TRANSPORTATION- DISADVANTAGED 

POPULATIONS

Coordination Efforts

are Underway, but 

Challenges Continue

Statement for the Record by Dave Wise, Director, 

Physical Infrastructure Issues

Statement for the Record

To the Special Committee on Aging,

U.S. Senate

For Release on Delivery

Expected at 2 p.m. EST 

Wednesday, November 6, 2013

GAO-14-154T

United States Government Accountability Office
United States Government Accountability Office

Highlights of GAO-14-154T, a statement for 

the record to the Special Committee on Aging, 

U.S. Senate

November 2013

TRANSPORTATION-DISADVANTAGED 

POPULATIONS

Coordination Efforts are Underway, but Challenges 

Continue

Why GAO Did This Study

Millions of Americans are unable to 

provide their own transportation or 

have difficulty accessing public 

transportation. Such transportationdisadvantaged populations may 

include those who are elderly, have 

disabilities, or have low incomes. Older 

adults represent the fastest-growing 

segment of the U.S. population, and 

access to transportation is critical to 

helping individuals remain independent 

as they age.

This statement addresses (1) the 

federal programs that provide funding 

for transportation services for the 

transportation-disadvantaged 

populations, including older adults, and 

(2) the types of challenges faced in

providing services to transportationdisadvantaged populations. This 

statement is based on GAO’s body of 

work in this area from 2004 through 

2012.

What GAO Recommends

GAO is not making any new 

recommendations. In 2012, GAO 

recommended that the Secretary of

Transportation, as the chair of the 

Coordinating Council on Access and 

Mobility, along with its member 

agencies, should (1) complete and 

publish a strategic plan that would

outline agency roles and

responsibilities and articulate a 

strategy to help strengthen interagency 

collaboration and communication, and 

(2) report on the progress of 

Coordinating Council 

recommendations and develop a plan 

to address any outstanding 

recommendations. DOT has begun 

taking action to implement these 

recommendations.

What GAO Found

In 2012, GAO reported that 80 federal programs in eight different agencies fund 

a variety of transportation services for transportation-disadvantaged populations, 

which include older Americans. Within the Department of Transportation (DOT), 

the Federal Transit Administration (FTA) is a key source of federal transportation 

funding for older Americans. For example, some FTA programs provide formula 

funding to states to serve transit-dependent populations with special needs. 

States typically distribute these funds to local nonprofit human service agencies 

to buy vehicles to transport older adults and people with disabilities, and the 

funds may support transportation to access a range of activities, such as grocery 

shopping. While some federal funding programs are transportation focused, 

transportation was not the primary mission for the vast majority of the 80 

programs GAO identified in 2012. For example, the Department of Health and 

Human Services’ Medicaid program reimburses states that provide Medicaid 

beneficiaries with bus passes, among other transportation options, to access 

eligible medical services. Total federal spending on transportation services for 

the transportation disadvantaged remains unknown because federal departments 

did not separately track spending for roughly two-thirds of the programs identified 

in 2012. Through regulations, guidance, or agency initiatives, some agency

programs require or encourage their grantees to coordinate transportation 

services. For example, FTA’s Enhanced Mobility of Seniors and Individuals with 

Disabilities program required grantees to coordinate and establish locally 

developed, coordinated public transit-human services transportation plans.

While some transportation planning and service coordination efforts are under 

way at the federal, state and local levels, GAO previously identified continuing

challenges such as insufficient leadership at the federal level and limited financial 

resources and growing unmet needs at the state and local level. For example, in 

2012 GAO reported that insufficient federal leadership and guidance about how 

to coordinate transportation services for the transportation disadvantaged and 

navigate various federal program requirements might hinder the coordination of 

transportation services among state and local providers. Selected state officials 

also said that the federal government could provide state and local entities with 

improved guidance on transportation coordination—especially related to 

instructions on how to share costs across programs (i.e., determining what 

portion of a trip should be paid by whom). Limited financial resources and 

growing unmet needs challenge state and local providers as well. Several state 

and local officials expressed concern about their ability to adequately address 

expected growth in elderly, disabled, low-income, and rural populations. For 

example, transit agency officials reported to GAO in 2012 that demand for 

Americans with Disabilities Act paratransit—a service that can be more costly to 

operate than traditional fixed-route transit and that is often used by 

transportation-disadvantaged populations including the elderly—has increased 

because of the growing older population.

View GAO-14-154T. For more information, 

contact David J. Wise at (202) 512-2834 or 

wised@gao.gov.
Page 1 GAO-14-154T 

Chairman Nelson, Ranking Member Collins, and Members of the 

Committee:

I am pleased to submit this statement discussing GAO’s work on 

transportation-disadvantaged populations, including older adults. Millions 

of Americans are unable to provide their own transportation or have 

difficulty accessing public transportation. Such transportationdisadvantaged populations may include those who are elderly, have 

disabilities, or have low incomes. Older adults represent the fastestgrowing segment of the U.S. population, and access to transportation, via 

automobile or other modes, is critical to helping individuals remain 

independent as they age. In the face of limited financial resources, state 

and local transportation providers are concerned about growing elderly 

populations and unmet transportation needs.

This statement describes: (1) the federal programs that provide funding 

for transportation services for the transportation-disadvantaged 

populations, including older adults, and (2) the types of challenges 

federally-funded programs face in providing services to transportationdisadvantaged populations. This statement is drawn from a body of work 

that we completed from 2004 through 2012 regarding transportationdisadvantaged populations.1

 1

GAO, ADA Paratransit Services: Demand Has Increased, but Little is Known about 

Compliance,

The reports cited in this statement contain 

more detailed explanations of the methods used to conduct our work. The 

work on which this statement is based was conducted in accordance with 

generally accepted government auditing standards. Those standards 

require that we plan and perform the audit to obtain sufficient, appropriate 

evidence to provide a reasonable basis for our findings and conclusions 

based on our audit objectives. We believe that the evidence obtained 

provides a reasonable basis for our findings and conclusions based on 

our audit objectives.

GAO-13-17 (Washington, D.C.: Nov. 15, 2012); TransportationDisadvantaged Populations: Federal Coordination Efforts Could Be Further Strengthened,

GAO-12-647 (Washington, D.C.: June 20, 2012); Opportunities to Reduce Potential 

Duplication in Government Programs, Save Tax Dollars, and Enhance Revenue, 

GAO-11-318SP (Washington, D.C.: March 1, 2011); Older Driver Safety: Knowledge 

Sharing Should Help States Prepare for Increase in Older Driver Population, GAO-07-413

(Washington, D.C.: April 11, 2007); and Transportation-Disadvantaged Seniors: Efforts to 

Enhance Senior Mobility Could Benefit from Additional Guidance and Information, 

GAO-04-971 (Washington, D.C.: Aug. 30, 2004). 
Page 2 GAO-14-154T 

Older adults represent the fastest-growing segment of the U.S. 

population. According to 2010 U.S. census data, the population aged 65 

and older grew 15 percent from 2000 to 2010, compared with growth of 

about 10 percent in the overall population. As people age, their physical, 

visual, and cognitive abilities may decline, making it more difficult for them 

to drive safely. Public transportation can be an option for the elderly, but 

access and ease of use can be a challenge.

Federal programs play an important role in helping transportationdisadvantaged populations, including older adults, by providing funds to 

state and local grantees that, in turn, offer transportation services either 

directly or through private or public transportation providers. This includes 

contracting with private transit providers or providing transit passes, taxi 

vouchers, or mileage reimbursement to program participants, or some 

combination of these methods. Some programs may use federal funds to 

purchase and operate their own vehicles. Federal programs provide 

funding for transportation under a variety of services including education, 

employment, medical care, and other human services.

We have previously reported that people in need of transportation often 

benefit from greater and higher quality services when transportation 

providers coordinate their operations. Additionally, federal coordination of 

transportation services can lead to economic benefits, such as funding 

flexibility, reduced costs, or greater efficiency. The Department of 

Transportation (DOT) chairs the Interagency Coordinating Council on 

Access and Mobility (Coordinating Council), which among other things, 

assists federal transportation program coordination efforts so that 

transportation-disadvantaged persons have access to improved 

transportation services. The Coordinating Council launched the “United 

We Ride” initiative in fall 2003 to act as a forum for interagency 

communication and to help states and communities overcome obstacles 

to coordination. Coordinating Council actions included issuing 

publications such as policy statements and progress reports on efforts 

taken.

Background
Page 3 GAO-14-154T 

In 2012, we reported that 80 federal programs in eight different agencies 

fund a variety of transportation services for transportation-disadvantaged 

populations.2 Within the DOT, the Federal Transit Administration (FTA) is 

a key source of federal transportation funding for older Americans. For 

example, FTA’s Enhanced Mobility of Seniors and Individuals with 

Disabilities program—authorized at approximately $255 million for fiscal 

year 2013 and $258 million for fiscal year 2014—provides formula funding 

to states to serve the special needs of transit-dependent populations 

beyond traditional public transportation services.3

While some federal funding is targeted to programs with a transportationrelated mission, transportation was not the primary mission of the vast 

majority of the programs we identified. Other key federal agencies that 

provide transportation funding include the Departments of Health and 

Human Services (HHS), Education, and Housing and Urban 

Development. These departments’ programs primarily provide a variety of 

human services, such as medical care, which incorporate transportation 

as an eligible program expense to ensure that participants can access a 

service. For example, HHS’s Medicaid program reimburses states that 

provide Medicaid beneficiaries with bus passes, among other 

transportation options, to access eligible medical services.

States typically 

distribute these funds to local nonprofit human service agencies to buy 

vehicles that transport older adults and people with disabilities, and the 

agencies funded may support a range of activities including visiting 

friends or grocery shopping.

The total spending on transportation services for the transportation 

disadvantaged—including the elderly—remains unknown because, in 

many cases, federal departments do not separately track spending for 

these services. Of the 80 programs that we identified in 2012, roughly 

two-thirds of the programs were unable to provide spending information 

for eligible transportation services offered in fiscal year 2010. However, 

 2

GAO-12-647. In 2012, we reported on the universe of fiscal year 2010 federal programs 

that provide funding for transportation services for the transportation disadvantaged. 

3

Moving Ahead for Progress in the 21st Century Act (MAP-21), Pub. L. No. 112-141, 

§ 20028, 126 Stat. 405, 726, codified as positive law at 49 U.S.C. § 5338(a)(2)(D).

Eighty Federal 

Programs Fund 

Transportation 

Services for the 

Transportation 

Disadvantaged and 

Total Spending is 

Unknown
Page 4 GAO-14-154T 

total expenditures and obligations4

Through regulations, guidance, or agency initiatives, some federal 

programs require or encourage their grantees to coordinate transportation 

services. For example, FTA’s Enhanced Mobility of Seniors and 

Individuals with Disabilities program required grantees to coordinate their 

transportation services and establish locally developed, coordinated 

public transit-human services transportation plans.

for the 28 programs that did track or 

estimate transportation spending were at least $11.8 billion in fiscal year 

2010.

5 Additionally, there are 

some federal partnership efforts underway, such as the Veterans 

Transportation and Community Living Initiative Grant Program, a 

coordinated effort by the Departments of Defense, HHS, Labor, 

Transportation, and Veterans Affairs to support one-call transportation 

resource centers.6

 4

Spending was reported by program officials, and we did not verify the information. 

Amounts obligated or expended on transportation are given, depending upon the 

information available. When actual information was not available, agency officials provided 

estimates.

5

MAP-21, Pub. L. No. 112-141, § 20009, 126 Stat., 675-680, codified at 49 U.S.C. § 5310,

consolidated DOT’s Transportation Services for Individuals with Disabilities and New 

Freedom programs into the Mobility of Seniors and Individuals with Disabilities program. 

Among other things, section 5310 further provides for the apportionment of funds for 

urbanized and rural areas based on the population distribution of seniors and individuals 

with disabilities. Recipients must certify that projects selected are included in a locally 

developed, coordinated public transit-human services transportation plan. The plan must 

undergo a development and approval process that includes seniors and people with 

disabilities, transportation providers, among others, and is coordinated to the maximum 

extent possible with transportation services assisted by other federal departments and 

agencies.

6

One-call centers support human service and other specialized transportation services by 

providing program information such as service characteristics, eligibility criteria, and 

referrals for appropriate service providers. For example, a regional planning commission 

in Virginia operates a one-call center that provides clients with information on the public, 

private, and volunteer transportation options available in the region. 
Page 5 GAO-14-154T 

While some transportation coordination efforts are under way at the 

federal, state and local levels, we have previously identified key 

challenges to providing services to transportation disadvantaged 

populations, such as insufficient leadership and guidance at the federal 

level, changes to state legislation and policies, limited financial resources, 

and growing unmet needs. In 2012 we reported that insufficient federal 

leadership and guidance on how to coordinate transportation services for 

the transportation disadvantaged and varying federal program 

requirements may hinder the coordination of transportation services 

among state and local providers. For example, state and local officials in 

four out of the five states we selected in 2012 said that with the exception 

of DOT, other federal agencies were not actively encouraging 

transportation coordination. Officials in each of the five states we selected 

also said that the federal government could provide state and local 

entities with improved guidance on transportation coordination—

especially as it relates to instructions on how to share costs across 

programs (i.e., determining what portion of a trip should be paid by 

whom).7 To promote and enhance federal, state, and local coordination 

activities, we recommended that the Secretary of Transportation report on 

the progress of Coordinating Council recommendations and develop a 

plan to address any outstanding recommendations, including the 

development of a cost-sharing policy and the actions taken by member 

agencies to increase federal program grantee participation in locally 

developed, coordinated planning processes.8 We also recommended that 

the Coordinating Council meet and complete and publish a strategic plan 

to clearly outline agency roles and responsibilities and articulate a 

strategy to help strengthen interagency collaboration and communication, 

which could help address state and local challenges in understanding 

program requirements.9

 7

In 2012, we reported on the types of coordination that occurred at the state and local 

level by conducting interviews with officials from five states—Florida, Texas, Virginia, 

Washington, and Wisconsin.

DOT and the Coordinating Council’s member 

agencies responded to this recommendation by issuing a strategic plan 

for 2011-2013, which established agency roles and responsibilities and 

identified a shared strategy to reinforce cooperation, and officials have 

8

As of November 2013, this recommendation remained open, meaning that DOT has not 

taken action on the recommendation. 

9

GAO-12-647. In 2012, we reported that the Coordinating Council was largely active from 

2003 to 2007, and that the Secretary-level members of the council had last met in 2008. 

Despite 

Transportation 

Planning and Service 

Coordination Efforts, 

Challenges Continue
Page 6 GAO-14-154T 

indicated they will continue to take steps to implement these 

recommendations. For example, the Coordinating Council’s member 

agencies agreed, among other things, to demonstrate federal leadership 

on transportation coordination through: developing, promoting, and 

implementing an effective human service transportation policy that 

facilitates local- and state-level coordination practices and supports 

national priorities.

Changes in state legislation or state policies may also pose challenges to 

coordinating services for the transportation disadvantaged at the state 

and local level. State officials in four of the five states we met with in 2012 

told us that such changes have caused some uncertainty. For example, in 

2012 we reported some state coordinating bodies’ authority had not been 

renewed or was about to expire, causing uncertainty in the states’ efforts 

to coordinate human services transportation going forward. In addition, 

uncertainty regarding how developments—such as a state shifting 

responsibilities for Medicaid nonemergency medical transportation from a 

coordinated state-level transportation system to a private managed care 

system—may affect state Medicaid program’s participation in state and 

local efforts to coordinate transportation services for the transportation 

disadvantaged.

Limited financial resources and growing unmet needs are also challenges 

for state and local providers and their ongoing coordination efforts—both 

now and in the future. Several state and local officials expressed concern 

about their ability to adequately address expected growth in elderly, 

disabled, low-income, and rural populations. For example, transit agency 

officials told us in 2012 that demand for Americans with Disabilities Act of 

1990 (ADA)10 paratransit,11 a service often used by transportationdisadvantaged population including the elderly, has increased because of 

the growing older population.12

 10 Pub. L. No. 101–336, 104 Stat. 327 (1990), codified at 42 U.S.C. ch. 126.

However, ADA paratransit trips are much 

more costly to provide than fixed-route trips because they may, for 

example, provide door-to-door service. Officials pointed to the growth in 

11As defined at 49 C.F.R. § 37.3.

12Paratransit service, broadly defined, is accessible, origin-to-destination transportation 

service that operates in response to calls or requests from riders. It is an alternative to 

fixed-route transit service, which operates according to regular schedules along 

prescribed routes with designated stops.
Page 7 GAO-14-154T 

the older adult population as a reason why more people are living with 

disabilities and need ADA paratransit services. Additionally, some 

agencies and their potential partners reported that they find it difficult to 

come up with funding, even when it is a modest local match for grants. 

Similarly, state and local officials in Virginia told us that state and local 

match requirements may preclude some entities from applying for federal 

funds. Given these growing unmet needs in an environment of limited 

resources, additional information on (1) the current extent of 

transportation services and funding available for older adults, and (2) 

efforts to coordinate services, including with the private sector and at the 

federal, state, and local levels could help identify both challenges and 

leading practices for providing funding and transportation services for 

older Americans going forward.

This concludes my statement for the record.

For further information on this statement, please contact David J. Wise at 

(202) 512-2834 or wised@gao.gov. Contact points for our offices of 

Congressional Relations and Public Affairs may be found on the last page 

of this statement. In addition to the contact named above, Bert Japikse, 

Delwen Jones, Heather MacLeod, Sara Ann Moessbauer, Maria Wallace, 

and Betsey Ward-Jenks made key contributions to this statement.

GAO Contacts and 

Acknowledgements
Related GAO Products

Page 8 GAO-14-154T 

ADA Paratransit Services: Demand Has Increased, but Little is Known 

about Compliance. GAO-13-17. Washington, D.C.: November 15, 2012.

Transportation-Disadvantaged Populations: Federal Coordination Efforts 

Could Be Further Strengthened. GAO-12-647. Washington, D.C.: 

June 20, 2012.

Government Operations: Opportunities to Reduce Potential Duplication 

in Government Programs, Save Tax Dollars, and Enhance Revenue.

GAO-11-318SP. Washington, D.C.: March 1, 2011.

Older Driver Safety: Knowledge Sharing Should Help States Prepare for 

Increase in Older Driver Population. GAO-07-413. Washington, D.C.: 

April 11, 2007.

Transportation-Disadvantaged Seniors: Efforts to Enhance Senior 

Mobility Could Benefit from Additional Guidance and Information.

GAO-04-971. Washington, D.C.: August 30, 2004.

Related GAO Products

(542227)
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