The Older Americans Act of 1965 (OAA) was enacted to provide services  to older adults to help them remain in their homes and communities for as  long as possible. The Coordinating Council is chaired by the  Secretary of Transportation and is charged with improving the efficiency  and effectiveness of human service transportation by coordinating related  programs at the federal level and promoting the maximum feasible  coordination at the state and local levels. These key  features include defining outcomes; monitoring progress to show  accountability; establishing clear leadership; and determining key  resources, such as funding. Transportation Funding Flows to Older Adults through Key Federal Programs, but Outcomes of Coordination Efforts Are Not Measured

		Transportation Funding Can Flow to Older Adults through Two Targeted Federal Programs and Several Other Federal Programs That Serve Broader Populations

We identified two key federal agency programs, AoA’s Title III Part B  Supportive Services and FTA’s Enhanced Mobility program, and six other  federal agency programs that can provide funding or transportation  services for older adults. FTA’s Enhanced Mobility program also targets older adults as one of its  primary populations and is focused on improving the mobility of seniors  and people with disabilities. Federal Coordination Efforts Vary and Outcome Measures Are Not Clearly Identified or Tracked

Federal agency involvement in the Coordinating Council varies, with  coordination on older adult transportation primarily occurring between  FTA and AoA, the two primary agencies involved in human services  transportation planning activities. For example, current working  group initiatives have focused on mobility management tools, such as  one-call one-click centers, to better connect transportation service  providers and riders. Our concurrent report related to the coordination of NEMT  services recommended that the Council update its strategic plan, which  covered the period from 2011 through 2013. In addition, current federal coordination efforts do not identify or  incorporate clear short- and long-term desired outcomes, a key issue to  consider when implementing interagency collaborative mechanisms to  ensure participation from all member agencies. Additionally, without a  clear method to collect and track information and data to demonstrate  progress, it is difficult to show the benefits of coordination, and whether  current Coordinating Council efforts are achieving the outcomes intended  to improve transportation coordination for transportation-disadvantaged  populations, including older adults. State and Local Transportation Agencies and Aging Network Organizations Coordinate in Various Ways, but Challenges Continue

		A Variety of State and Local Coordination Efforts Are Under Way

State and local transportation agencies and aging network organizations  in the four states we selected used a variety of different mechanisms to  coordinate transportation services for older adults. In our  selected states, they were also being used to help older adults access  transportation services (see table 2). Building from the efforts described above, some selected transportation  and aging network organizations have implemented or are piloting more  extensive or innovative approaches to coordination intended to help older  adults access transportation services, such as offering a wide range of  volunteer transportation and expanded mobility management services. For example, Ride Connection—a transportation provider operating in  Oregon—relies heavily on volunteers and a network of service partners  throughout the region to provide over 400,000 rides a year to older adults,  people with disabilities, and those living in rural areas through a range of  programs. Challenges May Inhibit Coordination and Make It Difficult to Meet Older Adults’ Needs

We identified funding eligibility and reporting requirements for different  programs, geographic boundaries, and limited data on the extent of need  given the growing population of older adults as challenges at the state  and local levels that may inhibit coordination in our selected states. Officials in all four of  our selected states noted that rural areas often have very few  transportation options available to serve older adults and other residents. In addition, examples from our selected  states suggest that transportation for life-sustaining needs in those states  are being met (e.g., to access medical and nutrition services), but there is  a significant gap in transportation for social and recreational purposes. Recommendation

To promote and enhance federal, state, and local coordination activities,  we recommend that the Secretary of Transportation, as the chair of the  Coordinating Council, convene a meeting of the member agencies of the  Coordinating Council and define and report on desired outcomes and  collect related data to track and measure progress in achieving results,  including the extent of coordination efforts that are under way, such as  improved services for older adults. DOT  partially concurred with our conclusions and recommendation in an email  response. What federal programs provide funding for transportation services for  older adults, and to what extent are the programs that fund these  services coordinated? To identify federal programs that provide funding for transportation  services for older adults, we reviewed our 2012 report on transportation- disadvantaged populations, which identified federal programs that provide  funding and services for transportation-disadvantaged populations, which  includes older adults, a 2013 AARP report that that identified federal  programs that provide funding for older adults, and conducted a search  of the Catalog of Federal Domestic Assistance. To determine how selected state and local transportation agencies and  aging network organizations coordinate transportation for older adults and  the challenges they face in coordinating or providing these services, we  conducted site visits in four states—Florida, Oregon, Pennsylvania, and  Texas—to discuss the coordination of transportation services between  transportation agencies and aging network organizations.
Why GAO Did This Study

As the U.S. population ages, access to safe and reliable transportation alternatives is critical to helping older adults remain in their homes as long as possible. HHS, DOT, VA, and other federal agencies may provide funds to state and local entities to help older adults access transportation. GAO was asked to review access to transportation services for older adults. This report examines (1) the federal programs that provide funding for transportation services for older adults and the extent to which the programs that fund these services are coordinated, and (2) how state and local transportation agencies and aging network organizations in selected states coordinate transportation for older adults and the challenges they face in coordinating or providing these services. GAO reviewed past work on programs for transportation-disadvantaged populations, reviewed federal program information, and conducted interviews with HHS, DOT, and VA, as well as, state and local transportation agencies and aging organizations in selected states. GAO selected four states based on populations of older adults, federal funding received for transportation, and geography, among other factors.

What GAO Found

Two key federal programs and several other programs identified by GAO provide funding for transportation services for older adults. The Administration on Aging (AoA) within the Department of Health and Human Services (HHS) provides funding for supportive services—including transportation—to state and local agencies exclusively for older adults. Within the Department of Transportation (DOT), the Federal Transit Administration's (FTA) Enhanced Mobility of Seniors and Individuals with Disabilities program is focused on improving the mobility of older adults as one of its two primary populations. Other federal agency programs, including some within the Department of Veterans Affairs (VA), can fund access to transportation services for eligible older adults, among other beneficiaries. The Interagency Coordinating Council on Access and Mobility (Coordinating Council) is responsible for leading federal efforts to improve the efficiency and effectiveness of human service transportation by coordinating related programs. Federal agencies' involvement in the council and its activities varies, with coordination on older adult transportation primarily occurring between AoA and FTA through working groups, initiatives, and technical assistance efforts. While some federal coordination activities are ongoing, current efforts do not identify desired outcomes, a key feature GAO has identified to consider when implementing interagency collaborative mechanisms. Specifically, the Coordinating Council's latest strategic plan, which covers the period 2011 to 2013, lacks clearly defined outcomes and measures to track progress toward those outcomes. Without defined outcomes and a clear method to collect data to monitor progress, it is difficult to determine whether current efforts of the council are achieving their intended results and providing the benefits of coordination, such as improved access to transportation, for older adults. In a concurrent report ( GAO-15-110 ), GAO is recommending that the council update its plan.
State and local transportation agencies and aging organizations in the four states GAO visited used a variety of mechanisms to coordinate transportation services for older adults. For example, many state and local activities are currently focused on mobility management approaches—such as travel training programs—to help older adults identify and access the various transportation resources available. Some organizations GAO interviewed have also implemented more extensive approaches to coordination that are intended to help older adults access transportation services, such as offering a wide range of volunteer transportation. For example, Ride Connection—a transportation provider operating in Oregon—relies heavily on volunteers and service partners to provide over 400,000 rides a year to older adults and others, through travel training, community shuttles, and other programs. However, funding eligibility and reporting requirements for different programs , geographic boundaries , and limited data on the extent of need were identified as challenges that, at the state and local level, may inhibit coordination in the selected states. For example, officials in all four of the selected states noted that rural areas often have very few transportation options available to serve older adults and other residents, particularly for social and recreational outings. Examples from the selected states also suggest that funding for these types of life-enhancing activities may be limited as states prioritize their funding to ensure life-sustaining trips, such as medical and nutrition services, are provided.

What GAO Recommends

GAO recommends that DOT define and report on desired outcomes and collect related data to track and measure progress in achieving results, including the extent of coordination efforts under way. DOT partially concurred with the recommendation and plans to consider what information may be needed to measure and evaluate ongoing coordination efforts.