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31 APPENDIX A Survey Questionnaire TCRP SB-15: Practices for Effectively and Efficiently Meeting ADA Paratransit Demand You should be able to complete this survey in about 20 minutes. Section 1 asks you for contact information (name, address, phone no., e-mail). Section 2 asks you for characteristics of your paratransit service. Section 3 asks you about how you organize and manage your paratransit service. Section 4 asks you to tell us about innovative policies and practices in your paratransit service. Section 5 asks whether you or someone else will answer questions about innovative policies and practices on your agency's fixed-route service. Section 6 asks for contact information for the person who will complete Section 7 (if not yourself). Section 7 asks you to tell us about innovative policies and practices on your fixed-route service. CONTACT INFORMATION 1. Who You Are and How We Can Get in Touch? 1. Transit Agency 2. FTA National Transit Database (NTD) ID 3. Street Address 4. City 5. State 6. Zip 7. Your Name (first and last) 8. Title 9. Phone No. (999-999-9999) + extension (if you have) 10. Cell No. (If better to contact) (999-999-9999) 11. Fax No. (999-999-9999) 12. E-mail Address

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32 2. YOUR PARATRANSIT SERVICE Basic Characteristics and Numbers 13. Name of Paratransit Service 14. ADA Trips on an Average Weekday Under 250 250 to 499 500 to 999 1,000 + 15. Total Paratransit Trips on an Average Weekday (include ADA and all other) Under 250 250 to 499 500 to 999 1,000 + 16. Total Individuals Registered for ADA Paratransit Service Under 500 500 to 1,999 2,000 to 4,999 5000 + 17. Total "Active" ADA riders (at least one trip in past year) Under 200 200 to 499 500 to 999 1000 + 18. Subscription Trips (% of all ADA trips) 19. ADA Service Area Minimum Required Somewhat Larger Significantly Larger 20. ADA Service Hours Minimum Required Somewhat Extended Hours Significantly Extended Hours 21. Check the Type of Vehicles That Are in Your Dedicated Paratransit Fleet Sedans/Taxis Vans Small Buses Other (please specify): 22. Peak Fleet Under 25 Vehicles 25 to 99 100 to 199 200 +

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33 23. Other (Non-Dedicated) Vehicles Available for Paratransit Service Sedans/Taxis Vans Small Buses Other (please specify): 3. SERVICE ORGANIZATION 24. Who Is Responsible for the Following? (Check all that apply.) You Must Check at Least One Box in Each Row. In-House Broker Other Contractors Eligibility Determination Customer Information Trip Reservations Vehicle Scheduling Vehicle Dispatching Vehicle Ownership Vehicle Maintenance Driver Hiring and Supervision Driver Training Training for Other Paratransit Staff 4. POLICIES AND PRACTICES FOR MORE EFFECTIVE AND/OR EFFICIENT PARATRANSIT SERVICE Is your agency doing something innovative? When answering the questions on this page, please check the second or third column if you think that other transit providers would want to learn about it. For the questions in this section, please note that you must check one box (and only one box) in each row. Mailing and contact information appears at the end of this survey. 25. Does Your ADA Paratransit Service Make Use of Any of the Following Eligibility Policies or Practices? No Yes Yes and I am Yes and please sending you material contact me for on this policy/practice more information Conditional eligibility Trip-by-trip eligibility Periodic recertification Feeder service to/ from fixed route Travel training

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34 Other eligibility policies and practices 26. Please Include Any Comments on Your Eligibility Responses Here. 27. Does Your ADA Paratransit Service Make Use of Any of the Following Policies or Practices for Trip Reservations? No Yes Yes and I am Yes and please sending you material contact me for on this policy/practice more information On-demand or same-day reservation Internet access for trip requests, changes, confirmations, cancellations TTDs Multi-lingual call-takers Other trip reservation policies and practices 28. Please Include Any Comments on Your Trip Reservations Responses Here. 29. Does Your ADA Paratransit Service Use Special Policies or Practices in Any of the Following Elements of Daily Operations? No Yes Yes and I am Yes and please sending you material contact me for on this policy/practice more information Vehicle scheduling Dispatching Feeder service Use of technology Flexible staffing Allocation of drivers, vehicles, or other resources Other daily operations policies and practices 30. Please Include Any Comments on Your Daily Operations Responses Here.

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35 31. Does Your ADA Paratransit Service Make Use of Taxis in Any of the Following Ways? No Yes Yes and I am Yes and please sending you material contact me for on this policy/practice more information Accessible taxis Taxis as regular contractors Taxis as overflow contractors Taxis as same-day contractors Taxis as other premium service contractors Other uses of taxis 32. Please Include Any Comments on Your Taxi Responses Here. 32. Does Your ADA Paratransit Service Coordinate with Social Service Agencies in Any of the Following Ways? No Yes Yes and I am Yes and please sending you material contact me for on this policy/practice more information Social service agencies as contracted paratransit providers Social service agencies as contractor for non- ADA paratransit service Lease vehicles to social service agencies Coordinate program schedules for more efficient schedules Dedicate vehicles and/ or drivers to particular sites or agencies Leverage funding from other sources (e.g., Medicaid) Other coordination policies and practices 34. Please Include Any Comments on Your Coordination Responses Here.

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36 35. Does Your ADA Paratransit Service Have Any of the Following Special Management or Administrative Programs? No Yes Yes and I am Yes and please sending you material contact me for on this policy/practice more information Service monitoring Incentive programs for riders Incentive programs for sponsors of riders Alternate sources of revenue Creative budgeting Other management and administrative programs 36. Please Include Any Comments on Your Management/Administrative Program Responses Here. 5. FIXED-ROUTE POLICIES AND PRACTICES 37. The Final Set of Questions Deals with Your Transit Agency's Fixed-Route Service. Can You Also Answer These Questions? YES, I will answer the questions on fixed-route policies and practices (you will proceed to these questions). NO, someone else at my agency (or another agency) will answer the questions on fixed-route policies and practices (a final question will ask you for contact information). 6. CONTACT FOR FIXED-ROUTE POLICIES AND PRACTICES 38. Please Provide the Contact Information for the Person at Your Transit Agency Who Is More Knowledgeable About Fixed-Route Policies and Practices: Name: Telephone: E-mail Address: 7. FIXED-ROUTE QUESTIONS Is your agency doing something innovative in your fixed-route service? When answering the questions on this page, please check the second or third column if you think that other transit providers would want to learn about it. For the questions in this section, please note that you must check one box (and only one box) in each row. 39. Does Your Transit Agency Provide or Help with Any of the Following Fixed-Route Improvements for Your Riders with Disabilities? No Yes Yes and I am Yes and please sending you material contact me for on this policy/practice more information Vehicle accessibility

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37 Design guidelines for improved accessibility for stations, paths, facilities Stop accessibility Path accessibility Public information Station/stop visual and audio communications Other fixed-route improvements 40. Please Include Any Comments on Your Fixed-Route Improvement Responses Here. 41. Does Your Transit Agency Provide Any of the Following Fixed-Route Incentives for Your Riders with Disabilities? No Yes Yes and I am Yes and please sending you material contact me for on this policy/practice more information Reduced or no fare for ADA-certified rider and/or attendant Targeted marketing to persons with disabilities Other fixed-route incentives 42. Please Include Any Comments on Your Fixed-Route Incentive Responses Here. Thanks. On behalf of TRB, thank you for contributing to this research. For any information that you can mail or e-mail me, here's where you can reach me. Also, if you have any questions, please contact me: David Chia Principal Investigator Planners Collaborative, Inc. 273 Summer Street, 7th Floor Boston, MA 02210 617-338-0018, ext. 117 617-338-4228 fax dc@thecollaborative.com