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Making Transportation Work for People with Disabilities in Rural America
The Supported Volunteer Rural Transportation Voucher Programby Brad Bernier, Tom Seekins, & Kitty Herron |
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Sponsored by:
The Research and Training Center on Disability in Rural Communities, The SVRT program advisors would like to thank the following agencies for their support and contributions: Summit Independent Living Center, Inc., Missoula, MT; Peter Shauer Associates, Booneville, MO; Brenda Farnham and Denise Jones of Prairie Freedom Center, Yankton, SD; James Walker and Mike Chaffin of Ravalli Services Corporation, Hamilton, MT; Larry Noonan and Cindy Eleson of Aware Inc., Anaconda, MT; and Greg Olsen, Developmental Disabilities Planning and Advisory Council, Helena, MT. This work was supported by grant # H133B20002. This study is part of a larger effort supported by NIDRR to develop effective strategies for providing rehabilitation services in rural areas. Additional support was provided by the Montana Developmental Disabilities Planning and Advisory Council. The opinions expressed are those of the authors and do not necessarily reflect those of the agencies. How To Use This Handbook Appendices:A. Sample Budget Outline Each section answers questions and leads you through every step of the process.
Feel free to send comments and suggestions to:
Tom Seekins, SVRT Program Although you'll likely experience new situations or discover different ways to navigate your program, the end product should be the same: A reliable and accessible transportation program to meet the needs of people with disabilities so they can enjoy full participation in their communities. Section 1 :What is the Supported Volunteer Rural Transportation Voucher Program? Where did it begin? For many years transportation has been recognized as a need for people with disabilities. Unfortunately, unlike their urban neighbors, rural residents have even less access to transportation, which in turn further limits their lives. The Supported Volunteer Rural Transportation Program (SVRT) is a means of providing rides to people with disabilities who cannot drive and who live in communities with limited public transportation. The SVRT program is similar to self-directed personal assistance service models (PAS) in that consumers control who their ride providers are, when they can get rides, and where they can go. Transportation programs similar to SVRT have been operating off and on since the late 1970s, but were discontinued in many cases because of liability issues and the lack of public transit services in rural areas. In other words, consumers couldn't use their transportation vouchers. However, liability issues can be resolved, and coordinating a system of volunteer drivers in rural areas is feasible. This handbook will show you how to set up a transportation program in your community, how to handle liability issues, where to look for financial assistance, and what to expect from the program. It also provides guidelines for recruiting and training volunteer drivers. How does the SVRT Program work? In general the program advocates one of two methods for providing rides. One method is to distribute vouchers to consumers in areas where public transportation or private specialized transportation services are available. Consumers pay for rides with vouchers. The other method is to recruit, train, coordinate, and reimburse volunteer drivers where no or limited transit services are available. Vouchers are given to consumers who then give them to ride providers, volunteers, and public or private transit drivers. The SVRT program reimburses drivers for each voucher. When using licensed public or private transit services, you can be assured that they have liability coverage and the proper driver training certifications. When using volunteers, you will need to clarify what their responsibilities are and what kind of training they will need to be safe, responsible drivers. Why is the service important and who is eligible? Because regular or reliable transportation is often unavailable in rural areas, people with disabilities have additional limits to work opportunities, advanced education or vocational training, proper health care, or recreation. In short, they aren't able to participate in their communities if they can't get to where they need to be. Service agencies in every state know that transportation is a problem for people with disabilities, yet planning for those needs is difficult. In addition, many states have wonderful services, but what use are they if the people they serve can't access them? Eligibility to receive rides may depend on your community's needs, participating agencies' goals, and how you want to administer the program. In general, you will want to target those with the greatest need for transportation. This includes, but is not limited to, people whose disabilities prevent them from getting where they need to go, those who don't have access to a taxi service or who live outside bus routes, or those who have no reliable transportation. The Independent Living PhilosophySome advantages of a voucher system are:
The Independent Living Philosophy
Section 2Where Does the Funding Come From
Who can fund an SVRT Program? State, county, and city governments; How do we apply for financial assistance?The first person you should call is your state's 5310/5311 coordinators with the department of transportation. They manage federal and state funds that support rural and small city transportation programs. The 5310/5311 mandate provides funding to finance both the purchase of vehicles and the hiring of staff to operate transportation programs. It pays for vouchers and operating costs for nonprofits and public transit districts. Less often it has funds for private for-profit providers, such as taxis. Tell your 5310/5311 coordinators that you would like to start a voucher program or augment existing transportation services for people with disabilities. They will tell you how to apply for funding and let you know who else in your area, if anyone, is already providing a rider service. Don't overlook your county or city governments. Some SVRT programs in rural Montana have operated moderately well on budgets under $2,000 per year directly supported by local government funds. Call the state to find out about Title 19 reimbursements for non-emergency medical trips. Hospitals and Medicare and Medicaid programs regularly use Title 19 reimbursements for services such as standard doctor visits and therapy treatments. This system works exceptionally well for ride voucher programs because you can actually profit from collecting Title 19 funds. Using Title 19 Reimbursements
Title 19 is a federal Medicaid reimbursement program for non-emergency medical trips.
This includes doctor visits, therapy sessions, and counseling, to name
a few. Title 19 provides a certain dollar amount to a registered driver per person per
trip. Whether or not a trip costs you as much as the reimbursement rate, you still
get the full dollar amount. For example, you drive a consumer to a doctor's appointment,
and that two-way trip costs you $5 to provide. Title 19 may have a $10 reimbursement rate
for that trip. You've just made $5. You can put that money into your coffers and use it
for other expenses. It's important to note that any transportation provider can register themselves as a
vendor to receive Title 19 reimbursements. So if your local taxi service is hesitant to
provide services to people with disabilities, tell them to call the state's Medicaid
Services Division in the capital city to find out how they can profit from Title 19. In addition, there are many other funding sources both public and private. Most funding sources have their own grant applications. They are usually clear about what type of information they need from you. But if you have questions you should call the source to get them answered. Some funding sources might provide money for certain types of transportation, such as for trips related only to work or job training. Call your state's vocational rehabilitation services for information on funding for work-related ride reimbursements. Also, your state's developmental disability planning and advisory councils can refer you to funding sources and provide you with grant applications. Remember, every state has enough resources to fund transportation costs for people with disabilities, no matter what their needs are. The key to getting funding is persistence.What does an SVRT program cost to operate? You can spend anywhere from $1,500 per year to several million on an SVRT program. How much it will cost to operate depends on:
Operating expenses might include employee wages, ride reimbursements, insurance and driver training, and basic office and supply costs. For an average budget projection, refer to Appendix A. Section 3:How Is the SVRT Voucher Program Managed? Who are the players and what do they do? Below is a list of some of the primary duties and suggestions for who might carry them out. Often, tasks will be shared, so it's up to you to decide who will be responsible for specific duties. Just as important as cost-sharing is to a well managed program, job sharing among agencies prevents any one person or agency from becoming overwhelmed. For example, if a taxi service is your primary transit provider, they could handle ride scheduling, taking the burden off a service agency. Consumers given control over their own resources,
can become active in finding volunteers, coordinating their own rides, and managing the
system; offer suggestions for improving the program so that it meets their needs; role is
similar to PAS models.
Section 4 :Where do We Start? How is an SVRT program set up? Again, the first call you should make is to your state's department of transportation 5310/5311 coordinators. They can send you a list of transit providers in your area, including a list of service agencies that have their own vehicles. If service agencies do operate in your area, call them and find out if they have a transportation program that meets consumers' needs. Some agencies offer transportation services, but they may be limited. Also, if transit systems (taxis and buses) operate in your community, find out if they are equipped to meet the needs of people with disabilities. They may be interested in expanding or improving their services. Set up a meeting with local service agencies and transit providers to discuss consumers' needs and the costs, determine who is able to provide transportation, and who will pay for it. There might already be a transportation advisory council or similar group in your community that meets regularly. If so, meet with them. They might have funds to augment existing programs or estimates of the transportation needs in your area. If there isn't a committee, consider organizing one. You can contract with local transit providers, or in the absence of such services, you can recruit volunteer drivers from the community. Service agencies may already have a list of volunteers from which you can recruit. See Section 5 for organizing volunteer drivers. Here are examples of how SVRT programs have been started:
How An SVRT Program Could Work
A service agency spends $20,000 per year giving rides to consumers. Rather than schedule
the rides themselves, the agency pays $20,000 per year to a taxi service to schedule and
provide rides. The agency distributes vouchers to consumers to use for taxis and
saves administrative costs by letting the taxi service handle ride scheduling. The agency
uses the money it saves to provide more vouchers to consumers. Thus, it still spends
$20,000 annually on its transportation program, but the agency has eliminated some costs
and increased its services to consumers. In turn, the taxi company gets more business, and
consumers have greater access and freedom in getting transportation. How do we keep records and monitor the program?Recordkeeping and monitoring are essential to running an effective program. By keeping track of money spent, consumers' changing needs, and where and how vouchers are used, you can streamline the program for efficiency and see where you need to make changes, if necessary. Keep lists of names, phone numbers, and addresses handy and make separate lists for each. For example, keep your list of volunteer drivers separate from your list of government contacts or funding sources. Take notes of phone conversations and meetings to easily recall all parties' obligations. Keep a calendar to record when tasks should be completed. In addition you may want to have standard forms for recordkeeping, such as quarterly and annual voucher reports, expenses, and reimbursements. See Appendix B for examples. It's a good idea to keep records of:
Your top priority is serving your consumers. Informally keeping track of consumer needs or conducting on-going surveys of their needs will ensure that the program is meeting its goals. Monitoring may help ensure continued funding for the program year after year. Your supporters will want to know how effective the program is. Also, you'll want to show other communities how to set up their own ridership plan. Accurate and faithful recordkeeping will prove helpful to your transportation program's success. What can we expect when setting up the program?There may be some resistance to organizing rider services in your community. Transit providers or service agencies might think the program too costly or be concerned about liability issues. Assure participants that liability issues can be resolved and money is available to fund an SVRT program. Keep in mind that one person's perception of a need may be different than another's. Consumers may not use vouchers as much as you would expect them to. Or people who need rides might not take advantage of the service at all. Don't be surprised if this happens. It's difficult for some people to change their habits, and if they're not accustomed to getting out, they likely have a routine they're comfortable with at home. Over time those routines could change, so keep in mind people's lives are often structured around their access to transportation. Suggestions for using the voucher system:How you decide to use the voucher system will depend on what
works best. Whatever decisions you make, it's important to have a set of
guidelines so the plan runs smoothly. Here are some suggestions: The Voucher
Vouchers can be used for rides for any purpose and any destination, as you see fit. Carbon copies can be distributed to people who need them for recordkeeping. Section 5:How Do We Organize Volunteers? Where do we look for volunteers?
As long as they have safe, clean driving records, the proper insurance coverage and make good faith efforts to be available for rides, anyone can be a volunteer driver. You can recruit friends, family, neighbors and church-affiliated groups. Contact community service organizations in your area to see if they are willing to share their lists of volunteers. Sample Press Release For Recruiting Volunteers"Did you know that there are (number) people
with disabilities in (your community, county, etc.)? Furthermore, (number) can't drive,
putting additional limits on work opportunities, advanced education, vocational training,
proper health care, and recreation. In short, they aren't able to participate in (your
community, county, etc.) because lack of transportation keeps many people with
disabilities at home. What are the qualifications and responsibilities for volunteer drivers?It is prudent to establish a policy that outlines volunteer duties and responsibilities. Consider developing clearly defined job descriptions to ensure that each volunteer receives proper training to carry out those duties and is qualified to do the work. For example, should volunteers be responsible for assisting with wheelchair transfers? Should they be responsible for assisting in shopping, or do they simply drop off their consumers and pick them up later? At a minimum, you may want to have your volunteer drivers meet the same requirements as service agency drivers. This may include a physical checkup with drug testing, if applicable; valid driver's license for the vehicle type they will drive; a license check for violations and accidents; a road test in the vehicle they will drive; and a safety inspection of their own vehicle, if they intend to use them. You will also need to decide what expenses will be reimbursed. Will your volunteers be paid on an hourly basis or for mileage or both? Do you want to include the costs of vehicle maintenance, meals, or other on-the-road expenses? By clearly establishing a policy beforehand, you can avoid any potential misunderstandings or conflicts and maintain a satisfied volunteer corps. What kind of training should volunteers receive?Establishing a training program for your volunteers before they hit the road will ensure that their responsibilities are clearly defined, they are prepared to handle emergencies if they arise, and that they are qualified to provide safe, reliable transportation to consumers. Training programs might also alert administering agencies of the more risky duties, thereby forcing agencies to give the proper training to the most qualified volunteers. Most importantly, training will help define liability issues and promote confidence in volunteer drivers. Service agencies and non-profits who are considering using volunteer drivers should contact their insurance agencies first. Insurance companies may have training materials or be able to refer you to driver training and safety programs. Consider including CPR, first aid, and consumer assistance techniques as part of the training. Adopt an emergency procedure plan for drivers in the event their consumers experience medical problems. Who should your drivers call? Make sure drivers know where the nearest medical facilities are located and the quickest route to them. Be sure to thoroughly discuss all emergency and personal issues as part of a training program and clearly define drivers' responsibilities in handling them. Contact your insurance company and the state department of transportation to see if they have training programs for specialized transport or if they can refer your drivers to existing training programs for certification. Volunteer SupportVolunteers work hard and often receive little appreciation for what they do. Consider a means of showing appreciation and saying "thanks" to your volunteer drivers by honoring them at banquets or other events. Let them know they're important, and they will continue to support worthwhile services in the community.
What about liability and insurance issues?In the past, insurance and liability issues have shut down volunteer driver programs and prevented others from starting. Some states treat this type of reimbursed volunteerism as driving for hire. Under these circumstances, where the service must be regulated by the state, tariffs, licensing, and insurance, an SVRT program would be prohibitive. This issue was addressed in Montana's legislature by exempting the transport of people with disabilities by a nonprofit agency from state regulation. See Appendix E for a copy of Montana's statute. You can use it as a guideline for developing one in your state. To find out your state's position on this issue, ask the 5310/5311 coordinator at the department of transportation or contact your state's public service commission. Today, insurance and liability issues are more easily resolved, and they should not be an obstacle in developing a safe, effective transportation program. Proof of insurance should be supplied and kept on file for every volunteer driver. It is most important to clearly define the duties of volunteer drivers and what they are liable for. For example, if a driver gets in an accident on her way to picking up a consumer, who is liable? Another aspect to consider is a consumer's use of family, friends, and neighbors as volunteer drivers. Because these volunteers allow consumers more flexibility in scheduling rides, they are sometimes the best source of transportation. Will your program require them to take driver training, and if not, will they be eligible for reimbursement under your program? Will they be covered by a service agency's insurance who administers a transportation program? If not, what will these volunteers be liable for? Clearly defining and periodically examining these issues will help your SVRT program run smoothly and effectively. Therefore, it is essential that you establish driver responsibilities and liabilities, as well as the type and amount of training volunteers will need and what they will be reimbursed for. A nonprofit agency receiving public funds will, in most cases, be held ultimately liable for accidents involving volunteer drivers they reimburse for services. For this reason the following questions should be answered when considering an SVRT program using volunteers:
These questions were developed by Florida's Transportation Disadvantaged Commission. You can contact them at 605 Suwannee Street, MS-49, Tallahassee, FL 32399-0450; (904) 488-6036. Before preceding with an SVRT program, make sure all issues of liability are clear and that you understand all state regulations. Section 6:Now You Are on Your Way Supported Volunteer Rural Transportation Program can be an effective way of providing rides to people with disabilities who cannot drive and who live in communities with limited public transportation. In addition, public and private transit operators can benefit directly by improved services, and local businesses benefit from increased patronage. Although, the SVRT program is a proven method for organizing and managing rider services using vouchers, keep in mind that this handbook offers only guidelines. You may find that some things work better for you than others. However, if you follow the suggestions in this handbook, you should have a successful program with continued funding to meet the needs of consumers in your community. Liability issues and funding need not be stumbling blocks. Liability issues are easily resolved with clearly defined policies and by thorough discussion with insurance companies and your state's public service commission. And because transportation is a recognized need for people with disabilities, federal, state and local agencies have funding (and other resources, like vehicles) to provide rides to people who need them. The key to finding that money is persistence, and with it, your SVRT program will travel far. Happy trails!
Appendix A:Sample Budget Outline* A. Salaries...................................................................................................$3,569.49 Appendix B:Sample Recordkeeping Forms Report of (agency) Implemented by: (agency) ____________________________________________ Coordinator: (person responsible) _____________________________________ Applicant report as of: (date) __________________________________________ Voucher applicants: 51 Applicants accepted into program: 47 Applicants denied into program: 4 Voucher report from: January 1, 1996 - March 31, 1996 Vouchers sent: 531
Vouchers used: 176
Vendors: 2
Amount of funds used for vouchers: $353.25 Amount of funds used for printing: $81.21 Another Sample Recordkeeping Form:
Appendix C:Sample Customer Satisfaction Survey Please help us serve you better by answering the following questions about our SVRT program and your needs. We appreciate your thoroughness and honesty.
Please feel free to add further suggestion or comments. Please stamp and mail the survey to the (agency) in the enclosed envelope. Thank you! Appendix D:Additional Sources of Information Association of Programs for Rural Independent Living (APRIL), Linda Gonzales,
Don't forget to check the blue pages in your local phone book for numbers of your state's department of transportation, Medicare/Medicaid programs, disability services agencies, and public and private transit authorities. Appendix E:Montana State Statute In 1991 Montana State amended Montana Code Annotated § 69-12-102 to exempt the transportation of people with disabilities by non-profit organizations from regulation by the Public Service Commission. Previously, just about anyone transporting passengers or goods for hire in Montana was subject to PSC regulation and was required to hold a certificate of authority. Here is the statute exempting transport of people with disabilities from regulation:
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