W. Joe King, Jr.

Director of Community Services

Access Services

Los Angeles, CA 90071

David Lee, PT

Project Manager, Access Paratransit Evaluation Center

CEO CARE Evaluators LLC

Los Angeles, CA 90023

Ron Kelderhouse, PT, DPT

Training and Research Director

CARE Evaluators LLC

Los Angeles, CA 90023

ABSTRACT

Individuals who are unable to use fixed route transportation as the result of an impairment related condition are eligible to use paratransit service. The ADA recognizes an impairment related condition may only prevent the use of fixed route transportation for some trips. Identifying individuals who are able to use fixed route some of the time (i.e. restricted eligibility) has the potential to significantly reduce the cost of providing paratransit services. (The cost of providing fixed route is 1/20 the amount of paratransit services for the same trip.) Additionally, in recognizing that individuals may be able to use fixed route for some trips, fare programs and travel training programs have the potential to further reduce operating costs by promoting the use of fixed route transportation. 

The consideration of restricted eligibility requires identifying the skills necessary to use fixed route and then determining the extent an impairment related condition affects these skills. The abilities to travel to a transit stop, travel to a destination, and then board, ride, and disembark from the fixed route system encompass the physical and cognitive skills necessary for fixed route travel. Some impairments may be overcome with coping strategies and/or the use of mobility equipment, and thus may not prevent the use of fixed route transportation.

Access Service in Los Angeles has initiated trip qualifiers based on functional ability and common environmental barriers. The majority of trip qualifiers are general in nature and can be considered for a significant portion of applicants. For example, most eligibility is granted under Category Three, and distance trip qualifiers may have the most potential to reduce costs.  A trip qualifier of 1/4  mile would allow individuals who cannot travel more than 1/4 mile to use paratransit services if their origin or destination is more than one quarter mile from a transit line stop.

To enforce compliance with the trip qualifiers, rides taken on paratransit are audited and riders are notified in writing if a trip completed on paratransit could have been completed on fixed route according to the trip qualifiers. In addition, riders are informed of the details of the fixed route option and are also allowed to provide details on the circumstances of the audited trip which may have qualified the trip for paratransit service. Repeat offenders receive punitive action in the form of temporary suspension with the right to appeal.

PARATRANSIT ELIGIBILITY AND THE AMERICAN WITH DISABILITIES ACT

The American with Disability Act (ADA) is a civil rights legislation protecting the rights of people with disabilities to equal access throughout American society. Not only does the ADA guarantee that the doors of the social economic system remain open to a person with disabilities but that when a person is placed at a disadvantage based solely on their disabling condition, reasonable mitigating steps must be implemented to insure their access. The ADA does not empower people with disabilities with greater rights; rather it guarantees the same rights everyone enjoys. The spirit of the ADA is for people with disabilities to become an integrated part of the American social fabric. People with and without disabilities can become woven in this cosmopolitan quilt of life when the artificial barriers are removed.

True integration is only achieved through a change in attitude. The attitudinal change will occur only after continued interaction. True permanent change is achieved through understanding, not demonstrations, legislation, or militant actions. When the interaction between the disabled community and the non-disabled community occurs on a daily basis and is repeated a thousand times over by millions of people, the spirit of the ADA will have been achieved.

Removing the physical and program barriers within America will have little effect if people with disabilities cannot get out of their home to partake of these newly opened opportunities. To achieve this integration, the ADA recognized the need for people to be mobile.  Mobility is so important that the ADA addresses it in two ways. The ADA, first and foremost, mandates that the public transportation systems throughout the nation be accessible to persons with disabilities. This is the endowed right of a person with a disability. The ADA makes it the primary responsibility of those operating a public transportation system to meet the reasonable and measurable standards of accessibility as outlined in the regulations. The ADA also makes it the primary responsibility of people with disabilities, who need public transportation, to use the same public transportation system available to everyone. Secondly, the ADA recognized the fact that some people with disabilities will not be able to fully exercise their right to use standard public transportation based on limitations created by their disability. To insure their access to the opened doors of their communities, the ADA defined and mandated the reasonable mitigating steps for public transportation systems, ADA paratransit.

To avoid ADA paratransit from becoming the segregated primary transportation for people with disabilities, either at the choice of the disability community or the transit industry, the regulations call for strict eligibility criteria (1). Fundamentally, the criteria are simple. Is there a disability related condition that prevents the person from exercising his/her right and responsibility to use general public transportation? Simply put, eligibility is all about using standard public transportation. The eligibility process defines when the person with a disability is prevented from doing so. They may be prevented all the time or only under specific conditions.

The word “prevented” is used in the regulations when referring to the use of fixed route. It is not meant to mean literally impossible, but rather, would a reasonable person be strongly discouraged from using standard public transportation. The regulations qualify this by stating that increased difficulty or inconvenience (real or perceived) does not create eligibility for paratransit. The comparison of difficulty or inconvenience is not based in relationship to a person without a disability. The regulations specifically acknowledge that using standard public transportation may be more difficult and less convenient for a person with a disability than it is for a person without a disability, but that does not create eligibility.

Reducing costs is a necessary issue in maintaining paratransit service; however, it is possible to reduce costs and be advocates for people with disabilities by understanding the requirements for eligibility and incorporating the philosophy of the ADA into our decision making process for paratransit service. Determining when general public transportation (i.e. fixed route) should be used can significantly reduce costs by reducing the number of trips provided on paratransit service. Furthermore, reducing trips increases the financial base to improve services and to accommodate unforeseen costs (e.g. fluctuating fuel prices). The standard public transportation system also benefits through increased ridership, and thus increased revenue, which can be used to better serve the disabled and non-disabled communities. 

WHAT ARE THE TRANSIT SKILLS NECESSARY TO USE STANDARD PUBLIC TRANSPORTATION?

Determining restricted eligibility begins with identifying the skills necessary to use fixed route transportation:

–        the ability to travel to and from a transit stop.

–        the ability to navigate the system.

–        the ability to board, disembark, and ride.

A lack of one or more of these abilities creates eligibility for paratransit service. However, the resources of the individual also need to be considered. Some impairments may be overcome with coping strategies and/or the use of mobility equipment, and thus may not prevent the use of fixed route transportation.

Travel to and from a bus stop.

The ability to travel to and from a transit stop involves traveling a certain distance and negotiating terrain with hills, cut curbs, and sidewalks.  Also necessary is the ability to orient oneself in the community by recognizing landmarks and intersections, and then locating a transit stop. The presence of an environmental obstacle, (e.g. a hill) or lack of negotiable terrain (e.g. no cut curbs or sidewalks) may affect this ability. For example, an individual with a cardiopulmonary impairment may not be able to reach a destination if he/she is unable to travel up a hill, or an individual with a power wheelchair may not be able to travel to the closest bus stop due to a lack of cut curbs and the lack of an alternate route. Additionally, for some people with visual impairments the time of day may affect the ability to orient oneself in the community and travel independently to a transit stop or reach a destination.

Navigating the system.

The ability to navigate the system involves understanding what fixed route vehicle to get on and where to get off, and may include the ability to make several transfers to reach a destination. Navigating the system primarily requires cognitive and not visual ability. For individuals with visual impairments, there are accommodations within the fixed route system to assist getting on the correct route and getting off at the correct stop. Fixed route operators in Los Angeles County are required to announce stops, and also honor requests to inform individuals of a particular stop.

Utilizing the fixed route vehicle.

The ability to board and disembark as well as the ability to sit or stand on the transit vehicle are also necessary to use fixed route transportation. Additionally, in Los Angeles County, some transit operators do not allow their drivers to assist riders to either count fare or place the fare in the fare box.

THE ROLE OF A FUNCTIONAL EVALUATION.

An in-person functional evaluation is necessary to determine the extent of the applicant’s ability since every disability is unique to the individual and is influenced by several factors. Additionally, abilities such as those needed to operate a powered assistive device cannot be assessed otherwise. The functional evaluation used integrates the specific visual, cognitive, and physical abilities to use public transportation, regardless of the disability. Thus, all applicants are treated equally. If an applicant has the ability to reasonably use fixed route transportation to all potential destinations within three quarters of a mile of the fixed route lines independently, then there is no eligibility for paratransit, regardless of the disability.

The professionals who conduct the evaluations in Los Angeles have a bachelors degree in an allied health or special education field with a current license/certificate issued by the State of California and two years experience relating to the functional abilities of individuals with disabilities (E.g. physical therapists, physical therapist assistants, occupational therapists, certified occupational therapist assistants, or  psychology bachelors degree).

The evaluation process consists of a personal interview and observations of the customer’s functional abilities.  The opportunity for an applicant to explain his/her disability is the main advantage of a personal interview. The applicant and the evaluator have an opportunity to dialog on abilities, disabilities, and how a disability affects the use of general public transportation in order to develop the greatest level of understanding possible. The dialog can yield additional information through specific follow-up questions relevant to the applicant’s disability. The education and experience of the evaluator raises the chance that an applicant’s circumstances surrounding his/her disability will be understood and the correct eligibility decision made, foregoing an unnecessary appeal.

Observations of the transit skills may continue with a simulated transit walk. Combined with the information gathered during the interview, an eligibility determination is made considering the interplay of multiple diagnoses, the impact of assistive devices, and the influence of transit policies on the ability to use fixed route. Observations of the applicant’s performance may be used to validate or refute the applicant’s reports.

An in-person functional evaluation also serves as a deterrent to individuals seeking ADA paratransit for the wrong reasons. Many people have never used public transportation and are intimidated by having to use it. Typically, people who used to drive do not consider using fixed route transportation as an option and seek the paratransit service for the convenience, which may not be related to any lack of ability. While Free Fare programs related to paratransit eligibility do encourage people to use fixed route, it also encourages people to seek eligibility for the sole reason of obtaining a free “bus pass”.

In Los Angeles County, evaluations are conducted at one central location, which conveniently allows other services to be immediately available for the sole purpose of promoting the use of other transportation options including fixed route. These services include completing travel training applications, trip planning on fixed route, and educating applicants of transportation policies (E.g. Use of lifts. Free Fare Program). Also available at the evaluation center are fixed route schedules, and contact information for other services which assist the disabled community with transportation.

Public transportation is comprised of many layers: fixed route bus, light rail, subway, commuter rail, commuter bus, and paratransit.  The historical lack of accessible fixed route transit has created psychological and skill related barriers to using fixed route transportation among people with disabilities. The use of fixed route and other transportation services is promoted through Travel Training. All applicants have the opportunity to sign up for travel training and those most likely to succeed are identified through the functional evaluation. The goal of Travel Training is to increase the person’s transportation options and thereby improve their mobility.

RESTRICTED ELIGIBILITY

Transit skills are general abilities that can be measured and used to determine the ability to use fixed route transportation. Each transit skill is reflected in the general trip qualifiers approved by Access Services of Los Angeles County (See table 1). The trip qualifiers encompass environmental, functional, and equipment considerations as well as allow trips of specific origin and destination. An appropriate determination insures that the individual can reach all potential destinations within three quarters of a mile of the fixed route transportation lines either through the paratransit service or through the individual’s own ability to use fixed route.

When a functional limitation is identified that limits the use of fixed route transportation, a trip qualifier describes when an individual is able to use fixed route transportation or conversely when the individual is able to use paratransit services. For example, a combination of trip qualifiers may specify a person may use paratransit service when his origin or destination is more than a quarter mile from a transit stop or when a hill prevents travel from his origin or to his destination.

In Los Angeles County the majority of eligibility for paratransit services is given under Category Three. If an applicant is unable to travel three quarters of a mile to and from a transit stop, then there is at least some eligibility for paratransit service under the ADA. However, a person who is unable to travel three quarters of a mile may be reasonably able to travel one quarter of a mile and thus be able to use general public transportation some of the time. Within the metropolitan area of Los Angeles, many fixed route lines are within a half a mile or less of each other. Therefore, the ability to travel a quarter of a mile enables people to use general public transportation for the majority of destinations, because common destinations such as banks, pharmacies, stores, malls, grocery stores, hospitals, and other businesses are generally located close to or on fixed route lines.. Distance qualifiers may be the most useful trip parameter in identifying individuals who may use fixed public transportation some of the time. The means to identify eligible trips by distance and transfers is available through a local trip planning database.

Power wheelchairs and power scooters are becoming more common. The reasonable accommodation provided under the ADA is the availability of lifts and securement areas to access public transportation. Distance to and from a transit stop will generally not be an issue, since power mobility devices normally have the range of 20 plus miles on a single charge.  Cut curbs are now common, and even…

Table 1. Trip qualifiers used in Los Angeles County

…when absent, alternate routes are often possible such as using the cut curb at the next intersection. Other obstructions that may prevent travel are road construction and   poles   blocking   sidewalks.   If   an   individual   is determined to have the ability to maneuver a powered mobility device in the community, then these individuals have the ability to use general public transportation except when specific barriers have been identified and the lack of an alternate route has been established. If a barrier is identified that prevents travel, then a “to and from” trip qualifier may be given to allow use of paratransit services to a specific destination.

Multiple assistive devices create the possibility that standard public transportation may be used depending on the device used. For people who are able to use their powered mobility device on fixed route, but still maintain the ability to travel on paratransit without it, a trip qualifier is given which does not allow the use of paratransit service with the powered mobility device. To promote the use of fixed route transportation, these individuals are eligible for travel training to become familiar with accommodations for powered devices on fixed route, plan trips, and have transit policies explained.

A final consideration for powered mobility devices is size. ADA policy sets the reasonable accommodation for powered  mobility device on fixed route, but still maintain mobility devices to be 30 inches wide, 48 inches in length, and no more than 600 pounds combined weight. Some people may not be able to maneuver a mobility device onto a fixed route vehicle; however, if the inability to board and disembark is due to the device being non-ADA compliant, then there are no grounds for eligibility, since the ability to board/disembark is related to the size of the device and not the ability of the individual.

For some, a combination of their disability and transit policies prevent the use of general public transportation. For example, in spite of having the ability to use a powered mobility device, people with high cervical spinal cord injuries are unable to manipulate coins and physically place them consistently and accurately in a fare box. Since transit policy prevents some Los Angeles County transit operators from assisting a rider from counting or physically paying fare, these individuals have eligibility for paratransit service. However, a Free Fare Program using the paratransit ID card as a fare media has allowed people to use their paratransit identification in lieu of physically paying the fare on many of the general public transportation systems. This program enables individuals to exercise their right to use general public transportation. A trip qualifier was implemented providing paratransit service when the paratransit identification does not allow free access to the general public transportation system. This trip qualifier also promotes the central philosophy of the ADA – integration.

Other applicant’s with severe cognitive impairments have had previous travel training and have learned to use fixed route to a specific destination, but lack the transit skills to plan and learn a trip on their own. For these applicants, the appropriate trip qualifier is the use of paratransit for all trips except the trip for which they have been previously trained.

Orientation mobility training for people with visual impairments may have included using public transportation. Many may be able to use public transportation for some trips, for which an origin-destination trip qualifier is also appropriate. Other visual impairments cause night blindness and prevent independent travel at night. For these individuals, a daytime trip qualifier does not allow use of paratransit during the daylight hours, but allows the use of paratransit at night.

ENFORCEMENT OF RESTRICTED ELIGIBILITY

In keeping with the ADA requirements that no eligible trip will be denied, all requests for paratransit service from riders with restricted eligibility are honored during the reservation process except for specific origin-destination trips. The enforcement of restricted eligibility is done after the fact, by randomly reviewing trip histories of riders with restricted eligibility and comparing the actual trip with the rider’s trip qualifiers. If any trip is found to not be appropriate, the rider is notified in writing that the trip should have been taken on fixed route and details of the fixed route options are provided. The notification permits the customer to explain new circumstances that may have qualified the trip. Review of any mitigating circumstances could involve inspection of the trip route or a re-evaluation of the rider’s functional abilities. Only repeat offenders using the paratransit service outside of their eligibility for a specific trip receive disciplinary actions in the form of a temporary suspension with the right to appeal.

RESTRICTED ELIGIBILITY REDUCES OVERALL COSTS

Incorporating a system which determines when people can use fixed route, uses general trip parameters to identify eligible trips, and promotes the use of fixed route has the potential to yield substantial cost savings.

The population over 65 is expected to nearly double by 2030, and the number of those individuals classified as disabled will increase even more due to an increase in life span and the associated increase in disability (2,3).

The subsidized cost of providing a trip on paratransit service is 20 times the cost of a comparable trip on a fixed route. Determining eligible trips on paratransit according to a person’s ability creates a reduction in trips and therefore cost savings for the overall transit system.

The use of an in-person functional evaluation in Los Angeles County implementing the general use transit skill model described above has significantly increased the number of applicants being found eligible for paratransit with trip qualifiers rather than being given unrestricted use of the paratransit system, as shown below:

Table 2. Fiscal year eligibility determinations.

Fiscal Year (FY) 2004-05 saw the implementation of the functional transit evaluation by Access Services and Fiscal Year 2005-06 implemented the restricted eligibility trip qualifiers.

Calculated using a few simple postulations, a dollar amount can be attached to the cost benefit of restricted eligibility.  For this model the following assumptions will be made:

–    Access Paratransit projects the following over its three year eligibility cycle for new and recertification applicants:

o        FY05-06 evaluations completed 24,983

o        FY06-07 evaluations completed 27,953

o        FY07-08 evaluations completed 29,231

–    A constant rate of 8% for restricted eligibility.

o        FY05-06 restricted eligibility 1,999

o        FY06-07 restricted eligibility 2,236

o        FY07-08 restricted eligibility 2,338

–    A marginal paratransit cost of $21.75 per trip (one way)

–    One round trip per month is diverted from paratransit to general public transit per restricted eligible rider.

After one year of general public transit usage the dollar value due to trips diverted from riders granted restricted eligibility can be estimated at:

Table 3. Projected cost savings by restricted eligibility

The compounding value of implementing a restricted eligibility strategy amounts to $6,685,148 over three years (3 years of value for FY05-06 riders, 2 years for FY06-07 riders and 1 year for FY07-08 riders).

CONCLUSION

Proper eligibility is the gatekeeper to any ADA paratransit system.  Restricted eligibility, appropriately determined, embodies the essence of the ADA through a shared vision by transit operators and customers with disabilities that general public transit and paratransit are vital to the mobility of people with disabilities.  The inappropriate use of paratransit diverts limited resources from the overall transit system which negatively impacts everyone, with or without a disability. Restricted eligibility identifies and encourages the use of the proper mode of transportation thereby helping to safeguard the fiscal integrity of the transit system to insure all transit users needs are met. 

ENDNOTES:

-    Federal Transit Administration, U.S. Department of Transportation, “Transportation Services for Individuals with Disabilities (Part 37).” Available at: http://www.fta.dot.gov/14534_5606_ENG_HTML.htm.

-    Administration on Aging, U.S. Dept of Health and Human Services, “Projections of Future Growth of the Older Poplulation,” Available at: http://www.aoa.gov/prof/Statistics/future_growth/future_growth.asp.

-    Congressional Budget Office, “Projections of Expenditures for Long-Term Care Services for the Elderly,” March 1999. Available at:  http://www.cbo.gov/showdoc.cfm?index=1123#pt1.