Transportation-Disadvantaged Populations: Some Coordination	 
Efforts Among Programs Providing Transportation Services, but	 
Obstacles Persist (30-JUN-03, GAO-03-697).			 
                                                                 
Millions of Americans are unable to provide their own		 
transportation--or even use public transportation--for Medicaid  
appointments, Head Start classes, job training, or other	 
services. Such "transportation disadvantaged" persons are often  
disabled, elderly, or low income. Various federal programs are	 
authorized to provide transportation services to them. GAO was	 
asked to (1) identify the federal programs that fund such	 
transportation services and the amount spent on them, (2) assess 
the extent of coordination among the various programs, and (3)	 
identify any obstacles to coordination and potential ways to	 
overcome such obstacles.					 
-------------------------Indexing Terms------------------------- 
REPORTNUM:   GAO-03-697 					        
    ACCNO:   A07400						        
  TITLE:     Transportation-Disadvantaged Populations: Some	      
Coordination Efforts Among Programs Providing Transportation	 
Services, but Obstacles Persist 				 
     DATE:   06/30/2003 
  SUBJECT:   Disadvantaged persons				 
	     Federal aid for transportation			 
	     Interagency relations				 
	     Program evaluation 				 
	     Public assistance programs 			 
	     Strategic planning 				 
	     Arizona						 
	     Florida						 
	     New York						 
	     South Dakota					 
	     Wisconsin						 

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GAO-03-697

Report to Congressional Requesters

United States General Accounting Office

GAO

June 2003 TRANSPORTATIONDISADVANTAGED POPULATIONS Some Coordination
Efforts Among Programs Providing Transportation Services, but Obstacles
Persist

GAO- 03- 697

Sixty- two federal programs* most of which are administered by the
Departments of Health and Human Services, Labor, Education, and
Transportation* fund transportation services for the
transportationdisadvantaged. The full amount these programs spend on
transportation is unknown because transportation is not always tracked
separately from other spending. However, available information (i. e.,
estimated or actual outlays or obligations) on 29 of the programs shows
that federal agencies spent at least

an estimated $2.4 billion on these services in fiscal year 2001.
Additional spending by states and localities is also not fully known but
is at least in the hundreds of millions of dollars.

Efforts to improve services and achieve cost savings through coordination
of transportation activities (through sharing resources or information or
consolidating services under a single agency) among federal agencies vary.
The Coordinating Council on Access and Mobility* a body with
representation from the Departments of Transportation and Health and

Human Services* has undertaken some activities to improve coordination.
However, other agencies that administer a substantial number of programs
for the transportation- disadvantaged, such as the Departments of Labor
and Education, are not part of the Council. In addition, the Coordinating
Council*s strategic plan is not linked to its action plan and contains few
measurable performance goals. The strategic and annual performance plans
of the Departments of Transportation and Health and Human Services contain
few references to coordination relating to their subagencies and programs
that fund transportation services for the transportationdisadvantaged, and
the plans of the Departments of Labor and Education do not mention
coordinating these services.

Obstacles impeding coordination include concern among administrators that
their own participants might be negatively affected, program rules that
limit use by others, and limited guidance and information on coordination.
To mitigate these obstacles, officials and experts suggested making
federal standards more consistent, creating a clearinghouse or better Web
site to facilitate interagency communication and provide better guidance
on coordination, and providing financial incentives or instituting
mandates to coordinate. Examples of Vehicles Used to Serve the
Transportation- Disadvantaged

Millions of Americans are unable to provide their own transportation* or
even use public transportation* for Medicaid appointments, Head Start
classes, job training, or other services. Such
*transportationdisadvantaged* persons are often disabled, elderly, or low
income. Various federal programs are authorized to provide transportation
services to them. GAO was asked to (1) identify the federal programs that
fund such

transportation services and the amount spent on them, (2) assess the
extent of coordination among the various programs, and (3)

identify any obstacles to coordination and potential ways to overcome such
obstacles.

GAO recommends that the Departments of Labor and Education join the
Coordinating Council on Access and Mobility. GAO also recommends that the

Departments of Health and Human Services, Labor, Education, and
Transportation (1) strengthen the

Coordinating Council*s strategic plan, (2) include long- term goals and
measures for coordination in their agencies* strategic and annual
performance plans, and (3) develop

and distribute additional guidance and information to encourage
coordination. The Departments of Health and Human Services, Labor,
Education, and Transportation generally concurred with the findings and
recommendations in this report.

www. gao. gov/ cgi- bin/ getrpt? GAO- 03- 697. To view the full product,
including the scope and methodology, click on the link above. For more
information, contact. Katherine Siggerud at (202) 512- 2834.

Highlights of GAO- 03- 697, a report to congressional requesters

June 2003

TRANSPORTATION- DISADVANTAGED POPULATIONS

Some Coordination Efforts Among Programs Providing Transportation
Services, but Obstacles Persist

Page i GAO- 03- 697 Transportation Coordination Letter 1 Results in Brief
3 Background 6 Sixty- Two Federal Programs Fund Transportation Services to
Transportation- Disadvantaged Populations 8 Extent of Spending on Services
for the TransportationDisadvantaged

Is Not Fully Known but Is in the Billions of Dollars 12 Coordination
Efforts Vary, but Some Successful Efforts Show

Promising Results 17 Officials Cited Numerous Obstacles to Successfully
Coordinating Services and Provided Potential Options to Mitigate Them 28
Conclusions 36 Recommendations for Executive Action 37 Agency Comments and
Our Evaluation 38 Appendix I Scope and Methodology 40

Appendix II Inventory of Federal Programs Providing Transportation
Services to the TransportationDisadvantaged

42

Appendix III Federal and State Coordination Efforts 55 Federal
Coordination 55 State Coordination 60 Appendix IV Informational Resources
on Coordination 62

Web Sites 62 Reports 62 Appendix V Comments from the Department of Health
and Human Services 63 GAO Comments 66 Contents

Page ii GAO- 03- 697 Transportation Coordination Appendix VI Comments from
the Department of Education 67

Appendix VII GAO Contacts and Staff Acknowledgments 69 GAO Contacts 69
Staff Acknowledgments 69 Tables

Table 1: Sixteen Programs Identified by CTAA as Regularly Providing
Funding for Transportation 10 Table 2: Eleven Programs Spending at Least
$4 Million in Fiscal

Year 2001 11 Table 3: Estimated Spending on Transportation Services for
the Transportation- Disadvantaged by Eight Federal Agencies in Fiscal Year
2001 13 Table 4: Status of Federal Responses to GAO*s Recommendations

to Improve Coordination 23 Table 5: Federal Actions Taken in Response to
GAO Recommendations for Improving Coordination 55 Table 6: Examples of
State Coordination of Services for the Transportation- Disadvantaged 60
Figures

Figure 1: Number of Programs Providing Transportation Services to the
Transportation- Disadvantaged, by Agency 9 Figure 2: Overlapping Daily
Routes of Vehicles Serving the

Transportation- Disadvantaged in Sioux Falls, South Dakota 21

Page iii GAO- 03- 697 Transportation Coordination Abbreviations

ADA Americans with Disabilities Act of 1990 CTAA Community Transportation
Association of America CTAP Community Transportation Assistance Project
DOL U. S. Department of Labor DOT U. S. Department of Transportation FTA
Federal Transit Administration GPRA Government Performance and Results Act
of 1993 HHS U. S. Department of Health and Human Services HUD U. S.
Department of Housing and Urban Development JARC Job Access and Reverse
Commute MOE maintenance of effort P. L. public law RTAP Rural Transit
Assistance Program TANF Temporary Assistance for Needy Families TEA- 21
Transportation Equity Act for the 21 st Century TCRP Transit Cooperative
Research Program U. S. C. U. S. Code VA U. S. Department of Veterans
Affairs VR Vocational Rehabilitation WETAP Wisconsin Employment
Transportation Assistance Program

This is a work of the U. S. Government and is not subject to copyright
protection in the United States. It may be reproduced and distributed in
its entirety without further permission from GAO. It may contain
copyrighted graphics, images or other materials. Permission from the
copyright holder may be necessary should you wish to reproduce copyrighted
materials separately from GAO*s product.

Page 1 GAO- 03- 697 Transportation Coordination June 30, 2003 The
Honorable Don Young

Chairman The Honorable James L. Oberstar Ranking Democratic Member
Committee on Transportation and Infrastructure House of Representatives

The Honorable Thomas E. Petri Chairman The Honorable William O. Lipinski
Ranking Democratic Member Subcommittee on Highways, Transit, and Pipelines
Committee on Transportation and Infrastructure House of Representatives

The ability to access personal or public transportation is fundamental for
people to connect with employment opportunities, health and medical
services, educational services, and the community at large. However,
certain populations in the United States lack the ability to provide their
own transportation or have difficulty accessing whatever conventional
public transportation may be available. These
*transportationdisadvantaged* persons may have an age- related condition,
a disability, or income constraints. This is potentially a sizeable group.
For example,

according to the 2000 U. S. Census, 35.1 million people were over age 65,
44.5 million people were over age 21 and disabled, and 33.9 million people
were living below the poverty line. Many within these populations face
significant problems in accessing transportation.

Many federal programs authorize use of funds to provide transportation for
transportation- disadvantaged people so they can access government
programs. Programs that provide incidental transportation include health
and medical programs, job- training programs, or programs for the aging.

The coordination of these transportation services* through pooling
resources, consolidating trips provided by various agencies under a single
agency, or sharing information between programs* has been found to improve
the quality and cost- effectiveness of service. At the federal level, the
Coordinating Council on Access and Mobility* a body consisting of
representatives from the Departments of Health and Human Services and
Transportation* is charged with coordinating transportation services
provided by federal programs and promoting the maximum feasible

United States General Accounting Office Washington, DC 20548

Page 2 GAO- 03- 697 Transportation Coordination coordination at the state
and local levels. In a 1999 report, 1 we found that these coordination
efforts needed strengthening. We have also issued

other reports raising concerns about service coordination. 2 You asked
that we study the extent to which government agencies and programs are
currently providing transportation services to the transportation-
disadvantaged and coordinating the provision of these transportation
services and that we update you on actions taken by the Coordinating
Council since our 1999 report. This report addresses (1) the federal
programs that provide transportation services for
transportationdisadvantaged populations and the types of services they
provide; (2) federal, state, and local government spending for
transportation services through these federal programs; 3 (3) the extent
of coordination among state, local, and federal agencies in delivering
transportation services for the transportation- disadvantaged, including
actions taken by the Coordinating Council; and (4) any obstacles that may
impede effective coordination and potential options for overcoming such
obstacles.

Our overall approach was to (1) review federal laws and regulations
governing the use of federal funds for services for
transportationdisadvantaged populations; (2) analyze spending data where
available; (3) review federal and other governmental activities and the
research literature related to the coordination of transportation
services; and (4) obtain the views of more than 100 officials from
federal, state, and local government agencies, industry and client
advocacy groups, and other experts involved with or affected by the
coordination process on the obstacles and options for improving
coordination. Many of these interviews were part of case studies that we
conducted in five states* Arizona, Florida, New York, South Dakota, and
Wisconsin* to understand how these various federal programs were
implemented and coordinated at the state and local level. We chose these
states to include a cross section

1 U. S. General Accounting Office, Transportation Coordination: Benefits
and Barriers Exist, and Planning Efforts Progress Slowly, GAO/ RCED- 00- 1
(Washington, D. C.: Oct. 22, 1999).

2 U. S. General Accounting Office, Welfare Reform: Job Access Program
Improves Local Service Coordination, but Evaluation Should Be Completed,
GAO- 03- 204 (Washington, D. C.: Dec. 6, 2002); Hindrances to Coordinating
Transportation of People Participating in Federally Funded Grant Programs:
Volume I, GAO/ RCED- 77- 119 (Washington, D. C.: Oct. 17, 1977).

3 For the purposes of this report, spending refers to estimated or actual
outlays or obligations, depending on what information was available from
the agency.

Page 3 GAO- 03- 697 Transportation Coordination of characteristics
including urban/ rural mix, geographic area of the country, and presence
or absence of a state council or other coordinating

body. Appendix I contains more information about our scope and
methodology.

We identified 62 federal programs* most of which are administered by the
Departments of Health and Human Services, Labor, Education, and
Transportation* that are used to fund transportation services for
transportation- disadvantaged populations. Sixteen of these seem
particularly relevant in that the Community Transportation Association of
America 4 identified them as being regularly used to fund transportation
services. In addition, based on available information, we identified 11
other programs that are notable, in that transportation spending under
each one was at least $4 million in fiscal year 2001. While the remaining
programs also fund transportation services, they do so minimally, or the
extent of transportation services funded is unknown, according to program
officials. Most programs purchase transportation services from existing
private or public providers. For example, several programs in the

Department of Labor typically provide bus tokens, and Medicaid providers
often contract with local transportation providers. 5 In contrast,
Department of Transportation programs and several others such as Head

Start in the Department of Health and Human Services typically purchase
and operate vehicles or modify them for use by individuals with
disabilities. Several of these 62 programs are required to coordinate
services they provide with other agencies providing similar services,
which can include transportation.

Federal, state, and local spending for these transportation services is in
the billions of dollars, although the full extent of spending is unknown
because transportation spending is not always tracked separately from
other program spending. In the 29 programs for which we could obtain

actual spending amounts or estimates from program officials, federal 4 The
Community Transportation Association of America is a national,
professional membership association that conducts research and provides
technical assistance for community transportation providers. See Community
Transportation Association of America, Building Mobility Partnerships:
Opportunities for Federal Investment

(Washington, D. C.: March 2002). 5 Medicaid is a joint federal- state
program to finance health care coverage for certain categories of low-
income individuals, including families with children, persons with
disabilities, and elderly individuals. Results in Brief

Page 4 GAO- 03- 697 Transportation Coordination spending on transportation
services for transportation- disadvantaged populations was at least $2.4
billion in fiscal year 2001. Department of Health and Human Services
programs spent about three- quarters of this

amount. State and local agencies also provide funding for many of these
programs, often to fulfill matching requirements, which generally range
from 5 to 50 percent of total program costs for these programs. Estimates
of state and local spending are generally not available because few
agencies track such information at the federal or state level. However,
based on available information, it is evident that state and local
contributions for these services are significant* at least several hundred
million dollars.

Efforts to improve services and achieve cost savings through coordination
of transportation activities among agencies at all levels of government
vary; however, in some areas we visited, close coordination among
providers has shown promising results. Some local agencies have realized
substantial benefits by coordinating their transportation services through
sharing vehicles, consolidating services under a single agency, or sharing
information about available services. For example, a transit agency in
South Dakota consolidated the transportation services previously provided
by both senior and medical centers as well as other federal, state, and
local programs. This consolidation allowed the agency to expand its

service hours and increase the number of trips provided while reducing the
average cost of providing each trip by about 20 percent. We found
instances, however, in which there were overlapping, fragmented, or
confusing services among programs that did not coordinate. For example, a
local official said that the vans delivering clients to the local job
center are owned by many different programs, but because the programs do
not coordinate, only a few people ride in each van. At the federal level,
agencies have taken some limited steps to coordinate their transportation
programs since our 1999 report. 6 For example, the Coordinating Council on
Access and Mobility has finalized a strategic plan and issued guidelines
for coordinating transportation services. However, the long- term goals
and objectives in its strategic plan are generally not measurable, and
they are not linked to the activities in the Council*s action plan. Also,
the strategic and annual performance plans of the Departments of
Transportation and Health and Human Services contain few references to
coordination of programs for the transportation- disadvantaged, and the
plans of the Departments of Labor, Education, and the other federal
agencies contain

6 GAO/ RCED- 00- 1.

Page 5 GAO- 03- 697 Transportation Coordination no such references. In
addition, the Coordinating Council only includes officials from two
federal departments (Transportation and Health and

Human Services), representing less than half of the 62 federal programs
that can be used to fund services for the transportation- disadvantaged,
while the Departments of Labor and Education, which administer onethird of
the programs, are not members of the Council. Furthermore, while the
Coordinating Council is working to improve its Web site, the site is not
linked to the Web site of the Department of Health and Human Services,
making it more difficult for human service agencies at all government
levels to be aware of and access the site.

Although decision makers face numerous obstacles in trying to coordinate
transportation services for the transportation- disadvantaged, officials
and experts that we consulted also offered several potential options to
mitigate these obstacles and enhance coordination among federal, state,
and local agencies. We grouped the obstacles into three categories: (1)
reluctance to share vehicles and fund coordination activities due to
concerns about

possible adverse effects on clients; (2) different eligibility
requirements, safety standards, and other programmatic requirements that
can limit programs* ability to share transportation resources; and (3)
lack of leadership and commitment to coordinate, as evidenced by the
limited guidance and information provided by federal and state agencies on
the possible techniques for coordinating services. To mitigate these
obstacles, officials and experts suggested three potential options. One
option is to

harmonize standards among federal programs* such as safety standards
related to types of seat belts and driver training requirements* so that
programs can serve additional populations or better share transportation
resources. Another option is to expand interagency forums that would
facilitate communication among agencies involved in coordination efforts
and to share additional technical guidance and information on coordination
among federal and state agencies through a central clearinghouse or
improved Web site. The third option is to provide financial incentives or
mandates that would give priority in federal funding to those grant
applicants that show a strong commitment to coordinate or

require specific coordination efforts among grant recipients as a
condition of receiving federal funding. We did not assess the costs and
benefits of these options; however, some would require extensive statutory
or regulatory changes and could cause agencies to incur significant costs.

Given the multiplicity of federal programs that can fund transportation
services for the transportation- disadvantaged, and the significant
amounts spent on those services, effective coordination efforts are needed
to ensure that transportation services reach the greatest number of

Page 6 GAO- 03- 697 Transportation Coordination recipients. Accordingly,
our report contains several recommendations designed to strengthen and
enhance coordination activities in the four

federal departments that administer most of the programs that fund
transportation services* Health and Human Services, Labor, Education, and
Transportation. In commenting on the draft of this report, those four

departments generally concurred with the findings and recommendations. In
addition, we provided the draft report to two other departments that
provide services to the transportation- disadvantaged* Housing and Urban
Development and Veterans Affairs* and those departments also agreed

with the findings. In some cases, these departments also provided
technical clarifications, which were incorporated as appropriate to ensure
accuracy.

Many elderly, disabled, and low- income individuals face significant
challenges in accessing transportation. For example, some of these
challenges are as follows:

 Sixteen percent of respondents over age 75 reported not having a
driver*s license in 2001, and 25 percent of the respondents had not driven
at least once in the last month according to an AARP survey. 7 Elderly
people are also more likely to have difficulty accessing traditional
public transportation due to physical ailments.

 Thirty percent of respondents with disabilities reported difficulty in
accessing transportation, compared to 10 percent of respondents without a
disability, according to a 2000 survey by the National Organization on
Disabilities.

 Low- income households are less likely to own a car than other
households due to the prohibitive cost of purchasing, insuring, and
maintaining a car, and public transportation may not provide sufficient
options for their needs. Over 90 percent of public assistance recipients
do not own a car. 8 7 Anita Stowell Ritter, Audrey Straight, Ed Evans,
Understanding Senior Transportation:

Report and Analysis of a Survey of Consumers Age 50+ (Washington, D. C.:
AARP Public Policy Institute, 2002).

8 U. S. Federal Highway Administration and U. S. Federal Transit
Administration, 2002 Status of the Nation*s Highways, Bridges, and
Transit: Conditions and Performance

(Washington, D. C.: Department of Transportation, 2003). Background

Page 7 GAO- 03- 697 Transportation Coordination The importance of
coordinating transportation services for transportationdisadvantaged
populations has been evident since the 1970s. In 1977, we

issued a report on transportation coordination, 9 which concluded that the
most significant hindrance to the coordination of transportation services
under these programs was confusion at all levels of government as to how
much coordination federally funded projects could engage in. Since 1986,
responsibility for coordinating transportation programs at the federal
level has rested in the Coordinating Council on Access and Mobility, which
was created under a memorandum of understanding between the Department of
Health and Human Services (HHS) and the Department of Transportation
(DOT). This body is composed of representatives from program offices
within these departments, and employees of the two departments meet its
staffing needs, on a part- time basis.

More recent reviews have continued to identify a need for stronger efforts
in this area. In a 1999 report on transportation coordination, 10 we found
that coordination efforts of the Coordinating Council, DOT, and HHS were
ongoing but still needed strengthening. This report also noted that the
Congress had endorsed increased coordination as evidenced by several
provisions in the Transportation Equity Act for the 21st Century (TEA21),
11 and significant financial benefits had been realized through

coordination. In addition, reports by advocacy groups and transportation
researchers have raised concerns over continuing duplication of effort
among federal programs and certain sub- populations still not being served
effectively. 12 9 GAO/ RCED- 77- 119. 10 GAO/ RCED- 00- 1.

11 P. L. 105- 178. 12 For example, a report prepared for AARP found that
transportation resources for the elderly, disabled, and other groups were
often not coordinated, leading to duplication of services. The services
were also found to vary in quality and to fail to address the needs of
individuals who did not meet specific agency or program eligibility
requirements. See Jon E. Burkhardt, Coordinated Transportation Systems
(Washington, D. C.: AARP, September 2000).

Page 8 GAO- 03- 697 Transportation Coordination We identified 62 federal
programs that fund transportation services to populations that are
transportation- disadvantaged. 13 As shown in figure 1, the bulk of these
programs are administered by four federal agencies* 23 programs in HHS, 15
programs in the Department of Labor (DOL), 8

programs in the Department of Education, and 6 programs in DOT. 14 The
remaining 10 programs are administered by the Departments of Housing and
Urban Development (HUD), Veterans Affairs (VA), Agriculture, and the
Interior. A full listing of programs, their authorizing legislation,
typical uses, types of trips provided, target populations, and spending
information is found in appendix II.

13 In addition to these 62 programs, it is likely that there other federal
programs that could be used to fund transportation improvements or other
transportation services. Our scope included programs that provide
nonemergency, nonmilitary, surface transportation services, targeted to
transportation- disadvantaged populations. We excluded most programs that
were strictly for research or demonstration activities or provided
strictly cash assistance with no restrictions on use, as well as some
economic development programs that benefit the general public and are not
targeted to transportationdisadvantaged

populations. Efforts by other researchers to inventory all federal
programs that could conceivably provide transportation yielded additional
programs not found in our inventory due to differing selection criteria.
See Building Mobility Partnerships: Opportunities for Federal Investment.

14 Two DOT programs that are included here, the Urbanized Area and
Nonurbanized Area Formula Programs, are used to support mass transit
intended for the general public, many of whom could conceivably provide
their own transportation. We include them because the Americans with
Disabilities Act (ADA) of 1990 (42 U. S. C. 126) requires that transit
operators provide accessible paratransit service that is comparable to
their regular service for disabled individuals who are unable to provide
their own transportation or access the regular transit system, and TEA- 21
allows a portion of these transit formula grants to be used to offset
paratransit operating costs. Sixty- Two Federal

Programs Fund Transportation Services to TransportationDisadvantaged

Populations

Page 9 GAO- 03- 697 Transportation Coordination Figure 1: Number of
Programs Providing Transportation Services to the Transportation-
Disadvantaged, by Agency

Many of the 62 programs are significantly involved in providing
transportation services to their recipients. These include 16 programs
identified by the Community Transportation Association of America

(CTAA) 15 as being routinely used to provide transportation and an
additional 11 programs that we identified as spending at least $4 million
for transportation services to transportation- disadvantaged populations
in fiscal year 2001 on the basis of funding data or estimates that were

available. The remaining programs also fund transportation services, but
do so minimally, or the extent of transportation services funded is
unknown, according to program officials. Table 1 shows the 16 programs
identified by CTAA and how they provide transportation. These 16 programs
are administered by DOT, HHS, Education, and DOL. As the table shows,
transportation is not the primary purpose of most of these programs. For
example, Medicaid provides payments for medical services, and the
Vocational Rehabilitation Grants Program provides training and employment
services to individuals with disabilities. 15 Building Mobility
Partnerships: Opportunities for Federal Investment.

Page 10 GAO- 03- 697 Transportation Coordination Table 1: Sixteen Programs
Identified by CTAA as Regularly Providing Funding for Transportation
Agency Program Description

Department of Education Vocational

Rehabilitation Grants Assists states in operating programs that provide
vocational rehabilitation services

for individuals with disabilities. Services include counseling, training,
job placement, and other supportive services, including transportation.
Grants for Supportive Services and Senior Centers

Assists states in developing a community- based system of services for
older individuals. Services provided include nutrition services, caregiver
support services, senior centers, and transportation services. Program for
American Indian, Alaskan Native, and Native Hawaiian Elders

Assists tribal organizations in the delivery of supportive services to
older Native Americans. Services provided include nutrition services,
caregiver support services, senior centers, and transportation services.

Head Start Assists local grantees in providing a program of comprehensive
health, educational, and other services to promote school readiness for
low- income children. Transportation to and from program services is
generally provided. Medicaid Assists states in payments for medical
assistance to populations that meet categorical eligibility (such as
families with children or persons who are elderly or

disabled) as well as income and resource requirements. States are required
to assure transportation to medical services. Department of

Health and Human Services

Temporary Assistance for Needy Families Provides grants to states or
tribes to assist needy families with children. Grantees

have the flexibility to use funds in any manner that meets the purposes of
the program, which can include transportation to services. Senior
Community Service Employment Program

Assists states and other grantees in providing work opportunities in
community service activities for low- income individuals 55 years of age
and older. Transportation to training and job placements can be provided.

Workforce Investment Act Adult Services Program

Assists states in providing workforce investment activities. *Intensive*
services provided to low- income participants include occupational and
basic skills training, and transportation can be provided to access such
services. Workforce Investment Act Dislocated Worker Program

Assists states in providing workforce investment activities. *Intensive*
services provided to low- income participants include occupational and
basic skills training, and transportation can be provided to access such
services. Department of

Labor Workforce Investment Act Youth Activities Assists states in
providing workforce investment activities that will help low- income

youth acquire the skills, training, and support needed to achieve
employment success. Transportation can be provided to access services.
Capital Investment

Grants Assists states in financing facilities for use in mass public
transportation service. Projects can include those that are designed to
meet the special needs of elderly or

disabled individuals. Urbanized Area Formula Program Assists urbanized
areas in financing capital projects for use in mass transportation
service. Ten percent of funds may be used to pay for ADA paratransit
operating

costs. a Nonurbanized Area Formula Program Assists nonurbanized areas with
capital and operating expenses needed to provide

public transportation service. Ten percent of funds may be used to pay for
ADA paratransit operating costs. Job Access and Reverse Commute Provides
grants to develop transportation services to connect low- income persons
to

employment and support services. Funds can be used for capital and
operating costs associated with new or expanded service. Department of

Transportation Capital and Training Assistance for Overthe- Road Bus
Accessibility

Assists private operators of over- the- road buses with financing capital
and training costs associated with making buses accessible to individuals
with disabilities.

Page 11 GAO- 03- 697 Transportation Coordination Agency Program
Description

Capital Assistance Program for Elderly Persons and Persons with
Disabilities

Provides financial assistance to nonprofit organizations in meeting the
transportation needs of elderly persons and persons with disabilities
where public transportation services are unavailable, insufficient, or
inappropriate. Funds may be used for eligible capital expenses, such as
purchasing vehicles, or to contract for service. Sources: CTAA and Catalog
of Federal Domestic Assistance.

a The ADA required that all fixed route transportation services and
facilities be accessible to individuals with disabilities, including
wheelchair users. While the ADA gave priority to providing such
transportation in the same vehicles used by the general riding public, it
also required complimentary paratransit systems as a *safety net* for
individuals whose disabilities prevent them from using accessible fixed-
route services.

Table 2 shows the 11 programs we identified as spending at least $4
million on transportation for the transportation- disadvantaged in fiscal
year 2001.

Table 2: Eleven Programs Spending at Least $4 Million in Fiscal Year 2001
Agency Program

Department of Agriculture Food Stamp Employment and Training Program
Department of Education 21st- Century Community Learning Centers
Department of Labor Job Corps

Community Health Centers HIV Care Grants Social Services Block Grants
Department of Health and

Human Services State Children*s Health Insurance Program Community
Development Block Grant Department of Housing and Urban Development
Supportive Housing Program Automobiles and Adaptive Equipment for Certain

Disabled Veterans Department of Veterans Affairs Veterans Medical Care
Source: GAO. Under most of the federal programs providing transportation
services,

funding recipients typically purchase the services from existing sources,
according to program officials. This includes contracting for services
with private transportation providers or providing bus tokens, transit
passes, taxi vouchers, mileage reimbursement to volunteers or program
participants, or some combination of these methods. For example,

recipients of funds from DOL*s Workforce Investment Act Adult Services
Program typically provide bus tokens or mileage reimbursement for
participants to access training, while recipients of HHS*s Grants for
Supportive Services and Senior Centers most often contract with local
transportation providers to provide client transportation. The funding
recipients of several programs, however, typically purchase and operate

Page 12 GAO- 03- 697 Transportation Coordination vehicles, or modify
existing vehicles for use by individuals with disabilities. These programs
include Head Start and the Program for

American Indian, Alaskan Native, and Hawaiian Elders in HHS; the
Vocational Rehabilitation Grants Program in the Department of Education;
and the six programs within DOT.

Several of these programs have requirements for grantees to coordinate
their services with other agencies providing similar services, which would
include transportation, among other services. For example, Head Start
grantees are required to make every reasonable effort to coordinate
transportation services they provide with other human service
transportation in their communities. Similarly, DOT*s Capital Assistance
Program for Elderly Persons and Persons with Disabilities, Job Access and
Reverse Commute, and Nonurbanized Area Formula Program have requirements
for grantees to coordinate their transportation services. In addition,
some programs have provisions designed to avoid duplication of effort and
encourage the use of existing community resources. For example, Workforce
Investment Act programs may use funds to support those who are
participating in the program only if those individuals are unable to
obtain services through other programs, according to program officials.
Also, the Veterans* Workforce Investment Program requires

grantees to provide information on the linkages this program will have
with other providers of services to benefit veterans.

Available information shows that federal programs spent an estimated $2.4
billion on transportation services for transportation- disadvantaged
populations in fiscal year 2001, and additional state and local spending
for these populations was several hundred million dollars more. Complete
spending information is not available because many federal funding
recipients are not required to distinguish transportation from other
spending when reporting spending information to federal agencies. Extent
of Spending on

Services for the TransportationDisadvantaged Is Not Fully Known but Is in
the Billions of Dollars

Page 13 GAO- 03- 697 Transportation Coordination Information on federal
spending for transportation is available for 29 of the 62 programs we
identified. 16 These programs spent an estimated $2.4 billion on
transportation services in fiscal year 2001. (Appendix II lists

available spending data for each federal program.) Based on available
information, HHS programs as a whole spent the most on transportation for
transportation- disadvantaged populations in 2001* an estimated $1.8
billion. Table 3 shows estimated transportation spending by the eight

federal agencies that fund services for the transportation- disadvantaged.

Table 3: Estimated Spending on Transportation Services for the
Transportation- Disadvantaged by Eight Federal Agencies in Fiscal Year
2001

Agency Amount spent on

transportation for transportationdisadvantaged

(in millions) Percent of total estimate Number of programs

included in estimate Total number of

programs that provide transportation

Department of Health and Human Services $1,771.0 72.4% 10 23

Department of Transportation $317.3 13.0% 6 6

Department of Veterans Affairs $160.8 6.6% 3 3

Department of Education $135.3 5.5% 2 8

Department of Labor $26.4 1.1% 3 15

Department of Housing and Urban Development $21.7 0.9% 4 4

Department of Agriculture $13.0 0.5% 1 1

Department of the Interior Not available 0.0% 0 2 Total (for 8 agencies)
$2,445.5 100.0% 29 62

Sources: GAO summary of HHS, DOT, VA, Education, DOL, Agriculture, HUD,
and Interior data and estimates. More than three- quarters of our estimate
is based on spending for transportation in five programs. Of the five,
Medicaid and Head Start, both in HHS, spent the most on transportation in
fiscal year 2001* an estimated $976.2 million and $514.5 million,
respectively. The three other programs, all of which spent more than $100
million on services for the

transportation- disadvantaged in fiscal year 2001, were DOT*s Capital
Assistance Program for Elderly Persons and Persons with Disabilities,

16 Of these 29 programs, 17 provided actual spending data for fiscal year
2001. Program officials for the remaining 12 programs provided an estimate
of transportation spending for 2001. Spending by 29 Federal

Programs Is Estimated at $2.4 billion in Fiscal Year 2001

Page 14 GAO- 03- 697 Transportation Coordination HHS*s Temporary
Assistance for Needy Families (TANF), and VA*s Veterans Medical Care
Benefits.

The amount spent on transportation services by the remaining 33 federal
programs is unknown, mainly because the majority of programs do not
require recipients of federal funds to report transportation spending
information to the federal agency. 17 Total state and local spending for
transportation services, which

supplements federal spending for such programs, is likely significant* at
least in the hundreds of millions of dollars* although the total is
unknown because most programs do not require grantees to report these
data. Matching requirements, which represent the nonfederal contributions
to the program*s costs that come from state, local, or private funds,
provide some information on state and local spending on transportation for
the transportation- disadvantaged. About half of the 62 programs have
matching requirements that generally require states and localities to
contribute between 5 and 50 percent of total costs. 18 Additionally,
limited information from officials in the five states we visited indicates
that total

17 Total program obligations for these 33 programs were about $14.8
billion in fiscal year 2001. While information was not available on the
portion of the $14.8 billion devoted to providing transportation services,
we were able to analyze data on other human services programs which
indicate that, on average, about 3 percent of total spending on those

programs was devoted to transportation. We do not know whether this 3
percent is an appropriate estimate of transportation spending for these 33
programs because grantees are not required to report transportation
spending information to the federal agency. Furthermore, several officials
who administer programs that had no spending data told us that
transportation services probably represented less than 1 percent of their
total program spending. 18 It is difficult to determine the amount of
nonfederal contributions to transportation services on the basis of
matching requirements because grantees are generally required to

match total program spending rather than spending for a particular
service, such as transportation. To illustrate, Head Start grantees are
required to contribute 20 percent of total program costs, not necessarily
20 percent of transportation costs. Transportation under the program could
be entirely funded from federal dollars while the local share is used to
fund teachers or other program costs. The issue is further complicated
because

some of these programs have maintenance of effort (MOE) requirements
(which require states and localities to maintain their contributions to a
program at some pre- determined level) rather than matching requirements.
Under the TANF program, for example, the state*s MOE requirement is
determined through an index against the amount the state spent

for fiscal year 1994 under the Aid to Families with Dependent Children
program. MOE funds will, therefore, constitute a different percentage of
total program spending for each state in each year. State and Local

Transportation Spending Is Unknown, but Is Likely Significant

Page 15 GAO- 03- 697 Transportation Coordination state and local spending
on transportation runs into the hundreds of millions of dollars. For
example:

 Nonfederal contributions for Medicaid nonemergency transportation ranged
from 32 to 50 percent of the total spending on this service in the five
states that we visited. 19 In New York, 50 percent, or an estimated $139.4
million, of the state*s total spending on Medicaid funded transportation
in 2001 was from nonfederal sources. In Florida and Wisconsin
approximately 40 percent of the total amount spent on nonemergency medical
transportation in the state was from nonfederal sources; state
contributions in those states were $28.6 million and $13.4 million,
respectively, in 2001. In Arizona and South Dakota, approximately one-
third of the total amount spent on Medicaid transportation was from
nonfederal sources in those states in 2001, approximately $7.0 million and
$490, 000, respectively.  In Wisconsin nearly 38 percent, or $922,000, of
the funding to provide

transportation services through DOT*s Capital Assistance Program for
Elderly Persons and Persons with Disabilities in 2001 was from nonfederal
sources. The program requires grantees to provide 20 percent of total
program funding.

 In New York, about 30 percent of the spending on transportation under
the Department of Education*s Vocational Rehabilitation Program in 2002,
or $2.6 million, was from nonfederal sources. 20 Similarly, about 27
percent or

$673,000 of Florida*s funding was from nonfederal sources in 2001. The
program requires states to contribute 21.3 percent of total costs.

Although some states and localities currently spend a significant amount
for transportation through federal programs, many now face budget deficits
that could diminish their future contribution to these programs. In a 2003
survey by the National Conference of State Legislatures, 21 36 states

19 The amount that states are required to contribute depends on how states
claim transportation under Medicaid. If states claim Medicaid as an
optional medical expense, the state or local portion ranges from 17 to 50
percent of total costs, based on a measure known as the Federal Medical
Assistance Percentage. If states claim transportation as an administrative
expense, the state or local portion is 50 percent of total costs. 20 Data
for state fiscal year 2001 were not available. Program officials indicate
that there should not be significant differences in 2001 and 2002 spending
information. 21 National Conference of State Legislatures, State Budget
Update: February 2003

(Washington, D. C.: February 2003).

Page 16 GAO- 03- 697 Transportation Coordination reported budget deficits
midway through their fiscal year. Fifteen of these states reported
deficits in excess of 5 percent of the state budget, and four

states are facing deficits greater than 10 percent of the state budget.
Because 49 states have balanced budget requirements, such large deficits
could lead to a decrease in the amount of funds available to states for

programmatic spending, including transportation programs. For example,
according to the National Conference of State Legislatures report, 29
states have imposed across- the- board cuts in response to budget
deficits.

State budget deficits have affected state transportation spending
differently in the five states that we visited. For example:

 Two of the states have cut their state programs that local grantees used
to fund services for the transportation- disadvantaged, according to
transportation officials in those states. In one state, the state
legislature eliminated the state*s transportation assistance program to
help deal with the state*s budget deficit; as a result, the state official
and the director of a senior center in the state said that some of the
projects funded through the

program will likely be discontinued because grantees cannot find
replacement funds. In the other state, the state legislature cut a state
fund that grantees used to supplement federal transportation funding.

According to an official, the loss of this fund, combined with the
increasing costs of fuel and insurance, may lead providers to cut service
to transportation- disadvantaged populations by as much as 40 percent.

 In another state, the Governor*s plan for closing the state*s budget gap
includes reducing spending on Medicaid nonemergency medical transportation
by $5 million, or 7.6 percent; however, the state*s fund dedicated to
providing other services for the transportation- disadvantaged was not
recommended for cuts.

 Transportation officials in two states told us that they had not yet
experienced cuts in state funding for services for the
transportationdisadvantaged. In one of the states, local grantees rely on
a state transportation fund and a large set- aside of TANF funds to
provide services to transportation- disadvantaged populations. Without
these two funds, local grantees would have difficulty financing services
for the transportation- disadvantaged, according to an official. The other
state is not currently anticipating cuts in state funding for services for
transportation- disadvantaged populations, however, according to an
official, the full impact of the fiscal situation in that state will not
be known until local governments develop program budgets for 2004 because
the local governments* which are also facing budget constraints* play a
key role in determining what services will be provided.

Page 17 GAO- 03- 697 Transportation Coordination While some states are not
currently experiencing reductions in their transportation programs, many
states are anticipating that budget deficits

will continue into 2004. According to the National Conference of State
Legislatures report, 36 states are anticipating budget gaps for 2004;
nearly all of these states anticipate gaps greater than 5 percent of their
state

budget and half of these states expect gaps greater than 10 percent. 22
Efforts to improve services and achieve cost savings through coordination
of transportation activities among agencies at all levels of government
vary. At the state and local levels, the extent and the type of
coordination activities differ, ranging from one state body providing
guidance and overseeing coordination efforts for most of its programs to
two local agencies sharing vehicles. In some areas within the five states
we visited, coordination among providers has resulted in significant
benefits, such as improved customer service and lower unit costs. However,
we also found some examples of overlapping, fragmented, or confusing
services resulting

from a lack of coordination. At the federal level, DOT, HHS, and* to some
extent* DOL have undertaken some activities aimed at improving
coordination among their programs. DOT and HHS implement many of their
activities through the Coordinating Council on Access and Mobility.
However, DOT and HHS make only a few mentions of coordinating services for
the transportation- disadvantaged in their strategic and annual
performance plans, and other agencies do not mention such activities at
all. Also, several federal agencies that provide services to the
transportation- disadvantaged are not involved in coordination efforts at

the national level. While agencies within each state we visited were
involved in some form of coordination, the extent of coordination of
transportation services varies widely. For example, Florida has a state
organization that oversees the

coordination of most of the transportation services for the
transportationdisadvantaged, while some other states we visited had no
statewide coordination body. Even in states without such a coordinating
body, however, some state and local agencies are engaged in coordination
efforts. This variation also occurred in the nation as a whole, according
to data from a preliminary report by the National Academy of Sciences*
Transportation Research Board, which found that roughly half of U. S.

22 Eleven states and the District of Columbia did not report 2004 budget
deficit information. Coordination Efforts

Vary, but Some Successful Efforts Show Promising Results

Extent of State and Local Transportation Coordination Varies

Page 18 GAO- 03- 697 Transportation Coordination states have a state
transportation coordinating body. 23 (See appendix III for information on
the type of coordination in the five states we visited

and the state agencies involved.) Within each state, local efforts also
varied. Examples of coordination activities include the following:

Coordinated planning: In this type of coordination, some combination of
human service and transportation agencies and providers work together to
plan transportation services for their clients. For example, in
northwestern

Wisconsin, at the initiative of staff from a center for independent
living, the Area Consortium on Transportation was formed in 2001 to
improve the planning and provision of transportation for the disabled and
others who

are transit- dependent. The council* which consists of consumers, transit
providers, county and city officials, disability organizations, and aging
groups* is instituting several pilot programs to test various methods of

coordination.

Brokerage: 24 In this type of coordination, one agency or provider serves
as the central point of contact for providing ride and eligibility
information or actually arranging transportation services for clients of
multiple programs. For example, officials in several New York counties
wanted to maximize residents* mobility by coordinating transportation
services offered by various federal and state programs, but lacked the
expertise or start- up costs to do so. With a grant from the state
Departments of Transportation and Health, the counties instituted a
coordination demonstration project whereby one agency arranges an average
of 2, 500 daily trips for clients from a number of populations* such as
the disabled, senior citizens, former welfare recipients, and others*
served by different federal and state programs.

23 Westat, Toolkit for Rural Community Coordinated Transportation
Services, Transit Cooperative Research Project of the Transportation
Research Board, Project B- 24, Interim Report (Rockville, MD: March 2002).

24 The Community Transportation Association of America defines brokerage
as a method of providing transportation where riders are matched with
appropriate transportation providers through a central trip- request and
administration facility. The transportation

broker may centralize vehicle dispatch, record keeping, vehicle
maintenance, and other functions under contractual arrangements with
agencies, municipalities, and other organizations. Actual trips are
provided by a number of different vendors.

Page 19 GAO- 03- 697 Transportation Coordination Shared use of vehicles
among multiple programs: In this type of coordination, one agency may
provide transportation for clients of

multiple programs, or each program may own its own vehicles but allow them
to be used by other programs. For example, in Arizona, vans from one
county*s vocational rehabilitation center travel to a neighboring county
to pick up program clients. While there, they also transport clients of
Jobs Administration programs. The two programs split the cost of
transportation equally.

Appendix IV contains a list of some informational resources available for
agencies interested in coordinating. In some areas we visited,
coordination among providers* through sharing

vehicles, consolidating services under a single agency, or sharing
information about available services* has resulted in significant
benefits, such as improved customer service and lower unit costs. State
and local

agencies providing transportation under the 62 federal programs often
serve similar client groups, provide similar services, and operate in
similar geographic areas, so there can be duplication of effort and
inefficiency in providing transportation when those agencies do not
coordinate. In our

site visits, we found several examples of overlapping, fragmented, or
confusing services in places where agencies were not coordinating.

Through coordination, some local agencies have realized both improved
levels of service and financial benefits, such as reduced costs of
providing each trip, as follows:

Improved customer service:

 A coordinated system in central Florida provides transportation for
Medicaid, vocational rehabilitation, and other programs. According to
local officials, vans used to show up late, if at all, and clients had
difficulty finding out the status of their ride. Since consolidating
services under a single provider and bringing scheduling and dispatch
services in- house, officials report service improvement.

 Through collaboration, information- sharing, and cost- sharing among
county agencies, the Clinton County transit system in New York serves both
Medicaid and elderly populations, making it easier for those populations
to access medical and community services because they only have to be
familiar with one system. Coordination Has Led to

Improvements, While Lack of Coordination Can Result in Overlap

Benefits of Coordination

Page 20 GAO- 03- 697 Transportation Coordination  A federal regional
official said that coordination could remove the stigma of specialized
transportation because all recipients use the same service

and are treated equally.

Financial benefits:

 Three New York counties joined in a transportation brokering service
that saved an estimated $92,000 in 2001 by identifying a lower- cost
alternative means of transportation, that is, moving groups of clients in
buses rather than transporting individual clients in taxis. This brokerage
service provides transportation to Medicaid patients, the disabled,
veterans, and other client groups.

 In Aberdeen, South Dakota, the local transit agency consolidated the
transportation services previously provided by both senior and medical
centers as well as other federal, state, and local programs. This
consolidation allowed the agency to increase the number of trips provided
while reducing the average cost of providing each trip by about 20

percent* from about $5 to $4. The agency has also improved its services by
coordinating with local taxi companies to provide night and weekend trips.

Although the various programs we reviewed target specific populations,
some populations are eligible to receive transportation services from
multiple programs, resulting in duplication and inefficiency in some
cases. In our visits with state and local transportation and human service
agencies and providers, officials we interviewed identified several
examples of overlapping services in areas or programs that were not
coordinating. A for- profit transportation provider in one state told us
that he often has two vehicles overlap on the same route at the same time,
one for medical trips and one for paratransit, 25 because it is too
difficult to mix clients due to complicated fee structures and paperwork
requirements imposed by the state for the two programs. An official from a
workforce development program in another state told us that many programs
in his county use their own vans to deliver clients to the job center, but
because the programs do not coordinate, only a few people ride in each
van. In another locality that state and local officials said has had
difficulty

coordinating, several human service providers hired a consultant to study
25 Paratransit most often refers to wheelchair- accessible, demand-
response van service, according to the Community Transportation
Association of America, and is more flexible than fixed route transit but
more structured than the use of a private automobile. Effects of a Lack of

Coordination

Page 21 GAO- 03- 697 Transportation Coordination the extent to which
various agencies provide similar transportation services within a
geographic region. This research showed substantial

overlap in local services for the transportation- disadvantaged, as shown
in figure 2. The consultant identified ways in which the number of routes
could be substantially reduced through better coordination, which are
being considered by the agencies involved.

Figure 2: Overlapping Daily Routes of Vehicles Serving the
TransportationDisadvantaged in Sioux Falls, South Dakota

Note: This picture shows the daily routes of vehicles operated by seven
different agencies in the same region of Sioux Falls, South Dakota.
Overlap occurs when routes have the same or nearby starting and ending
points and are transporting similar clients at similar times. This graphic
illustrates that many of these agencies have similar starting and ending
points. Among the agencies shown in

this graphic are two vocational rehabilitation agencies (serving the same
general population) as well as agencies that serve low- income clients or
clients with disabilities. While the graphic cannot show the time element,
many of these routes represent trips occurring within 30 minutes of each
other in the morning and afternoon.

Page 22 GAO- 03- 697 Transportation Coordination State and local officials
also provided examples of fragmented services and confusion in localities
without coordinated programs. One official in an uncoordinated area said
that a lack of coordination results in

fragmented services, placing a burden on people who receive transportation
through many different programs, depending on trip purpose, because they
must be familiar with multiple systems, rules, and requirements.
Fragmentation also occurs when adjoining counties do not coordinate their
public transportation routes, leaving riders stranded due to unconnected
transit systems. In one state, local officials told us that paratransit
services do not extend beyond county lines, so people have to schedule two
separate trips to get from their homes in one county to

medical services in an adjoining county. When the first paratransit ride
is behind schedule, a passenger sometimes has to wait for hours for the
connecting ride. A provider in another state has contracts to provide
transportation services for clients in multiple human service programs.
Because of a lack of coordination among those programs, the transportation
provider said that his company has to maintain two separate dispatching
and reservation systems for its vehicles to comply with differing
reporting and eligibility requirements. Vehicles can only operate under
one dispatching system at a time, so the drivers cannot provide rides to
more than one type of client at a time. The provider also said that
clients who call for rides are confused by the sheer number of programs,
and the agents who make their reservations do not know for which programs
the clients are eligible.

Although the Coordinating Council on Access and Mobility and various
federal agencies have taken a number of steps to improve coordination,
these efforts have had mixed results.

As shown in table 4, the Coordinating Council on Access and Mobility* a
body consisting of representatives from DOT and HHS* has responded to
three of the recommendations we made in our 1999 report 26 by adopting a

strategic plan, developing an action plan, and helping to ensure that
planned coordination efforts reinforce one another by issuing guidelines
for coordinating transportation services. Goals and objectives in the
strategic plan include such things as promoting interdepartmental
collaboration at the federal level through the development of a joint
agenda for transportation research that is of common use to multiple

26 GAO/ RCED- 00- 1. Federal Progress toward

Improved Coordination Varies Some Prior Recommendations

to the Coordinating Council Have Been Implemented

Page 23 GAO- 03- 697 Transportation Coordination federal departments.
According to the most recent action plan, the Council has completed some
activities, such as producing a series of *how to*

publications on using intelligent transportation systems to assist in the
coordination of HHS programs with local transit agencies.

Table 4: Status of Federal Responses to GAO*s Recommendations to Improve
Coordination Recommendations from 1999 GAO report Completed Under way

The DOT/ HHS Coordinating Council on Access and Mobility should adopt a
prioritized strategic plan. X The Coordinating Council should develop an
action plan with specific responsibilities. X The Coordinating Council
should issue an annual report on its major initiatives and accomplishments
to the Secretaries of DOT and HHS. X DOT and HHS should ensure that
planned coordination efforts reinforce one another. X DOT and HHS should
direct their regional working groups to assess obstacles to transportation
coordination.

X The Coordinating Council should strengthen its Web site and make
information available on obstacles to coordination and strategies to
overcome them.

X Source: GAO. The Council*s responses to the other three recommendations
are still

ongoing. For example, Council representatives told us that they plan to
issue their first annual report on coordination achievements in June 2003,
although this report was originally due to be issued in October 2000,
according to the Council*s strategic plan. With regard to the

recommendation on regional working groups, the 10 DOT and HHS regional
offices have been convening workshops with state transportation officials
during 2003 to discuss obstacles to coordination and other issues.

Finally, the Council*s efforts to strengthen its Web site have had mixed
results. One of the tasks listed in the Council*s strategic plan is to
develop and maintain a Web site that would, among other things, enhance
the exchange of coordination ideas, issues, and concerns. The Council has
developed a Web site 27 *operated by DOT in conjunction with CTAA* that is
reachable through a link on the Federal Transit Administration*s section

of DOT*s Web site. However, there is no similar link from HHS*s Web site
27 www. fta. dot. gov/ CCAM/ www. index. html.

Page 24 GAO- 03- 697 Transportation Coordination (or the Web sites of
other federal agencies that fund transportation services for the
transportation- disadvantaged), possibly making it more

difficult for human service and other agencies to be aware of and access
the site. In addition, the site does not yet contain specific information
on obstacles to coordination or strategies for overcoming them, which we
recommended in 1999, though it does contain links to some reports on the
subject. There is also a page from which viewers can E- mail the Council
with questions or suggestions. The Council is working with CTAA to further
strengthen the site.

Through the Council, DOT and HHS have sponsored a number of other efforts
to enhance coordination. For example, as part of an item in the Council*s
action plan, DOT and HHS helped initiate a consortium of national
professional organizations and interest groups 28 to conduct research and
provide educational activities related to coordinating services for the
transportation- disadvantaged. Among other tasks, the consortium has been
asked to pursue several items from the Council*s action plan, such as
identifying promising practices and obstacles in transportation
coordination and developing strategies for addressing the obstacles.
Officials from the Council said that working with the consortium provides
a depth of knowledge and experience because consortium members represent
local as well as national interests so that issues are pursued *from both
ends.*

As part of the upcoming regional workshops sponsored by the DOT and HHS
regional offices, participants will discuss expanded opportunities for
achieving more coordinated delivery of transportation services in medical,
aging, and other assistance programs, and technical assistance resources
will be shared with participants. Intended audiences include state
transportation coordinating councils; state agencies that administer
medical, aging, and other assistance programs; and agencies serving
individuals with disabilities. According to DOT and HHS, participants will
be asked to develop state transportation coordination action plans for
their home state, and resources will be made available to assist states in

28 To date, the consortium consists of the AARP, Amalgamated Transit
Union, American Association of State Highway and Transportation Officials,
American Public Transportation Association, American Public Human Services
Association, American Public Works Association, American Red Cross,
Association of Metropolitan Planning Organizations, Children*s Health
Fund, Community Transportation Association of America, Easter Seals
Project Action, National Association of Area Agencies on Aging, National
Conference of State Legislatures, National Governor*s Association, and the
Taxicab, Limousine, and

Paratransit Association. DOT and HHS Have Sponsored

Other Coordination Activities

Page 25 GAO- 03- 697 Transportation Coordination implementing their plans
following the workshop. (See appendix III for more information on federal
coordination activities.)

Because it is not a federal executive branch agency, the Coordinating
Council is not subject to the requirements of the Government Performance
and Results Act (GPRA) of 1993 29 and, therefore, does not have to follow
the act*s guidance for producing strategic plans, annual performance
plans, and annual reports. However, there are several best practices in
strategic planning that could be useful guides for improving the Council*s
strategic plan when it is updated at the end of 2003 and the action plan

when it is next updated. For example, the current strategic plan does not
contain an overall mission statement for the Council or performance
measures that clearly relate to its long- term goals and objectives, both
of which are considered best practices in strategic planning. 30 In
addition, there are no explicit links between the stated goals and
objectives in the strategic plan and the activities in the action plan.
For example, the current action plan includes seven tasks related to the
use of information technology systems, but those tasks are not clearly
linked to any of the Council*s long- term goals or objectives.

Because the Council has no funding or full- time staff of its own, it is
dependent on support from HHS and DOT. However, neither department
currently highlights the coordination of services for the
transportationdisadvantaged as a priority in its long- term strategic plan
or annual performance plan. According to GPRA guidance, agencies are
encouraged to identify programs with common purposes or crosscutting
issues in their strategic plans. In addition, the agencies* annual
performance plans should identify performance goals that reflect
activities being undertaken to support programs of a crosscutting nature,
and show evidence of coordination among crosscutting programs. 31 DOT*s
most recent strategic plan and performance plan do not explicitly mention
the Coordinating

Council, although both briefly discuss coordinating special- needs
transportation with other federal agencies under DOT*s Job Access and
Reverse Commute (JARC) program. However, there is no mention of
coordination of DOT*s Transit Capital Assistance Program for Elderly

29 P. L. 103- 62. 30 U. S. General Accounting Office, Agencies* Strategic
Plans Under GPRA: Key Questions to Facilitate Congressional Review, GAO/
GGD- 10.1.16 (Washington, D. C.: May 1, 1997).

31 U. S. General Accounting Office, The Results Act: An Evaluator*s Guide
to Assessing Agency Annual Performance Plans, GAO/ GGD- 10.1.20
(Washington, D. C.: Apr. 1, 1998). Coordination Remains Largely

Unaddressed in Strategic Planning Efforts

Page 26 GAO- 03- 697 Transportation Coordination Persons and Persons with
Disabilities with other programs for elderly or disabled populations. 32
At the subagency level, the Federal Transit

Administration*s strategic plan includes the Coordinating Council in an
appendix on coordination of crosscutting functions, under the strategic
goal of promoting economic growth and trade, and its performance plan
mentions working with the Council under a different goal* that of
promoting mobility and accessibility. 33 HHS*s current strategic plan does
not discuss coordination of transportation services with other agencies,
but its draft plan for 2003- 2008

specifically lists DOT and state and local transportation and human
service agencies as important partners in providing transportation to
access services in distressed communities and for health care and
employment and training programs elsewhere. Education, DOL, HUD, and VA
are not listed, however. 34 The performance plans of individual HHS
components vary widely in their treatment of transportation coordination.
For example, the performance plan of the Centers for Medicare & Medicaid
does not mention transportation at all, while the Administration on
Aging*s performance plan states that the agency works closely with HHS and
DOT officials on the Coordinating Council in pursuit of improved
transportation services.

The strategic and annual performance plans of the other federal agencies
that fund transportation services for the transportation- disadvantaged
generally do not mention coordination of such services.

Other federal agencies are also involved in some coordination efforts
outside the scope of the Council. For example, DOL is working with CTAA
and DOT to implement several rounds of pilot projects testing various
transportation strategies in support of local one- stop employment and

32 U. S. Department of Transportation, Strategic Plan 2000- 2005
(September 2000) and U. S. Department of Transportation, Performance Plan-
FY 2004 (Washington, D. C.: February 2003).

33 U. S. Department of Transportation Federal Transit Administration,
Strategic Plan 1998- 2002 (Washington, D. C.: March 1998) and U. S.
Department of Transportation Federal Transit Administration FY 2002
Performance Plan.

34 U. S. Department of Health and Human Services, draft of Strategic Plan
Fiscal Years 2003- 2008, Appendix A (Washington, D. C.: July 2002). Other
Federal Agencies Are

Involved in Some Coordination Efforts

Page 27 GAO- 03- 697 Transportation Coordination training centers. 35
Officials from DOT and DOL are also in the process of developing
guidelines for using Workforce Investment Act funds (a DOL

program) for Job Access purposes (a DOT program). In addition, some of
DOL*s research studies and technical assistance materials provide examples
of transportation coordination efforts. 36 However, we did not find
examples of involvement in transportation coordination efforts at the
national level at the Departments of Education, HUD, and VA, although some
of these agencies are involved in transportation working groups in some of
the federal regional offices. The membership of the Coordinating Council
only consists of DOT and HHS officials, representing less than half of the
62 federal programs that can be used to fund services for the
transportation- disadvantaged. Although these two agencies comprise the
majority of funding for transportation that we were able to identify, the
Departments of Labor and Education also have a significant number of
programs* more than one- third of the total* that provide services to the
transportation- disadvantaged. Officials from the Council said that other
agencies had expressed interest in coordination activities and had been
invited to observe Council meetings in the past, but only DOL sent a
representative for a short time period. 37 Council officials said it would
be very beneficial to have other agencies formally involved in their
coordination efforts, which would require a renewal of the Council*s
charter and memorandums of understanding among all agencies involved as
well as other formal mechanisms to ensure that the proper people are
engaged in the effort.

35 In an effort to coordinate service delivery for employment and training
programs, the Workforce Investment Act established one- stop centers in
all states. Individuals seeking employment opportunities and training can
receive services from more than a dozen federal programs that are required
to offer their services through these one- stop centers.

36 See *One- Stop Innovations: Leading Change under the WIA One- Stop
System,* a report prepared for the U. S. Department of Labor by the John
H. Heldrich Center for Workforce Development at Rutgers, the State
University of New Jersey (Mar. 12, 2002). 37 In addition, one of DOL*s
divisions in 2001 had a liaison to the Council*s Technical Committee*
which focused on coordinating employment programs for low- income
individuals. However, the DOL liaison indicated that little activity
ensued after the liaison briefed the committee on the one- stop centers,
and the committee later went dormant with the change in administration.

Page 28 GAO- 03- 697 Transportation Coordination Although some federal,
state, and local agencies encourage the coordination of services for the
transportation- disadvantaged and some

coordination efforts have been established, federal, state, and local
officials, as well as representatives of national advocacy and industry
organizations with whom we spoke, identified numerous obstacles that
impede effective coordination. We clustered the wide range of identified
obstacles into three categories related to (1) sharing vehicles and the
low priority given to funding coordination activities; (2) programmatic
differences; and (3) limited federal, state, and local leadership and
commitment to undertake and sustain coordination efforts. To mitigate
these obstacles, these officials and other experts suggested three
potential options: harmonizing standards and requirements among federal
programs

with a transportation component, providing and disseminating additional
guidance and information on coordination, and providing financial
incentives or mandates to coordinate.

One set of obstacles was related to officials* reluctance to share
vehicles or their tendency to give low priority to funding coordination
activities. In addition, some areas have limited transportation services
available, thus

limiting any opportunities to benefit from coordination. In interviews in
every state we visited, as well as with national advocacy and industry
organizations, the unwillingness or inability to share vehicles was
identified as a major obstacle. Administrators of some federal programs
may be apprehensive about sharing vehicles for coordination due, in part,
to their belief that only they understand their clients* needs and can
provide the necessary personalized services. For example, program
administrators reported being concerned about a loss of control over the
quality and convenience of transportation services for their clients and
wanted to maintain their discretion over how to serve their clients and
which transportation resources to purchase. Program administrators also
expressed concern over mixing vulnerable populations, such as the
developmentally disabled and children, or frail,

sick, and healthy populations, in one coordinated system. According to a
report on coordinated transportation systems, this reluctance among
providers to cooperate can lead to an underutilization of vehicles. 38 38
Moss Adams, LLP, Community Transportation Association of America, The
Coordination

Challenge (Seattle, WA: June 2000). Officials Cited

Numerous Obstacles to Successfully Coordinating Services and Provided
Potential Options to Mitigate Them

Officials May Be Reluctant to Share Vehicles and Provide Financial
Resources for Coordination

Apprehension about Sharing Vehicles

Page 29 GAO- 03- 697 Transportation Coordination Likewise, some human
service clients may be apprehensive about using coordinated transportation
because they may be uncomfortable mixing

with members of other populations with whom they are unfamiliar or they
may fear a loss of accommodation or convenience, such as having to switch
from door- to- door service to curb- to- curb service or public transit.
The overall costs of coordination, which can include additional staff

members and staff time needed for maintaining and overseeing coordination
efforts, can be significant. For example, a transportation brokerage firm
in one state faced substantial added costs when it began coordinating
transportation for human services programs due to

requirements to meet more stringent state and federal safety standards.
However, some officials stated that the low priority given to funding
coordination activities could impede coordination efforts. For example,
according to officials in one state, although recipients of funds from
DOT*s Capital Assistance Program for Elderly Persons and Persons with
Disabilities are required to coordinate with other local transportation
services provided from federal sources, the program*s current allotment
for administrative expenses would not support any staff to work on
coordination activities. In addition, some states invest in coordination,
while others do not allocate funds specifically for coordination, and
efforts to coordinate often become ancillary activities for those
involved.

Guidelines issued by the Coordinating Council state that coordination will
not solve all transportation problems in all communities. 39 Coordination
may not be an effective strategy in those communities that have limited
transportation services available, particularly in those communities that

are not served by public transportation. For example, in some remote
areas* such as the northwestern part of South Dakota where services
available to many communities are 40 to 60 miles away* there are few
transportation services available to transport individuals to hospitals or
other services. In these areas, coordination may not be a workable or
costeffective option.

39 Coordinating Council on Access and Mobility, Planning Guidelines for
Coordinated State and Local Specialized Transportation Services
(Washington, D. C.: Dec. 20, 2000). Low Priority Given to Funding

Coordination Activities Limited Transportation Services Available to
Realize Benefits from Coordination

Page 30 GAO- 03- 697 Transportation Coordination Coordinating multiple
programs administered at various levels of government is complicated
because the programs have different

requirements with respect to eligibility, funding, reporting, and safety;
and they differ in their programmatic goals and missions. Federal program
rules that specify the eligible populations that each program can serve
may limit opportunities for collaboration. For example, DOT officials in
one region stated that they were unable to combine DOL and DOT funds for a
DOT transportation program for migrant farm workers because DOL funds are
designated for U. S. citizens, while there is no such restriction on the
use of DOT funds. In addition, some liability

insurance policies specify that a program*s vehicles may serve only a
certain population, thus those programs face additional insurance costs to
transport individuals other than program clients. Such restrictions may
lead to inefficient transportation services within a community. For
example, an official in one state we visited commented that one agency*s
vehicle provided medically related trips three times per week to that
agency*s clients, but would not transport other individuals seeking
similar medical services provided under other federal programs due, in
part, to liability insurance restrictions. Safety requirements may also
vary by program and jurisdiction, thus complicating efforts to transport
multiple client groups. Some programs, such as Head Start, have specific
vehicle standards that are often more stringent than those of other
programs, making it difficult to share vehicles. For instance, different
standards for roof strength, types of seat belts, and driver
qualifications pose problems for schools, human service agencies, and
public transit providers interested in sharing vehicles. Some areas have
been able to overcome specific program rules to share vehicles. For
example, a Head Start

grantee in one state we visited was able to transport students using
vehicles supplied by the local public transit provider because these
vehicles met the same safety standards as school buses.

Funding streams and cycles vary across federal programs, making
coordination more difficult. For example, DOT funds generally flow from
the state to counties or cities, while DOL funds flow through the state to
local designees. In addition, funding for programs such as Head Start flow
directly to grantees rather than through states, making it more difficult
for

the states to directly manage the coordination activities of local
grantees, according to an official in one state. There is also complexity
in working with different funding time frames and cycles under multiple
federal programs. For example, although DOT*s JARC program allows grantees
to use other federal funds to provide the local *match* required to obtain
Differing Program

Requirements Can Impede Coordination

Different Eligibility Requirements

Varying Funding Streams and Cycles

Page 31 GAO- 03- 697 Transportation Coordination JARC funds, the funding
time frames and cycles of these other funding sources are different,
complicating efforts to combine financial resources.

Different reporting requirements among programs can create excessive
paperwork in a coordinated system and may make it difficult for agencies
to determine their true transportation costs and the benefits that may be
realized from coordination. For example, one report commented that a
transit provider was required to give each of several human service
agencies a separate bill for services provided, which reflected the unique
requirements imposed by each of those agencies. 40 Furthermore, according

to officials, Medicaid requires the state Medicaid agency to demonstrate
that individuals receiving transportation under Medicaid are not receiving
transportation from any other source and that the transportation is

medically necessary, complicating the determination of how to fund
transportation services for each Medicaid recipient in a coordinated
system in which costs are shared among agencies. In addition, human
service agencies and providers may not be required or accustomed to
collecting complete and uniform transportation data for their programs. A
recent report concluded that such information was beneficial because it
enabled administrators to re- evaluate how best to provide transportation
services and the savings they could achieve through coordination. 41 For
example, when Florida*s statewide coordination program was established,
state and local agencies in Florida reported their total estimated annual
transportation- related expenditures at $8 million. However, once
reporting requirements were in place for all agencies providing services
for the

transportation- disadvantaged, actual expenditures were estimated to total
$224.9 million statewide* much higher than the initial estimate. Such
information has helped agencies in Florida understand the true costs of
providing transportation and has encouraged some agencies to become more
interested in coordination as they realize the potential for cost

savings. Unlike transportation agencies, human service agencies provide
transportation as a secondary service so that their clients may access
primary human services. Therefore, while DOT- funded transportation
agencies have specific and relatively uniform federal requirements for

40 Ecosometrics, Inc., Recommended Framework for Developing State and
Local Human Services Transportation Planning Guidance (Bethesda, MD: Sept.
22, 1998). 41 Volpe National Transportation Systems Center, Innovative
State and Local Planning for Coordinated Transportation (U. S. Department
of Transportation, February 2002). Lack of Uniform Data

Collection and Reporting Requirements among Programs

Distinct Purposes and Goals among Agencies

Page 32 GAO- 03- 697 Transportation Coordination transportation planning,
human service agencies do not typically conduct transportation planning or
collect transportation- related data for their programs, making the
planning of coordinated transportation between

transit and human service agencies challenging. 42 In addition, human
service, transportation, medical, and workforce agencies all have distinct
technical languages and cultures, which may inhibit collaboration among
these agencies. In one state we visited, the labor and transportation
departments experienced difficulty collaborating because some common terms
have completely different meanings within each agency. For example,
transportation officials interpreted the term *cost- allocation* as an
accounting methodology to estimate the overall cost of operating
transportation services in order to determine the appropriate rate to
charge for these services, while state labor officials interpreted the
term as a way to determine what proportion of overall costs will be funded
by each agency.

Although some federal and state agencies have recognized the potential
offered by coordination and provided some assistance toward this end,
officials we interviewed expressed concerns about the amount and
effectiveness of the guidance they have received on coordination. In
addition, the absence of interagency forums or other mechanisms to develop
and share information about coordination initiatives limits the support
that local providers receive to effectively coordinate. Officials in some
states we visited said that they receive little federal

guidance on potential strategies to coordinate services. As a result, they
develop their own approaches without the benefit of guidance on the most
effective way to coordinate services. We found the following examples of
this in our work:

 Officials in one state said that the guidance on how to share costs
among programs for projects funded jointly by DOT*s JARC grants, HHS*s
TANF Program, and DOL*s Welfare- to- Work Program funds did not indicate
how such sharing could or should be done. Instead, the officials had to
seek

advice from other states. 42 Volpe National Transportation Systems Center,
Innovative State and Local Planning for Coordinated Transportation.

Program Officials May Not Know How to Coordinate Effectively

Limited Federal Guidance and Information on Coordination

Page 33 GAO- 03- 697 Transportation Coordination  While FTA disseminated
coordination guidelines for FTA and HHS programs to transportation
officials, some HHS and transportation

officials said these guidelines were not widely disseminated to human
services officials or programs.

 According to state Medicaid offices and a national organization of
individuals and agencies concerned with human services, the Centers for
Medicare & Medicaid Services have not provided sufficient guidance on how
to coordinate Medicaid transportation with existing public transit or
other transportation resources.

 The Coordinating Council on Access and Mobility has limited visibility
for agencies actually involved in implementing coordination efforts. In
several states, human service program administrators with whom we spoke
were

not aware of the Council or its Web site. In the five states we visited*
even in those states with a coordinating body* there was limited state
guidance to help local areas implement coordination, and some officials
stated that the lack of leadership and commitment at the state level was a
major obstacle to local coordination. In addition, while some states have
established coordinating councils or

bodies or have designated a lead agency for coordination, nearly half of
the states have no coordinating body, according to one report. 43
Officials in one state explained that the lack of a coordinating body that
requires various agencies to discuss and resolve transportation issues is
the main obstacle toward a more coordinated system.

Even in states with a coordinating council or a lead state agency, there
may be a lack of local leadership or commitment to coordination efforts.
For example, one city we visited was unsuccessful in achieving a
coordinated system despite state encouragement to coordinate and some
state- provided technical assistance. Stakeholders there described a lack
of local commitment and leadership in maintaining lines of communication

among those involved in coordination efforts as a factor leading to the
failure. In addition, program administrators may not have data on the
extent of existing transportation services that may be available to their
clients within a geographic region and, therefore, may fail to realize the
extent of overlapping and complementary services within their local area.
Such data can produce improvements. For example, in response to a lack 43
Westat, Toolkit for Rural Community Coordinated Transportation Services.

Limited State Guidance and Leadership on Coordination

Limited Local Leadership and Commitment to Coordinate

Page 34 GAO- 03- 697 Transportation Coordination of data on local
services, an agency in one state we visited took the lead in conducting a
study that showed the extent to which various agencies provide similar
transportation services within a geographic region. An

agency official was hopeful that once other agencies saw the extent of
overlap, they would be more willing to coordinate.

Federal, state, and local officials, as well as experts in the area, have
suggested three potential options to improve coordination of
transportation services among federal programs: (1) harmonizing standards
and requirements among federal programs, (2) expanding interagency forums
and providing and disseminating additional guidance and information on
coordination, and (3) providing financial incentives or coordination
mandates.

Officials and experts expressed a need to harmonize requirements among
federal programs, such as providing more flexible regulatory language that
would allow providers to serve additional client groups, creating
consistent cost accounting methods, and adopting common safety standards.
For example, one official commented that federal program regulations could
include language permitting other client groups to make use of available
transportation options. Also, some officials believed that adopting
standard accounting procedures among all federal human service

programs could provide a consistent measure for comparing services,
allowing administrators to evaluate how best to provide transportation
services and determine the savings they could achieve through
coordination. Likewise, making standards for safety (e. g., types of seat
belts), driver training, and liability insurance provisions uniform among
federal human service programs, as appropriate, may facilitate the shared
use of vehicles and drivers in one coordinated system, according to some
officials. Finally, some officials suggested that federal grant programs
that

allow the use of funds from multiple sources should be under the same
funding cycle or time frame so that these funds may be combined more
easily. These officials also commented that harmonizing the time frames
under which federal funding is allocated could possibly aid collaborative
planning. However, differing program standards exist to ensure that the
distinct needs of specific target populations are adequately served and
that

agencies maintain accountability for providing these services. Thus, the
benefits from any change in standards or requirements would need to be
balanced against continuing to properly meet client needs and sufficiently

control funds distributed to grantees. In addition, harmonizing program
standards and requirements among 62 federal programs authorized by more
than 20 pieces of legislation would necessitate extensive legislative
Potential Options to

Improve Coordination Harmonizing Program Standards and Requirements

Page 35 GAO- 03- 697 Transportation Coordination changes and could impose
additional costs for agencies to meet new requirements.

Some officials advocated expanding the number of agencies involved in
coordination, establishing interagency forums, and improving central
clearinghouses as ways to better develop and disseminate guidance on
coordination. To enhance coordination efforts at the federal level, some
officials suggested expanding the membership of the Coordinating Council

on Access and Mobility to include additional federal agencies, so that a
broader array of agencies that serve the transportation- disadvantaged are
represented. This could include agencies such as DOL and the Department of
Education that we identified as being significant because a large number
of their programs authorize funding of transportation services for the
transportation- disadvantaged. In addition, establishing state- level
forums may also facilitate communication among agencies involved in
coordination and can lead to benefits. For example, one state has

established an interagency task force on transportation coordination,
which has resulted in a number of benefits* including the pooling of
vehicles and the expansion of services* in some areas of the state. Some
officials and experts suggested that federal agencies provide additional
guidance and other information that result from forums or other sources to
clearly define the allowable uses of funds, assist agencies in developing
cost- sharing arrangements for transporting common clientele, and
encourage the establishment and participation in interagency forums. This
additional guidance and information could be better disseminated through a
central clearinghouse, such as the Coordinating Council*s Web site.

Some officials and experts believed that incentives or mandates could help
improve coordination, although others expressed concerns that such actions
would have negative effects on the ability of local agencies to respond to
community needs. Officials provided several examples, including the
following:  Federal grant applications could contain provisions giving
priority in

funding to those grantees committed to coordination efforts.  With
legislative changes, current funds allotted by multiple federal sources

could be combined into one federal, state, or local fund for
transportation services for the transportation- disadvantaged.

 Funding opportunities could be tied to federal or state coordination
mandates so that there are financial consequences for a failure to
coordinate. Expanding Interagency Forums

and Providing and Disseminating Additional Guidance and Information on
Coordination

Providing Financial Incentives or Mandates

Page 36 GAO- 03- 697 Transportation Coordination However, officials
pointed out that these options also had some potential downsides that
would need to be carefully considered. For example, combining funds into a
single source could result in some populations

being unfairly overlooked because smaller agencies at the state or local
level would be at a disadvantage in competing for funding with larger
agencies serving more clients. Several officials also raised concerns
about mandates to coordinate. For example, some officials said that
mandates might reduce the flexibility of agencies to design and deliver
transportation services that specifically address their communities*
needs. In addition, some officials noted that state efforts or mandates
might not

guarantee successful local coordination. For example, a city in one state
we visited was unsuccessful in coordinating its multiple transportation
services despite state encouragement to do so and despite losing some
federal funding as a result.

Successful coordination among programs for the transportationdisadvantaged
is not a simple matter. One clear need, given the sheer number of programs
involved, is active and sustained leadership at the federal level. While
the Coordinating Council on Access and Mobility is positioned to supply
that leadership, its efforts are constrained in two main ways. The first
is limited membership: only two departments* DOT and HHS* are members.
While these departments administer nearly 30 programs that can be used for
transportation, the Departments of Education and Labor administer almost
as many. The absence of Education and Labor lessens the ability to muster
a collective effort for greater coordination. The second constraint is a
limited ability to translate a strategic vision into a set of actions. At
present, there are no clear links between the long- term goals in the
Council*s strategic plan and the individual tasks in its action plan.
Without such links, the Council risks judging its progress on the basis of
activities undertaken rather than on the outcomes of those activities and
their contribution toward achieving long- term goals. Linking these goals
and actions to the strategic and annual performance plans of participating
departments* because the

Council relies heavily on support from its member agencies* would provide
an additional incentive to pursue coordination activities in the
departments* activities.

There is great diversity in the specific suggestions we received about how
to overcome obstacles to greater coordination. Two of the three main
options raised by various officials we interviewed* making federal program
standards more uniform and creating some type of requirement or financial
incentive for coordination* would require substantial Conclusions

Page 37 GAO- 03- 697 Transportation Coordination statutory or regulatory
changes and include potential costs. The third option, expanding forums
and disseminating guidance, can be done in the

context of existing laws, regulations, and procedures, and may, therefore,
be the most expeditious starting point. In this regard, clarification from
federal agencies about how funds can be used for coordination could help
state and local agencies overcome some of the obstacles identified.

Similarly, state and local agencies may be in a better position to
coordinate efforts if they have more knowledge about what has worked
elsewhere. Although the Council has a Web site with information about
coordinating transportation services, some state and local officials were
unaware of it. State and local officials* point of contact is more likely
to be the Web site of the department administering the program at the
federal level. Establishing better links between the Council*s Web site
and the

sites of the departments could help connect grantees with information that
may help them coordinate with other programs, better serve clients, and
use funds more efficiently.

 To increase communication and collaboration among the major agencies
involved in providing transportation services for the
transportationdisadvantaged, we recommend that the Secretaries of the
Departments of Labor and Education join the Coordinating Council on Access
and Mobility.

 To promote and enhance federal, state, and local transportation
coordination activities, we recommend that the Secretaries of the
Departments of Health and Human Services, Labor, Education, and
Transportation take the following actions:

 As member agencies of the Coordinating Council on Access and Mobility,
ensure that the long- term goals in the Council*s strategic plan have
clear links to the individual tasks in its action plan and that these
actions are tied to measurable annual performance goals.

 Ensure that strategic and annual performance plans discuss their
departments* transportation coordination efforts and incorporate longterm
goals and performance measures that address the need for coordination
among programs for the transportation- disadvantaged.

 Develop and distribute additional guidance to states and other grantees
that encourages coordinated transportation by clearly defining the
allowable uses of funds, explaining how to develop cost- sharing
arrangements for transporting common clientele, and clarifying
Recommendations

for Executive Action

Page 38 GAO- 03- 697 Transportation Coordination whether funds can be used
to serve individuals other than the program*s target population.

 Link the Web sites of their agencies involved in providing services for
the transportation- disadvantaged to the Coordinating Council*s Web site
and advertise the site in agency correspondence and during conferences or
other outreach opportunities.

We provided the Departments of Health and Human Services, Labor,
Education, Transportation, Housing and Urban Development, and Veterans
Affairs with draft copies of this report for their review and comment. We
requested verification of key facts from the Departments of Agriculture
and the Interior, but we did not seek comments from these departments
because they did not administer significant numbers of programs that
benefit the transportation- disadvantaged.

All six departments generally agreed with the findings and conclusions in
the report and provided technical clarifications, which were incorporated
as appropriate. The four departments to whom we made recommendations*
Health and Human Services, Labor, Education, and Transportation* also
generally concurred with those recommendations. In particular:

 The Department of Health and Human Services provided written comments on
the draft of this report which are presented and evaluated in appendix V.
The department noted that it has initiated actions to implement our
recommendations, including (1) strengthening the linkage between the
Coordinating Council*s strategic and action plans, (2) reviewing the
department- wide strategic plan for opportunities to reflect its
transportation coordination efforts, (3) developing coordination guidance,
and (4) linking the Coordinating Council*s Web site to the Department of
Health and Human Services* Web site. The department also suggested that we
consider incorporating other researchers* estimates of transportation
spending by health and human service programs. However, we estimated
program expenditures only for those programs where there was sufficient
evidence to support an estimate.

 Department of Labor officials stated that the department looks forward
to joining the Coordinating Council on Access and Mobility to improve the
transportation services provided by federal human service programs. In
addition, department officials commented that the reauthorization of some
human service and surface transportation legislation was forthcoming
during the preparation of this report and that these legislative changes
Agency Comments

and Our Evaluation

Page 39 GAO- 03- 697 Transportation Coordination may impact the future
directions of the federal programs included in this report.

 The Department of Education provided written comments on the draft of
this report, which are presented in appendix VI. The department said that
it would look favorably on an opportunity to join the Coordinating Council
on Access and Mobility and it would consider developing coordination
guidance for state and other grantees and instituting methods of linking
Web- based information resources about transportation.

 Department of Transportation officials said that the Federal Transit
Administration is committed to accomplishing effective transportation
coordination and noted that the list of the agency*s activities and
accomplishments in appendix III of this report demonstrate its commitment
and support for coordination. It also stated that the administration*s
proposal for the reauthorization of surface transportation legislation,
introduced in May 2003, includes provisions that would encourage further
coordination efforts.

We are sending copies of this report to the appropriate congressional
committees and to the Secretaries and other appropriate officials of the
Departments of Transportation, Health and Human Services, Labor,
Education, Housing and Urban Development, Veterans Affairs, Agriculture,
and the Interior. We also will make copies available to others upon
request. In addition, the report will be available at no charge on the

GAO Web site at http:// www. gao. gov. If you have any questions about
this report, please contact me at siggerudk@ gao. gov or at (202) 512-
2834. Additional GAO contacts and acknowledgments are listed in appendix
VII.

Katherine Siggerud Acting Director Physical Infrastructure Issues

Appendix I: Scope and Methodology Page 40 GAO- 03- 697 Transportation
Coordination Our scope of work included federal programs that provide
transportation services to the transportation- disadvantaged. To provide
information on

the purposes and types of such federal programs, we first determined the
universe of programs by reviewing an existing inventory produced by the
Community Transportation Association of America 1 and a report prepared
for the Coordinating Council on Access and Mobility. 2 We then
supplemented and modified this inventory of programs on the basis of
interviews with agency officials and searches of the Catalog of Federal
Domestic Assistance. We included only those programs that provide
nonemergency, nonmilitary, surface transportation services of any kind,
targeted to transportation- disadvantaged populations. We interviewed
program administrators to identify the general target population and the
types of transportation services and trips that are typically provided
under each program. To address the issues related to program funding,
effects of coordination, and coordination obstacles and options, we (1)
conducted interviews and

document reviews in the pertinent eight federal agencies that administer
the 62 federal programs that fund transportation services for the
transportation- disadvantaged; (2) conducted five case studies in Arizona,
Florida, New York, South Dakota, and Wisconsin; (3) reviewed the
literature on the challenges encountered in coordinating services for the
transportation- disadvantaged; and (4) interviewed industry
representatives and advocacy groups representing elderly and disabled
populations. We did not verify spending data or estimates received from
federal agencies for accuracy.

At the federal level, we interviewed officials from the headquarters of
the Federal Transit Administration in the Department of Transportation;
the Administration on Aging, the Administration for Children and Families,
the Centers for Medicare & Medicaid Services, the Health Resources
Services Administration, the Office of Intergovernmental Affairs, and the
Substance Abuse and Mental Health Services Administration in the
Department of Health and Human Services; the Employment and Training
Administration in the Department of Labor; the Department of Agriculture;
the

Department of Education; the Department of Housing and Urban 1 Community
Transportation Association of America, Building Mobility Partnerships:
Opportunities for Federal Investment (Washington, D. C.: March 2002). 2
Coordinating Council on Access and Mobility, Planning Guidelines for State
and Local Coordination (Washington, D. C.: Dec. 20, 2000). Appendix I:
Scope and Methodology

Appendix I: Scope and Methodology Page 41 GAO- 03- 697 Transportation
Coordination Development; the Department of the Interior; and the
Department of Veterans Affairs. We also interviewed federal officials from
the 10 regional

offices of the Federal Transit Administration and some regional officials
in the Departments of Health and Human Services and Labor. The federal
officials we met with included representatives of the Coordinating Council
on Access and Mobility from the Federal Transit Administration and the
Department of Health and Human Services. In conducting our case studies in
the five states, we reviewed documentation and interviewed more than 100
officials from state and local transportation and human service agencies
and service providers, as well as consumers of transportation services. We
judgmentally chose the

states to include three states without a state mandate or state
coordinating body and two states with such conditions. We also chose
states on the basis of relative concentrations of elderly, disabled, and
low- income populations, and for some, geographic dispersion. Within each
state, we spoke with state officials responsible for coordinating
transportation services for the transportation- disadvantaged and/ or
overseeing funds from the 62 federal programs we identified. We also asked
some of these state officials for recommendations of local officials and
transportation providers to interview in a range of urban, suburban, and
rural areas and coordinated and uncoordinated programs within the state.

Finally, we interviewed representatives of professional, industry, and
advocacy organizations that are part of the National Consortium on the
Coordination of Human Services Transportation, a group that represents a
broad spectrum of stakeholders involved with coordination of
transportation for the disadvantaged. We conducted our work from July

2002 through June 2003 in accordance with generally accepted government
auditing standards.

Appendix II: Inventory of Federal Programs Providing Transportation
Services to the Transportation- Disadvantaged Page 42 GAO- 03- 697
Transportation Coordination Program

Popular title of authorizing legislation

U. S. Code provisions authorizing funds for transportation

Typical uses as reported by program officials

Types of trips as reported by program officials

Target population as defined by program officials a Fiscal year

2001 federal spending on transportation b Department of Agriculture, Food
and Nutrition Service Food Stamp

Employment and Training Program

Food Stamp Act of 1977, as amended

7 U. S. C. S: 2015( d)( 4)( I)( i) (I)

Reimbursement or advanced payment for gasoline expenses or bus fare

To access education, training, employment services, and employment
placements

Low- income persons between the ages of 16 and 59

$12,952,956 c Department of Education, Office of Elementary and Secondary
Education 21st- Century Community Learning Centers

No Child Left Behind Act of 2001

20 U. S. C. S: 7173( a)( 10) Contract for

service To access educational services

Students from low- income families

$84,600,000 (estimate) d Department of Education, Office of Innovation and
Improvement

Voluntary Public School Choice No Child Left Behind Act of 2001

20 U. S. C. S: 7225a( a) Contract for

services, purchase and operate vehicles, hire bus drivers and
transportation directors, purchase bus passes, redesign transportation
plans including new routing

systems, offer professional development for bus drivers

To access educational services and programs

Students from under performing schools who

choose to transfer to higher performing schools

New program, no actual data or estimate available from the federal agency

Department of Education, Office of Special Education and Rehabilitative
Services Assistance for Education of All Children with Disabilities

Individuals with Disabilities Education Act

20 U. S. C. S:S: 1401( a)( 22), 1411( a)( 1)

Purchase and operate vehicles, contract for service

To access educational services

Children with disabilities No actual data or

estimate available from the federal agency

Centers for Independent Living Workforce

Investment Act of 1998

29 U. S. C. S:S: 796f- 4( b)( 3) and 705( 18)( xi) Referral,

assistance, and training in the use of public transportation

To access program services

Persons with a significant disability

No actual data or estimate available from the federal agency

Appendix II: Inventory of Federal Programs Providing Transportation
Services to the Transportation- Disadvantaged

Appendix II: Inventory of Federal Programs Providing Transportation
Services to the Transportation- Disadvantaged Page 43 GAO- 03- 697
Transportation Coordination Program

Popular title of authorizing legislation

U. S. Code provisions authorizing funds for transportation

Typical uses as reported by program officials

Types of trips as reported by program officials

Target population as defined by program officials a Fiscal year

2001 federal spending on transportation b Independent Living

Services for Older Individuals Who Are Blind

Workforce Investment Act of 1998

29 U. S. C. S: 796k( e)( 5) Referral,

assistance, and training in the use of public transportation

To access program services, for general trips

Persons aged 55 or older who have significant visual impairment

No actual data or estimate available from the federal agency

Independent Living State Grants Workforce

Investment Act of 1998

29 U. S. C. S:S: 796e- 2( 1) and 705( 18)( xi)

Referral, assistance, and training in the use of public transportation

To access program services, employment opportunities

Persons with a significant disability

No actual data or estimate available from the federal agency

Supported Employment Services for Individuals with Most Significant
Disabilities

Workforce Investment Act of 1998

29 U. S. C. S:S: 795g and 705( 36)

Transit subsidies for public and private transportation (e. g. bus, taxi,
and paratransit), training in the use of public transportation

To access employment placements, employment services, and vocational
rehabilitation services

Persons with most significant disabilities

No actual data or estimate available from the federal agency e Vocational

Rehabilitation Grants Rehabilitation Act of 1973, as amended 29 U. S. C.
S:

723( a)( 8) Transit subsidies for public and private transportation (e. g.
bus, taxi, and paratransit), training in the use of public transportation

To access employment placements, employment services, and vocational
rehabilitation services

Persons with physical or mental impairments

$50,700,000 (estimate) e Department of Health and Human Services,
Administration for Children and Families Child Care and Development Fund
Child Care and Development

Block Grant Act of 1990, as amended

42 U. S. C. S: 9858c States rarely use

CCDF funds for transportation and only under very

restricted circumstances To access

child care services Children from

low- income families

$0 (estimate) f Community Services Block Grant Programs Community

Opportunities, Accountability, Training, and Educational Services Act of
1998

42 U. S. C. S: 9904 Taxi vouchers,

bus tokens General trips Low- income persons No actual data or

estimate available from the federal agency

Appendix II: Inventory of Federal Programs Providing Transportation
Services to the Transportation- Disadvantaged Page 44 GAO- 03- 697
Transportation Coordination Program

Popular title of authorizing legislation

U. S. Code provisions authorizing funds for transportation

Typical uses as reported by program officials

Types of trips as reported by program officials

Target population as defined by program officials a Fiscal year

2001 federal spending on transportation b Developmental Disabilities
Projects of

National Significance Developmental Disabilities

Assistance and Bill of Rights Act of 2000

42 U. S. C. S:S: 15002, 15081( 2)( D)

Transportation information, feasibility studies, planning

General trips Persons with developmental disabilities

No actual data or estimate available from the federal agency g Head Start
Augustus F.

Hawkins Human Services Reauthorization Act of 1990

42 USCA S: 9835( a)( 3)( C) (ii)

Purchase and operate vehicles, contract with transportation providers,
coordinate with local education agencies

To access educational services

Children from low- income families

$514,500,000 (estimate) h Refugee and Entrant

Assistance Discretionary Grants

Refugee Act of 1980, as amended

8 U. S. C. S:S: 1522( b)( 7)( D), 1522( c)

Bus passes To access employment and educational services

Refugees No actual data or estimate available from the federal agency

Refugee and Entrant Assistance State Administered Programs

Refugee Act of 1980, as amended

8 U. S. C. S:S: 1522( b)( 7)( D), 1522( c)

Bus passes To access employment and educational services

Refugees No actual data or estimate available from the federal agency

Refugee and Entrant Assistance Targeted Assistance

Refugee Act of 1980, as amended

8 U. S. C. S:S: 1522( b)( 7)( D), 1522( c)

Bus passes To access employment and educational services

Refugees No actual data or estimate available from the federal agency

Refugee and Entrant Assistance Voluntary Agency Programs

Refugee Act of 1980, as amended

8 U. S. C. S:S: 1522( b)( 7)( D), 1522( c)

Bus passes To access employment and educational services

Refugees No actual data or estimate available from the federal agency

Social Services Block Grants Social Security Act, as amended 42 U. S. C.
S:

1397a( a)( 2)( A) Any transportationrelated use

To access medical or social services States

determine what categories of families and children

$18,459,393

Appendix II: Inventory of Federal Programs Providing Transportation
Services to the Transportation- Disadvantaged Page 45 GAO- 03- 697
Transportation Coordination Program

Popular title of authorizing legislation

U. S. Code provisions authorizing funds for transportation

Typical uses as reported by program officials

Types of trips as reported by program officials

Target population as defined by program officials a Fiscal year

2001 federal spending on transportation b State Councils on

Developmental Disabilities and Protection and Advocacy Systems

Developmental Disabilities Assistance and Bill of Rights Act of 2000

42 U. S. C. S:S: 15002, 15025 State Councils

provide small grants and contracts to local organizations to establish
transportation projects or collaborate in improving transportation for
people with disabilities; Protection and Advocacy Systems ensure that
people with disabilities have access to public transportation as required
by law All or general trips Persons with

developmental disabilities and family

members $786,605 (partial

outlay) i Temporary Assistance for Needy Families Personal

Responsibility and Work Opportunity Reconciliation Act of 1996, as amended

42 U. S. C. S:S: 604( a), (k) Any use that is reasonably

calculated to accomplish a purpose of the TANF program and the

allowable matching portion of JARC grants General trips No assistance

is provided to families without a minor child, but

states determine specific

eligibility $160,462,214

(partial outlay) j Department of Health and Human Services, Administration
on Aging Grants for Supportive Services and Senior Centers

Older Americans Act of 1965, as amended

42 U. S. C. S: 3030d (a)( 2) Contract for

services To access program services, medical, and for general trips

Program is targeted to persons aged 60 or over

$72,496,003 Program for American Indian, Alaskan Native, and Native
Hawaiian Elders

Older Americans Act of 1965, as amended

42 U. S. C. S:S: 3057, 3030d( a)( 2)

Purchase and operate vehicles To access

program services, medical, and for general trips

Program is for American Indian, Alaskan Native, and Native Hawaiian elders

No actual data or estimate available from the federal agency

Appendix II: Inventory of Federal Programs Providing Transportation
Services to the Transportation- Disadvantaged Page 46 GAO- 03- 697
Transportation Coordination Program

Popular title of authorizing legislation

U. S. Code provisions authorizing funds for transportation

Typical uses as reported by program officials

Types of trips as reported by program officials

Target population as defined by program officials a Fiscal year

2001 federal spending on transportation b Department of Health and Human
Services, Centers for Medicare & Medicaid Services Medicaid Social
Security Act, as amended 42 U. S. C. S:S:

1396a, 1396n( e)( 1)( A)

Bus tokens, subway passes, brokerage services

To access health care services

Recipients are generally lowincome

persons, but states determine specific

eligibility $976,200,000

(estimate) k State Children*s Health Insurance Program Medicare,

Medicaid, and SCHIP Benefits Improvement and Protection Act of 2000

42 U. S. C. S:S: 1397jj( a)( 26), (27)

Any transportationrelated use

To access health care services

Beneficiaries are primarily children from low- income families, but states
determine eligibility

$4,398,089

Department of Health and Human Services, Health Resources and Services
Administration Community Health Centers Public Health Service Act, as

amended 42 U. S. C. S:

254b( b)( 1)( A) (iv) Bus tokens,

vouchers, transportation coordinators, and drivers

To access health care services

Medically underserved populations

$4,200,000 (estimate) l Healthy Communities

Access Program Public Health Service Act, as amended

42 U. S. C. S: 256( e)( 1)( B)( iii) Improve

coordination of transportation To access

health care services

Uninsured or underinsured populations

No actual data or estimate available from the federal agency

Healthy Start Initiative Public Health Service Act, as amended

42 U. S. C. S: 254c- 8( e)( 1) Bus tokens, taxi

vouchers, reimbursement for use of own

vehicle To access

health care services

Residents of areas with significant perinatal health disparities

No actual data or estimate available from the federal agency

HIV Care Formula Grants Ryan White

Comprehensive AIDS Resources Emergency Act of 1990

42 U. S. C. S:S: 300ff- 21( a), 23( a)( 2)( B)

Bus passes, tokens, taxis, vanpools, vehicle purchase by providers,
mileage reimbursement To access

health care services

Persons with HIV or AIDS $19,500,000

(estimate) m Maternal and Child Services Grants Social Security Act, as
amended 42 U. S. C. S:

701( a)( 1)( A) Any transportationrelated use

To access health care services

Mothers, infants and children, particularly from lowincome

families No actual data or

estimate available from the federal agency

Appendix II: Inventory of Federal Programs Providing Transportation
Services to the Transportation- Disadvantaged Page 47 GAO- 03- 697
Transportation Coordination Program

Popular title of authorizing legislation

U. S. Code provisions authorizing funds for transportation

Typical uses as reported by program officials

Types of trips as reported by program officials

Target population as defined by program officials a Fiscal year

2001 federal spending on transportation b Rural Health Care,

Rural Health Network, and Small Health Care Provider Programs

Health Centers Consolidation Act of 1996

42 U. S. C. S: 254c Purchase

vehicles, bus passes

To access health care services

Medically underserved populations in

rural areas No actual data or

estimate available from the federal agency

Department of Health and Human Services, Substance Abuse and Mental Health
Services Administration Community Mental Health Services Block Grant

ADAMHA Reorganization Act, as amended

42 U. S. C. S: 300x- 1( b)( 1) Any

transportationrelated use

To access program services

Adults with mental illness and children with emotional disturbance

No actual data or estimate available from the federal agency

Substance Abuse Prevention and Treatment Block Grant

ADAMHA Reorganization Act, as amended

42 U. S. C. S: 300x- 32( b) Any

transportationrelated use

To access program services

Persons with a substance related disorder and/ or recovering

from substance related disorder

No actual data or estimate available from the federal agency

Department of Housing and Urban Development, Office of Community Planning
and Development Community Development Block Grant

Housing and Community Development Act of 1974

42 U. S. C. S: 5305( a)( 8) Purchase and

operate vehicles General trips Program must serve a majority of lowincome

persons $6,761,486

(partial outlay) n Housing Opportunities for Persons with AIDS AIDS
Housing

Opportunity Act 42 U. S. C. S: 12907( a)( 3) Contract for

services To access health care and other services

Low- income persons with HIV or AIDS and their families

$190,252 (partial outlay) o Supportive Housing

Program McKinney- Vento Homeless Assistance Act of 1987, as amended

42 U. S. C. S: 11385 Bus tokens, taxi

vouchers, purchase and operate vehicles To access

supportive services

Homeless persons and families with children

$14,000,000 (estimate) p Department of Housing and Urban Development,
Office of Public and Indian Housing Revitalization of

Severely Distressed Public Housing Housing and

Community Development Act of 1992, as amended

42 U. S. C. S: 1437v( l)( 3) Bus tokens, taxi

vouchers, contract for services

Trips related to employment or obtaining necessary supportive services

Residents of the severely distressed housing and residents of the
revitalized units

$700,000 (estimate) q

Appendix II: Inventory of Federal Programs Providing Transportation
Services to the Transportation- Disadvantaged Page 48 GAO- 03- 697
Transportation Coordination Program

Popular title of authorizing legislation

U. S. Code provisions authorizing funds for transportation

Typical uses as reported by program officials

Types of trips as reported by program officials

Target population as defined by program officials a Fiscal year

2001 federal spending on transportation b Department of the Interior,
Bureau of Indian Affairs Indian Employment

Assistance Adult Indian Vocational Training Act, as amended

25 U. S. C. S: 309 Gas vouchers To access

training Native American persons between the ages of 18 and 35

No actual data or estimate available from the federal agency

Indian Employment, Training and Related Services r Indian Employment,

Training and Related Services Demonstration Act of 1992

25 U. S. C. S: 3401 Gas vouchers Employment related Low- income

Native American persons

No actual data or estimate available from the federal agency

Department of Labor, Employment and Training Administration Job Corps
Workforce Investment Act of 1998

29 U. S. C. S:S: 2888( a)( 1), 2890

Bus tickets To access Job Corps sites and employment services

Low- income youth $21,612,000

Migrant and Seasonal Farmworker s Workforce

Investment Act of 1998

29 U. S. C. S:S: 2801( 46), 2912( d)

Mileage reimbursement To access

employment placements or intensive and training services

Low- income persons and their dependents who are primarily employed in
agricultural

labor that is seasonal or migratory

No actual data or estimate available from the federal agency

Native American Employment and Training Workforce

Investment Act of 1998

29 U. S. C. S: 2911( d)( 2) Bus tokens,

transit passes, use of tribal vehicles and grantee staff vehicles, mileage
reimbursement for participants operating *car

pool* services To access

employment placements, employment services

Unemployed American Indians and other persons of Native American descent

No actual data or estimate available from the federal agency

Senior Community Service Employment Program

Older Americans Act of 1965 42 U. S. C. S:

3056( c)( 6)( A) (iv) Mileage

reimbursement, reimbursement for travel costs,

and payment for cost of transportation

To access employment placements

Low- income persons aged 55 or over

$4,400,000 (estimate) s

Appendix II: Inventory of Federal Programs Providing Transportation
Services to the Transportation- Disadvantaged Page 49 GAO- 03- 697
Transportation Coordination Program

Popular title of authorizing legislation

U. S. Code provisions authorizing funds for transportation

Typical uses as reported by program officials

Types of trips as reported by program officials

Target population as defined by program officials a Fiscal year

2001 federal spending on transportation b Trade Adjustment

Assistance - Workers Trade Act of 1974, as amended

19 U. S. C. S: 2296( b) Mileage

reimbursement, transit fares

To access training Persons found

to be impacted by foreign trade, increased imports, or shift in production

No actual data or estimate available from the federal agency

Welfare- to- Work Grants to Federally Recognized Tribes and Alaska Natives
t Personal

Responsibility and Work Opportunity Reconciliation Act of 1996

42 U. S. C. S: 612( a)( 3)( C) Any

transportation related use, though purchasing vehicles for individuals is
not allowable

To access employment placements, employment services

American Indians and other persons of Native American descent who are
long- term welfare recipients or are low- income

No actual data or estimate available from the federal agency

Welfare- to- Work Grants to States and Localities t Personal

Responsibility and Work Opportunity Reconciliation Act of 1996

42 U. S. C. S: 603( a)( 5)( C) Any

transportation related use, though purchasing vehicles for individuals is
not allowable

To access employment placements, employment services

Long- term welfare recipients or low- income individuals

No actual data or estimate available from the federal agency

Work Incentive Grants Workforce Investment Act of 1998, as amended

29 U. S. C. S:S: 2801( 46), 2864( d)( 2)

Encourage collaboration with transportation providers

To access one- stop services

Persons with disabilities who are eligible for

employment and training services

No actual data or estimate available from the federal agency

Workforce Investment Act Adult Services Program

Workforce Investment Act of 1998, as amended

29 U. S. C. S:S: 2801( 46), 2864( e)( 2)

Mileage reimbursement, bus tokens, vouchers

To access training Priority must

be given to people on assistance and low- income

individuals No actual data or

estimate available from the federal agency

Workforce Investment Act Dislocated Worker Program

Workforce Investment Act of 1998, as amended

29 U. S. C. S:S: 2801( 46), 2864( e)( 2)

Transportation allowance or reimbursement, bus/ subway tokens

To access transition assistance in order to find or qualify for new
employment

Includes workers who have been laid off, or have

received an individual notice of termination, or notice that a facility
will close

No actual data or estimate available from the federal agency

Appendix II: Inventory of Federal Programs Providing Transportation
Services to the Transportation- Disadvantaged Page 50 GAO- 03- 697
Transportation Coordination Program

Popular title of authorizing legislation

U. S. Code provisions authorizing funds for transportation

Typical uses as reported by program officials

Types of trips as reported by program officials

Target population as defined by program officials a Fiscal year

2001 federal spending on transportation b Workforce Investment

Act Youth Activities Workforce Investment Act of 1998, as amended

29 U. S. C. S:S: 2801( 46), 2854( a)( 4)

Public transportation To access

training and other support services

Youth with low individual or family income No actual data or

estimate available from the federal agency

Youth Opportunity Grants Workforce

Investment Act of 1998, as amended

29 U. S. C. S:S: 2801( 46), 2914( b)

Bus tokens To access program services

Youth from high poverty areas, empowerment zones, or enterprise
communities

$415,000 (estimate) u Department of Labor, Employment Standards
Administration Black Lung Benefits

Program Black Lung Benefits Reform Act of 1977

30 U. S. C. S: 923 Mileage

reimbursement, transit fares, taxi vouchers

To access health services Disabled coal

miners No actual data or estimate available from the federal agency v
Department of Labor, Veterans Employment and Training Service

Homeless Veterans* Reintegration Project Homeless

Veterans Comprehensive Assistance Act of 2001

38 USCA S:S: 2011, 2021 Bus tokens To access employment services

Homeless veterans No actual data or

estimate available from the federal agency

Veterans* Employment Program Workforce

Investment Act of 1998, as amended

29 U. S. C. S:S: 2801( 46), 2913 Bus tokens,

minor repairs to vehicles

To access employment services

Veterans No actual data or estimate available from the federal agency

Department of Transportation, Federal Transit Administration Capital and
Training Assistance Program for Over- the- Road Bus Accessibility

Title 49 Recodification, P. L. 103- 272

49 U. S. C. S: 5310 To make

vehicles wheelchair accessible and training required by ADA

General trips Persons with disabilities $2,877,818

Capital Assistance Program for Elderly Persons and Persons with
Disabilities

Title 49 Recodification, P. L. 103- 272

49 U. S. C. S: 5310 Assistance in

purchasing vehicles, contract for services

To serve the needs of the elderly and persons with disabilities

Elderly persons and persons with disabilities

$174,982,628

Appendix II: Inventory of Federal Programs Providing Transportation
Services to the Transportation- Disadvantaged Page 51 GAO- 03- 697
Transportation Coordination Program

Popular title of authorizing legislation

U. S. Code provisions authorizing funds for transportation

Typical uses as reported by program officials

Types of trips as reported by program officials

Target population as defined by program officials a Fiscal year

2001 federal spending on transportation b Capital Investment

Grants Transportation Equity Act for the 21st Century

49 U. S. C. S: 5309 Assistance for

bus and busrelated capital projects

General trips General public, although some projects are for the special
needs of elderly persons and persons

with disabilities $17,500,000 (estimate) w Job Access and

Reverse Commute Transportation Equity Act for the 21st Century

49 U. S. C. S: 5309 note Expand existing public

transportation or initiate new service

To access employment and related services

Low income persons, including persons with disabilities

$85,009,627 Nonurbanized Area Formula Program Title 49

Recodification, P. L. 103- 272 49 U. S. C. S:

5311 Capital and operating assistance for public transportation service,
including paratransit services, in nonurbanized areas

General trips General public, although paratransit services are for the
special needs of persons with disabilities

$0 (partial obligation) x Urbanized Area Formula Program Title 49

Recodification, P. L. 103- 272, as amended

49 U. S. C. S: 5307 Capital

assistance, and some operating assistance for public transit, including
paratransit services, in urbanized areas

General trips General public, although paratransit services are for the
special needs of persons with disabilities

$36,949,680 (partial obligation) y Department of Veterans Affairs,
Veterans Benefits Administration Automobiles and

Adaptive Equipment for Certain Disabled Veterans and Members of the Armed
Forces

Disabled Veterans and Servicemen*s Automobile Assistance Act of 1970

38 U. S. C. S: 3902 Purchase of

personal vehicles, modifications of vehicles

General trips Veterans and service members with disabilities

$33,639,000

Department of Veterans Affairs, Veterans Health Administration VA Homeless
Providers Grant and Per Diem Program

Homeless Veterans Comprehensive Service Programs Act of 1992

38 U. S. C. S: 7721 note 20 vans were

purchased under this program

General trips Homeless veterans $565,797

Appendix II: Inventory of Federal Programs Providing Transportation
Services to the Transportation- Disadvantaged Page 52 GAO- 03- 697
Transportation Coordination Program

Popular title of authorizing legislation

U. S. Code provisions authorizing funds for transportation

Typical uses as reported by program officials

Types of trips as reported by program officials

Target population as defined by program officials a Fiscal year

2001 federal spending on transportation b Veterans Medical Care

Benefits Veterans* Benefits Improvements Act of 1994

38 U. S. C. S: 111 Mileage

reimbursement, contract for service

To access health care services

Veterans with disabilities or low incomes

$126,594,591

Total (reported or estimated spending on transportation services for the
transportationdisadvantaged) $2,445,453,139

Sources: GAO analysis of information from the Departments of Agriculture,
Education, Health and Human Services, Housing and Urban Development, the
Interior, Labor, Transportation, and Veterans Affairs; the Coordinating
Council on Access and Mobility; the Catalog of Federal Domestic
Assistance; the U. S. Code; the Code of Federal Regulations; and the
Community Transportation Association of America.

a A supplemental source for the target populations was the Catalog of
Federal Domestic Assistance. b Actual outlays or obligations on
transportation are given for programs that track this information. All
data are outlays, except for the following programs, which are
obligations: Capital Investment Grants, Urbanized Area Formula Program,
Nonurbanized Area Formula Program, Job Access and Reverse Commute, Capital
and Training Assistance for Over- the- Road Bus Accessibility, Capital
Assistance Program for Elderly Persons and Persons with Disabilities,
Automobiles and Adaptive Equipment for

Certain Disabled Veterans and Members of the Armed Forces, and Veterans
Medical Care Benefits. Actual data and estimates are the total for the
program, unless otherwise noted as partial outlays or obligations in the
table. When actual information was not available, estimates are given
based on information provided by program officials or the officials agreed
with an estimate made by another source. c According to a program
official, outlays for the Food Stamp Employment and Training Program have
increased due to changes in the program from the 2002 Farm Bill. The 2002
Farm Bill eliminates the

$25 per month cap that the Department of Agriculture will reimburse the
states for transportation and other work costs incurred by participants.
In fiscal year 2002, federal outlays for transportation were $18,523,535.
d A program official said that 10 percent of total program outlays would
be a conservative estimate of

transportation outlays. e Grantees report total expenditures and
unliquidated obligations made by the state Vocational

Rehabilitation (VR) Agency for transportation services provided to
individuals served under the State VR Services Program for a fiscal year.
Total obligations include both federal and nonfederal funds under the
State VR Services Program, the supplemental federal funds awarded to the
State VR Agency for the cost of supported employment services under the
Supported Employment Program, and funds from other rehabilitation sources.
The Department of Education does not collect data on the specific sources
of funds used for transportation obligations under the program. However,
based on information available from total annual obligations on a national
aggregate basis, a program official estimated that of the total amount
reported for transportation, about 96 percent would be from the State VR
Services Program, and of that amount approximately 76 percent would be
federal funds. Similar estimates could not be made for the Supported
Employment Program. f A program official said that, while transportation
is an allowable use of funds, using funds for

transportation is not encouraged. Program officials estimate that
transportation expenditures are zero or close to zero for this program. g
Fiscal year 2001 data are not available because transportation was not an
area of emphasis until fiscal year 2002. The preliminary fiscal year 2002
outlays for transportation projects totaled $1,084,798. h A program
official estimated that transportation outlays were 8.3 percent of total
outlays.

Appendix II: Inventory of Federal Programs Providing Transportation
Services to the Transportation- Disadvantaged Page 53 GAO- 03- 697
Transportation Coordination i This is a partial outlay based on voluntary
reporting by grantees. Full outlays are not available

because, according to a program official, grantees were not required to
report transportation outlays prior to fiscal year 2002. Fiscal year 2002
data are incomplete, however preliminary data on transportation outlays
from 46 of the 51 grantees totaled $2,215,498. j This is a partial outlay
based on the amount grantees reported as non- assistance outlays in a

category exclusively for transportation. States reported an additional
$356.5 million as outlays on assistance in a category that includes
transportation and supportive services, however program officials were
unable to determine what percentage of the outlays on assistance were
spent on transportation. k Program officials indicate that federal data on
nonemergency medical transportation are not

available. Estimate assumes that transportation outlays are 0.73 percent
of total program outlays, based on previous research, including a survey
of state Medicaid programs. l According to a program official, grantees
report total outlays for transportation and it is not possible to

distinguish between federal and nonfederal funds. The official said 22
percent of total transportation outlays would be a good estimate of the
federal portion of fiscal year 2001 transportation outlays. m Estimate of
transportation outlays is based on data from grantee*s budget allocations,
as suggested

by an agency official. n This is a partial outlay for transportation
through the Community Development Block Grant program. This figure
includes transportation outlays for the Entitlement program, but excludes
the State

Administered program. o This is a partial estimate because, according to a
program official, data on transportation outlays are

not available from all grantees. The program official could not provide an
estimate of outlays for transportation for all grantees. p HUD provided
data for transportation spending by 3,187 grantees in fiscal year 2001
that totaled

$7,221,569. According to HUD program officials, there are a total of 6,323
grantees, about twice as many as reported data. The officials therefore
estimated that about $14,000,000 would have been spent on transportation
from all grantees in fiscal year 2001. q Estimate of outlays for
transportation is based on a program official*s review of the budgets from
15 grantees who renewed their grants in fiscal year 2001. The official
projected total transportation

outlays for the program based on these 15 grantees. r Public Law 102- 477
is applied to allow tribal governments to consolidate funding from several
federal

programs. These include: the Department of Health and Human Services*s
Temporary Assistance for Needy Families, and Child Care and Development
Fund programs; the Department of Labor*s Native American Employment and
Training, and Welfare- to- Work Grants for Federally Recognized Tribes

programs; and the Bureau of Indian Affairs* Employment Assistance, Indian
Social Service and Welfare Assistance, Adult Basic Education, and Higher
Education programs. The Indian Social Services and Welfare Assistance
Program is not used for transportation outside 102- 477. The Adult Basic
Education and Higher Education programs do not target transportation-
disadvantaged populations as defined in this study outside of 102- 477.
The Employment Assistance program and the HHS and DOL programs provide
transportation assistance separately from 102- 477. s A program official
estimated that transportation outlays were approximately 1 percent of
total

program outlays. t Program funding from fiscal year 1998 and 1999 may
still be spent, but the program no longer receives funding. u Estimate of
transportation outlays is based on a program official*s review of grantee
obligations. v According to a program official, fiscal year 2001 data are
not available due to changes in the program*s reporting system. The
official reported that transportation outlays for fiscal year 2002 totaled
$478,408.

Appendix II: Inventory of Federal Programs Providing Transportation
Services to the Transportation- Disadvantaged Page 54 GAO- 03- 697
Transportation Coordination w According to a program official, there are
three distinct allocations of funds under the Capital

Investment Grants: the New Starts allocation, which funds new rail
projects; the fixed- guideway modernization allocation, which provides
funding to maintain and update aging rail systems; and the bus allocation,
which provides funding for the purchase of buses, bus- related equipment
and

paratransit vehicles, and for the construction of bus- related facilities.
Because the Capital Investment Grants fund projects that provide services
for the general public, the transportation- disadvantaged likely benefit
from many projects funded through each of the three allocations, but
information was not available to estimate what portion of these funds for
the general public benefit the transportationdisadvantaged. However, the
program official said that the bus allocation would likely provide the
most direct benefit for the transportation- disadvantaged and the
obligation level could be estimated by totaling allocations to purchase
vans, buses for the elderly or disabled, or paratransit vehicles and
equipment. x The Nonurbanized Area Formula Program funds projects that
provide services for the general public,

however grantees can use up to 10 percent of their funds to provide
complementary ADA paratransit services. Although grantees did not report
obligations for complementary ADA paratransit, a program official said
that transportation- disadvantaged populations might benefit from other
services provided

through this grant, such as demand- responsive services. However, the
program official could not identify the amount of spending that directly
benefits the transportation- disadvantaged. y According to a program
official, the Urbanized Area Formula Program funds projects that provide

services for the general public, however grantees can use up to 10 percent
of their funds to provide complementary ADA paratransit services. The
figure listed in the table is the total obligations that grantees reported
for providing complementary ADA paratransit services. Although grantees
may benefit from other services provided through this grant, such as
demand- responsive services, the amount spent on complementary ADA
paratransit is the only portion that program officials could identify as
directly benefiting the transportation- disadvantaged.

Appendix III: Federal and State Coordination Efforts Page 55 GAO- 03- 697
Transportation Coordination Federal and state efforts to coordinate the
services for the transportationdisadvantaged provided through their
programs vary widely. This

appendix offers some examples of those efforts. In 1999, we reviewed the
coordination efforts of the Coordinating Council on Access and Mobility, a
body of representatives from the U. S. Department of Transportation (DOT)
and the U. S. Department of Health and Human Services (HHS). 1 We made
several recommendations for improving coordination between these two
agencies. Table 5 shows the recommendations and actions taken in response.

Table 5: Federal Actions Taken in Response to GAO Recommendations for
Improving Coordination Recommendations from 1999 GAO report Specific
actions completed or products

issued in response Actions in progress and further concerns The DOT/ HHS
Coordinating Council on Access and Mobility should adopt a prioritized
strategic plan.

In August 2000, the Coordinating Council adopted a prioritized strategic
plan for fiscal years 2000 to 2004 and distributed the plan to its
members.

The plan has not been updated or distributed widely because the Council is
now focused on a more *product- oriented* approach. The plan will be
updated at the end of 2003. The entire Coordinating Council has not met
formally since December 2000, but specific workgroups have been developing
action agendas and interagency agreements. The Coordinating Council should
develop an action plan with specific responsibilities. The Council
developed and issued an action plan in fiscal year 2003 and a

number of actions have been completed, such as producing a series of *how
to* publications on using intelligent transportation systems to assist in
the coordination of HHS programs with local transit agencies.

Other actions were not completed by the expected date, such as the
preparation of a promotional brochure on state Medicaid brokerage
initiatives. Also, the outcome of actions is unknown due to the lack of an
annual report.

The Coordinating Council should issue an annual report on its major
initiatives and accomplishments to the Secretaries of DOT and HHS. No
annual report has yet been issued. The Council plans to issue its first
annual

report in June 2003.

1 U. S. General Accounting Office, Transportation Coordination: Benefits
and Barriers Exist, and Planning Efforts Progress Slowly, GAO/ RCED- 00- 1
(Oct. 22, 1999). Appendix III: Federal and State Coordination

Efforts Federal Coordination

Appendix III: Federal and State Coordination Efforts Page 56 GAO- 03- 697
Transportation Coordination Recommendations from 1999 GAO report Specific
actions completed or products

issued in response Actions in progress and further concerns DOT and HHS
should ensure that planned coordination efforts reinforce one another.

The document *Planning Guidelines for Coordinated State and Local
Specialized Transportation Services* was issued by the Council in December
2000 and distributed to state and local transit agencies. The guidelines
are also available on the Web sites of the Council and DOT*s Federal
Transit Administration (FTA). These guidelines provide information to
facilitate the coordination of transportation services for 12 HHS and 10
DOT programs.

Distribution to health and human service providers may not have been as
thorough. According to some regional FTA and HHS officials we interviewed,
the guidelines might have more impact if they are delivered to human
service agencies and providers. Other officials mentioned the need for
more specific guidance, such as models for cost sharing.

DOT and HHS should direct their regional working groups to assess
obstacles to transportation coordination.

The Council*s strategic plan provides for regional coordination action
plans, including the identification and assessment of obstacles to
transportation coordination.

All 10 of the regions produced action plans, but most have not been
updated since fiscal year 2000. In addition, the outcomes of actions are
not routinely tracked. The FTA and HHS regional offices are jointly
sponsoring conferences in spring 2003 for state transportation and human
service officials to, among other things, identify obstacles to
coordination and best practices in successfully overcoming them. The
Coordinating Council should strengthen its Web site and make information
available on obstacles to coordination and strategies to overcome them.

The Council*s official Web site was discontinued due to lack of funding,
but another site was established in May 2002, operated by FTA in
conjunction with the Community Transportation Association of America. The
site is linked to FTA*s Web site. (www. fta. gov/ CCAM/ www. index. html)

The Coordinating Council*s Web site is not yet linked to HHS*s Web site.
The Council*s Web site does not contain an explicit list of obstacles to
coordination or strategies to overcome them, but it does contain links to
several reports that address these issues. Source: GAO. As a result of
items in the Coordinating Council*s strategic plan and action

plan, FTA and HHS have undertaken multiple efforts to coordinate
transportation services provided through their programs. Other federal
agencies are also involved in coordination activities. Examples of federal
coordination efforts include the following:

 The FTA and HHS*s Administration on Aging have entered into a memorandum
of understanding to increase coordination of transportation for older
adults. For example, the agreement says that FTA and the Administration on
Aging will work together to better coordinate the provision of funding
opportunities to the aging services and transportation networks for the
purpose of fostering coordination of transportation services and
developing innovative service delivery models.

 FTA and HHS*s Centers for Medicare & Medicaid Services are developing an
action plan between them to address the coordination of Medicaid funded
transportation.

Appendix III: Federal and State Coordination Efforts Page 57 GAO- 03- 697
Transportation Coordination  Department of Labor (DOL) and DOT officials
are developing guidelines about using Workforce Investment Act 2 funds for
programs funded under

DOT*s Job Access and Reverse Commute Program.  Some federal regional
offices have interagency working groups to discuss

transportation and other areas of mutual concern. Four of the 10 regions
have formal working groups that meet regularly to discuss ways to use
federal funds more efficiently, including for transportation services.
These groups include officials from FTA, HHS and, in some regions, the
Departments of Labor, Education, Housing and Urban Development, Veterans
Affairs, and others. In 4 other regions, FTA and some components of HHS
work together informally. One of the regions also has a formal working
group that meets quarterly to discuss Workforce Investment Act programs.

 A study undertaken on behalf of DOT and HHS examined seven specific
planning strategies that can be used as part of a flexible regional
planning process for coordinating transportation services of health and
human

service and transit agencies. The report is available on the Coordinating
Council*s Web site. 3  The Community Transportation Association of
America (CTAA) is an

organization consisting primarily of rural and small community
transportation providers, and it serves the dual role of transportation
industry representative and mobility advocate. It also has responsibility
for updating and maintaining the Coordinating Council*s Web site. CTAA
sponsored a National Summit on Coordination in May 2003 to encourage
federal, state, and local coordination. The participants* who came from
federal departments, human service agencies, state associations, and
transit providers* discussed, among other things, obstacles to
coordination and strategies for addressing them.

 CTAA established a Web site for the National Transit Resource Center, an
information clearinghouse funded by DOT and HHS. 4 The site contains links
to the Coordinating Council as well as to the Community Transportation
Assistance Project (CTAP) and the Rural Transit

2 P. L. 105- 220. 3 Volpe National Transportation Systems Center,
Innovative State and Local Planning for Coordinated Transportation, (U. S.
Department of Transportation, February 2002). 4 http:// www. ctaa. org/
ntrc.

Appendix III: Federal and State Coordination Efforts Page 58 GAO- 03- 697
Transportation Coordination Assistance Program (RTAP). CTAP, funded by
HHS, provides information about transportation issues, such as
accessibility, coordination, funding

opportunities, training, management, and legislation and regulations. CTAP
also compiled a comprehensive list of federal funding resources for
community transportation providers. The purpose of RTAP, funded by FTA, is
to provide training and technical assistance for rural public
transportation operators, improve professionalism and safety of rural
public transit services, promote efficiency and effectiveness of rural
transit services, and support coordination with human service
transportation.

 HHS and CTAA have developed and distributed an Employment Transportation
Toolkit designed to help communities improve access to transportation for
employment purposes.

 DOL is working with CTAA and DOT to implement several rounds of pilot
projects testing various transportation strategies in support of local
onestop employment and training centers. 5 According to DOL officials,
these strategies can include referral services, transportation
information, transportation services coordination, mobility management,
and other transportation strategies.

 DOL also provides funding to CTAA to convene regional workshops among
workforce development, human services, transportation, and business
communities, and to update a technical assistance toolkit for employment
transportation. The toolkit includes promising practices from the state
and local levels, as well as information on how businesses can be
employment transportation partners.

 According to agency officials, DOL*s Employment and Training
Administration sponsored a *Promising Practices* project that includes
transportation coordination efforts.

 The National Consortium on the Coordination of Human Services
Transportation* an initiative of FTA and HHS, under the direction of CTAA*
plans to design and conduct a survey of state Medicaid directors to
compile data on the Medicaid transit pass program, brokerages, and other
transportation funding mechanisms within Medicaid; develop a new

5 In an effort to coordinate service delivery for employment and training
programs, the Workforce Investment Act established one- stop centers in
all states. Individuals seeking employment opportunities and training can
receive services from more than a dozen federal programs that are required
to offer their services through these one- stop centers.

Appendix III: Federal and State Coordination Efforts Page 59 GAO- 03- 697
Transportation Coordination brochure outlining the benefits of the
Medicaid pass program; develop case studies of successful brokerage
programs and design a brochure

describing them; identify promising practices and obstacles in human
service transportation coordination and develop strategies for addressing
these obstacles; and provide outreach on coordination efforts and
resources. 6  The federally- funded Transportation Research Board, an arm
of the

National Academy of Sciences, has several completed and ongoing projects
on transportation coordination, including the following:

 In June 2000 the board issued *Welfare- to- Work: Integration and
Coordination of Transportation and Social Services.* This report
identifies obstacles former welfare recipients face in making the
transition to work and suggests practical strategies to improve access to
job opportunities.

 A draft report of TCRP Project B- 24, *Toolkit for Rural Community
Coordinated Transportation Services,* is expected in June 2003. The
objective of this research is to develop a practical toolkit for use by
local communities, state agencies, and tribal governments in planning and
implementing coordinated community transportation services in rural areas.

 The final report of TCRP Project H- 26, *Economic Benefits of
Coordinating Human Service Transportation and Transit Services,* is
expected in late 2003. The executive summary has been made available for
distribution. In this project, the researchers are examining the economic
benefits associated with various strategies and practices for coordinating
health and human services and transit providers, as well as additional
benefits (beyond costs) that might be obtained through further
coordination efforts.

 TCRP Project H- 30, *Strategies to Increase Coordination of
Transportation Services for the Transportation Disadvantaged,* has an

6 To date, the consortium consists of the AARP, Amalgamated Transit Union,
American Association of State Highway and Transportation Officials,
American Public Transportation Association, American Public Human Services
Association, American Public Works Association, American Red Cross,
Association of Metropolitan Planning Organizations, Children*s Health
Fund, Community Transportation Association of America, Easter Seals
Project Action, National Association of Area Agencies on Aging, National
Conference of State Legislatures, National Governor*s Association, and the
Taxicab, Limousine, and

Paratransit Association.

Appendix III: Federal and State Coordination Efforts Page 60 GAO- 03- 697
Transportation Coordination expected completion date of January 2004. The
objective of this

research project is to develop strategies for initiating or improving
coordination of local and regional publicly funded transportation services
for the transportation- disadvantaged.

Coordination of transportation services at the state level varies. We
visited two states with formal coordinating bodies, one state with a
formal arrangement between two agencies, and two states with no formal
coordination. Table 6 identifies the states* coordination arrangements and
the agencies involved in formal coordination efforts.

Table 6: Examples of State Coordination of Services for the
Transportation- Disadvantaged State Type of coordination Statewide

coordinating body Departments/ organizations involved in formal
coordination Arizona None None None

Florida State- administered brokerage system Commission for the

Transportation Disadvantaged  Departments of Transportation, Education,
Veterans Affairs, Children and Families, Elder Affairs, Labor and
Employment Security

 Agency for Health Care Administration

 Florida Transit Association

 Community Transportation Coordinators

 Transportation operators

 Nontransportation business community

 Florida Association for Community Action

 Early Childhood Council

 Representatives for the disabled, elderly, rural, and urban populations
New York None None None South Dakota Statewide planning

body Transportation Planning and

Coordinating Task Force

 Departments of Transportation, Human Services, Social Services, Labor,
and Health

 Coalition of Citizens with Disabilities Wisconsin None for entire state
None  Departments of Transportation and Workforce Development jointly
administer Wisconsin Employment Transportation

Assistance Program (WETAP) Source: GAO.  Arizona does not have formal
transportation coordination efforts at the

state level, though some state agencies work together informally, and some
localities have similar arrangements. For example, an official from the
Jobs Administration in the Department of Economic Security said that

the Administration works with the Department of Transportation to try to
avoid duplication of services in rural areas.  Florida has a state
coordinating body that oversees local coordination

efforts among most programs. This body is called the Commission for the
Transportation- Disadvantaged and was created in 1989 by the Florida State
Coordination

Appendix III: Federal and State Coordination Efforts Page 61 GAO- 03- 697
Transportation Coordination Legislature to oversee the implementation of
coordinated transportation disadvantaged services. The commission appoints
local Community

Transportation Coordinators who are responsible for the arrangement or
delivery of transportation services for transportation- disadvantaged
persons, either by brokering services or by providing transportation
directly. Agencies are required to purchase transportation through the
coordinated system, unless the services offered do not meet the needs of
the client or the agency can find a lower cost alternative that meets the
same safety standards.

 New York does not have a formal coordinating body, but some state
agencies work together informally and many local agencies have entered
into brokerage agreements. Officials from the Departments of Labor and
Transportation say they have been working together to identify needs and
initiate transportation projects for employment programs. In addition,
five

state agencies review and comment on applications for FTA*s Transit
Capital Assistance Program for Elderly Persons and Persons with
Disabilities.

 South Dakota has a state coordination task force that provides guidance
to local coordination efforts, but not all localities or programs have
developed coordinated systems. South Dakota established its Transportation
Planning and Coordinating Task Force in 1998 at the initiative of the
governor*s office. Additionally, the Departments of Human Services and
Transportation require all of their programs or applicants to coordinate
with other resources in the community.

 Wisconsin does not have a single body in state government that
coordinates all of Wisconsin*s services for the
transportationdisadvantaged, but some state and local programs do
coordinate. The state Departments of Transportation and Workforce
Development jointly administer the Wisconsin Employment Transportation
Assistance Program (WETAP), which uses a combination of federal, state,
and local funds to provide transportation for low- income residents to get
to jobs and employment services. WETAP applicants are required to
demonstrate coordination, and only one grant application is accepted per
county. Other agencies are also working to improve coordination. The
Departments of Transportation and Health and Family Services are trying to
coordinate Medicaid transportation. In addition, the Department of Health
and Family Services convened a conference in August 2002 to discuss ways
to

improve coordination of transportation for people with disabilities.

Appendix IV: Informational Resources on Coordination

Page 62 GAO- 03- 697 Transportation Coordination Coordinating Council on
Access and Mobility, www. fta. dot. gov/ CCAM/ www. index. html

Community Transportation Association of America, www. ctaa. org Workforce
Investment Act Transportation Resources, www. doleta. gov/ usworkforce/
resources/ transport. asp

Community Transportation Association of America. 2002. Building Mobility
Partnerships: Opportunities for Federal Investment.

Washington, D. C.: Community Transportation Association of America.
Coordinating Council on Access and Mobility. 2000. Planning Guidelines for
State and Local Coordination. Washington, D. C.: Coordinating Council on
Access and Mobility.

Creative Action, Inc. 2001. Coordinating Transportation Services: Local
Collaboration and Decision- Making. Prepared for Project Action. Akron,
OH: Creative Action, Inc.

National Governor*s Association. 2002. Improving Public Transportation
Services through Effective Statewide Coordination. Washington, D. C.: U.
S. Department of Health and Human Services and U. S. Department of
Transportation.

Volpe National Transportation Systems Center. 2002. Innovative State and
Local Planning for Coordinated Transportation. Washington, D. C.: U. S.
Department of Transportation.

Westat. Economic Benefits of Coordinating Human Service Transportation and
Transit Services. Transit Cooperative Research Project of the
Transportation Research Board. Forthcoming.

Westat. Toolkit for Rural Community Coordinated Transportation Services.
Transit Cooperative Research Project of the Transportation Research Board.
Forthcoming.

National Transportation Consortium of States, Ecosometrics, Inc., and the
American Public Works Association for the Coordinating Council on Access
and Mobility. 2000. Working Together: A Directory of State Coordination
Programs, Policies, and Contacts: 1999- 2000. Washington, D. C. Appendix
IV: Informational Resources on

Coordination Web Sites

Reports

Appendix V: Comments from the Department of Health and Human Services

Page 63 GAO- 03- 697 Transportation Coordination Appendix V: Comments from
the Department of Health and Human Services

Note: GAO comments supplementing those in the report text appear at the
end of this appendix.

Appendix V: Comments from the Department of Health and Human Services

Page 64 GAO- 03- 697 Transportation Coordination See page 7.

Appendix V: Comments from the Department of Health and Human Services

Page 65 GAO- 03- 697 Transportation Coordination See comment 2. See
comment 1.

Appendix V: Comments from the Department of Health and Human Services Page
66 GAO- 03- 697 Transportation Coordination The following are GAO*s
comments on HHS*s letter dated May 30, 2003.

1. HHS suggested that we consider incorporating other estimates of
transportation spending by health and human service programs, particularly
one estimate that assumed transportation spending accounted for 5 percent
of total program spending. In developing our

estimate of transportation spending, we only included actual or estimated
figures for which the agencies could provide supporting evidence. For
those programs that had actual or estimated spending information, on
average, about 3 percent of total spending for those programs was devoted
to transportation. We do not know whether this 3 percent is an appropriate
estimate of transportation spending for other programs because grantees
are generally not required to report transportation spending information
to the federal agency administering the program. Furthermore, several
officials who administer programs that had no spending data told us that
transportation services probably represented less than 1 percent of their
total program spending.

2. HHS proposed that we identify the levels, sectors, and affiliations of
officials and others we interviewed. In all agencies and locations we
talked with key human service and transportation officials responsible for
the delivery and coordination of human and transportation services. We
interviewed more than 100 officials in numerous federal, state, and local
transportation and human service agencies as well as individuals
representing service providers, consumers, and professional and industry
advocacy organizations. In our scope and methodology section (see app. I),
we generally describe the responsibilities and affiliations of those we
interviewed. GAO Comments

Appendix VI: Comments from the Department of Education

Page 67 GAO- 03- 697 Transportation Coordination Appendix VI: Comments
from the Department of Education

Appendix VI: Comments from the Department of Education Page 68 GAO- 03-
697 Transportation Coordination

Appendix VII: GAO Contacts and Staff Acknowledgments Page 69 GAO- 03- 697
Transportation Coordination Katherine Siggerud (202) 512- 2834 or
siggerudk@ gao. gov Rita A. Grieco (202) 512- 2834 or griecor@ gao. gov
Randall Williamson (206) 287- 4860 or williamsonr@ gao. gov In addition to
the individuals above, Christine Bonham, Bradley Hunt, Bert Japikse,
Jessica Lucas- Judy, Sara Ann Moessbauer, Hilary Murrish, Ryan

Petitte, Stanley Stenersen, and Andrew Von Ah made key contributions to
this report. Appendix VII: GAO Contacts and Staff

Acknowledgments GAO Contacts Staff Acknowledgments

(542009)

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