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                        North American Conference on Elderly Mobility (NACEM) Noteworthy Practices


            
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                Alternative Transportation, Mobility Management, and Coordination
myride2

In 2010, the Area Agency on Aging 1–B6 in Michigan partnered with Jewish Family Service to create **myride2**, a "one–call, one–click" Mobility Management Service. **myride2** helps seniors and adults with disabilities in Oakland, Macomb, and western Wayne counties in Michigan find transportation options best suited for their individual needs. The program also provides information on safe driving, making the transition when driving is no longer an option, Complete Streets, and instructional information for riding the bus. Trained mobility specialists offer public, private, and volunteer transportation options, and can schedule rides.

"myride2 website address (www.myride2.com) and toll-free phone number (855-697-4332)"

**myride2** offers a toll–free phone line and an interactive website (myride2.com) where people can search for transportation providers and request a ride. The program incorporates:

A toll–free multi–lingual phone line;
	A system where the rider only has to provide personal information one time;
	An interactive web site where users can search for providers, request a ride, or get information; and
	Assistance with Americans with Disabilities Act applications.**myride2** was launched in May 2012 and the company received more than 1,600 calls in its first year alone. The program sponsors hope to expand their services in the future to assist veterans as well.

"Image shows the myride2 homepage with links to resources and information about requesting a ride and finding a ride provider"**Figure 14.** Homepage of the myride2 Website
Source: Area Agency on Aging 1–B

For additional information:

Agency: Area Agency on Aging 1–B
Contact: Roberta Habowski
Telephone: 248–262–9211
Email: rhabowski@aaa1b.com

Kansas City: Link for Care

Link for Care helps provide veterans and senior citizens with easy information and a variety of options for senior services. It is designed to be a community service for caregivers, individuals needing personal assistance, healthcare professionals, social workers, discharge planners, mental health professionals, and transportation services. Link for Care is a free online resource to search a variety of services in the greater Kansas City area comprising 9 counties, 119 cities, and 50 transportation services. Link for Care lists a total of more than 1,400 services. Though there are other resource guides available throughout the Kansas City Region, Link for Care is the only one to comprehensively list services in all the counties across multiple disciplines (transportation, health services, housing services, legal, etc.).

"Image shows sample search results for from the Link for Care website"**Figure 15.** Results from a Sample Search on the Link for Care Website

One of the convenient features of Link for Care is that it allows users to build a profile and save their favorite services. This characteristic allows users to simply log in and find the contact information for their favorite services without performing a followâ€‘up search. There are future plans to install a trip planning tool on the website that will allow users to find services and then map the transportation to get them to the service provider and home again. The Kansas City Area Transportation Authority (KCATA) Call Center uses Link for Care if one of the region's transit agencies cannot provide a ride to a customer. The KCATA operator uses the website to help the customer find the best service that fits that individual's needs.

The University of Kansas (KU) Medical Center, Mid–America Regional Council, and the KCATA Call Center have promoted Link for Care with an extensive public outreach and media campaign. Marketing strategies have included commercials on radio and television, newspaper advertisements, and information on Facebook and other social media platforms. The KU Medical Center conducts additional public outreach with "lunch–and–learn" sessions for hospital dispatch agents, train–the–trainer sessions, and information provided at various public fairs and festivals.

As the website was developed, focus groups were conducted with veterans, older adults, persons with disabilities, and service providers. Input obtained during these focus group sessions was used to assist with the design of the website. Link for Care went live in November 2013 and is maintained and managed by the Central Plains Geriatric Staff at the KU Medical Center, Landon Center on Aging. Since its launch, the site has had more than 4,000 unique visitors and the numbers continue to grow.

"Image shows the homepage of the link for care website"**Figure 16.** Homepage of the Link for Care Website

For additional information:

Agency: Mid–America Regional Council
Contact: Tyler Means, Transportation Planner
Telephone: 816–701–8261
Email: tmeans@marc.org

Aging, Disability, and Transportation Agencies Working Together: Mobility Management in Wisconsin

In 2006 and 2007, the Wisconsin Department of Transportation (WisDOT) collaborated with Regional Planning Commissions to develop Coordinated Public Transit–Human Services Transportation Plans at the State and county level. As a result of the plans, several initiatives were started. In 2008, WisDOT developed a formal training program for mobility managers to build their awareness of resources and best practices. In 2009, a process to certify mobility managers was developed. Requirements for certification include completion of the training program, 1 year of field experience, and achieving a passing score on the final exam. The formal certification adds to the mobility managers' credibility as well as the value of their position, knowledge, and activities within their local communities. Mobility managers in Wisconsin operate out of aging units, independent living centers, transit facilities, employment centers, and other non–profit organizations. These individuals typically serve in a wide variety of roles, including operating volunteer drivers, paratransit, and other transportation services; coordinating between agencies; and educating communities about transportation options. One of the most valuable aspects of having a mobility manager in each county or region is that there is a single point of contact for customers.

In 2010, a group of mobility managers formed the Wisconsin Association of Mobility Managers (WAMM) to continue the support networking, training, and certification of among mobility managers. WAMM connects mobility managers across the state, facilitating the dissemination of best practices and resources and providing mobility management training and certification. WAMM helps connect local mobility managers with their counterparts across the state, which has led to an increase in the spread of information and best practices and offers the potential for pooled resources and innovative solutions.

While WisDOT was instrumental in beginning the mobility management movement, WAMM has since taken on the responsibility for training and communication with mobility managers in the state. WAMM partners with the other transportation associations in the state representing transit, taxicab owners, and specialized medical vehicles, as well as WisDOT.

WAMM is a 501 (c) 6 non–profit organization with a volunteer board of directors. Membership fees are assessed to anyone in the State or Nation who wants to join. These fees are used to create training opportunities to maintain mobility manager certification standards. WAMM has committees to coordinate training, track membership, and develop resources for more effective policy advocacy. New mobility managers can be matched with a mentor through the WAMM Mentorship Program. WAMM organizes members and responds to policy and programmatic issues, for example, non–emergency Medicaid transportation brokerage, volunteer driver program challenges, long–term stable funding, regional transit authorities, and livable communities.

Mobility management is a priority in Wisconsin, and WisDOT and WAMM continue to collaborate and work closely together to increase regional transportation options, expand service areas, develop coordination agreements across transportation programs, and increase knowledge about model programs.

For additional information:

Agency: Dane County Department of Human Services
Contact: Norah Cashin, Transportation Manager
Telephone: 608–242–6486
Email: cashin@countyofdane.com

Agency: Greater Wisconsin Agency on Aging Resources
Contact: Carrie Porter, OAA Consultant
Telephone: 608–228–8092
Email: carrie.porter@gwaar.org

A Bus is a Bus: Making Efficient Use of Unused Transportation Avenues

Many elderly would–be drivers rely on public transportation as their primary means of mobility. At the same time, the need for transit services is on the rise, leading to an overburden of existing transit systems. This has led the Shiawassee Area Transportation Agency (SATA) to extend existing transit services by employing an underutilized, sizable bus system–church vans and buses.

SATA is the bus service that serves the areas in and around Michigan's Shiawassee County. The county has a geographical area of 541 square miles and a population of 70,648, according to the 2010 census. In 2008, SATA partnered with area churches to use their buses and vans. The premise is simple, yet powerful–use church buses for public transport when they are not being used for their primary church function on Sundays and Wednesday nights. It appears to be a win–win for all involved–churches are able to recruit volunteer drivers directly from their congregations and these volunteer drivers save SATA money that they can then use for other needs. In return, SATA occasionally helps local churches with their transportation needs–usually in the form of one–time, large–group trips for church members–by coordinating passenger needs and helping to create a schedule. The church then uses its own vehicle and a volunteer from the congregation follows the schedule and directions given by SATA.

SATA has also provided the conduit to match individuals needing transportation with a member of a church congregation who volunteers for that individual on an on–going basis.7 This happens outside of the program described; however, it goes to show the mutual benefits from a partnership between a transit authority and local non–profit organizations that support and encourage volunteerism, especially one or more churches.

This program maximizes the efficient use of community–wide buses by pooling together vehicles already dedicated to general public transport. Church buses happen to be the largest fleet of buses available for use behind school buses. The ownership is not a factor to users; a bus is a bus, as long as it takes users where they want to go.

SATA provided 93,336 passenger trips per year for the fiscal year 2011. The program currently has one bus and two vans committed, but this is likely to change in the future as SATA intends to increase participation dramatically during 2015. There are 120 churches in Shiawassee County, potentially providing for 25 or more additional buses/vans to be used in this program.

For additional information:

Agency: Shiawassee Area Transportation Agency
Contact: MaLissa Schutt, Mobility Manager
Telephone: 989–725–9303
Email: mschutt@satabus.org

ITN*America*

The Independent Transportation Network (ITN) began in 1995 in Portland, Maine, as the Federal Transit Administration's model for sustainable, community–based transportation for seniors. With support from AARP, the Transit IDEA Program, numerous private philanthropies, and corporate sponsors, ITNAmerica has helped more than 25 communities in 22 states start an ITN affiliate of their own. More than 1,600 volunteer drivers and 11,000 members have participated in the service, which combines the power of information technology and the strength of local support to create an efficient and financially sustainable solution to the transportation needs of seniors and their families.

ITN America is designed to recreate the comfort and convenience of private automobile ownership for seniors and to be sustainable without relying on taxpayer dollars for ongoing operating expenses. Through its CarTradeTM ITN helps seniors to trade vehicles that they no longer use to pay for their own rides. As part of the initiative the Transportation Social Security Program gives volunteers transportation credits in the system when they drive others, and the Road Scholarship Program encourages volunteers to donate these credits for low–income riders who cannot afford their share of the far. ITN supplements publicly funded transportation by using private automobiles and is available to seniors 24 hours a day, 7 days a week for any purpose, without restriction. Through innovative payment plans, ITN integrates previously inaccessible private resources to help pay for rides, storing the resources in personal transportation accounts, and sending members monthly account statements. No money ever changes hands in the vehicles. Merchants and healthcare providers participate through the Ride & Shop and Healthy Miles programs. Seniors and people with visual impairments describe ITN as "the next best thing to driving."

ITNAmerica is working towards a national solution for a national problem:

Seniors have the highest fatal crash risk of any group except teenagers.
	Seniors take 88 percent of trips in private automobiles.
	Seniors take fewer than 3 percent of trips on public transit.
	Nearly 55 percent of seniors live in communities without public transit.With increasing concern for the safety and mobility issues of older drivers, many groups across the country are trying to find a solution. ITNAmerica is the first and only national non–profit whose mission is to address these transportation needs. It accomplishes this mission through research, policy, and technology, and by supporting communities across the country through replication of the ITN.

Though pricing is structured so that a user pays more for on–demand service and more to ride alone instead of sharing, it is still affordable since 38 to 46 percent of its users have an income of less than $25,000 per year. Some other statistics on the program include:

Approximately 43 percent of rides are for healthcare,
	The most common age of members is 86,
	About 80 percent of members are women living alone in the community, and
	Half of all riders report mobility impairments.By a ratio of 10 to 1, people who take rides report that ITN's arm–through–arm and door–through–door transportation is inexpensive for the service they receive.

For additional information:

"Image shows the location of ITNAmerica Affiliate sites across the continental United States"**Figure 17.** ITNAmerica Affiliate Sites

Agency: ITN*America*
Contact: Katherine Freund, Founder & President
Telephone: 207–591–6926
Email: Katherine.Freund@ITNAmerica.org

New York City's Senior Pedestrian Focus Areas

Walking New York City's busy streets can be challenging, especially for older adults. Even though adults age 65 and older make up only 12 percent of New York City's population, they account for 39 percent of the city's pedestrian fatalities. In an attempt to combat this over–representation, in 2008, the New York City Department of Transportation (NYC DOT) identified areas with high concentrations of senior pedestrian crashes that resulted in fatalities or severe injuries and designated them Senior Pedestrian Focus Areas (SPFAs). These SPFAs received infrastructure improvements and pedestrian–focused changes to traffic operations, in order to increase safety for senior pedestrians, and by extension, all pedestrians in New York City.

"Image shows a crosswalk with intersection daylight (a blocked out parking space allowing for increased visibility)"**Figure 18.** Intersection daylights

The NYC DOT created the SPFA program entirely in–house, incorporating a three–step process. The DOT first performed data analysis in order to characterize crash trends–in this case, related to senior pedestrians. Once it was able to identify each SPFA, and knowing both the crash types and the crash locations, the DOT then reviewed each SPFA for any potential contributing issues. Once all the information had been assembled, the agency developed solutions to counteract the crash types.

Finally, NYCDOT installed the infrastructure improvements that would combat the safety challenge, such as:

*Installing or replacing pedestrian ramps.*
	*Adding curb or median extensions.*Curb extensions help protect pedestrians not currently crossing the street from cars that may drive onto the curb or median.
	*Designating a leading pedestrian interval.* Leading pedestrian intervals provide an exclusive pedestrian walk phase to allow pedestrians movement through the intersection without interference from vehicular traffic.
	*Modifying walk signs to allow visible countdowns and more time for pedestrians to cross.* Walk signals were adjusted for the slower average pace of older adults, and countdown indications allow them to see exactly how much time is left to cross, enabling them to exercise their own judgment as to whether they can make it during the remaining walk time or whether they should just wait for the next walk phase.
	*Constructing pedestrian refuge islands within crosswalks at long, busy intersections.* Pedestrian refuge islands are raised medians normally located between opposing traffic lanes that offer a place for pedestrians to stand if they cannot cross an entire intersection during the pedestrian walk phase. Refuge islands turn one long crosswalk into two (or more) shorter ones. Since seniors typically walk at a slower rate than the average adult, installing pedestrian refuge islands makes crossing a long intersection much safer. This is especially true in a dense, urban setting, due to high traffic volumes, high vehicular speeds, and wide streets. These solutions became permanent infrastructure improvements and are accessed by all users as they attempt to cross these new, more pedestrian–friendly intersections. A pedestrian refuge island installed at the intersection of Northern Boulevard and Bowne Street in Queens has decreased pedestrian injuries by 45 percent.
	*"Daylighting" at intersection corners for better visibility.* This is the term for blocking out the parking spot closest to the crossroad, so that drivers on the road have a better view of pedestrians waiting to cross, as shown in Figure 18.
	*Implementing a Road Diet.* A Road Diet is the term for reducing the number of vehicle travel lanes and converting newly freed space into parking, bike lanes, landscaping, walkways, or medians. The NYC DOT implemented a Road Diet on Manhattan's Chrystie Street, which has resulted in a 66 percent reduction in pedestrian crashes at that location.
	*Installing rest locations through the City Bench Program.* The City Bench program installs new benches outside of senior centers, on main streets, and in front of any business that requests them, has adequate sidewalk width, and is willing to maintain them.According to the NYC DOT, "Since the program began, annual senior pedestrian fatalities have decreased 19 percent citywide, from 58 senior fatalities in 2008 to 48 in 2012."8

"Image shows Allerton Avenue in New York City before and after the construction of left turn bays, pedestrian refuge islands, and bike lanes"**Figure 19.** Allerton Ave, Bronx, New York City: Road Diet with Left Turn Bays, Pedestrian Refuge Islands and Bike Lanes (installed 2009)
Source: Hillary Poole, NYC DOT

For additional information:

Agency: New York City Department of Transportation
Contact: Jesse Mintz–Roth, Senior Project Manager
Telephone: 212–839–7751
Email: jmintz–roth@dot.nyc.gov

TimeBanking and Transportation

There are many ways to promote volunteering, but one new method, called TimeBanking has been expanding rapidly. TimeBanking is a new economic concept, in which, instead of trading money for goods and services, members of a TimeBank contribute their time towards services requested by other members, to earn hours. In exchange, those volunteers can then use the hours they accrue to request services from other members of the TimeBank.

Essentially, TimeBanks are community networks that provide service exchanges–for example, allowing one TimeBank member to earn an hour helping another member with their gardening, and then using that hour to offer a different TimeBank member to drive their child to soccer practice, who then earns an hour that they can use on whatever they want or need. TimeBank members can use their own time contributions providing a service for another member of the TimeBank as a de facto currency, tracked by the TimeBank, usually through an online system. Hour for hour, participants "bank" their time in order to receive goods or services from others within the program. This allows users access to goods or services they might not have access to otherwise and to be contributors as well as recipients of volunteer efforts.

Seniors need safe, reliable, and frequent transportation both to and from medical services. In order to promote volunteers to provide this transportation, the Dane County, Wisconsin Department of Human Services coordinated with a local TimeBanking organization, the Dane County TimeBank (DCTB). This allows patients to connect to volunteer drivers so they can receive transportation to and from their treatment centers, especially older adults living in rural areas who do not have access to public transportation.

The City of Madison is the urban center of Dane County, Wisconsin, surrounded by both suburban and rural areas. Some of these rural areas have population densities of between 1 and 5 people per square mile, which has resulted in a lack of readily available public transportation. Instead, thanks to the partnership between the Dane County Department of Human Services and the DCTB, senior transportation needs are being met in all areas of Dane County.

To find volunteers who can provide transportation services, the DCTB recruits, screens, and trains members who are qualified to be volunteer drivers for older adults needing transportation to local dialysis centers. The Dane County One–Call Center coordinates between the DCTB, dialysis centers and other needed services, and older adults needing transportation.

The Dane County Department of Human Services did not initiate the concept of TimeBanking, but instead put it to effective use to help patients in need of dialysis to receive such treatment. This practice could be implemented again virtually anywhere, as it requires only a TimeBank, or a system that keeps track of hours that TimeBank members contribute toward benefiting others–hours that can then be exchanged for service from others.

For riders, this service contributes to positive mental and physical health. Pairing senior riders with volunteer drivers diminishes feelings of social isolation which can lead to depression. The service contributes to riders' physical health as well; frequent, regular visits to needed medical services leads to better care, as doctors can more accurately track the progress of their patients and identify problems as soon as they may arise. This practice also increases riders' compliance with their treatment, now being held accountable by others besides themselves and their doctors.

For additional information:

Agency: National Center on Senior Transportation
Contact: Virginia Dize, Co–Director
Telephone: 202–872–0888
Email: vdize@n4a.org

Seniors Training Seniors How to Use Transit

As people age, they may need to change certain aspects about their lives to better meet their needs and reflect their abilities. This may mean creating new routines as older people begin to rely more heavily on public transportation; however, those unfamiliar with public transportation may be uncomfortable learning a new system and may be reluctant to do so on their own. The unfamiliarity can be daunting and confusing, but peer volunteers can provide support, knowledge, and guidance in this transition period, making it easier for all seniors to use public transportation as their primary means of mobility.

""Image shows seniors riding the The Rapid (the bus system serving Grand Rapids, Michigan**Figure 20.** Walker Senior Neighbors Riding the Rapid

Michigan's Rapid Senior Mentor Program pairs an experienced senior volunteer with any senior who may be new to using fixed route service. Through the guidance of these peer mentors, new senior passengers learn how easy and safe riding the bus can be. The mentor answers transit service questions, plans the route to a destination of the passenger's choosing, and travels with the new passenger. The program also provides the participant a free 10–ride fare card to start his or her bus travels. All training programs are free to participants, including free rides during training.

Recruitment for mentors was targeted through personal relationships with current bus riders, recommendations of bus operators, senior centers, and key non–profits. Mentors went through an initial training before they began working with clients. Recruitment of potential clients is on–going. Any transit organization could replicate this program–it only requires a group of dedicated volunteers and the desire to market the program to potential riders so that they know that this personal and friendly transit–planning service is available to them. Some on–going recruitment of volunteers may be necessary.

The Rapid, the bus system serving Grand Rapids, Michigan, and the surrounding areas, created this program. This program has been beneficial not only to seniors themselves, but to the broader community as seniors are able to live more actively. According to an article describing the practice from the National Center on Senior Transportation, "over 800 older adults have been served through the Rapid's Senior Mentor Program. By allowing older adults to remain independent, their mental and physical fitness improves." 9 Businesses benefit from increased patronage from older adults who were once inactive due to previous apprehension about driving or using public transportation. There are savings associated with aging–in–place as long as needs such as reliable transportation are met. Many organizations can benefit from seniors' ability to volunteer or otherwise be engaged in activities. This program provides significant returns for the investment of time and resources needed to start and maintain a senior peer training program.

For additional information:

Agency: Interurban Transit Partnership
Contact: Sarah Green, Travel Training Coordinator
Telephone: 626–456–7514
Email: sgreen@ridetherapid.org

References

6The Area Agency on Aging 1–B is a non–profit 501(c)3 agency responsible for services to more than 620,000 persons age 60 and older residing in Livingston, Macomb, Monroe, Oakland, St. Clair and Washtenaw counties in Michigan. It is one of 16 area agencies in the state of Michigan.

7SATA menu of transportation solutions. Accessed December 29, 2014. http://www.michigan.gov/documents/mdot/VolunteerServiceAmongMenuOf_Transp_Solutions_SATA_Michigan_409378_7.pdf

8New York City DOT Safe Streets for Seniors. Accessed July 10, 2014. http://www.nyc.gov/html/dot/html/pedestrians/safeseniors.shtml

9National Center on Senior Transportation. Accessed November 17, 2014. http://www.seniortransportation.net/ResourcesPublications/TheRapid.aspx
      
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