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02 February 8, 2006 Citizens advisory committee / Social services transportation advisory council75676 RECORDS RIVERSIDE COUNTY TRANSPORTATION CONi mraa. .r- CITIZENS' ADVISORY COMMITTEE/SOCIAL SERVICES TRANSPORTATION ADVISORY COUNCIL TIME: 11:30 A.M. DATE: February 8, 2006 LOCATION: Conference Room "A," 3' Floor County of Riverside Administrative Center 4080 Lemon Street, Riverside *** COMMITTEE MEMBERS *** Judy Nieburger, Office of Supervisor Ashley, County of Riverside, Chairman Andrea Puga, Corona, Vice Chairman Peter Benavidez, Blindness Support Services, Riverside Jim Collins, Include Me, Inc., Indio Eunice Lovi, SunLine Transit Agency, Thousand Palms Mike Pistilli, City of Beaumont Scott Richardson, Riverside Transit Agency, Riverside Cindy Scheirer, Office of Supervisor Tavaglione, County of Riverside Sherry Thibodeaux, Community Access Center, Riverside. Mary Venerable, Office of Supervisor Buster, County of Riverside *** STAFF *** Tanya Love, Program Manager 11.36.10 RIVERSIDE COUNTY TRANSPORTATION COMMISSION CITIZENS' ADVISORY COMMITTEE/ SOCIAL SERVICES TRANSPORTATION ADVISORY COUNCIL www.rctc.org AGENDA* *Actions may be taken on any item listed on the agenda 11:30 A.M. Wednesday, February 8, 2006 COUNTY ADMINISTRATIVE CENTER 4080 Lemon Street, Riverside, CA 92501 CONFERENCE ROOM A, 3rd FLOOR In compliance with the Americans with Disabilities Act and Government Code Section 54954.2, if you need special assistance to participate in a Commission meeting, please contact the clerk of the Commission at (951) 787-7141. Notification of at least 48 hours prior to meeting time will assist staff in assuring that reasonable arrangements can be made to provide accessibility at the meeting. PLEASE NOTE: The Chairperson of the CAC/SSTAC kindly requests that cell phones be turned off during the meeting. 1. CALL TO ORDER 2. ROLL CALL 3 PUBLIC COMMENTS 4. APPROVAL OF MINUTES 5. • ADDITIONS/REVISIONS (The CAC/SSTAC may add an item to the agenda after making a finding that there is a need to take immediate action on the item and that the item came to the attention of the CAC/SSTAC subsequent to the posting of the agenda. An action adding an item to the agenda requires 2/3 vote of the Committee. if there are less than 2/3 of the CAC/SSTAC members present, adding an item to the agenda requires a unanimous vote. Added items will be placed for discussion at the end of the agenda.) Riverside County Transportation Commission Agenda February 8, 2006 Page 2 6. ELECTION OF OFFICERS 7. RIVERSIDE COUNTY TRANSPORTATION COMMISSION STRUCTURE, OFFICERS AND MEMBERSHIP FOR 2006 Pg. 1 Overview This item is for the CAC/SSTAC to receive and file the report on the structure and membership of the Riverside County Transportation Commission and its Committees. 8. MEASURE A SPECIALIZED TRANSPORTATION PROGRAM — NON - EMERGENCY MEDICAL TRANSPORTATION Pg. 9 Overview This item is for the Committee to: 1) Receive and file the Measure A Specialized Transportation Program's Fact Finding Paper on Non -Emergency Medical Transportation; and 2) Seek appointment of three members of the CAC/SSTAC Committee to review proposals on the western Riverside ' County Measure A Specialized Transit Program. 9. CAC/SSTAC COMMITTEE APPOINTMENTS Pg. 46 Overview This item is to appoint CAC/SSTAC members to serve on the following committees: • Unmet Transit Needs Hearing: Appoint one member to attend and be a member of the hearing board at the Unmet Transit Needs Hearing in Blythe on. March 1, 2006. • SB 821 Evaluation Committee: Appoint three members to review and score applications. Timefrarne: SB 821 applications are due in May and review of the applications is expected to be in June. • FTA's Section 5310 Program: Appoint three members to review and score applications on March 14, 2006, 9:00 A.M. to 1:00 P.M. Riverside County Transportation Commission Agenda February 8, 2006 Page 3 10. 2006 MEETING SCHEDULE AND AGENDA TOPICS Pg. 49 Overview This item is for the Committee to receive and approve the proposed 2006 Meeting Schedule and Agenda Topics as presented. 11. COMMITTEE MEMBER COMMENTS AND INFORMATION Overview This item provides the opportunity for the Committee Members to report on attended and upcoming meetings/conferences and issues related to Committee activities. 12. ADJOURNMENT The next Citizens' Advisory Committeel/Social Services Transportation Advisory Council meeting is scheduled to be held at 11:30 A.M., Wednesday, May 10, 2006, Riverside County Transportation Commission, County Administrative Center, 4080 Lemon', Street, Riverside, CA 92501, 3rd Floor, Conference Room A. MINUTES RIVERSIDE COUNTY TRANSPORTATION COMMISSION CITIZENS' ADVISORY COMMITTEE/ SOCIAL SERVICES TRANSPORTATION' ADVISORY COUNCIL Minutes August 10, 2005 1. CALL TO ORDER The Citizens' Advisory Committee/Social Services Transportation Advisory Council was called to order by Judy Nieburger at 11:35 A.M. at the Riverside County Transportation Commission Offices, 4080 Lemon Street, Riverside, California 92501, 3rd Floor, Conference Room "A." Members Present Peter Benavidez Jim Collins (Conference Call) Eunice Lovi Judy Nieburger Andrea Puga Scott Richardson Cindy Scheirer Sherry Thibodeaux Mary Venerable Members Absent Mike Pistilli (vacation) Also in Attendance: Charlene Ariza, Metrolink Deena Barrett, Care Connexxus Cathy Bechtel, RCTC Shirley Gooding, RCTC Cheri Haggerty, RTA Tanya Love, RCTC Chris Millen, City of Banning Fortunato Penilla Sheldon Peterson, RCTC Colleen Richter, Metrolink Viren Shah, City of Corona John Standiford, RCTC Robin Unruh, Blindness Support Virginia Werly, RTA Stephanie Wiggins, RCTC Irene Buonarigo, Include Me, Inc. Robin Buonarigo, Include Me, Inc. Rick Marsh, include Me, Inc. Dolores Rodriguez, Include Me, Inc. Paul Torterella, Include Me, Inc. Citizens' Advisory Committee/ Social Services Transportation Advisory Council August 10, 2005 Page 2 2. ROLL CALL 3. PUBLIC COMMENTS Via teleconference, Jim Collins, Include Me, Inc., introduced the following citizens who stated their concerns: Rick Marsh, Include Me, Inc., daily SunLine rider, said that when more than 2 wheelchairs are on the bus, there is a wait for another bus and that a supervisor is not available to pick them up, especially in hot weather. Paul Torterella, Include Me, Inc., daily SunLine rider, uses the SunLine transit system to and from work in Palm Desert. (No problems reported.) Dolores Rodriguez, daily SunLine rider, Include Me, Inc., uses the bus. (No problems reported.) Robin Buonarigo, Include Me, Inc., daily SunLine rider, uses the paratransit system to and from work and to other appointments. (No problems reported.) Irene Buonarigo, Include Me, Inc., daily SunLine rider. (No problems reported.) Jim Collins stated that rider problems will be addressed at SunLine. He further stated that in addition to today's speakers, there are many clients of Include Me, Inc. who are raising the same issues. An Include Me, Inc. staff member will apply for a seat on SunLine's Advisory Board to address these concerns. 4. APPROVAL OF MINUTES M/S/C (Puga/Venerable) to approve the May 11, 2005 Minutes. Abstain: Jim Collins, due to absence caused by telephone technical difficulties at the May 11, 2005 meeting. 5. ADDITIONS/REVISIONS There were no additions/revisions to the agenda. Citizens' Advisory Committee/ Social Services Transportation Advisory Council August 10, 2005 Page 3 6. COMMUNITY AND ENVIRONMENTAL TRANSPORTATION ACCEPTABILITY PROCESS Cathy Bechtel, RCTC, stated that the Community and Environmental Transportation Acceptability Process (CETAP), a multi -year process, focuses on looking at transportation needs in western Riverside County in coordination with other planning processes that are going on in Riverside by the County of Riverside. Through a series of public meetings, working', with the Advisory Committee and Riverside County Transportation Commission, four new transportation corridors were identified. Two corridors are within western Riverside County and two are inter -county corridors, all moving on separate schedules. The inter -county corridors are between Riverside County and ''San Bernardino County. There is also a cooperative effort with Orange County to build a new transportation corridor between Riverside County and Orange County. A new corridor, starting at Cajalco Road and 1-15 going westbound, coming out at about the 241/133 in Orange County around Irvine has been identified. Improvements to SR 74 may also be required since it is only one lane in each direction. Improvements adjacent to SR 91 in the Santa Ana Corridor near the river are also being evaluated. Ms. Bechtel provided a Mid County Parkway newsletter and reported that with the significant growth in western Riverside County, a new transportation facility is planned between SR 79 in the San Jacinto area going west to 1-15, a 32 mile facility. A tier one environmental document was completed for a fourth internal corridor, Winchester to Temecula. After much work, a decision was made to do the improvements along 1-215 and 1-15 in the Murrieta/Temecula area. She summarized the CETAP effort as recognizing the growth coming to western Riverside County. Citizens' Advisory Committee/ Social Services Transportation Advisory Council August 10, 2005 Page 4 7. REVIEW OF EVALUATION CRITERIA FOR UPDATE OF ALAMEDA CORRIDOR EAST (ACE) TRADE CORRIDOR RAIL CROSSING GRADE SEPARATION PRIORITY LIST Stephanie Wiggins, RCTC, stated that the ports of Los Angeles in Long Beach are the busiest in the nation and among the top 5 busiest ports in the world. They are the gateway to Asia in moving goods not only to Southern California but to the rest of the nation. More than 50% of the goods coming through this area are not destined for this area thus causing many negative impacts. Some freight trains are 2 miles long, causing delays to the driving public along with the noise of lengthy freight train horns. About 85 freight trains travel through Riverside County on a daily basis. She further stated that in 2001 the Commission developed a Grade Crossing Priority List in conjunction with Los Angeles County, Orange County and San Bernardino County to identify the needs of grade crossings. Ms. Wiggins explained the criteria used in evaluating the grade crossings and reported that a 2005 list is being prepared. In response to a timeline question regarding Avenue 48/Dillion Road, Ms. Wiggins stated that it is fully funded and is in the design stage and should be cleared within the next 3-5 years. In response to a scoring question, she explained the criterion. Ms. Wiggins advised that she is currently developing a revised preliminary priority list for the Commission which she will make available to the CAC/SSTAC. (See attached.) 8. TRANSIT MARKETING STRATEGIES: NEW AND INNOVATIVE MARKETING IDEAS Colleen Ricter, Manager of Marketing Sales, informed the CAC/SSTAC that some of Metrolink's marketing goals for this fiscal year are to expand their employer outreach, to build customer loyalty and retention, to reach new residential targets, to cultivate Hispanic ridership, promote connectivity, support member agencies and increase revenue. In the Marketing Department at. Metrolink, they are primarily focused on rider acquisition. The ridership turnover is about 25% annually. Citizens' Advisory Committee/ Social Services Transportation Advisory Council August 10, 2005 Page 5 She further stated that in the residential market, a mailer goes to new residential movers — renters and home -buyers. This year the area to which mailers are sent was expanded to include south county towards Temecula and shows the station closest to their homes, how to get there, and offers a ticket for 2 round trips. Metrolink also works with developers for new residential areas contacting the sales groups and they have their information placed at model homes or contractor trailers. Ms. Ricter introduced a new campaign that is destination -end oriented to reach large employers. She introduced Charlene Ariza, Metrolink, who elaborated on a new resident program in conjunction with RCTC. The focus is the Eastvale development of 5,000 homes, all of which are hardwired together with internet access. They have their own internet system with an online newsletter. Metrolink put together a campaign to reach the Eastvale area via a newsletter article that Eastvale posted online and mailed it to residents as well. The article ran from April until the end of June and as a result, 48 people responded to the campaign. Although the response rate was minimal, the conversion rate could be a great ridership source for Metrolink. She further explained Metrolink`s relationship with Riverside Transit Agency and Los Angeles County. In response to a question of how employees can get their employers to provide buses or other service to Metrolink stations, Ms. Ariza stated that a brochure is being developed that will go to employees to help them approach employers regarding Metrolink. She recommended calling Metrolink at 1-800-371-LINK. Chris Millen, City of Banning, reported that his agency is actually 2 transit agencies. Pass Transit is a cooperative venture between the City of Banning and the City of Beaumont. The communities of Banning, Beaumont, unincorporated area of Cherry Valley, unincorporated area of Cabazon, and the Morongo Reservation are one population center. He explained how the 2 agencies redesigned the systems to be a single system with 2 separate entities operating it. He further detailed the RideGuide, which is attractively designed to better detail the Pass Transit service. Mr. Millen spoke of the new visibility of the buses and bus stops that now include a telephone number. Citizens' Advisory Committee/ Social Services Transportation Advisory Council August 10, 2005 Page 6 Scott •Richardson, Director of Marketing, Riverside Transit Agency, detailed RTA's organization. He stated that press releases are used for promotions, such as new routes, meeting changes, events, while posters, flyers and the Ride Guide are used to educate the public on how to use the RTA service. RTA's website is currently being revamped. On the website, the public can enter their destination, origin, desired arrival time and they can get a trip mapped online. RTA has an effective Student Transit Education Program (STEP) for which the agency has won awards. He expressed RTA's willingness and eagerness to entertain new pass outlets and summarized themarketing programs that are designed to better serve their existing customers, attract new customers and offer overall awareness and understanding of RTA's business in the community. 9. ANNOUNCEMENTS Judy Nieburger, Chair, announced that the next meeting of the Citizens' Advisory Committee/Social Services Transportation Advisory Council will be February 8, 2006. 10. COMMITTEE MEMBER COMMENTS AND INFORMATION There were no comments or information to report. 11. ADJOURNMENT There being no further business for consideration by the Citizens' Advisory Committee/Social Services Transportation Advisory Council, the meeting adjourned at 1:55 P.M. The next meeting is scheduled for 11:30 A.M., February 8, 2006, County of Riverside Administrative Center, Conference Room "A," 3rd Floor, 4080 Lemon Street, Riverside 92501. Respectfully submitted, Tanya Love Program Manager 2005 Rail Crossing Grade Separation• Priority List Rail Line BNSF (SB SUB) 7•1319$&..1)P(SB.'SUB). UP (SB SUB) BNSF SB SUB SB...SUB BNSF (SB SLIB) BNSF SB SUB) UP (YUMA MAIN) BNSF S13:SLII3BNSF SBSUB) UP LA SUB BNSF (SB SIJB) UP (YUMA UP LA SUB BNSF(SB SUB) UP (YUMA MAIN) BNSF & UP (SB SUB) UP LA SUB) EINSECOP(SB-SU(3).:': BNSF (SB SUB) BNSF & UP (SB SUB) BNSF (SB SUB) BNSF & UP (SB SUB) UP LA SUB) BNSF (SB SUB) BNSF & UP (RIV) BNSF (SB SUB) UP (YUMA MAIN) UP (LA SUB) UP LA SUB BNSF SB SUB UP YUMA MAIN) UP (YUMA MAIN) Cross Street Magnolia Av ChicagoAv 3rd St Columbia Av (BNSF) McKinley St Adams S1 Smith Av Sunset Av Jurupa Rd Auto Center Dr Hrave St Magnolia Ay:2:r2. Madison St Avenue 48/Dillon Road Center St Clay St Pierce St Palmyrita Av (UP) Railroad St Spruce St (BNSF) Riverside Av Buchanan St Cridge St Washington St Avenue 62 Streeter Av Brockton Av Jefferson S 22nd St Jurisdiction Overall Riverside County. Riversicle Riverside Riverside Corona Riverside Riverside Corona Weighted Score 4525 4060 4380 4000 3950 3820 3665 3613 Banning 3500 'Riverside. ;" • 3500 Riverside • ' 3465 Riverside County 3462 Corona Banning Riverside RVerside Indio/Coachella Riverside County Riverside County - Riverside Riverside Riverside Corona Riverside Riverside Riverside Riverside Riverside Riverside County Riverside Riverside Riverside Banning UP YUMA MAIN) UP (YUMA MAIN) BNSF (SB SUB) UP (YUMA MAIN) UP (LA SUB) UP (YUMA MAIN) UP (LA SUB) UP (yumA MAIN) BNSF (SB SUB) UP (LA SUB) UP (YUMA MAIN) BNSF & UP (SB SUB) UP YUMA MAINy BNSF (SB SUB) BNSF SB SUB UP (YUMA MAIN) UP (LA SUB) BNSF (SB SUB) BNSF (SB SUB) UP (LA SUB) UP (YUMA MAIN) UP (YUMA MAIN) BNSF (SB SUB) UP (YUMA MAIN) BNSF (SB SUB) UP (YUMA MAIN) San Gorgonio Av Avenue 66 Avenue 52 Cote St San Timoteo Canyon Rd Bellgrave Av Viele Av Palm Av Airport Drive Jackson St Rutile St Apache Trail Main St Broadway Harrison St Joy St California Av Mountain View Av Radio Rd Jane St Panorama Rd Tipton Rd Pennsylvania Av Sheridan St Avenue 54 Gibson St Avenue 58 Banning Riverside County Coachella Corona Calimesa ; Riverside County Beaumont Riverside Riverside County Riverside 3438 3425 3380 3340 3325 3283 3235 3135 3090 3010 2925 2845 2810 2800 2650 2580 2525 2515 2400 2380 2375 2300 2265 2233 2113 2100 2048 1983 1965 1892 1805 Group 1 1 1 1 1 2 2 2 2 2 2 2 2 2 2 2.... 3 3 3 3 3 3 3 3 3 3 3 3 3 3 Riverside County 1746 Riverside County__ 1727 Riverside County1681 Riverside County • 1604 Riverside 1545 Corona 1525 Beaumont Riverside Corona Riverside Riverside Palm Springs Beaumont Corona Coachella Riverside Riverside County 1500 1450 1450 1310 1290 4 4 4 4 4 4 4 4 4 4 4 1100 917 5 813 5 767 5 695 5 638 5 as of 10/12/05 TABLE 3-1- PRIORITY FACTORS SCORING Ref No. Rail Line' Cross Street Jurisdiction Rat'm Points Year 2005 Veh Hrs o1 Delay Per Day Year 2030 Veh Hrs of Delay Per Day Overall Accident Score Adjacent Grade Separations Local. Rankin Emissions Score Residential Noise Score UP (LA SUB Bell rave Av - - is 1 1 2 ® I 11E011 45 2 Rutile St Riverside Coun 1 2 0 5 17 40 20 3 Jumps Rd Riverside Cou 2 4 4 5 23 80 20 Cla St Riverside Cou 4 5 1 3 19 80 30 Mountain View Av Riverside 0 0 _ 3 5 0 2D 50 Streeter Av Riverside 2 3 1 5 12 65 50 Palm Av Riverside 2 2 0 5 7 45 60 8 Brockton Av Riverside 2 3 1 5 j 10 60 40 . Magnolia Av Riverside 4 4 1 ' 5 24 80 40 10 Riverside Av Riverside 3 3 2 5 13 60 30 11 Panorama Rd Riverside 1 2 _ 0 3 2 30 40 12 BNSF (SB SUB) Auto Center Dr Corona 3 5 1 5 - 22 100 4D 13 Smith Av Corona 5 5 0 5 16 100 60 Railroad St Corona 3 5 0 1 19 100 70 Cots St Corona 1 3 0 5 9 55 _ 70 . Sheridan St Corona 0 1 0 1 3 20 70 m Joy St Corona 1 3 _ 0 M.Mil 6 60 60 .111 Radio Rd Corona 1 2 0 ©® _ 30 l m McKinle St - Corona 5 5 1 3 25 100 90 20 Magnolia Av Riverside Coun 5 5 • 3 5 25 95 90 21 Buchanan St Riverside 1 2 5 5 _ 5 40 80 22 Pierce St Riverside 3 4 1 3 m 80 0 23 T Ier St Riverside 4 5 1 3 20 90 70 _ 24 Hanson St Riverside 2 2 0 1 - 6 _ 45 60 25 Gibson St Riverside 0 1 0 0 1 25 70 26 Jackson St Riverside 2 2 1 - 1 4 35 90 27 Adams St Riverside 5 5 _-_ 1 1 . 22 95 90 28 Jefferson St Riverside 2 3 _ 1 ' 5 9 40 - 60 29 Madison St Riverside 4 3 _ 2 5 - 22 60 60 30 Washington St Riverside 3 © 0 5 14 60 60 31 Mary St Riverside 4 4 1 5 22 75 70 32 Jane St Riverside 1 2 0 1 3 30 80 33 BNSF 8 UP (RIV) Cndge SI Riverside 4 3 0 1 15 BO 90 34 BNSF & UP (ISUB 7th St Riverside 4 5 0 0 18 95 10O 35 3rd St Riverside 5 5 1 5 _ 23 100 80 36 Mr231312131. Riverside 0 3 4 5 11 65 80 37 • Riverside 5 5 3 5 19 100 80 38 Columbia Av(BNSF) - Riverside 5 5 __. 1 - 5 25 100 60 39 Palm la Av (UP Riverside 1 3 5 5 8 50 40 - Iowa Av(BNSF) Riverside 5 5 1 5 21 100 40 41 Center St Riverside County 4 5 0 5 15 85 50 42 Main St Riverside County 1 2 0 5 12 30 40 43 UP (YUMA MAIN San Timoteo Canyon Rd Calimesa 0 0 5 5 25 20 0 44 Viele Av Beaumont 0 0 5 5 17 _ _ 20 10 45California Av Beaumont 0 3 0 0 25 60 20 46 Penns Ivania Av Beaumont 0 2 0 1 8 40 10 _ 47 Sunset Av Rennin • 4 5 : 1 5 25 80 20 48 22nd St Bannin• 3 3 0 5 13 55 30 49 San Gorgonio Av Banni . 3 3 1 3 6 65 30 50 Fla •rave St Benin. 4 5 1 5 • 19 100 10 51 • Apache Trail Riverside Cou 0 4 0 5 4 70 0 52 Broadway Riverside County 1 1 2 5 8 20. 10 Tipton Rd Palm Springs 0 0 0 5 25 20 0 UP YUMA MAIN Avenue 481Dillon Road Indio/Coache0a 2 5 2 5 25 75 30 Avenue 52 Coachella - 2 3 0 5 17 50 30 Avenue54 Coachella 0 0 0 5 0 20 0 ' Airport Drive Riverside Coun 1 2 2 5 10 20 20 Avenue 58 Riverside Cou _ _ 0 0 0 5 2 20 0 Avenue 62 Riverside Coun 0 5 _ 3 3 13 80 0 Avenue 66 Riverside Coun 2 © 3 5 0 14 AGENDA ITEM 7 RIVERSIDE COUNTY TRANSPORTATION COMMISSION DATE: February 8, 2006 TO: Citizens' Advisory CommitteelSocial Services Transportation Advisory Council FROM: Jennifer Harmon, Acting Clerk of the Board THROUGH: Stephanie Wiggins, Director of Regional Programs SUBJECT: Riverside County Transportation ',Commission Structure, Officers and Membership for 2006 STAFF RECOMMENDATION_ This item is for the Committee to receive and file'. the report on the structure and membership of the Riverside County Transportation Commission and its Committees. BACKGROUND INFORMATION: Membership SB 1851, approved in August 24, 1998, revised the membership of the Commission from 8 members to 30 members as follows: - 5 Members of the Riverside County Board of Supervisors; - 1 Member from each incorporated city in Riverside County; (must be either a mayor or city council member); and, 1 Non Voting member appointed by the Governor. Commission Officers In accordance to the Administrative Code, the Commission must annually hold an election of officers. The officers of the Commission consist of the Chair, Vice Chair, and Second Vice Chair, which shall annually alternate between a regular member of the Commission representing a city and a regular member of the Commission who is a member of the Riverside County Board of Supervisors. The Vice Chair shall perform the duties of the Chair in the absence of the Chair and the Second Vice Chair shall perform the duties of the Chair in the absence of the Chair and the Vice Chair. When so acting, the Vice Chair and Second Vice Chair shall have all the powers of and be subject to all the restrictions upon the Chair. For 2006, Marion Ashley, Riverside County Board of Supervisors, is the Chair; Terry Henderson, city of La Quinta, is the Vice Chair; and Jeff Stone, Riverside County Board of Supervisors, is the Second Vice Chair. 1 Executive Committee The Executive Committee is charged with evaluating and approving the Executive Director's contract, staff salary and fringe benefit changes and office operations. The Executive Committee is comprised of ten Commissioners as follows: 1) Chair; 2) Vice Chair; 3) Second Vice Chair; 4) Past Chair; 5) A Commissioner representing one of the following cities: Riverside, Corona, Moreno Valley; 6) A Commissioner representing one of the following cities: Banning, Beaumont, Calimesa, Canyon Lake, Hemet, Lake Elsinore, Murrieta, Norco, Perris, San Jacinto, and Temecula; 7) A Commissioner representing one of the following cities: Blythe, Cathedral City, Coachella, Desert Hot Springs, Indian Wells, Indio, La Quinta, Palm Desert, Palm Springs and Rancho Mirage; and, 8) Three Riverside County Board of Supervisors. With the exception of the Chair, Vice Chair, and the Second Vice Chair, the term of the Executive Committee members is two years. This year, the Executive Committee members are Robin Lowe, Marion Ashley, Terry Henderson, Jeff Miller, Chris Buydos, Mike Wilson, Bob Buster, Jeff Stone, John Tavaglione, and Roy Wilson. Policy Committees There are three policy committees that review items prior to Commission approval - Budget and Implementation Committee, Plans and Programs Committee, and Transit Policy Committee. Each year, the newly elected Chair appoints membership to the Committees. The Budget and Implementation Committee reviews items relating to budget development and oversight, strategic plan, legislation, Measure A implementation and capital programs, public communications and outreach programs, competitive grant programs such the TEA 21 - CMAQ and Surface Transportation Program, transportation enhancement and SB 821 Bicycle and Pedestrian, property management, Service for Freeway Emergencies/Freeway Service Patrol, TUMF and other areas that may be prescribed by the Commission. The Plans and Programs Committee reviews items relating to the State Transportation Improvement Program, Regional .Transportation Improvement Program, new corridors, intermodal programs such 'as transit, rail, rideshare, air quality and clean fuels, regional agencies/regional planning, intelligent transportation system planning and programs, congestion management program, and other areas that may be prescribed by the Commission. 2 The Transit Policy Committee is charged with making recommendations regarding policy directions to prepare transit vision and to bring regional perspective to transit, monitor transit implementation, and review performance of transit operators and their services. In addition to appointing membership to the Commission's policy and ad hoc committees, the Chair also appoints the Commission's representative(s) to other agency board and committees. The representative must be a regular member of the Commission. Some boards and committees include the Southern California Regional Rail Authority (Metrolink), South Coast Air Quality Management District Mobile Source Review Committee, Toll Road Advisory Committee, and SCAG Transportation and Communications Committee. Attachment: 2006 Committee Membership 3 BUDGET AND IMPLEMENTATION COMMITTEE - Annual Budget Development and Oversight, Countywide Strategic Plan, Legislation, Measure "A" Implementation and Capital Programs, Public Communications and Outreach Programs, Competitive Grant Programs: TEA 21-CMAQ & STP, Transportation Enhancement and SB 821-Bicycle & Pedestrian, Property Management, SAFE/Freeway Service Patrol, and other areas as may be prescribed by the Commission. 2006 APPOINTMENT Barbara Hanna / City of Banning Roger Berg / City of Beaumont Robert Crain / City of Blythe Gregory S. Pettis / City of Cathedral City Juan DeLara / City of Coachella Alex Bias / City of Desert Hot Springs Terry Henderson / City of La Quinta Bob Magee / City of Lake Elsinore Rick Gibbs / City of Murrieta Ron Meepos / City of Rancho Mirage Steve Adams / City of Riverside Chris Buydos / City of San Jacinto John Tavaglione / County of Riverside Jeff Stone / County of Riverside PLANS AND PROGRAMS COMMITTEE - State Transportation Improvement Program, Regional Transportation Improvement Program, New Corridors, Intermodal Programs (Transit, Rail, Rideshare), Air Quality and Clean Fuels, Regional Agencies/Regional Planning, Intelligent Transportation System Planning and Programs, Congestion Management Program. 2006 APPOINTMENT John Chlebnik / City of Calimesa Mary Craton / City of Canyon Lake Jeff Miller / City of Corona Robin Lowe / City of Hemet Mary Roche / City of Indian Wells Michael Wilson / City of Indio Frank West / City of Moreno Valley Frank Hall / City of Norco Dick Kelly / City of Palm Desert Ronald Oden / City of Palm Springs Daryl Busch / City of Perris Ron Roberts / City of Temecula Bob Buster / County of Riverside Roy Wilson / County of Riverside 4 TRANSIT POLICY COMMITTEE - Review items and makes recommendations on policy directions to prepare for transit vision and to bring regional perspective to transit; monitor transit implementation; and, review performance of transit operators and its services. 2006 APPOINTMENT Roger Berg / City of Beaumont John Chlebnik / City of Calimesa Terry Henderson / City of La Quinta Frank West / City of Moreno Valley Frank Hall / City of Norco Dick Kelly / City of Palm Desert Daryl Busch / City of Perris Ameal Moore / City of Riverside Jeff Stone / County of Riverside John Tavaglione / County of Riverside Roy Wilson / County of Riverside 5 2006 APPOINTMENT BOARD/ COMMITTEE REPRESENTATIVE RESPONSIBILITIES MOBILE SOURCE REVIEW COMMITTEE Frank West Alex Bias, Alt MOBILE SOURCE AIR POLLUTION REDUCTION REVIEW COMMITTEE - MEETS MONTHLY AT THE SCAQMD OFFICES IN DIAMOND BAR. ESTABLISH DISCRETIONARY PROGRAM (AB 2766) AND AWARDS FUNDING WITH SCAQMD BOARD CONCURRENCE. REGIONAL TRANSPORTATION AGENCIES CONSORTIUM Robin Lowe John Chlebnik, Alt REGIONAL TRANSPORTATION AGENCIES CONSORTIUM - MEETS ON A MONTHLY BASIS AT SCAG OFFICES. THE CONSORTIUM WAS ESTABLISHED FROM THE AB 1246 PROCESS, MADE UP OF COUNTY TRANSPORTATION COMMISSIONS, CALTRANS AND SCAG. THEY ADVISE THE REGIONAL COUNCIL REGARDING TRANSPORTATION MATTERS, ESPECIALLY ON MULTI -COUNTY AND INTER -COUNTY CONFLICT ISSUES. SOUTHERN CALIFORNIA ASSOCIATION OF GOVERNMENTS- SCAG REGIONAL COUNCIL Robin Lowe SCAG REGIONAL COUNCIL - GOVERNING BODY OF SCAG AND MEETS ON THE FIRST THURSDAY MORNING OF EVERY MONTH IN LOS ANGELES. SOUTHERN CALIFORNIA ASSOCIATION OF GOVERNMENTS- SCAG TCC Robin Lowe SCAG TRANSPORTATION & COMMUNICATIONS COMMITTEE - MEETS MONTHLY ON THE FIRST THURSDAY OF EVERY MONTH FROM 12 NOON TO 3 P.M. IN LOS ANGELES. REVIEWS AND RECOMMENDS TO THE REGIONAL COUNCIL ON TRANSPORTATION ISSUES. SOUTHERN CALIFORNIA REGIONAL RAIL AUTHORITY — SCRRA (BOARD & COMMITTEES) Ron Roberts Frank West Daryl Busch, Alt John Chlebnik, Alt SOUTHERN CALIFORNIA REGIONAL RAIL AUTHORITY - THE BOARD MEETS MONTHLY, ON THE 2' FRIDAY MORNING OF EACH MONTH, IN LOS ANGELES, REGARDING COMMUTER RAIL (METROLINK) MATTERS. REGULAR MEMBERS AND ALTERNATES ARE ASSIGNED TO A COMMITTEE OF SCRRA AND THEY MEET MONTHLY ON THE FOURTH FRIDAY OF EACH MONTH IN LOS ANGELES. 6 BOARD/ COMMITTEE REPRESENTATIVE RESPONSIBILITIES TOLL ROAD ADVISORY COMMITTEE Bob Buster Frank Hall Bob Magee Jeff Miller John Tavaglione Ron Roberts, Alt THIS A BI COUNTY (ORANGE/RIVERSIDE) COMMITTEE THAT MEETS EVERY TWO MONTHS TO DISCUSS TOLL ROAD ISSUES, WITH MEETING LOCATIONS ALTERNATING BETWEEN RIVERSIDE AND ORANGE COUNTIES. MAY BE APPOINTED TO OTHER AD HOC COMMITTEES SUCH AS THE MAJOR INVESTMENT STUDY AD HOC COMMITTEE. PROPERTY COMMITTEE 1 Marion Ashley Alex Bias Robin Lowe John Tavaglione Roy Wilson MAKES DETERMINATIONS AND TAKES ACTIONS ON RIGHT OF WAY ACQUISITION ISSUES. THE COMMITTEE ONLY MEETS IF THE COMMISSION SCHEDULE DOES NOT MEET THE TIME LINED FOR NEEDED ACTION(S). MEETINGS ARE ON AS NEEDED BASIS ONLY. AUDIT AD HOC COMMITTEE Chris Buydos Barbara Hanna Terry Henderson Ron Meepos REVIEW RESULTS ,AND ISSUES RELATED TO AUDITS. A MEETING IS CALL ON AN AS NEEDED BASIS. THIS IS AN AD HOC COMMITTEE OF THE BUDGET AND IMPLEMENTATION COMMITTEE SO THE APPOINTED MEMBER MUST BE A MEMBER OF THE COMMITTEE. COMMUNICATIONS AND LEGISLATION AD HOC COMMITTEE Bob Buster Barbara Hanna Terry Henderson Robin Lowe Jeff Miller John Tavaglione Roy Wilson REVIEWS & MAKES ECOMMENDATIONS ON DISSEMINATION OF INFORMATION AND ON COMMUNICATION TOOLS, AND ON ANY PROPOSED LEGISLATION. THIS AD HOC COMMITTEE MEETS ON AN AS NEEDED BASIS. HIGH SPEED RAIL AD HOC TASK FORCE Robin Lowe Ron Roberts HIGH SPEED RAIL AD HOC TASK FORCE - MEETS WHEN NEEDED REGARDING HIGH SPEED RAIL MATTERS. LAND VALUE TRENDS AD HOC COMMITTEE Marion Ashley Alex Bias Barbara Hanna Terry Henderson Robin Lowe Jeff Miller John Tavaglione Roy Wilson REVIEWS ECONOMIC AND LAND VALUE TRENDS IN RIVERSIDE COUNTY AS IT RELATES TO RIGHT OF WAY ACQUISITIONS FOR RCTC PROJECTS. THIS AD HOC COMMITTEE MEETS ON AN AS NEEDED BASIS. 7 BOARD/ COMMITTEE REPRESENTATIVE RESPONSIBILITIES MID COUNTY PARKWAY AD HOC COMMITTEE Steve Adams Marion Ashley Daryl Busch Bob Buster Chris Buydos Robin Lowe Jeff Miller Frank West THE AD HOC COMMITTEE WAS FORMED AS A SOUNDING BOARD FOR STAFF TO DISCUSS PROCESS BEING UNDERTAKEN ON THE MID COUNTY PARKWAY STUDY. THIS AD HOC COMMITTEE MEETS ON AN AS NEEDED BASIS. PASS TO DESERT RAIL AD HOC COMMITTEE Marion Ashley Roger Berg John Chlebnik Dick Kelly Ron Oden Mary Roche Michael Wilson, Chair Roy Wilson TO DISCUSS THE FEASIBILITY OF A RAIL SERVICE FROM THE PASS AREA TO THE COACHELLA VALLEY AREA. PUBLIC/ PRIVATE FINANCING AD HOC COMMITTEE Marion Ashley Terry Henderson Dick Kelly Jeff Miller Ron Roberts John Tavaglione Frank West Roy Wilson MAKE RECOMMENDATIONS REGARDING POLICY DIRECTIONS TO PREPARE TRANSIT VISION AND TO BRING REGIONAL PERSPECTIVE TO TRANSIT, MONITOR TRANSIT IMPLEMENTATION; AND REVIEW PERFORMANCE OF TRANSIT OPERATORS AND ITS SERVICES. THIS AD HOC COMMITTEE MEETS ON AN AS NEEDED BASIS. SAN JACINTO BRANCH LINE AD HOC COMMITTEE Steve Adams Marion Ashley Daryl Busch Bob Buster Robin Lowe Frank West THIS AD HOC COMMITTEE WAS FORMED TO DISCUSS ISSUES RELATING THE SAN JACINTO BRANCHLINE. THIS AD HOC COMMITTEE MEETS ON AN AS NEEDED BASIS. 8 Commission Structure, Officers and Membership for 2006 Membership • 5 Members of the Riverside County Board of Supervisors • 1 Member from each incorporated city in Riverside County; (must be either a mayor or city council member) • 1 Non Voting Member appointed by the Governor Commission Officers • Chair, Vice Chair, and Second Vice Chair • Annually alternate between a regular member of the Commission representing a city and a regular member of the Commission who is a member of the Riverside County Board of Supervisors. Commission Officers For 2006: • Chair - Marion Ashley Board of Supervisors — 5th District • Vice Chair - Terry Henderson City of La Quinta • Second Vice Chair - Jeff Stone Board of Supervisors — 3rd District Executive Committee Composition: • Chair • Vice Chair • Second Vice Chair • Past Chair • Three Riverside County Board of Supervisors A Commissioner representing one of the following cities: • Riverside, Corona, Moreno Valley • Banning, Beaumont, Calimesa, Canyon Lake, Hemet, Lake Elsinore, Murrieta, Norco, Perris, San Jacinto, and Temecula • Blythe, Cathedral City, Coachella, Desert Hot Springs, Indian Wells, Indio, La Quinta, Palm Desert, Palm Springs and Rancho Mirage Policy Committees • Budget and Implementation Committee — Annual Budget Development and Oversight - Countywide Strategic Plan - Legislation - Measure A Implementation and Capital Programs - Public Communications and Outreach Programs — Competitive Grant Programs: TEA 21-CMAQ & STP, Transportation Enhancement and SB 821- Bicycle &Pedestrian - Property Management - SAFE/Freeway Service Patrol - TUMF Program Policy Committees • Plans and Programs Committee — State Transportation Improvement Program — Regional Transportation Improvement Program — New Corridors — Intermodal Programs: Transit, Rail, Rideshare — Air Quality and Clean Fuels — Regional Agencies, Regional Planning — Intelligent Transportation System Planning and Programs — Congestion Management Program Policy Committees Transit Policy Committee - Policy directions to prepare for transit vision and to bring regional perspective to transit - Monitor transit implementation — Performance of transit operators and its services AGENDA ITEM 8 RIVERSIDE COUNTY TRANSPORTATION COMMISSION DATE: February 8, 2006 TO: Citizens' Advisory Committee/Social Services Advisory Council Transportation FROM: Tanya Love, Program Manager THROUGH: Stephanie Wiggins, Director of Regional Programs SUBJECT: Measure A Specialized Transportation Program — Medical Transportation Non -Emergency. STAFF RECOMMENDATION: • This item is for the Committee to: 1) Receive and file the Measure A Specialized Transportation Program's Fact Finding Paper on Non -Emergency Medical Transportation; and 2) Seek appointment of three members of the CAC/SSTAC Committee to review proposals on the western Riverside County Measure A Specialized Transit Program. BACKGROUND INFORMATION: At the July 2005 Commission meeting, staff received approval to develop a Call for Projects for the western Riverside County Measure A Specialized Transportation program for the provision of non -emergency medical transportation services (NEMT). The NEMT services will be designed for senior citizens, persons with disabilities and the truly needy who need specialized transportation services over and above what the public transit operators can provide. The Call for Projects will be developed to seek services designed to meet the in-between need for those passengers too frail to use traditional public transit yet not requiring expensive ambulance transport. The focus of the Call for Projects will include, but not be limited to, the provision of non -emergency medical transportation for: 1) Medical appointments to veterans' administration facilities; 2) Inter -regional transportation for medical appointments; and 3) Dialysis, chemotherapy and/or radiation medical treatments. 9 To develop the specifics for the Call for Projects and to identify NEMT characteristics in western Riverside County, Heather Menninger of A-M-M-A contacted 60+ individuals representing various agencies in both the transportation and health care industries. Based on those interviews, the attached Fact Finding Paper for western Riverside County was developed. It is anticipated that the Call for Projects will be released in early February with responses due in April 2006. A Local Review Committee will convene April 12, 2006 to evaluate proposals. It is anticipated that the specialized transportation services will begin in July 2006. Staff is seeking three members of the Commission's Citizens' Advisory Committee to assist with the review process. Background of Measure A Specialized Transportation Funding The current Measure A half -cent sales tax identifies 5% of the annual revenues for implementation of specialized transportation programs. In the western county, Commission policy apportions 2.5% of these funds for the Commuter Assistance Program and the remaining 2.5% for the Specialized Transit program, which benefits seniors, persons with disabilities and the truly needy. The Commission has had a long-time commitment to meeting the special transit needs of seniors and persons with disabilities through its specialized transit grant program. In addition to traditional public dial -a -ride services, ,the Commission has granted funds to non-profit agencies to provide transit assistance in hard to serve rural areas for inter -community travel and for riders having very special transit needs. In addition, in October 2003 a taxi demonstration program was developed and implemented utilizing Measure A specialized transit funding. Due to the success of the taxi demonstration program, the Riverside Transit Agency included the use of taxi vehicles in its FY 2005/06 service profile. The specialized transit programs have been successful over the years in providing improved transit access for western county residents. Attached is a historical listing of Measure A Specialized Transit funding recipients. Attachment: NEMT Fact Finding Paper Measure A Specialized Transit Recipient List 10 MEASURE A SPECIALIZED TRANSPORTATION PROGRAM CALL FOR PROJECTS NON -EMERGENCY MEDICAL TRANSPORTATION Fact Finding Paper for Western Riverside County Prepared for: Tanya Love, Program Manager Prepared by: Heather Menninger-Mayeda A-MENNINGER-MAYEDA-ALTERNATIVE January 25, 2006 11 Riverside County Transportation Commission MEASURE A: SPECIALIZED TRANSPORTATION PROGRAM CALL FOR PROJECTS NON -EMERGENCY MEDICAL TRANSPORTATION Fact Finding Paper for Western Riverside County Table of Contents Ags Executive Summary 1.0 Introduction and Approach 2.0 Non -Emergency Medical Trip Needs by Specific Market Niches 2 2.1 Mental Health System NEMT Needs and Issues 2 2.2 Dialysis Patient NEMT Need and Issues 5 2.3 First Five Riverside NEMT Issues 8 2.4 Senior Transportation Issues — MSSP and Linkages Programs 9 2.5 Senior Transportation Issues — Pockets of Unserved Areas 12 2.6 Veterans — V.A. Hospital NEMT Issues 13 2.7 Medical Facilities Comments on NEMT Needs 16 3.0 Existing Public Transit and Measure A Providers in Relation to NEMT Needs 18 4.0 Recommendations for an NEMT Call for Projects 22 Appendices Appendix A — Riverside and San Bernardino Counties Health Access [NEMT] Project — Summary of Issues, January 2005 Appendix B —Western Riverside County NEMT Contact and Interview Listing, Fall 2005 List of Tables Table E-1, Proposed Measure A Categories of Need For NEMT Call for Projects Table 1, Riverside County Mental Health System Clinic Locations Table 2, Jerry L. Pettis V.A. Medical Center: Consumers and Visits By Western Riverside County Region and Community of Origin, FY 2005 Table 3, Proposed Measure A Categories of Need for NEMT Call for Projects Winter 2006 11 12 Riverside County Transportation Commission MEASURE A SPECIALIZED TRANSPORTATION PROGRAM CALL FOR PROJECTS NON -EMERGENCY MEDICAL TRANSPORTATION Fact Finding Paper for Western Riverside County EXECUTIVE SUMMARY This paper characterizes non -emergency medical transportation (NEMT) needs in Western Riverside County to provide direction for an upcoming Call for Projects. The impetus for this effort was a study on the same topic, non -emergency medical transportation issues across the Inland Empire, the Riverside and San Bernardino Counties Health Access [NEMT] Project, a Ca!trans-funded Study of Statewide Significance conducted during 2003 and 2004. That study identified need for additional transportation services that can respond to highly individualized transportation need and long travel distances, sometimes across county lines, to regional medical facilities where treatments are provided. Riverside County Transportation Commission'; (RCTC) has responded to the Health Access study's recommendations, with an anticipated release of a Call for Projects for non -emergency medical transportation in Western Riverside County early in 2006. To develop the specifics of an RCTC Call for Projects and to identify in greater detail NEMT characteristics in Western Riverside County, this paper was conceived and interviews were conducted. We talked with more than 60 individuals who represent or work with persons in the wide range of circumstances that can result in non -emergency medical transportation need. The consumer needs represented in these interviews are considered in relation to seven groups: • persons with behavioral health and mental health concerns • dialysis patients • children age 5 and under, often with low-income mothers • frail seniors at risk of institutionalization • seniors in geographically isolated housing developments in the county not served by Riverside Transit Agency (RTA) or other Western Riverside County transit providers • veterans who do not have service -related status with the V.A. • persons served by medical facilities Also reported here are comments from the five (5) public transit operators of Western Riverside County, as well as eight (8) existing Measure A transportation providers about non -emergency medical transportation and the capabilities of these entities. Characteristics of NEMT trips, detailed through these discussions, include: high costs for private NEMT service; need for personal assistance in arranging the trip or in taking the trip; the immediacy of the trip need in terms of time; regional trip patterns characterized by long trip distances, time and spatial issues that make these trips difficult to serve; and information or coordination issues that require significant hands-on involvement in order to make the trip happen. aM till Winter 2006 13 iii To respond to the findings developed through this effort the following goals by which to address NEMT needs in Western Riverside County are proposed: 1. Increasing the capacity of Western Riverside County providers to supply the highly specialized trip that characterizes NEMT, with both capital and operating investment. 2. Developing communication between transportation and health care providers so as to address patient access requirements collaboratively. 3. Minimizing duplication of services by ensuring that projects are complementary to existing services and not duplicative, through coordination and communication among existing transportation providers. 4. Ensuring that NEMT need is addressed for individual riders by newly proposed projects through effective design and implementation. 5. Ensuring that Measure A funds do not supplant existing transportation resources but are used only to extend and expand NEMT options. 6. Establishing match levels that ensure support by the proposing entity and represent appropriate and sustainable match funding. Categories of need that address this paper's findings are presented in Table E-1. Table E-1, Proposed Measure A Categories of Need For NEMT Call for Projects Category of Need Examples of Expense Operations Driver wages, dispatch, supervision and administration, escort wages; insurance, preventative and routine maintenance; fuel; facility leasing and other expense directly related to the transportation operations. Could include expense to purchase transportation from a third -party or a subcontractor. Capital Vehicles and vehicle -related equipment, including dispatching capabilities, requiring a 50%cash match in order to procure. Trip or Appointment Coordinators Labor expense directly related to staffing a coordination function within social service agencies that helps to link consumers, transportation providers and medical facilities in ways that can serve the needs of all parties. Information Graphic design, printing expense and staff time to develop printed and electronic information about available transit resources; staff time to get these materials into the hands of key professional staff who can then, in turn, provide them to consumers at appropriate times: It Winter 2006 iv 14 Riverside County Transportation Commission MEASURE A SPECIALIZED TRANSPORTATION PROGRAM CALL FOR PROJECTS NON -EMERGENCY MEDICAL TRANSPORTATION Fact Finding Paper for Western Riverside County 1.0 INTRODUCTION AND APPROACH Riverside County Transportation Commission (ROTC) administers the Measure A half -cent sales tax program, including 5% designated for the implementation of specialized transportation programs in Western Riverside. Currently the special transit needs of seniors and persons with disabilities are addressed by this grant program using an allocation of 2.5% of the Measure A funds. This paper looks towards an expansion of that program, directed specifically to medically -oriented transportation needs or non -emergency medical transportation needs. RCTC was part of a collaborative study of "statewide planning significance" on non- emergency medical transportation: Health Access in San Bernardino and Riverside Counties: Non -Emergency Medical Transportation (NEMT) Needs and Resources (Dec. 2004). The study funded with Section 5313 planning funds, administered by Southern California Association of Governments (SCAG) and partners with RCTC included San Bernardino Associated Governments (SANBAG), Kaiser Permanente, Inland Empire Health Plan, Molina Health Care, Health Net, Inc. and Community Hospital of San Bernardino. The study concluded that NEMT needs do exist, that these were widely dispersed across the two counties, in both urbanized areas but particularly in the lower density, lower -cost housing areas that typify the rural areas of each county (Appendix A). While the quantities of NEMT need identified were modest, the kinds of solutions and programmatic responses suggested by the study must be varied, widely distributed geographically and able to respond to very individual consumer needs. This fact finding paper describes efforts to understand the NEMT need in Western Riverside County in more concrete detail, so that Measure A resources might be appropriately directed in an NEMT Specialized Transit Call for Projects. Our approach was to develop a broad -based set of contacts, conducting interviews with selected constituencies who might have insight into NEMT needs. Contacts developed through a 10-week investigative period during the fall of 2005 are included as Appendix B. Consultant staff was accompanied in some instances by RCTC's Transit Program Manager. This paper summarizes these conversations, developing a picture of NEMT need in Western Riverside County. The paper concludes with recommendations to help shape an NEMT Specialized Transit Call for Projects offered by RCTC during 2006. Winter 2006 1 15 2..0 NEMT TRIP NEEDS BY SPECIFIC NICHES OR MARKETS This section presents fact-finding efforts in relation to non -emergency medical transportation need in Western Riverside County. The meetings represented by these summaries are representative of seven (7) user groups or trip types. Undoubtedly additional and• further need exists but the interviews undertaken do provide insight into the specific of NEMT need that the Call for Projects must address. The user groups considered in these interviews included: • persons with behavioral health and mental health concerns • dialysis patients • children age 5 and under, often with low-income mothers • frail seniors at risk of institutionalization • seniors in geographically isolated housing developments in the county not served by RTA or other Western Riverside County transit providers • veterans who do not have service -related status with the V.A. • persons served in medical facilities 2.1 Mental Health System NEMT Needs and Issues General Description Related to Transportation Needs County of Riverside Department of Mental Health (DMH) consumers attend programs at service centers distributed across three regions in the county: north western, mid -county and desert. DMH provides a range of services to an annual caseload of approximately 35,000, most of who make multiple trips to various service center locations during the period of their association with the Department. Service centers are located across the county as presented in Table 1 following. Table 1, Riverside County Mental Health System Clinic Locations REGION OF THE COUNTY LOCATIONS: CASELOAD North Western Region: - Corona: 1195 Magnolia - Moreno Valley: 23119 Cottonwood Ave., #A- 110 - Riverside: 9900, 9890 & 10000 County Farm Rd.; 1827 Atlanta Ave.; #D-3; 6355 Riverside Drive; 769 Blaine Street, #B; 4095 County Circle Dr. Not available . Mid -County: - Hemet: 650 N. State Street - Perris: 1688 N. Perris Blvd., Sts/ L7 — L11 - Temecula: 41002 County Center Dr, #B - San Jacinto: 950 Ramona Blvd., #2 Approx. 1,400 Approx. 1,200 Approx. 600-700 Approx. 300 Desert Region: Banning, Blythe, Cathedral City, Indio Not available tit VIA Winter 2006 16 2 Programming is generally provided by age group: children, teens, older adults and the general adult population who are DMH consumers. Consumers travel to service centers both for group programs and for individuals' appointments. Group activities are generally organized by age with children and youth not mixing with the adults. The California Mental Health Initiative and Its Transportation Implications The Mental Health Services Act (MHSA) is a new law that has taken effect January 1, 2005. It is the result of the passage of Proposition 63 in November, 2004 by California voters. The ACT clearly challenges the Department of Mental Health to work with stakeholders to create a state-of-the-art, culturally competent system that promotes recovery/wellness for adults and older adults with severe mental illness and resiliency for children with serious childhood disorders and their families. In response to this initiative, DMH is committed to looking beyond "business as usual" to help build a system where access will be easier, services are more effective, out - of -home placement and institutional care are reduced and stigma toward those with severe mental illness or serious emotional disturbance no longer exists. The Department has many opportunities to collaborate with agencies in meeting the vision outline above. One of those opportunities is in the area of transportation. In a geographically disperse county such as Riverside, access to service is a major challenge for our consumers and family members. To increase access to mental health services, both geographically and culturally, there is a variety of barriers that must be reduced including transportation. Mental Health System Transportation Needs Summary Transportation issues of this population include: • Flexibility and same day transportation needs: Problems arise quickly, unexpectedly; it isn't possible to plan a day ahead or more for some trips. • Difficulties in using fixed -route transit include: - medications result in sun -sensitivity; must stay out of the sun - consumers easily frightened by others - difficulty navigating or processing information when acutely ill • Issue of distances: rural areas with its lower -income housing means that many consumers at considerable distances from service centers. • Late buses (both fixed -route and dial -a -ride): adapting to the uncertainty of late buses is harder for DHM consumers than for the general population, as many have difficulty adapting to changing or uncertain circumstances. • Teens: DMH staff desire to develop independence among teens that travel in to service centers; may be an opportunity to teach use of fixed -route services; there is currently no training in how to use transit. • Children ages 0 to 5: very difficult for moms to transport or travel on buses with very young children with mental health issues, with other children in tow. Winter 2006 3 17 Issues bv Region North Western Region: Interest has been expressed by elected officials in developing a service center in Rubidoux, near Tyler and Arlington, serving Glen Avon and Mira Loma, communities on "the other side of the river." There is a corridor of travel form Moreno Valley into Riverside for various appointments and groups. There is another corridor of travel from Corona into Riverside; high demand as there is no clinic in the Corona area. Mid County Region: Service centers have good relations with RTA in the mid - county. RTA stops at the door of most service centers and has assisted with the ADA certification processes. Distances are problem in the mid -county, with many long trips for consumers because they often live in rural, isolated areas at distances from the clinics in Hemet and Perris, Temecula and San Jacinto. There is no Lake Elsinore clinic and so long trips are necessary for these residents into Hemet and Perris. Staff report many missed appointments by DMH consumers living in Lake Elsinore, thought to be related transportation difficulties due to clinic in the immediate Lake Elsinore area. The desert region was not included in this analysis of NEMT needs, given the focus on Western Riverside County, although DMH staff did provide some information about desert region issues. Existing Transportation Resources Each clinic has some very limited transportation, one or two vehicles per site. Drivers are hired specifically for transportation and are used for other duties, as appropriate, when driving is not required of them. Information on the number of vehicles or the number of trips (one-way passenger trips) provided was not readily available but could conceivably be collected. Mechanisms do exist for counselors, social work staff and others to obtain a vehicle from the county fleet when a consumer needs to be transported. This is however a lengthy process and requires staff to take a significant piece of time out of their day to sign -out and then return a county vehicle. Possible Opportunities Travel training and individualized route planning — by specific routes; possibly for teenagers and young adults. Coordination between centers — possible opportunity for greater efficiency in use of vans. Replacing capital equipment and adding to existing fleets of one to two vehicles at each site. Some routing and scheduling opportunities — grouping trips by geographic area by clinic by day with some opportunity to move appointments [group sessions] to accommodate service by geographic areas. MI Winter 2006 18 Working with case managers — case managers as a group have little opportunity to think about transportation in an organized way (e.g. grouping trips by geographic area; pursuing travel training doing individualized trip planning.) Locating the site of new programs near existing transit — particularly in the Rubidoux, Corona and Lake Elsinore areas when and if service centers are located in these areas. 2.2 Dialysis Patient NEMT Needs and Issues General Description Related to Transportation Needs DaVita is the proprietary organization responsible for a majority of the dialysis units in Western Riverside County, of which there are nine (9) sites at present and 15 total in Riverside County. DaVita recently purchased Gambro Healthcare, the other area dialysis provider, expanding their number of units or facilities from about 500 to 1,000 nationally. Staff reports that DaVita is the largest outpatient provider of renal dialysis nationwide. A site such as the Riverside Dialysis Center has a caseload of about 300 patients, at capacity. This represents an estimate of about 3,000 patients on dialysis in Western Riverside County within the DaVita system. Need for dialysis is commonly associated with diabetes and blood pressure. Projections by DaVita anticipate a doubling in the population requiring dialysis by 2010, in part related to the increasing proportion of seniors in the general population and in part a consequence of the increasing incidence of diabetes. Existing DaVita Western Riverside facilities are located in: Riverside (2), Moreno Valley, Corona, Hemet (2), Lake Elsinore, Murrieta and Temecula. There are also facilities in Palm Springs, Palm Desert, and Indio. Persons on dialysis average age 60 and are often on dialysis for years, some as long as 12 to15 years. Many are on kidney transplant lists, a wait which can be three to five years. Patients prescribed for center -based dialysis must come in for treatment every other day.' This schedule runs throughout the year, across holidays and weekends. Centers see patients on a Monday -Wednesday -Friday schedule or a Tuesday -Thursday -Saturday schedule. DaVita's sites are closed on Sundays. Dialysis Patient NEMT Needs Volume of Need: Dialysis units have "chairs" in which patients are provided their treatments. The DaVita system sees patients in these chairs over four shifts. In the case of the Riverside Dialysis Center, there are 32 chairs served by four shifts daily, the first beginning at 5:15 a.m. and the last ending as late as 10:30 p.m. These 32 There are some patients on home dialysis who attend the clinic only once monthly, with a family member training for as much as three months to provide in -home dialysis. Winter 2006 5 19 chairs over four shifts represent approximately 128 patients seen daily and an estimated 256 one-way trips to and from the facility each day. Because many existing dialysis facilities are at capacity, some individuals are on waiting lists for their "neighborhood" dialysis center and so traveling a longer distance to a facility with an open time slot. With most of the Western Riverside facilities are operating at capacity, ,with waiting lists, and filling almost every time slot daily, the DaVita Corporation anticipates opening at least two new facilities in Western Riverside over the next 18 months. Patient Frailty and 21-Day ADA Waiting Period: When patients are newly referred into dialysis treatment, usually from an in -patient hospital stay, they are typically very ill. Their systems are filled with toxins that their kidneys are unable to process. With time on dialysis, these patients improve. The ADA's 21-day waiting period policy for ADA certification is therefore very difficult for these persons as patients newly coming into dialysis are very frail and not at all candidates for fixed - route transit services. Scheduling the WAVE: DaVita has established a new scheduling system for its patient visits which has individuals arriving in 15 minute "waves" over the course of the day, within the four -shift framework. This has been problematic for transportation services as the traffic through the agency over the course of the day take on much more variability than previously when individuals' arrival times were grouped more closely together. Late Vehicle Arrivals with the WAVE: On -time arrival of vehicles is the largest and most pressing transportation concern for dialysis staff. With the WAVE scheduling, the timing on patient arrival and departures is much more complicated. Vehicles arriving late, even 15 minutes beyond a patient's scheduled time slot in the chair, have negative impacts on the center's scheduling and the individual patient. Significantly late arrivals of 45 minutes to an hour or more will have serious consequences for that patient in that his or her time in the dialysis chair is reduced. Dialysis center staff indicated that this is the only way they can handle late vehicle arrivals and still meet the needs of other scheduled dialysis patients. Late Patient Departures: The nature of dialysis and the response of the individual means that sometimes the patient "bleeds out", when the arm continues to bleed after the dialysis equipment is removed. In these instances, the patient is not released and staff cannot readily predict how long it will take to control the bleeding. These circumstances represent dilemma for the transit provider in that they have a scheduled vehicle departure time but the patient cannot leave and it is uncertain how long the consumer will be delayed. Further, the subsequently scheduled pick- ups on that vehicle's manifest will be delayed while the driver and vehicle wait. MediCal Eligibility Issues: A gap exists for patients who are too ill to use public transit dial -a -ride but have enough income so that they are not MediCal eligible. These individuals do not qualify for even the limited MediCal transportation assistance that is provided to low-income individuals and are paying up to $75 per one-way trip to private vendors to transport them to and from dialysis. Winter 2006 6 20 Existing Transportation Resources Transportation services to dialysis centers, in this case specifically the Riverside Dialysis Center, are many. Social workers estimate that of the 250 patients with every -other -day dialysis,2 about 30% arrive on some form of public transit including RTA's demand response service, Riverside Special Transportation Services, Corona Dial -a -Ride and in a few instances, RTA fixed -route service. Additional persons are brought by private venders (Good Faith, HealthLink.MediVan, St. Paul), reimbursed by MediCal (Medicaid), estimated by staff at about one-third. The rest are either brought by family members or friends. The reimbursement for transportation under MediCal is quite problematic in that it is based upon the functional abilities of the individual, and not on whether or not they need transportation assistance. As some patients improve with dialysis, particularly in the early part of their treatment, there have been instances where MediCal has removed the individual's authorization for transportation. Staff reported one such instance where the individual had been transported on the MediCal provider, lost the transport authorization and began riding his bicycle to and from dialysis. With the onset of winter rains, he caught a bad cold which developed complications and he died. Staff also reports that provision of service by private vendors is not always reliable. Companies turn down private -pay patients if they are at capacity or find the trip geographically, or othenrvise, difficult to serve. Possible Opportunities r Social workers indicate there would be great patient -benefit to a policy modification to the ADA certification procedures whereby the 21-day review period could be waived for those newly referred to dialysis from the hospital. This would allow them immediate use of public specialized transit, including RTA Dial -a -Ride, Riverside Special Transportation or Corona Dial -a -Ride, to get to and from dialysis services until or while other transportation resources were developed. Late arrival is very difficult to accommodate. Transit efforts to ensure shorter time windows of arrival for dialysis patients, to minimize late arrivals, would be extremely helpful and more "healthful" for the patients where the late arrival can translate into reduced time in the dialysis chair. y A mechanism for handling the delayed departure of a patient is needed. Of value would be some type of floater vehicle or capacity for an "on -call" vehicle to transport a patient who misses their scheduled departure time. ➢ One-way trip assistance would be of considerable value. Some family members can manage one leg of the trip, either arrival or departure, but would be greatly z The remaining 50 persons (17%) on the center's caseload are on home dialysis and come to the center about once a month. Winter 2006 7 21 assisted by help with the other trip leg. Currently most trips get booked as round -trips. Reducing social worker time spent on transportation would be of value to both staff and patients. Assistance with coordinating transportation could benefit both the center staff and the public transit provider. Y Shared -ride service is difficult for the consumer on the departing trip. They leave dialysis in a weakened condition and the sometimes hour -or -more duration of their trip home is harder on the consumer than at other times. y Consolidating scheduling of patients using public transit onto the 2nd and 3rd shifts of the WAVE could enable greater efficiencies in transit vehicle scheduling. The first shift starts at 5:15 a.m. before Riverside Special Transportation is available and with limited RTA Dial -a -Ride. The fourth shift begins at 5 p.m. and ends as late as 10:30 p.m. again after selective public paratransit service has ended. 2.3 First Five Riverside NEMT Issues and Needs General Description Related to Transportation Need The First Five program provides funding for programs oriented to children ages zero through five years, with its resources coming from the Tobacco Revenue Settlements. Children ages zero to five numbered almost 122,000 in Riverside County in the 2000 Census and estimated as 137,000 in 2004 or a 12% increase. Low income families numbered approximately 40,000 families in the 2000 Census, representing 10.7% of all Riverside County families identified as below the 1999 poverty level. First Five services are provided to any Riverside County child eligible by virtue of age and their parents, irrespective of income, although a majority of targeted households are low-income. Staff estimates that 60% of their populations are MediCal recipients. Existing Transportation Resources Annual receipts of the First Five Program are about $30 million, distributed through a wide range of competitive grants but with no focus on transportation provision. First Five has provided very limited transportation funding in the past, including some capital funding for a vehicle (YMCA Corona) and voucher expense for Desert Health Car. First Five staff worked to explore coordinated transportation proposals on behalf of the Baker and the Banning/Beaumont pass area communities. NEMT Transportation Issues and Needs In two Western Riverside County areas, some transportation needs have been observed by First Five staff: Romoland: RTA has scheduled service that does not work easily for Romoland families trying to use transit to get their children to elementary school into Perris. Ai Al t1 Winter 2006 22 Banning! Beaumont/San Gregonio Pass: Transportation to health care services, particularly for specialty appointments at medical facilities in Riverside can, require up to three buses. Trips to Loma Linda are even more difficult. These numbers of transfers are difficult for mothers with young children. Improved transportation from the Pass area is needed in both directions, east and west. First Five staff commented on the lack of specialized transportation resources that go across regions of the County and are eligible for mothers and children. Staff was aware of general public dial -a -ride users being bumped for ADA certified riders. Potential Opportunities It may be feasible to develop jointly funded projects, for example special medically - related shuttles out of the Pass area could be one such opportunity. First Five clearly serves the population that the NEMT study identified as having greatest unmet need for transportation to medical facilities. While it was not clear with whom such collaborative opportunities might be developed, entities such as family service organizations could be encouraged to come forward. There was concern about the quantities of demand, whether these would be adequate to support targeted specialized transportation but no demand estimates were readily available. First Five staff sees the primary challenge as one of "growing" the number of providers of specialized transportation, particularly those who can transport children and their parents to specialty medical appointments that are often at significant distances from their homes. 2.4 Senior Transportation Issues -- Multipurpose Senior Services Program (MSSP) and Linkages Program General Description Related to Transportation Need The Riverside County Office on Aging supports two case management programs designed to prevent premature or inappropriate institutionalization of frail, "at risk" elderly or functionally impaired adults who live in Riverside County by providing care management, with comprehensive information and assistance services. The Linkages program and the Multipurpose Senior Services Program (MSSP) have related missions, although the MSSP program is restricted to low-income seniors while Linkages is open to adults of all ages and is not necessarily income restricted. Enrollment in the two programs combined represent slightly over 400 persons, individuals targeted as being most "at risk" of institutionalization without these additional, supportive services. These are often persons who have multiple physical problems and conditions, possibly a limited family or friend support -system and often low income. Most of these individuals are unlikely to "get better", face declining health situations. Sustaining them in their own homes represents a delicate balancing of needs and resources. Mi Winter 2006 9 23 Transportation was identified as one of the handful of topics that every social worker covers with every consumer. It is viewed as a critical component to enabling these particular individuals to remain in their own homes. Existing Transportation Resources Transportation resources reported by MSSP/Linkages professional staff include RTA Dial -a -Ride, Riverside Special Transportation Services, Corona Dial -a -Ride, chore or homemaker workers, private transportation, the TRIP program and the client's family or friends. Each of these resources, while they are effective for some riders and serving some trips are often more than this particular, very frail population can navigate. It is that frailty that is the central reason why the social worker or public health nursing staff are so often involved in transportation arrangements. MSSP/Linkages Consumer NEMT Needs Difficulties experienced by the MSSP/Linkages client population include: Public transit difficulties and needs: This population is too frail to use fixed route transit. In the Riverside area, RTA Dial -a -Ride or Riverside Special Transportation's curb -to -curb service is difficult for many because: - Some consumers need door -through -door assistance and have trip chaining requirements — upon returning from the doctor's office they need to stop to fill a prescription and pick up minimal groceries on the way home. - The trip scheduling process can require too much for some confused or very limited energy consumers. - The two-hour window of a wait for the vehicle is difficult for these limited energy persons, many of whom have multiple physical conditions. - The potentially long ride -times and the minimal shock absorbers on large vans are ride characteristics that are hard on physically frail individuals. - Many trip needs are same -day, when other resources, such as care providers or family members fall through. - Very obese consumers cannot be boarded with public transit's lifts which are limited to 600 pounds, including wheelchair and individual. Some. MSSP or Linkages clients could use public transit dial -a -ride services with a companion or escort, but have no such resource. Social workers report they are often socially isolated and without a broader support system upon which to draw. Chore, personal care or homemaker transportation: Consumers in the MSSP and Linkages programs may be eligible to receive some support from outside, paid assistants. Sometimes these individuals can provide transportation. The problem of obesity of some MSSP/Linkages consumers makes it difficult or impossible to get into a caregiver's car. The caregiver can't easily fold up a wheelchair and lift it into the trunk of the car, particularly where the chair is larger and exceeds basic weight -lifting limitations established by the job. Winter 2006 10 24 The nature of the labor pool from which chore or homemaker services draw means that these individuals are themselves of low-income, may not have a reliable car and cannot always show up for work with the reliability and predictability that is desirable. These characteristics all have transportation implications. Private transportation: There are some vendored transportation services which provide trips upon request for private paying individuals. Health Link and Good Faith were named by staff. Costs of these services can be prohibitive for limited - income individuals, at $60 to $90 per one-way trip. Also staff reports that such private transportation vendors can be unreliable in responding to individuals' requests for trips and much more likely to serve the regularly -scheduled dialysis trip. Gurney trips are also a great need and while these private providers can serve the gurney trip request, their response is unreliable and patients often go unserved with trips not provided, even for private -pay trips. TRIP — Transportation Reimbursement and Information Project: This resource works extremely well for individuals with a neighbor, friend or family member to transport them and with the capability to make a transportation request of such a person — the capacity for organizing the overall trip, by making the appointment and arranging the transportation. The MSSP/Linkages consumers are less able to use TRIP mileage reimbursement resources because this task is difficult. These individuals are often without a family or friends' support system, social workers report. Even where an individual may potentially have a support system around them, many are now too frail to organize trips and transportation assistance for themselves. Again, this population is an exceedingly vulnerable, high need group that requires considerable assistance in order to be sustained at home. Staff observed that the TRIP resource better supports individuals who are at higher levels of functioning than are those enrolled in the MSSP/Linkages programs. Potential Opportunities The MSSP/Linkages staff saw two primary needs/ opportunities to be addressed by this Measure A Call for Projects program: ➢ Grow the resources — staff see need for more services that can address these highly individualized transportation needs of their client populations. Same -day trip requests, often door -through -door, very individualized services are needed. Developing that kind of transportation resource, on a countywide basis, will help to maintain this group of frail persons still living in their own homes. ➢ Transportation Coordination for social workers — centralization of the transportation function, within these programs, may have value for three reasons: 1. A single individual making transportation reservations and connecting MSSP/Linkages consumers with available services could enable improved working relationships with each of the Winter 2006 11 25 various transportation options which could, in turn, lead to improved services. 2. A coordinator individual could also work to coordinate the "destination -end" of the trip, working with hospitals and clinics frequented by these consumers to develop geographically -based appointment schedules that transportation can then better serve. 3. This frees social workers and nursing staff of transportation coordination will enable them to provide other services that only they can. 2.5 Senior Transportation Issues — Pockets Unserved by Public Transit General Description Related to Transportation Need There exist in Riverside County several geographic locations with senior -oriented housing that are unserved by RTA fixed -route, by ADA complementary paratransit services, or by the other public transit operators, including Riverside Special Transportation, Banning, Beaumont or Corona. Some individuals move into these locations while still driving their own vehicle and unaware of the public transit limitations. Transportation needs from these areas often surface to County Supervisors' offices as residents realize they need transit assistance and that there are no readily available transportation services. Specific areas discussed, while not a complete list, include: • Off the 1-15 Freeway, the Swan Lake Mobile Home Park at Limonite and Hammer, west of Mira Loma. • Off the 60 Freeway, at Mission, Limonite and La Rue, in the Jurupa area. • Off Limonite at Clay Street, in the Pedley area. • At the Hammer, Riverside Drive and Mission Blvd. triangle, at the county line with Riverside and San Bernardino. • Off the Corona Freeway at Temescal Canyon Road_, Tom's Farm area, Mead Valley, north west of Lake Elsinore. • Wildomar area, east of the 1-15 and north of Murrieta. • Cabazon area, east of Banning and Beaumont. Transportation dependent persons are living in these locations, including adults with disabilities who cannot drive themselves or seniors who are driving less and less, particularly diminishing their driving at night. Public transit services are not yet available, presumably because the densities remain low. Opportunities There is need for some type of limited transportation resource to serve these areas currently not served by existing public transportation. Winter 2006 12 26 2.6 Veterans — Jerry L. Pettis Memorial Veterans Medical Center Transportation Issues General Description Related to Transportation Need The Jerry L. Pettis Memorial Veterans Medical Center is providing services now in a series of community clinics, including in Victorville, Palm Desert, Upland, and in Western Riverside County, in Corona and Temecula. These have developed in response to the difficulties of traveling into the central Jerry L. Pettis Memorial Veterans Medical Center, the federal acute care medical facility serving veterans in the Inland Empire, eastern Los Angeles County and northern San Diego County. Acute care and in -patient services, as well as some specialty services including dialysis and chemotherapy are provided at the V.A. Medical Center. Additionally, several off -site clinics have been developed to provide basic health care closer to the veterans' home and minimize the transportation need and time requirement of fully centralized services. Administrative staff of this V.A. Medical Center report that its target population is expected to grow through 2030. Patient growth rates slowed to a little over 3% increase In recent years, down from 10% annual patient growth in previous years, net growth after deaths. Table 2 depicts by geographic subregion the patient visits from Western Riverside County during the 2004/2005 fiscal year. These data were prepared by V.A. Medical Center staff, drawn from residence zip code information about patients. Almost 30,000 veterans utilized services through the Jerry L. Pettis V.A. Medical Center last year, making 368,535 visits to its facility in Loma Linda. Over half of these people and visits (52%) were from North Western Riverside County, 42% from communities in the central part of Western Riverside County and between 7% of people and 6% of trips from the southern most communities. The overall average number of trips for this group of persons was 12.6 trips made during the year by each individual. The averages trips rates by subregion reveals somewhat higher average numbers of trips per person are apparent in the north and central Western Riverside communities, 12.7 and 12.9 trips per person for the northern and central communities respectively versus 10.1 trips per person for the southern most communities. Existing Transportation Resources The V.A. Medical Center is required, by statute, to provide transportation to individuals who have a service -related condition and to certain individuals whose medical conditions require highly specialized services, such as gurney or litter transportation. Resources by which these services are provided include: • Disabled American Veterans (DAV) which provides transport from 6 a.m. to 2:30 p.m. ▪ V.A. specialized services for gurney transportation ■ V.A. taxi voucher service points are being explored by the transportation unit, focused currently on the Victor Valley areas of Apple Valley, Hesperia, not funded by the V.A. but ensuring a predictable fare for consumers using this service. Winter 2006 13 27 Table 2, Jerry L. Pettis V.A.'Medical Center: Consumers and Visits By Western Riverside County Region and Community of Origin, FY 2005 Arlington 679 9,811 14.4 Arnold Heights 485 2,555 5.3 Banning 829 10,085 12.2 Beaumont 509 7,284 14.3 Box Springs 530 6,723 12:7 Cabazon 77 1,022 13.3 Calimesa 295 4,826 16.4 Canyon Crest 530 6,723 12.7 Casa Blanca 539 7,543 14.0 Corona 1,295 16,753 12.9 Jurupa 1,221 16,693 13.7 La Sierra 348 4,939 14.2 March AFB(part) 485 2,555 5.3 Mira Loma 311 4,114 132 Moreno Valley 2,032 27,361 13.5 Norco 253 2,944 11.6 Riverside 4,424 55,457 12.5 Rubidoux 1,221 16,693 13.7 Woodcrest(part) 539 7, 543 14.0 Ti?!al iy itegn t 60 C. x2T ° °f� ° '.. Bonnie Bell 20 318 - 15.9 Canyon Lake 210 2,398 11.4 Cherry Valley 509 7,284 14.3 East Hemet 769 9,933 12.9 Gilman Hot Springs 455 6,327 13.9 Hemet 2,709 35,328 13.0 Holcomb Village 98 933 9.5 Homeland 199 2,769 13.9 Idyllwild 76 892 11.7 Lake Elsinore 541 6,668 12.3 Lakeview 124 -1,661 13.4 Menifee 381 3,940 10.3 Mountain Center 39 390 10.0 Nuevo - 124 1,661 _13.4 Perris 880 12,470 14.2 Pinyon Pines 39 390 10.0 Quail Valley 210 2,398 11.4 Romoland 209 2,530 12.1 San Jacinto 492 6,824 13.9 Snow Creek 20 318 15.9 Soboba Hot Springs 455 6,327 :13.9 Sun City 1,740 20,715 ' 11.9 Suncity 209 2,530 12.1 Whiter Water 20 318 15.9 Na nia Anza 97 Murrieta 782 8,261 10.6 Rancho Califomia 296 2,942 9.9 Temecula 536 5,256 9.8 Wildomar 307 3,756 12.2 Winchester 116 1,374 11.8 eik. `-x e. 9 � - _ Grand Tot al 29,264 368,535 12.6 Winter 2006 28 14 Consumer NEMT Needs Late Shift Transportation Needs: Dialysis patients are served on three shifts, the last one ends at 3:30 or 4 p.m. after the DAV transportation is no longer operating. Specialty Appointment Need: There is need to bring individuals in to specialty appointments, even with the planned opening of primary care clinics in Western Riverside County: Corona and Temecula. One -Way Transportation: There is need for one-way transportation assistance: sometimes family members can bring the individual but can't wait until treatments/ medical appointments are completed. Consumers have very long days at the V.A. One-way transportation could both shorten their day and/or make possible one-way transportation support by a family member or friend. Veterans' Education on Transportation Resources: Some veterans have not learned about the availability of RTA routes serving the V.A. and are not aware of how these might serve their needs. Such veterans could travel in on fixed -route service but haven't considered how to use it. Opportunities Developing additional transportation capacity for those veterans who are not eligible for the V.A. Medical Center transportation or who cannot be served by the DAV services have considerable value. ➢ Coordination of these trips, potentially "brokering" them through the V.A. Transportation Unit could ensure that the most appropriate service is used first and that a Measure A supported service was in fact supplemental and not "taking the place of existing services. ➢ Specialized, destination -specific information to guide veterans on using public transportation to get to the V.A. could have considerable value. ➢' Localized transportation that could help veterans get to the new clinics in Corona and Temecula is of considerable interest to V.A. administration as they work to develop the consumer -base of these facilities. Winter 2006 15 29 2.7 Medical Facilities Comments on NEMT Needs During this interview process, we spoke with various medical- facilities, experiencing considerable difficulty finding the "right" person who had insight into transportation issues. This is indicative of transportation's support role in the medical environment — it is not part of the core services, but a service that enables the provision of medical services and, as such, not considered by medical facility staff. Comments that were -made by a limimted number of medical contacts identified are summarized here. Medically -Related Transportation Issues Kaiser Permanente's Palliative Care Program: This is a new program established by Kaiser for persons whose medical prognosis is longer than the six months that would make them eligible for Hospice care, but probably less than 18 months. Enrolled consumers are living at home and the Kaiser program's intent is to strengthen the medical and psycho -social support systems to . improve the individual's quality -of -life in whatever time they may yet have. Transportation was identified as a continuing and significant need by social workers serving Kaiser palliative care patients in the Inland Empire. Many of the programs' consumers are elderly, have a minimal support system at best and are often very ill. Individuals are often in active treatment for cancer, undergoing chemotherapy and radiation therapy, sometimes oriented to cure and sometimes to simply shrink tumors to reduce pain or allow for greater comfort. Transportation is difficult to access because: • Palliative care patients, particularly those receiving chemotherapy, are sometimes too ill to make arrangements for transportation themselves, with limited physical energy, nausea or confusion. + These patients sometimes have an immediacy of need as treatments, such as radiation, are prescribed for immediate intervention to ease pain or discomfort. • These patients often travel considerable distances to specialty services, e.g. chemotherapy or radiation therapy delivered in regional facilities at a distance from the consumers' home. • Given the elderly profile of these patients, many do not have other family members or have very limited support systems to assist them with transportation arrangement or during the trip itself. Corona Regional Medical Center Behavioral Health Program: This hospital has a fleet of 5 vans, including two lift vans and one min -van that are used exclusively for the Behavioral Health program, as well as a transport agreement with a local taxi provider. The hospital's vehicles are transporting between 80 to 120 outpatients daily to its outpatient partial hospital or day treatment programs. Drivers pick up passengers generally between 7 a.m. and 3:30 p.m. One of the major problems faced by program personnel is when patients need to leave after 3:30 when the transportation resources are not generally available. By providing its own transportation, the hospital has flexibility to meet a range of transportation needs. But after -hour service, under the hospital's taxi arrangement, is problematic. Staff 11In Winter 2006 16 30 report that its taxi provider is not always reliable, either not arriving at all or arriving very late. Parkview Community Hospital: This acute care facility needs transportation service to take patients to radiation and chemotherapy appointments. There is an off -site clinic for selective specialty treatments and insurance does not pay for transport. The social work manager said the transportation piece of the patient's care plan is the hardest to arrange. Some in -patients do take public dial -a -ride services but often the patient is so incapacitated that these options are not feasible. Magnolia Rehabilitation Facility: This private facility provides residential, rehabilitative care for persons who no longer need acute care hospital services. The facility contracts with Kaiser Permanente. Its social services manager reports that there is no affordable transportation for patients. Rehabilitation patients often need two to three appointments at the Kaiser facilities while they are in Magnolia Rehab. Using Premier or Comfortline, commercial NEMT providers, costs families $66 to travel to Kaiser Riverside (from Riverside) and $100 to go to Kaiser Fontana. These costs must be born by the patient or his or her family. This social service manager was not aware of Riverside ADA complementary transportation or the feasibility of that service for meeting her consumers' needs. Extended Care Facility: This Riverside area nursing home, like Magnolia Rehabilitation, has regular instances where patients need to leave the facility to go to services or treatments at other medical facilities. For example, the director described a current patient who is post -amputee and has continuing follow-up appointments with a vascular surgeon. The surgeon is located in Moreno Valley and Riverside Special Transportation Services does not travel outside the city limits. This patient is paying $80 round trip for the transportation. While MediCal may eventually pay for the transportation, there is uncertainty and the paperwork is extensive without assurance of payment. Possible Opportunities Developing lower -cost transportation options to and from medical facilities is of high priority to the social services staff who regularly work with consumers. Providing trips across distances is necessary, given the dispersion of specialized medical resources. i%' Facilitating consumer scheduling of these trips is necessary, given the poor health, physical frailty and medication involvement of many patients in need of mobility assistance. Addressing immediacy of need is important as medical services often present the need now, not as an emergency, but with some urgency of same -day or next -day service. Winter 2006 17 31 3. 0. EXISTING PUBLIC TRANSIT AND MEASURE A PROVIDERS IN RELATION TO NEMT NEEDS 3.1 Current Service Quantities Western Riverside County's Measure A -supported specialized transportation program during FY 04/05 provided the following levels of trips or transportation support: • 21,649 one-way passenger trips in FY 04/05 provided by 8 non-profit providers and 5 municipal or public transit programs • 29,393 mileage reimbursed passenger trips funded through TRIP • 72,740 discounted or free bus passes provided through TAP These supplemental services are modest in scope, representing a total of 51,000 trips to Western Riverside County residents, augmenting an extensive public transportation system with its own array of providers. Such Measure A -supported supplemental services are very small in actual number, yet these are significant in relation to serving specialized and unique consumer niches. Expansion of the specialized transportation program to meet non - emergency medical transportation needs will further enhance the mobility options of Western Riverside County and particularly those for whom mobility is most difficult. 3.2 Issues from Existing Transportation Providers This section reports briefly on contacts with the transportation providers in operation in Western Riverside County, including the five public transit bus operators and eight existing Measure A providers. Staff comments about transportation need related to non -emergency medical purposes are reported. These programs each see interesting, and quite varied, perspectives on the nature of this need. Public Transit Operators Riverside Transit Agency, under renewed efforts to increase the productivity of its RTA Dial -a -Ride services, is exploring creative alternatives that could have positive impacts on the dilemma of non -emergency medical transportation. The Buddy Fare program is one such attempt to encourage passengers to group themselves and thereby obtain a discounted fare, even as the transit program provides more efficient service. This program allows passengers to share the $2.50 fare if several passengers living within a mile of one another are traveling to the same destination. With some assistance around scheduling, seniors traveling to medical clinics or even neighboring individuals with similar chemotherapy or radiation treatments could be well -served by this discount opportunity. RTA is also exploring the feasibility of selective routed- services, for example for dialysis patients from the same general residential area, with their predictable schedules, could be served in a routed, subscription -type manner. Such routing of demand response service could improve service levels to consumers while contributing to improved RTA Dial -a -Ride productivity. Winter 2006 18 32 An additional issue is that of pick-up locations in and around large medical complexes. RTA reports that vehicles and passengers frequently miss one another at the Loma Linda facilities, among others. Often a passenger is dropped at one building but then referred by health care personnel to treatment or testing at another building. The transit vehicle returns to the original location and misses the passenger who has assumed that the new pick-up location was transmitted to the driver. RTA is now identifying specific consumer pick-up locations within these spread -out medical campuses in order to help reduce the number of missed connections and the confusion of drivers and consumers about pick-up locations. Corona Dial -A -Ride is an on -demand, shared -ride public transportation system available to all members of the community. Staff report no observed or significant unmet need for medical purposes. Staff report that they are asked once or twice a year about non -emergency medical transportation, sometimes for gurney transportation. This type of service is outside the bounds of what Corona can provide. Other medically -related trips are provided where these are within the city limits, to the Corona Medical Center and to local doctors' offices. Staff believes that residents understand clearly that RTA provides trips to seniors and persons with disabilities outside of the city limits and use RTA appropriately for those trips. Banning and Beaumont examined non -emergency medical trip needs during the Health Access NEMT study and various regional corridors of travel were identified: into Riverside, to the County hospital in Moreno Valley, to Loma Linda and the V.A., to Fontana and to medical facilities in Palm Springs. These needs have not changed extensively, although efforts have been made to improve transfer arrangements with RTA for selected regional trips. Riverside Special Transportation Services reports that as much as one-third of their trips are medically related, transporting passengers to Kaiser, Loma Linda and the V.A., and to Riverside Community Hospital. What is most difficult for this operator is the expansion of the city, from 77 to 87 square miles, with the recent annexation of additional areas. This increased service area, combined with continuing demand for long trips, has translated into long travel times for consumers. Riverside Special Services' staff commented on the need for a coordination function to help their most frail elderly patients to make their medical appointments at times that can be served by this transportation program. Winter 2006 19 33 Specialized Transit Providers Care -A -Van One of the original Measure A providers, this operator serves the area around Hemet and San Jacinto, limiting its service to a geographic area that it can readily serve with its four vehicles not currently transporting people outside of its core service area. Care-A-Van's administrator reports that they no longer are asked for medically -related trips, outside the immediate area, as people have learned that trips such as to Kaiser, Loma Linda or the V.A. Medical Center cannot be served. Care -A -Van staff does believe the need exists and is significant. They would consider increasing their fleet by one vehicle, to take on more regional NEMT trips for persons living within their service area. Care -A -Van has two concerns. One is that of marketing, a function that they do not now undertake except in very modest ways as they are receiving about as many trip requests as they can handle. If additional, regional NEMT service were added, albeit at the modest level of a single vehicle, Care -A -Van would need assistance with marketing this service. Secondly, Care -A -Van sees a need for assistance to the consumers in scheduling their medical appointments so that these trips could be reasonably served by a limited transportation program. With a single vehicle, service could be provided one or more days a week to the County Regional Medical Center, once or twice a week to the Loma Linda and V.A. complexes, once a week to Kaiser and possibly service to Riverside Community Hospital on part of one or more of those days. However, making such a schedule work would involve coordinating patients' schedules with the days of service and a staff function — even at a very part-time level -of -effort would assist greatly in making this work. Beaumont Adult School Staff at this Measure A one -vehicle program do see a real need by their young mothers' population for transportation support into regional medical facilities. The program provides local trips, in and around Banning, Beaumont, Cabazon and Cherry Valley. Many of their consumers are teen parents of school age, usually MediCal recipients who receive medical services at locations that are not in the Banning or Beaumont communities. At this time, the Beaumont Adult School officials cannot consider growth in program but are in agreement that the need exists. Inland Aids This program provides almost exclusively non -emergency medical transportation to its population with a small fleet that includes low -floor sedans with paid drivers. Staff reports that they have an insufficient number of drivers, both in terms of the driver pool and of the ability to reimburse drivers for time required to serve all trip requests. They have need for more drivers and increased funding for more driver time. Partnership to Preserve Independent Living: TRIP Program This mileage reimbursement program has been identified as a "best practices" model by several entities in national literature. It provides a significant resource to individuals by enabling them to offer something back to the persons off whom they request transportation assistance. This becomes even more important as gasoline prices climb. Winter 2006 20 34 TRIP management report difficulty with regard to information, that information about the array of public transportation resources that do exist, is hard to get into the hands of the case workers, front-line staff, including DMV offices, and first responders of fire and police. These individuals sometimes are first to become aware of serious transportation needs of a senior or person with disability. It is these front-line personnel who often see the isolated individual who has not connected with any services but may no longer be able to manage independently, particularly in relation to driving. Creative methods to reach out directly to such front-line staff, to provide them with contact information about the potentially complex array of available transportation options, can strengthen the connection to those persons whose mobility options became very limited. Blindness Support Services (BSS) BSS provides an on -going travel training resource for persons who are blind or have low -vision. This training develops individuals' confidence in using Riverside County public transportation resources. In the course of providing the training, BSS staff becomes aware of those trips that individuals have difficulty making, with the existing transportation resources. In relation to non -emergency medical transportation, staff reports that the immediacy of the need, in combination with typical long-distance nature of the trip, makes it difficult to meet. While there is some ability to travel across jurisdictions with RTA Dial -a -Ride service, advance reservation requirements make it unavailable to individuals with same -day medical issues and resulting transportation needs. Care Connexxus This is a new Measure A program providing transportation out of two facilities, in Riverside and in the Sun City, Menifee Valley area. Care Connexxus primary programs are adult day and adult day health care services to seniors and persons with disabilities. Staff sees several needs that are currently unmet. One is for an attendant on -board the vehicles who can assist passengers door-to-door, without requiring the driver to leave the vehicle. The high levels of dependency of many of the consumers whom Care Connexxus serves would benefit from this greater level of assistance, as would other individuals in the community who could conceivably be served. Additionally, Care Connexxus sees two types of training that are needed: ■ For public transit operators: Care Connexxus staff have developed extensive skills and sensitivity for working with populations suffering from Alzheimer's disease and related disorders. Some of these skills are transferable and could have value to public transit drivers of specialized transit vehicles. ■ For care providers, spouses or consumers themselves, to assist individuals in recognizing when they should no longer be driving and when they can no longer use the basic general public transportation. Creating the setting and developing the materials to show individuals what alternatives exist to driving or to using public fixed -route service is seen as an important need. Friends of Moreno Valley Senior Center (Mo-Van) This voluntary organization is on of the original Measure A providers, serving persons in and around Moreno Valley with one vehicle, including the provision of some non -emergency medical trips within a 35 mile radius of Moreno Valley. Administrative staff clearly sees a need for additional transportation of the individualized nature that Mo-Van provides. Winter 2006 21 35 Varying levels of denied trip requests are routinely reported to RCTC. The difficulty that Mo-Van faces is in meeting the match requirement. One of its funding sources, Community Development Block Grants (CDBG) has been declining and there are no . clear replacement options for these dollars. Any expansion in its programming would require finding additional match funds; doing so, as the program administrator sees it for this small and long-standing program would be quite difficult. Norco Parks and Recreation Service — This new Measure A provider is operating one vehicle from the Norco Senior Center and providing trips to Norco residents within the Norco city limits and to selected locations within Corona. Medical trips can be provided within a 30 mile radius, depending upon the availability of the vehicle. Staff does see a need for additional medical trips, particularly for people living beyond Norco city limits in the adjacent county areas, including Mira Loma and Swan Lake. This is a new program that is still developing its transit experience and so staff is concerned about growing too much too soon. There may be possible interest in adding a half -day or additional six hours of driver time to increase the utilization of the single vehicle now operated. 4.0 RECOMMENDATIONS FOR AN NEMT CALL FOR PROJECTS 4.1 Discussion This review has both affirmed certain findings of the two -county NEMT study but also delved more deeply into the characteristics of these trips that make them difficult to serve by public transit. The factors that influence need and identified through these conversations include: Income: Need for non -emergency medical transportation is often income -related but not always. Clearly lower income people, whether they are seniors or young single moms, will have greater need. However, the high cost of NEMT resources available from the private sector, of $60 to $90 per trip and up, means that even reasonably well-off middle -income households are going to have difficulty with trip requirements that continue over time. This was particularly true for persons on dialysis, as reported by DaVita, and persons receiving chemotherapy or radiation treatments, as reported by Kaiser and Parkview Community Hospital. There continues a significant problem with MediCal/Medicaid reimbursement for NEMT, as identified in the Riverside/San Bernardino Health Access Project, in that it has strict functional criteria and does not recognize inability to pay as a legitimate reason for transportation authorization. California's policy on Medicaid reimbursement for transportation is different from that of most other states across the nation. Need for Assistance: Individuals requiring NEMT support appear to require greater assistance than other persons. This can be assistance from the door to the vehicle, assistance from within the house (door -through -door) or inside at the destination. Assistance on -board the vehicle was identified as a need, including provision of an on- board escort for those persons who do not have their own escort or companion. Trip Winter 2006 22 36 scheduling assistance was identified as a need by many persons. This assistance was in making the trip reservation and in negotiating times to develop a fit between the medical appointment and the transportation availability. Immediacy of Trip Need: The nature of non -emergency medical transportation is often need that presents itself on the day of or the next day. The individual wakes up not feeling well and needs to get to an appointment. Or the pain of a growing tumor results in a palliative prescription of radiation therapy to contain the tumor's size. This makes utilizing advance reservation transportation difficult. information Issues: There is a continuing problem of getting resource information into the hands of those who need to know about it when they need to know about it. Individuals often don't know about transit resources and when need presents, don't realize that some specialized transportation does exist. Also, the complexity of the resources available makes it difficult for even seasoned professionals to keep track of all the options, their requirements and limitations. During this fact finding effort, there were instances among the professionals interviewed of partial, incomplete or inaccurate information about other transportation services Regional Trip Patterns, Long Distance Trips, And Frequent Trips: Most of the trips for which assistance is needed are the long, regional trips traveling to centralized hospital or medical facilities. These are not trips for which one can easily ask a neighbor or a friend. And these trips become difficult to provide by family members who must manage their own lives, while assisting an ill or frail family member. When the trips are repetitive in nature, such as on -going chemotherapy or a series of radiation treatments, this places even greater burden on whatever support system an individual may have. These long trips have implications too for the type of vehicle. With the older or frail individuals who may be requiring the trip, the mid -sized and larger vans can be an uncomfortable ride for persons with painful medical conditions or frail, arthritic bodies. The. smaller, low -floor type vehicle is likely to provide a more comfortable ride for ,many individuals. Time and Spatial Issues: Trips with medically -related purposes are difficult to serve by conventional public transit because the population is typically dispersed in low -density areas. The 2004 Health Access NEMT study did identify that many needing assistance with transportation for medical purposes often lived in the rural or dispersed suburban areas not well served by public transportation. And while the destinations and trip generators are somewhat definable -- in terms of the large medical complexes of the V.A., Loma Linda, Kaiser, and Riverside area hospitals -- the areas from which patients travel encompass every part of Western Riverside County. Time is the second variable that makes these trips particularly complex. Riders often don't know when they will be done with a medical appointment or treatment. Staff is no more able to advise a patient as to when they will be ready to leave, as with the dialysis patient who "bleeds out" and must wait until the bleeding is controlled. This is very complicated for a driver and dispatcher with a full manifest of pick-ups, beyond that particular one. Coordination Critical: Coordination issues surfaced repeatedly, in a variety of forms. Some of it is informational, with a recognition that neither consumers nor helping services Winter 2006 23 37 staff always know what resources exist and how best to access them. Coordination needs between healthcare providers and transit providers was viewed as a critical missing link. It is, reportedly, extremely difficult for consumers to negotiate appointment times that will work for transportation. Tightening the link between the transit resource and the health care scheduler with the aim of improving access to health care is a goal that suggests promise for the consumer, the transportation provider and the health care provider. 4.2 Types of Projects Potentially Supported Under this Call and Responsive to NEMT Need The characteristics discussed above suggest goals for an NEMT Call for Projects for Western Riverside County. These are proposed as follows: 1. Increasing the capacity of Western Riverside County providers to supply the highly specialized trip that characterizes NEMT, with both capital and operating investment. 2. Developing communication between transportation and health care providers so as to address patient access requirements collaboratively. 3. Minimizing duplication of services by ensuring that projects are complementary to existing services and not duplicative, through coordination and communication among existing transportation providers. 4. Ensuring that NEMT need is addressed for individual riders by newly proposed projects through effective design and implementation. 5. Ensuring that Measure A funds do not supplant existing transportation resources but are used only to extend and expand. NEMT options. 6. Establishing match levels that ensure support by the proposing entity and represent appropriate and sustainable match funding. The Call itself will need to address these goals, by its design and the types of information requested, both during the proposal process and during subsequent implementation by awardees. To meet the kinds of NEMT issues identified, the following categories of expense are recommended: Operating Expense — Driver wages, escort wages and trip scheduler wages, as well as appropriate supervision and administration expense are appropriate NEMT expenses. This could support driver time during hours not currently served by an existing program, such as evenings or weekends, or to provide service into expanded geographic areas, or simply to provide additional trips that cannot be served under the existing program capacity. Escorts, on -board the vehicles, could provide additional support to consumers at the pick-up or destination -end. This will also include other operating expense of insurance and vehicle maintenance, including fueling, preventative and on -going routine maintenance. Facility rental or lease expenses, within levels appropriate to the scale of the program, are expected expenses. Winter 2006 24 38 Capital Expense — Providing some capital funding is desirable for two reasons: one, it enables potentially new providers who might not be competitive in the S. 5310 program to get started in provision of transportation; secondly, this promises faster delivery of a vehicle. If vehicle reimbursement was established at a 50% level, this would keep the 5310 program, with its 80% Federal funding as the primary capital resource and this as a secondary option. Y Trip/ Appointment Coordinators — This is a new expense category that recognizes the specific role of connecting people, trips and medical services. This complex process, if enabled by someone who can recognize the priorities and requirements of all three parties, may enable better use of existing resources and ensure a more satisfactory experience for all involved. Y Information Expense — Given the somewhat fragmented nature of transportation services in Western Riverside County, it is important to continue to invest in creative and proactive ways to "get information into the hands of the people who need to know it when they need to know it." For purposes of the initial call, it is recommended that there be some prioritization of the levels of funding within each category. These can be adjusted with time, or even based upon the experience of this initial call. But establishing a basic framework communicates the funding priorities to prospective applicants and helps them develop responsive proposals. Table 3 on the following page presents a summary of the categories of need which the Call for Projects should address. Tab a 3, Proposed Measure A Categories of Need For NEMT Call for Projects Category of Need Examples of Expense Operations Driver wages, dispatch, supervision and administration, escort wages; insurance, preventative and routine maintenance; fuel; facility leasing and other expense directly related to the transportation operations. Could include expense to purchase transportation from a third -party or a subcontractor. Capital Vehicles and vehicle -related equipment, including dispatching capabilities, requiring a 50% cash match in order to procure. Trip or Appointment Coordinators Labor expense directly related to staffing a coordination function within social service agencies that helps to link consumers, transportation providers and medical facilities in ways that can serve the needs of all parties. Information Graphic design, printing expense and staff time to develop printed and electronic information about available transit resources; staff time to get these materials into the hands of key professional staff who can then, in turn, provide them to consumers at appropriate times. Winter 2006 39 25 Appendices Appendix A — Riverside and San Bernardino Counties Health Access [NEMT] Project, December 2004 — Summary of Issues, January 2005 Appendix B — Western Riverside County NEMT Contact and Interview Listing, Fall 2005 Winter 2006 40 26 APPENDIX A Health Access in San Bernardino and Riverside Counties: Non - Emergency Medical Transportation (NEMT) Needs and Resources Cahrans/ Federal Transit Administration S. 5313 Study of Statewide Planning Significance Winter 2003 to Winter 2005 Project Management Team: Caltrans, Southern California Association of Governments, San Bernardino Associated Governments, Riverside County Transportation Commission, Inland Empire Health Plan, Kaiser Permanente, Molina Health Care, Health Net, Community Hospital of San Bernardino Consultant Team: Judith Norman — Transportation Consultant (JNTC) In association with D'Melia Consulting Civic Technologies, Inc. David Raphael- Medical Transportation Consulting Medical Transportation Management, Inc. UCLA Center for Health Policy Research The Fairfax Research Group i Project Development Team: 25+ health care, public transit agencies and community based organizations in Riverside and San Bernardino Counties' Inland Empire Overall Project Goal: To identify solutions to non -emergency medical transportation in these two expansive counties, through a; regional planning study, by rigorously documenting issues and devising solutions, refined by community input, that are implementable through partnership between the transit and health care industries. Project Components: Project Management Team (funding sponsors) and Project Development Team (other stakeholders) Consultant study by JNTC and team Way -finding maps of medical facilities for bus riders Conference in March 2005 to report and disseminate findings, engage in dialogue, proceedings. JNTC Study Objective'NEMT trip needs Quantify NEMT need in geographic areas Describe available resources and potential barriers - Devise recommendations to meet geographic area needs with identified resources - Identify challenges of NEMT geographic areas potentially applicable to other areas of Calif. - Facilitate continuing education of project stakeholders regarding issues and potential solutions to NEMT. Study Elements: - Stakeholder interviews and focus groups Resource analysis of transportation services - Review of state and national NEMT models - Examination of funding resources and barriers - Household telephone survey - Geographic information system (GIS) analysis of multiple data sets. - Analysis and direction Four Organizing Questions: 1. Is there currently a need for non -emergency medical transportation to medical appointments for consumers residing within the study areas? 2. If the need exists, what segment of the population is demonstrated to have the greatest need for non -emergency medical transportation in the study areas? 3. Where in the study areas does the target population reside? 4. To what extent does the target population have access to public transit as a transportation alternative to get to medical appointments? Study process and findings, significantly affected by the Healthcare Insurance Portability and Accountability Act (HIPAA), made it premature to develop the anticipated transportation demonstration projects. Importantly, the project has refined our understanding of NEMT issues, to better inform both healthcare and transportation stakeholders. Policy direction to address the needs identified requires continued dialogue and adaptation by all parties involved, at local and state levels. !l�ll�Eli' Winter 2006 41 27 Selected Overall Findings: Population segments have missed medical appts. due to lack of transportation, including those with their own transportation and those depending upon others for transportation. Demographic characteristics of those missing appts. due to transportation are: women, 25 to 34 years of age, household incomes of less than $20,000, MediCal recipients and Spanish speakers. - Seniors -appear to be getting to scheduled medical appts., missing or rescheduling fewer medical appts. than other age groups. - The San Bernardino Valley area surfaced as the destination target area for most medical appointments while the populations missing appointments reside primarily in the rural areas of the two counties. Healthcare Related Findings: - State level data suggests that California's NEMT policies are not on par with those of other states. Program based upon physical ability and not economic need or the availability of transportation. - Nationally, operating NEMT programs continue to rest on the shoulders of healthcare organizations due to Medicaid funding policies: - Confusion and differences in the interpretation of HIPAA requirements limited the amount of healthcare related data collected and analyzed in this study. - Wide variations in the levels and methods of reporting NEMT transportation expenses in California make it difficult to determine financial resources targeted to transportation by healthcare organizations. - Missed appt data is the most important factor for assessing the severity of NEMT need but is not currently being collected by healthcare organizations. . Lack of funding is cited by stakeholders as number one barrier to direct NEMT provision: - Perceived success of NEMT programs operating across the country relates to ability to focus on the target population and consolidate administration, rather than cost per trip, and to obtain adequate financial resources. - Significant cooperation between healthcare and transit is necessary to ensure successful, cost- effective NEMT programs. Public Transportation Related Findings: - Access to public transit services for IEHP members is very good. Data shows that IEHP population segments are in most cases close to public transit, living within '/a mile walk to a transit stop. - Although 57% of the total study area population is within '/a mile of fixed -route service, only 31 % of the population live near high frequency routes (15 . to 30 minute headways). - Vast majority (93%) of IEHP facilities are located within '/a mile of fixed -route services. Nearly half (45%) of IEHP facilities are located within close proximity to high frequency transit routes. These facilities generate demand for 63% of NEMT trips of IEHP cases analyzed. - Dial -a -Ride and ADA-related services are operating in each area for eligible seniors and persons with disabilities, but not to those identified as having difficulty getting to appointments, suggesting [CTSA] transportation brokerages as one possible options. - Public transit connections medical destinations outside the local areas are limited. Inter -regional connectivity needs significant improvement. Conclusions: - The State of California should consider the overall impacts of its current funding policies and practices relative to non -emergency medical transportation. - The State's policies and practices relative to funding medical transportation under MediCal are inconsistent with other states and contrary to Federal regulation. - The issue of allowing expenditure of MediCal funding for NEMT for low-income MediCal recipients must be recognized and accepted as a critical core issue in the State's efforts to identify and further local efforts to address NEMT needs. - Rapidly changing socioeconomic conditions of the Inland Empire do suggest that in-depth "destination - based" information about missed appts. would logically assist transit operators in developing services that better replicate travel patterns of study area participants. - Destination -type data could be collected as part of ongoing transit data collection efforts to serve as a valuable tool in designing more productive services, based upon demonstrated demand. - There is no one answer, no one-time answer as each recommended action must serve to enhance and support the overall objective of addressing NEMT. Winter 2006 42 28 Appendix B, Measure "A" Specialized Transportation Progam = NEMT,,- Contact Listing as of 1/06/06 CONTACT TYPE AGENCY NAME TITLE ADDRESS ADD 2. CITY/ STATE ZIP CODE TELEPHON E EXT. FAX# Community Member Resident of California Meadows Denise Hernandez (951) 277-4110 Dialysis DaVita -Diamond Valley Dialysis Center Nicole Hughes, MSW Social Worker 1030 East Florida Avenue Hemet, CA 92543 (951) 766-4581 (951) 766-4585 Dialysis DaVita- Diamond Valley Dialysis Center Maryanne Biendowski, MSW Social Worker 1030 East Florida Avenue Hemet, CA 92543 (951) 766-4581 (951) 766-4585 Dialysis DaVlta - Hemet Dialysis Ctr. Sonya Farrow, MSW Social Worker 1330 So. State St., Ste. B San Jacinto, CA 92583 (909) 654-1056 (909) 654-3596 Dialysis DaVita Montclair Dialysis Kris Podley, LCSW Social Worker 5050 Palo Verde, Ste. 100 Montclair, CA 91763 (909) 625-0339 (909) 625-4189 Dialysis DaVita Riverside Dialysis Center Adriana Torres, MSW, ACSW Social Worker 4361 Latham St., Ste. 100 Riverside, CA 92501 (951) 682-2700 (951) 682-3024 Dialysis DaVita Riverside Dialysis Center Marion Wilson, MSW,ACSW Social Worker 4361 Latham St Ste. 100 Riverside, CA 92501 (951) 682-2700 (951) 682-3024 Education Beaumont Adult School Mike Neary Principal (951) 845-6012 Electeds City of Rivreside City Council Dom Betro Councilm ern ber Electeds Prime of Life - Hemel Robin Lowe Chairwoman, RCTG Electeds Supervisor bob buster First Dist. Riverside Co. Sandra J. Isom Legislative Assistant 4080 Lemon St., 5th Floor N.U. Box 1527 Riverside, CA 92592- 1527 (951) 955-1010 (951) 955-1019 Electeds Supervisor Jett Stone, Third Dist. Riverside Co. Tommy Tunson Legislative I eam Member (951)955-1030 Electeds Supervisor Jett Stone, Ihlyd D161. Hlverslde Co. Ron Roberts Legislative Assistant (951) 955-9500 Electeds Supervisor John Tavaglione Second Dist. Riverside Co. Donna Johnston Legislative Assistant 4080 Lemon St. P.U. Box 1646 Riverside, CA 92502- 1646 (951) 955-1024 (909) 955-2362 Electeds Supervisor Marion Ashley, Fifth Dist. Riverside Co. Rick Hoffman, Jaime Hurtado Electeds Supervisor Hoy Wilson, Fourth Dist. Riverside Co. 760.863.8211 Homeowners Assoc. Horsethief Canyon- Walters Managmenl John Thorpe 27349 Jefferson Ave., #20 Temcula, CA. 93590- 5628 909 296-1588 Homeowners Assoc. California Meadows - Euclid Mangemt. Resident 909-981-4161 Medical Community Care and Rehabilitation Besly Morrison 4070 Jurupa Riverside, CA. (951) 680-6500 Medical Corona Regional Medical Center Kathy DeWitt Community Liaison (951)736-7230 pager 951-963- 7080 Medical Corona Regional Medical Center Linda Pearson Hospital Administration (951) 737-4343 Medical Desert Healthcare Foundation Samantha Prior (7603) 323-6645 Medical Extended Gare Facility Tammy Social Services Director 8171 Magnolia Riverside, CA. (951) 687-3842 Medical Inland AIDS - Joy Gould Executive Director (951)346-1910 Medical Inland Empire Health Plan Gary Melton Deputy Director 303 E. Vanderbilt Way, #400 San Bernardino, CA, 92408 (909) 890-2903 Medical Kesler Permanente Palliative tare Program Carolyn Simmons, LCSW Social Worker 9661 Sierra:Bldg. 3A Fonatana, CA. 92335 (909) 743-9979 Medical Kesler Permanente Palliative Care Program Michelle Ugolini, LCSQ - Social Worker 9661 Sierra, Bldg. 3A - - - - - Fonatana, CA. 92335 (909) 743-9979 Winter 2006 43 CONTACT TYPE AGENCY NAME TITLE ADDRESS ADD CITY/ STATE ZIP CODE TELEPHON E EXT. FAX# Medical Magnolia Rehabilitation Center Patty James Social services Manager 8133 Magnolia Riverside; CA. (951) 688-4321 Medical Orange Tree Mrs. Dawson 4000 Harrsion Riverside, CA. (951) 785-6060 Medical Parkview Community Hospital Donna DeLeon Social Services Manager • - (951) 779-3905 Mental Health Dept. of Mental Health Riverside Co. Bill Brenneman, LCSW, MHSS Services At, I Coordinator - 4095 County Circle Dr. Riverside, CA 92503 (951) 358-4522 (951) 358-4513 Mental Health Dept. of Mental Health Riverside Co.. Erlys A. Daily, RN, MPH Services Chlldren's Services 9707 Magnolia Ave. Riverside, CA 92563 3609 (951) 358-4520 (g51) 358-4560 Mental Health Dept. of Mental Health Riverside Co. Luis A. Zapata, Ph.D. - Psychologist 1688 N. Perris bilvd. Ste., L7- 11 Perris, CA 92571 (951) 443.2231 (951) 443-2240 MentalHealthDept. of Mental Health Riverside Co. Maria I Marquez, MFT Mental Health Services Manager 769 Blaine St., Ste. B Riverside, CA 92507 • (951) 358-4523 (951) 358-4607 Mental Health Dept. of Mental Health Riverside Co. Steve Steinberg, LCSW Mental Health Services Manager 9707 Magnolia Ave. #30 Riverside, CA 92503 (951) 358-7347 (951) 358-7308 Mental Health Dept. of Mental Health, Older Adults Services Barbara Mitchell (951) 690-0219 Mental Health Dept. of Mental Health, Riverside Co. Donna Dahl Program Chief 4095 County Circle Dr. Riverside, CA 92503 • (951) 358-4511 (951) 358-4513 Seniors Riverside County Office on Aging Luverne Molberg Director 6926 Rivercrest Dr., Ste. K Riverside, CA 92507- 0738 (951) 697-4697 (951) 697-4667 Seniors Desert Samaritans for the Elderly Cheryl Scarinci (760)837-9066 Seniors Riverside Co. Foundation on Aging Michael E. Carbine President 6296 Rivercrest Dr., Ste, K - Riverside, CA 92507- 0738 (951) 776-7792 (951) 697-4698 Seniors Riverside County Office on Aging Agnes Payne MSSP/Linkages 6926 Rivercrest Dr., Ste. K Riverside, CA 92507- 0738 (951) 697-4697 Seniors Riverside County Office on Aging Annie Dawson MSSP/Linkages 6926 Rivercrest Dr., Ste. K Riverside, CA 92507- 0738 (951) 697-4697 x319 Seniors Riverside County Office on Aging Ben Mopera MSSP/Linkages 6926 Rivercrest Dr., Ste. K Riverside, CA 92507- 0738 (951) 697-4697 x316 Seniors Riverside County Office on Aging Cathy Andre, M.S.W. Coordinated Care Programs 6926 Rivercrest Or., Ste. K Riverside, CA 92507- 0738 (951) 697-4697 x315 (951)69J-4667 Seniors Riverside County Office on Aging Ed Welch MSSP/Linkages 6926 Rivercrest Or., Ste. K Riverside, GA 92507- 0738 (951) 697-4697 x229 Seniors Riverside County Office on Aging Gloria Roffner MSSP/Linkages 6926 Rivercrest Dr., Ste. K Riverside, CA 92507- 0738 (951) 697.4697 x262 Seniors Riverside County Office on Aging Grace Deisler MSSP/Linkages 6926 Rivercrest Dr., Ste. K Riverside, CA 92507- 0738 (951) 697-4697 x272 Seniors Riverside County Office on Aging Lorna LeVias, S.S.W. Coordinated Care Programs 6926 Rivercrest Dr., Ste. K Riverside, CA 9250/- 0738 (951) 697-4697 x222 (951) 697-4667 Seniors Riverside County Office on Aging Rosemary Vincent MSSP/Linkages 6926 Rivercrest Dr., Ste. K Riverside, CA 92bU/- 0738 (951) 697-4697 x237 Seniors Riverside County Office on Aging Traci D'Codelius MSSP/Linkages 6926 Rivercrest Dr., Ste. K Riverside, CA 9250f- 0738 (951) 697-4697 x272 Seniors Riverside County Office on Aging Valeria Robinson MSSP/Linkages 6926 Rivercrest Dr„ Ste. K Riverside, CA 915U/- 0738 (951) 686-4674 Seniors I he Partnership I o Preserve Independent Living Richard Smith (951) 697-4697 x263 (951) 697-4698 Social Sys. - Alternatives for Domestic Violence Jill Walker Director (951) 320-1370 Social Sys. Blindness Support Services Peter Benevidez President (951)341-6333 (951) 341-6335 Social Sys. First 5 Riverside Harry Freedman Executive Director 2002 Iowa Ave., Ste 100 Riverside, CA 92507-. 2423 (951) 248-0014 (951) 248.0079 Social Sys. First 5 Riverside Stella M. Smith Deputy Director .. 2002 Iowa Ave., Ste 100 - Riverside, CA 9250/- 2423 (951) 248-0014 (951) 248-0079 Winter 2006 44 CONTACT TYPE AGENCY NAME TITLE ADDRESS ADD CITY / STATE ZIP CODE TELEPHON E EXT. FAX # Social Sys. First Riverside Michelle Burroughs Adm. Community Engagement 20021owa Ave., Ste 100 Riverside, CA 92b0L 2423 (951) 248-0014 (951) 246-0079 Social Svs. First 5 Riverside Nancy Maich Special Projects 2002 Iowa Ave., Ste 100 Riverside, CA 9250/- 2423 (951) 248-0014 (951) 246-0079 Social Svs. Phoenix Program Don Cox (951) 203.3617 Jeanne Transit CAC/SSTAC Judy Neiberger Chairwoman (951)242-1777 Transit Care Connexxus Adult Day Services Jeanne Klingenberger Executive Director 4130 Adams St., Ste. B Riverside, CA 92504 (951) 509-2500 (951) 509-2578 Transit Care -A -Van Ron Cole (951) 791-3595 Transit City of Banning Chris Millen UIr. Ut Community Services 789 N. San Gorgonio Banning, CA 92220 (951) 922-3241 (951) 849-0639 Transit City of Beaumont Mike Pistilli Vehicle Malnl. 8 Transp. Supt. P.O. Box 158 Beaumont, CA 92223- 0150 (951) 769-8530 (051) 769-8531 Transit City of Corona - Transit Yard Viren Shah, Herb Mundun 730 W. Corporation Yard Corona, CA (951) 520-0679 Transit City of Norco Parks 9, Recreation Dept. Michelle Anglin, Jerilyn Kennedy (951) 371-5646 (951) 371 -1553 Transit City of Riverside Vicki Paz Measure A Tfanslt Oper. 8095 Lincoln Avenue Riverside, CA 92504 (951) 351-6182 (951) 351-6069 Transit Friends of Moreno Valley -MoVan Dorothy Grzeskowiak President (951)243.6890 (951) 243-6890 Transit Maryland Transit Adm. LaTrina Trotman (410)767-7272 Transit Riverside Transit Agency Vince Rouzaud Uir. Ut Purchasing 8 Materials Management 1825 Third St. P.O. Box 59968 Riverside, CA 9251 /- 1968 (951) 565-5000 (951) 565-5001 Transit Riverside Transit Agency Virginia Werly L,ontract Operations Mgr. 1825 Third St. P.O. Box 59968 Riverside, CA 9251 r- 1968 (951)565.5184 (951)565-5185 Transit Sunline Transit Agency Eunice Lovi Director of Planning 32-505 Harry Oliver Trail I housand Palms, CA 922(b. 3501 (760) 343-3456 x119 (760) 343-3845 Transport Health Link MediVan Greg Linsme ier Vice President 1890 S. Betmor Lane Anaheim, CA 92805 (909) 792-1105 Veterans Dept. of Veteran's Services William Densmore Director 1153A Spruce Street Riverside, CA 92507- 2428 (951) 955-6050 (951) 955-6061 Veterans VA Loma Linda Healthcare System John Zeller Supervisor, Travel Unit 11201 Benton St. Loma Linda, CA 92357 (909) 825-7084 x2171 (909) 422-3142 Veterans VA Loma Linda Healthcare System Annie Tuttle Public Affairs Officer 11201 Benton St. Loma Linda, CA 92357 (909) 583-6193 (909) 422-3108 Winter 2006 45 Riverside County Transportation Commission Historical Listing of Measure "A" Specialized Transit Program Western Riverside County Area AGENCY FISCAL YEAR DOLLAR AMOUNT APPROVED SERVICE AREA 89-90 90-91 91-92 92-93 93-94 94-95 95-96 96-97 97-98 98-99 99-00 00-01 01-02 02-03 - 03-04 04-05 05-06 TOTAL Ability Counts Corona/Riverside $44100 00 Anza Valley Seniors Anu - $32,740 $32,740 $85,500 $92,373 $30,791 274,144 $$98,959 343,199 $637,144 $1,637,144 Beaumont Adult School $62,465 195,500 $195,500 $65,342 210,000 $210,000 Blindness Support Riverside City $16,003 $139,134 139,134 165,000 $165,000 181,500 $181,500 Care -A -Van Transit System Westem County Area $30,428 $81,073 $89,000 $97,W0 $116,000 $t00,1100 $100,000 132,509 $132,509 Care Connexxus $130,000 $130,000 City of Banning City of Banning $28,000 $11,244 $73,085 $112,329 City of Beaumont City of Beaumont $12181 $45,000 $50,000 $107,181 City of Corona City of Corona $24,000 $27,000 $15,840 $15,825 $95.385 $98,157 $85,120 $41,000 $39,000 - $441,327 Corona -Norco Family YMCA $14,813 $20.535 $35,348 City of Norco Parks and Recreafion $40,000 $17,112 $17,843 $74,955 Family Service Association of Westem Riverside County Jumpa, Mira Loma, Pedley, Rubidoux Areas $46,154 $51,657 $75,500 $100,000 $109,740 $100,000 $125,000 $125000 $114,621 $72,500 $920.172 Friends of Moreno Valley Senior Center City of Moreno Valley $14,000 $23,250 $38,500 $26.000 $28,000 $27,300 $27.300 $28,500 $28,500 $29.157 $29157 $44,800 $46,880 $389,344 Housing Authority of Riverside Jumpa Area $7,500 $7.500 Inland AIDS Project Westem County Area $39,000 $49,433 $62,062 $62,062 562,000 $62,000 $87,449 $87,449 $88000 $89,O00 $89,000 $100,000 $877,455455 Menl(ee Valley Medical Center Southwestem County Area $16,800 $16,800 M1. San Jacinto Alliance San JacintoArea $925 - $925925 Partnership to Preserve Independent Living Westem County Area $43,408 $43,409 $152,000 $171,050 $260,864 $300,000 $240,000 $240,000 $240,000 $240,000 $240,000 $240,000 $304,973 $340,698 $3,056,402 Refired & Senior Volunteers' Program Westem County Area $7,985 - $7,985 Riverside County Dept Community Action Westem County Area - $6,948 $6,948 Riverside County Housing Authority (Eddie Dee Smith Senior Center) $7,500 $7,500 $7500 $22,500 Riverside County Office of Education Westem County Area $5,130 $3,480 $3,480 $3,480 $3,480 $4,255 $4255 $27,560 Riverside County Service Area 143 Murriela/femecula $24,550 $24,550 Riverside General Hospital Westem County Area $70,518 $70,112 - $40,990 $50,190 $16,688 $22,250 5270,748 Riverside Special Services City of Riverside $23,696 $15,295 $19,000 $22,880 $80,612 $46,000 $24,804. $22,200 $51,000 $26,000 $331,487 Riverside Transit Agency Westem County Area $43,911 $11.950 $480,893 $363,450 $293,519 $1,335,851 $381,000 $260,000 $3,170,574 Riverside Transit Agency/RCTC Westem County Area $20,000 $20,000 Riverside County Transportation Commission Riverside/Pedley $16,000 $16,000 Transportation Specialists/Meditrans Southwestern County Area $10,120 $20.320 $20,320 $40,250 $100,915 $95,400 $142.000 $142,000 $204,700 $150,000 $150.000 $226,500 $238,500 $140.088 $1,681,113 Volunteer Center of Greater Riverside Transpodabon Information System $22.850 $68.551 $129,980 $92,070 $80.366 $80,366 $80,000 $80.000 $80,000 $80.000 $81.120 $83,820 $88,360 $91010 $1.138,493 $ T•,;,1^':.' ",,;;s._,'s" 'M�--':.;:'s'3;s.-' TOTAL $56,274 $150,464 $155.183 $323,595 $393,973 $1,319,711 $1,245,063 $1,253,365 $2,560,817 $1,333,141 $1,054,020 $1,016,285 $962,325 $850,354 $679,220 $982,442 $1,059,010 $15,395,242 1 High-water mark - Measure 'A" Specialized Transit funded programs 2/2/2006 Citizens' Advisory Committee/Social Services Transportation Advisory Council February 8, 2006 Measure A Specialized Transportation Program — Non Emergency Medical Transportation Mobility and Independenc • Measure A Ordinance: half -cent sales tax identifies 5% of annual revenues for implementation of specialized transportation programs (Western Riverside) 4 Program benefits: Seniors, persons with disabilities and the truly needy 4 Niche market: service over and above what typical mass transit provides Health Access Study • Health Access in San Bernardino & Riverside Counties: NEMT • Study administered by Southern California Association of Governments Partners: - Community Hospital of San Bernardino - Health Net, Inc. - Inland Empire Health Plan - Kaiser Permanente - Molina Health Care - Riverside County Transportation Commission - San Bernardino Associated Governments Transit Operators and Measure A Recipients provided in put Call for Projects • July 2005: Approval to develop a call for Projects for Western Riverside County • Focus of call: — Medical appointments to veteran facilities; — Inter -regional transportation for medical appointments; and — Dialysis, chemotherapy and/or radiation medical treatments. Decision made to combine NEMT call with on -going two-year call for projects to address transportation needs of seniors, disabled and truly needy residents of WRC Interviews/Outreach • A-M-M-A staff interviewed 60+ individuals representing health care and transportation industries 4 Transit & Measure A Recipients Seven user groups identified: Behavioral & mental health concerns Persons served in medical facilities Frail seniors (risk of institution) Dialysis patients Seniors (geographically isolated) Young children/low income parents Veterans (non - service related injuries) Categories of Need Directly Operated Services (50% match) a • Vehicle Operations • Coordinator/Trip Scheduling Function Non -Directly Operated Services P5% match) • Special Programs: TRIP, TAP, Travel Training Capital Equipment (50% match) • Vehicles • Communication equip. • Computers INFORMATION/COMMUNICATIONS Schedule Of Events Release of Call February 8, 2006 Pre -Proposal Conference March 7, 2006 — 2:30 P.m. Proposals Due April 7, 2006 — 12:00 noon Applicant Interviews April 11, 2006 RCTC's Policy Board Reviews 4/24/06 & 5/10/06 Start-up of New Contracts July 1, 2006 Staff Recommendations • Receive and file the Fact Finding Paper on NEMT; and • Seek appointment of three members of CAC/SSTAC Committee to review proposals on the western Riverside County Measure A Call for Projects. 4 Applicant Interviews: April 11, 2006 AGENDA ITEM 9 RIVERS/DE COUNTY TRANSPORTATION COMM/SS/ON DATE: February 8, 2006 TO: Citizens' Advisory Committee/Social Services Transportation Advisory Council FROM: Tanya Love, Program Manager THROUGH: Stephanie Wiggins, Director of Regional Programs SUBJECT: CAC/SSTAC Committee Appointments: Unmet Transit Needs Hearing; SB 821 Evaluation Committee, and FTA's Section 5310 Program STAFF RECOMMENDATION: This item is to seek appointment of CAC/SSTAC Committee members to the following review committees: 1) One member to attend and be a member of the hearing board at the Unmet Transit Needs Hearing in Blythe on March 1, 2006; 2) Three members to serve on the FY 2005/06 SB 821 Evaluation Committee; and 3) Three members to review and score the Federal Transit' Administration's Section 5310 applications. BACKGROUND INFORMATION: For the past several years, staff has requested CAC/SSTAC's participation in reviewing the testimony of the Commission's Unmet Transit Needs Hearing, the SB. 821 Bicycle and Pedestrian Facilities Program and the Federal Transit Administration's (FTA) Section 5310 program. Following is a brief description of, each program: Unmet Transit Needs Hearing State' law 'requires that prior to making any allocations of Local Transportation Funds (LTF) not directly related to public transit, the Commission must identify the unmet transit needs in the area and determine those that are reasonable to meet. At least one public hearing must be held to solicit comments on unmet transit needs. The only area that this determination of unmet needs is applicable to is the Palo Verde Valley where it is anticipated that not all funds will be needed for transit. In the western 46 county and the Coachella Valley, all available local transit funds are being used for transit services. The Unmet Transit Needs Hearing is scheduled for Wednesday, March 1, 2006 at 1:30 P.M. in Blythe, California. SB 821 Bicycle and Pedestrian Facilities Program Each year 2% of the LTF revenue is made available for use on bicycle and pedestrian facility projects through the Commission's SB 821 Program. This is a discretionary program administered by the Commission. There are three steps to carry out the program: 1. All cities and the county are notified of the SB 821 program estimate of available funding and are requested to .submit project proposals. (All school districts in the county are also notified and asked to coordinate project submissions with either their local city or the County Transportation Department. ) The Commission's SB 821 program policies, project application, and selection criteria are also provided with the notification; 2. The Commission's SB 821 Evaluation Committee, comprised of members of the Commission's Technical and Citizens' Advisory Committees (3 each), meets to review and rank the project applications using the evaluation criteria adopted by the Commission and recommends projects and funding amounts to the Commission for approval; and 3. The Commission reviews the Committee's recommendations and approves a program of bicycle and pedestrian projects for funding. Staff has tentatively set the meeting of the Evaluation committee for the week of June 12th or June 19th (2006) depending on the availability of the committee members. FTA's Section 5310 Program The FTA Section 5310 Program provides capital grants for the purpose of assisting private, non-profit corporations and public agencies, under certain circumstances, in providing transportation services to meet the needs of 47 seniors and persons with disabilities for whom public transportation services are otherwise unavailable, insufficient or inappropriate. The program provides funding for approved projects on an 80% federa1/20% loca► match basis. This year the Local Review Committee is schedu►ed to meet on March 14, 2006, 9:00 A.M. to 1:00 P.M. 48 AGENDA ITEM 10 RIVERS/DE COUNTY TRANSPORTATION COMM/SS/ON DATE: February 8, 2006 TO: Citizens' Advisory Committee/Social Services Advisory Council Transportation FROM: Tanya Love, Program Manager THROUGH: Stephanie Wiggins, Director of Regional Programs SUBJECT: 2006 Meeting Schedule and Agenda Topics , STAFF RECOMMENDATION: This item is for the Committee to receive and approve the proposed 2006 Meeting Schedule and Agenda Topics as presented. BACKGROUND INFORMATION: Section 99238 of the Transportation Development Act establishes a social services transportation advisory council to annually participate in the identification of transit needs in the county including unmet transit needs. Additionally, the Committee advises the Commission on any other major transit issues, including the coordination and consolidation of specialized transportation services. For calendar year 2006, the following meeting schedule and agenda topics are presented for review, discussion and approval: PROPOSED 2006 MEETING SCHEDULE AND AGENDA TOPICS Date Topics February 8, 2006 RCTC Commission Structure, Officers and Membership for 2006 Measure A Specialized Transportation Program - Non -Emergency Medical Transportation CAC/SSTAC Committee Appointments Proposed Committee Calendar May 10, 2006 FY 2006/07 - FY 2008/09 Short Range Transit Plans FY 2006/07 Unmet Transit Needs Testimony August 9, 2006 Education Program: Suggestions from CAC/SSTAC Members 49