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Guidelines for developing trip priority procedures for non-sponsored trips purchased with TD commission funds

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Title:
Guidelines for developing trip priority procedures for non-sponsored trips purchased with TD commission funds final report
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1 online resource (various pagings) : ill. ;
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English
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University of South Florida -- Center for Urban Transportation Research
Florida -- Commission for the Transportation Disadvantaged
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Center for Urban Transportation Research
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Transportation -- Planning -- Florida   ( lcsh )
Local transit -- Management   ( lcsh )
Paratransit services -- Florida   ( lcsh )
Older people -- Transportation -- Florida   ( lcsh )
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government publication (state, provincial, terriorial, dependent)   ( marcgt )
non-fiction   ( marcgt )

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prepared for the Florida Transportation Disadvantaged Commission by the Center for Urban Transportation Research, College of Engineering, University of South Florida.
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Title from e-book t.p. (viewed Aug. 24, 2011).
General Note:
"June 1993."

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aleph - 029015660
notis - (OCoLC)36064591
oclc - 36064591
oclc - 747738714
usfldc doi - C01-00017
usfldc handle - c1.17
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GUIDELINES FOR DEVELOPING TRIP PRIORITY PROCEDURES FOR NON-SPONSORED TRIPS PURCHASED Wim TD COMMISSION FUNDS F inal Report

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GUIDELINES FOR DEVELOPING TRIP PRIORITY PROCEDURES FOR NON-SPONSORED TRIPS PURCHASED WITH TD COMMISSION FUNDS Prepared for the F lorida Tmnsportation Disadvantaged Commission By the Center for Urban Transportation Research College of Engineering U niversity of South Florida Final Report June 1993

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Transportation Disadvantaged Commission 605 Suwannee Street, MS-49 Tallahassee, Florida 32399-0450 (904) 488-6036 Executive Director: Project Manager: Jo Ann Hutchinson Floyd G. Webb, lll Center for Urban Transportation Research University of South Florida 4202 E. Fowler Avenue, ENG 118 Tampa, Florida 33620 (813) 974-3120 Director: Project Director: Project Manager: Project Staff: Gary L. Brosch F. Ron Jones Rosemary G. Mathias Gerald L. Harter Rebecca Rahimi

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Preface PREFACE This report was prepared for the Florida Transportation Disadvantaged (TD) Commission by the Center for Urban Transportation Research (CUTR) at the University of South Florida. The TD Commission asked CUTR to undertake this study to develop alternative needs based procedures for the establishment of trip priority strategies for providing trips purchased with TD Trust Fund monies. This study included a survey of Florida's community transportation coordinators (CTCs) a national review of current trip priority practices, and an evaluation of the applicability of the Americans with Disabilities Act. This report is divided into three sections. Section One: Background Information describes the role of eligibility criteria and various paratransit provider types, as well as strategies for establishing trip priority procedures that may be used when the demand for service exceeds the available supply. Section Two: CTC Trip Priorities Survey shows the resu lts of the survey that was conducted to assess the extent and types of trip priority procedures currently being used by CTCs in Florida. Section Three: Implementation Strategies delineates various approaches for establishing system design strategies and trip priority procedures. Special thanks is given to the many CTCs who took the time to answer the questionnaire and who provided examples of trip priority procedures currently being used in Florida. I

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Table of Contents TABLE OF CONTENTS PREFACE .............. ........ .. 0 0 I LIS T OF FIGURES . . . . . . . . . . . . . . . . . . . . . . v LIST OF TABLES . . . . . . . . . . . . . . . . . . . . . v EXECUTIVE SUMMARY . ........ ............... ..... ......... vii INTRODUCTION . . . . . . . . . . . . . . . . . . . . . . . . I Increasing the Supply of Paratransit Services . . . . . . . . . . . . . 2 De creasing the Demand for Paratransit Services . . . . . . . . . . . . 3 SECTION ONE: BACKGROUND INFORMATION 0 5 EI. "b"I" C . 1g1 1 Jty ntena ........... .. ................. ...... ....... Paratransit Provider Types . ............. .......... ............. Trip Priority Options ..................... ..... ... ....... ...... SECTION TWO: CTC TRIP PRIORITIES SURVEY ..... ..... ...... ..... Survey Overview ........ . ................ ... .... . ..... Survey Findings ...... ... ....... ................. ............ Program v General Trips ..... ... ..................... . . . Use of TO T rust Fund .................................... 5 6 8 13 13 14 14 14 Supply and Demand Issues . . . . . . . . . . . . . . . . . 15 General Use of Trip Priority Practices . . . . . . . . . . . . . 18 Specific Use of Trip Priority Practices . . . . . . . . . . . . 1 8 Survey Impli cations . . . . . . . . . . . . . . . . . . . . 24 SECTION THREE : I MPLEMENTATION STRA TEGJES . . . . . . . . . . 27 S ys tem Design Strategies . . . . . . . . . . . . . . . . . . . 28 Screening and Eligibility Criteria . . . . . . . . . . . . . . . 28 S hared v Exclusive Ride . . . . . . . . . . . . . . . . . 29 Advance Reservation Re qui rements . . . . . . . . . . . . . 3 0 Geographic Service Area . . . . . . . . . . . . . . . . 31 Trip Priority Strategie s . . . . . . . . . . . . . . . . . . . 32 T rip Purpose . . . . . . . . . . . . . . . . . . . . . 35 T ravel During a Certain Time of Day . . . . . . . . . . . . . 36 Number of Trip s . . . . . . . . . . . . . . . . . . . . 37 A Note of Caution . . . . . . . . . . . . . . . . . . 38 CONCLUSION . . . . . . . . . . . . . . . . . . . . . . . . 41 UJ

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Guidelines for Developing Trip Priority Procedures T A BLE O F CONTENTS (Continued) APPENDIX A: GLOUCESTER COUNTY (N.J.) DEPARTMENT ON AGING SPECIAL TRANSPORTATION SERVICE PASSENGER PROCEDURES . . . . . . . . . . . . . . . . . A-1 APPENDIX B : PENNSYLVANIA DEPARTMENT OF AGING SECTION 203 TRANSPORTATION PRIORITY SETTING DISCUSSION PAPER . . . . . . . . . . . . . . . B 1 APPENDIX C: CTC TRIP PRIORITIES SURVEY . . . . . . . . . . . C 1 APPENDIX D: SAMPLE WRITTEN POLICIES . . . . . . . . . . D-1 Exampl e I Example 2 Example 3 Example 4 Example 5 Example 6 Example 7 Example 8 iv

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List of Figur e s and T a bles LIST O F FIGURES Figure I: Survey Questions No. I & No. 2 . . . . . . . . . . . . . . 16 Fi gure 2: Survey Questions No. 3 & No. 4 . . . . . . . . . . . . . . 17 F igur e 3: Survey Question No. 6 . . . . . . . .. . . . . . . . . . . . 19 F igure 4: Survey Question No. 5 . . . . . . . . . . . . . . . . . 20 Figur e 5: Survey Question No. 7 . . . . . . . . . . . . . . . . . . 2 1 Fig ur e 6: Percentage of CTCs Using a Trip Priority Procedure . . . . . . . . 22 Figure 7 : Trip Priority Decision Pro c ess . . . . . . . . . . . . . . . . 34 LIS T OF TABLES Table 1: F l orida's ADA Complementary Puatransit Service Provid e rs . . . . . . 7 Table 2: Swnmary of C TCs . . . . . . . . . . . . . . . . . . . 15 Table 3 : Overall Ranking by Trip Purpose . . . . . . . . . . . . . . 23 v

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ExecuJive Summary EXECUTIVE SUMMARY The purpose of this report is to document and analyze methods for establishing trip priorities for potential use by community transportation coordinators (CTCs) in Florida. This research was conducted to identify practi ces already being used in F lorida, and to suggest alternative approaches for establishing trip priorities based on the experience of other paratransit providers and as a result of a national review. This study is not intended to recommend or require that CfCs use trip priorities. Rather, the impetus for this study was the fact that the demand for transportation for those persons in Florida who are defined as being transportation disadvantaged (TD) far exceeds the supply ofTD transportation currently available. Although the TD Trust Fund provides some funding to pay for the cost of transporting TO-eligible persons who are not otherwise subsidized by another funding agency, it alone cannot meet the potential demand for trips at' this time. This report includes an overview of possible trip priority practices, an analysis of the results of the study of CTCs trip priority practices in Florida, and information about implementing trip priority practices if a CTC desires to do so. VII

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Introduction INTRODUCTION When the demand for transportation disadvantaged (TD) trips exceeds the supply of available time slots for trips, the community transportation coordinator (CTC) finds itself in the unfortunate position of having to say "no" to a passenger's request for service. What is the "best" way to deal with this situation? How should a CTC decide which trips will be provided and which will not? During 1992, the total demand for TD transportation service in Florida was estimated to be 26.6 million trips.' However, during that same time period, only 15.9 million trips were actually provided by CTCs and by other transportation providers who are not part of the coordinated system. The CTCs provided 10.5 million (66 percent) of those trips.2 Thus, in 1992, the estimated unmet demand for TD trans portation service may have been as high as I 0.6 million trips. Virtually all of these trips appear to h ave been general (non sponsored) trips that are not funded by a sponsoring program or agency. A detailed analysis shows that this unmet demand includes approximately 3.7 million medical trips, 2.1 million education and work trips, 1.1 million shopping trips, and 3.7 million social, recreational, and other trips.' The TD Trust Fund was established in 1989 to provide assistance to CTCs for the provision of general/non-sponsored trips. In 1992, the TD Trust Fund prov ided $5.6 million for TD services. Nonetheless, the data suggest that there is considerable need for additional funding to meet the unmet demand. There are a variety of ways in which to address the issue when the demand for service exceeds the available supply. These solutions could i nclude increasing supply through i mprov ing 'CUTR. Florida Fi>-e-Year Transporuuion Disadvantaged Plan: Final Report. June 1 992, p. II. 'CUTR. Statewide Operations Report: Fiscal YeaTs 1990191 and 199 1/91 June 1993 p. 4 JFiveYear Plan p 13. I

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Guidelines for Developing Trip Priority Procedures productivity, reducing overall system costs, and/or increasing revenue. Other solutions include decreasing demand through increasing fares, changing service parameters, and/or restricting use of the service. This report will examine options for developing eligibility criteria and trip priority procedures. Increasing the Supply of Paratransit Services Prudent business practices dictate that CTCs take reasonable steps to ensure that the services they provide are as productive as possible Good productivity is achieved through such practices as efficient trip scheduling and dispatching, good driver training (both on-the-road and passenger assistance techniques), and by eliminating any unnecessary or cumbersome practices that become barriers to the provision of service. By improving productivity, a provider can increase the supply of trips \vithout increasing actual costs. When a system is operating productively, it is able to serve more passengers than an unproductive or inefficient system, even if additional financial resources are not available. A second way to increase the overall supply of trips is to reduce the overall system cost of providing TO transportation service. One way of reducing the overall system cost is to shift passengers from the more expensive paratransit system to the less expensive fixed-route service if available. For example, some CTCs have found that it is cheaper to provide monthly bus passes for those Medicaid program-sponsored passengers who can use fixed-route service than it is to provide more expensive (per trip) door-to-door paratransit service. Passengers who are given bus passes may use the pass as often as they like. As a result, the CTC may be able to coordinate more trips while reducing the overall cost of providing service. At the same time, passengers benefit because they are able to achieve greater flexibility and mobility with the monthly bus pass. A third way to increase supply is to obtain more revenue to help pay for service expansion. Revenue comes from a variety of sources including the TO Trust Fund; local, state, and federal subsidies; grants; service contracts; fares; and donations. By generating additional revenue, particularly wuestricted government subsidies, the provider may be able to meet at least some of the additional demand for service. 2

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Introduction Decreasing the Demand for Paratransit Services A simple way to the reduce demand for paratransit services is to increase the amount of the fare or contract rate paid for each trip Even a small increase will motivate some passengers to seek alternate transportation, although new passengers may fill the void resulting in no decrease in service. In addition, with respect to non-sponsored persons making trips using TO services, raising the fare could eliminate the ability for low income riders to access the system. This approach has limited applicability because fares should be based on covering fully allocated costs Artificially inflating contract rates or fares to decrease demand is not a sound practice; however, requiring passengers to pay a higher percentage of the cost of subsidized trips is an option Fares and contract rates should be established only after undertaking a rigorous analysis of the potential demand for service and projected cost of providing that service. Any subsidies (such as federal operating assistance) should be taken into account when setting fares. A second approach to reduce demand is through modifying service parameters For example, the demand for s pur-of-the-moment trips will not be served if passengers are required to request trips 24 hours in advance. (While there still may be latent demand for these types of trips, overall service leve ls may be reduced by restricting passengers' access to the system.) Caution should be exercised before making such serv ice changes however, because reducing service too much could result in higher per trip costs for the remaining trips. This approach will be discussed in more detail in Section Three of this report A third way to deal with excess demand for paratransit services is to develop a strategy for restricting trips. This approach involves such techniques as setting eligibility criteria and establishing trip priority procedures Screening procedures using established eligibility criteria define who may and who may not use the service. Thus, only those persons who meet certain specified criteria are allowed to use the service. Those who do not meet the stated criteria may not use the service. Similarly, trip priority procedures provide a consistent approach to restricting or rationing trips by defining w h o may use the service, where it will go, when, for what trip purpose and how much it will cost. These procedures often attempt to serve the most urgent trips first (as defmed by the system) and allow for the less important trips (again, as defined by the system) only if capacity permits This approach will be discussed in more detail under System Design and Strategies in Section Three of this report 3

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Guidelines for Developing Trip Prio rity Procedures A fourth way to manage demand is to expend TO non-sponsored funds for those services that are at a certain level of cost effectiveness or efficiency. For example, TD non-sponsored funds could be used to purchase group trips of four or more persons traveling together. Another option would be to purchase bus passes for persons living in fixed-route service areas and requiring those persons (if they are able) to use fixed-route buses instead of more costly paratransit services The purpose of this document i s to describe various methods for establishing eligibility criteria and trip priority procedures. Further, in Element 6 of the annual Service Plan, the TO Commission asks CTCs to describe any procedures tbat are in place for controlling the rate at which TD funds are expended for non-sponsored TO transportation service.' Such mechanisms might include establishing eligibility criteria, developing trip priority procedures, or i mposing other limitations (such as a monthly spending cap) to control the demand for service. The information contained in this report will assist crcs with completion of this task. Although eligibility criteria, trip priorities, and spending caps are restrictive, the advantage of using them is that they provide a consistent, rational approach to determining who may and who may not use service, thereby eliminating or reducing arbitrary or discriminatory decision making on the part of the CTC or its service provider(s). Because these strategies often are controversial, their implementation should be undertaken only after seeking the advice and guidance of the CfC's local coordinating boatd (LCB) and others, as appropriate. 4Fiorida TO CommissioD.t Instruction Manual and Minimum Criteria for the Preparation of the I. Memorandum of 2. ere Service Plan, and 3 Purchase of Service eonlracts. Tallahassee, Florida: Revised, 2124/'Yl, p. 19. 4

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Section One: Background Information SECTION ONE BACKGROUND INFORMATION This section of the report describes the various methods for restricting access or rationing paratransit services. The ftrst part deals with the establishment of eligibility criteria for defining who may and who may not use the paratransit service The second part of this section deseribes various options for providing paratransit service. The third part defines techniques for establishing trip priorities. As is the case for eligibility criteria, establishing formal, written trip priority policies can avoid disputes and misunderstandings. Eligibility Criteria Eligibility criteria refer to the rules or guidelines used to determine who may and who may not use a particular service. Written procedures for implementing eligibility criteria are essential to avoid disputes and misunderstandings with passengers, their families, and others. Eligibility criteria may be very simple. An example of one criterion is age (e.g., service will be provided for anyone who is 65 years of age or older). Elig i bility criteria may be more complex. Under Florida's TD transportation classification, for example, service is provided to those persons who are in one of two groups. The first group (TD Category I) is broadly defined to include persons with disabilities, senior citizens, low income persons, and "high risk" or "at risk" children. These persons are eligible to receive certain governmental and social service agency subsidies for program-related trips. The second group (TO Category II) is a subset of the TD Category I population and includes only those persons who are transportation disadvantaged for the purpose of accessing non-sponsored service purchased by the TO Commission (i.e they are unable to transport themselves or to purchase transportation). In addition to the subsidies provided for persons included in the Category I population, persons included in Category II are eligible to receive TO Trust Fund monies for non-sponsored general trips 5

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Guidelines for Developing Trip Priority Procedures Eligibility criteria require record-keeping and screening capabilities. For example, Medicaid clients must be recertified each month to ensure that they are still eligible to receive Medicaid funded services. Thus, TD transportation providers must ascertain eligibility for these trips to ensure that they are reimbursed for the services they provide. This information must be stored with the client's file, either on paper or in a computer file, to ensure proper billing. In general, the more complex the eligibility criteria, the more important the process for determining eligibility and the more i mportant record-keeping becomes. It also may be more cost effective to coordinate eligibility certification efforts with another agency that has similar eligibility requirements. In the situation where demand exceeds supply strict adherence to eligibility criteria is the first step toward managing demand. Paratransit Provider Types For the purposes of this report, paratransit providers are divided into the following three categories: (I) ADA complementary paratransit programs, (2) special purpose paratransit programs, and (3) combinations of paratransit programs ADA Complementary Paratransit. With the passage of the Americans with Disabilities Act (ADA) of 1990, public transit agencies (as defined by Title II of the Act) that provide fixed route public transportation are required to develop complementary paratransit services for those persons who are unable to use the fixed-route service because of their disability. This service must be operated during the same days and hours of operation as the fixed-route service, and must meet a variety of other criteria as described in the regulations.' Complementary paratransit passengers must meet the eligibility criteria established by each system in accordance with section 37.123 of the ADA regulations.6 The ADA prohib its the use of trip priorities for ADA comp lementary paratransit service; all eligible passengers must be transported, regardless of the trip purpose. The regulations require transit agencies to be fully compliant with the ADA by 1997. The locations of ADA complementary paratransit providers in Florida is shown in Table I '49 CFR Parts 37 & 38. 6 ADA Paratransit Handbook: Jmplemeniing the Complementary Paratransit Service Requirements of the Americans with Disabilities Act. Washington, D.C.: U S Department ofTransponation, September 1991, Chapter 4. 6

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Section One: Background Information Table 1 Florida's ADA Paratransit Service Providers AIMr County CTC I Agency Provider I) I 9-X ; ; F :. > :mrr X IJ" ;pc n ,c.\, . ,; 'L.;; ' "J .. >:; .. : : ''X ; .X Polk X ; .. x ... .f::>,,. . : E. X X 1 """'" agency is he ere. Source: CUTR. Special Purpose Paratransit. Many paratrans it programs restrict their serv ices to those persons who meet certain program or funding requirements The TO transportation program is an example of this category of service. As described earlier the Florida TO Commission has defmed two broad categories of passengers: Category I and Category II. This report is pri marily concerned with persons in Category II, who are subsidized by the TO Trust Fun d. Under Florida's TO transportati on program, CTCs may establish trip priorities as long as they are applied equally to all passengers. In other words, a person with a disability may not be denied a trip b ecause he or sh e requires special equipment and/or assistance to use the service if an ab le bodied person would be allowed to make the same trip. This category of service typica lly is broader than the ADA comp lementary paratr ansit service described above because speci al purpose 7

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Guidelines for Developing Trip Priority Procedures paratransit programs usually includes non-disabled passengers who qualify based on income level, age or some other criterion. Combined ParatraDSit Programs. Some Florida paratransit programs carry both ADA complementary paratransit passengers, as well as those who are covered under the TD transportation program. When combining both passenger types, care must be taken to ensure that the respective rules are applied correctly and consistently within each group. For example although trip priorities may be permissible for the TD program portion, the ADA prohibits trip priorities for those clients who are transported under the ADA portion of the program. Twelve crcs prov ide at least some ADA complementary paratransit in addition to TD transportation services (see T able I). Trip Priority Options While conducting a national review, CUTR found little written documentation concerning the development of trip priority procedures. In addition to a literature review CUTR contacted a variety of state organizat i ons and transit agencies to determine whether trip priorities were being used in other parts of the country. Most systems were reluctant to discuss the issue of trip priorities and, if used, they often were not written policies. One system, Gloucester County (N. J.) Department on Aging's Special Transportation Services (STS) provided a copy of its "Passenger Procedures." Requests for STS service must be made in advance and only a limited number of trip types are served including : various medical, vocational training Medicaid limited recreational, and rural transportation trips. A copy of these procedures are included in A ppen dix A A few states have explored the adoption of statewide trip priority procedures. For example in 1 990 the Pennsylvania Department of Aging (PDA) undertook an effort to establish trip purpose priorities for the lottery-funded shared-ride transportation program for senior citizens. Although to date no statewide trip priority procedures have been adopted, some counties in PeMsylvania have adopted formal or informal trip purpose priorities and/or prohibitions In particular many coordinators will not provide airport trips. A copy of PO A's preliminary trip priorities discussion paper is included in Appendix B 8

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Section One: Background lnfonnation CUTR bas identified seven general procedures for establishing trip priorities, which are described below. Implementation strategies for these system design and trip priority practices are described in Section Three of this report. Basing Trip Priorities on Trip Purpose. This approach assigns a priority to each type of trip purpose that may be requested. Trip purpose priorities often are determined at the local (in this case CTC) level. U sually they are ranked with the advice of an advisory board (such as the local coordinating board) or by the provider. Prior to implementation, each trip purpose is ranked in priority order Often, dialysis trips and other medical trips are deemed a high priority. Low priority trips often include recreational and non-food shopping trips. An advantage to th i s approach is that it ensures that trips classified (by a CTC) as more essential are served fust; however, if capacity is severely constrained, this option may never allow trips to be made that are perceived as less important. Basing Trip Priorities on Geographic Area. This approach assigns priority to trips that are made within a specified geographic service area. Usually, trips that are outside of the service area are not served. Exceptions may be made for transportation to Veterans' Administration Hospitals or for travel to other regional medical facilities for treatments that are not available locally. An advantage to this approach is that it allows the provider to manage system productivity by restricting trip length and dispersion However, this approach may limit the user's choice of destinations for trip purposes or restrict out-of-area trips to certain days or times that may not coincide with a passenger's treatment schedule Basing Trip Priorities on Traveling During a Certain Time of Day. This approach attempts to spread the demand for transportation more evenly throughout the day, thereby avoid i ng peaks and valleys in service provision. As is the case with commuters on fixed-route transit systems, most paratransit systems experience periods of high (peak) demand in the early morning and late afternoon. Under this approach passengers with flexible schedules are asked to schedule trips during midday or other off-peak hours. By spreading demand more evenly, the provider will be able to accommodate more trips throughout the day, with fewer vehicles. One drawback to this approach is that passengers may be inconvenienced by the restricted travel times (e.g., some persons may have difficulty scheduling doctors' appointments during these restricted hours). 9

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Guidelines for Developing Trip Priority Procedures Basing Trip Priorities on Reservation Time. This approach requires that trips be reserved during a specific time period before the trip is to be taken (e.g., at least two days but not more than 30 days prior to the trip) In theory, this procedure enables the provider to know the demand for trips in advance to help facilitate scheduling One shortcoming of this procedure is that spur-of-the-moment trips (e.g., unplanned doctors' appointments) cannot be accommodated. A second shortcoming of this approach is that it may artificially restrict service availability by not allowing the provider the flexibility to replace trips that are canceled between the time the reservation was made and the time the trip was scheduled to be delivered. Also, the incidence of passenger no-shows tends to increase as reservation lead times increase (Accepting reservations or providing trips on a first-come, ftrst-served basis is not a true trip priority procedure. Although someone may argue that this approach is a way of establishing trip priorities, first-come, first-served is really a "do nothing" or "status quo" approach. Whoever calls ftrSt gets a ride. Nonetheless, for many systems this approach to accepting trip reservations works well and implementing a trip priorities procedure would not improve service.) Basing Trip Priorities on Number of Persons Traveling Together. This approach encourages group trips. For example, under this option priority may be given to groups of three or more persons traveling from the same origin to the same destination. A variation of this approach is for the provider to assemble groups and add individuals to the group when space is available. This passenger grouping enables the provider to be more efficient by limiting the number of pick-ups and drop-offs. A disadvantage is that this approach may reduce availability of transportation services for individual passengers who do not readily fit into a group trip. A variation of this approach is to give priority to persons requesting trips that may be added easily to existing trip patterns. Basing Trip Priorities on Number of Trips Allowed. This approach only allows a certain number of trips per time period for a specific user. With this approach the passenger is able to decide on how to ration his/her own trips. A variation of this approach allows the passenger to pay a premium for additional trips beyond his/her quota. One problem with this trip priority procedure is that someone with a large number of essential trips (e.g., dialysis three times a week) may not have trips left over for any other trip purpose. 10

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Section One: Background Information Basing Trip Priorities on Income. This approach limits the availability of service by using income eligibility requirements. Under this approach, passengers with higher incomes may not be eligible to ride or may have to pay a higher percentage of the cost of the trip. Persons whose incomes exceed the maximum threshold would not be allowed to ride (or would have to pay the full cost of providing the trip). l.n practice this approach often is difficult to apply because of the problems associated with confidentiality and income verification Further in practice, it may be difficult to collect fares from individuals on a sliding-fee basis As an alternative, it may be possible to piggyback onto another program's income eligibility certification process (e.g., Medicaid), or at least to combine efforts with another program that also uses income as an eligibility parameter Section Two of this report describes the results of a survey of CTCs undertaken to determine the extent to which trip priority practices are used in Florida. II

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Section Two: CTC Trip Priorities Survey SECTION TWO CTC TRIP PRIORITIES SURVEY This section describes the results of the questionnaire used to survey CTCs about their trip priority practices and use ofTD Trust Fund monies. Appendix C contains a sample survey, with the responses noted Survey Overview In November 1992, CUTR conducted a survey of Florida's CTCs. The survey was prompted by two questions First, do CTCs have consistent (and documented) procedures for determining who will and who will not be served when the demand for TD transportation services exceeds the available supply ? Second, how are TO Trust Fund monies being used for the provision of TO trips? The TO Trust Fund is intended to help provide additional service for general non-sponsored trips and are not supposed to "supplant or replace funding of transportation disadvantaged services which are currently funded to a recipient by any federal, state or local governmental agency. "7 (As a reminder, a "program trip" is one made by a client of a governmental or social service agency for the purpose of participating in a program of that agency and a "general trip" is one made by a TO-eligible person to a destinatio n of his or her choice, and not paid for by a funding agency or program.) The survey was not intended to be used as the basis for developing a statewide, standard trip priority procedure; rather, the intent of the survey and subsequent report was to educate CTCs and the TO Commission about the potential benefits and drawbacks of various trip priority procedures. The three-page survey was mai led to CTCs throughout Florida. At the time the survey was mailed, there were 48 active CTCs. More than two-thirds of the CTCs responded to the survey; 31 surveys were returned, representing 33 CTCs. (In two cases, one organization serves as the CTC in two separate service areas ) The CTCs were divided into three categories: Rule 41.014 (I) F.A . C. 13

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Guidelines for Developing Trip Priority Procedures Urban and rural; Private not-for-profit, government, public transit agency, and private for-profit; and Comp l ete brokerage, partial brokerage, and sole service provider. About half of the CTCs in Florida (25) are classified as urban and 23 are rural. Most CTCs (30) are organized as private not-for-profit agencies and 13 CTCs are part of county government. Only three CTCs are part of a public transit agency, and two are private, for-profit organizations. Eleven CTCs are complete brokerages (contracting with other operators for service delivery), 1 9 CTCs coordinate service as partial brokerages (directly operating some paratransit service and contracting for the provision of service with one or more other providers), and 18 CTCs are sole providers ofTD transportation. Table 2 shows the representation of CTCs in each category from the survey. All categories were well-represented with 50 percent or more of the CTCs responding to the survey. Survey Fiodiogs The survey i ncluded questions dealing with the two key areas. The first four questions related to the current supply of and demand for TD transportation. They also addressed the issue of the use of TD Trust Fund monies. The remaining questions asked for specific information concerning trip priority practices currently used by CTCs. Program v. Geoeral Trips In Question No. I the CTCs were asked to estimate the percentage of total trips (regardless of funding source) provided that were for program versus general trips. According to the survey, 54 percent of the total trips provided by the CTCs were for program trips and 46 percent were for general trips (see Figure 1) These figures coincide with expectations that trips are split fairly evenly between program and general trips. Use of TD Trust Fund In Question No. 2, the CTCs were asked to estimate the percentage of trips paid for by the TD Trust Fund that were for program versus general trips. With respect to trips provided by T D Trust Fund monies, CTCs reported that 20 percent were program trips and 80 percent were 14

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C T Cs ..< *' .. Rural i> f;t;!'' . < ;liit:l: A t;;; 'it <\: A "' .. "-' 23 17 7 1:r 30 21 7 . w 3 3 .. .. . .. ,< . ;:'.:_,_ 48 33 f iJ. . : 19 14 1 8'; 10 \ 48 33 Percentag e R es p onding ;h 74% ?>:' ?9%v ... 70% 100% IV!J. % : 69% ':' i82'Yo 7 4 % 56% .. b9% NOTE: T h irty-one surveys were r eturned, representing 33 CTCs Source: CUTR. general trips (see Figure 1). Although the TO Commission would prefer that 100 percent ofTD Trust F u n d monies be used for general tri p s, the 80 percent figure does suggest a strong emphasis on gene ral trips. It also suggests so m e s upplanting may be occurring or that T O funds are being used for trip s that never were paid for by an agency an d now are able to b e made. S upply and D emand I ss ues CTCs next were asked about whether they wer e able to meet demand for TO transporta t ion services consideri n g TD Trust Fund mon i es only Q uest i on No. 3 asked whether the CTCs cou l d meet all of the demand for program trips. Forty three percent of the respondents said they wer e abl e to m eet all of the d e mand for program trips. Que s tion N o 4 asked whether the CTCs could meet a ll of the demand for gener a l trips. On l y 35 per c ent of the CTCs said t h e y were ab l e to meet the d emand for general t rips (see Figure 2) Based on these respon ses, it is clear that the demand for service may far exceed available supplies. IS

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Guidelines for Developing Trip Priority P rocedures Figure 1 [ Survey Question No. 1) Approximately what percentage of all trips fall into the following categories {program or general trips)? General 1----1 Program Trips N s29 General Trips N=30 [ Survey Question No. 2) Approximately what percentage of trips funded by the TO Iru.sJ Fund are for: (program or general trips)? General Program Trips N=29 General Trips N=28 Source : Trip Suovey, CUTR, November 1992. 16 Program

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No Section Two: CTC T rip Priorities Survey Figure 2 (Survey Question No. 3) Are you able to meet demand for program !rips In your service area? [ Survey Question No. 4 ) Are you able to meet demand for In your service area? No I-/ N=31 Source: T ri p Priorities Survey, CUTR November 199Z. 17

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Guidelines for Developing Trip Priority Procedures The profile of the "typical" ere that was able to meet demand for all trips (both general and program trips) also was identified. The "typical" ere that was able to meet all of the demand was a rural, sole provider, and a private-not-for-profit organization. As a rule, these same eres also reported having some form of trip priority procedures in place. General Use of Trip Priority Practices Another question relating to general and program trips was Question No. 6, which asked CTCs about whether general or program type trips (paid for by tbe TD Trust Fund) were given priority (see Figure 3). They also had the choice of "no difference in priority." Sixty percent of the ercs indicated that they had no difference in priority Twenty-three percent said that program trips had priority and 17 percent said general trips bad priority. This result may be of some concern because the intent of the TD Trust Ftind is to provide general trips. Again, although respondents were instructed to consider trips paid for by the TD Trust Fund, there may have been a tendency to an s wer this question thinking about all trips (including program/agency sponsored trips). Question No. S asked the ercs whether they provided trips on a first-come, first-served basis. Eighty-four percent of the eres responded, "yes," implyi n g t hat t hey do not use formal trip priorities (see Figure 4). Despite the perception that most trips are provided on a ftrst-come, first-served basis, in Question No. 7, 55 percent of the CTCs reported u s ing some form o f trip priorities when demand exceeds supply. Of those who said they h ad e stablished trip priorities, 47 percent said they had written procedures. Although 45 percent (14 out of 3 1 respondents) claimed they had not i m plemented trip priorities, 5 of those CTCs answered "yes" to a subsequent question about what type(s) of trip priorities they used. With these ercs included, the percentage of CTCs using trip priority procedures increased to 71 percent (see Figure 5) Specific Use of Trip Priority Practices Next, th e survey asked questions about specific trip priority procedures to determine which ones were being used by eres. Questions No. 8 No. IS listed specific trip priority approaches and asked the ercs to indicate which one(s) they implemented. Figure 6 compares the responses for eacb trip priority procedure. These procedures correspond to the definitions found in Section One of this report. 18

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Section Two: CTC Trip Priorities Survey Figure 3 [ Survey Question No. 6 ) Which of the following trips have priority (program, general or no difference)? N=30 Source: Trip Priorities Survey, CUTR. November 1992. Limiting trips based on trip purpose (Question No. 8) was clearly the most popular trip priority procedure, with 65 percent of all CTCs reporting that they use this approach. As part of Question No. 8, respondents were asked to rank trip purposes based on their priority. Table 3 shows the frequencies of the different trip purposes. There were three distinct groupings identified by respondents. Kidney dialysis and other medical trips ranked highest in priority in all cases. To further emphasize the importance of dialysis and medical trips, 25 CTCs gave top priority to dialysis and medical trips, and noted all other trips as secondary, if capacity permitted. Other shopping/personal business and recreation/entertainment/ visiting ranked lowest in priority in most cases. The rest of the trips (employment, educational, grocery shopping, nutrition site, and social service agency trips) fell into an area of medium prio rity. Limiting trips based on a specific geographic area (Question No. 10) was the second most popular trip priority procedure with 42 percent of all CTCs imp lementing this approach. A large number of CfCs said they limited trips to their service area except for life sustaining trips Other CTCs provide prescheduled trips to Veterans' Administration hospitals or other regional specialty 19

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Guidelines for D eveloping Trip Priority Procedures Figure 4 [Survey Question No. 5) Do you provide trips on a first-come, first-served basis? No N=31 Source: Trip Priorities Survey, CUTR November 1992. Yes facilities. One CTC only provides trips to the rural areas of the service area on Tuesdays and Thursdays. Li_ miting trips based on advance reservation time (Question No. 14) was third with 29 percent Reserving a trip 24 hours in advance was the most popular response for this question, appearing 70 percent of the time. Of the responding CTCs that limit trips based on advance reservation time, 66 percent (six out of nine) were rural providers. Limiting trips based on traveling during a certain time of day (Question No. 11) was tied for fourth most popular trip priority procedure, with 23 percent Some of the e>
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Section Two: CTC Trip Priorities Survey Figure 5 [ Survey Question No. 7 ) Do you have a procedure for setting trip priorities when demand exceeds supply? No If yes, is this procedure written? N a 14 Includes five CTCs who responded no to Question No. 7 and then responded "yes to a later question about using trip priority procedures. Source: Trip Priorities Survey, CUTR November 1 992. 21

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Guideline s for Developing Tr i p Priority Procedures Q) .... ::I "'C Q) (.) 0 .... 0. -.... 0 -.... 0. a. -.... 1-Q) en :::> 0 .!::. 3: en (.) 1-(.) 0) c -"0 c 0 a. en Q) a: -0 Q) 0) cu c Q) Q) 0. Source: 70% 0% Priomies Figure 6 Percent age o f CTCs Usi n g a Trip Priority P r o ce dur e Do you set trip priorities based on: Trip purpose (Question No. 8) Geographi c area (Question No. 10) E\l) Advanc e resetvatlon (Question N o 14) IITlD T ravel i n g duri n g a certain ti!TMl of day (Question N o 1 1 ) Number of person s traveling t o same destination (Question No. 1 2) Iii Income ( Questi o n No. 13) ll Number of trips (Question No. 9) Other (Questi on No. 1 5) N = 3 1 Type o f Tri p Priority ClJTR, November 1992. 22

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Section Two: CTC Trip Priorities Survey ' . Table 3 Overall Ranking by Trip Purpose Overall Trip Purpose o of I"" Raoking High ? f;P I P i i:,O s 0 O I O I O 0 0 0 Medium Low < 1.:1, 0 t j O 1 II : o programs 0 l 2 6 3 2 2 0 l ; o 3 3 2 > '
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Guidelines for Developing Trip Priority Procedures The least chosen trip priority procedure was regulating the number of trips a passenger may take during any time period (Question No. 9) Only 6 percent of responding CTCs said they use this approach to limit trips when demand exceeds supply. Two different approaches were given as responses. One approach was to limit shopping and recreational trips to three per week. The other approach was to limit grocery shopping to once a week and to limit other shopping to once a month. Question No. IS asked about any other trip priority procedures that the CTCs may have used that were different from the previous choices. All of the CTCs that responded to this question (26 percent) reemphasized that medical (and dialysis) trips were their flrst priority. Only one CTC described something different. That CTC reported accepting up to SO percent subscription trips as well as placing a priority on medical trips. (Subscription trips are standing order trips that regularly recur without the need for the passenger to call in a reservation for each trip. An example of a typical subscription trip would be a standing order for service to dialysis.) Survey lmplicatioos Although the TD Trust Fund is intended to be used exclusively for non-sponsored Category II individuals, approximately 20 percent of the trips that are being provided appear to be for program-type trips. This information may be interpreted in a variety of ways. It may indicate that 20 percent of the TD Trust Fund monies are supplanting service that should have been sponsored by an agency It may also mean that 20 percent of the trips funded by the TD Trust Fund were never sponsored by an agency and the availability of those funds now makes it possible for those trips to occur. Further research into the exact nature of this 20 percent flgure is necessary before a definitive conclusion may be made. To cope better with excessive demand and to be fair to every purchaser of service, CTCs could establish a formal trip priority procedure to use when demand exceeds supply Trip priority procedures provide a con sistent approach in allocating trips. Fifty-five percent of responding CTCs implement some type of trip priority and 47 percent of those CTCs reported having written procedures (se e Appendix D). When including the CTCs that said they did not implement trip priorities but said yes to one of the specific trip priority procedures, the percentage of CTCs using trip priority procedures increased to 71 percent. 24

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Section Two: CTC Trip Priorities Survey The most common fonn of trip priority procedure reportedly in use was limiting trips based on trip purpose with 65 percent of responding CTCs using this approach. The least chosen trip priority was limiting trips based on the number of trips allocated to a specific user with only 6 percent of responding C T Cs using this approach. The only other approach suggested was to estab l ish quotas for the number of subscription trips. Section Three of this report describes implementation strateg ies for establishing trip priority procedures 25

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Section Three: Implementation Strategies SECTION THREE IMPLEMENTATION STRATEGIES At the outset of this report, CUTR identified seven general trip priority procedures that could be applied to TD transportation services funded by TO Trust Fund monies. As part of the study, CTCs were surveyed and asked to describe any other strategies they used to set trip priorities. No new strategies were identified, although one CTC reported that it set a 50 percent limi t on the number of standing order subscription trips that could be booked. (As an aside, the ADA regulations do not allow an ADA complementary paratransit system to book more than 50 perce nt subscription trips if there are capacity problems. Some systems, even though they do not provide ADA complementary paratransit service, have begun t o use a similar standard for consistency.) After analyzing the surveys conducting a literature review, and discussing trip priority practices with other professionals throughout the country, CUTR classified the eligibility criteria and the trip priority procedures into the following two categories: System design strategies and Trip priority strategies. The four approaches described under System Design Strategies are operational in nature; the three strategies defined under Trip Priority Strategies are optional demand management approaches. Although these trip priority strategies may be applied to TO transportation services, particularly for service provided by TO T rust Fund money, they may nor be applied to ADA complementary paratransit service because the ADA prohibits the imposition of trip priorities. 3 Further, trip priorities often are not applied to trips that are paid for by a third-party funding source (such as Medicaid), because the provider has already agreed to provide such trips under formal or informal contractual arrangements and payment for the trips has been agreed upon 'Some trip priority proeedures may be used during the phase-in of ADA complementary paratransit service For further infonnation refer to the ADA regulations, 49 CFR Par/.f J7 & J8. 27

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Guidelines for Developing Trip Priority Procedures The remainder of this section will deal with issues faced by CTCs providing general TD trips, particulady those funded by the TD Trust Fund, and is not intended to address question s specifically related to ADA comp l ementary paratransit. System Design Strategies System design strategies are used to define the paratransit service being offered so that it is clear to potential passengers who will and who will not be able to use the service. These are not trip priority strategies per se. These system design strategies must be developed in keeping with requirements defined by local funding agencies, state statutes and/or rules, as well as federal statutes and/or rules. These strategies are operating decisions bas i c to the prov i sion of TO transportation services, and usually are defmed prior to starting service. The four system design strategies discussed in this section of the report include: Eligibility criteria. Shared v exclusive ride. Advance reservation requirements. Geographic serv ice area. There are many other basic design strategie s that also must be established at the start of service, including the types of vehic les that will be used (sedans vans, buses) and the days and hours that service will be offered. For the purposes of this report, however, only the four basic design features described above will be discussed s i nce they were originally discussed in tbe context of trip priority procedures. Screening and Eligibility Criteria Eligibility criteria may be vague or specific By definition, the TO Commission has endorsed restrictive eligibility criteria (i.e., those perso n s who fit into Category II, as described earlier) for persons who are transported through the TD T rust Fund subsidy. These eligibility criteria were selected in an attempt to control demand for services paid for by limited TD Trust Fund dollars 9Income eligibility (originally listed as a separate criterion in the survey) has been combined into the overall topic of eligibility criteria. 28

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Section Three: Implementation Strategies The successful use of eligibility criteria tequites screening capabilities, accurate recotd keeping and a consistent and fair approach to applying the eligibility criteria in effect For example, if a system defines a senior citizen as someone who is 65 or older, but makes an exception and allows someone who is 64 to ride, anyone else who is 64 and also wants a ride would feel entitled to use the service as well. An application form should be developed to determ ine client eligibility and to document information about the potential passenger. If a person wUI be r equired to show proof of his/her eligibility, the documents that are acceptable should be listed in the instructions. A variety of registration forms are possible; generally, the simpler the form, the better, as long as it captures the essential information. Whether the information is kept on paper, inde x cards, or entered into a computer, the data must be easily retrievable from the data base for reservation purposes. If information from a papet application is going to be entefed into a computet data base, it is a good idea to =ange the informa tion gathefed on paper in the same order as the data e ntry on the computer screen. A related issue is whether identification cards are required. Identification cards sometimes include a photo or may simply ptovide pert inent information about the passenget (name, address, J.D. No., telephone number, etc.). Some systems require photo J.D. cards to ensure that the person is eligible to make the trip. Although photo J.D. cards help to reduce potential abuses of the system, the processing of cards require s special carneta equipment, laminator, etc. The cost of pmducing the photo J.D. card may not be justified when compared to any potential cost savings. Two examples of brief eligibility statements received from CTCs who completed the survey are shown in Appendix D (Examples I and 2). Shared v. Exclusive Ride A basic design strategy or philosophy is the extent to which a system encourages or forces passengers to share rides. It is common sense that a group of three or four persons traveling from the same origin to the same destination is more cost-effective to transport than three or four persons traveling independently. At the start of ti!e service, it is wise to determine whether rides will be provided on an exclusive ride basis (like a taxi system) or whether passengers will be 29

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Guidelines for Developing Trip Priority Procedures required to share rides when possible Most CTCs would probably prefer to group trips and share rides when possible to make scarce resources go further. I f sharing rides is a priority that philosophy should be explicitly stated both to the transportation operator and the passengers. In addition to providing shared rides for persons who are traveling i n similar parts of the service area (even if their origins and destinations are different), a system may adopt a policy of encouraging group trips from the same origin to the same destination. Incentives may be used to encourage group trips, such as providing special rates (paid either by passenge r fares or by funding agencies) for three or more persons traveling together at the same time and making more efficient use of the vehicle. Although described under the system design strategy portion of this report, this partic u lar strategy is closely related to trip priorities In fact, 23 percent of the CTCs that said t hey gi v e priority to group trips over individual trips. Advance Reservation Requirements A basic service design strategy is the way in which reservations may be made for service. Although this system design strategy might also be construed as being somewhat of a trip priority strategy, it is fundamentally a service design issue. There are three bas ic types of trip reservations : Advance reservations; Immediate response ; and Subscriptions or standing orders. Most CTCs currently operate on an advance reservation basis; that is, reservations are accepted one or more days prior to the trip. The argument in favor of such an approach is that it allows the service provider to schedule trips ahead of time. A drawback to this approach is that it makes last-minute schedule changes difficult to accommodate because of cancellations, no shows, accidents, or other unforeseen events. For the purposes of discussion, it is assumed that reservations are accepted on a first-come, first-served basis (A variation of this strategy will be addressed under trip purpose priorities, below ) 30

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Section Three: Implementation Strategies Some systems, generally those providing a large percentage of individual trips rather than program or agency -sponsored trips, provide trips on an immediate-response basis. This form of schedu ling and dispatching operates very much like a taxi system. Trips are assigned on a real time basis, according to which driver is available. "Will calls" for return trips from doctors' appointments are another example of an immediate-response trip. An advantage to these approaches is that they improve productivity by allowing for schedule adjustments throughout the day so that the system i s not overly affected by unforeseen events. On the negative side, if capacity constraints exist, passengers may not be assured of getting a ride. A subscription or standing order trip is another reservation method used by many TD systems. Under a subscription program, requests are made once for trips that recur on a regular basis For example, a kidney dialysis patient who receives treatments three times a week could place a request for service on an on-going basis There would be no need to call repeatedly to schedule individual trips. The only additional calls would be to cancel a particular trip if the passenger was not going to dialysis The i mportant aspect of subscription trips is ensuring that passengers do not abuse their standing orders by repeatedly making adjus tments to the reques t or by missing trips. A policy should be developed so that passengers are aware of their responsibility to minimize changes and notify the system in advance if they need to cancel. Many systems use a combination of reservation approaches and allow for a balance of reservation types. For example, one CTC reported allowing a maximum of 50 percent subscription trips, thereby allowing at least 50 percent advance-reservation and will call trips. Other systems hold a certain number of time slots open on the schedule to allow for last-minute, same-day trip requests and will calls. This basic design strategy may also be combined with trip priority strategies, which will be discussed below. Geographic Service Area The fourth and final system design strategy that will be discussed in this report is determining the geographic service area. CTCs have designated service areas that correspond to the political boundaries of a county or counties Some CTCs may have a defined local service 31

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Guidelines for Developing Trip Priority Procedures area, yet, for some types of trips, may transport passengers to regional activity centers for medical appointments and treatments that are not available within the local service area. As has been stated previously, it is important to determine the area to be served at the outset of service. A clearly defined service area allows the CTC to make informed judgmen t calls about projected trip length and volume throughout the service area. As in the case of eligibility criteria, the CTC should consider carefully how rigid a boundary to establish and the criteria that will be used in the event of an exception. According to the survey respondents, 42 percent said they used geographic service area. In fact, although most systems have define d service areas, it can be inferred from the survey that less than half of the CTCs actively use their service areas to manage trips. Trip Priority Strategies Trip priority strategies are optional service parameters that often are used by systems where demand for service exceeds the supply of available resources. These strategies are a systematic approach to determining which trips will and will not be served. Trip priority strategies may be defmed when service is started; however, often they are not implemented until after service has been in operation for some period of time. The three basic strategies identified in this report include defining trip priorities based on: Trip purpose; Time of day; and Number of trips allowed. Before deciding to implement any trip priority procedure, it would be wise to conduct a basic evaluation of how productive the system is currently. At a minimum, this analysis should include (see Figure 7): An evaluation of trip purposes currently being served (medical work, grocery shopping, visiting, etc.); A review of overall system productivity; and An estimation of the number or percentage of trip requests being refused. 32

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Se ction Three: Implementation Strateg ies Figure 7 ( Trip Priority Decision Process ) Trip purposes What i s the current distribution? currently served \ If System / What i s the system's productivity? productivity Can productivity be improved? measures '-. w Trip refusal At what times are trips be ing refused? ) data How many trips are being refused? A 9 .;..;........ ... ........... If Which trip priority procedure wou l d "1 Are trip priorities be best? Trip purpose needed? j Time of tri p Number of trips "' 33

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Guidelines for Developing Trip Priority Procedures Trip Purposes Currently Served. As a first step, the ere should analyze the current mix of trips being provided. A sample of trip data should be reviewed to determine what percentage of trips are being provided in various trip purpose categories. The trip purpose categorizes developed for the ere survey may be used for this exercise. For example, how many (and what percentage of) trips are for each of the following trip purposes. Dialysis Social service agency Medical appointments Grocery shopping Nutrition sites Other shopping/persona! business Education/ training programs RecreationlentertainmentJvisiting EmploymentJsheltered workshops This information is useful both for understanding current service and for predicting the effect of selecting priorities by trip purpose. For example, if 25 percent of the trips currently provided are for grocery shopping, and if grocery shopping is made a low priority, those riders may no longer be served, even though they are a significant part of the current trip distribution. Virtually eliminating grocery shopping trips could affect a large number of people and create a great deal of discontent with the system. System Productivity Measures. Productivity is a measure of how efficiently a system is operating. If a ere is only able to provide one trip per vehicle hour, for example, very few passengers can be served. A system that provides two trips per vehicle hour can serve twice as many passengers during the same number of hours, and so on. System prod u ctiv i ty should be measured on a regular basis so that trends can be noted and adjustments made, as necessary. Establishing trip purpose priorities may not solve the problem if a system is inh erently inefficient priorities may only contro l the types of trips that are allowed. Trip Refusal Data. F inally, it is also important to have an understanding of the magnitude of trip requests that are not being accommodated. It is good practice to record information about trips that wete refused. At a mi n imum, the trip's origin, destination, and time should be recorded (including the return trip if the request was for a roundtrip). This log should be reviewed regularly to look for pattern s and to attempt to increase capacity as time and resources allow. 34

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Section Three: Implementation Strategies If only one or two trips are being refused each day, it ll)ay not be necessary to institute a system of trip priorities. The trips may be able to be accommodated through improved scheduling or dispatching practices. If a significant number of trips (as defined by the CTC) cannot be accommodated on a regular basis, and the system is relatively productive, then p erhaps a system of trip priorities would be appropriate. There are a variety of approaches for establishing trip priorities. The three identified above will be described in detail below. Trip Purpose The most common form of trip priority strategy is limiting trips based on trip pllrpQse. Of those cres who responded to the survey, 65 percent said they set trip plll')lQse priorities. Although on the surface it may seem relatively easy to establish a list of trip priorities and simply accept trip requests for the top priorities before accepting trips for lower priorities, implementation of such an approach may be difficult. As part of the survey, CTCs were given a list of nine trip plll')lQses and asked to indicate the ranking of trip purpose priorities from "I" (highest) to "9" (lowest). Although there was some variation in the exact order with major groupings, three distinct sets of priorities were evident, as shown below. High Priority Trips Dialysis (and other life-sustaining treatments) Medical appointments Medium Priority Trips Nutrition sites Education/training programs Emp lo yment/shelt ered workshops Social service agency Grocery shopping 35

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Guidelines for Developing Trip Priority Procedures Low Priority Trips Other shopping/personal business Recreation/entertainment/visiting It is common to see a system group trips into some variation of high, medium, and low priority because in practice it is difficult to rank-order trip requests from many different categories. In other words, it is difficult to accept calls in numeric priority order because of the random nature of calls. It is more realistic to accept trips for certain types of broader trip purposes first (high priority) and then open up to other "less important" trip purposes later (medium and low priority). For example, a ere using trip purpose priorities might accept only high priority trip requests up until two days before the trip is to be made. The day before the trip is to be made a CTC might allow medium priority trips to be booked up until 3 p.m. Then, from 3 p.m. to 4:30 p.m., low priority trips are accepted, if space is available. (As an aside, dialysis patients, and others receiving on-going medical treatments, should be allowed and encouraged to request subscription trips so that these trips are always built into the schedule. This approach will make the implementation of trip priorities easier to manage by eliminating the repetitive calls for trips that are somewhat universally recognized as being of a h.igb priority.) An alternative approach is to reco rd all trip requests, develop the schedule, and then call each passenger to confirm or deny the trip request Such a practice is very time-consuming and can lead to unpleasant confrontations. Appendix B contains a detailed list of possible trip purpose priorities proposed for use in Pennsylvania by tbe commonwealth's Department of Aging. Appendix D shows trip purpose priority policies submitted by CTCs who completed the CUTR survey (Examples 3-8). Travel During a Certain Time of Day Another way to set trip priorities is to provide lower priority or discretionary trips only during certain times of the day (e.g., during off-peak hours). As shown by the survey results, 23 percent of the CTCs said they restricted travel for some types of trips to certain times of day. 36

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Section Three: Implementation Strategies This priority-setting approach can be used alone or in combination with other trip priorities For example, if dialysis and medical trips are considered to be high priority, they may be able to be scheduled for any time during the service hours All other trips might be allowed only during midday, evening, or on weekends, space permitting. No non-priority (or low priority) trips would be allowed to be booked during peak hours of service. Example 8 in Appendix D shows a variatio n of this approach to setting trip priorities. Although the system has a set of trip priorities (medical, life sustaining activities, education, business work, recreational), bi-weekly shopping service also is p r ovided. On Mondays, service is provided to one community, on Tuesdays to another community, and so on. In this way the ere avoids having to make shopping trips to destinations all over the service area on any one day, and can concentrate on providing trips to specified parts of the service area during that area's assigned day. The decision to use this type of trip priority should be based on the analysis of current service, described earlier in this section. In particular, if many or all of the requests f or service that are denied occur repeatedly during the same time of day, and yet there is still capacity at other times of the day then the problem may be eased or even resolved by redirecting trips to le s s busy times. This approach may be accomplished verbally by advising passengers that it is easier" to book a trip for midday, or passengers may be advised that they must book a trip during certain days and times, depending on its purpose. Number of Trips Although not commonly used by crcs in Florida (only 6 percent reported using this approach), limiting the number of trips a person may make during a specified period of time is another way to set trip priorities. Under this approach, each person is limited in the number of trips he/she may make during a certain interval (usually during a one-month period). Thus instead of the transportation provider deciding which types of trips may or may not be made, or when certain trips will be allowed, the passenger decides how to ration his/her own trips. If, for example, passengers were limited to a total of I 0 trips per month, then the person would decide which trips were most 37

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Guidelines for Developing Trip Priority Procedures important or which trips had to be made using the ere system rather than being transported by some other means. In some instances passengers may still make additional trips beyond their quota; however, they are generally responsible for paying the full cost for any extra trips. Having some flexibility is particularly helpful for someone who must travel frequently to a doctor or treatment program A drawback to this approach is that it may appear to be "heavy-handed" on the part of the provider because it limits access to the transportation program. If limiting the number of trips is selected as a trip priority strategy, the users must be educated about how to use the system and the importance of planning ahead during the month. Also, the CTC will have to develop a method for tracking trips during the month to ensure that the limit is not exceeded. This may be done using index cards, and simply recording each trip that is made. Alternatively, the number of completed trips may be recorded and stored in a computer program. As a courtesy, it might be useful to remind the passenger when there are only two or three trips remaining. It also will be important to remember not to count cancellations as completed trips, if the passenger calls to reschedule a trip. Likewise, if a passenger is a no show, the system will need to have a policy on whether to deduct that trip from the passenger's quota. To determine the limitation on the number of trips to use, the CTC will have to analyze its records to determine capacity and to identify how many trips individual passengers (who are non-sponsored and are provided service using funding from the TO Trust Fund) make on average. The number of trips should be sufficiently large so as to allow for at least one round trip per week on average, if possible The exact number of trips al lowable will be a judgment call and may need to be reevaluated at a later date. A Note of Ca u tion In Section One of this document a distinction was made among various types of paratransit service providers, particularly those who provide TO transportation services and those who provide ADA complementary paratransit services. Throughout this document, trip priority practices for the TO transportation provider have been discussed. By law, those systems that provide ADA complementary paratransit service may not use trip priorities. 38 .

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Section Three: Implementation Strategies Even though it is pennissible for CTCs to use trip priority strategies for their TD passengers, CTCs may not discriminate against anyone who has a disability and are required to accommodate persons with disabilities. In other words, if trip purpose priorities are used, they must be applied equally. A person who uses a wheelchair, for example, may be limited in the number of trips he/she makes or when he/she may travel, as long as the same restrictions are imposed on ambulatory passengers. It would not be legal for a person with a particular disability to be more restricted in his/her use of the service than a person who does not have that disability Thus, when developing any trip priority procedure, be sure that it is designed to be appl ied equally and equitably to all passengers, regardless of any disability. 39

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Conclusion CONCLUSION This report was written to convey the range of possibilities for establishing trip priority procedures if a CTC decides it wishes to manage demand through trip priorities. This study also d i stinguishes between basic design strategies (i.e. eligibility criteria, trip type, advance reservation requirements geographic service area), which are sometimes construed as trip priorities, and "true" trip priority practices (i.e., trip purpose, travel during a certain time of day number of trips allowed). Any of these design strategies or trip priority procedures may be used alone or in combination, to help a CTC address limited service availability. The results of the CTC survey suggest that many CTCs already use trip priority practices, even if they do not recognize or label them as such Of the CTCs responding more than half reported using some form of trip priority. When the responses were analyzed in detail nearly three-quarters of the CTCs were found to be using some type of trip priority practice. Using appropriate system design strategies and trip priority practices may indeed enhance service at least from the point of view of the CTC, i f not the passengers. Nonetheless, this study does not suggest that trip priorities must be used by every C TC. The ultimate decision about whether trip priorities would be beneficial for allocating trips purchased using TD Trust Fund dollars is left to each individual CTC and its local coordinating board. 41

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Appendix A APPENDIX A GLOUCESTER COUNTY (N.J.) DEPARTMENT ON AGING SPECIAL TRANSPORTATION SERVICE PASSENGER PROCEDURES A-I

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GLOUCESTER COUNTY DEPARTMENT ON AGING SPECIAL TRANSPORTATION SERVICES (STS) PASSENGER PROCEDURES The Special Transportation services program under the Gloucester County Department on Aging is an advanced reservation, curb-to-curb transportation service for senior citizens (60 years or older) and handicapped persons. STS offers fare-free transportation to non-emergency medical appointments, vocational training sites, essential personal business needs and on occasion, to various recreational endeavors. Specific information will be found under these headings. You are asked to read and abide by the passenger procedures outlined. If you have questions and/or need clarification, please call the office at 384-6915. MAKING AN APPOINTMENT 1. Call 384-6915 between the hours of 9 A.M. and 3 P.M. to make arrangements for your ride. Be prepared to provide the scheduler withyour name, address, phone number, destination information including address, date and time of appointment. 2. Appointments should be made directly by the individual client whenever possible to minimize confusion. 3. Rides are provided on a first come-first serve basis. Call STS at least 7 to 10 business days in advance to schedule your transportation. A general rule to follow is: the longer the trip in miles, the more advanced notice is necessary. STS provides transportation between 9 A.M. and 3 P.M. 4. People requiring specific vehicles such as wheelchair lift van or a station wagon must request this vehicle when calling to arrange a ride. 5. Advise the scheduler if anyone will accompany you. Often it is advisable for clients to have company if they need assistance. 6. Notify STS office immediately if you have to cancel a trip. 7. All rides should be confirmed the working day before an appointment. When you call to confirm, you will be given the approximate pick up time. GENERAL PROCEDURES 1. Be prepared for pick up within 5 to 10 minutes either way of the scheduled pick up time. Drivers have commitments to other clients: we appreciate your promptness and understanding.

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2. STS is a curb-to-curb service. Persons utilizing the service must be able to meet the vehicle at the street level. STS DRIVERS ARE INSTRUCTED AND PERMITTED TO PROVIDE MINIMAL ASSISTANCE ONLY TO CLIENTS. THOSE WHO CANNOT STEP INTO VANS OR WHO HAVE SEVERE MOBILITY PROBLEMS MUST PROVIDE THEIR OWN AIDE AND/OR USE THEIR OWN WHEELCHAIR, AS NECESSARY. Those in wheelchairs must make certain that they can meet the STS vehicle at the street and are able to reach the medical office from the vehicle on their own. STS encourages you to call our office if you have any questions regarding your responsiblities. 3. All passengers must wear seat belts. 4. Children under 14 years of age must be accompanied by a re sponsible adult. Children under 18 months of age must be properly buckled into a federally approved child care seat regardless of where they ride in the vehicle. All children under five must also be in a child car seat if they ride in the front seat, or belted if riding in a rear seat. Safety seats are to be supplied by the client. 5 Clients will be picked up and dropped off at the exact same location unless other arrangements have been approved in advance. 6. Drivers are instructed not to tolerate abusive behavior on the part of any client. Unbecoming bahavior will result in that client's being denied further service. 7. Drivers may not deviate from the scheduled trip. not stop at the bank, pharmacy, etc., unless proper have been made thru the office prior to the planned A driver may arrangements trip. 8. Please remember STS is trying to get you to your appointment on time. Many factors can delay us. STS asks that clients practice courtesy at all times and, on occasion, exercise patience. 9. STS has a donation policy which enables riders to contribute to the transportation program. Clients may ask drivers for pink envelopes and use them to mail donations in check form directly to the office. No driver may accept donations or tips from riders. We ask your cooperation in refraining from offering cash to drivers. ELIGIBLE TRIP PURPOSES (all trips are limited to residents of Gloucester County regardless of purpose) Medical -General: Transportation is provided to senior citizens and persons for non-emergency medical appointments. No person may be transported more often than three times per week. STS reserves the right to ask for identification and/or documentation to support the eligibility of riders.

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Medical transportation is available to facilities in Gloucester, and camden Counties and to specific portions of Salem, Burling ton, Cumberland, the southern portion of Philadelphia county and to specific locations in the state of Delaware. NO OUT OF TRIPS ARE MADE ON FRIDAYS. Service to Philadelphia is limited to 9 A.M. to 12 N. Monday thru Thursday. out of county transportation is provided only when the specific need cannot be addressed by medical facilities within Gloucester county. Medical -Dialysis: STS provides limited transportation to our Lady of Lourdes Regional Dialysis Facility in camden. For further information, call 384-6918. Medical -Therapy: we provide transportation for physical, speech and/or occupational therapy only at Gl9ucester County facilities. Therapy transportation is limited to a maximum of three trips each week per person. When need for therapy is the result of an acci dent, any applicable insurance coverage must be utilized to reimburse STS for costs. Essential Personal Business: When space permits, STS will provide transportat1on to Soc1al Services (Welfare), Social Secur ity, local banks, post offices, and for legal assistance. Vocational Training: Limited transportation to vocational and educational centers for the handicapped is provided. Inquiries concerning this service should be made to 384-6915. Nursing/Convalescent Homes: STS will provide medical transportation only to clients considered Residential. When a resident is not fully ambulatory or mentally competent, an aide must accompany him/her. Medicaid Eligible Persons: All persons having Medicaid coverage must arrange their med1cal transportation thru the Board of Social Services (582-9200). STS transports Medicaid eligible persons for medical purposes only on authorization by the Board of Social services. When possible, wewill transport Medicaid eligible people to essential personal business. Recreational Trips: Group trips are arranged in cooperation with Parks and Recreation Department. Requests for specific group trips should be directed to 384-6918. Rural Transportation (Title 18): STS provides fixed transportation for rural area residents five days per week. We follow a set point-to-point schedule. Riders must meet the bus at scheduled points. Copies of this schedule are available by calling 384-6917. Additionally, rural residents are eligible for transportation without trip priority.

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GRIEVANCE PROCEDURE If a client believes service has been denied unfairly, he/she may send a written request for review and reconsideration to: Local Citizens Advisory Committee Budd Boulevard Complex Rt. 45 and Budd Boulevard Box 337 Woodbury, N.J., 08096

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APPENDIXB PENNSYLVANIA DEPARTMENT OF AGING SECTION 203 TRANSPORTATION PRIORITY SETTING DISCUSSION PAPER'0 10Source: Pennsylvania Department of Aging. B I Appendix B

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SECTION 203 TRANSPORTATION PRIORITY SETTING DISCUSSION PAPER (Tentative) The Pennsylvania Department of Aging intends to develop a set of core trip purpose priorities which will be implemented uniformly throughout Pennsylvania. AAA's will determine what the trip purposes will be beyond the core services. The Pennsylvania Department of Aging has established a state wide Advisory council which will meet April 1, 1991 to discuss the suggested priority trip purposes. I. Medical (Treatment and Therapies) Kidney Dialysis Chemotherapy and Radiation Hospital Discharge/Admissions Physician Appointments Dental Chiropractor optometrist Ophthalmologist Podiatrist Other Medical Specialist Mental Health centers Drug and Alcohol Clinic Pharmacist Adult Day care Facility II. Social Services Senior Centers congregate Meal Site Food Bank III. Essential Personal Business Human Services or Government Agencies social security county Board of Assistance Area Agency on Aging Internal Revenue Service County Court House Local Tax Collector Bank Shopping Grocery Clothing Vocational Volunteer Assignment Training Visiting (i.e., in a nursing home) Voting

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Page 2 203 Transportation Priority Setting Discussion IV. piscretionary Trips Vocational i.e., Employment Hairdresser or Barber Sight Seeing Theatre Religious Services Bingo Mall Club Meetings Restaurant PrOhibited Trips Emergency Ambulance Transportation Airport Train Station Bus Station Taverns Liquor Stores

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Appendix C APPENDIXC CTC TRIP PRIORITIES SURVEY CI

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CTC TRIP PRIORITIES SURVEY CTCName __________ ConbctPernon ____________________ Tel. No. _________________ The Transportation Disadvantaged (TO) Commission has asked the Center for Urban Transportation Research (CUTR) to develop options that can be used by CTCs for esbblishing for trips pu r chased with TO Trust Fund money. We are asking you to complete this suNey, which will assist us with the development of general options for trip priority-setting procedures. The suNey should take only a few m i nutes to complete. Thank you in advance for your cooperation. 1. Approximately what percenbge of all trips fall into the following categories? 54% Program trips (N = 29) 46% General trips (N=30) A program trip is one made by a clien t of a governmental or social seNice agency for the purpose of participating i n a program of that agency. A general (non-program) trip is one made by a TD person to a destination of his or her cho i ce not to an agency or program. Please answer the remaining questions trips that subsidized by TO Trust Fund money only. 2. Approximately what percenbge of trips funded by the TO Trust Fund for: 20% Program trips (N=29) 80% General (non prog r am) trips (N=28) 3. Are you able to meet all of the demand for program trips in your seN ice area? 43% Yes 57% No (N=28) If no approx i mately what percentage of requests for program TO serv i ce do you accommodate? 13% less than 50% 25% 50%-75% 25% 37% more than 75% do not keep statistics 4. Are you able to meet all of the demand for general trips in your seNice area? 35% Yes 65% No (N=31) If no, approximate l y what percentage of requests for general TO service do you accommodate? 25% l ess than 50% 25% 50%-75% 20% 30% more than 75% do not keep statistics

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5. Do you provide trips on a first-come, first-served basis? 84% Yes 16% No (N=31) 6. Which of the following trips have priority? (choose one) 23% Program trips (N=30) 17% Genera l trips 60% No difference in pr i ority 7. Do you have a procedure for setting trip priorities when demand exceeds supply? 55% Yes 45% No (N=31) If yes, is the procedure written? 47% Yes 53% No (N=14) 8. Do you set trip priorities according to trip purpose? 65% Yes 35% No (N =31) If yes, please rank: (1=highest priority; 10=1owest priority) __ Dialysis (includes check-ups, dental, etc.) __ Nutrit ion site __ Social service agency trip __ Education/training programs __ EmpioymenVsheltered workshop __ Grocery shopping __ Other shopping/personal business __ RecreationallentertainmenVvisiting __ Other------------See Table 3 for Details 9. Do you set trip priorities based on the number of trips a passenger may take during any specific time period? 6% Yes 94% No (N=31) Comments Shopping and recreational trips 3 trips per week Grocery shopping once a week, s hopp ing trips once a month. 10. Do you set trip priorities based on traveling within a specific geographic area (or distance traveled)? 42% Yes 58% No (N=31) Comments Restrict trips to l ocal area. Wrthin the county and for specific services to [city) not available here ii

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[ I County only at this time. Only med i cal trips which are l i fe sustaining are permitted out-of-county. Trips limited to [ ) County or for tours just over the border. [ ) County only. Trips to local area have priority. (City] and (city). Runs to [city) and [city] for VA trips are scheduled once a month because of the long distance travelled. Tuesday and Thursday service i s provided to rural areas of the county Must go when trip to that area is scheduled except med i cal when unable to reschedule. Except for dialys i s patients, riders must stay in their zone. 11. Do you set trip priorities based on traveling during a certain time of day? 23% Yes no/o No (N=31) Comments Prefer c l ients to schedule between 10 a.m and 2 p.m. Grocery shopping we try to make in the morning Shopping trips to take clients to WaiMart etc. we try to set up to leave at 10 a.m. and try to return before dark so that clients can be back in their homes before dark. Recreation between 10:00 2:00 We encourage non medical, non-employment tr i ps between the hours of 9 2. No restraint between 6 a.m. and 6 p .m., restra i ned from 6 p.m -6 a.m. by numbe r of passengers to warrant expense of travel. Trave l during ope r ating hours 8 a.m. 5 p .m. Mon-Fri except holidays. 12. Do you set trip priorities based on the number of persons traveling to the same destination? Yes (N=31) Comments All med i cal trips and monthly shopping trips. Mall trips on Saturdays (to [ city)) r equire 8 passengers or more. Medical. We try to have at least 3 persons, if not we go ahead and transport a single individual Must have frve or more trave ling to same direction or is canceled Want to save money by having more peop l e travel to same area ...

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13. Do you set trip priorities based on income? 10% Yes 90% No (N=31) Comments Community Service Block Grant will only fund trips of individuals meeting 125% of federal poverty guidelines. It is our intent to give priority to individuals with income levels of 125% of poverty guidelines. Sometimes if a person can afford to purchase transportation they might have limited access. 14. Do you set trip priorities based on how far in advance the reservation is made? 29% Yes 71% No (N=31) Comments 24 hours advanced not ice is required on all trips Same day serv ic e depends on space available. All reservations made 24 hours in advance except medical emergencies. We require 24 hour reservations for guaranteed trip work any or all others in if possible. 24 hours notice. Reservations are accepted 24 hours in advance. Trips are usually consumed within 20 minutes of phone l ines opening. Must call 24 hours in advance. Must call at least 24 hours in advance Accommodate prescheduled trips will attempt to work in last minute tri ps as schedule permits. Trips are scheduled as calls come in. Most riders that want to go out of the service area know to call far in advance to reserve the bus. 15 Do you have some other means of setting trip priorities? 26% Yes* 74% No (N=31) NOTE : Only 1 respondent (3%) i ndicated a true "other" ; remainder were restatements of other techniques.

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Comments Up to 50% of the trips can be subscription. Dialysis, because of its life sustaining nature, takes a natural priority. Emergency on a case by case basis. We by to make medica l runs/dialys i s our first priority Medical is always taken care of first. If for any reason a choice must be made about a passenger trip, the Coordinating Board and the CTC will provide medical transportation service as the first or highest priority for service. Medical trips are first priority. Highest priority is life-sustaining medical careall others given equal access on 1st come 1st served basis. Serve the med i cally needy first. ...... ., To be sure we have correctly interpreted your responses and to provide additional ideas regarding trip priority-setting policies, please send us a copy of any written procedures, brochures, or board resolutions concerning your trip priorities. Thank you for your assistance. Please return the survey to CUTR no later than November 18, 1992 Rosemary Math i as Center for Urban Transportation Research USF College of Engineering 4202 E. Fowler Ave., ENG 118 Tampa, FL 33620 (813) 974 3120 SunCom 574-3120 Fax (813) 974-5168

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Appendix D APPENDIXD SAMPLE WRIITEN POLICIES D I

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Appendix D Example 1

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COUN1Y. FLORIDA funds. The :rransponation Disadvantaged Coordinating Board adopted the following criteria. ELIGIBIUTY CRITERIA FOR NON-SPONSORED TRIPS Transportation serv i ce under the Trip/Equipment Grant will be available for all residents of County "who because of physical or mental disability, income status, or age or who for other reasons are unable to transport themselves or to purchase transportation and are, therefore, dependent upon others to obtain access to health care, employment, education, shopping social activities, or other life-sustaining activities." and as such are "transportation disadvantaged" as defined by Chapter 427, Florida Statutes. Individuals eligible for transportation utilizing nonsponsored dollars must not be eligible for transportation funded by a sponsoring transportation disadvantaged agency. Service will be provided on a first come first serve basis, the only exception being for those citizens for whom transportation is needed to and from life supporting medical treatment. Transportation for these individuals will be scheduled first. The funds from the Trip/Equipment Grant will be allocated on a monthly basis No service will be provided when the demand for service exceeds the available, allocated funds.

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Appendix D Example 2

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TRANSPORTATION DISADVANTAGED PROGRAM OF ___ couNTY POLICIES/PROCEDURES POliCIES RIDERSHIP If space is available, no one shall be denied service. Riders who are not transportation disadvantaged or are p a ssenger assistants (escorts) shall pay a specified fare determined by the Transportation Disadvantaged Coordinating Board in accordance with applicable State and Federal regulations Passengers who are reg! stered under a subs i dized program with a contractua 1 agreement with the Coordinator will pay, if so stipulated the amount as required under the specified program. Transporta t ion disadvantaged riders are defined by the Florida Statute 427, Rule 41 as "those persons who because of physical or mental disability, income status, or age or who for other reasons are unable to transport themselves or

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TO Policies April 11, 1991 Page 2 to purchase transportation and are therefore dependent upon others to obtain acces s to health care, employment, education, shopping, social activities, or other life-sustaining activities". County further defines the following categories, referred to in the Florida Statute 427 below: ohvslcal or mentll. disability -status af individual disability confirmed by either a funding source, government a 1 agency or physician and registered with Coordinator. This definition does not include pregnancy, drug, and/or alcohol addictions unless temporary physical disability confirmed by physician; income status County Threshold figures are established at 100% Federal Poverty Guidelines as follows: T hese figures shall be revised yearly effective May 1. of Family I person (unre l ated in dividual) 4 persons 9 or more persons age 60 and over; Threshold s 6,311 12,675 25,480 other reason s -person lives more tha n a quarter mile from fixed transit route and does not own a functional vehicle. guide dogs accompanying handicapped passengers shal l be transported on same vehicle.

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Appendix D Example 3

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TRANSPORTATION PRIORITIES 1. MEDICAL: 2. LIFE-SUSTAINING ACTIVITIES 3. EDUCATION: 4 BUS I NESS: 5. WORK: 6 RECREATIONAL: (Non-sponsored trips) Kidney Dialysis Cancer Treatment Doctor Appointments Therapy Prescriptions Food/Food Stamps Medicaid Recertification supplies Children with Disabilities Day care a. abused and;or neglected children b. low-income children Banking Social Security V isits to Hospital or Nursing Home Anyone with a lower priority may be scheduled with a higher priority ride if time and space allow.

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Appendix D Example 4

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GUIDELINES TO BE UTILIZED IN AUTHORIZING NON-SPONSORED TRIPS A. Medicel trips shall be. given eop priority within County. crossing zones w ill be discouraged and out-of-county trips will be limited to only life-sustaining treatments; i.e., dialysis and chemotherapy treatments. B. Employment trips shall be allowed will be given to utilize t h e every onsideration ---------systems. The above guidelines and their respective ranking are consisten t with those adopted by the Local Coordinating Soard (LCB) on Jyly 27, 1992 Furthermore, at priority listing 1. 2. 3. 4. 5. 6. 7. their regular meeting on July 27th, the LCB approved for non-sponsored trips 1 n the following order: Medical Employment (in County) Social Services Training/Education Shopping Recreation Other the

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Appendix D E xample 5

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____ COUNTY LOCAL COORD]J{M.']J{G BOARD FOR TRAHSPOR'l:A!l'ION DISADVANTAGED PROGRAM PROCEOORE PASSENGER MANAGEMENT SYSTEM

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I. IN'l'ROOUC'l'ION The Passenger Management System has been developed as a result of the input of members of the Local coordinating Board (LCB) the Community Transportation Coordinator (CTC) the Transportation Operator, and the Metropolitan Planning organization (MPO) staff. The need for a Passenger Management System (PMS) is well established in the fact that demand far exceeds supply or available funding. The Transportation Disadvantaged Administrative Rules allow for the prioritization of trips based upon purpose. The LCB and the Board of county Commissioners approved such priorities. These priorities are as follows: l.. Medical/doctor prescriptions 2 Food shopping 3 Employment appointments/physical therapy, 4. Others including recreation, general shopping, personal business The Low-Income subcommittee recommended the establishment of a PMS in lieu of additional efforts to clarify priorities or establish new ones. The purpose of this system is to provide a framework for administration of the TO funding and to assist the Transportation Operator in determining the focus areas for trip activity. II. PASSENGER MANAGEMENT SYSTEM A The PMS is a simpl e system that is used by the Transportation Operator to determine how trips are booked. This procedure provides a mechanism which centers on the needs each citizen;passenger. This is done by intake workers that ask questions about the passengers and the trip requested. These questions can include: Biographical Infoi'lllation (Name, Address, Birth Date, etc.)? Origination & Destination? Medicaid Status? Purpose(s) Of The Trip? Can The Trip Be Delayed? B. Once the basic information is given then the intake worker assigns a pick-up time and date of trip for the passenger. All efforts will be made to accommodate the passenger needs based on available resources and the established trip goals. c. The TO operator reserves several slots daily to react to emergencies (unforeseen circumstances) needs of citizens. This could include any circumstance in which the health or safety of a citizen is at risk.

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Appendix D Example 6

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TO: FROK: Local Coordinating Board Transportation Engineer --COUNTY, FLORIDA INTER-OFFICE HEHORANDUM DATE: July 9, 1992 SUBJECT: Prioritization of Non Sponsored TO Trips At the LCB meeting in June, the LCB requested that the Technical Advisory Committee (TACI recommend a prioritization of non sponsored TD trips. The TAC recommends that the LCB adopt the following prioritization of non sponsored TD trips. 1. Medical 2. Shopping (Grocery) and Keals (Congregate) 3. Social Service Agency Trips 4. Employment (Job Training)/Volunteer Services S. Social 6. Shopping (Other I 7. Other Trips

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Appendix D Example 7

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--COUNTY BOARD OF COUNTY COMMISSIONERS ----'COONTY TlWISPORTl\TION SYSTEM -CTc TRANSPORTATION DISADVANTAGED PROGRAM PRIORITIZATION POLICY RECOMMENDATIONS FOR General Public Requests September 1992 Based upon the statistical breakdown of purposes of trips provided by the Community Transportation Coordinator {CTC) during the period January 1991 through June 1992, and the decrease in funding available for FY92-93 of the Transportation Disadvantaged Trust Fund Grant Program, the following procedures are recommended for consideration and approval by the Coordinating Board for the CTC effective with approval by the Transportation Disadvantaged Coordinating Board on September 16, 1992. These procedures apply to transportation outside of the Transit District or subsequent out of district service. The five {5) major categories of service for general public requests will emphasize: {not in priority order) 1. Medical, 2. education/job training, 3. employment, 4 personal business, shopping, miscellaneous, and 5. social activities Other service requests will be evaluated on a case by case basis by the Transportation Disadvantaged Coordinator or Transportation Director. POLICY: I. INTAKE (SCREENIN9) INFORMATION: a. All requests for transportation under the Transportation Disadvantaged Trust Fund Program will be screened according to a standardized needs assessment procedure. b. Determine: 1. a if other social service agency with trip request or whether service agency must pre-qualify to TD program consideration,. serv1ce program. can assist the social client prior i.e., aging b. referral will then be made to respective agency/program.

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.c. 2. if client can participate in transportation, (25% initially of the cost of the trip). the cost of their increasing to 50% After TD qualification is made: determination of 'short term or recurring (long term) service must be established. II. SHORT TERM SERVICE DELIVERY: a. determine time, place, etc., then b. assign to appropriate provider. III. LONG TERM SERVICE DELIVERY: 1. During the first month, transportation services provided for a client will be paid by the Trust Fund up to $100. Each client will then be required to pay 25% for all transportation costs which exceed SlOO during the first month. 1st MONTH OF SERVICE COST =NO CHARGE UP TO $100, 25% OF COST ASSESSED FOR COST EXCEEDING $100 2. After the first month of subsidized transportation (no charge up to $100), the client wi l l b e responsible for 25% of the total cost per trip, i.e., if trip cost is $20 round trip (2 way), client's portion of that trip will be $5. 3. 2nd MONTH OF SERVICE COST = 25% Client will be informed service client's portion transportation costs. that will during the 3rd month of increase to 50% of all 3rd MONTH OF SERVICE COST : 50\ 4 Consideration will be given on a case-by-case basis to those individuals who cannot provide the 25% or 50% match requirement. TRANSPORTATION SERVICES SUBSIDIZED BY THE TROST FUND WILL NOT BE PROVIDED BEYOND THREE (3) MONTHS UNLESS SPECIAL PERMISSION IS GRANTED BY THE CTC. Client will be informed of transportation, i.e., private taxi Prioritization Procedures 9/92 other sources service, etc. of 2

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IV. PAYMENT FOR SERVICE: 1. At the time transportation services are scheduled with the CTC, the client will be informed of their cash requirement, and the amount to be paid to the CTC. The client will also be told that non-payment may result in the termination of their services. V. NO SHOW 1. If client no-shows three {3} times (barring any emergency situations), will be terminated for one (1) month. letter will be provided to the termination. in one month, service delivery Notification by client prior to VI. REINSTATEMENT OF SERVICE: Upon termination of service for any reason, client MUST speak with TD Coordinator or Division Director prior to any consideration for reinstatement of transportation service. VII. PASSENGER 1. On trips where a parent escorting a minor child, allowed to accompany said emergency basis (round other arrangements must be or guardian, etc. will be additional children will be parent/guardian only on an trip only). A sitter or made. a. The file of the c lient who uses the serv1ce as a s itter service will be updated to indicate that additional children will not be funded on future trips. b. The CTC will continue in efforts to arrange for group rates in order to accommodate the transportation needs of their clients who must also transport their children. Prioritization Procedures -9/92 3

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A ppendix D Example 8

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WHEELCHAIR SERVICES: Clients In wheelchair.; can be trans ported by a specially equipped v ehicle if there Is a ramp in place at their home. Shoppers in wheelchairs must make appointments with us in advance. Your safety is ourprimazyconcem. We reserve the right to determine If we should serve you on the basis of health and other conditions For other information on services avail able for seniors cal County Senior Services at A United Way Agency Fund4d through The Oeparlment of Bder Alfalrs; of Florida: Florida OepMtment ol Transportation; United W ay, County Commission; Community Cliont conlrltKitions. _ County Senior Services TRANSPORTATION TELEPHONE MEDICAID TRAl'ISI'ORTATION Transportation in County for seniors, handicapped persons. transportation disadvantaged and clients sponsored by other agencies

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SCHEDULII'IG A RIDE: Please call our office a minimum of 3 working days in advance to reserve a ride. Refer to our schedule below and make your appointment on the day we are scheduled to be in your area. \ APPOII'IIMEI'tT SCHEDULII'IG HOURS: 9:00a.m. 12:00 noon 1:00 p.m. 4:00 p.m. MEDICAID-SPONSORED CLIEI'ITS mustcalltheMedicaldTransportation number, to sched ule their appointment. PVR BI-WEEKLY SHOPPII'IG SCHEDULES: Monday: Tuesday: Wednesday: Thursday: Friday: 'Out of town shoppers arrive in town by 10:00 a.m. and are picked up at their shopping location for their return trip by 2:00 p.m. OVR PRIORITIES: Clients who do not own or drive a car and clients without family or friends to assist. have priority for transportation service. Service is provided according to the following needs as space is available. 1. Medical 2. Life sustaining activities 3. education 4. Business 5. Work 6 Recreational Transportation to the hospital will be made for admissions only. No emergency transportation is provided. COST: Riders are encouraged to contribute towards the cost of their trip. Your driver will give you an envelope for some guidelines on suggested contribution amounts based on income level.