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Report to Congressional Requesters:

United States General Accounting Office:

GAO:

June 2003:

Transportation-Disadvantaged Populations:

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

Transportation Coordination:

GAO-03-697:

GAO Highlights:

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

Why GAO Did This Study:

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.

What GAO Found:

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. 

What GAO Recommends: 

GAO recommends that the Departments of Labor and Education join the 
Coordinating Council on Access and Mobility. GAO also recommends that 
the Departments of Health and Human Services, Labor, Education, and 
Transportation (1) strengthen the Coordinating Council’s strategic 
plan, (2) include long-term goals and measures for coordination in 
their agencies’ strategic and annual performance plans, and (3) 
develop and distribute additional guidance and information to 
encourage coordination.

The Departments of Health and Human Services, Labor, Education, and 
Transportation generally concurred with the findings and 
recommendations in this report.

www.gao.gov/cgi-bin/getrpt?GAO-03-697.

To view the full product, including the scope and methodology, click 
on the link above. For more information, contact. Katherine Siggerud 
at (202) 512-2834.

[End of section]

Contents:

Letter:

Results in Brief:

Background:

Sixty-Two Federal Programs Fund Transportation Services to 
Transportation-Disadvantaged Populations:

Extent of Spending on Services for the Transportation-Disadvantaged Is 
Not Fully Known but Is in the Billions of Dollars:

Coordination Efforts Vary, but Some Successful Efforts Show Promising 
Results:

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

Conclusions:

Recommendations for Executive Action:

Agency Comments and Our Evaluation:

Appendix I: Scope and Methodology:

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

Appendix III: Federal and State Coordination Efforts:

Federal Coordination:

State Coordination:

Appendix IV: Informational Resources on Coordination:

Web Sites:

Reports:

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

GAO Comments:

Appendix VI: Comments from the Department of Education:

Appendix VII: GAO Contacts and Staff Acknowledgments:

GAO Contacts:

Staff Acknowledgments:

Tables:

Table 1: Sixteen Programs Identified by CTAA as Regularly Providing 
Funding for Transportation:

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

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

Table 4: Status of Federal Responses to GAO's Recommendations to 
Improve Coordination:

Table 5: Federal Actions Taken in Response to GAO Recommendations for 
Improving Coordination:

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

Figures:

Figure 1: Number of Programs Providing Transportation Services to the 
Transportation-Disadvantaged, by Agency:

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

Abbreviations:

ADA: Americans with Disabilities Act of 1990:  

CTAA: Community Transportation Association of America:  

CTAP: Community Transportation Assistance Project:  

DOL: U.S. Department of Labor:  

DOT: U.S. Department of Transportation:  

FTA: Federal Transit Administration:  

GPRA: Government Performance and Results Act of 1993:  

HHS: U.S. Department of Health and Human Services:  

HUD: U.S. Department of Housing and Urban Development:  

JARC: Job Access and Reverse Commute:  

MOE: maintenance of effort:  

P.L.: public law:  

RTAP: Rural Transit Assistance Program:  

TANF: Temporary Assistance for Needy Families:  

TEA-21: Transportation Equity Act for the 21ST Century:  

TCRP: Transit Cooperative Research Program:  

U.S.C.: U.S. Code:  

VA: U.S. Department of Veterans Affairs:  

VR: Vocational Rehabilitation:  

WETAP: Wisconsin Employment Transportation Assistance Program:

United States General Accounting Office:

Washington, DC 20548:

June 30, 2003:

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

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

The ability to access personal or public transportation is fundamental 
for people to connect with employment opportunities, health and medical 
services, educational services, and the community at large. However, 
certain populations in the United States lack the ability to provide 
their own transportation or have difficulty accessing whatever 
conventional public transportation may be available. These 
"transportation-disadvantaged" persons may have an age-related 
condition, a disability, or income constraints. This is potentially a 
sizeable group. For example, according to the 2000 U.S. Census, 35.1 
million people were over age 65, 44.5 million people were over age 21 
and disabled, and 33.9 million people were living below the poverty 
line. Many within these populations face significant problems in 
accessing transportation.

Many federal programs authorize use of funds to provide transportation 
for transportation-disadvantaged people so they can access government 
programs. Programs that provide incidental transportation include 
health and medical programs, job-training programs, or programs for the 
aging. The coordination of these transportation services--through 
pooling resources, consolidating trips provided by various agencies 
under a single agency, or sharing information between programs--has 
been found to improve the quality and cost-effectiveness of service. At 
the federal level, the Coordinating Council on Access and Mobility--a 
body consisting of representatives from the Departments of Health and 
Human Services and Transportation--is charged with coordinating 
transportation services provided by federal programs and promoting the 
maximum feasible coordination at the state and local levels. In a 1999 
report,[Footnote 1] we found that these coordination efforts needed 
strengthening. We have also issued other reports raising concerns about 
service coordination.[Footnote 2]

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

Our overall approach was to (1) review federal laws and regulations 
governing the use of federal funds for services for transportation-
disadvantaged populations; (2) analyze spending data where available; 
(3) review federal and other governmental activities and the research 
literature related to the coordination of transportation services; and 
(4) obtain the views of more than 100 officials from federal, state, 
and local government agencies, industry and client advocacy groups, and 
other experts involved with or affected by the coordination process on 
the obstacles and options for improving coordination. Many of these 
interviews were part of case studies that we conducted in five states-
-Arizona, Florida, New York, South Dakota, and Wisconsin--to understand 
how these various federal programs were implemented and coordinated at 
the state and local level. We chose these states to include a cross 
section of characteristics including urban/rural mix, geographic area 
of the country, and presence or absence of a state council or other 
coordinating body. Appendix I contains more information about our scope 
and methodology.

Results in Brief:

We identified 62 federal programs--most of which are administered by 
the Departments of Health and Human Services, Labor, Education, and 
Transportation--that are used to fund transportation services for 
transportation-disadvantaged populations. Sixteen of these seem 
particularly relevant in that the Community Transportation Association 
of America[Footnote 4] identified them as being regularly used to fund 
transportation services. In addition, based on available information, 
we identified 11 other programs that are notable, in that 
transportation spending under each one was at least $4 million in 
fiscal year 2001. While the remaining programs also fund transportation 
services, they do so minimally, or the extent of transportation 
services funded is unknown, according to program officials. Most 
programs purchase transportation services from existing private or 
public providers. For example, several programs in the Department of 
Labor typically provide bus tokens, and Medicaid providers often 
contract with local transportation providers.[Footnote 5] In contrast, 
Department of Transportation programs and several others such as Head 
Start in the Department of Health and Human Services typically purchase 
and operate vehicles or modify them for use by individuals with 
disabilities. Several of these 62 programs are required to coordinate 
services they provide with other agencies providing similar services, 
which can include transportation.

Federal, state, and local spending for these transportation services is 
in the billions of dollars, although the full extent of spending is 
unknown because transportation spending is not always tracked 
separately from other program spending. In the 29 programs for which we 
could obtain actual spending amounts or estimates from program 
officials, federal spending on transportation services for 
transportation-disadvantaged populations was at least $2.4 billion in 
fiscal year 2001. Department of Health and Human Services programs 
spent about three-quarters of this amount. State and local agencies 
also provide funding for many of these programs, often to fulfill 
matching requirements, which generally range from 5 to 50 percent of 
total program costs for these programs. Estimates of state and local 
spending are generally not available because few agencies track such 
information at the federal or state level. However, based on available 
information, it is evident that state and local contributions for these 
services are significant--at least several hundred million dollars.

Efforts to improve services and achieve cost savings through 
coordination of transportation activities among agencies at all levels 
of government vary; however, in some areas we visited, close 
coordination among providers has shown promising results. Some local 
agencies have realized substantial benefits by coordinating their 
transportation services through sharing vehicles, consolidating 
services under a single agency, or sharing information about available 
services. For example, a transit agency in South Dakota consolidated 
the transportation services previously provided by both senior and 
medical centers as well as other federal, state, and local programs. 
This consolidation allowed the agency to expand its service hours and 
increase the number of trips provided while reducing the average cost 
of providing each trip by about 20 percent. We found instances, 
however, in which there were overlapping, fragmented, or confusing 
services among programs that did not coordinate. For example, a local 
official said that the vans delivering clients to the local job center 
are owned by many different programs, but because the programs do not 
coordinate, only a few people ride in each van. At the federal level, 
agencies have taken some limited steps to coordinate their 
transportation programs since our 1999 report.[Footnote 6] For example, 
the Coordinating Council on Access and Mobility has finalized a 
strategic plan and issued guidelines for coordinating transportation 
services. However, the long-term goals and objectives in its strategic 
plan are generally not measurable, and they are not linked to the 
activities in the Council's action plan. Also, the strategic and annual 
performance plans of the Departments of Transportation and Health and 
Human Services contain few references to coordination of programs for 
the transportation-disadvantaged, and the plans of the Departments of 
Labor, Education, and the other federal agencies contain no such 
references. In addition, the Coordinating Council only includes 
officials from two federal departments (Transportation and Health and 
Human Services), representing less than half of the 62 federal programs 
that can be used to fund services for the transportation-disadvantaged, 
while the Departments of Labor and Education, which administer one-
third of the programs, are not members of the Council. Furthermore, 
while the Coordinating Council is working to improve its Web site, the 
site is not linked to the Web site of the Department of Health and 
Human Services, making it more difficult for human service agencies at 
all government levels to be aware of and access the site.

Although decision makers face numerous obstacles in trying to 
coordinate transportation services for the transportation-
disadvantaged, officials and experts that we consulted also offered 
several potential options to mitigate these obstacles and enhance 
coordination among federal, state, and local agencies. We grouped the 
obstacles into three categories: (1) reluctance to share vehicles and 
fund coordination activities due to concerns about possible adverse 
effects on clients; (2) different eligibility requirements, safety 
standards, and other programmatic requirements that can limit programs' 
ability to share transportation resources; and (3) lack of leadership 
and commitment to coordinate, as evidenced by the limited guidance and 
information provided by federal and state agencies on the possible 
techniques for coordinating services. To mitigate these obstacles, 
officials and experts suggested three potential options. One option is 
to harmonize standards among federal programs--such as safety standards 
related to types of seat belts and driver training requirements--so 
that programs can serve additional populations or better share 
transportation resources. Another option is to expand interagency 
forums that would facilitate communication among agencies involved in 
coordination efforts and to share additional technical guidance and 
information on coordination among federal and state agencies through a 
central clearinghouse or improved Web site. The third option is to 
provide financial incentives or mandates that would give priority in 
federal funding to those grant applicants that show a strong commitment 
to coordinate or require specific coordination efforts among grant 
recipients as a condition of receiving federal funding. We did not 
assess the costs and benefits of these options; however, some would 
require extensive statutory or regulatory changes and could cause 
agencies to incur significant costs.

Given the multiplicity of federal programs that can fund transportation 
services for the transportation-disadvantaged, and the significant 
amounts spent on those services, effective coordination efforts are 
needed to ensure that transportation services reach the greatest number 
of recipients. Accordingly, our report contains several recommendations 
designed to strengthen and enhance coordination activities in the four 
federal departments that administer most of the programs that fund 
transportation services--Health and Human Services, Labor, Education, 
and Transportation. In commenting on the draft of this report, those 
four departments generally concurred with the findings and 
recommendations. In addition, we provided the draft report to two other 
departments that provide services to the transportation-disadvantaged-
-Housing and Urban Development and Veterans Affairs--and those 
departments also agreed with the findings. In some cases, these 
departments also provided technical clarifications, which were 
incorporated as appropriate to ensure accuracy.

Background:

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

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

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

* Low-income households are less likely to own a car than other 
households due to the prohibitive cost of purchasing, insuring, and 
maintaining a car, and public transportation may not provide sufficient 
options for their needs. Over 90 percent of public assistance 
recipients do not own a car.[Footnote 8]

The importance of coordinating transportation services for 
transportation-disadvantaged populations has been evident since the 
1970s. In 1977, we issued a report on transportation 
coordination,[Footnote 9] which concluded that the most significant 
hindrance to the coordination of transportation services under these 
programs was confusion at all levels of government as to how much 
coordination federally funded projects could engage in. Since 1986, 
responsibility for coordinating transportation programs at the federal 
level has rested in the Coordinating Council on Access and Mobility, 
which was created under a memorandum of understanding between the 
Department of Health and Human Services (HHS) and the Department of 
Transportation (DOT). This body is composed of representatives from 
program offices within these departments, and employees of the two 
departments meet its staffing needs, on a part-time basis.

More recent reviews have continued to identify a need for stronger 
efforts in this area. In a 1999 report on transportation 
coordination,[Footnote 10] we found that coordination efforts of the 
Coordinating Council, DOT, and HHS were ongoing but still needed 
strengthening. This report also noted that the Congress had endorsed 
increased coordination as evidenced by several provisions in the 
Transportation Equity Act for the 21st Century (TEA-21),[Footnote 11] 
and significant financial benefits had been realized through 
coordination. In addition, reports by advocacy groups and 
transportation researchers have raised concerns over continuing 
duplication of effort among federal programs and certain sub-
populations still not being served effectively.[Footnote 12]

Sixty-Two Federal Programs Fund Transportation Services to 
Transportation-Disadvantaged Populations:

We identified 62 federal programs that fund transportation services to 
populations that are transportation-disadvantaged.[Footnote 13] As 
shown in figure 1, the bulk of these programs are administered by four 
federal agencies--23 programs in HHS, 15 programs in the Department of 
Labor (DOL), 8 programs in the Department of Education, and 6 programs 
in DOT.[Footnote 14] The remaining 10 programs are administered by the 
Departments of Housing and Urban Development (HUD), Veterans Affairs 
(VA), Agriculture, and the Interior. A full listing of programs, their 
authorizing legislation, typical uses, types of trips provided, target 
populations, and spending information is found in appendix II.

Figure 1: Number of Programs Providing Transportation Services to the 
Transportation-Disadvantaged, by Agency:

[See PDF for image]

[End of figure]

Many of the 62 programs are significantly involved in providing 
transportation services to their recipients. These include 16 programs 
identified by the Community Transportation Association of America 
(CTAA)[Footnote 15] as being routinely used to provide transportation 
and an additional 11 programs that we identified as spending at least 
$4 million for transportation services to transportation-disadvantaged 
populations in fiscal year 2001 on the basis of funding data or 
estimates that were available. The remaining programs also fund 
transportation services, but do so minimally, or the extent of 
transportation services funded is unknown, according to program 
officials. Table 1 shows the 16 programs identified by CTAA and how 
they provide transportation. These 16 programs are administered by DOT, 
HHS, Education, and DOL. As the table shows, transportation is not the 
primary purpose of most of these programs. For example, Medicaid 
provides payments for medical services, and the Vocational 
Rehabilitation Grants Program provides training and employment services 
to individuals with disabilities.

Table 1: Sixteen Programs Identified by CTAA as Regularly Providing 
Funding for Transportation:

Agency: Department of Education; Program: Vocational Rehabilitation 
Grants; Description: Assists states in operating programs that provide 
vocational rehabilitation services for individuals with disabilities. 
Services include counseling, training, job placement, and other 
supportive services, including transportation. 

Agency: Department of Health and Human Services; Program: Grants for 
Supportive Services and Senior Centers; Description: Assists states in 
developing a community-based system of services for older individuals. 
Services provided include nutrition services, caregiver support 
services, senior centers, and transportation services. 

Program: Program for American Indian, Alaskan Native, and Native 
Hawaiian Elders; Description: Assists tribal organizations in the 
delivery of supportive services to older Native Americans. Services 
provided include nutrition services, caregiver support services, senior 
centers, and transportation services. 

Program: Head Start; Description: Assists local grantees in providing a 
program of comprehensive health, educational, and other services to 
promote school readiness for low-income children. Transportation to and 
from program services is generally provided. 

Program: Medicaid; Description: Assists states in payments for medical 
assistance to populations that meet categorical eligibility (such as 
families with children or persons who are elderly or disabled) as well 
as income and resource requirements. States are required to assure 
transportation to medical services. 

Program: Temporary Assistance for Needy Families; Description: Provides 
grants to states or tribes to assist needy families with children. 
Grantees have the flexibility to use funds in any manner that meets the 
purposes of the program, which can include transportation to services. 

Agency: Department of Labor; Program: Senior Community Service 
Employment Program; Description: Assists states and other grantees in 
providing work opportunities in community service activities for low-
income individuals 55 years of age and older. Transportation to 
training and job placements can be provided. 

Program: Workforce Investment Act Adult Services Program; Description: 
Assists states in providing workforce investment activities. 
"Intensive" services provided to low-income participants include 
occupational and basic skills training, and transportation can be 
provided to access such services. 

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

Program: Workforce Investment Act Youth Activities; Description: 
Assists states in providing workforce investment activities that will 
help low-income youth acquire the skills, training, and support needed 
to achieve employment success. Transportation can be provided to access 
services. 

Agency: Department of Transportation; Program: Capital Investment 
Grants; Description: Assists states in financing facilities for use in 
mass public transportation service. Projects can include those that are 
designed to meet the special needs of elderly or disabled individuals. 

Program: Urbanized Area Formula Program; Description: Assists urbanized 
areas in financing capital projects for use in mass transportation 
service. Ten percent of funds may be used to pay for ADA paratransit 
operating costs.[A].

Program: Nonurbanized Area Formula Program; Description: Assists 
nonurbanized areas with capital and operating expenses needed to 
provide public transportation service. Ten percent of funds may be used 
to pay for ADA paratransit operating costs. 

Program: Job Access and Reverse Commute; Description: Provides grants 
to develop transportation services to connect low-income persons to 
employment and support services. Funds can be used for capital and 
operating costs associated with new or expanded service. 

Program: Capital and Training Assistance for Over-the-Road Bus 
Accessibility; Description: Assists private operators of over-the-road 
buses with financing capital and training costs associated with making 
buses accessible to individuals with disabilities. 

Program: Capital Assistance Program for Elderly Persons and Persons 
with Disabilities; Description: Provides financial assistance to 
nonprofit organizations in meeting the transportation needs of elderly 
persons and persons with disabilities where public transportation 
services are unavailable, insufficient, or inappropriate. Funds may be 
used for eligible capital expenses, such as purchasing vehicles, or to 
contract for service. 

Sources: CTAA and Catalog of Federal Domestic Assistance.

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

[End of table]

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

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

Agency: Department of Agriculture; Program: Food Stamp Employment and 
Training Program.

Agency: Department of Education; Program: 21st-Century Community 
Learning Centers.

Agency: Department of Labor; Program: Job Corps.

Agency: Department of Health and Human Services; Program: Community 
Health Centers.

Program: HIV Care Grants.

Program: Social Services Block Grants.

Program: State Children's Health Insurance Program.

Agency: Department of Housing and Urban Development; Program: Community 
Development Block Grant.

Program: Supportive Housing Program.

Agency: Department of Veterans Affairs; Program: Automobiles and 
Adaptive Equipment for Certain Disabled Veterans.

Program: Veterans Medical Care.

Source: GAO.

[End of table]

Under most of the federal programs providing transportation services, 
funding recipients typically purchase the services from existing 
sources, according to program officials. This includes contracting for 
services with private transportation providers or providing bus tokens, 
transit passes, taxi vouchers, mileage reimbursement to volunteers or 
program participants, or some combination of these methods. For 
example, recipients of funds from DOL's Workforce Investment Act Adult 
Services Program typically provide bus tokens or mileage reimbursement 
for participants to access training, while recipients of HHS's Grants 
for Supportive Services and Senior Centers most often contract with 
local transportation providers to provide client transportation. The 
funding recipients of several programs, however, typically purchase and 
operate vehicles, or modify existing vehicles for use by individuals 
with disabilities. These programs include Head Start and the Program 
for American Indian, Alaskan Native, and Hawaiian Elders in HHS; the 
Vocational Rehabilitation Grants Program in the Department of 
Education; and the six programs within DOT.

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

Extent of Spending on Services for the Transportation-Disadvantaged Is 
Not Fully Known but Is in the Billions of Dollars:

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

Spending by 29 Federal Programs Is Estimated at $2.4 billion in Fiscal 
Year 2001:

Information on federal spending for transportation is available for 29 
of the 62 programs we identified.[Footnote 16] These programs spent an 
estimated $2.4 billion on transportation services in fiscal year 2001. 
(Appendix II lists available spending data for each federal program.) 
Based on available information, HHS programs as a whole spent the most 
on transportation for transportation-disadvantaged populations in 
2001--an estimated $1.8 billion. Table 3 shows estimated transportation 
spending by the eight federal agencies that fund services for the 
transportation-disadvantaged.

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

Agency: Department of Health and Human Services; Amount spent on 
transportation for transportation-disadvantaged (in millions): 
$1,771.0; Percent of total estimate: 72.4%; Number of programs included 
in estimate: 10; Total number of programs that provide transportation: 
23.

Agency: Department of Transportation; Amount spent on transportation 
for transportation-disadvantaged (in millions): $317.3; Percent of 
total estimate: 13.0%; Number of programs included in estimate: 6; 
Total number of programs that provide transportation: 6.

Agency: Department of Veterans Affairs; Amount spent on transportation 
for transportation-disadvantaged (in millions): $160.8; Percent of 
total estimate: 6.6%; Number of programs included in estimate: 3; Total 
number of programs that provide transportation: 3.

Agency: Department of Education; Amount spent on transportation for 
transportation-disadvantaged (in millions): $135.3; Percent of total 
estimate: 5.5%; Number of programs included in estimate: 2; Total 
number of programs that provide transportation: 8.

Agency: Department of Labor; Amount spent on transportation for 
transportation-disadvantaged (in millions): $26.4; Percent of total 
estimate: 1.1%; Number of programs included in estimate: 3; Total 
number of programs that provide transportation: 15.

Agency: Department of Housing and Urban Development; Amount spent on 
transportation for transportation-disadvantaged (in millions): $21.7; 
Percent of total estimate: 0.9%; Number of programs included in 
estimate: 4; Total number of programs that provide transportation: 4.

Agency: Department of Agriculture; Amount spent on transportation for 
transportation-disadvantaged (in millions): $13.0; Percent of total 
estimate: 0.5%; Number of programs included in estimate: 1; Total 
number of programs that provide transportation: 1.

Agency: Department of the Interior; Amount spent on transportation for 
transportation-disadvantaged (in millions): Not available; Percent of 
total estimate: 0.0%; Number of programs included in estimate: 0; Total 
number of programs that provide transportation: 2.

Agency: Total (for 8 agencies); Amount spent on transportation for 
transportation-disadvantaged (in millions): $2,445.5; Percent of total 
estimate: 100.0%; Number of programs included in estimate: 29; Total 
number of programs that provide transportation: 62.

Sources: GAO summary of HHS, DOT, VA, Education, DOL, Agriculture, HUD, 
and Interior data and estimates.

[End of table]

More than three-quarters of our estimate is based on spending for 
transportation in five programs. Of the five, Medicaid and Head Start, 
both in HHS, spent the most on transportation in fiscal year 2001--an 
estimated $976.2 million and $514.5 million, respectively. The three 
other programs, all of which spent more than $100 million on services 
for the transportation-disadvantaged in fiscal year 2001, were DOT's 
Capital Assistance Program for Elderly Persons and Persons with 
Disabilities,

HHS's Temporary Assistance for Needy Families (TANF), and VA's Veterans 
Medical Care Benefits.

The amount spent on transportation services by the remaining 33 federal 
programs is unknown, mainly because the majority of programs do not 
require recipients of federal funds to report transportation spending 
information to the federal agency.[Footnote 17]

State and Local Transportation Spending Is Unknown, but Is Likely 
Significant:

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

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

* In Wisconsin nearly 38 percent, or $922,000, of the funding to 
provide transportation services through DOT's Capital Assistance 
Program for Elderly Persons and Persons with Disabilities in 2001 was 
from nonfederal sources. The program requires grantees to provide 20 
percent of total program funding.

* In New York, about 30 percent of the spending on transportation under 
the Department of Education's Vocational Rehabilitation Program in 
2002, or $2.6 million, was from nonfederal sources.[Footnote 20] 
Similarly, about 27 percent or $673,000 of Florida's funding was from 
nonfederal sources in 2001. The program requires states to contribute 
21.3 percent of total costs.

Although some states and localities currently spend a significant 
amount for transportation through federal programs, many now face 
budget deficits that could diminish their future contribution to these 
programs. In a 2003 survey by the National Conference of State 
Legislatures,[Footnote 21] 36 states reported budget deficits midway 
through their fiscal year. Fifteen of these states reported deficits in 
excess of 5 percent of the state budget, and four states are facing 
deficits greater than 10 percent of the state budget. Because 49 states 
have balanced budget requirements, such large deficits could lead to a 
decrease in the amount of funds available to states for programmatic 
spending, including transportation programs. For example, according to 
the National Conference of State Legislatures report, 29 states have 
imposed across-the-board cuts in response to budget deficits.

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

* Two of the states have cut their state programs that local grantees 
used to fund services for the transportation-disadvantaged, according 
to transportation officials in those states. In one state, the state 
legislature eliminated the state's transportation assistance program to 
help deal with the state's budget deficit; as a result, the state 
official and the director of a senior center in the state said that 
some of the projects funded through the program will likely be 
discontinued because grantees cannot find replacement funds. In the 
other state, the state legislature cut a state fund that grantees used 
to supplement federal transportation funding. According to an official, 
the loss of this fund, combined with the increasing costs of fuel and 
insurance, may lead providers to cut service to transportation-
disadvantaged populations by as much as 40 percent.

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

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

While some states are not currently experiencing reductions in their 
transportation programs, many states are anticipating that budget 
deficits will continue into 2004. According to the National Conference 
of State Legislatures report, 36 states are anticipating budget gaps 
for 2004; nearly all of these states anticipate gaps greater than 5 
percent of their state budget and half of these states expect gaps 
greater than 10 percent.[Footnote 22]

Coordination Efforts Vary, but Some Successful Efforts Show Promising 
Results:

Efforts to improve services and achieve cost savings through 
coordination of transportation activities among agencies at all levels 
of government vary. At the state and local levels, the extent and the 
type of coordination activities differ, ranging from one state body 
providing guidance and overseeing coordination efforts for most of its 
programs to two local agencies sharing vehicles. In some areas within 
the five states we visited, coordination among providers has resulted 
in significant benefits, such as improved customer service and lower 
unit costs. However, we also found some examples of overlapping, 
fragmented, or confusing services resulting from a lack of 
coordination. At the federal level, DOT, HHS, and--to some extent--DOL 
have undertaken some activities aimed at improving coordination among 
their programs. DOT and HHS implement many of their activities through 
the Coordinating Council on Access and Mobility. However, DOT and HHS 
make only a few mentions of coordinating services for the 
transportation-disadvantaged in their strategic and annual performance 
plans, and other agencies do not mention such activities at all. Also, 
several federal agencies that provide services to the transportation-
disadvantaged are not involved in coordination efforts at the national 
level.

Extent of State and Local Transportation Coordination Varies:

While agencies within each state we visited were involved in some form 
of coordination, the extent of coordination of transportation services 
varies widely. For example, Florida has a state organization that 
oversees the coordination of most of the transportation services for 
the transportation-disadvantaged, while some other states we visited 
had no statewide coordination body. Even in states without such a 
coordinating body, however, some state and local agencies are engaged 
in coordination efforts. This variation also occurred in the nation as 
a whole, according to data from a preliminary report by the National 
Academy of Sciences' Transportation Research Board, which found that 
roughly half of U.S. states have a state transportation coordinating 
body. [Footnote 23] (See appendix III for information on the type of 
coordination in the five states we visited and the state agencies 
involved.) 
Within each state, local efforts also varied. Examples of coordination 
activities include the following:

Coordinated planning: In this type of coordination, some combination of 
human service and transportation agencies and providers work together 
to plan transportation services for their clients. For example, in 
northwestern Wisconsin, at the initiative of staff from a center for 
independent living, the Area Consortium on Transportation was formed in 
2001 to improve the planning and provision of transportation for the 
disabled and others who are transit-dependent. The council--which 
consists of consumers, transit providers, county and city officials, 
disability organizations, and aging groups--is instituting several 
pilot programs to test various methods of coordination.

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

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

Appendix IV contains a list of some informational resources available 
for agencies interested in coordinating.

Coordination Has Led to Improvements, While Lack of Coordination Can 
Result in Overlap:

In some areas we visited, coordination among providers--through sharing 
vehicles, consolidating services under a single agency, or sharing 
information about available services--has resulted in significant 
benefits, such as improved customer service and lower unit costs. State 
and local agencies providing transportation under the 62 federal 
programs often serve similar client groups, provide similar services, 
and operate in similar geographic areas, so there can be duplication of 
effort and inefficiency in providing transportation when those agencies 
do not coordinate. In our site visits, we found several examples of 
overlapping, fragmented, or confusing services in places where agencies 
were not coordinating.

Benefits of Coordination:

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

Improved customer service:

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

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

* A federal regional official said that coordination could remove the 
stigma of specialized transportation because all recipients use the 
same service and are treated equally.

Financial benefits:

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

* In Aberdeen, South Dakota, the local transit agency consolidated the 
transportation services previously provided by both senior and medical 
centers as well as other federal, state, and local programs. This 
consolidation allowed the agency to increase the number of trips 
provided while reducing the average cost of providing each trip by 
about 20 percent--from about $5 to $4. The agency has also improved its 
services by coordinating with local taxi companies to provide night and 
weekend trips.

Effects of a Lack of Coordination:

Although the various programs we reviewed target specific populations, 
some populations are eligible to receive transportation services from 
multiple programs, resulting in duplication and inefficiency in some 
cases. In our visits with state and local transportation and human 
service agencies and providers, officials we interviewed identified 
several examples of overlapping services in areas or programs that were 
not coordinating. A for-profit transportation provider in one state 
told us that he often has two vehicles overlap on the same route at the 
same time, one for medical trips and one for paratransit,[Footnote 25] 
because it is too difficult to mix clients due to complicated fee 
structures and paperwork requirements imposed by the state for the two 
programs. An official from a workforce development program in another 
state told us that many programs in his county use their own vans to 
deliver clients to the job center, but because the programs do not 
coordinate, only a few people ride in each van. In another locality 
that state and local officials said has had difficulty coordinating, 
several human service providers hired a consultant to study the extent 
to which various agencies provide similar transportation services 
within a geographic region. This research showed substantial overlap in 
local services for the transportation-disadvantaged, as shown in figure 
2. The consultant identified ways in which the number of routes could 
be substantially reduced through better coordination, which are being 
considered by the agencies involved.

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

[See PDF for image]

Note: This picture shows the daily routes of vehicles operated by seven 
different agencies in the same region of Sioux Falls, South Dakota. 
Overlap occurs when routes have the same or nearby starting and ending 
points and are transporting similar clients at similar times. This 
graphic illustrates that many of these agencies have similar starting 
and ending points. Among the agencies shown in this graphic are two 
vocational rehabilitation agencies (serving the same general 
population) as well as agencies that serve low-income clients or 
clients with disabilities. While the graphic cannot show the time 
element, many of these routes represent trips occurring within 30 
minutes of each other in the morning and afternoon.

[End of figure]

State and local officials also provided examples of fragmented services 
and confusion in localities without coordinated programs. One official 
in an uncoordinated area said that a lack of coordination results in 
fragmented services, placing a burden on people who receive 
transportation through many different programs, depending on trip 
purpose, because they must be familiar with multiple systems, rules, 
and requirements. Fragmentation also occurs when adjoining counties do 
not coordinate their public transportation routes, leaving riders 
stranded due to unconnected transit systems. In one state, local 
officials told us that paratransit services do not extend beyond county 
lines, so people have to schedule two separate trips to get from their 
homes in one county to medical services in an adjoining county. When 
the first paratransit ride is behind schedule, a passenger sometimes 
has to wait for hours for the connecting ride. A provider in another 
state has contracts to provide transportation services for clients in 
multiple human service programs. Because of a lack of coordination 
among those programs, the transportation provider said that his company 
has to maintain two separate dispatching and reservation systems for 
its vehicles to comply with differing reporting and eligibility 
requirements. Vehicles can only operate under one dispatching system at 
a time, so the drivers cannot provide rides to more than one type of 
client at a time. The provider also said that clients who call for 
rides are confused by the sheer number of programs, and the agents who 
make their reservations do not know for which programs the clients are 
eligible.

Federal Progress toward Improved Coordination Varies:

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

Some Prior Recommendations to the Coordinating Council Have Been 
Implemented:

As shown in table 4, the Coordinating Council on Access and Mobility--
a body consisting of representatives from DOT and HHS--has responded to 
three of the recommendations we made in our 1999 report[Footnote 26] by 
adopting a strategic plan, developing an action plan, and helping to 
ensure that planned coordination efforts reinforce one another by 
issuing guidelines for coordinating transportation services. Goals and 
objectives in the strategic plan include such things as promoting 
interdepartmental collaboration at the federal level through the 
development of a joint agenda for transportation research that is of 
common use to multiple federal departments. According to the most 
recent action plan, the Council has completed some activities, such as 
producing a series of "how to" publications on using intelligent 
transportation systems to assist in the coordination of HHS programs 
with local transit agencies.

Table 4: Status of Federal Responses to GAO's Recommendations to 
Improve Coordination:

Recommendations from 1999 GAO report: The DOT/ HHS Coordinating Council 
on Access and Mobility should adopt a prioritized strategic plan.; 
Completed: Yes; Under way: No.

Recommendations from 1999 GAO report: The Coordinating Council should 
develop an action plan with specific responsibilities.; Completed: Yes; 
Under way: No.

Recommendations from 1999 GAO report: The Coordinating Council should 
issue an annual report on its major initiatives and accomplishments to 
the Secretaries of DOT and HHS.; Completed: No; Under way: Yes.

Recommendations from 1999 GAO report: DOT and HHS should ensure that 
planned coordination efforts reinforce one another.; Completed: Yes; 
Under way: No.

Recommendations from 1999 GAO report: DOT and HHS should direct their 
regional working groups to assess obstacles to transportation 
coordination.; Completed: No; Under way: Yes.

Recommendations from 1999 GAO report: The Coordinating Council should 
strengthen its Web site and make information available on obstacles to 
coordination and strategies to overcome them.; Completed: No; 
Under way: Yes.

Source: GAO.

[End of table]

The Council's responses to the other three recommendations are still 
ongoing. For example, Council representatives told us that they plan to 
issue their first annual report on coordination achievements in June 
2003, although this report was originally due to be issued in October 
2000, according to the Council's strategic plan. With regard to the 
recommendation on regional working groups, the 10 DOT and HHS regional 
offices have been convening workshops with state transportation 
officials during 2003 to discuss obstacles to coordination and other 
issues.

Finally, the Council's efforts to strengthen its Web site have had 
mixed results. One of the tasks listed in the Council's strategic plan 
is to develop and maintain a Web site that would, among other things, 
enhance the exchange of coordination ideas, issues, and concerns. The 
Council has developed a Web site[Footnote 27]--operated by DOT in 
conjunction with CTAA--that is reachable through a link on the Federal 
Transit Administration's section of DOT's Web site. However, there is 
no similar link from HHS's Web site (or the Web sites of other federal 
agencies that fund transportation services for the transportation-
disadvantaged), possibly making it more difficult for human service and 
other agencies to be aware of and access the site. In addition, the 
site does not yet contain specific information on obstacles to 
coordination or strategies for overcoming them, which we recommended in 
1999, though it does contain links to some reports on the subject. 
There is also a page from which viewers can E-mail the Council with 
questions or suggestions. The Council is working with CTAA to further 
strengthen the site.

DOT and HHS Have Sponsored Other Coordination Activities:

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

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

Coordination Remains Largely Unaddressed in Strategic Planning Efforts:

Because it is not a federal executive branch agency, the Coordinating 
Council is not subject to the requirements of the Government 
Performance and Results Act (GPRA) of 1993[Footnote 29] and, therefore, 
does not have to follow the act's guidance for producing strategic 
plans, annual performance plans, and annual reports. However, there are 
several best practices in strategic planning that could be useful 
guides for improving the Council's strategic plan when it is updated at 
the end of 2003 and the action plan when it is next updated. For 
example, the current strategic plan does not contain an overall mission 
statement for the Council or performance measures that clearly relate 
to its long-term goals and objectives, both of which are considered 
best practices in strategic planning.[Footnote 30] In addition, there 
are no explicit links between the stated goals and objectives in the 
strategic plan and the activities in the action plan. For example, the 
current action plan includes seven tasks related to the use of 
information technology systems, but those tasks are not clearly linked 
to any of the Council's long-term goals or objectives.

Because the Council has no funding or full-time staff of its own, it is 
dependent on support from HHS and DOT. However, neither department 
currently highlights the coordination of services for the 
transportation-disadvantaged as a priority in its long-term strategic 
plan or annual performance plan. According to GPRA guidance, agencies 
are encouraged to identify programs with common purposes or 
crosscutting issues in their strategic plans. In addition, the 
agencies' annual performance plans should identify performance goals 
that reflect activities being undertaken to support programs of a 
crosscutting nature, and show evidence of coordination among 
crosscutting programs.[Footnote 31] DOT's most recent strategic plan 
and performance plan do not explicitly mention the Coordinating 
Council, although both briefly discuss coordinating special-needs 
transportation with other federal agencies under DOT's Job Access and 
Reverse Commute (JARC) program. However, there is no mention of 
coordination of DOT's Transit Capital Assistance Program for Elderly 
Persons and Persons with Disabilities with other programs for elderly 
or disabled populations.[Footnote 32] At the subagency level, the 
Federal Transit Administration's strategic plan includes the 
Coordinating Council in an appendix on coordination of crosscutting 
functions, under the strategic goal of promoting economic growth and 
trade, and its performance plan mentions working with the Council under 
a different goal--that of promoting mobility and 
accessibility.[Footnote 33]

HHS's current strategic plan does not discuss coordination of 
transportation services with other agencies, but its draft plan for 
2003-2008 specifically lists DOT and state and local transportation and 
human service agencies as important partners in providing 
transportation to access services in distressed communities and for 
health care and employment and training programs elsewhere. Education, 
DOL, HUD, and VA are not listed, however.[Footnote 34] The performance 
plans of individual HHS components vary widely in their treatment of 
transportation coordination. For example, the performance plan of the 
Centers for Medicare & Medicaid does not mention transportation at all, 
while the Administration on Aging's performance plan states that the 
agency works closely with HHS and DOT officials on the Coordinating 
Council in pursuit of improved transportation services.

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

Other Federal Agencies Are Involved in Some Coordination Efforts:

Other federal agencies are also involved in some coordination efforts 
outside the scope of the Council. For example, DOL is working with CTAA 
and DOT to implement several rounds of pilot projects testing various 
transportation strategies in support of local one-stop employment and 
training centers.[Footnote 35] Officials from DOT and DOL are also in 
the process of developing guidelines for using Workforce Investment Act 
funds (a DOL program) for Job Access purposes (a DOT program). In 
addition, some of DOL's research studies and technical assistance 
materials provide examples of transportation coordination 
efforts.[Footnote 36] However, we did not find examples of involvement 
in transportation coordination efforts at the national level at the 
Departments of Education, HUD, and VA, although some of these agencies 
are involved in transportation working groups in some of the federal 
regional offices. The membership of the Coordinating Council only 
consists of DOT and HHS officials, representing less than half of the 
62 federal programs that can be used to fund services for the 
transportation-disadvantaged. Although these two agencies comprise the 
majority of funding for transportation that we were able to identify, 
the Departments of Labor and Education also have a significant number 
of programs--more than one-third of the total--that provide services to 
the transportation-disadvantaged. Officials from the Council said that 
other agencies had expressed interest in coordination activities and 
had been invited to observe Council meetings in the past, but only DOL 
sent a representative for a short time period.[Footnote 37] Council 
officials said it would be very beneficial to have other agencies 
formally involved in their coordination efforts, which would require a 
renewal of the Council's charter and memorandums of understanding among 
all agencies involved as well as other formal mechanisms to ensure that 
the proper people are engaged in the effort.

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

Although some federal, state, and local agencies encourage the 
coordination of services for the transportation-disadvantaged and some 
coordination efforts have been established, federal, state, and local 
officials, as well as representatives of national advocacy and industry 
organizations with whom we spoke, identified numerous obstacles that 
impede effective coordination. We clustered the wide range of 
identified obstacles into three categories related to (1) sharing 
vehicles and the low priority given to funding coordination activities; 
(2) programmatic differences; and (3) limited federal, state, and local 
leadership and commitment to undertake and sustain coordination 
efforts. To mitigate these obstacles, these officials and other experts 
suggested three potential options: harmonizing standards and 
requirements among federal programs with a transportation component, 
providing and disseminating additional guidance and information on 
coordination, and providing financial incentives or mandates to 
coordinate.

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

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

Apprehension about Sharing Vehicles:

In interviews in every state we visited, as well as with national 
advocacy and industry organizations, the unwillingness or inability to 
share vehicles was identified as a major obstacle. Administrators of 
some federal programs may be apprehensive about sharing vehicles for 
coordination due, in part, to their belief that only they understand 
their clients' needs and can provide the necessary personalized 
services. For example, program administrators reported being concerned 
about a loss of control over the quality and convenience of 
transportation services for their clients and wanted to maintain their 
discretion over how to serve their clients and which transportation 
resources to purchase. Program administrators also expressed concern 
over mixing vulnerable populations, such as the developmentally 
disabled and children, or frail, sick, and healthy populations, in one 
coordinated system. According to a report on coordinated transportation 
systems, this reluctance among providers to cooperate can lead to an 
underutilization of vehicles.[Footnote 38] Likewise, some human service 
clients may be apprehensive about using coordinated transportation 
because they may be uncomfortable mixing with members of other 
populations with whom they are unfamiliar or they may fear a loss of 
accommodation or convenience, such as having to switch from door-to-
door service to curb-to-curb service or public transit.

Low Priority Given to Funding Coordination Activities:

The overall costs of coordination, which can include additional staff 
members and staff time needed for maintaining and overseeing 
coordination efforts, can be significant. For example, a transportation 
brokerage firm in one state faced substantial added costs when it began 
coordinating transportation for human services programs due to 
requirements to meet more stringent state and federal safety standards. 
However, some officials stated that the low priority given to funding 
coordination activities could impede coordination efforts. For example, 
according to officials in one state, although recipients of funds from 
DOT's Capital Assistance Program for Elderly Persons and Persons with 
Disabilities are required to coordinate with other local transportation 
services provided from federal sources, the program's current allotment 
for administrative expenses would not support any staff to work on 
coordination activities. In addition, some states invest in 
coordination, while others do not allocate funds specifically for 
coordination, and efforts to coordinate often become ancillary 
activities for those involved.

Limited Transportation Services Available to Realize Benefits from 
Coordination:

Guidelines issued by the Coordinating Council state that coordination 
will not solve all transportation problems in all communities.[Footnote 
39] Coordination may not be an effective strategy in those communities 
that have limited transportation services available, particularly in 
those communities that are not served by public transportation. For 
example, in some remote areas--such as the northwestern part of South 
Dakota where services available to many communities are 40 to 60 miles 
away--there are few transportation services available to transport 
individuals to hospitals or other services. In these areas, 
coordination may not be a workable or cost-effective option.

Differing Program Requirements Can Impede Coordination:

Coordinating multiple programs administered at various levels of 
government is complicated because the programs have different 
requirements with respect to eligibility, funding, reporting, and 
safety; and they differ in their programmatic goals and missions.

Different Eligibility Requirements:

Federal program rules that specify the eligible populations that each 
program can serve may limit opportunities for collaboration. For 
example, DOT officials in one region stated that they were unable to 
combine DOL and DOT funds for a DOT transportation program for migrant 
farm workers because DOL funds are designated for U.S. citizens, while 
there is no such restriction on the use of DOT funds. In addition, some 
liability insurance policies specify that a program's vehicles may 
serve only a certain population, thus those programs face additional 
insurance costs to transport individuals other than program clients. 
Such restrictions may lead to inefficient transportation services 
within a community. For example, an official in one state we visited 
commented that one agency's vehicle provided medically related trips 
three times per week to that agency's clients, but would not transport 
other individuals seeking similar medical services provided under other 
federal programs due, in part, to liability insurance restrictions. 
Safety requirements may also vary by program and jurisdiction, thus 
complicating efforts to transport multiple client groups. Some 
programs, such as Head Start, have specific vehicle standards that are 
often more stringent than those of other programs, making it difficult 
to share vehicles. For instance, different standards for roof strength, 
types of seat belts, and driver qualifications pose problems for 
schools, human service agencies, and public transit providers 
interested in sharing vehicles. Some areas have been able to overcome 
specific program rules to share vehicles. For example, a Head Start 
grantee in one state we visited was able to transport students using 
vehicles supplied by the local public transit provider because these 
vehicles met the same safety standards as school buses.

Varying Funding Streams and Cycles:

Funding streams and cycles vary across federal programs, making 
coordination more difficult. For example, DOT funds generally flow from 
the state to counties or cities, while DOL funds flow through the state 
to local designees. In addition, funding for programs such as Head 
Start flow directly to grantees rather than through states, making it 
more difficult for the states to directly manage the coordination 
activities of local grantees, according to an official in one state. 
There is also complexity in working with different funding time frames 
and cycles under multiple federal programs. For example, although DOT's 
JARC program allows grantees to use other federal funds to provide the 
local "match" required to obtain JARC funds, the funding time frames 
and cycles of these other funding sources are different, complicating 
efforts to combine financial resources.

Lack of Uniform Data Collection and Reporting Requirements among 
Programs:

Different reporting requirements among programs can create excessive 
paperwork in a coordinated system and may make it difficult for 
agencies to determine their true transportation costs and the benefits 
that may be realized from coordination. For example, one report 
commented that a transit provider was required to give each of several 
human service agencies a separate bill for services provided, which 
reflected the unique requirements imposed by each of those 
agencies.[Footnote 40] Furthermore, according to officials, Medicaid 
requires the state Medicaid agency to demonstrate that individuals 
receiving transportation under Medicaid are not receiving 
transportation from any other source and that the transportation is 
medically necessary, complicating the determination of how to fund 
transportation services for each Medicaid recipient in a coordinated 
system in which costs are shared among agencies. In addition, human 
service agencies and providers may not be required or accustomed to 
collecting complete and uniform transportation data for their programs. 
A recent report concluded that such information was beneficial because 
it enabled administrators to re-evaluate how best to provide 
transportation services and the savings they could achieve through 
coordination.[Footnote 41] For example, when Florida's statewide 
coordination program was established, state and local agencies in 
Florida reported their total estimated annual transportation-related 
expenditures at $8 million. However, once reporting requirements were 
in place for all agencies providing services for the transportation-
disadvantaged, actual expenditures were estimated to total $224.9 
million statewide--much higher than the initial estimate. Such 
information has helped agencies in Florida understand the true costs of 
providing transportation and has encouraged some agencies to become 
more interested in coordination as they realize the potential for cost 
savings.

Distinct Purposes and Goals among Agencies:

Unlike transportation agencies, human service agencies provide 
transportation as a secondary service so that their clients may access 
primary human services. Therefore, while DOT-funded transportation 
agencies have specific and relatively uniform federal requirements for 
transportation planning, human service agencies do not typically 
conduct transportation planning or collect transportation-related data 
for their programs, making the planning of coordinated transportation 
between transit and human service agencies challenging.[Footnote 42] In 
addition, human service, transportation, medical, and workforce 
agencies all have distinct technical languages and cultures, which may 
inhibit collaboration among these agencies. In one state we visited, 
the labor and transportation departments experienced difficulty 
collaborating because some common terms have completely different 
meanings within each agency. For example, transportation officials 
interpreted the term "cost-allocation" as an accounting methodology to 
estimate the overall cost of operating transportation services in order 
to determine the appropriate rate to charge for these services, while 
state labor officials interpreted the term as a way to determine what 
proportion of overall costs will be funded by each agency.

Program Officials May Not Know How to Coordinate Effectively:

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

Limited Federal Guidance and Information on Coordination:

Officials in some states we visited said that they receive little 
federal guidance on potential strategies to coordinate services. As a 
result, they develop their own approaches without the benefit of 
guidance on the most effective way to coordinate services. We found the 
following examples of this in our work:

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

* While FTA disseminated coordination guidelines for FTA and HHS 
programs to transportation officials, some HHS and transportation 
officials said these guidelines were not widely disseminated to human 
services officials or programs.

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

* The Coordinating Council on Access and Mobility has limited 
visibility for agencies actually involved in implementing coordination 
efforts. In several states, human service program administrators with 
whom we spoke were not aware of the Council or its Web site.

Limited State Guidance and Leadership on Coordination:

In the five states we visited--even in those states with a coordinating 
body--there was limited state guidance to help local areas implement 
coordination, and some officials stated that the lack of leadership and 
commitment at the state level was a major obstacle to local 
coordination. In addition, while some states have established 
coordinating councils or bodies or have designated a lead agency for 
coordination, nearly half of the states have no coordinating body, 
according to one report.[Footnote 43] Officials in one state explained 
that the lack of a coordinating body that requires various agencies to 
discuss and resolve transportation issues is the main obstacle toward a 
more coordinated system.

Limited Local Leadership and Commitment to Coordinate:

Even in states with a coordinating council or a lead state agency, 
there may be a lack of local leadership or commitment to coordination 
efforts. For example, one city we visited was unsuccessful in achieving 
a coordinated system despite state encouragement to coordinate and some 
state-provided technical assistance. Stakeholders there described a 
lack of local commitment and leadership in maintaining lines of 
communication among those involved in coordination efforts as a factor 
leading to the failure. In addition, program administrators may not 
have data on the extent of existing transportation services that may be 
available to their clients within a geographic region and, therefore, 
may fail to realize the extent of overlapping and complementary 
services within their local area. Such data can produce improvements. 
For example, in response to a lack of data on local services, an agency 
in one state we visited took the lead in conducting a study that showed 
the extent to which various agencies provide similar transportation 
services within a geographic region. An agency official was hopeful 
that once other agencies saw the extent of overlap, they would be more 
willing to coordinate.

Potential Options to Improve Coordination:

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

Harmonizing Program Standards and Requirements:

Officials and experts expressed a need to harmonize requirements among 
federal programs, such as providing more flexible regulatory language 
that would allow providers to serve additional client groups, creating 
consistent cost accounting methods, and adopting common safety 
standards. For example, one official commented that federal program 
regulations could include language permitting other client groups to 
make use of available transportation options. Also, some officials 
believed that adopting standard accounting procedures among all federal 
human service programs could provide a consistent measure for comparing 
services, allowing administrators to evaluate how best to provide 
transportation services and determine the savings they could achieve 
through coordination. Likewise, making standards for safety (e.g., 
types of seat belts), driver training, and liability insurance 
provisions uniform among federal human service programs, as 
appropriate, may facilitate the shared use of vehicles and drivers in 
one coordinated system, according to some officials. Finally, some 
officials suggested that federal grant programs that allow the use of 
funds from multiple sources should be under the same funding cycle or 
time frame so that these funds may be combined more easily. These 
officials also commented that harmonizing the time frames under which 
federal funding is allocated could possibly aid collaborative planning. 
However, differing program standards exist to ensure that the distinct 
needs of specific target populations are adequately served and that 
agencies maintain accountability for providing these services. Thus, 
the benefits from any change in standards or requirements would need to 
be balanced against continuing to properly meet client needs and 
sufficiently control funds distributed to grantees. In addition, 
harmonizing program standards and requirements among 62 federal 
programs authorized by more than 20 pieces of legislation would 
necessitate extensive legislative changes and could impose additional 
costs for agencies to meet new requirements.

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

Some officials advocated expanding the number of agencies involved in 
coordination, establishing interagency forums, and improving central 
clearinghouses as ways to better develop and disseminate guidance on 
coordination. To enhance coordination efforts at the federal level, 
some officials suggested expanding the membership of the Coordinating 
Council on Access and Mobility to include additional federal agencies, 
so that a broader array of agencies that serve the transportation-
disadvantaged are represented. This could include agencies such as DOL 
and the Department of Education that we identified as being significant 
because a large number of their programs authorize funding of 
transportation services for the transportation-disadvantaged. In 
addition, establishing state-level forums may also facilitate 
communication among agencies involved in coordination and can lead to 
benefits. For example, one state has established an interagency task 
force on transportation coordination, which has resulted in a number of 
benefits--including the pooling of vehicles and the expansion of 
services--in some areas of the state. Some officials and experts 
suggested that federal agencies provide additional guidance and other 
information that result from forums or other sources to clearly define 
the allowable uses of funds, assist agencies in developing cost-sharing 
arrangements for transporting common clientele, and encourage the 
establishment and participation in interagency forums. This additional 
guidance and information could be better disseminated through a central 
clearinghouse, such as the Coordinating Council's Web site.

Providing Financial Incentives or Mandates:

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

* Federal grant applications could contain provisions giving priority 
in funding to those grantees committed to coordination efforts.

* With legislative changes, current funds allotted by multiple federal 
sources could be combined into one federal, state, or local fund for 
transportation services for the transportation-disadvantaged.

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

However, officials pointed out that these options also had some 
potential downsides that would need to be carefully considered. For 
example, combining funds into a single source could result in some 
populations being unfairly overlooked because smaller agencies at the 
state or local level would be at a disadvantage in competing for 
funding with larger agencies serving more clients. Several officials 
also raised concerns about mandates to coordinate. For example, some 
officials said that mandates might reduce the flexibility of agencies 
to design and deliver transportation services that specifically address 
their communities' needs. In addition, some officials noted that state 
efforts or mandates might not guarantee successful local coordination. 
For example, a city in one state we visited was unsuccessful in 
coordinating its multiple transportation services despite state 
encouragement to do so and despite losing some federal funding as a 
result.

Conclusions:

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

There is great diversity in the specific suggestions we received about 
how to overcome obstacles to greater coordination. Two of the three 
main options raised by various officials we interviewed--making federal 
program standards more uniform and creating some type of requirement or 
financial incentive for coordination--would require substantial 
statutory or regulatory changes and include potential costs. The third 
option, expanding forums and disseminating guidance, can be done in the 
context of existing laws, regulations, and procedures, and may, 
therefore, be the most expeditious starting point. In this regard, 
clarification from federal agencies about how funds can be used for 
coordination could help state and local agencies overcome some of the 
obstacles identified. Similarly, state and local agencies may be in a 
better position to coordinate efforts if they have more knowledge about 
what has worked elsewhere. Although the Council has a Web site with 
information about coordinating transportation services, some state and 
local officials were unaware of it. State and local officials' point of 
contact is more likely to be the Web site of the department 
administering the program at the federal level. Establishing better 
links between the Council's Web site and the sites of the departments 
could help connect grantees with information that may help them 
coordinate with other programs, better serve clients, and use funds 
more efficiently.

Recommendations for Executive Action:

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

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

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

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

* Develop and distribute additional guidance to states and other 
grantees that encourages coordinated transportation by clearly defining 
the allowable uses of funds, explaining how to develop cost-sharing 
arrangements for transporting common clientele, and clarifying whether 
funds can be used to serve individuals other than the program's target 
population.

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

Agency Comments and Our Evaluation:

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

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

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

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

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

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

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

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

Katherine Siggerud 
Acting Director 
Physical Infrastructure Issues:

Signed by Katherine Siggerud: 

[End of section]

Appendix I: Scope and Methodology:

Our scope of work included federal programs that provide transportation 
services to the transportation-disadvantaged. To provide information on 
the purposes and types of such federal programs, we first determined 
the universe of programs by reviewing an existing inventory produced by 
the Community Transportation Association of America[Footnote 44] and a 
report prepared for the Coordinating Council on Access and 
Mobility.[Footnote 45] We then supplemented and modified this inventory 
of programs on the basis of interviews with agency officials and 
searches of the Catalog of Federal Domestic Assistance. We included 
only those programs that provide nonemergency, nonmilitary, surface 
transportation services of any kind, targeted to transportation-
disadvantaged populations. We interviewed program administrators to 
identify the general target population and the types of transportation 
services and trips that are typically provided under each program.

To address the issues related to program funding, effects of 
coordination, and coordination obstacles and options, we (1) conducted 
interviews and document reviews in the pertinent eight federal agencies 
that administer the 62 federal programs that fund transportation 
services for the transportation-disadvantaged; (2) conducted five case 
studies in Arizona, Florida, New York, South Dakota, and Wisconsin; (3) 
reviewed the literature on the challenges encountered in coordinating 
services for the transportation-disadvantaged; and (4) interviewed 
industry representatives and advocacy groups representing elderly and 
disabled populations. We did not verify spending data or estimates 
received from federal agencies for accuracy.

At the federal level, we interviewed officials from the headquarters of 
the Federal Transit Administration in the Department of Transportation; 
the Administration on Aging, the Administration for Children and 
Families, the Centers for Medicare & Medicaid Services, the Health 
Resources Services Administration, the Office of Intergovernmental 
Affairs, and the Substance Abuse and Mental Health Services 
Administration in the Department of Health and Human Services; the 
Employment and Training Administration in the Department of Labor; the 
Department of Agriculture; the Department of Education; the Department 
of Housing and Urban Development; the Department of the Interior; and 
the Department of Veterans Affairs. We also interviewed federal 
officials from the 10 regional offices of the Federal Transit 
Administration and some regional officials in the Departments of Health 
and Human Services and Labor. The federal officials we met with 
included representatives of the Coordinating Council on Access and 
Mobility from the Federal Transit Administration and the Department of 
Health and Human Services.

In conducting our case studies in the five states, we reviewed 
documentation and interviewed more than 100 officials from state and 
local transportation and human service agencies and service providers, 
as well as consumers of transportation services. We judgmentally chose 
the states to include three states without a state mandate or state 
coordinating body and two states with such conditions. We also chose 
states on the basis of relative concentrations of elderly, disabled, 
and low-income populations, and for some, geographic dispersion. Within 
each state, we spoke with state officials responsible for coordinating 
transportation services for the transportation-disadvantaged and/or 
overseeing funds from the 62 federal programs we identified. We also 
asked some of these state officials for recommendations of local 
officials and transportation providers to interview in a range of 
urban, suburban, and rural areas and coordinated and uncoordinated 
programs within the state.

Finally, we interviewed representatives of professional, industry, and 
advocacy organizations that are part of the National Consortium on the 
Coordination of Human Services Transportation, a group that represents 
a broad spectrum of stakeholders involved with coordination of 
transportation for the disadvantaged. We conducted our work from July 
2002 through June 2003 in accordance with generally accepted government 
auditing standards.

[End of section]

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

Program: Department of Agriculture, Food and Nutrition Service:

Program: Food Stamp Employment and Training Program; Popular title of 
authorizing legislation: Service: Food Stamp Act of 1977, as amended; 
U.S. Code provisions authorizing funds for transportation: 
7 U.S.C. § 2015(d)(4)(I)(i)(I); Typical uses as reported by program 
officials: Reimbursement or advanced payment for gasoline 
expenses or bus fare; Types of trips as reported by program officials: 
To access education, training, employment services, and employment 
placements; Target population as defined by program officials[A]: 
Low-income persons between the ages of 16 and 59; Fiscal year 2001 
federal spending on transportation[B]: $12,952,956[C]. 

Program: Department of Education, Office of Elementary and Secondary 
Education:

Program: 21st-Century Community Learning Centers; Popular title of 
authorizing legislation: No Child Left Behind Act of 2001; U.S. Code 
provisions authorizing funds for transportation: 20 U.S.C. § 7173(a)
(10); Typical uses as reported by program officials: Contract for 
service; Types of trips as reported by program officials: To access 
educational services; Target population as defined by program 
officials[A]: Students from low-income families; Fiscal year 2001 
federal spending on transportation[B]: $84,600,000 (estimate)[D].

Program: Department of Education, Office of Innovation and Improvement: 

Program: Voluntary Public School Choice; Popular title of authorizing 
legislation: No Child Left Behind Act of 2001; U.S. Code provisions 
authorizing funds for transportation: 20 U.S.C. § 7225a(a); Typical 
uses as reported by program officials: Contract for services, purchase 
and operate vehicles, hire bus drivers 
and transportation directors, purchase bus passes, redesign 
transportation plans including new routing systems, offer professional 
development for bus drivers; Types of trips as reported by program 
officials: To access educational services and programs; Target 
population as defined by program officials[A]: Students from under-
performing schools who choose to transfer to higher performing schools; 
Fiscal year 2001 federal spending on transportation[B]: New program, no 
actual data or estimate available from the federal agency.

Program: Department of Education, Office of Special Education and 
Rehabilitative Services:

Program: Assistance for Education of All Children with Disabilities; 
Popular title of authorizing legislation: 
Individuals with Disabilities Education Act; U.S. Code provisions 
authorizing funds for transportation: 20 U.S.C. §§ 1401(a)(22), 
1411(a)(1); Typical uses as reported by program officials: Purchase and 
operate vehicles, contract for service; Types of trips as reported by 
program officials: To access educational services; Target population as 
defined by program officials[A]: Children with disabilities; Fiscal 
year 2001 federal spending on transportation[B]: No actual data or 
estimate available from the federal agency.

Program: Centers for Independent Living; Popular title of authorizing 
legislation: Workforce Investment Act of 1998; U.S. Code provisions 
authorizing funds for transportation: 29 U.S.C. §§ 796f-4(b)(3) and 
705(18)(xi); Typical uses as reported by program officials: 
Referral, assistance, and training in the use of 
public transportation; Types of trips as reported by program officials: 
To access program services; Target population as defined by program 
officials[A]: Persons with a significant disability; Fiscal year 2001 
federal spending on transportation[B]: No actual data or estimate 
available from the federal agency.

Program: Independent Living Services for Older Individuals Who Are 
Blind; Popular title of authorizing legislation: Department of 
Agriculture, Workforce Investment Act of 1998; U.S. Code provisions 
authorizing funds for transportation: 29 U.S.C. § 796k(e)(5); 
Typical uses as reported by program officials: Department of 
Agriculture, Referral, assistance, and 
training in the use of public transportation; Types of trips as 
reported by program officials: To access program services, for general 
trips; Target population as defined by program officials[A]: Persons 
aged 55 or older who have significant visual impairment; Fiscal year 
2001 federal spending on transportation[B]: No actual data or estimate 
available from the federal agency.

Program: Independent Living State Grants; Popular title of authorizing 
legislation: Workforce Investment Act of 1998; U.S. Code provisions 
authorizing funds for transportation: 
29 U.S.C. §§ 796e-2(1) and 705(18)(xi); Typical uses as 
reported by program officials: Referral, assistance, and training in 
the use of public transportation; Types of trips as reported by 
program officials: To access program services, employment 
opportunities; Target population as defined by program officials[A]: 
Persons with a significant disability; Fiscal year 2001 federal 
spending on transportation[B]: No actual data or estimate available 
from the federal agency.

Program: Supported Employment Services for Individuals with Most 
Significant Disabilities; Popular title of authorizing legislation: 
Workforce 
Investment Act of 1998; U.S. Code provisions authorizing funds for 
transportation: 
29 U.S.C. §§ 795g and 705(36); Typical uses as reported by program 
officials: 
Transit subsidies for public and private transportation (e.g. bus, 
taxi, and paratransit), training in the use of public transportation; 
Types of trips as reported by program officials: To access employment 
placements, employment services, and vocational rehabilitation 
services; Target population as defined by program officials[A]: Persons 
with most significant disabilities; Fiscal year 2001 federal spending 
on transportation[B]: No actual data or estimate available from the 
federal agency[E].

Program: Vocational Rehabilitation Grants; Popular title of authorizing 
legislation: 
Rehabilitation Act of 1973, as amended; U.S. Code provisions 
authorizing funds for transportation
29 U.S.C. § 723(a)(8); Typical uses as reported 
by program officials: 
Transit subsidies for public and private transportation (e.g. 
bus, taxi, and paratransit), training in the use of public 
transportation; Types of trips as reported by program officials: To 
access employment placements, employment services, and vocational 
rehabilitation services; Target population as defined by program 
officials[A]: Persons with physical or mental impairments; Fiscal year 
2001 federal spending on transportation[B]: $50,700,000 (estimate)[E].

Program: Department of Health and Human Services, Administration for 
Children and Families:

Program: Child Care and Development Fund; Popular title of authorizing 
legislation: 
Child Care and Development Block Grant Act of 1990, as amended; U.S. 
Code provisions authorizing funds for transportation: Department of 
Agriculture, 42 U.S.C. § 9858c; Typical 
uses as reported by program officials
States rarely use CCDF funds for transportation 
and only under very restricted circumstances; Types of trips as 
reported by program officials: To access child care services; Target 
population as defined by program officials[A]: Children from low-income 
families; Fiscal year 2001 federal spending on transportation[B]: $0 
(estimate)[F].

Program: Community Services Block Grant Programs; Popular title of 
authorizing legislation: 
Community Opportunities, Accountability, Training, and 
Educational Services Act of 1998; U.S. Code provisions authorizing 
funds for transportation: 
42 U.S.C. § 9904; Typical uses as reported by program 
officials: Taxi 
vouchers, bus tokens; Types of trips as reported by program officials: 
General trips; Target population as defined by program officials[A]: 
Low-income persons; Fiscal year 2001 federal spending on 
transportation[B]: No actual data or estimate available from the 
federal agency.

Program: Developmental Disabilities Projects of National Significance; 
Popular title of authorizing legislation: 
Developmental Disabilities Assistance and 
Bill of Rights Act of 2000; U.S. Code provisions authorizing funds for 
transportation: 
42 U.S.C. §§ 15002, 15081(2)(D); Typical uses as reported by program 
officials: 
Transportation information, feasibility studies, planning; Types of 
trips as reported by program officials: General trips; Target 
population as defined by program officials[A]: Persons with 
developmental disabilities; Fiscal year 2001 federal spending on 
transportation[B]: No actual data or estimate available from the 
federal agency[G].

Program: Head Start; Popular title of authorizing legislation: 
Augustus F. 
Hawkins Human Services Reauthorization Act of 1990; U.S. Code 
provisions authorizing funds for transportation: Department of 
Agriculture, 42 USCA § 9835(a)(3)(C) (ii); 
Typical uses as reported by program officials: Department of 
Agriculture, Purchase and operate vehicles, 
contract with transportation providers, coordinate with local education 
agencies; Types of trips as reported by program officials: To access 
educational services; Target population as defined by program 
officials[A]: Children from low-income families; Fiscal year 2001 
federal spending on transportation[B]: $514,500,000 (estimate)[H].

Program: Refugee and Entrant Assistance Discretionary Grants; Popular 
title of authorizing legislation: 
Refugee Act of 1980, as amended; U.S. Code 
provisions authorizing funds for transportation: Department of 
Agriculture, 8 U.S.C. §§ 1522(b)(7)(D), 
1522(c); Typical uses as reported by program officials: Department of 
Agriculture, Bus passes; Types of trips as 
reported by program officials: To access employment and educational 
services; Target population as defined by program officials[A]: 
Refugees; Fiscal year 2001 federal spending on transportation[B]: No 
actual data or estimate available from the federal agency.

Program: Refugee and Entrant Assistance State Administered Programs; 
Popular title of authorizing legislation: 
Refugee Act of 1980, as amended; U.S. Code 
provisions authorizing funds for transportation: Department of 
Agriculture, 8 U.S.C. §§ 1522(b)(7)(D), 
1522(c); Typical uses as reported by program officials: Department of 
Agriculture, Bus passes; Types of trips as 
reported by program officials: To access employment and educational 
services; Target population as defined by program officials[A]: 
Refugees; Fiscal year 2001 federal spending on transportation[B]: No 
actual data or estimate available from the federal agency.

Program: Refugee and Entrant Assistance Targeted Assistance; Popular 
title of authorizing legislation: 
Refugee Act of 1980, as amended; U.S. Code 
provisions authorizing funds for transportation: Department of 
Agriculture, 8 U.S.C. §§ 1522(b)(7)(D), 
1522(c); Typical uses as reported by program officials: Department of 
Agriculture, Bus passes; Types of trips as 
reported by program officials: To access employment and educational 
services; Target population as defined by program officials[A]: 
Refugees; Fiscal year 2001 federal spending on transportation[B]: No 
actual data or estimate available from the federal agency.

Program: Refugee and Entrant Assistance Voluntary Agency Programs; 
Popular title of authorizing legislation: 
Refugee Act of 1980, as amended; U.S. Code 
provisions authorizing funds for transportation: Department of 
Agriculture, 8 U.S.C. §§ 1522(b)(7)(D), 
1522(c); Typical uses as reported by program officials: Department of 
Agriculture, Bus passes; Types of trips as 
reported by program officials: To access employment and educational 
services; Target population as defined by program officials[A]: 
Refugees; Fiscal year 2001 federal spending on transportation[B]: No 
actual data or estimate available from the federal agency.

Program: Social Services Block Grants; Popular title of authorizing 
legislation: 
Social Security Act, as amended; U.S. Code provisions authorizing funds 
for transportation: 
42 U.S.C. § 1397a(a)(2)(A); Typical uses as reported by 
program officials: 
Any transportation-related use; Types of trips as reported by 
program officials: To access medical or social services; Target 
population as defined by program officials[A]: States determine what 
categories of families and children; Fiscal year 2001 federal spending 
on transportation[B]: $18,459,393.

Program: State Councils on Developmental Disabilities and Protection 
and Advocacy Systems; Popular title of authorizing legislation: 
Developmental 
Disabilities Assistance and Bill of Rights Act of 2000; U.S. Code 
provisions authorizing funds for transportation: Department of 
Agriculture, 42 U.S.C. §§ 15002, 15025; 
Typical uses as reported by program officials: Department of 
Agriculture, State Councils provide small 
grants and contracts to local organizations to establish transportation 
projects or collaborate in improving transportation for people with 
disabilities; Protection and Advocacy Systems ensure that people with 
disabilities have access to public transportation as required by law; 
Types of trips as reported by program officials: All or general trips; 
Target population as defined by program officials[A]: Persons with 
developmental disabilities and family members; Fiscal year 2001 federal 
spending on transportation[B]: $786,605 (partial outlay)[I].

Program: Temporary Assistance for Needy Families; Popular title of 
authorizing legislation: 
Personal Responsibility and Work Opportunity Reconciliation 
Act of 1996, as amended; U.S. Code provisions authorizing funds for 
transportation: 
42 U.S.C. §§ 604(a), (k); Typical uses as reported by program 
officials: Any 
use that is reasonably calculated to accomplish a purpose of the TANF 
program and the allowable matching portion of JARC grants; Types of 
trips as reported by program officials: General trips; Target 
population as defined by program officials[A]: No assistance is 
provided to families without a minor child, but states determine 
specific eligibility; Fiscal year 2001 federal spending on 
transportation[B]: $160,462,214 (partial outlay)[J].

Program: Department of Health and Human Services, Administration on 
Aging:

Program: Grants for Supportive Services and Senior Centers; Popular 
title of authorizing legislation: 
Older Americans Act of 1965, as amended; U.S. Code 
provisions authorizing funds for transportation: Department of 
Agriculture, 42 U.S.C. § 3030d (a)(2); 
Typical uses as reported by program officials: Department of 
Agriculture, Contract for services; Types 
of trips as reported by program officials: To access program services, 
medical, and for general trips; Target population as defined by program 
officials[A]: Program is targeted to persons aged 60 or over; Fiscal 
year 2001 federal spending on transportation[B]: $72,496,003.

Program: Program for American Indian, Alaskan Native, and Native 
Hawaiian Elders; Popular title of authorizing legislation: Department 
of Agriculture, Older Americans Act of 
1965, as amended; U.S. Code provisions authorizing funds for 
transportation: 
42 U.S.C. §§ 3057, 3030d(a)(2); Typical uses as reported by program 
officials: 
Purchase and operate vehicles; Types of trips as reported by program 
officials: To access program services, medical, and for general trips; 
Target population as defined by program officials[A]: Program is for 
American Indian, Alaskan Native, and Native Hawaiian elders; Fiscal 
year 2001 federal spending on transportation[B]: No actual data or 
estimate available from the federal agency.

Program: Department of Health and Human Services, Centers for Medicare 
& Medicaid Services:

Program: Medicaid; Popular title of authorizing legislation: Department 
of Agriculture, Social Security Act, as 
amended; U.S. Code provisions authorizing funds for transportation: 
42 U.S.C. §§ 
1396a, 1396n(e)(1)(A); Typical uses as reported by program officials: 
Bus tokens, 
subway passes, brokerage services; Types of trips as reported by 
program officials: To access health care services; Target population as 
defined by program officials[A]: Recipients are generally low-income 
persons, but states determine specific eligibility; Fiscal year 2001 
federal spending on transportation[B]: $976,200,000 (estimate)[K].

Program: State Children's Health Insurance Program; Popular title of 
authorizing legislation: 
Medicare, Medicaid, and SCHIP Benefits Improvement and 
Protection Act of 2000; U.S. Code provisions authorizing funds for 
transportation: 
42 U.S.C. §§ 1397jj(a)(26), (27); Typical uses as reported by program 
officials: Any 
transportation-related use; Types of trips as reported by program 
officials: To access health care services; Target population as defined 
by program officials[A]: Beneficiaries are primarily children from low-
income families, but states determine eligibility; Fiscal year 2001 
federal spending on transportation[B]: $4,398,089.

Program: Department of Health and Human Services, Health Resources and 
Services Administration:

Program: Community Health Centers; Popular title of authorizing 
legislation: 
Public Health Service Act, as amended; U.S. Code provisions authorizing 
funds for transportation: 
42 U.S.C. § 254b(b)(1)(A) (iv); Typical uses as reported by 
program officials: 
Bus tokens, vouchers, transportation coordinators, and 
drivers; Types of trips as reported by program officials: To access 
health care services; Target population as defined by program 
officials[A]: Medically underserved populations; Fiscal year 2001 
federal spending on transportation[B]: $4,200,000 (estimate)[L].

Program: Healthy Communities Access Program; Popular title of 
authorizing legislation: 
Public Health Service Act, as amended; U.S. Code provisions 
authorizing funds for transportation
42 U.S.C. § 256(e)(1)(B)(iii); Typical uses as 
reported by program officials: 
Improve coordination of transportation; Types of 
trips as reported by program officials: To access health care services; 
Target population as defined by program officials[A]: Uninsured or 
underinsured populations; Fiscal year 2001 federal spending on 
transportation[B]: No actual data or estimate available from the 
federal agency.

Program: Healthy Start Initiative; Popular title of authorizing 
legislation: 
Public Health Service Act, as amended; U.S. Code provisions authorizing 
funds for transportation: 
42 U.S.C. § 254c-8(e)(1); Typical uses as reported by program 
officials: Bus 
tokens, taxi vouchers, reimbursement for use of own vehicle; Types of 
trips as reported by program officials: To access health care services; 
Target population as defined by program officials[A]: Residents of 
areas with significant perinatal health disparities; Fiscal year 2001 
federal spending on transportation[B]: No actual data or estimate 
available from the federal agency.

Program: HIV Care Formula Grants; Popular title of authorizing 
legislation: 
Ryan White Comprehensive AIDS Resources Emergency Act of 1990; U.S. 
Code provisions authorizing funds for transportation: Department of 
Agriculture, 42 U.S.C. §§ 300ff-21(a), 
23(a)(2)(B); Typical uses as reported by program officials: Department 
of Agriculture, Bus passes, tokens, taxis, 
vanpools, vehicle purchase by providers, mileage reimbursement; Types 
of trips as reported by program officials: To access health care 
services; Target population as defined by program officials[A]: Persons 
with HIV or AIDS; Fiscal year 2001 federal spending on 
transportation[B]: $19,500,000 (estimate)[M].

Program: Maternal and Child Services Grants; Popular title of 
authorizing legislation: 
Social Security Act, as amended; U.S. Code provisions 
authorizing funds for transportation
42 U.S.C. § 701(a)(1)(A); Typical uses as 
reported by program officials: 
Any transportation-related use; Types of trips as 
reported by program officials: To access health care services; Target 
population as defined by program officials[A]: Mothers, infants and 
children, particularly from low-income families; Fiscal year 2001 
federal spending on transportation[B]: No actual data or estimate 
available from the federal agency.

Program: Rural Health Care, Rural Health Network, and Small Health Care 
Provider Programs; Popular title of authorizing legislation: Department 
of Agriculture, Health Centers 
Consolidation Act of 1996; U.S. Code provisions authorizing funds for 
transportation: 
42 U.S.C. § 254c; Typical uses as reported by program officials: 
Purchase 
vehicles, bus passes; Types of trips as reported by program officials: 
To access health care services; Target population as defined by program 
officials[A]: Medically underserved populations in rural areas; Fiscal 
year 2001 federal spending on transportation[B]: No actual data or 
estimate available from the federal agency.

Program: Department of Health and Human Services, Substance Abuse and 
Mental Health Services Administration:

Program: Community Mental Health Services Block Grant; Popular title of 
authorizing legislation: 
ADAMHA Reorganization Act, as amended; U.S. Code provisions 
authorizing funds for transportation
42 U.S.C. § 300x-1(b)(1); Typical uses as 
reported by program officials: 
Any transportation-related use; Types of trips as 
reported by program officials: To access program services; Target 
population as defined by program officials[A]: Adults with mental 
illness and children with emotional disturbance; Fiscal year 2001 
federal spending on transportation[B]: No actual data or estimate 
available from the federal agency.

Program: Substance Abuse Prevention and Treatment Block Grant; Popular 
title of authorizing legislation: 
ADAMHA Reorganization Act, as amended; U.S. Code 
provisions authorizing funds for transportation: Department of 
Agriculture, 42 U.S.C. § 300x-32(b); 
Typical uses as reported by program officials: Department of 
Agriculture, Any transportation-related 
use; Types of trips as reported by program officials: To access program 
services; Target population as defined by program officials[A]: Persons 
with a substance related disorder and/or recovering from substance 
related disorder; Fiscal year 2001 federal spending on 
transportation[B]: No actual data or estimate available from the 
federal agency.

Program: Department of Housing and Urban Development, Office of 
Community Planning and Development:

Program: Community Development Block Grant; Popular title of 
authorizing legislation: 
Housing and Community Development Act of 1974; U.S. Code 
provisions authorizing funds for transportation: Department of 
Agriculture, 42 U.S.C. § 5305(a)(8); 
Typical uses as reported by program officials: Department of 
Agriculture, Purchase and operate vehicles; 
Types of trips as reported by program officials: General trips; Target 
population as defined by program officials[A]: Program must serve a 
majority of low-income persons; Fiscal year 2001 federal spending on 
transportation[B]: $6,761,486 (partial outlay)[N].

Program: Housing Opportunities for Persons with AIDS; Popular title of 
authorizing legislation: 
AIDS Housing Opportunity Act; U.S. Code provisions authorizing 
funds for transportation: 
42 U.S.C. § 12907(a)(3); Typical uses as reported by program 
officials: 
Contract for services; Types of trips as reported by program officials: 
To access health care and other services; Target population as defined 
by program officials[A]: Low-income persons with HIV or AIDS and their 
families; Fiscal year 2001 federal spending on transportation[B]: 
$190,252 (partial outlay)[O].

Program: Supportive Housing Program; Popular title of authorizing 
legislation: 
McKinney-Vento Homeless Assistance Act of 1987, as amended; U.S. Code 
provisions authorizing funds for transportation: Department of 
Agriculture, 42 U.S.C. § 11385; Typical 
uses as reported by program officials
Bus tokens, taxi vouchers, purchase and operate 
vehicles; Types of trips as reported by program officials: To access 
supportive services; Target population as defined by program 
officials[A]: Homeless persons and families with children; Fiscal year 
2001 federal spending on transportation[B]: $14,000,000; 
(estimate)[P].

Program: Department of Housing and Urban Development, Office of Public 
and Indian Housing:

Program: Revitalization of Severely Distressed Public Housing; Popular 
title of authorizing legislation: 
Housing and Community Development Act of 1992, as 
amended; U.S. Code provisions authorizing funds for transportation: 
42 U.S.C. § 
1437v(l)(3); Typical uses as reported by program officials: Department 
of Agriculture, Bus tokens, taxi vouchers, 
contract for services; Types of trips as reported by program officials: 
Trips related to employment or obtaining necessary supportive services; 
Target population as defined by program officials[A]: Residents of the 
severely distressed housing and residents of the revitalized units; 
Fiscal year 2001 federal spending on transportation[B]: $700,000 
(estimate)[Q].

Program: Department of the Interior, Bureau of Indian Affairs:

Program: Indian Employment Assistance; Popular title of authorizing 
legislation: 
Adult Indian Vocational Training Act, as amended; U.S. Code provisions 
authorizing funds for transportation
25 U.S.C. § 309; Typical uses as reported by 
program officials: 
Gas vouchers; Types of trips as reported by program officials: 
To access training; Target population as defined by program 
officials[A]: Native American persons between the ages of 18 and 35; 
Fiscal year 2001 federal spending on transportation[B]: No actual data 
or estimate available from the federal agency.

Program: Indian Employment, Training and Related Services[R]; Popular 
title of authorizing legislation: 
Indian Employment, Training and Related Services 
Demonstration Act of 1992; U.S. Code provisions authorizing funds for 
transportation: 
25 U.S.C. § 3401; Typical uses as reported by program officials: 
Gas vouchers; 
Types of trips as reported by program officials: Employment-related; 
Target population as defined by program officials[A]: Low-income Native 
American persons; Fiscal year 2001 federal spending on 
transportation[B]: No actual data or estimate available from the 
federal agency.

Program: Department of Labor, Employment and Training Administration:

Program: Job Corps; Popular title of authorizing legislation: 
Workforce 
Investment Act of 1998; U.S. Code provisions authorizing funds for 
transportation: 
29 U.S.C. §§ 2888(a)(1), 2890; Typical uses as reported by program 
officials: Bus 
tickets; Types of trips as reported by program officials: To access Job 
Corps sites and employment services; Target population as defined by 
program officials[A]: Low-income youth; Fiscal year 2001 federal 
spending on transportation[B]: $21,612,000.

Program: Migrant and Seasonal Farmworker[S]; Popular title of 
authorizing legislation: 
Workforce Investment Act of 1998; U.S. Code provisions 
authorizing funds for transportation
29 U.S.C. §§ 2801(46), 2912(d); Typical uses as 
reported by program officials: 
Mileage reimbursement; Types of trips as reported by 
program officials: To access employment placements or intensive and 
training services; Target population as defined by program 
officials[A]: Low-income persons and their dependents who are primarily 
employed in agricultural labor that is seasonal or migratory; Fiscal 
year 2001 federal spending on transportation[B]: No actual data or 
estimate available from the federal agency.

Program: Native American Employment and Training; Popular title of 
authorizing legislation: 
Workforce Investment Act of 1998; U.S. Code provisions 
authorizing funds for transportation
29 U.S.C. § 2911(d)(2); Typical uses as reported 
by program officials: 
Bus tokens, transit passes, use of tribal vehicles and grantee 
staff vehicles, mileage reimbursement for participants operating "car 
pool" services; Types of trips as reported by program officials: To 
access employment placements, employment services; Target population as 
defined by program officials[A]: Unemployed American Indians and other 
persons of Native American descent; Fiscal year 2001 federal spending 
on transportation[B]: No actual data or estimate available from the 
federal agency.

Program: Senior Community Service Employment Program; Popular title of 
authorizing legislation: 
Older Americans Act of 1965; U.S. Code provisions authorizing 
funds for transportation: 
42 U.S.C. § 3056(c)(6)(A) (iv); Typical uses as reported by 
program officials: 
Mileage reimbursement, reimbursement for travel costs, and 
payment for cost of transportation; Types of trips as reported by 
program officials: To access employment placements; Target population 
as defined by program officials[A]: Low-income persons aged 55 or over; 
Fiscal year 2001 federal spending on transportation[B]: $4,400,000 
(estimate)[S].

Program: Trade Adjustment Assistance - Workers; Popular title of 
authorizing legislation: 
Trade Act of 1974, as amended; U.S. Code provisions 
authorizing funds for transportation
19 U.S.C. § 2296(b); Typical uses as reported by 
program officials: 
Mileage reimbursement, transit fares; Types of trips as 
reported by program officials: To access training; Target population as 
defined by program officials[A]: Persons found to be impacted by 
foreign trade, increased imports, or shift in production; Fiscal year 
2001 federal spending on transportation[B]: No actual data or estimate 
available from the federal agency.

Program: Welfare-to-Work Grants to Federally Recognized Tribes and 
Alaska Natives[T]; Popular title of authorizing legislation: Department 
of Agriculture, Personal Responsibility and 
Work Opportunity Reconciliation Act of 1996; U.S. Code provisions 
authorizing funds for transportation
42 U.S.C. § 612(a)(3)(C); Typical uses as 
reported by program officials: 
Any transportation-related use, though purchasing 
vehicles for individuals is not allowable; Types of trips as reported 
by program officials: To access employment placements, employment 
services; Target population as defined by program officials[A]: 
American Indians and other persons of Native American descent who are 
long-term welfare recipients or are low-income; Fiscal year 2001 
federal spending on transportation[B]: No actual data or estimate 
available from the federal agency.

Program: Welfare-to-Work Grants to States and Localities[T]; Popular 
title of authorizing legislation: 
Personal Responsibility and Work Opportunity 
Reconciliation Act of 1996; U.S. Code provisions authorizing funds for 
transportation: 
42 U.S.C. § 603(a)(5)(C); Typical uses as reported by program 
officials: Any 
transportation-related use, though purchasing vehicles for individuals 
is not allowable; Types of trips as reported by program officials: To 
access employment placements, employment services; Target population as 
defined by program officials[A]: Long-term welfare recipients or low-
income individuals; Fiscal year 2001 federal spending on 
transportation[B]: No actual data or estimate available from the 
federal agency.

Program: Work Incentive Grants; Popular title of authorizing 
legislation: 
Workforce Investment Act of 1998, as amended; U.S. Code provisions 
authorizing funds for transportation
29 U.S.C. §§ 2801(46), 2864(d)(2); Typical uses 
as reported by program officials: 
Encourage collaboration with transportation 
providers; Types of trips as reported by program officials: To access 
one-stop services; Target population as defined by program 
officials[A]: Persons with disabilities who are eligible for employment 
and training services; Fiscal year 2001 federal spending on 
transportation[B]: No actual data or estimate available from the 
federal agency.

Program: Workforce Investment Act Adult Services Program; Popular title 
of authorizing legislation: 
Workforce Investment Act of 1998, as amended; U.S. 
Code provisions authorizing funds for transportation: Department of 
Agriculture, 29 U.S.C. §§ 2801(46), 
2864(e)(2); Typical uses as reported by program officials: Department 
of Agriculture, Mileage reimbursement, bus 
tokens, vouchers; Types of trips as reported by program officials: To 
access training; Target population as defined by program officials[A]: 
Priority must be given to people on assistance and low-income 
individuals; Fiscal year 2001 federal spending on transportation[B]: No 
actual data or estimate available from the federal agency.

Program: Workforce Investment Act Dislocated Worker Program; Popular 
title of authorizing legislation: 
Workforce Investment Act of 1998, as amended; U.S. 
Code provisions authorizing funds for transportation: Department of 
Agriculture, 29 U.S.C. §§ 2801(46), 
2864(e)(2); Typical uses as reported by program officials: Department 
of Agriculture, Transportation allowance or 
reimbursement, bus/subway tokens; Types of trips as reported by program 
officials: To access transition assistance in order to find or qualify 
for new employment; Target population as defined by program 
officials[A]: Includes workers who have been laid off, or have received 
an individual notice of termination, or notice that a facility will 
close; Fiscal year 2001 federal spending on transportation[B]: No 
actual data or estimate available from the federal agency.

Program: Workforce Investment Act Youth Activities; Popular title of 
authorizing legislation: 
Workforce Investment Act of 1998, as amended; U.S. Code 
provisions authorizing funds for transportation: Department of 
Agriculture, 29 U.S.C. §§ 2801(46), 
2854(a)(4); Typical uses as reported by program officials: Department 
of Agriculture, Public transportation; 
Types of trips as reported by program officials: To access training and 
other support services; Target population as defined by program 
officials[A]: Youth with low individual or family income; Fiscal year 
2001 federal spending on transportation[B]: No actual data or estimate 
available from the federal agency.

Program: Youth Opportunity Grants; Popular title of authorizing 
legislation: 
Workforce Investment Act of 1998, as amended; U.S. Code provisions 
authorizing funds for transportation
29 U.S.C. §§ 2801(46), 2914(b); Typical uses as 
reported by program officials: 
Bus tokens; Types of trips as reported by program 
officials: To access program services; Target population as defined by 
program officials[A]: Youth from high poverty areas, empowerment zones, 
or enterprise communities; Fiscal year 2001 federal spending on 
transportation[B]: $415,000 (estimate)[U].

Program: Department of Labor, Employment Standards Administration:

Program: Black Lung Benefits Program; Popular title of authorizing 
legislation: 
Black Lung Benefits Reform Act of 1977; U.S. Code provisions 
authorizing funds for transportation
30 U.S.C. § 923; Typical uses as reported by 
program officials: 
Mileage reimbursement, transit fares, taxi vouchers; Types of 
trips as reported by program officials: To access health services; 
Target population as defined by program officials[A]: Disabled coal 
miners; Fiscal year 2001 federal spending on transportation[B]: No 
actual data or estimate available from the federal agency[V].

Program: Department of Labor, Veterans Employment and Training Service:

Program: Homeless Veterans' Reintegration Project; Popular title of 
authorizing legislation: 
Homeless Veterans Comprehensive Assistance Act of 2001; U.S. 
Code provisions authorizing funds for transportation: Department of 
Agriculture, 38 USCA §§ 2011, 2021; Typical 
uses as reported by program officials
Bus tokens; Types of trips as reported by 
program officials: To access employment services; Target population as 
defined by program officials[A]: Homeless veterans; Fiscal year 2001 
federal spending on transportation[B]: No actual data or estimate 
available from the federal agency.

Program: Veterans' Employment Program; Popular title of authorizing 
legislation: 
Workforce Investment Act of 1998, as amended; U.S. Code provisions 
authorizing funds for transportation
29 U.S.C. §§ 2801(46), 2913; Typical uses as 
reported by program officials: 
Bus tokens, minor repairs to vehicles; Types of 
trips as reported by program officials: To access employment services; 
Target population as defined by program officials[A]: Veterans; Fiscal 
year 2001 federal spending on transportation[B]: No actual data or 
estimate available from the federal agency.

Program: Department of Transportation, Federal Transit Administration:

Program: Capital and Training Assistance Program for Over-the-Road Bus 
Accessibility; Popular title of authorizing legislation: Department of 
Agriculture, Title 49 Recodification, P.L. 
103-272; U.S. Code provisions authorizing funds for transportation: 
49 U.S.C. § 
5310; Typical uses as reported by program officials: Department of 
Agriculture, To make vehicles wheelchair 
accessible and training required by ADA; Types of trips as reported by 
program officials: General trips; Target population as defined by 
program officials[A]: Persons with disabilities; Fiscal year 2001 
federal spending on transportation[B]: $2,877,818.

Program: Capital Assistance Program for Elderly Persons and Persons 
with Disabilities; Popular title of authorizing legislation: Department 
of Agriculture, Title 49 Recodification, 
P.L. 103-272; U.S. Code provisions authorizing funds for 
transportation: 
49 U.S.C. § 5310; Typical uses as reported by program officials: 
Assistance in 
purchasing vehicles, contract for services; Types of trips as reported 
by program officials: To serve the needs of the elderly and persons 
with disabilities; Target population as defined by program 
officials[A]: Elderly persons and persons with disabilities; Fiscal 
year 2001 federal spending on transportation[B]: $174,982,628.

Program: Capital Investment Grants; Popular title of authorizing 
legislation: 
Transportation Equity Act for the 21st Century; U.S. Code provisions 
authorizing funds for transportation
49 U.S.C. § 5309; Typical uses as reported by 
program officials: 
Assistance for bus and bus-related capital projects; Types of 
trips as reported by program officials: General trips; Target 
population as defined by program officials[A]: General public, although 
some projects are for the special needs of elderly persons and persons 
with disabilities; Fiscal year 2001 federal spending on 
transportation[B]: $17,500,000 (estimate)[W].

Program: Job Access and Reverse Commute; Popular title of authorizing 
legislation: 
Transportation Equity Act for the 21st Century; U.S. Code provisions 
authorizing funds for transportation
49 U.S.C. § 5309 note; Typical uses as reported 
by program officials: 
Expand existing public transportation or initiate new service; 
Types of trips as reported by program officials: To access employment 
and related services; Target population as defined by program 
officials[A]: Low income persons, including persons with disabilities; 
Fiscal year 2001 federal spending on transportation[B]: $85,009,627.

Program: Nonurbanized Area Formula Program; Popular title of 
authorizing legislation: 
Title 49 Recodification, P.L. 103-272; U.S. Code provisions 
authorizing funds for transportation
49 U.S.C. § 5311; Typical uses as reported by 
program officials: 
Capital and operating assistance for public transportation 
service, including paratransit services, in nonurbanized areas; Types 
of trips as reported by program officials: General trips; Target 
population as defined by program officials[A]: General public, although 
paratransit services are for the special needs of persons with 
disabilities; Fiscal year 2001 federal spending on transportation[B]: 
$0; (partial obligation)[X].

Program: Urbanized Area Formula Program; Popular title of authorizing 
legislation: 
Title 49 Recodification, P.L. 103-272, as amended; U.S. Code provisions 
authorizing funds for transportation
49 U.S.C. § 5307; Typical uses as reported by 
program officials: 
Capital assistance, and some operating assistance for public 
transit, including paratransit services, in urbanized areas; Types of 
trips as reported by program officials: General trips; Target 
population as defined by program officials[A]: General public, although 
paratransit services are for the special needs of persons with 
disabilities; Fiscal year 2001 federal spending on transportation[B]: 
$36,949,680 (partial obligation)[Y].

Program: Department of Veterans Affairs, Veterans Benefits 
Administration:

Program: Automobiles and Adaptive Equipment for Certain Disabled 
Veterans and Members of the Armed Forces; Popular title of authorizing 
legislation: 
Disabled Veterans and Servicemen's Automobile Assistance Act of 1970; 
U.S. Code provisions authorizing funds for transportation: Department 
of Agriculture, 38 U.S.C. § 3902; Typical 
uses as reported by program officials
Purchase of personal vehicles, modifications of 
vehicles; Types of trips as reported by program officials: General 
trips; Target population as defined by program officials[A]: Veterans 
and service members with disabilities; Fiscal year 2001 federal 
spending on transportation[B]: $33,639,000.

Program: Department of Veterans Affairs, Veterans Health 
Administration:

Program: VA Homeless Providers Grant and Per Diem Program; Popular 
title of authorizing legislation: 
Homeless Veterans Comprehensive Service Programs Act 
of 1992; U.S. Code provisions authorizing funds for transportation: 
38 U.S.C. § 7721 
note; Typical uses as reported by program officials: Department of 
Agriculture, 20 vans were purchased under 
this program; Types of trips as reported by program officials: General 
trips; Target population as defined by program officials[A]: Homeless 
veterans; Fiscal year 2001 federal spending on transportation[B]: 
$565,797.

Program: Veterans Medical Care Benefits; Popular title of authorizing 
legislation: 
Veterans' Benefits Improvements Act of 1994; U.S. Code provisions 
authorizing funds for transportation
38 U.S.C. § 111; Typical uses as reported by 
program officials: 
Mileage reimbursement, contract for service; Types of trips as 
reported by program officials: To access health care services; Target 
population as defined by program officials[A]: Veterans with 
disabilities or low incomes; Fiscal year 2001 federal spending on 
transportation[B]: $126,594,591.

Program: Total (reported or estimated spending on transportation 
services for the transportation-disadvantaged): $2,445,453,139.

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

[A] A supplemental source for the target populations was the Catalog of 
Federal Domestic Assistance.

[B] Actual outlays or obligations on transportation are given for 
programs that track this information. All data are outlays, except for 
the following programs, which are obligations: Capital Investment 
Grants, Urbanized Area Formula Program, Nonurbanized Area Formula 
Program, Job Access and Reverse Commute, Capital and Training 
Assistance for Over-the-Road Bus Accessibility, Capital Assistance 
Program for Elderly Persons and Persons with Disabilities, Automobiles 
and Adaptive Equipment for Certain Disabled Veterans and Members of the 
Armed Forces, and Veterans Medical Care Benefits. Actual data and 
estimates are the total for the program, unless otherwise noted as 
partial outlays or obligations in the table. When actual information 
was not available, estimates are given based on information provided by 
program officials or the officials agreed with an estimate made by 
another source.

[C] According to a program official, outlays for the Food Stamp 
Employment and Training Program have increased due to changes in the 
program from the 2002 Farm Bill. The 2002 Farm Bill eliminates the $25 
per month cap that the Department of Agriculture will reimburse the 
states for transportation and other work costs incurred by 
participants. In fiscal year 2002, federal outlays for transportation 
were $18,523,535.

[D] A program official said that 10 percent of total program outlays 
would be a conservative estimate of transportation outlays.

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

[F] A program official said that, while transportation is an allowable 
use of funds, using funds for transportation is not encouraged. Program 
officials estimate that transportation expenditures are zero or close 
to zero for this program.

[G] Fiscal year 2001 data are not available because transportation was 
not an area of emphasis until fiscal year 2002. The preliminary fiscal 
year 2002 outlays for transportation projects totaled $1,084,798.

[H] A program official estimated that transportation outlays were 8.3 
percent of total outlays.

[I] This is a partial outlay based on voluntary reporting by grantees. 
Full outlays are not available because, according to a program 
official, grantees were not required to report transportation outlays 
prior to fiscal year 2002. Fiscal year 2002 data are incomplete, 
however preliminary data on transportation outlays from 46 of the 51 
grantees totaled $2,215,498.

[J] This is a partial outlay based on the amount grantees reported as 
non-assistance outlays in a category exclusively for transportation. 
States reported an additional $356.5 million as outlays on assistance 
in a category that includes transportation and supportive services, 
however program officials were unable to determine what percentage of 
the outlays on assistance were spent on transportation.

[K] Program officials indicate that federal data on nonemergency 
medical transportation are not available. Estimate assumes that 
transportation outlays are 0.73 percent of total program outlays, based 
on previous research, including a survey of state Medicaid programs.

[L] According to a program official, grantees report total outlays for 
transportation and it is not possible to distinguish between federal 
and nonfederal funds. The official said 22 percent of total 
transportation outlays would be a good estimate of the federal portion 
of fiscal year 2001 transportation outlays.

[M] Estimate of transportation outlays is based on data from grantee's 
budget allocations, as suggested by an agency official.

[N] This is a partial outlay for transportation through the Community 
Development Block Grant program. This figure includes transportation 
outlays for the Entitlement program, but excludes the State 
Administered program.

[O] This is a partial estimate because, according to a program 
official, data on transportation outlays are not available from all 
grantees. The program official could not provide an estimate of outlays 
for transportation for all grantees.

[P] HUD provided data for transportation spending by 3,187 grantees in 
fiscal year 2001 that totaled $7,221,569. According to HUD program 
officials, there are a total of 6,323 grantees, about twice as many as 
reported data. The officials therefore estimated that about $14,000,000 
would have been spent on transportation from all grantees in fiscal 
year 2001.

[Q] Estimate of outlays for transportation is based on a program 
official's review of the budgets from 15 grantees who renewed their 
grants in fiscal year 2001. The official projected total transportation 
outlays for the program based on these 15 grantees.

[R] Public Law 102-477 is applied to allow tribal governments to 
consolidate funding from several federal programs. These include: the 
Department of Health and Human Services's Temporary Assistance for 
Needy Families, and Child Care and Development Fund programs; the 
Department of Labor's Native American Employment and Training, and 
Welfare-to-Work Grants for Federally Recognized Tribes programs; and 
the Bureau of Indian Affairs' Employment Assistance, Indian Social 
Service and Welfare Assistance, Adult Basic Education, and Higher 
Education programs. The Indian Social Services and Welfare Assistance 
Program is not used for transportation outside 102-477. The Adult Basic 
Education and Higher Education programs do not target transportation-
disadvantaged populations as defined in this study outside of 102-477. 
The Employment Assistance program and the HHS and DOL programs provide 
transportation assistance separately from 102-477.

[S] A program official estimated that transportation outlays were 
approximately 1 percent of total program outlays.

[T] Program funding from fiscal year 1998 and 1999 may still be spent, 
but the program no longer receives funding.

[U] Estimate of transportation outlays is based on a program official's 
review of grantee obligations.

[V] According to a program official, fiscal year 2001 data are not 
available due to changes in the program's reporting system. The 
official reported that transportation outlays for fiscal year 2002 
totaled $478,408.

[W] According to a program official, there are three distinct 
allocations of funds under the Capital Investment Grants: the New 
Starts allocation, which funds new rail projects; the fixed-guideway 
modernization allocation, which provides funding to maintain and update 
aging rail systems; and the bus allocation, which provides funding for 
the purchase of buses, bus-related equipment and paratransit vehicles, 
and for the construction of bus-related facilities. Because the Capital 
Investment Grants fund projects that provide services for the general 
public, the transportation-disadvantaged likely benefit from many 
projects funded through each of the three allocations, but information 
was not available to estimate what portion of these funds for the 
general public benefit the transportation-disadvantaged. However, the 
program official said that the bus allocation would likely provide the 
most direct benefit for the transportation-disadvantaged and the 
obligation level could be estimated by totaling allocations to purchase 
vans, buses for the elderly or disabled, or paratransit vehicles and 
equipment.

[X] The Nonurbanized Area Formula Program funds projects that provide 
services for the general public, however grantees can use up to 10 
percent of their funds to provide complementary ADA paratransit 
services. Although grantees did not report obligations for 
complementary ADA paratransit, a program official said that 
transportation-disadvantaged populations might benefit from other 
services provided through this grant, such as demand-responsive 
services. However, the program official could not identify the amount 
of spending that directly benefits the transportation-disadvantaged.

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

[End of table]

[End of section]

Appendix III: Federal and State Coordination Efforts:

Federal and state efforts to coordinate the services for the 
transportation-disadvantaged provided through their programs vary 
widely. This appendix offers some examples of those efforts.

Federal Coordination:

In 1999, we reviewed the coordination efforts of the Coordinating 
Council on Access and Mobility, a body of representatives from the U.S. 
Department of Transportation (DOT) and the U.S. Department of Health 
and Human Services (HHS).[Footnote 46] We made several recommendations 
for improving coordination between these two agencies. Table 5 shows 
the recommendations and actions taken in response.

Table 5: Federal Actions Taken in Response to GAO Recommendations for 
Improving Coordination:

Recommendations from 1999 GAO report: The DOT/ HHS Coordinating Council 
on Access and Mobility should adopt a prioritized strategic plan.; 
Specific actions completed or products issued in response: In August 
2000, the Coordinating Council adopted a prioritized strategic plan for 
fiscal years 2000 to 2004 and distributed the plan to its members.; 
Actions in progress and further concerns: The plan has not been updated 
or distributed widely because the Council is now focused on a more 
"product-oriented" approach. The plan will be updated at the end of 
2003.; The entire Coordinating Council has not met formally since 
December 2000, but specific workgroups have been developing action 
agendas and interagency agreements. 

Recommendations from 1999 GAO report: The Coordinating Council should 
develop an action plan with specific responsibilities.; Specific 
actions completed or products issued in response: The Council developed 
and issued an action plan in fiscal year 2003 and a number of actions 
have been completed, such as producing a series of "how to" 
publications on using intelligent transportation systems to assist in 
the coordination of HHS programs with local transit agencies.; Actions 
in progress and further concerns: Other actions were not completed by 
the expected date, such as the preparation of a promotional brochure on 
state Medicaid brokerage initiatives. Also, the outcome of actions is 
unknown due to the lack of an annual report. 

Recommendations from 1999 GAO report: The Coordinating Council should 
issue an annual report on its major initiatives and accomplishments to 
the Secretaries of DOT and HHS.; Specific actions completed or products 
issued in response: No annual report has yet been issued.; Actions in 
progress and further concerns: The Council plans to issue its first 
annual report in June 2003. 

Recommendations from 1999 GAO report: DOT and HHS should ensure that 
planned coordination efforts reinforce one another.; Specific actions 
completed or products issued in response: The document "Planning 
Guidelines for Coordinated State and Local Specialized Transportation 
Services" was issued by the Council in December 2000 and distributed to 
state and local transit agencies. The guidelines are also available on 
the Web sites of the Council and DOT's Federal Transit Administration 
(FTA). These guidelines provide information to facilitate the 
coordination of transportation services for 12 HHS and 10 DOT 
programs.; Actions in progress and further concerns: Distribution to 
health and human service providers may not have been as thorough. 
According to some regional FTA and HHS officials we interviewed, the 
guidelines might have more impact if they are delivered to human 
service agencies and providers. Other officials mentioned the need for 
more specific guidance, such as models for cost sharing. 

Recommendations from 1999 GAO report: DOT and HHS should direct their 
regional working groups to assess obstacles to transportation 
coordination.; Specific actions completed or products issued in 
response: The Council's strategic plan provides for regional 
coordination action plans, including the identification and assessment 
of obstacles to transportation coordination.; Actions in progress and 
further concerns: All 10 of the regions produced action plans, but most 
have not been updated since fiscal year 2000. In addition, the outcomes 
of actions are not routinely tracked.; The FTA and HHS regional offices 
are jointly sponsoring conferences in spring 2003 for state 
transportation and human service officials to, among other things, 
identify obstacles to coordination and best practices in successfully 
overcoming them. 

Recommendations from 1999 GAO report: The Coordinating Council should 
strengthen its Web site and make information available on obstacles to 
coordination and strategies to overcome them.; Specific actions 
completed or products issued in response: The Council's official Web 
site was discontinued due to lack of funding, but another site was 
established in May 2002, operated by FTA in conjunction with the 
Community Transportation Association of America. The site is linked to 
FTA's Web site. (www.fta.gov/CCAM/www.index.html); Actions in progress 
and further concerns: The Coordinating Council's Web site is not yet 
linked to HHS's Web site.; The Council's Web site does not contain an 
explicit list of obstacles to coordination or strategies to overcome 
them, but it does contain links to several reports that address these 
issues. 

Source: GAO.

[End of table]

As a result of items in the Coordinating Council's strategic plan and 
action plan, FTA and HHS have undertaken multiple efforts to coordinate 
transportation services provided through their programs. Other federal 
agencies are also involved in coordination activities. Examples of 
federal coordination efforts include the following:

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

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

* Department of Labor (DOL) and DOT officials are developing guidelines 
about using Workforce Investment Act[Footnote 47] funds for programs 
funded under DOT's Job Access and Reverse Commute Program.

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

* A study undertaken on behalf of DOT and HHS examined seven specific 
planning strategies that can be used as part of a flexible regional 
planning process for coordinating transportation services of health and 
human service and transit agencies. The report is available on the 
Coordinating Council's Web site.[Footnote 48]

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

* CTAA established a Web site for the National Transit Resource Center, 
an information clearinghouse funded by DOT and HHS.[Footnote 49] The 
site contains links to the Coordinating Council as well as to the 
Community Transportation Assistance Project (CTAP) and the Rural 
Transit Assistance Program (RTAP). CTAP, funded by HHS, provides 
information about transportation issues, such as accessibility, 
coordination, funding opportunities, training, management, and 
legislation and regulations. CTAP also compiled a comprehensive list of 
federal funding resources for community transportation providers. The 
purpose of RTAP, funded by FTA, is to provide training and technical 
assistance for rural public transportation operators, improve 
professionalism and safety of rural public transit services, promote 
efficiency and effectiveness of rural transit services, and support 
coordination with human service transportation.

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

* DOL is working with CTAA and DOT to implement several rounds of pilot 
projects testing various transportation strategies in support of local 
one-stop employment and training centers.[Footnote 50] According to DOL 
officials, these strategies can include referral services, 
transportation information, transportation services coordination, 
mobility management, and other transportation strategies.

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

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

* The National Consortium on the Coordination of Human Services 
Transportation--an initiative of FTA and HHS, under the direction of 
CTAA--plans to design and conduct a survey of state Medicaid directors 
to compile data on the Medicaid transit pass program, brokerages, and 
other transportation funding mechanisms within Medicaid; develop a new 
brochure outlining the benefits of the Medicaid pass program; develop 
case studies of successful brokerage programs and design a brochure 
describing them; identify promising practices and obstacles in human 
service transportation coordination and develop strategies for 
addressing these obstacles; and provide outreach on coordination 
efforts and resources.[Footnote 51]

* The federally-funded Transportation Research Board, an arm of the 
National Academy of Sciences, has several completed and ongoing 
projects on transportation coordination, including the following:

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

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

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

* TCRP Project H-30, "Strategies to Increase Coordination of 
Transportation Services for the Transportation Disadvantaged," has an 
expected completion date of January 2004. The objective of this 
research project is to develop strategies for initiating or improving 
coordination of local and regional publicly funded transportation 
services for the transportation-disadvantaged.

State Coordination:

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

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

State: Arizona; Type of coordination: None; Statewide coordinating 
body: None; Departments/ organizations involved in formal coordination: 
None.

State: Florida; Type of coordination: State-administered brokerage 
system; Statewide coordinating body: Commission for the Transportation 
Disadvantaged; Departments/ organizations involved in formal 
coordination: * Departments of Transportation, Education, Veterans 
Affairs, Children and Families, Elder Affairs, Labor and Employment 
Security; * Agency for Health Care Administration; * Florida Transit 
Association; * Community Transportation Coordinators; * Transportation 
operators; * Nontransportation business community; * Florida 
Association for Community Action; * Early Childhood Council; * 
Representatives for the disabled, elderly, rural, and urban 
populations.

State: New York; Type of coordination: None; Statewide coordinating 
body: None; Departments/ organizations involved in formal coordination: 
None.

State: South Dakota; Type of coordination: Statewide planning body; 
Statewide coordinating body: Transportation Planning and Coordinating 
Task Force; Departments/ organizations involved in formal coordination: 
* Departments of Transportation, Human Services, Social Services, 
Labor, and Health; * Coalition of Citizens with Disabilities.

State: Wisconsin; Type of coordination: None for entire state; 
Statewide coordinating body: None; Departments/ organizations involved 
in formal coordination: * Departments of Transportation and Workforce 
Development jointly administer Wisconsin Employment Transportation 
Assistance Program (WETAP).

Source: GAO.

[End of table]

* Arizona does not have formal transportation coordination efforts at 
the state level, though some state agencies work together informally, 
and some localities have similar arrangements. For example, an official 
from the Jobs Administration in the Department of Economic Security 
said that the Administration works with the Department of 
Transportation to try to avoid duplication of services in rural areas.

* Florida has a state coordinating body that oversees local 
coordination efforts among most programs. This body is called the 
Commission for the Transportation-Disadvantaged and was created in 1989 
by the Florida Legislature to oversee the implementation of coordinated 
transportation disadvantaged services. The commission appoints local 
Community Transportation Coordinators who are responsible for the 
arrangement or delivery of transportation services for transportation-
disadvantaged persons, either by brokering services or by providing 
transportation directly. Agencies are required to purchase 
transportation through the coordinated system, unless the services 
offered do not meet the needs of the client or the agency can find a 
lower cost alternative that meets the same safety standards.

* New York does not have a formal coordinating body, but some state 
agencies work together informally and many local agencies have entered 
into brokerage agreements. Officials from the Departments of Labor and 
Transportation say they have been working together to identify needs 
and initiate transportation projects for employment programs. In 
addition, five state agencies review and comment on applications for 
FTA's Transit Capital Assistance Program for Elderly Persons and 
Persons with Disabilities.

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

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

[End of section]

Appendix IV: Informational Resources on Coordination:

Web Sites:

Coordinating Council on Access and Mobility, www.fta.dot.gov/CCAM/
www.index.html:

Community Transportation Association of America, www.ctaa.org:

Workforce Investment Act Transportation Resources, www.doleta.gov/
usworkforce/resources/transport.asp:

Reports:

Community Transportation Association of America. 2002. Building 
Mobility Partnerships: Opportunities for Federal Investment. 
Washington, D.C.: Community Transportation Association of America.

Coordinating Council on Access and Mobility. 2000. Planning Guidelines 
for State and Local Coordination. Washington, D.C.: Coordinating 
Council on Access and Mobility.

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

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

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

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

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

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

[End of section]

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

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

See page 7.

See comment 2.

See comment 1.

DEPARTMENT OF HEALTH & HUMAN SERVICES:

Office of Inspector General:

Washington, D.C. 20201:

MAY 30 2003:

Ms. Katherine Siggerud:

Acting Director, Physical Infrastructure Issues 
United States General Accounting Office 
Washington, D.C. 20548:

Dear Ms. Siggerud:

Enclosed are the department's comments on your draft report entitled, 
"Transportation-Disadvantaged Populations: Some Coordination Efforts 
Among Programs Providing Transportation Services, but Obstacles 
Persist." The comments represent the tentative position of the 
department and are subject to reevaluation when the final version of 
this report is received.

The department also provided several technical comments directly to 
your staff.

The department appreciates the opportunity to comment on this draft 
report before its publication.

Sincerely,

Dennis J. Duquette:

Acting Principal Deputy Inspector General:

Signed by Dennis J. Duquette:

Enclosure:

The Office of Inspector General (OIG) is transmitting the department's 
response to this draft report in our capacity as the department's 
designated focal point and coordinator for General Accounting Office 
reports. The OIG has not conducted an independent assessment of these 
comments and therefore expresses no opinion on them.

Comments of the Department of Health and Human Services on the General 
Accounting Office's Draft Report, "Transportation-Disadvantaged 
Populations: Some Coordination Efforts Among Programs Providing 
Transportation Services, but Obstacles Persist" (GAO-03-697):

The Department of Health and Human Services (department / HHS) 
appreciates the opportunity to comment on the General Accounting 
Office's (GAO) draft report, "Transportation-Disadvantaged 
Populations: Some Coordination Efforts Among Programs Providing 
Transportation Services, but Obstacles Persist." Overall, this is a 
comprehensive, well-written report that should inspire further interest 
in seeking ways to resolve the ongoing problem of coordination and 
limited resources. The department would like to offer several general 
comments that we feel would strengthen this report.

The department concurs with the GAO's recommendations for executive 
action. Implementation of several of the GAO's recommendations are 
already underway, including strengthening the linkage between the 
Coordinating Council on Access and Mobility's (Coordinating Council) 
Strategic and Action Plans, reviewing the HHS Strategic Plan for 
opportunities to reflect the department's transportation coordination 
efforts, working with HHS program offices to develop coordination 
guidance for the specific program networks, and linking the 
Coordinating Council's web site to the department's web site.

The department also concurs with the GAO findings regarding the need to 
harmonize program eligibility and reporting requirements as well as the 
need to develop mandates or incentives to improve coordination.

General Comments:

The department suggests that the GAO consider a more concise, specific 
title for the report, such as "Coordination of Human Services 
Transportation: Progress Made but Obstacles Persist." The report has 
generated significant interest within Congress, federal agencies and 
among states and localities. A title containing the word "coordination" 
will make it easier for interested parties to obtain the report through 
electronic searches.

The report makes clear the difficulty of accessing detailed data on the 
expenditures or investments that fund human service transportation. Of 
equal importance for the planning and coordination of transportation 
resources is the need for detailed information on the need for these 
services. The department has found determining the level of need to be 
almost as difficult as identifying current funding outlays.

Although implied, the report does not make explicit that the 
Coordinating Council owes its existence to a 15 year-old memorandum of 
understanding between HHS and the Department of Transportation. There 
is no congressional charge that underlies the Coordinating Council.

The department has found it useful to attempt estimates of 
transportation expenditures despite the lack of available data in some 
of the department's programs. In earlier work by Jon Burkhardt through 
Ecosometrics, Inc., an estimate of 5 percent of the program 
expenditures was used to identify a working figure for discussion. When 
specific programs voiced concern that this estimate was too high, a 
more conservative estimate was made. Using this methodology, the 
department's expenditures were estimated at just under $2 billion and 
by extrapolation could be estimated at close to $3 billion currently. 
We suggest that the GAO take a second look at possible estimates based 
on the role transportation plays in health and human service programs 
where data is available.

The draft HHS 2002-2008 Strategic Plan is under review for 
opportunities to strengthen the language with regard to coordination 
and human services transportation. It is anticipated that there will be 
areas within the Strategic Plan that present options for addressing the 
department's support for the coordination of transportation services.

The department would like to highlight some recent hopeful developments 
in the effort to enhance federal coordination. The Coordinating Council 
recently established three targeted workgroups to address the specific 
transportation needs and coordination strategies for the target 
populations of the elderly, the medically indigent and individuals with 
disabilities. The Coordinating Council has also announced its intention 
to establish a fourth workgroup on rural transportation issues. These 
workgroups are using a similar model of action: developing goals and 
objectives, signing a memorandum of agreement between the appropriate 
HHS agencies and the Federal Transit Administration, developing an 
action plan with timeframes and performance measures, and assigning 
responsibility for the actions. In addition, the workgroup addressing 
transportation of individuals with disabilities has also been 
designated as a subcommittee for the HHS New Freedom Initiative. 
Discussions are already underway on the most effective way to include 
the Departments of Labor and Education in these efforts.

A description of coordination efforts quickly becomes complex for many 
reasons and requires careful delineation of the various sectors and 
governmental levels involved. The report will achieve better clarity 
with identification of the levels, sectors and affiliations of 
officials and other interviewees.

The following are GAO's comments on HHS's letter dated May 30, 2003.

GAO Comments:

1. HHS suggested that we consider incorporating other estimates of 
transportation spending by health and human service programs, 
particularly one estimate that assumed transportation spending 
accounted for 5 percent of total program spending. In developing our 
estimate of transportation spending, we only included actual or 
estimated figures for which the agencies could provide supporting 
evidence. For those programs that had actual or estimated spending 
information, on average, about 3 percent of total spending for those 
programs was devoted to transportation. We do not know whether this 3 
percent is an appropriate estimate of transportation spending for other 
programs because grantees are generally not required to report 
transportation spending information to the federal agency administering 
the program. Furthermore, several officials who administer programs 
that had no spending data told us that transportation services probably 
represented less than 1 percent of their total program spending.

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

[End of section]

Appendix VI: Comments from the Department of Education:

UNITED STATES DEPARTMENT OF EDUCATION:

OFFICE OF SPECIAL EDUCATION AND REHABILITATIVE SERVICES:

MAY 28 2003	
THE ASSISTANT SECRETARY:

Ms. Katherine Siggerud:

Acting Director, Physical Infrastructure Issues General Accounting 
Office:

441 G Street, NW Washington, DC 20548:

Dear Ms. Siggerud:

Thank you for the opportunity to review the draft report entitled, 
"Transportation-Disadvantaged Populations: Some Coordination Efforts 
Among Programs Providing Transportation Services, but Obstacles Persist 
" (GAO-03-697). I am pleased to respond on behalf of the Department of 
Education. Deputy Assistant Secretary Loretta Petty Chittum testified 
for the Department at the related joint hearing on transportation 
coordination held May 1 by the House Committees on Transportation and 
Infrastructure and Education and the Workforce.

We have reviewed the draft report and have only minor technical 
suggestions to Appendix II as reflected below. The Secretary of 
Education would look favorably on an opportunity to join the 
Secretaries of Transportation and Health and Human Services on the 
Coordinating Council on Access and Mobility. The Department would 
consider guidance on transportation coordination for State and other 
grantees, and methods of linking Web-based information resources about 
transportation. The Department's involvement in transportation 
services is in all cases to provide or allow access to the educational 
and other services provided through programs we administer.

While the Rehabilitation Act was reauthorized in 1998 as part of WIA, 
the Rehabilitation Act is typically cited independently as has been 
done in the entry for Vocational Rehabilitation. The Supported 
Employment program is contained in title VI of the Rehabilitation Act 
and the cite for the program should be the Rehabilitation Act of 1973, 
as amended, title VI, Part B. The Independent Living Programs are 
contained in title VII of the Rehabilitation Act and the cites for 
those programs are as follows: Centers for Independent Living - 
Rehabilitation Act of 1973, as amended, Title VII, chapter 1, Part C; 
Independent Living Services for Older Individuals who are Blind - 
Rehabilitation Act of 1973, as amended, Title VII, chapter 2; and 
Independent Living State Grants - Rehabilitation Act of 1973, as 
amended, Title VII, chapter 1, Part B. The reference to the Supported 
Employment program (page 41) should be edited by replacing "Severe" 
with "Most Significant" and a conforming change should be made to 
"Target Population." The USC cite for the Supported Employment program 
should be 29 USC 795g et seq. The USC cite for the Centers for 
Independent Living program should be 29 USC §§ 796f-4(5) and 
706(18)(xi). The USC cite for the Independent Living State Grants 
should be 29 USC §§ 796e-2(1) and 706(18)(xi). The "Target Population" 
box for the Vocational 
Rehabilitation program (page 41) could be read to imply that any 
individual with a disability could be eligible for transportation 
services. A better description would be "Persons with disabilities that 
result in a substantial impediment to employment and who require VR 
services to obtain or maintain employment.":

I hope you find that our comments have been helpful.

Sincerely

Robert H. Pasternack, Ph. D.

Signed by Robert H. Pasternack:

[End of section]

Appendix VII: GAO Contacts and Staff Acknowledgments:

GAO Contacts:

Katherine Siggerud (202) 512-2834 or siggerudk@gao.gov Rita A. Grieco 
(202) 512-2834 or griecor@gao.gov Randall Williamson (206) 287-4860 or 
williamsonr@gao.gov:

Staff Acknowledgments:

In addition to the individuals above, Christine Bonham, Bradley Hunt, 
Bert Japikse, Jessica Lucas-Judy, Sara Ann Moessbauer, Hilary Murrish, 
Ryan Petitte, Stanley Stenersen, and Andrew Von Ah made key 
contributions to this report.

FOOTNOTES

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

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

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

[4] The Community Transportation Association of America is a national, 
professional membership association that conducts research and provides 
technical assistance for community transportation providers. See 
Community Transportation Association of America, Building Mobility 
Partnerships: Opportunities for Federal Investment (Washington, D.C.: 
March 2002). 

[5] Medicaid is a joint federal-state program to finance health care 
coverage for certain categories of low-income individuals, including 
families with children, persons with disabilities, and elderly 
individuals.

[6] GAO/RCED-00-1.

[7] Anita Stowell Ritter, Audrey Straight, Ed Evans, Understanding 
Senior Transportation: Report and Analysis of a Survey of Consumers Age 
50+ (Washington, D.C.: AARP Public Policy Institute, 2002).

[8] U.S. Federal Highway Administration and U.S. Federal Transit 
Administration, 2002 Status of the Nation's Highways, Bridges, and 
Transit: Conditions and Performance (Washington, D.C.: Department of 
Transportation, 2003).

[9] GAO/RCED-77-119.

[10] GAO/RCED-00-1.

[11] P.L. 105-178.

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

[13] In addition to these 62 programs, it is likely that there other 
federal programs that could be used to fund transportation improvements 
or other transportation services. Our scope included programs that 
provide nonemergency, nonmilitary, surface transportation services, 
targeted to transportation-disadvantaged populations. We excluded most 
programs that were strictly for research or demonstration activities or 
provided strictly cash assistance with no restrictions on use, as well 
as some economic development programs that benefit the general public 
and are not targeted to transportation-disadvantaged populations. 
Efforts by other researchers to inventory all federal programs that 
could conceivably provide transportation yielded additional programs 
not found in our inventory due to differing selection criteria. See 
Building Mobility Partnerships: Opportunities for Federal Investment.

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

[15] Building Mobility Partnerships: Opportunities for Federal 
Investment.

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

[17] Total program obligations for these 33 programs were about $14.8 
billion in fiscal year 2001. While information was not available on the 
portion of the $14.8 billion devoted to providing transportation 
services, we were able to analyze data on other human services programs 
which indicate that, on average, about 3 percent of total spending on 
those programs was devoted to transportation. We do not know whether 
this 3 percent is an appropriate estimate of transportation spending 
for these 33 programs because grantees are not required to report 
transportation spending information to the federal agency. Furthermore, 
several officials who administer programs that had no spending data 
told us that transportation services probably represented less than 1 
percent of their total program spending. 

[18] It is difficult to determine the amount of nonfederal 
contributions to transportation services on the basis of matching 
requirements because grantees are generally required to match total 
program spending rather than spending for a particular service, such as 
transportation. To illustrate, Head Start grantees are required to 
contribute 20 percent of total program costs, not necessarily 20 
percent of transportation costs. Transportation under the program could 
be entirely funded from federal dollars while the local share is used 
to fund teachers or other program costs. The issue is further 
complicated because some of these programs have maintenance of effort 
(MOE) requirements (which require states and localities to maintain 
their contributions to a program at some pre-determined level) rather 
than matching requirements. Under the TANF program, for example, the 
state's MOE requirement is determined through an index against the 
amount the state spent for fiscal year 1994 under the Aid to Families 
with Dependent Children program. MOE funds will, therefore, constitute 
a different percentage of total program spending for each state in each 
year.

[19] The amount that states are required to contribute depends on how 
states claim transportation under Medicaid. If states claim Medicaid as 
an optional medical expense, the state or local portion ranges from 17 
to 50 percent of total costs, based on a measure known as the Federal 
Medical Assistance Percentage. If states claim transportation as an 
administrative expense, the state or local portion is 50 percent of 
total costs.

[20] Data for state fiscal year 2001 were not available. Program 
officials indicate that there should not be significant differences in 
2001 and 2002 spending information.

[21] National Conference of State Legislatures, State Budget Update: 
February 2003 (Washington, D.C.: February 2003).

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

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

[24] The Community Transportation Association of America defines 
brokerage as a method of providing transportation where riders are 
matched with appropriate transportation providers through a central 
trip-request and administration facility. The transportation broker may 
centralize vehicle dispatch, record keeping, vehicle maintenance, and 
other functions under contractual arrangements with agencies, 
municipalities, and other organizations. Actual trips are provided by a 
number of different vendors.

[25] Paratransit most often refers to wheelchair-accessible, demand-
response van service, according to the Community Transportation 
Association of America, and is more flexible than fixed route transit 
but more structured than the use of a private automobile.

[26] GAO/RCED-00-1.

[27] www.fta.dot.gov/CCAM/www.index.html.

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

[29] P.L. 103-62.

[30] U.S. General Accounting Office, Agencies' Strategic Plans Under 
GPRA: Key Questions to Facilitate Congressional Review, GAO/GGD-10.1.16 
(Washington, D.C.: May 1, 1997).

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

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

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

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

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

[36] See "One-Stop Innovations: Leading Change under the WIA One-Stop 
System," a report prepared for the U.S. Department of Labor by the John 
H. Heldrich Center for Workforce Development at Rutgers, the State 
University of New Jersey (Mar. 12, 2002).

[37] In addition, one of DOL's divisions in 2001 had a liaison to the 
Council's Technical Committee--which focused on coordinating 
employment programs for low-income individuals. However, the DOL 
liaison indicated that little activity ensued after the liaison briefed 
the committee on the one-stop centers, and the committee later went 
dormant with the change in administration.

[38] Moss Adams, LLP, Community Transportation Association of America, 
The Coordination Challenge (Seattle, WA: June 2000).

[39] Coordinating Council on Access and Mobility, Planning Guidelines 
for Coordinated State and Local Specialized Transportation Services 
(Washington, D.C.: Dec. 20, 2000).

[40] Ecosometrics, Inc., Recommended Framework for Developing State and 
Local Human Services Transportation Planning Guidance (Bethesda, MD: 
Sept. 22, 1998).

[41] Volpe National Transportation Systems Center, Innovative State and 
Local Planning for Coordinated Transportation (U.S. Department of 
Transportation, February 2002).

[42] Volpe National Transportation Systems Center, Innovative State and 
Local Planning for Coordinated Transportation.

[43] Westat, Toolkit for Rural Community Coordinated Transportation 
Services.

[44] Community Transportation Association of America, Building Mobility 
Partnerships: Opportunities for Federal Investment (Washington, D.C.: 
March 2002).

[45] Coordinating Council on Access and Mobility, Planning Guidelines 
for State and Local Coordination (Washington, D.C.: Dec. 20, 2000).

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

[47] P.L. 105-220.

[48] Volpe National Transportation Systems Center, Innovative State and 
Local Planning for Coordinated Transportation, (U.S. Department of 
Transportation, February 2002).

[49] http://www.ctaa.org/ntrc.

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

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

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