Administration of ADA Paratransit Eligibility Appeal Programs (2018)

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1 The Americans with Disabilities Act of 1990 (ADA) guarantees civil rights protections, including access to public transportation, to people with disabilities. Under U.S.DOT regu- lations (49 CFR Part 37), public transit agencies that provide local fixed-route bus or rail ser- vice must also provide ADA complementary paratransit service to individuals who, because of their disabilities, cannot use the fixed-route service. A transit agency that provides ADA paratransit service must allow an individual to apply for the service and must have a process to determine if that individual is eligible. The eligibil- ity determination process may yield one of four outcomes: 1. Unconditional. The individual may use ADA paratransit for all trips. 2. Conditional. The individual may use ADA paratransit for some trips but not others, depending on the individual’s disabilities, the availability of accessible fixed-route service, and the barriers to reaching it (§ 37.123(b)). 3. Temporary. The individual may use ADA paratransit for a limited period, usually defined in months (§ 37.123(c)). An individual may receive a combination of temporary and condi- tional eligibility. 4. Not eligible. The individual is not eligible to use ADA paratransit for any trip. If a transit agency makes a determination other than unconditional eligibility, it must have procedures to allow the applicant to appeal the decision (§ 37.125(g)). This synthesis describes the policies, methods, and practices transit agencies use to administer the ADA paratransit eligibility appeal process. It is intended to fill gaps in knowledge and help practitioners and researchers learn the state of the practice. Information in this synthesis was gathered through a literature review; an online survey of 45 transit agencies, 37 of which responded (a response rate of 82%); and follow-up telephone interviews and e-mail correspondence with five transit agencies. The literature review found that, in the broader area of paratransit eligibility, transit agencies have focused on refining the process used to make the initial determinations (e.g., conducting in-person interviews and assessments to supplement paper applications and medical verifica- tions). Research on the appeal process has focused on an explanation of the process or a discus- sion of the transit agency’s existing procedures. Highlights of the survey responses from 37 transit agencies include: • In FY 2016, transit agencies granted unconditional eligibility to 60% of applicants and denied eligibility to 5%; the remaining 35% of applicants received conditional, temporary, or visitor eligibility. • Agency staff carry out eligibility-related tasks in a majority of the responding agencies: Of the 37 responding agencies, 21 agencies (56.8%) perform their own interviews and S U M M A R Y Administration of ADA Paratransit Eligibility Appeal Programs

2 Administration of ADA Paratransit Eligibility Appeal Programs assessments, or conduct them jointly with contractors; 30 agencies (81.1%) make eligibil- ity determinations. • The appeal process is managed on a day-to-day basis by 34 of the responding agencies (91.9%), and 26 agencies (70.3%) conduct the actual eligibilities appeals. • With regard to development of their appeal process, 22 of the responding agencies (59.5%) report having worked with a rider advisory group. • Before proceeding with a formal appeal hearing, 31 of the responding agencies (83.8%) report that they conduct internal reviews of the initial determinations. • At 27 agencies (73%), an appeal solely in writing is allowed in place of an in-person hear- ing. Several agencies offer the option to conduct a hearing via a conference call. • Free paratransit service to the appeal hearing is offered by 32 responding agencies (86.5%). • At nine agencies (24.3%), all or certain members of the appeal committee (e.g., medical professionals) receive compensation. • The most common size of an appeal committee is three members (14 agencies, or 37.8%). Five agencies (13.5%) have a one-person committee. • Appeals are decided within 30 days of hearings at 24 agencies (65% of respondents). The other responding agencies (13 agencies, or 35% of respondents) report a shorter maximum time frame. • All agencies provide presumptive eligibility to an appellant if a decision is not made within their respective deadlines. • Respondents reported the outcomes of more than 1,300 appeals over a 2-year period. Appeal committees upheld 62% of the initial determinations. For the transit agencies with the most appeals (at least 25 in a year), the proportion of upheld determinations was similar to the overall proportions: 64.3% in FY 2016 and 61% in FY 2015. • Four agencies (10.8%) offer appellants some form of secondary appeal if the appellants disagree with the outcome of the initial appeal. • Only nine agencies (24.3%) could provide an actual or estimated budget for their appeals processes. Another 18 agencies (48.6%) provided an estimate of staff and/or contractor hours, but not an overall budget, for their appeals processes. The synthesis team derived two appeal process metrics for the survey responses. The first metric, percent of initial determinations upheld, is a measure of consistency between ini- tial determinations and appeal decisions. This metric also can be viewed as a measure of the quality of the initial determinations. A higher percent of upheld initial determinations, independent of other factors, is desirable. It indicates that the eligibility staff and the appeal committee are aligned in their understanding of applicants’ abilities to use fixed-route ser- vice; however, a rate that greatly exceeds the mean value of 62% may indicate that appellants are not receiving an adequate opportunity to present their cases. The second metric is ratio of appeals to applicants. One can view this as a measure of applicant satisfaction and the quality of the initial determinations. Among 21 survey respondents that provided data, the median ratio was approximately 1%. A lower rate could indicate a greater satisfaction and better quality of initial determinations. By itself, a lack of appeals does not necessarily signify a good initial determination process; a lack of appeals also can result from other factors (e.g., overly generous initial determinations, limited public awareness of the availability of appeals). Among the survey respondents that provided data, 11 agencies had an appeal rate of less than 1%. The highest reported appeal rate was 3.9%. The five transit agencies selected for case examples had a variety of approaches for eligi- bility appeals. All five agencies were satisfied overall with their respective processes, though they saw ways to improve. Among the challenges that they mentioned were:

Summary 3 • Recruiting qualified appeal committee members, who understand their role, from within the community. • Providing appropriate training for committee members who come from a wide range of professional backgrounds. • Inconsistency in the appeal outcomes—both from appeal to appeal, and compared with the initial determinations. • Appellants who are “no shows” at their hearings. The survey responses and case examples identified agency challenges. The most common challenge facing transit agencies is a practical one: the availability of committee members to hear appeals. Committee participation by agency employees may conflict with the employees’ other responsibilities. Getting agency employees to commit to a hearing time is often dif- ficult, as the primary job duties of these members—particularly those who work in transit operations—usually take priority. Agencies also have problems with gaining commitments from committee members from outside the agency. A solution is to have several individuals available to serve in a given committee role, but a potential disadvantage is that the alternate members may lack the experience and knowledge of the person they are replacing. The second most frequently cited challenge is recruiting and retaining committee mem- bers with the appropriate expertise to hear the appeals. Committees hear appeals from appli- cants with a wide range of disabilities. Applicants include people with mobility impairments and people with sensory, cognitive, and combinations of disabilities. Committee members must understand how an applicant’s disability prevents use of fixed-route transit for some or all travel. Such insight comes with appropriate training and understanding of an applicant’s functional abilities and limitations. The survey results and case examples point out areas for future research. The first is to explore the benefits of different appeal committee types by comparing the efficacy of a one-person committee versus larger committees. Does a one-person committee—provided it is the “right” person—yield the most effective and consistent decision-making process, or is it inherently better to have several people share the decision, applying their collective knowl- edge and range of experience? Given the range of applicants’ disabilities, what is the most useful mix of knowledge and experience? The second is to explore how transit agencies with multi-member appeal committees recruit and use members of the community to serve on the committees. Agencies are look- ing to improve both recruitment and preparation of committee members. This includes bringing in members of the community who have disabilities, who understand public tran- sit, and/or who understand the ADA. The effort may also include compensating committee members for their efforts. Transit agencies also are looking for promising training practices that focus on an applicant’s ability to reach and independently use fixed-route services. The third is to conduct a more detailed survey and analysis of the full costs of admin- istering an eligibility appeal process. Most agencies do not separately account for the labor and other resources used for eligibility appeals. Information on average labor hours per appeal collected in such a survey can be useful as a reference point for other agencies. Cost data varies greatly, however, so it would be valuable to collect more cost information.