North American

Conference on

ELDERLY

MOBILITY

Noteworthy Practices Guide
It was an honor to sponsor and participate in the North American Conference on Elderly Mobility held May 

11-14, 2014 in Detroit, Michigan. As our population ages, it is increasingly important that we account for 

the safety and needs of older adults and people with disabilities in our transportation system. Keeping our 

aging population mobile is important for maintaining independence and quality of life. We must also be 

mindful that older adults are especially vulnerable to injury and death in crashes. Communities across the 

nation recognize the transportation challenges facing older adults and are looking for methods to keep 

them safely on the move. The Federal Highway Administration is committed to improving the safety of our 

transportation system, and we hope this publication will help.

This guide showcases several national and international noteworthy practices presented during each 

conference track: alternative transportation, infrastructure and vehicles, driver education and training, 

driver screening and assessment, and housing and land use. The agencies and organizations featured on 

the following pages have significantly improved the safety and mobility of our older population through 

the use of various techniques and programs. 

We hope you will consider implementing these successful programs and initiatives in your community. 

Sincerely,

Tony Furst

Associate Administrator for Safety 

Federal Highway Administration

Notice

This document is disseminated under the sponsorship of the U.S. Department of Transportation in 

the interest of information exchange. The U.S. Government assumes no liability for the use of the 

information contained in this document.

The U.S. Government does not endorse products or manufacturers. Trademarks or manufacturers’ 

names appear in this report only because they are considered essential to the objective of the 

document.

Quality Assurance Statement 

The Federal Highway Administration (FHWA) provides high-quality information to serve Government, 

industry, and the public in a manner that promotes public understanding. Standards and policies are 

used to ensure and maximize the quality, objectivity, utility, and integrity of its information. FHWA 

periodically reviews quality issues and adjusts its programs and processes to ensure continuous quality 

improvement.

Foreword
Form DOT F 1700.7 (8-72)

1. Report No. FHWA-SA-14-095 2. Government 

Accession No.

3. Recipient’s Catalog No.

4. Title and Subtitle 

North American Conference on Elderly Mobility – Noteworthy 

Practices Guide

5. Report Date

December 2014

6. Performing 

Organization Code

7. Authors

 Heather Rigdon, Jennifer Atkinson, John Bosack, Cara O’Donnell, and 

Julie Lambert

8. Performing 

Organization Report No.

9. Performing Organization Name and Address

Leidos

11251 Roger Bacon Drive

Reston, VA 20190

10. Work Unit No. (TRAIS)

11. Contract or Grant No.

DTFH61-10-D00024-T-12006

12. Sponsoring Agency Name and Address

Federal Highway Administration

Office of Safety

1200 New Jersey Avenue SE

Washington, DC 20590

13. Type of Report and 

Period Covered

Noteworthy Practices 

Guide

 May 2014 - 

December 2014

14. Sponsoring Agency 

Code

FHWA

15. Supplementary Notes

Rebecca Crowe, Office of Safety Technologies, served as the Technical Manager for the 

Federal Highway Administration.

16. Abstract

It is increasingly important to account for the safety and needs of older adults in our transportation 

system as the population ages. The North American Conference on Elderly Mobility (NACEM) was 

held May 11-14, 2014 in Detroit, Michigan and featured best practices in older adult mobility and 

highlighted new developments since the conference was first held in 2004. 

This guide showcases national and international noteworthy practices presented during each 

conference track: infrastructure and vehicles; driver screening and assessment; driver education and 

training; alternative transportation, mobility management, and coordination; and housing and land 

use. The agencies and organizations featured in this guide have significantly improved the safety and 

mobility of our older population through the use of various techniques and programs that can be 

replicated nationwide.

17. Key Words

Older Driver, Senior, Transportation, Mobility, 

Safety

18. Distribution Statement 

 No restrictions. 

19. Security Classif. 

(of this report) 

Unclassified

20. Security Classif. 

(of this page) 

Unclassified

21. No of Pages

 41

22. Price 

 N/A

Form DOT F 1700.7 (8-72) Reproduction of completed page authorized.

Table of Contents

Elderly Mobility Noteworthy Practices Guide 1 

Acronyms and Abbreviations ................................................................................................................................................................ 3

Infastructure and Vehicles

Handbook for Designing Roadways for the Aging Population................................................................................... 4

Michigan Showcase Roadway ................................................................................................................................................ 7

Adaptive LED Lighting in New Zealand.............................................................................................................................10

Vernon, British Columbia: Older Driver Pilot Project ....................................................................................................11

Alberta Traffic Safety Guide to Accommodating Older Drivers ................................................................................12

Driver Screening and Assessment

Collaboration Between Law Enforcement and Public Health Organizations: 

 The Cognitive Assessment Tool .......................................................................................................................................13

Maryland’s Multi-tiered System to Assess Medical Fitness .........................................................................................14

Driver Education and Training

Florida’s Aging Road User Strategic Safety Plan .............................................................................................................16

Michigan’s Guide for Aging Drivers and Their Families ................................................................................................18

CarFit ..............................................................................................................................................................................................20

Using Driving Rehab Specialists to Help Older Drivers Keep the Keys ..................................................................22

New and Improved AARP Smart DriverTM Course ..........................................................................................................24

Alternative Transportation, Mobility Management, and Coordination

myride2 .........................................................................................................................................................................................25

Kansas City: Link for Care ........................................................................................................................................................26

Aging, Disability, and Transportation Agencies Working Together: 

 Mobility Management in Wisconsin ..............................................................................................................................28

A Bus is a Bus: Making Efficient Use of Unused Transportation Avenues .............................................................29

ITNAmerica ..................................................................................................................................................................................30

New York City’s Senior Pedestrian Focus Areas ..............................................................................................................32

TimeBanking and Transportation ........................................................................................................................................34

Seniors Training Seniors How to Use Transit ....................................................................................................................36

Housing and Land Use

Engaging Older Adults in Emergency Preparedness Planning .................................................................................37

It Takes a Village: Transportation Options .........................................................................................................................39
2 Federal Highway Administration

List of Tables

Table of Contents, cont’d

List of Figures

Figure 1. Handbook for Designing Roadways for the Aging Population...................................................4

Figure 2. Older Driver Showcase Roadway in Detroit.......................................................................................7

Figure 3. Signal Backplates with No Reflective Strip (left) and Signal Backplates with 

 Yellow Retroreflective Strip (right).......................................................................................................................8

Figure 4. Adaptive LED Road Lighting..................................................................................................................10

Figure 5. Senior Focus Group...................................................................................................................................11

Figure 6. Alberta Traffic Safety Plan 2015 ............................................................................................................12

Figure 7. Curve Delineation......................................................................................................................................12

Figure 8. Law enforcement screening driver for cognitive impairment with DOSCI tool..................13

Figure 9. Florida’s Aging Road User Strategic Safety Plan .............................................................................17

Figure 10. Michigan’s Guide for Aging Drivers and Their Families..............................................................18

Figure 11. CarFit Process............................................................................................................................................21

Figure 12. Driving Rehab Specialists Conduct an In-vehicle Evaluation..................................................22

Figure 13. Genesis Rehab Services Outlines Four Key Steps that clients can Take to 

 Get Started with Driving Rehabilitation ..........................................................................................................23

Figure 14. Homepage of the myride2 Website..................................................................................................25

Figure 15. Transportation Search Options for the Link for Care Website .................................................26

Figure 16. Homepage of the Link for Care Website .........................................................................................27

Figure 17. ITNAmerica Affiliate Sites.....................................................................................................................31

Figure 18. Intersection daylights............................................................................................................................32

Figure 19. Allerton Ave, Bronx, New York City: Road Diet with Left Turn Bays, 

 Pedestrian Refuge Islands and Bike Lanes (installed 2009) ......................................................................33

Figure 20. Walker Senior Neighbors Riding the Rapid....................................................................................36

Figure 21. Seniors Participating in Emergency Planning...............................................................................37

Figure 22. Emergency Personnel Evacuating Seniors.....................................................................................38

Figure 23. Current number of Village communities across the nation as of August 2014 ................40

Table 1. Treatments Recommended for Proven Practices...............................................................................5

Table 2. Treatments Recommended for Promising Practices ........................................................................6
Elderly Mobility Noteworthy Practices Guide 3 

Acronyms and Abbreviations

AAA American Automobile Association

ASTM American Society for Testing and Materials

DCTB Dane County TimeBank

DMV Department of Motor Vehicles

DOSCI Driver Orientation Screen for Cognitive Impairment

DOT Department of Transportation

DRS Driving Rehab Specialist

FCT Functional Capacity Screening Test

FHWA Federal Highway Administration

GRS Genesis Rehab Services

ICBC Insurance Corporation of British Columbia

ITN Independent Transportation Network

JFS Jewish Family Service

KCATA Kansas City Area Transportation Authority

KU University of Kansas

LED Light Emitting Diode

MAB Medical Advisory Board

MDOT Michigan Department of Transportation

MVA Maryland Motor Vehicle Administration

NACEM North American Conference on Elderly Mobility

NYC DOT New York City Department of Transportation

RSA Road Safety Audit

SATA Shiawassee Area Transportation Agency

SPFA Senior Pedestrian Focus Area

TCD Traffic Control Device

TREDS Training, Research and Education for Driving Safety

UC University of California

WAMM Wisconsin Association of Mobility Managers

WisDOT Wisconsin Department of Transportation
4 Federal Highway Administration

Infastructure and Vehicles

Handbook for Designing Roadways for the 

Aging Population

The 2014 Federal Highway Administration (FHWA) Handbook 

for Designing Roadways for the Aging Population, (Figure 1) 

contains 33 proven treatments, 18 promising treatments, and 143 

recommendations. The Handbook now in its third edition; and under 

a new title, incorporates the latest research and advancements in 

treatments since the previous editions were published in 1998 

and 2001.

The Handbook is composed of two parts. Part I includes 

recommendations for treatments and countermeasures to address 

specific areas of concern for aging road users. Treatments focus on five 

categories of roadway features: intersections, interchanges, roadway 

segments, work zones, and highway-railway grade crossings. Within 

each category treatments are classified as a “proven” or “promising” 

practices. Proven practices are based on supporting evidence 

drawn from a comprehensive review of field and laboratory research 

addressing human factors and highway safety. Promising practices are 

new to this edition of the Handbook and are treatments being used by 

one or more agencies. Although they are not fully evaluated, they are 

believed to benefit aging roadway users. 

As an example, Chapter 2 of the Handbook focuses on intersections, which is the most serious and 

enduring crash problem area for aging road users. This particular chapter includes treatments for 16 

Proven Practices and 8 Promising Practices. 

Some of the treatments recommended for intersection Proven Practices are detailed in Table 1.

Figure 1. Handbook for Designing 

Roadways for the Aging Population
Elderly Mobility Noteworthy Practices Guide 5 

Infastructure and Vehicles

Table 1. Treatments Recommended for Proven Practices

Intersection Proven 

Practice

Treatment Recommendation

Traffic Signals

Install 12-inch signal heads.

Provide yellow retroreflective 

borders on backplates

Pedestrian Crossings

Revise walking speed from 2.8 feet per 

second to 3.0 feet per second.

Measure crossing distance 6 feet back 

from the curb or edge of travel lane.

Install countdown pedestrian signals at 

all signalized intersections.

Roundabouts

Provide Advance Warning Signs (W2-6).

Provide Directional Arrow Signs (R6-4).

Install Roundabout Circulation Plaque 

(R6-5P).
6 Federal Highway Administration

Infastructure and Vehicles

Part II of the Handbook presents the rationale and supporting evidence for each treatment. 

The Handbook for Designing Roadways for the Aging Population is a resource that practitioners can use 

to improve the safety of the transportation system for the aging population. To download a copy, visit 

http://safety.fhwa.dot.gov/older_users. 

For additional information:

Agency: Federal Highway Administration

Contact: Rebecca Crowe, Transportation Specialist

Telephone: 804-775-3381

Email: rebecca.crowe@dot.gov

Some of the treatments recommended for intersection promising practices are detailed in Table 2.

Table 2. Treatments Recommended for Promising Practices 

Intersection Promising 

Practice

Treatment Recommendation

Right-Turn Channelization 

Design

Right-turn channelization should be 

considered during design. A tighter 

turning radius reduce turning 

speeds to approximately 17 to 18 

mph, decrease pedestrian crossing 

distances, and optimize the rightturning motorists’ line of sight.

Combination Lane-Use/

Destination Overhead 

Guide Signs

Provide combination lane-use/

destination overhead guide signs at 

intersections with complex design 

features or heavy traffic.

Signal Head Visibility Install one signal head per lane, 

centered over each lane.

High-Visibility Crosswalks 

Use marking patterns that are more 

visible than standard markings (such 

as ladder or diagonal patterns).

Supplemental Pavement 

Marking for Stop and 

Yield Signs

Install word or symbol pavement 

markings to supplement signs.
Elderly Mobility Noteworthy Practices Guide 7 

Infastructure and Vehicles

Michigan Showcase Roadway

For the 2004 North American Conference on Elderly Mobility (NACEM), the Michigan Department of 

Transportation (MDOT) partnered with the FHWA and the American Automobile Association (AAA) to 

develop a 7.4 mile “showcase roadway” (Figure 12). During 

the conference, tours were organized that allowed 

attendees to see first-hand selected solutions that benefit 

elderly drivers. 

For the 2014 NACEM, MDOT invested $137,000 to upgrade 

five signs to show the side-by-side comparison of the Type 

XI sheeting versus Type III sheeting and ClearviewTM font 

versus Series E Mod fonts. MDOT also painted curb islands 

and curb radii to improve visibility. These enhancements 

supplemented the safety countermeasures still in 

place from the 2004 conference including traffic signal 

backplates, retroreflective borders, pedestrian countdown 

signals, arrow-per-lane signing, and upgraded sign sheeting 

for warning signs. With the old and new traffic control devices (TCDs) placed side-by-side, conference 

attendees could compare the differences. 

Upgraded TCDs designed to enhance visibility and increase safety by being easier to read, notice, or 

understand by older road users, were included in MDOT’s showcase roadway. These improvements 

included:

•	 Implementation of fluorescent yellow sheeting for warning signs;

•	 Use of the ClearviewTM font on guide and street name signs;

•	 Application of enhanced borders on regulatory signs;

•	 Arrow-per-lane guide signing for highways;

•	 Application of backplates with retroreflective borders on traffic signals;

•	 Installation of Light Emitting Diode (LED) lenses in the signals, instead of the standard

incandescent lenses. Addition of new pedestrian signing that has shown to be more easily 

understood by both pedestrians and drivers;

•	 Installation of pedestrian countdown signals. These allow traffic engineers to maintain the traffic

flow, while informing pedestrians about the time available to cross the intersection. This is an 

especially important improvement for older adults, who typically walk slower than the average 

adult. This gives them information to allow them to decide for themselves whether or not they 

have time to cross; 

•	 Painting wider edge and lane lines and some curbs to increase their visibility (6-inch longitudinal

pavement markings);

•	 Application of LED lenses in some warning lights to improve the visibility of curves; and

•	 Additional markers to provide direction to drivers where lanes merge.

Figure 2. Older Driver Showcase Roadway in Detroit

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Remaining Signs from 2004 NACEM

Intersection Changes/

Pavement Marking Comparisons 

LED signals, back plates, black doors, 

visors and street signs from 2004 NACEM,

pedestrian countdowns, and 

painted curbs on Jeerson Avenue 

near Woodward Avenue.

Locations of 2014 NACEM Signs

Showcase Roadwa

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8 Federal Highway Administration

Infastructure and Vehicles

Government agencies and transportation research facilities around the country researched and 

extensively tested each of the various TCDs displayed in the 7.4-mile-loop. They found that as drivers age, 

the ability to read signs becomes increasingly difficult, which is the main reason why the florescent yellow 

sheeting was used on warning signs instead of high-intensity yellow sheeting1. Another example of 

specific research that supported the implementation of certain TCDs was conducted by the Texas 

Transportation Institute and the New Hampshire Department of Transportation for improving the legibility 

of guide signs. The results showed that the most cost-effective method to improve visibility on green 

guide signs was to use Type IX sheeting for the white legend and Type III sheeting for the background, 

which is what MDOT then used for guide signs on highways around the loop.

Other departments of transportation can implement these improved TCDs in much the same way that 

MDOT did, although the cost will depend on the scale of implementation. In 2004, MDOT budgeted 

$250,000 for the upgrades to the TCDs in the 7.4-mile demonstration loop, which included replacing 25 

warning signs with brighter sheeting on arterial roads and freeways, installing backplates at 4 signalized 

intersections, and installing pedestrian countdown signals at 3 crosswalks. The City of Detroit replaced 

eight older street signs that were using 5 3/8-inch Series C lettering with street signs using ClearviewTM 5W 

lettering. All TCD upgrades on the showcase road were considered “low cost” improvements. 

Many of these implementations were for purposes of demonstration. For example, several traffic signals 

were modernized on this showcase roadway as real-world examples of traffic signals with backplates. Two 

different styles of backplates were used; one was black with no reflective strip, and the other was black 

with a 3-inch yellow retroreflective strip (Figure 3).

1 Benekohal, R.F., P. Resende, E. Shim, R.M. Michaels and B. Weeks., Highway Operations Problems of Elderly Drivers in 

Illinois. Illinois Department of Transportation and FHWA, 1992

Figure 3. Signal Backplates with No Reflective Strip (left) and 

Signal Backplates with Yellow Retroreflective Strip (right)
Elderly Mobility Noteworthy Practices Guide 9 

Infastructure and Vehicles

As a result of the showcase roadway, MDOT has updated its standards and now uses:

•	 ClearviewTM font on all guide signs;

•	 American Society for Testing and Materials (ASTM) Type IV sheeting on background on all

guide signs;

•	 ASTM Type XI sheeting for white legends on overhead guide signs and ASTM Type IV sheeting for

white legends on ground mounted signs;

•	 ASTM Type IX fluorescent sign sheeting for all warning signs;

•	 Six-inch pavement marking edge lines;

•	 Box span traffic signal displays: a new method for positioning traffic signals in an intersection by

arranging traffic signals in a rectangular shape instead of diagonally across an intersection; and 

•	 Pedestrian countdown signals.

As a follow-up to the implementation of these engineering improvements, MDOT has initiated research 

with Western Michigan University. The research will develop safety performance functions and crash 

modification factors for four of these improvements: ClearviewTM font, ASTM Type IX fluorescent sign 

sheeting for warning signs, box span traffic signal displays, and pedestrian countdown signals.

For additional information:

Agency: Michigan Department of Transportation

Contact: Mark Bott, Engineer of Traffic and Safety

Telephone: 517-335-2625

Email: bottm@michigan.gov
10 Federal Highway Administration

Infastructure and Vehicles

Adaptive LED Lighting in New Zealand

Nighttime driving can become an increasingly difficult task 

as people age. The absence of roadway lighting makes it 

challenging to see hazards and the path of the road. Too 

much lighting can create a detrimental glare. To help 

drivers navigate during nighttime conditions, agencies can 

increase roadway delineation with retroreflective signs and 

markings. Another successful strategy being used in New 

Zealand is the use of adaptive LED lighting.

Adaptive LED lighting (Figure 4) is lighting that may be 

changed depending on current conditions and is varied 

using modern computer control systems. The lighting can 

also be tailored to circumstances such as the predominant 

road users’ demographic. Individual lights can be turned 

on and off. They can also be dimmed depending on the 

atmospheric conditions and the need for more or less road 

lighting. This method uses less electricity than standard lighting and will become more affordable over 

time. Adaptive LED lighting is becoming more prominent in many parts of the world, and the technology 

needed for implementation is currently being used in North America.

Adaptive LED lighting is part of New Zealand’s Safe System approach, which includes the following 

objectives.

•	 Prioritize projects to ensure that limited funding is well spent.

•	 Eliminate high-risk situations.

•	 Design to reduce the chance and consequences of human error.

•	 Encourage driving speeds that are appropriate for conditions.

For additional information:

Agency: Opus Research

Contact: Bill Frith, Research Leader, Road Safety

Telephone: 644-587-0690

Email: William.frith@opus.co.nz

Figure 4. Adaptive LED Road Lighting

Source: Mike Jackett
Elderly Mobility Noteworthy Practices Guide 11 

Infastructure and Vehicles

Vernon, British Columbia: Older Driver Pilot Project

The Older Driver Pilot Project was a comprehensive city-wide study that looked at older driver safety from 

a holistic perspective. The pilot project was a community initiative funded by the Insurance Corporation of 

British Columbia (ICBC) in the city of Vernon, British Columbia.

Between now and 2030, the number of residents over the age of 65 in British Columbia is expected 

to grow to almost a quarter of the population. The ICBC conducted an analysis of the entire province 

of British Columbia to see where the aging population was based and found that Vernon had a 

disproportionately high percentage of residents over the age of 65. 

Focus groups with Vernon’s seniors were conducted at the beginning of the project. The information 

gathered from the focus groups was combined with an analysis of 

the ICBC’s claims data to identify and target problem sites within 

the city. A multi-disciplinary team conducted Road Safety Audits 

(RSAs) at these sites to identify the key issues and to determine the 

proper safety countermeasures that should be applied. The RSAs 

showed a number of concerns such as inadequate sight distances, 

faded crosswalks, small wording on signs, and narrow sidewalks. 

A majority of these issues was the result of limited city funding 

available for improvements.

 The RSAs were unique in that they were conducted with a senior 

road user’s perspective in mind. This pilot project identified both 

spot and systemic road safety countermeasures to improve older 

user safety. The ICBC funded many of the improvements and 

upgrades that were needed to make Vernon safer for older road users.

For additional information:

Agency: City of Vernon

Contact: Amanda Watson, Eng.L.

Telephone: 250-550-7655

Email: awatson@vernon.ca

Agency: Atkins North America

Contact: Jeff Bagdade

Telephone: 248-836-8499

Email: jeff.bagdade@atkinsglobal.com

Figure 5. Senior Focus Group
12 Federal Highway Administration

Infastructure and Vehicles

Alberta Traffic Safety Guide to Accommodating 

Older Drivers

The Alberta Traffic Safety Guide to Accommodating Older Drivers is a practitioner guide that 

provides a set of strategies for transportation agencies in Alberta, Canada, to address and safely 

accommodate aging drivers. Although overall fatal and injury crashes were decreasing, data 

showed that the involvement of older drivers in serious collisions was growing in both proportion 

and frequency, which was and is expected to continue as the “Baby Boom” 

generation ages. This guidebook was developed as part of an effort to 

make the road environment responsive to the needs of aging drivers.

The development of this guidebook was funded by the Canadian 

Automobile Association club in Alberta, called the Alberta Motorist 

Association. The 2001 edition of FHWA’s Highway Design Handbook 

for Older Drivers and Pedestrians2 was used in combination with other 

literature and local workshop inputs to develop the guidebook. The 

purpose of the guidebook is to present a comprehensive list of traffic 

safety practices that benefit the aging driver. Although many of the 

enhancement practices were drawn from the FHWA document, they 

were evaluated against Canadian and Albertan guidelines and standards. The recommendations 

in the guidebook include: channelization, slotted left-turn lanes, left-turn signalization, right-turns, 

street name signing, stop- and yield-control signing, traffic signals, 

roundabouts, and curve delineation (Figure 6).

The guidelines are meant to be used by agencies in areas with high 

proportions of older drivers, but can also be used in all locations 

to accommodate older drivers as a general policy. The Alberta 

Strategic Highway Safety Plan (Figure 7) has a section dedicated to 

older drivers, and the province is required to consider the concepts 

included in the Traffic Safety Guide to Accommodating Older Drivers 

in all transportation projects. The guidelines are meant to act as a 

reference to supplement existing standards, not to replace them. 

There is currently an initiative to begin applying these safety concepts 

on a systemic basis.

For additional information:

Agency: Alberta Motor Association

Contact: Don Szarko

Telephone: 780-430-5733

Email: Don.szarko@ama.ab.ca

Agency: Atkins North America

Contact: Jeff Bagdade

Telephone: 248-836-8499

Email: jeff.bagdade@atkinsglobal.com

Figure 6. Curve Delineation

Figure 7. Alberta Traffic Safety 

Plan 2015

Source: Wendy Doyle, Alberta Transportation, 

Office of Traffic and Safety.

2 The FHWA Highway Design Handbook for Older Drivers and Pedestrians was updated in 2014 and given a new 

title. Detailed information on the newest edition can be found in this guide.
Elderly Mobility Noteworthy Practices Guide 13 

Driver Screening and Assessment

Collaboration Between Law Enforcement and 

Public Health Organizations: The Cognitive 

Assessment Tool

Age-related driving impairment is a serious and growing public health and safety problem. Older drivers 

have crash rates per mile driven similar to teenage boys, but have more than four times the fatality rate that 

younger drivers do. Law enforcement officers, who have traditionally been lenient with older driver violators, 

play an important role in identifying cognitively impaired drivers. Older drivers with cognitive impairments 

often exhibit erratic driving behaviors resembling a DUI; however, it can be difficult to distinguish cognitive 

impairment during a traffic stop without a targeted assessment. 

The Training, Research and Education for Driving Safety (TREDS) group at the University of California (UC), 

San Diego, collaborated with the California Highway Patrol and the California Department of

 Motor Vehicles (DMV) to develop and deliver the POST-certified (Peace Officer Standards and Training) 

training, Law Enforcement’s Role in Older Driver Safety. The Driver Orientation Screen for Cognitive 

Impairment (DOSCI) tool for law enforcement was developed as part of this training to aid in the 

identification of cognitive impairment at traffic stops. The DOSCI tool was validated at the UC San Diego 

Alzheimer’s Disease Research Center. The training program and the DOSCI tool provide a model for how law 

enforcement and public health organizations can work together to keep the public safe as drivers age and 

are driving longer.

At a traffic stop of the potentially impaired driver, the DOSCI guides the 

officers to first screen for intoxication then to rule out any medical issues. 

Once these are ruled out, the officer is to conduct a nine question exam 

to determine the driver’s orientation of person, place, and time. The 

questions include the driver’s date of birth, full home address, state and 

town currently in, time estimate (within an hour), day of week, and the 

current date. The DOSCI tool includes suggested actions based on the score. 

The purpose of the tool is to guide and aid the officer, but officers are also 

expected to use their own judgment.

In California, over 2,500 officers are currently trained on how to use the 

DOSCI tool. In surveys administered immediately after training, 89 percent 

responded they were likely or very likely to incorporate the DOSCI into 

their assessment of older drivers, and 92 percent responded that the 

results of the DOSCI will help in preparing the DMV “Notice for Priority 

Re‐Examination of Driver.” Officer interviews conducted 2 years after the 

training were equally positive. The TREDS training, with the DOSCI tool, has 

been well received, and found to be feasible and useful in the field. Funding for this program was 

provided by a grant from the California Office of Traffic Safety through the National Highway Traffic 

Safety Administration.

For additional information:

Agency: University of California, San Diego Training, Research and Education for Driving Safety (TREDS)

Contact: Linda Hill, MD, MPH

Telephone: 858-534-9330

Email: Llhill@ucsd.edu

Figure 8. Law enforcement screening 

driver for cognitive impairment with 

DOSCI tool

Source: TREDS - Training, Research and Education for 

Driving Safety, University of California, San Diego
14 Federal Highway Administration

Driver Screening and Assessment

Maryland’s Multi-tiered System to Assess 

Medical Fitness

There are times when a person’s medical condition may require an assessment to determine their ability to 

safely operate a vehicle. The Maryland Motor Vehicle Administration (MVA) has a multi- tiered system for 

referring, screening, and evaluating an individual’s medical fitness to drive. The mission statement of the 

MVA is to provide exemplary driver and vehicle services that promote Maryland’s mobility and safety while 

enhancing process and product security.

The use of a Functional Capacity Screening Test (FCT) has become routine in Maryland. The FCT screening 

consists of a short series of tests that measure basic visual, cognitive, and physical abilities that are needed 

to safely operate a motor vehicle. While FCT screening cannot predict a safe or unsafe driving experience, 

poor results can be a warning sign that a person is placing themselves, or others, at a higher risk when 

driving. A driver’s license cannot be suspended simply because of poor performance in one or more 

segments of the FCT; however, poor test scores are a concern and may cause the reviewer to require a 

driving skills test with the MVA. FCT screenings are recommended for drivers who are referred to the 

Medical Advisory Board (MAB) or the Division of Driver Wellness and Safety because of concerns about 

physical and mental decline that can affect their ability to drive safely.3

The MAB is composed of physicians from various medical specialties who assess an individual’s 

medical fitness to drive when there is a medical condition that can impact the person’s ability to safely 

operate a vehicle. The MAB reviews the medical information of drivers and then provides advice and 

recommendations to the Driver Wellness and Safety Division of the MVA. Each case is reviewed on an 

individual basis.

When a person is referred to the MAB for evaluation, they review pertinent medical information from the 

individual’s personal physician(s) or other treatment provider(s), since those clinicians are the ones most 

familiar with the individual’s condition. Upon review of those materials, the MAB may request additional 

information or evaluations. The MAB does not perform medical examinations. They may, on occasion, 

request a personal interview with an individual before a recommendation is made to the Driver Wellness & 

Safety Division of the MVA, who then makes the final decision whether to suspend a driver’s license.

Approval by the MVA’s Driver Wellness & Safety Division and/or the MAB is required if a person has any of 

the conditions listed below, which may affect their ability to drive. If someone has one of these medical 

conditions, they must notify MVA when the condition is diagnosed or when applying for or renewing a 

driver’s license:

3 Maryland Department of Transportation, Motor Vehicle Administration. Accessed November 17, 2014. 

http://www.mva.maryland.gov/safety/older/fct-screening.htm
Elderly Mobility Noteworthy Practices Guide 15 

Driver Screening and Assessment

•	 Cerebral Palsy

•	 Diabetes requiring insulin

•	 Epilepsy

•	 Multiple sclerosis

•	 Muscular dystrophy

•	 Irregular heart rhythm or heart condition

•	 Stroke,“mini-stroke,”or transient

ischemic attack

•	 Alcohol dependence or abuse

•	 Drug or substance dependence or abuse

•	 Loss of limb or limbs

•	 Traumatic brain injury

•	 Bipolar disorder

•	 Schizophrenic disorders

•	 Panic attack disorder

•	 Impaired or loss of consciousness, fainting,

blackout, or seizure

•	 Disorder which prevents a corrected

minimum visual acuity of 20/70 in at least 

one eye and a field of vision of at least 

110 degrees

•	 Parkinson’s disease

•	 Dementia, for example, Alzheimer’s disease

or multi-infarct dementia

•	 Sleep disorders, for example, narcolepsy or

sleep apnea

•	 Autism

Depending on the severity and progress of a medical condition, individuals may be re-evaluated at 

various intervals. In many cases, drivers whose license privileges have not been approved or have 

been suspended may be approved at a later time when their medical condition improves.

For additional information:

Agency: Maryland Motor Vehicle Administration

Contact: Dr. Carl Soderstrom, Chief, Medical Advisory Board

Telephone: 410-768-7406

Email: csoderstrom@mdot.state.md.us
16 Federal Highway Administration

Driver Education and Training

Florida’s Aging Road User Strategic Safety Plan

Over 18 percent of the population in Florida is over age 65 and by the year 

2030, this demographic is predicted to increase to 27 percent. To address 

the transportation safety challenges of the State’s aging population, the 

Florida DOT and the Pepper Institute on Aging and Public Policy formed 

Florida’s Safe Mobility for Life Coalition and together developed an Aging 

Road User Strategic Safety Plan.

4 The Safe Mobility for Life Coalition is a 

statewide alliance of 28 member organizations that represent the fields 

of engineering, enforcement, safety, health, transportation, and aging. A 

central goal of the Aging Road User Strategic Safety Plan is to reduce the 

number of driving-related injuries and fatalities among older drivers in 

Florida. The plan also helps aging Floridians maintain their independence 

and remain active in the community even when driving is no longer 

feasible. To meet these goals, the plan includes 10 Emphasis Areas that 

balance the safety and mobility needs of Florida’s aging population. 

During the plan’s development process, coalition members met four times 

between August 2010 and September 2011; the emphasis area teams 

met twice. During these meetings, members developed goals, objectives, 

performance measures, and strategies for implementing improvements in 

each emphasis area. 

Some of the objectives identified in the plan include:

•	 Increase the number of drivers who are proactive about staying safe on the road;

•	 Increase the number of livable communities in Florida;

•	 Increase communication opportunities with elected officials to promote policies that enhance

safety, access, and mobility for aging road users;

•	 Increase the statewide capacity of driver rehabilitation specialists; and

•	 Identify and implement effective design elements and safety countermeasures to benefit

aging vulnerable road users.

Aging Road User Strategic Safety 

Plan Emphasis Areas:

•	 Advocacy and Policy

•	 Aging in Place

•	 Assessment, Remediation, and

Rehabilitation

•	 Data Collection and Analysis

•	 Licensing and Enforcement

•	 Other Road Users

•	 Outreach and Education

•	 Prevention and Early Recognition

•	 Program Management, Evaluation,

and Resources

•	 Transitioning from Driving

4 The Aging Road User Strategic Safety Plan. Accessed December 29, 2014. 

http://www.safeandmobileseniors.org/pdfs/FlagingRoadUserStrategicSafetyPlan.pdf
Elderly Mobility Noteworthy Practices Guide 17 

Driver Education and Training

In addition to the expertise offered by the Coalition, three focus groups were conducted to obtain 

stakeholder input on the plan. Finally, to identify the habits, needs, and concerns of Florida’s aging road 

users, a survey was conducted with Florida residents age 50 and older. The results were used to establish 

a baseline for the strategic plan and further refine the plan’s strategies. Survey respondents indicated 

that the availability of transportation options, planning for transitions away from driving, awareness 

of Coalition resources and safety events, and general safety 

concerns like distracted driving are critical issues for aging road 

users. In response, the strategic plan incorporates objectives 

and strategies to address these issues.

As the Coalition began implementing the plan, one of the first 

resources developed was Florida’s Guide for Aging Drivers (Figure 

9). This guide is designed to help older Floridians continue 

driving as long as safely possible and shares information to help 

them prepare for their transportation needs should they need 

to stop driving. Ultimately, the Aging Road User Strategic Safety 

Plan was aligned with the Florida DOT Strategic Highway Safety 

Plan5 and is included in the emphasis area that focuses on 

at-risk drivers.

For additional information:

Agency: Florida Department of Transportation

Contact: Gail Holley, Safe Mobility for Life Program Manager

Telephone: 850-410-5414

Email: gail.holley@dot.state.fl.us

 

Figure 9. Florida’s Aging Road User 

Strategic Safety Plan

Source: Florida Department of Transportation

5 Florida Strategic Highway Safety Plan. Accessed December 29, 2014. 

http://www.dot.state.fl.us/safety/SHSP2012/StrategicHwySafetyPlan.pdf
18 Federal Highway Administration

Driver Education and Training

Michigan’s Guide for Aging Drivers and 

Their Families

Since 1997, the Michigan Senior Mobility Work Group, a statewide 

group of safety partners, has been addressing the challenges of 

the State’s aging population. Organized under the direction of the 

Governor’s Traffic Safety Advisory Commission, the goals of the Senior 

Mobility Work Group are to improve the safety and mobility of aging 

Michigan residents even when driving is no longer a safe option, 

and reduce serious injury and fatal crashes involving older drivers. To 

assist with meeting these goals, the Michigan DOT partnered with the 

Michigan Department of State, the Office of Highway Safety Planning, 

and AAA Michigan to publish and distribute Michigan’s Guide for Aging 

Drivers and their Families (Figure 10).

The guide is a resource for Michigan’s aging drivers and their families 

and caregivers. It emphasizes the importance of understanding how 

aging and age-related changes affect the ability to drive safely. A 

portion of the guide includes information to help establish whether a 

person is safe to drive. Tools include a driving self-assessment, a list of 

behaviors that may affect safe driving, guidance on partnering with 

the medical community, and how to request a driver evaluation. The 

guide also includes strategies to improve the safety of older drivers 

such as:

•	 Drive only during daylight;

•	 Avoid rush hour and heavy traffic;

•	 Make three right turns instead of a left turn or make left turns at traffic signals; and

•	 Map out safe routes that include well-lit streets, less traffic, left turns at traffic signals, and

clear signs.

The guide also reminds readers that not all road users are drivers; many people walk, ride bicycles, or 

motorcycles. Accordingly, the guide includes safety strategies for these more vulnerable users, as well as 

winter safety strategies. 

Figure 10. Michigan’s Guide for 

Aging Drivers and Their Families
Elderly Mobility Noteworthy Practices Guide 19 

Driver Education and Training

The guide concludes with a section on the impact of age-related ability changes on driving. Driving 

presents particular challenges to older people because of changes in their vision, cognition, and physical 

function. To address these impacts, there is detailed information on the types of changes that occur with 

vision, hearing, medication, cognition, dementia, and physical condition and how these changes impact 

safe driving. There is also guidance for drivers who must limit or stop driving for their safety and the 

safety of others. The guide encourages aging drivers to develop a transportation plan that incorporates 

alternative transportation options such as walking, senior shuttles, and bus services for that time when 

they may no longer be able to drive.

For additional information:

Agency: Michigan Department of Transportation

Contact: Kimberly Lariviere, Strategic Highway Safety Engineer

Telephone: 517-373-3889

Email: larivierek@michigan.gov
20 Federal Highway Administration

Driver Education and Training

CarFit

CarFit is an educational program created by the American Society on Aging and jointly developed by AAA, 

AARP, and the American Occupational Therapy Association. The program is designed to help older drivers 

find out how well they fit their vehicle, highlight actions they can take to improve their fit, and promote 

conversations about safety and mobility. It also provides information and materials on resources that can 

enhance their safety as drivers and increase their mobility in the community. 

Older drivers may contend with physical changes that affect their driving. For example, a reduced range 

of motion can limit head rotation and visual impairments can delay recovery from glare. Older drivers are 

also more likely to be killed or seriously injured in a crash due to greater fragility. 

While driver safety programs address cognitive abilities and skills, older drivers can also improve their 

safety by ensuring their vehicles are properly adjusted for 

them. At a CarFit event, a trained professional asks simple 

questions and completes a 12-point CarFit checklist. This list 

includes checking items such as the position of the vehicle’s 

mirrors, the steering wheel tilt, and the driver’s position 

to the brake pedal. The entire process takes 20 minutes 

and drivers leave with recommended car adjustments and 

adaptations as well as a list of resources in their area. By 

making individual adjustments to reach their best personto-vehicle fit, drivers can better benefit from their vehicle’s 

safety features and have better control behind the wheel. 

For example, good foot positioning on the gas and brake 

pedals is important. If the driver is reaching to press on the 

pedals, it can cause fatigue in the leg and slow reaction 

times. The top opportunities for a better fit include steering wheel tilt, head restraint position, and 

improved line of sight.

CarFit was pilot tested in 2005 with more than 300 older drivers. Based on findings from the completed 

checklists and follow-up surveys with participants, the program is proving to be effective, with 37 percent 

of participants having identified at least one critical safety issue that needed to be addressed. Survey 

respondents indicate that as a result of their participation in CarFit, they have made a change to improve 

the fit to their vehicle, their use of safety features in their vehicle, and/or willingness to discuss their driving 

with family or health care providers. 

There is no charge to participate in a CarFit event. A complete list of CarFit events scheduled throughout 

the country can be found by visiting www.car-fit.org. 

A good car fit means:

•	 Clearline ofsight overthe steering wheel.

•	 Room (atleast 10 inches) between the driver’s

chest and air bag in the steering wheel.

•	 Properly adjusted head restraint.

•	 Easy accessto gas and brake pedals.

•	 A seat you fitin safely and comfortably.

•	 A seat beltthat holds you in the proper position

and remains comfortable while driving.
Elderly Mobility Noteworthy Practices Guide 21 

Driver Education and Training

For additional information:

Agency: AARP Driver Safety

Contact: Frank Carroll, Curriculum Development

Telephone: 202-434-3919

Email: fcarroll@aarp.org

Figure 11. CarFit Process
22 Federal Highway Administration

Driver Education and Training

Using Driving Rehab Specialists to Help Older 

Drivers Keep the Keys

By the year 2020, there will be more than 40 million licensed drivers 65 and older. It is essential for 

occupational therapy practitioners as well as driving rehab specialists (DRSs) to help older adults address 

community mobility. Personal mobility is critical to healthy aging, quality of life, and independence, 

therefore, it is important to explore the resources that are available to help aging adults “keep the keys.” 

Genesis Rehab Services (GRS) provides physical therapy, 

occupational therapy, speech therapy, respiratory therapy, and 

wellness services for the older adult population. GRS partners 

with nursing centers, assisted living facilities, independent living 

facilities, hospitals, home health companies, adult day care 

programs, and outpatient clinics to provide comprehensive therapy 

services. They employ over 18,000 therapists and assistants in 

approximately 1,500 rehabilitation gyms which operate in 46 States 

and the District of Columbia and that see 45,000 patients each day.

GRS employs DRSs who work with clients to help them gain the 

skills they need to stay safe, comfortable, and confident behind 

the wheel of their car, even as they experience age-related physical 

and mental changes. Their goal is to keep clients as mobile, 

independent, and safe as possible for as long as possible. 

GRS provides a variety of services for older adult drivers, including driving wellness consultations, 

specialized in-vehicle evaluations, client education and support, and training and specialized adaptive 

driving equipment. In the case of a client needing to cease driving, either temporarily or permanently, GRS 

will help them transition from driver to passenger. DRSs are highly-skilled occupational therapists with 

advanced training in driving rehabilitation. Their role is to guide and support clients through the driving 

evaluation, training, and if necessary the transition process to non-driver. They also work with clients to 

set reasonable goals for driving. GRS works with licensed, older adult drivers with a wide range of medical 

conditions, including:

•	 Cataracts

•	 Congestive heart failure

•	 Dementia

•	 Diabetes

•	 Diabetic retinopathy

•	 Glaucoma

•	 Heart attack

•	 Knee replacement

•	 Left foot drop

•	 Mild cognitive impairment

•	 Mini stroke

•	 Multiple sclerosis

•	 Neuropathy

•	 Parkinson’s disease

•	 Pulmonary disease

•	 Recent falls

•	 Sleep apnea

•	 Stroke

•	 Syncope

•	 Traumatic brain injury

Figure 12. Driving Rehab Specialists 

Conduct an In-vehicle Evaluation

Courtesy of Driving Rehabilitation by Genesis Rehab 

Services
Elderly Mobility Noteworthy Practices Guide 23 

Driver Education and Training

Currently, GRS has trained 10 DRSs and educated staff at approximately 100 facilities on the 

occupational therapist role in driving and community mobility. The GRS Driving Program is dedicated 

to raising general awareness of issues that face older adult drivers, which is the first step in making 

this movement successful and helping seniors keep their keys.

For additional information:

Agency: Genesis Rehab Services

Contact: Susan Touchinsky, Director of Driving Rehabilitation

Telephone: 484-650-2280

Email: susan.touchinsky@genesishcc.com

Figure 13. Process to Get Started with Driving Rehabilitation

Get a referral from 1 your doctor.

In order to begin driving rehabilitation 

with us, you must first get a referral from 

your doctor for “OT Driving Evaluation 

and Treatment.” You must also have 

a valid driver’s license. We will work 

closely with your doctor throughout the 

driving rehabilitation process.

Talk to your local 2 Driving Rehab Specialist.

Call 1-800-992-9711 to discuss your 

driving needs with a local Driving Rehab 

Specialist and schedule an appointment. 

Before starting your program with us, 

you will need to sign a liability and 

medical waiver. 

What you can expect from Driving Rehabilitation from Genesis 

Complete a thorough 3 clinical evaluation.

Your Driving Rehab Specialist will review your 

medical and driving history and evaluate any 

pain or discomfort. Next, you will perform 

a series of simple tests to assess your driving 

skills and identify any risk factors. These tests 

will measure your reaction time, motor skills, 

visual perception, cognitive skills, hearing, 

and general road knowledge.

Get real-life training & 4 specialized education.

Based on your clinical evaluation, you may 

be ready for an in-vehicle assessment. Your 

Driving Rehab Specialist may recommend 

the use of adaptive equipment and will 

provide education and training on any 

vehicle modifications. Our goal is to get 

you back on the road to independence. 

Getting started with driving rehabilitation by Genesis Rehab Services

REHABILITATION

DRIVINGSM

Courtesy of Driving Rehabilitation by Genesis Rehab Services
24 Federal Highway Administration

Driver Education and Training

New and Improved AARP Smart DriverTM Course

In 1979, AARP initiated “55 Alive” to help keep older drivers safe while 

on the road. In 2014, AARP Driver Safety launched a new and improved 

refresher course called AARP Smart DriverTM, available nationwide in a 

classroom or online setting. The curriculum is based on new research in 

adult learning, consumer interest, and behind-the-wheel data gathered 

through driving simulators. The new course teaches safety strategies and 

defensive driving methods using adult learning principles. Participants 

learn about new traffic laws and rules of the road, how to safely navigate 

adverse weather conditions, and information on automobile technology. 

The course also provides guidance on driving techniques such as the 

safest way to change lanes and make turns at intersections, maintaining 

a safe driving distance, the effects of medication on driving, and reducing 

distractions such as cell phone use.

The process used by AARP Driver Safety to develop the course curriculum 

can be applied by other organizations. When developing the course 

curriculum, AARP Driver Safety collaborated with experts in mobility, 

aging, technology, and vehicle and driver safety. Data-based research 

led to changes in the course content to focus more on areas where 

older drivers can benefit from additional training. These areas include 

roundabouts, pavement markings, stop sign compliance, red light 

running, and driver behavior (such as seat belt use and speeding). AARP 

Driver Safety also conducted focus groups and incorporated participant 

feedback into the course revision. The course was field tested prior to its 

official launch and a simulator study validated its effectiveness at reducing driver errors.

The end result, a course designed with the participant in mind, is different in many ways from its 

predecessors. For example, course materials are in a new format that features reader-friendly print types 

and full-color pages. Products developed as part of the new course include a participant guidebook, 

instructor manual, course video, PowerPoint presentation, an instructor self-preparation and review guide, 

and an online Driving Resource Center at www.aarp.org/drc. Surveys conducted by AARP since launching 

the new course indicate that the updated curriculum is effective and drivers are changing their behavior.

Participants can take the course online at www.aarpdriversafety.org or find a classroom course at 

www.aarp.org/findacourse.

For additional information:

Agency: AARP Driver Safety

Contact: Frank Carroll, Curriculum Development

Telephone: 202-434-3919

Email: fcarroll@aarp.org

AARP Smart DriverTM Course 

can help to:

•	 Update driving skills and

knowledge of road rules and road 

hazards.

- Maintain proper following 

distance.

- Safely change lanes and make 

turns at intersections.

•	 Learn about normal age‐relate

physical changes and how 

to adjust driving habits to 

compensate.

•	 Reduce chances ofreceiving a

traffic violation, being involved in a 

traffic crash, or becoming injured.

•	 Bring awareness ofthe effects

of medications on driving and 

driver distractions such as eating, 

smoking, and cell phone use.
Elderly Mobility Noteworthy Practices Guide 25 

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, oneclick” 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 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 lin

•	 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.

For additional information:

Agency: Area Agency on Aging 1-B

Contact: Roberta Habowski

Telephone: 248-262-9211

Email: rhabowski@aaa1b.com

Figure 14. Homepage of the myride2 Website

Source: Area Agency on Aging 1-B

6 The 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.
26 Federal Highway Administration

Alternative Transportation, Mobility Management, and Coordination

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.). 

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 follow-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. 

Figure 15. Results from a Sample Search on the Link for 

Care Website
Elderly Mobility Noteworthy Practices Guide 27 

Alternative Transportation, Mobility Management, and Coordination

For additional information:

Agency: Mid-America Regional Council

Contact: Tyler Means, Transportation Planner

Telephone: 816-701-8261

Email: tmeans@marc.org

Figure 16. Homepage of the Link for Care Website

Source for all images on pages 26-27: The Landon Center on Aging at the University of Kansas Medical Center
28 Federal Highway Administration

Alternative Transportation, Mobility Management, and Coordination

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
Elderly Mobility Noteworthy Practices Guide 29 

Alternative Transportation, Mobility Management, and Coordination

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

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

VolunteerServiceAmongMenuOf_Transp_Solutions_SATA_Michigan_409378_7.pdf
30 Federal Highway Administration

Alternative Transportation, Mobility Management, and Coordination

ITNAmerica

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:
Elderly Mobility Noteworthy Practices Guide 31 

Alternative Transportation, Mobility Management, and Coordination

•	 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:

Agency: ITNAmerica

Contact: Katherine Freund, Founder & President

Telephone: 207-591-6926

Email: Katherine.Freund@ITNAmerica.org

Figure 17. ITNAmerica Affiliate Sites
32 Federal Highway Administration

Alternative Transportation, Mobility Management, and Coordination

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.

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.

Figure 18. Intersection daylights
Elderly Mobility Noteworthy Practices Guide 33 

Alternative Transportation, Mobility Management, and Coordination

•	 “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 locationsthrough 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

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

8 New York City DOT Safe Streets for Seniors. Accessed July 10, 2014. 

http://www.nyc.gov/html/dot/html/pedestrians/safeseniors.shtml

Source: Hillary Poole, NYC DOT

Figure 19. Allerton Ave, Bronx, New York City: Road Diet with Left Turn Bays, Pedestrian Refuge Islands and Bike Lanes 

(installed 2009)
34 Federal Highway Administration

Alternative Transportation, Mobility Management, and Coordination

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.
Elderly Mobility Noteworthy Practices Guide 35 

Alternative Transportation, Mobility Management, and Coordination

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
36 Federal Highway Administration

Alternative Transportation, Mobility Management, and Coordination

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.

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

Figure 20. Walker Senior Neighbors Riding 

the Rapid

Source: The Rapid Senior Mentor Program

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

ResourcesPublications/TheRapid.aspx
Elderly Mobility Noteworthy Practices Guide 37 

Housing and Land Use

Engaging Older Adults in Emergency 

Preparedness Planning

In the United States, more than 1,300 natural disasters occur each year. Many times, these disasters require 

implementing evacuation plans to facilitate the immediate and rapid movement of people away from 

the threat or actual occurrence of a hazard. These plans should detail the partnerships and agreements 

between transportation agencies and private companies that are in place to evacuate older and 

vulnerable populations.

The 2009 Red River flooding in North Dakota and 

Minnesota brought record flood levels to the FargoMoorhead area. The flood was a result of saturated and 

frozen ground, spring snowmelt, and additional rain and 

snow storms. Communities along the Red River prepared 

for more than a week as the U.S. National Weather 

Service continuously updated the predictions for the 

city of Fargo, North Dakota, with an increasingly higher 

projected river crest. 

The 2009 Fargo flood led to the evacuation of all nursing 

homes and assisted living centers as well as the area’s largest hospital. To execute such a large-scale 

evacuation, various transportation providers pooled resources. This was possible in large part due to the 

partnerships already in place to permit the use of community resources, such as school buses, during an 

evacuation. Once evacuated, disaster relief shelters had to be prepared to accommodate the special needs 

of the elderly and disadvantaged occupants; for example, individuals with mobility devices could not 

navigate between the beds if cots were placed too closely together. Shelters also had to coordinate their 

staffing plans to ensure there were personnel to provide extra assistance for older and disabled occupants.

When developing disaster plans, communities should engage older adults and people with disabilities 

(or their representatives) to obtain their input. This ensures that their needs are being considered and 

resources are designated to assist them during a disaster. One way to include older adults in disaster 

planning is to invite their participation during table top exercises. This provides an opportunity for 

them to give direct input on emergency operation procedures, policies, communication protocols, and 

shelter requirements. They can also provide input on appropriate staging locations during an evacuation, 

effective protocols for serving passengers on paratransit while evacuating, and helping individuals with 

assistive devices (e.g., wheelchairs, walkers, oxygen tanks).

Figure 21. Seniors Participating in Emergency Planning
38 Federal Highway Administration

Housing and Land Use

Fargo’s preparations for the disaster made 

it possible to evacuate early, when roads 

were still accessible and shelter staff and 

volunteers were available to assist. When 

communities are able to provide advance 

notice to their residents, it creates a window 

of opportunity for briefings and early 

communication with both staff at shelters 

as well as the public. However, successful 

disaster preparedness relies heavily on 

existing plans, procedures, experience, and 

training when advance notice is not possible.

For additional information:

Agency: National Center on Senior Transportation 

Contact: Carol Wright, Co-Director

Telephone: 202-403-8365

Email: cwright@easterseals.com

Figure 22. Emergency Personnel Evacuating Seniors
Elderly Mobility Noteworthy Practices Guide 39 

Housing and Land Use

It Takes a Village: Transportation Options

The Village model was born from the need for reliable, affordable, and readily available services to support 

the aging population in the community. Villages are non-profit, grass-roots organizations, offering services 

and programs catered towards their specific members’ demographic. They are membership-driven, usually 

requiring a recurring fee that is much less than a conventional retirement home. This allows the Village to 

maintain some permanent staff who, along with administrative volunteers, provide health and wellness 

services for older adult members and provide a transportation service that reflects the needs of the Village 

members and the characteristics of the surrounding community. The Village administration also organizes 

social events, trips, and even home repairs—whatever the members request. Transportation is the most 

requested service that Villages provide to their members.

The high yearly cost of retirement communities is one of the major reasons why many older adults decide 

to live at home as long as possible. Older adults’ hope to remain connected with their communities and 

their goal of maintaining their overall independence are two other factors that contribute to the desire 

to stay at home. The Village model provides an alternative to moving to a retirement community and can 

allow older adults the choice to age in their own homes. A Village can provide the services, connections, 

and care expected from retirement communities while still allowing Village members to remain 

independent by living at home in their familiar surroundings.

Potential members sign up to be included in their local Village typically by going to the Village offices 

and learning details about the organization, signing whatever forms may be required, and paying the 

membership fee. The Village provides members with transportation and other services using existing 

assets and resources found in the community such as volunteer drivers, discounted shared ride services, 

or discounted senior taxis. The exact methods used to provide transportation services vary from Village to 

Village and depend on a number of factors, such as:

•	 Availability and access to transportation options,

•	 Number of Village members and outside volunteers who are willing and able to provide	

transportation services, and

•	 Potential for local car-sharing businesses to provide discounted services to seniors who are

Village members.

The overall goal is for the Village to work with the member to identify the types and methods of 

transportation that best fits the needs of the individual member.

The Village model was conceived in 2001 by Beacon Hill residents in Boston, Massachusetts. The Village 

to Village Network, a joint partnership between the Beacon Hill Village and Capital Impact Partners, a 

nationwide non-profit focused on community development, connects each Village through this peer to 

peer network, providing them with a platform to share ideas with other Villages to strengthen and sustain 

their organizations. According to the Village to Village Network, “145 Villages are operating across the 

country, in Canada, Australia and the Netherlands.” 10

10 Village to Village Network. Accessed November 17, 2014. http://www.vtvnetwork.org/
40 Federal Highway Administration

Housing and Land Use

Using the Village model to provide transportation for seniors is something that could easily be replicated 

elsewhere. In fact, currently there are “over a 100 additional Villages in development,” according to the 

Village to Village Network. No two Villages are identical, but the use of the Village model will effectively 

serve the members of any Village. The following two Village examples show how the Village model allows 

a Village to provide transportation service to its members despite drastic differences: 

Monadnock at Home is a Village located in rural New Hampshire that spans almost 400 square miles. For 

members of this Village, one’s neighbors may not be in sight; grocery stores may be more than 30 miles 

away; and long, cold winters can leave individuals isolated at home for long periods of time. The Village 

coordinates transportation for members wherever they live (within a reasonable boundary that includes 

eight neighboring towns). They partner with the local Red Cross and a local transportation company, 

coordinating volunteer drivers for themselves and their organizational partners in exchange for route 

planning skills provided by the two partner organizations. This system of coordination among volunteer 

drivers provides an invaluable service in such a rural setting.

The Capitol Hill Village in Washington, D.C. provides transportation for its members using approximately 

70 volunteer drivers who respond to email or phone request for rides anywhere within or around the 

Nation’s capital. In addition, the Village coordinates ridesharing to Village events. The urban setting of this 

Village allows for direct communication between the Village administration, members, and 

volunteer drivers.

Figure 23. Current number of Village communities across the nation as of August 2014

Source: Village to Village Network, LLC
Elderly Mobility Noteworthy Practices Guide 41 

Housing and Land Use

This is the beauty of the Village model. Although these two locations are very different, they each have a 

solution that suits their specific needs. With service of the members as their guiding mission, the Village 

inevitably chooses the best options for the members, relying heavily on members’ feedback and stated 

needs in order to find the best solution. With that model in place, the most likely outcome is that members 

will be paired with transportation services that best meet their individual needs.

For additional information:

Agency: Capitol Hill Village

Contact: Julie Maggioncalda, Director of Volunteers and Social Services

Telephone: 202-543-1778

Email: jmaggioncalda@capitolhillvillage.org

Agency: Monadnock at Home

Contact: Frank Harnden, Chair, Board of Directors

Telephone: 603-878-1010

Email: chair@monadnockathome.org

Agency: Capital Impact Partners

Contact: Candace Baldwin, Director of Strategy for Aging in Community

Telephone: 617-299-9638

Email: cbaldwin@capitalimpact.org or candace@vtvnetwork.org

 

For More Information:

Visit http://safety.fhwa.dot.gov/

FHWA, Office of Safety

Rebecca Crowe

rebecca.crowe@dot.gov

804-775-3381

FHWA-SA-14-095