Many elderly, disabled, and low-income individuals face significant challenges in accessing transportation. For example, some of these challenges are as follows: Sixteen percent of respondents over age 75 reported not having a driver’s license in 2001, and 25 percent of the respondents had not driven at least once in the last month according to an AARP survey. Elderly people are also more likely to have difficulty accessing traditional public transportation due to physical ailments. Thirty percent of respondents with disabilities reported difficulty in accessing transportation, compared to 10 percent of respondents without a disability, according to a 2000 survey by the National Organization on Disabilities. Low-income households are less likely to own a car than other households due to the prohibitive cost of purchasing, insuring, and maintaining a car, and public transportation may not provide sufficient options for their needs. Over 90 percent of public assistance recipients do not own a car. The importance of coordinating transportation services for transportation- disadvantaged populations has been evident since the 1970s. In 1977, we issued a report on transportation coordination, which concluded that the most significant hindrance to the coordination of transportation services under these programs was confusion at all levels of government as to how much coordination federally funded projects could engage in. Since 1986, responsibility for coordinating transportation programs at the federal level has rested in the Coordinating Council on Access and Mobility, which was created under a memorandum of understanding between the Department of Health and Human Services (HHS) and the Department of Transportation (DOT). This body is composed of representatives from program offices within these departments, and employees of the two departments meet its staffing needs, on a part-time basis. More recent reviews have continued to identify a need for stronger efforts in this area. In a 1999 report on transportation coordination, we found that coordination efforts of the Coordinating Council, DOT, and HHS were ongoing but still needed strengthening. This report also noted that the Congress had endorsed increased coordination as evidenced by several provisions in the Transportation Equity Act for the 21st Century (TEA- 21), and significant financial benefits had been realized through coordination. In addition, reports by advocacy groups and transportation researchers have raised concerns over continuing duplication of effort among federal programs and certain sub-populations still not being served effectively. We identified 62 federal programs that fund transportation services to populations that are transportation-disadvantaged. As shown in figure 1, the bulk of these programs are administered by four federal agencies—23 programs in HHS, 15 programs in the Department of Labor (DOL), 8 programs in the Department of Education, and 6 programs in DOT. The remaining 10 programs are administered by the Departments of Housing and Urban Development (HUD), Veterans Affairs (VA), Agriculture, and the Interior. A full listing of programs, their authorizing legislation, typical uses, types of trips provided, target populations, and spending information is found in appendix II. Many of the 62 programs are significantly involved in providing transportation services to their recipients. These include 16 programs identified by the Community Transportation Association of America (CTAA) as being routinely used to provide transportation and an additional 11 programs that we identified as spending at least $4 million for transportation services to transportation-disadvantaged populations in fiscal year 2001 on the basis of funding data or estimates that were available. The remaining programs also fund transportation services, but do so minimally, or the extent of transportation services funded is unknown, according to program officials. Table 1 shows the 16 programs identified by CTAA and how they provide transportation. These 16 programs are administered by DOT, HHS, Education, and DOL. As the table shows, transportation is not the primary purpose of most of these programs. For example, Medicaid provides payments for medical services, and the Vocational Rehabilitation Grants Program provides training and employment services to individuals with disabilities. Table 2 shows the 11 programs we identified as spending at least $4 million on transportation for the transportation-disadvantaged in fiscal year 2001. Under most of the federal programs providing transportation services, funding recipients typically purchase the services from existing sources, according to program officials. This includes contracting for services with private transportation providers or providing bus tokens, transit passes, taxi vouchers, mileage reimbursement to volunteers or program participants, or some combination of these methods. For example, recipients of funds from DOL’s Workforce Investment Act Adult Services Program typically provide bus tokens or mileage reimbursement for participants to access training, while recipients of HHS’s Grants for Supportive Services and Senior Centers most often contract with local transportation providers to provide client transportation. The funding recipients of several programs, however, typically purchase and operate vehicles, or modify existing vehicles for use by individuals with disabilities. These programs include Head Start and the Program for American Indian, Alaskan Native, and Hawaiian Elders in HHS; the Vocational Rehabilitation Grants Program in the Department of Education; and the six programs within DOT. Several of these programs have requirements for grantees to coordinate their services with other agencies providing similar services, which would include transportation, among other services. For example, Head Start grantees are required to make every reasonable effort to coordinate transportation services they provide with other human service transportation in their communities. Similarly, DOT’s Capital Assistance Program for Elderly Persons and Persons with Disabilities, Job Access and Reverse Commute, and Nonurbanized Area Formula Program have requirements for grantees to coordinate their transportation services. In addition, some programs have provisions designed to avoid duplication of effort and encourage the use of existing community resources. For example, Workforce Investment Act programs may use funds to support those who are participating in the program only if those individuals are unable to obtain services through other programs, according to program officials. Also, the Veterans’ Workforce Investment Program requires grantees to provide information on the linkages this program will have with other providers of services to benefit veterans. Available information shows that federal programs spent an estimated $2.4 billion on transportation services for transportation-disadvantaged populations in fiscal year 2001, and additional state and local spending for these populations was several hundred million dollars more. Complete spending information is not available because many federal funding recipients are not required to distinguish transportation from other spending when reporting spending information to federal agencies. Information on federal spending for transportation is available for 29 of the 62 programs we identified. These programs spent an estimated $2.4 billion on transportation services in fiscal year 2001. (Appendix II lists available spending data for each federal program.) Based on available information, HHS programs as a whole spent the most on transportation for transportation-disadvantaged populations in 2001—an estimated $1.8 billion. Table 3 shows estimated transportation spending by the eight federal agencies that fund services for the transportation-disadvantaged. More than three-quarters of our estimate is based on spending for transportation in five programs. Of the five, Medicaid and Head Start, both in HHS, spent the most on transportation in fiscal year 2001—an estimated $976.2 million and $514.5 million, respectively. The three other programs, all of which spent more than $100 million on services for the transportation-disadvantaged in fiscal year 2001, were DOT’s Capital Assistance Program for Elderly Persons and Persons with Disabilities, HHS’s Temporary Assistance for Needy Families (TANF), and VA’s Veterans Medical Care Benefits. The amount spent on transportation services by the remaining 33 federal programs is unknown, mainly because the majority of programs do not require recipients of federal funds to report transportation spending information to the federal agency. Total state and local spending for transportation services, which supplements federal spending for such programs, is likely significant—at least in the hundreds of millions of dollars—although the total is unknown because most programs do not require grantees to report these data. Matching requirements, which represent the nonfederal contributions to the program’s costs that come from state, local, or private funds, provide some information on state and local spending on transportation for the transportation-disadvantaged. About half of the 62 programs have matching requirements that generally require states and localities to contribute between 5 and 50 percent of total costs. Additionally, limited information from officials in the five states we visited indicates that total state and local spending on transportation runs into the hundreds of millions of dollars. For example: Nonfederal contributions for Medicaid nonemergency transportation ranged from 32 to 50 percent of the total spending on this service in the five states that we visited. In New York, 50 percent, or an estimated $139.4 million, of the state’s total spending on Medicaid funded transportation in 2001 was from nonfederal sources. In Florida and Wisconsin approximately 40 percent of the total amount spent on nonemergency medical transportation in the state was from nonfederal sources; state contributions in those states were $28.6 million and $13.4 million, respectively, in 2001. In Arizona and South Dakota, approximately one-third of the total amount spent on Medicaid transportation was from nonfederal sources in those states in 2001, approximately $7.0 million and $490,000, respectively. In Wisconsin nearly 38 percent, or $922,000, of the funding to provide transportation services through DOT’s Capital Assistance Program for Elderly Persons and Persons with Disabilities in 2001 was from nonfederal sources. The program requires grantees to provide 20 percent of total program funding. In New York, about 30 percent of the spending on transportation under the Department of Education’s Vocational Rehabilitation Program in 2002, or $2.6 million, was from nonfederal sources. Similarly, about 27 percent or $673,000 of Florida’s funding was from nonfederal sources in 2001. The program requires states to contribute 21.3 percent of total costs. Although some states and localities currently spend a significant amount for transportation through federal programs, many now face budget deficits that could diminish their future contribution to these programs.