Presented by: Judith Norman - Transportation Consultant (JNTC) In Association with:

Draft Presentation to:

California Department of Transportation (Caltrans)

Mobility Action Plan (MAP) Phase IImplementation Study

MAP PAC Committee Meeting

Presented by:

Judith Norman - Transportation Consultant (JNTC)

In Association with: The National Conference of State

Legislatures

January 21, 2009

Judith Norman-Transportation Consultant 2

MEETING PURPOSE AND OUTCOMES

Present study updates, discuss and receive feedback on thefollowing MAP Study work tasks and activities:

Legislative Update/Action Item Follow-up: Federal and California Human Service Transportation-Related Acts and Statutes

Technical Update: Coordinated Plan Review and Gap Analysis Methodology: Draft Study Geographic Regions and Information Analysis Process


LEGISLATIVE UPDATE

Revised and updated California Coordinated Human Service Transportation Matrix to include historical Federal and California Acts and Statutes

Conducted further research to address MAP PAC last meeting action items to update information on Federal and California statutes related to public transit- human service coordination


LEGISLATIVE UPDATE

New Research and Updates by NCSL on key Statutes: Americans with Disabilities Act (ADA) Transportation Development Act (TDA) Social Service Transportation Improvement

Act (SSTIA) Technical Assistance to Paratransit Providers Deficit Reduction Act Medi-Cal


ADA

The Americans with Disabilities Act (ADA) of 1990:

Gives civil rights protections to individuals with disabilities

Guarantees equal opportunities for individuals with disabilities


ADA

Title I of the Act prohibits discrimination against people with disabilities in employment practices Includes job applicants.

Employers with 15 or more employees are required to comply with the ADA.


ADA

Title II of the act prohibits discrimination against individuals with disabilities in all programs, activities, and services of public entities.

Applies to all state and local governments, and other instrumentalities of state or local governments. This includes public and private entities that

provide public transportation


ADA

Title II requires public entities: To have vehicles for regular transit services be

readily accessible and usable by persons with disabilities, including those who use wheelchairs.

Fixed route service also provide paratransit and other special transportation services to persons with disabilities, including those who use wheelchairs.

Service has to be comparable to regular transit services.

To provide the paratransit and special transportation services within their service area.

New vehicles for public demand responsive transit service be accessible and usable by persons with disabilities, including those who use wheelchairs.


ADA

Title II requires private entities: That purchase or lease vans with a seating capacity

in excess of 16 passengers (including driver) to be accessible and usable by persons with disabilities, including those who use wheelchairs.

That provide a fixed route service with a vehicle with a seating capacity of 16 passengers (including driver), that is similar in service to regular transit services to persons without disabilities.

That provide a demand responsive system with a vehicle with a seating capacity of 16 passengers (including driver), that is comparable in service to regular transit services.


ADA

FTA published a rule explaining the transit-related requirements of the ADA. They provide that:

A public entity operating a fixed route system has to provide a complementary paratransit or other special service to persons with disabilities. To qualify as complementary, the service has to:

Provide service within a width of three-fourths of mile of each fixed route.

Provide paratransit service to any ADA eligible person at a specified time in response to that person's request made the previous day.

Charge a fare that does not exceed twice the fare charged to a person paying a full fare at the similar time of day on the entity's fixed route.

Provide service during the same hours as the fixed route service.


ADA

The public entity cannot: Impose restrictions on the type of trip Restrict the number of trips a person can take Impose waiting lists for access to the service Have a pattern or practice that significantly limits the

availability of the service Accompanying persons to the disabled individual are

allowed to ride with them. Develop a process for establishing the eligibility of

persons who want to use the paratransit service. Allow visitors (persons who do not reside in the

entities jurisdiction) to access the complementary service.


ADA AND NEW FREEDOM

The New Freedom Program (49 USC § 5317) funds are available to public transportation service providers whose services go beyond those required by the ADA, which are: New public transportation, or New alternatives to public

transportation


ADA AND NEW FREEDOM

Complementary paratransit services can be eligible under New Freedom in several ways if the services provided meet the definition of "new," which is: Not operational as of August 10, 2005

or Did not have an identified funding

source before August 10, 2005.


ADA AND NEW FREEDOM

"Going beyond" the ADA means: Paratransit service beyond the three-quarter

mile requirement Paratransit hours beyond fixed route hours Incremental cost of providing same day

service Incremental cost of door-to-door service to

eligible ADA riders Level of service enhancements: escorts,

door-through door service Vehicles with mobility aids for persons with

disabilities


ADA AND NEW FREEDOM

The New Freedom Program is direct consequence of the Supreme Court Olmstead v. L.C. decision.

The Court interpreted Title II to require states to place persons with mental disabilities in community settings instead of institutions.

Executive Order 13217 orders the Fed Govt. to help states implement the Olmstead decision.


TDA

The Transportation Development Act (TDA) consists of nine articles in the California Public Utilities Code, which makes it lengthy in both size and detail.

The TDA specifies in great detail how public transportation is to be funded by state resources.

The TDA was enacted to ensure that public transportation is an essential component to a balanced transportation system


TDA

The transportation planning agency in each area of the state is in charge of funding claims.

Transit operators and city or county governments transit operators can only file claims for money that was apportioned to their area.

CTSAs are funded under TDA articles 4.5 and 6.5.


TDA

If a CTSA or other transit operator receives funding under the TDA it will be held accountable by the state by:

Filing claims with the transportation planning agency,

Submitting annual certified fiscal audits, and Maintaining required fare revenue ratios for

transit services The CTSA must participate in and audit that the

funds were spent within laws and regulations. Since the CTSA is a claimant, it alone has these

responsibilities, even when the CTSA’s primary function is to channel funds to other organizations which are actually providing the transit services.


TDA

Social services transportation advisory councils: Have to consist of the elderly, disabled,

transit providers for seniors, the local CTSA Have to:

Annually identify unmet transit needs in their area Review and recommend action to the

Transportation Planning Agency, and Advise the Transportation Planning Agency on

transit issues


TDA

Citizen Participation Process Transportation planning agencies have to

establish an advisory council to get advice from the transit dependent, and transit disadvantaged persons.

Have to hold at least one hearing, with broad community participation

In addition to hearings, teleconferences, questionnaires, telecanvassing, and email can be used to obtain feedback.


SOCIAL SERVICE TRANSPORTATION IMPROVEMENT ACT (SSTIA)

Created Consolidated Transportation Service Agencies or CTSAs

CTSAs are designated by: County Transportation Commissions (CTCs), Local Transportation Commissions (LTCs), Regional Transportation Planning Agencies

(RTPAs), or Metropolitan Planning Organizations (MPOs)



The SSTIA required Regional Transportation Planning Agencies or County Transportation Commissions to adopt and submit an action plan

The Action Plan has to: Designate a CTSA within the area of the

transportation planning agency. Could designate more than one CTSA if there

was improved coordination An identification of the social service recipients

to be served. Measures to coordinate the social service

transportation services with existing fixed-route services.



Each CTSA is an entity separate of the transportation planning agency.

A CTSA can be: A public agency including a city, county, operator,

any state department or agency, public corporation, or public district, or a joint powers

A common carrier of persons A private entity operating under a franchise or

license. A nonprofit corporation

A private entity (nonprofit) or a private company may be a CTSA if it is a legal entity eligible to file TDA claims and provide transit services.

A CTSA designation can be rescinded by the transportation planning agency.


TECHNICAL ASSISTANCE UNDER SSTIA

Technical Assistance to Paratransit Providers (Cal. Government Code § 15984 (West 2009)) Requires Caltrans to provide technical

assistance to paratransit providers who want to explore coordination strategies but lack implementation capability.


MEDICAID

Medicaid is a federal-state partnership that was created by Congress in 1965.

Is an optional state program, but every state and territory participates

Today Medicaid provides funding for: Low income parents People with significant disabilities Long term care for the elderly


MEDICAID

States that Medicaid transportation related costs are either administrative costs, or medical assistance. Administrative costs are reimbursed

at a flat rate of 50% Medical assistance is reimbursed at

the state's federal rate, which is anywhere from 50% to 77% - California's rate is 50%


MEDICAID

Providers can be reimbursed for travel and other travel related expenses (42 CFR 440.170(a)). They are: The cost of transportation The costs of meals and lodging to and

from the medical facility The cost of an attendant, if necessary


MEDICAID

A state Medicaid plan must "specify that the Medicaid agency will ensure necessary transportation for recipients to and from providers…" (emphasis added) (42 CFR 431.53)

States have a lot of flexibility in meeting the mandate of assuring medical transportation.


MEDICAID

How a state will provide non-emergency transportation all depends on its definition of "necessary".

Many states look to this criteria to define "necessary:"

Transportation to and from Medicaid covered services; Use of the least expensive mode of transportation

available that is appropriate for the client; Restrictions to the nearest qualified provider No other transportation services available free of

charge; and, Exclusions for clients receiving services that include

transportation.


MEDI-CAL

California’s Medicaid plan includes a simple “Assurance of Transportation,” guaranteeing necessary transportation to and from covered medical services. Reimbursement of travel to medical

appointments is restricted to persons who are physically unable to use conventional modes of transportation (22 CCR § 51151).

Costs are only covered if transportation by ordinary means is medically inadvisable (22 CCR § 51323).


MEDI-CAL

Bingham v. Obledo (1983) Recipients sued the state because the

state plan violated the assurance of transportation requirement since it did not assure necessary transportation to all recipients.

Argument was that Medi-Cal transportation was only offered to the severely disabled.


MEDI-CAL

Bingham v. Obledo (1983) Court ordered the state to amend its plan

that takes into account all qualifying recipients.

Court then mentions that that the state is not required to furnish transportation or pay for it.

To comply with the court order, Department of Health Care Services expanded upon the information about transportation options that Medi-Cal offices provide to county welfare and local Social Security Offices.


MEDI-CAL

To provide transportation to Medi-Cal beneficiaries, transit providers have to be certified by the Dept. of Health Care Services

Application process


MEDI-CAL

California's emergency and nonemergency transportation programs are decentralized.

Usually administered by the local Medi-Cal offices

Ambulances, wheelchair vans and litter vans are the only acceptable modes.

Local public transit agencies are not eligible for reimbursement under current Medi-Cal rules (22 CCR § 51151)


NEW CMS RULEDEFICIT REDUCTION ACT

Deficit Reduction Act of 2005 rule (42 CFR Part 440) Before the rule, a state couldn't contract

with a broker or provide different services in different areas of the state without obtaining a waiver.

The new rule does away with the waiver requirement.

Gives states the option of using a non-emergency medical transportation broker when providing transportation as medical assistance under the state plan.


DEFICIT REDUCTION ACT:NEW CMS RULE

The rule: Allows brokers to provide for transportation services that

include wheelchair vans, taxis, stretcher cars, bus passes and tickets.

Allows the Secretary to allow for the use of other forms of transportation.

Creates a competitive bidding process. Creates oversight procedures Requires the broker must be an independent entity Provides an exception for a non-governmental broker If a governmental agency is the broker it can subcontract

with a government-owned or controlled transportation provider

Gives the Secretary the authority to add any other medical care which can be covered by the state


END OF TECHNICAL PART I


STUDY TECHNICAL ELEMENTS

Review of Public Transit – Human Service Coordinated Transportation Plans

Large and Small Urban Plans Rural Plans Summarize and profile existing needs, strategies and

implementation of local priorities Element of Statewide Executive Summary

Interregional Gap Analysis Derived from review of individual coordinated plans Element of Statewide Executive Summary


GOAL OF COORDINATED PLAN REVIEW

Provide a Statewide View of all Coordinated Transportation Plans in California

Inform the development of the Statewide Implementation Plan


COORDINATED PLANS:ELEMENTS TO BE REVIEWED

Current transportation needs by target population

Inventory of transportation resources available within the region

Real or perceived barriers to coordination

Identification of current or potential funding sources expended on transportation for client populations


COORDINATED PLANS:ELEMENTS TO BE REVIEWED

Strategies and plans to address needs, gaps and deficiencies

Identification of duplicative or restrictive local regulations and/or policies which serve to limit coordination;

Priorities for selection of coordinated projects, including regional mobility management; and

Specific coordinated plan and project recommendations; including timing and phasing of projects.


COORDINATED PLAN REVIEW METHODOLOGY

Review individual plans and analyze by geographic region with each MPO/RTPA

Code Responses and Construct a Microsoft Excel Matrix to summarize plan review elements in detail


PROPOSED MAP STUDY GEOGRAPHIC REGIONS


PROPOSED MAP STUDY GEOGRAPHIC REGIONS: RATIONALE

Utilizes established Caltrans Districts framework

Condenses to 11 geographic regions (Districts 7 – Los Angeles and 12- Orange County combined)

County groupings used for locale of Regional Roundtables


2008 REGIONAL POPULATION ESTIMATES

District 1Provisional

County July 1, 2007

Del Norte 29,401Humboldt 132,690Lake 64,069Mendocino 90,051Total 316,211


County July 1, 2007

Lassen 35,763Modoc 9,727Plumas 20,696Shasta 182,470Siskiyou 46,017Tehama 62,466Trinity 13,898Total 371,037


County July 1, 2007

Alameda 1,548,492Contra Costa 1,056,477Marin 257,522Napa 137,010Santa Clara 1,846,757San Mateo 742,251San Francisco 842,625Solano 426,026Sonoma 484,547Total 7,341,707


County July 1, 2007

Butte 220,769Colusa 21,848El Dorado 179,969Glenn 29,286Nevada 99,116Placer 338,750Sacramento 1,427,885Sierra 3,353Sutter 96,541Yolo 200,009Yuba 72,351Total 2,689,877


County July 1, 2007

Monterey 429,083San Benito 57,629San Luis Obispo 270,046Santa Barbara 429,109Santa Cruz 267,541Total 1,453,408


County July 1, 2007

Fresno 936,828Kern 823,550Kings 155,024Madera 151,938Tulare 438,276Total 2,505,616


2008 REGIONAL POPULATION ESTIMATES


County July 1, 2007

Los Angeles 10,347,437Orange 3,125,756Ventura 830,343Total 14,303,536


County July 1, 2007

Riverside 2,106,328San Bernardino 2,060,722Total 4,167,050


County July 1, 2007

Inyo 18,011Mono 13,726Total 31,737


County July 1, 2007

Alpine 1,202Amador 37,863Calaveras 45,980Mariposa 18,297Merced 256,114San Joaquin 687,044Stanislaus 526,047Tuolumne 56,470Total 1,629,017


County July 1, 2007

Imperial 177,820San Diego 3,161,477Total 3,339,297


GAP ANALYSIS:PURPOSE

Evaluation and assessment of existing needs, strategies, and implementation

Identify interregional gaps, needs, and strategies to identify and address deficiencies across the regions

Provides solid framework for development of Statewide Executive Summary


GAP ANALYSIS:METHODOLOGY

Using Excel Matrix which was constructed in

Plan review:

Populate a relational Access analytical database to allow thorough review of plan elements


HOW WILL THE DATABASE HELP US?

Organize and Sort Large Amounts of Plan Information

Compile and cross tabulate information

Identify trends, commonalities and unique issues within the plans (urban, rural, regionally and statewide)

Can ultimately be used for information-sharing and coordinated planning purposes


NEXT STEPS/MEETING

Work with Human Services on additional statute research and analysis

Begin Large/Small Urban Coordinated plan review

Complete Access database structure Develop stakeholder involvement draft

interview questions and topics Commence regional roundtable planning and

scheduling efforts Next Meeting: March 25, 2009 – Southern

California – City of Norwalk, CA.

Documents

Presented by: Judith Norman - Transportation Consultant (JNTC) In Association with: