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Americans with Disabilities Act (ADA) Paratransit Eligibility Manual - Draft
DOT-T-93-17 DRAFT Americans with Disabilities Act (ADA) Paratransit Eligibility Manual September 1993 Advance Copy Americans with Disabilities Act (ADA) Paratransit Eligibility Manual Prepared for the Volpe National Transportation Systems Center Funded through the Office of Grants Management Acknowledgements This manual was prepared by EG&G Dynatrend under contract to Battelle. Funding was provided by the Federal Transit Administration's Office of Grants Management through the Volpe National Transportation Systems Center. Several individuals in each of these organizations were involved in the development of the manual. Robert Stout, Nancy Solkowski, Gary DeLorme, and Irv Chor of the Office of Grants Management, and David Spiller of the Transportation Systems Center were instrumental in defining and initiating the project. David Norstrom of Battelle assisted in the preparation of the initial document outline and provided administrative support throughout the project. Nancy Solkowski and David Spiller also served as Project Managers and provided valuable guidance and input on the structure and content of the manual. Much of the information in this report was gathered from selected transit providers across the country. Several individuals assisted in identifying providers with particular experience in the development of ADA paratransit eligibility materials and processes. Recommendations and referrals were provided by John Balog, John Morrison, and Anne Schwarz of the Ketron Division of the Bionetics Corporation, Nancy Coburn of Battelle, David Cyra of the University of Wisconsin-Milwaukee, Rich Garrity of AG Planning & Management, David Koffman of Crain & Associates, and Robbie Sarles of RLS Associates. This report would not have been possible without the cooperation of the employees of each of the transit agencies contacted. Special thanks to each of the following persons for sharing insights and for developing and providing the materials and information contained in this manual: - Robin Boshell, Delaware Administration for Specialized Transportation (DAST) - Daniel Brogan, OMNITRANS, San Bernardino, California - Jan Choti, City of Durango, Colorado - Margaret Coffey, New York City Transit Authority - Lisa Darnall, Mass Transportation Administration, Baltimore, Maryland - Richard DeRock and Chip Hazen, Los Angeles County Metropolitan Transportation Authority - Ed Frost, Ben Franklin Transit, Richland, Washington - Gail Heald and Mary Ellen Blunt, Central Massachusetts Regional Planning Commission, Worcester, Massachusetts - Susan Hafner and Tessie Johnston, Riverside Transit Agency, Riverside, California - Mark Huddleston, Oshkosh Transit System, Oshkosh, Wisconsin - Robert Johnson, Waukesha Transit System, Waukesha, Wisconsin - Micki Kaplan, Lane Transit District, Eugene, Oregon - Kimberlee Kelly, Greater Bridgeport Transit District - Dianna Lake, San Mateo County Transit District, San Carlos, California - Paul Larrousse, Madison Metro Transit System - Terry Lathrop, City of Charlotte, North Carolina - John Lee, City of Greeley, Colorado - Avon Makel, Washington Metropolitan Area Transit Authority - Kathy McCune, Utah Transit Authority, Salt Lake City - Tina Morris, Transit Authority of River City, Louisville, Kentucky - Lynn Ritter Otte and Shirley Fraser, Regional Transportation Authority, Chicago - Nancy Poultney, Seattle Metro - Jon Roth, Southeastern Pennsylvania Transportation Authority, Philadelphia - Christopher White, Ann Arbor Transportation Authority - Cathy Williams, Port Authority of Allegheny County, Pittsburgh Finally, several employees at EG&G Dynatrend provided input, assistance and support. Karla Karash reviewed draft material. Carol Schweiger and Larry Harman provided information on the final chapter concerning advanced technologies. Marsha Gangi provided administrative support and assisted in document preparation. Table of Contents Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 Chapter 1. Understanding ADA Paratransit Eligibility . . . . . . . . 3 Section 1. Who Must Develop an ADA Paratransit Eligibility Determination Process and When Must it be Implemented? 3 Section 2. How is ADA Paratransit Eligibility Defined in the Regulations? 4 Category 1 Eligibility . . . . . . . . . . . . . . . . . . . . 5 Category 2 Eligibility . . . . . . . . . . . . . . . . . . . . 7 Category 3 Eligibility . . . . . . . . . . . . . . . . . . . . 8 Companions/Personal Care Attendants. . . . . . . . . . . . . . 12 Visitors . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 Temporary Disabilities . . . . . . . . . . . . . . . . . . . . 14 Section 3. Key Differences between ADA Paratransit Eligibility and Past Paratransit Eligibility . . . . . . . . . . . . . . . . . 15 ADA Paratransit Eligibility as a Civil Right . . . . . . . . . 15 Functionally-based Determinations of Eligibility . . . . . . . 16 Conditional or "Trip-by-Trip" Eligibility. . . . . . . . . . . 16 Determining Eligibility Based on the Most Limiting Factors . . 20 Section 4. The Importance of a Thorough Initial Determination . 21 Managing Demand. . . . . . . . . . . . . . . . . . . . . . . . 21 Documenting an Undue Financial Burden. . . . . . . . . . . . . 21 Chapter 2. Elements of an ADA Paratransit Eligibility Policy . . . . 23 Section 1. Required Elements. . . . . . . . . . . . . . . . . . 23 Strictly Limiting Eligibility. . . . . . . . . . . . . . . . . 23 Accessible formats . . . . . . . . . . . . . . . . . . . . . . 24 Processing Time/Presumptive Eligibility. . . . . . . . . . . . 25 Notice of Initial Determination. . . . . . . . . . . . . . . . 25 Documentation of Eligibility . . . . . . . . . . . . . . . . . 25 Administrative Appeal Process. . . . . . . . . . . . . . . . . 26 Section 2. Optional Elements. . . . . . . . . . . . . . . . . . 27 Recertification of ADA Paratransit Eligibility . . . . . . . . 27 Recertification of Other Paratransit Customers . . . . . . . . 28 No-Show Suspension Policy. . . . . . . . . . . . . . . . . . . 28 Chapter 3. Establishing an ADA Paratransit Eligibility Determination Process 29 Section 1. General Considerations . . . . . . . . . . . . . . . 30 Public Participation . . . . . . . . . . . . . . . . . . . . . 30 Public Information and Marketing . . . . . . . . . . . . . . . 31 Additional Charges and Fees. . . . . . . . . . . . . . . . . . 33 Section 2. Alternative Processes. . . . . . . . . . . . . . . . 34 Self-certification with professional verification as needed. . 34 Self-certification and professional verification . . . . . . . 36 In-Person Assessments. . . . . . . . . . . . . . . . . . . . . 39 Combined Approaches. . . . . . . . . . . . . . . . . . . . . . 40 Considerations for Future Recertification of Riders. . . . . . 42 Section 3. Deciding Who Will Do Initial Determinations. . . . . 48 In-House Determinations. . . . . . . . . . . . . . . . . . . . 48 Utilizing Contract Reviewers . . . . . . . . . . . . . . . . . 48 In-House Determination with Third-Party Assistance as Needed . 51 Reviewer Training. . . . . . . . . . . . . . . . . . . . . . . 52 Section 4. Developing Application Forms and Materials . . . . . 53 Accessible Formats . . . . . . . . . . . . . . . . . . . . . . 53 Terminology. . . . . . . . . . . . . . . . . . . . . . . . . . 54 Transmittal/Cover Letter . . . . . . . . . . . . . . . . . . . 54 Application/Assessment Forms . . . . . . . . . . . . . . . . . 55 General Information. . . . . . . . . . . . . . . . . . . . . . 57 Questions about Mobility Aids Used . . . . . . . . . . . . . . 58 Questions about the Applicant's Disability . . . . . . . . . . 59 Questions/Functional Tests Regarding Travel Capabilities . . . 60 Travel Training Information. . . . . . . . . . . . . . . . . . 68 Other Service Information. . . . . . . . . . . . . . . . . . . 69 Administrative Information . . . . . . . . . . . . . . . . . . 69 Request for Professional Reference(s). . . . . . . . . . . . . 70 Professional Verification Form . . . . . . . . . . . . . . . . 72 Section 5. Reviewing Applications and Making Determinations . . 73 Pre-Tests of Materials . . . . . . . . . . . . . . . . . . . . 73 Regulatory Review Timetable and Presumptive Eligibility. . . . 73 Establishing a Management Information System to Track Determinations. . . . . . . . . . . . . . . . . . . . . . 74 Developing Reviewer Guidelines and Maintaining Consistency in Reviews . . . . . . . . . . . . . . . . . . . . . . . . . 78 Observing Privacy Rights . . . . . . . . . . . . . . . . . . . 79 Recent Certification Experiences of Selected Providers . . . . 79 Section 6. Notifying Individuals of Initial Determinations. . . 85 Section 7. Documentation of ADA Paratransit Eligibility . . . . 92 Section 8. Appeals Procedures . . . . . . . . . . . . . . . . . 94 Structuring an Appeal Process. . . . . . . . . . . . . . . . . 96 Holding an Appeal Hearing. . . . . . . . . . . . . . . . . . .102 Section 9. Refusing, Conditioning, or Suspending Service. . . .103 Circumstances Under which Service Can be Refused . . . . . . .103 Circumstances Under which Service Can be Conditioned . . . . .104 Circumstances Under Which Service Can be Suspended . . . . . .104 Developing a "No-Show" Suspension Policy . . . . . . . . . . .105 Process Issues Associated with Suspending Service. . . . . . .111 Section 10. Visitor Policies . . . . . . . . . . . . . . . . . .112 Chapter 4. Applying Eligibility Determinations to Daily Operations .115 Section 1. Important Operational Information. . . . . . . . . .115 Section 2. Trip-by-Trip Eligibility Determinations. . . . . . .118 Review Subscription Trips. . . . . . . . . . . . . . . . . . .119 Review Other Frequently Made Trips . . . . . . . . . . . . . .119 Generalize Limitations of Eligibility. . . . . . . . . . . . .119 Consideration of Easily Tracked Eligibility Conditions . . . .120 Section 3. Using Advanced Technologies to Make Trip Eligibility Determinations . . . . . . . . . . . . . . . . . . .122 Relational Database Management Systems (RDMS). . . . . . . . .122 Automated Client Information Systems . . . . . . . . . . . . .122 Automated Routing and Scheduling Systems . . . . . . . . . . .123 GIS and Computer Mapping Systems . . . . . . . . . . . . . . .133 Section 4. Providing Alternatives/Market-Based Approaches . . .133 References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .135 Index. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 137 Appendix A. 49 CFR Part 37 Sections 37.121 through 37.127 and related sections of Appendix D Appendix B. ADA Paratransit Eligibility Policy Checklist Appendix C. Listing of Selected Transit Providers Contacted for Information in the Preparation of this Manual Appendix D. Sample Marketing and Public Information Materials Appendix E. Sample Eligibility Material Developed by the San Mateo County Transit District (SAMTRANS) Appendix F. Sample Eligibility Material Developed by the Madison Metro Transit System Appendix G. Sample Eligibility Material Developed by the Utah Transit Authority Appendix H. Sample Eligibility Material Developed by the Worcester Regional Transit Authority Appendix I. Sample Eligibility Material Developed by the Municipality of Metropolitan Seattle (Metro) Appendix J. Sample Eligibility Material Developed by the Washington Metropolitan Area Transportation Authority Appendix K. Sample Eligibility Material Developed by the Delaware Administration for Specialized Transportation (DAST) Appendix L. Sample Eligibility Material Developed by the Regional Transportation Authority (Chicago) Appendix M. Sample Eligibility Material Developed by the Port Authority of Allegheny County (PAT) Appendix N. Information about the Applicant Tracking System used by Seattle Metro List of Tables Table 1. Eligibility by Functional Impairment/Disability. . . . . . . . 18 Table 2. Eligibility Determination Processes Used by Selected Transit Providers 43 Table 3. Eligibility Determination Results for Selected Transit Providers 80 Table 4. Descriptions of Appeal Procedures for Selected Transit Providers 99 Table 5. Details of No-Show Suspension Policies for Selected Transit Providers 107 Table 6. Capabilities of Selected Computer Scheduling and Dispatching Systems to Capture and Display ADA Paratransit Eligibility Information.125 Table 7. Capabilities of Selected Computer Scheduling and Dispatching Systems to Display the ADA Paratransit Service Area and Calculate Distances to and From Stops/Stations . . . . .127 Table 8. Capabilities of Selected Computer Scheduling and Dispatching Systems to Track Service Provided to Visitors . . . . . . . .129 Table 9. Capabilities of Selected Computer Scheduling and Dispatch Systems to Track and Analyze Capacity Constraints and Subscription Service .131 List of Figures Figure 1. Examples of Eligibility Under Category 3. . . . . . . . . . . 11 Figure 2. Required and Optional Policy Elements . . . . . . . . . . . . 23 Figure 3. Steps in Developing an ADA Paratransit Eligibility Process. . 29 Figure 4. Examples of Types of Professionals that can Assist with Eligibility Determinations. . . . . . . . . . . . . . . . . . . . . . . . . . . 50 Figure 5. Sample Flow Chart of Eligibility Determination Process (sheet 1 of 3) 75 Figure 6. Sample Photo ID Format for ADA Paratransit Eligibility Documentation 93 Figure 7. Letter Sent by SEPTA to Riders with Greatest Number of No-Shows Each Month . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .110 Introduction Section 223 of the Americans with Disabilities Act of 1990 (ADA) requires that public entities which operate non-commuter fixed route transportation services also provide complementary paratransit service for individuals unable to use the fixed route system. The regulations issued by the U.S. Department of Transportation, which implement this portion of the law, specify to whom and under what circumstances this service is to be provided. In addition, the regulations require public entities which are subject to the complementary paratransit requirements to develop and administer a process for determining if individuals who request service meet the regulatory criteria for eligibility. Initial guidance on the development of complementary paratransit plans, including the establishment of eligibility determination processes, was provided in the ADA Paratransit Handbook immediately following the issuance of the regulations. Since that time, numerous questions about the definition of eligibility and about the determination process have been raised. The review of initial ADA paratransit plans and first year updates also has identified innovative approaches used by transit providers in the development of eligibility determination programs. This manual has been prepared to provide further guidance to transit providers in the development and implementation of ADA paratransit eligibility determination processes. The most common questions raised about eligibility are addressed. Experience gained in the first one and a half years of implementation of the paratransit provisions is also summarized. As part of the preparation of this manual, public entities that had particular expertise and positive experiences with eligibility determination were contacted and copies of the forms and procedures which they had developed were collected. Key issues raised by these transit providers are included in the text and copies of sample forms and policies are provided in the appendices. This manual is organized in three parts. The first part, which includes Chapters 1 and 2, presents a thorough discussion of the concept of ADA paratransit eligibility and describes the regulatory requirements which apply. The second part, Chapter 3, offers practical advice in all aspects of designing and administering an eligibility determination process. This chapter is structured to lead the reader through the process of eligibility determination as it would occur in actual practice. The sequence of presentation is: deciding on the appropriate process; creating appropriate forms for the selected process; conducting the initial determination; notifying individuals about determinations; providing documentation of eligibility; establishing and conducting an appeals process; policies for suspending service to eligible persons; and providing service to visitors. The final chapter focuses on key operational issues. It discusses the use of eligibility information in daily operations. Possible approaches to determining the eligibility of specific trip requests are reviewed and advanced technologies which can assist with trip-by-trip determinations are presented. This manual is also intended to be a comprehensive guide to eligibility issues. In addition to practical information and suggestions, all regulatory information has been included. The full text of those portions of the regulation that address eligibility issues are reprinted in Appendix A. Applicable sections of the appendix to the regulation which provide interpretation of the eligibility provisions are also included. Throughout the manual, relevant portions of the regulations and interpretive guidance are inserted. While this manual offers extensive guidance on the development of application material and an eligibility process, it does not provide a single model for eligibility determination applicable in all cases. As noted in Chapter 3, there are many different ways that the process can be structured. Application forms and materials will vary depending on the approach selected. Instead, the appendices contain several model forms and materials that apply to all of the possible approaches. Chapter 3 also offers advice on the types of questions and information that should be included in eligibility materials, regardless of the approach which is selected. Public input is required in the design of the eligibility determination process. The importance of involving people with disabilities and local disability organizations in the development of all aspects of the eligibility policy and process cannot be overemphasized. The guidance and advice offered in this manual should be shared with and reviewed together with these individuals and organizations. Chapter 1 Understanding ADA Paratransit Eligibility Section 1. Who Must Develop an ADA Paratransit Eligibility Determination Process and When Must it be Implemented? Access to mainline, fixed route transportation services is the main goal of the transportation provisions of the ADA. The law recognizes, however, that some persons with disabilities are not able to use fixed route services even if these services are fully accessible. The law also acknowledges that many fixed route systems are not accessible and that alternative means of transportation are needed until full accessibility is achieved. Complementary paratransit service is required by Section 223 of the ADA to serve those persons whose needs cannot be met by fixed route systems. All public entities which operate non-commuter fixed route transportation services for the general public are required to also provide complementary paratransit service. This paratransit service must be comparable to the fixed route service. Six service criteria which define comparability are detailed in the USDOT implementing regulations. Complementary paratransit service is to be provided to those individuals determined to be ADA paratransit eligible when these individuals are unable to use the fixed route service to meet particular trip needs. As described in Section 2 of this Chapter, the regulations provide detailed guidelines which define who is to be considered ADA paratransit eligible and what trips are to be considered eligible. All public entities which operate complementary paratransit services must establish a process for certifying individuals as ADA paratransit eligible. Requests for certification must be accepted and processed for local residents and long-term visitors. An eligibility determination process must be established even if the public entity operates a paratransit system with broader eligibility requirements than the ADA. All potentially ADA paratransit eligible persons may be covered by the broader system, but individuals must have the opportunity to apply for and receive documentation of ADA paratransit eligibility which can be used in other areas. The regulations required that the implementation of complementary paratransit service begin on January 26, 1992. Services must be fully implemented (i.e., must meet all of the regulatory service criteria) by January 26, 1997 unless an "undue financial burden waiver" is granted by the FTA Administrator. The determination of those persons who are eligible to receive service is a necessary first step in this process. Therefore, an eligibility determination process is required early in the five-year implementation period. Regardless of local implementation schedules, all public entities should have an eligibility determination process in place by January 26, 1994. Section 2. How is ADA Paratransit Eligibility Defined in the Regulations? Eligibility for complementary paratransit service is directly related to the inability of a person with a disability to use the existing fixed route service. A person's inability to use the fixed route service could be related to the fact that the system has not yet been made fully accessible. It could also result from the nature of a person's disability. The person may not be able, due to their disability, to get to or from the system or to board, ride, and disembark from the vehicles even if they are fully accessible. While eligibility is conferred on individuals, it is conferred based on the fact that there are certain trips that the person cannot make on the fixed route system. For some individuals, their disabilities may prohibit them from ever using the fixed route service. For others, however, they may not be able to use the fixed route service under certain circumstances. ADA paratransit eligibility can, therefore, be considered as having two elements. First, an individual is considered ADA paratransit eligible if there are any circumstances under which the fixed route system cannot be used. Second, the extent of eligibility conferred on an individual depends on the conditions and circumstances under which they are not able to travel on the fixed route service. Individuals who can never use the fixed route service are unconditionally eligible. Persons who can use fixed route service in certain circumstances are conditionally eligible and the limitations on their eligibility should be determined. Because the regulations establish this concept of trip-by-trip eligibility, it is important that the eligibility determination process be detailed enough to identify not only eligible individuals but to determine the conditions under which their specific trip requests would be eligible. The regulations describe three specific circumstances under which a person would be considered ADA paratransit eligible. Within the industry, these have been referred to as the three "categories" of eligibility. The regulations also require that service be provided to personal care attendants and companions of eligible individuals and to visitors from outside a transit district's jurisdiction. Following is a detailed discussion of each of the three "categories" of eligibility and of requirements for serving companions, personal care attendants, and visitors. Category 1 Eligibility The first category of eligibility includes those persons unable to use fully accessible fixed route services. Included in this category is: "Any individual with a disability who is unable, as the result of a physical or mental impairment (including a vision impairment), and without the assistance of another individual (except the operator of a wheelchair lift or other boarding assistance device), to board, ride, or disembark from any vehicle on the system which is readily accessible to and usable by individuals with disabilities." [37.123(e)(1)] Examples of eligibility under this category would include: a person with a mental disability who cannot "navigate the system". Navigating the system might involve obtaining and understanding system information, recognizing and boarding the correct vehicle, having available the correct fare and/or using the fare collection system, recognizing destinations, and understanding transfers that might have to be made; a person with a vision impairment who cannot "navigate the system". Entering and traveling through a busy station or transit center may not be possible. Recognizing and boarding the correct vehicle, and recognizing the appropriate destination - even though announcements are made - are also considerations; a person with a physical disability who cannot stand on a crowded bus or rail car when seats, including priority seats, may not be available; a person with a physical disability who uses a wheelchair and who cannot get on or off the lift or to or from the wheelchair securement area without assistance. It is important to note that eligibility under this category depends on the complexity of the fixed route system. The type and extent of disability that would confer eligibility in a rural area with a one or two route bus system would be different from that in a large urban system. Transit providers should base determinations on the characteristics of their fixed route service and the abilities needed to use it. Other key issues and questions associated with this category of eligibility are summarized below. (1) Travel training: Many persons who cannot negotiate the entire fixed route system can be travel trained for certain trips. Typically, training is provided for trips that the person makes frequently, such as to work or school. These individuals would only be ADA paratransit eligible for trips they have not been trained to make. As part of the application and determination process, it should be determined if such training has been provided. Individuals cannot, however, be required to participate in travel training. The public entity may choose to offer training and may encourage individuals to take advantage of this service. Until the individual takes advantage of this service and is adequately trained, paratransit service must be provided. (2) Operator assistance: Eligibility under this category is not necessarily based on a person's ability to get on and off the lift, up and down a ramp, to and from the securement area, or secure their mobility device. While the regulation states that a person is eligible for paratransit service if they cannot independently use the fixed route system, operator assistance is assumed. The regulations, in fact, specify the level of assistance that must be provided by the public entity. Section 37.165(f) of the regulations states that "the drivers or other personnel must provide assistance with the use of lifts, ramps, and securement devices." Beyond this level of required assistance, however, public entities may choose to offer additional assistance, such as assistance getting to and from the securement area, in order to enable persons to utilize the fixed route service. If the individual is able to use the fixed route system with this assistance, complementary paratransit service does not have to be provided. Local policy concerning operator assistance should be developed with full public participation, including the input of persons with disabilities; (3) Assistance of another person: With the exception of assistance provided by the driver or other employees of the service, eligibility under this category is based on a person's ability to independently use the service. A person traveling with a friend or attendant is still eligible for paratransit service even if they would be able to use the fixed route system with this other person's help. (4) Accommodating mobility aids: The regulations set standards for vehicle and station/stop accessibility. To be considered accessible, equipment and facilities must be able to accommodate mobility aids of a certain size and persons and mobility aids up to a certain weight. The regulations define a "common wheelchair" as a "wheelchair" which does not exceed 30 inches in width and 48 inches in length (measured two inches above the ground) and which does not weigh more than 600 pounds when occupied. A "wheelchair" is defined as any mobility aid belonging to any class of three or four-wheeled devices, usable indoors, designed for and used by individuals with mobility impairments, whether operated manually or powered. All common wheelchairs and their users are to be accommodated on accessible fixed route and complementary paratransit systems. The regulations do not, however, require public entities to provide service to persons using mobility aids that are not "common wheelchairs". An individual would not be eligible for paratransit service under category 1 if they could not use an accessible bus because their mobility aid is too large or too heavy for the lift. (5) Standees on lifts: The regulations require public entities to allow persons with ambulatory disabilities who do not use wheelchairs ( e.g., persons who use leg braces and canes) to enter the vehicle by standing on the lift. Therefore, individuals who cannot climb the steps to get into a bus would not be eligible for paratransit service if they could enter the vehicle using the lift. Category 2 Eligibility The second category of eligibility includes: "Any individual with a disability who needs the assistance of a wheelchair lift or other boarding assistance device and is able, with such assistance, to board, ride, and disembark from any vehicle which is readily accessible to and usable by individuals with disabilities if the individual wants to travel on a route of the system during the hours of operation of the system at a time, or within a reasonable period of such time, when such a vehicle is not being used to provide designated public transportation on the route." [37.123(e)(2)] The majority of persons eligible under this category would be those with ambulatory disabilities who could not enter an inaccessible rail facility or would need to travel on a vehicle with a lift or ramp and other accessibility features. This would include persons who use wheelchairs as well as persons who use other mobility aids such as walkers, leg braces, or canes. Eligibility under this category depends on the accessibility of vehicles and stations/stops. A person is eligible for paratransit service if the fixed route on which they want to travel is not yet accessible. Guidance on exactly what constitutes an "accessible" fixed route is provided in the regulations and explanatory appendix. For example: A person is eligible if the bus route on which they want to travel is not 100 percent accessible. The requested trip would be eligible if the fixed route that would otherwise be used is only partially accessible (e.g., every other bus is accessible). Similarly, a person is eligible if they need to travel on a rapid or light rail system that is not yet accessible - meaning that all key stations are accessible and one car per train is accessible. An individual would be eligible in this example even if accessible fixed route bus service is provided in the same area. An individual is eligible for paratransit if a vehicle's lift or boarding device cannot be deployed at the stop which they want to use. An individual who uses a "common wheelchair" but cannot be served by the fixed route system because the lift on the vehicle they need to use does not meet the equipment standards contained in Part 38 of the regulation is eligible for paratransit service. One important issue related to category 2 eligibility is the use of on-call bus services as a way to increase the overall accessibility of the fixed route service. Basically, on-call bus programs allow an individual to call in advance and request that an accessible bus be assigned to a particular route at a time when they need to travel. Typically, an on-call bus program is implemented when a significant percent of the fixed route fleet is accessible. Successful programs have been implemented when 20-30 percent of all peak hour vehicles are accessible. On-call bus services do not technically make the fixed route fleet fully accessible. Therefore, even if an on-call bus service is offered, individuals who are eligible under category 2 must be certified. On-call bus service is, however, considered an acceptable form of complementary paratransit service and can be provided in lieu of a separate van service to those who are eligible under this category. A second important issue is how this category of eligibility should be treated by transit providers whose fixed route systems are fully accessible. Clearly, individuals who could use accessible vehicles would not be Category 2 eligible in these areas and transit districts are not required to include questions that address this category of eligibility in their application materials or assessment processes if the fixed route service is 100 percent accessible. These same individuals may not, however, be able to use inaccessible vehicles if they travel to other transit districts. Therefore, transit providers are encouraged to address this category of eligibility even if it is not applicable to their local system and to note on the eligibility documentation provided that individuals are ADA paratransit eligible if accessible fixed route vehicles are not available when needed. Category 3 Eligibility The third category of eligibility includes: "Any individual with a disability who has a specific impairment-related condition which prevents such individual from traveling to a boarding location or from a disembarking location on such system." [37.123(e)(3)] Two important qualifiers to this category are included in the regulations. First, environmental conditions and architectural barriers not under the control of the public entity do not, when considered alone, confer eligibility. If, however, travel to or from a boarding location is prevented when these factors are combined with the person's specific impairment- related condition, paratransit service must be provided. Examples of architectural and environmental factors that, in combination with certain disabilities, could prevent travel include: a lack of curb-cuts the distance from the stop/station to the trip origin or destination steep terrain snow and/or ice extremes in temperature (hot or cold) major intersections or other difficult to negotiate architectural barriers temporary construction projects severe air pollution Second, the specific impairment-related condition must prevent the person from using the fixed route system. Conditions which make getting to or from stops/stations more difficult do not confer eligibility. A determination of whether travel is difficult rather than "prevented" will need to be made. Appendix D of the regulations offers the following guidance to clarify the concepts of "prevented" travel and the relationship between architectural and environmental conditions and a person's disability: "For anyone, going to a bus stop and waiting for a bus is more difficult and less comfortable than waiting for a vehicle at one's home. This is likely to be all the more true for an individual with a disability. But for many persons with disabilities, in many circumstances, getting to a bus stop is possible. If an impairment-related condition only makes the job of accessing transit more difficult than it might otherwise be, but does not prevent the travel, then the person is not eligible. For example, in many areas, there are not yet curb cuts. A wheelchair user can often get around this problem by taking a less direct route to a destination than an ambulatory person would take. That involves more time, trouble, and effort than for someone without a mobility impairment. But the person can still get to the bus stop. On the basis of these architectural barriers, the person would not be eligible. Entities are cautioned that, particularly in cases involving lack of curb cuts and other architectural barrier problems, assertions of eligibility should be given tight scrutiny. Only if it is apparent from the facts of a particular case that an individual cannot find a reasonable alternative path to a location should eligibility be granted. If we add a foot of snow to the scenario, then the same person taking the same route may be unable to get to the bus stop. If it is not the snow alone that stops him; it is the interaction of the snow and the fact that the individual has a specific-impairment related condition that requires him to push a wheelchair through the snow that prevents the travel. Inevitably, some judgment is required to distinguish between situations in which travel is prevented and situations in which it is merely made more difficult. In the Department's view, a case of "prevented travel" can be made not only where travel is literally impossible (e.g., someone cannot find the bus stop, someone cannot push a wheelchair through the foot of snow or up a steep hill) but also where the difficulties are so substantial that a reasonable person with the impairment-related condition in question would be deterred from making the trip. The regulation makes the interaction between an impairment-related condition and the environmental barrier (whether distance, weather, terrain, or architectural barriers) the key to eligibility determinations. This is an individual determination. Depending on the specifics of their impairment-related condition, one individual may be able to get from his home to a bus stop under a given set of conditions, while his next-door neighbor may not." Given the judgement required to determine if travel is truly prevented and the relationship between environmental conditions and an individual's disability, making eligibility determinations based on this third regulatory category is likely to be the most difficult. Figure 1 on the following page provides additional hypothetical examples to further define eligibility under this category. It includes situations that would result in a person being determined eligible as well as examples that would not confer eligibility. Figure 1. Examples of Eligibility Under Category 3 Companions/Personal Care Attendants Paratransit service also must be provided to a personal care attendant (PCA) traveling with an eligible rider. In addition to a personal care attendant, the regulations require that service be provided to one companion accompanying an eligible rider. Other persons accompanying the rider are to be accommodated on a "space available" basis. Persons are considered to be accompanying the eligible rider if they are picked up and dropped off at the same locations as the eligible rider. Companions must be charged the same fare as the eligible rider and PCAs must ride free. The following additional guidance on requirements for serving PCAs and companions is provided in the interpretive appendix to the regulations: "The one individual who is guaranteed space on the vehicle can be anyone-family member, business associate, friend, date, etc. The provider cannot limit the eligible individual's choice of type of companion. The transit authority may require that the eligible individual reserve a space for the companion when the individual reserves his or her own ride. This one individual rides even if this means that there is less room for other eligible individuals. Additional individuals beyond the first companion are carried only on a space available basis; that is, they do not displace other ADA paratransit eligible individuals. A personal care attendant (i.e., someone designated or employed specifically to help the eligible individual meet his or her personal needs) always may ride with the eligible individual. If there is a personal care attendant on the trip, the eligible individual may still bring a companion, plus additional companions on a space available basis. The entity may require that, in reserving the trip, the eligible individual reserve the space for the attendant. To prevent potential abuse of this provision, the rule provides that a companion (e.g., friend or family member) does not count as a personal care attendant unless the eligible individual regularly makes use of a personal care attendant and the companion is actually acting in that capacity. As noted under 37.125, a provider may require that, as part of the initial eligibility certification process, an individual indicate whether he or she travels with a personal care attendant. If someone does not indicate the use of an attendant, then any individual accompanying him or her would be regarded simply as a companion." [Appendix D to 49 CFR Part 37, 37.123] As indicated above, a PCA may be an employee of the ADA paratransit eligible rider or may be a family member or friend. Regardless of the relationship, a PCA is clearly meant to be someone whose services are required by the rider. In determining if eligible individuals require PCA services, it is important to realize that the need for a personal care attendant is not necessarily related to travel on the paratransit service. PCAs are often needed by individuals with disabilities to assist with other activities of daily living. For example, a quadriplegic may be assisted by a PCA in filing and holding papers at work or in eating meals. A blind person may need a PCA to assist with shopping or to serve as a reader at work. Individuals may need PCAs for these activities but be fully capable of traveling on the paratransit service with the assistance provided by transit personnel. The need for PCA services can be intermittent or occasional and still be considered "regularly" needed. "Regular" use should be interpreted to be consistent with the underlying need - for example, a blind person regularly using a PCA for shopping. It is also important to note that once a person has been certified as needing to travel with a PCA, it should be the eligible individual, not the transit agency, that determines if a PCA is needed for a particular trip. Section 4 of Chapter 3 of this manual offers guidance on questions that can be added to the application form or assessment process to determine if eligible individuals will need the services of PCAs when using the paratransit program. Visitors The needs of visitors with disabilities who cannot use the fixed route system also are addressed in the regulations. Complementary paratransit service must be provided to ADA eligible individuals who travel to areas outside of the region in which they live. If these individuals have been certified as "ADA paratransit eligible" by a public entity, that certification must be honored and the host transit agency must provide up to 21 days of paratransit service. If individuals have not been certified as eligible by another public entity but claim that they are ADA paratransit eligible, they are entitled to "presumptive eligibility" and must be provided with 21 days of service. Individuals who are not certified by another transit provider and who claim presumptive eligibility can be requested to provide certain documentation such as their place of residence and the nature of their disability. Individuals are only considered "visitors" if they reside outside of the transit provider's jurisdiction. The "jurisdiction" means the total area within which the provider is authorized to operate, not the sub-area designated as the ADA paratransit service area. In joint paratransit plans, the jurisdiction is considered the total area of all partners in the plan. The interpretive appendix to the regulation offers the following explanation and example: "A visitor is defined as someone who does not reside in the jurisdiction or jurisdictions served by the public entity or other public entities with which it coordinates paratransit service. For example, suppose a five-county metropolitan area provides coordinated paratransit service under a joint plan. A resident of any of the five counties would not be regarded as a visitor in any of them. Note that the rule talks in terms of "jurisdiction" rather than "service area." If an individual lives in XYZ County, but outside the fixed route service area of that county's transit provider, the individual is still not a visitor for purposes of paratransit in PQR County, if PQR is one of the counties with which XYZ provides coordinated paratransit service." Visitors from communities outside the transit agency's jurisdiction must be served even if the community in which they reside does not contribute financially to the transit system. The "21 days" of service that must be provided are to be calculated as 21 days of service over a defined period of time, not as a 21 calendar day period of time, beginning from the first day that service is provided. For example, a person may travel to the ADA service area two-days a week on the commuter rail system. Eligibility should be extended in this case over the eleven week period of time within which 21 days of paratransit service would be required. Visitors who require more than 21 days of service within the period of time established can be required to apply for local eligibility. Finally, the level of service provided to visitors must be the same as that provided to local ADA paratransit eligible individuals who would be traveling in the same area. This means that there can be no difference in the area within which visitors can travel, the times that they can travel, the fares charged, or any of the other service criteria established in the regulations. Visitors are to be treated exactly like eligible local customers. Temporary Disabilities Persons with temporary disabilities are to be considered for ADA paratransit eligibility. This may include: someone with a medical condition such as a broken leg who temporarily is unable to use the fixed route service; someone who has recently undergone an operation or other medical treatment and who is unable to use the fixed route service; or someone with a cognitive disability that can be expected to be resolved over time through treatment or medication. Temporary eligibility should be granted for the period of time that the disabling condition is expected to last. An expiration date should be included on the documentation provided to individuals determined temporarily ADA paratransit eligible. Section 4 of Chapter 3 of this manual includes a suggested approach for determining the period of disability as part of the application/assessment process. Section 3. Key Differences between ADA Paratransit Eligibility and Past Paratransit Eligibility Many public transit providers offered paratransit services prior to the enactment of the ADA. In the mid-1970's, eligibility was determined by governing boards based on expressed local needs. Throughout the 1980's, transit providers which opted to meet their Section 504 obligations by offering paratransit service adopted the general definition of eligibility provided in that regulation. Eligibility for ADA complementary paratransit service is different from these past notions of paratransit eligibility in four key ways. These differences are discussed below. ADA Paratransit Eligibility as a Civil Right Failure to conduct a determination process that meets the regulations or failure to provide complementary paratransit service in accordance with the requirements established in the regulations are violations of the civil rights of the affected individual. This difference between ADA paratransit and past services has several important implications for the eligibility determination process. First, in designing review procedures and policies, it is important that they adhere to all of the requirements contained in 37.123 and 37.125, described above and in Chapter 2 of this manual. All elements of the policy and process also should be formally adopted by each public entity with the public participation required in 37.137 of the regulations. Second, due process standards must be observed in appeals, suspensions of service, or in any other actions which affect a person's right to the service. This is particularly true once individuals have been determined eligible. In addressing the suspension of service for "no-shows", the interpretive appendix states: "Once an entity has certified someone as eligible, the individual's eligibility takes on the coloration of a property right. (This is not merely a theoretical statement. If one depends on transportation one has been found eligible for to get to a job, and the eligibility is removed, one may lose the job. The same can be said for access to medical care or other important services.) Consequently, before eligibility may be removed "for cause" under this provision, the entity must provide administrative due process to the individual."[Appendix D to 49 CFR Part 37, Federal Register, Sept. 6, 1991, page 45747]. Finally, transit providers should maintain adequate records of certification requests, reviews completed, notification provided, and any appeals requested and should be prepared to demonstrate that regulatory requirements were met in the handling of each request for eligibility. Applications should be dated upon receipt. Decisions made throughout the review process (e.g., the completeness of the application, the need for more information, reasons for determinations, requests for appeals, etc.) should be recorded. Functionally-based Determinations of Eligibility Many policies prior to the ADA conferred paratransit eligibility based on a particular medical condition, disability, or on the use of a particular mobility aid. For example, persons who were certified as paratransit eligible if they were "blind" or "legally blind". Individuals who used wheelchairs, walkers, or leg braces were considered eligible for paratransit. Certification from a social service agency or a medical professional that the person used a particular aid or had a particular disability automatically conferred paratransit eligibility. ADA paratransit eligibility, however, is based not just on the presence of a disability, but on the effect that the disability has on the person's ability to use the fixed route service. Several factors must be considered in determining ADA paratransit eligibility. These include: (1) the applicant's disability; (2) the accessibility of the fixed route system; (3) architectural barriers that, in combination with the person's disability, prevent use of the fixed route service; and (4) environmental conditions that, in combination with the person's disability, prevent use of the fixed route service. While documentation of a particular disability or use of a mobility aid is still important, this information alone can not be used to make an eligibility determination. Questions about the functional ability of the applicant to use fixed route transit must be included in the application or assessment process. The accessibility of the fixed route service and the effects of environmental and architectural barriers must also be considered. Conditional or "Trip-by-Trip" Eligibility The paratransit eligibility processes employed by most transit providers prior to the ADA used an "all or nothing" determination approach. If it was determined that certain persons met the criteria established for eligibility, they could call and request paratransit service for any trip. If they were determined to not be eligible, they could not request any rides. The ability to use the fixed route system for some trips and not for others was not considered. Under the ADA, complementary paratransit service is only required for trips that cannot be made on the fixed route system. Many persons may qualify because there are certain specific conditions which prevent them from using the fixed route service. For example, a paraplegic wheelchair user may be able to use accessible fixed route buses during most of the year, but may require paratransit service when traveling on a route that is not fully accessible or when traveling when there is a significant accumulation of snow. Such a person would be ADA paratransit eligible. Eligibility would be for trips that are not served by accessible fixed routes and might be limited to certain months of the year. The documentation of ADA paratransit eligibility provided to this individual should identify these conditions of eligibility. While transit providers must identify whether or not applicants are conditionally or unconditionally eligible and must include limitations of eligibility in the documentation provided, they are not required to conduct trip-by-trip determinations in daily operation. If full compliance with the paratransit requirements can be achieved within the allowed implementation period, a broader service can be provided. If an undue financial burden waiver is eventually requested, however, only those costs associated with the provision of eligible trips can be used to calculate ADA paratransit costs. An ability to distinguish between trips that are eligible and those that are not will be needed. Table 1 on the following pages, adapted from the ADA Paratransit Handbook, illustrates the relationship between ADA paratransit eligibility and selected types of disabilities/medical conditions/functional impairments. For selected disabilities, the applicability of eligibility conditions is indicated. The types of conditions that should be considered are also noted. While the table is not intended to be an exhaustive listing of disabilities or eligibility conditions, it does illustrate the fact that conditions of eligibility need to be considered in most cases. There are limited instances in which it would be reasonable to assume that paratransit service is needed "in all cases". This would include, for example, individuals with profound mental retardation who are unable to negotiate the fixed route system even with travel training. It would also include persons with disabilities that are episodic or intermittent (i.e., the extent of disability can vary from day to day). In this latter instance, it would probably be unrealistic to specify the condition that would trigger an inability to use fixed route service. Table 1. Eligibility by Functional Impairment/Disability Functional Impairment/ Disability Type of Eligibility Determining Factors Ambulatory Disability, Uses Wheelchair Conditional (2,3)* - Availability of accessible fixed route service - Distance to/from bus stop or rail station for trip requested - Environmental conditions (terrain) Ambulatory Disability, Uses Walker Conditional (2,3) - Distance to/from bus stop or rail station for trip requested - Availability of accessible fixed route service - Environmental conditions (terrain) Ambulatory Disability Uses Braces Conditional (2,3) - Distance to/from bus stop or rail station for trip requested - Availability of accessible fixed route service - Environmental conditions (terrain) Ambulatory Disability, Uses Other Mobility Aid Conditional (2,3) - Distance to/from bus stop or rail station for trip requested - Availability of accessible fixed route service - Environmental conditions (terrain) Temperature Sensitivities Conditional (3) - Distance to/from stop/station - Waiting time at Stop/station - Temperature Cardiac Condition Conditional (3) - Distance to/from stop/station - Environmental conditions (temperature, terrain) Pulmonary Condition Conditional (3) - Distance to/from stop/station - Environmental conditions (temperature/terrain) Arthritis Conditional (3) - Distance to/from stop/station - Environmental conditions (temperature/terrain) * Indicates category of eligibility. (1) = unable to board, ride, or disembark from an accessible vehicle; (2) = able to use accessible vehicle but accessible vehicle is not available; (3) = unable, due to impairment related conditions to get to stop/station. Table 1 (continued) Functional Impairment/ Disability Type of Eligibility Determining Factors Conditions resulting in severe fatigue (HIV, radiation/chemotherapy, dialysis) Conditional (1,3) - Distance to/from stop/station - Environmental (temp./terrain) Severe lack of coordination/motor function (e.g., cerebral palsy, brain/spinal/peripheral nerve trauma, neurological conditions) In all cases (1,3) Moderate lack of coordination/motor function (e.g., cerebral palsy, brain/spinal/peripheral nerve trauma, neurological conditions) Conditional (2,3) - Distance to/from stop/station - Availability of accessible fixed route service Profound or severe mental retardation In all cases (1,3) Mild or moderate mental retardation Conditional (1,3) - Has person received travel training for trip requested? Psychiatric disabilities causing disorientation (as distinct from behavioral) In all cases (1,3) Visual impairments (blindness, restricted vision) Conditional (1,3) - Has person received travel training for trip requested? - Effective fixed route communications practices in place (announcements, card systems, etc.)? - Physical barriers in the environment Hearing Impairments Conditional (1) - Effective fixed route communications practices in place (signage, card system, etc.) Communication Disabilities (disability related speech or reading impairments) Conditional (1) - Effective fixed route Communications practices in place (signage, card system, etc.) Determining Eligibility Based on the Most Limiting Factors Determinations of ADA paratransit eligibility must consider the ability of applicants to travel to any origins and destinations in the paratransit service area under all possible conditions. Determinations cannot be based on a person's ability to use fixed route service some of the time or under "typical" conditions. For example, a person with an ambulatory disability may live only one block from the nearest bus stop and the terrain between their home and the stop may be level and accessible. They may not be able, though, to independently travel more than 1/2 mile and may not be able to negotiate steep terrain. Even though this person could get to the fixed route system from their home, there would be possible destinations more than 1/2 mile from fixed routes that she or he would not be able to reach. There may be other destinations in areas of steep terrain that would also be inaccessible. Conditional eligibility would therefore be appropriate. Section 4. The Importance of a Thorough Initial Determination The development of a process that can accurately determine ADA paratransit eligibility, including conditions and limitations of eligibility, is important for several reasons. First and foremost, as mentioned in Section 3 above, individuals who are unable to use fixed route service have a right to receive complementary paratransit service within the service limits established by the regulations. Because this is a right established in national law, the ultimate arbiter of eligibility for complementary paratransit service is the judicial system. An applicant who feels that a local determination of eligibility is not consistent with the regulatory criteria can take this concern to court. It is therefore in the interest of all involved that initial determinations of ADA paratransit eligibility are made accurately and in keeping with the established criteria and procedures. In addition, an accurate determination of eligibility has important operational and planning implications. These include: Managing Demand In many systems, the level of paratransit service that must be provided to persons determined ADA paratransit eligible exceeds that which was provided prior to the ADA. Once complementary paratransit service is brought into full compliance, individuals can request any and all trips for which they have been determined eligible. Essentially, unconstrained service must be provided in corridors served by fixed routes at all times that the service is in operation. Unless granted an "undue financial burden waiver," transit providers will not be permitted to ration service, by limiting supply or by other means, for these customers. If the cost of providing fully compliant ADA paratransit service is a local concern, it is important to carefully identify those individuals who are eligible, determine when these persons can use the fixed route system, and when paratransit is necessary. Unless eligibility and appropriate limitations/conditions are determined at the outset, it may not be possible to implement a trip-by-trip scheduling system (see Chapter 4) as a way to manage paratransit demand. Documenting an Undue Financial Burden In the event that providing fully compliant ADA paratransit service presents an undue financial burden, the regulations permit transit providers to request a waiver from the Administrator of the Federal Transit Administration. Undue financial burden waiver requests must document the cost of providing fully compliant service and must detail why this cost is an undue burden. In developing service costs, the regulations specifically note in 37.155(b) that costs must be limited to those "required by (the regulations) to ADA paratransit individuals" and "attributable to ADA-mandated trips". Transit providers requesting waivers must be able to document that they have counted only those costs associated with eligible trips made by persons who have been determined ADA paratransit eligible. They must also be prepared to show that local determination of eligible individuals and trips is consistent with the regulations. The local eligibility determination process is, therefore, an important concern in any decision regarding a request for an undue financial burden waiver. If there is reason to believe that the process has not accurately determined ADA paratransit eligibility consistent with the regulations, the costs of ADA complementary paratransit service included in a waiver request may be questioned. Chapter 2 Elements of an ADA Paratransit Eligibility Policy In addition to providing a definition of ADA paratransit eligibility, the USDOT regulations establish requirements for several aspects of the determination process. As shown in Figure 2 below, six specific process requirements are included in 37.125 of the regulations. Additional process issues are discussed but left to the option of transit providers. Each of these required and optional policy elements is described in this chapter. Figure 2. Required and Optional Policy Elements All transit providers should establish a written eligibility policy as part of their ADA paratransit plan. The policy should detail exactly how the ADA paratransit eligibility determination process is structured. The policy must address the requirements of 37.125 and indicate how compliance with each is being achieved. It can also address the optional elements noted above. A checklist which can be used to ensure that all key elements are included in an ADA eligibility policy is provided in Appendix B. Section 1. Required Elements Strictly Limiting Eligibility The certification process that is established must strictly limit ADA paratransit eligibility to the regulatory definition of eligibility. Only those persons who meet the regulatory definition can be given documentation indicating that they are "ADA Paratransit Eligible". In addition, if individuals who are determined to be ADA paratransit eligible can use fixed route service under certain conditions, the documentation which they are given must indicate the limitations/conditions of their eligibility. Public entities which foresee no financial difficulty fully meeting the complementary paratransit requirements and who wish to offer a broader service can do so. A parallel process for determining eligibility for this broader service can be established and documentation of eligibility for this non-ADA service can be provided. Documentation for this broader service cannot, however, indicate that these other customers are ADA paratransit eligible. Entities also may develop an integrated eligibility determination process which they use for all local paratransit services. Questions included in the application material can be used to determine if individuals qualify for broader services even if they do not qualify as ADA paratransit eligible. Documentation of eligibility must, however, distinguish between those who qualify for the broader service and those who meet ADA paratransit eligibility standards. Similarly, if full compliance with the complementary paratransit requirements poses no undue financial burden, entities may opt to accept all trip requests, regardless of conditions and circumstances, from individuals determined ADA paratransit eligible. It may be too administratively burdensome to implement trip-by-trip eligibility or may not be cost effective to attempt to operationalize all aspect of trip eligibility. The determination process and the documentation provided must still, however, be designed to identify the extent of eligibility conferred on individuals. Application or assessment forms and guidelines must be detailed enough to allow for conditions of eligibility to be noted where applicable. The process must also be thorough enough to reasonably ensure that the criteria for eligibility are being properly interpreted and applied. As noted in Section 4 of the previous chapter, should it become necessary to request an undue financial burden waiver, only those costs attributable to ADA-mandated trips can be counted in the request. Accessible formats Subsection (b) of 37.125 states that "All information about the process, materials necessary to apply for eligibility, and notices and determinations concerning eligibility shall be made available in accessible formats upon request." Accessible formats include large print, audio tape, braille, and computer disk. Information does not need to be made available in the format a requester prefers, but does have to be made available in a format that the person can use. There is no use, for example, giving a braille document rather than a document on tape to a person who does not read braille. Section 4 of Chapter 3 of this manual includes a more detailed discussion of this requirement and suggests ways to assist individuals with sensory impairments. Processing Time/Presumptive Eligibility Applicants are to be granted presumptive eligibility if a determination of eligibility has not been made within 21 calendar days of the submission of a completed application. Service must be provided, and the applicant presumed to be eligible, until and unless the determination is complete and the person is found to be ineligible. An application is considered to be complete once the person has provided all of the information required. Subsequent investigations or requests for additional information by the public entity would be considered part of the review process and within the 21 day timetable. For example, if an application process requires that individuals complete a form which includes the name of a professional who can be contacted for further information, the application would be considered "complete" once the requested information and professional contact were indicated. Follow-ups by the public entity in getting additional professional verification and information would be part of the 21 day review process. Notice of Initial Determination Applicants must be notified in writing of the initial determination of eligibility. If the determination is that the person is not eligible, the written notification must state the reasons for the finding. Appendix D to the regulations indicates that notification of ineligibility must be specific. Information provided in the application or obtained in the review process must be related to the eligibility criteria (e.g., the categories of eligibility) and to the review process which the entity has designed. Simply indicating that the person is not ADA paratransit eligible because it has been determined that they "are able to use the fixed route system" is not sufficient. Section 6 of Chapter 3 provides more information and suggestions on the notification process. Documentation of Eligibility If an applicant is determined to be eligible, documentation of eligibility must be provided. This documentation must specifically state that the person is "ADA Paratransit Eligible". It must also contain, at a minimum, the following information: the name of the eligible individual; the name of the transit provider providing the certification; the telephone number of the transit provider's paratransit coordinator; an expiration date for eligibility (if applicable); any conditions or limitations on the individual's eligibility; and the need for a personal care attendant. The telephone number of the transit provider's paratransit coordinator is meant to facilitate communication between transit providers if additional eligibility information is needed when the person travels to another area. The person identified (and the phone number listed) should be the individual who has access to and can readily provide eligibility information. Administrative Appeal Process Section 37.125(g) of the regulations requires that an administrative appeal process be available to any individuals who are determined to be ineligible for complementary paratransit service. Because the provision of ADA complementary paratransit service is a civil right, the denial of eligibility is a serious matter. A fair and effective appeal process is not only required but is in the interest of all parties. The appeal process must be available not only to individuals who are determined ineligible in all situations, but to persons who are deemed conditionally eligible. Limiting eligibility is in fact denying eligibility for certain trips. The appeal process established must comply with the following requirements: Individuals must be permitted to request an appeal within 60 days of the initial eligibility decision; Individuals must have an opportunity to be heard in person and to present additional information and arguments regarding their disability and ability to use the fixed route service; There must be a "separation of function" between those involved in the initial eligibility determination and those selected to hear appeals; Applicants must be notified of appeal decisions in writing, or in accessible format if requested, and the notification must state the reasons for the decision if eligibility is still denied; If a decision on the appeal is not made within 30 days of the completion of the process, individuals must be considered "presumptively eligible" and must be provided paratransit service until and unless a decision to deny the appeal is issued. Paratransit service does not have to be provided, however, during other phases of the appeal. Section 8 of Chapter 3 offers guidance on establishing an appeal process and includes information about the processes adopted by several selected transit agencies. Section 2. Optional Elements In addition to the above items, eligibility determination policies can include the following three additional features. These are not, however, required elements of the process. Recertification of ADA Paratransit Eligibility Transit providers can require that individuals periodically reapply for ADA paratransit eligibility. While a person's disability may be permanent, other factors which go into the determination of eligibility may change. For example, the percent of accessible vehicles in the fixed route service may increase. Improved technologies and/or operating procedures also may be introduced which would permit greater use of the fixed route service by individuals with disabilities. While the regulations do not specify the period for which individuals should be certified as ADA paratransit eligible, some general guidance is provided. The ADA Paratransit Handbook suggests recertification every three to five years. It also notes that the period of recertification can be flexible and can consider the applicant's particular disability. For example, a person who is frail and 75 years old could be determined eligible without any expiration date while an applicant whose disability might be expected to change can be certified for a specific period of time. Another important factor in setting the recertification interval is whether or not changes in the level of fixed route accessibility are planned. A longer interval might be appropriate in an area where fixed route service is already 100 percent accessible versus a system that is just beginning to make fixed route vehicles and stations accessible. Regardless of the policy regarding recertification, individuals have the right to request a new determination if they believe that there have been changes in their situation. This would include individuals determined ineligible as well as those whose eligibility has been limited or conditioned. Recertification of Other Paratransit Customers If paratransit service was provided prior to the ADA, transit providers may elect to require that all current riders be recertified. Such a recertification is not, however, required by the regulations. Current riders can continue to receive service and can apply for ADA paratransit eligibility as they choose. If existing riders are allowed to choose whether or not to apply for ADA paratransit eligibility, transit providers should make these riders aware of any potential benefits of certification. This would include the ability to use paratransit services in other areas and "priority" service should capacity constraints exist. It would also provide individuals with certain rights and "due process" protections. A recertification of existing riders will become important, however, if fully compliant paratransit service cannot be developed in the five year implementation period provided by the regulation. Any request for an undue financial burden waiver can only count those costs associated with the provision of required paratransit service. A recertification of existing riders will be needed to determine which individuals and which trips are in fact required. No-Show Suspension Policy Finally, the regulations permit transit providers to suspend paratransit service to those persons who establish a "pattern or practice" of missing scheduled rides (i.e., "no-show"). Service can be suspended for a "reasonable period of time". Allowances must be made for missed trips that are beyond the control of the individual. The number of no-shows considered a pattern or practice and the period of suspension must be developed through the public participation process required for the development and updating of paratransit plans. Before service can be suspended for cause under this provision, individuals must be provided with an opportunity to appeal the proposed suspension. A two-stage notification and appeal process is detailed in 37.125(h) of the regulations. Section 9 of Chapter 3 provides further guidance on no-show policies and includes information about policies established by selected transit agencies. Chapter 3 Establishing an ADA Paratransit Eligibility Determination Process The establishment of an appropriate eligibility determination process involves several key decisions. Figure 3 summarizes the basic steps that must be taken to establish a determination process. At the outset, a decision must be made as to the process that will be used. It is then necessary to decide who will conduct initial determinations. An appeal process must be structured and no-show and recertification policies considered. Application materials and forms must then be developed. Public participation in all of these aspects of the process is required. A management information system for tracking reviews should be created before the process is implemented. Training also should be provided to those involved in the process. Consideration should be given to pre-testing materials before they are widely distributed. Once established and operational, administrative oversight of the process should be maintained, particularly in the initial months. This chapter details and provides guidance on each of these steps and decisions. Section 1 discusses overall considerations, including public participation in the development of the process and the issue of application/assessment fees and charges. Sections 2 and 3 present alternative processes that can be used for conducting determinations, and discuss issues Figure 3. Steps in Developing an ADA Paratransit Eligibility Process associated with conducting determination in-house versus contracting with an outside agency or agencies for this service. Section 4 addresses the development of application forms and related materials. Suggestions for the development of application forms and other materials are presented. Issues associated with conducting reviews, providing notification of determinations, structuring an appeal process, and establishing details of a no-show policy and a visitor policy are discussed in Sections 5 through 10. Much of the information in this chapter is based on the policies, procedures, and materials that have been developed by selected transit providers during the first year and a half of implementation of the complementary paratransit service requirement. Detailed information about eligibility determination was obtained from 25 selected transit providers across the country. Reference is made to these systems throughout this chapter. Appendix C provides a listing of the transit systems contacted, addresses, phone numbers, and contact persons should additional information be desired. Section 1. General Considerations Public Participation Major elements of the process must be developed with full public participation, including a public hearing. This would include decisions on the overall initial determination process that will be used, the structure of the appeal process, or a decision to establish or change the specifics of a no-show policy. It would also include major changes to the application/assessment form such as the addition or deletion of key questions regarding travel capabilities. Procedural changes such as the wording of notification letters or minor changes to the layout of forms and other materials can be made without full public participation. Obtaining less formal input is still, however, recommended. The ongoing mechanism for obtaining the input of persons with disabilities in the development and implementation of the paratransit service should be used throughout. Given the detail involved in developing all aspects of a determination process, consider establishing a small but representative working group to help in the development of draft materials and process recommendations. Make these draft materials and recommendations available to any advisory committee or distribute them to agencies and interested individuals for review and comment. Finally, present the recommended process and materials at a pubic hearing for broader comment and review. If eligibility materials are to be revised over time, consider combining the review and revision with the required annual ADA paratransit plan update process. Conversations with transit providers that have successfully implemented an eligibility determination process suggest that public involvement in the development and implementation of the process is vital. Individuals with disabilities and agency staff can assist with the preparation and testing of materials. They will provide a detailed knowledge about disabilities and travel capabilities and requirements that the transit provider staff do not necessarily have. Involving consumers and agencies will also allow for the development of options for outside assistance with initial reviews and appeals. For additional guidance on developing a public participation process, see the ADA Public Participation Handbook. This document, funded by FTA and prepared through Project ACTION, offers numerous suggestions and readily adapted material for strengthening local public participation. Public Information and Marketing In addition to a thorough public participation process, it is highly recommended that a public information/marketing program be developed to educate potential applicants and local disability organizations about ADA paratransit eligibility. The program should utilize a variety of media to reach persons with different types of disabilities, and program materials should be made available in accessible formats. It is likely that individuals and agencies may not fully understand the functional nature of ADA paratransit eligibility, the difference between individual and trip eligibility, the appeal process, or other key issues. Misunderstanding of the nature of eligibility for service can lead to incomplete and/or inappropriate applications, as well as political and customer relations problems. Communicating the trip-by-trip nature of ADA paratransit eligibility is particularly important. Several transit agencies have reported that individuals are hesitant to use fixed route services for fear this will make them ineligible for ADA paratransit. The public information program should emphasize that paratransit may still be appropriate even if fixed route service can be used some of the time. The eligibility determination process is intended to determine when each mode is appropriate rather than to make an absolute distinction between those who are to use fixed route and those who require paratransit. Another public perception issue raised by several transit agencies was that applicants often do not provide information about all of the difficulties they may have using the fixed route service. Applicants may think that, as long as the primary difficulty using transit is noted, they will qualify for paratransit and be able to request any trip. It is important that they understand that all difficulties be noted so that appropriate conditions/limitations of eligibility can be determined. While a public information campaign is recommended in all cases, it is particularly important in the following situations: If current paratransit customers are being required to reapply and be recertified as eligible for paratransit service. Differences between past eligibility policy and ADA paratransit eligibility will need to be explained; If a broader paratransit service will be provided with priority given to those determined ADA paratransit eligible. In this situation, it is important that the benefits of applying for and being determined ADA paratransit eligible be communicated to all riders. Some public information and marketing efforts to consider are listed below. (1) Develop a brochure that explains ADA paratransit eligibility. It could be displayed with other service materials and mailed to current riders. It could also be displayed at locations which are frequented by the general public and persons with disabilities such as public libraries, municipal buildings, senior centers, aggregate housing locations, social service agencies, and medical facilities. Appendix D contains copies of brochures developed by Seattle Metro, the Regional Transportation Authority of Chicago, and the Riverside Transit Agency of Riverside, California that explain the ADA, ADA paratransit, eligibility, and the appeals process. (2) As mentioned in Section 4 of this chapter, include a summary of ADA eligibility with certification materials that are sent to applicants. (3) Work with local human service agencies and disability organizations to include information about ADA paratransit eligibility in any publications that they may have. Organizations such as United Cerebral Palsy councils, local chapters of the National Easter Seal Society, commissions for the blind and visually-impaired, commissions for the deaf and hearing-impaired, area agencies on aging, mental health agencies, independent living programs, and state,regional, or local commissions on people with disabilities prepare newsletters which are sent to members and clients. (4) Request the opportunity to discuss eligibility issues with the governing boards of human service agencies and disability organizations and to make presentations at any workshops, conferences, or consumer meetings which they may sponsor. (5) Make a particular effort to explain the details of ADA paratransit eligibility to the staff of local agencies. Depending on the certification process employed, these individuals may be asked to supplement applicant information or may assist individuals in completing application materials. Even if not involved in the certification process, agency staff who are knowledgeable about eligibility issues will be able to better advise clients. (6) Sponsor a special public forum at which ADA paratransit issues, including eligibility, can be discussed. Invite current riders and other interested agencies and individuals as well as advertising it to the general public. A notice of such a forum, prepared by the Worcester Regional Transit Authority, is provided in Appendix D. (7) Work with local media to develop public interest stories that help to explain the service and eligibility. Feature a customer who uses the fixed route service for certain trips but has been certified for paratransit service for other trips. Additional Charges and Fees Section 37.5 of the regulations, which defines general requirements for nondiscrimination for all aspects of transportation services covered, states that: "An entity shall not impose special charges, not authorized by this part, on individuals with disabilities, including individuals who use wheelchairs, for providing services required by this part or otherwise necessary to accommodate them." [37.5(d)] For determinations of ADA paratransit eligibility, this means that there can be no charges associated with the process, including the filing and processing of applications, any in-person assessments that may be requested, the documentation of eligibility that is provided, or any other aspect of obtaining eligibility. In particular, if the process involves obtaining information from a professional or an in- person assessment, the transit provider or any third-party contractors acting on behalf of the transit provider cannot impose a fee for this service. If professional information is needed for the initial application to be considered complete, alternatives should be made available should the applicant not be able to obtain this information from a professional or not be willing to incur any costs that might be associated with obtaining this information. For example, the transit provider should make arrangements with local professionals to whom applicants can be referred and the transit agency should pay any fees associated with this service. Transportation to and from any in-person assessments or other appointment required by the process also should be made available to applicants. Similarly, a fee cannot be charged for the preparation of documentation of eligibility, including photo identification cards. A transit provider may, however, charge a nominal fee, meant to cover the cost of production, for replacement of lost I.D. cards. Local policy concerning such charges should be developed with full public participation, including the input of persons with disabilities. In addition to prohibiting obvious direct charges, the regulations note that the process may not impose "unreasonable administrative burdens" on applicants. Repetitive and superfluous documentation, questions, or tests must not be included. Section 2. Alternative Processes There are several ways that ADA paratransit eligibility determinations can be conducted. In general, the many approaches that have been developed can be characterized as one of the following: Self-certification with professional verification as needed; Self-certification and professional verification; In-person assessment; and Combined approaches. These alternative processes can be conducted either in-house by transit provider staff or can be contracted out and conducted by a third-party agency. It is also possible to conduct some determinations in-house and have third-party assistance available as needed. The best process and approach to conducting reviews depends on local circumstances. Some alternatives are better suited to smaller systems. Others are more appropriate for larger urban systems. Whether or not a paratransit service was provided prior to ADA complementary paratransit service is also an important consideration in the alternative selected. Each alternative also has its own benefits and issues that must be considered. Regardless of the approach selected, the goal of the determination process should be the same - to enable the public entity to accurately determine when and under what circumstances the fixed route service can and cannot be used by applicants. Information collected and reviewed must be sufficient to enable the reviewer to identify the relationship between a person's disability and their travel capabilities given factors such as: the accessibility of the fixed route service; the distance to and from stops/stations; environmental factors such as snow, ice, heat, cold; and natural and man-made architectural barriers such as steep terrain, lack of curb-cuts, and busy roads and/or intersections. Following is a description of each of the alternative processes listed above. For each, general recommendations are made concerning the applicability of the process to different types of systems. Major considerations associated with each alternative are also discussed. Self-certification with professional verification as needed This alternative involves the completion of a form by the applicant or a person assisting the applicant. The form which the applicant completes typically includes all of the information required for a determination of eligibility. As part of the form, applicants are requested to identify a professional who can be contacted if more information is needed, and are asked to sign a release authorizing the professional to provide the transit agency with pertinent information. While the applicant chooses the professional who can be contacted, the transit agency can request the identification of particular type(s) of professionals. Professional verification can be obtained under this model by phone, through the use of a second form which is mailed to the professional by the transit provider, or both. While it is theoretically possible to establish a determination process that only utilizes information provided by the applicant, it is highly likely that at least some determinations will require more detailed information. Verification of "hidden disabilities" such as cardiac conditions, pulmonary conditions, cognitive disabilities, and mental illness will be needed. It is therefore recommended that the ADA paratransit eligibility determination process allow for professional contact, at least as an option, in all cases. In addition to contacting the identified professional when additional information is needed, some transit providers will randomly contact named professionals to verify the information provided by applicants. Verification can also be done following certification if there is cause to believe that the information provided by the applicant is not correct. Applicability Self-certification with professional verification as needed is used extensively by smaller fixed route operators in small urban and rural areas. It is most appropriate in areas where the size of the system allows transit providers to be familiar with paratransit riders. It is also appropriate in cases where the transit agency offered paratransit services prior to the implementation of ADA service. In these instances, it is likely that the provider already has information about riders, possibly including professional verifications, on file. An ADA paratransit eligibility determination process which does not require professional verification can be used to reduce unnecessary duplication of existing eligibility information. Considerations This certification process is perhaps the least burdensome on applicants. Appointments with professionals to have forms completed or to have personal assessments conducted are not required. Greater burden is placed on reviewers, however, as follow-up may be needed if sufficiently detailed information is not provided in the initial application. If this alternative is selected, particular attention should be given to the 21 day timetable allowed by the regulations for reviewing applications and presumptive eligibility beyond this time. Applications must be considered complete if applicants complete all items on the form and name a professional contact as requested. Any follow-up by reviewers to obtain professional verification would be part of the 21 day review timetable. An initial review and decision whether or not professional information is needed should be made within the first few days after receipt of the application. Another important issue associated with this approach is getting information from the most appropriate professional. Depending on the nature of an applicant's disability, different types of professional verification are desirable. For example, for someone with a physical disability, information from a physical therapist or occupational therapist may be most helpful. For an applicant with a vision-impairment, information from an opthomologist which can provide the degree of sight which the applicant has may be helpful. It is not always possible, however, to control the type of professional named by the applicant. If allowed, many applicants may provide the name of a personal physician with a knowledge of the person's disability but with little understanding of their ability to travel on the fixed route service. If possible, applicants should be directed to identify professionals most appropriate to their disability or medical condition. Section 4 of Chapter 3 of this manual suggests wording that can be added to the application form to direct applicants to identify an appropriate professional. It is also possible under this approach to request that a different professional be identified if the person originally listed cannot provide adequate information. Finally, because this process relies on information provided by the applicant and/or a professional, it is important that they understand the nature of ADA paratransit eligibility. A major issue encountered by transit providers using this form of certification is that applicants/professionals will identify a primary disability or travel limitation but may not detail all problems that may be encountered using the fixed route service. This may be due to the fact that applicants feel they only need to qualify and that they will then receive service as needed. Professionals also may have a tendency to provide cryptic medical information. The introductory section of the form should describe ADA paratransit eligibility in detail. The notion of trip-by-trip eligibility also needs to be made clear so that the applicant and professional understands that detailed information is required in order to identify appropriate eligibility conditions/limitations. Self-certification and professional verification In this eligibility determination process, the initial application form contains two parts - one part completed by the applicant (or his/her representative) and the other part to be completed by a professional familiar with the applicant's condition. The information from the professional is requested as part of the initial submission and the application is not considered complete without it. As with the first alternative described above, each applicant selects the professional from which they request additional information. Transit providers can, however, specify the types of professionals that can provide this information. The professional verification portion of the application is typically designed in one of two ways. In some cases, the questions asked of both the applicant and the professional are very similar and the separate responses are compared for accuracy and consistency by the reviewer. In other cases, the applicant is asked only general information and more detailed information about travel capabilities and the nature of the person's disabilities is included in the professional verification section of the form. While information is requested from both applicants and professionals under this process, follow-up may still be required. Contact with the applicant may be needed if a different professional, with a better understanding of the person's functional abilities, is needed. Follow-up with professionals may be necessary if the information provided is not sufficiently detailed to allow a determination to be completed. Applicability This process is often used by larger transit providers who, because of the expected volume of certification requests, may find it administratively difficult to do the necessary professional follow-up within the required processing timetable. The inclusion of professional information as part of all applications received can help to facilitate the review process. It may also be applicable if past eligibility for paratransit service was not functionally based or if information that may be on file as part of past determinations needs to be updated. Considerations If this approach to certification is used, transit providers must allow for those instances when applicants are not able to easily obtain information from professionals. While systems report that most individuals are able to obtain the needed information from a professional, there will be some individuals who will not have an ongoing relationship with a professional or may have to pay for this information to be provided. In order for the process to be consistent with the regulatory prohibition against special charges and unreasonable administrative burdens, professional verification should be requested. Applicants should be instructed to contact the transit provider if professional verification cannot be obtained. A list of appropriate professionals to whom applicants can be referred should be maintained and the cost associated with any required appointments should be paid by the transit provider. As with "self-certification with professional verification as needed", it is important that an effort be made to obtain information from the most appropriate professional. Applicants can be instructed to provide verification from particular professionals or can be directed to contact a professional appropriate to their disability. Paratransit eligibility determination prior to the ADA often specified that this type of professional verification be provided by a personal physician. Under the ADA, the use of physicians may not be appropriate in many cases. While personal physicians may be the professionals most readily available to applicants, they may not understand the applicants functional capabilities as well as other professionals. The interpretive appendix to the regulation offers the following advice concerning the use of information from physicians: "The substantive eligibility process is not aimed at making a medical or diagnostic determination. While evaluation by a physician (or professionals in rehabilitation or other relevant fields) may be used as part of the process, a diagnosis of a disability is not dispositive. What is needed is a determination of whether, as a practical matter, the individual can use fixed route transit in his or her own circumstances. That is a transportation decision primarily, not a medical decision."[Appendix D to 49 CFR Part 37, Federal Register, September 6, 1991, page 45746] In certain instances, information from a physician will be appropriate. Verification of a cardiac condition or the degree of vision impairment may, for example, be needed. Transit providers should consider allowing applicants to obtain information from several different types of professionals, including physicians. Direction should also be provided encouraging applicants to obtain information from a professional most appropriate to their particular disability. It is also important that professionals understand that the verification which they provide is not considered a determination. Eligibility determinations are to be made by transit providers or contractors hired to conduct eligibility determinations. Professionals must understand that they are simply providing information to the reviewers and that they are not being asked to make the determination. This should be made clear on the forms provided. Avoid having professionals answer broad questions which ask them if they think that the person is ADA paratransit eligible. They should not be asked to make a final judgement. This will only cause problems and possible confrontations if the final determination differs from their professional opinion. Many systems also indicate that information provided by professionals is cryptic and general in nature. Transit providers should make questions concise and explain on the form that detailed information is needed. The concept of trip-by-trip eligibility should be explained and professionals should be informed that the information needs to be of sufficient detail to allow the reviewer to not only determine that paratransit service is needed but to decide when and under what circumstances paratransit service is needed. In some cases, transit providers will allow human service agencies to provide professional verification for their clients. Such agencies may have conducted assessments of clients to determine their eligibility for other programs. They often will have detailed functional information on file which can be of assistance in the process. Because of the obvious benefit to these agencies of having clients certified for paratransit service, it is recommended that consideration be given to the extent of this type of agency involvement in the process. If the staff of human service agencies are to be used for professional information and verification, transit providers may want to consider limiting the types of agency verifications accepted to those agencies that promote independent living. It is important that agencies authorized to provide verifying information be concerned not just with obtaining a convenient service for their clients but with mainstreaming them. Independent living centers, certain agencies for persons with vision-impairments, and rehabilitation centers are examples of such agencies. As with other types of professional verification, it is important that information provided by these agencies be one factor in the determination rather than being used as a final eligibility decision. If reviewers used by the transit provider are skilled in interpreting standard human service assessments, another option available under this model would be to request copies of any functional tests which these agencies may have on file. In-Person Assessments Under this model, all applicants are required to meet with a reviewer selected by the transit provider. At this assessment meeting, the reviewer will typically ask the applicant a series of questions, similar to those contained in an application form, meant to determine the person's disability and ability to use fixed route service. Often, the reviewer will also elaborate on standard questions to get more detailed information as appropriate. In addition to a face-to-face interview, in-person assessments may also involve the administration of functional tests. These may include physical tests such as the ability to board and disembark from an inaccessible bus, use a wheelchair-lift, or see and read signs or other visual information. It may also involve administering standard cognitive tests to determine the applicants ability to perform tasks such as asking for and following directions. Because of the skill required to administer and interpret detailed tests and draw immediate conclusions from such assessments, determinations under this process are typically performed by third-party agencies under contract to the transit provider. Transit providers may also work with contractors to develop testing centers containing equipment needed to simulate travel on the fixed route system. The Transit Authority of River City (TARC) in Louisville, Kentucky, for example, has created a testing center at a local rehabilitation center that is equipped with a specially constructed bus stop and a spare bus. The site also contains sidewalks with varying terrain and varying surfaces. For applicants with visual impairments, the site includes typical transit signage and symbols and can simulate varying degrees of light and darkness. For applicants with mental disabilities, a cognitive and orientation assessment is conducted by a clinical psychologist. In addition to information collected by the reviewer, the process may require applicants to complete a general information form and sign necessary releases/certifications. Applicability In-person assessments may be particularly applicable in larger urban systems with complex fixed route services. The in-person process is able, in these circumstances, to obtain detailed information about using various parts of the system that may be difficult or complex to collect on standard application forms. This approach may also be more appropriate in areas that did not provide paratransit service prior to the ADA. While transit providers with established paratransit services and longstanding customers may not deem it necessary to require all riders to undergo an in- person assessment, new systems will have no past record of riders to rely on. New riders may also be more amenable to an in-person assessment process. Considerations The use of in-person assessments has many advantages. It allows eligibility determination to be done by a limited number of professional who can be trained by the transit provider. Obtaining information from an appropriate professional, which is a major concern in self- certification/professional verification models, is eliminated. In-person assessments also are not bound by standard application questions. The process can be more personalized to the person's particular disability. Even though standard questionnaires are used to guide the process, reviewers can ask follow-up questions as needed. This process also allows reviewers to explain ADA paratransit eligibility in-person and to answer questions about eligibility which the applicant may have. The applicant also has an opportunity to request clarification of questions before providing an answer. The information received is therefore more likely to be complete and accurate. Because of the degree of flexibility which reviewers may have, it is important that efforts be made to maintain consistency in the process. Transit providers should consider establishing standards for the types of professionals who are used as reviewers. Detailed training of reviewers is also vital. Perhaps the greatest drawback to requiring in-person reviews in all cases is that many applicants may have disabilities which do not require such elaborate assessments. To many applicants, such a required process may seem an unnecessary and burdensome procedure. Another issue with this type of process is assessing disabilities that are intermittent or episodic. A single visit and review may not generate the same level of information about a person's capabilities that may be available to a professional who has worked with the individual for years. Consideration should be given, in such cases, to obtaining supplemental information from a professional identified by the applicant. Similarly, an assessment of cognitive ability based on a single visit or series of tests may not be as complete as information which can be obtained from the person's social worker or mental health counselor. Finally, it may be difficult to simulate all environmental conditions which may affect a person's ability to use fixed route service. The limitations of certain physical tests need to be considered and the applicability of these tests to the process carefully weighed against the cost of their administration and inconvenience to the applicant. Regardless of the sophistication of the tests administered, information obtained in the personal interview is likely to still be an important part of the determination. Combined Approaches In addition to the basic approaches described above, eligibility determination can also be conducted by combining the features of each of these processes. Table 2, presented at the end of this section, includes information about the processes used by several selected transit providers across the country. As can be seen, many different combined models are possible. Perhaps the combined model that is most widely used combines self-certification/professional verification with in-person assessments as needed. For example, the Madison Metro Transit System in Madison, Wisconsin relies primarily on a self-certification process which asks applicants to identify a professional that can be contacted for verification and additional information. Metro's in-house reviewers will seek verification as needed. Metro also reserves the right to ask applicants to appear in-person for an assessment by a local rehabilitation center. Several providers, including Lane Transit District, Baltimore's MTA, Seattle METRO, and the Utah Transit Authority obtain information from both the applicant and a professional ("self-certification and professional verification"). In addition, they will refer applicants for an in-person assessment if a final determination is still not possible. The Riverside Transit Agency (RTA) requires an in-person assessment in most cases. They will, however, accept professional verification from applicants with severe mental retardation. An in-person assessment is not required if a psychological evaluation is provided which indicates severe mental retardation and has been signed by 4 or more professionals of the regional mental health program. It is also interesting to note that the RTA has arranged for in-person assessments to be conducted either at the local clinic or at the applicant's home. The Regional Transportation Authority of Chicago, which will be administering eligibility determinations for CTA and PACE, combines self-certification with in-person assessments as needed. A similar process is being established by the New York City Transit Authority. It is interesting to note that in systems that employ "combined" processes using both self- certification/professional verification and in-person assessments, relatively few in-person reviews are necessary. As shown in Table 2, 90 percent of all determinations can typically be completed based on the information supplied by the applicant and/or the named professional. Seattle Metro, for example, has found it necessary to refer only 5 percent of all applicants for an in-person assessment. The Utah Transit Authority relies on in-person reviews in 7 percent of all cases. The Lane Transit District, located in a medium sized urban area, finds in-person assessments necessary in only 1 percent of all determinations. As transit providers complete recertification efforts and begin doing determinations of new riders, in-person assessments may become more important. Madison Metro reports, for example, that during the process of recertifying existing riders, only 10 percent of all determinations of existing riders required in-person reviews. Following the recertification of existing riders, in-person assessments have been deemed necessary in 25-30 percent of all determinations. Another model developed by the Port Authority of Allegheny County's ACCESS Program in Pittsburgh combines in-person assessment with professional verification. An in-person assessment is required in all determinations. In addition, applicants who receive services from a local human service agency are also encouraged to bring verification information from that agency to the assessment. PAT provides a "Professional Verification" form to applicants for this purpose. Finally, the Oshkosh Transit System in Oshkosh, Wisconsin uses a self-certification with professional verification as needed process but also relies heavily on two local human service agencies for verification of eligibility. The Oshkosh Transit System recently consolidated local paratransit services and assumed operating responsibility from the local Red Cross and the County Committee on Aging. As the past operators of service, these two agencies were familiar with existing riders. The Oshkosh Transit System therefore accepts professional verification from these two agencies for all existing riders seeking ADA paratransit eligibility. Applicability and Considerations Combined models may be appropriate in any number of situations. The use of in-person assessments as needed or professional verification to supplement an in-person review process may be needed to strengthen the original process. As experience is gained with the eligibility determination process, transit providers and their reviewers may discover that these additional steps are needed to ensure the accuracy and consistency of determinations. Depending on the features combined, the issues noted above for each of the basic processes would apply. Considerations for Future Recertification of Riders As noted in Chapter 2 of this manual, the regulations permit transit providers to require periodic recertification of riders. It is possible that the process used for this recertification will be different from that used in the initial determination or to certify new riders. For example, if a self-certification/professional verification process was used for initial determinations, it may be possible to forward the information that was originally provided by the applicant and request that they indicate whether this information is still current and correct. Updating of the original form may also be supplemented by a limited number of new questions. Applicants could be asked if the professional who provided the initial verification is still the appropriate person to contact and new verification could be sought only in those cases where significant changes in capabilities are noted. Transit providers using an in-person assessment process for all initial determinations could opt to not require another detailed review but instead could use a self-certification type of form that asks if the persons disability or ability to use the fixed route service has changed. In-person assessments may be limited to those recertifications where significant changes are noted. Table 2. Eligibility Determination Processes Used by Selected Transit Providers Name of Transit Provider Type of Determination Process Determination Performed by % Determination Referred to Outside Contractor(s) Cost per Contract Review (in-house costs are not included) Ann Arbor Transportation Authority Ann Arbor, MI Self-certification and professional verification. In-house N/A N/A Ben Franklin Transit Richland, WA Self-certification with professional verification as needed In-house N/A N/A City of Charlotte Charlotte, NC Self-certification and professional verification. In-house N/A N/A Delaware Administration for Specialized Transportation (DAST) Dover, DE Self-certification and professional verification In-house N/A N/A Greater Bridgeport Transit District Bridgeport, CT Self-certification with professional verification as needed. In-house N/A N/A Greeley, CO Self-certification with professional verification as needed. In-house N/A N/A Lane Transit District Eugene, OR Combined: Self-certifica- tion and professional verification with in- person assessment as needed. Initially by paratransit contractor. Referred as needed to one of two OT's under contract. 1% $30-$50 per hour (one hour review medical) Los Angeles County Metropolitan Transportation Authority Los Angeles, CA In-person assessment "Certification Analysts" selected by LACMTA - either registered nurse with at least two years experience; physical therapist; occupational therapist; or clinical social worker. 100% Initial review: $27.60 Madison Metro Transit System Madison, WI Combined: Self-certifica- tion with professional verification and/or in- person assessment as needed. Initially in-house. Referred to Rehabilitation Center as needed 10% during re- certification, 25-30% ongoing $120 per in-person assessment Mass Transit Administration (MTA) Baltimore, MD Combined: Self-certifica- tion and professional verification with in- person assessment as needed. In-house N/A N/A Municipality of Metropolitan Seattle (METRO) Seattle, WA Combined: Self-certifica- tion and professional verification with in- person assessment as needed Initially in-house, referred to Evergreen Medical Center as needed. 5% Cognitive Test: $82 Physical Test:$82 Both: $164 New York City Transit Authority New York, NY Self-certification with in- person assessment as needed In-house review of self-certification information. Assessments by third- party contractors to be determined. N/A (process only recently implemented) N/A OMNITRANS San Bernardino, CA Self-certification with professional verification as needed. Also, doing random verifications to check accuracy of self- certifications. In-house N/A N/A Oshkosh Transit System Oshkosh, WI Self-certification and professional verification. Work closely with previous operators - the Red Cross and County Committee on Aging for professional verification. In-house N/A N/A Port Authority of Allegheny County (PAT); ACCESS Program Pittsburgh, PA In-person assessment and professional verification Local Chapter of the Easter Seal Society; Behavior Neuropsychology Associates, Inc; and a network of orientation and mobility specialist for persons with vision impairments 100% $20 Regional Transportation Authority (for CTA/PACE) Chicago, IL Self-certification with in- person assessment as needed In-house review of self-certification information. Assessments by local non-profit organizations with occupational and physical therapists on staff who are often involved in administering eligibility screening for human service programs. N/A (process only recently implemented) $150 Riverside Transit Agency Riverside, CA In-person assessment or professional verification (for persons with severe mental retardation). Local medical clinic. 100% $62 for reviewat clinic; $85 for assessment at home. SAMTRANS San Mateo County, CA Self-certification with professional verification as needed In-house N/A N/A Southeastern Pennsylvania Transportation Authority Philadelphia, PA Self-certification and professional verification In-house N/A N/A Transit Authority of River City (TARC) Louisville, Kentucky Self-certification with in- person assessment as needed Initial review is in-house. Assessments conducted by local rehabilitation center 10% $105 Utah Transit Authority Salt Lake City, UT Combined: Self-certifica- tion with in-person assessment as needed. In-house initially. Referral as needed to either: State Services for the Visually-Impaired; University Spine Rehabilitation Center; or local mental health agencies and associations for retarded citizens. 7% State Services for the Visually- Impaired: $0 Others: $25 Washington Metropolitan Area Transportation Authority (WMATA) Washington, DC Self-certification and professional verification. Will be third party contractor. 100% N/A Waukesha Transit System Waukesha, WI Self-certification with professional verification as needed. In-house N/A N/A Worcester Regional Transit Authority Worcester, MA Self-certification and professional verification. Three independent rehabilitation specialists under contract to the authority review forms. 100% $35/hour (initially 2/hour; recently 5- 10/hour). Section 3. Deciding Who Will Do Initial Determinations A second major decision that must be made when designing an eligibility determination process is who will actually review application materials or conduct in-person screenings. The basic choice is to either conduct initial determinations in-house, using staff of the public entity, or to contract with a third-party to perform this service. It is also possible to involve staff in part of the process and utilize outside help for specific functions as needed. Issues related to each of these options are discussed below. The approach taken by selected transit providers is also presented in Table 2 in the previous section. In-House Determinations If eligibility decisions are to be made by in-house staff, it is important to be sure that this staff has the capabilities and qualifications to make accurate and consistent determinations. While ADA paratransit eligibility is a functional transportation-related decision, it also involves relating specific types of disabilities to reported functional capabilities. A knowledge of various types of disabilities and the likely functional capabilities of persons with such disabilities is, therefore, important. Public entities which operated paratransit services prior to the ADA and have been conducting eligibility determinations may already have staff with such capabilities. Others may elect to hire new staff or train existing staff to handle this job. Consideration should also be given to combining the task of doing ADA paratransit eligibility determinations with other similar in-house tasks. For example, it may be possible to combine the job of ADA eligibility determinations with the review of applications for reduced fare cards. If an in- house travel training program is developed, staff in this program could also assist with determinations of eligibility. A medical officer hired to work on drug and alcohol testing might also be a good person to involve in the eligibility determination process. In-house determinations are more common among providers that have elected to use either a self-certification with professional verification as needed or a self-certification with required professional verification system. It is also common among smaller providers and providers which offered paratransit services to persons with disabilities prior to the ADA. Utilizing Contract Reviewers It is likely that there are a variety of local organizations in the area that could be hired to either do or assist in initial eligibility determinations. This might include a clinic that employs occupational or physical therapists, a rehabilitation center, an independent living center or program, a rehabilitation center, or a visiting nurses program. If it is determined that in-house staff capabilities are not adequate, or if the impartiality of having an organization other than the transit provider is an important consideration, contracting with one of these organizations may be appropriate. When selecting a third-party contractor for eligibility reviews, consider both the capabilities of the employees of the agency as well as the general philosophy and mission of the agency. Figure 4 on the following page identifies several types of professionals that can assist in the process. Certain professionals will have the skills necessary to perform determinations of functional capabilities. Others will be most helpful in verifying the nature and extent of particular disabilities. Note in particular the capabilities of physiatrists. Doctors of physiatry specialize in the mobility and travel capabilities of persons with disabilities - skills ideally suited to ADA paratransit certification. Physiatry is a narrow specialty, however, and such doctors may not be available in many areas. If there are physiatrist(s) in the area, consideration should be given to involving them in the process - either to assist with development of the process or to assist with actual determinations. Doctors of physiatry may be particularly well suited to assisting with appeals, for example. Occupational therapists are also well suited to determine capabilities associated with activities of daily living. In addition to considering the type of professional to be used, transit providers may want to develop specific qualifications for reviewers who may be proposed or used by third-party contractors. As noted in Table 2, for example, the Los Angeles County Metropolitan Transportation Authority includes certified nurses in the list of professional that can be "Certification Analysts" but requires persons in this profession to have at least two years of experience. When involving human service agencies in the process, consider any conflicts or biases which may exist - particularly with agency clients. Organizations which support the concept of independent living and mainstreaming of persons with disabilities are also more likely to make determinations which strictly limit eligibility to those who are unable to use the fixed route system. Third-party contractors can be particularly appropriate if a large number of existing paratransit riders are to be recertified as part of the implementation of the program. Conducting a large-scale recertification process in-house may require several reviewers who would only be used for a limited period of time. The scope of a third-party contract, on the other hand, could be adjusted to meet the particular demand. Third-party review contractors also should be considered if it is decided that the determinations will be done through in-person assessments. Correctly interpreting responses to questions and/or the results of specific tests may require skills not available in-house. Both of the transit providers contacted as part of the preparation of this manual which require in-person assessment in all cases utilized third-party reviewers. The Port Authority of Allegheny County's ACCESS Program utilizes the local chapter of the Easter Seal Society, a local neuropsychology agency, and a network of orientation and mobility specialists for persons with vision-impairments. Los Angeles has developed a network of "Certification Analysts" representing various professions. Figure 4. Examples of Types of Professionals that can Assist with Eligibility Determinations Sources: Mosby's Medical, Nursing, and Allied Health Dictionary, the C.V. Mosby Company, 1990; and, Dictionary of Occupational Titles, Volume 1, Fourth Edition, U.S. Department of Labor, 1991. In-House Determination with Third-Party Assistance as Needed It is also possible to combine an in-house staff review with the option to obtain third-party assistance as needed. A significant percentage of the reviews of eligibility may be relatively straightforward. In-house staff may be able to easily make determinations in these cases. Other applications or assessments may be more difficult. In these cases, the application material can be forwarded to a contract reviewer for further review and recommendation. If information forwarded by the applicant or the named professional is not sufficient to make a determination, it may be desirable to request that the person appear in person for a more in- depth assessment. Such assessments can then be contracted out. Many of the transit providers contacted as part of the preparation of this manual used third- party reviewers as needed. The Utah Transit Authority utilizes a self-certification with professional verification as needed process. In-house staff have been able to determine eligibility in 93 percent of the cases using information initially submitted and follow-up information obtained from named professionals. In the remaining instances, applicants have been requested to participate in in-person assessments conducted by several local organizations. The assessment is done by an agency familiar with the particular disability of the applicant. The UTA utilizes the Spine Rehabilitation Center of the University of Utah, the State Services for Visually Impaired, and local Associations for Retarded Citizens to conduct assessments. Seattle Metro, which utilizes a self-certification with required professional verification process, works with the occupational and physical therapists at a local medical center when in-person assessments are required. Metro reports that 5 percent of all applicants are referred to the Center for in-depth assessments. One consideration in using third-party review contractors, either as needed or in all cases, is the cost of these services. The cost of contracting out for this service must be compared to the costs that would be incurred if in-house staff performed this function. Current availability of qualified staff, training costs, and long-term employment issues must all be considered. Table 2, included in the previous section of this manual provides a summary of cost information obtained from providers who utilize third-party review contractors. As can be seen, costs range from about $18 to $164 per review, depending on the type of review performed. In person assessments contracted by Lane Transit, Los Angeles, Madison Metro, Seattle Metro, Riverside Transit, and the Utah Transit Authority range from $25 to $164. It appears that assessments done only as needed (implying a lower volume) may be more expensive while assessments of all riders in Pittsburgh and Los Angeles are considerably less expensive ($20 - $30). The transit provider that contracts for the review of self-certification forms, Worcester Regional Transit Authority, reported that this service costs approximately $18 per review. It may also be possible to lower the cost of needed assessments by working with other available public agencies. The Utah Transit Authority, for example, refers individuals with vision impairments to the State Services for the Visually-Impaired. This state agency has agreed to conduct assessments free of charge. Reviewer Training Regardless of whether determinations are conducted in-house or by a third-party, it is important that those involved in the determination are adequately trained. As noted above, in-house staff may have an adequate knowledge of the existing transit system but may need training regarding types of disabilities and their functional characteristics. Such training could be provided by local organizations. Sensitivity training materials, such as that developed by the Rural Transportation Assistance Program, may also be helpful. Third-party staff may need a more complete understanding of the services offered on the fixed route system. They may not be aware, for example, of the extent of accessibility and driver assistance that is now offered. They may also not be aware that individuals with ambulatory impairments are permitted to enter the vehicle by standing on the lift. Both in-house and third-party staff should also be given thorough instruction about ADA complementary paratransit and ADA paratransit eligibility. A complete understanding of the concepts discussed in Chapter 1 of this manual will be needed. Section 4. Developing Application Forms and Materials Once decisions have been made concerning the process to be used and the persons or agencies that will actually conduct reviews, the next step in the process is to develop application/assessment forms and related materials. This section discusses the development of this material. Before addressing the development of application material, it is important to note two general considerations - accessible formats and terminology - that apply to all forms and materials. These are discussed below. Accessible Formats As noted in Chapter 1, the regulations require that all information about the eligibility determination process, including materials necessary to apply, notifications of determinations, and other related correspondence be made available in accessible format upon request. This could include large print, audio tape, braille, or computer disk. The requested format does not always have to be provided, but the format provided must be usable and appropriate for the purpose. While all materials must be available in accessible formats upon request, transit providers can require that application be made in a standard format. Making information available in accessible formats does not mean that applications and information must be accepted on tape or in braille. Even though individuals may be asked to complete a standard form, providing the form and related information available in an accessible format is important. It allows individuals to study the information and questions. This allows for a better understanding of ADA eligibility and the process for applying than could be obtained by having the information read over the phone. As part of the application process, transit providers should determine if applicants would like to have future correspondence sent in an accessible format. The application should also ask if another person assisted in the completion of the form(s). The determination letter and other correspondence could then be sent to this other person as well. In some cases, it may be necessary to provide documentation of ADA paratransit eligibility in a standard as well as an accessible format. A standard letter or pass would be needed as proof to present to other transit agencies if the person traveled to another area. Providing the same information in an accessible format would be important if the person needed to periodically refer to the exact conditions associated with their eligibility. Terminology Several of the transit providers contacted reported that many of the modifications made to original materials related to terminology. Applicants had difficulty understanding the questions being asked. Much of this difficulty was due to the inclusion of industry jargon in the application or other materials. Particular attention should be given to using terminology that can be easily understood by the general riding public. For example, applicants and professionals providing verification may not understand what a "paratransit" service is or even what the "fixed route" system is. Use terms such as the "regular city buses" or "van service" and refer to services by their public name, such as "ACCESS-A-RIDE" or "OMNITRANS". The public also may not fully understand what an "accessible" bus is. Provide more detail on the features of the vehicle or use terms such as "wheelchair-lift-equipped". Transmittal/Cover Letter If the process selected involves sending application forms to individuals and/or professional for completion, it is strongly recommended that a detailed transmittal letter explaining the material and ADA paratransit eligibility be developed and included. The transmittal letter should include: a summary and description of the material attached and instructions for completing and submitting the forms; A concise and clear description of ADA paratransit eligibility; and A description of the fixed route transportation services provided, particularly policies designed to facilitate use by persons with disabilities. Particular attention should be given to explaining the trip-by-trip nature of ADA paratransit eligibility. It is important that individuals and professionals realize that the process is intended to determine not only if they require paratransit service but when and under what conditions they require paratransit service. It should be stressed that in order to make a complete and accurate decision, detailed information about their travel capabilities is needed. Information about the fixed route service should include the latest changes made to improve accessibility. Describe the level of accessibility in the fleet, improvements in signage, recent driver training efforts, new policies such as the standee policy and the bus stop announcement policy. Also describe available services such as route identifier or destination card systems that are available. Many applicants may have a preconceived notion about the service or may have attempted to use the service when there was a low level of accessibility and/or operational problems with the service. Application/Assessment Forms Once a decision has been made about the type of process to be used and the person(s) who will conduct determinations, a form or forms will have to be developed for obtaining information, either by mail or in person, from individuals requesting ADA paratransit eligibility certification. This form or set of forms can be completed by the applicant, a professional verifying the applicant's disability and capabilities, an evaluator conducting an in-person assessment, or a combination of these people. The information obtained will then be used to determine whether or not the person is ADA paratransit eligible and under what conditions they require complementary paratransit service. Regardless of the type of determination process selected, the same basic information should be collected. This includes: General information about the applicant; The nature of the person's disability or disabilities; The person's ability to use the fixed route service; Information which may be needed for operations; and Administrative information needed to complete the determination. How the form(s) and questions are organized depends on the type of review process used. In a "self-certification with professional verification as needed" process, the form completed by the applicant is typically comprehensive. All of the basic information needed is requested of the applicant. In a "self-certification and professional verification" process, the applicant is often only asked for general information and some basic information about their disability and travel capabilities. The professional is then asked more detailed questions about the exact nature of the person's disability and functional capabilities. In "in-person assessment" processes, the applicant may be requested to file a form with general information. The professional(s) conducting the assessment then complete the more detailed form based on their discussion with the applicant and/or functional tests that are administered. The type of questions used can also vary. Some forms use open-ended questions that rely on applicants to clearly detail their situation and capabilities. Other forms are more detailed and use multiple choice answers to guide the applicant in providing information in the required level of detail. The approach used will depend on local needs and circumstances. It is important, however, that if open-ended questions are used, applicants and/or professionals are clearly instructed to provide enough detail to describe all of the factors that affect their use of the fixed route service. Similarly, if directed, multiple-choice questions are used, the possible answers suggested must be comprehensive. Several sample forms, developed by transit providers which use various determination processes, are included in the appendices to this manual. A summary of the sample forms included and the type of process within which they are used is provided on the following page. APPENDIX TRANSIT PROVIDER TYPE OF PROCESS E San Mateo County Transit District (SAMTRANS) San Carlos, CA Self-certification with professional verification as needed F Madison Metro Transit System Madison, Wisconsin Self-certification with professional verification and in- person assessments as needed G Utah Transit Authority Salt Lake City, Utah Self-certification with in-person assessment as needed H Worcester Regional Transit Authority Worcester, Massachusetts Self-certification and professional verification I Municipality of Metropolitan Seattle (Metro) Seattle, Washington Self-certification and professional verification with in-person assessment as needed J Washington Metropolitan Area Transportation Authority (WMATA) Washington, D.C., Northern Virginia, and Suburban Maryland Self-certification and professional verification K Delaware Administration for Specialize Transportation (DAST) Dover, DE Self-certification and professional verification L Regional Transportation Authority (for CTA and PACE) Chicago, IL Self-certification with in-person assessment as needed M Port Authority of Allegheny County (PAT) Pittsburgh, Pennsylvania In-person assessment and professional verification Following is a summary of the type of information that can be collected in each of the basic sections of the application/assessment form. Sample questions are also provided. General Information The first part of the form should request information about the applicant. Following is the type of information that is commonly requested in this first part of the application form. the applicant's name street address, apartment number, city/town, state, and zipcode mailing address (if different) telephone number, including home and work number, and TDD number (if applicable) Social Security Number (optional) date of birth the name and phone number of a person to be contacted in an emergency and the relationship of this person to the applicant To assist in communicating with the applicant in the future, many forms also ask if applicants would like communications to be sent in an accessible format. For example, the following question could be included: A question such as the following can also be included to determine if communication in another language would be helpful. This question should be tailored to include the languages, other than English, that are common to the area. Questions about Mobility Aids Used Application/assessment forms also should include a section which requests information about the types of mobility aids used by the applicant following the "General Information" section. This information is not only useful in the eligibility determination process but is important information that will be needed in daily operations should the applicant be determined eligible for service. As shown in the sample question below, information about mechanical aids, life support, as well as service animals should be requested. It may also be helpful to request detailed information about the type, size, and weight of wheelchairs to determine if the applicant uses a "common wheelchair". Some forms indicate prior to this question that the information is needed to ensure that appropriate paratransit service is provided. Information can also be requested in this section about the applicant's need for a personal care attendant (PCA). When asking about the need for a PCA, it is important to note that assistance may be needed at the final destination, not just in transit. It is also important to consider that some applicants, particularly frail elders, may not consider those who assist them to be "PCAs" or "attendants". General language, as shown below, may be appropriate. Additional information about the need for attendants can be requested if there is particular concern about this issue. The Port Authority of Allegheny County, for example, requires applicants to complete and sign a "Personal Assistance Certification" (see Appendix M). Questions about the Applicant's Disability Complementary paratransit service is required if trips cannot be made on the fixed route system due to a person's disability. In order to verify that a person's inability to use the fixed route service is due to a disability, the application/assessment form should include a question or questions requesting information about the nature and extent of the applicant's disability. This could include a functional description of the disability (e.g., "Difficulty Walking", or "Vision Impairment"), a medical diagnosis (e.g., "Cerebral Palsy", or "Glaucoma"), or both. For sensory impairments and hidden disabilities, it may also be helpful to obtain information about the extent of the disability (e.g., the degree of vision loss or the mental/cognitive disability). Questions that determine if the disability is temporary or if it is episodic (the effects vary over time) can also be included here. If the process selected involves getting information from the applicant as well as from a professional, general information (functional descriptions) can be obtained from applicants and more detailed information (degree of impairment, diagnosis, etc.) can be obtained from the professional. The type of information requested should also match the expertise of those responsible for conducting reviews. If non-medical, in-house transportation staff will be reviewing application forms, request applicants and/or professionals to describe the disability in non- clinical terms. It is important to realize that many applicants may have multiple disabilities that affect their ability to use fixed route service. Questions should be structured to encourage applicants to list all applicable conditions. Information can be obtained using general open-ended questions or detailed multiple-choice questions. For example, many forms begin this section by asking: Information on the type of disability can also be obtained by providing applicants with detailed lists of various conditions/disabilities and asking them to check all that apply. The application form used by Seattle Metro (see Appendix I) includes such a comprehensive list. Questions/Functional Tests Regarding Travel Capabilities Perhaps the most critical part of the application/assessment form is the section that requests information about the person's functional capabilities as they relate to using the fixed route service. Questions in this section should be designed to reflect the functional capabilities needed to use the local transit system. They also should allow applicants to explain how environmental and architectural barriers affect their ability to travel. Finally, it is important that questions be detailed enough to enable reviewers to determine not only if the person is ADA paratransit eligible but under what conditions they need to use paratransit. As in previous sections, information can be obtained using general questions, detailed lists, or both. For example, the following general question could follow one regarding the nature of the person's disability: This general question could then be followed by more detailed questions that ask specific questions about the capabilities associated with using the fixed route service. These questions can be organized around the regulatory categories of eligibility or the four "tests" detailed in Chapter 4 of the ADA Paratransit Handbook. When structuring this section, simulate the decisions that must be made and actions that must be taken to make trips on the fixed route system and consider the environmental and physical barriers that might prevent a person with a disability from making a trip. In order to identify conditions under which travel is and is not possible, ask not only if applicants are or are not able to perform certain functions, but allow for a "Sometimes" response and follow this with a request for an explanation of barriers that can prevent travel. The types of questions asked in this section will vary somewhat depending on the local transit system. Transit providers that operate rail as well as bus services should consider questions about climbing flights of stairs in addition to getting on and off of vehicles. Assessing an applicant's capability to learn the system and make complex connections and transfers will also be important. Depending on the type of process used, some questions can be asked of applicants and other may be more appropriate for professionals asked to provide an assessment of the applicant's abilities. Certain questions about cognitive ability, in particular, may be more appropriately addressed to a professional. The general categories of capabilities that should be considered and sample questions that could be used are presented below. In several categories, two sample questions are provided - an open-ended question and one that is more structured. The ability to obtain information about the fixed route service and to understand and "negotiate" the system: Questions under this category should address issues such as the ability to read and understand schedules, to call for information about the service, and to understand and follow directions. As noted above, if professional verification is part of the process, this information may be more appropriately included on a verification form. Specific questions that might be asked are shown on the following page. In-person assessment processes can utilize accepted tests to obtain this information or to augment information from these questions. For example, Behavior Neuropsychology Associates, Inc., under contract to the ACCESS Program in Pittsburgh, uses sections of the following standardized tests to determine the applicant's cognitive ability: the Mini-Mental State Examination (MMSE) the Weschler Adults Intelligence Scale (WAIS-R) the Communicative Abilities in Daily Living (CADL) the Cognitive Competency Test (CCT) the River Mead Behavioral Memory Test Trail Making A description of the various tests performed, along with the forms used, is included in Appendix M. Sample Questions Regarding Ability to "Negotiate" the Fixed Route System The ability to get to and from bus stops/stations within the ADA paratransit service area: This section should ask/assess the applicant's ability to travel certain distances to get to and from stops/station. The effects of environmental conditions and architectural barriers on the distance that can be traveled should also be determined. Because eligibility must be based on the most limiting condition (see Section 3 of Chapter 1 of this manual), information obtained in this part of the form/assessment should not be limited to travel to and from specific stops/stations. For operational reasons, it may be helpful to know if applicants can get to the stop/station closest to their home, but this information cannot be used to determine overall eligibility. An individual should be provided paratransit service if there are any trips that they cannot make within the entire service area. When asking about maximum distances that can be traveled, consider a measure that will be most easily understood by applicants in the area. In urban settings, it may be appropriate to ask about the number of blocks that can be traveled. In general, nine city blocks are approximately 3/4 of a mile in length. In non-urban areas, measures could include fractions of a mile, feet, or yards. For example, the following questions could be asked to determine how far applicants are able to independently travel: The effects of environmental conditions and/or architectural barriers on applicants' ability to travel these distances could be determined by asking: or, a specific list of environmental/architectural barriers could be provided as follows: The ability to wait at a stop or station: Questions in this section should determine if applicants are able to wait for a bus or train. This can be determined by asking for the maximum time that applicants can wait or by asking if they can wait more than a predetermined time (e.g., 10 minutes or 30 minutes). If a predetermined time is used, it should relate to typical headways and expected wait times on the fixed route service in question. As with travel distance, conditions that might affect applicants' ability to wait at a stop or station should be determined as well. Possible questions regarding this ability could include: The person's ability to board, ride, and disembark from accessible and non-accessible vehicles or in and out of transit stations: Questions in this section should address applicants' ability to use bus or rail services once at the stop or station. Abilities that need to be determined include: climbing the steps of a vehicle or a flight of stairs at a subway stop; getting on and off a lift; getting to and from a seat or securement area; paying fares; riding on the bus or rail car if a seat is not available; and recognizing when to get off the bus/rail car. Some forms include a direct question about the ability to use fixed route service, such as: The response to this question can then be compared to answers to more detailed questions about use of fixed route service. If the fixed route service in question is fully accessible, a determination of applicants' ability to use non-accessible services is not required. As mentioned in Section 2 of Chapter 1 of this manual, it may be beneficial to include questions about using non-accessible services, however, to assist riders who may travel to areas where the fixed route service is not yet fully accessible. Possible questions that should be considered in this part of the form could include: Travel Training Information While transit providers cannot require that applicants undergo travel training, complementary paratransit service does not have to be provided if individuals have been travel trained and are able to use part of the fixed route service. The application form should, therefore, include a question that asks if the person has received travel training. For example: The eligibility determination process provides an excellent opportunity to determine if applicants could benefit from travel training, to make them aware that training is available (or may be made available), and to ask if they would be interested in receiving training. Consider adding a question that describes what training is available and asks if the applicant would be interested in learning more about the program. For example: If travel training is an important part of the overall strategy to serve persons with disabilities, it may be useful to obtain information about the possible benefits of travel training throughout the form. Examples of how questions on travel training can be integrated in several parts of the form/assessment, see the material developed by Seattle Metro (Appendix I) and the forms developed by the Regional Transportation Authority of Chicago (Appendix L). Other Service Information The application process also provides an opportunity to get important travel information for later use in daily operations. For example, questions can be added to determine: If the person is able to use a standard taxi. This could be important if part of the service is provided through a contract with a local taxi company; If the person currently uses the fixed route service or if they used it in the past. If the person tried to use the service but stopped, it may be useful to determine why. There may have been equipment issues or policies that did not meet their needs. They may not be aware that current service can meet their travel needs. If the person can travel from their place of residence to the nearest stop/station. A large percentage of a person's trips originate and end at the home. Determining if applicants can get to and from the fixed route service from their place of residence can help in making trip-by-trip eligibility determinations. The most frequent destinations to which the applicant travels. Again, this information can be helpful in making trip eligibility determinations. Administrative Information Finally, the form may need to include reference(s) for professional(s( that can be contacted for additional information, a release to request this information, and other administrative items. At the end of any form completed by the applicant, space should be provided for the applicant's signature. A statement should proceed the signature indicating that the person has provided true and accurate information and noting any consequences that may be associated with the provision of false information. Following is an example of language that could be used for this purpose: If the form or a part of it must be completed by the applicant, it is also important to determine if another person assisted the applicant with the completion of the form. This other person can then be notified, in addition to the applicant, about the final determination or if additional information is needed. For example, the following question can be included: Request for Professional Reference(s) If a "self-certification with professional verification as needed" process is used to determine eligibility, the application form must include a request for the name of a professional who can be contacted for additional information about the person's disability and travel capabilities. As noted in Section 2 of this Chapter, it may be helpful to direct applicants to identify professionals who are familiar with their ability to use the fixed route service. Following is an example of the type of language that could be included in this section of the application to direct the identification of professionals: Professional Verification Form If the eligibility determination process selected includes obtaining information from a professional, a "Professional Verification Form" will need to be developed. As noted in Section 2 of this chapter, professional verification can be obtained as needed or can be requested as part of the initial application. It is also possible to contact identified professionals by phone rather than in writing. Even if contact is by phone, it is recommended that a standard form be prepared for use by staff or contractors collecting the information. If the professional verification form is sent separate from the standard application material, it should include basic information about ADA paratransit eligibility and the purpose of the request. This introductory information should also indicate that the applicant has authorized the release of records pertaining to their disability and functional capabilities. A copy of the release form signed by the applicant can also be included. If the professional verification is part of the application form, this information should be provided for both the applicant and the professional. As noted in Section 2 of this chapter, verification forms should not be used solely to request a definitive opinion as to the applicants eligibility. It should be clear that the information requested will be one element in the determination made by the transit provider's staff or contractor. Instead, professionals should be asked to verify the disability claimed by the applicant, the extent of this disability, and for functional assessments as to the applicant's ability to perform activities related to using fixed route transit service. If a general opinion is requested, it should be supplemented by more specific questions about the applicant's disability and capabilities. Professional verification will be particularly important in cases where applicants have claimed a "hidden" disability or a medical condition such as a cardiac or pulmonary condition, mental illness, or a joint disease. Verification will also assist in determining the extent of a sensory impairment (e.g., level of vision or visual acuity) or the degree of cognitive capability. Several sample professional verification forms are contained in the appendices to this manual. A verification form used by the Delaware Administration for Specialized Transportation (DAST) which is part of the initial application (a "self-certification and professional verification" process) is provided in Appendix K. A verification form used by the Worcester Regional Transit Authority which is sent by the WRTA separate from the initial application is provided in Appendix H. Section 5. Reviewing Applications and Making Determinations Pre-Tests of Materials Before formally initiating the eligibility process or broadly distributing application materials, it is strongly recommended that a pre-test be conducted using draft materials. Request the assistance of members of the advisory committee who have not been closely involved in the development of materials. Ask local human service agencies if they would be willing to have clients complete a few forms. Be sure to have draft materials completed by persons with different types of disabilities. Requesting the assistance of a local independent living program may be an effective way to obtain information from a full cross-section of the population. Collect the completed test materials and have the staff or third-party agency that will be responsible for reviews go through the process of making determinations. Have them note if they are getting adequate information to make thorough determinations. Also talk with individuals and professionals who have completed the draft forms to see if they fully understood the directions and questions. Such a pre-test can provide valuable insights and result in important revisions to materials before full-scale certification or recertification is undertaken. Regulatory Review Timetable and Presumptive Eligibility Determinations of eligibility should be made within 21 calendar days of the submission of a completed application form. If a determination is not made by the 21st day, the applicant must be treated as eligible and paratransit service provided on a presumption of eligibility until the review is completed. Unconditional service must be provided during this period of presumed eligibility unless the applicant has specifically requested conditional eligibility. In the case of a self-certification with professional verification as needed process, the calculation of the 21 day period would commence when the applicant submits requested information including the name of a professional who can be contacted. Follow-up information requested by the transit provider and provided from the professional would be considered part of the 21 decision period. In the case of self-certification with required professional verification, an application would be considered complete only if all information, including information required of a professional, is provided. For processes that involve in-person assessment, the 21 day period would begin when the person fulfills established requirements for requesting that an assessment be conducted. This could be a telephone request or could involve the completion of a brief request for determination form. Establishing a Management Information System to Track Determinations To ensure that reviews are handled expeditiously and that they are referred to the appropriate person or agency as needed, transit providers should establish a management information system to track applications as they go through the process. The first step in establishing this system is to determine all possible actions that could be required given the determination process selected. To do this, work back from the regulatory limit of 21 days to determine when each of these actions would need to be completed in order to complete the review in the required time. Develop a flow chart or outline that summarizes the timing of required actions for use by all staff involved in tracking or reviewing applications. Figure 5 provides an example of such a chart developed by the Commonwealth of Virginia in their guide on ADA paratransit eligibility. A system for tracking each application, according to the established timetable, should then be established. This could be accomplished by attaching a cover "tracking" sheet, which includes the date of receipt and the subsequent date of each required action, to each application. The date which is 21 days from the date of receipt should be added to the tracking sheet to alert reviewers to the target completion day. The tracking sheet should also include information and dates which pertain to the appeal process. A master file should then be maintained which includes critical dates from each individual tracking sheet. This file will provide information on overall progress as well as indicate which reviews have exceeded the maximum allowed determination times (21 days for initial reviews and 30 days for appeals). Information about the applicants who will then need to be treated as eligible can then be transmitted to the service operator(s). In larger transit systems, it may be necessary to utilize a computerized database system or other automated tracking system. One alternative is to use software developed for the human resource field to log and track job applications. Seattle Metro has customized software developed by Sigma to track ADA applications and determinations. In addition to accurately tracking progress in making determinations, the software allows Metro to print reports that include key information such as the number of applications received, the number in each stage of review, and a breakdown of determinations by type of finding (e.g., conditionally eligible, unconditionally eligible, ineligible, etc.). Information about the Seattle tracking system is contained in Appendix N. Figure 5. Sample Flow Chart of Eligibility Determination Process (sheet 1 of 3) Developing Reviewer Guidelines and Maintaining Consistency in Reviews Transit providers should develop reviewer guidelines and final evaluation forms to assist reviewers in properly interpreting answers and information provided by applicants and/or professionals. Guidelines and forms can also help to ensure consistency in the determination process. As mentioned in Section 3 of this chapter, reviewer training is also recommended. Ensuring consistency in the review process is particularly important if determinations will be conducted by several different individuals. A number of transit agencies have developed evaluation forms which are correlated with the information requested in the application forms. These evaluation forms ask the reviewer to draw conclusions from answers provided by applicants and/or professionals to particular questions. Depending on the responses provided, certain eligibility findings are suggested. For example, if an applicant indicates that she/he can usually travel independently up to half a mile but cannot negotiate in snow and ice, conditional eligibility based on distance from stops/stations and times of the year could be granted. Similarly, applicants who note that they use wheelchairs would automatically be eligible when they travelled on routes not yet fully accessible. Several examples of this type of summary evaluation form are contained in the appendices to this manual. Of particular note are forms developed by the Washington Metropolitan Area Transit Authority (see Appendix J), the Worcester Regional Transit Authority (see Appendix H), and San Mateo County (see Appendix E). Applications which use closed/multiple-choice type questions, such as the WMATA application, can be more directly correlated to particular types of eligibility. More open- ended questions will require the reviewer to draw a conclusion from the information provided. Other suggestions for ensuring consistency and for building important checks into the determination process include: Consider having reviewers double-check with supervisors or other review staff if a determination of ineligibility or conditional eligibility is being recommended. This type of confirmation and reinforcement may help reduce inappropriate findings and will be helpful if an appeal is requested. If several individuals are involved in making determinations, have them periodically exchange applications and compare findings. If there are differences in the recommendations that would be made, encourage general discussion on key issues and incorporate the results of this discussion in updated reviewer guidelines. Conduct random post-determination checks of findings. This may be particularly important if third-party contractors are utilized for determinations. Have staff who are familiar with ADA paratransit eligibility review the complete file, including the application form and related information and the final eligibility determination. Such administrative reviews will be an important part of the management of the determination process and will provide valuable insight needed to revise existing materials or strengthen reviewer training programs. Observing Privacy Rights The medical information that may be gathered as part of the ADA paratransit eligibility certification process should not be shared with any other party. This would include specific diagnosis provided by professionals and information about the nature of disabilities provided by the applicant. Access to eligibility files should be limited and those with access to these files should be informed and instructed to respect the privacy of applicants. This should include in-house staff as well as any third-party contractors used in the determination process. Information regarding a person's functional ability to use fixed route service, derived from the determination process can, however, be shared with other transit providers. Other entities may call to obtain more detailed information about a person's ability to travel if that person has requested service in another area as a visitor. Recent Certification Experiences of Selected Providers Table 3 on the following pages provides general information about the outcome of determinations conducted by selected transit providers to date. Information about the percent of applicants that have been determined ineligible, the percent determined conditionally eligible, and the number or percent of appeals of determinations is given. As shown, the general experience to date has been that relatively few applications are denied outright. Approximately half of the systems which had this information reported a denial rate of less than 3 percent. Several systems reported denials of between 7 and 15 percent. In general, it was the opinion of these transit providers that very few individuals were attempting to obtain certification inappropriately. It was reported by several providers that a significant number of those persons determined ineligible had misunderstood the nature of ADA paratransit eligibility. This general sense is supported by the fact that, typically, very few appeals are requested. Many individuals verbally question the final decision but are satisfied with the explanation given once they better understand the nature of the determination. Some of the variance may also be explained by differences in pre-ADA eligibility policy. Transit providers which previously used a functional eligibility criteria close to that established in the ADA have had relatively few ineligible determinations as most existing riders were eligible. This was noted by both the Ann Arbor Transportation Authority and Table 3. Eligibility Determination Results for Selected Transit Providers Name of Transit Provider Type of Determination Process Determination Performed by % Inelig. % Cond. Elig. % Appeal Ann Arbor Transportation Authority Ann Arbor, MI Self-certification and professional verification. In-house 1% 75% N/A Ben Franklin Transit Richland, WA Self-certification with professional verification as needed In-house 2% less than 1% no appeals (1100 apps. processed) Greater Bridgeport Transit District Bridgeport, CT Self-certification with professional verification as needed. In-house Less than 1% N/A no appeals to date Greeley, CO Self-certification with professional verification as needed. In-house 1% 50% no appeals (500 apps. processed) Lane Transit District Eugene, OR Combined: Self-certifica- tion and professional verification with in- person assessment as needed. Initially by paratransit contractor. Referred as needed to one of two OT's under contract. 10% 20% Only one appeal to date Los Angeles County Metropolitan Transportation Authority Los Angeles, CA In-person assessment "Certification analysts" selected by LACMTA. Are either registered nurse with at least two years experience; physical therapist; occupational therapist; or clinical social worker. 10% 40% 4% Madison Metro Transit System Madison, WI Combined: Self-certifica- tion with professional verification and/or in- person assessment as needed. Initially in-house. Referred to Rehabilitation Center as needed 15% of new appli- cants less than 20% 1% Municipality of Metropolitan Seattle (METRO) Seattle, WA Combined: Self-certifica- tion and professional verification with in- person assessment as needed Initially in-house, referred to Evergreen Medical Center as needed 4% 35% 2 of 1800 OMNITRANS San Bernardino, CA Self-certification with professional verification as needed. Also, doing random verifications to check accuracy of self- certifications. In-house 2.5% 7% no appeals to date Oshkosh Transit System Oshkosh, WI Self-certification and professional verification. Work closely with previous operators - the Red Cross and County Committee on Aging for professional verification. In-house Less than 1% N/A no appeals to date Port Authority of Allegheny County (PAT); ACCESS Program Pittsburgh, PA In-person assessment and professional verification Local Chapter of the Easter Seal Society; Behavior Neuropsychology Associates, Inc.; orientation and mobility specialists for persons with vision impairments. 7-10% 36% Less than 1% Riverside Transit Agency Riverside, CA In-person assessments or professional verification (for persons with severe mental retardation). Local medical clinic. 2% 9% 4 appeals (25% of those ineligible and cond. eligible) San Mateo County Transit District (SAMTRANS) San Carlos, CA Self-certification with professional verification as needed In-house 1-2% less than 1% no appeals to date Southeastern Pennsylvania Transportation Authority (SEPTA) Philadelphia, PA Self-certification and professional verification In-house 8-9% N/A no formal appeals to date; only verbal requests for clarification Transit Authority of River City (TARC) Louisville, KY Self-certification with in- person assessment as needed Initial determinations in- house. Assessments by local rehabilitation center 1.7% N/A 5 appeals (1800 apps. processed) Utah Transit Authority Salt Lake City, UT Combined: Self-certifica- tion with in-person assessment as needed. In-house initially. Referral as needed to either: State Services for the Visually-Impaired; University Spine Rehabilitation Center; or local mental health agencies and associations for retarded citizens. 10% 2% no appeals to date Worcester Regional Transit Authority Worcester, MA Self-certification and professional verification. One of three independent rehabilitation specialists 1.2% 8% Less than 1% Ben Franklin Transit. Agencies which had broader criteria in the past might expect a higher rate of ineligible determinations. There appears to be greater variance in the percentage of applicants being granted conditional rather than unconditional eligibility. Several systems reported that their initial determinations have not focused on conditions of eligibility. There is even a considerable range among those systems that are doing a more detailed identification of limitations/conditions of eligibility. The percent of applicants certified as eligible under particular conditions ranges between 20 percent and 75 percent. Some of this variance is probably attributed to whether or not the transit agencies intend to rely on trip-by-trip eligibility determinations to manage demand. Section 6. Notifying Individuals of Initial Determinations Applicants must be notified of initial eligibility determinations in writing. Efforts must also be made to provide this notification in a format that the individual is able to use and in a way that ensures effective notice. For example, as noted in Section 4 of this chapter, consider including a question in the application form which identifies whether the applicant needs to have information and correspondence provided in accessible formats. If so, notice of the initial finding should be provided in the requested format. Also, include a question in the application which identifies whether the form has been completed by someone acting on behalf of the applicant. If so, send the notice of initial determination to this person as well as to the applicant. If the initial determination finds that the applicant is ineligible, specific reasons for this finding must be included in the notification letter. Simply including a general statement that the person "is able to use the fixed route service" and is therefore not eligible for paratransit service is not acceptable. Reasons cited should relate directly to information contained in the application, obtained as part of the professional verification process, or derived through an assessment of the individual. For example, specific reasons for a finding that a person is not eligible might be stated as follows: "The particular reason included in the application for why you could not use regular bus service was that you are unable to independently travel distances greater than 1/2 mile to get to or from bus stops. Your diagnosis of disability, provided by the professional named in the application, did not, however, indicate a disability that limits your ability to independently travel throughout the full service area." "Your application indicated that you do not feel safe traveling on the regular bus and subway system. While the possibility of an incident occurring while traveling may be a factor in your decision to use available public transit service, it is not a reason, in and of itself, which requires that separate van service be provided. Similarly, if the initial determination is that the applicant is eligible for paratransit services under certain conditions, the reasons for limiting eligibility should be explained in the notification letter. For example, a person may be determined eligible but may have indicated that they have been travel trained for daily trips that they make to work. The letter of notification should, therefore, state that the person is ADA paratransit eligible with the following limitation: "Trips to your current work site from your current place of residence are not ADA paratransit eligible as you indicated in the in-person assessment that you have received instruction in the use of the regular bus service to make this particular trip." If strict control of travel with personal care attendants is an important consideration, consider noting any limitation on travel with PCAs directly in the notification letter. For example, if the application or assessment includes a specific question about the need for a PCA, a condition of eligibility that should be noted for all applicants that PCAs are not required could be: "As stated in the application (noted in the assessment), travel with a personal care attendant is not required." The notification letter should also contain information about the appeal process that is available if the initial determination is that the person is not eligible or if limitations are placed on the person's eligibility. Individuals must be able to question limitations of eligibility as well as findings of ineligibility in general. A copy of the appeal policy, noting the procedure for requesting appeals, the number of days within which appeals must be requested, and other aspects of the policy should be attached to the letter. Individuals determined ineligible or eligible with certain condition(s) should also be apprised of the fact that they can reapply should their situation or disability change. As noted in Section 7 below, many transit providers also use the notification letter as formal documentation of ADA paratransit eligibility. Others use it as an opportunity to promote specific incentive programs that encourage use of the fixed route service. In Los Angeles, for example, persons who are determined conditionally eligible are informed that their ADA paratransit eligibility documentation also serves as an identification card for a reduced fixed route fare. As part of the development of the eligibility determination process, several form letters should be developed. Separate letters should be developed for those determined unconditionally eligible, conditionally eligible, ineligible, and temporarily eligible. Additional letters may be needed if you combine ADA paratransit eligibility determination with other processes such as eligibility for other paratransit services. Sample letters of determination are provided on the following pages. DATE NAME ADDRESS CITY, STATE ZIP Dear Based upon a review of your application for certification of ADA paratransit eligibility, the (name of Transit agency) has determined that you are eligible for ADA paratransit service for any trip in our service area. This determination also enables you to use similar paratransit services nationwide. This certification of eligibility is valid until (expiration date) . You will automatically receive a recertification form in the mail so that you can reapply at that time. Attached is your identification card. Please carry it with you at all times. The identification number contains important information regarding your functional capabilities and requirements and must be given whenever you make a trip request. Also attached is a Rider's Manual which provides important information about the ADA paratransit service. It also describes how to use the service. Please read it carefully. If you have any questions about the service, or need any other assistance, please feel free to call the paratransit service office at (phone) , (TDD) , (FAX) . Sincerely, Enclosures: ADA paratransit eligibility ID Paratransit Rider's Manual DATE NAME ADDRESS CITY, STATE ZIP Dear Based upon a review of your application for certification of ADA paratransit eligibility, the (name of Transit agency) has determined that you are eligible for ADA paratransit service when one or more of the following conditions exist: (1) (2) (3) This determination also enables you to use similar paratransit services nationwide. The above conditions may be used by (name of transit agency) to determine if and when you may be able to use the regular bus/rail service. If you can use these services, federal law does not require that paratransit service be provided. You are encouraged to use the regular bus/rail service whenever possible. If you do not agree with the limitations that have been placed on your eligibility, you have the right to appeal this determination. Any request for an appeal must be made in writing and must be mailed within 60 days of the date of this letter. The enclosed description of the appeal policy provides additional information about the process. This certification of eligibility is valid until (expiration date) . You will automatically receive a recertification form in the mail so that you can reapply at that time. Please note that you may also reapply at any time if you feel that changes in your ability to use the regular bus/rail service could affect this determination. NAME DATE PAGE -2- Attached is your identification card. Please carry it with you at all times. The identification number contains important information regarding your functional capabilities and requirements and must be given whenever you make a trip request. Also enclosed is a Rider's Manual which provides important information about the paratransit service. Please review it carefully. If you have any questions about the service, or need any other assistance, please feel free to call the paratransit service office at (phone) , (TDD) , (FAX) . Sincerely, Enclosures: ADA paratransit eligibility ID Paratransit Rider's Manual Description of appeal policy DATE NAME ADDRESS CITY, STATE ZIP Dear Based upon a review of your application for certification of ADA paratransit eligibility, the (name of Transit agency) has determined that you are not eligible for ADA paratransit service. This determination is based on the following factors: (1) (2) (3) Federal law restricts eligibility for ADA paratransit service to persons who cannot, due to a disability, utilize fixed route transit service (regular bus/rail service). This determination applies only to your eligibility for ADA paratransit service offered by (name of transit agency) . We would encourage you to use the fixed route service and hope you will become a regular customer. For that reason, we have enclosed information about the bus/rail service and a complementary monthly pass to encourage you to find out just how convenient our services really are. You can also call our customer information office for assistance in planning trips. That number is (phone) , (TDD) . We hope to have you as a customer often. NAME DATE PAGE -2- If you do not agree with the decision that has been made, you have the right to appeal this determination. Any request for an appeal must be made in writing and must be mailed within 60 days of the date of this letter. The enclosed description of the appeal policy provides additional information about the process. Please also note that if there is any change in your ability to use the fixed route service in the future, you may submit a new application. Sincerely, Enclosures: Complementary monthly pass Regular bus/rail service information Description of appeal policy Section 7. Documentation of ADA Paratransit Eligibility All persons determined eligible must be provided with documentation stating that they are "ADA Paratransit Eligible". The following information is required by the regulations to be part of the documentation provided: the name of the eligible individual the name of the transit provider making the determination the telephone number of the transit provider's paratransit coordinator an expiration date for eligibility (if applicable) any conditions or limitations on the individual's eligibility including the use of a personal care attendant. As indicated, an expiration date is necessary if recertification will be required at some future date. The regulations allow such a recertification at "reasonable intervals". For a more complete discussion of recertification, see Section 2 of Chapter 2 of this manual. The "telephone number of the transit provider's paratransit coordinator" should be the number at which eligibility can be confirmed and specific information about the individual's functional ability to travel and any limitations or conditions of eligibility can be obtained. This requirement is meant to facilitate the exchange of specific eligibility information between transit providers. The number listed could be for the office which oversees determinations and maintains eligibility files, the system broker, or the service operator, depending on where this information is kept and is most readily available. Documentation can be provided in the form of an identification card, as part of the notification letter, on standard paper, or in other forms as long as the information required is included. It is also possible to provide detailed documentation in a letter or on standard paper and to supplement this with an I.D. card that contains more cryptic information. For example, the detailed documentation may describe conditions of eligibility and the reasons for such conditions as detailed in Section 6 above. The I.D. card, for obvious reasons of space, may include concise statements of limitations such as "can use accessible vehicles", "seasonal eligibility May through September" or "Requires PCA? X Yes No". When deciding on the type of documentation to be provided, take into consideration the ease of use by persons with disabilities. An I.D. card may be more durable and easier to carry by persons who will be traveling frequently to other transit districts. If the standard form of documentation provided is a letter, consider also offering a laminated I.D. which can be obtained by those who desire it. Also consider current and possible future uses of the documentation that is provided. For example, if ADA paratransit eligibility documentation will also be used to provide reduced fare access to fixed route services, an I.D. card should be considered. Similarly, if a user- side subsidy program is used to provide service or to supplement basic paratransit service, and I.D. card may be required. If the documentation will have a cash value (e.g., will be used for fare discounts, etc.) consideration should also be given to security and fraud issues. Typically, a photo I.D. is used and a "security seal" is incorporated. Figure 6 below offers a sample format for a photo I.D. Figure 6. Sample Photo ID Format for ADA Paratransit Eligibility Documentation Section 8. Appeals Procedures Individuals who are determined to be either ineligible or conditionally eligible must have an opportunity to appeal the initial decision. As noted in Section 1 of Chapter 2 of this manual, the regulations include a number of specific requirements related to this appeal process. These are: An individuals must be able to request an appeal for within 60 calendar days of the denial of their initial application; An individual must have an opportunity to be heard in person to present information and arguments; There must be a "separation of function" between those involved in the initial determination and those deciding appeals; Written notification of the appeal decision, stating the reasons for the finding, must be provided; and Presumptive eligibility must be granted to the individual if a decision is not made within 30 days of the completion of the appeal process. As indicated in Section 6 of this chapter, written notification to applicants determined eligible or conditionally eligible should include information about the appeal process. This information should indicate how to file an appeal and what they can expect if they request an appeal. One way to provide complete information would be to enclose a copy of the full appeal policy with the notification letter. Transit providers can require that appeals be requested in writing. Accommodation should be made, however, for individuals with vision impairments who may not be able to independently communicate in written form. Providers may also request that reasons for requesting an appeal be detailed by individuals. Some transit providers have people with different knowledge and specialties hear appeals depending on the individual's particular type of disability. Information about the reason(s) for the appeal may be helpful in structuring the process. The absence of such detailed information cannot, however, be used to preclude the scheduling of an appeal hearing. Individuals must still be given the opportunity to be heard in person, even if they decide not to provide written arguments in advance. As noted above, appeals must be able to be requested within 60 calendar days of the denial (or the limiting) of an individual's request to be determined ADA paratransit eligible. This 60 day period should be calculated from the time that the person is notified of the initial decision. There are several ways to administer the process to ensure that a full 60 days have been allowed for appeal. These include: (1) Sending notice of initial determinations by registered mail and then calculating the time between certified receipt and the date that the appeal request is received; (2) Adopting a policy that allows appeals to be filed for a period somewhat longer than 60 days from the date of the notification letter (e.g., 65 days) to account for time in the mail; (3) Calculating the period of time based on the date stamp on both the notification letter and the appeal request. Once a request for an appeal has been made, a hearing date should be established and the applicant should be provided with adequate written notice (in accessible formats if appropriate). The notice should ask what accommodations may be needed (such as an interpreter) and could request that adequate notice of the need for these accommodations be provided. In many areas, one or two weeks may be needed to arrange for interpreter services. A critical factor in ensuring that the individual is afforded "due process" is the separation of function between those involved in the initial determination and those hearing appeals. To the extent practicable, appeals should not be heard by individuals in the same office as those responsible for initial determinations. Similarly, if practicable, appeals should not be heard by subordinates or supervisors of staff responsible for initial decisions. Such a daily working relationship could bias those hearing appeals. If appeals are heard by a committee rather than an individual, person(s) involved in the initial decision should not sit as voting members on the committee - even if they do not constitute a majority of the committee members. It may be desirable to have those involved in initial determinations available at hearings to provide information and reasons for the initial finding, but they should not have a formal say in any appeal decision. The regulations recognize that the degree of separation of function may be less in smaller transit systems. With limited staff, all employees may have a daily working relationship. In these cases, if the appeal process is kept in-house, efforts should be made to ensure that the person(s) hearing appeals have not been involved in the original decision in any way and do not discuss appeals with initial decisionmakers prior to the hearing. It is also recommended that there be an elevation of authority between the initial decision and the appeal. Supervisors should hear appeals rather than subordinates to avoid the obvious influence that superiors hold over those they manage. To establish a clear "separation of function", transit providers both small and large should consider involving individuals from outside the agency in the process. Those responsible for making the appeal decision must be present at the hearing. It would not be acceptable, for example, to have a person appear before an advisory committee that makes a recommendation to the transit provider. Having the decisionmaker(s) hear firsthand the issues and the person's argument is an inherent part of the right to be heard "in-person". The appeal must be more than an administrative review of the initial determination. In addition to ensuring that the approved policy was followed, the appeal must also review the judgement(s) made regarding the individual's eligibility in the initial determination. The appeal should be based on additional information provided prior to or during the hearing as well as on information contained in the original application. For this reason, the process should allow those involved in deciding appeals to have access to all pertinent information and adequate time to review file documentation. As with the initial notification, the appeal finding must be communicated in writing and must include specific reasons for the decision. A simple statement that the person can use fixed route service or a statement that there was agreement with the original decision is not sufficient. The written decision should relate to the additional information provided (or lack thereof) and why these additional facts, combined with the information in the initial application, support the finding made. While the regulations establish a maximum time for deliberation on an appeal before presumptive eligibility must be granted, they do not set a maximum time for the holding of a hearing following the receipt of an appeal request. The amount of time that is required to bring appeals to a hearing will depend on the number of appeals received and the appeal structure selected. In keeping with the general principle of due process, transit providers should schedule and conduct hearings as soon as is administratively possible within the constraints of the established process. The public, including persons with disabilities, are required to have input into the appeal policy that is established. The expeditious handling of appeals should be one factor considered in the creation of the policy. Hearings that involve a large independent appeal panel, or a panel that relies solely on volunteers, may be more difficult to schedule or may be able to meet less frequently. Structuring an Appeal Process Appeals can be heard by single individuals or by panels comprised of several persons. Within the basic requirements for a "separation of function" detailed above, appeals can be decided by persons from other offices or divisions within the agency, by persons from other agencies, by rehabilitation or medical professionals, by consumers, or by a panel comprised of persons from several of these groups. Regardless of the size or make-up of the appeal "panel", several factors should be considered when structuring the process. First, it is vital that the process not only is but is perceived as being objective and unbiased by individuals with disabilities and the agencies representing them. The regulations require that the process and policy be established with full public participation. Suggestions made in this process should be carefully considered. If there appears to be general distrust with an in-house process (i.e., both initial decisions and appeals are decided by transit provider staff or representatives), serious consideration should be given to outside, independent representation in the process. Transit providers should avoid the temptation to want to "control" the process, the decisionmakers involved, or the findings made. Public trust in the objectivity of the process will help to avoid costly legal action and equally costly public skepticism. Second, individual(s) involved in appeal decisions should possess, either individually or collectively, certain knowledge and skills. Among these are: a working knowledge of the ADA complementary paratransit regulations, particularly the regulatory definition of ADA paratransit eligibility and the appeal process; an understanding of different types of disabilities and the functional capabilities characteristic of each; a knowledge of the fixed route system and the skills needed to understand and use it; and an understanding of the complementary paratransit service and the policies and procedures related to the service. Not all individuals need to be expert in all areas listed above. Many transit providers have structured their appeal panels to include several persons, each with particular knowledge. Training should be provided to appeal decisionmakers to augment the knowledge that they bring to the process. Individuals from outside the transit agency will need to be educated on the specifics of the ADA and the fixed route and paratransit services that are provided. Information on existing services should include the latest policies and equipment used (such as the level of operator assistance provided, allowing standees on lifts, mobility aid restraints, and lift specifications) as these will affect their understanding of the capabilities needed to use the service. Individuals representing the transit agency, on the other hand, may need training on types of disabilities and their effect on travel. Transit providers may also want to consider utilizing different appeal decisionmakers depending on the disability of the applicant. A pool of available panel members with different specialties could be created. Panel members could then be called to attend a hearing if the applicant has reported a disability similar to their area of expertise. Professionals specializing in mental retardation, vision impairments, physical disabilities, etc. would be included in the process as needed. Third, the ability of the structure selected to handle the expected number of appeals in an expeditious manner should be considered. Large panels may provide representation but may be difficult to schedule on a frequent basis. In addition to the ease of administration, consideration should also be given to the level of effort being requested from panel members, particularly if they are expected to volunteer their time. If a large number of appeals is expected, consideration should be given to creating a pool of available panel members and establishing a rotating schedule. Finally, regardless of the structure selected, consider the liability which individuals may be incurring by participating in the appeals process - particularly if they are consumers or volunteers who may not be covered by insurance which a contractor or medical professional may have. Consider providing professional liability insurance to these individuals, either through a separate policy or by adding them to a policy which may already exist. Table 4 on the following pages provides information about the appeal processes used by selected transit providers across the country. As can be seen, a wide variety of structures are used. In a number of instances, appeals are heard by employees of the transit agency who are not involved in the initial decision. Seattle Metro, which uses a third-party contractor for the initial review, uses other employees at this organization for appeals. The LACMTA in Los Angeles, which also uses third-party contract reviewers, uses a higher level professional for the appeal. For example, if an occupational therapist conducted the initial assessment, a physiatrist may hear the appeal. Several transit providers utilize appeal panels of between three and seven members. In some cases, panel members are selected based on their familiarity with the applicant's particular disability. In other cases, panels are structured to have members who are each familiar with a specific type of disability. Ben Franklin Transit works with the applicant to select panel members that are mutually agreed upon by both parties. The Regional Transportation Authority of Chicago has established a three-person Eligibility Review Board. One standing member is selected by the RTA and the other by its consumer advisory group. The third member is chosen by these standing members. SEPTA in Philadelphia has established a panel of three members plus one alternate who each serve two-year staggered terms. SEPTA and its consumer advisory committee share in the selection of these members. TARC, in Louisville, has established eight appeal panels so that appeal hearing responsibilities can be shared and will not become burdensome on any one panel. It is also interesting to note that several transit providers have established more than one level of appeal. A number of the agencies contacted use an informal review process if applicants verbally request an explanation of the decision. A more formal appeal is available if the applicant desires. Six of the agencies contacted have more than one level of formal appeals. OMNITRANS works with a private, non-profit mediation board and offers applicants an opportunity to obtain a non-binding recommendation from this board at any time during the process. The formal appeals process is also available. Table 4. Descriptions of Appeal Procedures for Selected Transit Providers Name of Transit Provider Person or Panel that Hears Appeals Ann Arbor Transportation Authority Ann Arbor, MI 1st Appeal: Paratransit Coordinator 2nd Appeal: Executive Director Ben Franklin Transit (BFT) Richland, WA Panel of three people mutually agreed upon by the applicant and BFT. Panel to consist of two people from the community familiar with the applicant's disability and one person from BFT. City of Charlotte Charlotte, NC Three person panel (Independent Living Center staff person, Transit Agency staff person, and one person from the City Manager's office) City of Durango, CO Transit Advisory Board Delaware Administration for Specialized Transportation (DAST) Dover, DE 1st Appeal: Paratransit Administrator 2nd Appeal: Paratransit Advisory Committee (comprised of consumers and disability organizations) Greater Bridgeport Transit District Bridgeport, CT Consumer Advisory Committee (20 people) Greeley, CO General Services Manager of City DPW Lane Transit District Eugene, OR Informal Review: If verbal questions by applicant, informal review by paratransit coordinator. Formal Appeal: If formal appeal: Appeal Committee (5 person: Director of group homes; two persons with disabilities; transit district representative; ad hoc person selected by applicant). Los Angeles County Metropolitan Transportation Authority Los Angeles, CA Higher level professionals appropriate to the type of disability (such as physiatrists, doctors, psychiatrists) under contract to the Authority. Cost is $60/appeal review. Madison Metro Transit System Madison, WI 1st Appeal: To general manager 2nd Appeal: Four person panel (paratransit/fixed route user with a disability; city council representative; city disability commission representative; ADA paratransit eligible senior. Municipality of Metropolitan Seattle (METRO) Seattle, WA Another professional staff person of the eligibility review contractor (Evergreen Medical Center) not involved in the initial determination. New York City Transit Authority New York, NY Three person appeal board (medical professional familiar with applicant's disability; NYCTA staff; consumer). OMNITRANS San Bernardino, CA Informal review: If applicant verbally questions the initial decision, the determination is reviewed by other OMNITRANS staff person. Formal Appeal: If appeal is formally requested, it is heard by OMNITRANS Board of Directors. Supplemental Review: Third-party mediation is available at any time upon request of the applicant. The recommendation, by the non-profit In-land Mediation Board, is non-binding. Oshkosh Transit System Oshkosh, WI 1st Appeal: City transit director. 2nd Appeal: County Coordinating Committee of Elderly and Handicapped Transportation. Port Authority of Allegheny County (PAT); ACCESS Program Pittsburgh, PA 1st Appeal: Nine person panel (orientation and mobility specialist for visually-impaired; mobility specialist for mentally retarded; consumer advisory committee member; physical therapist; specialist in cognitive disabilities; local advocacy agency representative; representative of area agency on aging; two consumers). 2nd Appeal: Paratransit Director or Assistant Director Regional Transportation Authority Chicago, IL Informal Review: Voluntary informal meeting with RTA staff within 30 days of the initial determination. Formal Appeal: Heard by a three-person Eligibility Review Board. The Board consists of two permanent members, one selected by the RTA and the other approved by the RTA's consumer advisory group. The third member is chosen for an individual hearing by the two standing members (from a list of persons with expertise in the type(s) of disability(ies) of the applicant). Riverside Transit Agency Riverside, CA Another professional not involved in the initial decision at the medical clinic which does initial determinations. San Mateo County Transit District (SAMTRANS) San Carlos, CA Three person panel (one person from the ADA Technical Advisory Committee, one health professional from the community, and one SAMTRANS representative) Southeastern Pennsylvania Transportation Authority (SEPTA) Philadelphia, PA Four people are selected (two by SEPTA and two by the consumer advisory committee) to serve on an appeal panel. All serve a two-year term and terms are rotating. Three panel members hear the appeal and one serves as an alternate. Transit Authority of River City (TARC) Louisville, KY Eight panels have been established to hear appeals. Each panel has three members; one with a visual impairment, one with a physical disability, and one from an agency representing persons with mental impairments. Utah Transit Authority Salt Lake City, UT 1st Appeal: Advisory Review Board (2 or 3 representatives from larger consumer advisory committee. 2nd Appeal: Transportation Disabled Advisory Committee (2 authority board members, 2 local operator staff, 1-2 consumers). Waukesha Transit System Waukesha, WI Transit System Board of Directors. Worcester Regional Transit Authority Worcester, MA Three person panel (occupational therapist; paratransit customer; independent living center representative). Holding an Appeal Hearing It is recommended that transit providers develop written guidelines for conducting appeal hearings. These guidelines will provide structure to the hearing and will ensure that the process is consistent from one review to the next. Guidelines should indicate the basic agenda and when and how the final decision will be reached. For example, they could indicate that the hearing will include: (1) an introduction of panel members (if appropriate); (2) an explanation of the appeal policy and the applicant's rights to ensure that there is a clear understanding of process; (3) a brief overview of eligibility policy to ensure that the applicant has a clear understanding of key issues such as the functional nature and trip-by-trip nature of ADA paratransit eligibility; (4) a summary of initial determination findings; (5) an opportunity for the applicant and/or her representative to provide additional information or dispute the initial determination findings; (6) an opportunity for the hearing officer or panel members to ask the applicant or her representative questions; and (7) the restatement of policy concerning a decision on the appeal so that the applicant clearly understands what will happen following the hearing. In addition to the basic agenda, the guidelines might indicate who will preside over the hearing (if a panel is involved) and who will be responsible for making presentations at certain stages. If large panels are involved, it may also be useful to specify in what order questions will be asked or who will be primarily responsible for responding to any questions asked by the applicant. The issue of conflict of interest should also be addressed should an applicant have a professional or personal relationship with a decisionmaker. The basis on which decisions will be reached (e.g., majority vote, etc.) also should be stated in the guidelines. Finally, because ADA paratransit eligibility can become the subject of a civil rights complaint and ultimately be reviewed by the courts, it is important that there be documentation of the proceedings. It is not required or necessary to have hearings transcribed, but documentation should be complete enough to capture the essential issues raised and note that the established process was followed. Section 9. Refusing, Conditioning, or Suspending Service The regulations provide for the refusal, conditioning, or suspension of complementary paratransit service only under specific, defined conditions. These are described below. Local policies regarding the refusal, conditioning, or suspension of service should be developed with full public participation, including the input of persons with disabilities. Circumstances Under which Service Can be Refused Section 37.5(h) of the regulations allows public entities to refuse to provide fixed route or paratransit service to persons with disabilities if they engage in "violent, seriously disruptive, or illegal conduct." This may include a person who assaults a driver or another passenger, who smokes or drinks on the vehicle in violation of established laws, or who engages in conduct that is so severe that the delivery of service is seriously disrupted. Conduct which is related to a person's disability and which annoys or offends is not to be considered "seriously disruptive". The interpretive appendix to the regulation uses the example of a person with Tourette's syndrome who may make involuntary profane statements. Such behavior would not be grounds to refuse service. Similarly, service cannot be refused based on an unfounded fear of a particular disability. For example, a person with HIV disease cannot be refused service because drivers or passengers are afraid of being near and being exposed to the condition. On the other hand, a person who refuses to use a seat belt and has a habit of not staying seated during transport could distract the driver and seriously disrupt service. Refusing service or requiring that the individual ride with an attendant might be appropriate in such a case. Similarly, customers are responsible for the behavior of service animals. Service can be refused or conditioned if a service animal is seriously disruptive. In determining what constitutes "seriously disruptive" or "violent" behavior, transit providers may want to rely on local ordinances. Most communities have established laws and standards that define unacceptable public behavior. Accurate and correct information about various disabilities and medical conditions is vital to ensuring that passengers are not subjected to discrimination. For example, it may be necessary to determine if a passenger's disability causes annoying behavior or if (s)he is prone to violence. As suggested in Section 4 of this chapter, information can be requested in the application form or from a professional that will assist with making these decisions. Follow-up with a professional identified by the passenger might also be necessary to request further guidance on actual incidents. This information should be available to operators of the service so that they can respond appropriately to the person's disability. The policies used in paratransit operation should also be consistent with those established for the fixed route service. Policies should not be adopted solely for the paratransit service unless the issue is unique to that mode. If particular issues arise in paratransit operation, examine the current general service policy and revise it for all types of service if necessary. For example, an agency or parent may request that paratransit service be provided to an infant or child with a disability. If the transit provider had a policy for the fixed route service that requires children under a certain age to be accompanied by a parent or guardian, the same policy could be applied to the paratransit service. Determination of the child's ability to use the fixed route system could then assume the assistance of a parent/guardian. The period for which service is refused should also be consistent between modes of service. For example, riders may be refused service for a particular trip on the fixed route service if they do not pay the fare. Similarly, paratransit service can be refused if the fare is not paid. It would not be acceptable, however, to not accept future trip requests on the paratransit service for a previous lack of payment if this is also not the policy on the fixed route system. Circumstances Under which Service Can be Conditioned In certain circumstances, it may be possible to mitigate the effects of a person's conduct by requiring that they meet certain conditions (e.g., use the service with an attendant). While the regulation does not allow transit agencies to require attendants in other cases, such a condition of use is permitted if the rider would otherwise be refused service. In other words, transit providers may place conditions on the use of service if they otherwise would have the right to refuse service. For example, a rider with mental retardation may have a tendency to move around the paratransit vehicle and accost other passengers. The behavior may be able to be controlled by the presence of an attendant. Because such conduct would be seriously disruptive to the service, the transit provider would have the right to refuse service. They could also, therefore, require that the person travel with an attendant. Circumstances Under Which Service Can be Suspended In addition to permitting service to be refused or conditioned as described above, the regulations also specify one additional circumstance under which paratransit service may be suspended. Section 37.125(h) of the regulations allows paratransit service to be suspended, for a "reasonable period of time," for individuals who establish a "pattern or practice" of missing scheduled trips. This provision is included in the regulations to allow transit providers to respond to chronic "no-shows". This provision does not apply to trips that are beyond the rider's control. For example, a rider could not be considered a "no-show" if: the vehicle arrived at the pickup location early or late and the person was not ready or had left to call or make other arrangements; a sudden family emergency caused the person to change plans and did not allow time to notify the dispatcher of this change; the person had made a reasonable effort to notify the operator that service would no longer be needed but experienced an unreasonable delay getting through on the phone; a sudden turn for the worse in someone with a variable condition causes them to miss the trip. It is important to note that "no-shows" are different than cancellations and that the regulations do not specify that service can be suspended for a pattern or practice of cancellations. A major cause of cancellations is the advance notice required for use of paratransit service - a policy that does not exist for fixed route service. Sanctions cannot be imposed on individuals whose schedules change frequently and who are therefore required to change or cancel their scheduled paratransit trips. Developing a "No-Show" Suspension Policy Before service can be suspended, a "no-show" suspension policy must be developed. Because the policy is part of the overall eligibility policy, it therefore must be developed with full public participation as specified in 37.137 of the regulations. This includes consultation with persons with disabilities (following an outreach effort to identify interested and affected persons), a public comment period, and a public hearing. The no-show policy should address the following items: the amount of notice that riders must give if they want to cancel a scheduled trip; the frequency of no-shows that will constitute a "pattern or practice"; and the length of time for which service will be suspended. Notice required for canceling a trip cannot exceed the amount of advance notice required to make a trip reservation. For example, riders cannot be asked to give 24 hours notice of a trip cancellation if "next day" service is provided. Suspension of service for no-shows must be based on a "pattern or practice " of such activity rather than infrequent, one-time incidents. The frequency of no-shows that will be considered a pattern or practice can be either an absolute measure or a relative measure. An absolute measure would establish a specific number of no-shows in a given period of time that would be considered excessive. For example, such a policy could set three no-shows in a three-month period as a "pattern or practice". A relative measure would set a percentage of no-shows to total trip requests. For example, it would be considered a pattern or practice if three percent of a person's trip requests in any three-month period resulted in no-shows. The advantage of an absolute measure is that it is easier to measure and easier for riders to understand. It also lends itself to progressive action (e.g., a call after one no-show, a letter after two, and suspension after three). The primary disadvantage is that it does not account for differences in the number of trips made by riders. For example, three no-shows in a three-month period for someone who makes four one-way trips per week would mean that the person no-shows six percent of the time. A person who uses the service five days a week for work and makes 20 trips per week would be no-showing one percent of the time. Regardless of the method used, the measure should be able to be defended as a pattern or practice. One way to do this is to compare the measure that is considered excessive to the systemwide average for no-shows. For example, if there is a one percent no-show rate for the entire system, establishing a standard that would equal a three percent rate, even for frequent users of the service, would be defensible. The regulations do not provide guidance on what would constitute a "pattern or practice" of no-shows or what would be a reasonable period of suspension. Table 5 provides the no- show policy details of selected transit providers. As shown, most providers use an absolute standard. Many also have a standard that will lead to an escalation of actions (e.g., a number that will trigger a letter and a number that will result in suspension). The Southeastern Pennsylvania Transportation Authority has established a sliding scale that allows a different number of no-shows depending on the frequency with which the customer uses the service. Before suspending service, Ben Franklin Transit and the Port Authority of Allegheny County consider each situation on a case-by-case basis. In general, the period of suspension should be long enough to be a deterrent but should not cause undue hardship. As shown in Table 5, a period of suspension of one month appears to be typical for a first violation. A number of providers increase the period of suspension for subsequent violations of the policy. Other approaches, incentives, and disincentives can also be used to reduce the incidence of no-shows. The suspension policy and the reason for it should be known by riders. Include this information in brochures and rider manuals. DAST keeps notices about the no-show policy posted on vans. SEPTA develops a list each month of the twenty riders with the greatest number of no-shows and sends each a letter noting the effect of no-shows on the overall service. A copy of the letter sent by SEPTA is provided as Figure 7. In addition to contacting riders, efforts should be made to determine the cause of the problem. Identify and address any operational problems that may be leading to no-shows. Many of the systems contacted for policy details indicated that they contact riders who no- show a first time to explain the importance of canceling in advance and to make sure that the person is aware of the service suspension policy. Extenuating circumstances and operational problems can also be noted and/or resolved at this time. Some systems also indicated that Table 5. Details of No-Show Suspension Policies for Selected Transit Providers Name of Transit Provider # No-shows Considered Excessive Period of Suspension Advance Notice Required Ann Arbor Transportation Authority Ann Arbor, MI 2 in one month postcard 2nd occurrence in 6 months second notice 1 more occurrence in 6 months suspension or $10 charge per no-show. 6 months 30 minutes Ben Franklin Transit Richland, WA 3 in one month letter 2nd occurrence letter 3rd occurrence suspension Determined case-by- case N/A City of Charlotte Charlotte, NC 3 in 2 months 6 months N/A Delaware Administration for Specialized Transportation (DAST) Dover, DE 3 in one month letter 2nd occurrence letter 3rd occurrence loss of subscription 4th occurrence suspension 90 days 2 hours Durango, CO 2 in 90 days letter 3 in 90 days suspension 2 weeks 30 minutes Greater Bridgeport Transit District Bridgeport, CT 3 in 1 month probation 2nd occurrence suspension 14 days 2 hours or when office opens Greeley, CO 3 in 1 month 1st time 1 month 2nd time 6 months 3rd time 1 year None. "No-show" only if vehicle arrives and person does not ride. Lane Transit District Eugene, OR 3 in 6 months 1 month Anytime prior to arrival of vehicle. Los Angeles County Metropolitan Transportation Authority Los Angeles, CA 1st no-show verbal notice 2nd no-show written notice 3rd no-show in 6 months suspension 30 days Anytime prior to arrival of vehicle. Madison Metro Transit System Madison, WI No set policy. Case-by-case review No set policy. Case-by-case review. Anytime prior to arrival of vehicle. New York City Transit Authority New York, NY 3 in 6 months 1 month N/A OMNITRANS San Bernardino, CA 3 in 1 month first warning 4 in 1 month 2nd warning 5 in 1 month suspension 30 days Cancellation must be made before the vehicle is dispatched (Generally 1 hour). Port Authority of Allegheny County (PAT); ACCESS Program Pittsburgh, PA 1st no-show letter 2nd no-show letter and phone call 3rd no-show charge of $5 Additional no-shows $5 case-by-case review for possible suspension 1st time 1 week 2nd time 2 weeks Cancellation must be made before the vehicle is dispatched (Generally 1 hour). Riverside Transit Agency Riverside, CA 2 in 1 month notice 3 in 1 month revocation of subscription privileges or suspension 60 days 1 hour Southeastern Regional Transportation Authority (SEPTA) Philadelphia, PA sliding scale based on rider's average trips/month: < 14 trips/mo. no limit 15-39 trips/mo. 4 no-shows/mo. allowed 40-59 trips/mo. 6 no-shows/mo. allowed 60-79 trips/mo. 8 no-shows/mo. allowed 80-99 trips/mo. 10 no-shows/mo. allowed 100+ trips/mo. 12 no-shows/mo. allowed either 2 week suspension or fine and possible loss of subscription 2 hours Transit Authority of River City (TARC) Louisville, KY 2 in 1 month suspension 30 days 2 hours Utah Transit Authority Salt Lake City, UT 3 in 1 month letter 4 in one month suspension 30 days Any notice prior to vehicle arrival Waukesha Transit System Waukesha, WI 2 in 1 month 30 days 1 hour Worcester Regional Transit Authority Worcester, MA 1st no-show letter 2nd no-show letter 3rd no-show in 1 year suspension 30 days Up to 6:30AM: no requirement. 6:30-9:30AM: 1 hour after 9:30AM: 3 hrs Figure 7. Letter Sent by SEPTA to Riders with Greatest Number of No-Shows Each Month they will still charge the fare or will charge the sponsoring agency the full cost of the trip. The Ann Arbor Transportation Authority indicated that, as an alternative to suspending service, customers may be assessed a $10 charge per no-show. Another effective approach used by some providers is to leave a notice at the person's home indicating that the vehicle arrived and that they were recorded as a no-show, The no-show policy and the importance of canceling trips is also included in the notice. Subscription service privileges can also be revoked if individuals regularly miss trips. For a period of time they can be required to call for each trip. Many times, no-shows will also be caused by guardians or human service agency staff who assist the rider in making and keeping scheduled appointments. Follow-up with these individuals and/or contact with supervisors or program directors may be an effective approach. Excessive no-show and cancellation rates can also be caused by inconvenient advance reservation and trip confirmation practices. In general, no-shows and cancellations will decrease as the "response time" is reduced. Confirming trip requests as they are placed also will reduce the number of cancellations. Process Issues Associated with Suspending Service Suspending a person's right to paratransit service is a serious matter. This is so not only because of the legal ramifications but because many riders may have few other or no transportation alternatives and may rely on services for employment, medical, and other essential services. Transit providers should have clear documentation of all missed trips and should be prepared to show that all aspects of the policy have been followed. The regulations also require that before a suspension of services is imposed, administrative due process must be extended to the individual. A two-stage process is required, including initial notification and an opportunity for an informal hearing followed by a second notice and an opportunity to appeal. The exact process that must be used is explained in Appendix D to the regulations as follows: "If the entity proposes to impose sanctions on someone, it must first notify the individual in writing (using accessible formats where necessary). The notice must specify the basis of the proposed action (e.g., Mr. Smith scheduled trips for 8 a.m. on May 15, 2 p.m. on June 3, 9 a.m. on June 21, and 9:20 p.m. on July 10, and on each occasion the vehicle appeared at the scheduled time and Mr. Smith was nowhere to be found) and set forth the proposed sanction (e.g., Mr. Smith would not receive service for 15 days). The entity would provide the individuals an opportunity to be heard (i.e., an in-person informal hearing before a decisionmaker) as well as to present written and oral information and arguments. All relevant entity records and personnel would be made available to the individual, and other persons could testify. It is likely that, in many cases, an important factual issue would be whether a missed trip was the responsibility of the provider or the passenger, and the testimony of other persons and the provider's records or personnel are likely to be relevant in deciding this issue. While the hearing is intended to be informal, the individual could bring a representative (e.g., someone from an advocacy organization, an attorney). The individual may waive the hearing and proceed on the basis of written presentations. If the individual does not respond to the notice within a reasonable time, the entity may make, in effect, a default finding and impose sanctions. If there is a hearing, and the individual needs paratransit service to attend the hearing, the entity must provide it. The entity must notify the individual in writing about the decision, the reasons for it, and the sanctions imposed, if any. Again, this information would be made available in accessible formats. In the case of a decision adverse to the individual, the administrative appeals process (detailed in 37.125 of the regulations) would apply." [Federal Register, September 6, 1991, page 45747] All of the process issues associated with appeals of initial eligibility determinations, described in Section 8 of this chapter must be followed in the final appeal noted above. This would include a separation of function, allowing 60 days for the appeal to be requested, making a determination within 30 days of the hearing, and providing interpreters if needed. The same individuals who hear appeals of initial eligibility determinations do not, however, have to hear appeals of proposed service suspensions. Finally, it is important to note that service must continue to be provided throughout the process. The transit provider cannot suspend service while any part of the process is pending. Section 10. Visitor Policies Section 2 of Chapter 1 of this manual describes the regulatory requirements concerning the provision of service to visitors. Basically, the regulations require that: ADA paratransit eligible visitors to an area must be provided 21 days of service; Eligibility determinations provided by other public entities are to be honored for this period of time; Individuals who do not have certification from another public entity are to be served if they claim to be ADA paratransit eligible. These individuals can be requested to provide documentation of place of residence and/or disability; The service provided to visitors must be the same as that provided to local residents traveling in the same area; and Visitors needing more than 21 days of service can be required to apply for local eligibility certification. Transit providers should establish, as part of their visitor policy, the period of time within which the 21 days of service can be made. For example, a policy may state that visitor service will be provided "for 21 days in any six month period". The timeframe should be established as part of the planning process and must be set with full public participation. Manual or automated rider and trip records can be coded to identify visitors, can display the period for which visitor travel will be provided, and can record the number of trips provided to date. To avoid a lapse in service, transit providers should inquire whether or not a visitor will be needing more than 21 days of service during the established period of time when they call for their first ride. Certain parts of the application process may need to be completed before the visitor leaves their place of residence. For example, if the process requests professional verification as part of the initial application, the individual may need to have this portion of the form completed by a local professional before they leave. Form(s) that the person and/or a professional may need to complete should be sent or faxed in advance so that the person can bring these with them or return them in advance. This will enable the process to be completed and an eligibility determination to be made before the person's eligibility as a visitor runs out. This is particularly important for travellers who will need 21 consecutive or nearly consecutive days of service. As noted above, visitors who have not been certified by another public entity and who claim to be eligible can be requested to provide certain documentation. Documentation of place of residence may be desired to ensure that the individual is from outside the transit providers jurisdiction or the combined jurisdiction of several transit agencies which may be providing coordinated, joint paratransit service. A picture ID would obviously be preferred, but it is important to note that many ADA paratransit eligible individuals may not have a drivers license or other form of photo identification. Several alternative forms of proof of residence should be considered. These might include a copy of a telephone bill that would provide an address and would list the visitor's phone number (which could be called to provide some form of verification). It may also include identification which the individual may have been provided by another service agency. Documentation of disability may not be necessary in all cases. It will be particularly important if the person claims to have a "hidden disability" such as a heart condition, mental illness or other disability that is not obvious. Types of acceptable documentation might include proof of eligibility for other services based on disability such as documentation from a veterans organization, Social Security, a rehabilitation agency, independent living program, or other agency. Such forms of documentation probably will not be detailed enough to definitively verify ADA paratransit eligibility and transit providers should not require such definitive proof. They will, however, be able to indicate that the person does in fact have a disability that would likely qualify them for paratransit service. Chapter 4 Applying Eligibility Determinations to Daily Operations As explained in Chapter 1 of this manual, eligibility for complementary paratransit service is based on trips that cannot be made on the fixed route transit system by individuals with disabilities. For this reason, the determination of ADA paratransit eligibility is not solely an administrative function performed separate from daily operations. While basic information about applicants' functional capabilities and need for paratransit service is developed in the initial eligibility certification process, the eligibility of specific trip requests made by individuals who are ADA paratransit eligible will be determined in daily operations. The availability and accessibility of fixed route service will need to be considered along with applicable environmental and architectural conditions to determine whether paratransit service is required or if travel on the fixed route service is an appropriate alternative. This chapter addresses the determination of trip eligibility in daily operations. Section 1 reviews key information that will need to be available to operations personnel. Section 2 discusses trip-by-trip determination and suggests several practical approaches that can be applied in most operations. Section 3 notes some advanced technologies and recent developments in commercially available software that can assist in the operation of ADA paratransit services. Finally, Section 4 offers suggestions for encouraging conditionally eligible individuals to use fixed route service and for providing additional transportation alternatives. Although the regulations do require that transit providers strictly limit eligibility and identify limitations and conditions of eligibility, it is important to note that they do not require that trip-by-trip determinations be conducted in daily operations. Transit providers can opt to offer broader service to ADA paratransit eligible individuals if it is decided that determining the eligibility of each trip is too difficult, not cost-effective, or not necessary to fully implement required paratransit service. Some level of trip-by trip eligibility determination should be considered, however, if full implementation of the paratransit service requirements could become a financial burden. Only those costs associated with the provision of eligible trips can be included in any request of an undue financial burden waiver request. Section 1. Important Operational Information Much of the information obtained or developed in the eligibility determination process will be needed by schedulers, drivers, and other operations personnel to provide appropriate, effective paratransit service. Paratransit services typically maintain customer files with much of this information. The determination of ADA paratransit trip eligibility may, however, require these records to be expanded and enhanced. In addition to name, address, and other general personal information, a customer record maintained by the operations department or contract operator will need to include: Information about the person's disability. In order to appropriately responding to a customer's needs and provide any necessary assistance, operations personnel will need basic information about the person's disability. For example, the customer record may indicate that the rider is blind, is moderately retarded, or has cerebral palsy and uses a wheelchair. Certain medical information should be released only if it is vital to the effective and safe operation of the service. For example, the customer record may show that a person suffers from chronic fatigue but would not indicate that the individual has been exposed to the HIV virus. Certain medical information, if deemed vital, can also be released only to limited personnel such as managers or supervisors. Operators will also need to have information about the particular effects of the disability. For example, it would be important to note if the individual is prone to seizures or certain types of behavior. It would also be helpful to provide suggestions for communicating with or otherwise assisting the individual that may have been noted in the application. Mobility aids used. This would include aids such as wheelchairs, walkers, braces, canes, and portable life support. It would also include information on service animals and/or the need for personal care attendants. Detailed information on the size and weight of wheelchairs will be important for determining if the lifts available can accommodate the rider or if vehicles with particular accessibility features (e.g., a certain securement system) will be needed. Functional capabilities. In addition to basic information about the nature of the person's disability, operations staff will need to know the functional capabilities of customers. This could include the person's ability to board an accessible vehicle, to negotiate steep terrain, or to travel under certain environmental conditions. It may also include information about travel training that the rider has received and specific fixed routes which they can independently use. Information provided to operations staff should be consistent with the information provided to the applicant. The level of detail provided should be determined by the degree of trip eligibility determination that will be conducted. For example, the specific temperature sensitivity of a rider (e.g., temperatures above 85 degrees Fahrenheit) would not be needed if trip determinations are going to be seasonally-based (e.g., the rider is eligible during hot weather months). Frequent travel information. If questions about common trips are included in the application, they can also be useful in determining the person's need for paratransit for frequently made trips. This information can also help in predicting travel demand and structuring future subscription service or daily routes. In addition to information obtained through the eligibility determination process, paratransit operations staff will also need information about fixed route services. They will also need certain geographic and architectural data in order to determine if there are conditions that could prevent customers with disabilities from getting to or from stops/stations. Again, the level of detail of this information depends on the degree of trip-by-trip determination that is done in operations. Additional information that should be considered includes: Fixed routes and schedules. Paratransit schedulers should have access to the latest fixed route information. A simple map that displays the routes overlaid on the ADA paratransit service area is one approach. In larger systems, giving schedulers access to computer programs used by public information staff that can show best routes given a particular origin and destination should be considered. Knowledge of accessibility features of the fixed route system is also important. Accessible routes should be highlighted. If an "on-call" lift bus service is utilized, consideration should be given to combining this program with the paratransit operation or closely linking the two. It would be beneficial to be able to directly arrange for on-call lift bus service for individuals calling for paratransit who could use accessible fixed route service. Location of accessible bus stops/rail stations. Information about stations and stops that are accessible can also be made available to paratransit schedulers. A survey of bus stops can be conducted to identify those areas where the geography or street conditions may prevent individuals from boarding and disembarking. Paratransit operators asked to do trip-by-trip eligibility determination will also need current information about system access such as the latest information on elevator outages. Map of the ADA service area. Maps used in scheduling should delineate the ADA paratransit service area. This is particularly important if the service area is limited to 3/4 mile corridors specified in the regulations. It may also be helpful to display other distance lines, such as a 1/4 mile or 1/2 mile distance from fixed routes. This will be helpful in determining if paratransit is required for individuals who can independently travel distances less than 3/4 of a mile and are conditionally eligible based on the distance to and from stops/stations. Areas of steep terrain. The map of the service area should also highlight areas of steep terrain that could prevent individuals with ambulatory disabilities from getting to or from stops/stations. While it may not be practical to highlight all areas which exceed the regulatory definition of an accessible grade, it may be useful to display extreme terrain that is a definite barriers to travel. Location of curb cuts and sidewalks. The location of curb cuts within the service area can also be displayed. Cites and towns are required by the Department of Justice's ADA regulations to include in their ADA transition plans a schedule for building curb cuts. Maps showing the location of existing and planned curb cuts may be available from local city engineering offices. Areas that lack sidewalks can also prevent independent travel to transit stops/stations. Local public works offices may also be able to assist in the collection of this information. Major intersections and other barriers. Finally, it may be helpful for schedulers to know the location of other manmade or natural features that could act as barriers to travel by individuals with disabilities. This might include highways, busy intersections, railroad tracks, waterways, or other similar features. It may also include streets and sidewalks that are under construction. This information will need to be regularly updated with the help of local planning and public works agencies. The above information can be developed and displayed manually. As discussed in Section 3 of this chapter, it can also be developed with the aid of certain advanced technologies. Section 2. Trip-by-Trip Eligibility Determinations The consideration of all factors that may affect trip eligibility is a difficult undertaking at best. Even with detailed information about the fixed route service and extensive environmental, geographic, and architectural information, it may still not be possible to determine if certain conditions, when combined with a person's disability prevent use of the fixed route service. For example, in advanced reservation operation, it is not be possible to know in advance the environmental conditions such as temperature, humidity, snow, ice, or air pollution that may exist at the time of travel. The effects of certain types of disabilities, such as multiple sclerosis and mental illnesses also can change from day to day. Transit providers will need to rely on the personal assessments of travel capabilities made by individuals with these disabilities. While it may be impractical or impossible to take into consideration all of the factors associated with trip eligibility, there are certain approaches that can be taken that can allow a significant portion of all trips provided to be reviewed, at some level, for eligibility. These approaches are described below. Review Subscription Trips Many paratransit programs permit riders to obtain reservations for repeat trips by calling only periodically. For example, a rider may have a standing reservation for daily travel to work which only needs to be reconfirmed once a month or every three months. These "subscription" trips have the same origin and are made to the same destination. In many systems, subscription trips can account for 40-50 percent of all trips provided. A detailed analysis of each subscription rider's ability to make this one repeat trip can be conducted using information obtained in the application for ADA paratransit eligibility. Additional information about exact travel distances involved or geographic/architectural features that might prevent travel can be obtained by a site review or by speaking to the rider. A single review can impact many future trips. Determining that ten current paratransit riders could use fixed route service for daily travel to work, for example, could reduce paratransit trip demand by about 5,200 trips per year. Review Other Frequently Made Trips Non-subscription trips are also often made from the same origin to the same destination. For example, individuals will often grocery shop at the same store or may be members of a particular civic organization. A review of possible use of fixed route service to meet these common travel needs can be done. As with subscription service, such reviews will impact many potential paratransit trip requests. As noted in Section 4 of Chapter 3 of this manual, information about common trips can be included in the initial eligibility application form. Commonly made trips can also be generated from trip records by sorting trips by rider and by origin and destination. Generalize Limitations of Eligibility Another approach to simplifying trip eligibility determinations is to generalize the conditions that have been placed on an individual's ADA paratransit eligibility. By broadening the condition, it may then become practical to consider the condition when reviewing a particular trip request. For example, a rider may not be able to use fixed route service when there is snow or ice. Instead of taking current weather conditions into consideration in the scheduling process, the rider could be considered eligible during those times of the year when snow and ice are present. Similarly, a person with a sensitivity to high temperatures and/or humidity could be granted eligibility during hot weather months. This person would be expected to use fixed route service at other times. These generalized conditions of eligibility could be included in the customer record file. Schedulers could then easily determine if the trip request should be accommodated. Consideration of Easily Tracked Eligibility Conditions Other conditions of eligibility may also be easily identified using information from the application review process. This information can then be prominently displayed on computer scheduling screens (or can be noted on rider record cards) to allow schedulers to determine if the use of fixed route service might be a reasonable alternative for a particular trip that is being requested. Individuals determined to be unconditionally eligible would be identified as such and no further consideration of their trip request would be necessary as long as both the origin and destination were within the ADA paratransit service area. Persons determined conditionally eligible would have key information about their eligibility indicated. Examples of conditions that can be easily identified and tracked and which may be practical to consider in the scheduling process include: whether the person has received travel training for certain trips; whether the person is able to use accessible fixed route services; whether eligibility is based on an inability to negotiate transfers and complex fixed route trips; the ability of the person to independently travel certain distances; whether travel is prevented at certain times of day (e.g., night blindness); or whether travel is prevented in certain seasons (e.g., winter due to snow/ice, or summer due to heat). Using basic information such as that listed above, schedulers may sometimes be able to definitively determine if paratransit is required. For example, a request for a trip for which the individual has been trained could be quickly assessed. A decision on a midday trip request by an individual determined eligible on the basis of night blindness could be easily made. Similarly, a determination on a trip request that involves the use of only one route could be made if eligibility is based on the person's inability to negotiate complex trips. In other cases, it may not be possible to arrive at a definitive determination of eligibility, but use of the fixed route service may be a distinct possibility. For example, the customer record of a wheelchair-user may show that he/she can use accessible vehicles and can travel up to 1/2 mile to and from bus stops. The origin and destination may both be close to an accessible route and the request may be at a time of the year when weather is not a factor. Without detailed information about curb cuts and terrain, it is not possible to make a final decision but there would seem to be a good chance that the person could use the fixed route service. In this case, the call-taker or scheduler may want to ask the person "Are you aware that Bus XYZ is now lift-equipped and is only 3 blocks from you?" or a stronger suggestion such as "Our records indicate that you are able to use accessible buses. Bus XYZ is lift equipped and can be used for this trip" could be made. The customer may decide that this fixed route alternative can be used or may point out that other barriers exist. Under this approach, transit providers would rely on customers to note difficult to track issues such as a lack of curb cuts and/or steep terrain. More accurate determinations would obviously be possible if schedulers were given easy access to other eligibility conditions and had detailed service area and environmental information. Examples of other factors that would be slightly more difficult to utilize in daily operation but which could be considered include: whether eligibility is based on an inability to travel in areas of steep terrain (combined with detailed knowledge of the terrain in the area); whether eligibility is based on a lack of curb cuts (combined with a map of curb cuts in the area); whether eligibility is based on an inability to cross busy streets and intersections (combined with information about busy roadways and difficult intersections in the area). As can be seen, trip-by-trip eligibility determinations can be considered at many levels of complexity. There is a clear benefit to using some of the simpler approaches outlined above. A careful analysis of the costs and benefits of maintaining more detailed data and asking operators to spend the additional time making trip determinations should be considered before more involved approaches are used in daily operation. Section 3. Using Advanced Technologies to Make Trip Eligibility Determinations A number of advanced technologies are available that can assist in maintaining and using ADA eligibility information. Following is a brief description of each and a discussion of possible applications to the eligibility process. Relational Database Management Systems (RDMS) Relational database management systems are "off-the-shelf" software packages that can be used to create and manage data files. Separate files can be created (e.g., customer files and trip files) and this information can then be "related" by using a common identifier (e.g., a customer ID). RDMS software is inexpensive and can be programmed by users with basic to moderate computer skills. Data files and reports can be customized to address the particular need. RDMS software could be used by smaller operators to store detailed eligibility information, including specific conditions/limitation of eligibility. As trip requests are received, call- takers or schedulers could recall information on the rider and use this data in making trip eligibility decisions. RDMS software could also keep trip records for individuals being served as visitors and assist schedulers in knowing when to request that these persons apply for local eligibility. In addition to assisting with ADA paratransit eligibility, RDMS software can be applied to many other paratransit operations needs such as general client information, trip records, reporting, and billing. For more information on RDMS, see: Commercial Software Applications for Paratransit, USDOT Report #DOT-I-84-51, available through the USDOT Technology Sharing Program. Automated Client Information Systems Several software packages are also available that are designed specifically to allow for the storage and retrieval of detailed information on clients/customers. In many cases, these systems have been developed from standard RDMS. While they serve the same basic purpose as RDMS, the main advantage of these customized packages is that they include special screen displays and menus that make information storage and retrieval quicker and easier for the user. Often, these systems are one piece of larger computer scheduling and dispatching programs. It is possible, however, to purchase client information system modules separate from the larger programs. Typically, these modules cost less than $5,000. Automated client information systems are also used extensively by human service agencies. Information about several available automated client information systems is included in: PCs in Transportation Software Directory, a catalog available through PC-TRANS at the University of Kansas Transportation Center. PC-TRANS' phone number is (913) 864- 5655. Automated Routing and Scheduling Systems Many of the commercially-available routing and scheduling programs developed for the paratransit industry have recently been upgraded to include features that address ADA information needs and requirements. As noted above, these packages typically include client information modules as well as trip files, scheduling algorithms, reporting routines, and other functions designed to offer full support in all aspects of paratransit operation. Some of the common features that have been developed for ADA paratransit operation include: ADA Paratransit Eligible Customer Information: Individuals who are determined ADA paratransit eligible can be distinguished from other riders. Conditions and limitations of eligibility and/or the regulatory categories under which riders are eligible can be displayed. If ADA paratransit eligible persons are also eligible under other programs, this multiple eligibility information can also be displayed. To be of immediate use to schedulers, the above client information can be displayed in "real-time", meaning that it can be immediately accessed as part of a scheduling routine. Relationship of Desired Trip to the Fixed Route System: The ADA regulations require transit providers to offer complementary paratransit service to eligible individuals in an area defined by corridors 3/4 of a mile to each side of fixed routes plus to other areas within a "core service area". In determining if a requested trip is eligible, transit providers will need to check the geographic relationship of the origin and destination to the fixed route service. In addition, customers may be able to get to and from bus stops up to a certain distance (e.g., up to 1/4 of a mile) but are eligible for paratransit when they would need to travel a greater distance to and from bus stops. Several scheduling systems are now capable of incorporating geographic information about the fixed route system. ADA paratransit service corridors can be displayed and calculations of distances from origin or destination to the closest fixed route can be made. More accurate systems will develop these calculations by using exact latitude/longitude coordinates or street centerlines. Trip eligibility can then be determined using this information. Visitors Information: As noted in Chapter 1 of this manual, the regulations require that ADA paratransit systems accommodate visitors to the area. Visitors are to be provided with 21 days of service over a reasonable period of time if they have been determined eligible by another transit agency or if they claim to be eligible. After 21 days of service, the person can be required to go through the local eligibility determination process. Several paratransit scheduling programs are able to process visitor requests, track the days of service provided to a visitor, and display this information as part of the scheduling routine. Documenting Compliance: In addition to assisting with determining individual and trip eligibility, these systems are also capable of providing data and developing reports that can assist in assuring compliance with the regulations. For example, the ADA regulations require that complementary paratransit service, when fully implemented, cannot have capacity constraints. Examples of capacity constraints are an excessive number of trip denials, late pick-ups, and long trips. Trip requests are to be considered denials if they cannot be scheduled within one hour of the requested pick-up time. Additionally, the regulations limit subscription trips ("standing orders") to no more than 50 percent of total trips when capacity constraints exist. Several software systems allow users to track and analyze capacity constraints and subscription trips. As part of the preparation of this manual, information about the availability of the above features was requested from 30 of the leading paratransit software companies. Twelve companies responded and indicated that one or more of these features was either currently available or in development. The tables on the following pages summarize this information. Table 6 summarizes client information features. Table 7 presents information about displaying the ADA paratransit service area and calculating distances to and from stops. Table 8 addresses features included to accommodate visitor requirements. Table 9 notes capabilities for collecting and analyzing capacity constraint and subscription information. For more information on the capabilities of automated routing and scheduling systems, see: Assessment of Computer Dispatch Technology in the Paratransit Industry, USDOT Report #DOT-T-92-23, available through the USDOT Technology Sharing Program. Advanced Public Transportation Systems: The State-of-the-Art Update '92, USDOT Report #DOT-VNTSC-FTA-92-3, available through the National Technical Information Service, Springfield, Virginia, 22161. Table 6. Capabilities of Selected Computer Scheduling and Dispatching Systems to Capture and Display ADA Paratransit Eligibility Information Company Name (Software Name) Contact Person: Phone # ADA Eligible Persons Identified in "Real-Time? Can Eligibility Conditions be Displayed? # of Conditions that can be Displayed Can "Categories" of Eligibility be Displayed? Can Multiple Eligibilities (ADA, Medicaid, etc.) be Displayed? # of Types of Eligibility that can be Displayed Aleph Computer Systems, Inc. (Share-Ride Scheduling Program) Mr. Ray Zhang: (510) 843-4443 Yes Yes 20 Yes Yes 20 Automated Business Solutions, Inc. (PtMS-Paratransit Management and Scheduling) Mr. Stephen Pellegrini: (215) 565-2800 Yes Yes Yes Yes 5 Automated Dispatch Services (ADS), Inc. (EMtrack) Mr. David Brown: (305) 471-0441 Yes Yes As Screen Space Allows Yes Yes As Screen Space Allows COMSIS Corporation (COMSIS Trip Planning System [CTPS]) Ms. Marcia G. DeJulio: (412) 279-9110 Yes In Development Yes In Development Decision Sciences, Inc. (Quick-Route [TM]) Mr. Chuck Jones: (708) 965-1581 Yes Yes 10 Yes Yes 3 Easy Street Software, Inc. (Easy Trips) Mr. Patrick Simmons: (919) 848-9991 Yes Yes 14 plus "other" Yes Yes No Practical Limit GIRO (GIRO/ACCESS) Mr. Nigel Hamer: (514) 383-0404 Yes Yes Seasonal Yes Multiple "Sponsors" Ketron Div. of The Bionetics Corp. (Paratransit Management Information and Scheduling System [PARMIS]) Mr. John N. Balog: (215) 648-9000 Yes Yes No Limit Yes Yes 6 Micro Dynamics Corporation (CADMOS - Prot) Mr. Paul D. Buroker: (812) 477-3090 Yes Yes As Needed- Customized Yes Yes As Needed Multisystems, Inc. (MIDAS) Mr. Kurt Dossin: (617) 864-5810 Yes Yes Unlimited Yes Yes 5 Paratransit Systems Int'l., Inc. (Rides Unlimited) Mr. Jeff Forville: (800) 926-2345 Yes Yes 32 Yes Yes 48 Philip A. Dorcas and Assoc. (PSP - Paratransit Scheduling Package) Mr. Phil Dorcas: (817) 921-9704 Yes Yes 36 Yes Yes 36 UMA Engineering Ltd. (QuoVadis) Mr. Mark Miller: (416) 238-0007 Yes Yes No Restriction Yes Yes No Restriction Table 7. Capabilities of Selected Computer Scheduling and Dispatching Systems to Display the ADA Paratransit Service Area and Calculate Distances to and From Stops/Stations Company Name (Software Name) Contact Person: Phone # Can ADA Service Area Corridors and Origins and Destinations be Displayed? Can Real-Time Calculations of Distance From Routes to Origins and Destinations be Made? Basis of Distance Calculations Aleph Computer Systems, Inc. (Share-Ride Scheduling Program) Mr. Ray Zhang: (510) 843-4443 Yes Yes Zonal-Based Centroids Automated Business Solutions, Inc. (PtMS-Paratransit Management and Scheduling) Mr. Stephen Pellegrini: (215) 565-2800 Yes Yes Street Centerlines Automated Dispatch Services (ADS), Inc. (EMtrack) Mr. David Brown: (305) 471-0441 Yes Yes Latitude/Longitude COMSIS Corporation (COMSIS Trip Planning System [CTPS]) Ms. Marcia G. DeJulio: (412) 279-9110 Yes In Development Latitude/Longitude Decision Sciences, Inc. (Quick-Route [TM]) Mr. Chuck Jones: (708) 965-1581 In Development In Development Latitude/Longitude Easy Street Software, Inc. (Easy Trips) Mr. Patrick Simmons: (919) 848-9991 Yes Yes Street Centerlines (preferred) or Zonal- Based Centroids or Latitude/Longitude GIRO (GIRO/ACCESS) Mr. Nigel Hamer: (514) 383-0404 In Development In Development Zonal-Based Centroids or Latitude/Longitude or Street Centerlines Ketron Div. of The Bionetics Corp. (Paratransit Management Information and Scheduling System [PARMIS]) Mr. John N. Balog: (215) 648-9000 In Development In Development Latitude/Longitude Micro Dynamics Corporation (CADMOS - Prot) Mr. Paul D. Buroker: (812) 477-3090 In Development In Development Zonal-Based Centroids or Latitude/Longitude Multisystems, Inc. (MIDAS) Mr. Kurt Dossin: (617) 864-5810 Yes In Development Latitude/Longitude Paratransit Systems Int'l., Inc. (Rides Unlimited) Mr. Jeff Forville: (800) 926-2345 Yes In Development Latitude/Longitude Philip A. Dorcas and Associates (PSP - Paratransit Scheduling Package) Mr. Phil Dorcas: (817) 921-9704 In Development In Development Options being evaluated UMA Engineering Ltd. (QuoVadis) Mr. Mark Miller: (416) 238-0007 Yes Yes Latitude/Longitude Table 8. Capabilities of Selected Computer Scheduling and Dispatching Systems to Track Service Provided to Visitors Company Name (Software Name) Contact Person: Phone # Can Requests from Visitors be Processed as part of Scheduling Routine? Can Days of Service Provided to Visitors be Tracked and Displayed? Aleph Computer Systems, Inc. (Share-Ride Scheduling Program) Mr. Ray Zhang: (510) 843-4443 Yes Yes Automated Business Solutions, Inc. (PtMS-Paratransit Management and Scheduling) Mr. Stephen Pellegrini: (215) 565-2800 Yes Yes Automated Dispatch Services (ADS), Inc. (EMtrack) Mr. David Brown: (305) 471-0441 Yes In Development COMSIS Corporation (COMSIS Trip Planning System [CTPS]) Ms. Marcia G. DeJulio: (412) 279-9110 Yes Yes Decision Sciences, Inc. (Quick-Route [TM]) Mr. Chuck Jones: (708) 965-1581 Yes Yes Easy Street Software, Inc. (Easy Trips) Mr. Patrick Simmons: (919) 848-9991 Yes Yes GIRO (GIRO/ACCESS) Mr. Nigel Hamer: (514) 383-0404 Yes Yes Ketron Div. of The Bionetics Corp. (Paratransit Management Information and Scheduling System [PARMIS]) Mr. John N. Balog: (215) 648-9000 Yes Yes Micro Dynamics Corporation (CADMOS - Prot) Mr. Paul D. Buroker: (812) 477-3090 Yes Yes Multisystems, Inc. (MIDAS) Mr. Kurt Dossin: (617) 864-5810 Yes Yes Paratransit Systems Int'l., Inc. (Rides Unlimited) Mr. Jeff Forville: (800) 926-2345 Yes Yes Philip A. Dorcas and Associates (PSP - Paratransit Scheduling Package) Mr. Phil Dorcas: (817) 921-9704 Yes Yes UMA Engineering Ltd. (QuoVadis) Mr. Mark Miller: (416) 238-0007 Yes Yes Table 9. Capabilities of Selected Computer Scheduling and Dispatch Systems to Track and Analyze Capacity Constraints and Subscription Service Company Name (Software Name) Contact Person: Phone # Can System Track and Analyze Can Analysis be Done by Trip Denials Late Pick-ups Long Trips Subscription Trips Time of Day and Day of the Week Subregions of the Service Area Individual Rider Aleph Computer Systems, Inc. (Share-Ride Scheduling Program) Mr. Ray Zhang: (510) 843-4443 Yes Yes Yes Yes Yes Yes Yes Automated Business Solutions, Inc. (PtMS-Paratransit Management and Scheduling) Mr. Stephen Pellegrini: (215) 565-2800 Yes Yes Yes Yes Yes Yes Yes Automated Dispatch Service (ADS), Inc. (EMtrack) Mr. David Brown: (305) 471-0441 Yes Yes Yes Yes Yes Yes In Develop- ment COMSIS Corporation (COMSIS Trip Planning System [CTPS]) Ms. Marcia G. DeJulio: (412) 279-9110 Yes Yes Yes Yes Yes Yes Yes Decision Sciences, Inc. (Quick-Route [TM]) Mr. Chuck Jones: (708) 965-1581 Yes Yes Yes Yes Yes Yes Yes Easy Street Software, Inc. (Easy Trips) Mr. Patrick Simmons: (919) 848-9991 Yes Yes Yes Yes Yes Yes Yes GIRO (GIRO/ACCESS) Mr. Nigel Hamer: (514) 383-0404 Yes Yes Yes Yes Yes No Yes Ketron Div. of The Bionetics Corp. (Paratransit Management Information and Scheduling System [PARMIS]) Mr. John N. Balog: (215) 648-9000 Yes Yes Yes Yes Yes Yes Yes Micro Dynamics Corporation (CADMOS - Prot) Mr. Paul D. Buroker: (812) 477-3090 Yes Yes Yes Yes Yes Yes Yes Multisystems, Inc. (MIDAS) Mr. Kurt Dossin: (617) 864-5810 Yes Yes No Yes Yes Yes Yes Paratransit Systems Int'l., Inc. (Rides Unlimited) Mr. Jeff Forville: (800) 926-2345 In Develop- ment Yes Yes Yes Yes Yes Yes Philip A. Dorcas and Associates (PSP - Paratransit Scheduling Package) Mr. Phil Dorcas: (817) 921-9704 In Develop- ment Yes In Develop- ment Yes In Development Yes Yes UMA Engineering Ltd. (Quo Vadis) Mr. Mark Miller: (416) 238-0007 Yes Yes Yes Yes Yes In Development Yes GIS and Computer Mapping Systems Geographic information systems (GIS) provide database management capabilities for the display of spatial data, and provide users with the ability to perform analysis of geographic features. Many of the scheduling and dispatching systems discussed above utilize GIS to code the location of origins, destinations, and fixed route services. This then allows distances from stops/stations to be calculated. In addition to assisting with the calculation of required travel distances, GIS can be used to locate and store information on other geographic features. This could include curb cuts, areas of steep terrain, or other manmade or natural barriers to travel. Such displays and information can then be incorporated into complex scheduling systems. GIS can also be used independent of scheduling programs to display the ADA paratransit service area, origins, destinations, and other key geographic information that can then be considered in the scheduling process. For more information on GIS, see: Current Use of Geographic Information Systems in Transit Planning, USDOT Report #DOT-T-92-02, available through the USDOT Technology Sharing Program. Section 4. Providing Alternatives/Market-Based Approaches Appropriate use of ADA paratransit service can also be achieved by encouraging eligible individuals to use fixed route service and by providing attractive alternatives to the paratransit service. Such approaches can supplement efforts to do trip-by-trip determinations as part of paratransit operations. Fare policies for fixed route and paratransit services will obviously impact rider choice. Individuals who are conditionally ADA paratransit eligible (i.e., they can use fixed route service for some trips) can be encouraged to utilize mainline service by maintaining a lower fare for this service. This can be achieved by pricing paratransit service higher than fixed route service (the regulations permit a paratransit fare that is a maximum of twice the base fixed route fare for a comparable trip) or by offering fixed route fare discounts and special promotions. Because a higher paratransit fare will also impact those who must use paratransit service (unconditionally ADA paratransit eligible persons), consideration of the latter approach may be preferable. Transit providers presently must offer persons with disabilities a 50 percent fare discount during off-peak hours. Consideration should be given to expanding this discount to all hours. ADA paratransit eligibility documentation could then be used as identification to qualify individuals for this discount. The Los Angeles County Metropolitan Transportation Authority presently has such a program for individuals who are conditionally ADA paratransit eligible. This encourages these eligible individuals to use the fixed route service when they are able. Also consider special promotions that allow persons with disabilities to use fixed route service free or at a discount for a limited time. Conditionally eligible persons could be mailed a monthly pass when they are notified of their eligibility determination. The notification letter could encourage use of the fixed route system and offer training, special instruction, trip planning services, or other assistance. Another alternative would be to encourage local private taxi companies to begin offering accessible taxi service. Initial capital and/or assistance could be considered to demonstrate the feasibility of the service. An ongoing accessible taxi program could also be funded to supplement ADA paratransit service. This program could provide a lower level of subsidy to riders than is provided on the standard paratransit system. Individuals may opt to pay a higher fare for immediate response taxi service rather than make arrangements for ADA paratransit service a day in advance. Utilizing these approaches will encourage ADA paratransit eligible persons to utilize fixed route services and will expand travel alternatives available to them. More decisions about the appropriate use of paratransit service will be made by riders which will ease requirements for trip-by-trip determinations in daily operation.References Americans with Diabilities Act of 1990, Public Law 101-336, July 26, 1990 CFR 49 Parts 27, 37 and 38, "Transportation for Individuals With Disabilities; Final Rule", Federal Register, September 6, 1991. Thatcher, R. H., Gaffney, J. K., ADA Paratransit Handbook: Implementing the Complementary Paratransit Service Requirements of the Americans with Disabilities Act of 1990, US DOT Report #UMTA-MA-06-0206-91-1, prepared for the UMTA Task Force on the Americans with Disabilities Act, funded through the Office of Technical Assistance and Safety, September 1991. Balog, John N., Schwarz, Anne N., Rimmer, Jennifer E., and Hood, Mark M., ADA Public Participation Handbook, prepared for Project ACTION, funded by the Federal Transit Administration, September, 1993. C. V. Mosby Company, Mosby's Medical, Nursing, and Allied Health Dictionary, Third Edition, 1990. U.S. Department of Labor, Dictionary of Occupational Titles, Volume 1, Fourth Edition, Revised 1991. DeAlba, M., Evolution of Functional Eligibility and Certification for Paratransit Service: The Chicago Experience, Transportation Research Record 1338. Hazen, C., ADA Implementation Evaluating Disabled Individuals for ADA Paratransit Eligibility, prepared for the University of Wisconsin - Milwaukee, April 27, 1993. CGA Consulting Services, Inc., EG&G Dynatrend, Katherine McGuinness & Associates, Inc., ADA Paratransit Eligibility: A Guide for Virginia Transit Systems for Complying with the Americans with Disabilities Act of 1990, prepared for the Virginia Department of Rail and Public Transportation, July 1, 1992. Coburn, N., Martin, C., Thompson, R., Norstrom, D., Guidelines for Improvements to Transit Accessibility for People with Disabilities, Technical Report #DOT-T-93-04, prepared for the Office of Technical Assistance and Safety, Federal Transit Administration, September 1992. Schwarz, A.N., Trip by Trip Eligibility: Can it Really Be Done? presented at Solving ADA Paratransit Problems: How to Cope with Reality, Phoenix, AZ, May 27-29, 1993. Cutler, M.R., Cabrera, A., Monahan, P.A., Harman, L.J., Commercial Software Applications for Paratransit, US DOT Report #DOT-I-84-51, prepared for the Office of Methods and Support UMTA, funded through the U.S. Department of Transportation, July 1984. University of Kansas Transportation Center, PC's in Transportation Software Directory, March 1991. Stone, J.R., Gorman, G., Nalevanko, A., Assessment of Computer Dispatch Technology in the Paratransit Industry, US DOT Report #DOT-T-92-23, prepared for Federal Transit Administration Office of Technical Assistance & Safety, March 1992. Labell, L.N., Schweiger, C.P., Kihl, M., Advanced Public Transportation Systems: The State of the Art, Update 1992, US DOT-VNTSC-FTA-92-3, April 1992. Schweiger, C.L., Current Use of Geographic Information Systems in Transit Planning, US DOT Report #DOT-T-92-02, prepared for the Office of Grants Management UMTA, August 1991. Index Accessible formats types of, 24 identifying the need for, 57 application materials,53 regulatory requirement for, 24 Accessible taxi programs, 134 Appeals required process, 26-27 of initial determination, 26-27 of proposed suspension of service, 28, 111-112 alternative approaches, 94-101 hearings, 102 separation of function in, 26, 95 Application forms accessible formats, 53 suggested contents, 54-72 pre-test of, 73 use of appropriate terminology in, 54 Architectural barriers application questions concerning, 64-65 construction, 9 curb-cuts, 9 data needs in daily operation, 117-118, 121 effects on eligibility, 8, 9, 16 major intersections, 9 Audiologist, 50 Category 1 eligibility examples of, 5 factors which affect, 5-7 suggested application questions, 62-63, 66-67 regulatory definition of, 5 Category 2 eligibility examples of, 7 factors which affect, 8 suggested application questions, 66-67 regulatory definition of, 7 Category 3 eligibility examples of, 11 factors which affect, 8 "prevented" travel, 9-10 regulatory definition of, 8 Clinical social worker, 50 Common wheelchair definition of, 6 suggested application question, 58 Companions, 12 Conditional eligibility defined, 4 examples of, 16-19 recent experience concerning, 79-84 sample determination letter for, 88-89 Conditioning service, 104 Curb-cuts application questions concerning, 64-65 data needs in daily operation, 118, 121 effects on eligibility, 9 Determinations of eligibility contracted vs. in-house, 48-52 maintaining consistency of, 78-79 recent experiences with, 79-83 selecting appropriate third-party reviewers, 48-49 Disability relationship to eligibility, 4, 16, 17-19 episodic and intermittent, 17, 59-60 suggested application questions, 59-60 Distance from fixed routes data needs in daily operation, 117-118 determining with advanced technology, 123 effects on eligibility, 9, 11, 18-19, 20 suggested application questions, 64 Documentation costs associated with, 33 requested from visitors, 13, 113-114 limiting to those eligible, 23-24 of appeals hearings, 15, 102 of eligibility, 25, 92-93 of the process, 15, 74 sample ID, 93 Environmental conditions air pollution, 9, 11 suggested application questions, 64-66 data needs in daily operation, 118, 119-121 humidity,11 ice, 9, 11 rain, 9, 11 snow, 9, 11 temperature, 9, 11 terrain, 9, 11 Fare incentives, 93, 133-134 Fees, application and process regulatory language concerning, 33 for applications/determinations, 33 for professional verification, 37 for documentation, 33 Functional ability relationship to eligibility, 16-19 suggested application questions, 60-67 tests to determine, 39, 62 Functionally-based determinations, 16 Independent living specialist, 50 Independent travel relationship to eligibility, 6 Infants/Children eligibility of, 11, 104 In-person assessment as part of determination process, 39-42 cost of, 51 questions and functional tests, 39, 62 Language ability obtaining information regarding, 58 Management information system example of automated system, 74 suggestions for, 74 Marketing (see "Public information") Mobility aids "common wheelchair" definition, 6 effects on eligibility, 6 requirements for accommodating, 6 suggested application questions, 58-59 Most limiting factors determining eligibility based on, 20 No-shows considerations in developing a policy, 105-111 regulatory requirements, 28 sample policies of selected providers, 106-109 suggested approaches to reduce, 106-111 Notice, providing of initial determination, 25, 85-91 of appeals decision, 26, 96 of service suspension, 28, 111-112 sample determination letters, 87-91 Occupational therapists, 35, 49-50 On-call accessible fixed route bus service, 8 Operator assistance effects on eligibility, 6 regulatory requirements for, 6 Opthomologists, 35, 50 Personal care attendants definition of, 12 requirements for serving, 12-13 suggested application questions, 59 Physiatrists, 49-50 Physical therapists, 35, 50 Physicians appropriate use of, 37-38 definition of, 50 Presumptive eligibility during initial determination, 24, 35, 74 during appeals, 26, 74, 94 for visitors, 13-14, 112-114 Privacy rights of applicants and customers, 79, 116 Process, establishing an eligibility alternative processes, 34-42 examples of selected processes, 43-47 general considerations in, 30-33 suggested "steps", 29 Process requirements required implementation date, 4 required elements of a policy, 23-27 who must establish eligibility processes, 3 Professional verification as needed, 34-36 forms for obtaining, 72 obtaining appropriate, 35, 37 questions in application concerning, 70-71 requested in all cases, 36-39 Psychologist, 50 Public information importance of, 31-32 suggestions for, 32 Public participation guidance on, 31 importance of, 30 regulatory requirements for, 30 Recertification future process considerations, 42 of ADA paratransit eligibility, 27, 92 of current paratransit customers, 27-28 Refusing service, 103-104 Registered nurses, 50 Rehabilitation specialists, 50 Reviewer guidelines, 78-79 Self-certification as part of determination process, 34-38 Separation of function (see "Appeals") Service animals, 58, 103 Standees on lifts noting in application material, 54, 67 regulatory requirements, 7 Strictly limiting eligibility, 23-24 Subscription service checking trip eligibility of, 119 documenting compliance, 124 Suspending service circumstances permitting, 104-105 process issues concerning, 111-112 Temporary eligibility regulatory requirements, 14 suggested application questions, 60 Training reviewer training, 40, 52 travel training for customers, 5, 68-69, 116 Travel training combining with eligibility process, 48 data needs in daily operation, 116, 120 effects on eligibility, 5 suggested application questions, 68-69 Trip-by-trip scheduling data needs for, 115-118 practical approaches to, 118-121 technology to assist with, 122-124 Trip eligibility, 4, 16-17 Unconditional eligibility defined, 4 examples of, 17-19 sample determination letter, 87 Undue financial burden waiver, 17, 21-22, 115 Vehicle/system accessibility data needed for trip-by-trip scheduling, 117 effects on eligibility, 7, 8, 16 Visitors data needs in daily operations, 124 documentation that can be requested, 113-114 regulatory definition, 13-14 requirements for serving, 13-14 suggestions for serving, 112-114 Appendix A 49 CFR Part 37 Sections 37.121 through 37.127 and related sections of Appendix D Appendix B ADA Paratransit Eligibility Policy Checklist ADA Paratransit Eligibility Policy Checklist Following is a list of required and recommended elements of an ADA paratransit eligibility policy. Those in bold are required by the regulations and must be included in the policy. Is the definition of ADA paratransit eligibility included in the policy consistent with the regulatory definition of eligibility? Does the definition of eligibility allow for one companion and a personal care attendant in all cases and additional companions on a space available basis? Does the definition of eligibility address the policy for visitors, note that service will be provided to those who have been determined eligible by another public entity as well as those who claim to be eligible? Does the visitor portion of the policy indicate the period of time, from the date of the first trip, over which 21 days of service will be provided? Does the visitor portion of the policy indicate what documentation of residence and disability will be accepted and when this will be required? Is the eligibility process and application material used detailed enough to identify not only who is eligible but under what conditions and circumstances they are eligible? Have arrangements been made to produce information about the process, materials needed to apply, notifications of eligibility, and other materials in accessible formats upon request? Does the policy provide for other assistance, such as a phone number to call or staff to provide individual assistance, that individuals may need to understand the process and complete application forms? Does the policy describe marketing and public information efforts to inform riders, potential riders, and other individuals and organizations about ADA paratransit eligibility? Does the policy describe the process that is used to make initial determinations? Does the policy indicate who will make initial determinations? ADA Paratransit Eligibility Policy Checklist, Page 2 Does the policy indicate that applicants will be notified in writing, and other accessible formats as required, of the initial decision regarding their eligibility? Does the policy note that applicants determined ineligible or conditionally eligible will be given the specific reasons for the finding when they receive their notification of the initial determination and that these reasons will specifically relate to the ADA paratransit eligibility criteria? Does the policy state that individuals will be provided service on a presumption of eligibility if an initial determination is not made within 21 days of the receipt of a completed application? Does the policy indicate the form of documentation that will be provided to individuals determined ADA Paratransit Eligible and include each of the following items in this documentation? the name of the eligible individual the name of the transit provider providing the certification the telephone number of the transit provider's paratransit coordinator an expiration date for eligibility (if applicable) any conditions or limitations on the individual's eligibility the need for a personal care attendant Does the policy note that individuals determined ineligible or conditionally eligible will be notified of the process to appeal the decision? Is the appeal process and the person or persons who will hear and decide appeals described and is there a "separation of function" between those hearing appeals and those involved in initial determinations? Does the appeal process note that appeals will be accepted within 60 days of the initial eligibility decision? Does the appeal process offer the individual an opportunity to be heard in person to present additional information and arguments? Does the policy include details for providing accommodations that the person may need at the appeal hearing and note how the need for accommodations will be determined? Does the policy indicate that appeal decisions will be made in writing, and in accessible formats as appropriate, and will detail any reasons for a continued finding of ineligibility or conditional eligibility? ADA Paratransit Eligibility Policy Checklist, Page 3 Is it noted that applicants will be provided paratransit service on a presumption of eligibility if a decision on their appeal is not made within 30 days of the completion of the appeal process? Does the policy indicate the period of time for which ADA paratransit eligibility will be granted and specify recertification requirements for those found eligible? Does the policy address requirements for existing riders to be recertified? Does the policy indicate under what circumstances service may be refused, suspended, or conditioned? If included, does the no-show suspension policy include the number/frequency of no- shows that will be considered a "pattern or practice" and the period of suspension? If included, does the no-show suspension policy provide for notification of the proposed suspension, an opportunity for an informal hearing, and an opportunity for a formal appeal? Have all aspects of the ADA paratransit eligibility policy been developed with full public participation as required in 37.137 of the regulations? Appendix C Listing of Selected Transit Providers Contacted for Information in the Preparation of this Manual Selected Transit Providers Contacted for Information in the Preparation of this Manual Name of Transit Provider Contact Person Phone # Ann Arbor Transportation Authority Ann Arbor, MI Mr. Christopher White (313) 677-3922 Ben Franklin Transit Richland, WA Mr. Ed Frost (509) 735-4131 City of Charlotte Charlotte, NC Mr. Terry Lathrop (704) 336-2261 Delaware Administration for Specialized Transportation (DAST) Dover, DE Ms. Robin Boshell (302) 739-3278 City of Durango Durango, CO Ms. Jan Choti (303) 385-2880 Greater Bridgeport Transit District Bridgeport, CT Ms. Kimberlee Kelly (203) 366-7070 City of Greeley Greeley, CO Mr. John Lee (303) 350-9280 Lane Transit District Eugene, OR Ms. Micki Kaplan (503) 741-6100 Los Angeles County Metropolitan Transportation Authority Los Angeles, CA Mr. Richard DeRock (213) 244-6524 Madison Metro Transit System Madison, WI Mr. Paul Larrousse (608) 267-8777 Mass Transit Administration (MTA) Baltimore, MD Ms. Lisa Darnall (410) 333-3328 Municipality of Metropolitan Seattle (METRO) Seattle, WA Ms. Nancy Poultney (206) 689-3107 New York City Transit Authority New York, NY Ms. Margaret Coffey (718) 694-3414 OMNITRANS San Bernardino, CA Mr. Daniel Brogan (909) 889-0811 Oshkosh Transit System Oshkosh, WI Mr. Mark Huddleston (414) 236-5280 Port Authority of Allegheny County (PAT) Pittsburgh, PA Ms. Cathy Williams (412) 237-7335 Regional Transportation Authority Chicago, IL Ms. Shirley Fraser (312) 917-1426 Riverside Transit Agency Riverside, CA Ms. Susan Hafner (909) 684-0850 San Mateo County Transit District (SAMTRANS) San Carlos, CA Ms. Dianna Lake (415) 508-6241 Southeastern Pennsylvania Transportation Authority (SEPTA) Philadelphia, PA Mr. Jon Roth (215) 580-7711 Transit Authority of River City (TARC) Louisville, KY Ms. Tina Morris (502) 561-5100 Utah Transit Authority Salt Lake City, UT Ms. Kathy McCune (801) 262-5626 Washington Metropolitan Area Transportation Authority (WMATA) Washington, DC Mr. Avon Makel (202) 962-1100 Waukesha Transit System Waukesha, WI Mr. Robert Johnson (414) 524-3594 Worcester Regional Transit Authority Worcester, MA Ms. Gail Heald (508) 756-7717 Appendix D Sample Marketing and Public Information Materials Materials included: "Paratransit Services on the Move with ADA" developed by Seattle Metro. "Eligibility Appeals Process" developed by Seattle Metro. "Special Services Certification" developed by the Regional Transportation Authority of Chicago. "The Americans with Disabilities Act: What is the ADA and how does it affect me?" prepared by the Riverside Transit Agency. Notice of public forum to discuss ADA issues developed by the Worcester Regional Transit Authority. Appendix E Sample Eligibility Material Developed by: San Mateo County Transit District (SAMTRANS) Materials included: Cover Letter to Applicants Application Form Eligibility Review Guidelines Appendix F Sample Eligibility Material Developed by: Madison Metro Transit System Materials included: Instructions with Detailed Explanation of Eligibility Application Form Appendix G Sample Eligibility Material Developed by: Utah Transit Authority Materials included: "Eligibility Information Sheet" Application Form Appendix H Sample Eligibility Material Developed by: Worcester Regional Transit Authority Materials included: Cover Letter to Applicants Request for Certification Form Professional Verification Form Review Checklists (to check for completeness) "Routing Slip" (to track the process) "Final Determination" Documentation Form Reviewer Guidelines Appendix I Sample Eligibility Material Developed by: Municipality of Metropolitan Seattle (Metro) Materials included: Flyer Sent to Registered Riders Regarding ADA Eligibility Application Form which Includes Professional Verification In-Person Assessment Forms Including Summary Information Page, "Physical Functional Evaluation" Form, "Cognitive Functional Evaluation" Form, and "Combined Functional Evaluation" Form "Eligibility Appeals Process" Brochure Appendix J Sample Eligibility Material Developed by: Washington Metropolitan Area Transportation Authority (WMATA) Materials included: Application Form Professional Verification Form Reviewer Guidelines Appendix K Sample Eligibility Material Developed by: Delaware Administration for Specialized Transportation (DAST) Materials included: Application Form Professional Verification Form Appendix L Sample Eligibility Material Developed by: Regional Transportation Authority (Chicago) Materials included: Application Form "In-Depth Review Report" Used in In-Person Assessments "Certification Categories" which Define General Types of Certification Provided Appendix M Sample Eligibility Material Developed by: Port Authority of Allegheny County (PAT) Materials included: Excerpt from ADA Paratransit Plan Update which Summarizes the Eligibility Process (Note "Functional Tests" on pp. 46 - 53) "Personal Assistance Certification" Form (certifies need for a PCA) Application Form "Functional Evaluation - Physical" Form Used in In- Person Assessment of Individuals with Physical Disabilities Appendix N Information about the Applicant Tracking System used by Seattle Metro
