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Policies and financing regarding transportation are more fragmented than other issues important to older adults. Indeed, Medicaid, state departments of transportation, Social Services Block Grants, the Older Americans Act and local governments all provide transportation funding with little or no coordination at the local, state or federal level.
The Brookings Institution’s Center on Urban and Metropolitan Policy offers a helpful 20-page article on the transportation needs of older adults and how federal, state and community policies and funds can be better used to meet those needs. The article covers demographic trends, special transportation needs of older adults, myths surrounding elderly drivers and their driving patterns, and possible policy strategies to address these issues. By analyzing the transportation needs of older adults in their communities, service providers may be able to develop more appropriate solutions. An example of an innovative transportation program is seen in Riverside County, California’s Transportation Reimbursement and Information Program (TRIP). TRIP provides transportation services to older adults who have no other options or who are too frail to access public transportation. The program reimburses volunteers for driving older adults to medical appointments, grocery shopping and other errands in the community.
In addition, the AAA Foundation for Traffic Safety and the Beverly Foundation offer an informative report on several successful local transportation programs for seniors. The case studies that are included may be of particular interest to community partnerships.
U.S. Department of Transportation (DOT)
The DOT’s Federal Transit Administration provides funds to states through the Transportation for Elderly Persons and Persons with Disabilities grant program.
This grant aims to assist private nonprofit groups in meeting the transportation needs of elders and people with disabilities when transportation is unavailable, insufficient or inappropriate.
To learn more about the specific requirements of this grant, see United States Transportation Code 49U.S.C.5310.
Funds available under this program are calculated by a formula (based on the size of a state’s population of these two groups) and appropriated on an annual basis. States may use these funds for capital projects such as buying vehicles or purchasing transportation services by contract, lease or other arrangements.
Projects are funded with 80% federal funds and 20% state match. A coalition of advocates for older adults and other groups in Arkansas, for example, successfully sought enactment of a rental-car sales tax that produces dedicated revenue to meet the state’s match requirement.
State departments of transportation typically solicit applications from qualified nonprofit organizations seeking capital assistance to purchase vehicles or provide transportation services for elders and people with disabilities.
Medicaid coverage for transportation falls into two categories:
- Ambulance services
- Non-emergency medical transportation.
All states cover transportation to the nearest hospital for emergency treatment, but each state has discretion in establishing Medicaid eligibility, services and payment policy.
Most states reimburse Medicaid-funded transportation on a fee-for-service basis. The Web site of the Henry J. Kaiser Family Foundation offers information on each state’s coverage of ambulance services.
Non-emergency Medical Transportation
Most states also cover non-emergency medical transportation to help beneficiaries get to medical appointments at doctors’ offices or hospitals. Some states require that these trips be pre-authorized or set limits on the number of trips allowed each month.
States use a variety of methods to provide and reimburse this service, including:
- paying volunteer drivers a mileage rate;
- providing beneficiaries with tokens for public transportation; and/or
- paying private taxis or other commercial transport companies on a mileage or trip basis.
The Web site of the Henry J. Kaiser Family Foundation offers information on each state’s coverage of non-emergency medical transportation.