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 or 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 Application Assessment In-person packet scheduled interview* submitted Summary Functional Determination report assessment* letter sent submitted *All applicants are interviewed; as appropriate based on the interview’s findings, the applicant may undergo the functional assessment

Abilities Tested During Assessments Physical Abilities Cognitive Abilities  Walk or wheel independently  Pay fare or make change  Move from sitting to standing  Recognize landmarks & routes position  Recognize & respond to safety  Safely cross street hazards  Traverse uneven terrains,  Tell time & the passage of time sloping walks, inclines & ramps  Display sound decision making  Maneuver mobility device skills  Walk up to ¼ or ½ mile  Stay focused  Ride fixed route bus  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 Individuals Assessments Dates of Client Served Performed Operation Annually Annually TriMet 15,000 3,200 1/2010 – Present Raleigh Capital Area Transit 14,000 900 10/2010 – Present District of Columbia Department of 40,000 500 10/2007 – Present Healthcare Finance Texas Health & Human Services 878,100 1,200 3/2012 – Present Commission Minnesota Metro Counties Consortium 445,245 400 6/2004 – Present Washington Metropolitan Area Transit 100 120 2/2012 – Present Authority Kansas City Area Transportation Authority 85 100 1/2012 – Present

Typical Assessment Results Unconditionally 15% Eligible Ineligible 40% Conditionally Eligible 38% Temporarily 7% Eligible

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 online • 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- Cons of Web- Based Model Based Model • Cost effective • No local presence or “boots on the • Customer friendly ground” • Online access to • Restrictive expertise customization

Web-Based Eligibility Model Results 24% Unconditionally Eligible Ineligible 6% 70% Conditionally Eligible

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 Cons of KCATA’s Model Model • Quick processing • Determinations times less than optimal • Easily understood • Lack of expertise & accepted • Results in capacity • Comfortable 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 opportunities

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: • A ccurately 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 Fall 2008 Winter 2008 Spring 2009 Refined process & Conducted public Internal discussions New process developed outreach workshop to to develop new approved plan with Citizen introduce new process Advisory Committee process Fall 2009 April 2010 May 2010 Leased & remodeled Implemented new Began recertifying facility, hired staff, process for new approximately 9,000 finalized process & applicants existing customers contracted with MTM

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?