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B-1 A P P E N D I X B Survey Questions TCRP Synthesis Survey SB-28 Section 1: Contact Information 1) Your Name and Title* First Name*: Last Name*: Title*: Department: Telephone #*: E-mail*: 2) Transit Agency* Full Name*: Short Name or Abbreviation (e.g., TriMet, SEPTA): City*: State* Zip code*:
B-2 Administration of ADA Paratransit Eligibility Appeal Programs Section 2: Paratransit Service and Operations Overview 3) Paratransit Ridership (most recent FY)* If your agency provides only ADA paratransit, enter 0 in the middle box (B). A. ADA Ridership B. Non-ADA Ridership C. Total Paratransit Ridership Passenger trips 4) Please indicate who (may be both) handles the following tasks* Agency Staff Contractor(s) Trip reservations Trip scheduling Trip dispatching Vehicle operations 5) Who handles the following ADA eligibility tasks?* Please check all that apply. If Agency staff, please specify which department in Comments box. Agency Staff Contractor Other (please explain below) Eligibility Interviews/ Assessments Eligibility Determinations Eligibility Appeals Comments:
Survey Questions B-3 Section 3: Eligibility Overview 6) Please provide registered ADA paratransit riders for the most recent FY, i.e., the number of individuals in your database/ list. If none for a category, please enter 0. A. Unconditional: B. Conditional: C. Temporary: D. Visitor: E. Presumptive: TOTAL ADA certified individuals: 7) ADA Paratransit Determinations* If none for a category, please enter 0. New Applicants: most recent FY Recertifications: most recent FY New Applicants: previous FY A. Unconditional B. Conditional C. Temporary D. Visitor E. Not eligible (denied) TOTAL number of determinations
B-4 Administration of ADA Paratransit Eligibility Appeal Programs Section 4: Appeal Program Structure and Administration 8) What type of outreach and education about the Appeal Process does your agency provide to riders and the overall public?* Check all that apply. Rider Guide Public Meetings Visit to target groups Other - Write In: No specific outreach and education on the Appeal Process 9) Does your agency have a rider advisory group that may work with you on the Appeal Process?* If yes, please describe the role of the advisory group in the Comment box. Yes, we work with a rider advisory group on the Appeal Process No Comments: 10) Who manages the eligibility Appeal Process on a day-to-day basis?* Agency or contractor?: Title: If agency, which department: 11) Which applicant categories for ADA paratransit can appeal the initial determination?* Check all that apply. Conditional Temporary Not eligible 12) At what stage of the eligibility determination process does your agency provide information to the applicant about the right to appeal?* Check all that apply. Part of application package Part of determination letter Rider Guide Stand-alone letter or information page Other - Write In: 13) In what formats is the Appeal Process information available?* Check all that apply. Print Large print Braille Audio Electronic file Other - Write In:
Survey Questions B-5 14) Up to how many days after the date of the initial determination letter may an applicant request an appeal?* 15) How can an applicant request an appeal?* Check all that apply. Form provided by agency In writing (letter) Telephone E-mail Fax Other - Write In: 16) Do you require an appellant to provide a reason for the appeal in the request?* If yes, please explain in the Comment box. Yes No Comments: 17) Can an appellant request to make an appeal in writing in place of an in-person hearing?* Yes No 18) Prior to an appeal hearing, does your agency conduct an internal review of the initial determination?* If yes, please describe, including who (title) conducts this review in the Comment box. Yes No Comments: 19) How do you communicate with an applicant prior to the appeal hearing?* Please check all that apply. In writing (letter) Telephone E-mail Other - Write In: 20) After receiving an appeal request, within how many days must the appeal hearing take place?* 21) How often does your agency schedule appeal hearings (when needed)? Weekly Twice per month Monthly Other - Write In:
B-6 Administration of ADA Paratransit Eligibility Appeal Programs 22) Maintaining information for an appeal* What information do you keep from an application file?* Check all that apply. Completed eligibility application Professional verifications Application scoresheet/ checklist Interview notes (if any) In-person assessment notes (if any) Other - Write In: How long do you keep this information?* 1 year 5 years Indefinitely Other - Write In: How do you ensure confidentiality of the information? 23) Do you provide presumptive eligibility for appellants?* Please check all categories that receive presumptive eligibility. Conditional Temporary Visitor Not eligible No category 24) Does your agency offer free paratransit service to/from the appeal hearing?* Yes No
Survey Questions B-7 Section 5: Appeal Committee Composition 25) Appeal Committee Members* Who selects the individuals who may hear an eligibility appeal?* Transit agency board Agency GM/ CEO Advisory group Paratransit director Other - Write In: What is the term length (if any) for committee membership?*: If not all members hear every appeal, how do you select members for a particular appeal?* 26) Who are the members?* If you have fewer than 9 members, please leave extra rows blank. Agency/ Company (or "none") Special Expertise or Experience Related to Disabilities or Appeals Process Represents Certain Constituency? (indicate constituency or "none") Member 1 Member 2 Member 3 Member 4 Member 5 Member 6 Member 7 Member 8 Member 9 27) Training for committee members* How does your agency provide training to committee members?* Check all that pply. Written instructions In-person training Videos Observations of other appeal hearings Other - Write In: What topics does the training cover?* Check all that apply. ADA paratransit overview ADA paratransit eligibility Specific types of disabilities Other - Write In:
B-8 Administration of ADA Paratransit Eligibility Appeal Programs 28) Compensating committee members* Do you compensate your appeal committee members? Yes No If yes, please describe, e.g., $50 per appeal. If this differs depending on the committee member, please describe. 29) Written agreement for appeal committee members* Does your agency have a written agreement signed by appeal committee members regarding compensation and confidentiality?* Yes No Not sure If yes, please describe and provide a copy. 30) Please describe how your agency addresses potential conflicts of interest of committee members for particular hearings?*
Survey Questions B-9 Section 6: Appeal Hearing Process 31) Number of committee members for a hearing* Minimum number: Maximum number (if none, enter '99'): 32) What criteria do you use to assign committee members to a particular appeal?* If all members take part, please enter 'NA.' All members hear all reviews Whoever is available Paratransit director decides Advisory committee decides Other - Write In: 33) Judge or arbiter for appeal hearing* Is there a judge or other arbiter for the appeal hearing? Yes No If yes, how is judge/ arbiter selected? 34) At the Appeal Hearing* Where is the location of the hearing?* Transit agency office Contractor office City hall Municipal courthouse Other government office Other - Write In: Please summarize the actual process during the hearing.* Who may speak and present information and opinions during the hearing?* How does the hearing panel make a decision?* Majority vote Consensus Other - Write In:
B-10 Administration of ADA Paratransit Eligibility Appeal Programs Section 7: Appeal Documentation 35) Documenting appeal hearings* Who records (documents) the appeal hearings?* Your agency Other public agency Contractor Other - Write In: How is the appeals hearing documented?* Audio recording Video recording Transcribed Summary notes Other - Write In: Who stores the documentation? Your agency Other public agency Contractor Other - Write In: How long is documentation stored?* 1 year 5 years Indefinitely Other - Write In: 36) Who prepares and sends letter with appeal outcome?* If agency staff, please provide title in Comment box. Please send sample copies (or templates) of the outcome letters that you send to appellants. Agency staff Contractor Comments: 37) Timeline for making decision* After an appeal hearing, within how many days must your agency inform the appellant about the appeal outcome?*: What may happen if your agency does not meet this deadline?* 38) Please describe your agencyâs quality control process. In particular, how do you make sure that an appeal outcome is consistent with: Other appeal outcomes Other initial eligibility determinations
Survey Questions B-11 Section 8: Budget and Resources 39) Please provide your best estimate of staff time to conduct your appeal process. Include preparation time, hearing time, and time to prepare the outcome letter.* Please fill in one box in each row. If you cannot provide a estimate, please tell us in the Comment box. Annual FTE or Annual Hours or Hours per Appeal Agency staff Contractor staff Comments: 40) What is your annual budget for the appeal process? ($)* Fill in boxes in both columns. Enter 0 if 0, or if you do not know. If you cannot provide a estimate, please tell us in the Comment box. Most Recent FY Previous FY Staff time Appeal committee members (compensation or reimbursement) Training Appellant resources, e.g., translator, sign language interpreter Appellant transportation Comments:
B-12 Administration of ADA Paratransit Eligibility Appeal Programs Section 9: Appeal Outcomes 41) Appeal Outcomes* Please provide numbers (not %). Fill in all boxes. Enter 0 if applicable. Most Recent FY Previous FY TOTAL Number of eligibility appeals Uphold initial determination Overturn: not eligible to unconditional Overturn: not eligible to conditional Overturn: conditional to unconditional Overturn: not eligible to temporary Overturn: temporary to unconditional Overturn: temporary to conditional Other decisions Comments: 42) What options, if any, are available to an appellant who does not agree with the outcome of the appeal?* Check all that apply. No further options Request another appeal Appeal to transit agency board Other - Write In:
Survey Questions B-13 Section 10: Overview Comments 43) Changes to your appeals process* Have you made recent changes to your appeals process?* Yes No If yes, please describe these changes. 44) Future changes to your appeals process Do you plan to make changes to your appeals process? Yes No If yes please describe and say when they will take place. 45) Please describe overall challenges that you have with your appeal process. What would you like to improve? Check all that apply. Please add any comments in the Comment box. In-house expertise Contractor expertise Availability of committee members Specialized expertise of committee members Staff time Existing process Consistency of decisions Recordkeeping Other - Write In: Comments: 46) Please upload any files here that you have that provide more data, explanation, or details about your agency's Eligibility Appeals Process.
