAO, GAO-04-971, August 2004,(page 2).
- George W. Bush, "Human Services Transportation Coordination," Executive Order 13330, 24 February 2004,
- U.S. Department of Transportation, Federal Transit Administration, "Report to the President Human Services Transportation Coordination Executive Order 13330 2005"
- George W. Bush, "The President's New Freedom Initiative for People with Disabilities: The 2004 Progress Report," March 2004
- Transit Cooperative Research Program, Economic Benefits of Coordinating Human Service Transportation and Transit Services, Report 91, 2003, pp. 5-6.
- Jon Burkhardt, Toolkit for Rural Community Coordinated Transportation Services (TCRP Report 101), 2004, page 2.
- Transit Cooperative Research Program, Communicating with Persons with Disabilities in a Multimodal Transit Environment, TCRP Synthesis 37, 2001, page 3.
- APTA, "The Benefits of Public Transportation – An Overview" September 2002, page 6.
- National Conference of State Legislatures (NCSL), "Coordinated Human Service Transportation – State Legislative Approaches", January 2005.
- National Conference of State Legislatures (NCSL), "Coordinated Human Service Transportation – State Legislative Approaches", January 2005.
- SAIC and TranSystems Corporation, 2003-2004 Regional Coordination Workshops: Executive Summary, DRAFT, March 23, 2005.
- Although security-related issues are referenced in this document, that has become a specialized topic that is being pursued in other endeavors. This project focuses more narrowly on issues related to access and mobility along with coordination issues.
- Oak Ridge National Laboratory (for the U.S. Department of Transportation ITS Joint Program Office), Human Services Transportation A Cross-Cutting Study. ITS Applications for Coordinating and Improving Transportation Options for the Elderly, Disabled, or Poor (DRAFT), April 14, 2005, page iii.
- Booz Allen & Hamilton, Technical Report: Technology Solutions For Persons With Disabilities, Phase 2: Foundation Research Support, October, 2004.