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89–855 PDF 2003

S. HRG. 108–177

KEEPING AMERICA’S SENIORS MOVING:

EXAMINING WAYS TO IMPROVE SENIOR

TRANSPORTATION

FORUM

BEFORE THE

SPECIAL COMMITTEE ON AGING 

UNITED STATES SENATE

ONE HUNDRED EIGHTH CONGRESS

FIRST SESSION

WASHINGTON, DC

JULY 21, 2003

Serial No. 108–15

Printed for the use of the Special Committee on Aging

(

SPECIAL COMMITTEE ON AGING 

LARRY CRAIG, Idaho, Chairman 

RICHARD SHELBY, Alabama 

SUSAN COLLINS, Maine 

MIKE ENZI, Wyoming 

GORDON SMITH, Oregon 

JAMES M. TALENT, Missouri 

PETER G. FITZGERALD, Illinois 

ORRIN G. HATCH, Utah 

ELIZABETH DOLE, North Carolina 

TED STEVENS, Alaska 

RICK SANTORUM, Pennsylvania 

JOHN B. BREAUX, Louisiana, Ranking 

Member 

HARRY REID, Nevada 

HERB KOHL, Wisconsin 

JAMES M. JEFFORDS, Vermont 

RUSSELL D. FEINGOLD, Wisconsin 

RON WYDEN, Oregon 

BLANCHE L. LINCOLN, Arkansas 

EVAN BAYH, Indiana 

THOMAS R. CARPER, Delaware 

DEBBIE STABENOW, Michigan 

LUPE WISSEL, Staff Director 

MICHELLE EASTON, Ranking Member Staff Director 

(II) 

C O N T E N T S 

Page 

Opening Statement of Senator Larry E. Craig ..................................................... 1

PANEL OF WITNESSES

Katherine Siggerud, Acting Director, Physical Infrastructure Team, U.S. 

General Accounting Office, Washington, DC ..................................................... 2

Sandra Rosenbloom, Director, Roy B. Drachman Institute for Land and 

Regional Development, University of Arizona, Tucson, AZ .............................. 7

Terri Lynch, Director, Arlington Agency on Aging, Department of Human 

Services, Arlington, VA ........................................................................................ 13

Jon E. Burkhardt, Senior Study Director, WESTAT Research Coporation, 

Rockville, MD ....................................................................................................... 25

Stephan O. Kline, Legislative Director, United Jewish Communities, 

Washington, DC ................................................................................................... 42

Helen Kerschner, President and Chief Executive Officer, The Beverly 

Foundation, Pasadena, CA .................................................................................. 53

Sandra Markwood, President and Chief Executive Officer, National 

Association of Area Agencies on Aging, Washington, DC ................................. 66

(III) 

(1)

FORUM ON KEEPING AMERICA’S SENIORS 

MOVING: EXAMINING WAYS TO IMPROVE 

SENIOR TRANSPORTATION 

MONDAY, JULY 21, 2003 

U.S. SENATE, 

SPECIAL COMMITTEE ON AGING, 

Washington, DC. 

The Forum convened, pursuant to notice, at 2:32 p.m., in room 

SD–628, Dirksen Senate Office Building, Hon. Larry E. Craig 

(chairman of the committee) presiding. 

Present: Senator Craig. 

OPENING STATEMENT OF SENATOR LARRY E. CRAIG, 

CHAIRMAN 

The CHAIRMAN. Ladies and gentlemen, let me begin this afternoon’s forum on senior transportation first and foremost by welcoming all of you. 

I am Senator Larry Craig, Chairman of the Special Committee 

on Aging here in the Senate, and I want to thank all of you for attending and especially thank our panelists for being with us this 

afternoon to discuss not only an important topic across America but 

a tragically timely topic for all of us to deal with and consider. 

Our goal today is to discuss the accessibility, efficiency, and affordability of senior transportation programs and to build a record 

as Congress and others look at possible solutions to many concerns 

out there. 

More specifically, it is my desire that the panel examine four key 

issues: the varying transportation needs of rural, urban and suburban seniors; the potential for better coordination of transportation 

services nationwide; characteristics of best practices in use today as 

well as gaps and problems in senior transportation services; and 

potential opportunities for Federal policies to improve senior transportation and coordination. 

In light of last week’s tragic accident in Santa Monica, it is reflective of an increasing problem in our country, and it is part of 

why we are here today to talk about senior transportation. 

Clearly, that particular incident underscores the importance and 

value of assuring transportation alternatives for seniors once they 

are no longer able to drive safely. This past year, about 600,000 

Americans over age 70 gave up the keys to their cars. For the teenager who has just gained his or her keys, it is the ultimate statement of freedom; for the senior who is giving up their set of keys, 

it is the ultimate statement of a loss of freedom, unless there is a 

2

corresponding transportation system to afford them what the loss 

of that automobile results in. 

Interestingly enough, we now know more than ever before that 

incidents with older Americans in fatal and damaging accidents at 

a certain age are nearly as high as those with young teenage drivers. 

It is a problem that we will deal with, but I hope we will deal 

with it at the State level where licensing occurs. One of my messages to the panelists today is to speak somewhat about this issue. 

But my message to the States is to be responsible in the effective 

screening of your drivers in the licensing process and to recognize 

when impairments result in the inability of that individual to drive 

safely and the very real question as to whether that individual 

should continue to drive. 

Those are all issues that need to be discussed, and certainly the 

situation in Santa Monica simply dramatizes that. 

In my home State of Idaho, there is an example of a transportation system for the aging in Twin Falls that has now been called 

one of the Nation’s five best, because it not only deals with urban 

but it deals with rural environments, and in many of our States’

rural environments and seniors still choosing to live there create 

very awkward and difficult transportation problems. 

There are a lot of issues to talk about here, and we have a most 

capable panel to discuss that with you this afternoon. So let me at 

this time cease my comments and turn to Katherine Siggerud. Ms. 

Siggerud is the Acting Director for physical infrastructure at the 

U.S. General Accounting Office. She is the author of a recent report 

examining transportation disadvantaged populations. Her background and expertise are impressive as are each of our panelists 

today. 

I am going to turn to Ms. Siggerud as our moderator to introduce 

our panel and to start our forum for the day. 

Thank you all very much for attending. We look forward to all 

of your statements and to the record you will help us build on this 

critical issue for our Congress and our States to be involved in. 

Thank you very much. 

STATEMENT OF KATHERINE SIGGERUD, ACTING DIRECTOR, 

PHYSICAL INFRASTRUCTURE TEAM, U.S. GENERAL 

ACCOUNTING OFFICE, WASHINGTON, DC 

Ms. SIGGERUD. Thank you, Senator Craig. 

As the Senator noted, I am Kate Siggerud, and I work for the 

U.S. General Accounting Office. I will be moderating today’s panel 

on senior transportation issues. 

I would like to start by thanking Chairman Craig, Ranking 

Member Breaux, all the members of the Senate Special Committee 

on Aging, and the committee staff for convening this forum and inviting a distinguished panel of experts to work with us. 

Given recent events, as Senator Craig noted, this forum could not 

be more important and timely. As we all know, last week, an 86-

year-old motorist crashed into the Santa Monica farmers’ market 

in California. Over 60 people in the market were injured, 10 of 

them fatally. 

3

The crash has renewed the debate on the Government’s role 

regarding the declining ability to drive as people grow older. For 

example, when compared to drivers of different ages, drivers over 

75 experience fatal crash rates that rival or exceed the rates for 16- 

and 17-year-old drivers. 

Nevertheless, the need for seniors to drive will only increase. 

There are more older drivers on the road today, and that number 

will increase as the baby boomers age. From 1991 through 2001, 

for example, the number of licensed drivers over 70 increased by 

32 percent, from 14.5 million to 19 million, and drivers over 70 are 

now 10 percent of the nation’s licensed drivers. 

The mobility brought about by driving and other means of travel 

is an important determinant of seniors’ quality of life. The ability 

of seniors to visit family and friends, to get medical care, to shop 

and to worship is directly influenced by their access to high-quality 

transportation. 

Surveys show that the majority of seniors prefer to drive rather 

than use other methods such as transit, using senior vans or walking. About 60 percent of people over 75 report that they have a 

driver’s license, and those who do not generally prefer to travel as 

a passenger in a car. 

When seniors stop driving, the number of trips they take away 

from home often plummets along with their quality of life. There 

are several reasons that seniors prefer to travel by car, and these 

factors present challenges that will be difficult to overcome. 

First, more than 70 percent of seniors live in suburban, small 

town, or rural settings that are not well-served by transit. Second, 

driving gives seniors control. They do not have to ask others for assistance, and they also do not have to make advance arrangements 

for their transportation. 

Therefore, today’s forum will focus primarily on seniors who have 

reduced their driving or do not drive at all and improving the 

options available to them for improved mobility. 

We have a distinguished panel of experts here to help us explore 

these issues. They are: Dr. Helen Kerschner, President and CEO 

of The Beverly Foundation; Mr. Jon Burkhardt, Senior Study Director from WESTAT Research Corporation; Ms. Sandra 

Markwood, CEO of the National Association of Area Agencies of 

Aging, known as ‘‘N4A’’; Mr. Stephan Kline, Founder of the Senior 

Transportation Task Force and Legislative Director of United Jewish Communities; Dr. Sandra Rosenbloom, Professor of Planning 

and Director of the Drachman Institute at the University of Arizona; and finally, Ms. Terri Lynch, Director of the Arlington County, Virginia Commission on Aging. 

Let me just explain this afternoon’s schedule. We will start with 

a brief discussion of issues related to safe driving by older drivers. 

Following that, we will move to each of our panelists’ opening 

statements. We will then move to a discussion around four themes. 

Senator Craig outlined these, and I will simply remind you of them 

at this time. 

The first is senior transportation needs in urban, suburban, and 

rural settings and the programs available to address them. The 

second is coordination of transportation services for seniors and the 

potential of coordination to improve efficiency, affordability and 

4

availability of services. Third is the characteristics of senior transportation programs that are successful and methods of communicating and adapting these programs in other places. Fourth and 

finally is the reauthorization of the Transportation Equity Act for 

the 21st Century, also known as ‘‘TEA–21,’’ and other opportunities 

for Federal, State, and local policies to impact and improve senior 

transportation. 

We will spend about 20 minutes on each of these themes and 

wrap up between 4:30 and 5 o’clock today. 

Finally, it is important to note that the committee plans to 

produce a record of today’s forum. It will include the opening statements of all the panelists, the discussion that follows, and other 

submitted statements. The committee will use this record to identify critical issues and innovations in senior transportation in order 

to guide its further work. The committee will also make the information available to other committees in the Senate and the House 

where it will be useful in considering transportation reauthorization and other legislation. 

Why don’t we move now to the issue that I think has brought 

many of you here today, and that is the safety issue. I would like 

each of our panelists to comment on two questions. The first is 

what steps could the Federal and State Governments take to help 

seniors retain their driving skills and also to assure an adequate 

response in cases where driving ability does decline. Second is how 

can family members, friends, and communities help a senior driver 

make decisions about whether to continue driving. 

Dr. Rosenbloom, I think some of your work has touched on these 

issues. Would you care to start us off, please? 

Dr. ROSENBLOOM. Yes. I would like to make a comment I think 

a lot of communities and States now are looking very quickly at 

mandatory relicensing and retesting of older drivers. 

The evidence from here and abroad however is that most testing 

does not work if the criterion is a lower crash rate among elderly 

drivers. I think there are a couple of reasons and some lessons to 

be learned from this research. 

The major reason is that we do not really know how to test people for the skills that they need to continue driving. Testing does 

indeed stop people from driving. We know that when we give these 

tests, some people stop driving. How is it possible that they stop 

driving and we do not have lower crash rates? We are stopping the 

wrong people from driving. We are stopping people who are not 

particularly dangerous to begin with, including a lot of women. 

There is substantial evidence that women stop prematurely when 

faced with these tests. Morever people who need the tests may fail 

them and keep driving; that is going to be an increasing concern 

with a population with increasing dementia. 

Finally, we cannot test people cost-effectively. The Government is 

working on that, and there are some tests going on in this area 

that I think are very promising, but most of the tests that people 

will rush to implement now will not help; there will just be a lot 

of money down the drain. 

I believe the Federal Government should take an active role with 

the States in finding better more cost-effective ways to test all drivers, not just older drivers. I do not believe in age-based testing; I 

5

believe in behavior-based testing. If people have markers—that is, 

they have crashes, they have a lot of tickets, their doctor says they 

need help, family members tell the motor vehicle division that they 

need help—then these are reasons to draw in people at any age to 

be retested. They ought to be retested with appropriate devices. We 

are still working on those. 

Ms. SIGGERUD. Ms. Lynch you told me that you had some information on some local initiatives. Would you care to share those, 

please? 

Ms. LYNCH. Yes. I am from Arlington, VA, right across the river 

here, and we are participating with the Association of Motor Vehicle Administrators, who are running a program in this metropolitan area to go out and do two things—educate older drivers about 

things that we already know they can do to be safer behind the 

wheel, and we are also at the same time talking about transportation options that do exist, because the idea is to entice people 

from behind their wheel. So it is both thing—how do you stay safer, 

and then what is available when you need to leave. I will add a 

caveat from the very local level—testing alone is not enough, because if you send somebody to the DMV and they get tested—and 

in Virginia, you can just ask that the DMV test somebody, and 

they will call you in and offer a specific test; that is already available—but you really have to do more than take away the license. 

If the problem really is driving, people may not remember they do 

not have a license. You have to take away the key, and sometimes 

you have to take away the battery. 

Ms. SIGGERUD. Mr. Burkhardt. 

Mr. BURKHARDT. I think we are all saddened by this really terrible tragedy in Santa Monica, but I think the point is not to get 

too focused on one particular incident. While one gentleman had a 

tragic, tragic accident, nearly 25 million older Americans are driving safely and were driving safely on that very day. 

People need to understand that mobility is an extremely important issue for everyone, and it is a particularly important issue for 

people who are older. People who are older need to go and get groceries, to visit friends, need to do personal business, and need to 

be involved in religious communities. The way our world is set up 

in this country, these activities all require movement from one location to another location. 

The key question is what kinds of travel choices are there? There 

really are very few choices, and in fact, departments of motor vehicles have problems taking licenses away from individuals who are 

habitual drunk drivers, or for older drivers who cannot drive very 

well because they cannot see very well, or from teenagers who have 

very high rates of crashes. If we had better choices in the way of 

public transportation, private transportation, taxi services, volunteer services through area agencies on aging and others, we would 

have better mobility choices in this country, and we would not have 

to traumatize people by hiding their keys, slashing their tires, or 

selling their cars which can lead to a lot of intergenerational strife. 

So we need to focus on what we can do to get people moving 

around and doing that safely. 

Ms. SIGGERUD. Mr. Kline. 

6

Mr. KLINE. I think that was really well-said. Seniors do not have 

a lot of choices in most communities as far as finding suitable alternatives, and that is obviously going to be the theme of this 

forum. 

We have talked to a lot of seniors about why they are not looking 

to the programs in their areas and what they can do and how they 

are going to need to change their behavior. It turns out that when 

seniors are still driving, they try to get rid of some of the easy stuff 

first, in order to maintain their driving—to not turn left, for instance, because they have to cut across traffic; or to avoid bad 

weather, or to stop driving at night. Obviously, figuring out what 

is the next part of driving that you can live without is not a great 

way of figuring out a good transportation system. 

One, we need to come up with alternatives—and we will talk 

about that in a few minutes—and two, I think we really need to 

strengthen supports for family caregivers, because even if there are 

good public and private programs, we are still going to really depend on family and friends to help shuttle people around, and that 

is something we can talk about. 

Ms. SIGGERUD. Thank you. 

Dr. Kerschner. 

Dr. KERSCHNER. Not so long ago, I heard a physician say that 

she has patients who would rather she tell them that they have 

Alzheimer’s than that they have to stop driving. It is a critical 

issue for older people and a terrible problem. 

I think we exacerbate the problem to some extent in the way we 

describe it and the way we describe the solutions. We talk about 

driving assessment, and we talk about taking away the keys. It 

seems to me that driver training or retraining or checkups and 

tuneups is a much better way to discuss this subject and to make 

those programs available to seniors so they can improve their driving skills, understand if they should limit their driving, understand 

if in fact it is time to stop driving. I think that is very important 

for us to consider. 

I also think that family members are probably the last people 

who want to take away the keys from an older adult, and they are 

the last people older adults want to have take their keys away. We 

see that in qualitative and quantitative research that we have all 

done. 

So I think we really have to depend on the professional community to help out in this, but I do think that driver training and retraining and checkups and tuneups can go a long way toward helping solve the problem. I can tell you, being from Los Angeles, from 

Pasadena, in California, that what happened recently is a wakeup 

call. It is a tragedy in California, and it is a wakeup call for all 

of us to say that we need to take this very seriously, and we need 

to give it a lot of thought. 

Ms. MARKWOOD. I think the issue of driver training and retraining is an important one that Helen just pointed out. When you define this as older drivers have a problem already, people are not 

going to search out the means to do a self-assessment. I think we 

need to look at this as a national issue and have it be part of our 

daily lives that everybody needs to have an assessment or reassessment or retooling to make sure that their driving skills are what 

7

they should be and, in saying that, having it tailored to taking the 

keys away is a very negative marketing approach to get people to 

do an assessment. 

Additionally on the issue of caregivers sine our agencies work 

very closely with them, again, I echo Helen’s sentiment. The caregivers are burdened right now with so many issues trying to take 

care of older adults that putting them in the position of saying, 

‘‘You can no longer drive; we need to take your keys away,’’ is a 

difficult one. 

However, they do need information. They need those hints. They 

need to be looking out for those different types of activities that 

may happen when an older person is driving that leads them to 

think that they may need to talk to the doctor or somebody in the 

professional community to lead them to an assessment or to lead 

them to some type of retraining activities. 

Additionally, in the professional community, oftentimes the medical community does not see this necessarily as their function, but 

it is a critical one. I think part of that is that the medical community needs to know the supports that are out there in the community, the options that are out there if someone’s keys are in fact 

taken away from them, if they are no longer able to drive, that 

there are transportation options—or we need to develop those adequate transportation options so that the mobility will not be impaired. 

Ms. SIGGERUD. Thank you. 

I think at this point, then, we will move to the original opening 

statements that everyone here has prepared. I will ask each panelist to keep his or her comments to 5 minutes or less, please. 

We will start with you, Dr. Rosenbloom. 

STATEMENT OF SANDRA ROSENBLOOM, DIRECTOR, ROY P. 

DRACHMAN INSTITUTE FOR LAND AND REGIONAL DEVELOPMENT, UNIVERSITY OF ARIZONA, TUCSON, AZ 

Dr. ROSENBLOOM. Thank you. 

I am Sandi Rosenbloom, and I am Director of The Drachman Institute, which is a research and public service unit of the University of Arizona. 

I am very concerned that we tend to misconceive the transportation problems of older people because we do not understand how 

complex their lives are and how central to their independence and 

freedom the car is. Because of that, I think we do not understand 

how much older people contribute to some of the societal problems 

we are trying to address from traffic congestion to urban sprawl to 

environmental pollution. I think we have to understand how older 

people live their lives to provide them safer and better transportation options and to make sure they can live a healthy and full 

life while also addressing those societal problems. 

To just briefly reprise the statistics that Katherine gave you, 

most older people today are drivers; almost all of them will be drivers in the future, because people over 40 today are almost all drivers. In fact, it is almost all men who drive; today older women are 

less likely to drive, but that gap is going away. Today, older Americans comprise about 14 percent of the driver pool. That is going to 

almost double. In under 30 years, they are going to comprise 25 

8

percent of all drivers. The Highway Safety Institute says they are 

going to be involved in 25 percent of all fatal crashes. 

One reason why older people are so dependent on their cars is 

that they are living in low-density areas. Between one-fifth and 

one-fourth live in rural areas; of the three-quarters who live in 

metropolitan ares, three-quarters of those live in the suburbs. Most 

older people do not move, on retirement since we now have suburbs 

where 30 or 40 percent of residents over 40, within a few decades 

we are going to have suburbs that are 40 and 50 percent people 

over 65. While most older people age in place—they do not move— those who do migrate to Arizona and Florida and so forth are moving to naturally occurring retirement communities in rural areas, 

and they are moving to the edges of metro areas like Atlanta and 

Phoenix and Houston and cities in Florida. 

So all of the problems of low-density development and no alternatives to the car will only worsen for the baby boomers as they 

come into their senior years. Not surprisingly, transit use has been 

falling among the elderly and 1995 was the first time that transit 

use among the elderly was less than among younger people, and 

it was very low, but between 1995 and 2001, it fell by half again 

in 2001 only 1.2 percent of all trips made by older people were 

made using public transit. Although there is a tremendous amount 

of discussion, and we are here today to discuss alternative modes, 

they have fallen so far—that is, special transit systems, special 

services, special services by aging—that you cannot break them out 

in national statistics in 2001. 

Where does this leave us? I think we have to make improvements in five areas, and I think everyone has touched on some of 

these. First, we have to improve and enhance all aspects of the 

highway system. We have to make cars smarter and safer and less 

environmentally polluting. We have to make the highway system 

safer. We have to have better signs. We have to have better tests. 

We have to have better ways to keep older drivers driving when 

they can do so safely. 

The Federal Highway Administration in fact has a series of voluntary standards for communities to use in making their highways 

more older-driver-friendly, but the standards are voluntary, and 

there is substantial evidence nobody is adopting them. 

The second thing we have to do is improve and enhance the pedestrian system and infrastructure. That seems like an obvious 

issue and easy to do. In fact it is not easy to do, and I want to point 

out to you that statistics suggest that an older person is 14 to 16 

times more likely to be killed or injured in a pedestrian crash than 

in a car crash. In other words, it is safer for them to be in a car 

than walking along the streets. 

Pedestrian death rates, among the elderly as you probably know, 

have been dropping rapidly around the world. The No. 1 reason is 

that older people are walking less and driving more. If we want to 

reverse that, if we want older people to have pedestrianism as a 

feasible mode as well as a health option, we have to figure out 

ways to make walking safer. 

Third, we have to expand and improve conventional public transit. We have to talk about funding services to move into suburban 

and rural areas. We have to talk about running at non-peak times 

9

when older people are more likely to want to travel. We have to 

talk about making the systems more safe and more secure—that is, 

no accidents and no crime—and that involves the pedestrian component of the trip to a transit station as well. We have to look at 

new kinds of transit services like service routes and community 

buses, which I think some of my colleagues are going to talk about. 

My fourth suggestion is that we have to encourage an active role 

for the private sector in transport delivery. We have to regularize 

informal services. In almost every community of color, for example, 

there are many informal, perhaps illegal, drivers providing a substantial amount of service to seniors. We have to find ways to make 

them safer and more secure but not put them out of business. We 

have to find a way to grow and support volunteer networks, and 

we have to use taxi and other transportation operators more effectively than we do now. 

Finally, we have to enhance the design of communities and make 

sure that the kinds of things that are being suggested for community revitalization, infill and so forth, do not create more hazardous 

communities for older people as they move them closer to services. 

I have prepared supporting material for the things that I have 

just talked about for a Brookings Institution Center policy reform 

debate, and some of them are still left on the table. 

I thank you for your time. 

[The prepared statement of Ms. Rosenbloom follows:]

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Ms. SIGGERUD. Ms. Lynch. 

STATEMENT OF TERRI LYNCH, DIRECTOR, ARLINGTON 

AGENCY ON AGING, DEPARTMENT OF HUMAN SERVICES, 

ARLINGTON, VA 

Ms. LYNCH. Thank you. 

My name is Terri Lynch, and I am the Director of Arlington’s 

Area Agency on Aging. It is unit within the Nation’s most comprehensive Department of Human Services. I want to thank you for 

the opportunity to share some of our efforts in creating a coordinated framework for services. It is coordinated, it is a framework, 

it is a skeleton; it is very thin. 

First, a little bit about Arlington. We are the 12th most dense 

population in the Nation, and for more than a generation, the county’s land use plans have been voted toward maximizing development in a way that makes effective use of mass transit. 

However, even in the most urban area that we are, if an older 

person cannot get anywhere near the mass transit, they can be as 

isolated and as remote as anybody in the most remote rural area. 

For those of you who know apartment buildings, you can live with 

12 families on the same floor, and you do not know any of them—

so you can be remote even when surrounded by people. 

We have had some publicly funded transportation for a generation—Older Americans Act funding to congregate nutrition programs, to the adult daycare programs, some for grocery shopping 

and medical appointments—and we have come to rely on the taxicab fleet in Arlington because we are so dense. It is in fact the 

most cost-effective way of providing that service. But we have also 

known that every day, there are people who are eligible for the 

services we provided who are doing without it. 

We have four senior highrises that have 960 residents, and we 

have tried to create coordinated systems for grocery shopping and 

medical appointments. It does not deal with any of the other places 

that people would want to go, but it gets them out for that. 

Our big growth in transportation occurred as a result of the 

ADA. When the Americans with Disabilities Act passed, Metro in 

this metropolitan area had to create a complementary paratransit 

system for people who could not use bus and rail. Arlington then 

created its own system called STAR, Specialized Transit for Arlington Residents, for people who would otherwise be using Metro Access. Because we coordinate and manage it, it is cheaper, and it is, 

once again, more cost-effective and the service is better. It is available for people with a transportation disability, meaning they cannot get to the Metro and use it. 

This is entirely local-government-funded, because as you know, 

ADA does not come with a funding stream, but it becomes available 

for people to use. It then gave us the opportunity to do some incremental add-ons—assisted transportation for STAR so that people 

who are already STAR users, which is a curb-to-curb service. If you 

want to get from your apartment or your house front door to the 

curb and then on the other side to where you are going, we added 

the assistance component. Because of limited funds, it is available 

only for health care appointments. In the interim, it takes a long 

14

time for Metro Access to process the applications, so we have set 

up an interim program again for health care appointments. 

We used to have money for a temporary program under STAR 

because if you have some kind of health care problem—chemotherapy, broken hip, recuperation of some sort—you are not going 

to have a long-term disability, but you need that transportation for 

short-term. We hope to somewhere find the money to start that 

program again. 

We have a subsidized taxicab voucher program, allowing people 

to, for a limited amount, buy coupons at half-price, and we have 

transportation to our senior centers. 

The STAR office coordinates a number of these transportation 

programs so everything is coordinated. Our challenges are threefold. No. 1, the simple thing, is making sure that people in fact 

know what is available—because everyone on this panel knows 

that you can have a program, and if people do not know about it, 

it does not do any good. You have new people who need it every 

day, so it is constant education. 

The second thing is helping more older residents understand that 

when Metro Access talks about having a ‘‘transportation disability,’’ it may well apply to them. People are so ready to say that to have 

a disability means that you use a wheelchair, and if you do not use 

a wheelchair, you do not have a disability. So that is another piece. 

Of course, the third and most critical one is funding to maintain 

these things. If I were to tell you, for example, that for our wonderful assisted transportation program, $7,000, it is a long waiting 

list. So it is a fine program, but it is very thin. 

The way we have been able to achieve all of this is through—as 

I said, Arlington is small, and we are an integrated department— effective collaboration with our public works, with Metro, with our 

community activists, with the nonprofit agencies in the area, with 

the taxicab company. It is the collaboration that has gotten us to 

our skeletal framework, and I do want to say it really is a skeleton. 

Thank you. 

Ms. SIGGERUD. Thank you. 

[The prepared statement of Ms. Lynch follows:]

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Ms. SIGGERUD. Mr. Burkhardt. 

STATEMENT OF JON E. BURKHARDT, SENIOR STUDY DIRECTOR, WESTAT RESEARCH CORPORATION, ROCKVILLE, MD 

Mr. BURKHARDT. My name is Jon Burkhardt, and I am Senior 

Study Director at WESTAT in Rockville, MD. WESTAT is an employee-owned research corporation. 

You have heard the statistics about older drivers and older individuals. I would just like to point out one of them. In 30 years, the 

number of people 65 and older in this country will double, and the 

proportion of people who are 65 and older is going to go from 12 

percent to 20 percent. There will be lots more of us. I want better 

transportation when I get there. 

Elders get many benefits from transportation. People do not stop 

traveling when they stop working. Elders still need access to economic opportunities. They need not to depend on or inconvenience 

other people. Elders talk about freedom and independence again 

and again, and again and again, when we do focus groups. They 

say: ‘‘Freedom and independence. That is why I need to get 

around.’’ Easier access to needed services, means more social interaction, 

which means less social isolation and loneliness, saving money and 

avoiding unnecessary institutionalization. These are the kinds of 

benefits that mobility provides. 

I think it is wonderful that the Senate Special Committee on 

Aging is convening this hearing, because I think this committee 

can take a great deal of leadership, and leadership is one of the key 

factors that we need. The second key factor that we need is innovation, and the third point is that we need leadership and innovation 

now, because if we do not start now, we will never meet the needs 

in 20 or 30 years, when they will be really, really severe. 

I have six points in my prepared testimony. One is that we need 

this comprehensive senior mobility program. 

The second is that there are public transportation improvements 

that could make public transportation significantly more attractive 

to seniors. 

There are high-payoff mobility improvement strategies around 

the United States, and these can serve as examples of what we can 

do. 

Coordination is certainly one of the things that we need to focus 

on. It offers significant economic and administrative benefits. 

Fifth, there are special needs for seniors who live in rural areas, 

and we need to focus on those needy. 

Finally, congressional leadership is going to be needed, and we 

need that desperately. 

When we talk about a comprehensive mobility program, we really mean the entire broad range, starting with driver safety efforts, 

including improved public transportation services, better taxi services and paratransit services, some of which will certainly be privately owned and operated, better pedestrian services. We will 

need many more volunteer services because volunteers are going to 

be a crucial component of mobility in the future. We will need 

hand-to-hand escort services, emergency transportation, and better 

information for the public, like the Grand Driver information camVerDate 0ct 09 2002 15:44 Nov 05, 2003 Jkt 000000 PO 00000 Frm 00029 Fmt 6633 Sfmt 6633 C:\DOCS\89855.TXT SAGING1 PsN: JOYCE
26

paign which was recently initiated. We will need better land use 

planning and research on how mobility and policy issues are intertwined. 

So we need better alternatives. What can Congress do? Congress 

can focus people’s attention on senior mobility. We all need to let 

people know that this is an issue that is important now, and it is 

going to grow in importance with every, single day. 

We need to support innovation, and we need to find out which 

innovations work in which communities and which can be transferred to others. 

We need enhanced funding of existing programs like FTA’s 

Section 5310 and 5311 programs for elderly persons, persons with 

disabilities, and persons living in rural areas. 

We need to simplify Federal grant reporting and grant administration procedures. 

We need to change Medicare legislation so that Medicare can pay 

for non-emergency transportation when people need it to get to 

health and other needed services. 

Congress should assist us in our coordinated transportation efforts by requiring that all agencies—not just the Federal Transit 

Administration and the Administration on Aging—coordinate all 

the transportation services that they provide. 

We need legislation for uniform cross-program reporting, and we 

need to insist on a community-wide focus for transportation—not 

just one travel mode, not just one client group, but a broad perspective including drivers, transit riders, pedestrians, and people who 

rely on volunteer services. 

Thank you. 

Ms. SIGGERUD. Thank you. 

[The prepared statement of Mr. Burkhardt follows:]

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Ms. SIGGERUD. Mr. Kline. 

STATEMENT OF STEPHAN O. KLINE, LEGISLATIVE DIRECTOR, 

UNITED JEWISH COMMUNITIES, WASHINGTON, DC 

Mr. KLINE. Good afternoon. I am Stephan Kline, Legislative 

Director for United Jewish Communities. 

Let me begin by telling you about Artis Joyce, a Chicago resident 

and, for the past 21⁄2 years, a patron of the Jewish Council for the 

Elderly Shalom Taxi Service. Ms. Joyce has arthritis and a herniated disc, making it very difficult for her to get around by herself, 

so she relies on Shalom Taxi for 12 or more times per month. 

She said: ‘‘Without the Shalom bus, I could get some rides to the 

doctor from the State, but I could not get to the grocery store with 

the best prices and the best quality.’’ Obviously, even seniors can 

be serious bargain shoppers. 

Ms. Joyce believes she would be lost without this program and 

really would not be able to get out and about. It is to help people 

like Artis Joyce that UJC entered the important debate over senior 

transportation. 

United Jewish Communities is a faith-based charity that represents 156 local Jewish federations and 400 independent communities across the country. As one of the country’s largest social 

service networks, our Federation has helped to plan, coordinate 

and fund programs for people in need like Artis Joyce. 

As Abraham Joshua Heschel, a well-known Jewish scholar and 

social activist stated: ‘‘The test of a people is how they behave toward the old.’’ You may know that the Jewish community has a 

much higher percentage of elderly persons than the general population. We are about 20 percent over the age of 65 compared to 

about 12 percent, and the 85-plus population in our community is 

actually the fastest-growing part. So we are dealing with the issues 

that this country is going to face in 2010 and 2030 with the baby 

boomers now. 

To this end, UJC is committed to increasing the quality of life 

for our parents and grandparents, and care for the elderly is at the 

very top of our domestic policy agenda. 

People over the age of 65 face the slow process of physical deterioration. Although many continue to drive, others must come to 

the difficult realization that it is not safe for them to be on the 

roads due to failing eyesight or slow reflexes. 

Russell Weller should not have been driving that car in Santa 

Monica last week, but imagine spending your entire life with the 

freedom to come and go as you wish and then having that freedom 

taken away from you. Faced with this life change, most seniors 

must rely on family and friends to get where they need to go. Many 

instead choose to stay inside in order to avoid becoming a burden 

on their loved ones. 

Senior transportation is a positive, dignified, and respectful way 

to give back to our seniors and to avoid creating a population of 

shut-ins isolated from society. That is why Artis Joyce refers to 

Shalom Taxi as her godsend. 

Many of our local agencies have shared with us stories demonstrating a common barrier regarding senior services. Excellent 

programs that care for the elderly may be in place and are amply 

43

funded by our community, but seniors do not have the capacity to 

attend the programs or receive services due to lack of transportation. 

Obviously, without access or transport, the impact of individual 

programs is severely diminished. With financial support provided 

by the Mount Sinai Health Care Foundation in Cleveland, OH, 

UJC responded by initiating a senior transportation project. This 

project has evolved into a national task force that focuses solely on 

this critical issue. 

While innovative methods to care and support well and frail elderly men and women are emerging, no coordinated senior transportation policy has existed at the national level. UJC recognized 

that the reauthorization of the Transportation Equity Act for the 

21st century presented a unique opportunity to influence the development of senior policies on transportation. While an opportunity 

has presented itself, there was no national voice that was dedicated 

to raising the profile of the senior transportation issue. 

UJC formed a senior transportation work group to fill this void, 

and over the last 12 months, we have brought together over 40 

groups from the aging, disability, environmental, faith-based, labor, 

and other communities of interest to jointly promote and advocate 

for senior transportation. Working together, we have compiled a 

dozen recommendations that will transform the national infrastructure of senior transportation through increased funding and innovative policies. I have included the full proposals in my submitted 

remarks, but the main recommendations are summarized in the 

following three points. 

First, Congress should significantly increase funding for the 5310 

Program. Funding for this program is currently set at $91 million 

and is set to go down to $87 million in fiscal year 2004. We 

recommend an expansion to $350 million, which would partially 

offset the estimated $1 billion per year in unmet transportation 

needs that exist for seniors in this country. 

Second, Congress should allow States to have more flexibility in 

their use of Section 5310 funds, allowing those funds to be utilized 

for operating expenses as well as capital expenditures, and should 

permit matching funds to be derived from any source including 

other Federal programs. These changes would make the 5310 program consistent with other Federal transportation programs. 

Third, Congress should set aside specific demonstration project 

funding within the Federal Transit Administration to help establish best practices at the local level and planning mechanisms for 

innovative and collaborative transportation projects for senior citizens. Congress should also establish a national technical assistance 

center to share models and best practices related to senior transportation, as it did in the disability community with Project Action, 

which is run by Easter Seals. 

Thank you very much. 

Ms. SIGGERUD. Thank you. 

[The prepared statement of Mr. Kline follows:]

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Ms. SIGGERUD. Dr. Kerschner. 

STATEMENT OF HELEN KERSCHNER, PRESIDENT AND CHIEF 

EXECUTIVE OFFICER, THE BEVERLY FOUNDATION, 

PASADENA, CA 

Dr. KERSCHNER. Thank you. 

I am Helen Kerschner, and I am pleased to be here today. I am 

representing The Beverly Foundation of Pasadena, CA. 

I would like to outline several senior transportation problems 

and solutions that we have identified in our national research that 

we have been undertaking at least for the last 7 years. My comments include six points. 

First, senior transportation options are critical. Much of the senior transportation discussion has in the past focused on older drivers and getting them off the road when they can no longer drive 

safely. However, to enable them to stop driving, senior-friendly options really must be available. You might ask what is ‘‘seniorfriendly.’’ Well, our Foundation’s national transportation focus 

group projects and our survey research projects have identified the 

5 A’s of senior-friendly transportation: availability, acceptability, 

accessibility, affordability, and adaptability. 

The second point is that we need to place special emphasis on 

the 85-plus population. The old-old are especially vulnerable. This 

is an age group for which driving can present particular problems—the problems that we have talked about in Santa Monica 

last week and many others like it. It is also an age group that, according to research by the National Institute on Aging, may outlive 

its driving expectancy and have to depend on others for transportation. For men, it can be up to 6 years; for women, 9 years. 

This means that many in the 85-plus age group could well live 

for 6 to 10 years not being able to drive and being transportationdependent. It is a growing problem, too, because this is the fastestgrowing segment of the older adult population. 

The third point is that family members may be the traditional 

transportation providers, but they are not always available, and 

seniors cannot always access traditional or standard transportation 

options. The health and mobility limitations that made it difficult 

or impossible for them to drive can make it impossible for seniors 

to access community transportation systems and services. This 

means that public transit, paratransit, taxi voucher programs, and 

many other transit options may not work for seniors, especially 

those in the 85-plus age group. 

The fourth point is that some good things are happening in traditional transportation services. Some systems and services are responding to the problem by trying to be more senior-friendly. What 

it means is that transit providers are open to developing innovations and many times do develop innovations such as door-throughdoor or door-to-door service, transportation escorts, even trip-chaining, in order to be more senior-friendly. 

The Beverly Foundation has joined with Community Transportation Association of America to undertake a study of these innovations so we can share those with other organizations throughout 

the country. We expect our report to be finished by the end of the 

year. 

54

Point No. 5 is that nonprofit groups are also responding to the 

problem. They are responding in the way that both Terry and 

Stephan have discussed. Communities know that traditional services cannot do everything, so they are creating a broad range of 

supplemental or complementary programs, many of which address 

both quantity and quality of life transportation, ‘‘quantity’’ meaning 

for the essentials, such as going to the doctor, and ‘‘quality’’ meaning for going to the grocery store, to visit the husband in the nursing home, and to do all kinds of personal things. Both are important, and I think public policy needs to recognize this. 

We have been looking at these kinds of programs for the last 5 

years, and we have undertaken what is called a STAR Search Program. We have studied 400 of these programs throughout the country. We have identified best practices. We will have 500 by the end 

of the year and will have given 17 awards for excellence for some 

of the really good programs. 

The sixth point is that such programs are what we call supplemental transportation programs for seniors, or STPs, ranging from 

what might be considered high-cost, high-maintenance to low-cost, 

low-maintenance programs. For example, a program that purchases 

and owns vehicles and hires drivers, schedulers, and other staff 

would probably be in the high-cost, high-maintenance category, 

meaning that it may have a budget of around $150,000 or more. 

Alternatively, one that has volunteer drivers, volunteer automobiles, and limited paid staff would probably be in the low-cost, 

low-maintenance category. This means that even in economic 

downturns and when communities and community groups have 

limited funds, they still can meet the transportation gaps faced by 

many seniors. Community organizations throughout the country 

are tapping their enormous volunteer pools and enabling volunteers to help seniors get where they need to go in a senior-friendly 

way. 

We have just completed a pass-ride pilot in Pasadena that is at 

the lowest of the low-cost kinds of programs that can be adapted 

in any community. 

In conclusion, now is the time to take action. There are indeed 

gaps in transportation, gaps in driver education and support, gaps 

for seniors who do not drive, gaps that caregivers face in trying to 

provide transportation to seniors, gaps in quantity and quality of 

life transportation, gaps in the availability of supplemental transportation, gaps because services are not coordinated. 

Today we have an opportunity to fill those gaps and to shape the 

future, to provide the incentive for public transportation to do more 

than provide point-to-point transit, to encourage efforts by paratransit services to make adaptations that will improve their service 

to seniors, to create new opportunities for nonprofit organizations 

to initiate and expand their services, to mobilize America’s volunteer force to become drivers for senior transportation programs, to 

support both the concept and the development of low-cost, lowmaintenance transportation programs, to improve senior mobility 

management through better service coordination, and finally, to realize that by making transportation senior-friendly, it improves 

transportation for seniors and for Americans in all age groups. 

Thank you. 

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Ms. SIGGERUD. Thank you. 

[The prepared statement of Ms. Kerschner follows:]

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Ms. SIGGERUD. Ms. Markwood. 

STATEMENT OF SANDRA MARKWOOD, PRESIDENT AND CHIEF 

EXECUTIVE OFFICER, THE NATIONAL ASSOCIATION OF 

AREA AGENCIES ON AGING, WASHINGTON, DC 

Ms. MARKWOOD. Thank you. 

Good afternoon. My name is Sandi Markwood, and I am the 

Chief Executive Officer of the National Association of Area Agencies on Aging. N4A represents the 655 area agencies on aging in 

this Nation, as well as being the voice in Washington for the 243 

Title VI Native American aging programs. We are proud to have 

the Arlington County area agency on aging as one of our members. 

Across the country, N4A is working with area agencies and Title 

VI agencies to promote home and community-based services. Additionally, area agencies and Title VI agencies plan, coordinate, and 

deliver a wide range of services, including home-delivered meals, 

chore services, home health care, and transportation services. 

We are pleased to be here this afternoon because we know that 

even the best aging services are of little value if people cannot get 

to them. 

Transportation services consistently rank as one of the top three 

issues that older adults and their caregivers call the National 

Eldercare Locator looking for assistance with. The Eldercare Locator is a toll-free number and a website that N4A and the National 

Association of State Units on Aging, together with the Administration on Aging, provide to older adults and their caregivers to find 

aging services throughout the country. 

What we find is people calling in to the Eldercare Locator, looking for nursing home placement for an older adult, when what they 

really need is transportation on a weekly basis to dialysis. 

For many AAAs, especially those in suburban and rural areas, 

transportation is their No. 1 concern. Transportation we know is 

the vital link between home and community for older adults, and 

actually, for all adults, for all Americans, but it is particularly an 

issue for older adults who have fewer options. 

Older adults, like younger adults, like younger people in general, 

depend on the automobile for the majority of their trips. We have 

already heard the statistics. Older adults are driving. They are 

driving because they want to. They are driving because they need 

to. 

We have also heard the statistics about the fact that there are 

numerous factors that impact older adults as they age that also 

impact their driving—vision problems, cognitive limitations, side 

effects of medications, slower reaction times, as well as muscular 

difficulties that can make driving more difficult. 

The tragic event in Santa Monica last week emphasizes the need 

to develop older driver retool programs, to get the issue of assessing your driving ability out into the public and not to make it an 

onerous task, but something that people do naturally, from the 

time they are in their 30’s, 40’s, 50’s, 60’s, and up, to determine 

whether any impairment that they have may affect their driving 

ability. 

The National Highway Traffic Safety Administration is doing a 

great deal of research in the area of older driver safety, and our 

67

organization’s Area Agencies on Aging are working with NHTSA to 

get this information out to older adults and their caregivers. But 

we are also partnering with the Grand Driver Program that is run 

through the American Association of Motor Vehicle Administrators 

and also the other AAA group, the American Automobile Association, has also taken this issue on. NHTSA is also working with the 

American Medical Association. 

This is an issue whose time has come. It is an issue that we all 

need to get behind and make sure that we have the programs, the 

policies, and the funding in place to be able to address. 

Looking at the issue of senior mobility, we need to look at it as 

a continuum, we need to look at it as an issue from driving to the 

fact that once people stop driving, they focus in and rely on their 

friends and families. But oftentimes their friends and families have 

conflicts, and they feel as if they are imposing on their friends and 

families for these mobility issues. So volunteer driving programs 

are key, and they are ones that we need to find additional incentives to be able to promote on an even broader basis. 

Additionally, we know that older adults, like all adults, are not 

relying as they should on public transportation. We also know the 

statistics that if you do not rely on public transportation when you 

are young, you are a lot less likely to rely on it when you become 

older. 

So I think there need to be more programs that are focused in 

on getting all adults and older adults acclimated for the use of public transportation that does exist, and we need more funding and 

more support for more public transportation options as well as 

paratransit options. 

When you are looking at the issue of older driver safety, when 

you are looking at the issue of senior mobility in general, the time 

is now. The aging of the baby boomers is upon us. Now is the time 

that we have to plan and to act to meet the senior mobility transportation needs. We cannot wait any longer. It is a wonderful testament to Congress that we are holding this hearing today, and we 

are looking forward to the reauthorization of TEA–21 as well as 

down the line to the Older Americans Act reauthorization, to get 

more funding and support for these critical programs. 

Thank you. 

Ms. SIGGERUD. Thank you. 

[The prepared statement of Ms. Markwood follows:]

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That was a wonderful set of opening remarks. I think it lays a 

very strong foundation for getting into the more detailed questions 

that we would like to go to at this point. 

Our first theme today is looking at current programs that address transportation for seniors and the extent to which these programs are meeting their needs. I think there are a couple of useful 

ways that we can break this out. 

One is by the issue of density—rural, urban, and suburban elders 

and the extent to which programs are meeting their needs—and 

the distinction between seniors and the old-old or the frail elderly, 

who really have some different needs. 

I think it might be useful at this point to start by talking about 

seniors living in a rural setting and the extent to which programs 

are meeting their needs. 

Mr. Burkhardt has done a fair amount of research in this area, 

and perhaps he can start us out. 

Mr. BURKHARDT. Thank you. I would be happy to. 

Rural areas are particularly difficult for seniors because there 

are fewer transportation options. Part of the good news is that between the 1990 Census and the recent National Household Travel 

Survey, seniors own automobiles at much, much greater rates than 

they did before, and there are now relatively few seniors in rural 

communities without automobiles in their households. 

The bad news is that many small communities have no taxi service, they have no inner-city bus service, they have no air connections, and there are very few ways to get around if you don’t have 

a car. The bad joke is that if you go blind in Des Moines, they take 

away your license, and if you go blind in Sioux City or Cedar Rapids, they let you drive, because when there are no options, there 

is still a necessity to get around. 

Rural areas generally have older populations than to urban 

areas. In 1997, 18 percent of the rural population was elderly compared to 15 percent of the urban population. There were also greater concentrations of the oldest elderly in rural areas. There were 

also greater concentrations of poor elderly in rural areas. There are 

longer distances to travel to almost any kind of service, but in particular to medical services. As medical services become more specialized, rural areas lose their hospitals, and people have to travel 

longer and longer distances to get to the medical services that they 

need. 

We have heard in particular that this is an issue for dialysis, and 

as dialysis centers cluster around metropolitan regions, and rural 

residents take 3- and 4-hour trips to get to dialysis centers for dialysis services. 

So there are particular transportation challenges in rural areas. 

The growth of the rural public transit industry is one really shining bright spot in this picture, as are a few other trends, one in 

particular being that of innovation. Rural transit operators have 

been among the most innovative operators in the country. There is 

lots of coordination going on because there is not enough money 

around to do anything but coordinate in rural areas. 

So we have some good news and we have some not-so-good news 

in rural areas. We see communities from Portland, ME to Portland, 

OR, from Louisiana to Idaho, from Florida to California where 

82

there are great examples of good rural public transportation systems, some of which rely on volunteers, some are more elderly oriented than public-oriented. These are sort of fledgling services that 

are being developed, and we hope that hearings like this can inspire the rest of the country to adopt similar kinds of services. 

Ms. SIGGERUD. Thank you. 

Are there other comments from the panelists on rural issues? 

Does anyone else care to weigh in on that? 

Dr. ROSENBLOOM. Jon was saying there are some good rural systems out there. I think they are all good systems. They are facing 

overwhelming odds, and their services are a drop in the bucket, but 

they are all incredible. It is an honor to meet some of the people 

running these systems and the volunteers who are involved with 

them. They clearly need more funding and more help. 

But I also think we need to be looking at alternatives to build 

on what Jon was calling innovations. We need to find ways to expand volunteer systems. We need to find ways to link land use, 

growth, and service delivery with transportation. When people are 

going 4 hours into the center of a city, 70, 80, and 100 miles away 

for dialysis, we need to talk about—dialysis is much more portable 

than it used to be. We need to talk about partnering with people 

who can bring the services to older people. Those of us in the transportation community are always blamed when people cannot get 

somewhere. People build things in out-of-the-way places, in ridiculous places, and it is our fault they cannot get there. 

We need to work with people who are placing services, who are 

organizing services, who are delivering services for older people 

and those in rural areas and so forth to see if we cannot come to 

some accommodation, if we cannot find some way so we do not 

have to transport someone who has to go to dialysis 3 times a 

week, has to be in a van 12 to 24 hours a week. That is ridiculous. 

There is never going to be a way to overcome that problem unless 

we start looking at how services are delivered and coordinating 

with those folks as well. 

Dr. KERSCHNER. I think there are some rural areas that are the 

forefront of transportation innovation. It seems to me there has 

been a mindset about public funding in transportation, particularly 

the 5310 Program that provides buses and vans at 80 percent of 

the cost. So it was a real incentive to buy buses and vans, but 

buses and vans do not necessarily work in rural areas, and I think 

the rural areas have begun to say, as Sandi said, ‘‘We really do 

need to have the involvement of volunteers and the involvement of 

volunteer vehicles because many of these seniors, particularly people who go to dialysis, need to have a transportation export or a 

transportation caregiver to stay with them while they are there— they cannot go off and leave them.’’ So it seems to me that the rural areas have really come up with 

some wonderful, innovative ways of integrating the volunteer 

transportation with the traditional public and paratransit services 

to better serve their population groups, and we might learn something from them in urban areas as well. 

Ms. SIGGERUD. With that, why don’t we move to urban areas? 

Presumably, the availability of transit and taxi’s and other types 

of transportation is better in suburban and urban areas, but we 

83

know there are problems. I would like to move at that point to the 

extent to which these programs are in fact serving seniors who 

need transportation in these areas. 

Dr. Rosenbloom, would you like to start? 

Dr. ROSENBLOOM. First of all, I am alarmed often when I give 

public presentations and invariably, somebody gets up from the audience and says, ‘‘There is an ADA paratransit system in my neighborhood, and that is what is going to take care of my elderly mother, myself,’’ or whomever. 

In fact, there is no way that those small services, even if most 

older people qualified for them, are going to meet all the needs of 

older people. 

First of all, in an urban area increasingly, transit operators have 

cut ADA service back to within three-quarters of a mile of fixedroute buses and only during the hours that those buses run. That 

is all they are required to do by the ADA. They are not required 

to serve any other areas. Increasingly, because of the high cost of 

providing services, urban transportation systems have cut back the 

ADA services they provide geographically. So a huge percentage of 

older people are not even eligible by reason of geography. They 

simply do not live in an area where ADA services are provided. 

Second, one of the outcomes of the high cost of the ADA services 

is that many of these systems have become very, very, very strict 

about their eligibility criteria. They fail to certify older people constantly. 

It is really important to understand that simply being unable to 

drive does not make you eligible for most ADA paratransit services. 

You must have some fairly significant disabilities that prevent you 

from getting on and off buses. 

As a result a lot of older people who cannot drive or should not 

drive cannot get ADA service. Those are good services, and they 

should be expanded, and particularly for, as Helen said the over 85 

group. But for all the rest of our senior folks who maybe should not 

be on the road, who may have minor disabilities, the ADA services 

are not the answer. We need to be looking for a family of services, 

some that Jon listed, some that I talked about. We cannot just rely 

on one source. 

Ms. SIGGERUD. Ms. Lynch, you administer a program in an 

urban/suburban area. Would you care to comment? 

Ms. LYNCH. I guess I would like to echo what has been said here, 

that what we really need is an enhanced program of all the various 

modes of transportation, because even the ones that we have, 

which are extensive in their type—we have a program that uses 

volunteers, we have programs that use taxicabs. We rely on vouchers. We rely on ADA paratransit. But with all of those, we know 

that—I do not have good numbers because we do not have those—

but we know that every day, people call us for service, and we are 

unable to meet their needs. 

So funding is a critical point. People who would pay for the service but cannot afford—we have people in our country, and we are 

one of the most affluent counties in this country, but we have people who cannot afford the $2 per one-way trip it takes to use ADA 

paratransit if they are going to go to dialysis 5 days a week. That 

is 10 trips; that is $20 a week. They do not have the money to do 

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that. That does not even count the public funding. That is what we 

expect people to fund. 

So we really need a family of services, and we need it in greater 

numbers for a whole array of people. Let me tell you one thing in 

this area is that we are in an area that is a multi-ethnic, multilingual community, so that we also have to focus—and it costs 

money—on answering the phone and speaking in our area Korean, 

Vietnamese, Spanish, Russian, Amheric, just to name the top five, 

because we have 45 languages spoken among our elders. 

So there is a whole array of issues. 

Ms. SIGGERUD. Ms. Markwood, please go ahead. 

Ms. MARKWOOD. To add to that, when people believe that the 

public programs are going to be able to meet the needs, the fact 

is that with limited funding, I know under the Older Americans 

Act, the Title III–B funding, which we use to fund transportation 

services, is limited. So instead of being able to take any trip you 

want, it is specifically limited in most communities just to medically necessary trips to and from a doctor’s appointment, or to and 

from dialysis. So those appointments to see family and friends, to 

go to church, to do things that are really critical to a person’s quality of life, there may not be a transportation option available to 

older adults to be able to get to those necessary places. 

Ms. SIGGERUD. Mr. Kline. 

Mr. KLINE. In the urban areas, I think money is certainly at the 

root of solving this problem, but there is another issue, which is 

that in metropolitan areas, you have a lot of different jurisdictions, 

and a lot of the transportation services provided, whether through 

a public entity or through a nonprofit, kind of stop at the jurisdictional line. A lot of that ends up, because of money reasons, the 

county or the nonprofit cannot afford to provide transportation beyond that, but a lot of it actually gets down to planning issues— is there the possibility for a central coordinated planning entity 

that would allow the different nonprofits and Government entities 

to collaborate, work together, figure out how to best maximize the 

routes that they are using for these senior vans and buses. That 

is starting to take place at some local levels, that they are working 

together, and that seems to be not the wave of the future, but an 

important method to fix part of this problem. 

Of course, planning itself is an expensive endeavor, just getting 

the people either around the table to plan for the future of the 

services or the centralized resource that will allow different buses 

to be plugged into a central system. That takes money also. 

Ms. SIGGERUD. Anyone else on that issue? 

Dr. Kerschner. 

Dr. KERSCHNER. I have just a quick comment. I think one thing 

that I would like to say is that in planning transportation, I think 

we sometimes assume that the only thing that seniors need is to 

go to the doctor, and I hope there is more to life when I become 

a senior than going to the doctor. I think that reflects the rationale 

for setting up a lot of these transportation programs; they really 

are single-purpose. 

Also, particularly in paratransit, they are really not set up to 

meet many of the needs of seniors. For example, can they provide 

transportation escorts that many seniors need? Many of them canVerDate 0ct 09 2002 15:44 Nov 05, 2003 Jkt 000000 PO 00000 Frm 00088 Fmt 6633 Sfmt 6633 C:\DOCS\89855.TXT SAGING1 PsN: JOYCE
85

not. Some of them try very hard. Can they provide door-throughdoor transit, actually going through the door and helping someone 

get to the van or the vehicle? No; it is very hard for them. Can they 

provide trip-chaining, where you make a stop and another stop and 

another stop? They are not set up for that; it makes it really hard 

for them. Do they have geographic boundaries? As Stephan said, 

yes, they have geographic boundaries, and maybe somebody’s doctor or their church or something is outside the geographic boundary 

of this particular program. It is isolating people in their communities. Do they provide quantity and quality of life transportation? 

All of these things are very important, and many of the systems 

and services, particularly paratransit, are not really set up to do 

that, and we have to recognize that. Perhaps they can develop innovations that will help them do that, but maybe there are some 

other options that we should be exploring. 

Ms. SIGGERUD. Why don’t we now move to a discussion about the 

needs of the old versus the old-old, the frail elderly. There are different kinds of services required, for example, Dr. Kerschner talked 

about seniors who need door-to-door service versus seniors who are 

in fact able to be more mobile. 

Dr. Kerschner, would you care to start? 

Dr. KERSCHNER. Yes, I would. I tend to believe that our real area 

of emphasis now—the 65-plus population is really very important, 

and I acknowledge that—but the 85-plus population is the population that may in fact not be driving or may need to give up their 

keys. So when we talk about the problems of senior transportation, 

I think we need to really, really hone in on that population and 

take a hard look at it. That is the population that may in fact need 

an escort. 

Now, some interfaith programs that create these transportation 

programs say that that escort is not just to physically help someone 

get into the doctor’s office or into the social service agency, but if 

that person hears bad news, that escort is there to take care of 

them and help them if they do hear bad news. 

So it is a supportive—in a sense, it is social support in addition 

to transportation support. I tend to call them ‘‘transportation caregivers,’’ if you will. For that window of time, these people are providing caregiving while they are providing transportation. 

The door-through-door service is extremely important. Many programs provide door-to-door. It is very hard for the driver of a van 

that may have fix or six people in it to go up to the door and help 

someone. They are not supposed to leave the van. They really 

worry about what might happen with people in the van, so they 

cannot really do that—and yet someone may not be able to walk 

to the curb let alone just to the driveway to get to the van. 

So I think that that door-to-door or door-through-door service is 

absolutely critical if we are really going to meet the needs of people 

who are frail. 

I hope that policymakers will really hear the call that I think almost everyone here has talked about—the quantity and quality of 

life transportation. The essentials are important, but the nonessentials are important. I think going to the hairdresser is essential, 

quite honestly. A lot of people call that nonessential. But these are 

very essential parts of our lives. Why do we limit the lives of older 

86

adults because they hit 85? Why do we do that? I really have to 

question that, and we do it through the establishment of our transportation programs, and it is a real shame. 

Mr. BURKHARDT. If I could jump in there, we sometimes talk 

about life-sustaining activities, and then there are life-enriching activities, which include visiting a loved one in a senior home or 

going out to a concert or doing something in the evening when lots 

of public transportation services do not run, or going to religious 

services on the weekend when lots of public transportation services 

do not run. It is really critical that we begin to match our transportation services to the great variety of transportation needs and the 

great variety of people out there. 

There are people who are seniors, who are old and do not have 

much money, and there are seniors out there in certain communities who cannot get a ride no matter how much money they have. 

So everybody has some differences, and we have had people in our 

focus groups say to us, ‘‘I may not feel like going for a ride today, 

but I might want a ride tomorrow.’’ So there are even differences 

from day to day. That is why it is so important to do what Sandi 

is talking about in terms of getting a family of services. Some days, 

they may need special, hands-on care. Some days, a person may be 

fine, and they can be independent and on their own. 

We need to have this range of choices. We need to have a range 

of payment options that goes along with it, but not just have transportation services available from 9 to 5, Monday through Friday. 

Ms. SIGGERUD. Other comments? [No response.] 

OK. I think we will move on to our second theme for this afternoon’s discussion, and that has to do with coordination of transportation services for seniors. 

Several of our panelists today have talked about some of the barriers to coordinating transportation services—for example, the 

many jurisdictions in urban areas, the many existing programs 

that are funded from different Federal and State pots of money. 

I guess what I would like to hear people talk about, then, is what 

are the obstacles and what solutions do they know of in order to 

achieve better coordination with the goal of actually improving efficiency, affordability, and/or availability of transportation services 

for seniors. 

I think our most published expert on that on this panel is Dr. 

Burkhardt—I am sorry—Mr. Burkhardt. Would you please go 

ahead and address those issue? 

Mr. BURKHARDT. Honorary doctorate degrees are always good. 

Ms. SIGGERUD. You have published an impressive amount of research; that is why I got confused. 

Mr. BURKHARDT. Coordination has been tough in a number of 

areas. It basically means sharing power and sharing resources. 

This comes up against some individuals’ or organizations’ need to 

have the limelight to themselves or to have fiscal or political control. So sharing is perhaps something that is not automatic but has 

lots of benefits. You can get more money, more efficiency, more productivity, and certainly more mobility if there is transportation. 

We have found that to get some of these benefits, particularly the 

economic ones, that if you have particular strategies, it works out 

best. One strategy would be getting new revenue sources. Another 

87

strategy would be decreasing the cost of providing the services. Another strategy is increasing efficiency and productivity, and then finally, increasing mobility. 

There are examples all over the country of people doing things 

that are innovative in coordination. A number of public transit 

agencies are coordinating with the Medicaid Program to provide 

trips for Medicaid patients at substantially reduced costs, and the 

transit agency gets more money, and the Medicaid Program saves 

money. 

Similar kinds of arrangements can be made with transit agencies 

and school districts. In terms of cost savings, one that we have 

written about is STAR in Arlington, really saving money versus the 

Metro Access System, and providing services that are patronized by 

a factor of almost ten to one. So, Terri, you must be doing something right. 

There are services all over the country. One of the really interesting ones is in the suburban Detroit area, where the local public 

transit authority is coordinating services across a wide range of different jurisdictions, so that for all these jurisdictions, if they buy 

into the metropolitan-wide compact, the ‘‘SMART’’ system, which is 

the large regional transit system, will provide training and vehicles, and the local communities provide the operating funds, sometimes even providing drivers. So as long as the local communities 

agree to be associated in the special taxing district, everybody is 

working together. 

All of those things show the potential benefits of coordination. 

Again, it is not necessarily something people come to comfortably. 

As Stephan said, the planning takes a lot of time. You have to talk 

to people who may not talk the same language you do—the acronyms are different, the client types are different, the service needs 

are different. But if people remain involved, then, for persons who 

are elderly or persons who have disabilities or persons who need 

additional assistance in learning, all of their needs can still be met, 

and we do not have three transportation systems out there, we just 

have one transportation system. So it is possible. 

Ms. SIGGERUD. Ms. Markwood, did you have anything to add 

from some of the agencies you are familiar with? 

Ms. MARKWOOD. The interesting thing is that a few years ago, 

I did a project called ‘‘Aging of the Population and Aging of the Infrastructure,’’ looking at the parallels between the two, because infrastructure is aging, and the population is aging, and the fact is 

this really provides an opportunity for the two systems to really 

look at each other in a new and integrated way. 

In saying that, I think there are barriers. There are barriers in 

funding, there are barriers in jurisdictional issues, and there are 

also barriers because traditionally, a lot of the folks who work in 

the transportation arena—county engineers, public works directors, 

highway department engineers—talk an entirely different language 

than we do in human services. So when you are talking about coordinating between human services and the transportation arena, 

there are additional barriers even in nomenclature and acronyms 

that people throw out that need to be overcome to get everybody 

at the table on an even plane to be able to deal with these issues 

and to deal with them well. 

88

In saying that, as Jon pointed out, there are a number of different communities that have been able to overcome them, and the 

key there is to get everybody to the table and to try to reduce the 

turf-ism associated with funding resources, to get people to realize 

that improving transportation services for older adults, whether it 

be highway transportation services, public or paratransportation 

services or driving safety issues, improves transportation services 

for everyone in that community. 

I think that once you get that issue across, it changes the conversations that you are having at the table, and then people can 

look for the common goals and ways to get beyond the barriers of 

jurisdictional issues like they did in Detroit and to get beyond the 

issues of funding the best they can without additional funding to 

be able to pool resources to make these programs work. 

There are barriers, but there are also opportunities, and I think 

that if you can pull people together to realize, again, that improving transportation for older adults improves transportation for all 

ages, then you have overcome one of the biggest ones. 

Ms. SIGGERUD. Mr. Kline. 

Mr. KLINE. I think there are a couple of efficiencies that can be 

realized. One of them that Jon spoke of before deals with Medicare, 

which for seniors only pays for the use of ambulances to get them 

to emergency health care situations. It turns out that there have 

been a lot of payment in ambulances but for non-emergency use situations, and what Medicare should allow is transportation for 

medically necessary transportation and perhaps a significantly 

lower degree of intensity. So it might be a specialized van they 

could use to take someone to a doctor’s appointment or a taxi. If 

it is medically necessary, Medicare should pay for it. It might not 

necessarily cost Medicare more money for that given the extent to 

which it is being used now. 

A different situation in Detroit—our Commission on Jewish 

Eldercare Services is a collaborative of seven different Jewish agencies that provide social services for older adults. All of them had 

their own vans and buses, and they got into a common system and 

figured out how they could maximize the use of them. They got rid 

of some vans, they came up with a common insurance policy for all 

of them. That is done at the nonprofit level. There are similar 

methods that can be done with for-profits or for Government entities. 

We talked briefly about the use of public buses in different communities, using schoolbuses, perhaps, on weekends or evenings for 

programs that involve seniors. So those are some of the ideas that 

we are talking about at the local level. 

At the Federal level, over the last 6 or 8 months, the Federal 

Transit Administration and the Administration on Aging have 

started a formal collaboration on different senior transportation 

issues which seems to be starting with quite a degree of enthusiasm from both agencies. There are a lot of other agencies that 

deal with seniors and deal with transportation issues that could be 

brought into that collaboration, whether it is the Department of 

Housing and Urban Development or the Department of Labor or 

the Corporation for National and Community Services. There are 

a lot of different programs in the Federal Government that deal 

89

with senior issues and deal with transportation and senior issues, 

and that should be carried over to the Federal collaboration. 

Ms. SIGGERUD. Ms. Lynch. 

Ms. LYNCH. The piece I can add is that in terms of the collaboration that folks are talking about, one of the reasons that we have 

had the degree of success that we have had is that our Commission 

on Aging is a board-appointed commission that advises them, and 

the area agency on aging has sponsored a transportation committee 

for about 10 years. It has included within that committee senior 

advocates, people from our office, people from public works, from 

the Red Cross, which uses volunteer drivers, the taxicab companies, the private vendors, and we have looked at an array of issues, 

so that once STAR had conceptually begun to be Arlington’s prearranged ADA program, or transportation program, that was what 

gave us the venue to add on to STAR. STAR was there to begin 

with, and we could see what were the pieces that were missing— the assisted transportation or door-through-door was one, a temporary arrangement, so that we can focus all the folks together. 

The piece that we have thus far had zero success with—and it 

is a goal for the future—is that Virginia’s Medicaid transportation 

is not involved in this at all. So that is a piece that we need to 

work on. 

Ms. SIGGERUD. Thank you. 

Now I think we will move on to our third theme this afternoon. 

You have heard all of our panelists give some examples and talk 

about interesting and innovative senior programs in their communities. I think we will actually turn to that topic at this point and 

ask our panelists to comment on what are some of the hallmarks 

or characteristics of successful senior transportation programs that 

they are familiar with and, knowing that, how can that information 

be communicated with an eye to replicating that elsewhere. 

I think Dr. Kerschner has done quite a bit of research in this 

area, and perhaps you can comment first, please. 

Dr. KERSCHNER. Thank you. 

Yes, as I mentioned earlier, our foundation joined with the AAA 

Foundation for Traffic Safety about 4 years ago and started what 

we called the STAR Search Program. We hoped at that time that 

we would maybe identify 50 or 75 or 100 of these senior transportation programs around the country, and with our first little inquiry, we got 350 responses within about a month. 

We decided that it was a hotter topic than we even realized. Actually, we ended up in our data base with completed surveys of 

237. Now, several years later, we have 400 surveys, and we expect 

to have 500 at the end of the year. We have given 14 awards for 

excellence. 

This has been an interesting agenda because we have looked not 

only at urban but also rural and suburban programs, so we have 

a real mix and a real sample of what is going on out there. 

I was asked today if I thought we had about maxed out on this, 

and I said no—I think it is just the tip of the iceberg. There are 

wonderful things happening in communities around the country. 

I have mentioned some of the things that I think are absolutely 

critical to these supplemental, if you will, transportation programs 

for seniors in terms of best practices. I think there are some best 

90

practices with regard to escorts. That is a key component for many 

of these programs and something that people need to think about. 

If you will, ‘‘transportation escorts’’ or ‘‘transportation caregivers’’ is what we call them. 

I think also the issue of volunteer drivers is a really important 

component. Many of them have a mix of volunteer as well as paid 

drivers, and that becomes an absolutely critical part of a really 

good dynamic and integrated program. Many of them include both, 

and they work very well together, and they integrate very well 

within the community. 

Now, I think the fact that a large number of these include transportation by automobile is very satisfying to older adults. Older 

adults would rather go in an automobile than any other mode of 

transportation. So the private automobile helps out a lot. Even in 

the volunteer programs, many of the volunteer programs will allow 

people to take their wheelchairs. They will say, ‘‘Don’t bring the 

Cadillac wheelchair, bring the little, bitty wheelchair with you if 

you can, so we can put it in the trunk of the car.’’ I think there 

are also some best practices just in terms of models. As I mentioned earlier, many of these programs are interfaith programs. 

There is a Shepherd Center Program up in Kalamazoo, MI. It is 

a wonderful program. When we first looked it, it had zero budget. 

It now has a budget of $9,000. 

These are what I would describe as low-maintenance, low-cost 

programs. They provide escorts, and the escort stays with the person, but they have a unique fundraising mechanism, because as 

they go into the doctor’s office or whatever social service they are 

taking people to, or many times the grocery store, the transportation escort will just drop off a card at the desk and say, ‘‘This 

transportation was provided by Shepherd Centers of America,’’ and 

it has achieved many unsolicited donations to the program, because 

physicians and other people are very appreciative of this. It is a 

unique fundraising tool, and I think that is an important component of these programs that have no budget. That is why the program now has a $9,000 budget. 

A program in Indian country, out in the San Felipe Pueblo outside Albuquerque, sent us in a response, and we took a look at it, 

and I thought, well, this is not really any different than most programs—it has a van, and they take seniors places—but let us just 

take another look. So I talked with the people out at San Felipe, 

and they said, ‘‘No—this program is wonderful because it allows us 

to take seniors to places they would never—many of them have 

never been off the Pueblo—they can go to places in Albuquerque, 

maybe even to the Grand Canyon and to other places, and it allows 

them to play the role of elders in our community.’’ It allows them 

to have that status and that background and that experience, and 

I think that is unique. 

There is also a program in Jefferson County, KS. As you might 

guess, that is a very rural area. It really has become, if you will, 

the public transportation program. It is automobile-based, but it 

has not only volunteer but paid drivers. The program is a wonderful program, and the seniors say that without that program, there 

would be no transportation available in the whole county. It is run 

very efficiently. 

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I have to comment about our Pass Ride pilot that we did in Pasadena recently. It is a very unique program. It is a program that is 

totally volunteer. The idea was that we could develop the program 

without adding staff to an organization—and I have to tell you, if 

The Beverly Foundation can do it, anybody can do it, because we 

are not a service provider. We are a research foundation. 

So what we did was organize it according to the idea that the 

riders are recruited by service agencies, the riders recruit their own 

drivers, the drivers drive for the program, and then we reimburse 

the drivers for some of their costs for providing transportation. 

That means that we do not have to schedule rides; they are 

scheduled between the rider and the driver. We maxed out at 25 

riders and 25 drivers. That is as many as we wanted. We provided 

rides for $6.20 per ride. Now, that is compared to—and it is not 

really fair to compare it—but it is compared to $32 per ride by the 

local paratransit. It is not saying that this is any better; it is saying that it is a really good option for people to consider. 

Ms. SIGGERUD. Thank you. 

Mr. Burkhardt. 

Mr. BURKHARDT. I will offer a couple of comments here. You 

asked what is good transportation service, and how do you know, 

and the ‘‘How do you know?’’ question is always a good one. 

I would say that a good program for elders is one that has a real 

customer focus, one where the older persons’ needs are really catered to, and people are treated with dignity and respect. There 

should be elements of customer choice so that a customer can 

choose where to go, and for different kinds of trip purposes. A system that has more than just trips to the doctor is going to be preferred over a system that has only medical trips. Grocery trips, 

trips to nursing homes to visit a loved one and trips for personal 

business—these are really important. 

Having coordination with other kinds of services so that the administrative costs are shared by a wide variety of programs is important. This broad spectrum of services in terms of wide ranges 

of hours, wide ranges of destinations, wide ranges of days of the 

week—in fact, the closer you get to a 24/7/365 service, the better 

off these services are. 

Finally, this family of services—being able to have an escort 

when an escort is needed, being able to use public transportation 

when public transportation is needed, getting financial assistance 

when it is financial assistance that is needed to get the ride—having all these things build into a program would make a highly effective and highly customer-oriented program. 

Ms. SIGGERUD. Mr. Kline. 

Mr. KLINE. I want to comment on the medical appointment issue. 

Nursing homes and institutional care is obviously a very important 

option and necessity for the aging population, and there are of 

course many great institutions out there. But a lot of seniors really 

want to remain in their homes and in their communities. The programs that provide only transportation to doctors and health appointments—they are not shortsighted; it is a question of money— but from our perspective, if that is the only time seniors can get 

out of their houses, they are not going to last very long in their 

homes and communities, and in Government practice, if we get 

92

more money for Section 5310—and we will talk about that in a 

minute—but if the services are geared only toward health systems, 

the transportation, then it is not going to be a significant step forward in this area, because I do not think that getting to synagogue 

on Friday night or Saturday, or getting to a nursing home—that 

cannot be considered a luxury if our purpose is to allow people to 

remain in their homes and communities. 

I think a lot of policymakers think of these kinds of things as 

fluff, and part of our job is to convince people that more than 

health care is a necessity when we are talking about transportation 

for seniors. 

Ms. MARKWOOD. Following up on Stephan’s point and on Terri’s 

point earlier, the success of the Arlington program is in part because of the local community’s support for that program, the fact 

that it was the board of supervisors in that community who took 

this on and appointed a transportation committee. 

So when you are looking at best practices and surveying them, 

I think local support is critical as well as a local dependable funding source which could bring in Federal and State funding as well. 

But there needs to be a dependable funding source, a dependable 

provider who is trained to be able to work with the older population. Whether they be volunteers, paid or unpaid drivers, people 

still need to be trained to be able to provide that door-to-door or 

door-through-door service. 

Coordination is critical to be able to maximize service potential. 

I think the one thing you have heard from everybody is that to ensure the quality of life of older adults, we cannot just limit transportation services to those medically necessary appointments; we 

need to look at transportation across the board and the quality of 

life of older adults. 

Ms. SIGGERUD. Dr. Rosenbloom. 

Dr. ROSENBLOOM. Jon and I have studied what transit operators 

have done, which I would like to put on the table. 

Somebody earlier mentioned that many of the current generation 

of older people have never really used public transit, and if they 

did not use it when younger, they would not use it when older. But 

there are a number of systems that have done transit or travel 

training for older people, some with disabilities, some without. 

Their experiences suggest that if you find a group of older people 

and show them how to use the bus, how to read schedules, how to 

figure out where to go, how to figure out where the bus stops are, 

how to use the accessibility features on buses, ridership increases 

dramatically among the people that you train. A lot of these folks 

had no idea where the bus went, and they were reluctant to find 

out, and suddenly realized that although transit was certainly not 

going to take care of all their trips, it might take care of some trips. 

Not only that—in I believe it was Eugene some of the drivers who 

were trained actually gave up driving when they realized what 

kinds of public transit options were available to them. 

I think this is a cheap, long-lasting, and very effective option 

that we ought to be spreading to other transit operators. 

Mr. BURKHARDT. That is a great point, and in particular the 

Eugene, OR system made riding public transit a real accomplishment in terms of mastering a complex system, so this was not seen 

93

as a second-best option or third-best option but as something that 

was really a statement of empowerment. Sandi is right—it let people be very happy about walking away from driving. 

Ms. SIGGERUD. Thank you for transitioning us to the next subissue I wanted to get to under that topic. Are there other opportunities for communities to make use of their fixed-route transit systems and to make seniors comfortable with using them in addition 

to those that have already been discussed? 

Ms. LYNCH. I guess the one piece I would add to that is—Arlington has the opportunity, so I suspect many other communities do 

as well—to talk to the transit arranger to change routes. Many 

times, routes have been changed so they go right in front of one 

of the senior highrises or the new assisted living or the new whatever, to try to make it so it is particularly convenient. 

I will echo what happens when you do some training about how 

to use Metro’s very complicated fare structure. Some of the senior 

centers did some training of their members, and they started to use 

it more. So it is a very effective tool. 

Ms. SIGGERUD. Other comments? 

Dr. KERSCHNER. I think this was mentioned a little bit before, 

but I think training drivers for public transit becomes a very important issue. In focus groups throughout the country, one of the 

reasons seniors say they do not want to use public transit is because the drivers are rude to them. They hurry them, they criticize 

them, and so forth. So I think driver training in public transit becomes a really important contribution to enable seniors to be able 

to use those programs. 

Dr. ROSENBLOOM. Problems is related to driver training is that 

public transit is geared toward the lowest common denominator. 

Today, public transit systems try to find a way to cram as many 

people on a bus as they possibly can, so if they have a few seniors, 

a few kids, a few commuters, etc., a few that—of course the drivers 

are always yelling at people to hurry up. 

But if we get transit operators to invest in what the industry 

calls ‘‘route restructuring,’’ finding new routes that meet the needs 

of different people, routing services to naturally occurring retirement communities, trailer parks, senior centers, places where older 

people want to go or where they live, providing extra service in the 

middle of the day, it is more likely that it will not be kids and 

workers riding in the middle of the day during the week—it will 

be older people. Drivers can then be urged to and trained to provide a better quality of service geared toward the people who are 

riding at that time of day or using those special services. 

I think this is really crucial. If you remember that the majority 

of older folks living in metropolitan areas are in the suburbs, we 

must provide effective public transit services in the suburbs, and 

that can only be done by route restructuring, it can only be done 

by looking at where routes go and how well they serve the needs 

of the senior population. Studies strongly suggest that older people 

will use public transit if it is more geared to their needs, both in 

terms of time and location. 

I think we have a lot of opportunity within public transit services. Why don’t transit operators do it? They do not have enough 

money. That is going to lead into the next issue—it is not that all 

94

public transit services are resistant because they are not smart 

enough to figure this out. It is not because they go for the lowest 

common denominator because they know no better. It is because 

they do not have enough funding to do these kinds of things. We 

have to be looking at trying to not just fund them, but fund them 

to do specific things that will make services better for older people. 

I feel strongly that the two things have to go together. You cannot just throw money at transit operators. You have to insist on a 

quality and a kind of service for older people. 

Ms. SIGGERUD. That was an excellent transition into our final 

topic today, and this is where we give all of our expert panelists 

a chance to get on record and give advice to this committee and 

others, moving forward on these issues. We have an important 

reauthorization coming up—the TEA–21 legislation expires on September 30 of this year—and there are also other legislative opportunities coming before the Congress in the next few years. 

I would like to ask all of our panelists to comment on the 

opportunities that the TEA–21 reauthorization and other legislative opportunities provide in terms of improving programs to address senior transportation needs. 

I think I will call on Mr. Kline first, since his task force has quite 

a lengthy list of ideas in that area. 

Mr. KLINE. Yes; we have no shortage of ideas in the area. 

TEA–21 provides a wonderful opportunity to highlight the issue 

for Congress to get up and say that the interests of seniors within 

the transportation planning process and the transportation provider process is really important, and it was the reason that we 

came together to form this task force. 

It is forums like this that provide an opportunity to get Congress 

to highlight the issue. We have had at this point I would say some 

success in highlighting these issues with Members. We have met 

with probably 20 percent of Members or staff who work on transportation on the Hill, and they are receptive. Obviously, they all 

have seniors in their communities, and they understand this issue 

empirically. 

The problem is that while we have a lot of ideas, and some of 

those ideas will be picked up, the first issue is really money. The 

first issue is money, and we have all talked about the need for increased resources in this area. The Section 5310 Program is currently for fiscal year 2003 funded at about $91 million. It is not 

going in the right direction; the administration has encouraged 

that the program be cut to $87 million in the next fiscal year as 

part of its reauthorization proposal, and it would get up to probably 

a little over $97 million by the end of a 6-year reauthorization process. We think that that is going in the wrong direction. 

As I mentioned in my opening remarks, we believe that there is 

$1 billion worth of unmet needs in the area of senior transportation. Probably the 5310 Program could use $400 million of this 

for things like paying for operating costs, paying for replacing capital expenses by new capital for the increased need, and paying for 

some extra point-of-service contracts. 

So there is a lot of increased need in this area, and to date, the 

administration has, I think, failed to step up to the plate and take 

this on seriously. In their SAFE–TEA proposals—which is their 

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version of TEA–21—they have taken, I think, some of what we 

have said to heart, and they are issues that are mainly somewhat 

peripheral, I think, to the core points. 

They have included the concept of mobility managers, which 

would be kind of a one-stop shop, a person who would be knowledgeable of the interests of seniors and other communities, and it 

would be kind of increasing what they have done in the senior 

housing area, service coordinators; it is taking the concept of knowing what are the resources in the community and how can I help 

the individual consumers who need help. They have taken that 

idea to heart. 

They have included additional funding for planning for transportation. Now, we think there needs to be dedicated funding for planning for seniors, but at least they have tried to bolster some of 

their planning issues, and that is important. 

Probably most important from the funding perspective, while 

they have not agreed at this point to increase funding for the overall area, they have for the 5310 Program allowed the idea of using 

matching funds from other Federal sources that could be dedicated 

to transportation, for instance, from the Older Americans Act. In 

the previous authorizations, that has not occurred. 

Finally, they have an idea for getting some funding for their New 

Freedom Initiative, and we think that is important. We are hopeful 

that the money that they are thinking of dedicating for the New 

Freedom purposes will not come at the expense of some of the 

other programs. 

So I think the bottom line is they have taken some of the issues 

to heart, but there is a lot more that the administration needs to 

do and that Congress needs to incorporate into their proposals as 

the bills go forward this year. 

It turns out that at this point it seems likely that there will be 

a shorter-term—not a reauthorization, but a short-term gap proposal that would last for a year or two, perhaps until after the 

2004 election. It is unclear, and that is changing day-by-day, but 

at this point, there is likely to be a short-term piece rather than 

one that would last for 6 years. 

Ms. SIGGERUD. Ms. Markwood, do you have a comment? 

Ms. MARKWOOD. What N4A is urging in the reauthorization of 

TEA–21 is to really focus in on the issue of coordination. We believe that we need to foster a coordinated approach to human services transportation as we have discussed this afternoon, and we 

need to provide additional funding to support that planning and coordination, because as we have also discussed, there is a price tag 

associated with that. We also need to reduce the regulatory burdens and provide incentives for Federal grantees to work cooperatively at the community level on aging and older mobility issue. 

Additionally, besides coordination, we too are working toward 

and we too want more money in the 5310 Program to be able to 

support older transportation options in the community. We also believe that there should be a set-aside demonstration project funded 

through the Federal Transit Administration to help establish those 

innovative programs targeted to meet the needs of older adults and 

to utilize creative partnerships at the local levels to make these 

partnerships happen. 

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We also think that the Federal Transit Administration should 

develop and disseminate effective models and best practices 

through a national technical assistance center that would be targeted to meeting the needs of older adults. 

In addition to the reauthorization statements related to the Federal Transit Administration, we also think that the National Highway Traffic Safety Administration should focus additional attention—they have already focused a lot, but they need to focus additional attention—on older driver assessments and older driver safety issues, and specifically, public information needs to be disseminated about older driver issues. 

Additionally, we focus a lot on older driver safety and senior mobility, and the Federal Highway Administration is also key in that. 

When you are looking at promoting older driver safety, we have 

talked initially about the need for more markings, for better left 

turn exchanges. There is a whole range of different highway improvements that can be implemented that improve driving options 

for older adults. 

Unfortunately, especially in times of budget cuts, which is what 

the States are experiencing right now, these enhancements are 

usually the first things to be dropped. 

Again, the aging of the baby boomers is upon us. We cannot afford to drop any of these alternatives. We need to focus in on the 

continuum of senior mobility issues through the TEA–21 reauthorization, from older driver safety to public transportation and paratransit options to redesigning our highways to make them safer for 

older adults and for all adults. 

Ms. SIGGERUD. Dr. Kerschner. 

Dr. KERSCHNER. Just a couple of quick points. I would really emphasize the importance of TEA–21 and the reauthorization in the 

area of 5310. As you can tell, I am particularly interested in senior 

transportation options and looking beyond the traditional options, 

particularly funding what we call the ‘‘low-cost, low-maintenance’’

option. 

I think it is important to address that in a couple of ways. First, 

I think we could put in matching funds for startup and operational 

costs of these kinds of services. I say matching funds because it is 

very important that funds come from the community or from the 

organizations themselves, and that they are willing to do that; it 

would show support at the national level. 

I think the second thing is to help programs identify insurance 

carriers and pay for insurance costs in the early years of the programs. Insurance is the breaker in terms of these community-based 

transportation programs. In a conversation, people are talking at 

a meeting about, ‘‘Oh, we could really support seniors if we started 

a transportation program,’’ and somebody raises their hand and 

says, ‘‘But what about insurance?’’ and the conversation stops. It is 

really unfortunate, because insurance is available, and it is not always that expensive. For our program, I think we provided total insurance for all the volunteers for the whole program for about 

$2,500 a year. It is available, and it is possible to get it, but I think 

people need to know about it, and some of the support would be 

helpful. 

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I think travel reimbursement costs for volunteer drivers for these 

programs could be extremely helpful in supporting the programs 

and helping them get off the ground and supporting the whole idea 

of volunteerism. With the increased expense of gasoline now, this 

becomes a really important issue. 

Finally, to support the recruitment and training of volunteers 

who can be drivers but who can also be transportation caregivers 

could contribute a lot. 

All of that could happen under the 5310 legislation. 

Ms. SIGGERUD. Mr. Burkhardt. 

Mr. BURKHARDT. I would like to support all the comments that 

I have heard so far today, and what I would like to do, and speaking as a private individual and researcher, is to wrap this all together into a brand, new program. I would like to see the Senate 

Special Committee on Aging support a senior mobility initiative as 

part of the reauthorization of TEA–21. 

This should be a multi-agency approach. It would include the 

Federal Transit Administration, the Administration on Aging, the 

National Highway Traffic Safety Administration, and the Federal 

Highway Administration—just to start. There should be other 

agencies involved in this effort as well. 

One of the first key issues is the publicity campaign to let the 

rest of America understand how important it is to consider the 

older driver and senior mobility issues that are going to face all of 

us in the very, very near future. 

A very important component of this senior mobility initiative 

would be demonstration programs. They would be demonstration 

programs to work with shared-ride taxi options, they would work 

with the kinds of volunteer options that we have been talking 

about, they would look at the kinds of coordinated services that we 

found in Detroit, and they would be supported by Federal funding 

which then would also be used to say which of these programs 

could be replicated across the country and under what conditions 

and circumstances, which are cost-effective in rural areas, which 

are cost-effective in urban areas. 

I certainly support more funds for FTA’s Section 5310 program, 

but that alone is not enough. We really need something new, and 

if we call it a ‘‘senior mobility initiative’’ or if we call it something 

else, it does not matter much to me. But it does matter to me that 

the Administration on Aging gets involved as well as these three 

agencies that are directly affected by the TEA–21 legislation. I 

hope that the Special Committee on Aging will push for this. 

Ms. SIGGERUD. Thank you. 

Ms. LYNCH.

Ms. LYNCH. Thank you. 

I would like to build on what Mr. Burkhardt has said. It seems 

to me that the place we are today is that we need to break down 

the barrier that exists between transportation and human services 

transportation. We really need to move forward and make sure 

that transportation systems in this country focus on the needs of 

all the users—and that includes older drivers, transportation users, 

paratransit users, transit users—and take a philosophical leaf from 

the passage of the Americans with Disabilities Act, which tried to 

say in very simple language that the fact that a person has a disVerDate 0ct 09 2002 15:44 Nov 05, 2003 Jkt 000000 PO 00000 Frm 00101 Fmt 6633 Sfmt 6633 C:\DOCS\89855.TXT SAGING1 PsN: JOYCE
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ability should not prevent them from access to everything in American life. What we need to do in transportation is exactly the same 

thing. 

There was an assistant secretary of aging some years ago who 

used to talk about the need to ‘‘gerontologize’’ America, to make 

people understand what it means to have an aging society, and 

how so many of our systems need to change, and transportation is 

a wonderful place to start. 

Ms. SIGGERUD. Dr. Rosenbloom. 

Dr. ROSENBLOOM. Of course I echo what has gone before, but I 

would like to suggest that we not ghetto-ize these issues. If we 

focus only on additional 5310 funds, we are only doing triage; we 

are only taking care of the people with the most serious problems. 

But we are rapidly becoming an aging society. We have to take 

care of the older folks who could use public transportation, could 

use other options, who do not need door-to-door but need something, who do not need an escort with them but need some kind 

of superior level of service. 

I would like to push for additional funding for transit operators 

to do travel training and transit familiarization for older people, to 

increase security at bus stops along the way, to increase information and communication en route so a rider will know, if the bus 

is late, whether it will be possible to make a transfer or not, etc. 

I would like to stress that we need more funding for—I would 

like to echo Jon’s point that we need more funding for demonstration projects. I was recently working with the Harvard Project on 

Civil Rights, which is looking at the civil rights issues in the reauthorization of TEA–21, and those folks are absolutely amazed. They 

say that DOT is the only organization which does not do major 

demonstration projects that they follow for years and see how they 

work. 

So I think we need to be looking at that kind of thing that you 

see at HUD, that you see at Labor. We need to fund projects that 

deal with various aspects of things that you have heard about 

today, and then follow them not for a year, not for 2 years, but for 

5 or 10 years to see how people do, what the problems are, in what 

situations they can be transferred to other communities. This is 

really, really crucial. 

I would like to see more funding or more demonstration projects 

in the whole area of informal providers and private providers. 

I would also like to see more funding for ‘‘growing’’ transportation providers. FTA had a demonstration project, a very successful one, in Tennessee where they trained welfare recipients to be 

small-scale transport entrepreneurs in rural areas where there 

were no taxis and no volunteer programs. I would like to see some 

money put into those kinds of ideas. 

Also, someone earlier mentioned transportation planning. If any 

of you know how regional councils of government work, there is always one person—usually a young woman—who is the elderly, 

handicapped, minority—whatever the PC thematic issue of the day 

is—and after a long, complicated process goes on, she writes the 

last chapter of the transportation plan without it having anything 

to do with the major issues that have been grappled with for the 

whole process. 

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I think it is crucial that older folks and people with disabilities 

should be mainstreamed into the transportation planning process. 

It is very hard to see how, if the transportation planning process 

does not consider these issues front and center, providers and people who deliver programs and services are going to see it. 

Finally, I think some of you may know that in TEA–21, roadway 

projects were required to consider the impact of accessible pedestrian facilities, but transit is not. Transit operators who take Federal money for Federal improvements, for improvements in their 

transit system, are not required to consider accessible pedestrian 

facilities. 

I have a huge collection of pictures of bus stops, accessible bus 

stops—that are totally unconnected to anything. No sidewalk goes 

to them. But if you could be put down by a Star Trek transporter 

right on that landing pad, you could easily get on and off the bus. 

In the reauthorization of TEA–21, we need to put the same regulatory requirements on transit operators for the use of Federal 

money as are now put on highway operators—that the pedestrian 

infrastructure is absolutely crucial to the use of transportation 

services. 

Thank you. 

Ms. SIGGERUD. Now that everyone has had a chance to get their 

initial set of ideas out on the table, are there any reactions from 

panelists? Does anyone want a second chance at it? [No response.] 

OK. We have had a great panel today. I asked early on, perhaps 

in our third theme, about what can we do to communicate what we 

know about best practices and innovative ideas to the rest of the 

United States and the rest of the communities that are struggling 

with these same issues we have addressed today. We did not get 

into that issue in a lot of detail, but I have to say that I think the 

record of this forum and this panel will in fact provide an excellent 

starting point to get those ideas on the record, and I hope we can 

continue to explore that. 

Let me thank each of our panelists, who have traveled from near 

and far to participate with us today. We had an excellent discussion with great participation. 

I know it would be very useful to the Senate Special Committee 

on Aging as they move forward, and as I said, they plan to make 

a record of the meeting we have had today and share it throughout 

the Congress, to be able to have an impact on legislation in both 

the House and the Senate. 

Again, I thank the committee staff and the Senators on the committee for giving us this opportunity to raise all of these issues, 

and thanks to the audience for sitting with us and being a very 

good audience, rapt, and a very large one as well. So it is great to 

see this amount of attention paid to these issues. 

Thank you. 

[Whereupon, at 4:40 p.m., the forum was concluded.]

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