Transportation for Older Adults: Measuring Results Could Help Determine If Coordination Efforts Improve Mobility

GAO-15-158 Published: Dec 10, 2014. Publicly Released: Dec 10, 2014.
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Highlights

What GAO Found

Two key federal programs and several other programs identified by GAO provide funding for transportation services for older adults. The Administration on Aging (AoA) within the Department of Health and Human Services (HHS) provides funding for supportive services—including transportation—to state and local agencies exclusively for older adults. Within the Department of Transportation (DOT), the Federal Transit Administration's (FTA) Enhanced Mobility of Seniors and Individuals with Disabilities program is focused on improving the mobility of older adults as one of its two primary populations. Other federal agency programs, including some within the Department of Veterans Affairs (VA), can fund access to transportation services for eligible older adults, among other beneficiaries. The Interagency Coordinating Council on Access and Mobility (Coordinating Council) is responsible for leading federal efforts to improve the efficiency and effectiveness of human service transportation by coordinating related programs. Federal agencies' involvement in the council and its activities varies, with coordination on older adult transportation primarily occurring between AoA and FTA through working groups, initiatives, and technical assistance efforts. While some federal coordination activities are ongoing, current efforts do not identify desired outcomes, a key feature GAO has identified to consider when implementing interagency collaborative mechanisms. Specifically, the Coordinating Council's latest strategic plan, which covers the period 2011 to 2013, lacks clearly defined outcomes and measures to track progress toward those outcomes. Without defined outcomes and a clear method to collect data to monitor progress, it is difficult to determine whether current efforts of the council are achieving their intended results and providing the benefits of coordination, such as improved access to transportation, for older adults. In a concurrent report ( GAO-15-110 ), GAO is recommending that the council update its plan.

State and local transportation agencies and aging organizations in the four states GAO visited used a variety of mechanisms to coordinate transportation services for older adults. For example, many state and local activities are currently focused on mobility management approaches—such as travel training programs—to help older adults identify and access the various transportation resources available. Some organizations GAO interviewed have also implemented more extensive approaches to coordination that are intended to help older adults access transportation services, such as offering a wide range of volunteer transportation. For example, Ride Connection—a transportation provider operating in Oregon—relies heavily on volunteers and service partners to provide over 400,000 rides a year to older adults and others, through travel training, community shuttles, and other programs. However, funding eligibility and reporting requirements for different programs , geographic boundaries , and limited data on the extent of need were identified as challenges that, at the state and local level, may inhibit coordination in the selected states. For example, officials in all four of the selected states noted that rural areas often have very few transportation options available to serve older adults and other residents, particularly for social and recreational outings. Examples from the selected states also suggest that funding for these types of life-enhancing activities may be limited as states prioritize their funding to ensure life-sustaining trips, such as medical and nutrition services, are provided.

Why GAO Did This Study

As the U.S. population ages, access to safe and reliable transportation alternatives is critical to helping older adults remain in their homes as long as possible. HHS, DOT, VA, and other federal agencies may provide funds to state and local entities to help older adults access transportation. GAO was asked to review access to transportation services for older adults. This report examines (1) the federal programs that provide funding for transportation services for older adults and the extent to which the programs that fund these services are coordinated, and (2) how state and local transportation agencies and aging network organizations in selected states coordinate transportation for older adults and the challenges they face in coordinating or providing these services. GAO reviewed past work on programs for transportation-disadvantaged populations, reviewed federal program information, and conducted interviews with HHS, DOT, and VA, as well as, state and local transportation agencies and aging organizations in selected states. GAO selected four states based on populations of older adults, federal funding received for transportation, and geography, among other factors.

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Recommendations

GAO recommends that DOT define and report on desired outcomes and collect related data to track and measure progress in achieving results, including the extent of coordination efforts under way. DOT partially concurred with the recommendation and plans to consider what information may be needed to measure and evaluate ongoing coordination efforts.

Recommendations for Executive Action

Agency Affected Recommendation Status
Department of Transportation To promote and enhance federal, state, and local coordination activities, the Secretary of Transportation, as the chair of the Coordinating Council, should convene a meeting of the member agencies of the Coordinating Council and define and report on desired outcomes and collect related data to track and measure progress in achieving results, including the extent of coordination efforts that are under way, such as improved services for older adults. This effort could be conducted as a part of the Coordinating Council's process to update its strategic plan, which we have also recommended in a concurrent report.
Closed – Implemented
As the U.S. population ages, access to safe and reliable transportation alternatives is critical to helping older adults remain in their homes as long as possible. HHS, DOT, VA, and other federal agencies may provide funds to state and local entities to help older adults access transportation. In addition, the Interagency Coordinating Council on Access and Mobility (Coordinating Council) is responsible for leading federal efforts to improve the efficiency and effectiveness of human service transportation by coordinating related programs. In 2014, GAO reported that Federal agency involvement in the Coordinating Council varies, with coordination on older adult transportation primarily occurring between HHS and FTA-the two primary agencies involved in human services transportation planning activities. The Coordinating Council's Executive Committee had not met since 2007, but Coordinating Council officials told GAO that the lack of meetings was not a sign of inactivity, as working groups comprised of staff-level program officials from some of the 11 member agencies have developed initiatives intended to further federal coordination efforts. While some federal coordination activities were ongoing, the existing coordination efforts did not identify or incorporate clear short- and long-term desired outcomes, a key issue to consider when implementing interagency collaborative mechanisms to ensure participation from all member agencies. Specifically, the Coordinating Council's prior strategic plan lacked clearly defined outcomes and measures to track progress toward those outcomes. Without defined outcomes and a clear method to collect data to monitor progress, it is difficult to determine whether current efforts of the Coordinating Council are achieving their intended results and providing the benefits of coordination, such as improved transportation coordination for transportation-disadvantaged populations, including older adults. Therefore, GAO recommended that the Secretary of Transportation, as the chair of the Coordinating Council, convene a meeting of the member agencies of the Coordinating Council and define and report on desired outcomes and collect related data to track and measure progress in achieving results, including the extent of coordination efforts that are under way, such as improved services for older adults. In 2020, GAO confirmed that the Coordinating Council met and adopted a new strategic plan covering the fiscal year 2019 through 2022 period. This plan, among other things, established a goal of improving access to the community for members of the transportation disadvantaged population and an objective of reducing federal policy barriers to coordinated transportation. In 2021, GAO confirmed that DOT had also taken steps to identify federal programs that may provide funding for human services transportation for people with disabilities, older adults, and/or individuals of low income. Also, in 2020, the Coordinating Council published a Report to the President that identifies challenges that if addressed, may help eliminate barriers to transportation coordination. As a result of these actions to collect data and information related to human services transportation coordination efforts underway, the Coordinating Council is better positioned to measure the benefits of improved access to transportation.

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