Eligibility Assessments November 21, 2013 Introduction Chris - - PowerPoint PPT Presentation

Promoting Independence through Public Transit & Eligibility Assessments

November 21, 2013

Introduction

• Chris Hunter
• Assessments Project Director, MTM, Inc.
• Jameson Auten
• Director of ADA Compliance & Customer Relations ,

Kansas City Area Transportation Authority (KCATA)

• Kathy Miller
• Manager of LIFT Eligibility & Community Relations, TriMet

ADA Paratransit Eligibility

• ADA regulations define paratransit eligibility as

individuals with disabilities who have specific impairment-related condition(s) that prevent them from boarding or disembarking public transit

• Public transit systems must provide complementary

paratransit service for such individuals

ADA Paratransit Eligibility

• ADA mandates that the

paratransit eligibility process:

• Does not impose administrative

burden or application fees

• Is not aimed at making a medical
• r diagnostic determination
• Practically determines ability to use fixed route
• Ensures only those who meet criteria are eligible

Goals of ADA Eligibility Process

• Create a person-centered process that considers

functional ability

• Ensure consistent, objective & reliable results
• Include individuals in the process
• Determine independent travel abilities
• Determine which mode(s) of service are appropriate

based on the individual’s most limiting condition(s)

In-Person Assessments

• In-person assessments have higher initial cost, but cost is

quickly exceeded by savings

• In-person assessments recommended because they:
• Thoroughly indicate ability
• Are more accurate than paper-based assessments
• Reduce error, bias, fraud & abuse
• Are based on abilities, not diagnoses
• Are performed by qualified & trained Mobility

Assessment Evaluators

MTM’s Assessment Workflow

*All applicants are interviewed; as appropriate based on the interview’s findings, the applicant may undergo the functional assessment

Functional assessment* Summary report submitted Determination letter sent Application packet submitted Assessment scheduled In-person interview*

Abilities Tested During Assessments

Physical Abilities

 Walk or wheel independently  Move from sitting to standing position  Safely cross street  Traverse uneven terrains, sloping walks, inclines & ramps  Maneuver mobility device  Walk up to ¼ or ½ mile  Ride fixed route bus

Cognitive Abilities

 Pay fare or make change  Recognize landmarks & routes  Recognize & respond to safety hazards  Tell time & the passage of time  Display sound decision making skills  Stay focused  Follow directions

The Assessment Experience

• Assessments should

always be comfortable for the applicant, from initial scheduling to final determination

• Process should be

streamlined to ensure efficiency

MTM Assessment Highlights

Client Individuals Served Annually Assessments Performed Annually Dates of Operation TriMet 15,000 3,200 1/2010–Present Raleigh Capital Area Transit 14,000 900 10/2010–Present District of Columbia Department of Healthcare Finance 40,000 500 10/2007–Present Texas Health & Human Services Commission 878,100 1,200 3/2012–Present Minnesota Metro Counties Consortium 445,245 400 6/2004–Present Washington Metropolitan Area Transit Authority 100 120 2/2012–Present Kansas City Area Transportation Authority 85 100 1/2012–Present

Typical Assessment Results

Unconditionally Eligible Ineligible Conditionally Eligible Temporarily Eligible

38% 15% 40% 7%

Typical Assessment Results

• 20% opt-out rate
• Applicant decides not to

participate in assessment process

• 5% of applicants moved

from paratransit to public transportation

Web-Based Eligibility Model

• Applicants submit applications via mail, fax, or
• nline
• Online application offers flexibility & efficiency
• Approved by riders & Board of Directors
• Application assessed by subject matter experts
• Option for conditional eligibility
• Typical processing time of one to two days

Web-Based Eligibility Model Pros & Cons

Pros of Web- Based Model

• Cost effective
• Customer friendly
• Online access to

expertise

Cons of Web- Based Model

• No local presence
• r “boots on the

ground”

• Restrictive

customization

Web-Based Eligibility Model Results

Unconditionally Eligible Ineligible Conditionally Eligible

70% 24% 6%

KCATA Current Eligibility Model

• Paper-based process
• Applicants submit original paper application with

professional verification

• Inaccurate or incomplete applications returned to

applicants

• KCATA makes eligibility determination
• Eligibility is all or nothing—no conditional eligibility

KCATA Eligibility Model Pros & Cons

Pros of KCATA’s Model

• Quick processing

times

• Easily understood

& accepted

• Comfortable

Cons of KCATA’s Model

• Determinations

less than optimal

• Lack of expertise
• Results in capacity

restraints

KCATA Results

Unconditionally Eligible

100%

KCATA Future Eligibility Model

• Shifting to new model with:
• Some level of functional

assessments

• Revised applications
• Experts to oversee the process
• Shift is intended to:
• Increase operational efficiency
• Identify travel training
• pportunities

KCATA Future Eligibility Model

• Changing the assessment model through community

input & organizational buy-in

• All involved need to be on board
• Includes keeping elected officials in the loop
• Communication with paratransit customers—what is

changing, why its changing & benefits of the change

• Develop a Request for Proposals based on local

preferences for determining eligibility

TriMet Transit Mobility Center

• Located on the transit mall in

downtown Portland

• Central location
• Convenient bus & light rail access
• LIFT-designated stops
• Administrative offices for TriMet
• Assessment center for MTM

TriMet LIFT Eligibility Model

• In-person interview &

evaluation

• Functional assessment of

physical abilities (if needed)

• Functional assessment of

cognitive abilities (if needed)

• Recertification every three

years

LIFT Eligibility: Interview & Evaluation

• New applicants must complete in-person interview
• Conducted by TriMet LIFT Eligibility Coordinator
• Eligibility Coordinator:
• Evaluates mobility device (measurements & weight)
• Determines need for further assessment
• If needed, functional assessment occurs immediately
• Makes the final eligibility determination

LIFT Eligibility: Functional Assessment

• Need for functional assessment determined based on

interview & evaluation

• Physical functional assessment
• Conducted by MTM
• Simulated and/or actual fixed route trip
• Cognitive functional assessment
• Conducted by MTM
• Functional Assessment of Cognitive Transit Skill (FACTS) test

LIFT Eligibility: Past Process

• Before moving to functional assessment process,

TriMet self-certified

• Challenges of this process:
• Accurately evaluating applicants’ functional abilities
• Encouraging applicants to use fixed route & participate in

travel training when appropriate

• Addressing increased ridership & paratransit service costs

Implementing a New Eligibility Model

• Educate applicants & the community on the

appropriate use of paratransit services

• Ensure accurate, consistent determinations
• Demonstrate appropriate processes to manage

paratransit demand & resources

• Ensure continuing availability of resources to provide

quality service to appropriate customers

Implementing a New Eligibility Model

Spring 2008

Internal discussions to develop new process

Fall 2008

New process approved

Winter 2008

Refined process & developed outreach plan with Citizen Advisory Committee

Spring 2009

Conducted public workshop to introduce new process

Fall 2009

Leased & remodeled facility, hired staff, finalized process & contracted with MTM

April 2010

Implemented new process for new applicants

May 2010

Began recertifying approximately 9,000 existing customers

Benefits of TriMet’s New Model

• Improved information exchange during interview
• Assessments make a more accurate determination
• Allows TriMet to promote fixed route accessibility &

its benefits as appropriate

• Provides greater opportunity to educate agencies,

service organizations & medical professionals on appropriate paratransit use

Financial Impacts of TriMet’s New Model

• Fewer new applicants
• Self-certification process: 350 to 400 per month
• In-person process: 260 per month
• 20% to 25% of new applicants submit application but do not

complete the assessment process

• Ridership has declined by an average of 1% per year
• By establishing process in advance of anticipated future

growth, TriMet is prepared for aging population

Closing

• For questions about

MTM’s On the Move assessments program contact Chris Hunter

• chunter@mtm-inc.net
• Questions?