Older adults are considered among the transportation-disadvantaged population, or those millions of Americans who are unable to provide their own transportation or have difficulty accessing public transportation because of age, disability, or income. The total number of transportation- disadvantaged older adults is unknown, and groups of transit dependent riders can overlap because some older adults may also be disabled or low income, or both. However, the older adult population is growing more rapidly than any other age group in the United States. Specifically, according to 2010 U.S. Census data, the population aged 65 and older grew 15 percent from 2000 to 2010, compared to about a 10 percent growth in the overall population, and by 2030, older adults are expected to comprise about 20 percent of the overall population. In 2012, the estimated population of veterans 65 and older was 9.6 million. Although about 83 percent of older adults are licensed drivers, approximately 20 percent of older adults no longer drive, according to the Federal Highway Administration’s 2009 National Household Travel Survey. A range of mobility options can allow older adults to maintain their independence and age in place in their communities. For example, for those older adults who no longer drive, some may walk, bike, or use public transportation to meet their mobility needs. Others, including those with disabilities, may require more specialized transportation, such as paratransit in order to access services. According to 2010 U.S. Census data, 50 percent of adults 65 and older had a disability. Paratransit service, broadly defined, is accessible, origin-to-destination transportation service that operates in response to calls or requests from riders. It is an alternative to fixed-route transit service, which operates according to regular schedules along prescribed routes with designated stops. The Older Americans Act of 1965 (OAA) was enacted to provide services to older adults to help them remain in their homes and communities for as long as possible. authorizes federal funding for a variety of home- and community-based supportive services that allow older adults to maintain independence. For example, Part B of Title III provides funding for a variety of supportive services, including transportation for older adults with and without mobility impairments. In fiscal year 2014, about $1.2 billion in Title III grants were provided to states, of which $344 million were grants for supportive services. The OAA, as amended, established the Administration on Aging (AoA) within HHS as the chief federal advocate for older Americans and assigned responsibility for home- and community-based services to AoA. In 2012, HHS established the Administration for Community Living (ACL), which brought together AoA, the Office on Disability, and the Administration on Developmental Disabilities—within HHS—to better align the federal programs that address the community living service and support needs of both the aging and disability populations, among other things. AoA distributes funding through grants to state units on aging, which allocate these funds to AAAs that either directly provide services, or contract with local service providers. 42 U.S.C. §§ 3001 and 3003. include private nonprofit and government organizations; 244 tribal and Native American organizations; and 2 organizations serving Native Hawaiians. Nearly 20,000 local organizations provide services through this network. The state units on aging and AAAs are responsible for the planning, development, and coordination of an array of home- and community-based services within each state. In particular, the OAA requires state units on aging to submit plans to the AoA for 2, 3, or 4 years. Among other types of information, the plans must evaluate older adults’ needs for home- and community-based services, which may include transportation. In addition, the OAA requires that state units on aging develop a standardized process to determine the extent to which public or private resources (including volunteers and programs and services of voluntary organizations) are capable of meeting needs. MAP-21, Pub. L. No. 112-141, § 20028, 126 Stat. 405, 726, codified at 49 U.S.C. § 5338 (a)(2)(D). include activities previously eligible under the New Freedom program and to public transportation projects that improve access to fixed-route service and decrease reliance by individuals with disabilities on complementary paratransit. In particular, Enhanced Mobility program funds can be used for capital planning and operations: 55 percent of all allocations for each grant recipient must be used for public transportation projects where traditional services are unavailable, inappropriate, or insufficient, while the remaining 45 percent can be used for other eligible services, including capital and operating expenses and projects previously eligible under the New Freedom program. States typically distribute these funds to local nonprofit human service agencies to buy vehicles that transport older adults and people with disabilities, and the agencies funded may provide transportation to support a range of activities, such as visiting friends. The Enhanced Mobility program requires grantees to develop coordinated public transit-human services plans. development and approval process that includes seniors, people with disabilities, and transportation providers, among others, and is coordinated to the maximum extent possible with transportation services assisted by other federal departments and agencies. The program also allows other federal non-DOT funds, such as Title III Part B funds, to be used as matching funds in order to better meet the transportation needs of older adults and promote federal coordination. Human-service transportation refers to transportation services provided by or on behalf of a human service agency to provide access to agency services and to meet the basic, day-to-day mobility needs of transportation-disadvantaged populations, especially individuals with disabilities, seniors, and people with low incomes. income individuals. Medicaid programs, which are administered by each state subject to the oversight of CMS, are required to assure that program beneficiaries—such as low-income children, people with disabilities, and older adults, among others—have access to necessary Medicaid providers when the beneficiaries cannot transport themselves to these providers. Under federal regulations, VA also provides transportation to medical services for those veterans who have service connected injuries or disabilities and meet certain eligibility criteria. Our past work on transportation-disadvantaged populations has found that federal coordination has the potential to reduce federal transportation program costs by clustering passengers; using fewer one-way trips; and sharing the use of personnel, equipment, and facilities. Federal efforts to coordinate transportation for the disadvantaged, including older adults, began in 1986 when DOT and HHS formed what is now known as the Coordinating Council. The Coordinating Council is chaired by the Secretary of Transportation and is charged with improving the efficiency and effectiveness of human service transportation by coordinating related programs at the federal level and promoting the maximum feasible coordination at the state and local levels. In 2003, the Coordinating Council launched the “United We Ride” initiative to act as a forum for interagency communication and to help states and communities overcome obstacles to coordination. The Coordinating Council’s actions have included issuing publications such as policy statements and progress reports on efforts taken. However, our June 2012 report on transportation-disadvantaged populations concluded that insufficient federal leadership and a lack of guidance for furthering collaborative efforts might hinder coordination efforts among state and local providers. To promote and enhance federal coordination efforts, we therefore recommended in 2012 that the Secretary of Transportation, as the Chair of the Coordinating Council, along with the council’s 11 member agencies, should meet and complete and publish a strategic plan outlining agency roles and responsibilities and articulate a strategy to help strengthen interagency collaboration and communication. In response to our recommendations, the Coordinating Council’s member agencies issued a strategic plan for 2011 to 2013, which established agency roles and responsibilities and identified a shared strategy to reinforce cooperation. Our prior work has shown that coordination can lead to improved quality and cost-effectiveness of transportation-disadvantaged services. In addition, we have previously identified key features and issues to consider when federal agencies collaborate and implement collaborative mechanisms, such as an interagency group or council. These key features include defining outcomes; monitoring progress to show accountability; establishing clear leadership; and determining key resources, such as funding. For example, various approaches can help enhance and sustain collaboration among federal agencies, such as developing a plan to identify short- and long-term outcomes and tracking progress toward those outcomes. We identified two key federal agency programs, AoA’s Title III Part B Supportive Services and FTA’s Enhanced Mobility program, and six other federal agency programs that can provide funding or transportation services for older adults. These eight identified programs are not an exhaustive list of all existing programs, but rather we focused on programs administered by the three primary Coordinating Council member agencies that provide transportation funding or services that may benefit older adults. Not all of the programs we identified focus solely on the older adult population. (For additional information on how we identified these, see appendix I. Also, see appendix II for the complete program list, including program descriptions.) In addition, as we reported in 2012, total federal spending on transportation services for transportation-disadvantaged populations is unknown because in many cases federal agencies do not separately track spending for these services. As such, transportation spending for older adults is also unknown because the funds are used to provide transportation services for a broader population. Of the eight federal programs we identified, the only programs that specifically provide funding exclusively for older adults were established in the OAA, which includes Title III Part B Supportive Services. Specifically, Title III Part B provides funds to 11 categories of supportive services for older adults, including transportation and assisted According to HHS officials, transportation can include a transportation.range of services such as shared rides and public transportation access, while assisted transportation serves eligible older adults who have difficulties using regular vehicular transportation and involves providing assistance, such as an escort, to those adults. Because this program targets services for older adults—including transportation—spending information for that population is available, as states are required to annually report their Title III Part B spending across the different supportive services.