This is the accessible text file for GAO report number GAO-04-420R entitled 'Transportation-Disadvantaged Populations: Federal Agencies Are Taking Steps to Assist States and Local Agencies in Coordinating Transportation Services' which was released on February 24, 2004. This text file was formatted by the U.S. General Accounting Office (GAO) to be accessible to users with visual impairments, as part of a longer term project to improve GAO products' accessibility. Every attempt has been made to maintain the structural and data integrity of the original printed product. Accessibility features, such as text descriptions of tables, consecutively numbered footnotes placed at the end of the file, and the text of agency comment letters, are provided but may not exactly duplicate the presentation or format of the printed version. The portable document format (PDF) file is an exact electronic replica of the printed version. We welcome your feedback. Please E-mail your comments regarding the contents or accessibility features of this document to Webmaster@gao.gov. This is a work of the U.S. government and is not subject to copyright protection in the United States. It may be reproduced and distributed in its entirety without further permission from GAO. Because this work may contain copyrighted images or other material, permission from the copyright holder may be necessary if you wish to reproduce this material separately. February 24, 2004: The Honorable Thomas E. Petri: Chairman: Subcommittee on Highways, Transit, and Pipelines: Committee on Transportation and Infrastructure: House of Representatives: Subject: Transportation-Disadvantaged Populations: Federal Agencies Are Taking Steps to Assist States and Local Agencies in Coordinating Transportation Services: Dear Mr. Chairman: In June 2003, we reported that over 60 federal programs can fund transportation services for certain "transportation-disadvantaged" populations (such as some elderly persons, persons with disabilities, or low-income persons) that lack the ability to provide their own transportation or have difficulty accessing conventional public transportation, but that several obstacles impede coordination of these programs.[Footnote 1] Most of the programs are administered by four federal departments--Transportation, Health and Human Services, Labor, and Education. Coordinating these disparate federal efforts could result in more efficient use of federal resources and in improved services for these transportation-disadvantaged populations. In fact, some local areas that have overcome existing obstacles and successfully coordinated the services offered by federal programs and others available in their area have realized improved customer service and substantial cost savings. To promote and encourage further coordination of the transportation services provided by these programs, we recommended that (1) the Departments of Labor and Education join the Departments of Transportation and Health and Human Services as members of the Coordinating Council on Access and Mobility (Coordinating Council);[Footnote 2] (2) the members of the Coordinating Council develop and distribute additional guidance to states and other grantees that encourages the coordination of transportation services; (3) the member departments ensure that the Coordinating Council's strategic plan and each member department's strategic and annual performance plans have long-term goals and performance measures related to coordinating the departments' programs and improving transportation for transportation-disadvantaged populations; and (4) the member departments link their Web sites to the Web site of the Coordinating Council and advertise the site in departmental correspondence and other outreach opportunities. In addition to these recommendations, we identified several more general options for improving coordination-- including developing improved leadership and establishing interagency forums at the federal, state, and local levels; harmonizing differing federal program standards and requirements; and providing financial incentives to encourage state or local agencies to coordinate. You asked us to (1) determine whether the four federal departments and the Coordinating Council have taken steps to address our recommendations and (2) identify actions taken by the four federal departments in relation to the options we outlined for improving coordination. To determine what actions have been taken or planned in response to our June 2003 report, we interviewed officials at the Departments of Transportation, Health and Human Services, Labor, and Education responsible for those departments' transportation coordination efforts, as well as officials from the Coordinating Council. We reviewed internal agency documents and publicly available documents describing several of the departments' planned actions regarding coordination. We reviewed departmental strategic plans issued since June 2003 and determined whether linkages had been established between the Web sites of the Coordinating Council and the Web sites of the four departments. We also reviewed the departments' written responses to questions posed at a congressional hearing on coordination held in May 2003,[Footnote 3] as well as their written responses to our recommendations. We compared the departments' actions to the recommendations and options we outlined in our June 2003 report. To obtain perspectives on the extent to which the departments' actions are responsive to the recommendations and options we outlined, we sought the input of officials responsible for implementing some of these actions, and officials from the Community Transportation Association of America and associations representing transportation-disadvantaged populations, including AARP and the National Council for Independent Living. We conducted our work from November 2003 through February 2004 in accordance with generally accepted government auditing standards. Results in Brief: Federal departments and the Coordinating Council have made progress implementing the recommendations in our June report, which should result in improved coordination of federal programs at the state and local level. However, the departments have made limited efforts to include coordination in their strategic and annual performance plans. The Departments of Labor and Education have been invited to join the Coordinating Council, and have been active in interdepartmental working groups under the council. In addition, several efforts are under way to improve and expand the range of guidance and technical assistance offered by three of the four federal departments; however, the Department of Education has yet to begin developing guidance on coordination for its programs. These federal coordination efforts are designed to help state and local agencies coordinate some of the key federal programs, such as Health and Human Services' Medicaid program and Labor's programs under the Workforce Investment Act, with transportation services funded by the Department of Transportation. All of these actions are in the early stages of implementation, and their success will depend on whether the departments can muster a sustained effort focused on measurable performance goals related to coordination efforts. While the Federal Transit Administration--an agency within the Department of Transportation--has included coordination-related performance goals in its strategic plan, other agencies and departments have not yet fully incorporated transportation coordination objectives, goals, or performance measures related to coordination in their strategic and annual performance plans. Officials within the involved departments and agencies, however, have identified transportation and the coordination of these services as an area to consider in the next cycle of planning efforts. Finally, while some of the agencies within the Departments of Health and Human Services, Labor, and Education have linked their Web sites to the Coordinating Council's Web site, or have plans to do so, other agencies within these departments have not yet implemented this recommendation. The Departments of Transportation, Health and Human Services, Labor, and Education have also taken additional actions related to the other options outlined in our report for improving coordination. In December 2003, the four departments launched a five-part coordination initiative--"United We Ride"--that is designed to help states and communities overcome obstacles to coordination. This initiative is designed to provide financial incentives for coordination and establish an interagency forum for communication. While this initiative holds promise for improving coordination at the state and local levels, it is too soon to comment on its ability to do so. Also, while there have been some onetime funding contributions from three of the four departments, a more long-term commitment of resources could make the success of these ongoing actions more likely. The Departments of Transportation, Health and Human Services, Labor, and Education all commented on a draft of this report. All agreed with the findings of the report and provided technical comments that have been incorporated where appropriate. Background: Many federal programs authorize use of funds to provide transportation to transportation-disadvantaged people so they can access government programs. Programs that can fund incidental transportation services include health and medical programs or job-training programs. For example, Medicaid, which is administered by the Centers for Medicare & Medicaid Services within the Department of Health and Human Services (HHS), spent an estimated $976.2 million on transportation in fiscal year 2001. In addition, the Community Transportation Association of America (CTAA)[Footnote 4] identified several programs as routinely providing transportation for clients, including Workforce Investment Act (WIA) programs, administered by the Department of Labor (DOL), and Vocational Rehabilitation Grants, administered by the Department of Education.[Footnote 5] In addition to these services, the Department of Transportation (DOT) funds several programs that focus on the specific transportation needs of transportation-disadvantaged populations. For example, Job Access and Reverse Commute Grants are aimed at connecting low-income individuals to employment and support services, and the Capital Assistance Program for Elderly Persons and Persons with Disabilities provides financial assistance to nonprofit organizations for meeting the transportation needs of elderly persons and persons with disabilities. Recognizing the potential problems created by uncoordinated approaches to providing transportation to transportation-disadvantaged populations, DOT and HHS formed the Coordinating Council on Human Services Transportation in 1986, renamed the Coordinating Council on Access and Mobility in 1998, to have responsibility to coordinate and address issues of transportation access and mobility in the member Departments' respective programs. Besides meeting as a whole body, members of the Coordinating Council also participate in various working groups to address coordination issues for specific populations, such as the elderly or persons with disabilities, or specific types of trips, such as medical trips. Federal Departments and the Coordinating Council Are Making Progress in Implementing Our Recommendations: Numerous actions and plans to implement our recommendations to improve coordination are under way by federal departments involved in providing transportation services for the transportation-disadvantaged and by the Coordinating Council, though some departments have made more progress than others. In addition, the Coordinating Council has recently formed a working group to address the obstacles to coordination we identified in our report. The group, which first met in January 2004, was formed to determine which obstacles can be addressed administratively and which require legislative action and to propose next steps for administratively addressing the obstacles. The Departments of Labor and Education Have Been Invited to Join the Coordinating Council: The Secretaries of Transportation and Health and Human Services sent the Secretaries of Labor and Education letters inviting them to join the Coordinating Council on January 29, 2004. While the Coordinating Council has yet to meet formally with its new members, the expectation of joining has led to increased communication and collaboration among the four major departments involved in providing transportation services for the transportation-disadvantaged. For example, representatives of DOL and Education attended the most recent Coordinating Council meeting in November 2003, and both departments have participated in the council's Obstacles Work Group and Persons with Disabilities Transportation Work Group. Federal Departments Are Taking Steps to Improve Guidance and Technical Assistance for Transportation Coordination: Federal departments have efforts under way to develop and disseminate additional guidance to states and other grantees that are designed to help clarify program rules and encourage coordination of some key programs (see table 1). Many of these efforts are centered in the Coordinating Council's work groups and focus on specific opportunities to coordinate transportation services for particular populations or types of trips. Table 1: Federal Actions in Response to Recommendation to Develop Additional Coordination Guidance: Recommendation: Develop and distribute additional guidance to states and other grantees that encourages the coordination of transportation services; Federal actions: * DOT and HHS: Medicaid transit-pass brochures being updated; * DOT and HHS: Guidance on Medicaid transportation brokerage under development; * DOL and DOT: Guidance on using WIA program funds in coordination with other program funds forthcoming; * DOT and HHS: Providing proactive technical assistance in eight states; * DOL, DOT, and HHS: Existing technical assistance centers are coordinating and streamlining their efforts; * DOL, DOT, and HHS: Developed the "Framework for Action," a human services transportation coordination self-assessment tool for states and communities. Source: GAO. [End of table] Guidance for Coordinating with Medicaid Is Being Updated: The Medical Transportation Work Group of the Coordinating Council, which includes officials from DOT's Federal Transit Administration (FTA) and HHS's Centers for Medicare & Medicaid Services (CMS), plans to issue an updated Medicaid transit-pass brochure[Footnote 6] that provides guidance on how to coordinate Medicaid transportation with local transit services. In addition, the group is working to issue a new brochure on Medicaid transportation brokerages aimed at providing guidance on coordinating the various medical transportation providers within a community.[Footnote 7] These materials, when issued, could help states better utilize existing transit systems and other medical transportation resources in communities to provide transportation for Medicaid beneficiaries. Medicaid transit-pass programs and brokerage systems in some states have resulted in significant cost savings and expanded transportation services for Medicaid beneficiaries, and additional guidance could encourage more states to develop these systems. In addition, an official from the work group said the group is working to clarify Medicaid's cost allocation policy, which was cited as an obstacle to coordinating transportation services provided under Medicaid with other programs. Guidance Is Being Developed to Help Communities Identify Resources and Improve Planning: Additional efforts designed to encourage local coordination are also under way by the Older Adult Transportation Work Group of the Coordinating Council, which includes officials from HHS's Administration on Aging and FTA. One effort involves developing a template, being piloted in 15 communities, for each community to use in identifying existing transportation resources. In our June 2003 report, we found that an important first step for communities to coordinate transportation services is to identify the extent of services being offered in the community. The group is also working with the National Consortium on the Coordination of Human Services Transportation[Footnote 8] to develop guidance for state and local transportation agencies to develop and coordinate state and local transportation plans with human services agencies that are involved in providing transportation for their older adult clients. Including human services agencies in transportation planning has been an important factor in the development of coordinated transportation projects under FTA's Job Access and Reverse Commute program, and further participation of human services agencies in transportation planning could lead to improved coordination of the transportation services provided by those agencies with other transportation resources. This project began in November 2003 and is scheduled for completion by the end of 2004, according to a CTAA official involved with the work group. Another effort, aimed at helping communities identify coordination resources, occurred when DOT and HHS convened four regional meetings of transportation and human services providers and staff from various state-funded programs.[Footnote 9] The purpose of these meetings was to discuss coordination issues and programs, such as the Medicaid transit- pass program and brokerage programs. According to a DOT official, attendees developed state action plans for coordination and discussed best practices in service delivery. DOT and HHS officials indicated that they plan to hold similar meetings in the remaining six regions in 2004 that will also include representatives from DOL and the Department of Education. Guidance on Coordinating DOL Programs Is Forthcoming: DOL, in conjunction with FTA, is developing additional guidance. According to officials from these agencies, the agencies are in the process of developing responses to questions posed by CTAA with regard to how DOL program funds, such as from the WIA programs, can be used for transportation and in conjunction with other programs that serve similar populations and purposes. In our June report, we found that the lack of guidance about how WIA funds could be used to coordinate transportation was a common obstacle for states trying to coordinate the transportation services provided under WIA with other programs. Agency officials told us the responses will also address other obstacles mentioned in our June report, such as liability insurance issues related to carrying participants of other programs, and the proper sharing of funds from multiple programs. The responses are currently awaiting administrative approval for release and dissemination. DOL plans to post the responses on its Web site, as does CTAA. Department of Education Has Not Developed Additional Guidance: While DOT, HHS, and DOL have developed guidance for some of their key programs, the Department of Education has not yet done so. According to Education's response to questions posed at the May hearing on coordination, the department agrees in principle with providing additional guidance and technical assistance with regard to how its programs can be coordinated at the local level. However, Education officials said they had been awaiting the invitation to join the Coordinating Council before pursuing the recommendations in our June report, and they also cited the impending reauthorization of some of the department's key programs as the reason for delaying action. Technical Assistance Programs Are Being Expanded and Coordinated: Federal departments are also improving and expanding technical assistance for coordination in several ways. First, as part of the "United We Ride" initiative, representatives from existing federally sponsored technical assistance programs--including DOT's Rural Transportation Assistance Program, Easter Seals Project ACTION technical assistance center, and Intelligent Transportation Peer-to- Peer Program; HHS's Community Transportation Assistance Project; and DOT's and DOL's Joblinks Technical Assistance Program--have begun meeting regularly with the goal of determining how best to collaboratively address the coordination of human services transportation and technical assistance needs. DOT and HHS have been conducting a pilot project using two technical assistance "ambassadors." These individuals, who are active technical assistance specialists with CTAA and Easter Seals Project ACTION, are testing a new approach in eight states (Alabama, Alaska, Delaware, Idaho, Missouri, New Mexico, Ohio, and Texas). According to agency officials, the ambassadors are to proactively assist these states, and communities within the states, in following through on coordination action plans and other initiatives begun in joint FTA/HHS regional workshops. The job of the ambassadors is to ensure that states are actively identifying the extent of coordination that currently exists in their states, to offer assistance along the way, and to pinpoint potential trouble spots and bring additional resources to bear in addressing them, according to a CTAA official who works with one of the ambassadors. For example, according to the official, the city of Birmingham, Alabama, was experiencing significant difficulties in their coordination efforts, and technical assistance from the Joblinks program was insufficient to overcome the difficulties. The CTAA official said he and the ambassador were able to tap into the other federal technical assistance programs' resources to help the city develop a strategic vision and plan, and to connect city officials with peers elsewhere in the country, with the goal of improving coordination of programs. DOT officials also said that they hope this pilot project will help the agencies within DOT and HHS assess the resources that would be required to provide such intense technical assistance to additional states. Additional Guidance Has Been Developed for Assessing Coordination Efforts: As part of the "United We Ride" initiative, DOL, DOT, and HHS recently developed the Framework for Action, a coordination self-assessment tool. According to DOT, states and communities can use the tool to identify areas of success and highlight the actions still needed to improve the coordination of human service transportation. It includes a facilitator's guide and descriptions of the core elements of a fully coordinated transportation system in a state or community. For example, the Framework for Action core elements for states include (1) evaluating the degree of existing state leadership and partnership; (2) determining whether current transportation resources have been identified, transportation needs have been assessed, and a strategic plan has been developed; (3) assessing the degree of customer focus; (4) identifying cost-sharing arrangements; (5) determining technology needs; and (6) assessing the extent of community-level mobility management arrangements. Federal Departments and the Coordinating Council Have Yet to Fully Incorporate Coordination Activities with Measurable Performance Goals in Their Strategic and Annual Performance Plans: Officials from DOT, HHS, DOL, Education, and the Coordinating Council have indicated that they plan to consider including information on coordinating transportation services for the transportation- disadvantaged in their next strategic and annual performance plans. However, for various reasons, only FTA has demonstrated progress in this area at this time (see table 2). Table 2: Federal Actions in Response to Recommendation to Incorporate Coordination in Strategic Planning Efforts: Recommendation: Ensure that the Coordinating Council's strategic plan and each member department's strategic and annual performance plans have long-term goals and performance measures related to coordinating the departments' programs and improving transportation for transportation-disadvantaged populations; Federal actions: * Coordinating Council and HHS strategic plans are under revision; * FTA has added coordination-related performance measures to its strategic plan; * Officials from DOL and Education say they are waiting for reauthorization of several key pieces of legislation before incorporating transportation coordination into their strategic and performance plans. Source: GAO. [End of table] DOT's most recent departmentwide strategic plan, issued in September 2003, does not specifically address coordination of transportation services for the transportation-disadvantaged. However, a DOT official noted that some of the strategies presented in the plan for increasing access to transportation-disadvantaged populations do support coordination. In particular, one strategy is to "work with stakeholders in all modes to … operate the system at its highest level of efficiency," which supports coordination with other service providers. Furthermore, FTA has added an objective to its own strategic plan creating, as a key deliverable, accountability for each of the 10 federal regions to help states complete assessments using the Framework for Action. The target goals for fiscal year 2004 are for 30 percent of states overall (15 states) to complete the assessment and for at least one state in each region to implement one or more of the core elements of the Framework for Action. HHS's strategic plan for fiscal years 2003-2008 is still in draft form. An HHS official said that the department is developing more detailed goals and measures of collaboration and transportation efforts that cut across departments. Officials from DOL and Education told us that their departments' ability to respond to our recommendations is limited by reauthorization issues. A DOL official said that the department is making an effort to make coordination of transportation services more of a priority in its strategic and performance planning process. However, the most recent departmentwide strategic plan, issued in September 2003, does not address transportation as a component of DOL's programs. In a written response to our recommendation, a DOL official stated that while the department's strategic plan does not specifically address transportation, it includes strategies for developing a competitive workforce through establishing crosscutting strategic initiatives with other government agencies. In a separate written response, an official from DOL's Employment and Training Administration noted that the administration plans to revisit its own strategic and annual performance plans to address coordination after reauthorization of WIA- -a key piece of legislation governing most of that administration's programs that can be used to fund transportation services. An official from Education had a similar response, saying that the department is limited in its ability to respond to this recommendation until several key pieces of legislation are reauthorized. However, DOT has included several provisions that are intended to improve coordination of human service transportation in the department's surface transportation reauthorization proposal. These provisions include (1) requiring local coordination plans for funds allocated through the Capital Assistance Program for Elderly Persons and Persons with Disabilities, New Freedom program, and Job Access and Reverse Commute program; (2) the ability to use other federal dollars for the required state/local match for these programs; (3) an increase in the percentage of funds for these programs that can be used for administrative, planning, and technical assistance purposes; and (4) allowing mobility management to be an eligible expense under the Urbanized Area Formula Program. DOT and HHS officials active in Coordinating Council activities estimate that the council's strategic and action plans will be updated by the end of 2004. The officials said they plan to align the tasks of the action plan with the Coordinating Council's long-term goals and objectives and to include measurable annual performance goals for coordination efforts. Federal Departments Provide Web Links to the Coordinating Council: The four federal departments have made progress in adding Web links to the Coordinating Council's Web site (see table 3). In our June report, we found that some state and local officials involved in providing transportation services were unaware of the Coordinating Council or the coordination information available on its Web site. Accordingly, we recommended that DOT, HHS, DOL, and Education link the Web sites of their agencies involved in providing services for the transportation- disadvantaged to the Coordinating Council's Web site and advertise the site in departmental correspondence and during conferences or other outreach opportunities. As we noted in our June report, the FTA Web site already contained a link to the Coordinating Council's Web site prior to our recommendation. Table 3: Federal Actions in Response to Recommendation to Provide Links to Coordinating Council's Web Site: Recommendation: Link departmental Web sites to the Web site of the Coordinating Council and advertise the site in departmental correspondence and other outreach opportunities; Federal actions: * HHS's Administration on Aging, DOL's Employment and Training Administration, and Education's Office of Special Education and Rehabilitative Services provide links to the Coordinating Council's Web site; * Other agencies within HHS, DOL, and Education have not linked their Web sites to the Coordinating Council. Source: GAO. [End of table] An official from CMS in HHS said that CMS plans to include transportation information and links to FTA and the Coordinating Council on its Web site. This action is awaiting administrative review. HHS's Administration on Aging's Web site contains transportation information and a link to the Coordinating Council's Web site. There is also a link to the Coordinating Council on HHS's Office of Intergovernmental Affairs Staff Information page under the name of a key member of the Coordinating Council. However, other HHS agencies that fund transportation services for the transportation- disadvantaged--Administration for Children and Families, Health Resources and Services Administration, and Substance Abuse and Mental Health Services Administration--do not provide such a link. DOL's Employment and Training Administration has added a link to the Coordinating Council in its Web page. Other DOL agencies involved in transportation, such as the Veterans Employment and Training Service, do not have links to the Coordinating Council. However, the Employment and Training Administration administers the majority of DOL's programs that can fund transportation services for the transportation- disadvantaged. The Office of Special Education and Rehabilitative Services administers the bulk of Education's programs for the transportation-disadvantaged, and that agency has added a link to the Coordinating Council on its Web page. Education's Office of Elementary and Secondary Education and Office of Innovation and Improvement do not provide links to the Coordinating Council on their Web pages. According to Education's written response to questions posed at the May hearing on coordination, the department indicated that its response to this recommendation could be accomplished through its participation as a member of the Coordinating Council. In addition, the department stated that it plans to cross-link Web-based resources with other departments and the Web site of the Coordinating Council after the Individuals with Disabilities Education Act and the Rehabilitation Act are reauthorized. The "United We Ride" Initiative Holds Promise to Improve State and Local Coordination of Transportation Services: A significant response to some of the other options identified in our June report has been "United We Ride," a five-part transportation coordination initiative--developed by DOT, HHS, DOL, and Education-- that was officially launched in December 2003. The options we identified for improving coordination include developing improved leadership and guidance and establishing interagency forums at the federal, state, and local levels and providing financial incentives to encourage state or local agencies to coordinate (see table 4). Table 4: The Five Components of the "United We Ride" Initiative and Their Relation to the Coordination Options in GAO's June 2003 Report: Component: Framework for Action; Description: A tool states and communities can use to assess their coordination efforts and identify areas for improvement; Related coordination options: Provides additional coordination guidance to states and communities. Component: State Leadership Awards; Description: Awards to recognize 3-5 states that have made significant progress in coordination; awards are to be presented at National Leadership Forum; Related coordination options: Recognizes successful state leadership efforts and encourages other states to coordinate. Component: National Leadership Forum on Human Services Transportation Coordination; Description: Transportation and human service teams from each state have been invited to participate in this February 2004 conference to highlight coordination successes, technical assistance programs, and peer advice; Related coordination options: Provides opportunities to demonstrate federal and state leadership in coordination; Provides forum for interagency communication. Component: State Coordination Grants; Description: Grants to address transportation coordination gaps and needs identified through the Framework for Action; states participating in the Forum are eligible to apply; Related coordination options: Provides financial incentives to encourage states to coordinate. Component: Help Along the Way; Description: Technical assistance program; federal departments and national organizations are working to coordinate existing technical assistance services and provide "hands-on" coordination assistance to states and communities (e.g., the technical assistance "ambassadors"); Related coordination options: Provides additional coordination guidance to states and communities. Source: GAO analysis of information from DOT, HHS, DOL, Education, AARP, Community Transportation Association of America, and National Councils for Independent Living. [End of table] The initiative takes steps to improve federal leadership and commitment to coordination by establishing coordination as a priority and providing some dedicated financial support and proactive technical assistance. According to FTA officials, states and local communities will be encouraged to use the Framework for Action to identify gaps in their coordination efforts and specific steps to address those gaps, and FTA is holding itself accountable--through performance measures in its strategic plan--for getting states to implement the Framework for Action. To date, DOT has committed approximately $1 million for the state coordination grants, which provides states with financial resources for addressing the identified gaps. According to DOT officials, other agencies have indicated that they plan to commit funds to these grants as well. The initiative also recognizes the importance of state leadership in successful coordination. Similar to what was outlined in our report, an expert panel[Footnote 10] advised DOT officials that strong leadership at the state level is necessary for coordination to succeed; subsequently the secretaries of all four departments invited the governor of each state and territory to appoint state leadership teams of transportation and human service officials to participate in an interdepartmental coordination forum. All four secretaries are scheduled to make presentations during this National Leadership Forum. According to DOT officials, State Leadership Awards will be presented to selected states that have implemented exemplary models of coordination transportation, and representatives from those states will be asked to share information on their successful coordination efforts. In addition, technical assistance resources are scheduled to be available at the National Leadership Forum to help states and localities implement the Framework for Action, identify peers who can coach them through coordination challenges, and provide other types of coordination advice and assistance, according to officials from FTA. The DOT officials also stated that FTA, the Federal Highway Administration, and DOL's Office of Disability Employment Policy have pledged financial support for the forum. In addition, DOL's Employment and Training Administration is also considering financial contributions in support of United We Ride activities, according to DOL officials. "United We Ride" shows promise for improving coordination because it addresses our recommendation for federal departments to provide additional guidance on transportation coordination and it addresses other options highlighted in our report. However, it is too soon to comment on the effectiveness of this initiative because many of the components are just being implemented. Also, with reauthorization of key federal legislation pending and with growing federal and state deficits, the future sustainability of funding for these activities is uncertain. A long-term commitment of resources could make the success of these ongoing actions more likely. Agency Comments: We provided the Departments of Transportation, Health and Human Services, Labor, and Education with a draft of this report for review and comment. All generally agreed with the findings in the report and provided technical comments, which we have incorporated where appropriate. The Department of Health and Human Services also provided general comments, which are presented in enclosure I. As agreed with your office, unless you announce the contents of this report earlier, we plan no further distribution until 30 days after the issue date. At that time, we will send copies of this report to the appropriate congressional committees and to the Secretaries of the Departments of Transportation, Health and Human Services, Labor, and Education. Copies will also be available at no charge on GAO's Web site at www.gao.gov. If you have any questions concerning this report, please contact me at (202) 512-2834 or firstname.lastname@example.org, or Rita Grieco at (202) 512-2834 or email@example.com. Jessica Lucas-Judy and Andrew Von Ah also made key contributions to this report. Sincerely yours, Signed by: Katherine Siggerud: Director of Physical Infrastructure Issues: Enclosure: Enclosure: Comments from the Department of Health & Human Services: DEPARTMENT OF HEALTH & HUMAN SERVICES Office of Inspector General: Washington, D.C. 20201: FEB 19 2004: Ms. Katherine Siggerud: Director, Physical Infrastructure Issues United States General Accounting Office Washington, D.C. 20548: Dear Ms. Siggerud: Enclosed are the Department's comments on your draft report entitled, "Transportation-Disadvantaged Populations: Federal Agencies Are Taking Steps to Assist States and Local Agencies in Coordinating Transportation Services." The comments represent the tentative position of the Department and are subject to reevaluation when the final version of this report is received. The Department provided several technical comments directly to your staff. The Department appreciates the opportunity to comment on this draft report before its publication. Sincerely, Signed by: Dara Corrigan: Acting Principal Deputy Inspector General: Enclosure: The Office of Inspector General (OIG) is transmitting the Department's response to this draft report in our capacity as the Department's designated focal point and coordinator for General Accounting Office reports. OIG has not conducted an independent assessment of these comments and therefore expresses no opinion on them. Comments of the Department of Health and Human Services on the General Accounting Office's Draft Report, "Transportation-Disadvantaged Populations: Federal Agencies Are Taking Steps to Assist States and Local Agencies in Coordinating Transportation Services" (GAO-04-420R): The Department of Health and Human Services (HHS) appreciates the opportunity to review and comment on the GAO's Draft Report 04-420R, "Transportation-Disadvantaged Populations: Federal Agencies Are Taking Steps to Assist States and Local Agencies in Coordinating Transportation Services.": In general, the report accurately reflects the current activities, efforts and plans of the Coordinating Council on Access and Mobility (the Coordinating Council). Several HHS agencies are working to link their websites with the Coordinating Council's website. The United We Ride Initiative is the focus of much of the transportation energy and interest within HHS, holding significant promise to stimulate State and local coordination efforts. HHS would like to note that the relatively short length of time from the issuance of GAO's previous report on transportation coordination (GAO-03-697 issued in June 2003) to the review for this update made it difficult for the Departments participating in the Coordinating Council to evidence much activity. Much of that time was consumed with achieving the expansion of the Coordinating Council as recommended by GAO in their previous report. [End of section] (542030): FOOTNOTES  U.S. General Accounting Office, Transportation-Disadvantaged Populations: Some Coordination Efforts Among Programs Providing Transportation Services, but Obstacles Persist, GAO-03-697 (Washington, D.C.: June 30, 2003).  The Departments of Transportation and Health and Human Services formally established the Coordinating Council on Human Services Transportation in 1986, renamed the Coordinating Council on Access and Mobility in 1998. The Secretaries of the two departments signed a Memorandum of Understanding to create a forum where coordination of transportation programs sponsored by the two departments could be pursued to achieve the basic objective of improving mobility.  Joint Hearing on Coordinating Human Services Transportation, House Committee on Transportation and Infrastructure and House Committee on Education and the Workforce; Washington, D.C.; May 1, 2003.  CTAA is a national, professional membership association that conducts research and provides technical assistance for community transportation providers.  Community Transportation Association of America, Building Mobility Partnerships: Opportunities for Federal Investment (Washington, D.C.: March 2002).  In the summer of 1999, DOT and HHS issued a brochure on the results of Medicaid bus-pass usage in six states. According to the Medical Transportation Work Group, the new brochure will highlight several communities and models that have implemented a transit-pass program.  CTAA defines brokerage as a method of providing transportation where riders are matched with appropriate transportation providers through a central trip-request and administration facility. The transportation broker may centralize vehicle dispatch, record keeping, vehicle maintenance, and other functions under contractual arrangements with agencies, municipalities, and other organizations. Actual trips are provided by a number of different vendors.  The National Consortium, composed of national professional organizations and interest groups, is designed to provide coordination information, support, and resources to those concerned with community transportation.  DOT and HHS each have 10 regional offices.  In August 2003, FTA convened a panel of transportation and human service experts--representing users, service providers, state governments, urban and rural areas, and other groups--to identify the elements of fully coordinated systems and the lessons that have been learned about how communities make progress toward becoming fully coordinated.