Draft Presentation to: California Department of Transportation (Caltrans) Mobility Action Plan (MAP) Phase I Implementation Study MAP PAC Committee Meeting

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Draft Presentation to California Department of
Transportation (Caltrans)Mobility Action Plan
(MAP) Phase IImplementation StudyMAP PAC
Committee Meeting

• Presented by
• Judith Norman - Transportation Consultant (JNTC)
• In Association with
• The National Conference of State Legislatures
• January 21, 2009

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MEETING PURPOSE AND OUTCOMES

• Present study updates, discuss and receive
  feedback on the
• following MAP Study work tasks and activities
• Legislative Update/Action Item Follow-up Federal
  and California Human Service Transportation-Relate
  d Acts and Statutes
• Technical Update Coordinated Plan Review and Gap
  Analysis Methodology Draft Study Geographic
  Regions and Information Analysis Process

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LEGISLATIVE UPDATE

• Revised and updated California Coordinated Human
  Service Transportation Matrix to include
  historical Federal and California Acts and
  Statutes
• Conducted further research to address MAP PAC
  last meeting action items to update information
  on Federal and California statutes related to
  public transit- human service coordination

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LEGISLATIVE UPDATE

• New Research and Updates by NCSL on key Statutes
• Americans with Disabilities Act (ADA)
• Transportation Development Act (TDA)
• Social Service Transportation Improvement Act
  (SSTIA)
• Technical Assistance to Paratransit Providers
• Deficit Reduction Act
• Medi-Cal

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ADA

• The Americans with Disabilities Act (ADA) of
  1990
• Gives civil rights protections to individuals
  with disabilities
• Guarantees equal opportunities for individuals
  with disabilities

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ADA

• Title I of the Act prohibits discrimination
  against people with disabilities in employment
  practices
• Includes job applicants.
• Employers with 15 or more employees are required
  to comply with the ADA.

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ADA

• Title II of the act prohibits discrimination
  against individuals with disabilities in all
  programs, activities, and services of public
  entities.
• Applies to all state and local governments, and
  other instrumentalities of state or local
  governments.
• This includes public and private entities that
  provide public transportation

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ADA

• Title II requires public entities
• To have vehicles for regular transit services be
  readily accessible and usable by persons with
  disabilities, including those who use
  wheelchairs.
• Fixed route service also provide paratransit and
  other special transportation services to persons
  with disabilities, including those who use
  wheelchairs.
• Service has to be comparable to regular transit
  services.
• To provide the paratransit and special
  transportation services within their service
  area.
• New vehicles for public demand responsive transit
  service be accessible and usable by persons with
  disabilities, including those who use
  wheelchairs.

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ADA

• Title II requires private entities
• That purchase or lease vans with a seating
  capacity in excess of 16 passengers (including
  driver) to be accessible and usable by persons
  with disabilities, including those who use
  wheelchairs.
• That provide a fixed route service with a vehicle
  with a seating capacity of 16 passengers
  (including driver), that is similar in service to
  regular transit services to persons without
  disabilities.
• That provide a demand responsive system with a
  vehicle with a seating capacity of 16 passengers
  (including driver), that is comparable in service
  to regular transit services.

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ADA

• FTA published a rule explaining the
  transit-related requirements of the ADA. They
  provide that
• A public entity operating a fixed route system
  has to provide a complementary paratransit or
  other special service to persons with
  disabilities. To qualify as complementary, the
  service has to
• Provide service within a width of three-fourths
  of mile of each fixed route.
• Provide paratransit service to any ADA eligible
  person at a specified time in response to that
  person's request made the previous day.
• Charge a fare that does not exceed twice the fare
  charged to a person paying a full fare at the
  similar time of day on the entity's fixed route.
• Provide service during the same hours as the
  fixed route service.

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ADA

• The public entity cannot
• Impose restrictions on the type of trip
• Restrict the number of trips a person can take
• Impose waiting lists for access to the service
• Have a pattern or practice that significantly
  limits the availability of the service
• Accompanying persons to the disabled individual
  are allowed to ride with them.
• Develop a process for establishing the
  eligibility of persons who want to use the
  paratransit service.
• Allow visitors (persons who do not reside in the
  entities jurisdiction) to access the
  complementary service.

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ADA AND NEW FREEDOM

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

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ADA AND NEW FREEDOM

• Complementary paratransit services can be
  eligible under New Freedom in several ways if the
  services provided meet the definition of "new,"
  which is
• Not operational as of August 10, 2005 or
• Did not have an identified funding source before
  August 10, 2005.

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ADA AND NEW FREEDOM

• "Going beyond" the ADA means
• Paratransit service beyond the three-quarter mile
  requirement
• Paratransit hours beyond fixed route hours
• Incremental cost of providing same day service
• Incremental cost of door-to-door service to
  eligible ADA riders
• Level of service enhancements escorts,
  door-through door service
• Vehicles with mobility aids for persons with
  disabilities

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ADA AND NEW FREEDOM

• The New Freedom Program is direct consequence of
  the Supreme Court Olmstead v. L.C. decision.
• The Court interpreted Title II to require states
  to place persons with mental disabilities in
  community settings instead of institutions.
• Executive Order 13217 orders the Fed Govt. to
  help states implement the Olmstead decision.

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TDA

• The Transportation Development Act (TDA) consists
  of nine articles in the California Public
  Utilities Code, which makes it lengthy in both
  size and detail.
• The TDA specifies in great detail how public
  transportation is to be funded by state
  resources.
• The TDA was enacted to ensure that public
  transportation is an essential component to a
  balanced transportation system

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TDA

• The transportation planning agency in each area
  of the state is in charge of funding claims.
• Transit operators and city or county governments
  transit operators can only file claims for money
  that was apportioned to their area.
• CTSAs are funded under TDA articles 4.5 and 6.5.

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TDA

• If a CTSA or other transit operator receives
  funding under the TDA it will be held accountable
  by the state by
• Filing claims with the transportation planning
  agency,
• Submitting annual certified fiscal audits, and
• Maintaining required fare revenue ratios for
  transit services
• The CTSA must participate in and audit that the
  funds were spent within laws and regulations.
• Since the CTSA is a claimant, it alone has these
  responsibilities, even when the CTSAs primary
  function is to channel funds to other
  organizations which are actually providing the
  transit services.

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TDA

• Social services transportation advisory councils
• Have to consist of the elderly, disabled, transit
  providers for seniors, the local CTSA
• Have to
• Annually identify unmet transit needs in their
  area
• Review and recommend action to the Transportation
  Planning Agency, and
• Advise the Transportation Planning Agency on
  transit issues

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TDA

• Citizen Participation Process
• Transportation planning agencies have to
  establish an advisory council to get advice from
  the transit dependent, and transit disadvantaged
  persons.
• Have to hold at least one hearing, with broad
  community participation
• In addition to hearings, teleconferences,
  questionnaires, telecanvassing, and email can be
  used to obtain feedback.

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SOCIAL SERVICE TRANSPORTATION IMPROVEMENT ACT
(SSTIA)

• Created Consolidated Transportation Service
  Agencies or CTSAs
• CTSAs are designated by
• County Transportation Commissions (CTCs),
• Local Transportation Commissions (LTCs),
• Regional Transportation Planning Agencies
  (RTPAs), or
• Metropolitan Planning Organizations (MPOs)

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SOCIAL SERVICE TRANSPORTATION IMPROVEMENT ACT
(SSTIA)

• The SSTIA required Regional Transportation
  Planning Agencies or County Transportation
  Commissions to adopt and submit an action plan
• The Action Plan has to
• Designate a CTSA within the area of the
  transportation planning agency.
• Could designate more than one CTSA if there was
  improved coordination
• An identification of the social service
  recipients to be served.
• Measures to coordinate the social service
  transportation services with existing fixed-route
  services.

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SOCIAL SERVICE TRANSPORTATION IMPROVEMENT ACT
(SSTIA)

• Each CTSA is an entity separate of the
  transportation planning agency.
• A CTSA can be
• A public agency including a city, county,
  operator, any state department or agency, public
  corporation, or public district, or a joint
  powers
• A common carrier of persons
• A private entity operating under a franchise or
  license.
• A nonprofit corporation
• A private entity (nonprofit) or a private company
  may be a CTSA if it is a legal entity eligible to
  file TDA claims and provide transit services.
• A CTSA designation can be rescinded by the
  transportation planning agency.

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TECHNICAL ASSISTANCE UNDER SSTIA

• Technical Assistance to Paratransit Providers
  (Cal. Government Code 15984 (West 2009))
• Requires Caltrans to provide technical assistance
  to paratransit providers who want to explore
  coordination strategies but lack implementation
  capability.

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MEDICAID

• Medicaid is a federal-state partnership that was
  created by Congress in 1965.
• Is an optional state program, but every state and
  territory participates
• Today Medicaid provides funding for
• Low income parents
• People with significant disabilities
• Long term care for the elderly

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MEDICAID

• States that Medicaid transportation related costs
  are either administrative costs, or medical
  assistance.
• Administrative costs are reimbursed at a flat
  rate of 50
• Medical assistance is reimbursed at the state's
  federal rate, which is anywhere from 50 to 77 -
  California's rate is 50

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MEDICAID

• Providers can be reimbursed for travel and other
  travel related expenses (42 CFR 440.170(a)).
  They are
• The cost of transportation
• The costs of meals and lodging to and from the
  medical facility
• The cost of an attendant, if necessary

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MEDICAID

• A state Medicaid plan must "specify that the
  Medicaid agency will ensure necessary
  transportation for recipients to and from
  providers" (emphasis added) (42 CFR 431.53)
• States have a lot of flexibility in meeting the
  mandate of assuring medical transportation.

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MEDICAID

• How a state will provide non-emergency
  transportation all depends on its definition of
  "necessary".
• Many states look to this criteria to define
  "necessary"
• Transportation to and from Medicaid covered
  services
• Use of the least expensive mode of transportation
  available that is appropriate for the client
• Restrictions to the nearest qualified provider
• No other transportation services available free
  of charge and,
• Exclusions for clients receiving services that
  include transportation.

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MEDI-CAL

• Californias Medicaid plan includes a simple
  Assurance of Transportation, guaranteeing
  necessary transportation to and from covered
  medical services.
• Reimbursement of travel to medical appointments
  is restricted to persons who are physically
  unable to use conventional modes of
  transportation (22 CCR 51151).
• Costs are only covered if transportation by
  ordinary means is medically inadvisable (22 CCR
  51323).

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MEDI-CAL

• Bingham v. Obledo (1983)
• Recipients sued the state because the state plan
  violated the assurance of transportation
  requirement since it did not assure necessary
  transportation to all recipients.
• Argument was that Medi-Cal transportation was
  only offered to the severely disabled.

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MEDI-CAL

• Bingham v. Obledo (1983)
• Court ordered the state to amend its plan that
  takes into account all qualifying recipients.
• Court then mentions that that the state is not
  required to furnish transportation or pay for it.
• To comply with the court order, Department of
  Health Care Services expanded upon the
  information about transportation options that
  Medi-Cal offices provide to county welfare and
  local Social Security Offices.

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MEDI-CAL

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

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MEDI-CAL

• California's emergency and nonemergency
  transportation programs are decentralized.
• Usually administered by the local Medi-Cal
  offices
• Ambulances, wheelchair vans and litter vans are
  the only acceptable modes.
• Local public transit agencies are not eligible
  for reimbursement under current Medi-Cal rules
  (22 CCR 51151)

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NEW CMS RULEDEFICIT REDUCTION ACT

• Deficit Reduction Act of 2005 rule (42 CFR Part
  440)
• Before the rule, a state couldn't contract with a
  broker or provide different services in different
  areas of the state without obtaining a waiver.
• The new rule does away with the waiver
  requirement.
• Gives states the option of using a non-emergency
  medical transportation broker when providing
  transportation as medical assistance under the
  state plan.

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DEFICIT REDUCTION ACTNEW CMS RULE

• The rule
• Allows brokers to provide for transportation
  services that include wheelchair vans, taxis,
  stretcher cars, bus passes and tickets.
• Allows the Secretary to allow for the use of
  other forms of transportation.
• Creates a competitive bidding process.
• Creates oversight procedures
• Requires the broker must be an independent entity
• Provides an exception for a non-governmental
  broker
• If a governmental agency is the broker it can
  subcontract with a government-owned or controlled
  transportation provider
• Gives the Secretary the authority to add any
  other medical care which can be covered by the
  state

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END OF TECHNICAL PART I
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STUDY TECHNICAL ELEMENTS

• Review of Public Transit Human Service
  Coordinated Transportation Plans
• Large and Small Urban Plans
• Rural Plans
• Summarize and profile existing needs, strategies
  and implementation of local priorities
• Element of Statewide Executive Summary
• Interregional Gap Analysis
• Derived from review of individual coordinated
  plans
• Element of Statewide Executive Summary

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GOAL OF COORDINATED PLAN REVIEW

• Provide a Statewide View of all Coordinated
  Transportation Plans in California
• Inform the development of the Statewide
  Implementation Plan

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COORDINATED PLANSELEMENTS TO BE REVIEWED

• Current transportation needs by target population
• Inventory of transportation resources available
  within the region
• Real or perceived barriers to coordination
• Identification of current or potential funding
  sources expended on transportation for client
  populations

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COORDINATED PLANSELEMENTS TO BE REVIEWED

• Strategies and plans to address needs, gaps and
  deficiencies
• Identification of duplicative or restrictive
  local regulations and/or policies which serve to
  limit coordination
• Priorities for selection of coordinated projects,
  including regional mobility management and
• Specific coordinated plan and project
  recommendations including timing and phasing of
  projects.

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COORDINATED PLAN REVIEW METHODOLOGY

• Review individual plans and analyze by geographic
  region with each MPO/RTPA
• Code Responses and Construct a Microsoft Excel
  Matrix to summarize plan review elements in
  detail

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PROPOSED MAP STUDY GEOGRAPHIC REGIONS
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PROPOSED MAP STUDY GEOGRAPHIC REGIONS RATIONALE

• Utilizes established Caltrans Districts framework
• Condenses to 11 geographic regions (Districts 7
  Los Angeles and
• 12- Orange County combined)
• County groupings used for locale of Regional
  Roundtables

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2008 REGIONAL POPULATION ESTIMATES
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2008 REGIONAL POPULATION ESTIMATES
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GAP ANALYSISPURPOSE

• Evaluation and assessment of existing needs,
  strategies, and implementation
• Identify interregional gaps, needs, and
  strategies to identify and address deficiencies
  across the regions
• Provides solid framework for development of
  Statewide Executive Summary

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GAP ANALYSISMETHODOLOGY

• Using Excel Matrix which was constructed in
• Plan review
• Populate a relational Access analytical database
  to allow thorough review of plan elements

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HOW WILL THE DATABASE HELP US?

• Organize and Sort Large Amounts of Plan
  Information
• Compile and cross tabulate information
• Identify trends, commonalities and unique issues
  within the plans (urban, rural, regionally and
  statewide)
• Can ultimately be used for information-sharing
  and coordinated planning purposes

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NEXT STEPS/MEETING

• Work with Human Services on additional statute
  research and analysis
• Begin Large/Small Urban Coordinated plan review
• Complete Access database structure
• Develop stakeholder involvement draft interview
  questions and topics
• Commence regional roundtable planning and
  scheduling efforts
• Next Meeting March 25, 2009 Southern
  California City of Norwalk, CA.