Transportation-Disadvantaged Populations: Many Federal Programs  
Fund Transportation Services, but Obstacles to Coordination	 
Persist (01-MAY-03, GAO-03-698T).				 
                                                                 
Numerous federal government programs provide assistance to	 
"transportation-disadvantaged" individuals--those who are unable 
to provide their own transportation as a result of a disability, 
an age-related condition, or an income constraint. The assistance
is provided to help these populations connect with services such 
as health and medical care, employment and training activities,  
and education programs. Coordination of this assistance--through 
such steps as pooling resources, consolidating transportation	 
services under a single state or local agency, and sharing	 
information about available services--has been found to improve  
the cost-effectiveness and quality of service. GAO was asked to  
identify (1) the federal programs that provide these		 
transportation services and the amount spent on these programs;  
(2) the effect of coordination--or lack of coordination--on the  
delivery of transportation services for the			 
transportation-disadvantaged; and (3) any obstacles that may	 
impede effective coordination and potential ways to overcome such
obstacles.							 
-------------------------Indexing Terms------------------------- 
REPORTNUM:   GAO-03-698T					        
    ACCNO:   A06747						        
  TITLE:     Transportation-Disadvantaged Populations: Many Federal   
Programs Fund Transportation Services, but Obstacles to 	 
Coordination Persist						 
     DATE:   05/01/2003 
  SUBJECT:   Disadvantaged persons				 
	     Federal aid for transportation			 
	     Interagency relations				 
	     Strategic planning 				 
	     Transportation legislation 			 
	     Transportation operations				 
	     Program evaluation 				 
	     Arizona						 
	     Florida						 
	     New York						 
	     South Dakota					 
	     Wisconsin						 

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GAO-03-698T

Testimony Before the Committees on Transportation and Infrastructure and
Education and the Workforce House of Representatives

United States General Accounting Office

GAO For Release on Delivery Expected at 10 a. m. EDT Thursday, May 1, 2003
TRANSPORTATIONDISADVANTAGED

POPULATIONS Many Federal Programs Fund Transportation Services, but
Obstacles to Coordination Persist

Statement of Katherine Siggerud, Acting Director Physical Infrastructure
Issues

GAO- 03- 698T

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. However, because this
work may contain copyrighted images or other material, permission from the
copyright holder may be necessary if you wish to reproduce this material
separately.

GAO found 62 federal programs* most of which are administered by the
Departments of Health and Human Services, Labor, Education, and
Transportation* that currently fund a variety of transportation services
for the transportation- disadvantaged. The full amount of spending for
these programs is unknown because transportation expenditures are not
always tracked separately from other program expenditures. However,
available information (i. e., estimated or actual outlays or obligations)
on 28 of the programs shows that

federal agencies spent at least an estimated $2. 4 billion in fiscal year
2001 on these services. Effective coordination can help avoid duplication
of effort and inefficiency in providing transportation services. GAO*s
preliminary results indicate that some jurisdictions have realized
significant benefits, such as improved customer service and lower unit
costs, and through coordination efforts such as sharing

vehicles, consolidating services under one provider, or sharing
information among programs. By contrast, GAO found several examples of
overlapping, fragmented, or confusing services resulting from a lack of
coordination.

Overlapping Routes of the Vehicles of Seven Agencies that Separately Serve
the Transportation- Disadvantaged in Sioux Falls, South Dakota

This graphic illustrates that many of these seven agencies* routes have
similar starting and ending points. Many of these routes represent trips
serving similar populations and occurring within 30 minutes of each other.

GAO identified numerous obstacles impeding coordination, including: (1)
reluctance to share vehicles and fund coordination; (2) differences in
federal program standards and requirements; and (3) limited guidance and
information on coordination. To mitigate these obstacles, officials and
experts suggested harmonizing standards among federal programs to better
share resources and serve additional populations, expanding forums to
facilitate communication among agencies, providing and disseminating
additional guidance, and providing financial incentives or instituting
mandates to coordinate. Numerous federal government programs provide
assistance to *transportation- disadvantaged* individuals* those who are
unable

to provide their own transportation as a result of a disability, an
agerelated condition, or an income constraint. The assistance is provided
to help these populations

connect with services such as health and medical care, employment and
training activities, and education programs.

Coordination of this assistance* through such steps as pooling resources,
consolidating transportation services under a single state or local
agency, and

sharing information about available services* has been found to improve
the cost- effectiveness and quality of service. GAO was asked to identify
(1) the federal programs

that provide these transportation services and the amount spent on these
programs; (2) the effect of

coordination* or lack of coordination* on the delivery of transportation
services for the transportation- disadvantaged; and (3) any obstacles that
may impede effective coordination and

potential ways to overcome such obstacles. This testimony is based on
ongoing work being done for the Transportation and Infrastructure
Committee. GAO expects to issue a

report in June 2003, at which time there may be recommendations.

www. gao. gov/ cgi- bin/ getrpt? GAO- 03- 698T. To view the full
testimony, including the scope and methodology, click on the link above.
For more information, contact Katherine Siggerud at (202) 512- 2834 or
siggerudk@ gao. gov. Highlights of GAO- 03- 698T, a testimony

before the Committee on Transportation and Infrastructure and the
Committee on Education and the Workforce, House of Representatives

May 1, 2003

TRANSPORTATION- DISADVANTAGED POPULATIONS

Many Federal Programs Fund Transportation Services, but Obstacles to
Coordination Persist

Page 1 GAO- 03- 698T

Messrs. Chairmen and Members of the Committees: We appreciate the
opportunity to testify on the coordination of transportation services for
people with limited access to transportation. At the request of the
Transportation and Infrastructure Committee, we have been examining
transportation assistance that the federal government funds to benefit
these individuals. Our work focuses on a population we call
*transportation- disadvantaged** that is, people who are unable to provide
their own transportation as a result of a disability, an age- related
condition, or an income constraint. This is a sizeable group. For example,
according to the 2000 U. S. Census, 35.1 million people were over age 65,
44.5 million people over age 21 were disabled, and 33.9 million people
were living below the poverty line. We have been studying the assistance
available to help such people connect with the services provided through
government programs, such as health and medical care, employment and
training activities, and education programs. For many people in this
group,

traditional public transportation may not be an option to access such
services.

Providing transportation services to these populations and coordinating
them across program lines are becoming more critical issues as the
transportation- disadvantaged populations grow and financial constraints
on the federal government and other government levels increase due to
budget deficits. With these trends, it will become more important to
maximize efficiency wherever possible to avoid having to reduce services.
The coordination of transportation services* through pooling resources,
consolidating transportation services under a single state or local
agency, or sharing information about available services* has been found to

improve the cost- effectiveness and quality of service. My statement
today, which is based on the preliminary results of our ongoing work for
the Transportation and Infrastructure Committee, addresses (1) the federal
programs that provide transportation services for transportation-
disadvantaged populations; the types of services they provide; and
federal, state, and local government spending for transportation through
these federal programs; (2) the effect of coordination* or lack of
coordination* on the delivery of transportation

services for the transportation- disadvantaged; and (3) any obstacles that
may impede effective coordination and potential options for overcoming
such obstacles. We are continuing to examine these issues and expect to
report on the final results of our work in June 2003.

Page 2 GAO- 03- 698T

Our work is based on an analysis of pertinent federal laws and
regulations, available data on federal and state spending, and the
research literature on coordination of transportation services. We also
conducted an in- depth

study of coordination efforts in five states* Arizona, Florida, New York,
South Dakota, and Wisconsin. We selected these five states to include a
cross- section of characteristics including the presence or absence of a
state- level coordinating body and geographic dispersion. Appendix I

contains more information about our scope and methodology. In summary: 
Sixty- two federal programs* most of which are administered by the

Departments of Health and Human Services, Labor, Education, and
Transportation* fund a variety of transportation services for the
transportation- disadvantaged, and spending for these programs is
estimated to be in the billions of dollars. 1 Most of these programs
purchase transportation from existing public or private sources, such as
providing bus tokens or passes, or contracting for service from private
providers. Also, several programs fund the purchase or modification of
vehicles for agencies to provide transportation for their clients. The
full amount of spending for these programs is unknown because
transportation is not always tracked separately from other program
spending. Available information on actual or estimated spending shows that
federal agencies spent at least an estimated $2.4 billion in fiscal year
2001 on various transportation services. Department of Health and Human
Services programs spent about three- quarters of this amount. State and
local agencies also provide significant 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. However,
estimates of state and local spending are not available because few
agencies track such information at the federal or state level.

 We found some agencies that have realized substantial benefits by
coordinating their transportation services through sharing vehicles,
consolidating services under a single agency, or sharing information about
available services, while others that do not coordinate have experienced
overlapping, fragmented, or confusing services. In locations where
coordination among programs has occurred, agencies and users are realizing
significant benefits, such as improved customer service and 1 In this
testimony, spending refers to actual or estimated outlays or obligations,
depending on what information was available from the agency.

Page 3 GAO- 03- 698T

lower unit costs. 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 increase the number of
trips provided while reducing the average cost of providing each trip by
more than 20 percent. The agency has also improved its services by

coordinating with local taxi companies to provide night and weekend trips.
In areas without coordination, local officials reported some examples of
(1) overlapping services, such as the transportation provider who often
runs two vehicles on the same route at nearly the same time to accommodate
different paperwork requirements; (2) fragmented services, when
transportation services provided by different counties or programs do not
connect and riders have difficulty scheduling complete trips; and (3)
confusion, when both providers and users are overwhelmed by the sheer
number of programs and their different requirements.

 Decision makers face numerous obstacles in trying to coordinate services
for the transportation- disadvantaged; officials and experts that we
consulted offered several potential options to mitigate these obstacles
and enhance coordination among federal, state, and local agencies. We
grouped the obstacles that impede coordination into three categories: (1)
reluctance to share vehicles and fund coordination activities; (2)
programmatic differences, including fragmented administration and distinct
reporting requirements among programs; and (3) limited guidance and
information on coordination, as shown by the limited technical assistance
provided by federal and state agencies on the possible techniques for
coordinating services. To mitigate these obstacles, some officials and
experts have suggested three potential options that may be

undertaken to improve coordination. 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 they may

serve additional populations or better share transportation resources.
Another option is to expand forums that would facilitate communication
among agencies involved in coordination 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 and mandates that would give priority in
federal funding to those applicants that show a strong

commitment to coordinate. Some of these options, however, would require
extensive statutory or regulatory changes and may cause agencies to incur
significant costs.

Page 4 GAO- 03- 698T

Concern over coordinating transportation services for
transportationdisadvantaged populations has been evident since the 1970s.
In 1977, we issued a report on transportation coordination, 2 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. This body is composed of representatives from program offices
within the Department of Health and Human Services (HHS) and Department of
Transportation (DOT), and its staffing needs are met, on a part- time
basis, by employees of these agencies. In a 1999 report on transportation
coordination, 3 we found that

coordination efforts of the Coordinating Council, DOT, and HHS were
ongoing but 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 (TEA- 21), 4 and
significant financial benefits had been realized through coordination.

More recently, reports and agency officials have raised concerns over
continuing duplication of effort among federal programs and certain
subpopulations still not being served effectively. 5 2 U. S. General
Accounting Office, 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 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).

4 P. L. 105- 178 (June 9, 1998). 5 For example, a report prepared for the
AARP found that transportation resources for the elderly, disabled, and
other groups were often not coordinated and led 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 (AARP, Washington, D. C.: September 2000).
Background

Page 5 GAO- 03- 698T

We identified 62 federal programs that fund a variety of transportation
services to populations that are transportation- disadvantaged. 6 The bulk
of these programs are administered by 4 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. 7 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 with their authorizing statutes, typical uses,
types of trips provided, target populations, and available spending
information is found in appendix II.

According to program officials, most of these 62 programs typically use
existing public or private transportation services through such methods as
contracting for services with private transportation providers, or through
providing bus tokens, transit passes, taxi vouchers, or mileage
reimbursement to volunteers or program participants. For example, DOL*s

Workforce Investment Act Adult Program typically provides participants
with bus tokens, while HHS*s Grants for Supportive Services and Senior
Centers program most often contracts with local transportation providers
to provide client transportation. Several programs, however, are typically
used to purchase, modify, or operate vehicles. These include Head Start

6 In addition to these 62 programs, it is likely that there are 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.
Community Transportation Association of America, Building Mobility
Partnerships: Opportunities for Federal Investment

(Washington, D. C.: March 2002). 7 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, 42 U. S. C. Chapter 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. Because it is impossible to
determine the amount

these programs spend to provide transportation to transportation-
disadvantaged populations, who are among the general population that is
served by these programs, we only report on the portion of these funds
used for ADA paratransit. Sixty- two Federal

Programs Fund Transportation Services for the TransportationDisadvantaged,
and Spending on Them Is in the Billions of Dollars

Page 6 GAO- 03- 698T

and the Program for American Indian, Alaskan Native, and Native Hawaiian
Elders in HHS; the Vocational Rehabilitation Grants program in the
Department of Education; and the Capital Assistance Program for Elderly
Persons and Persons with Disabilities, the Urbanized and Nonurbanized Area
Formula Programs, and the Job Access and Reverse Commute program in DOT.

Information on federal spending for transportation is available for 28 of
the 62 programs we identified. 8 These programs spent an estimated $2.4
billion on transportation services in fiscal year 2001. 9 (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 1 shows estimated transportation spending by the eight

federal agencies that fund services for the transportation- disadvantaged.
8 Of these 28 programs, 16 provided actual spending data for fiscal year
2001. Program officials for the remaining 12 programs provided an estimate
of transportation spending for 2001. 9 There was no spending information
available on four programs viewed as important providers of transportation
services. These programs included HHS*s Program for American Indian,
Alaskan Native, and Native Hawaiian Elders and DOL*s Workforce

Investment Act Adult Program, Workforce Investment Act Dislocated Worker
Program, and Workforce Investment Act Youth Activities. The Community
Transportation Association of America, a national, professional membership
association that conducts research and provides technical assistance for
community transportation providers, identified the four programs, whose
total obligations were $3. 7 billion in fiscal year 2001, as routinely
used to provide transportation. While information was not available on the
portion of the $3.7 billion devoted to providing transportation services,
we were able to analyze data on other

human services programs which indicates that, on average, about 3 percent
of total spending on those programs was devoted to transportation.
Spending by 28 Federal Programs Is Estimated at

$2.4 billion in Fiscal Year 2001

Page 7 GAO- 03- 698T

Table 1: Estimated Spending on Transportation Services for the
TransportationDisadvantaged by Eight Federal Agencies in Fiscal Year 2001

Agency Amount spent on

transportation (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 72.9% 10 23 Department of
Transportation $317.3 13.1% 6 6 Department of Veterans Affairs $160.8 6.
6% 3 3 Department of Education $133.8 5. 5% 2 8 Department of Labor $26.4
1. 1% 3 15 Department of Agriculture $13.0 0. 5% 1 1 Department of Housing
and Urban Development $7.5 0. 3% 3 4 Department of the Interior Not
available 0. 0% 0 2

Total for 8 agencies $2,429.8 100.0% 28 62

Source: GAO analysis of HHS, DOT, VA, Education, DOL, Agriculture, HUD,
and Interior data.

The amount spent on transportation services by the remaining 34 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.

Total state and local spending for transportation services, which
supplements federal spending for such programs, is likely significant*
reaching into the hundreds of millions of dollars at least* 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. For example,
according to state officials, state and local spending for one program*
Medicaid* made up between 32 and 50 percent of the total spending on
nonemergency medical transportation in the five states that we visited,
Total State and Local

Transportation Spending Is Unknown, but May Be Significant

Page 8 GAO- 03- 698T

totaling $188.9 million in 2001 in those five states. 10 Thirty- two of
the programs that we identified have matching requirements that generally
require states and localities to contribute between 5 and 50 percent of
total program costs.

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.

10 The amount that states are required to contribute depends on how states
claim transportation under Medicaid. If states claim transportation 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.
Coordination Has Led to Improvements,

while Lack of Coordination Can Result in Overlap

Coordination Has Financial Benefits and Can Lead to Improved Service

Page 9 GAO- 03- 698T

 A federal regional official said that coordination can 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 11
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 more than 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, we found examples of areas or programs that were
not coordinating, resulting in overlapping services. 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, 12 because it is too difficult to mix clients due
to complicated fee structures and paperwork requirements imposed by the

11 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. 12 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. Lack of Coordination Can

Lead to Overlapping Services and Confusion

Page 10 GAO- 03- 698T

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
area that has had difficulty coordinating, several human service providers
hired a consultant to study the extent to which various agencies provide

similar transportation services within a geographic region. This research
showed substantial overlap in local services for the
transportationdisadvantaged, as shown in figure 1. The consultant
identified ways in which the number of routes could be substantially
reduced through better coordination.

Page 11 GAO- 03- 698T

Figure 1: Overlapping Daily Routes of Vehicles Serving the
TransportationDisadvantaged in Sioux Falls, South Dakota

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.

We also found examples of fragmented services and confusion among users as
a result of uncoordinated programs. One official 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

Page 12 GAO- 03- 698T

riders stranded due to unconnected transit systems. For example, a local
transit administrator said that a 62- year old woman regularly walks 1.5
miles from the northern border of the county to her job in the next
county, along roads with no sidewalks, because the counties do not
coordinate and the bus service does not connect across county lines.
Another provider in the same 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 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. In
addition, the provider 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 program the clients are eligible.

Although some federal, state, and local agencies encourage the
coordination of services for the transportation- disadvantaged and some
coordination efforts have been established, officials representing these
agencies and experts in the area cited numerous obstacles that impede more
effective coordination of transportation services among agencies, as well
as potential ways for overcoming these obstacles.

Officials pointed out that agencies may be reluctant to share vehicles or
may give low priority to funding coordination activities. In addition,
some areas have limited transportation services available, thus limiting
any opportunities to benefit from coordination.

Administrators of federal programs may be apprehensive about sharing
vehicles for coordination due, in part, to their concerns about a loss of
control over the quality of client services or their concerns about mixing
frail, sick, and healthy populations in one coordinated system. According
to a report on coordinated transportation systems, this reluctance among
Officials Cited

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

Obstacles Related to Sharing Vehicles and Providing Financial Resources
for

Coordination Apprehension About Sharing Available Financial Resources and
Vehicles

Page 13 GAO- 03- 698T

providers to cooperate can lead to an underutilization of vehicles. 13
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 adjust from
door- to- door service to curb- to- curb service or public transit.
Despite the per unit cost- savings that some agencies have experienced

through coordinating, the overall cost of coordination can be significant.
For example, a transportation brokerage firm in one state faced
substantial added costs when it began providing transportation to human
service 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, DOT
does not currently encourage the use of these funds for administration of
the program and, thus, the current allotment for administrative expenses
would not support any staff to work on coordination activities.

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 cost- effective option.

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.

13 Moss Adams LLP, Community Transportation Association of America, The
Coordination Challenge (Seattle, WA: June 2000). Low Priority Given to
Funding

Coordination Activities Limited Availability of Transportation Services

Obstacles Related to Programmatic Differences

Page 14 GAO- 03- 698T

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 can
lead to inefficient transportation services within a community. For
example, an official in one state we visited commented that one federal
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 also vary
by program and jurisdiction, thus complicating efforts to transport
multiple client groups. 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
states to local workforce investment boards. In addition, funding for
programs such as Head Start flows directly to grantees rather than going
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 Job Access
and Reverse Commute (JARC) program encourages grantees to use other
federal funds to provide the local *match* required to obtain 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 Different
Eligibility Rules

Varying Funding Streams and Cycles

Lack of Uniform Data Collection and Reporting Requirements Among Programs

Page 15 GAO- 03- 698T

transit provider was required to give each of several human service
agencies a separate type of bill for services provided, which reflected
the unique requirements imposed by each of those agencies. 14 In addition,
human service agencies and providers may not be required or accustomed to
collecting complete and uniform transportation data for their programs,
even though such information may enable administrators to estimate their
transportation- related costs and re- evaluate how best to provide
transportation. 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 to the transportation- disadvantaged, actual
expenditures were estimated to total $224.9 million* much higher than the

initial estimate. Such information has helped human service agencies in
Florida understand their true transportation costs, which has encouraged
some of these agencies to be 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
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 services
between transportation and human service agencies challenging. 15 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
*costallocation* 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 14 Ecosometrics, Inc., Recommended Framework for Developing State and
Local Human

Services Transportation Planning Guidance (Bethesda, MD: Sept. 22, 1998).
15 Volpe National Transportation Systems Center, Innovative State and
Local Planning for Coordinated Transportation (Washington, D. C.: February
2002). Distinct Purposes and Goals

Among Agencies

Page 16 GAO- 03- 698T

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, some
state 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 initiatives to coordinate services 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. For example, officials in one state
said that there was insufficient guidance on how to share costs among
programs for projects funded jointly by DOT*s JARC grants, HHS*s Temporary
Assistance for Needy Families, and DOL*s Welfare- to- Work program funds.
Instead, they had to seek advice from other states. In addition, the
Coordinating Council on Access and Mobility is not directly funded and has
limited visibility for agencies actually involved in implementing
coordination efforts. For example, although the Council has developed a
Web site 16 that is accessible through a link on the Federal

Transit Administration*s section of DOT*s Web site, there is no similar
link from HHS*s Web site, possibly limiting human service agencies*
awareness of and ability to access the site. 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 one- half
of the states have no coordinating body, according to one report. 17
Officials

16 www. fta. dot. gov/ CCAM/ www. index. html 17 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). Obstacles Related to

Limited Federal and State Guidance and Information on Coordination

Limited Federal Guidance and Information on Coordination

Limited State Guidance and Information on Coordination

Page 17 GAO- 03- 698T

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.

Federal, state, and local officials, as well as experts in the area, have
suggested a number of potential ways to improve coordination of
transportation services among federal programs. We are still in the
process of collecting additional information and reviewing it with
stakeholders, but three key options have emerged thus far.

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 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) and driver training 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.
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
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
Potential Options to Improve Coordination

Harmonizing Program Standards and Requirements

Expanding Forums and Providing and Disseminating Additional Guidance and
Information on Coordination

Page 18 GAO- 03- 698T

officials suggested expanding the membership of the Coordinating Council
on Access and Mobility to include additional 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 the 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.  Current
funds allotted by multiple federal sources could be combined into

one state or local fund for transportation services for the
transportationdisadvantaged.  Funding opportunities could be tied to
federal or state coordination

mandates so that there are financial consequences for a failure to
coordinate.

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 would be at a
disadvantage in competing for funding with larger agencies serving larger
numbers of clients. In addition, several officials also raised concerns
about Providing Financial Incentives

or Mandates

Page 19 GAO- 03- 698T

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.

Messrs. Chairmen, this concludes my prepared statement. I would be happy
to respond to any questions you or Members of the Committees may have at
this time.

For further information on this testimony, please contact Katherine
Siggerud at (202) 512- 2834 or siggerudk@ gao. gov. Individuals making key
contributions to this testimony include Christine Bonham, Rita Grieco,
Bradley Hunt, Susan Irving, Jessica Lucas- Judy, Sara Ann Moessbauer,
Hilary Murrish, Ryan Petitte, Stanley Stenersen, Andrew Von Ah, and
Randall Williamson. Contact and

Acknowledgments

Page 20 GAO- 03- 698T

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 based on 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 strategies, we: (1) conducted
interviews

and document reviews in the pertinent federal agencies; (2) conducted five
case studies in Arizona, Florida, New York, South Dakota, and Wisconsin;
(3) reviewed the literature on the challenges encountered in providing and
coordinating services to 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 and Medicaid Services, the Health Resources
Services Administration, 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 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

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

Page 21 GAO- 03- 698T

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 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.

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 April 2003 in accordance with generally accepted government
auditing standards.

Page 22 GAO- 03- 698T

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 FY 2001

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 & 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 underperforming

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 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

Appendix II: Inventory of Federal Programs

Page 23 GAO- 03- 698T

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 FY 2001

spending on transportation b 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
Severe Disabilities

Workforce Investment Act of 1998

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

Vehicle modifications, bus tokens

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

Persons with a significant disability

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) Vehicle

modifications, bus tokens

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

Persons with physical or mental impairments

$49,200,000 (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 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

Page 24 GAO- 03- 698T

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 FY 2001

spending on transportation b 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 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 States are

encouraged to provide transportation services instead of vehicles

Attendance at meetings, conferences, trainings

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 transportationrelated use,

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

Page 25 GAO- 03- 698T

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 FY 2001

spending on transportation b 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

Department of Health and Human Services, Centers for Medicare and 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 Act of 2000

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

Any transportationrelated use To access health

care services Beneficiaries are 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)( 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 low- income
families

No actual data or estimate available from

the federal agency

Page 26 GAO- 03- 698T

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 FY 2001

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 low-
income 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

$73,000 (estimate) o Supportive

Housing Program

McKinneyVento 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

No actual data or estimate available from

the federal agency 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 Department of 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

Page 27 GAO- 03- 698T

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 FY 2001

spending on transportation b 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 Employmentrelated 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 Farmworkers

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 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 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

Page 28 GAO- 03- 698T

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 FY 2001

spending on transportation b 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 under
WIA

No actual data or estimate available from

the federal agency Workforce Investment Act Adult 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 public 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 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

Page 29 GAO- 03- 698T

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 FY 2001

spending on transportation b 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

Capital Investment Grants

Transportation Equity Act for the 21st Century

49 U. S. C. S: 5309 Assistance for bus and bus- related 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 Expand exisiting 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

Page 30 GAO- 03- 698T

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 FY 2001

spending on transportation b 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

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 spending on transportation services for the transportation-
disadvantaged $2,429,835,887

Source: GAO analysis of information from the Departments of Agriculture,
Education, Health and Human Services, Housing and Urban Development,
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.

Page 31 GAO- 03- 698T

d A program official said that 10 percent of total program outlays would
be a conservative estimate of transportation outlays. e According to a
program official, grantees report total transportation outlays for
Vocational

Rehabilitation Grants, Supported Employment Services for Individuals with
Severe Disabilities, and other rehabilitation sources together. The
program official reports that transportation outlays for Vocational
Rehabilitation Grants are approximately 90 percent of the total amount
reported, but did not provide a similar estimate for Supported Employment
Services for Individuals with Severe Disabilities. 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.

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

only available from competitive grantees; formula grantees are not
required to report outlays for transportation. The program official could
not provide an estimate of outlays for transportation through the formula
grant program. The program official said that fiscal year 2001 data for
the competitive

grant program are incomplete and the agency is still collecting fiscal
year 2001 data from approximately one- third of its competitive grantees,
due to differing reporting schedules. As of March 2003, competitive
grantees reported outlays of approximately $60,000 on transportation, and
the program official expects total outlays for transportation to reach the
level of outlays on transportation in fiscal year 1999 (approximately
$73,000) or more after all competitive grantees report data. p Data on
outlays for transportation are not available. The agency does collect data
on the amount that grantees request for various supportive services,
including transportation. These requests may cover

1, 2, or 3 years; a program official said that they could not easily
determine for how many years grantees are requesting money. In fiscal year
2001, grantees requested $12,973,992 for transportation. 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.

Page 32 GAO- 03- 698T

r Public Law 102- 477 allows 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*s 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 can 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 FY 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. 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.

(542022)
*** End of document. ***