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Senior Transportation Choices

August 2, 2012

Without accessible and safe travel options, seniors face isolation and a reduced quality of life. Moreover, seniors who can’t drive make fewer trips to their doctors and to see friends and family than their motoring counterparts.

Chuck Gehring — who runs the Life-Care Alliance in central Ohio — calls it the “pig in the python” phenomenon, a not-so-flattering reference to the 60-million-plus, post-WWII baby boomers who will soon be turning 65. Their needs, as they continue to age, will be enormous, he says.

And in order for them to stay in their homes — as nearly all older Americans say they want to do — transportation options for them need to be improved. Especially since surveys show 600,000 drivers are now hanging up their keys each year after hitting age 70.

“There is a huge and growing need for low-cost transportation,” says Gehring, whose nonprofit agency is based in Columbus, Ohio.

Without accessible and safe travel options, seniors face isolation and a reduced quality of life. Moreover, seniors who can’t drive make fewer trips to their doctors and to see friends and family than their motoring counterparts.

“If older folks don’t have transportation, they spend more days a year in the hospital than the national average than those who do,” he says. “And a day in the hospital can be very expensive.”

The same thing is true for nursing homes and assisted-living institutions.

“The AARP calculates that in this state [Ohio], we save $62,000 per client, per year for each client we keep independent and in their own home,” Gehring explains. “And in central Ohio, nursing home costs average about $5,500 a month. So there is a huge ROI (return on investment) for programs, because it is the taxpayer who covers the cost for low-income seniors being in the hospital or an institution. We have 15,000 clients, so our little agency is saving taxpayers $500 million a year.”

But experts agree, more needs to be done around the country to improve senior access to transportation.

Searching for Travel Options

According to a Transportation for America report published last year, a large number of seniors in the United States are stranded in their homes because of poor access to public transportation. Entitled “Aging in Place, Stuck Without Options,” the report says that by 2015, more than 15.5 million Americans 65 and older will dwell in communities where transportation is poor or even non-existent.

The study estimates those numbers will increase rapidly as the baby boomer generation ‘ages in place’ in suburbs and exurbs where often there are few mobility options for those who do not drive.

The report gives sprawling Atlanta the worst grade among metropolitan areas of 3 million or more for having poor transit access for seniors ages 65 to 79. San Bernardino, Detroit and Dallas were also graded poorly in the survey. The study defined poor transit access for seniors in terms of the average number of bus, rail or ferry routes within walking distance of their homes.

Henry Cisneros, secretary of the U.S. Department of Housing and Urban Development in the Clinton administration, says his mother is 88 and still lives in the San Antonio, Texas, home where he and his siblings grew up. (He visits her several times a week.)

Cisneros — a former mayor of San Antonio and executive chairman of CityView, an institutional investment firm geared to urban real estate — says surveys show one of the things seniors fear most is isolation.

“With no car, they worry they won’t be able to get places and will be cut off from family, friends and lose connections to their communities,” Cisneros says. “That’s one of the major reasons transportation is so important.”

Cisneros, who edited the recently released University of Texas book “Independent for Life,” says city streets and sidewalks need improvements to make them safer for seniors. In addition, homes and apartments often require retrofitting so seniors can safely age in place.

Mary Leary, assistant vice president for the Easter Seals Transportation Group, calls planning around the country for senior transportation needs a “mixed bag.”

Many communities are not doing enough, she says, noting examples of homeowners’ or condominium owners’ associations that have blocked the construction of bus shelters because they believed they were “unsightly” or attracted “the wrong type of person.” Worse, she cites one city that allowed the construction of a senior development marketed to people 55 and older that had a nursing home, but no sidewalks, so residents — including those in wheelchairs — had to use the streets.

On the positive side, communities that have strong leadership by organizations or individuals who understand the need of senior transportation are staying ahead of the curve and doing a good job of planning for the future. “These efforts benefit everyone,” she says. “This is an issue unlike any we’ve ever faced before as a country because we have so many people who are aging in place. This is an opportunity to improve our communities and the lives of those who live in them.”

Communities that are meeting senior transit needs tend to be places where there is a naturally occurring retirement community, an active Area Agency on Aging or even one individual who can champion the changing mobility needs of older residents. Typically, it’s simply a matter of education and communication to make positive changes. “Most of the time, when groups like homeowners associations are approached, they become supportive,” she says. “Often, they don’t understand why some of these infrastructure issues are so important.”

Likewise, navigating the regulatory mazes that deal with housing developments and transportation issues can be complicated. That’s where the National Center on Senior Transportation can help. The Center, jointly operated between Easter Seals and the National Association of Area Agencies on Aging (NAAAA), offers training and technical assistance.

It’s important to teach seniors how to use public transportation and other modes of transit as they turn in their keys. “We have a robust program — sometimes using mobility mentors or travel buddies — to train people about what’s available,” Leary adds. “Usually, seniors have driven all their lives and don’t know what their options are.”

Virginia Dize, co-director of NAAAA and the National Center on Senior Transportation, says fewer than half the cities it surveyed in 2005 were preparing to meet the transportation needs of older residents.

“Seniors tend to self-regulate by stopping driving, many of them at age 80. The impact will be profound with all the baby boomers coming on,” says Dize. “Communities are struggling, and leaders should be aware that this will be a big, big issue.

“Some are doing well, but others, not so much. Transportation is an increasing concern overall and ranked second in the 2010 (NAAAA) survey — in 2005, that wasn’t even in the top 10. Seniors really do want to stay in their own homes. But without adequate transportation, people might not be able to get to the doctor, go to the grocery store or participate in social activities. In other words, they’ll become isolated.”

Dize, who lives in downtown Washington, D.C., says she and her older neighbors are lucky because they have access to numerous public transportation options. But, she adds, public transportation is not always an easy fit for some older people, depending on their mobility level and where they live.

“Certainly, most Americans like to be in their cars to go when and where they want,” she says. “And that is how suburbia, for the most part, was built.” But that will become more problematic as more and more seniors stop driving.

Transportation resources for seniors are “even more abysmal” in rural areas, which she calls one of the greatest challenges to older Americans’ independence. And, due to the recession, many state and local governments have not kept up with growing senior transportation needs.

“The challenges are increasing every year with the growing number of older people and those with disabilities,” she says. “How the country and individual communities deal with those transit requirements will be a real test.”

Meeting the Need

New Carrollton, Md., a small (pop. 12,000) suburb of Washington D.C., offers many options other communities can emulate. The town’s Call-A-Bus program offers free, lift-equipped, door-to-door transportation for seniors and the disabled for medical appointments, hospital visits, shopping and some social activities within a five-mile radius of New Carrollton. The service is funded by Prince George’s County and is available Monday through Friday with a 24-hour advanced reservation required.

In addition, the Washington Metropolitan Area Transit Authority (WMATA) provides curb-to-curb service for people with disabilities who can’t use regular public transportation. Another option for residents is the Senior Transportation Services (STS) program, which provides free rides to county nutrition sites and medical appointments.

In the San Francisco Bay Area, Contra Costa County is a model of public funding for senior transportation needs. In 2004, 71 percent of voters approved Measure J, which includes money for senior and paratransit services.

“It’s high on our radar,” says Peter Engel the Lifeline Transportation Program manager for the Contra Costa County Transportation Authority. “We realized, even back then, that with the baby boomer bubble coming up we were going to need some way to handle the demand on our senior and paratransit service.

Engel says transportation programs for seniors and the disabled have a lot of support in the region.

“We have a very active senior advocacy population, especially when it comes to mobility, so these measures poll very well,” he says. “Even if people aren’t riding the buses, they might know an older or disabled person who does. Or they think their parents, or they themselves will be using these services in the not-too-distant future. They want to know there is that transportation option out there for them, too.”

In 2008, the first year the measure took effect, 3.5 percent of a countywide half-cent sales tax went for senior and paratransit services. It goes up one-tenth of a percent annually until the measure expires, so by the end of the program, 5.9 percent will go for transporting seniors and the disabled. The tax dollars fund a wide range of transit providers in the county.

“So for the 2011-2012 fiscal year, nearly $2.4 million was allocated,” explains Engel. “Ultimately, it helps seniors age in place and not have to go into institutions. They want to stay in their homes and this helps them get to doctors’ appointments, socialize and shop.”

Engel says the timing was right for the passage of Measure J because the economy was going “gangbusters” back in 2004.

“Would it pass now?” he muses. “I can’t say. But we were fortunate that we are able to fund it ahead of the curve. Other Bay Area counties have done the same thing.”

Now, Engel says, the transit authority is hoping to coordinate a “mobility management” program that coordinates all senior and disabled transportation programs in the area, including those run by nonprofits and faith-based organizations.

“We have a countywide volunteer driver program where senior drivers help other seniors with shopping trips and things like that,” he explains. “We’re trying to get arms around that and make people aware of what’s available so all the demand doesn’t fall on the shoulders of the public system.”

On the Front Range of the Rockies, the nonprofit Denver Regional Mobility and Access Council (DRMAC) has been doing just that since 2005.

“Our group helps connect older adults to all transportation resources in our area, in part by producing a ‘Getting There’ guide,” says Angela Schreffler, the DRMAC executive director.

In addition, the group has an online database called “Transit Options” that walks users through a series of questions to help them narrow down their transportation options. Plus it’s getting ready to launch a transportation information and assistance center this summer so that people can get further help by having someone who they can talk to about transportation resources.

The organization receives grants from government agencies, corporations, individuals and foundations. DRMAC also earns some money by running workshops for other human services agencies so they can better understand the transportation resources available to them. The impetus for the council was to better coordinate the numerous services out there, to make it more efficient and effective so that it then can provide even more transport for the people who need it.

“Our mission statement is mobility and access for all,” Schreffler says. “But in reality, most of those trying to find information are typically older adults or people with disabilities, including veterans.”

Schreffler believes that, overall, the Denver area is doing a good job helping older residents stay in their homes. “There are some improvements we could make and gaps we need to fill,” she says. “But we know what we need to focus on. One example is long-distance or cross-county transit, so we’re working with our partners to help people who need to get from Parker (southeast of Denver) to medical appointments in Boulder (northwest of Denver.)”

“We don’t run any transportation programs ourselves; we just coordinate them, and we work with 53 different groups, including transit providers, human service agencies and local municipalities,” says Schreffler. “We partner closely with the Area Agency on Aging here, which is run by the Denver Regional Council of Governments. And we all are very aware of what’s coming in terms of older adults who will need these services.”

Schreffler’s advice to communities that want to do more for senior transportation needs now and in the future is to start building relationships.

Building Support and Finding Resources

“For some reason, it’s not an easy conversation to have,” she says. “There are so many people working on transportation issues, but it is really important that all of them are at the table. It takes a while to build those relationships, so the sooner you can start the better. It took us a couple of years to get to a point that we were comfortable with what we were doing and people were really talking to each other and sharing resources.”

Back in Columbus, Gehring says his agency is constantly seeking volunteers to help with programs and seeking new sources of funding to deal with cuts in government support and the loss of some funding from United Way due to the recession.

“Companies help us out in different ways,” he says. “In fact, we have several REALTOR® groups with employees that deliver Meals On Wheels. They’re not just taking food to seniors, they are also checking in on them and making sure they’re OK. It’s a great way to give back to their communities.”

As traditional money sources such as government and United Way grants have dwindled, the LifeCare Alliance has managed to maintain its $15 million revenue by increasing fundraisers and social entrepreneurship efforts, which also include a corporate wellness program.

“If we are going to continue to accept clients, we have to find a way to support our growing efforts,” Gehring says. “The number of seniors in our area is growing rapidly. Even people who have moved to places like Florida are coming back to be with family and because services for the elderly are better here.”

Gehring says he would give the Columbus area an “A” for the support it gives his agency and its programs. “We’ll always need more volunteers and have to do more with fundraising and social entrepreneurship, but Columbus is a great place in terms of volunteers. College students help out a lot.”

“And did I tell you that we even offer a pet care component?” he asked. “Why, we have volunteers who even transport dogs and cats to clinics for check-ups and deliver pet food. I guess that falls under ‘senior transit’ services. In any case, it’s easy and simple and helps people stay in their homes,” he concludes.