Transportation-Disadvantaged Populations:

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

GAO-03-697: Published: Jun 30, 2003. Publicly Released: Jun 30, 2003.

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Millions of Americans are unable to provide their own transportation--or even use public transportation--for Medicaid appointments, Head Start classes, job training, or other services. Such "transportation disadvantaged" persons are often disabled, elderly, or low income. Various federal programs are authorized to provide transportation services to them. GAO was asked to (1) identify the federal programs that fund such transportation services and the amount spent on them, (2) assess the extent of coordination among the various programs, and (3) identify any obstacles to coordination and potential ways to overcome such obstacles.

Sixty-two federal programs--most of which are administered by the Departments of Health and Human Services, Labor, Education, and Transportation--fund transportation services for the transportation disadvantaged. The full amount these programs spend on transportation is unknown because transportation is not always tracked separately from other spending. However, available information (i.e., estimated or actual outlays or obligations) on 29 of the programs shows that federal agencies spent at least an estimated $2.4 billion on these services in fiscal year 2001. Additional spending by states and localities is also not fully known but is at least in the hundreds of millions of dollars. Efforts to improve services and achieve cost savings through coordination of transportation activities (through sharing resources or information or consolidating services under a single agency) among federal agencies vary. The Coordinating Council on Access and Mobility--a body with representation from the Departments of Transportation and Health and Human Services--has undertaken some activities to improve coordination. However, other agencies that administer a substantial number of programs for the transportation-disadvantaged, such as the Departments of Labor and Education, are not part of the Council. In addition, the Coordinating Council's strategic plan is not linked to its action plan and contains few measurable performance goals. The strategic and annual performance plans of the Departments of Transportation and Health and Human Services contain few references to coordination relating to their subagencies and programs that fund transportation services for the transportation disadvantaged, and the plans of the Departments of Labor and Education do not mention coordinating these services. Obstacles impeding coordination include concern among administrators that their own participants might be negatively affected, program rules that limit use by others, and limited guidance and information on coordination. To mitigate these obstacles, officials and experts suggested making federal standards more consistent, creating a clearinghouse or better Web site to facilitate interagency communication and provide better guidance on coordination, and providing financial incentives or instituting mandates to coordinate.

Recommendations for Executive Action

  1. Status: Closed - Implemented

    Comments: The Secretary of Education joined the Coordinating Council on Access and Mobility in January 2004, and Labor and Education officials have been actively participating in meetings of the Coordinating Council's work groups.

    Recommendation: To increase communication and collaboration among the major agencies involved in providing transportation services for the transportation disadvantaged, the Secretaries of the Departments of Labor and Education should join the Coordinating Council on Access and Mobility.

    Agency Affected: Department of Labor

  2. Status: Closed - Implemented

    Comments: The Secretary of Labor joined the Coordinating Council on Access and Mobility in January 2004, and Labor and Education officials have been actively participating in meetings of the Coordinating Council's work groups.

    Recommendation: To increase communication and collaboration among the major agencies involved in providing transportation services for the transportation disadvantaged, the Secretaries of the Departments of Labor and Education should join the Coordinating Council on Access and Mobility.

    Agency Affected: Department of Education

  3. Status: Closed - Implemented

    Comments: The Coordinating Council adopted an Action Plan on September 15, 2004, which outlines long term goals in six areas--(1) Education and Outreach; (2) Consolidated Access; (3) Regulatory Relief; (4) Coordinated Planning; (5) Cost Allocation; and (6) Useful Practices--with explicit links to specific actions with deliverable dates. Six interagency workgroups were formed to oversee the implementation of the objectives in each of these areas. Furthermore, each department established its own individual work plan, which identifies specific actions, linked to the Council's strategic goals, which it plans to undertake independently in each of these six areas. Each of the goals contained in every department's action plan has a specified time frame for completion as well as an identification of the sub-unit within the department responsible for its implementation, thus providing a way in which to measure the performance of the Council and the member agencies in meeting their goals.

    Recommendation: To promote and enhance federal, state, and local transportation coordination activities, the Secretaries of the Departments of Health and Human Services, Labor, Education, and Transportation should, as member agencies of the Coordinating Council on Access and Mobility, ensure that the long-term goals in the Council's strategic plan have clear links to the individual tasks in its action plan and that these actions are tied to measurable annual performance goals.

    Agency Affected: Department of Education

  4. Status: Closed - Implemented

    Comments: The Coordinating Council adopted an Action Plan on September 15, 2004, which outlines long term goals in six areas --(1) Education and Outreach; (2) Consolidated Access; (3) Regulatory Relief; (4) Coordinated Planning; (5) Cost Allocation; and (6) Useful Practices--with explicit links to specific actions with deliverable dates. Six interagency workgroups were formed to oversee the implementation of the objectives in each of these areas. Furthermore, each department established its own individual work plan, which identifies specific actions, linked to the Council's strategic goals, which it plans to undertake independently in each of these six areas. Each of the goals contained in every department's action plan has a specified time frame for completion as well as an identification of the sub-unit within the department responsible for its implementation, thus providing a way in which to measure the performance of the Council and the member agencies in meeting their goals.

    Recommendation: To promote and enhance federal, state, and local transportation coordination activities, the Secretaries of the Departments of Health and Human Services, Labor, Education, and Transportation should, as member agencies of the Coordinating Council on Access and Mobility, ensure that the long-term goals in the Council's strategic plan have clear links to the individual tasks in its action plan and that these actions are tied to measurable annual performance goals.

    Agency Affected: Department of Health and Human Services

  5. Status: Closed - Implemented

    Comments: The Coordinating Council adopted an Action Plan on September 15, 2004, which outlines long term goals in six areas--(1) Education and Outreach; (2) Consolidated Access; (3) Regulatory Relief; (4) Coordinated Planning; (5) Cost Allocation; and (6) Useful Practices--with explicit links to specific actions with deliverable dates. Six interagency workgroups were formed to oversee the implementation of the objectives in each of these areas. Furthermore, each department established its own individual work plan, which identifies specific actions, linked to the Council's strategic goals, which it plans to undertake independently in each of these six areas. Each of the goals contained in every department's action plan has a specified time frame for completion as well as an identification of the sub-unit within the department responsible for its implementation, thus providing a way in which to measure the performance of the Council and the member agencies in meeting their goals.

    Recommendation: To promote and enhance federal, state, and local transportation coordination activities, the Secretaries of the Departments of Health and Human Services, Labor, Education, and Transportation should, as member agencies of the Coordinating Council on Access and Mobility, ensure that the long-term goals in the Council's strategic plan have clear links to the individual tasks in its action plan and that these actions are tied to measurable annual performance goals.

    Agency Affected: Department of Health and Human Services

  6. Status: Closed - Implemented

    Comments: The Coordinating Council adopted an Action Plan on September 15, 2004, which outlines long term goals in six areas--(1) Education and Outreach; (2) Consolidated Access; (3) Regulatory Relief; (4) Coordinated Planning; (5) Cost Allocation; and (6) Useful Practices--with explicit links to specific actions with deliverable dates. Six interagency workgroups were formed to oversee the implementation of the objectives in each of these areas. Furthermore, each department established its own individual work plan, which identifies specific actions, linked to the Council's strategic goals, which it plans to undertake independently in each of these six areas. Each of the goals contained in every department's action plan has a specified time frame for completion as well as an identification of the sub-unit within the department responsible for its implementation, thus providing a way in which to measure the performance of the Council and the member agencies in meeting their goals.

    Recommendation: To promote and enhance federal, state, and local transportation coordination activities, the Secretaries of the Departments of Health and Human Services, Labor, Education, and Transportation should, as member agencies of the Coordinating Council on Access and Mobility, ensure that the long-term goals in the Council's strategic plan have clear links to the individual tasks in its action plan and that these actions are tied to measurable annual performance goals.

    Agency Affected: Department of Transportation

  7. Status: Closed - Implemented

    Comments: Within the United We Ride Action Plan, the Department of Education has identified several specific actions and deliverables with regard to furthering the coordination of transportation services provided under its programs, including such things as further dissemination of coordination guidance, developing lists of best practices, and a host of other activities. The plan identifies deliverable dates as well as the responsible agency or office within the Department.

    Recommendation: To promote and enhance federal, state, and local transportation coordination activities, the Secretaries of the Departments of Health and Human Services, Labor, Education, and Transportation should ensure that strategic and annual performance plans discuss their departments' transportation coordination efforts and incorporate long-term goals and performance measures that address the need for coordination among programs for the transportation-disadvantaged.

    Agency Affected: Department of Health and Human Services

  8. Status: Closed - Implemented

    Comments: The department's 2004-2009 strategic plan mentions working with the Department of Transportation to "encourage states and tribes to use their flexibility and capacity to coordinate human services and workforce programs so families can better access services to obtain and maintain employment." Furthermore, the plan contains a discussion of the factors that might limit the Department's ability to expand access to health care, with fragmentation of transportation infrastructure being one of the factors. The plan suggests developing strategies for coordinating transportation planning and the provision of transportation services. The Administration on Aging has not updated its strategic plan since GAO's report, but its 2005 performance plan includes a new measure on client satisfaction with transportation services. The plan also says that the administration works through the Coordinating Council on Access and Mobility to reduce barriers by coordinating approaches to human services transportation, and with the Federal Transit Administration to disseminate information on "promising practices" in coordinated transportation services for the elderly and conduct regional technical assistance sessions for state governments. The fiscal year 2005 performance plan of the Administration for Children and Families mentions coordination of programs for people with developmental disabilities with the Departments of Education, Labor, and Transportation; while there are no related performance measures or goals, there is a measure for percentage of individuals with developmental disabilities who are more independent as a result of transportation and other supportive services. The plan's coordination appendix also mentions working with those three departments on welfare reform, early child development, child care, and child support programs (similar to language that was in the administration's previous performance plan). Within the United We Ride Action Plan, HHS has identified several specific actions and deliverables with regard to furthering the coordination of transportation services provided under its programs, including such things as further dissemination of coordination guidance, developing lists of best practices, and a host of other activities. The plan identifies deliverable dates as well as the responsible agency or office within the Department.

    Recommendation: To promote and enhance federal, state, and local transportation coordination activities, the Secretaries of the Departments of Health and Human Services, Labor, Education, and Transportation should ensure that strategic and annual performance plans discuss their departments' transportation coordination efforts and incorporate long-term goals and performance measures that address the need for coordination among programs for the transportation-disadvantaged.

    Agency Affected: Department of Labor

  9. Status: Closed - Implemented

    Comments: Although the Department of Labor's strategic plan for fiscal years 2003-2008 does not directly address transportation coordination, it states that states that DOL is "working with the Departments of Education,...Transportation, Health and Human Services, and others to expand employment opportunities for all Americans by linking these Departments and their programs to the State and local job training and employment system." In addition, within the United We Ride Action Plan, the Department of Labor has identified several specific actions and deliverables with regard to furthering the coordination of transportation services provided under its programs, including such things as further dissemination of coordination guidance, developing lists of best practices, and a host of other activities. The plan identifies deliverable dates as well as the responsible agency or office within the Department.

    Recommendation: To promote and enhance federal, state, and local transportation coordination activities, the Secretaries of the Departments of Health and Human Services, Labor, Education, and Transportation should ensure that strategic and annual performance plans discuss their departments' transportation coordination efforts and incorporate long-term goals and performance measures that address the need for coordination among programs for the transportation-disadvantaged.

    Agency Affected: Department of Transportation

  10. Status: Closed - Implemented

    Comments: The Federal Transit Administration (FTA) added a key deliverable to its strategic plan for 30 percent of states to complete the Framework for Action (a self-assessment tool for states to systematically evaluate their coordination efforts) and for at least one state in each of FTA's ten regions to implement one or more of the improvements they identified by the end of fiscal year 2004, resulting directly in improved coordination. Furthermore, the United We Ride Action Plan contains specific actions and deliverables from the Department of Transportation with regard to furthering the coordination of transportation services.

    Recommendation: To promote and enhance federal, state, and local transportation coordination activities, the Secretaries of the Departments of Health and Human Services, Labor, Education, and Transportation should ensure that strategic and annual performance plans discuss their departments' transportation coordination efforts and incorporate long-term goals and performance measures that address the need for coordination among programs for the transportation-disadvantaged.

    Agency Affected: Department of Education

  11. Status: Closed - Implemented

    Comments: HHS has provided several guidance documents to their grantees with regard to coordination. They have updated joint guidance on coordinating transportation under TANF with DOT's JARC program and DOL's employment programs. The Centers for Medicare and Medicaid has provided technical assistance on medical transportation policy and will be facilitating a workshop on how medical transportation can be coordinated in the Fall of 2005. Further, the Administration on Aging has developed a guide for State Legislators about transportation coordination.

    Recommendation: To promote and enhance federal, state, and local transportation coordination activities, the Secretaries of the Departments of Health and Human Services, Labor, Education, and Transportation should develop and distribute additional guidance to states and other grantees that encourages coordinated transportation by clearly defining the allowable uses of funds, explaining how to develop cost-sharing arrangements for transporting common clientele, and clarifying whether funds can be used to serve individuals other than the program's target population.

    Agency Affected: Department of Transportation

  12. Status: Closed - Implemented

    Comments: The Department of Transportation (DOT) has been working with the Departments of Health and Human Services (HHS) and Labor (DOL) through Coordinating Council work groups to develop guidance for coordinating transportation services in some key programs. The council has updated its Medicaid transit-pass brochure that provides guidance on how to coordinate Medicaid transportation with local transit services and is developing a new brochure on Medicaid transportation brokerages aimed at providing guidance on coordinating the various medical transportation providers within a community. The council is also working to clarify Medicaid's cost allocation policy, which was cited as an obstacle to coordinating transportation services provided under Medicaid with other programs. The council has also developed a template for communities to use in identifying existing transportation resources for seniors and is working with the National Consortium on the Coordination of Human Services Transportation to develop guidance for state and local transportation agencies to develop and coordinate state and local transportation plans with human services agencies that are involved in providing transportation for their older adult clients. In addition to these efforts, DOT and HHS convened four regional meetings of transportation and human services providers and staff from various state-funded programs to develop state coordination action plans and discuss best practices in service delivery. Efforts are also underway to proactively assist states and communities in following through on coordination action plans and other initiatives begun in the joint regional workshops and to improve coordination of federally-sponsored technical assistance programs. DOT, HHS, and DOL developed the Framework for Action, a coordination self-assessment tool that states and communities can use to assess their coordination efforts and identify areas for improvement. DOT, HHS, DOL, and Education convened a National Leadership Forum in February 2004 for leadership teams of transportation and human service officials from 47 states and territories to discuss transportation coordination, showcase model transportation programs, and share best practices, and five states were presented with State Leadership Awards for their efforts to provide more and better transportation services for disadvantaged populations without increasing costs. The four federal departments have also announced state coordination grants that will give states a financial incentive to coordinate by providing funds to address transportation coordination gaps identified through the Framework for Action. Finally, the four departments are working through the Coordinating Council to develop and distribute further guidance on coordinating transportation services funded through their programs.

    Recommendation: To promote and enhance federal, state, and local transportation coordination activities, the Secretaries of the Departments of Health and Human Services, Labor, Education, and Transportation should develop and distribute additional guidance to states and other grantees that encourages coordinated transportation by clearly defining the allowable uses of funds, explaining how to develop cost-sharing arrangements for transporting common clientele, and clarifying whether funds can be used to serve individuals other than the program's target population.

    Agency Affected: Department of Health and Human Services

  13. Status: Closed - Implemented

    Comments: The Department of Labor, through actions listed in the Coordinating Council on Access and Mobility's action plan, has planned and completed several actions related to the development and dissemination of guidance on coordination of transportation services to its funding recipients. The Department distributed information on the United We Ride initiative, to all State Workforce Liaisons and State Workforce agencies. Also, the Division of Disability and Workforce Programs has provided contact information to all the One-Stop Career Centers for the United We Ride Technical Assistance Ambassadors. In addition, the Division of Seasonal and Migrant Farmworkers has developed a document which highlights the benefits of coordination and has disseminated it to all its grantees and the Office of Disability and Employment Policy is also developing a brochure for its grantees. In addition, the Coordinating Council has begun to develop guidance on cost sharing and vehicle sharing arrangements.

    Recommendation: To promote and enhance federal, state, and local transportation coordination activities, the Secretaries of the Departments of Health and Human Services, Labor, Education, and Transportation should develop and distribute additional guidance to states and other grantees that encourages coordinated transportation by clearly defining the allowable uses of funds, explaining how to develop cost-sharing arrangements for transporting common clientele, and clarifying whether funds can be used to serve individuals other than the program's target population.

    Agency Affected: Department of Education

  14. Status: Closed - Implemented

    Comments: The Department of Education, within the Coordinating Council on Access and Mobility's action plan, has disseminated some guidance on transportation coordination to some grantees and is developing further guidance for dissemination. For example, in July, 2005, the department disseminated a United We Ride DVD with supplemental training materials to all Centers for Independent Living in the country that receive federal funds. In addition, they plan to develop and disseminate guidance on how funds from the Individuals with Disabilities Education Improvement Act can be used to support travel training. Also, the Department has begun a collaboration with the Department of Transportation to disseminate transportation-related information to transition coordinators across the country, an effort that is scheduled to be completed by the end of 2005. Finally, in February, 2005, the Coordinating Council began to develop guidance on vehicle sharing arrangements and in June, 2005, it began developing guidance on cost sharing.

    Recommendation: To promote and enhance federal, state, and local transportation coordination activities, the Secretaries of the Departments of Health and Human Services, Labor, Education, and Transportation should develop and distribute additional guidance to states and other grantees that encourages coordinated transportation by clearly defining the allowable uses of funds, explaining how to develop cost-sharing arrangements for transporting common clientele, and clarifying whether funds can be used to serve individuals other than the program's target population.

    Agency Affected: Department of Labor

  15. Status: Closed - Implemented

    Comments: The Department of Education's Office of Special Education and Rehabilitative Services (OSERS), which administers the vast majority of programs in the Department of Education that have a transportation component, has linked its web site to the United We Ride Web site (formerly the Coordinating Council on Access and Mobility Web site). Furthermore, OSERS has worked with the Department of Transportation to develop fact sheets and frequently asked questions to advertise United We Ride to its funding recipients.

    Recommendation: To promote and enhance federal, state, and local transportation coordination activities, the Secretaries of the Departments of Health and Human Services, Labor, Education, and Transportation should link the Web sites of their agencies involved in providing services for the transportation-disadvantaged to the Coordinating Council's Web site and advertise the site in agency correspondence and during conferences or other outreach opportunities.

    Agency Affected: Department of Education

  16. Status: Closed - Implemented

    Comments: Although the Department of Transportation's Federal Transit Administration (FTA) already had a link to the Coordinating Council on its web page, FTA has since updated its site and now features coordination activities much more prominently and in several locations on the site. Administrator Jenna Dorn also continues to advertise FTA's efforts to improve coordination during her speeches at conferences and other events (such as the AASHTO and CTAA annual meetings).

    Recommendation: To promote and enhance federal, state, and local transportation coordination activities, the Secretaries of the Departments of Health and Human Services, Labor, Education, and Transportation should link the Web sites of their agencies involved in providing services for the transportation-disadvantaged to the Coordinating Council's Web site and advertise the site in agency correspondence and during conferences or other outreach opportunities.

    Agency Affected: Department of Transportation

  17. Status: Closed - Implemented

    Comments: The Department of Health and Human Services' Administration on Aging's web site contains transportation information and a link to the United We Ride web site. The Administration for Children and Families has a link to United We Ride on its Office of Family Assistance Web page under "Access to Transportation."

    Recommendation: To promote and enhance federal, state, and local transportation coordination activities, the Secretaries of the Departments of Health and Human Services, Labor, Education, and Transportation should link the Web sites of their agencies involved in providing services for the transportation-disadvantaged to the Coordinating Council's Web site and advertise the site in agency correspondence and during conferences or other outreach opportunities.

    Agency Affected: Department of Labor

  18. Status: Closed - Implemented

    Comments: The Department of Labor is linked to www.disabilityinfo.gov at several locations within its site. Disabilityinfo.gov has a link to United We Ride in its transportation section. Also, the Employment and Training Administration, which funds the majority of programs that can be used for transportation, has a link to the United We Ride Web site in its "What's new in workforce investment" section. DOL has also distributed information on United We Ride to all State Workforce Liaisons and state workforce agencies.

    Recommendation: To promote and enhance federal, state, and local transportation coordination activities, the Secretaries of the Departments of Health and Human Services, Labor, Education, and Transportation should link the Web sites of their agencies involved in providing services for the transportation-disadvantaged to the Coordinating Council's Web site and advertise the site in agency correspondence and during conferences or other outreach opportunities.

    Agency Affected: Department of Health and Human Services

 

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