Community Tools to Improve Transportation Options for Veterans, Military Service Members, and Their Families (2014)

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Page 2-1 Community Tools to Improve Transportation Options for Veterans, Military Service Members, and Their Families Chapter 2 presents information on transportation services currently available for veterans, active duty service members, and their families. Information on several new initiatives and programs is also provided. If you and your community are new to improving transportation for veterans, service members, and their families, Chapter 2 has useful material on existing mobility options. Transportaon for Veterans Transportation services designed for veterans have focused almost exclusively on access to healthcare and medical services. This includes transportation provided by the Federal Department of Veterans Affairs (VA), by volunteer drivers through the VA’s Volunteer Transportation Network (VTN) including the Disabled American Veterans (DAV) program, and through various veterans service organizations (VSOs). Some public transit systems provide special fares for veterans as well as service tailored to VA medical facilities. And there are community-based organizations that assist veterans as part of their broader human service mission, and this may include assistance with transportation. VA-Provided Transportaon The VA provides transportation for eligible veterans for healthcare-related trips through the Bene‡iciary Travel Program, part of the VA’s Veterans Health Administration (VHA). The Bene‡iciary Travel Program includes mileage reimbursement for healthcare-related trips for eligible veterans, “special mode” transportation, and, at some VA Medical Centers (VAMCs), the Medical Center provides transportation services for veterans directly with its own staff or with contractors. The VA’s Bene‡iciary Travel Program is a signi‡icant transportation program. Of 80 Federal transportation programs that fund transportation for those with special needs, the VA’s transportation program ranked fourth highest in expenditures in FY 2010, its total funding less than only two FTA programs (Urbanized Area Formula program and Capital Investment Grants) and Medicaid transportation (7). Current Transportaon for Veterans and Service Members: “What’s There Now?” Chapter 2

Page 2-2 Community Tools to Improve Transportation Options for Veterans, Military Service Members, and Their Families Chapter 2 Current Transportation for Veterans and Service Members: “What’s There Now?” Beneficiary Travel Program Costs for the Bene�iciary Travel Program have grown dramatically in recent years. Costs were $373 M in FY 2008. By FY 2010, costs almost doubled (to $745 M), and reached $861 M in FY 2012 (8). Reasons for the dramatic rise in costs include the mileage rate increase enacted in 2008 as well as increased numbers of claims and increased numbers of veterans claiming mileage reimbursement. In 1978, the VA set the travel mileage reimbursement rate at 11 cents per mile. The rate remained unchanged until February 2008 when the VA raised the rate to 28.5 cents per mile. In November 2008, VA raised the mileage reimbursement rate to 41.5 cents per mile (9). The Bene�iciary Travel Program provides reimbursements to eligible veterans and de�ined non-veterans (e.g., an attendant, a member of the veteran’s immediate family) for mileage costs, costs for special transportation modes (e.g., ambulance transport, wheelchair van service), and in certain cases the costs for taxis or hired cars for access to VA medical care. Eligibility for the program is generally de�ined by a service connected (SC) disability or pension considerations. Mileage Reimbursement: Reimbursements for eligible travel are handled by the Bene�iciary Travel Of�ice within each VAMC, paid in arrears upon approval of requests for bene�iciary travel made within 30 days of the trip. As of 2013, mileage is reimbursed at 41.5 cents per mile. Special Mode Transportation: Special Mode Transportation is provided to those veterans who meet the criteria of the Bene�iciary Travel Program and who are also determined by a VA provider to have a medical requirement for such service. Generally, this means that the veteran is not ambulatory. Special mode transportation will transport veterans to and from their homes to the VAMCs and often involves lift-equipped vehicles, including ambulance-type vehicles. Some VAMCs provide this transportation with their own vehicles and paid drivers. Some use contractors, such as private wheelchair van providers. Many VAMCs use both methods of transportation. Special Mode transportation is controlled through internal authorization procedures through the VA’s Bene�iciary Travel Of�ice and typically requires prior authorization.

Page 2-3 Community Tools to Improve Transportation Options for Veterans, Military Service Members, and Their Families Chapter 2 Current Transportation for Veterans and Service Members: “What’s There Now?” Volunteer Transportation Network The VA established the Volunteer Transportation Network (VTN) after changes to the VA’s Bene�iciary Travel Program in the mid 1980’s that instituted new limits on eligibility for VA healthcare travel reimbursement. The VA began to accept alternative transportation options for veterans, particularly those with special needs and who lived far from VA medical facilities. The VTN allows volunteers to provide transportation to veterans using a volunteer’s own vehicle or a government-owned vehicle, including donated vehicles, county vehicles, and Disabled American Veterans (DAV) vehicles. Disabled American Veterans (DAV) Transportation Since 1987, the DAV organization has been a major supporter of the VA’s Volunteer Transportation Network. The DAV, with help from the VA’s Voluntary Service Department (VAVS), staffs and funds a nationwide DAV volunteer-based transportation network. DAV funds the position of a Hospital Service Coordinator (HSC) at individual VAMCs, a person who is VAVS volunteer and responsible for coordinating the DAV volunteer transportation service. The local DAVs each have a Memorandum of Understanding (MOU) with their respective Medical Center. The MOUs provide authorization for transportation provision to veterans to and from the VA facility for medical treatment or appointments. The DAV volunteer drivers, who are often themselves veterans, transport veterans from their home communities to medical appointments at VA Medical Centers and af�iliated medical facilities without any charge to the veterans. Vehicles for the DAV transportation program are purchased by or donated to DAV. In turn, DAV donates the vehicles to the VA Medical Centers which then provide insurance, fuel, and maintenance for the vehicles at their medical facilities. DAV does not acquire accessible vehicles because of liability reasons and the use of volunteer drivers. The VA requires that volunteer drivers meet the criteria in the VA handbook for volunteer transportation, which includes, among others, a background check, a physical exam at a minimum every four years, and orientation and driver training. Training methods and length of training vary from state to state and from facility to facility. The DAV programs do not have rider eligibility criteria, other than that the individual must be a veteran traveling to or from the VA for medical services.

Page 2-4 Community Tools to Improve Transportation Options for Veterans, Military Service Members, and Their Families Current Transportation for Veterans and Service Members: “What’s There Now?” The spouse or personal care attendant of a veteran can ride along, but only if the veteran is traveling. During the most recent full year—2012—DAV volunteer drivers transported over 782,000 veterans to and from their VA medical appointments, traveling over 27.5 M miles and donating 1.9 M volunteer hours (10). Other VSO Transportaon There are many veterans service organizations (VSOs) across the country. Among the better known are the American Legion, AMVETS, and the Veterans of Foreign Wars (VFW). Many of these assist with transportation, directly or indirectly. In Southern California, AMVETS provides volunteer drivers as part of the Volunteer Transportation Network at one of the larger VAMCs. In North Carolina, a limited number of local VFW organizations have purchased and operate vans in their communities, however, more commonly, they refer veterans in need of transportation to the local DAV organization as well as to available public transportation resources. Other Transportaon Opons In addition to VSOs that focus on service to veterans, there are community- based organizations that include assistance to veterans as part of a broader range of services provided. In Seattle, Washington, for example, El Centro De La Raza, a non-pro”it human service agency with a wide array of services for Seattle’s Latino community, assists veterans with various services. Transportation is among these services, with referrals provided to available options in the Seattle area. Public transportation agencies may also tailor service for veterans, including route design and fare policies. In Las Vegas, the transit agency has implemented a route speci”ically to serve a newly-established VAMC, designed to serve veterans traveling for healthcare as well as VAMC employees. Among numerous examples of fare policies, Metro Transit serving Minneapolis/St. Paul gives free fare service to veterans with disabilities when they show a VA- issued ID card indicating a service connected disability. And Hampton Roads Transit, serving the Tidewater area of Virginia with a strong military presence, offers half-fare discounts to veterans with a VA-completed certi”icate of disability. New Transportaon Programs and Services for Veterans Several new transportation programs are underway to help meet the transportation needs of veterans. These include the VA’s Veterans Transportation Service (VTS), and the Veterans Transportation and Chapter 2

Page 2-5 Community Tools to Improve Transportation Options for Veterans, Military Service Members, and Their Families Chapter 2 Current Transportation for Veterans and Service Members: “What’s There Now?” Community Living Initiative (VCLI), a Federal grant program managed by the Federal Transit Administration (FTA) to help communities develop centralized transportation information resources. These two programs and their early experience in communities across the country may provide insights for other communities as they initiate local transportation improvement projects to bene�it veterans, service members, and their families. Veterans Transportation Services (VTS) Program The VA initiated the Veterans Transportation Service (VTS) in 2010, with an objective to provide veterans with access to VA Medical Centers, particularly veterans with disabilities and veterans living in rural areas. More speci�ically, the VTS program is intended to supplement and coordinate with existing transportation services at the VAMCs, with the provision of accessible vehicles, supporting equipment, and funds for start-up. The program began as a pilot at four VAMCs, with plans to implement a VTS at all VAMC locations by 2015. Typically, each VAMC implementing a VTS program receives two to four wheelchair-accessible vehicles, routing/scheduling software, and $225,000 to cover initial start-up costs for two successive years. (If a VAMC begins its VTS program mid-year, it will receive 2+ years of funding.) After that time period, the VTS budget becomes the responsibility of each individual VA Medical Center. VTS staf�ing includes, at a minimum, a mobility manager, which is a required position for each VTS site, and a scheduler as well as drivers— who may be paid or volunteers depending on the local site. The mobility manager is a key position, with responsibility for coordinating and consolidating other transportation services that may be provided by the Medical Center, including the DAV volunteer driver program. The mobility manager may also pursue coordination with transportation services available in the larger community. Each VAMC assembles a VTS Board, composed of selected upper management staff of the Medical Center. The VA has not prescribed that one speci�ic of�ice or department at each VA Medical Center house the VTS program; its home of�ice at each VAMC varies and depends on each individual Medical Center with direction from the Medical Center’s VTS Board. With each VTS site using the same software, standard data collection and reporting are facilitated. The software can provide weekly and monthly

Page 2-6 Community Tools to Improve Transportation Options for Veterans, Military Service Members, and Their Families Chapter 2 Current Transportation for Veterans and Service Members: “What’s There Now?” reports, with the capability for more sophisticated reporting and analysis over time. Experience from the VTS Program Experience with the VTS program is growing, as the transportation program is implemented at additional VAMCs across the country. Signiicantly, the VTS program has added new accessible transportation service, something that has been needed as the DAV volunteer driver program lacks accessible vehicles. There is also experience that shows coordination of VTS service with that of the DAV program, one of the VTS objectives. This was demonstrated at several VTS sites reviewed through the research project’s Phase 1; and one of the sites is using its new routing/dispatch software to coordinate—scheduling trips for both the VTS and DAV vehicles. The research project also found coordination between VTS and the community’s public transit services. For example, at the Fayetteville VAMC, VTS staff encourages veterans with local trips to use the public transit agency’s service for disabled riders when possible, allowing the VTS program to focus on trips for veterans who live beyond the transit agency’s service area. The VA expects that the VTS program will provide savings in overall expenditures for transportation and reports that the experience to-date shows cost savings, with some veterans traveling on the new VTS service rather than using mileage reimbursement through the Beneiciary Travel Program. For example, experience at the Cambridge VTS site on the rural Eastern Shore of Maryland show coordination between the VTS program and that provided through mileage reimbursement at the VAMC that the VTS program serves, with veterans using the VTS service rather than mileage reimbursement when the VTS schedule works for their medical appointments. Veteran Transportaon and Community Living Iniave (VTCLI) The VTCLI is a partnership among ive Federal agencies—the Departments of Transportation, Veterans Affairs, Defense, Labor, and Health and Human Services—with two primary goals: To increase information about and access to transportation options, enabling full participation in communities for veterans, service members and families, particularly for those with disabilities, and To create partnerships among the various stakeholders with an objective of increasing the availability, coordination and effectiveness of transportation services for veterans and military families that improves access to healthcare, jobs, and other community destinations.

Page 2-7 Community Tools to Improve Transportation Options for Veterans, Military Service Members, and Their Families Chapter 2 Current Transportation for Veterans and Service Members: “What’s There Now?” The initiative, managed and administered by the FTA, provides funds for capital technology projects to build, expand or enhance community “one- call/one-click centers” that improve information on transportation services for veterans, military families, and others in the community. According to the FTA, the initiative holds promise for fostering community-based coalitions of transportation providers, veteran and military family service providers, and veterans and military family stakeholders/advocates to address the mobility needs of veterans and military communities. The VTCLI initiative expands the One Call Center model that FTA’s United We Ride has successfully promulgated. The VTCLI premise anticipates that expansion of these one call centers into One-Call/ One-Click Centers could help to connect available transportation services with veterans and military families. Importantly, these centers could potentially coordinate both human service transportation as well as public transportation, while furthering an understanding of the transportation needs of existing older veterans and those newly returning from Iraq and Afghanistan. The FTA has provided two rounds of grant funding for the VTCLI program. The ‰irst round, awarded in November 2011, provided a total of $34.6 M to 55 organizations in 33 states and Guam, with 56 projects proposed. The second round was awarded in July 2012, providing a total of $29 M to support 64 projects; some of the second round grants support work of original grantees. Experience with VTCLI The VTCLI projects share a common objective of using technology to improve transportation for veterans, the military community, and families as well as others with specialized transportation needs, in keeping with a main theme of the grant program. The grantees also share resolve in working with their various partners to implement the planned projects. These efforts take time, commitment, and, importantly, leadership, which are attributes critical for all coordination projects. Many of the VTCLI projects plan to implement a One-Call/One-Click information center, and some plan to take this the next step and broker trips to community transportation providers. Progress towards implementing the grant proposals is continuing, perhaps more slowly in some cases than initially planned, and certain grantees are pursuing additional planning to better de‰ine transportation needs with a grant through the second round of VTCLI grants.

Page 2-8 Community Tools to Improve Transportation Options for Veterans, Military Service Members, and Their Families Chapter 2 Current Transportation for Veterans and Service Members: “What’s There Now?” Transportation for Military Service Members and Families For service members and their families, transportation options beyond personal vehicles include public transportation for local community travel and, for some, transportation service on the military installation. Important distinctions relate to whether service members and families live on the military base or in the local community “outside the gate.” On-Base Transportation A number of the larger military installations have some type of transportation service operating on the installation, which is available to service members, their families, and military contractors working on the base. The service may be provided by the military, by a contractor to the military, or it may be provided by the local transit agency. At Camp Pendleton in Southern California, the local transit agency operates two routes that extend from the surrounding communities onto the base. Such service is intended to provide circulation around the base, and access off the base as well. Where there are large numbers of service members and civilians employed by the military traveling to the installation for work, transportation onto the base may be provided by various transportation services. Fort Meade, located halfway between Baltimore, Maryland and Washington, D.C., has more than 56,000 employees, with commuter bus service provided onto the base by the public transit agency and by subscription buses, as well as by a number of shuttle services operating from the nearby commuter rail station. In less urban and suburban settings, commuter bus service may be provided onto the base when available housing for service members is distant. This is the case at Fort Hunter Liggett on California’s central coast, which is located an hour’s drive south of the nearest major city, Salinas. Regardless of location, security is a priority concern for transportation services that enter any military installation, with rigorous protocols in place, including, among others, background checks for vehicle drivers. (See Chapter 8, Business Practices.) For those military installations that are major employment sites and with effective public transit options for the commute trip, the Federal Transportation Incentive Program (TIP) can encourage service members to use transit services. This program, established through Executive Order 13150 in 2000, directed Federal agencies, including each of the military services, to

Page 2-9 Community Tools to Improve Transportation Options for Veterans, Military Service Members, and Their Families Chapter 2 Current Transportation for Veterans and Service Members: “What’s There Now?”establish a mass transit fringe bene�it program for their employees. Following this order and instructions from the U.S. Department of Defense (DoD), policies were established for inside the Washington, D.C. region, called the National Capital Region, and outside the region. The objective of the policies is to encourage commute alternatives for employees and help reduce traf�ic congestion and air pollution from daily single-occupant vehicle (SOV) commuting. The bene�it subsidizes use of �ixed route services (e.g., bus, rail, commuter rail) and vanpools. It is not available for carpools or biking. The subsidy, as of January 2013, is $245 per month. (A similar program is available for other employers to encourage commute alternatives through the American Taxpayer Relief Act of 2012’s “Quali�ied Transportation Fringe Bene�its.”) Transportation “Outside the Gate” The majority of service members and families—reportedly about 70%—live off-base, and their options for local community transportation are the same as for any member of their communities. And for most communities, that will include some level of public transit, as well as other locally based options such as taxis. Depending on location of the base relative to the community, however, public transit service may not reach the base. The military does not provide funding for public transit services “outside the gate,” so transit service to the installation is funded in other ways, such as a mix of local, state and Federal grant funding. The City of Fayetteville, North Carolina, home to Fort Bragg, a large Army installation, has worked with Fort Bragg of�icials on public transportation issues in the past. The installation is located just to the northwest of Fayetteville in Cumberland County. Recent mutual interest focused on improving the coordination of the city’s transit system, FAST (Fayetteville Area System Transit), with the on-post shuttle system, facilitating travel for military families living on and off the base. Recent planning efforts succeeded, so that a FAST route will enter the installation through one of the gates and meet up with the post shuttle on a coordinated, hourly basis. The service change, planned for implementation in 2014, will greatly improve the convenience of transit service for service members and their families; the existing arrangement has the FAST route stop before the gate to Fort Bragg, and the schedules of the two transit services are not coordinated. Negotiating security protocols for FAST to enter Fort Bragg was critical. Once service is initiated, the fare policy will allow soldiers in uniform to ride FAST for free, and pay the fare when in civilian clothes.

Page 2-10 Community Tools to Improve Transportation Options for Veterans, Military Service Members, and Their Families Chapter 2: Additional Resources Armed Forces Services Corporation, for the Federal Transit Administration and the National Resource Center for Human Service Transportation Coordination, March 7, 2012, A Guide to Serving Your Military Community, a Technical Assistance Document in Support of the Veterans Transportation and Community Living Initiative. http://www.fta.dot.gov/documents/VTCLI__A_Guide_to_Serving_Your_Military_Community_2012-03-07.pdf Federal Transit Administration, “VTCLI—Community Resources: Potential Partners;” see http://www.fta.dot.gov/grants/12305_13537.html U.S. Census Bureau, “Veterans Main:” Demographic, social, and economic data on veterans are collected through several U.S. Census Bureau surveys, including American Community Survey (ACS), Current Population Survey (CPS), and Survey of Income and Program Participation (SIPP). Data on veterans were also collected on the decennial census long-form prior to the 2010 Census. The American Fact�inder tool can be used to access data products, such as detailed tables, subject tables, and maps, from the 1990 and 2000 decennial censuses and from the 2000 and later American Community Survey (ACS). Users can quickly �ind the available products related to veterans by using the “by subject” or “by keyword” search features; available at: http://www.census.gov/hhes/veterans/ U.S. Department of Veterans Affairs, National Center for Veterans Analysis and Statistics. The National Center for Veterans Analysis and Statistics (NCVAS) supports planning, analysis, and decision-making activities through the collection, validation, analysis, and dissemination of key statistics on Veteran population and VA programs, available: http://www.va.gov/vetdata/index.asp Chapter 2 Current Transportation for Veterans and Service Members: “What’s There Now?”