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The Southern Regional Initiative to Improve Access to Benefits for Low Income Families With Children

Chapter 5

Transportation

The barriers that families without personal automobiles confront every day, especially if they live in rural areas or outside of city bus routes, are mind boggling. Because public and human services transportation systems in most states are inadequate, these families are often forced to rely on relatives, friends, or co-workers for rides. If they are able to find transportation at all, the time involved in getting to and from work, to and from health care services, to and from child care centers and to and from agencies that require face-to-face application interviews results in a substantial drain of time and energy.

Transportation consistently shows up as a barrier to accessing health care and other services, especially in rural areas. It also has been identified as a major impediment to gaining and sustaining employment for families on welfare. And it is cited in community and state human services needs assessments on a regular basis. Despite its prominence as a recognized problem, comprehensive solutions have been elusive.

It appears that much of the problem can be resolved with effective leadership and collaboration among public and private agencies currently delivering transportation services. Without such leadership initiatives, however, it is likely to remain a problem that continues to be passed around with no one entity accepting ownership to resolve it.

Transportation Strategies

On the state site visits, it was clear that the various agencies represented at the meetings had been struggling with transportation issues and were very attuned to the linkage between effective transportation and achievement of the goals of their health and human service programs. The general mood at the site visit meetings when the subject of transportation was broached was that the need was great and that solutions had not been found. Few examples of coordinated transportation approaches and innovative strategies were identified during the site visit meetings.

Transportation strategies mentioned by states included small scale private sector initiatives to provide donated cars to families and donated surplus government vehicles to families leaving welfare for work. Some states also mentioned attempts to work out arrangements with churches and schools to use vans and buses, but such attempts for the most part had been unsuccessful.

NORTH CAROLINA reported that under the leadership of Governor James B. Hunt, a Transit 2001 Commission was established to study the public transportation system in North Carolina and to make recommendations on how to improve the system.

GEORGIA reported that a Medicaid transportation broker system had been established in five regions of the state. The system is available to other agencies if a funding source is provided. The Georgia Department of Medical Assistance worked with state transportation officials to ensure that the brokers work with other organizations to see that services are not duplicated.

It was reported that some banks in MISSOURI offer individuals low interest loans to purchase a vehicle. The banks also make efforts to refer individuals to reliable dealers and mechanics. A federal law called the Community Reinvestment Act requires banks to dedicate a certain percentage of deposits to community needs and this is one strategy that was being utilized.

Two transportation initiatives mentioned on the site visits are presented below and contact information is provided.

Kentucky

Initiated by Governor Paul Patton, an Empower Kentucky Transportation Delivery Team with representatives from the Cabinet for Health Services, Cabinet for Families and Children, Workforce Development Cabinet, and the Transportation Cabinet was formed in January 1997. The mission of Empower Kentucky is to formulate new business procedures, policies, and technical provisions necessary for a statewide coordinated human service transportation delivery service network to implement the process.

The transportation delivery process includes the consolidation of the administration and funding for all human service transportation requirements under one agency. The Transportation Cabinet was selected to be the responsible agency to administer the program. The programs involved in the coordinated system include, but are not limited to: non-emergency medical, Aging, Job Training Partnership Act (JTPA), Temporary Assistance to Needy Families (TANF), Vocational Rehabilitation, Department of Blind and the general public.

Transportation will be provided through a system of transportation brokers/providers. There are sixteen human service transportation regions and a broker/provider will be selected for each area through the competitive bid process and will be responsible for coordinating and providing all required trips. Funding for the program will be based on a capitated rate determined for each transportation region. The Transportation Cabinet will contract for service, make all payments to providers, monitor service delivery, provide all required reporting, and establish a complaint tracking and monitoring system for recipients of all programs.

A Medicaid waiver for freedom of choice has been submitted to HCFA so that the most appropriate type of transportation for the trip can be provided.

In April 1998, three demonstration regions should be in operation with the entire state network expected to be operational by the end of 1998.

Contact:

Jerry Ross
Kentucky Transportation Cabinet
125 Holmes Street, 3rd Floor
Frankfort, KY 40622
502/564-7433

Charity Cars

Charity Cars, Inc. is a nonprofit program that provides vehicles to economically disadvantaged individuals to enable them to locate meaningful employment. The program provides participants with a vehicle which has been refurbished and the initial tag cost and down payment for insurance if necessary. Mechanical upkeep and towing services are also provided for a six month period. The individual is asked to pay for the cost of operating the car after six months.

Referrals for the program are accepted from a broad range of public and private service organizations. Government agencies participate in the screening process and in the delivery of support services related to transportation. Individuals and businesses donate the vehicles. Businesses also contribute automobile parts, oil and tires. Mechanics volunteer their repair services. Employment agencies offer intense placement services to help Charity Cars participants find employment.

Charity Cars has developed replication materials. The Charity Cars organizational structure for replication is similar to that of Habitat for Humanity. Affiliates will adhere to a flexible yet structured program with checks and balances to ensure quality control.

Contact:

Brian Menzies
Charity Cars, Inc.
1980 North Cameron Avenue
Sanford, FL 32771
407/324-5050

During follow-up work subsequent to the site visits, a national information and technical assistance resource was identified. The U.S. Department of Health and Human Services Community Transportation Assistance Project (CTAP) provides information and answers to questions about transportation issues, such as accessibility, coordination, funding opportunities, training, management, legislation and regulations. CTAP has an information clearinghouse called the National Transit Resource Center. The transit hotline is (800)527-8279. Information on the electronic bulletin board is available by calling (202)628-2537.

Transportation experts indicate that there are no statutory provisions prohibiting coordination of human services transportation. Coordination has been shown to be cost effective with savings of 10% to 20% being generally achievable and some programs reaching 30% to 35% savings. In a federal/state demonstration project, it has been found that transportation approaches based on volunteer networks did not work well and that group transportation delivery strategies worked better than trying unusual approaches.18

Asset Testing

There is one policy area where it is clear what not to do. Transportation is an area where asset limits have proven to be poor public policy. For many years, federal welfare rules did not allow a family to own a car worth more than $1,500 equity value. There were no exceptions for work or job training activities as was allowed under food stamp resource limits. Such strict resource limits required families to be impoverished in order to obtain and retain welfare assistance. Thus, it is reported that today only 6% of welfare families own cars.19 This represents a major barrier to these families reaching self sufficiency.

With the new flexibility that states now have under TANF, many states have taken action to remove an automobile asset test altogether or have raised the value limit.

Actions Needed to Help Families Overcome Transportation Barriers

Public policy attention to help families overcome transportation barriers is a critical need. Some actions that can lead to improvements are described below.

1) To develop more efficient and responsive transportation solutions for poor and low income citizens, states should create state level or multi-state work groups composed of the various public and private agencies that purchase or provide transportation services. The objectives would be to:

• Identify strategies to effectively and efficiently coordinate transportation services designed to assist low income citizens; and

• To identify strategies to help low income families acquire personal automobiles.

Including advocacy groups and/or family representatives in the deliberations will provide needed input from user groups. The experience of local initiatives should be examined and information on state or federal demonstration projects should be reviewed. Federal technical assistance should be provided to avoid misinterpretation of federal policies and rules and to identify coordination and collaboration opportunities.

2) To avoid penalizing low income families who own an automobile, states should eliminate automobile asset testing for families applying for child health coverage, child care assistance and other benefits.

____________________

18 Robert T. Goble, lecture presented at the Southern Regional Forum on Improving Access to Benefits for Families With Children, Charleston, SC, 12 December 1997.

19 Ibid.