United States General Accounting Office GAO Report to Congressional Committees October 1999 TRANSPORTATION COORDINATION Benefits and Barriers Exist, and Planning Efforts Progress Slowly GAO/RCED-00-1 United States GAO General Accounting Office Washington, D.C. 20548 Resources, Community, and Economic Development Division B-281617 October 22, 1999 The Honorable Phil Gramm Chairman The Honorable Paul S. Sarbanes Ranking Minority Member Committee on Banking, Housing, and Urban Affairs United States Senate The Honorable Bud Shuster Chairman The Honorable James L. Oberstar Ranking Democratic Member Committee on Transportation and Infrastructure House of Representatives For several decades, many human services agencies have provided special transportation services for seniors, persons with disabilities, and others through programs funded and administered by the Department of Health and Human Services (HHS). For example, program-related transportation services have enabled elderly people who no longer drive to get to sites offering nutrition services, ensured that isolated children receive benefits from Head Start programs, and transported clients to community health centers and welfare recipients to jobs. Local human services agencies providing these services have often purchased and operated their own vehicles or purchased transportation services from others. The estimates of overall spending on transportation by HHS programs in fiscal year 1998 ranged from about $2 billion to $3.5 billion.1 Similarly, the Federal Transit Administration (FTA), within the Department of Transportation (DOT), awards grants to local transit operators to provide assistance for general public transportation systems, such as bus and subway systems, and also makes awards for special purposes, such as grants and loans for the special needs of elderly individuals and individuals with disabilities. FTA’s overall expenditures for transportation services are estimated to exceed $4 billion for fiscal year 1998. 1 HHS’ and the Federal Transit Administration’s estimated transportation expenditures, as cited in Current State and Local Practices in Planning for Coordinated Transportation, Volpe National Transportation Systems Center, Department of Transportation (final revised draft, May 1999). Page 1 GAO/RCED-00-1 Transportation Coordination B-281617 HHS’ and FTA’s transportation investments, which totaled over $6 billion in fiscal year 1998, often failed to complement each other because of a lack of coordination. Coordination can range in scope from the shared use of local facilities, equipment, training, and/or maintenance services to the consolidation of various public and social service providers’ transportation services. As HHS and FTA have recognized, the lack of coordination among human services transportation providers and public transit operators contributes to the duplication or overlapping of transportation services. Thus, particular clients may be left unserved or underserved, while transportation providers serving other clients may have excess capacity. Section 3034 of the Transportation Equity Act for the 21st Century (TEA-21) (P.L. 105-178) requires that we report on federal agencies that provide nonemergency human services transportation. As agreed with you, we reviewed (1) the benefits and incentives to human services transportation coordination, (2) HHS’ and FTA’s efforts to identify barriers to transportation coordination, and (3) HHS’ and FTA’s efforts to enhance transportation coordination through state and local transportation planning. Transportation coordination can reduce federal transportation program Results in Brief costs by clustering passengers, utilizing fewer one-way trips, and sharing the use of transportation personnel, equipment, and facilities. In addition, people in need of transportation often benefit from the greater and higher quality transportation services available when transportation providers coordinate their operations. A study by the Community Transportation Association of America, a nonprofit transportation association, presented five case studies that showed significant reductions in the average cost per passenger and vehicle hour as a result of transportation coordination. In one instance, the local human services agency’s average cost per passenger trip decreased from $7.92 to $4.06, and the average cost per vehicle hour declined from $12.83 to $6.89. In addition, the five case studies showed that following transportation coordination, there was an increase in the number of trips per month and total trips per passenger hour, while the total number of vehicles in the agencies’ fleets held steady or declined. The most concerted effort by HHS and DOT to identify barriers occurred in 1988. At that time, acting through a Coordinating Council established in 1986, the agencies identified 64 factors that transportation and human Page 2 GAO/RCED-00-1 Transportation Coordination B-281617 services representatives believed were barriers to transportation coordination. For each barrier, the Council offered a federal response that, in some cases, simply attempted to clarify misunderstandings about program requirements. Other responses, however, did not resolve the barrier because the issues required legislation, needed additional study, or were outside of the control of the Departments. More recently, the Coordinating Council held transportation meetings with most states in 1995 and 1996, but when barriers were addressed in these meetings, the comments were often limited to a word or phrase. This level of generality made a federal response difficult, and none was undertaken. Since 1996, HHS and DOT have been directed by congressional committees to advance state and local transportation coordination through joint planning guidelines that would address issues such as the expanded use of public transit services to deliver human services transportation. In response, HHS and DOT, through the Coordinating Council, began developing planning guidelines in the spring of 1997. While some progress has been made, the joint planning guidelines are still under development. The Departments recognize that progress on the guidelines has been slow and have assigned a contractor to work with agency officials so the guidelines could be issued by the end of 1999. The agencies have also concluded that as an entity, the Coordinating Council needs to be strengthened. To this end, the two Departments are working on a draft strategic plan for the Council that not only lists goals and objectives, but specific tasks intended to make the goals and objectives a reality. However, this strategic plan has been in draft for several years, and it is unclear if and when any of the plan’s proposed tasks will be undertaken. In order to focus and expedite the work of the Coordinating Council, this report recommends that HHS and DOT issue a prioritized strategic plan by a specific date and increase accountability for achieving the work outlined in the strategic plan through an action plan and an annual report on the Council’s work to the Secretaries of HHS and DOT. In many cities, there are numerous public and private providers of Background specialized and paratransit services,2 often funded by multiple agencies or funding sources.3 All too often, state and local agencies are unaware that 2 Paratransit service is more flexible than conventional fixed-route transit service but is more structured than the use of private automobiles. It most often refers to wheelchair-accessible, demand-response van service. 3 Human services transportation systems developed primarily out of a lack of available service for agency clients, and this need continues in many areas, as HHS notes that 40 percent of counties do not have any public transit service. Page 3 GAO/RCED-00-1 Transportation Coordination B-281617 they are, in certain cases, providing transportation services identical and parallel to those of another agency. As participating agencies coordinate, the current schedules and passenger loads for each carrier/provider are analyzed to identify where opportunities exist to consolidate routes, develop ride-sharing or comingling agreements, and eliminate duplication and thereby realize efficiencies of scale. During oversight hearings on rural transportation in 1985, a congressional committee heard testimony prompted by concerns about the lack of transportation coordination between federal programs such as those managed by DOT and HHS.4 Witnesses documented the complexity of the problems, such as a wide range of programs, diverse client populations, different administrative practices, and different agencies involved at federal, state, and local levels. Federal agency heads, state officials, and program operators also cited instances where coordination had improved the cost-effective delivery of human services. They called, almost in unison, for federal leadership to halt fragmentation, duplication, and the waste of taxpayers’ dollars. One solution proposed by DOT during the hearings was the establishment of a joint coordinating council between DOT and HHS. In October 1986, the Secretaries of Health and Human Services and Transportation signed an agreement establishing a Joint DOT/HHS Coordinating Council on Human Services Transportation (Coordinating Council). The Coordinating Council was established to improve the efficiency and effectiveness of specialized and human services transportation by coordinating related programs at the federal level wherever possible and promoting the maximum feasible coordination at the state and local levels. The two Departments agreed to work in concert to promote five goals that include achieving the most cost-effective use of federal, state, and local resources for specialized and human services transportation, and six objectives that include removing barriers that adversely affect the coordination of transportation services. In 1998, the Council was renamed the Coordinating Council on Mobility and Access, which, in recent years, has tried to convene for quarterly meetings. Officials from various HHS and DOT program offices support the Council on a part-time basis, and their efforts are supplemented by assistance from contractors. 4 Hearings on Rural Transportation: The Role of Public and Non-Profit Providers, U.S. House of Representatives, Committee on Public Works and Transportation, Subcommittee on Oversight and Investigation (May 1985). Page 4 GAO/RCED-00-1 Transportation Coordination B-281617 The Coordinating Council has sought to encourage state-level actions to promote coordination as a key strategy in its effort to promote the coordinated delivery of transportation services. In 1986, when the Council was established, only seven states reported any involvement with transportation coordination, according to DOT officials. State involvement has increased over the years. A 1999 draft report prepared for the Coordinating Council cited various policies for coordinating transportation at the state level, including executive orders establishing statewide coordinating committees and interagency agreements.5 For some states, however, the relevance of the activity listed in this draft report for coordinating transportation was unclear—examples included no formal agreement, an expired executive order, and informal interagency cooperation. In recent years, the Congress has endorsed increased transportation coordination, as reflected by several provisions in TEA-21 supporting this coordination. For instance, one provision directs DOT to encourage transportation coordination through the metropolitan planning process. Another provision states that eligible projects funded through job access and reverse commute grants are to be part of a coordinated public transit-human services transportation planning process. In addition, another TEA-21 provision provides that to the extent feasible, governmental agencies and nonprofit organizations that receive assistance from government sources other than DOT for nonemergency transportation services shall coordinate the design and delivery of transportation services and be included in the planning for those services. Coordinated transportation services encourage efficiency by clustering Transportation passengers, utilizing fewer one-way trips, and reducing costs through the Coordination Has shared use of personnel, equipment, and facilities. As the Coordinating Been Shown to Have Council notes, transportation coordination can also improve overall mobility within a community, particularly in instances when human Numerous Benefits service agencies are separately providing transportation for their own clients. Coordination works by reducing the inefficiencies arising from the disparate operations and service patterns that often result from a multiplicity of providers. As the Council observes, coordination can lead to significant reductions in per-trip costs. Furthermore, people in need of transportation often benefit from the greater and higher-quality 5 Survey of State Coordination Programs and Policies, American Public Works Association, Ecosometrics Inc., and National Transportation Consortium of States (draft, Apr. 1999). Page 5 GAO/RCED-00-1 Transportation Coordination B-281617 transportation services available when transportation providers coordinate their operations. In a comparison of the cost and efficiency of transportation services before and after coordination, a 1992 study by the Community Transportation Association of America,6 funded by HHS and FTA, presented case studies from five sites that showed dramatic reductions in passenger trip costs and vehicle-hour costs after coordination activities were undertaken.7 In addition, the study showed an increase for all five sites in the number of passengers per vehicle hour and for total trips while the number of vehicles in the fleet held steady or decreased. Table 1 shows the results of the study. Table 1: Comparison of the Cost and Efficiency of Transportation Services Before and After Coordination/Consolidation at Five Sites Grand Rapids/ Kent Washington County, Greenville County, Howard County, Md. County, Mich. Pa. S.C. Pitt County, N.C. Measure Before After Before After Before After Before After Before After Average cost per passenger trip $7.92 $4.06 $6.11 $5.70 $28.46 $6.25 $6.31 $2.01 $7.13 $3.59 Average cost per vehicle hour 12.83 6.89 26.27 18.94 22.24 13.28 21.36 12.15 10.66 12.06 Average trips per month 2,236 4,713 12,180 54,762 2,800 6,300 12,558 15,850 3,880 5,126 Average passenger per vehicle hour 2.1 3.4 4.3 12.8 2.9 9.1 2.4 6.04 1.5 3.36 Number of vehicles 12 12 132 132 N/A N/A 65 12 41 15 Legend N/A = not applicable Source: An Analysis of Human Services Transportation: America’s Other Transit Network, CGA Consulting Services, Inc., for Community Transportation Association of America (Feb. 1992). Medicaid transit pass programs initiated at several locations around the country provide another example of the value of increased transportation 6 The Community Transportation Association of America 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. 7 See An Analysis of Human Services Transportation: America’s Other Transit Network, CGA Consulting Services, Inc., Community Transportation Association of America (Feb. 1992). Page 6 GAO/RCED-00-1 Transportation Coordination B-281617 coordination. Medicaid is the largest source of funding for medical and health-related services for America’s poorest people. In 1996, it provided health care assistance for more than 36 million persons, at a cost of $160 billion. As HHS officials noted, federal regulations mandate that each state Medicaid agency must describe how the agency will ensure necessary transportation for clients to and from providers for clients without their own transportation. The most frequent users of Medicaid-funded transportation services are disabled individuals, elderly persons, children who are receiving counseling or other services on a regular basis, and individuals who travel regularly to medical appointments for services such as dialysis, mental health treatment, chemotherapy, or physical therapy if they are severely disabled. When Medicaid provides participants with paratransit service, it often costs about 10 times the cost of transit fares. But instead of paying for paratransit services for physically able clients, HHS and DOT note that Medicaid could provide these clients with monthly bus passes, if they can access a bus route. HHS’ Health Care Financing Administration sent a letter to state Medicaid Directors in December 1996 advising them that a monthly bus pass program can be used if it is cost-effective and appropriate to the individual’s needs and personal situation. In the summer of 1999, HHS and DOT issued a brochure on the results of Medicaid bus pass usage in six states. According to DOT’s Volpe Center, a notable example of the merits of such an approach is the Metro Pass program in Dade County, Florida. The Dade County program encourages those Medicaid recipients who can use the public transit system to use the monthly Metro Pass, which gives them unlimited transportation on the fixed-route system at a cost of $30 to $50 per month (including administrative fees). A sample calculation of monthly savings from the use of the Metro Pass program is provided in table 2. Page 7 GAO/RCED-00-1 Transportation Coordination B-281617 Table 2: Comparison of Medicaid Recipient Transportation Costs Before Time period Registered Number of and After a Metro Pass Program October 1998 users trips Cost per user Total Before Metro 5,084 52,752 $15.28 per trip $806,051 Pass Program After Metro Pass 5,084 Unlimited $38.05 per $193,458 Program montha Total cost $612,592 savings for October 1998 a Average cost of monthly pass. Source: Current State and Local Practices in Planning for Coordinated Transportation, Volpe National Transportation Systems Center, Department of Transportation (final revised draft, May 1999). As table 2 shows, and as estimated by the community transportation coordinator for Florida’s Dade County, the program saved approximately $600,000 in October 1998. Furthermore, the local coordinator estimates that the program has saved $24.6 million since its implementation in 1993. HHS and DOT reported that on the basis of states’ experiences so far, if 1 percent of the Medicaid recipients in the nation’s 20 largest metropolitan areas were shifted to transit passes, the savings would be about $215 million per year. Furthermore, HHS and DOT projected that additional fares to transit agencies in the nation’s 20 largest metropolitan areas would be from $21 million to $43 million annually. However, HHS and DOT cautioned that while transit passes offer the opportunity of multiple trips per month at great savings to the Medicaid program, local conditions would affect specific breakeven points. Such conditions include the proportion of Medicaid recipients in the local community, the number of medical trips per month required, and the local costs of monthly transit passes. When HHS and DOT formed the Coordinating Council in 1986, one of the HHS’ and FTA’s primary objectives established for the Council was the elimination of Efforts to Identify and barriers to the coordination of transportation services. In this context, the Resolve Barriers to Council undertook an early effort to identify and respond to 64 factors that transportation and human services representatives believed were barriers Transportation to transportation coordination. For each barrier, the Council offered a Coordination Have federal response that in some cases simply attempted to clarify misunderstandings about program requirements. Other responses, Been Limited Page 8 GAO/RCED-00-1 Transportation Coordination B-281617 however, did not resolve the barrier because issues required legislation, needed additional study, or were outside of the Departments’ control. More recently, the Coordinating Council held transportation meetings with most states in 1995 and 1996, but when barriers were addressed in these meetings, the comments were often limited to a word or phrase. This level of generality made a federal response difficult, and none was undertaken. However, the Council is undertaking several general efforts to improve transportation coordination. For example, the National Transit Resource Center, funded by HHS and FTA, disseminates information on transportation coordination, and HHS is funding another effort related to reporting and recording burdens that may be thwarting transportation coordination. Most Concerted Effort to In 1988, the Coordinating Council initiated a nationwide effort to identify Identify Barriers Occurred statutory, regulatory, and programmatic barriers to the coordination of Over a Decade Ago transportation services. With the assistance of 10 Regional Working Groups—each group included one transportation representative and one human services representative from each of the states—the Coordinating Council solicited the viewpoints of a broad array of individuals and organizations, including transportation providers, local human services agencies, state agencies, and industry associations. The Regional Working Groups forwarded these findings to the Coordinating Council, which, in turn, submitted them to the appropriate offices within HHS and FTA.8 A total of 64 barriers were identified. For each barrier, the Council offered a federal response that in some cases simply attempted to clarify misunderstandings about program requirements. Other responses, however, did not resolve the barrier because issues required legislation, needed additional study, or were outside of the Departments’ control. Examples of the issues that were identified as barriers along with the federal responses follow. Uncertainty Regarding Federal One barrier to transportation coordination that was identified was unclear Responsibilities for federal roles and responsibilities for transportation, particularly when Transportation individuals are clients of multiple programs. This can lead individual programs to attempt to shift their client transportation costs to other programs, thus reducing the former’s own costs. For example, several states expressed concern that FTA funds were being used to transport clients of human services programs, thus replacing state or local funds that had formerly been provided through HHS programs. HHS and FTA did not address this issue head on. Instead, they noted that it was impossible 8 The Urban Mass Transportation Administration had responsibility for transit at this time but was renamed the Federal Transit Administration, which is the term used throughout this report. Page 9 GAO/RCED-00-1 Transportation Coordination B-281617 for them to control the amount of funding that local human services agencies elect to devote to clients’ transportation or to prevent reductions in their transportation expenditures. HHS and FTA noted that the larger question—“Where does DOT’s responsibility end and HHS’ begin?”—in the area of specialized or human services transportation is also unanswerable, except to say in broad terms that there is joint responsibility and that both Departments acknowledge this. Fragmented Accounting and Another barrier cited was the lack of standardized accounting and Reporting reporting procedures. Many states complained that there was no standardized accounting system that human services providers can use for all of their federal programs. In addition, they said that different programs have different reporting requirements, resulting in excessive paperwork for small operators and too many financial and program audits for the same system. In their view, this fosters a lack of accountability and coordination at the state level. In response, HHS and FTA pointed to simplified accounting procedures that they have suggested for use by rural and specialized transportation. Furthermore, FTA and HHS noted that they would continue to discuss existing reporting requirements and explore the development of more common performance standards, accounting, and reporting for all transportation components of FTA and HHS programs. Uncertainty in Using Resources Some grantees stated that they believed that governmentwide regulations for Other Than Program prohibit the use of equipment (vehicles) and facilities acquired under one Constituents grant to meet some of the needs of projects supported by different grants. HHS responded by noting that while there have been statutes governing individual grant programs that restricted use of grant equipment and facilities to activities supported by the grant, there is no general governmentwide regulation prohibiting shared use. HHS also noted that the governmentwide “common rules” on the fiscal and administrative aspects of grants require only that first priority for use of the equipment or facilities go to the grant project. Prohibition Against Charging Some states believed that elderly riders should be charged a fare to Fares Under the Older provide the needed local match for federal money. HHS noted, however, Americans Act that the Older Americans Act strictly prohibits means testing and denial of services because an older person cannot or will not pay for services. HHS noted that it proposed changing this provision in the past, but the necessary legislative action has not been taken. Nonetheless, HHS stated that each older person receiving a service under its programs should have the opportunity to make a contribution, but only the individual older person should determine whether to contribute and how much. Page 10 GAO/RCED-00-1 Transportation Coordination B-281617 Recent Efforts to Follow Since the 1988 effort by the Coordinating Council, little action has been Up on Earlier Barrier taken to identify and resolve transportation coordination barriers, and Identification Have Been problems continue to be reported in realizing transportation coordination between HHS and FTA programs. For example, the Council took no specific Limited action after a 1992 Community Transportation Association of America report, funded by HHS and FTA, used two focus groups to identify factors that prevent or impede transportation coordination. Among the most significant issues cited by focus group participants were those dealing with unclear federal guidelines on vehicle use by riders outside the funding agencies’ constituencies, a prohibition against charging fares under the Older Americans Act, the lack of uniform cost measurement systems, and record-keeping and accounting burdens. In 1995 and 1996, HHS and DOT sponsored another nationwide transportation coordination outreach effort. State transportation coordination meetings were held in 9 of 10 national regions,9 which were attended by national and regional representatives of HHS and DOT, their counterparts within the states, plus other invited experts and guests. Topics addressed at some of the meetings included respective levels of progress toward interagency coordination of transportation services, barriers to coordination, important problem areas and issues, and plans for action. This effort differed from the 1988 effort in that not all the states addressed barriers to transportation coordination. Furthermore, when barriers were addressed in these later state meetings, the comments were often limited to a word or a phrase, such as “turf protection” or regulations. This level of generality made a federal response difficult, and none was undertaken. However, the meetings did encourage transportation coordination efforts in some states. In particular, DOT noted that the meetings held in Maryland and New Jersey stimulated vigorous statewide efforts to develop coordination mechanisms, such as a state coordinating council. In addition, HHS noted that several items were identified for federal action following these regional meetings, such as case studies on how to incorporate services for Medicaid clients into local public transportation. While not planning any systematic efforts to identify the extent of transportation coordination barriers, the Council is undertaking other general efforts to improve transportation coordination. For example, the Community Transportation Assistance Project, funded by HHS, and the Rural Technical Assistance Program, funded by FTA, support, among other 9 Region 9 did not hold a meeting, but two of the Region 9 states—Arizona and Nevada—attended meetings held in other regions. Page 11 GAO/RCED-00-1 Transportation Coordination B-281617 efforts, a National Transit Resource Center that compiles and disseminates information to help agencies and communities develop better access and more cost-effective transportation. The Rural Technical Assistance Program, for example, supported the development of a training video entitled Transportation Coordination: A Guide to Making It Work for You that promotes the benefits of coordinated community and human services transportation by showing interviews with a number of individuals working in, or served by, such systems. Another effort is a 1996 report funded by the Community Transportation Assistance Project that identifies transportation funding sources in federal programs.10 Furthermore, on occasion, specific barriers to transportation coordination are discussed at HHS and DOT coordinating meetings. For instance, the issue of burdensome reporting and record-keeping was discussed at a July 1998 planning meeting, which led HHS to task a contractor, Ecosometrics, Inc., with doing some preliminary work at four locations to better analyze the problem. In the summer of 1999, the contractor was analyzing the results from these case studies. An initial finding from the case studies is that it is not so much any particular requirement that creates concerns but, rather, the weight of them together that frustrates transportation providers. In addition, the case studies indicate that the role of state reporting requirements may be contributing to reporting burdens to a greater extent than federal requirements. HHS considers these case studies to be the first phase of a larger project. HHS officials noted that they had received a draft report for this first phase of the project and expect to receive the final report by October 31, 1999. A representative of Ecosometrics stated that his firm expects to continue this effort with more case studies in 2000. One recent communication tool employed by the Coordinating Council that could have an impact on the elimination of coordination barriers is an Internet site developed for the Council by a contractor in the spring of 1999. The Council’s Internet site contains information about the Coordinating Council, the reasons for coordinating transportation services, transportation coordination strategies, a listing of publications about coordinated transportation, and related sites of interest. The site also solicits questions or comments about the Coordinating Council, thus providing an opportunity to clarify misconceptions that could be hampering transportation coordination efforts. The utility of the site for resolving barriers, however, is limited by two design weaknesses. First, as 10 Building Mobility Partnerships: Opportunities for Federal Funding, prepared for the Community Transportation Assistance Project by the Community Transportation Association of America (May 1996). Page 12 GAO/RCED-00-1 Transportation Coordination B-281617 of August 1999, the Council’s Internet site had not yet been linked to the main HHS or FTA Internet sites, although it can be accessed directly when the specific Internet address is known (www.ccamweb.org). Second, while the site is designed to enable users to search on key words, our tests indicated that this design component was not working. HHS and FTA officials recognized the site’s weaknesses and said the Internet site is still developmental, and they hope to develop the search feature for the site as well as develop a “frequently asked question” section that could help to mitigate barriers to transportation coordination. The Coordinating Council has been working on developing joint state and Improved local planning guidelines to advance transportation coordination, as Transportation directed by congressional committees since 1996. While some progress has Coordination Through been made, the joint planning guidelines are still under development and have a tentative issue date set for the end of 1999. In addition, TEA-21 State and Local directs DOT to encourage transportation coordination through the Planning Guidance metropolitan planning process. A revised DOT planning regulation is expected to address transportation coordination, and DOT expects to issue Not Yet Realized a proposed rule by the end of 1999. The Departments also recognize that the Coordinating Council, as an entity, needs to be strengthened. To this end, the two Departments are working on a draft strategic plan for the Council that not only lists goals and objectives, but specific tasks intended to make the goals and objectives a reality. However, this strategic plan has been in draft for several years, and it is unclear if and when any of the plan’s proposed tasks will be undertaken. Transportation Since 1996, congressional committees have repeatedly directed HHS and Coordination Planning DOT to develop guidelines for state and regional planning to achieve Guidelines Still in Progress specific transportation coordination objectives. For example, in reports accompanying the DOT appropriations bills for fiscal years 1997 and 1998, the Senate Committee on Appropriations noted that the coordination of transportation for persons with disabilities, seniors, and others funded by HHS programs or by public transit authorities must be planned and implemented at the state and regional levels in order to ensure cost-effective service delivery and improve access to HHS program services. Specifically, the Committee directed the Secretary of Transportation, working with the Secretary of Health and Human Services through the Coordinating Council, to develop guidelines for state and regional planning to achieve specific transportation coordination objectives, including, but not limited to, Page 13 GAO/RCED-00-1 Transportation Coordination B-281617 • the joint identification of the transportation needs of human services clients and the appropriate mix of transportation services to meet those needs, • the expanded use of public transit services for human services transportation, and • cost-sharing arrangements for HHS program clients transported by Americans With Disabilities Act paratransit systems based on a uniform accounting system. In the spring of 1997, the Coordinating Council established a working group to develop transportation coordination guidelines. The working group focused on three principal efforts. First, a report on developing a framework for state and local human services transportation planning was prepared by a consultant.11 The report noted fundamental differences in the role of transportation for the recipients of funding from HHS and DOT. As the report explains, transportation is the primary or even sole mission for most of the recipients of FTA funds; whereas, many recipients of HHS funding are multiservice organizations. For these multiservice organizations, transportation is seen as an ancillary service enabling them to accomplish their key missions; transportation is only one of many services offered to their clients. For FTA, the report identifies and provides background information on seven programs. For HHS, the report identifies and provides background information on 12 primary programs that frequently purchase transportation services or at times provide transportation services to program clients. As the report notes, although transportation activities vary significantly among the 12 HHS programs, many of these programs are required “to reflect the principles of devolution. This means they operate with minimal Federal guidance on transportation issues, including planning requirements, program review, priority setting, service provision, and oversight.” Recognizing the challenge of modifying the planning processes within the differing program cultures, the report presents various options for obtaining more coordinated planning, such as policy statements in support of coordinated planning efforts and technical assistance on coordinated planning practices and strategies. Second, in order to receive stakeholders’ input at an early stage in the development of the planning guidelines, the Council convened an advisory panel workshop on July 1, 1998. The advisory panel included representatives from transit authorities, health care representatives, and 11 Recommended Framework for Developing State and Local Human Services Transportation Planning Guidance, Ecosometrics, Inc. (Sept. 22, 1998). Page 14 GAO/RCED-00-1 Transportation Coordination B-281617 representatives from state and local governments. Key points expressed by the stakeholders at this meeting included the following: • More coordination in the planning process would increase the cost-effectiveness of human services transportation efforts. Planning is critical to starting, improving, or expanding the coordination of services. Coordinated planning should promote the free flow of information necessary to design more responsive transportation systems. • Coordination is difficult, and it is a lot of work. Many people need to be convinced that it is worth the effort. Most agencies do not have the basic facts and figures needed to analyze their own transportation services, particularly with respect to fully allocated costs. A data-intensive approach yields many benefits. • Public transit services for human services agencies’ programs and their clients may decline without a commitment to coordinate planning and resources. Growing elderly populations accentuate the need for additional services. • Financial and other incentives are needed to support transportation coordination efforts, and these incentives could include added consideration during grant reviews, special recognition through the Coordinating Council, and departmental recognition efforts. Third, DOT’s Volpe Center conducted an effort in support of the development of the joint planning guidelines. On the basis of a list of selected states and urban and rural areas believed to have experience in coordinating transportation services, staff of the Volpe Center conducted telephone interviews with representatives from the candidate areas to gather information on the history and background of transportation coordination efforts in their areas. Thereafter, Volpe staff conducted a second round of interviews focusing their efforts on developing 15 case studies of transportation coordination. The case studies were used to examine broad coordination strategies, such as the joint identification of clients’ needs, shared planning resources, and the establishment of cost-sharing arrangements, that can be used as part of a process for coordinating transportation services of human services and transit agencies. For instance, the Volpe Center study notes that the joint identification of clients’ needs can contribute to a coordinated approach to transportation service delivery in a number of ways. When the needs of each agency’s clients are regarded collectively, the participants are then able to take the first step in scoping the size and breadth of the coordinated system. The Page 15 GAO/RCED-00-1 Transportation Coordination B-281617 clients’ needs will include the type of transportation needed, the origins and destinations of trips, and the timing and frequency of required trips. Once participating agencies have this information, they will be able to adjust existing paratransit services or create new services as needed while achieving efficiencies through the comingling of clientele or coordinated dispatching of services. The study cited the Mass Transportation Authority (MTA) in Flint, Michigan, as an example of achieving efficiencies through a comingled clientele. MTA provides public transportation for the Flint School District (except for special education) and comingles school children with the general public at a considerable cost savings to the district. Formerly, it cost the district $660 per student for transportation on an annual basis. Now, MTA provides that service at $264 per student. Following the consultant’s and the Volpe Center’s reports, HHS and FTA officials planned to have their staff develop and distribute draft guidance through a multistep comment process. The status of the guidelines is addressed at periodic Council meetings along with comments about the need to bring this effort to closure. For instance, the FTA Deputy Administrator noted at an April 1998 Coordinating Council meeting that HHS and FTA have been working on a number of transportation coordination issues over the years, including the joint planning guidelines, and that these efforts need to be brought to closure. However, the development of the guidelines stalled, and, in the spring of 1999, HHS and DOT officials decided to have a contractor assist them in developing an initial draft of the guidelines. A first draft of the guidelines was prepared on July 30, 1999. The draft provides introductory information about coordination and how interest in coordination has developed over time. The draft also contains a checklist of general steps needed for a coordinated planning process, such as the need to understand and document the transportation needs and resources of the local area and involve the local community in the planning process. Other material excerpted from the reports to the Council from the Volpe Center and Ecosometrics, Inc., consists of background information on primary HHS programs providing transportation services and FTA programs, a discussion of planning requirements, and actual case studies of how coordinated planning has led to more cost-effective transportation services in different communities. However, it remains unclear how these guidelines, as drafted, will fulfill their intended purpose, which is to assist state and local officials in achieving specific coordination objectives, including, but not limited to, (1) the joint identification of clients’ transportation needs and the appropriate mix of transportation services to Page 16 GAO/RCED-00-1 Transportation Coordination B-281617 meet those needs, (2) the expanded use of public transit to deliver human services transportation, and (3) cost-sharing arrangements for program clients transported by paratransit systems based on a uniform accounting system. The guidelines will likely become more responsive to these objectives as they become fully developed and refined after reviews and revisions by various HHS and FTA program officials and outside parties via the Council’s new Internet site. After comments are received and considered by HHS and FTA, the guidelines will be issued. HHS officials estimate that the guidelines will be issued by the end of 1999. TEA-21 Encourages In addition to directing HHS and DOT to develop joint guidelines on Transportation transportation coordination during the appropriation process, TEA-21 has Coordination Planning several provisions supporting coordinated transportation planning. For instance, one provision directs DOT to encourage transportation coordination through the metropolitan planning process. In response to TEA-21’s planning provisions, DOT officials plan to issue a revised planning regulation. According to DOT, the transportation community provided extensive input on planning and environmental issues during a TEA-21 outreach effort conducted by DOT’s Office of the Secretary during 1998. In order to focus and continue discussion by partners and stakeholders, the Federal Highway Administration and FTA prepared a paper entitled “TEA-21 Planning and Environmental Provisions: Options for Discussion.” The document presents issues and implementation options relative to the planning and environmental provisions of TEA-21. However, the document does not address the TEA-21 provision that directs the Secretary of Transportation to encourage each metropolitan planning organization to coordinate, to the maximum extent practicable, the design and delivery of transportation services within the metropolitan planning area. According to FTA planning officials, this provision was not initially included in the options for the discussion paper because the legislative provision referred to encouraging rather than requiring coordination. These officials noted, however, that the revised planning regulation is expected to address the coordination issue. As of August 1999, the planning regulation was still under development, but FTA officials expect to issue the notice of proposed rulemaking by the end of 1999. Furthermore, FTA officials note that a coordinated planning environment may be advanced through other TEA-21 provisions and federal transportation coordination efforts. For instance, a TEA-21 provision Page 17 GAO/RCED-00-1 Transportation Coordination B-281617 provides that to the extent feasible, governmental agencies and nonprofit organizations that receive assistance from government sources other than DOT for nonemergency transportation services shall coordinate the design and delivery of transportation services and be included in the planning for those services. Another TEA-21 transportation coordination provision relates to job access and reverse commute grants and requires each application for funds to reflect coordination with and the approval of affected transit grant recipients. As an FTA official noted, advancing transportation coordination efforts becomes easier when a new program, such as job access and reverse commute grants, provides additional funds and links the receipt of the funds to the concept of transportation coordination. In addition, the Coordinating Council sent a memorandum to HHS’ and FTA’s regional offices on August 20, 1999, directing them to develop regional action plans that include plans to promote transportation coordination guidelines. Regional Working Groups were instrumental in the Coordinating Council’s early efforts to identify statutory, regulatory, and programmatic barriers to the coordination of transportation services. However, according to Coordinating Council members, only some regional groups continue to address transportation coordination, but the hope is that the recent memorandum will stimulate activity by all 10 Regional Working Groups. Proposed Strategic Plan to The Coordinating Council was established in 1986 to improve the Strengthen the efficiency and effectiveness of specialized and human services Coordinating Council Still transportation by coordinating related programs at the federal level wherever possible and promoting the maximum feasible coordination at Not Finalized the state and local levels. HHS and DOT agreed to work in concert to promote the purpose of the Council through five goals and six related objectives. A Council goal, for example, is to achieve the most cost-effective use of federal, state and local resources for specialized and human services transportation, and one of the objectives is to remove barriers that adversely affect the coordination of transportation services. In 1995, HHS and FTA officials began efforts to strengthen the future work of the Council by providing it with a draft strategic plan- -a blueprint- -for advancing transportation coordination. The draft strategic plan list goals and objectives, as well as specific tasks intended to make the goals and objectives a reality. A draft of the Council’s strategic plan shows that its efforts would be significantly expanded to 6 goals, 27 objectives, and 30 Page 18 GAO/RCED-00-1 Transportation Coordination B-281617 related tasks- -an ambitious undertaking, particularly since there is no prioritization of the goals, objectives, or tasks. One proposed goal is to achieve the most cost-effective use of federal, state, and local resources for transportation. Accompanying objectives for this goal include (1) maximizing opportunities for coordinating transportation program resources at federal, state, and local levels; (2) reducing the duplication of services; (3) identifying and encouraging cost-effective transportation services, and; (4) developing rapid response capabilities for implementing new technologies for transportation and/or access to community services. Several of the proposed tasks in the strategic plan relate to barriers. For instance, one proposed task is to identify regulatory barriers to coordination. Another proposed task would highlight the work of the Council through an annual report on efforts to reduce barriers, disseminate transportation coordination information, and note special projects. An additional proposed task would be to have action plans and annual updates submitted from each member agency to the Council. HHS’ and FTA’s attention to the development of this strategic plan has been sporadic, and there is no set date for finalizing the strategic plan. Although the need to issue this plan in the near future was noted at a June 1996 Council meeting, the strategic plan for the Council continues to languish in a draft state, thus it is unclear when proposed tasks would be undertaken. Furthermore, given the difficulties the Council has experienced in bringing issues to closure, the scope of the strategic plan- –6 goals, 27 objectives, and 30 tasks- -could prove to be an overwhelming agenda, particularly given the lack of any prioritization within the strategic plan. Transportation coordination has the potential for realizing more efficient Conclusions and cost-effective transportation services. While the Coordinating Council has a long record of supporting transportation coordination initiatives, the Council’s efforts have been erratic and slow to produce results. A draft strategic plan for the Coordinating Council has a number of good ideas for moving the Council forward, such as an annual report for the Council, which, at a minimum, should include a report on barriers, dissemination efforts, and special projects. However, the draft strategic plan for the Council entails 6 goals, 27 objectives, and 30 tasks, which is a broad and perhaps overwhelming agenda, given the Council’s past level of performance and the lack of any prioritization within the strategic plan. Furthermore, the strategic plan could continue to languish in draft, since there is no set issuance date. Page 19 GAO/RCED-00-1 Transportation Coordination B-281617 Congressional committees have repeatedly directed HHS and DOT to develop guidelines to enhance transportation coordination through state and local planning since 1996; these guidelines remain under development and now have a tentative issuance date set for the end of 1999. Also under development is a revised planning regulation that is expected to reflect a TEA-21 provision directing that DOT encourage each metropolitan planning organization to coordinate, to the maximum extent practicable, the design and delivery of transportation services within the metropolitan planning area. However, since both of these efforts remain works-in-progress, it is unclear how, if at all, they will reinforce each other. While efforts are under way to have the 10 Regional Working Groups develop action plans, HHS and FTA are not instructing these Regional Working Groups to assess barriers to transportation coordination. In addition, no similar action agenda exists for the Coordinating Council. However, the Coordinating Council recently developed its own Internet site, which has the potential to be a powerful communication tool, providing information on a host of coordination issues including barriers to coordination. The utility of the site for resolving barriers, however, is limited by two design weaknesses. First, as of August 1999, the Council’s Internet site had not yet been linked to the main HHS or FTA Internet sites, although it can be accessed directly when the specific Internet address is known (www.ccamweb.org). Second, while the site is designed to enable users to search on key words, our tests indicated that this design component was not working. In order to improve transportation coordination through better planning Recommendations and enhanced accountability, we recommend that the Secretary of Health and Human Services and the Secretary of Transportation (1) require the Coordinating Council to issue a prioritized strategic plan by a specific date, (2) charge the Coordinating Council with developing an action plan with specific responsibilities, and (3) require an annual report from the Council on its major initiatives and accomplishments. As part of these planning efforts, the agencies should also (1) make sure that transportation coordination planning efforts under development reinforce one another, (2) direct the Regional Working Groups to assess barriers to transportation coordination, and (3) make information on coordination barriers and strategies for overcoming the barriers readily available through the Council’s Internet site. Page 20 GAO/RCED-00-1 Transportation Coordination B-281617 We provided DOT and HHS with a draft of this report for their review and Agency Comments comment. DOT generally agreed with the draft report that measures could be taken to expedite some of the Coordinating Council’s actions and sharpen its strategic planning and management processes. DOT, however, stated that the draft report did not sufficiently recognize the Council’s accomplishments or the progress that has been made to improve transportation coordination. We recognize that progress has been made and conclude that the Council has a long record of supporting transportation coordination initiatives. But we also conclude that the Council’s efforts have been erratic. Furthermore, many of the examples of the Council’s accomplishments in improving transportation coordination cited by DOT were already recognized in our draft report. We agree with DOT that regional meetings may have led to improved coordination efforts in some states and have incorporated information in our draft report to reflect this point. Moreover, we expanded our discussion on the Transit Resource Center and its funding sources as a result of DOT’s comments. The complete text of DOT’s comments appears in appendix I. HHS generally agreed with the report’s recommendations. However, HHS stated that the draft report presented a narrow interpretation of the work of the Coordinating Council and noted that the draft report failed to recognize HHS establishment of the Community Transportation Assistance Project, which it considers to be the backbone of HHS’ technical assistance efforts on transportation issues. While the draft report recognized the Transit Resource Center, which receives funding through the Community Transportation Assistance Project, we have added a more detailed reference to the Community Transportation Assistance Project. HHS also commented that our draft report did not recognize the significance of the transportation planning guidelines under development. Our draft report traced the history of the development of these joint guidelines. On the basis of this first draft of the guidelines, we believe that the way that they will fulfill their intended purpose is unclear. However, we note that the responsiveness of the guidelines to their intended purpose will likely be strengthened as they become fully developed and refined after reviews and revisions by various HHS and FTA program officials and outside parties. The complete text of HHS’ comments appears in appendix II. Furthermore, HHS made additional technical clarifications, which were incorporated into the draft report, as appropriate. To review the benefits and incentives to human services transportation Scope and coordination, we analyzed state, regional, and local best practices in Methodology Page 21 GAO/RCED-00-1 Transportation Coordination B-281617 human services transportation for the benefits realized and the incentives that have fostered coordinated transportation. We discussed the benefits and the incentives with HHS and FTA officials participating in the Joint Coordinating Council and with consultants for the Council, and we reviewed federal research directories and reports, including reports at the National Transit Resource Center—a national transportation clearinghouse. To review the efforts that HHS and FTA have taken to identify and address barriers to coordination, we tracked barriers identified through surveys and state outreach meetings, HHS and FTA regional input and Coordinating Council meetings, and the federal response to barriers or perceived barriers identified through these sources. We discussed the barriers or perceived barriers with HHS and FTA officials participating in the Coordinating Council and with consultants for the Council, and we reviewed transportation coordination reports. To identify HHS’ and DOT’s actions to facilitate planning processes that enhance transportation coordination efforts, we focused on HHS’ and FTA’s efforts to develop coordinated guidelines. We reviewed their primary efforts—reports and meetings —expected to contribute to the development of the guidelines and monitored the progress of the guidelines through discussions with HHS and FTA officials and attendance at Coordinating Council meetings. We also considered provisions in TEA-21 that would reinforce planning efforts aimed at transportation coordination and discussed these issued with FTA officials. We performed our review from September 1998 through August 1999 in accordance with generally accepted government auditing standards. We are sending copies of this report to the appropriate congressional committees; the Honorable Donna E. Shalala, Secretary of Health and Human Services; the Honorable Rodney E. Slater, Secretary of Transportation; and other interested parties. We will also make copies available to others on request. Page 22 GAO/RCED-00-1 Transportation Coordination B-281617 Please call me at (202) 512-3650 if you have any questions. Major contributors to this report were Yvonne Pufahl and Ron Stouffer. Phyllis F. Scheinberg Associate Director, Transportation Issues Page 23 GAO/RCED-00-1 Transportation Coordination Appendix I Comments From the Department of Transportation Page 24 GAO/RCED-00-1 Transportation Coordination Appendix I Comments From the Department of Transportation Page 25 GAO/RCED-00-1 Transportation Coordination Appendix I Comments From the Department of Transportation Page 26 GAO/RCED-00-1 Transportation Coordination Appendix II Comments From the Department of Health and Human Services Page 27 GAO/RCED-00-1 Transportation Coordination Appendix II Comments From the Department of Health and Human Services Page 28 GAO/RCED-00-1 Transportation Coordination Appendix II Comments From the Department of Health and Human Services Page 29 GAO/RCED-00-1 Transportation Coordination Appendix II Comments From the Department of Health and Human Services (348124) Page 30 GAO/RCED-00-1 Transportation Coordination Ordering Information The first copy of each GAO report and testimony is free. 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Transportation Coordination: Benefits and Barriers Exist, and Planning Efforts Progress Slowly
Published by the Government Accountability Office on 1999-10-22.
Below is a raw (and likely hideous) rendition of the original report. (PDF)