National Academies Press: OpenBook

Improving Mobility for Veterans (2011)

Chapter: Chapter 5 - Improving Veterans Mobility: Strategies for Transportation Providers

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Suggested Citation:"Chapter 5 - Improving Veterans Mobility: Strategies for Transportation Providers." National Academies of Sciences, Engineering, and Medicine. 2011. Improving Mobility for Veterans. Washington, DC: The National Academies Press. doi: 10.17226/14507.
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Suggested Citation:"Chapter 5 - Improving Veterans Mobility: Strategies for Transportation Providers." National Academies of Sciences, Engineering, and Medicine. 2011. Improving Mobility for Veterans. Washington, DC: The National Academies Press. doi: 10.17226/14507.
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Suggested Citation:"Chapter 5 - Improving Veterans Mobility: Strategies for Transportation Providers." National Academies of Sciences, Engineering, and Medicine. 2011. Improving Mobility for Veterans. Washington, DC: The National Academies Press. doi: 10.17226/14507.
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Suggested Citation:"Chapter 5 - Improving Veterans Mobility: Strategies for Transportation Providers." National Academies of Sciences, Engineering, and Medicine. 2011. Improving Mobility for Veterans. Washington, DC: The National Academies Press. doi: 10.17226/14507.
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Suggested Citation:"Chapter 5 - Improving Veterans Mobility: Strategies for Transportation Providers." National Academies of Sciences, Engineering, and Medicine. 2011. Improving Mobility for Veterans. Washington, DC: The National Academies Press. doi: 10.17226/14507.
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Suggested Citation:"Chapter 5 - Improving Veterans Mobility: Strategies for Transportation Providers." National Academies of Sciences, Engineering, and Medicine. 2011. Improving Mobility for Veterans. Washington, DC: The National Academies Press. doi: 10.17226/14507.
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Suggested Citation:"Chapter 5 - Improving Veterans Mobility: Strategies for Transportation Providers." National Academies of Sciences, Engineering, and Medicine. 2011. Improving Mobility for Veterans. Washington, DC: The National Academies Press. doi: 10.17226/14507.
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Suggested Citation:"Chapter 5 - Improving Veterans Mobility: Strategies for Transportation Providers." National Academies of Sciences, Engineering, and Medicine. 2011. Improving Mobility for Veterans. Washington, DC: The National Academies Press. doi: 10.17226/14507.
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Suggested Citation:"Chapter 5 - Improving Veterans Mobility: Strategies for Transportation Providers." National Academies of Sciences, Engineering, and Medicine. 2011. Improving Mobility for Veterans. Washington, DC: The National Academies Press. doi: 10.17226/14507.
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Suggested Citation:"Chapter 5 - Improving Veterans Mobility: Strategies for Transportation Providers." National Academies of Sciences, Engineering, and Medicine. 2011. Improving Mobility for Veterans. Washington, DC: The National Academies Press. doi: 10.17226/14507.
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Suggested Citation:"Chapter 5 - Improving Veterans Mobility: Strategies for Transportation Providers." National Academies of Sciences, Engineering, and Medicine. 2011. Improving Mobility for Veterans. Washington, DC: The National Academies Press. doi: 10.17226/14507.
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Suggested Citation:"Chapter 5 - Improving Veterans Mobility: Strategies for Transportation Providers." National Academies of Sciences, Engineering, and Medicine. 2011. Improving Mobility for Veterans. Washington, DC: The National Academies Press. doi: 10.17226/14507.
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Suggested Citation:"Chapter 5 - Improving Veterans Mobility: Strategies for Transportation Providers." National Academies of Sciences, Engineering, and Medicine. 2011. Improving Mobility for Veterans. Washington, DC: The National Academies Press. doi: 10.17226/14507.
×
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Suggested Citation:"Chapter 5 - Improving Veterans Mobility: Strategies for Transportation Providers." National Academies of Sciences, Engineering, and Medicine. 2011. Improving Mobility for Veterans. Washington, DC: The National Academies Press. doi: 10.17226/14507.
×
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Suggested Citation:"Chapter 5 - Improving Veterans Mobility: Strategies for Transportation Providers." National Academies of Sciences, Engineering, and Medicine. 2011. Improving Mobility for Veterans. Washington, DC: The National Academies Press. doi: 10.17226/14507.
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57 Chapter 5 IMPROVING VETERANS’ MOBILITY: STRATEGIES FOR TRANSPORTATION PROVIDERS This chapter provides strategies that transportation providers can use to improve veterans’ mobility, assessment tools for transportation providers and planners, and a travel options survey. Public transportation agencies, human service transportation program managers, and community transportation providers will find this information useful in understanding the mobility needs of veterans. This chapter starts with a list of misconceptions concerning veterans’ mobility. If not understood, these misconceptions can stand in the way of implementing best practices. The next section of this chapter discusses strategies for transportation providers of different sizes and service types. This section is created for community transportation providers so that they can pick and choose strategies that are right for their programs and their communities. By answering questions in the needs assessment tool, transportation providers can evaluate veterans’ mobility needs in their areas

58 and review veterans’ mobility issues as an opportunity for serving future markets. In addition to the worksheets in the form of tables, the report is also includes a self-assessment tool for transportation providers and program managers. MISCONCEPTIONS CONCERNING VETERANS’ MOBILITY AND THEIR TRANSPORTATION SERVICES There are five key misconceptions about veterans’ mobility and their transportation services. 1. Transportation programs offered through the Department of Veterans Affairs meet all the transportation needs of veterans. 2. Volunteer driver programs meet most of the mobility needs of veterans. 3. Community transportation providers reach out to the veterans’ community to collaborate on transportation programs much like they work with groups representing older adults, individuals with disabilities, and low- income families. 4. Veterans must always be transported to medical facilities in small (or large) vehicles. 5. Veterans who cannot be treated in one VAMC must be transported to another VAMC and cannot be treated at a local non-VA site. These misconceptions are discussed and clarified below. Misconception # 1: Transportation Programs Offered Through the Department of Veterans Affairs Meet All the Transportation Needs of Veterans Transportation programs affiliated with the Department of Veterans Affairs can only serve veterans with specific trip purposes and destinations. They primarily transport veterans to VAMCs or other veteran-related facilities but not to other destinations. There is a growing need for community transportation providers and professionals to work with veterans and to provide necessary trips to private doctors, social and recreational engagement, health and nutrition sites, and volunteer activities.

59 Misconception # 2: Volunteer Driver Programs Meet Most of the Mobility Needs of Veterans Volunteer drivers affiliated with Veterans Service Organizations (VSOs) have been heavily involved in medical transportation. Voluntary Service Office within the Veterans Affairs reported that 10,000 volunteer drivers transported veterans to VAMCs nationwide. However, nearly all volunteer-based programs exclude accessible vehicles from their operations, meaning that veterans with high-level mobility needs may not be able to receive services through these programs. Veterans who require accessible vehicles for local trips and nonmedical trips could benefit from community transportation programs such as those provided by human service transportation agencies or local public paratransit services. Misconception # 3: Community Transportation Providers Reach Out to the Veterans’ Community to Collaborate on Transportation Programs Much Like They Work with Groups Representing Older Adults, Individuals with Disabilities, and Low-Income Families Levels of collaboration and coordination between human service agencies and community transportation providers have increased substantially over the years. Different models have developed to make coordination cost-efficient and to avoid service duplication. Unlike other transportation-disadvantaged populations, veterans do not seem to be a primary service market for community transportation. Veterans, however, are very likely to experience mobility barriers similar to those of other high-need groups due to disability status, old age, or low income. Both community transportation programs and VSOs need to work together to devise transportation programs that are mutually beneficial to all parties. Community transportation programs can increase their volume of trips by serving veterans, thus increasing revenues, and VSOs can purchase professional transportation services, often with reduced fees due to economies of scale. Misconception # 4: Veterans Must Always Be Transported to Medical Facilities in Small (or Large) Vehicles Some persons may automatically associate medical transport with vans. That is a common practice. However, that might not be the most efficient way, especially if large numbers of veterans are traveling long distances together. On the other hand, larger vehicles are more expensive to acquire

60 and to maintain. If there is no compelling need for larger vehicles, one may consider using smaller vehicles. For instance, one VSO used a 15-passenger van and a 17-passenger bus when the average number of passengers per vehicle was 5. Other regions have hired taxicab companies to transport veterans individually. In some instances, they were able to reduce costs per trip and provide veterans with quality service; in other situations, transporting only one passenger at a time proved to be extremely expensive. There is no “one size fits all” solution to improving the mobility of veterans; each community should find the program that works best for them given existing needs, resources, and constraints. Misconception # 5: Veterans Who Cannot Be Treated in One VAMC Must Be Transported to Another VAMC and Cannot Be Treated at a Local Non-VA Site Veterans often have to travel long distances to get to the nearest VAMC from their homes, but the nearest VAMC may not offer the kinds of service veterans need. When veterans cannot get treatments from a nearby VAMC or other government facility, VHA may work with a non-VHA facility to treat veterans. One permissible occasion for such arrangement is when a VHA facility is not within reasonable geographic proximity. While it is unknown how frequently this practice occurs, it definitely saves transportation costs, especially for long-distance travel. The VA Medical Center in Indianapolis has developed a computer program that lists the kinds of care offered at VAMCs, CBOCs, and local community facilities. When scheduling medical trips, the VAMC will advise veterans of the closest facility that offers the medical care needed. If appropriate, the VAMC will coordinate with medical staff to arrange transportation associated with non-VA care or VA care that is close to the patient’s residence. STRATEGIES FOR IMPROVING VETERANS’ MOBILITY This section on strategies for improving mobility for veterans is intended for transportation professionals, including public or private providers, who currently work with veterans or who wish to establish a business relationship with the veterans’ community. Some strategies may only apply to certain types of transportation providers. Others, however, may be broadly applied to many providers. VSOs should also be aware of all of these strategies. The following pages discuss operational strategies and coordination strategies for community transportation providers.

61 Operational Strategies Offer Reduced Fares for Veterans and Other Service Members Some transit agencies offer free or reduced fares to veterans who ride fixed route services. The Bay Area Rapid Transit (BART) system in California allows active duty military personnel to ride free on BART, which helps veterans and creates good will. Offer Flat-rate Rides for Veterans Some transportation providers have established contracts with the local VAMCs. As part of their contractual work, transportation providers receive regular trip requests and are able to increase their overall volume of business. This enables them to offer flat-rate rides to veterans. For VAMCs, this kind of arrangement eliminates the unpredictability of billing for rides by other methods, and veterans continue to receive quality service. For example, Indianapolis Yellow Cab has a contract with its local VAMC under which the taxi drivers serve veterans with flat-rate fares. Institute Competitive Contracting VAMCs and VSOs that purchase transportation services from transportation providers may benefit from competitively bidding transportation services for veterans. Agencies serving veterans can decide what contractual mechanisms would work better for them—mileage-based, trip-based, hourly-based, or fixed rate are pricing options that trip purchasing agencies can adopt—and find vendor(s) that can work with the agency. Alternatively, instead of asking the vendors to bid on one particular payment method, veterans’ agencies can be flexible about finding the best options for them by crafting requests for services that allow the vendor to propose different pricing mechanisms. In addition to pricing, trip purchasers may work with multiple vendors to create a competitive environment to ensure high-quality customer service. Provide Dispatching Services for a Veterans Service Agency Transit agencies or transportation vendors have professional dispatching capability. Other transportation providers may be able to offer rides but cannot keep up with in-house technology.

62 These small agencies could develop working relationships with transit agencies so that dispatching can be done by the experts. In a similar fashion, call center responsibilities could be fulfilled by an agency that has full-time staff devoted to that purpose. VSOs Should Work with Other Agencies with Transportation Programs Veterans’ service organizations often provide many services other than transportation. Sometimes their organizational structure or scope of activities may not allow them to provide transportation for their veterans. However, they can work with other entities that have transportation components, which may include other VSOs, non-profits, and public or private transportation providers. Provide Trips to Local VAMCs Local transit and paratransit services can actively work with veteran communities. Significant numbers of paratransit riders might also be veterans; transit and paratransit services could provide trips to local VAMCs for veterans within the scope of their current services. In Iowa, a rural veterans’ clinic was closed and veterans formerly using that clinic then needed to travel to Des Moines instead. Des Moines Area Regional Transit (DART) established a bus link directly from the closed medical clinic to the VAMC in Des Moines, providing rural veterans with continuity of care in the services they received. (See page 46 for more information.) Provide Feeder Service to DAV Vans Sometimes existing services need a little help in maintaining or improving services. In 2009, a Washington state bridge closure would have adversely affect DAV transportation programs accessing services in Seattle. The state DOT, working with local VAMC and DAV offices, devised a plan for veterans to access mainland services using existing DOT rural public transit routes which would link on the mainland with DAV vehicles which would transport veterans to the VAMC. A voucher-based subsidy was used to fund the transaction. The rural public transit services did not have to change their operation to accommodate veterans and the DAV vehicles were made more effective by eliminating a major part of their typical mileage. (See page 48 for more information.)

63 Offer Advance Scheduled Out-of-County Trips to VAMCs Transit agencies are in a position to add one more service line as long as there are enough customers. The Ocean Ride transit service operates an advance scheduled service for veterans. Each day of the week, veterans can travel to specific out-of-county destinations on a specific schedule. This type of advanced scheduling allows the transit agency to offer trips beyond county lines and has been a great resource for veterans whose nearest VA medical care is outside of their county. (See page 43 for more information.) Offer Assistance in Vehicle Acquisition Public transit and other transportation agencies may be in a position to include VSOs in capital acquisition plans or to transfer older vehicles to VSOs. These actions could take a large responsibility from the VSOs and enable them to focus resources on other activities. Community transportation providers could assist VSOs by referring them to the National Rural Transit Assistance Program (National RTAP) and other transportation industry resources. One of National RTAP’s recent publications is How to Buy a Vehicle; it contains a wealth of information about vehicles, relevant funding programs, and possible procurement programs.43 Both VSOs and VAMCs should be seen as contact points for the distribution of such information. Share Resources for Driver Training Transit agencies can offer their driver training programs to other drivers from smaller agencies. Volunteer driver programs can exchange information on driver training and share training responsibility among them. VAMCs can send their drivers to one of the transit agencies or to medical transportation providers to get professional training for the drivers. This will save management’s time spent on developing the training materials and actually training the drivers. 43 See http://www.nationalrtap.org/FeatureDetailsaspx.aspx?id=262&org=a2GSpnDbruI=.

64 Target Marketing Efforts to Veterans Sometimes veterans do not know what services are available to them, or they may be only aware of one service but not others. In order for veterans to learn about the existing transportation programs, transportation providers are encouraged to reach out to veterans’ communities, to veterans’ national/local events, and to work with veterans’ organizations to get the words out. Inform VSOs About FTA’s Section 5310 Program Veterans’ organizations need to know about Federal Transit Administration’s ( FTA’s) various programs, including the Section 5310 program that provides assistance for vehicle and other capital purchases for agencies (primarily nonprofit agencies) that serve seniors and persons with disabilities. This could serve as an additional source of capital funds for VSOs that are providing trips for veterans. One important proviso is that FTA funds are intended for the use of all riders, so that it would not be possible for the VSOs to restrict the use of the vehicles to veterans alone. (See also the Vehicle Acquisition section above.) Coordination Strategies for Community Transportation Providers Besides the operational strategies listed above, community transportation providers may need to adopt a variety of coordination strategies if they are interested in greater levels of coordination with agencies that are now offering transportation services to veterans. The following strategies are suggested for improving coordination: Be proactive: Get to know the veterans’ agencies and providers in your community. Gather information and research the operations of these organizations. See where you can assist: If you offer to help solve problems rather than take over services, your efforts are likely to be more successful. Focus on several key issues: o Veterans with mobility disabilities: Current veterans’ transportation services tend to focus on ambulatory riders; veterans with special travel needs can benefit from public transportation services. o Long-distance trips: Particularly in rural areas, long-distance trips can be a challenge for any transportation provider. The coordination of long-distance trips could serve the public and veterans at the same time, greatly enhancing the cost-effectiveness of both operations.

65 o Scheduling trips: Most VSOs are unfamiliar with current paratransit dispatching and scheduling software and could benefit from assistance with these tasks. Help train, maintain, and facilitate: This assistance includes training drivers and dispatchers, maintaining vehicles, and facilitating scheduling and transportation information dissemination. Coordinate transportation with medical schedulers and Hospital Service Coordinators: Persons who schedule medical appointments do not necessarily perceive transportation problems when they set up appointments. Especially if transportation resources are limited, work with medical schedulers to ensure that all resources are used cost-effectively. Develop plans that include all transportation modes and providers, including volunteer services: A large current strength of veterans’ transportation services are the efforts they receive from volunteer drivers. These volunteers are crucial to maintaining cost- effective transportation services. Work closely with them; they may be able to help you too. Include veterans in the planning process for future transportation services: Veterans and their service organizations have significant transportation needs and can offer substantial inputs into future plans. ASSESSMENT TOOLS FOR TRANSPORTATION PROVIDERS AND PLANNERS Local transportation providers and planners need to be able to assess their status and options with respect to improving the mobility of veterans. The classic planning process is one of assembling stakeholders, establishing mutual goals and objectives, gathering data, assessing needs, designing options, choosing and implementing the most attractive options, and then evaluating the results of those actions that were implemented in terms of the stated goals and objectives. Each of these steps should be conducted in a rigorous and in-depth fashion. This section presents some of the tools needed for gathering information to develop a coordinated transportation services plan focused on improving the mobility of veterans: a Needs Assessment Tool and a Travel Options Inventory. These tools are both intended to (a) identify current strengths and weaknesses in local transportation services for veterans and (b) suggest options for improved services and enhanced mobility. While these tools are directed at local transportation providers and human service agencies, these organizations will certainly need to contact individual veterans to obtain some if not all of the information required. In fact, a local veterans’ organization could be responsible for obtaining this information to improve response rates from veterans. To ensure that

66 transportation services plans are responsive to the needs of local veterans, a separate needs assessment should be conducted among the local veterans themselves. It should be recognized that the tools shown here, in their current form, represent just the beginning of a serious effort to engage a wide range of community stakeholders—all typical transportation stakeholders plus veterans and their representatives—in serious professional efforts to improve the mobility of veterans within a given locality. Much more work will be needed to develop a truly comprehensive transportation planning process for meeting veterans’ transportation needs. The work needed for developing a comprehensive transportation planning process involving veterans is described in the following chapter. Needs Assessment Tool The Needs Assessment Tool is a short questionnaire that asks for information about local transportation services for veterans and also asks how the agency completing the survey interacts with veterans’ mobility efforts. The short exercise of completing this information lays the groundwork for the next steps, those that involve potential community partners acting to identify collaborative strategies that they might jointly implement to improve services to their veterans. The questionnaire shown in Table 3 was created for community transportation providers, human service transportation program managers, or others who would like to expand their transportation services to the veterans’ community. The questions and statements below allow transportation professionals to assess where they stand in terms of involvement with veterans’ transportation. Based on the self-assessment results, transportation professionals can become aware of the strengths and weaknesses of their programs and may come up with strategies on how to more effectively market their services to veterans. Target Users: Transportation providers and human service agency program managers Purpose: To begin an assessment of veterans’ mobility need in the region Expected Outcome: Estimation of new market segment and key contacts identified Instructions: This assessment is to be completed by agency personnel who are experienced in program management and planning. Information may come from agency records or public records. The questionnaire may also require inquiries directed to other community leaders. Each assessment item includes sources for information.

67 Table 3: VETERANS’ MOBILITY NEEDS ASSESSMENT TOOL What Are the Mobility Needs of Veterans in Your Area? How Can You Be Involved in Veterans’ Transportation? 1) _______ (percent) of our registered riders are veterans. [Look up this information from the agency database. If your agency does not track veteran status, please consider adding this item to your client database] Where do they reside geographically? _________________________________ [Names of neighborhoods, cities or counties] 2) _______ (percent) of residents in our service area are veterans. Where do they reside geographically? ________________________________ [Names of neighborhoods, cities or counties] [You may contact your local Veterans Service Organizations or Veterans Service Commissions for the above information. U.S. Census data may also be available.] 3) ________, _________, and ________ (types of destinations) are the places to which veterans frequently request rides and we provide these rides to them. 4) ________, _________, and ________ (types of destinations) are the places to which veterans frequently request rides but we do not currently provide these rides to them. 5) Serving veterans’ trip requests are different from other riders’ requests because: a) ___________________________________________________ b) ___________________________________________________ c) ___________________________________________________ 6) Serving veterans’ trip requests are similar to riders from other groups because: a) ___________________________________________________ b) ___________________________________________________ c) ___________________________________________________

68 Table 3 (continued) 7) Name the agencies, advocacy groups, or facilities that work with veterans in your region. a) __________________________________________________________ (Names) b) We receive referrals from_________________________________________ c) We refer veterans to_____________________________________________ d) We would like to establish relationships with _________________________ 8) What additional requirements do you have to meet to earn business with the veterans’ community? 9) What kind of help do you need to establish a working relationship with veterans’ community? 10) What types of new funding are you likely to get as a result of working with the veterans community? 11) By how much are you likely to increase revenue or save costs by working with veterans’ community? 12) By how much are you likely to decrease revenue or increase costs by working with veterans’ community? 13) How do you plan to reach out to the veterans’ community? 14) What are your agency’s goals in terms of serving the mobility needs of veterans? Short-term goals? Long-term goals? The Travel Options Inventory The Travel Options Inventory is presented in Tables 4 and 5. They have been created to enable transportation providers and planners to first record, in a bit more detail, what is currently being done to improve the mobility of veterans. The second step would be to look at the empty cells that represent what is not being done at this time but what could also be considered for further action based on strategies successfully applied in other communities.

69 The worksheets in Tables 4 and 5 list nine different types of transportation providers, ranging from large-city transit agencies to nonprofits and other agencies. These tables also list strategies (described above) that transportation providers and VSOs can adopt to improve the mobility of veterans. Table 4 identifies the kinds of strategies that can be used to improve the mobility of individual veterans. This table is probably best filled out on a community-wide basis with entries for all transportation providers in the community. Table 5 illustrates some options for expanding transportation services to veterans. These ideas suggest how transportation providers might reach out to veterans and build a larger customer base. Transportation providers should find the types of agencies they represent from one of the nine columns and then review each row to see if they are doing all that they could be doing for veterans. This table is probably best filled out on a provider by provider basis. Note that, in order to ensure that transportation services plans are responsive to the needs of local veterans, a separate needs assessment should be conducted among the local veterans themselves. SUMMARY Community transportation providers who are interested in enhancing the mobility of veterans should use the information in this chapter. In order to enhance veterans’ mobility, transportation providers need to understand which current perceptions concerning veterans’ transportation are valid and which are not. After that step, the strategies that have been shown to be effective at other sites should be closely examined. To constructively apply strategies that have been effective elsewhere, it is important to have a full understanding of local resources and programs. Tables 3 through 5 describe how to collect information that will help to enhance trips for veterans and build connections with organizations now serving veterans.

70 Table 4: HOW TO IMPROVE VETERANS’ MOBILITY: HOW TRANSPORTATION AGENCIES CAN ENHANCE THE TRIPS VETERANS TAKE Strategies for improving mobility for veterans Types of transportation providers Large Transit Agency in Metro Area Small Transit Agency in Rural Area Volunteer- based Program VA- affiliated Program Human Service Trans- portation Taxi Contractor Medical Trans- portation Provider Non- profit Agency Others 1. Offer reduced fares to veterans 2. Offer flat-rate rides to VAMCs for veterans 3. Institute competitive contracting 4. Provide dispatching services for VSOs 5. Work with other agencies with transportation programs 6. Provide trips to local VAMCs 7. Provide feeder service to VA vans 8. Offer advance scheduled out of county trips to VAMCs

Table 5: HOW TO IMPROVE VETERANS’ MOBILITY: HOW TRANSPORTATION AGENCIES CAN BUILD SERVICES WITH VETERANS Strategies for building connections with VSOs Types of transportation providers Large Transit Agency in Metro Area Small Transit Agency in Rural Area Volunteer- based Program VA- affiliated Program Human Service Trans- portation Taxi Contractor Medical Trans- portation Provider Non- profit Agency Others 1. Provide vehicle acquisition assistance to VSOs 2. Share resources for driver training 3. Target marketing efforts to Veterans 4. Inform VSOs about the S. 5310 program

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TRB’s Transit Cooperative Research Program (TCRP) Research Results Digest 99: Improving Mobility for Veterans mobility explores issues facing our veterans and illustrates some potential strategies for community transportation providers who are interested in enhancing mobility options for our veterans.

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