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Toolkit for Rural Community Coordinated Transportation Services (2004)

Chapter: Section I: Basic Coordination Concepts

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Suggested Citation:"Section I: Basic Coordination Concepts." National Academies of Sciences, Engineering, and Medicine. 2004. Toolkit for Rural Community Coordinated Transportation Services. Washington, DC: The National Academies Press. doi: 10.17226/13751.
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Suggested Citation:"Section I: Basic Coordination Concepts." National Academies of Sciences, Engineering, and Medicine. 2004. Toolkit for Rural Community Coordinated Transportation Services. Washington, DC: The National Academies Press. doi: 10.17226/13751.
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Suggested Citation:"Section I: Basic Coordination Concepts." National Academies of Sciences, Engineering, and Medicine. 2004. Toolkit for Rural Community Coordinated Transportation Services. Washington, DC: The National Academies Press. doi: 10.17226/13751.
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Suggested Citation:"Section I: Basic Coordination Concepts." National Academies of Sciences, Engineering, and Medicine. 2004. Toolkit for Rural Community Coordinated Transportation Services. Washington, DC: The National Academies Press. doi: 10.17226/13751.
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Suggested Citation:"Section I: Basic Coordination Concepts." National Academies of Sciences, Engineering, and Medicine. 2004. Toolkit for Rural Community Coordinated Transportation Services. Washington, DC: The National Academies Press. doi: 10.17226/13751.
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Suggested Citation:"Section I: Basic Coordination Concepts." National Academies of Sciences, Engineering, and Medicine. 2004. Toolkit for Rural Community Coordinated Transportation Services. Washington, DC: The National Academies Press. doi: 10.17226/13751.
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Suggested Citation:"Section I: Basic Coordination Concepts." National Academies of Sciences, Engineering, and Medicine. 2004. Toolkit for Rural Community Coordinated Transportation Services. Washington, DC: The National Academies Press. doi: 10.17226/13751.
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Suggested Citation:"Section I: Basic Coordination Concepts." National Academies of Sciences, Engineering, and Medicine. 2004. Toolkit for Rural Community Coordinated Transportation Services. Washington, DC: The National Academies Press. doi: 10.17226/13751.
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Suggested Citation:"Section I: Basic Coordination Concepts." National Academies of Sciences, Engineering, and Medicine. 2004. Toolkit for Rural Community Coordinated Transportation Services. Washington, DC: The National Academies Press. doi: 10.17226/13751.
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Suggested Citation:"Section I: Basic Coordination Concepts." National Academies of Sciences, Engineering, and Medicine. 2004. Toolkit for Rural Community Coordinated Transportation Services. Washington, DC: The National Academies Press. doi: 10.17226/13751.
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Suggested Citation:"Section I: Basic Coordination Concepts." National Academies of Sciences, Engineering, and Medicine. 2004. Toolkit for Rural Community Coordinated Transportation Services. Washington, DC: The National Academies Press. doi: 10.17226/13751.
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Suggested Citation:"Section I: Basic Coordination Concepts." National Academies of Sciences, Engineering, and Medicine. 2004. Toolkit for Rural Community Coordinated Transportation Services. Washington, DC: The National Academies Press. doi: 10.17226/13751.
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Suggested Citation:"Section I: Basic Coordination Concepts." National Academies of Sciences, Engineering, and Medicine. 2004. Toolkit for Rural Community Coordinated Transportation Services. Washington, DC: The National Academies Press. doi: 10.17226/13751.
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Suggested Citation:"Section I: Basic Coordination Concepts." National Academies of Sciences, Engineering, and Medicine. 2004. Toolkit for Rural Community Coordinated Transportation Services. Washington, DC: The National Academies Press. doi: 10.17226/13751.
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Suggested Citation:"Section I: Basic Coordination Concepts." National Academies of Sciences, Engineering, and Medicine. 2004. Toolkit for Rural Community Coordinated Transportation Services. Washington, DC: The National Academies Press. doi: 10.17226/13751.
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Suggested Citation:"Section I: Basic Coordination Concepts." National Academies of Sciences, Engineering, and Medicine. 2004. Toolkit for Rural Community Coordinated Transportation Services. Washington, DC: The National Academies Press. doi: 10.17226/13751.
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Suggested Citation:"Section I: Basic Coordination Concepts." National Academies of Sciences, Engineering, and Medicine. 2004. Toolkit for Rural Community Coordinated Transportation Services. Washington, DC: The National Academies Press. doi: 10.17226/13751.
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Suggested Citation:"Section I: Basic Coordination Concepts." National Academies of Sciences, Engineering, and Medicine. 2004. Toolkit for Rural Community Coordinated Transportation Services. Washington, DC: The National Academies Press. doi: 10.17226/13751.
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Suggested Citation:"Section I: Basic Coordination Concepts." National Academies of Sciences, Engineering, and Medicine. 2004. Toolkit for Rural Community Coordinated Transportation Services. Washington, DC: The National Academies Press. doi: 10.17226/13751.
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Suggested Citation:"Section I: Basic Coordination Concepts." National Academies of Sciences, Engineering, and Medicine. 2004. Toolkit for Rural Community Coordinated Transportation Services. Washington, DC: The National Academies Press. doi: 10.17226/13751.
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Suggested Citation:"Section I: Basic Coordination Concepts." National Academies of Sciences, Engineering, and Medicine. 2004. Toolkit for Rural Community Coordinated Transportation Services. Washington, DC: The National Academies Press. doi: 10.17226/13751.
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Suggested Citation:"Section I: Basic Coordination Concepts." National Academies of Sciences, Engineering, and Medicine. 2004. Toolkit for Rural Community Coordinated Transportation Services. Washington, DC: The National Academies Press. doi: 10.17226/13751.
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Suggested Citation:"Section I: Basic Coordination Concepts." National Academies of Sciences, Engineering, and Medicine. 2004. Toolkit for Rural Community Coordinated Transportation Services. Washington, DC: The National Academies Press. doi: 10.17226/13751.
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Suggested Citation:"Section I: Basic Coordination Concepts." National Academies of Sciences, Engineering, and Medicine. 2004. Toolkit for Rural Community Coordinated Transportation Services. Washington, DC: The National Academies Press. doi: 10.17226/13751.
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Suggested Citation:"Section I: Basic Coordination Concepts." National Academies of Sciences, Engineering, and Medicine. 2004. Toolkit for Rural Community Coordinated Transportation Services. Washington, DC: The National Academies Press. doi: 10.17226/13751.
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Suggested Citation:"Section I: Basic Coordination Concepts." National Academies of Sciences, Engineering, and Medicine. 2004. Toolkit for Rural Community Coordinated Transportation Services. Washington, DC: The National Academies Press. doi: 10.17226/13751.
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Suggested Citation:"Section I: Basic Coordination Concepts." National Academies of Sciences, Engineering, and Medicine. 2004. Toolkit for Rural Community Coordinated Transportation Services. Washington, DC: The National Academies Press. doi: 10.17226/13751.
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Suggested Citation:"Section I: Basic Coordination Concepts." National Academies of Sciences, Engineering, and Medicine. 2004. Toolkit for Rural Community Coordinated Transportation Services. Washington, DC: The National Academies Press. doi: 10.17226/13751.
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Suggested Citation:"Section I: Basic Coordination Concepts." National Academies of Sciences, Engineering, and Medicine. 2004. Toolkit for Rural Community Coordinated Transportation Services. Washington, DC: The National Academies Press. doi: 10.17226/13751.
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Suggested Citation:"Section I: Basic Coordination Concepts." National Academies of Sciences, Engineering, and Medicine. 2004. Toolkit for Rural Community Coordinated Transportation Services. Washington, DC: The National Academies Press. doi: 10.17226/13751.
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Suggested Citation:"Section I: Basic Coordination Concepts." National Academies of Sciences, Engineering, and Medicine. 2004. Toolkit for Rural Community Coordinated Transportation Services. Washington, DC: The National Academies Press. doi: 10.17226/13751.
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Below is the uncorrected machine-read text of this chapter, intended to provide our own search engines and external engines with highly rich, chapter-representative searchable text of each book. Because it is UNCORRECTED material, please consider the following text as a useful but insufficient proxy for the authoritative book pages.

Section I Basic Coordination Concepts 9 BASIC COORDINATION CONCEPTS Coordination has been promoted as a means of improving the delivery of transportation services since the late 1960s. Many rural communities have benefited from increased coordination among the transportation services sponsored by various programs. Coordinating agencies, the riders of the services, and the localities all can receive measurable benefits, including additional funding, more cost-effective operations, and the benefits received from increased mobility. Section I includes basic information necessary to understanding coordination issues. It addresses the fundamental issue of “Why coordinate?" This section begins with basic coordination concepts, including definitions, an historical perspective about coordinated transportation services, an overview of the agencies often involved in coordinated transportation systems, and an examination of the kinds of problems that coordination addresses. The second chapter in this section provides more details about the benefits, costs, and barriers involved in coordination. This information lays the groundwork for understanding the basic elements of coordination, which can then be applied by following the steps outlined in Section II. Section I

Chapter 1 Basic Coordination Concepts 11 BASIC COORDINATION CONCEPTS SOME DEFINITIONS Coordination is a strategy for managing resources. It is applied within community political environments. Fundamentally, coordination is about shared power among organizations that are working together to achieve common goals. Typically, the necessary precursors to shared power are shared respect and shared objectives. After these preconditions are met, sharing the key components of power— responsibility, management, and funding—is possible. Coordination focuses on management, resources, cost-effectiveness, broad perspectives, multiple stakeholders, cooperation, and action. Skills required to succeed at coordination include knowledge, communications, dedication, perseverance, understanding, cooperation, curiosity, creativity, and energy. Coordination can be used to address problematic transportation situations, such as duplication of effort and opportunities for improving transportation resource efficiency. Coordinating transportation means doing better (obtaining more results, like trips) with existing resources by working together with persons from different agencies and backgrounds. According to Ohio’s Department of Transportation, “Coordination is the best way to stretch scarce resources and improve mobility for everyone.” (ODOT, 1997). Coordination of transportation systems is thus a process in which two or more organizations interact to jointly accomplish their transportation objectives. Coordination is like many other political processes in that it involves power and control over resources and can be subject to the Chapter 1 Coordination is . . . a strategy for managing resources. . . . about shared power, responsibility, management, and funding . . . a process involving power and control over resources.

usual kinds of political problems and pressures, such as competing personalities and changing environments. This report is defining coordination as the sharing of the transportation resources, responsibilities, and activities of various agencies with each other for the overall benefit of the community. (Even after many years, this “pooling of resources” definition of coordination is not necessarily accepted within every community—in some communities, mass transit operators and human service agencies still perceive coordination from narrow self-centered perspectives.) The broad perspective is a key element: effective coordination will require a focus on the entire community, or maybe even on multiple communities. The earliest study to focus on coordination of transportation services defined it in three phases: (1) cooperation, (2) coordination, and (3) consolidation (Revis et al., 1976). The definitions of these three levels of service integration are as follows: ✦ Cooperation: Working together in some loose association, perhaps focusing primarily on information sharing, in which all agencies retain their separate identities and authorities, including control over the vehicles which they own. ✦ Coordination: Joint decisions and actions of a group of agencies with formal arrangements to provide for the management of the resources of a distinct system. ✦ Consolidation: Vesting all operational authority in one agency that then provides services according to purchase of service agreements or other contractual relationships. More recent work has shown that these three levels of service integration are not necessarily part of the same continuum: each can be an end result by itself. Experience has shown that each of the phases mentioned above can be considered as a self-contained stage or a different level of service integration. Cooperation is necessary for both coordination and consolidation, but coordinated systems do not necessarily change to become consolidated systems. In fact, coordination is usually the end product—consolidation is rare. Consolidation is certainly one of the possible outcomes of efforts to work more closely together, but consolidation can be threatening to many agencies (whose political view may be one of “taking away” their vehicles, their funds, and their program control). But consolidation sometimes offers the potential for providing the greatest monetary benefits. 12 Basic Coordination Concepts SECTION I Coordination— the sharing of the transportation resources, responsibilities, and activities of various agencies with each other for the overall benefit of their community

Whatever level of integration is ultimately achieved, the process of working together entails joint efforts to convert perspectives of narrow self-interest into broader communitywide interests and actions. Individuals who may not be used to talking or working with each other will need to develop levels of trust, respect, confidence, and shared responsibilities. A willingness to be open-minded about changing long- standing operating procedures will be required. The results can include the blending of travel purposes, client types, travel modes, funding sources, vehicle types, and the needs of different political jurisdictions, as well as philosophies and perspectives. The results can be quite beneficial, as described below. THE EVOLUTION OF EFFORTS TO COORDINATE SPECIALIZED TRANSPORTATION SERVICES Understanding the history of coordination helps to understand some of the issues people now face when they attempt to implement coordinated transportation services. To meet national objectives for both human service and transportation programs—whether they focus on education, job training, welfare reform, elderly nutrition, health and medical care, other services, or simply transportation—the programs’ intended recipients must have access to those services. But the intended recipients of such programs are often individuals with limited access and mobility. In the late 1960s and early 1970s, human service program officials recognized that many of their intended clients lacked adequate transportation and that lack of transportation could be a key barrier to receiving important human services. When human service agencies realized that many of their clients had no means of accessing needed services that were available to them, many agencies started their own transportation systems. Transportation services for persons with special transportation needs multiplied. Agency-sponsored vans often offered transportation services only to their own clienteles, but they frequently served destinations or riders similar to (or the same as) the destinations or riders of other agencies, with each agency owning, operating, and maintaining separate vehicles. But these services didn’t address all of the transportation needs, the costs of the trips increased, Chapter 1 Basic Coordination Concepts 13 lack of transportation could be a key barrier to receiving important human services . . .working together entails joint efforts to convert narrow perspectives . . . into broader community- wide interests and actions

and the resources needed to provide the transportation services became more constrained. Funding agencies became concerned with how to reduce duplicative efforts and make existing transportation services more efficient and effective. A closer look at these specialized transportation systems showed that many of them operated without regard to certain principles of economic efficiency, but that real increases in cost-effectiveness could be achieved if certain steps were taken to analyze, understand, and improve services. One of the most talked about mechanisms for improving specialized transportation services was coordination. In the field of public mass transportation, coordination began to take on a new meaning with the advent, in 1970, of the special service requirements for elderly and “handicapped persons” under the Urban Mass Transportation Act of 1964. Implementation of the Americans with Disabilities Act (ADA) in the 1990s resulted in another source of transportation for persons with special travel needs. The ADA requires public transportation agencies to provide complementary paratransit services to transport certain persons with disabilities. (Eligibility for the complementary paratransit services mandated by the ADA is limited to persons who are unable to use accessible vehicles operated on fixed routes. The ADA is a civil rights law with the goal of preventing and remediating discrimination against persons with disabilities; like other civil rights laws, it does not provide funding for these goals.) Coordination became an important management strategy when we found that agencies dealing with human service transportation needs were doing so in a “silo” or “stovepipe” fashion: dollars and rules came down from above in a narrow and constrained manner, and the perspective was one of a closed system from the top to the bottom. The trip needs of one agency’s clients could be served, but often at considerable expense and with some service quality problems. Many agencies had similar client travel needs, but they fiercely guarded the rights and interests of their own clients against “competing” interests and the prerogatives of their own “turf” from “outsiders.” Many rural communities have evidenced real leadership in combining the travel resources of human service agencies and also opening such services to members of the general public. Despite these successes, transportation services in some of these same rural communities have been unable to cross township, county, or state boundaries to coordinate transportation services with neighboring communities. 14 Basic Coordination Concepts SECTION I One of the most talked about mechanisms for improving specialized transportation services was coordination.

The recognition that many agencies have real interests in improving the cost-effectiveness of human services transportation has led to an effort to build bridges between particular agency interests and mandates. Coordinating transportation services is one powerful way of building these bridges. As previously noted, coordination helps solve difficult problems and has real measurable benefits. But it isn’t always easy to achieve, and it won’t solve all problems. WHO NEEDS TO BE INVOLVED IN COORDINATED TRANSPORTATION SERVICES? In many communities in the United States, a variety of public and private agencies and organizations provide or purchase transportation services for persons who are somehow disadvantaged in their ability to obtain transportation. Persons eligible for these programs are usually those with functional impairments (who are often also older), disabilities, low incomes, and otherwise without access to private automobiles. They and their representatives need to be included in any transportation planning process, as do the agencies serving them. These agencies and organizations often include ✦ Public transportation providers, which are required by ADA to provide complementary paratransit services to transport persons with certified disabilities wherever the public transit agency provides fixed-route transportation (public transit providers sometimes also offer special services for the elderly and persons with disabilities which preceded ADA); ✦ Departments of human and social services, which arrange Medicaid transportation as well as transportation for low-income persons; ✦ Departments of health and mental health, which provide medical trips; ✦ Area agencies on aging, which transport clients to senior centers and other service destinations; Chapter 1 Basic Coordination Concepts 15 Riders and their representatives need to be included in any transportation planning process, as do the agencies serving them

✦ Vocational and/or developmental disabilities departments, which often transport clients to sheltered workshops for employment and training and to jobs in the community; ✦ Departments of employment, which are responsible for implementing U.S. Department of Labor (DOL)-funded programs, such as those serving individuals who are moving from welfare to work; ✦ Departments of education, which transport many students and provide specialized transportation for vocational rehabilitation students; and ✦ Many different private nonprofit organizations, such as the Red Cross and faith-based organizations, which provide transportation to a variety of persons for different purposes. (Burkhardt, 2000) Each of these agencies and organizations may receive funding for transportation services from one or more sources, including Federal, state, and local programs and nonprofit programs. Such funds are often accompanied by specific objectives for serving limited clienteles and by specific rules and operating requirements. Operating separately, such services often demonstrate the economic and service problems noted below. Operating in a coordinated fashion, these agencies can often achieve greater levels of transportation services for their own clients and others as well. PROBLEMS THAT COORDINATION ADDRESSES In communities without coordination efforts, the following kinds of inefficiencies and problems are often observed (Burkhardt et al., 1990): ✦ A multiplicity of operators, each with its own mission, equipment, eligibility requirements, funding sources, and institutional objectives, often resulting in significant duplication of expenditures and service efforts, as well as gaps in needed services; 16 Basic Coordination Concepts SECTION I

✦ The absence of a formal mechanism for cooperation or communication among these operators; ✦ A total level of service well below the total level of need—often, substantial unmet transportation needs among populations with growing numbers and proportions of older persons; ✦ Excess travel by transportation providers with underutilized vehicles; ✦ Significant variations in services available during particular times of day or days of the week and to specific groups of persons, and duplicative services in some neighborhoods but substantial gaps where no service is available in other areas; ✦ Substantial variations in service quality, including safety standards, from provider to provider; ✦ A lack of reliable information—for consumers, planners, and service operators—describing the services being provided and their costs; ✦ The absence of an overall compendium of services available or the funds being used to provide them; and ✦ The absence of a reliable mechanism to quantify overall service needs and create a comprehensive plan to address these problems. Coordination has been shown to be capable of resolving such problems and improving specialized transportation services. Coordination will not solve all transportation problems in all communities. It needs to be seen as one of several possible management or problem-solving tools. In order to determine if coordination can improve the transportation services in a particular locality, transportation planners must first gather data about the potential population to receive transportation services and the current transportation providers. The next step is to analyze the effectiveness and efficiency of current services in meeting the service population’s needs. Coordination may be an effective action strategy in communities where there is substantial unused vehicle time; substantial unused vehicle capacity; or a lack of economies of scale in planning, administration, Chapter 1 Basic Coordination Concepts 17 . . . coordination has its most substantial impact in communities where transportation efficiency can be improved . . .

operations, purchasing, or maintenance. Unless these conditions are present, strategies other than coordination are better suited to improve transportation services. Thus, coordination has its most substantial impact in communities where transportation efficiency can be improved. In communities where persons who need services are not being served but where there is little room for efficiency improvements, coordination by itself will not be an effective strategy; in these cases, additional resources are needed. Rural communities must carefully assess their own circumstances with respect to these conditions; only then will the most appropriate strategy become apparent. GOALS FOR COORDINATED TRANSPORTATION SERVICES A number of efforts to coordinate transportation services have not shown success because they failed to specify what they were trying to achieve by coordinating. Setting specific goals becomes a crucial initial step in the coordination process. On an overall (for example, statewide) basis, the kinds of goals set by Oregon’s State Agency Transportation Coordination Project are worth noting. They include ✦ Doing more with limited existing resources, ✦ Utilizing transportation investments more efficiently, ✦ Enhancing mobility within and between communities, ✦ Increasing access to jobs and job training, ✦ Preserving individual independence, and ✦ Enhancing the quality of life. On a local basis, coordination objectives can be even more specific. As noted in TCRP Report 91: Economic Benefits of Coordinating Human Service Transportation and Transit Services, they might include ✦ Generating new revenues, ✦ Reducing the costs of providing trips, 18 Basic Coordination Concepts SECTION I

✦ Increasing efficiency and productivity of transportation services, and ✦ Increasing mobility within the community. HOW COORDINATION WORKS The fundamental goals of coordinated transportation systems are to increase the numbers of people served and the numbers of rides provided with existing resources. Coordination achieves these goals through better resource management. The first set of resource management objectives, targeted on greater efficiencies, focuses on reducing duplication and fragmentation in operating, administering, planning, and funding transportation services. Specific strategies for achieving these objectives include reducing the following: ✦ Operating and administrative salaries, ✦ Capital costs on vehicles and other equipment, and ✦ Other operating costs (maintenance, insurance, etc.). The second set of resource management objectives, targeted on more productive services, focuses on improving the acceptability, accessibility, adaptability, affordability, and availability of transportation services within the community. Specific strategies for achieving these objectives include increasing the following: ✦ Days and hours of service, ✦ Service areas, ✦ The different kinds of persons and trip purposes served, ✦ The accessibility of vehicles in the fleet for persons with special needs, ✦ The kinds and amounts of public information concerning services, and ✦ The kinds and amounts of funding available to help pay the costs of specific trips. Chapter 1 Basic Coordination Concepts 19 The fundamental goals . . . are to increase the numbers of people served and the numbers of rides provided . . .

Additional information on how coordination works is found in the next chapter in the section on coordination’s benefits. SUMMARY This introduction to fundamental coordination concepts has focused on these areas: ✦ Coordination is a technique for managing limited resources and focuses on shared power arrangements among partners, ✦ Coordinated transportation services evolved as a means of meeting the transportation needs of special needs populations more effectively and efficiently than is possible with single- client transportation services, ✦ A very broad range of transportation operators, consumers, and policymakers needs to be involved in coordinated transportation efforts within a locality, ✦ Coordination addresses problems created by inefficient services that operate without overall direction, ✦ Key goals for coordinated transportation services include more productive and more cost-effective services, and ✦ Coordinated transportation works by reducing the costs of providing transportation and expanding services. The following chapter presents details concerning coordination’s benefits and costs. The issue of barriers to coordination is also discussed. 20 Basic Coordination Concepts SECTION I

Chapter 2 Coordination Details: Benefits, Costs, and Barriers 21 COORDINATION DETAILS: BENEFITS, COSTS, AND BARRIERS Coordination really is more complex than its basic “let’s work together” message. Successful coordination depends on a full understanding and appreciation of the details concerning what can or cannot reasonably be expected to happen as a result of coordination activities. Valid expectations are particularly critical in the areas of coordination’s benefits and costs, as well as the often misunderstood concept of “barriers to coordination.” THE OVERALL BENEFITS AND COSTS OF COORDINATION Coordination is one of a number of management strategies for improving the performance of various individual transportation services, as well as the overall mobility within a community. It wrings inefficiencies out of the disparate operations and service patterns that often result from a multiplicity of providers. Overlapping, duplicative, and inefficient services can be combined for more efficient service delivery. As a result, coordinated services may achieve economies of scale not available to smaller providers. Coordinated services often also provide higher quality services. Greater efficiency helps to stretch the limited (and often insufficient) funding and personnel resources of coordinating agencies. Coordination can lead to significant reductions in per-trip operating costs for transportation providers. Many communities use these savings to expand services to persons or areas not previously served. Persons Chapter 2 Coordination is one of a number of management strategies for improving the performance of various individual transportation services . . .

with special transportation needs often benefit from the greater amount of transportation and higher quality services when transportation providers coordinate their operations. WHAT ARE THE POSSIBLE BENEFITS OF COORDINATION? Coordination has a wide range of potential benefits. Detailed benefits realized in various rural communities are described in Chapter 8. The three major potential benefit categories can be described as follows: ✦ Coordinated transportation services often have access to more funds and thus are better able to achieve economies of scale. They also have more sources of funds and other resources, thus creating organizations that are more stable because they are not highly dependent on only one funding source. ✦ Higher quality and more cost-effective services can result from more centralized control and management of resources. ✦ Coordinated services can offer more visible transportation services for consumers and less confusion about how to access services. Some of the most important specific benefits can include ✦ Filling service gaps in a community by offering transportation to additional individuals and geographic areas within existing budgets; ✦ Providing trips to consumers at lower costs; ✦ Providing more trips for community members, thus enhancing their quality of life and providing economic benefits to their communities; ✦ Reducing total vehicle travel within a community, thus enhancing air quality and making other positive environmental contributions; and ✦ Generating cost savings to some participating agencies in special forms of coordinated transportation service. 22 Basic Coordination Concepts SECTION I

The largest and most frequent economic benefits of coordinating human service transportation and regular fixed-route transit services (Burkhardt et al., 2003) are listed below. These benefits are generally applicable to other coordination examples as well. The largest and most frequent economic benefits are the following: ✦ Additional funding—more total funding and a greater number of funding sources; ✦ Increased efficiency—reduced cost per vehicle hour or per mile; ✦ Increased productivity—more trips per month or passengers per vehicle hour; ✦ Enhanced mobility—increased access to jobs or health care, or more trips provided to passengers at a lower cost per trip; and ✦ Additional economic benefits—increased levels of economic development in the community or employment benefits for those persons associated with the transportation service. How Do the Benefits of Coordinating Transportation Services Occur? How are the potential benefits actually realized? These are the ways in which the benefits of coordination usually come about: ✦ A more cost-effective use of resources is created through productivity increases, economies of scale, eliminating waste caused by duplicated efforts, and more centralized planning and management of resources. ✦ Greater productivities and efficiencies can be used to fill service gaps in a community by offering services to additional individuals and geographic areas within existing budgets. These also result in more trips for community members, thus enhancing their quality of life and generating economic benefits for the entire community, and generating cost savings to some participating agencies in some forms of coordinated transportation services. Chapter 2 Coordination Details: Benefits, Costs, and Barriers 23

✦ A more centralized management of existing resources can result in greater visibility for transportation services and an enhanced appreciation of their value, reduced consumer confusion about how to access services, clearer lines of authority, and more professional (more comfortable, reliable, and safe) transportation services. The most powerful coordination strategies for generating economic benefits by reducing inefficiencies are reducing the number of drivers and the total driver wages paid, reducing capital costs, and reducing administrative labor costs. The most powerful coordination strategies for generating economic benefits by increasing service effectiveness include extending service hours and boundaries, offering services that are more responsive to customer needs, and offering higher quality and safer services. Within rural communities, the most significant results of coordination are probably the following factors: ✦ Provider/program cost savings: There are two kinds of reduced costs per trip: those associated with decreased resource inputs (costs) and those associated with increasing service outputs (trips). The first type of cost reduction, the cost to provide trips, is created by increased efficiencies from vehicle sharing, use of volunteers, lower fuel cost, lower insurance cost, economies of scale, or similar coordination measures. From the point of view of a human service agency that participates in a coordination arrangement, the same benefit could be in the form of reduced cost to purchase a trip compared to a non-coordinated arrangement. The second type of cost reduction on a per-trip basis comes from the increase in the number of trips consumed, or the productivity of the services. ✦ User cost savings: These savings result from trips made by target populations at lower costs than would otherwise be the case. ✦ Mobility increases: These result from additional trips provided to target populations that would not otherwise be made. The value of these additional trips depends on the type of trip—for example, the ability to obtain needed services, obtain medical care, or hold down a job. 24 Basic Coordination Concepts SECTION I The most powerful coordination strategies for generating economic benefits are reducing inefficiencies and increasing service effectiveness.

✦ Service quality: This results from trips that are safer, more reliable, or more convenient because of coordinated arrangements for driver training, maintenance, access to advanced technology, and so forth. An overall list of the possible benefits of coordination is shown in Tables 2 through 5 (Burkhardt et al., 2003). Not all of these benefits occur in all communities, and not all consequences of coordination lead to reduced costs or outcomes that are universally considered desirable. Table 2 shows the desired or expected changes to transportation system characteristics (the inputs to transportation services) that may come about as a result of coordination. Coordinated operations can actually lower some of the fundamental transportation system inputs, such as numbers of drivers, vehicles, and transportation providers. Duplication of services is reduced in this way. Table 3 shows the desired or expected changes to transportation system performance measures (the results of transportation services) that may come about as a result of coordination. Both efficiency measures (for example, cost per mile) and effectiveness measures (such as passenger trips per vehicle mile) should show improvements as a result of coordination. Table 4 shows coordination’s desired or expected changes to users’ assessments of basic transportation system attributes such as accessibility or affordability. Users should rate all of these system attributes higher after coordination is implemented. Table 5 shows the desired or expected changes to users’ overall transportation system service assessments that may come about as a result of coordination. Coordinated transportation services should result in greater accessibility throughout the community, providing greater mobility and independence for residents, and leading to decreased isolation. Tables 2 through 5 can be used in the initial stages of planning coordinated transportation services. These tables can be used as checklists for possible coordination goals within a specific community. Chapter 2 Coordination Details: Benefits, Costs, and Barriers 25 Tables 2 through 5 can be used as checklists for possible coordination goals within a specific community.

26 Basic Coordination Concepts SECTION I Factor Desired or Expected Change System Characteristics (Inputs) Number of transportation providers Lower Number of agencies purchasing transportation Higher Number of vehicles Lower Number of drivers Lower Part-time/full-time driver ratio Lower Average hourly driver wage Higher Total driver wages Lower Level and quality of driver training Higher Hours when service is provided each day Expanded Days when service is provided each week Expanded Vehicle hours of service May be lower Vehicle miles of service May be lower Total service area Expanded Number of persons who can get services Expanded Joint purchasing More frequent Joint dispatching of agency-owned vehicles More frequent Centralized oversight and management More frequent Level of route duplication Lower Number of funding sources Higher Total transportation funding Higher One central community information source More frequent Segregated client types Less frequent Limited trip purposes Less frequent Community-wide transportation perspective More frequent Time spent in meetings Higher Level of planning processes Higher Table 2: POTENTIAL COORDINATED TRANSPORTATION BENEFITS: SYSTEM CHARACTERISTICS (INPUTS)

Chapter 2 Coordination Details: Benefits, Costs, and Barriers 27 Table 3: POTENTIAL COORDINATED TRANSPORTATION BENEFITS: PERFORMANCE MEASURES Desired or Expected Change Factor Performance Measures Number of passenger trips Higher Number of passenger trips per service area population Higher Passenger trips per vehicle mile Higher Passenger trips per vehicle hour Higher Number of driver hours per passenger trip Lower Number of admin staff hours per passenger trip Lower Cost per vehicle hour Lower Cost per vehicle mile Lower Cost per passenger trip Lower Community benefits: Economic activity Higher Economic growth Higher Nursing home admissions per 1,000 population Lower Table 4: POTENTIAL COORDINATED TRANSPORTATION BENEFITS: SERVICE ATTRIBUTE ASSESSMENTS Desired or Expected Change Service Attribute Assessments Factor Acceptability Greater Accessibility Greater Adaptability Greater Affordability Greater Availability Greater

Program/Provider Cost Savings Table 6 shows details of the provider/program cost savings categories. This table takes the fundamental operating components of a transportation service and estimates for each component how coordination might affect system costs. For example, drivers’ salaries are the largest single expense of any transportation service. If coordination results in a lower number of paid drivers, this would reduce overall costs. But coordination might result in more professional, better-trained drivers who drive more hours: these factors would tend to increase costs. Some coordination plans could result in fewer volunteer drivers; if this happens, driver wages would probably increase. These efficiency-related provider/program cost savings are really the heart of coordination, the part that sets coordination apart from other service improvements. The other kinds of benefits (user cost savings, mobility benefits, and service quality improvements) are those generated by most transportation services. If some of these efficiency- related impacts cannot be achieved, coordination may not be worth the effort it requires. 28 Basic Coordination Concepts SECTION I If some of these efficiency-related impacts cannot be achieved, coordination may not be worth the effort it requires. Table 5: POTENTIAL COORDINATED TRANSPORTATION BENEFITS: USERS’ OVERALL SERVICE ASSESSMENTS Desired or Expected Change Factor Users’ Overall Service Assessments Alternative travel options Greater Ratings of transportation services More Positive Outcomes Independence Increased Security Increased Mobility Increased Isolation Decreased

Chapter 2 Coordination Details: Benefits, Costs, and Barriers 29 Table 6: HOW TO GENERATE PROVIDER/PROGRAM COST SAVINGS Cost Category of Total System Cost Probable Effect of Coordination Possible Change in this Category’s Percent Cost Drivers’ salaries 35 Reduces total number of drivers Drivers drive more hours, are more skilled, and earn higher wages Less input from volunteer drivers -20 +10 to 25 +10 to 20 Administrative salaries 15 Frees agency heads from transportation hours Requires hiring a professional transportation director -10 +20? Dispatcher and bookkeeper salaries 6 Reduces total number of dispatchers and bookkeepers needed -25 Gasoline, oil, and tires 16 Joint purchasing reduces prices; coordinated system may receive special tax advantages -15 Capital expenses 12 Reduces total need for vehicles, radios, and computers -25 Insurance 4.5 Standardizes rates for service but changes rate class to a higher risk level +25 Maintenance 8 Eliminates duplication and underutilization of space, tools, and personnel -25 Other costs 3.5 Saves on rent and office equipment -25 Typical Percent

The Economic Benefits of Mobility Transportation’s mission has been succinctly expressed as follows: “Transportation is necessary to support overall economic growth and activity in the national economy, but it also is expected to serve other goals of the community, support the desires of those who use its services, and do all this with the least expenditure of scarce resources” (Fuller, 2000). These other goals that transportation is expected to address include an extremely wide range, such as “facilitate welfare reform, narrow regional wealth or opportunity disparities, manage growth, and help produce more livable cities or neighborhoods,” accomplishing these as it “provides employment, facilitates changed land uses, links businesses and employees, broadens distribution, enhances recreation, and in short is called upon to put in place the agenda of every political body” (Fuller, 2000). Coordination’s typical service improvements make significant increases to the mobility of transportation system users. Typical service improvements that result from coordination include the following: ✦ Lowered trip costs for travelers and for human services agencies; ✦ Extended service hours; ✦ Services to new areas or new communities and to more people; ✦ More trips made by persons needing transportation; ✦ Services more responsive to schedules, points of origin, and destinations of customers; ✦ Greater emphasis on safety and customer service; ✦ More door-to-door service; and ✦ More flexible payment and service options. We need to recognize that some service limitations may still exist, even with coordination. Customers may have to preschedule their trips 24 hours or more in advance, and they may have to register with the service provider before being eligible to request trips. Some coordinated systems do not offer trips to all persons but only to those who meet certain qualifications, even though that approach runs contrary to most understandings about coordination. 30 Basic Coordination Concepts SECTION I We need to recognize that some service limitations may still exist, even with coordination.

When such service improvements occur, mobility increases and substantial benefits result. The American Public Transportation Association (APTA) reports that the major benefits from transit investments include mobility benefits, efficiency benefits, economic development benefits, and economic productivity benefits. Overall, the ratio of benefits to public costs is said to range between 4:1 and 5:1 (APTA, 1998). A study found that rural public transportation services provide large economic benefits for their communities (Burkhardt, Hedrick, and McGavock, 1998), demonstrating that personal transportation services are a good investment for rural communities. The kinds of benefits that rural transit systems generate for their communities include the following: ✦ With access to jobs, workers get better jobs and there is reduced unemployment; ✦ Riders become (and stay) more independent with better access to health care, welfare, and shopping; ✦ Riders can shop where costs are lower; ✦ Riders save on their travel costs when using transit; ✦ Local businesses increase their level of activity, more money is spent locally, and new businesses and visitors are attracted to the community; and ✦ Communities benefit by the best use of their unique environments. Added to such benefits are the wages paid to transit employees, the costs of goods and services the transit system purchases locally, and the multiplier effects of wages and system purchases in the local economy. Achieving these goals can create returns on investment of greater than 3:1 for rural communities, as shown by both national and local analyses. HOW TO USE COORDINATION’S BENEFITS The uses of the benefits of coordination are highly significant. Some communities will choose to apply coordination’s benefits in one way, while others will opt for different strategies. If there are cost savings on a unit cost basis (which is possible but does not always occur)—that is, cost per trip, per mile, or per hour—the savings from these greater Chapter 2 Coordination Details: Benefits, Costs, and Barriers 31 The American Public Transportation Association reports that the major benefits from transit investments include mobility benefits, efficiency benefits, economic development benefits, and economic productivity benefits.

efficiencies can be used to serve more passengers. This is basically the approach used by the vast majority of communities simply because the transportation service in most communities serves only a fraction of the total travel needed. The most frequent use of these coordination benefits is the expansion of service to previously unserved portions of the community, to previously unserved client types, or to previously unserved hours and days. To be sure, it is possible that some agencies will actually save money through coordination. Since these cases are rare, they are notable. To a large extent, monetary savings have been the result of the use of programs such as transit passes to serve Medicaid clients needing frequent trips. Transit passes cost only a fraction of comparable paratransit trips; the Medicaid program saves money, the transit agency receives more revenue (at essentially zero cost increases), and the Medicaid clients receive additional mobility. Lee County, North Carolina, (CTAA, 1994) and Sweetwater County, Wyoming, (Burkhardt, 2000) are examples of cases where all participating agencies paid less on a per-trip basis after coordination, and some actually paid less in total for their trips after services were coordinated (but some agencies simply purchased more trips for the same or even increased levels of expenditure). THE COSTS OF COORDINATION Coordination has its costs. It may be initially more expensive, more difficult, and more time consuming to achieve than most interested stakeholders expect. Coordination may increase overall cost effectiveness or reduce unit costs (for example, costs per trip), but may not necessarily make transportation dollars available for other activities. While some agencies have hoped to see money returned to them, this has seldom happened because any cost savings realized are most often devoted to addressing the many unmet travel needs found in most rural (and urban) communities. Also, coordination agreements can unravel over time, so that constant attention is necessary to ensure that all parties keep working together. Coordination depends on mutual trust, respect, and goodwill among all parties involved, so long-standing coordination arrangements can be jeopardized if antagonistic or self- serving individuals become involved in transportation activities. 32 Basic Coordination Concepts SECTION I The transportation service in most communities serves only a fraction of the total travel needed. Coordination . . . may be initially more expensive, more difficult, and more time consuming to achieve than most interested stakeholders expect.

FACTORS THAT INHIBIT COORDINATION An oft-heard complaint from local transportation operators is that they would like to coordinate their services with those of other providers, but they are “prohibited,” or otherwise unable to do what makes sense to them by “barriers” in the legislation or regulations of programs through which they receive funding. On the other hand, many local operators have succeeded in coordinating the transportation resources of various Federal and state-funded programs. They have done so by working through the same administrative, interpersonal, and institutional obstacles that other operators have found more difficult to surmount. In short, this means that obstacles for some operations have not been barriers for others operations. Why is this? It is apparently due to the nature of coordination, part of which involves stepping out into the unknown territories of other persons’ interests and jurisdictions. This is an obvious challenge. To be successful, coordination also requires many other traits. Among these are a substantial amount of knowledge about possible approaches to coordination, a willingness to learn new information, and the flexibility and confidence to work cooperatively along paths that are only defined as one proceeds along the journey. The case studies in this Toolkit should provide the information and inspiration needed to implement successful coordinated rural transportation systems. Much work has been devoted to investigating the issue of barriers to coordinated transportation. Because some persons have succeeded in implementing coordinated systems, it is now clear that many coordination efforts have been slowed or halted by perceived rather than actual barriers. Certainly, coordination requires lots of effort. But it may be more accurate to say that, while there are hindrances or challenges, there are seldom actual barriers that cannot be overcome no matter what. During hearings in 1975, the U.S. Senate became concerned about the lack of coordination of human service transportation and commissioned a review by the General Accounting Office (GAO) which resulted in a detailed 1977 report to the Comptroller General of the United States, Hindrances to Coordinating Transportation of People Participating in Federally Funded Grant Programs (GAO, 1977). In this review, the Chapter 2 Coordination Details: Benefits, Costs, and Barriers 33 It is now clear that many coordination efforts have been slowed or halted by perceived rather than actual barriers. Obstacles that have troubled some individuals and operations have not been barriers to others.

GAO identified 114 Federal programs that provided transportation. (In a new report, GAO identified 62 Federal programs—most of which are administered by the Departments of Health and Human Services, Labor, Education, and Transportation—that fund transportation services for the transportation-disadvantaged [GAO, 2003]). The 1977 report could not identify any specific legislative or regulatory restrictions on coordination, but it did point out a number of “hindrances.” Many of the hindrances were inherent in the categorical nature of Federal grant programs. Problems in coordinating transportation services for multiple client groups often stem from the incompatibilities or perceived incompatibilities in program purposes or services for the members of these different client groups. After some substantial efforts in investigating this issue of barriers, it is clear that many operators are responding to perceived rather than actual barriers. Issues that have been described as hindrances in the past include the following: ✦ Problems in dealing with the various requirements of a large variety of Federal funding programs; ✦ Not being certain that coordination is allowed or authorized; ✦ Problems with accountability, cost allocation, paperwork, and reporting; ✦ Funding issues including matching requirements for Federal funds, funding cycles, and lack of sufficient funding; ✦ Perceived incompatibility of goals, needs, or client eligibility; ✦ Expectations of no significant benefits from coordinated operations; ✦ Regulatory requirements (such as prohibitions on crossing local or state boundaries); and ✦ Lack of concerted Federal effort to encourage or require coordination (GAO, 1977; HEW, 1976). In addition, some agencies and individuals are not familiar with the concept of “fully allocated resource costs” of transportation services. Another hindrance has been the inability of others to address issues of service quality. All of these hindrances or challenges have been addressed and resolved in one community or another. 34 Basic Coordination Concepts SECTION I All of these hindrances or challenges have been addressed and resolved in one community or another.

REQUIREMENTS OF FEDERAL FUNDING PROGRAMS Many Federal programs offer funds that could be used for coordinated transportation services in rural communities. Some persons view this fact as a problem; in reality, having multiple funding sources is probably a real strength. The popularity of various Federal programs waxes and wanes over time, particularly within Congress, where funding decisions are made. Still, having to work with a variety of rules and regulations from different funding sources certainly adds a level of complexity to coordination tasks. No Overall Coordination Restrictions There has been a misperception that categorical funding “does not permit” the sharing of resources among client groups of different types. Both the U.S. Departments of Transportation (DOT) and Health and Human Services (HHS) have issued instructions that are clear on such issues: as long as there is excess capacity and service is not being denied to the primary client group, it is indeed possible to use vehicles and other resources to serve a variety of client types, and it is possible to have clients from different sponsoring agencies riding on vehicles at the same time. If there are misperceptions about the possibilities of resource sharing, these misperceptions should be relatively easy to resolve with appropriate detailed information. Restrictions within Specific Programs There have been concerns about specific Federal programs concerning legislation or regulations that make coordination much more difficult than necessary (or that provide support to the views of those individuals not ordinarily inclined to share resources and responsibilities). Most of these issues have been successfully dealt with by the individual agencies or the efforts of the Federal Coordinating Council on Access and Mobility. There are still some issues that need further work; chief among these are those relating to coordination with the Head Start and Medicare programs (both of which are being addressed but need further work before coordination obstacles are removed). Chapter 2 Coordination Details: Benefits, Costs, and Barriers 35 Having to work with a variety of rules and regulations from different funding sources certainly adds a level of complexity to coordination tasks.

Head Start—The Head Start program accounts for a substantial part of human service transportation nationwide. According to a 2000 survey conducted by School Transportation News, Head Start provides daily transportation to over 582,000 children across the country. Many of these children receive transportation from coordinated transportation systems, using either transit vehicles or agency vans. For many coordinated systems, such as the one found in Iowa, Head Start transportation is a substantial part of the system. The Iowa Office of Public Transit estimates that between 20 and 25 percent of the trips in their statewide coordinated system are provided to Head Start clients. If these trips were lost, the consequences to their coordinated systems could be serious. The Coordinating Council has been working with Head Start to ensure that rural transportation systems will continue to be able to transport Head Start children. A key issue is the issue of the types of vehicles that are allowed to be used for transporting Head Start children. Unless there is progress on manufacturing alternative vehicles or modifying the Head Start regulations, all Head Start trips will have to be provided with school buses starting in 2006. Since no transit system or human service agency uses school buses, they will no longer be able to provide Head Start trips. Current Head Start regulations (45 CFR 1310.12) state that “Effective January 18, 2006, each agency providing transportation services must ensure that children enrolled in its programs are transported in school buses or allowable alternative vehicles. . . .” Most transit agencies assume that “allowable alternative vehicles” include vans, buses, and other transit vehicles. That assumption is incorrect. The Head Start regulations clearly define an allowable alternative vehicle as “a vehicle designed for carrying eleven or more people, including the driver, that meets all Federal Motor Vehicle Safety Standards applicable to school buses, except 49 CFR 571.108 and 571.131.” What are the Federal Motor Vehicle Safety Standards applicable to school buses? The Code of Federal Regulations Section 571 lists well over 100 very specific regulations and parameters for school buses. These regulations and parameters go into extremely minute detail in specifying nearly every component of a school bus, such as window size, door size, door location, emergency exit handle location, minimum tensile body joint strength, and rollover thresholds. For example, Section 571.222.S.5.1.2, “Seat back height and surface area,” states that: 36 Basic Coordination Concepts SECTION I All Head Start trips will have to be provided with school buses or allowable alternative vehicles starting in 2006. Head Start provides daily transportation to over 582,000 children across the country, many of whom receive transportation from coordinated transportation systems

Each school bus passenger seat shall be equipped with a seat back that, in the front projected view, has a front surface area above the horizontal plane that passes through the seating reference point, and below the horizontal plane 508 millimeters above the seating reference point, of not less than 90 percent of the seat bench width in millimeters multiplied by 508. Transit vehicles may not be able to meet such standards for seat back size or the equally specific standards for window size. Is there any possibility that these transit vehicles will comply with the rear door regulations that specify door size down to the millimeter? Is it possible that a transit agency will cut apart the body of one of its buses in order to test the body joints? At the moment, it does not appear possible for any vehicle to meet these standards, other than a school bus (which was designed to meet these standards). So unless rural transit and human service agencies switch their fleets to school buses, their Head Start contracts could expire in January 2006. Head Start sponsored a demonstration program of alternative vehicles in North Carolina. These vehicles may provide an option to permit continued coordination between public transportation operators and the Head Start program. Clearly, this is an outstanding issue of some importance. Medicare—The Medicare program, administered by the Centers for Medicare & Medicaid Services of HHS is one of the key health care programs in this country. This program has two distinct components: hospital insurance (known as “Part A”) and supplemental medical insurance (“Part B”). Both programs provide insurance protection for covered services for persons age 65 or older, certain persons with disabilities, and individuals with chronic renal disease who elect this coverage. Transportation costs are allowable expenses under Medicare Part B, but serious restrictions apply. By statute and regulation, Medicare will provide reimbursement only for transportation services provided by ambulances. Furthermore, the use of an ambulance is limited to very severe medical situations such as a life-threatening emergency or a bed-ridden patient. These restrictions unnecessarily increase transportation costs and limit access to necessary health care. Previous research has questioned the “emergency” nature of some Medicare transportation now being provided. This is particularly true for regularly scheduled dialysis trips for end-stage renal disease (ESRD) patients. ESRD Medicare patients are especially likely to have a critical Chapter 2 Coordination Details: Benefits, Costs, and Barriers 37 Previous research has questioned the “emergency” nature of some Medicare transportation now being provided. Head Start sponsored a demonstration program of alternative vehicles in North Carolina.

need for transportation support to access life-extending dialysis treatments. Such transportation problems are particularly severe in rural areas, which often lack local dialysis facilities and may lack long- distance transportation options to urban dialysis treatment centers. Medicare patients seeking dialysis transportation via ambulance must present a written order from their doctor stating that any other form of transportation would be harmful to their health. Of course, in some parts of the country, there may be no means of transportation except by ambulance. Since missing dialysis treatments can lead to serious medical problems, including death, it seems that some doctors are doing whatever it takes to get their patients to dialysis, even if this entails bending some regulatory definitions of what entails an emergency. Research indicates that there are many nonemergency Medicare patients arriving at hospitals via ambulance. With Medicare ambulance transportation costs approaching 2 billion dollars annually, Medicare’s insistence on ambulance transportation—instead of, for example, rural public transportation systems—appears to be creating unnecessarily high costs. Research is now under way to examine the potential benefits to the Medicare program of changes to their legislation that would permit travel by services other than ambulances. PROBLEMS WITH ACCOUNTABILITY, COST ALLOCATION, PAPERWORK, AND REPORTING Rural transportation providers need detailed information to overcome the following kinds of potential coordination obstacles: ✦ Program-by-program variations in eligibility for services; ✦ Billing, accounting, recordkeeping, and reporting requirements; ✦ Funding issues, including differing matching ratios and funding cycles; and ✦ Service regulations (such as prohibitions on crossing local or state boundaries). While not constituting “barriers” that are impossible to surmount, the burdens imposed by differing regulations and procedures can be quite 38 Basic Coordination Concepts SECTION I Research indicates that there are many nonemergency Medicare patients arriving at hospitals via ambulance. The burdens imposed by differing regulations and procedures can be quite expensive for local transportation operators.

expensive for local transportation operators. Recently completed case studies showed that overall administrative accounting and reporting burdens can be extremely expensive: 24 percent of all administrative costs of the Pee Dee RTA in South Carolina are devoted to accounting and reporting; administrative costs account for 58 percent of the total cost of Medicaid transportation provided by the Community Transit service in York, Pennsylvania. Most of the commonly identified obstacles or barriers to coordination have specific strategies to overcome them. For example, problems of billing and accounting, which used to consume vast amounts of administrative staff resources for large coordinated transportation services (like OATS in Missouri) are now handled with relative ease because of the installation of computerized accounting systems (like that used by Jefferson Area United Transportation System [JAUNT] in Virginia) which allow detailed reporting to a wide variety of funding sources. The issue of cost allocation can be resolved by working through cost sharing arrangements in which all parties agree to certain specific formulas for sharing. OPERATIONAL CHALLENGES TO COORDINATED TRANSPORTATION In Chapter 8, local transportation providers describe the operational challenges they have faced when trying to coordinate services in their localities. These challenges were the following: ✦ Funding, ✦ Interpersonal relationships, ✦ Political support and power sharing, ✦ Lack of knowledge, and ✦ Understanding coordination. Excluding funding, these topics can be addressed through greater understanding of coordination, including its likely benefits, costs, challenges, and successes in similar communities. All of these topics are covered in depth in this Toolkit. Chapter 2 Coordination Details: Benefits, Costs, and Barriers 39 Most of the commonly identified obstacles or barriers to coordination have specific strategies to overcome them.

SUMMARY The major potential benefits of coordinating transportation services are access to more funds and more funding sources, higher quality and more cost-effective services, and more visible transportation services for consumers. Reducing inefficiencies (by reducing cost inputs) and increasing service effectiveness (by expanding available services) are the two key coordination strategies. It is important to recognize that successful coordination will take real work. Part of that work will involve dealing with persons who are unfamiliar with the missions, objectives, terminology, rules, and regulations of agencies other than their own. Other persons may not be used to cooperation as an operating procedure. Serious coordination efforts constitute a new way of doing business, outside of the traditional programmatic boundaries of service delivery. Generally, these “bumps in the road” are worth handling and eliminating because of the substantial benefits that coordination can provide. The major institutional barrier to coordination lies at the very heart of coordination: the need to work with people from different agencies and having different perspectives. The key strategy to ensure that this obstacle does not become an insurmountable barrier is education—to obtain detailed knowledge about the programs, objectives, regulations, and operating procedures of persons representing other agencies. Another major strategy would be flexibility—one agency agreeing to accept some variations to its usual procedures to accommodate the operations of a coordinated service. The idea that funding programs for specific client groups “do not permit coordination with other programs” is not correct; while each program may have unique administrative and reporting requirements, there are no prohibitions to coordination in Federal legislation. 40 Basic Coordination Concepts SECTION I The major institutional barrier to coordination is the need to work with people from different agencies and having different perspectives.

Next: Section II: Implementing New Coordination Efforts »
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TRB’s Transit Cooperative Research Program (TCRP) Report 101: Toolkit for Rural Community Coordinated Transportation Services examines strategies and practices used to coordinate rural transportation services, and identifies model processes used for local coordination efforts in rural communities. A stand-alone executive summary of the report provides information, instructions, and lessons learned from rural communities that have implemented coordinated transportation services.

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