[Senate Hearing 112-880]
[From the U.S. Government Publishing Office]
S. Hrg. 112-880
THE AMERICANS WITH DISABILITIES ACT AND ACCESSIBLE TRANSPORTATION:
CHALLENGES AND OPPORTUNITIES
=======================================================================
HEARING
OF THE
COMMITTEE ON HEALTH, EDUCATION,
LABOR, AND PENSIONS
UNITED STATES SENATE
ONE HUNDRED TWELFTH CONGRESS
FIRST SESSION
ON
EXAMINING THE AMERICANS WITH DISABILITIES ACT AND ACCESSIBLE
TRANSPORTATION, FOCUSING ON CHALLENGES AND OPPORTUNITIES
__________
NOVEMBER 17, 2011
__________
Printed for the use of the Committee on Health, Education, Labor, and
Pensions
Available via the World Wide Web: http://www.gpo.gov/fdsys/
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COMMITTEE ON HEALTH, EDUCATION, LABOR, AND PENSIONS
TOM HARKIN, Iowa, Chairman
BARBARA A. MIKULSKI, Maryland MICHAEL B. ENZI, Wyoming
JEFF BINGAMAN, New Mexico LAMAR ALEXANDER, Tennessee
PATTY MURRAY, Washington RICHARD BURR, North Carolina
BERNARD SANDERS (I), Vermont JOHNNY ISAKSON, Georgia
ROBERT P. CASEY, JR., Pennsylvania RAND PAUL, Kentucky
KAY R. HAGAN, North Carolina ORRIN G. HATCH, Utah
JEFF MERKLEY, Oregon JOHN McCAIN, Arizona
AL FRANKEN, Minnesota PAT ROBERTS, Kansas
MICHAEL F. BENNET, Colorado LISA MURKOWSKI, Alaska
SHELDON WHITEHOUSE, Rhode Island MARK KIRK, Illinois
RICHARD BLUMENTHAL, Connecticut
Daniel E. Smith, Staff Director
Pamela Smith, Deputy Staff Director
Frank Macchiarola, Republican Staff Director and Chief Counsel
(ii)
C O N T E N T S
__________
STATEMENTS
THURSDAY, NOVEMBER 17, 2011
Page
Committee Members
Harkin, Hon. Tom, Chairman, Committee on Health, Education,
Labor, and Pensions, opening statement......................... 1
Witnesses
Capozzi, David M., Executive Director, U.S. Access Board,
Washington, DC................................................. 5
Prepared statement........................................... 8
Bristo, Marca, President and CEO, Access Living, Chicago, IL..... 12
Prepared statement........................................... 15
Altom, Billy W., Executive Director, Association of Programs for
Rural Independent Living, North Little Rock, AR................ 19
Prepared statement........................................... 21
Houghton, Jill, Executive Director, U.S. Business Leadership
Network, Washington, DC........................................ 25
Prepared statement........................................... 27
ADDITIONAL MATERIAL
Statements, articles, publications, letters, etc.:
Community Transportation Association of America (CTAA), Dale
J. Marsico, Executive Director, Scott Bogren, Associate
Director, Charles Henry Dickson, Associate Director,
prepared statement......................................... 41
Letters:
Abilities!, John Kemp, President & CEO....................... 57
Catskill Center for Independence, Joshua King, Disability
Rights Advocate............................................ 59
Clifton Perez, M.S.W., Systems Advocate, Independent Living
Center of the Hudson Valley (ILCHV), NY, and Chair,
National Council on Independent Living's NCIL) Policy Sub-
Committee on Transportation................................ 59
Southern Tier Independence Center, Susan Ruff, Advocacy
Director (STIC)............................................ 62
(iii)
THE AMERICANS WITH DISABILITIES ACT AND ACCESSIBLE TRANSPORTATION:
CHALLENGES AND OPPORTUNITIES
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THURSDAY, NOVEMBER 17, 2011
U.S. Senate,
Committee on Health, Education, Labor, and Pensions,
Washington, DC.
The committee met, pursuant to notice, at 10 a.m., in Room
SD-430, Dirksen Senate Office Building, Hon. Tom Harkin,
chairman of the committee, presiding.
Present: Senator Harkin.
Opening Statement of Senator Harkin
The Chairman. The Senate Committee on Health, Education,
Labor, and Pensions will come to order.
The title of this hearing this morning is ``The Americans
with Disabilities Act and Accessible Transportation: Challenges
and Opportunities.'' This is the fifth in a series of HELP
Committee hearings that have examined promising ways to improve
employment outcomes for Americans with disabilities.
We always hear about how much unemployment there is in
America--9 percent. Actually, it's a little bit more than that,
and we think that's just devastating. But for people with
disabilities, the unemployment rate is over 60 percent; over 60
percent. How would we feel as a nation if we had 60 percent
unemployment? But that's a fact of life for people with
disabilities.
In the last 3 years, the rate of people with disabilities
leaving the workforce because of unemployment has been over
twice that of nondisabled persons. So I just want to put this
in context.
Thanks to the Americans with Disabilities Act, our country
has made significant progress in the area of accessible
transportation. There's no question that the ADA has produced a
transformation in the accessibility of buses that people ride
in our country's great cities, and that newer mass transit
systems like the DC Metro are much more accessible than older
systems that were built in an era when our country just didn't
think much about accessibility.
Before the ADA, less than 5 percent of city buses were
accessible to wheelchair users. Today, more than 98 percent of
city buses are accessible.
It's a shame that we are not seeing the same rate of
progress in subways and taxis and trains and shuttles that
we've seen in the bus system and in the paratransit area.
Unfortunately, as many of our witnesses discuss in their
written testimony for today's hearing, more than 21 years after
the passage of the ADA we have not yet achieved equality in
access to transportation.
The current situation in New York City with regard to
taxicab accessibility is a good illustration of the barriers
that people with mobility disabilities continue to face. And,
also, not just those physical barriers, but also outdated
attitudes. I'm concerned that if we allow people with
disabilities to continue to be treated like second-class
citizens when it comes to transportation access, we will not
achieve the goals of the ADA and will not open up the doors to
employment for everyone who can work and wants to work.
So you may ask: What's the problem in New York City? Well,
let's start with the status quo. At this moment in New York
City, there are about 13,000 yellow taxicabs driving around
Manhattan, picking up riders, taking them to their destinations
around Manhattan, to the airports, or to other boroughs. Of
those 13,000 cabs, only 231 are accessible to wheelchair users.
The city of New York has been sued by the United Spinal
Association and others for violating the ADA. The status quo in
New York City treats wheelchair users like second-class
citizens. To add insult to injury, when the New York City Taxi
and Limousine Commission recently held a competition to
create--get this, now--to create the ``taxi of tomorrow,'' they
made accessibility optional and ultimately selected a Nissan
van that is not wheelchair accessible.
Now, the RFP that went out from New York should not have
made it optional. If they want a true taxi of tomorrow, then it
should not have been optional that it be accessible.
When the U.S. Department of Justice filed a Statement of
Interest in the United Spinal Association lawsuit and asserted
that the city of New York was not doing enough to ensure equal
transportation access for their citizens with disabilities,
Mayor Bloomberg personally engaged in the debate. He argued,
``You just can't take a wheelchair out into the street and hail
a cab.''
He said that in the accessible taxicabs, this is his quote,
``A lot of drivers say that passengers sit too far away and so
they can't have a good dialog and they can't get good tips.''
That's not my words. That's the mayor's words.
Finally, Mayor Bloomberg argued, ``Fewer people may use
cabs because the suspension is worse.'' Having ridden in many
yellow taxicabs in New York City, I don't see how any
suspension could be worse than what I've ridden in in those
taxicabs up there. I have spoken personally with Mayor
Bloomberg about this situation. I am hopeful that he will gain
a better understanding that people with disabilities have a
federally protected right to hail a taxicab just like everyone
else.
The witnesses today all have personal experience with
accessible transportation and barriers to accessible
transportation. I want to take this opportunity to make it
clear that I don't agree with Mayor Bloomberg, and I'm going to
do everything in my power as a U.S. Senator, as a chief sponsor
of the Americans with Disabilities Act, to challenge the
blatant discrimination that is occurring in taxicab
accessibility.
I think it is a gross injustice that less than 2 percent of
the taxicabs in New York City are wheelchair accessible. I
think it is a throw-back to pre-ADA America that the city
thought it was OK to make accessibility optional when they held
a competition to design the taxi of tomorrow.
I want to make it clear that New York City is in the
process of having this taxi of tomorrow program, which will
result in several thousand new taxis. And it seems to me this
is an opportunity, both for New York City and for America, to
make this step forward.
It's not just New York City. I don't mean just to be
picking on New York City. But this is a place where as they
move ahead with this massive replacement of taxis in New York
City that if we can include universal design, then companies
will make more of these accessible vehicles, and then
Washington, DC, and Los Angeles and Miami and Des Moines, IA,
and other places now will begin to have accessible cabs.
I'm delighted there is now a new American-made wheelchair
accessible vehicle. I'm told it's made in Indiana, although I'm
not certain about that. It's called the MV-1 that has the
potential to become the standard taxicab in New York and other
cities.
I've got a picture of it right here, and it's parked
outside if anybody wants to see it. It's parked right outside
of this building on First and C streets, right in back of the
Dirksen Building.
If London can have a taxicab fleet that is 100-percent
wheelchair accessible--and I can tell you I was over there this
summer and I rode in those cabs. Now, it may not be the best
design, but at least they're accessible. And to the statement
that Mayor Bloomberg said, that people in wheelchairs can't go
out in the street and hail a cab, they do it all the time in
London. And they drive pretty fast over there too.
I saw this with my own eyes and experienced it. London has
100 percent accessibility for their cabs. They've achieved that
status. I can't understand why New York City and other American
cities can't achieve the same goal. I'm also told this MV-1 can
run on compressed natural gas. I'm hopeful they'll come out
with a version that runs on flex fuel so it can be both
accessible and green.
I want to make it clear I am not shilling for a company. I
don't know this company. I've seen the cab. I'm not trying to
tout one company. I'm just pointing out that a universally
designed cab is possible, feasible, and practical.
The bottom line is if large cities like New York were to
require that their taxicabs be of universal design, wheelchair
accessible--not just wheelchair users would benefit. How about
mothers with baby strollers? How about elderly people who use
walkers--maybe can't step into or can't bend down to get into a
cab? It's a universal design.
If we can take that step, then automobile manufacturers
would compete with each other to go after the business, and
maybe this company would have some competition out there. We're
all for that.
But I'm very well aware that the taxicab issue is one of
many transportation access issues that are playing out as we
enter the third decade since the enactment of the ADA. I
appreciate the thorough exploration of those issues that our
witnesses provided in their written testimony.
I want to repeat I'm also aware that New York City is not
alone in their failure to prioritize accessibility. I'm just
pointing out that we are on the verge of an issue for a city
that has an unusually large taxicab fleet, more than any other
city in America--that when they are now transforming and
beginning to move into a taxi of tomorrow, it just gives us a
significant point in time to make it mandatory, not optional,
that every one of those taxicabs be fully accessible. If they
do that there, it will lead to breakthroughs in every city in
America.
Mobility is so crucial for people to get to work; visit the
doctor; go to visit family, children, others; to be full
members of society. Lack of transportation hurts the ability of
those with disabilities to have gainful employment. It's not
something that our society should tolerate any longer. We've
waited 21 years, 21 years. It's time to get on with it, time to
get on with universal design in transportation.
Today's hearing gives us all a chance to hear from leading
experts about where the transportation challenges and
opportunities exist 21 years after the passage of the ADA. I
appreciate all of you for your leadership and your
participation in this hearing. I read all of your testimonies
last evening. I thank you for that. I will now leave the record
open for any opening comments by Senator Enzi.
Let me introduce our witnesses this morning. David Capozzi
is the executive director of the U.S. Access Board, an
independent Federal agency devoted to accessibility for people
with disabilities. The Access Board develops and maintains
design criteria for the built environment, transit vehicles,
telecommunications, electronic information technology. It also
provides technical assistance and training on these
requirements and accessible design.
Mr. Capozzi joined the Access Board in 1992, was named the
executive director in 2008. Prior to that, Mr. Capozzi was vice
president of Advocacy for Easter Seals and was the National
Advocacy director for the Paralyzed Veterans of America.
Our second witness, Marca Bristo, is a pioneer of Chicago's
disability rights movement. Ms. Bristo helped launch Access
Living in 1979, one of the country's first 10 centers of
independent living. In 1987, Access Living became an
independent nonprofit with Ms. Bristo at the helm as the
president and CEO.
Since that time, Access Living has provided peer services
and advocacy to over 40,000 people with disabilities; has won
systemic improvements in housing, public schools, public
transportation, public access, and long-term care. Having
personally visited, I can attest it is one magnificent
institution.
Ms. Bristo has been an important national and international
advocate for the rights of individuals with disabilities. Marca
Bristo was also very instrumental in the passage of the
Americans with Disabilities Act--she was here many, many times
in 1987, 1988, 1989, and 1990.
In 1994, President Clinton appointed Ms. Bristo as
chairperson of the National Council on Disability--the first
person--get this--the first person with a disability to hold
that position. Today, she serves as vice president of North
America for Rehabilitation International and is president of
the U.S. International Council on Disabilities, where she is
leading a campaign to promote the ratification of the United
Nations Convention on the Rights of People with Disabilities--
ratified here in the United States.
We welcome you.
Our next is Billy Altom. Mr. Altom is the executive
director of the Association of Programs for Rural Independent
Living, called APRIL. APRIL provides leadership and resources
on rural independent living through a national network of rural
centers for independent living programs and individuals
concerned with the unique aspect of rural independent living. I
can also attest from being in a rural State that APRIL has a
rich history in rural transportation advocacy.
Prior to this, Mr. Altom was the director of the Delta
Resource Center for Independent Living in Pine Bluff, AR, where
he supervised a program providing transportation vouchers for
people with disabilities who were employed, who were looking
for employment, and who were in training for employment. The
program had well over 300 people enrolled in 17 rural counties
of southeast Arkansas.
Our final witness is Jill Houghton. Ms. Houghton is the
executive director of the U.S. Business Leadership Network, a
national, nonprofit, nonpartisan business-to-business network
promoting workplaces, marketplaces, and supply chains where
people with disabilities are included.
Ms. Houghton has over 20 years of diverse leadership
experience at the Federal, State, and local levels to advance
the employment and economic self-sufficiency of all people with
disabilities. Prior to joining the USBLN, Ms. Houghton served
as the executive director of the Ticket to Work and the Work
Incentives Advisory Panel from 2005 to 2008.
Ms. Houghton is a graduate of the University of Kansas and
served as an intern for Senator Robert Dole. Was that during
the ADA time?
Ms. Houghton. It was.
The Chairman. Was it?
Ms. Houghton. Yes.
The Chairman. He was a great supporter, as you know, a
great help in that.
Ms. Houghton was appointed in 2009 by Governor Crist to
serve a 3-year term on Florida's Commission for Transportation
of the Disadvantaged and also serves on the board for the
Broward Center for Independent Living.
We welcome you all here. Obviously, you're all very well
credentialed to respond to these questions about transportation
and accessibility for transportation. Your statements will all
be made a part of the record in their entirety. And if you
could sum it up in 5 or 7 minutes, we'd certainly appreciate
it, and then we can get into a dialog. So we'll just start in
order of introduction.
David Capozzi, we'll start with you. Welcome and please
proceed.
STATEMENT OF DAVID M. CAPOZZI, EXECUTIVE DIRECTOR, U.S. ACCESS
BOARD, WASHINGTON, DC
Mr. Capozzi. Thank you. Thank you for the opportunity to
testify.
I have over 25 years of experience in transportation
accessibility. When I began my career with the Paralyzed
Veterans of America, I was a member of the Department of
Transportation's Regulatory Negotiation Committee that
negotiated regulations to implement the Air Carrier Access Act,
and then was chair of DOT's Federal Advisory Committee that
wrote the first ADA regulations for the transportation
provisions.
When I was at Easter Seals, I was the second director of
Project ACTION following Bob Burgdorf, who was the first. And
Project ACTION is a program created by Congress to promote
cooperation between the disability community and the transit
industry to improve access to transportation for people with
disabilities.
But I want to talk about the challenges that remain in
spite of legislation, in spite of regulations, and the
guidelines that the Access Board issues. Laws, regulations, and
guidelines are important ingredients in establishing the legal
basis to ensure nondiscrimination on the basis of disability.
But when those exist and barriers still remain, we need to look
for more answers.
Last Wednesday, the Department of Transportation held a
celebration to mark the 25th anniversary of the signing of the
Air Carrier Access Act. And that law was enacted to ensure that
people with disabilities receive consistent and
nondiscriminatory treatment when traveling by air. In 1990, DOT
first issued regulations to enforce the law, but
inconsistencies still remained.
By way of example, one of the provisions in the regulations
is to stow a passenger's personal folding wheelchair in the
cabin of a coat closet. As most frequent travelers know, coat
closets are disappearing in favor of creating more space for
passenger seats. Additionally, based on my travel experiences,
airline staff are largely unaware of the requirement for
onboard storage of personal wheelchairs.
Since regulations were first issued in 1990, I've made it a
practice to carry the regulations with me with the relevant
provisions highlighted in yellow so that they can be shown to
the crew. What other minority group has to carry regulations
with them to prove their rights?
Even with the regulations in hand, I find it necessary to
argue for the right to stow my wheelchair on board the
aircraft. Airline staff who deal with the traveling public are
also required to be trained to proficiency on the regulations,
and for staff involved in boarding and deplaning, they are
required to be trained in assistance procedures to safeguard
the safety and dignity of passengers.
Just a few weeks ago at our November 2011 board meeting, we
welcomed two new presidential appointees to the Access Board.
Both use power wheelchairs. Our member from Texas was dropped
by the airport staff not once but twice, on both legs of her
trip from Dallas to Washington, DC. Her wheelchair was damaged
as well after it was stowed in the aircraft's baggage
compartment. Unfortunately, these problems are not infrequent.
In the mid-1980s, the Paralyzed Veterans of America had a
program called Access to the Skies. And like Project ACTION
after it, Access to the Skies was founded on the principle of
cooperation to improve access to air transportation for people
with disabilities. The program ended in the early 1990s because
of a lack of funding, but we could benefit from a program like
that today to provide technical assistance, training,
publications development, and research on airline accessibility
issues.
The second topic that I'd like to talk about is mass
transit. Mass transit accessibility has been one of the great
success stories of the ADA. As you mentioned in your opening
statement, before passage of the ADA, 36 percent of fixed route
buses were accessible. Today, 98 percent are accessible. But
even with this success, problems persist in compliance with
other ADA requirements, such as maintaining lifts and ramps,
announcing transit stops, and gaining independent access to
Amtrak rail stations.
The ADA required that all Amtrak stations be made
accessible as soon as practical, but no later than 20 years
after the law's enactment. Since the ADA's enactment, twenty
years has now passed. According to an August 2011 Amtrak
report, 481 of Amtrak's stations come with an ADA obligation
and by December 31 of this year, 90 percent of the stations
will have barrier-free access between the train and the station
platform.
But much of this access will depend on hand-operated mobile
crank lifts that are not independently operable by people with
disabilities. Congress and the Federal Railroad Administration
need to maintain a vigorous oversight role regarding station
accessibility.
The last topic I'd like to talk about is taxicab
accessibility. We've not progressed much in the 21 years after
passage of the ADA in terms of providing accessible taxis, as
you noted. People with disabilities still need to call in
advance for the few taxis that exist. Going outside and
expecting to hail an accessible taxi in most cities in this
country is simply not possible.
In Washington, DC, there are 20 accessible taxis, and
that's relatively new. In New York City, there are about 230-
231, as you mentioned. In London, metropolitan legislation has
required all new taxis to be wheelchair accessible since 1989.
Under the ADA, private entities primarily engaged in the
business of transporting people and providing demand responsive
service, the category that includes taxis, are not required to
buy accessible sedan type automobiles. Such entities are
required to purchase accessible vans, when they buy vans,
unless the entity can demonstrate that it provides equivalent
service. Publicly controlled taxi companies, on the other hand,
have to meet a higher standard.
Equivalent service is determined based on factors such as
response time, fares, geographic area of service, hours and
days of service, and reservations capability. Accessibility is
governed by the Access Board's ADA accessibility guidelines,
and from what we know, few accessible taxis have been
purchased. More needs to be done to promote good practices and
develop incentives for taxicab accessibility nationwide.
My experience has shown me over the past 25 years after
passage of the Air Carrier Access Act and 21 years after
passage of the ADA that many countries are closely watching our
progress. They have modeled their own legislation on ours. Many
want to learn from our successes and challenges. And just last
week, the Access Board sponsored an information exchange with
the government of Ontario, Canada, and representatives from the
European Commission. Both are developing accessibility
provisions that will be greatly informed by what we have done
here in the United States.
We can certainly learn from what other countries are doing
and their experiences with accessibility. But it's clear that,
still, the United States is a model of inclusion and
accessibility and is a leader in this area. However, issues
remain in implementing the laws and regulations that are in
effect today. We have many successes that we can be proud of,
but we can still do better.
Thank you for the opportunity to testify, and I'd be happy
to answer any questions later. Thank you.
[The prepared statement of Mr. Capozzi follows:]
Prepared Statement of David M. Capozzi
Thank you for the opportunity to testify today on the topic of
accessible transportation. My name is David Capozzi and I am the
Executive Director of the U.S. Access Board. The Access Board is the
only Federal agency whose sole mission is accessibility for people with
disabilities. Our agency develops accessibility guidelines for the
Americans with Disabilities Act, the Architectural Barriers Act, the
Telecommunications Act, and accessibility standards for electronic and
information technology and medical diagnostic equipment under the
Rehabilitation Act. We also enforce the Architectural Barriers Act and
provide training, technical assistance, and research on accessibility
issues.
Prior to joining the Access Board in 1992, I was vice president of
Advocacy for the National Easter Seal Society and managed Project
ACTION (Accessible Community Transportation In Our Nation), a
congressionally created program to promote cooperation between the
disability community and the transportation industry to improve access
to transportation for people with disabilities.
Prior to working at Easter Seals, I was the National Advocacy
Director for the Paralyzed Veterans of America. I worked with Federal
agencies and the U.S. Congress to promote the rights of individuals
with disabilities including the Fair Housing Act Amendments, the Air
Carrier Access Act, the Civil Rights Restoration Act, and the Uniform
System for Handicapped Parking Act. I served as the lead negotiator on
the Department of Transportation's (DOT) Federal Advisory Committee
that negotiated regulations to implement the Air Carrier Access Act.
While in the private sector, I testified in support of the
Americans with Disabilities Act (ADA) before the House Committee on
Public Works and Transportation, was a member of the nine-person ADA
``legal team'' for the disability community that helped Congress craft
the legislation and then served as Chairman of DOT's ADA Federal
Advisory Committee that developed the 1991 regulations implementing the
transportation provisions of the ADA.
I have made over 300 presentations during my career including
keynote addresses, was a guest lecturer at Georgetown University Law
Center, and provided international presentations in Prague, Czech
Republic; Toronto and Montreal, Canada; Kobe City, Japan; Madrid,
Spain; Vienna, Austria; Dublin, Ireland; Rio de Janeiro, Brazil;
Kranjska Gora, Slovenia; and Brussels, Belgium. I have been a
wheelchair user since 1977.
access board activities
For a small agency (29 staff, a Board of 25, and a budget of $7.4
million) the Access Board has a very ambitious rulemaking agenda. We
are developing new accessibility guidelines for outdoor developed
areas, shared use paths, passenger vessels, public rights-of-way, self-
service transaction machines, emergency transportable housing,
classroom acoustics, and medical diagnostic equipment. We are updating
existing requirements for information and communication technology and
transportation vehicles. Below is a summary of our current
transportation-related rulemaking activities.
Shared Use Paths
When the Board approved draft final accessibility guidelines for
trails, coverage of shared use paths was deferred to a future
rulemaking. Commenters on our outdoor developed areas rule had raised
concerns about the need for differing guidelines for shared use paths
(commonly called hiker-biker or multi-use trails). Commenters noted
that shared use paths differ from trails and typically are located in
more developed outdoor areas, as opposed to more primitive trail
settings. Unlike trails, shared use paths are designed to serve both
bicyclists and pedestrians and are used for transportation and
recreation purposes. As a result, the Board has initiated a separate
rulemaking to cover shared use paths. In March 2011, the Board
published an advance notice of proposed rulemaking on this topic.
Passenger Vessels
The Board's guidelines will apply to passenger vessels that are
permitted to carry more than 150 passengers or more than 49 overnight
passengers, all ferries, and certain tenders that carry 60 or more
passengers. In June 2008, we published revised draft guidelines for the
purpose of holding information meetings to collect data necessary for a
regulatory assessment. Meetings were held in August 2008 to collect
this data. In 2009, we contracted with the Volpe National
Transportation Systems Center to assist the Board in finalizing the
regulatory assessment. The Board intends to vote to approve a notice of
proposed rulemaking at its January 2012 meeting and then submit the
rulemaking to the Office of Management and Budget for review.
Public Rights-of-Way
In 2009, we contracted with the Volpe Center to assist the Board in
finalizing a regulatory assessment for this rulemaking. The guidelines
provide design criteria for accessible public streets and sidewalks,
including pedestrian access routes, street crossings, curb ramps and
blended transitions, on-street parking, street furniture, and other
elements. The Board published a notice of proposed rulemaking for
public comment in July 2011. We have held two public hearings on the
proposed rule; the comment period ends on November 23, 2011.
Self-Service Transaction Machines
The Access Board and the Departments of Transportation and Justice
are undertaking related rulemakings on self-service transaction
machines. In September 2011, DOT published a proposed rule under the
Air Carrier Access Act to address accessibility issues relating to
airline check-in kiosk machines used in airports. The Board will issue
a proposed rule in 2012 for machines covered by the ADA. These
rulemakings present an opportunity to work collaboratively to develop a
single set of technical requirements that would be referenced and
scoped by each participating agency.
Transportation Vehicles Guidelines Update
In November 2008, the Board released for public comment a second
draft of revisions updating its accessibility guidelines for buses and
vans covered by the ADA. The second draft was issued because the format
changed significantly, provisions for over-the-road buses were added,
and changes were made in response to comments on a first draft that was
published in April 2007. The proposed updates address new types of
systems, such as bus rapid transit and low-floor buses, and advances in
technology, including automation of announcements. In addition, the
proposed guidelines revise specifications for vehicle ramps,
circulation routes, wheelchair spaces, and securement systems. In 2009,
we contracted with the Volpe Center to assist the Board in finalizing
the regulatory assessment for this rulemaking. In July 2010, we
published a proposed rule to revise and update the accessibility
guidelines for buses, over-the-road buses, and vans. Two public
hearings were held. The comment period closed in November 2010. A final
rule is planned for early 2012.
Our new guidelines and the update of existing provisions will
certainly improve the transportation landscape in America. However, I
would like to talk about challenges that remain in spite of
legislation, regulations, and guidelines. Laws, regulations, and
guidelines are important ingredients in establishing the legal basis to
ensure nondiscrimination on the basis of disability--but when those
exist and barriers still remain--we need to look for more answers.
air transportation issues
Last Wednesday the Department of Transportation held a celebration
to mark the 25th anniversary of the signing of the Air Carrier Access
Act. The 1986 law was enacted to ensure that people with disabilities
would receive consistent and nondiscriminatory treatment when traveling
by air. In 1990, DOT first issued regulations to enforce the law and
those initial regulations have been enhanced over the years through
many amendments. While some provisions of these regulations require the
design of aircraft to be more accessible, most require airlines to
modify their practices and to provide training to their employees to
ensure that passengers with disabilities do not face discrimination.
However, inconsistencies still remain. By way of example, one of
the provisions in the regulations is to require carriers to stow at
least one passenger's personal folding wheelchair in the aircraft
cabin. The regulations require carriers to ``ensure that there is a
priority space in the cabin of sufficient size to stow at least one
typical adult-sized folding, collapsible, or break-down manual
passenger wheelchair, the dimensions of which are within a space of 13
inches by 36 inches by 42 inches without having to remove the wheels or
otherwise disassemble it. This requirement applies to any aircraft with
100 or more passenger seats and this space must be other than the
overhead compartments and under-seat spaces routinely used for
passengers' carry-on items.'' 14 CFR 382.67(a) and (b). The regulations
also provide that carriers ``must ensure that a passenger with a
disability who uses a wheelchair and takes advantage of the opportunity
to preboard the aircraft can stow his or her wheelchair with priority
over other items brought onto the aircraft by other passengers or crew
enplaning at the same airport; items must be moved that crew have
placed in the priority stowage area (e.g., crew luggage, an on-board
wheelchair) to make room for the passenger's wheelchair, even if those
items were stowed in the priority stowage area before the passenger
seeking to stow a wheelchair boarded the aircraft.'' 14 CFR
382.123(a)(1).
As most frequent travelers know, coat closets are disappearing in
favor of creating more space for passenger seats. Additionally, based
on my travel experiences and those of our staff and Board members who
travel frequently, airline personnel still are largely unaware about
the requirement for on-board storage of personal wheelchairs. Since the
regulations were first issued in 1990, I have made it a practice to
carry the regulations with me with the relevant provisions highlighted
so that they can be shown to the crew. What other minority group has to
carry regulations with them? Even with the regulations in hand I often
find it necessary to argue for the right to stow my wheelchair on-board
the aircraft. In June 2011, DOT issued a proposed rule (the so-called
``seat-strapping'' rule) that would require alternative means of
securing wheelchairs in the cabin where there are no closets. It is an
attempt on DOT's part to ensure wheelchair access in the cabin.
Airline personnel who deal with the traveling public are also
required to be trained to proficiency on the Air Carrier Access Act
regulations concerning the requirements of the regulations; airline
procedures including the proper and safe operation of any equipment
used to accommodate passengers with a disability; and for those
personnel involved in providing boarding and deplaning assistance, the
use of the boarding and deplaning assistance equipment used by the
carrier and appropriate boarding and deplaning assistance procedures
that safeguard the safety and dignity of passengers. 14 CFR 382.141(a).
It is not the responsibility of the passenger to train airline
personnel. Yet, in order to ensure compliance, we still carry the
regulations with us and have to convince airline personnel of their
obligations.
At our November 2011 Board meeting we welcomed two new presidential
appointees on the Board. Both use power wheelchairs. Our member from
Texas was dropped by the airport staff not once but on both legs of her
trip; her wheelchair was damaged as well after being stowed in the
aircraft's baggage compartment. Unfortunately, these problems are not
infrequent.
DOT has made significant outreach efforts to the industry and the
disability community, through direct oversight as well as public
forums. DOT also has taken enforcement action against airlines for
violations of its regulations, with its February 2011 consent order
assessing a $2 million civil penalty against a major carrier for, among
other things, failing to provide proper enplaning and deplaning
assistance.
However, further outreach, particularly between the airline
industry and disability community, should be undertaken. In the mid-
1980s the Paralyzed Veterans of America had a program called ``Access
to the Skies''. Like Project ACTION after it, Access to the Skies was
founded on the principle of cooperation between the disability
community and the airline industry to improve access to air
transportation for people with disabilities. The program ended in the
early 1990s because of a lack of funding. But, we could benefit from a
program like that today to provide technical assistance, training,
publications development, and research on airline accessibility issues.
The law and regulations are in place. What is needed is a sustained and
concentrated program to implement these requirements.
mass transit issues
Mass transit accessibility has been one of the greatest success
stories of the ADA. Before passage of the ADA in 1989, 36 percent of
fixed route buses were accessible to wheelchair users. Today, 98
percent of fixed route buses are accessible as new, accessible vehicles
replace older inaccessible ones. When independent accessibility is
achieved it can be quite liberating. I remember around 10 years ago
when the Washington Metropolitan Area Transit Authority (Metro) added
accessible faregates to its stations. Previously, the faregates were
too narrow for a wheelchair to pass through so I had to hand my
farecard to a station attendant, have them process it, and then go
through a separate gate that was wide enough to pass through. When the
first accessible faregates were installed, going through one by myself
was a liberating experience. I can still remember the feeling 10 years
later. It is that independent travel and liberating experiences that we
should be striving for.
Accessibility is also about dignity. Dignity means being able to
access vehicles and facilities like anyone else. No more having to
depend on a station attendant for assistance--or going through the
kitchen to get to the restaurant. After my injury in the late 1970s I
would call ahead to a restaurant or other place of business to
determine if it was accessible before I left home. Today, I expect them
to be accessible and in large part they are. The ADA, its regulations,
and advocacy efforts are largely responsible for that success.
Even with the success of mass transit accessibility, problems
persist in compliance with other ADA requirements, such as maintaining
lifts and ramps, announcing transit stops, ensuring access to visual
information by people with vision impairments and audio information for
people with hearing impairments, and gaining independent access to
intercity (Amtrak) rail stations.
The ADA required that all stations in the intercity rail
transportation system be made readily accessible to and usable by
individuals with disabilities, including individuals who use
wheelchairs, as soon as practicable, but in no event later than 20
years after the date of enactment of the ADA. Since the ADA was signed
into law, 20 years have now passed. According to an August 2011 report,
entitled ``Intercity Rail Stations Served by Amtrak: A Report on
Accessibility and Compliance with the Americans with Disabilities Act
of 1990'' Amtrak serves more than 500 stations in the United States and
Canada. Of these, 481 stations come with an ADA obligation. Amtrak has
determined that responsibility at 84 of the Amtrak-served stations lies
with other entities. Amtrak will address compliance needs at the
remaining 398 stations. By December 31, 2011, according to the report,
90 percent of Amtrak stations will have barrier-free access between the
train and the station platform--but much of this access will depend on
mobile lifts that are not independently operable by people with
disabilities. Station-based mobile lifts require Amtrak staff to
operate and take more time for boarding than would independent access.
In September 2011, DOT issued a final rule requiring nondiscriminatory
access to require intercity, commuter, and high-speed passenger
railroads to ensure, at new and altered station platforms, that
passengers with disabilities can get on and off any accessible car of
the train. Congress and the Federal Railroad Administration need to
maintain a vigorous oversight role regarding station accessibility.
taxicab accessibility issues
We have not progressed much in 20 years in terms of providing
accessible taxis. As much as 10 percent of the customer base for taxi
service consists of people with disabilities. And we have the same
needs and interests as everybody else. We have jobs, families, classes,
meetings, travel plans, and other activities to keep us on the move,
and we need transportation, including taxicabs, to help us get where we
are going. But, people with disabilities still need to call in advance
for the few accessible taxis that might exist. Going outside and
expecting to hail an accessible taxi in most cities in this country is
simply not possible. In Washington, DC (through a new program that
began in 2011) there are only 20 wheelchair accessible taxis; in New
York City there are about 230 accessible taxis. In London, England
metropolitan legislation has required all new taxis to be wheelchair
accessible since 1989 (most are manufactured by The London Taxi
Company). The London Taxis feature integral ramps and securement
mechanisms; a swivel seat used in conjunction with an intermediate step
for easier access for passengers with limited mobility; large colored
grab handles for people with low vision; and an induction loop for
people with hearing impairments.
Under the ADA, private entities primarily engaged in the business
of transporting people and providing demand responsive service (the
category that includes taxis) are not required to buy accessible new
sedan-type automobiles. Such entities are required to purchase new
accessible vans--when they buy new vans, unless the entity can
demonstrate that it provides equivalent service. Equivalent service is
determined based on response time, fares, geographic area of service,
hours and days of service, availability of information, reservations
capability, any constraints on capacity or service availability, and
restrictions priorities based on trip purpose. 49 CFR 37.103(c).
If a private taxi company purchases or leases a new van with a
seating capacity of fewer than eight persons (including the driver),
the acquired vehicle must be accessible, unless the company is already
providing ``equivalent service''. The Access Board's ADA accessibility
guidelines for transportation vehicles specify that for new vehicles 22
feet in length or less to be considered accessible, the overhead
clearance between the top of the door opening and the raised lift
platform or highest point of a ramp must be a minimum of 56 inches.
These vehicles must have a two-part securement system to secure a
wheelchair and a seatbelt and shoulder harness for the customer using a
wheelchair. There must be enough room inside the vehicle so the
customer using a mobility aid can reach the securement location. Lifts
or ramps must be 30 inches wide minimum and hold a capacity of at least
600 lbs. Lift or ramp surfaces, securement locations, and all places
where people walk must have continuous and slip-resistant surfaces.
Ramp slopes shall not exceed 1:4 when deployed to ground level
(although the Board's proposed rule to amend the ADA accessibility
guidelines for transportation vehicles would modify this).
But nothing in the statute requires a private entity to acquire a
van; if a private taxi company acquires only automobiles, it need never
obtain an accessible vehicle. According to DOT's preamble to its 1991
regulations, ``given the absence of specific statutory language
requiring a mix of accessible vehicles in taxi fleets, we believe that
to impose such a requirement based only on a general concept of
`accessible in its entirety' would be inappropriate.'' (See DOT's ADA
final rule issued on September 6, 1991 ``Transportation for Individuals
with Disabilities'' preamble at 49 CFR 37.29 ``Private providers of
taxi service''.) Publicly controlled taxi companies on the other hand
have to meet a higher standard and this issue is presently in
litigation in New York.
Project ACTION has developed materials about taxicab accessibility.
These include: Moving Forward Together: A Workbook for Initiating and
Increasing Accessible Taxi Services (2005), The Americans with
Disabilities Act and You: Frequently Asked Questions on Taxicab Service
(2005 with the Taxicab, Limousine & Paratransit Association), and The
Taxicab Pocket Guide (2006). The Taxicab, Limousine & Paratransit
Association recently developed a new publication entitled, ``Assessing
the Full Cost of Implementing An Accessible Taxicab Program'' (March 1,
2010). However, much more needs to be done to promote good practices
and develop incentives for taxicab accessibility nationwide.
conclusion
My experience has shown me that over the past 25 years after
passage of the Air Carrier Access Act and 20 years after passage of the
ADA, that many other countries are closely watching our progress.
Countries have modeled their own legislation on ours. Standards
development efforts around the globe are informed by what we do here in
the United States. Many want to learn from our successes and
challenges. Implementation of the Convention on the Rights of Persons
with Disabilities will further this desire. Just last week the Access
Board sponsored an information exchange with the government of Ontario,
Canada and representatives from the European Commission. Both are
developing accessibility provisions that will be greatly informed by
what we have done here. We can certainly learn from other countries and
their experiences with accessibility--but it is clear that the United
States still serves as a model of inclusion and accessibility. The
Access Board's new guidelines and the update of existing provisions
will certainly improve the transportation landscape in America. But,
issues remain in implementing the laws and regulations that are in
effect today. We have many successes that we can be proud of but we can
still do better.
Thank you for the opportunity to testify today on the topic of
accessible transportation. I would be happy to answer any questions.
The Chairman. Thank you very much, Mr. Capozzi.
Ms. Bristo, welcome back. How many times have you been
here----
Ms. Bristo. A while.
The Chairman [continuing]. In the past 20 years? Welcome
back.
STATEMENT OF MARCA BRISTO, PRESIDENT AND CEO, ACCESS LIVING,
CHICAGO, IL
Ms. Bristo. Senator Harkin, thank you so very much for
holding this hearing. Not enough attention has been paid to the
issues of public transportation for people with disabilities,
and we really, really appreciate your leadership in bringing
attention. I'm here today not only as the president of Access
Living, but also as a mother and as an employer of a good
number of people with disabilities.
As you know, in 1977, I broke my neck in a diving accident,
and pretty much like that, I went through the transformation
into understanding what discrimination feels like firsthand. I
lost my home. I lost my job. I lost my health insurance. And,
very significantly, I lost the only kind of transportation I
had ever used in Chicago--public transportation.
There was no way for me to get around. Therefore, thinking
about going back to work was a really big deal. When I was
finally given a job offer, one of my first barriers was how I
was going to get to work. And fortunately, for me, I had a
grandmother who gave me a loan, and I was able to learn how to
drive with hand controls. Many, many, many people with
disabilities don't have that opportunity, either financially or
physically, and, therefore, what worked for me still left so
many other people out in the cold.
We've come a long, long way since then. My testimony that
we submitted for the record covers a lot of different areas.
Today, I'd like to just focus on a few things that are going on
in Chicago.
First, 100 percent of our buses are accessible, and all of
the key stations in Chicago have been made accessible. However,
that still leaves a third of the stations in the subway system
of Chicago not accessible. Between those two systems, 92,000
rides per day are used by people with disabilities. And this is
a pretty big undercount, because they can only count those
people who have free fares.
The Chairman. How----
Ms. Bristo. Ninety-two thousand----
The Chairman. Every day?
Ms. Bristo [continuing]. Rides per day. That is people with
disabilities who are on the free fare, for people who are
indigent. We have incentivized getting people off of
paratransit by providing free transportation on mainline. That
has worked pretty well, but not well enough, because there is
inadequate training programs to help people make that
transition.
And as we're seeing bus routes, because of budget
reductions, get reduced and cut back, we're now watching people
leave mainline to go back on paratransit because they have to
wait for four or five buses before one of the two spots for
wheelchairs are available to them.
Paratransit, at the same time, has been growing in an out-
of-
control way. I'm sure you know this, but the baby boomers are
about to age into their disabilities. A lot more of us are
going to be working longer, and a lot more of us are going to
be living in our homes rather than in nursing homes. So we have
an aging community that's going to want to use public
transportation. And we have a choice about whether they're
going to be trapped into the expensive paratransit or whether
we're going to remove the remaining barriers to make mainline
accessibility a reality for them.
In Chicago, taxis are a big part of our solution. And I
want to say that while we have 92 accessible cabs and some 35
or 40 coming on board, I think, this year, that is still not
enough. The reason we've been successful in getting that many
is because we've had commissioners who have worked hand-in-hand
with the disability community to open up more options.
I also want to say that cabs like the MV-1 are the only
socially responsible designs. Combining universal design with
green technology really is the way of the future. And I asked
Mayor Bloomberg whether he would like to be a person with a
disability trying to get a cab in New York City where they
simply don't exist.
I've traveled in New York quite a bit. For starters, when
you hail a cab, it's not the danger that prevents me from
getting a cab. It's the cab drivers that just pass me by.
That's the problem. Discrimination is still rampant, Senator.
If we make cabs accessible, more and more people who are on
the paratransit system will shift over to the taxicab system.
In Chicago, we're using public dollars to allow that to happen.
People can get what's called a voucher, and the Transit
Authority will pay portions of their cab fare in order to get
us who can use the regular cabs onto taxis and off of the
paratransit.
The final thing I'd like to comment on is the air carrier.
Taxis and airplanes are a big part of my life. I travel a lot
in my international role. I'm on planes on a regular basis.
I had an incident that occurred about 3 weeks ago on
Southwest Airlines in Albany, NY, where I went up to the gate
after checking in and telling them what my needs were, that I
was going to need two people to help lift me onto the plane and
I'd need an aisle chair. The man at the gate said, ``Are you
traveling alone?'' I said, ``Yes.'' And he said with a straight
face, ``I may not be able to board you on this flight.'' I
thought he was joking, and I made a comment that I thought he
was joking.
And he said to me, ``You're not to speak to me like that,''
and I said, ``Are you kidding? You are kidding.'' And then I
realized he was not kidding. A big production occurred, where
they brought up two or three different supervisors. Finally,
someone came out of the plane and said to me, ``Can you move
your arms?'' And I said, ``Yes, look.'' I moved my arms, and
they said, ``Well, OK. We'll let you board.''
So they got me in the plane. In the plane, I called the
supervisor over and I said, ``Are you telling me that if I
couldn't have moved my arms, you weren't going to put me on the
plane?'' And she said,
``We're not required to. We've just returned from
training in Dallas, and the FAA has told us that we're
not required to allow people who are not independent to
fly.''
I went back and checked the regulations and, actually,
there is a regulation in there that says it's up to the
discretion of the pilot to make the decision as to whether the
airline provides you assistance through a volunteer that might
volunteer to assist you in flight. That's a regulation I had
forgotten. But it's long overdue that we get rid of those kinds
of regulations and once and for all create a private right of
action under the Air Carrier Access Act.
We do not have the enforcement tools needed in that law.
It's extremely important to understand that civil rights laws
do not self-enforce. I know you know this. The advances we've
seen in Chicago have not come just because the authorities
decided there's a law and we're now going to do it.
We've had to sue the CTA not once but twice; first, to get
the lifts on the buses before the ADA; second, to cause the
drivers to operate the lifts and to cause the CTA to put the
lifts and elevators on a routine maintenance schedule and to do
consumer-directed training. We have to have those kinds of
enforcement mechanisms available in the Air Carrier Access Act
as well or the airlines will continue.
I have just returned from a meeting in Brazil. In fact, I
was in an accessible cab in Brazil when I received the email
from your staff asking me if I would come to testify. I was
amazed to see the accessibility improvements, not only there
but also recently in Seoul, Korea. The transit system in Seoul
was fully accessible--the subway system. The signage was better
than any in this country. When I asked why, they said Michael
Winter, who works for the Department of Transportation, had
been hired by the Korean officials to give technical
assistance.
And I'm here to say that as the U.N. Treaty on the Rights
of People with Disabilities is a bigger part of everyone's
life, transit and global transit is becoming a more important
thing.
Finally, as all these officials come from all over the
world to the United Nations, it's a travesty that those people
who are traveling from all over the world to this great country
which gave us the ADA which led to the U.N. treaty in the first
place--that they can't get the transportation through the taxi
system that they need. We can do better. We must do better.
It's time for us to go back legislatively and administratively
to shore up the areas that remain weak.
Thank you.
[The prepared statement of Ms. Bristo follows:]
Prepared Statement of Marca Bristo
My name is Marca Bristo and I am president and CEO of Access Living
in Metropolitan Chicago--Chicago's Center for Independent Living. I am
also currently president of the U.S. International Council on
Disability. As a person with a disability, a mother, and as an employer
I know firsthand the importance of transportation to the employment,
health, and quality of life of people with disabilities. When I broke
my neck in 1977, I was a public transit user--never having learned to
drive. Suddenly my ability to move about the city came to a screeching
halt. There was no accessible transportation in Chicago in 1977.
Fortunately for me, a loan from my grandmother to purchase a car with
hand controls enabled me to go back to work and maintain my social
life. But the experience of being denied access to transit and other
things people take for granted led to the movement which gave us the
ADA. This testimony is intended to highlight the advances and remaining
challenges in meeting the transportation needs of the Nation's growing
disability community.
The basic mandates of the Americans with Disabilities Act (ADA) are
that all new vehicles for use in mass transit, which include buses,
rail cars and vans, have to be accessible; that key rail stations on
both rapid rail systems and commuter rail systems had to be made
accessible; that a paratransit system be established by operators of
rapid rail and bus systems to ensure that transportation is provided to
those who cannot use mass transit; and that all new rail systems and
facilities such as stations have to be built accessibly; that private
taxi companies comply with service requirements of the ADA and provide
accessible cabs when purchasing vans unless the company is already
providing equivalent service.
The statute, and USDOT's implementing regulations, provided
operational mandates for paratransit systems. Years of experience with
ineffective paratransit, which operated prior to the ADA's passage,
made disability advocates fear that paratransit would always be of
secondary importance to mass transit operators, so minimum service
criteria were established. No artificial restraints on paratransit
demand were permitted. To be eligible for ADA complimentary paratransit
service, a person with a disability must be unable to use mass transit
for the trip requested and must live within the paratransit catchment
area (i.e. within \3/4\ mile from a fixed bus route or rapid or light
rail station). Transit operators were prohibited from placing
priorities or restrictions on trip purposes, and the hours of operation
of paratransit must be identical to those of mass transit.
Unconscionably, the regulation allows paratransit fares to be double
mass transit fares, despite the fact that only those who cannot use
mass transit are eligible for paratransit, and they are by and large
low income.
Paratransit has become an essential part of the lives of people
with disabilities who cannot use mass transit. Since transit providers
cannot lawfully suppress demand, and people with disabilities
increasingly reside in their home communities and need transportation
for work and recreational purposes, the cost of paratransit has
skyrocketed. Life expectancies continue to increase, and the
coincidence of aging and mobility impairment has increased the demand
for paratransit. New York City Transit (NYCT) spent over $500 million
on paratransit this year, which is about as much as it costs to run the
Metro North Railroad that operates between Westchester, Connecticut and
New York City.
The rationale of disability advocates who promoted minimum service
criteria for paratransit was twofold: (1) prevent abuse by transit
operators and (2) encourage transit operators to make their mass
transit systems as accessible and user friendly to people with
disabilities as possible, so they would begin to see themselves as mass
transit users rather than paratransit dependents. This approach did not
achieve the desired result.
Unfortunately, ADA paratransit systems continue to be plagued by
many problems. They often fail to comply with important ADA
requirements through failing to provide on-time performance, failing to
provide telephone access for call requests that do not require
inordinate waiting on hold, driver failure to assist from the door of
the origin or destination to the vehicle if needed, failing to base
eligibility on an individual's functional ability rather than relying
on blanket denials based on type of disability, and limiting penalties
for no-shows to situations within the rider's control.
Paratransit fare increases (i.e., in Chicago from $2.25 to $3.00
one way) have made transportation too expensive for many, particularly
those living on fixed incomes. Further, as budget pressures cause
elimination of some bus routes in the mainline system, riders of
paratransit are having service totally eliminated leaving them stranded
altogether because they are now outside the catchment areas.
On the positive side, ADA paratransit systems were created faster
than, for example, accessible rail systems. Obviously, making only key
stations accessible, rather than making all stations accessible, which
is all that the ADA mandates of existing rail systems, builds in
significant obstacles to mass transit use and keeps people paratransit
dependent. Mass transit systems set up paratransit programs that
operate independently and do not interface with mass transit. Transit
operators do not encourage the use of mass transit or transit training
for people with disabilities, although some have created incentives to
get people off of their paratransit systems and onto their bus and rail
systems, including free or discounted rides for paratransit to mass
transit switchers. Training programs, where they do exist, are
inconsistent and inefficient. In Chicago, the demand for training far
outstrips the trainers' capacity to train, especially for young people
with disabilities graduating high school and people who are newly
disabled.
Lift equipped buses have been in use since the late seventies in
the United States. Operating personnel in some cities are currently
familiar and proficient at lift operation and maintenance, but in some
locations, there are still unnecessary breakdowns (due to poor
maintenance programs) and failure to provide the required alternative
service. But despite those problems, the word ``bus'' in the United
States has come to mean accessible bus, as passengers with and without
disabilities expect buses to be accessible, and people using
wheelchairs and scooters to board. Some transit systems (such as
Chicago) have responded to advocacy by disabled riders by adding
scrolling visual marquees and automated stop voice call-outs on buses
to improve communications access for deaf and blind individuals.
Large ``over-the-road'' style buses, operated privately, in
intercity travel and on tours, and publicly and privately as commuter
buses, became accessible slowly. Because of lobbying by intercity
carriers, over-the-road style buses were exempt from access
requirements until 1998. Larger private companies operate accessible
over-the-road buses adequately, for the most part. However, smaller
carriers and charters continue to operate inaccessible vehicles and
have no ability to make arrangements for alternate transportation for
wheelchair and scooter users. Federal enforcement for scofflaw
companies has come slowly, but has improved markedly in the last year
or two.
Gap problems continue to deter people using wheeled mobility aids
from accessing rail systems. The gap is the distance between the
platform and the rail car and is both horizontal and vertical. New rail
systems have minimal gaps, but older rail systems contain gaps of 4" or
more and are a significant disincentive to use. In Chicago after
litigation against the CTA to require improved maintenance and service,
access to rail service has greatly improved through the improved use of
``gap fillers''.
Issues concerning rail platform heights and lengths have surfaced
as ADA has been implemented. A low-level platform at a commuter train
which must be boarded by climbing car-borne steps makes it impossible
for people using mobility aids to board. Transit systems have proposed
alternatives to raising the entire platform, which do not work. The
construction of a mini high-level platform on top of a low-level
platform which is accessed by ramps provides access to only one rail
car. All cars must be accessible, according to ADA, so mini high-level
platforms are not a solution, although they exist on some systems (for
example, Niagara Frontier Transit Authority light rail system in
Buffalo, NY).
Elevator installation at key stations, mandated by ADA, has just
not provided meaningful access on older rail systems, as they have been
installed slowly because of expense and difficulty, and are few and far
between. In Chicago, this problem is exacerbated by lack of urban space
for expansion along the sides of the stations during renovation and
installation of elevators or large ramps.
Perhaps the worst example of ADA compliance on rail systems is the
Amtrak system. On the 20th anniversary of the Americans with
Disabilities Act, the statutory deadline for 100 percent of Amtrak's
stations to be ADA compliant, Amtrak had only 20 percent of its
stations in compliance. Moreover, Amtrak ``discovered'' at
approximately the same time that it did not own most of the stations at
which it operates and therefore must persuade entities of local
government to assist in making facilities accessible. Complicating this
problem is the fact that most of Amtrak's tracks are owned by freight
railroads. These railroads do not want high-level boarding platforms
built next to their tracks because of what appears to be a historical
resistance to improving passenger service. Many of the Amtrak platforms
that must be made accessible are just concrete slabs which are
currently in disrepair and need to be rebuilt. The U.S. Department of
Transportation (DOT) recently issued a disappointingly weak regulation
requiring only a performance standard for equal boarding access if
there is freight traffic in a location as well, which there usually is.
This rule unfortunately allows solutions I've already mentioned, as
well as others, that have proven ineffective in the past.
In Chicago, we have been extremely frustrated by the fact that we
know that the trains can handle three wheelchairs per car; however, we
are only allowed to reserve three wheelchair spots per train. Amtrak
says this is due to an outdated online reservation schedule. However,
when we have simply showed up with a group of wheelchair users for
travel, we have been subjected to poor customer service and a negative
attitude because our needs were not outlined in the passenger manifest.
A significant transportation alternative has been largely unused by
transit operators to reduce costs of paratransit. If taxis were
accessible, paratransit costs would be reduced for several reasons.
First, taxis are privately operated and purchased. Many people with
disabilities would choose the taxi, which permits spontaneous travel,
rather than deal with a demand-response, advanced reservation
paratransit system. Transit operators themselves might employ private
taxi services to reduce paratransit costs as invariably taxi fares are
lower than the average cost of a paratransit ride. In New York City,
for example, paratransit rides cost the transit system about $60 per
ride, far more than the cost of a taxi ride. Nevertheless, New York
City's Taxi of Tomorrow program shockingly chose an inaccessible
vehicle to be New York City's taxi for the next 10 years. Mayor
Bloomberg, in commenting on the situation stated accessible taxis cost
$16,000 more than inaccessible taxis; that it is dangerous for
wheelchair users to hail a taxi; that wheelchair users will not
``establish a dialog'' with the driver and therefore would be bad
tippers; and that ``normal'' riders will complain about the suspension
in accessible cabs. The Mayor has repeated his offensive remarks,
despite being wrong on the facts. He is a champion of some civil rights
but has overlooked the needs and rights of disabled passengers.
Unforgivably, New York City Transit has not opposed the Mayor despite
the fact that if cabs were accessible their paratransit expenses would
be dramatically reduced.
If taxis were accessible, dollars spent on ambulettes to bring
Medicaid patients using wheelchairs and scooters to doctor appointments
can be spent on healthcare instead of transportation, as taxis would be
a cheaper alternative. All ``benefits-
related travel'' by wheelchair users, such as trips to the Department
of Veterans Affairs' clinics and medical centers and vocational
rehabilitation, and even some special education trips, could be made
cheaper and more efficiently by accessible taxis than by privately
operated ambulettes or public paratransit systems.
A small percentage of taxis are accessible nationally, though some
cities such as Washington, Boston, Las Vegas, San Francisco, Chicago,
and others have begun programs in earnest. I'm proud to say that, in my
home town, Chicago's program of accessible taxis is a particularly
outstanding model for many reasons, but chiefly because the rules are
actually enforced, something that should be true everywhere, but is
not. Chicago has used various incentives to increase the number and
quality of accessible cabs. Currently there are approximately 100
accessible cabs with many more to be added this year. The new MV-1 is
the first cab designed to be accessible and the Chicago disability
community played a part in assuring that it will go beyond ADA
requirements. It will also use natural gas and the city has
incentivized the purchase of such environmental friendly vehicles with
a fund to defray the costs of acquisition. We hope this will add even
more accessible cabs to our fleet.
The only gatekeeper for paratransit eligibility, however, correctly
remains the physical or intellectual inability to use mass transit.
Transit could create incentives for mass transit use, such as reduced
or free fares for those who are eligible for paratransit, providing
accessible streets and sidewalks including bus stops, complying with
the ADA's rules for calling out the stops, and transportation training
in schools and vocational rehabilitation programs.
There is one more very significant problem and we look to the
Department of Transportation to resolve it. Several Federal courts have
misunderstood the intended relationship between the Department of
Justice and Department of Transportation ADA regulations, with the
resulting catch-22 that, unlike hotels, libraries, and every other type
of organization covered by the ADA, public transit agencies are
arguably not required to make reasonable modifications of their
policies, practices, and procedures when necessary to avoid
discriminating against a person with a disability. Something as simple
as the right of a person with diabetes to eat food when medically
necessary while on the train, even though there is a no-eating policy,
is not guaranteed under the ADA until DOT acts. DOT made an excellent
proposal in 2006 to add this provision to its regulation, but has
neglected to finalize it. We urge rapid action that maintains full
consistency with the excellent proposed rule.
The ADA does not address air transportation since the Air Carrier
Access Act (ACAA) was passed in 1986, 4 years prior to the enactment of
the ADA; however, the ACAA does cover access to the airport structure
and grounds. The ACAA prevents both domestic and foreign airlines
operating in the United States, from discriminating against passengers
with disabilities. The nondiscrimination mandate covers all aspects of
air transportation including reservations, boarding, deplaning,
handling of mobility devices, and connecting service. Complaints
stemming from lack of training of airline personnel and personnel of
airline contractors are still prevalent 25 years after the passage of
the ACAA. Also, in the past 25 years little has been done to improve
the access of airplanes as the ACAA mandate for accessible aircraft is
minimal. Without firm mandates, the industry has not voluntarily made
airplanes wheelchair accessible.
In summary, 21 years after ADA's passage, transportation
alternatives for people with disabilities are still extremely limited.
While Amtrak cars are largely accessible, stations are difficult or
impossible to access in many locales. The reservation system creates a
vortex of discrimination and poor customer service. A clear success is
that virtually 100 percent of mass transit buses are accessible in the
United States, and all newer rail systems are accessible and used by
people with disabilities. Rail systems that pre-existed the ADA have
until 2020 for key stations access and are not heavily used by people
with disabilities, because so little of each system is required to be
accessible. Paratransit, while a life-style changer for people with
disabilities, as it permits us to work, shop and socialize, even if
we're unable to use the bus or train, is always at risk of budget
problems. Transit should take meaningful, effective steps to make more
rail stations accessible and encourage the switch from paratransit to
bus and rail service. And in 2011, there should be no more failures to
comply fully with the letter and spirit of the ADA.
The progress we have made here in the United States is being
closely watched and has great potential to open transportation options
for people with disabilities worldwide. The U.N. Convention on the
Rights of People with Disabilities calls upon countries who ratify to
improve transportation options for people with disabilities. Some
countries have already made these changes, such as Seoul, South Korea
and Rio de Janeiro, Brazil. We hope that the U.S. ratification of the
CRPD will position the United States to further assist countries to
open up transit to the 1 billion disabled people worldwide.
In closing, we have come a long way in opening transportation to
people with disabilities but there is still so much more to do. Some
will say we've done enough. In the period of tight budgets, we cannot
do more. That is short-sighted and fails to take into account the
growing population of people with disabilities who will be aging into
their disabilities. They will be working longer and unlike their
predecessors they will live in the community rather than in
institutions. Improved accessibility in the taxi and mainline systems
can take some pressure off of more expensive publicly funded
transportation, like school buses and medical transportation.
Finally, if we are ever to reverse the terrible unemployment of
people with disabilities, transportation is the key.
Thank you for giving me the opportunity to provide this testimony.
I can be reached at [email protected] or (312) 640-2104 for further
information.
The Chairman. Thank you again for a very provocative and
strong statement, Marca. You never fail us by pointing things
out to us. I appreciate it.
Mr. Altom, welcome. Please proceed.
STATEMENT OF BILLY W. ALTOM, EXECUTIVE DIRECTOR,
ASSOCIATION OF PROGRAMS FOR RURAL INDEPENDENT LIVING, NORTH
LITTLE ROCK, AR
Mr. Altom. Thank you, Senator Harkin.
Today, it is my pleasure to talk about a topic which
affects so many Americans, and that is transportation and, in
particular, rural transportation. Rural transportation, as you
know, looks totally different than transportation in other
parts of the country. And the lack of affordable, available and
accessible transportation is one of the most significant and
persistent problems faced by people with disabilities, people
who are elderly, and those with low incomes.
This is especially true for individuals who live and work
in rural America, which is why APRIL has been so concerned with
accessible and effective rural transportation for well over a
decade, because in the rural areas, we rely on human service
providers. We rely on private vehicles, and we rely on taxi
companies, which is why I'm thrilled to see the taxi folks here
today.
I'd like to start by giving you just a brief retrospective
of transportation legislation as it pertains to people with
disabilities. I'd like to start with the Urban Mass
Transportation Act of 1970, which stated that,
``It is hereby declared to be national policy that
elderly and handicapped persons have the same right as
other persons to utilize mass transportation facilities
and services.''
Then 20 years later, we have the Americans with
Disabilities Act, which reinforced those statements by clearly
stating that where public transportation is provided, it must
be accessible for people with disabilities. And then with those
thoughts in mind, the current transportation act, the Safe,
Accountable, Flexible, Effective Transportation Equity Act: A
Legacy for Users, or SAFETEA-LU, created the New Freedom
Program, or section 5317, to support new public transportation
services and transportation alternatives beyond those required
by the ADA in order to assist individuals with disabilities
with their transportation needs.
So I'd like to describe a couple of programs that utilize
some of these human service providers and voucher models and
also car ownership, just to show the effectiveness of how
transportation can be provided in rural areas if we coordinate
our programs.
First, the Center for Independent Living in Western
Wisconsin created a Regional Mobility Management and New
Freedom Transportation Program that used a combination of the
regional approach to coordinating and providing transportation
to those largely without access to transportation and has
resulted in a robust and growing program. In 2011, more than
12,000 rides were provided through the program and recently
surpassed 1 million miles of service to a diverse population of
individuals with disabilities in rural Wisconsin.
The center uses more than 140 volunteer drivers to serve
the majority of those programs. This is funded through a
variety of moneys from the FTA New Freedom Program, Mobility
Management Program funds--which I want to talk a little bit
about Mobility Management in just a moment. But those who
access the program are people with disabilities of all ages,
and they do so for a variety of reasons, including medical,
social, recreation, and employment.
Oftentimes, folks do not think of transportation as
anything other than a ride back and forth to work. And in rural
areas, we need more than just a ride back and forth to work. We
have to be holistic in our approach to providing transportation
and ensure that folks have social opportunities and recreation.
Another program, the Living Independence Network, LINC, in
Boise, ID, has a transportation program that is the user-side
subsidy friendly that allows people with disabilities that
prevent them from driving to defray the cost of public
transportation by using vouchers. For each $1 they spend, they
get a $3 voucher. So, for example, a $9 ride costs the user
three bucks. Then the transportation provider can redeem this
unused portion and be reimbursed from the Center.
Currently, there are 1,325 people utilizing this program,
809 of those are over 60 years of age, and 698 use the program
specifically for employment. Participating transportation
providers have had to increase staff to deal with the increased
demand as this system has grown, creating new jobs. This
program works because of cooperation and coordination between
human service agencies; public and private transportation
providers; the ridership; and Federal, State, and local funding
resources.
Using creativity, the program provides a significant link
between people with disabilities and seniors in rural America
and their communities and employment opportunities. These two
programs are voucher models. Next, I'd like to describe quickly
a car ownership program.
The Good News Mountaineer Garage Program in West Virginia
is a nonprofit organization that takes donated cars, repairs
them, and provides them to families in need of transportation
to get to work and/or training. The vehicles are matched
according to the individual needs of the recipient and are
provided a warranty and training in how to care for the car and
keep it running. The families are required to have insurance
and budget for maintenance.
Having available transportation is crucial to economic
independence. Economic independence means personal
independence, and car ownership can be a solution to many
transportation challenges. Research has shown that parents with
a car are more likely to be employed and to work more hours
than a parent without a car. And when a parent has a stable and
consistent means to get back and forth to work, their chances
of obtaining and maintaining better jobs with higher pay are
much greater.
Finally, 2 years ago, Easter Seals Project ACTION and the
Association of Programs for Rural Independent Living and the
National Council on Independent Living started a project in 20
States to create mobility management independent living
coaches. These coaches are people with disabilities. The
coaches enlighten mobility managers in disability perspectives
as they pertain to various forms of transportation, because we
realize that one-size-does-not-fit-all.
They also train the mobility managers to coordinate and
work closely with other disability organizations in their
respective communities. In the IL world, we have a slogan for
this. It's ``nothing about us, without us.'' The thing that we
really need to do is to ensure that the enforcement of our
civil rights protections afforded to us under the ADA and other
pieces of legislation that impact transportation are enforced.
I thank you very much for your time, and I would be glad to
answer any questions that you may have later.
[The prepared statement of Mr. Altom follows:]
Prepared Statement of Billy W. Altom
Chairman Harkin, Ranking Member Enzi and members of the Senate
Health, Education, Labor, and Pensions Committee, I would like to start
by thanking you for the opportunity to address the HELP Committee
regarding The Americans with Disabilities Act and Accessible
Transportation: Challenges and Opportunities.
My name is Billy Altom and I am the executive director of the
Association of Programs for Rural Independent Living (APRIL). APRIL is
a national membership organization dedicated to advancing the rights
and responsibilities of people with disabilities in rural America. We
provide leadership and resources through a national network of rural
centers for independent living, programs and individuals concerned with
the unique aspects of rural independent living. The goal of APRIL is to
work with others to find solutions to common problems and to bring
rural issues in independent living into focus on the national level.
The lack of available, affordable and accessible transportation is
one of the most significant and persistent problems faced by people
with disabilities, people who are elderly and those with low incomes.
This is especially true for individuals who live and work in rural
America and is why APRIL has been concerned with accessible and
effective rural transportation for well over a decade.
``It is hereby declared to be the national policy that
elderly and handicapped persons have the same right as other
persons to utilize mass transportation facilities and services;
that special efforts shall be made in the planning and design
of mass transportation facilities and services so that the
availability to elderly and handicapped persons of mass
transportation which they can effectively utilize will be
assured; and that all Federal programs offering assistance in
the field of mass transportation (including the programs under
this Act) should contain provisions implementing this policy.''
Urban Mass Transportation Act of 1970, P.L. 91-453.
The above 1970 statutory language, establishing national
transportation policy, was written 20 years before the 1990 Americans
with Disabilities Act (ADA). We need to use the 1970 Transportation
Act's words as a challenge and a reminder of promises to keep.
Minimal or non-existent transit services in rural areas still
create serious barriers to employment, accessible health care and full
participation in society for people with disabilities, 40 years after
initial national policy, and 20 years post-ADA. Lack of public
transportation is one of the most serious, persistent problems reported
by people with disabilities who live in rural America. Compared to the
resources allocated to urban areas, those allocated for rural public
transportation are significantly inequitable.
APRIL's guiding principles in addressing transportation needs in
rural America include:
``All'' public transportation should be accessible to
``All'' users, ``All'' the time.
Transportation must address the needs of all transit
dependent groups, including people with disabilities, senior citizens,
youth and low-income individuals.
Systems designed to meet the transit needs of people with
disabilities will meet the needs of all transit users.
Systems must be accountable for the accessibility, quality
and quantity of services they provide.
Accessible transportation includes systems, services,
vehicles, routes, stops, programs and all other aspects of
transportation and must at least meet or exceed the minimum
requirements set forth in the Americans with Disabilities Act.
The current Transportation Act--the Safe, Accountable, Flexible,
Efficient Transportation Equity Act: A Legacy for Users (SAFETEA-LU)
created the New Freedom Program (Sec. 5317) to support new public
transportation services and public transportation alternatives beyond
those required by the ADA, in order to assist individuals with
disabilities with their transportation needs.
There are models that demonstrate the spirit and intent: Mobility
Management and Voucher Programs.
Mobility Management refers to the consideration of all modes of
transportation in order to meet the needs of users. In utilizing the
practice of mobility management, communities rely upon a variety of
transportation sources in an effort to move rural and small town
residents from point A to point B as safely and efficiently as
possible. This is a people-oriented approach that accounts for a
rider's age, income level and accessibility needs to determine the best
transportation option.
Effective mobility management ensures that residents are familiar
with available resources and that communities coordinate transit
programs effectively. Customer-focused coordination is essential to
ensure that services create sufficient access to jobs, groceries and
health care services.
Easter Seals Project ACTION (ESPA), the Association of Programs for
Rural Independent Living (APRIL) and the National Council on
Independent Living (NCIL) started a project 2 years ago, in 20 States,
to train mobility management independent living coaches who are people
with disabilities.
These coaches educate mobility managers in disability perspectives
as they pertain to various forms of transportation. They also work with
mobility managers to coordinate their services with disability
organizations in their respective communities. In the Independent
Living world we have a slogan for this . . . Nothing about us, without
us!
But currently, many mobility plans do not take all modes into
account, leaving some residents without options. A comprehensive and
flexible mobility management program should include various types of
mobility, from carpools and vouchers, intercity and local buses, rail,
vanpools, personal vehicles, to walking and biking.
Vouchers are tickets or coupons that eligible riders give to
participating transportation providers in exchange for rides. In
general, voucher programs target those with the greatest need for
transportation who cannot use existing transportation services for one
or more reasons. For example, they cannot operate a private vehicle
because they have a disability that prevents them from doing so, they
lack insurance or a driver's license, or they do not own a vehicle.
Perhaps they cannot afford to use existing taxi services or those
services are not available or they live outside of the fixed-route bus
service area.
So, how does this voucher system work and who's involved?
A voucher system involves three parties:
1. The riders who use public and private transportation services at
a fully or partially subsidized rate and pay for those rides with the
vouchers.
2. The transportation providers who, based on previously negotiated
arrangements, agree to accept the vouchers or coupons as payment for
the trips and submits the coupons to the sponsoring agency for
reimbursement. The transportation provider can be a private taxi, human
services transportation provider, neighbor, other volunteer or even a
family member.
3. The community, through its local agency or agencies that support
the subsidized cost of the voucher, determine customer eligibility for
the voucher program, provide the vouchers to the customer and reimburse
the transportation providers for trips.
benefits of a voucher program
A voucher program helps customers afford the cost of a trip that
allows them to access essential services and destinations. The customer
may pay nothing or just a small co-payment for the ride. Using vouchers
means that the customer encounters little hassle in paying for a ride.
For example, in some cases, the rider may have to submit only a voucher
or check to the transportation provider to receive a ride.
The rider becomes more involved in the process if he or she also
chooses the provider, such as when the provider is also a family
member, friend or neighbor.
Being able to rely on voucher-supported services means additional
independence for the customer previously dependent on the good will of
family members and friends for their personal transportation.
A voucher system allows customers to choose transportation services
that match their needs; from the type of vehicle, to the time and day
of travel, including evenings and weekends, to the type of service
(e.g., door-to-door). And from the transportation provider's
perspective, participation in a voucher program allows public
transportation providers to increase their ridership; taxis and human
services transportation providers to expand their contract revenue; and
family members, neighbors and others to receive reimbursement for trips
they may have been funding out of their own pocket.
So here we are, 40 years after initial national policy, and 20
years post-ADA, and minimal or non-existent transit services in rural
areas still create serious barriers to employment, accessible health
care and full participation in society for people with disabilities.
I would like to highlight three programs operating in rural America
that provide transportation options for people with disabilities and
those with low incomes.
Center for Independent Living for Western Wisconsin (CILWW) Regional
Mobility Management/ New Freedom Transportation Program
The Center for Independent Living for Western Wisconsin's efforts
to increase transit options for rural Western Wisconsin residents has
two critical components: Regional Coordination and provision of
transportation to rural communities with few or no transit resources.
The center employs a certified Regional Mobility Manager, who also
serves as the center's transportation program coordinator. The center
formed and staffs a seven-county transportation coordinating committee
that serves to knit together the required locally developed human
service coordinated transportation plans into a truly regional
approach.
The regional coordinating committee is comprised of public and
private stakeholders and meets quarterly in rotating locations within
the region.
The combination of the regional approach to coordination and
providing transportation to those largely without access to
transportation has resulted in a robust and growing program. In 2011,
more than 12,000 rides were provided, and the program recently
surpassed 1 million miles of service to a diverse population of
individuals with disabilities. The center uses more than 140 volunteer
drivers to serve the majority of those who use the program. The program
is funded through a combination of Federal FTA New Freedom, Section
5317 funds, mobility management project funds, and moneys received for
delivering transit services. The rest is ``local match'': fee-for-
service funds, rider reimbursement, agreements (cash and in-kind) from
county partners, contracts and value of the driver's time (in-kind).
Those who access the program (people with disabilities of all ages)
do so for a variety of reasons including medical, social, recreation
and employment. Since 2008, a third of those who request transportation
services are seeking education, training, employment or employment-
related programs.
In addition, (largely due to the success of meeting the unmet needs
of the rural counties) the center has engaged in a number of contracts
with county human service and Aging and Disability Resource Centers
(ADRCs), to coordinate and provide a portion of the transportation for
those eligible under State and Federal programs. Additionally, the
centers' transportation program has garnered contracts to provide
transportation to consumers of two regional managed care organizations
(MCOs).
Due to a recent collaboration with another private non-profit
center for independent living, the program now coordinates and provides
transportation to residents in an 18-county area of Western and
Northwestern Wisconsin. A growing segment of those served are veterans
with no transportation to regional Veterans Administration centers. The
program currently serves more than 130 veterans weekly.
Finally, the recognition of a growing demand for transportation
options for rural Wisconsin residents with disabilities has led to an
unprecedented successful collaboration. In partnership with the Eau
Claire County Aging and Disability Resource Center, the center was
awarded the first ever Federal Veterans Transportation Community Living
Initiative grant for the next 5 years. The public-private collaborative
was the only program in Wisconsin funded.
living independence network corporation (linc)--boise, id
Living Independence Network Corporation (LINC) is a center for
independent living (CIL) with offices in Boise, Caldwell and Twin
Falls, ID.
The LINC office in Twin Falls operates a rural transportation
program that serves a four-county area in south central Idaho that is
approximately the size of the State of Connecticut. The four-county
area has a population of just over 100,000 people and 64,000 of them
live in Twin Falls County.
The LINC transportation program is a ``user-side subsidy'' service
that allows people with disabilities that prevent them from driving to
defray the cost of public and private transportation. Users purchase
vouchers from LINC and each dollar spent purchases $3 worth of
transportation. Users use the vouchers to pay for rides (for example, a
$9 ride costs the user $3), then the transportation provider redeems
the unreimbursed portion of the ride from the CIL. Users can use their
vouchers to pay for rides from private providers such as taxis, from
public transportation such as fixed-route and paratransit or to pay for
mileage to ``community inclusion drivers'' implemented through
contracts with private and public transportation providers.
1,325 people use the program.
809 of those are over 60 years of age.
698 use the program specifically for employment.
Participating transportation providers have had to increase staff
to deal with increased demand as the system has grown, creating new
jobs.
The transportation program is funded by a combination of:
5,310 Elderly Individuals & Individuals with Disabilities
Program.
5,316 Job Access and Reverse Commute Program (JARC).
5,317 New Freedom Initiative Program.
Older Americans Act funds through the local Area Agency on
Aging.
LINC provides required matching funds from unrestricted
revenues.
As described above, users pay a portion of the cost.
A link to an online news story about the program: http://
www.dailyyonder.com
/twin-falls-transportation/2011/02/0l/3155.
The program works because of cooperation and coordination between
human service agencies, public and private transportation providers,
the ridership and Federal, State and local funding resources.
Using creativity and existing programs, providers and resources,
the program provides a significant link between people with
disabilities and seniors in rural America and their communities and
employment opportunities.
good news mountaineer garage--west virginia
Good News Mountaineer Garage is a West Virginia non-profit
organization that takes donated cars, repairs them and provides them to
families in need of transportation to get to work or training. The
vehicles are matched according to the needs of the recipients who are
provided a warranty and training in how to care for the car and keep it
running. The families are required to have insurance and budget for
maintenance.
Having available transportation is crucial to economic
independence. Economic independence means personal independence. Car
ownership can be a solution to many transportation challenges. Research
has shown that a parent with a car is more likely to be employed and to
work more hours than a parent without a car. When a parent has a stable
and consistent means to get back and forth to work, their chances of
obtaining and maintaining better jobs with higher pay are much greater.
The Good News Mountaineer Garage, which opened its door in 2001
after having been organized by a group of concerned citizens, has
helped over 1,700 West Virginia families meet their transportation
needs.
The GNMG is involved in an ongoing program to measure the outcomes
of its programs. The results of this past year's respondent followup
study showed that:
The number of cars provided to families total
approximately 1,700 since it started in 2001: Most of the vehicles were
provided to referred clients of the WV Works--Temporary Assistance to
Needy Families--statewide.
In 2009, GNMG entered an agreement with the Department of
Rehabilitation Services to provide vehicles to referred clients. Since
that time, 90 vehicles have been provided.
In the past 3 years we have provided vehicles to meet the
transportation needs of 829 adults and 1,107 children.
DHHR TANF's director reported to the USDHHS that GNMG was
one of the case managers' most valuable programs to help people get off
public assistance.
WVDHHR-DRS has asked if GNMG has the capacity to increase
the number of vehicles provided to their referred clientele indicating
that GNMG is helping the agency move their clients to gainful
employment or training.
A followup survey of TANF vehicle recipients conducted in fiscal
year 2009 showed the following:
87 percent were no longer on TANF.
9 percent were on TANF but were in training or the 6 month
transition stage of moving to employment.
4 percent were still receiving TANF and not in training or
transition.
36 percent are able to attend more school activities.
36 percent accessed better child care.
21 percent moved to better housing.
31 percent accessed improved medical care.
In closing, we have to move past those us versus them scenarios. We
need to consolidate the silo approach and give transportation providers
the flexibility they need in order to serve the entire community. Not
just individual segments. We should systematically encourage and fund
innovative private and public sector models that can address
unavailable and/or insufficient rural transportation.
Solutions might include: accessible taxi services; using private
drivers, including those with disabilities; vehicle pools similar to
those used by intercity bus programs and voucher models administered by
community-based organizations. Allocate innovative program funds to
support tribal transportation programs that are coordinated with other
public transit and community transportation services.
We are all in this together. We hear a lot of talk these days about
the principles upon which our country was founded. I ran across this
passage the other day written by John Winthrop on his voyage to the
Massachusetts Bay Colony in 1630. He was preparing his shipmates and
his family for their arrival in the new country and how they should
live their lives to make their new homeland truly a city on the hill .
. . to be admired by all other countries.
``We must delight in each other; make others' conditions our
own; rejoice together, mourn together, labor and suffer
together, always having before our eyes our commission and
community in the work, as members of the same body.''--John
Winthrop written onboard the Arbella en route to Massachusetts
Bay Colony in 1630.
I think this still holds true today and we should accept it as a
challenge as we move forward in the development of our new
transportation legislation.
Thank you so much for your time and attention.
The Chairman. Mr. Altom, thank you very, very much.
Ms. Houghton, welcome and please proceed.
STATEMENT OF JILL HOUGHTON, EXECUTIVE DIRECTOR,
US BUSINESS LEADERSHIP NETWORK, WASHINGTON, DC
Ms. Houghton. Chairman Harkin, Ranking Member Enzi, and
members of the committee, thank you for this opportunity to
provide testimony today.
My name is Jill Houghton. I'm the executive director of the
US Business Leadership Network, also known as the USBLN. We're
a nonprofit, nonpartisan organization promoting workplaces,
marketplaces, and supply chains where people with disabilities
are fully included. We have over 60 Business Leadership Network
affiliates across the Nation, and we represent over 5,000
employers.
I have to tell you we go to our members all the time and
ask them for feedback from A to Z. And when we went to them and
asked for feedback on accessible transportation, they are still
providing feedback. Never in the history of any issue that we
have raised with them thus far has there been an issue so
important to business. And the bottom line of what they've told
us is that access to accessible transportation inhibits their
ability to effectively recruit, hire, retain, and sometimes
even advance their employees with disabilities.
And I will tell you that as the workforce continues to age
and the incidence of disability continues to grow, this issue
is only going to become more catastrophic to business. Some of
the examples that they cited is, some of our members have
facilities in Iowa, in rural locations, where there is no
access to accessible transportation. So if they're trying to
drive their employment efforts there around people with
disabilities, they have a problem. If they're trying to drive a
national, multisite, multistate employment effort, they have a
problem because of the lack of access to accessible
transportation.
I will tell you that they shared many stories with us. One
member company shared a story about an employee that recently
became legally blind. That employee's job was to go out and
meet with their clients. And because they're legally blind,
they now have issues with transportation.
As a company, they've worked with that individual to try to
find solutions, and at the end of the day, the employee has
become so completely overwhelmed by the daunting experience of
dealing with accessible transportation and the access to it
that she's decided to take another position within the company
that inhibits her ability to continue to grow. So now she's
going to sit back, and she's watching, and they're going to
work with her to try to find the right opportunity where she
can use her experience and, hopefully, have some really good
luck to find a position that will allow her to continue to grow
in her position.
Another member company--a senior executive leader cited
that she has to travel, and that travel is oftentimes not safe.
She's a person that uses a small pediatric chair that folds.
She cited examples like we've heard earlier today, where when
she's flying on the airlines, she needs them to fold the chair
and put it in the closet. But they opt to take it down the jet
way, put it underneath, put the suitcases on top. She arrives
at her location, and now she has a broken chair and can't get
to the work that she needs to attend to.
She talked about accessing trains and not having bridge
plates or ramps--trying to force her on the train; once getting
on the train, needing to ask people to move from the accessible
seating so that she has a place to sit. She talked about taxis.
She talked about the issues with people not knowing how to fold
her chair, putting her chair in the back and breaking it.
I can tell you from personal experience--I'm married to a
gentleman with a spinal cord injury. He uses taxis. He's got to
get around. He was in DC the other day. It was pouring down
rain. He sat outside for 15 minutes, waiting for a taxi to
stop. And he called me and he said, ``The best thing happened
to me today.'' I said, ``What happened?'' He said,
``The lady that waited on me in Starbucks saw me
sitting out in the rain for 15 minutes. She was able-
bodied. She came out, and she flagged a taxi for me,
you know.''
I mean, unbelievable.
Now, I will tell you that while nothing replaces access to
accessible transportation, there are some opportunities. And
many of our members are looking to use things like
telecommuting. So if they're trying to drive employment in
rural communities, telecommuting is absolutely an option that's
alive and well and many of our members are using it.
Other members are looking at things like online booking,
because we know that in a global economy, exempt employees need
to be able to travel just like that. So they need to have
access to accessible, online booking, bus kiosks, et cetera.
One of our member companies is actually working on prototyping
accessible technology through mobile phone applications and bus
kiosks, et cetera. If you go to www.accessmynyc.com, it'll take
you to a nice video on You Tube talking about some technology
that IBM is creating on a mobile phone app around creating
accessible routes--very interesting stuff.
Some other examples--employer-provided transportation, not
a perfect solution, but like one of our member companies in
South Carolina partnered with a local disability service
organization. They got a grant. They got a vehicle. They charge
a subscription rate to their employees, and they transport
their employees to work. Now, if somebody's got to work
overtime, everybody's got to wait until that person is done.
It's not perfect.
But one of our member companies in Wyoming uses a company-
owned vehicle and the executive goes out and gives people
rides. So, certainly, they are looking for opportunities and
solutions to this problem.
I would tell you in closing, here we are, nearly three
decades past the passage of the Americans with Disabilities
Act, and access to accessible transportation is still a huge
issue, not just for people with disabilities, but for business
as they try to recruit, hire, retain, and advance employees
with disabilities. So please--thank you so much for the
opportunity to provide testimony today. As a business, we want
to be part of the solution.
[The prepared statement of Ms. Houghton follows:]
Prepared Statement of Jill Houghton
Chairman Harkin, Ranking Member Enzi, and members of the Health,
Education, Labor, and Pensions Committee, thank you for the opportunity
to provide testimony regarding The Americans with Disabilities Act and
Accessible Transportation: Challenges and Opportunities. My name is
Jill Houghton and I am the executive director of the US Business
Leadership Network (USBLN), a national non-profit, non-partisan
business to business network promoting workplaces, marketplaces, and
supply chains where people with disabilities are included. The USBLN
serves as the collective voice of over 60 Business Leadership Network
affiliates across the United States, representing over 5,000
businesses. Additionally, the USBLN runs the Nation's leading third-
party certification program for disability-owned businesses, including
service-disabled veterans.
As the USBLN executive director, I'm here today because access and
accessible transportation as it relates to employment is an important
issue for our corporate members including small, medium and large
businesses across the Nation.
As the former executive director for the Ticket to Work and Work
Incentives Advisory Panel, between 2005 and 2008, I had the pleasure of
working with bipartisan members and staff on this committee. I very
much appreciate your commitment to equality of opportunity, full
participation, independent living, and economic self-sufficiency for
youth and adults with all types of disabilities in all aspects of
society. My testimony is grounded in my professional experience with
the USBLN, as a policy advisor, commissioner on the Florida Commission
for Transportation Disadvantaged and my personal experience as a person
who is married to someone with a spinal cord injury.
In preparation for my testimony today we asked our members about
their challenges and opportunities related to the Americans with
Disabilities Act and Accessible Transportation and here is what they
had to say:
challenges
Many of our employers are located in places that are not easy to
get to for people with transit-dependent disabilities. This is a
significant disadvantage for business when recruiting, retaining, or
advancing employees with disabilities who do not drive. Although access
varies considerably by city, transportation barriers often complicate a
company's ability to implement employment initiatives in a broad,
multi-site manner.
Many of our members have U.S. facilities that are rural and draw
from an employee base within a large geographic radius who don't have
access to public transportation. In many instances this had led
prospective candidates with disabilities that don't drive to withdraw
from consideration for employment. Similarly, some businesses have
sought out assistance in sourcing talent with disabilities from local
disability service organizations only to be turned away due to the lack
of availability of public transportation. For example, when a job calls
for people to work extended or unusual hours, as can be true in the
entertainment industry, employees who rely on public transportation are
unable to do so because there is no access after ``normal'' business
hours. It is next to impossible for their employees to find a public
bus at 1 a.m.
In areas of the country where public transportation is an issue
because of the amount of territory that the system must cover many
employees with disabilities are faced with work/life balance
challenges. These challenges are due to the amount of time that one can
spend trying to navigate bus schedules, connections, etc. Sometimes
employees with disabilities try so hard to prove that they can do the
job that they are forced to use taxicab services, which in the end can
prove to be cost-prohibitive or not an option due to lack of
accessibility. In many of these instances when the individual with the
disability performs a cost-benefit analysis of transportation costs or
time spent traveling to and from their jobs, it usually surfaces that
they are better off seeking financial support in ways other than work.
This creates a huge missed opportunity to business because skilled and
valuable employees are unable to accept or keep their positions. It
also results in higher expenditures for public programs like Social
Security Disability Insurance and Medicare.
Poorly maintained and unreliable public transportation systems
disproportionately impact employees with disabilities particularly
those who are unable to drive, cannot afford vehicles that are
accessible or who have difficulty locating accessible parking in
congested areas. Buses that do not have working lifts, broken elevators
in subways, unreliable paratransit and taxis that bypass individuals
with service dogs and wheelchair users create significant barriers to
employment. Speaking of taxis that bypass individuals in wheelchairs,
my husband uses a lightweight, sporty chair that can easily fit in the
trunk of a taxi. However, he has become accustomed to taxis that as he
describes them, ``put the pedal to the medal'' when they see him. One
of his tactics to overcome this is to have me, a colleague, or even a
Starbucks clerk go out and hail the cab while he sits off to the side.
While many employees with disabilities face these challenges on a
daily basis, allowing for additional time and alternate plans can
become so obtrusive that work becomes an unrealistic option. Lack of
access to transportation means that individuals may choose to leave the
workforce unnecessarily--when able to perform the essential functions
of the job but unable to get to and from work reliably. This robs
companies of valuable employees. As the workforce ages, and with it the
incidence of disability grows, if transportation systems are not
improved the problem will become catastrophic to business.
Even when accessible transportation is available, there may be
issues with actually using the transportation option. For example, one
of the USBLN's members, a senior executive leader, shared that
traveling alone on business is not safe or feasible due to
accessibility issues as a wheelchair user. Literally on every trip she
takes she runs into challenges loading and unloading her wheelchair and
she has a light weight pediatric-sized chair.
Some issues she highlighted were:
Airplanes: Refusing to put her chair in the flight attendant closet
and throwing her wheelchair underneath from the jet way with luggage
placed on top resulting in damage to her chair.
Trains: Not having a bridge plate or lift readily available and
rushing to get her ``over the gap'' to stay on time. She described it
as really scary when they grab her chair and try to pull her over the
gap, and her personal assistant has had to intercede and either insist
on the bridge plate, or get her across himself more carefully. Also:
Not having a clearly marked place to park her wheelchair and having to
ask passengers to find another seat so she can sit in a disability
accessible location.
Car Services/Taxi: Drivers disassembling, bending or breaking her
chair while loading/unloading into trunk so it does not operate when
she arrives.
Finally, she emphasized that there really needs to be training for
personnel in all of the above areas. Her assistant carries tools to
repair her chair everywhere they go, and tries to instruct
transportation personnel on proper handling, but often there are
language barriers or people are in too much of a rush to listen.
An additional USBLN member, a senior executive leader who is blind
mentioned that getting assistance from gate to gate at airports in a
timely manner can be challenging and has caused her to miss connecting
flights.
opportunities
Telework
While telework does not replace adequate accessible transportation
systems, for some industries, it can be a good solution to recruit and
retain employees with disabilities. For our members attempting to
recruit in rural or low population areas where there is not available
or adequate public transportation, telework can provide access to
employees without requiring relocation. In addition, distance learning
can also provide an opportunity to teach employees new work skills.
Telecommuting can also be a stop gap measure during and after natural
disasters such as earthquakes, tornadoes or hurricanes and for shifts
when public transportation is not available and/or when work hours are
not consistent.
Given the increased accessibility of information and communications
technology, an employee located at a distance can often perform the
same work regardless of location. This said, like many agencies in the
Federal Government, companies must first purchase accessible
technologies and be knowledgeable about the functions and features that
can make information and communications accessible to their employees
with disabilities.
Online Booking
In this global world, many of our member companies expect their
exempt employees to travel at moment's notice. This requires that the
transportation system of the future will be accessible for things like
route planning, ticket purchasing and accessory services inclusion 24/
7.
In fact, one of our member companies has been working on
prototyping accessible airline/bus kiosk and mobile phone-based
accessible city routing (e.g. www.access
mynyc.com). These solutions are available now but the usage rate is
slow probably because both the Government and the transportation
industry still need to be educated about the needs of people with
disabilities and the market potential.
Workplace Flexibility
Additional solutions include creating flexible work schedules by
re-working start and end times. One member even cited that in areas
within their geographical region, they have evaluated the potential for
setting up a satellite office within a school or support facility
instead of the employee coming to them. Others have leveraged ride
shares through van and car pools where feasible. Those enrolled in this
program are often rewarded with prize drawings and reserved close
parking privileges.
Employer-Provided Transportation
A member company in South Carolina worked with their main
disability service partner to create a solution by accessing a grant to
purchase a small bus and they charge the employees a subscription fee
to cover the operational costs of running that bus. It operates with a
``hub'' system so that in most cases, the employees need a ride to the
pick-up spot, but it eliminates family members needing to drive
individuals for an hour each way every day. This system also has
limitations because if one person on the bus has overtime, everyone has
to stay at the building until the last person's shift ends. However,
their Texas location partnered with the agency that provided the
largest number of employees with disabilities and selected them as the
charity for 1 year's campaign. The funds raised were matched by a grant
and the money was used to purchase a bus to transport individuals for
training as well as for work.
In Wyoming, one of our members has had members of management drive
a company vehicle to transport their team members to and from work.
However, this is limited by the size of the vehicle and territory they
are able to cover.
conclusion
Developing transportation solutions can create complex issues for
both the individual and employer. While flexible work hours and
telecommuting may provide a partial solution for some job categories,
it is not a complete solution. Not every individual thrives in a
telework or telecommuting position. Even for those with positions that
can be performed primarily from a remote location, there are formal and
informal meetings and events that must be held onsite. The glass
ceiling, or chrome ceiling as it has been called in the disability
world, will be reached very quickly by employees who face
transportation barriers. In the words of one of our members, who is
with a company with very flexible worksite policies, related the
following story:
``One individual who became legally blind and could no longer
drive to her clients took public transportation some places,
car services to others (the firm paid), and carpooled with
colleagues when possible. Ultimately, the complex arrangements
proved so daunting and inefficient that she changed roles and
is still looking for the right opportunity where she won't need
to travel regularly to different client sites. This has had a
huge career impact for her and others, and it takes both an
exceptional track record and luck to be able to carve out the
right role at the right time that's not career-limiting.''
In conclusion, 21 years after the passage of the Americans with
Disabilities Act accessible, reliable, courteous and affordable public
transportation continues to be one of the major, if not the major,
barrier for business when recruiting, hiring, retaining and advancing
people with disabilities in the workplace. For this reason, employers
need to be part of transportation policy discussions at all levels of
government. This country is experiencing major workplace challenges and
our country needs the talents, dedication and creativity that people
with disabilities bring to the workplace, marketplace and supply chain.
We applaud this committee's leadership in examining this issue and
Congress' oversight of the agencies, regulations, policies and actions
that have been developed to insure that the intent of the Americans
with Disabilities Act to level the playing field is realized.
The Chairman. Thank you very much. That was also very
powerful. Thank you. I appreciate that very much and all of you
for being here today.
This is a general question or maybe an observation
question. We have some specific legislation, the Air Transit
Act, that we talked about and the regulations pertaining
thereto; the Surface Transportation Act and the regulations
pertaining thereto. Do we need to modify the ADA? Do we need to
add something? Or do we need to look at air transportation,
surface transportation, taxicabs, of course, as slices of it
and address those individually?
How much needs to be changed legislatively, and how much
just needs to be enforced, regulatory? We have the regulations,
and as you point out--most of you pointed out, the regulations
aren't being followed. Where should we be focusing some of our
attention on this issue? Should we be focusing it on those
slices or an overarching modification of the ADA? Any thoughts
on that?
Mr. Capozzi.
Mr. Capozzi. I think the answer depends. For example, under
the Air Carrier Access Act, the law is very short. It's modeled
after section 504, so it basically just says ``air carrier
shall not discriminate on the basis of disability and
regulations shall be written.'' And so the teeth is in the
regulations. The particulars are in the regulations.
Regulations have been written. They were first written in
1990. They've been modified many times since. They now cover
international carriers as well through a piece of legislation
that extended the coverage to international carriers. So part
of it is regulatory, but I think a large part is just
enforcement, compliance, training.
I mean, it was very interesting when Marca talked about the
training that the employees for that airline had gone through,
and they misunderstood the regulations, because the regulations
in that case would say that if you had a disability so severe
that you couldn't assist in any way, then they could require an
attendant to fly with the passenger, but they can't deny you
boarding. So they kind of missed the nature of the issue.
So I think training has a large part of any disability
legislation or regulations. Compliance, though, is a big part
of it. Most of our legislation is all complaint-driven, as you
know. And so that sometimes is a failing. There are probably
places, though, that could benefit from both some legislative
oversight and some--perhaps retooling.
When the ADA was passed in 1990, the issues really were
different. The issues at that time were having mainline
accessibility to buses and trains. I mean, people were still
chaining themselves to buses before 1990. So the issue wasn't
really private sector transportation or taxicab accessibility
or shuttle buses from hotels. But I think those are now the
issues of today.
The Chairman. Any other thoughts?
Mr. Altom. And then Marca.
Mr. Altom. Thank you. I just want to echo those thoughts of
enforcement. Since there are no ADA police, so to speak, it is
complaint-driven. And a lot of times for an individual with a
disability doing that complaining or filing that complaint,
they have the fear of the repercussions that may come from
that.
If you live out in a rural area, and you start griping,
well, the squeaky wheel gets the grease. Sometimes it does get
the grease, and it's just out of the way, and you don't think
about it anymore. So I would like to see enforcement mechanisms
in place and maybe not so much onus on the individual sometimes
of being the lone wolf out there.
Ms. Bristo. Senator Harkin, as you remember, the ADA and
most laws that we have are a byproduct of the compromise
process. And in 1989, when we were working on the ADA, there
were a lot of different forces going on that caused us to have
certain elements of the laws that weren't as strong as we'd
like them to be. That, coupled with the advances in
technology--I think if we were writing the ADA today, we might
have come up with certain differences.
For example, the concept of key stations which are built
into the law--it doesn't require 100 percent of subway stations
to be made accessible, just key stations. Well, we're now 20
years after--shouldn't we start going back to revisit that
idea? Can we now raise the bar and either elevate the number of
key stations or set a goal of making all of the subway stations
accessible unless they cannot structurally ever be made to do
so?
Another example would be in the area of taxis. Right now,
taxis are not required to be accessible unless they purchase a
van of a certain size. And even then, if they can prove that
they're providing equivalent service--which none of them can,
in my opinion--they have a loophole to get out of it.
It's a question I think we should be asking. Why can't we
create a standard where all taxicabs are accessible for
everybody? Increasingly, our population are going to need them,
and, as you pointed out, there are many people who take
advantage of accessibility features besides just wheelchair
users.
The Chairman. I want to followup one thing, Ms. Bristo, and
that is you, in your written testimony that I read last night--
just a second. Let me find it again here. Oh, yes. You
mentioned, ``If taxis were accessible, paratransit costs would
be reduced for several reasons,'' and you go through those.
Then in another part, you said, ``New York City transit spent
over $500 million on paratransit this year.''
And you said,
``In New York City, for example, paratransit rides
cost the transit system about $60 per ride, far more
than the cost of a taxi ride. Nevertheless, New York
City's taxi of tomorrow program shockingly chose an
inaccessible vehicle to be New York City's taxi for the
next 10 years.''
Mayor Bloomberg--and I'm reading from your testimony--
``Mayor Bloomberg, commenting on the situation, stated that
accessible taxis cost $16,000 more than inaccessible taxis.''
Then you go on about--dangerous for them to hail a taxi, some
of the things I mentioned. And so I think what you're pointing
out here is that if taxis were accessible, dollars spent on
paratransit, ambulettes, and other things would be reduced.
Ms. Bristo. Yes. I believe that's the case. I know that's
one of the things that we've been working on in Chicago, as I
mentioned, trying to get users who can use cabs out of
paratransit into cabs. Also, there's a lot of people who have
incomes who would gladly pay a cab fare rather than wait the
long waits that you have to for paratransit if they could. But
if they have to wait just as long to get a private cab to come
pick them up, there's no incentive.
I do think that the issue of cost is an issue that's worth
having more conversation about. I do believe, for example, if
you build something from the ground up, over time, the costs of
doing so are much less than if you're trying to convert
something. I don't know the difference in the cost between this
and a converted vehicle. But I also think if demand takes over,
competition will drive those costs down. And also, there could
be ways that we could incentivize the acquisition of accessible
vehicles.
In Chicago, the city contributed funding at the beginning
to incentivize the cab companies to purchase accessible cabs.
Why couldn't we take some of the public funding that we're now
putting into other types of transportation and find incentives
for the private system to make more of their fleet accessible?
The Chairman. Ms. Houghton, you said something that caught
my attention--that from the business standpoint, you can't
retain, train, promote, et cetera, people with disabilities
because of transportation problems. You talked about
telecommuting and online--I understand all that. But I guess
what I wanted to point out--I've just met recently with the
Secretary of Defense, being on Defense Appropriations, and we
have a lot of GIs, veterans now, with some pretty severe
disabilities.
Because of the advances in medicine and our rapidity with
which we can go in and get injured soldiers out, get them to
Ramstein, and get them here within 24 hours, we're saving a lot
more lives than we would have, let's say, in Vietnam or some
place like that. But some of these are really pretty badly
banged up. I mean, they have some pretty severe disabilities.
They're going to have mobility problems.
At the same time, we have just passed a bill in Congress,
the Vow to Hire Veterans bill, to give more tax credits to
businesses to hire veterans and a bigger tax credit if you hire
a veteran with a disability. I'm all for that. But they're
still going to have mobility problems.
You mentioned that we're having an aging population, aging
baby boomers. We have a whole new cohort of veterans coming
through that have disabilities, and they're going to need
transportation. And on the one hand, we're saying to businesses
hire more, but I think you pointed out the problem. You can
hire more, but how are they going to get to work? How are they
going to get the mobility?
I think that's another thing that we're going to have to
factor in and think about in terms of--not only with the aging
baby boomers, but those individuals that are young, and they're
going to need to be upwardly mobile to get promoted and that
kind of thing. So that's a whole other aspect where we're sort
of telling the business community to do one thing, but they're
going to have a problem doing it, unless we make sure that they
have the transportation systems in place.
Ms. Bristo. Senator Harkin, I wanted to expand upon what
you're saying in that regard. I'm an employer as well as an
advocate and employ quite a few people with disabilities. And I
would say for the folks with mobility impairments, the single
greatest accommodation that we have to offer is flexibility in
their arrival times, completely driven by transits.
They're perfectly capable to do the job. They're perfectly
capable to get to work. But all these problems we've talked
about often mean that they show up later than they'd like to
for reasons that have--through no fault of their own.
The Chairman. Good point.
Ms. Bristo. So I think it's extremely important to
underscore what the challenges are. But I want to make sure
that we're also going on the record talking about--the talents
and the skills that people have to offer in the workplace are
themselves an untapped resource, and we don't want transit to
be a limit to it. But in the meantime, we want employers to
make accommodations for those employees so that they can be
there when these kinds of provisions are causing them to
perhaps show up late when they don't want to.
The Chairman. Ms. Houghton.
Ms. Houghton. Chairman Harkin, I think that Marca raises a
really good point. Many of our members have created flexible
work schedules so that people can start at different times and
end at different times, as well as, like we talked about,
creating telecommuting opportunities. In fact, we even had a
member company in Florida located next to a very large Navy
base that has created alternate work environments that are
closer to where individuals, in fact, live to try to make it
easier and more accessible for their employees to come to work.
So, absolutely, these returning veterans with disabilities
are definitely on our members' radar screen, and we want to
work together to find creative opportunities and not let the
lack of access to accessible transportation be the reason why
we're unable to recruit and hire these returning veterans, and
at the same time work together to create solutions to this
access to accessible transportation issue so that we can hire
more people.
Mr. Capozzi. I'd just like to add about the notion of--I
think your comment about veterans was very appropriate, and it
reminds me of when I worked at Paralyzed Veterans of America.
The veteran population returning from World War II really
started to drive accessibility. There wasn't an accessibility
movement before returning veterans from World War II. They had
high expectations. They were independent people before they
went to war, and they wanted to be independent citizens when
they returned home as well.
I think today's veterans have those same expectations and
probably higher expectations to be fully participating members
of society. More veterans today are still on active duty even
with a disability. That didn't happen years ago. So
expectations have changed as well.
The Chairman. Mr. Capozzi, just getting back to you again,
you're a professional. You travel a lot. I'm sure you've been
to New York City a few times in your life. Have you had any
taxi experiences there or other places that you--what do you do
when you get there?
Mr. Capozzi. I've actually had some pretty horrendous
experiences with the taxis. One time I was in New York--I don't
remember if it was in an EPVA conference or not. It was in the
wintertime--trying to hail a cab--couldn't get it, couldn't get
a taxi.
Finally, these people in a bar saw me trying to get a taxi
in the snow storm. It was a driving snow storm. And they came
out of the bar, grabbed a taxi, and in the middle of doing
that--they tried to help me get off the curb and into the taxi.
It was a totally inaccessible taxi, by the way. And in the
process of doing this in a snow storm, I fell in the middle of
the street, broke my nose--luggage everywhere. It wasn't a
great experience. I don't have very good experiences in New
York.
But I can say that in Boston, whenever I travel to Boston
and get off the airplane and ask for a cab, the people that are
organizing the cabs at the airport will generally get an
accessible taxi within a matter of minutes. That's, I think, a
good success story. I don't know about hailing a taxi downtown
in Boston. I don't think I'd have very good luck there. But at
the airport, you wait just a few minutes to get an accessible
taxi.
The Chairman. That's encouraging.
Marca.
Ms. Bristo. It's a joke in the disability community that if
you're in a wheelchair and you're trying to hail a regular cab,
we hide. We get our friends to go--we hide behind a tree or a
bush. I'm not kidding. Andy can attest to this. I wonder how
Mayor Bloomberg would feel about having to hide to get a cab.
So that's one thing.
I also wanted to come back to the issue of the cost-
effectiveness of this approach to moving to a more universal
design. We're bleeding money in healthcare. The cost of
transporting people for healthcare purposes is extraordinarily
high. For people on dialysis, for example, they're not only
paying that $60 paratransit. They're paying the Medivan fee,
which is much higher than that.
In Chicago, recognizing that, we've started a program where
people get a different kind of card if they're low income and
they have medical needs, and those cabs can be used for people
to go to and from dialysis. And I will also say here--another
cab story for you. DC has amongst, in my opinion, the hardest
time hailing cabs. I'm happy to see the new accessible cabs
here. But the design features that they've used in that cab--in
the new cabs here are really dangerous. I don't use them that
frequently.
But three times, they didn't tie me down properly, because
it's so clumsy for the drivers to do it. And my chair has
flipped backward and I've hit the back of my head three times,
you know. There's something wrong with the way these cabs are
being designed.
There's also no central dispatch, so you have three
jurisdictions--not enough cabs in any of them. You should
consider a central dispatch and allow the accessible cab
drivers not to face the penalties of picking up people in DC if
they're a Virginia cab. They should be given a waiver so that
all the cabs in this area can be deployed for people with
disabilities.
The Chairman. Help me out, all of you. When we passed the
ADA, we gave lengths of time for certain accessibilities and
accommodations, building designs, transit designs, things like
this, which take some time. We know you can't do all the old
stuff. But if you're going to do something new, make it
accessible.
Every building being built in America today is fully
accessible. We didn't go back and say you've got to redo every
building built in the 19th century. We understood you couldn't
do that.
So here we are--taxicab fleets and stuff change over. I
mean, why can't we just say, ``OK, all new taxis'' in
Washington, DC--if you want to get a taxi permit, they've got
to be accessible. You can't get a taxi permit, and if you have
one, and you want to get it renewed, and you're getting a new
taxi, it has to be accessible, period.'' Why can't we do
something like that?
Ms. Bristo. You can.
[Laughter.]
It would take an act of Congress.
The Chairman. I don't know that we could do that in a local
jurisdiction. We might be able to do it in DC because of DC
being sort of the last plantation, I guess, of the Federal
Government. But I don't know if we could do it in other cities.
I'm not certain we would have that jurisdiction. I'm not
certain. I'd have to think about that. I don't know. I'd have
to ask the experts back here.
But you're saying to me that we could do other things. We
could provide some tax credits. If you have a taxi, and you've
got to get a new one, and the new one costs a little bit more
than the one that's--OK, maybe we'll give a tax credit and spur
that changeover so that as we move ahead, every new cab is
accessible, no matter where you are. I mean, I don't know why
we can't do that. We did that for other things in ADA, but we
didn't do it in taxicabs.
My staff just said it's likely that the paratransit savings
to New York City would be greater than the cost difference for
an accessible cab in just 1 year if they had one ride per day
transporting one person with a disability. One person, one ride
per day--that the paratransit savings would be greater than
that cost difference in just 1 year. So there you go.
I'm sorry. Mr. Altom, you were going to say something. I
kind of interfered.
Mr. Altom. That's perfectly fine. Thank you. Another quick
cab anecdote here in DC, where I've kind of seen--it's a little
bit of the drivers who have the hesitancy to pick someone up.
The other day I called and got a cab to come. So as I come
outside and I see the cab driver, immediately, I see his
expression change--oh, God, here comes a guy in a chair.
So I get in the back of the cab, and I'm taking my chair
apart and I hand it to him. As he walks around, he's still
grumbling, and he picks it up, and I could tell immediately, as
soon as he touched the chair, it was like, uh-oh. So he got in.
As soon as he sits down, I go,
``Wheelchair technology has come a long way, hasn't
it, buddy, since the last time you picked a chair up,
because you expected that to weigh 800 pounds, and it
weighs about 15 or 20.''
And I said,
``So how many times have you passed up one of my
brothers and sisters on the street because you thought
that it was going to break your back to put it in the
back of your vehicle?''
And he goes, ``All the time.'' And I went, ``Well, stop
that,'' and I said, ``because let me tell you one other thing
about people with disabilities.'' And I said,
``Most of my brothers and sisters are incredibly
smart people. We would never hail you down if we didn't
think we could get in and out of this vehicle. So stop
having this mind set of, oh, I'm not going to pick them
up for whatever reason, but mainly because you think
it's going to be too difficult for you to do this.''
Because most of the time, like this morning--in fact, I got
a cab this morning, and I put my chair inside the cab. I took
it apart and had it in the cab before the guy even got out. And
he's like, ``Holy cow. What's happening here? ''
So a lot of times, it's the drivers who have such a
misconception about a person's abilities whenever they get
there. And I know most of the folks that I know that have a
disability would never try to hail a cab if they didn't think
that they could make this happen.
The Chairman. Sure.
Mr. Altom. And one other point on the veterans that I--I
want to brag on one of my member center organizations, the
Center for Independent Living in western Wisconsin, who just
got in partnership with the Eau Claire County Aging and
Disability Resource Center and was awarded one of the first
Federal Veterans Transportation Community Living Initiative
grants for the next 5 years to provide transportation for our
veterans who are back.
The Chairman. Where is that?
Mr. Altom. The Center for Independent Living in western
Wisconsin? It's in Menomonie. Mr. Tim Sheehan is the director
of that center. So it's an awesome program. They were the only
center in the United States that got funding. There were a lot
of other organizations that got funding, but the only Center
for Independent Living that was funded.
The Chairman. Marca.
Ms. Bristo. A lot of my comments today have been focused on
my own experience and, therefore, it's been biased a little on
the physical disability side. Transportation issues for people
who have other disabilities are equally challenging. A
colleague of ours was telling us just the other day that they
were traveling with a child with autism, and they were in the
airport, and their child had an outburst and started crying and
was just a little bit out of control. And the father took the
child off to calm them down.
In the meantime, the mother and the other child got on the
plane. And when the father came to get on the plane, they
wouldn't let him board. They said, ``Your child was too
disruptive.'' And then they wouldn't let the mother get off the
plane. So the mother took off, not even knowing what occurred
with her child until she landed and was able to find her
spouse.
But these kinds of things, whether it's people who are
blind trying to hail a cab with a seeing-eye dog--and even
though the law says you've got to let the dog in, still a lot
of cab drivers will say, ``I don't want them in my cab because
they're going to mess up my upholstery.'' And it's so funny to
us how many things apply to us and not to others. How about all
those big suitcases that people throw in the back seat that
might scuff up your upholstery?
There's still a lot of bias and prejudice. And comments
like those that the mayor made in New York don't help.
The Chairman. No, they don't.
Ms. Bristo. They don't help.
The Chairman. They sure don't. I've focused a lot this
morning on taxicabs, because that's one area where we just
haven't made any progress at all, except for a few, where you
have to call them up and wait for them. And yet more and more
people are relying upon taxis. And we see how much money we're
spending on paratransit, for example, in New York City--$500
million a year.
It just seems to me it's sort of one of the last frontiers
in transportation where there's blatant discrimination and sort
of the attitudes that somehow you can't hail a cab. Why can't
you--I mean, I was in London this summer. The cabs are
comfortable--good head room, a lot of room in them, totally
accessible. They've been doing it, you said, since 1989. I
didn't even know that. I thought this was recent or something,
but they've beat us at it.
And you say that you've been in other countries, Seoul and
other places, where they're actually having better mobility
than what we have here. That's shameful. That's shameful. But
this attitude that it can be optional--that's got to change.
It's just got to change.
I'm sorry, David. Go ahead.
Mr. Capozzi. I just wanted to add two points. One is I
think we could benefit from better data and better information.
There is no central place to find out information about what
cities have accessible taxis. That doesn't exist.
Second, I wanted to followup on Marca's point about other
people with disabilities and the challenges that they face and
just take two examples within our own Metro system here in
Washington, DC. If you're traveling on the Metro, and you are
wanting to see when the next train is coming, there's a little
sign board that indicates when the next train is coming. It's
visual only. So if you're blind or visually impaired, you don't
have that same information.
When you're on the train, they'll tell you what the next
stop is and what the line is to make sure that you're on the
right train. It's audible only.
The Chairman. Right.
Mr. Capozzi. So if you're hearing impaired, you're not
getting that information. And if you have residual hearing, you
could benefit from having a loop in the train, but those don't
exist, you know, in most transit vehicles in this country.
The Chairman. And the cost of doing that is so minimal.
Mr. Capozzi. It is. Yes.
The Chairman. So minimal to do things like that. By the
way, I just wanted to say that my staff had acquired some data
on taxis--I won't read them all--for some of the major cities.
New York City, approximately 13,000 taxis, 231 wheelchair
accessible--we've already talked about that--Chicago, 6,951
taxis, 92 accessible; Washington, DC--are you ready for this
one--5,700 taxis, 20 are accessible.
There's some other ones here--Los Angeles, 2,300 taxis, 222
accessible; Houston, 2,245, 200 accessible; Miami, 2,100 taxis,
80 are accessible; Boston, 1,825 taxis, 78 accessible--must all
be at the airport, David.
[Laughter.]
Wow. Philadelphia, 1,600 taxis, zero accessible. Now, I've
got in parentheses 50 expected. I don't know what that means.
What's that mean, 50--oh, the advocates are working on getting
50. San Francisco, 1,500 taxis, 140 accessible; Seattle, 900
taxis, 45 accessible; Portland, 382 taxis, 38 accessible.
That's shameful. That's just some of the major cities. I don't
even have Des Moines on there. But you can imagine what that's
like, and other cities.
I guess that's why I've focused so much on taxis, because
it's an opportune time with what New York is doing, and it's so
big. They're sort of the behemoth when it comes to number of
taxis, and they're making this changeover, and they've dubbed
it the taxi of tomorrow. The taxi of tomorrow has got to be
accessible. That's the taxi of yesterday, not the taxi of
tomorrow.
This just gives us an opportune time, and, as I said in my
remarks, I'm hopeful that Mayor Bloomberg will get a better
understanding of this. And I hope that, maybe not him, but his
staff and others around him will pay attention to this hearing
and some of the things that you've brought forward to get a
better idea of what it means.
And, quite frankly, I think from some of the savings they
would accrue on paratransit--I would not be so unreasonable as
to say, ``Well, they've got to go back and do every old one.''
You can't do that, but every new one ought to be fully
accessible in New York.
I've focused a lot on that today, because I think it's one
area where we've waited too long and we haven't made enough
progress. You've pointed out we need to do something about
regulations on the air transportation. I think we ought to have
a hearing on that and get the regulators up here.
I want to get the right people up here. I'll let my staff
find the right people to come up here and start talking about
some of these regulations in both that and the Surface
Transportation Act. And you could be helpful if you've got more
information that you want us to get from these people and what
we need to do to change these regulations.
Did I cut somebody off again? Did I cut you off, Marca? No,
I was still on the taxis.
Have you ever taken those taxis in London?
Mr. Capozzi. I haven't, but I've taken one in Singapore
that was a London taxi, and it was independently usable.
The Chairman. When I looked at them this summer, I think
that there are some people who probably could not--I think the
slope is a little too steep on that ramp. And you really have
to be pretty strong or have a power chair--a power chair could
do it. But if you didn't have a power chair, it would be pretty
tough, I think.
Ms. Bristo. I've used the London cabs quite a bit, and they
worked OK for my chair as long as I had assistance getting in.
There were no tie-down devices. For some people that's a
problem. For people who had either larger chairs or taller
chairs, there would be a lot of difficulty using them. So
they're universally accessible to some people with disabilities
but not to everybody.
That's why when the MV-1 people came to Chicago originally
thinking that they were going to bring the London cab, the
disability community through Access Living weren't too hot on
the idea and urged them to go back to the drawing board, and I
was very, very happy to see that they did. And, to me, that
underscores a final point that I just want to make--which is,
how important it is for the voice of people with disabilities
to be in the transit industry.
A lot of the things we've done in Chicago we've done
because we've gotten people on the board of the Chicago Transit
Authority. We have a person on the Pace board. And it's
extremely important that, as you're looking at budget cuts as
we go forward, the programs that support people with
disabilities and give us our voice--please keep them strong.
The P&A system, the independent living network, the parent
training centers--we understand these are discretionary
programs that could get cut. But they are the vigilant
overseers that have held accountable all the different systems,
that have made the rights that you've worked so hard to get on
paper a reality in our lives.
The Chairman. Thank you for that.
As you said, Mr. Altom, the phrase you all use is ``nothing
about us, without us.'' And that is absolutely true. It's
absolutely true.
Does anybody have anything else they want to bring out that
I didn't ask or you didn't bring out that you wanted to point
out before we close down the hearing?
Ms. Houghton, anything else at all?
Ms. Houghton. I would just thank you again for the
opportunity to highlight this issue.
The Chairman. Thanks for being here and bringing this
perspective.
Mr. Altom, thank you for all your----
Mr. Altom. Thank you very much for having me here.
The Chairman [continuing]. For rural transportation.
Marca, thank you again for everything.
Ms. Bristo. Just to you, personally, for being our
champion, not just on this, but on everything.
The Chairman. You're sure welcome.
Ms. Bristo. You mean so much to us.
The Chairman. But we need your help to get this taxicab
thing. I appreciate that very much.
Mr. Capozzi. Thank you for your leadership.
The Chairman. Mr. Capozzi, thank you again for your service
for so many years.
And thank you all. We'll keep the record open for 10 days
for any statements or insertions by other Senators. That's 10
business days because we have the holiday coming up. So it'll
be open for 10 business days. And I look forward to working
with you as we proceed on making transportation more
universally accessible.
Thank you all very much for being here. I appreciate it.
By the way, if any of you want to see this, it's right down
on the corner. If you take these elevators right out here to
the right and go down to--what floor is it--G, it's right
outside the door. You can take a look at it.
[Additional materials follow.]
ADDITIONAL MATERIAL
Prepared Statement of The Community Transportation Association
of America (CTAA)
On behalf of the Community Transportation Association of America
and it's over 4,000 members I want to express my appreciation for your
decision to hold this hearing.
Today's testimony allows us to provide information and ideas about
the state of accessibility in the Nation's important surface
transportation systems. It also gives us an opportunity to discuss the
equipment used to deploy various mobility options and the people who
provide these services across America every single day.
Mobility services in the United States are as diverse as the
physical landscape that makes our country unique. Some communities in
our country have vast mobility resources that include a full range of
surface mobility options from subways to taxi cabs. Others have a
smaller range of options that can range from a weekly van service for
seniors to one taxicab. Despite the range and type of services that
exist they are all linked by one common element, ``need.'' All
Americans need mobility to function in our society and there are ways
we address that need both as individuals or groups of individuals. For
many Americans that need is fulfilled by owning their own vehicle
usually a car or a truck. There are other ways we achieve that mobility
without individual car ownership and that comes from using public
transit, the services of not-for-profit non-governmental organizations,
taxicabs, car sharing efforts, volunteer transportation efforts, ferry
boats, bicycles, and of course by walking.
My testimony today concentrates on three important issues within
this mobility community. These include our views on the status of
accessibility within the Nation's taxi-based transportation system, the
continuing crisis for accessible and often person-centered
transportation in our growing outpatient health care system, and the
continuing ways we can help coordinate our efforts not just between
government agencies but between those who provide transportation to
make more of that system accessible and affordable for the American
people. Let me begin my testimony by discussing America's taxi
industry.
America's Taxi Systems and their role in our mobility systems: We
want to see a taxi industry that is accessible, affordable, and
environmentally sensitive. And we want to see this industry fully
coordinated in partnership with all forms of surface mobility
especially public and community transportation. There are many comments
we could make about our country's taxi industry, but like the diverse
landscape that makes up our country, a similar diversity is present
across the taxi industry as well. In looking at the industry we think
that there are some ``fundamentals'' that are important to remember and
keep in mind the outset.
These fundamental points include:
American communities need a flexible network of mobility
services since no one service can meet the diverse service needs of all
Americans. This mobility network is made up of various delivery
components ranging from ambulances, through private automobiles to
taxis, vans, buses, bicycles and walking. Taxicabs are vital to this
network.
Taxicabs have long been part of the American mobility
experience and have their origin in horse drawn vehicles prior to the
discovery of the internal combustion engine.
Unlike many of the other forms of our surface mobility
network the taxi industry is still predominantly a ``for profit'' form
of transportation unlike its public or community transit partners who
are usually public agencies or non-profit corporations. Taxis do not
usually receive financial support from Federal, State, or local
governments.
Taxi companies, especially those in smaller communities,
are usually made up of independent small business cab owners or lessors
often working under a ``brokerage'' arrangement. Because of that
arrangement ``ownership'' in the taxi business has created numerous
business and employment opportunities for minority and immigrant-based
small businesses.
The Future of the Taxi Side of the Mobility Market: Like all
American businesses related to the transportation industry the taxi
business and market has changed a great deal over the last several
decades. In recent times, the harsh economic climate--the high price of
financing coupled with the high price of fuel--have created numerous
difficulties and dislocations in the industry. The increased ownership
of private automobiles and changing patterns of movement from cities to
suburban areas have created other negative financial changes affecting
the size and operation of taxicab companies. We believe that there will
be more change in the industry beyond the current economic difficulties
that have bearing on its future. These will include:
The Role of Health Care and Individualized Mobility Needs:
Regardless of the final implementation of the Affordable Care Act there
is a continuing commitment to enhance ``outpatient'' medical treatment
across all health care institutions and those who pay for them. Many
forms of treatment that were previously ``hospital''-based are done in
freestanding day facilities, or other treatment centers that are
specifically designed to avoid hospitalization at all costs. For those
actually needing in-patient hospitalization time, as an inpatient has
been consistently lowered over the last decade. This dynamic creates
the need for personalized transportation services especially when
returning from medical facilities. Since many people leave these
medical settings in less than perfect health using a bus or driving
oneself is often impossible. As our society ages, the number of people
finding themselves in need of this level of service can only increase.
For some services like those related to kidney dialysis this
transportation need is already acute. I will discuss that impact in
more detail during my testimony.
Technological Impact: Right now we're seeing a dramatic
switch within the taxi industry to smaller and more fuel-efficient
vehicles being configured as taxicabs. There is a growing popularity of
specific vehicle brands like the ``Prius'' in the taxi business with
its dramatic engine efficiency and low operating costs. These lower
cost vehicles help operators keep the growth of expenses down
especially in the areas associated with high fuel prices. These smaller
vehicles also produce extremely small environmental footprints, adding
to their desirability. In addition to technology centered on engines
and fuel systems the rise of technology that creates the ``fastest and
most efficient'' routes of service based on GPS technology will grow in
the industry. This technology will impact taxi costs and operations by
allowing a higher volume of utilization benefiting the volume service
that makes taxis profitable.
A Continuing Urbanization: Trends in the current census
data illustrate a return to more traditional urbanized area with many
of those living in these areas choosing not to own or maintain their
own personally owned vehicles. Even where there is good public transit
there will still be a need for the personalized services that only
taxis can provide since besides medical transportation there will be a
need for the flexibility and timing that make taxis popular.
The Challenge to Achieving Accessibility: First and foremost our
Association has always supported full accessibility in the
transportation industry both public and private. Our support precedes
the passage of the American's with Disabilities Act. In support of this
accessibility commitment we've provided a host of technical assistance
services to help small transit agency's to develop and implement full
accessibility services. We developed and provided to hundreds of
communities the PASS Driver education program, which trains those who
provide transportation in the best possible methods of providing that
service for people with disabilities. Using the resources of our
certified development financial institution, the Community Development
Transportation Lending Services Corporation, we've loaned both private
and public sector transportation providers financing to improve and
expand their own commitments to full accessibility.
We believe that the greatest barrier to the taxi industry's growth
and development is the need to become fully accessible to meet the
transportation needs of all Americans especially those with
disabilities. This is critical since we see many opportunities for the
taxi industry in the health care area where accessibility demand will
become more important in the years ahead. Within this challenge there
are two kinds of issues preventing the implementation of fully
accessible taxicab systems in our country. The first of these barriers
is a technological one, while the second is one of financing.
Technology: There is currently a challenge created by the inability
to match vehicles accessibility in the industry and while maintaining a
cost structure that will continue to allow the taxi industry to remain
affordable. As I mentioned previously in my testimony smaller vehicles
similar to the ``Prius'' offer low operating costs that help maintain
affordable costs for taxi operations. Recent strides in accessibility
like the recently developed MV-1 or a version of the ``London Taxi''
offer full accessibility but with much higher vehicle operating costs.
What is needed for the industry is the ability to pull the full
accessibility of the MV-1 and the operational costs of the ``Prius''
like vehicles into one ``universal taxi'' for the American market. We
believe that such a vehicle is possible and it is a way to move more of
the taxi portion of the American mobility market to both accessibility
and maintain it's operational affordability. We propose that the
committee consider looking at the development of this ``universal
taxi'' using the same approach that the Environmental Protection Agency
(EPA) developed its SMARTWAY technology in the trucking industry. In
that effort, the EPA developed the necessary technology to achieve
higher efficiency in diesel engines while reducing emissions. This
technology was then licensed to the private sector and has become
available in the market place. We believe there are other such vehicle
developments that have been worked on in the bus industry by the
Department of Transportation where government helps with the research
that then can be incorporated in bus design. We need the same vision
for the creation of a ``universal taxi.''
Putting a Universal Taxi into the Mobility Market Place: Because
the majority of the taxi industry is in the private sector and made up
of many small operators it is necessary to consider how once such a
vehicle is developed it can be placed into general operation. We again
turn to an example developed with the Environmental Protection Agency
in which we were a participant. We believe making SMARTWAY technology
available to owner operators in the trucking industry is similar to the
way such technology can be made available in the taxi industry. The
independent owner operator in the trucking industry faces a significant
barrier to adopting new equipment because of the high price for
financing that many of these smaller businesses find in the current
financial markets. Conventional financing is often difficult to obtain
and the financial history of the industry in the last several years has
negatively affected the credit ratings of many independent operators.
It is not unusual to find some borrowers paying well over 20 percent
interest for operating let alone capital costs. Such high interest
prevents even good sense and cost-efficient technology from entering
the market place. Blending funds from the EPA with private sector
financing our subsidiary financing operation, the Community Development
Transportation Lending Services Inc., a Certified Development Financial
Institution of the U.S. Treasury's CDFI Program dramatically leveraged
lower financing rates in the trucking industry. In some cases we were
able to finance newer trucks fully equipped with improved environmental
equipment for as low as 4 percent. Considering the previously high
rates being paid for financing, this created the kind of incentive that
we feel would be needed within the taxi industry. Lower rates could be
the key to rapid adoption of a ``universal taxi'' once it is developed.
Such financing help would also allow individual small ownership to
remain an integral part of the taxi industry and help provide the
platforms we'll need in a more health-orientated market place.
Until Universal Design Becomes a Reality: Even as we look toward
the development of a new ``universal taxi'' there are still things we
can and must do to promote accessibility with the tools currently
available to us. For the last several months we've been engaged in a
financing demonstration of a new taxi company in the mid-west that
combines low-cost ``Prius'' taxis and the MV-1 as part of a fleet that
provide partial accessibility, one-third of the taxi fleet. By
supporting low-cost capital for this project we hope to measure the
full impact of higher operating costs of more expensive equipment
balanced against lower operating cost units. It is our hope to maintain
a mixed but affordable platform until the development of the
``universal taxi'' we have proposed.
We intend to report on this outcome of this effort to the committee
at some future time once we have more financial and operating
experience in this project. It is our hope that success in this project
will lead to a broader demonstration focusing on a higher percentage of
fully accessible vehicles at different locations across the country. We
still believe that lower cost financing can be leveraged to add
accessibility.
An Underlying Crisis in Health Care Connectivity: Earlier in my
testimony I spoke about the need for additional platforms for the
delivery of medical transportation that may become the most important
markets for taxi-based service operations. A significant part of our
thinking is focused on the continued utilization of outpatient medical
treatment for many kinds of illnesses that were once done as inpatient
procedures. The committee know well of this expansion in terms of not
just publicly supported health care but in the private insurance market
as well. Looking at today's situation we believe that one current form
of medical transportation that is a ``preview'' of the way this growing
outpatient service approach creates challenges for mobility can be
found in the issue of dialysis transportation. At this time I would
like the committee to hear from Scott Bogren, associate director of our
association who has extensively reviewed this issue.
______
Thank you Mr. Chairman, I am Scott Bogren, associate director of
the Community Transportation Association of America and I recently
reviewed the status of Dialysis Transportation and its impact on not
just patients but on the transportation providers who make these
services possible. It is both a rural and urban issue and one that
lends itself to, as Mr. Marsico referred to in his testimony, the need
for not just additional service platforms but for improved
coordination--something we will also address in this testimony.
The Dialysis Report, When: Transportation Demand Outstrips Supply:
Everyday, thousands of Americans who need regular kidney dialysis board
a community or public transit vehicle to access this life-sustaining
care. The trips these patients take are time-consuming--they often last
more than 4 hours in duration--and essential, as they absolutely must
be made, regardless of the weather or any other circumstances. Dialysis
trips also are changing the nature of public transit in many
communities. The role of providing transportation for dialysis
treatment has long been an area of challenge--as well as
accomplishment--for community, public and human services
transportation. Early outpatient dialysis treatment created significant
needs for demand-responsive transportation services in communities of
all sizes. Since, initially, many of the clinics providing dialysis
were located in urban areas, transportation in rural communities took
on greater importance for patients and their families. In the ensuing
years, the growth in the overall number of dialysis patients brought
increased needs for responsive mobility services in urban and suburban
areas, too.
The regular and consistent need for dialysis treatment requires
similar consistency in transportation access. Paratransit services,
rural public transit, human service networks and volunteer programs not
only provided many of these life-sustaining trips, but also raised
funds to support them. Although public funding helped with purchasing
equipment or even operating costs, many programs needed to raise local
funds to meet various match requirements or to meet the needs of
individuals that didn't fit into some categorical program or individual
eligibility requirement. In one of the greatest and often undisclosed
success stories, these transportation providers and networks made
dialysis treatment possible for millions of Americans--and changed many
people's lives. Over the last 30 years, dialysis transportation
services have made it possible for patients to stay in their homes and
in their communities, thus greatly lowering the overall cost of
providing the treatment. And although these efforts stretched the
resources and ingenuity of the Nation's transportation services--the
need for dialysis transportation was met day-in and day-out across the
Nation.
The significant growth of dialysis treatment--as is detailed later
in this report--makes daunting the prospect of continuing to meet the
demand under the current structure. It seems that one of our Nation's
greatest medical challenges is equally a test of our transportation
system. Across the Nation those who created the current dialysis
mobility solutions are faced with dramatic increases in demand as the
number of dialysis patients and the number of clinics--which often work
on a 24-hour basis to serve more patients--require both additional
resources and tools. Because there are many patients needing evening
services and since many patients experience difficulties with
treatment, there are now needs for more individualized dialysis
transportation service strategies that are more expensive to provide.
For community and public transit operators, these trips are a mounting
challenge. Demand for dialysis transportation, according to every
transit manager interviewed for this article, is skyrocketing at the
same time payment mechanisms dwindle. Trips distances have grown even
as available dialysis center chairs are expanded locally to keep up
with the number of patients. What is needed today, clearly, are new
solutions, new partnerships and new thinking. ``We've reached the
tipping point,'' says Santo Grande, executive director of Delmarva
Community Transit, headquartered in Maryland's rural Eastern Shore.
``We just don't have the resources to meet the need--vehicles, drivers
and money.''
The Dialysis Transportation Task: Dialysis is a process by which
excess waste and water are removed from the blood of patients whose
natural kidney filtration system is no longer effectively functioning.
Typically, individuals on dialysis have moved from one of the first
four stages of chronic kidney disease and into what is known as end-
stage renal disease (ESRD). Physicians and researchers agree that once
an individual is diagnosed with chronic kidney disease, they will
eventually require either dialysis or a kidney transplant--the end
stage for the disease. Dialysis treatment frequencies and the duration
of individual sessions are largely dependent upon the patient. That
said, for more than 40 years the generally accepted standard of care
for ESRD patients has been dialysis treatments thrice weekly, each at
around 4 hours in duration. More recently, several studies have
suggested that increased frequency in shorter duration treatments--six
times a week for 2\1/2\ hours--increased overall health and quality of
life in patients. Needless to say, the mobility ramifications of this
potential treatment schedule change are frightening as it would
effectively double the current, necessary transportation service, a
service that many community and public transit systems already find
daunting. ``We're struggling to meet growing demand already,'' says Jim
Wood of Kennebec Valley Community Action in Waterville, ME. ``Doubling
the service would be frightening.'' To undergo dialysis treatment,
patients typically sit at reclining chairs with tubes leading from
themselves into humming dialysis machines. Though life sustaining, the
process often wears out patients and leaves them susceptible to a
number of side effects such as nausea, infection, bleeding and more. In
fact, this bleeding--due to a patient's inability to clot--was cited
time and again in the preparation of this article as a chronic
challenge with dialysis patients on community and public transit
vehicles. In some cases, dialysis patients may be able to board a
fixed-route community or public transit bus to get to their scheduled
service. But the return trip, after the debilitating process, must be
made on a demand-response service. ``In all honesty, the ability to use
fixed-route transit for dialysis is limited,'' says United We Ride
Region 3 Ambassador Rex Knowlton, who managed dialysis transportation
service in Philadelphia for more than two decades. The regimentation of
dialysis treatments creates additional health care and transportation
costs, too. Typically, patients on a Monday-Wednesday-Friday schedule
are more likely to be private-paid, particularly those receiving their
dialysis in the middle of the day. Conversely, Tuesday-Thursday-
Saturday patients and those early morning and later night clients are
more likely to be Medicare patients. These are also the dialysis
patients more likely to be dependent upon community and public
transportation--in the most difficult and costly to serve time slots.
``The cost of off-peak and Saturday treatments is much more than an
incremental cost increase to transit,'' says Knowlton. ``It's a
significant increase.''
ESRD By the Numbers: Today, the National Kidney Foundation reports
that 26 million Americans suffer from Chronic Kidney Disease--a more
than 20 percent increase since 1994--with millions more at increased
risk due to the increasing prevalence of such health risk factors as
diabetes and high blood pressure. This figure represents approximately
13 percent of the adult population of the United States. Though
smaller, the statistics are no less daunting for end-stage renal
disease. More than half a million Americans are currently suffering
from ESRD, the vast majority of whom require dialysis treatments to
stay alive. Growth rates of ESRD are staggering. In 1980, 60,000
patients received treatment for the disease; 571,000 received the same
treatment in 2009, a growth of 900 percent in 30 years. The rate of
ESRD incidence is 355 per million population; the rate of prevalence of
ESRD per million is 1,738. In 1980, 19,000 Americans began treatment
for ESRD, as compared to 116,000 in 2009. The rise in ESRD incidence
has, not surprisingly, led to a significant rise in health care
expenses associated with the disease and its treatment. Total Medicare
ESRD expenses for 2009 came to $42.5 billion--or $82,285 per person per
year for hemodialysis patients. Just over 1 percent of Medicare
patients have end-stage renal disease, yet these same patients account
for more than 8 percent of total Medicare spending. The dialysis
transportation challenge is so great that major changes in public
policy must occur to enable this mobility link to continue. First the
time has come to extend reimbursement for this vital health support
service. Second there must be increased communication between those
providing dialysis treatment and transportation.
Who really pays? The crux of the transportation challenge is that
the majority of dialysis patients are covered by Medicare, which--
unlike Medicaid--does not offer non-emergency transportation as a
benefit. Three out of four dialysis patients in our country are
Medicare primary, meaning that Medicare sets the reimbursement rate and
pays 80 percent of that amount. Reimbursements include one rate for
routine dialysis services and another for dialysis medications. This
leaves 20 percent of the typical dialysis charges to be paid by a
secondary insurer. For roughly half of the Medicare primary dialysis
patients, the secondary insurer is Medicaid, thus creating the so-
called dual eligibles. How much of that 20 percent that Medicaid covers
depends upon the State.
Recent studies indicate that only 1 in 10 dialysis patients are
Medicaid primary, in which case Medicaid pays between 80 percent and
100 percent, depending on the State and its Medicaid plan. Finally, 10
percent of dialysis patients are covered through some form of private
insurance. Clearly, demographics and health care treatment trends are
creating the steady growth of people needing dialysis transportation.
At the same time, fewer dialysis patients have the ability to pay for
the life-sustaining trips, which is taxing the ability of community and
public transportation providers to respond--particularly given the
current constrained fiscal environment at Federal, State and local
levels. ``Twenty-five years ago when we first launched this service, it
seemed to us that 90 percent of the dialysis patients we encountered
were on Medicaid,'' says Grande. ``Today that equation has flipped, and
90 percent are on Medicare, which is why we're hurting. I know it's
happened, but I don't know why.'' Bill McDonald, executive director of
Medical Motors in Rochester, NY, has seen the same transition: ``We
hardly do any Medicaid dialysis anymore, so our focus is on the
patients who aren't Medicaid eligible and who still very much need that
ride.''
The Transit Perspective: ``The first thing you have to remember is
that without the trip, these passengers won't live,'' says Ann August
of the Santee Wateree RTA in South Carolina. ``So when we receive a
call requesting this type of service, we understand the ramifications
and don't want to say no.'' Indeed, in background discussions with
community and public transit officials around the country for this
article, a common refrain was the difficult position in which many
transit operators find themselves--how to continuously add new dialysis
patients to the transit schedule with no means of payment. Some worried
that their general public service was, in effect, being usurped by the
swiftly growing dialysis transportation demand that is, in many ways,
life-and-death. ``It's terribly challenging,'' says Jim Wood of KVCAP
in Waterville, ME. ``We're really concerned about our ability to
continue meeting the growing demand without finding a way to pay for
the service.'' At KVCAP, as with a surprising number of transit systems
nationwide, the system reserves its local United Way funding
specifically for this purpose. But community and public transit
managers around the Nation are reporting that these United Way funding
sources, like many others, is not growing nearly as quickly as the
dialysis transportation demand.
Another key issue some transit managers point to, is that the
privately owned and operated dialysis centers--many of which operate
from before 5 a.m. to midnight--seem to believe there is a statutory
rule that prohibits them from actually paying a portion of the
transportation costs to get their patients to their chairs. In
researching for this article, we could find no such rule.
A Different Kind of Solution: Of course, an obvious solution to the
growing demand for dialysis transportation is to reduce the demand. A
key component is the need for kidney donors across the United States.
In 2008, more than 16,000 kidney transplants were performed across the
country with either organs harvested from cadavers or from living
donors.
Today, the average wait time for a kidney donation can regularly
exceed 2 years, at the minimum. The Community Transportation
Association of America is hereby calling on its members around the
country to be sure to designate themselves organ donors and to work
with transit employees and advocates to do the same. Transplants can
add decades to people's lives and significantly forestall the need for
dialysis, but only when the needed organs are available. One way to
help solve this problem is to support donor programs like that of the
National Kidney Foundation.
Moving Forward: The key solution for community and public
transportation, moving forward, is to develop a funding mechanism for
dialysis transportation in Medicare.
Currently, Medicare will only reimburse for emergency
transportation services--read: ambulances--and not for non-emergency
dialysis transportation. For Medicare, dialysis transportation is not
an emergency. ``Yet we all know that not providing dialysis
transportation results in life-threatening emergency situations that
include both emergency transports and emergency room stays--both of
which are exceedingly expensive to the program,'' says Coordinated
Transportation Solutions Executive Director David White. ``If you're
wondering what happens when we can't do the trip,'' says McDonald,
``the patients simply dial 9-1-1.'' Yet once a dialysis patient does
dial 9-1-1, the Medicare program, in many cases, still refuses to pay.
Just last month in West Virginia, for example, a private rural
ambulance company paid a more than $1 million penalty to Medicare for
dialysis trips taken thrice weekly for 2 years by five local ESRD
patients. The penalty was levied, not surprisingly, because Medicare
inspectors had ruled that, ``ambulances were not needed.'' Community
and public transportation managers that were interviewed for this
article were asked to roughly estimate the transportation costs
incurred for a year of dialysis transports. Most came to a figure in
the neighborhood of $5,000 per patient, per year. When Medicare is
paying more than $82,000 per year per person for dialysis, it does not
seem unreasonable to build in a 6 percent increase to ensure that the
patient arrives safely and efficiently at the dialysis clinic to
receive life-sustaining treatment. ``That's really the issue,'' says
August. ``We are, by transporting dialysis patients, saving Medicare
and the taxpayers a lot of money. We just can't keep up with the demand
without a payment system.'' Additionally, new solutions, partnerships
and thinking are necessary for both health care and transportation
providers to best manage the significant, continued growth in dialysis
patients that researchers expect. A national dialog between
transportation providers and the dialysis industry, to include the
National Kidney Foundation, must be a part of any short- or long-term
solution. As Mr. Marsico said, dialysis transportation is the
foundation of much of the non-emergency medical transportation provided
in our country.
``The dialysis transportation issue--because of the life-and-
death nature of the service and the overwhelming demand--is the
logical place to first focus when considering the role of
community and public transit in health care provision and
transportation.''
It's really another first step in the long journey that our
Association and its members have embarked upon to bring together
successful health care and transportation outcomes for the American
people.
______
The Need for Coordination: One way we can help better manage the
current situation is to support and encourage transportation services
to work together to resolve some of the situation cited by Scott
Bogren. For instance a coordinated approach utilizing transit to get
patients to dialysis needs to be coordinated with taxi services to meet
the return needs of patients who experience difficulties in being
physically able to make a return trip on public transit vehicles is
absolutely necessary. Coordination means bring public and private
transportation providers into partnerships at the local level that
focus on patient needs. This has been an important part of our
Association's continuing efforts on coordination. Congress has been
helpful in this effort by supporting the Community Transportation
Assistance Program within the Department of Health and Human Services
and in the National Resource Center on Coordination within the U.S.
Department of Transportation. My colleague Charles Dickson, associate
director for Technical Assistance has recommendations in these areas
that we feel will help us to continue these efforts that promote
coordination and improved services to patients.
Mr. Chairman, I am Charles Dickson, associate director of our
Association for Technical Assistance, and I have been engaged in
working to provide greater coordination for the benefit of not just
medical services but a range of other activities where private and
public efforts come together. Whether it's employment service
transportation, health care, or the special needs of Americas' seniors,
coordination is a vital way we make those services better and more
efficient for everyone. Mobility is an oft-overlooked and misunderstood
component in modern American life. For many, the ability to get there--
wherever that may be--is simply assumed. Yet for millions of
transportation disadvantaged Americans--those who do not or cannot
drive, cannot afford cars, or who have only one car available for
several family members--getting there is a supreme challenge. Today,
more than 100 million Americans are transportation disadvantaged. This
growing group includes 46 million people with disabilities, 44 million
elders, 60 million people living in rural areas and 38 million people
living in poverty.
For these isolated and at-risk citizens, the transit services
funded by the U.S. Department of Health and Human Services and the U.S.
Department of Transportation provide life-changing access to jobs,
education, childcare, social services and especially healthcare. For
most, there is no alternative. In 1991, Senator Tom Harkin recognized
the need to help communities of all sizes around the Nation provide
mobility to those residents most in need--America's growing
transportation-disadvantaged population--by creating the Community
Transportation Assistance Project, or CTAP. The goal: building a more
accessible society. Initially, the CTAP program provided targeted
technical assistance to the human services transportation network that
had no other forms of guidance available to it. Efforts focused on
developing and maintaining a human service-focused information station
providing resources on improving access, implementing the ADA, and
providing effective welfare-to-work transportation, as well as
identifying experts in all aspects of human service transportation. The
accessibility component that was central to the program's founding has
been a focus throughout this effort.
In recent years, the work of the CTAP program has broadened to
include assistance with cost-effective mobility coordination and
management strategies, employment transportation services, practical
technology applications and, innovative health care transportation.
Health care is a central focus for all communities and has been a major
focus for our CTAP program for the past two decades. The program's
initial mantra that, all the human services in the world are useless if
people cannot access them, is as vital today as it was when first
coined. The recently passed health care reform legislation will
significantly add to the number of Americans receiving health care
benefits through the Medicaid program. More Americans will have greater
access to preventative health care programs. Yet these programs are
destined to fail without an adequate mobility strategy. Our program's
mission of ensuring access to vital services like health care and of
providing the necessary strategic technical assistance has never been
more important. The CTAP Coordination effort has conducted extensive
research in the field of non-emergency medical transportation.
Medicaid's Medical Transportation Assurance: Origins, Evolution,
Current Trends, and Implications for Health Reform. In 2009, we
released a report on medical transportation as it related to the
important role it plays in helping outpatient services in Medicaid that
we believe is similar for all areas of outpatient transportation. The
key findings in this report were:
The assurance of transportation to medically necessary
health care is one of several basic program features that set Medicaid
apart from traditional concepts of health insurance. In combination,
these features embody an approach to health care financing whose aim is
to assure not only coverage and payment but also access to medically
necessary care.
Since Medicaid's enactment, medically necessary, non-
emergency transportation has been woven into the program.
While there is considerable variation, virtually all
States recognize non-emergency medical transportation as a fundamental
aspect of program administration and healthcare.
Non-emergency medical transportation represents a small
portion of overall Medicaid spending, slightly more than $3 billion in
fiscal year 2006, yet it constitutes the second largest Federal
transportation payment system, behind only programs administered by the
U.S. Department of Transportation. Indeed, Medicaid NEMT expenditures
represent almost 20 percent of the entire Federal transit budget.
States have increased the use of transportation brokers as
a way to provide transportation benefits since the Deficit Reduction
Act permitted the use of brokerage systems when providing
transportation as medical assistance under the State plan. Between 2001
and 2009, the number of States using exchange brokers rose from 29 to
38 (an increase of 31 percent).
Brokerage programs may include wheelchair vans, taxis,
stretcher cars, transit passes and Medicaid non-emergency medical
transportation tickets, and other transportation methods. Although
there is still little evidence about the effects of brokerage services,
some research indicates their use may reduce costs and improve access
to services.
Moving from research to action, the Community Transportation
Association through the CTAP Coordination project developed a training
course for public and private non-emergency transportation providers to
help them cope with the changing demands of the program. This course
entitled the ``The Competitive Edge'' helps community and public
transportation providers become efficient, safe, cost-effective and
accountable in order to maintain important medical transportation
services. This training helps both public and private providers by
identifying the following important concepts:
Value: Determining the true cost of service.
Pricing: Lowering your costs to be competitive.
Accountability: Building a recordkeeping and reporting
process.
Training: Focusing on the patient.
The CTAP Coordination effort has also created a Medical
Transportation Toolkit to help communities better provide access to
medical care that focuses on coordination. The toolkit describes how
non-emergency medical transportation works in communities across the
country and how communities can work to improve access to medical care
for individuals who lack mobility options and for people with
disabilities. In the past year, this document has been downloaded more
than 7,000 times. In addition, the CTAP program hosted two webinars on
non-emergency medical transportation that explored the creation of the
Medicaid NEMT program and how it operates today. These two programs are
archived on the CTAP Web site. Some of the additional work we've done
in individual communities has focused on ways to improve access to
health care and coordination. These have included:
Worked with the Mid America Regional Access to Care
committee for the metropolitan planning organization in Kansas City,
MO, to discuss how transportation impacted access to health care.
Helped the committee form a transportation task force.
Assisted in the development of a Health Care Coalition, in
Lafayette County, MO.
Assisted the State of Rhode Island in coming into
compliance with CMS regulations, which helped them maintain non-
emergency medical transportation services.
Worked in concert with the Veterans Integrated Service
Network in Nashville, TN, to create a veteran's health mobility summit.
Met with the New York State Department of Health about its
non-emergency medical transportation program--and specifically
discussed new CMS regulations and their impact.
``We have made a beginning but only begun.'' We believe that the
committee can help us build on this record by supporting the
continuation of the CTAP coordination effort through investment from
the U.S. Department of Health and Human Services. Our goals for an
expanded effort would include:
Continue the ability of the CTAP program to help
communities meet their non-emergency medical transportation by
providing technical assistance through a medical transportation Web
site, telephone support and in-person technical assistance as needed.
Expand the ability of the CTAP program to offer impactful
technical assistance by creating a research program to demonstrate the
cost savings potential of providing timely and affordable
transportation for chronic conditions such as end-stage renal disease
and cancer. Also provide funds to conduct demonstration programs with
Medicare providers to demonstrate potential benefits of including
transportation as a benefit in that program.
Provide technical assistance to traditional providers of
public transportation on methods they can use to improve services for
human service agencies and coordinate other services in their
communities.
Beyond Heath Care: Although we have singled out health care for
separate discussions relative to coordination we would like to comment
on the more general question of how larger coordination efforts can
improve access services for all Americans with special needs. We were
pleased that in the last highway and transit reauthorization, Congress
created the National Resource Center for Human Services within the
Federal transit programs administered by the Federal Transit
Administration within the Department of Transportation. We are pleased
to have worked with the Federal Transit Administration to improve
transportation not just in the human services area but also between
human service providers and public transportation. Coordination of this
kind has been the topic of various Federal activities over the last two
decades, but the National Resource Center is the first effort to work
on this situation not just from the Washington perspective, but at the
State and local level as well. Through the work of the NRC Steering
Committee individuals who represent all facets of those who can benefit
from transportation coordination come together to work on issues as a
team. There are also coordination Ambassadors in every Federal region
to help State and local agencies achieve better ways to work together
for more effective and efficient transportation that looks at the needs
of communities as well as the needs of individuals. In the pursuit of
these efforts the NRC has been an important partner of our Associations
efforts to create ``Coordination Institutes'' across the country that
bring local providers together with strong technical support to further
efforts to collaborate. These efforts are often linked back to the work
done by these regional Ambassadors.
I'd like to provide some information about our recent efforts with
Veterans in this behalf that show how this kind of coordination is both
possible and needed. Let me begin with the words of President Abraham
Lincoln when he said:
``Let us strive on to finish the work we are in, to bind up
the Nation's wounds, to care for him who shall have borne the
battle and for his widow and his orphan.''
The lines from President Abraham Lincoln's second inaugural are the
most elegant statements about the responsibilities all Americans share
in caring for our Nation's veterans and their families. Although he
spoke these words in the midst of a terrible war, they were meant not
just for then, but for all time. These words can be found engraved in
many monuments and on the walls of the U.S. Department of Veterans
Affairs--but they are embodied in the words and actions of many
institutions and individuals across America. As America has changed
since Lincoln's time, so have the needs of our veterans and their
families. We've seen these needs evolve as each generation of veterans
has faced new and often complicated challenges resulting from their
service to the Nation. Some of these changes are designed to provide
rehabilitation services that were impossible to imagine in Lincoln's
time. The GI bill with its approach to educational benefits for
veterans was another response to changing needs. The individual
contributions to support today's veterans by employers and their
communities are still other ways we live up to the words and thoughts
behind President Lincoln's promise.
In our own times, we face complex challenges in meeting veteran's
needs in the areas that we call transportation and mobility. Some of
these challenges result from service-related disabilities, some by a
larger population of older veterans who need continuing medical care,
and some by the needs for mobility that are required for those going to
work or education. Many of these challenges exist not just for
veterans, but also for the families and dependents. Addressing these
mobility and transportation-related issues is not just an issue for the
Department of Veteran's Affairs or traditional Veterans Services
Organizations--they are shared, societal responsibilities. More
specifically, these mobility and transportation-related issues are a
key component in the ongoing work of the network of mobility providers
we call community and public transit and the human services
transportation network. Those who provide many of these mobility
services are linked through the National Resource Center of Human
Services Transportation (NRC). Created by Congress in the U.S.
Department of Transportation, the NRC has a priority to bring together
many programs and interests together to address gaps in the mobility
needs of all Americans, especially the needs of our veterans. In the
process of fulfilling its mission, the center has supported
coordination issues in every region of the country to enhance mobility
services and resources across the Nation. This report is designed to
present the ongoing progress in this vital area and how the NRC and its
constituents are doing our part in addressing the needs of our veterans
and their families.
The National Resource Center's Work with America's Veterans and
their Families: The National Resource Center for Human Service
Transportation Coordination (NRC) was established as a result of
SAFETEA-LU. The Community Transportation Association of America (CTAA)
through a cooperative agreement with the Federal Transit Administration
(FTA) operates it. The fundamental purpose of the NRC is to provide
States and communities with the support they need to better integrate
public transportation services with the services and demands of their
human services networks--including America's veterans and their
families. The goal is simple: that communities across the country are
able to better coordinate human services and transportation provision,
making them more livable, especially for the people who are customers
and beneficiaries of human services programs. The NRC focuses on
providing the education; facilitation and technical assistance that
helps local communities improve their residents' mobility through
strong partnerships among public transportation providers, human
service agencies, private institutions, businesses, volunteers,
consumers, political leaders, and other public agencies and non-profit
organizations.
Through its staff, through its network of United We Ride
Coordination Ambassadors, and through the materials on the NRC Web
site, the center provides the strategies; information and assistance
that allow communities to develop locally appropriate solutions for
their mobility challenges. Working diligently and respectfully with
State and Federal agencies and policymakers, the NRC helps to assure
that communities receive the support they need to improve local
mobility through coordination between public transportation, human
services and their partners. What follows are examples and best
practices of the NRC's valuable work in assuring cost-effective,
efficient mobility for America's veterans and their families.
Ann Arbor VA: Tapping the Region's Mobility Resource: The VA Ann
Arbor Healthcare System is one of six pilot sites for the Department of
Veterans Affairs' Veterans Transportation Service (VTS). Under its VTS
activities, veterans living in portions of Michigan's Wayne, Oakland
and Livingston counties who have appointments at the Ann Arbor VA
medical campus are to receive no-cost shuttle service from their homes
to these appointments, and there also is a shuttle to transport
veterans between the Toledo (Ohio) VA outpatient clinic to the Ann
Arbor facility. Like most VA medical facilities, the VA Ann Arbor
Healthcare System has not historically engaged in providing
transportation services, assuming instead that veterans would use
existing resources of their families or communities--or the resources
of local veterans service organizations (VSOs)--to get to and from
necessary medical services. As such, it has been a challenge for this
center to get its transportation program up and running, especially
given the timelines and prompt performance set forth by the VA national
staff, the VTS Resource Center was able to step in and aid the Ann
Arbor VA Healthcare System in arranging the partnerships to help this
important project get off the ground and running. As could be expected,
there were many phone calls and e-mails in which the NRC team, the
national VTS team and other experts shared ideas and information with
the Ann Arbor VTS project staff, but the seminal event was an in-person
meeting one of our Ambassadors arranged between the Ann Arbor VTS
manager and key personnel from the Detroit-area SMART transit system.
SMART is the largest of the public transit providers operating in
the counties that are to be served through the Ann Arbor VTS project
initiative. Through its corps of United We Ride Coordination
Ambassadors, the National. Through the introductions and facilitation
provided by the Ambassador at this meeting, SMART offered to partner
and provide service, management, planning and public relations
resources to help with the VTS program. The VTS team was struggling
with the challenge of producing significant, almost immediate, results
throughout the entire region to be served by this program. Without the
Ambassador's intervention, it's entirely possible that the Ann Arbor
VTS staff would not even have considered partnering with their regional
public transit system. As a result of the NRC's assistance in this
project, not only is the Ann Arbor VA Healthcare System partnering with
SMART, but they also are entering into relationships with the other
transit agencies in the three-county area to be served under the
project. And there's a bonus: because the VTS staff are finding
strength and opportunity in partnerships with public transit, they are
entering into relationships with the transit agencies in Ann Arbor
itself and in Flint, all of which are above and beyond the programmatic
expectations of the VTS initiative and which expand mobility options
for veterans and their families to access the healthcare they need.
Temple VA: Building a Coordinated Approach: On September 17, 2010,
the Central Texas Veterans Health Care System began operating its
Veterans Transportation Service (VTS) project, which is intended to
provide transportation for veterans with special needs and veterans who
don't have transportation to-and-from their outpatient appointments at
the Olin E. Teague Veterans Medical Center in Temple, TX. Every one of
the VTS pilot sites is unique; in Central Texas' case, they've given
priority to meeting the transportation needs of female veterans and of
veterans with physical disabilities--including wheelchair-dependent
veterans. The project focused exclusively on providing transportation
to their VA Medical Center in Temple, and began its service with a
number of directly operated vehicles. Although they successfully and
quickly launched their service, challenges and opportunities almost
immediately presented themselves, and the NRC was poised to help ensure
the success of this project's service. The leading challenge was one of
geography. The Central Texas Veterans Health Care System operates two
VA Medical Centers and six outpatient clinics spanning 39 of Texas'
counties. The enormous service area covers 35,243 square miles and has
a population base of more than 252,000 veterans. There simply was no
way the Central Texas VTS staff could use the limited number of
vehicles at its disposal to meet the burgeoning transportation demands
of its target population. Through connections made via the national
project staff, and contacts that had arisen at some of the other sites,
the Central Texas VTS manager reached out to one of the NRC's United We
Ride Coordination Ambassadors, who set to work helping the VTS staff
get connected with the transportation partners and resources that would
help the project succeed. As a result of this technical assistance
effort, there have been many accomplishments, including:
The VTS manager is an active participant in the Heart of
Texas Council of Government's MPO Transportation Committee for Temple,
from which he is able to see that veterans' issues and mobility needs
are considered in the area's federally supported transportation
planning, programming and service delivery.
Hill Country Transit, which is the regional public transit
system serving Temple and a nine-county rural area surrounding Temple,
has worked with the VTS site to establish a program of tokens veterans
can use for riding Hill Country Transit for all their transportation,
regardless of destination or trip purpose.
A service has been designed in partnership with CARTS, the
regional public transit system operating in nine counties along the
southern part of the Central Texas VA service area, through which CARTS
picks up veterans from origins in Burnet and Williamson counties and
transport them to a transfer point in Georgetown, TX, from which a
scheduled VTS van makes daily round-trips from Georgetown to the VA
Medical Center in Temple. Moreover, there would be no fares charged to
the individual passengers for using this CARTS-VTS transportation
service.
Having secured these operating relationships between the
Central Texas VTS, Hill County Transit and CARTS, additional
opportunities for cost-effective partnership are being discussed,
including possible technical assistance or coordination on vehicle
procurements, and the likelihood of service expansion in the area to
bring even more of Central Texas' veterans to medical appointments and
other destinations.
Pacific Northwest: The NRC's Successful Role in Convening the Right
People and Forging Results: With respect to veterans and military
families, the States of Oregon and Washington have much higher
concentrations of veterans' populations in both urban and rural areas,
as compared to national averages. And as is the case in many places,
more and more of the health care services, jobs and social services
needed by these veterans has been concentrated in major metropolitan
core areas, which makes life and mobility increasingly challenging for
rural veterans, especially rural veterans with disabilities and rural
veterans with limited economic and transportation resources.
Clearly, for veterans to enjoy mobility in the Pacific Northwest,
particularly in more rural areas, partnerships between transportation
providers and the networks of health care and services for veterans
would have to be forged. However, putting that clarity into practice
was a challenge that had vexed this region for years. Almost
immediately upon establishment of the NRC, we began to do our part to
help these communities tackle this challenge. The NRC's first step was
to help bring partners together at the community level. We focused our
attention on one area having both need and capacity to address that
need--Washington's Olympic Peninsula. A United We Ride Coordination
Ambassador began bringing together the peninsula's two public transit
providers, Mason Transit and Jefferson Transit, along with numerous
community-based groups serving veterans and other populations, and
essentially challenged them with the question: What can we do to better
serve the needs of this important segment of our community with the
resources available to us? Those conversations--both formal and
informal--led to a number of ready and successful outcomes in the areas
of information, outreach and inclusion of veterans' needs in the
delivery of transportation services to veterans living in the
peninsula. Another outcome that took more time to materialize, but
which ultimately was successful, was to incorporate veterans with
disabilities among the people who are able to receive discounted
universal Regional Fare Permits that are accepted not only on Jefferson
Transit and Mason Transit, but also on eight additional public transit
systems in Washington State, and on the State's ferry system. The
successes of this first step, though, uncovered greater challenges.
While the Olympic Peninsula has many veterans among its population,
and has its share of economic and social services for veterans, the
only VA health services on the peninsula are those that can be provided
at a single outpatient clinic in Port Angeles, WA. Once our Ambassador
began talking to veterans' service organizations, and to individual
veterans, the enormity of this challenge became clear. Almost every
element of health care that a veteran on the Olympic Peninsula would
require--whether for a one-time doctor's visit or for recurring
treatments or therapies--involved a trip to the Seattle VA Medical
Center, which can be as far as 200 miles away from some communities on
the peninsula, and which inevitably involves either a ferry ride or a
surface journey of significantly greater length. Almost every veteran
our Ambassador encountered had his or her own story of health care that
had been self-rationed, or services not received, because the
transportation challenges were too great, or the logistics of how to
arrange the time and travel for a medical trip from their home to
Seattle were too complicated, even with the availability of relatively
affordable public transportation.
To get a more concrete grasp on the extent of these mobility
challenges--and to help begin to get stakeholders talking about
possible solutions--the NRC's United We Ride Coordination Ambassador to
this region worked with State, local and national partners to convene
the Washington State Veterans Forum: A Symposium on Transportation
Access for Veterans, Military Personnel and Their Families. The primary
participants in this event were more than a hundred veterans, active-
duty military personnel, and members of military families. They were
joined by a cadre of transportation providers and veterans' service
organizations, and by representatives from the VA and from State
agencies addressing veterans' health care and other needs. Many
pressing needs surfaced in this symposium, including:
The need to minimize the burden of repeated veterans'
medical trips to Seattle, whether through efficiencies of coordinating
medical and transportation services, or by bringing more medical
services for veterans to the communities in which they live.
The need to reduce the extent to which rural homeless
veterans are at a medical transportation disadvantage.
The need to improve communication to veterans, their
families and their support networks about the transportation-related
options available to them and how they may be used.
The need to improve the coordination of transportation
services used by veterans, including those services provided by the
various public transit agencies and the services provided by DAV and
other veterans' service organizations.
The need to address aspects of veterans' mobility that are
not specifically related to health, such as jobs, social services, and
senior services for older veterans.
The need for local governments and service delivery
agencies to have a better and more accurate understanding of veterans'
needs, issues, and programs.
The need to take into account that trip chaining is to be
expected, can be efficient, and should be supported; in other words, if
a veteran has to spend part of a day receiving medical care in Seattle,
the veteran or his or her family will want to--and should--be able to
take advantage of that transportation experience to take care of other
necessary functions, which could include shopping, personal
appointments, etc.
The forum raised a high profile among the region's veterans'
community, and among the State and local agencies charged with
addressing aspects of veterans' needs. As a result, many organizations
took a fresh look at, and in some cases restructured, the ways in which
they addressed veterans' services and transportation. More
significantly, a working group of key public and private transportation
providers was organized, which continues to work together to carry out
strategies that assure as simple, efficient and seamless a mechanism
for providing regional mobility to veterans as structures and
circumstances will allow. In addition, the State agencies in Washington
whose missions address various aspects of veterans' services and
mobility also began working together more closely to do their part to
help make State-delivered veterans' services as simple, efficient and
seamless as could be realized. And although all the activity reported
above was taking place within Washington, their neighbors to the south,
in Oregon, were witnessing the news and the discussion, and hearing the
reports from their United We Ride Coordination Ambassador, and also
began to find ways within Oregon's State agencies to find ways to work
together to improve the coordination and delivery of services to
Oregon's veterans. The bottom line from this step, then, is that one
event led to an ongoing working group in the Olympic Peninsula and
Puget Sound region, an ongoing State-level working group in Washington,
and an ongoing State-level working group in Oregon. With the NRC having
helped tackle what first presented itself as a local challenge of
veterans' mobility on the Olympic Peninsula--and which then became
additionally addressed as a statewide issue in both Washington and
Oregon--it was not long before national attention and the prospects of
national solutions emerged. In the spring and summer of 2010, the
Department of Veterans Affairs began committing its internal resources
to a pilot program of Veterans Transportation System sites, such as
those cited above in Texas and Michigan.
At that same time, many of the key Federal players active in the
Federal Interagency Coordinating Council on Access and Mobility (CCAM)
were beginning to revisit the question of what can we, as an
interagency body of Federal departments, do together to improve
veterans' transportation? Since one of the other functions of the NRC
is to provide technical expertise in support of the CCAM, it helped
channel the headquarters-level Federal concern into a pair of listening
sessions in the autumn of 2010, which the NRC's regional United We Ride
Coordination Ambassador helped organize. One was in Olympia, WA; the
other was in Portland, OR. In both listening sessions, Federal
personnel from both the headquarters and regional offices of the
Departments of Labor, Transportation and Veterans Affairs were on hand
to listen to dozens of veterans, veterans and military family members,
transportation providers, veterans' service organizations, local and
State government officials, and other stakeholders as they described
issues, challenges, solutions, and ideas for how the Federal partners
could help to address these challenges. The Federal agency personnel
left these sessions not only with a keener grasp of the breadth of
mobility challenges facing veterans and their families and networks,
but also with an appreciation of the many locally developed,
appropriate and effective solutions that already were being put into
place, with some support from the NRC and its Ambassadors, but also
with the knowledge that there would be a degree of support and
encouragement from local, State and Federal governmental agencies. Even
in the absence of additional funding, that atmosphere of governmental
supportiveness and cooperation already was making a world of difference
in Oregon and Washington.
Some key considerations were raised in these listening sessions.
One was that veterans have a host of community and mobility needs
beyond the basic need to access health care at VA facilities, and that
there need to be ways to get these needs recognized across the family
of transportation plans and programs. Related to this was the
consideration that categorically defined transportation programs, even
exciting initiatives such as the Veterans Transportation Service, can
pose problems when veterans or their family members are trying to
access all sorts of activities and destinations, including employment,
education, social services as well as health care.
There already was frustration that veterans might have to call one
number to access the DAV or other VA-related transportation, and then
have to call some other number to access their public transit service,
and then maybe even another number if trying to get transportation at a
time or location not served by the public transit. Therefore, a clamor
was raised to simplify the access to these transportation services
through some type of simplified ``one-call'' service, in which the
providers could sort out who's doing or paying for which part of which
trip, and the only up-front burden on the veteran is to call one, and
only one, phone number to request the trip. This last finding from
these listening sessions that the NRC helped organize led to a result
with national implications. On November 9, 2011, the U.S. Department of
Transportation, working in partnership with the Departments of Labor,
Defense and Veterans Affairs, announced the award of more than $30
million in discretionary grants to support 55 communities across the
country in the development of coordinated, inclusive one-call/one-click
services to help address and respond to the transportation needs of
veterans and military families through a CCAM-backed Federal
interagency Veterans Transportation and Community Living Initiative.
Community and Public Transportation's Coordinated Response to the
Growing Mobility Needs of Veterans and Their Families: Across the wide
spectrum of community and public transportation, service to America's
veterans and their families is a long-standing commitment. And these
services are as varied as the mobility needs they seek to address. From
the thousands of veterans who board public transit buses and trains
everyday to commute to-and-from work, to the coordinated transportation
service specifically designed to connect veterans with VA Healthcare
Centers, community and public transportation plays an ongoing and
pivotal role in the lives of veterans and their families. What follows
is a series of veteran's transportation best practices from across the
country and representing the family of community and public transit
providers making this service possible.
Free and Discounted Fares for Veterans: The Bay Area Rapid Transit
(BART) system--serving the metropolitan areas of San Francisco and
Oakland--is one of the busiest transit networks in the Nation. With
five lines operating over 100 miles of rail, BART connects 43 stations
and moves nearly 350,000 passengers daily. It will become the largest
transit system to offer free trips to all active duty military service
personnel. With a large number of military personnel living or
stationed in the Bay Area, BART's regional rail network is a crucial
means to access destinations across the area. As a result, on Nov. 19,
BART's board of directors voted to offer a $50 ticket to any active
duty military service personnel on formal leave from the conflicts in
Iraq and Afghanistan. ``We want to recognize the tremendous sacrifices
the men and women of the military make,'' said Murphy, who represents
the Contra Costa County communities of Concord, North Concord,
Lafayette, Martinez, Orinda, Pleasant Hill and Walnut Creek on the BART
Board. ``Even in these tough budget times, we want to send our military
personnel a message that BART, on behalf of the Bay Area community,
values their service and sacrifice.'' Houston, TX is the third-largest
U.S. city in terms of population and has a service area of 1,285 square
miles. The local transit system (METRO) has a daily ridership that
exceeds 600,000 passengers. METRO's complementary ADA paratransit
service, METROLift, has annual ridership of about 1.3 million.
METROLift has innovative services in that, in addition to deploying a
traditional paratransit service with large lift-equipped vehicles, they
contract out a large portion of the METROLift service to a taxicab
company, which, in turn, deploys a fleet of 160 wheelchair-accessible
vehicles dedicated to this service. Houston Metro offers deep fare
discounts to veterans who are more than 50 percent disabled (as
certified by the VA). For example, according to transportation program
staff, instead of paying a $2.00 fare each way, a veteran might only
pay $0.75. Across Minnesota--a land dubbed with evocative nicknames
such as the North Star or Gopher State, or the Land of 10,000 Lakes--
community and public transportation systems provide more than 11
million rides each year, spanning 76 of the State's 81 counties (68 of
those offering county-wide service). Meanwhile, more than 50,000
disabled veterans live across Minnesota. As of the summer of 2009, all
of them can ride for free on any fixed-route transit service in the
State.
Providing Efficient Transit Service to VA Medical Centers: In 2008,
Veterans Administration (VA) leaders in Seminole County, FL, were faced
with a challenge. Its existing Community-Based Outpatient Clinic (CBOC)
in Sanford was lightly used and sparely staffed. A new facility in
Orange City--about 13 miles to the north--would offer better services
and reach more veterans in need of care. However, the relocation of the
CBOC to Orange City would introduce travel difficulties for those
veterans utilizing the Sanford clinic. Representative John Mica, after
consulting with Sanford County VA officials and veterans organizations,
decided to try transit first and turned to the local experts in
addressing mobility needs: LYNX, the region's public transportation
system. Fortunately, LYNX was already actively involved in working with
area veterans and their advocates to overcome transportation
challenges. The agency's leadership had cultivated relationships with
veterans' service officers in Seminole, Osceola and Orange counties, as
well as officials at the Orlando VA Medical Center, to provide veterans
with unlimited-use transit passes and evaluate how the system's fixed-
route and AccessLYNX paratransit operations responded to veterans'
transportation needs. These joint efforts between transit professionals
and veterans representatives established a foundation to build future
enhancements for veterans' mobility. Due to the groundwork established
between LYNX and the veterans' community, a solution to the challenge
in Seminole County became readily apparent. Representative Mica and
LYNX chief executive officer Linda Watson arranged for one of LYNX's
VanPool vehicles to be assigned to the Orange City VA Clinic, which
would operate the vehicle between the Central Florida Regional Hospital
in Orlando and the Orange City clinic. LYNX also would deliver veterans
to the hospital via its Link 34 or 46 fixed-route bus lines, or on its
AccessLYNX service. The arrangement allowed LYNX to leverage its
existing service network to provide the connection to link with a
regional transportation nexus--the Hospital, in this case--while the VA
was able to prioritize its transportation resources to ensure veterans
could access its services.
For area leaders, the solution represented both an efficient and
responsive outcome to a significant, but not insurmountable challenge.
Through Representative Mica's leadership in Congress, a new VA Medical
Center will soon be completed in Orlando's Medical City health services
campus in Lake Nona. The Lake Nona Orlando VA Medical Center will
include 134 inpatient beds, a 120-bed community living center, and 60-
bed rehabilitation center. Projected to employ more than 2,100 people
and serve more than 113,000 veterans each year, the new facility will
also be located near the University of Central Florida's Medical
School, the Burnham Institute for Medical Research and Nemours
Children's Hospital. Already, LYNX is planning for how best to serve
the thousands of riders it projects to carry to the campus. The new
Center's substantial size, innovative medical services provided and the
numerous clients to be treated by the various facilities at the Medical
City campus demands it. ``The new Lake Nona VA Medical Center will be
an important origin and destination of trips across all of LYNX's
services,'' says Masselink. ``We will be diligent in making sure that
the veterans who need transportation for the care the center will
provide will be able to access it.''
Near the confluence of the Potomac and Shenandoah rivers, three
States come together--Maryland, Virginia and West Virginia--in the
heart of the Blue Ridge Mountains. And much like the meeting of these
iconic waterways at Harper's Ferry, WV, the meeting of mobility options
in the Eastern Panhandle of West Virginia is equally significant. Near
Martinsburg, WV, the Blue and Orange Routes of the Eastern Panhandle
Transit Authority--known locally as PanTran--meet at the Martinsburg VA
Medical Center. Here, PanTran's bus lines originating from the small
cities of Martinsburg and Charles Town serve one of the region's most
important destinations--one that serves more than 129,000 veterans in
Western Maryland, West Virginia, South Central Pennsylvania, and far
Northern Virginia. That the facility serves as the terminal point for
two regional transit routes is not one of coincidence, but of strategy.
In as much as PanTran's routes to the VA Medical Center anchor two of
the system's five routes with a steady stream of veterans and employees
accessing the facility, the services find a just as vital role in
connecting those veterans with other destinations and community-based
services in the region.
The Blue Route--which offers 11 trips on weekdays and 7 on
Saturdays--provides connections to the Martinsburg Mall, Senior Center
and Martinsburg train station, which hosts Amtrak's Capitol Limited
between Washington, DC, and Chicago as well as MARC commuter trains to
the Nation's capital. ``PanTran is a tremendous resource for veterans
in the area,'' says Bobby Simpson, Veterans' Service Officer for
Jefferson County. ``Because of their half-price fares and direct lines
to and from the VA center, its easier for our veterans to become
involved in the community.'' Beyond the coordination of its two transit
routes at the Medical Center, PanTran also serves veterans more
directly, by contracting with the VA to provide trips for veterans on
Tuesday and Friday evenings to ongoing rehabilitation treatment outside
the Medical Center in Martinsburg and Charles Town. For more than a
decade, PanTran has partnered with VA to operate two vehicles, which
have produced more than 6,500 rides over that span. Since
rehabilitation treatment is vital for continued well-being, but not
urgent medical care, it is provided off-site from the VA Medical
Center. Rather than establishing its own transportation operation to
transport these clients from the Medical Center to the treatment
facilities, local VA officials tried transit first. ``PanTran are the
folks around here who know how to provide transportation,'' explains
the VA's Simpson. ``Since the treatment is offered on a predictable
schedule, working with the transit system made the most sense. It's
been a great partnership for us.''
A unique partnership has led to a daily veterans transportation
route between the towns of Lufkin and Livingston in East Texas and the
Michael E. DeBakey VA Medical Center, a 118-acre campus, in downtown
Houston. Everyday, 30 veterans and their family companions board an
over-the-road coach operated by Coach America under contract to Brazos
Transit to access the therapeutic and routine care provided by the VA.
The veterans transportation service between Lufkin, Livingston and
Houston was launched in 1995 and last year two new buses were added to
the service to help Brazos Transit's capacity to connect veterans with
both the local VA facility in Lufkin, and to the transportation
available there to the larger Houston VA medical center. It's a highly
successful example of local cooperation, one that was led by the late
Congressman Charlie Wilson. ``Charlie was always supportive of good
public transportation in East Texas,'' says Brazos Transit director
John McBeth. ``He understood the nature of rural transit and the
importance of connecting veterans to the services they need.'' The way
Wilson made such a dramatic difference in the case of this service is
to work with Brazos Transit's board's vice chair Louis Bronaugh to
bring along the Temple Foundation to help pay for increased transit
service using better, more comfortable equipment--the Coach America
vehicle has a video system, restroom and room for two veterans in
wheelchairs. Any veteran traveling to Houston for an appointment at the
DeBakey VA Medical Center can reserve, in advance, a seat on the bus by
contacting the Charlie Wilson Outpatient Clinic in Lufkin on a first-
come, first-served basis. The VA and Brazos Transit operate several
vehicles that they use to collect veterans from the surrounding rural
areas and bring them to Lufkin for the longer ride to Houston. The
veterans bus runs Monday through Friday--except Federal holidays--
departing Lufkin at 7:30 a.m., Livingston at 8:30 a.m., and arriving at
the Houston VA facility at 10 a.m. It departs Houston for the return at
3 p.m. ``One thing's for sure,'' says McBeth. ``The veterans sure love
the service. They are so thankful for it and are very courteous to the
drivers and staff.'' ``It's an important service,'' says Coach
America's Peggy Doyal. ``We need to be serving those who served our
country.''
Making This the Rule and Not the Exception: This work in the
Veteran area needs to become the foundation of how we can do more in
other areas on coordination. As in the case of the Human Services
coordination effort of which I spoke earlier, we believe continuing the
efforts of the National resource Center on Coordination are in
everyone's interest. Since the Human Service community benefits in this
effort we would appreciate this committee advising its colleagues on
the Senate Banking Committee of the importance of coordination to these
constituencies. In a way we're asking you to ``coordinate'' with your
colleagues so that we can continue to ``coordinate'' at the local
level. I want to thank the committee for it's time and I believe Mr.
Marsico has some closing comments.
In closing, Mr. Chairman I want to thank you again for holding this
hearing and allowing us to testify. Accessible transportation remains
an important ``work in progress'' in our country. Our testimony
attempts to address several key issues that reflect only a portion of
this important need. We hope that the committee will look at other
aspects of this issue in the future and I hope that you will keep in
mind that we will always be supportive of your interest and grateful
for your continuing support.
Thank you.
[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]
______
Abilities!,
Albertson, NY 11507,
November 28, 2011.
Hon. Tom Harkin, Chairman,
Hart Senate Office Building,
Washington, DC 20510.
Hon. Michael B. Enzi, Ranking Member,
Russell Senate Office Building,
Washington, DC 20510.
Senator Harkin & Senator Enzi: Thank you for allowing me to be a
voice on the subject of transportation for people with disabilities. It
has been my high honor to work with you both over the past 20 years on
serious disability policy matters, and you both have been stalwart
protectors of our rights and opportunities. I thank you on behalf of
millions of people with disabilities.
Today, I have the privilege of serving as president and CEO of
Abilities!, located on Long Island, NY, a non-profit agency dedicated
to empowering people with disabilities to be active, independent, and
self-sufficient participants in our society, and annually serving more
than 2,000 adolescents and adults and 185 severely disabled and
medically fragile children. Through education, training, research,
leadership, and example, we seek to provide the highest quality
services and to influence national attitudes, policies, and legislation
in ways that will lead to the greatest benefits for the people we
serve.
Transportation poses a major obstacle for people with disabilities
who wish to utilize transportation for work as well as a means of
assuring that we can live independently within their communities. Some
of the pressing issues, particularly for those of us who reside on Long
Island, revolve around the following:
Transportation routes are generally very limited, which
often means that people with disabilities may have difficulties getting
to the bus stop locations;
Fares are high yet schedules have been reduced severely,
so that evening and weekend bus and paratransit services are very
limited;
Utilizing buses for work becomes extremely difficult;
lifts, which are supposed to be available on every bus route, often do
not work;
Government fails to recognize the importance of buses and
public transportation generally in the lives of persons with
disabilities and those who may have limited funds to consider
purchasing a vehicle if they have the ability to drive, especially in
this difficult economy. It is short-sighted and discriminatory to cut
back on already limited and unequal public transportation services,
thereby making it even more difficult for people with disabilities and
limited means to participate fully in our society;
Finally, it is inherently contradictory in public policy
terms to want people with disabilities to work but not provide them
with a reliable means to get to their places of work.
Traveling around Long Island is very difficult for people who do
not own or have access to a car. If people with disabilities want to
work and live more independently, we must be able to rely on accessible
public transportation in real-time. We want to be full participants in
our society--but public policy does not assure us of this.
What should be done:
State unequivocally in public policy that public mass
transportation must be substantially equivalent to public mass
transportation services available to non-
disabled persons. Train bus and train personnel continually to be
respectful to all those who utilize their services, providing
continuous and recurrent training on disability etiquette/customer
service, especially on the use of lifts and how to respond to those
people who need them.
Ensure that all lifts are working before rolling stock
departs on scheduled runs, in the same way planes are checked to assure
all parts are working properly and safely before takeoff.
Assure bus schedules reflect the needs of all its
citizens, including people with disabilities.
Recognize that public mass transportation must be a civil
and equal right for all tax-paying citizens; alternately, reduce taxes
of people with disabilities who are not able to participate fully in
our society due to inaccessible mass transportation.
As you have recently said, Senator Harkin,
``I'm concerned if we continue to allow people with
disabilities to be treated like second-class citizens when it
comes to transportation access we will not achieve the goals of
the ADA and we will not open up the doors to employment to
everyone who can work and wants to work.''
Sincerely,
John D. Kemp,
President & CEO.
______
Catskill Center for Independence,
Oneonta, New York 13820,
December 2, 2011.
Hon. Tom Harkin, Chairman,
Hon. Michael Enzi, Ranking Member,
Committee on Health, Education, Labor, and Pensions,
U.S. Senate,
Washington, DC 20510.
Please accept these comments on the challenges and opportunities
for consideration toward improvements in accessible transportation.
Feel free to contact me with any questions and we would appreciate
receiving a response from you on this important issue. Thank you for
your time and commitment to the U.S. Senate HELP Committee.
______
The current state of transportation which is obtainable,
inexpensive and accessible for individuals with disabilities is
deficient at best and poses a number of challenges in all areas,
particularly for those living and working within rural communities.
Despite these impediments, there are many opportunities to improve
existing systems and provide full and complete access for individuals
with disabilities. Decades after the establishment of laws which
recognized the rights of individuals with disabilities, including
specifications related to transportation, proper implementation and
allocations continue to lack, creating a mass of concerns, barriers and
inequities for those whom are otherwise reliant upon this public
offering. In addressing these issues, we must also strive toward
upholding the affirmations contained in the Americans with Disabilities
Act (ADA), the Olmstead v. L.C. decision and the Urban Mass
Transportation Act of 1970 (P.L. 91-450), which states:
``It is hereby declared to be the national policy that
elderly and handicapped persons have the same right as other
persons to utilize mass transportation facilities and services;
that special efforts shall be made in the planning and design
of mass transportation facilities and services so that the
availability to the elderly and handicapped persons of mass
transportation which they can effectively utilize will be
assured; and that all Federal programs offering assistance in
the field of mass transportation (including the programs under
this Act) should contain provisions implementing this policy.''
Catskill Center for Independence is an Independent Living Center
(ILC) and a community-based non-profit provider of advocacy, various
services and supports for consumers of all ages with various
disabilities in upstate New York. The Catskill Center for Independence,
like all ILCs, serve as the influence for the direction of the
disabilities rights movement, focusing upon the procurement and
resolution of difficulties toward full integration of individuals with
any disability. In addition, it is part of our mission to ensure that
the individuals we serve have the ability to exercise choice and
control in order to achieve individual success and independence.
Joshua King,
Disability Rights Advocate.
______
December 2, 2011.
Hon. Tom Harkin, Chairman,
Hon. Michael Enzi, Ranking Member,
Committee on Health, Education, Labor, and Pensions,
U.S. Senate,
Washington, DC 20510.
Dear Senator Harkin, Senator Enzi and Committee Members: As the
systems advocate of the Independent Living Center of the Hudson Valley
(ILCHV) in New York and the chair of the National Council on
Independent Living's (NCIL) Policy Sub-Committee on Transportation, I
am writing--first and foremost--to thank you very much for your
tireless work and support of legislation designed to enhance access for
Americans with disabilities. In particular, on November 17, both the
House and the Senate discussed Transportation legislation, but largely
due to the leadership of Senator Harkin and Senator Enzi, the Senate
discussion focused primarily on issues that affect persons with
disabilities.
As Senator Harkin, said at the November hearing, ``the Americans
with Disabilities Act (ADA) does not address air transportation because
of the Air Carrier Access Act''. Further, the lack of accessible
private transportation, demonstrated by what we have been experiencing
in New York City, in their recent decision not to purchase accessible
taxi cabs, is an area that has escaped the intent of the ADA. However,
this is a much greater and pervasive problem beyond New York City,
affecting millions of Americans with a variety of disabilities
throughout America.
I have been advocating for the rights of persons with disabilities
for over 26 years and I have been involved more specifically with
transportation issues for the past 10 years, with the last 3 years as
chair of NCIL's Transportation Committee. As a committee we have
developed a Transportation Position Paper where we have focused on
three basic areas of transportation services. The three areas of
concentration that will maximize community integration, involvement and
participation of people with disabilities are:
1. Rural transportation services: NCIL strongly supports increased
availability and greater access to affordable and accessible rural
transportation, including small airplanes.
2. Livable communities: Safe and accessible rights-of-ways
including complete streets & pedestrian safety that are all essential
elements of community life.
3. Private Transportation Services: Legislation is needed to
increase the number and availability of accessible vehicles within the
private transportation industry, i.e., taxis, limousines, shuttle
service, car rentals, buses, trains, etc.
Without reforming the current outdated transportation
infrastructure, increased investment in transportation alone will not
solve the problems that plague Americans, especially individuals with
disabilities on a daily basis who are ready for a new direction and
demand transportation options that are affordable and accessible. It is
essential for Congress to move toward a 21st Century system that
focuses on accountability and results while creating jobs, providing
access to opportunity for all Americans, including individuals with
disabilities, reducing carbon emissions and our dependence on foreign
oil, and improving America's economic competitiveness.
In today's society, economic competitiveness and success in the
21st Century is dependent upon revolutionary ideas and solutions
providing Americans, including individuals with disabilities, with
accessible transportation options which connect our cities, regions,
and rural areas. Our goal is to promote the inclusion of people with
disabilities into society by designing accessible transportation
systems and encourage pedestrian safety. All new and innovative public
and private transportation systems that transfer passengers including
individuals with disabilities from one point to another must be
accessible for all passengers. Also, pedestrian safety and the rights
of way must be designed to maximize their access to all community-based
services, programs, activities employment opportunities, etc., that are
available to the general public.
Rural areas have higher proportions of lower income and older
populations who would directly benefit from increasing the availability
of affordable public and private transportation options. Due to the
lack of affordable and accessible transportation services, disabled
veterans and aging Americans, including persons with disabilities,
often remain isolated and segregated in their homes with few options to
become an integrated member of their own community. Additionally, these
minimal transit services must remove architectural barriers and
eliminate the discriminatory policies and procedures in all modes of
transportation services as required by the ADA.
Along with enhancing rural and private transportation services to
maximize community integration and comply with the 1999 Supreme Court
Olmstead decision, accessible public rights-of-way are also critical
for community integration. People with disabilities typically rely on
the ability to traverse public rights-of-way to access both public and
private transportation, to get to their jobs, to stores, to visit
friends and family, and to live. Lack of accessibility contributes to
the abysmal unemployment rate for people with disabilities and prevents
people with disabilities from being integrated as full members of the
American community.
For millions of Americans with disabilities, the right to fully
participate in their communities and access services is significantly
hampered by the current inequities in our country's transportation
network. It is a matter of fairness and in spirit with the principles
and provisions of the Americans with Disabilities Act (ADA) that all
residents and visitors to this great country of ours are afforded equal
access to all modes of transportation. Due to the lack of universally
designed and wheel chair accessible vehicles, especially within the
taxi and limousine industry, legislation is required to create greater
accessibility in pre-arranged for-hire vehicle transportation service.
A national study conducted by the U.S. Bureau of Transportation
Statistics in 2002 found that 6 million people with disabilities have
difficulties obtaining the transportation they need. Four times as many
disabled people as nondisabled people lack suitable transportation
options to meet their daily mobility needs. In 2000, a Harris Poll
funded by the National Organization on Disability established that
nearly one-third of people with disabilities report having inadequate
access to transportation. In addition, an aging population means that
the demand for universally accessible transportation will increase.
According to the American Public Transportation Association (APTA), to
serve the rapidly growing portion of Americans older than 65, public
transportation will incur increased operating and capital costs--an
additional $3.9 billion annually--by 2030.
For many communities, pre-arranged for-hire vehicles, such as
taxis, are a fundamental part of the transportation system. The
Community Transportation Association of America reports that nearly 40
percent of the country's transit-dependent population--primarily older
Americans, persons with disabilities, and low-income individuals--
reside in rural areas. However, in many rural communities, little to no
public transportation exist, leaving people with disabilities without
accessible transportation since current law does not require private
for-hire vehicle companies to offer universally accessible vehicles. In
New York City, an estimated 60,000 people use wheelchairs, but only 238
of the 13,000 medallion yellow cabs (less than 2 percent) are able to
accommodate passengers with wheelchairs. Even fewer livery vehicles and
limousines are accessible for customers in wheelchairs. The lack of
accessible taxis currently costs the Medicaid program millions of
dollars because people who use wheelchairs presently have no
alternative but to use very expensive Medicaid funded ambulettes for
transportation to non-emergency medical appointments. This cost could
be dramatically reduced if accessible taxi service were available.
As for the Airline Industry, not covered by the ADA, discrimination
and lack of access against people with disabilities is very much alive.
Especially, as a result of recent events concerning people with
disabilities and the Airline Industry--where they were prohibited from
flying--it is alarming to think that the Department of Transportation
(DOT) may further weaken aircraft access for many wheelchair users, by
removing the obligation to stow folding wheelchairs in the cabin
closet. For many wheelchair users, a well-signed, designated space in
the main cabin is all that is needed to ensure people with disabilities
are able to fly independently. Some airlines stow wheelchairs by
strapping the manual wheelchair on the back of an airline seat,
potentially damaging to the chair as well as increasing the potential
for injury to cabin crew. It simply makes little sense. Further, it
amplifies the spectacle and stigmatization that so many people with
disabilities must endure to board an aircraft with the help of
untrained ground staff who transfer wheelchair users from their
wheelchair to straight backs, (which are often left exposed to the
elements at medium and smaller airports. Rather than weakening
accessibility, the DOT should be strengthening the Air Carriers Access
Act by ensuring that every aircraft, including commuter jets serving
small airports, provide a designated space onboard that holds a folded
manual wheelchair and does not require ``seat strapping''. The DOT
should also ensure signage at aircraft entries and at the stowage
location to easily identify the right of passengers to stow their
manual chairs onboard. Finally, the Department must prohibit United
States and foreign carriers from removing existing closets or other
priority spaces used for stowing a passenger's wheelchair on aircrafts.
This is just one example of ``our continued lack of access and
independence''.
On June 19, 2011, TheDenverChannel.com posted an article about a
young man who was told by the pilot that because of his quadriplegia he
would have to get off of the plane. There are hundreds of individuals
that fly with the same or similar disability every year. In fact, the
same individual being thrown off the flight flew 2 days earlier from
Denver International Airport to Dallas to attend a family wedding.
Again, this is just one more example of this kind of treatment being
endured by persons with disabilities. Others with different
disabilities have recently been experiencing similar treatment by other
airlines.
Honorable Senators and committee members, on behalf of the
Independent Living Center of the Hudson Valley in New York, and as the
Chair of the National Council on Independent Living's Policy Sub-
Committee on Transportation, I thank you for focusing your efforts
toward addressing transportation inequities for persons with
disabilities. In advance, I would like to again thank you for all and
any support you can render, which will serve to maximize and enhance
the availability of accessible and affordable transportation options
for all, including individuals with disabilities.
Respectfully,
Clifton Perez, M.S.W.,
Systems Advocate.
______
Southern Tier Independence Center (STIC),
Binghamton, NY 13905,
December 2, 2011.
Hon. Tom Harkin, Chairman,
Hon. Michael Enzi, Ranking Member,
Committee on Health, Education, Labor, and Pensions,
U.S. Senate,
Washington, DC 20510.
Dear Senator Harkin, Senator Enzi, and members of the Senate
Health, Education, Labor, and Pensions Committee: I am writing today to
commend you for holding five public hearings since March, hearings that
have addressed the barriers facing people with disabilities in the area
of employment:
The Americans with Disabilities Act and Accessible
Transportation: Challenges and Opportunities;
Leveraging Higher Education to Improve Employment Outcomes
for People Who Are Deaf or Hard of Hearing;
The Future of Employment for People with the Most
Significant Disabilities;
Lessons from the Field: Learning From What Works for
Employment for Persons with Disabilities; and
Improving Employment Opportunities for People with
Intellectual Disabilities.
Southern Tier Independence Center, located in Binghamton, NY, has
been in operation since 1983. STIC provides several programs and
services for children and adults with all types of disabilities, as
well as family members, agencies, businesses and government entities.
Serving over 3,000 people a year, STIC programs and services cover a
wide geographic area across the Southern Tier. Staff and consumers have
watched the hearings during and after their recording. Members of the
local deaf community were deeply moved by the hearing held at
Gallaudet.
STIC has provided supported employment services since 1995,
assisting people with the most severe disabilities to find and keep
employment in integrated settings. Consumers and staff members have,
for decades, also been very active in working with local government to
develop accessible and affordable transportation options. As pointed
out by the people on your panels: people with disabilities want to
work, want to receive a fair wage for their work, and want to be able
to get to their jobs.
I wish to share our thoughts and deep concerns with the committee.
STIC consumers and staff have been advocating with our legislative
representatives as WIA (the Workforce Investment Act) has been
reviewed. We believe that the sub-minimum wage and segregated
employment should be eliminated. We strongly support four bills
currently being considered in the House of Representatives: the TEAM
Acts (H.R. 602, 603, and 604) and the Fair Wages for Workers with
Disabilities Act of 2011 (H.R. 3086). Ten of the eighteen co-sponsors
of H.R. 3086 are from New York and we are very pleased with this
support. We continue to write the other members of the House from New
York State, encouraging them to also sign on. Three of the co-sponsors
of the TEAM Act bills are from New York. One of our local House
members, Maurice Hinchey, supports all these bills. We wish to point
out, however, that there are no comparable bills in the Senate and we
would strongly encourage you to introduce similar legislation in the
Senate.
In addition, we would like to address the issue of transportation.
Both consumers of services and employees of STIC rely on public
transportation to get to work, school, medical appointments, shopping
sites, and community events. We consider transportation to be in the
same category as other publicly financed necessities (fire and police
protection, education, infrastructure, etc.). Those of us who live and
work in this upstate New York community echo the observations and
experiences of your transportation panelists.
Over the past 3 years we have lost transit services. After a major
route line was cut last year, we took a 1-day survey of 323 riders (a
small sample). Six percent of the riders we surveyed had lost their
jobs because they were no longer able to get to work on time. Although
that route was partially restored, we are now facing further reductions
of service that will start in January. The time between route buses is
being increased, which will result in buses filling quicker and going
``out of service,'' as full buses will have to drive past waiting
customers. The people waiting will have to hope that the next bus
(coming in 45 minutes) will have a spot for them. For people who use
wheel chairs, a full bus will not be able to pick them up. Service will
end around 9 p.m. weekdays and 6 p.m. Saturdays. Second and third shift
workers who rely on public transit will be negatively affected.
Students with disabilities who attend local schools are scrambling to
come up with alternative ways to get to classes, libraries, and campus
activities.
We have worked very hard for many years to train people to use
regular transit. We suspect that people will re-apply for para-transit
when they are not able to get to work, medical appointments, etc. We
continue to meet with local transit officials and county legislators to
try to find answers to the lack of adequate transportation in our
community. The comments made at your hearing about taxis were very
revealing. We have asked local officials for decades to invest in
smaller vehicles for para-transit for people who are blind or who have
cognitive disabilities. There are ways to be more efficient, save
dollars and still provide service.
As you look ahead at legislative, regulatory, and budgetary issues,
we thank you for your recognition of the very real employment problems
facing people with disabilities. We have much to contribute to our
communities if we can just get to the doors of employers and be
welcomed inside as their employees.
Sincerely,
Susan Ruff,
Advocacy Director,
Southern Tier Independence Center.
[Whereupon, at 11:27 a.m., the hearing was adjourned.]