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 siggerudk@gao.gov, or Rita 
Grieco at (202) 512-2834 or griecor@gao.gov. 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

[1] 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).

[2] 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.

[3] 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.

[4] CTAA is a national, professional membership association that 
conducts research and provides technical assistance for community 
transportation providers.

[5] Community Transportation Association of America, Building Mobility 
Partnerships: Opportunities for Federal Investment (Washington, D.C.: 
March 2002). 

[6] 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.

[7] 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. 

[8] 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. 

[9] DOT and HHS each have 10 regional offices.

[10] 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.