Angelica: Has not heard of any changes regarding LogistiCare transport.

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Regional Coordinating Council Meeting Notes November 21, 2013 2:00 pm Attending: Tara Styer- TTD Judy Weber- TRPA Mike Reynolds- RSVP Carson City Julia Tohlen- TNT-TMA Bojana Vujeva- Community House Gordon Shaw- LSC Transportation Consultants Deirdre Slater- EDCOE CDP Graham Dollarhide: JAC Angelica Nungaray: Senior Outreach Specialist with Anthem Blue Cross Medicaid Business Amy Bakker- Seniors First (MyRides) Solvi Sabol- Placer County Transportation Planning Agency (PCTPA) (MyRides) Tara: There are updated contacts for LogistiCare in California (list attached). The Director of Operations, Michael Fell, stated the volunteer driver program has been put on hold and if LogistiCare decides to start the program back up he will contact me. Angelica: Has not heard of any changes regarding LogistiCare transport. Tara: Introduces MyRides discussion Solvi: (Refer to MyRides presentation) Slide two illustrates the CTSA jurisdiction, which is all of Placer County except for the portion that falls in the TRPA area. Programs prior to MyRides served more of the urban areas in the western portion of the County. This left significant portions of the County without specialized services. Slide three discusses the three specialized transportation services. Health Express Door to Door nonemergency medical transportation Private operators provide rides Partner funding: Sutter Auburn Faith, Sutter Roseville, Kaiser Permanente Door-to-Door Rides Door-to-door transportation for medical, grocery shopping, errands Volunteers provide rides Partner funding: Area 4 Agency on Aging Voucher Program Last resort nonemergency medical transportation Seniors First determines eligibility Vouchers provided to four social service agencies Private operators provide rides

Slide four: All services described have had long-term success; the volunteer driver program has been operating since 1971. The more rural areas of Placer County do not have transportation. CTSA short range transit plan recommended implementing a pilot rural mileage reimbursement program. A working group was created to establish how this would work in Placer County; who it would serve, where the most need is, and if there are current and future partnership opportunities. Specialized transportation services are grouped under the MyRides program, with the exception of Health Express, the MyRides program includes the door to door, voucher programs, and the rural mileage reimbursement programs. Slide five: The mileage reimbursement program is basically the same as the door-to-door program, except in the rural areas volunteers are more difficult to identify. The rider finds their own driver (i.e. friend or neighbor). The drivers are cleared by Seniors First. The rural mileage reimbursement program is for two populations: 1) seniors and individuals with disabilities are eligible for non-emergency medical transportation (NEMT) and 2) low income families with young children-funding provided by First 5 Placer Commission. Transportation for the low income families with children extend beyond NEMT to public assistance (WIC) and essential needs trips (grocery store); also a recommendation of the short range transit plan. Programs support populations to find a driver, knowing the driver will be reimbursed for expenses at the end of the month. Slide six illustrates the expanded service area, which includes Sheridan and the area northeast of Colfax including Emigrant Gap and North Tahoe. The services provided by First 5 are shown in green. The goal is for the services to be offered to residents of Placer County. Also note the TRPA area is the crosshatched region on the map, which is out of the CTSA service area. Should look for opportunities for a countywide program. Individuals in need of transportation do not necessarily understand the jurisdictional boundaries or know where they are. Slide seven shows the funding mechanisms. There are three different funding agencies: CTSA, Area 4 Agency on Aging, and First 5 Families. The majority of funding comes from CTSA with A4AA providing the 25% match required and First 5 contributing $15,000. Program Cost breakdown: Door to Door 100,000 Voucher Program 10,000 Rural Mileage Reimbursement 37,500 First 5 Rural Mileage 15,000 Reimbursement Total 162,500 Solvi asks for questions. Bojana: To qualify for the programs, does the individual need to be a documented citizen; both drivers and riders? Solvi: Yes, it does restrict. The driver must have a driver s license and proof of insurance. Tara: What if the rider is undocumented?

Solvi: No, they can use the program. Confirms the driver must have a valid driver s license and insurance. Gerri: What are the qualifications to use the program (i.e. age, income)? Solvi/Amy: It is not based on income and the age is 60 and older and those with disabilities. There are also funds available for those between 0-5 years or in need of prenatal care. Tara: Inquires who makes the determination regarding disability status. Solvi/Amy: It is a case by case determination, but they will not require documentation. Solvi: Ideally, people would take public transportation; this program is for those who cannot. Bojana: Inquires about the driver s training requirement; what does it entail and who covers the cost? Solvi/Amy: There is no cost associated with the training. A Seniors First staff member would meet with the prospective volunteer (ideally a group of interested volunteers) in Truckee or North shore to go over mandated reporting and answer any questions. Tara: Inquires about the mandated reporting requirement. Amy: If the volunteer driver hears about abuse they must call Adult Protective Services (APS) or Seniors First to report. Deirdre: Ask for more explanation about the First 5 mileage reimbursement program and if the program covers travel between SLT and Sacramento for a dental appointment. Amy/Solvi: First 5 Placer recommended the program, so they recognized a need. The program has been around since February, but there has not been anyone enrolled. Deirdre: Inquires if an El Dorado County resident can use the program. Amy/Solvi: No, El Dorado County residents cannot. Tara: Inquires if the program would reimburse for grocery shopping in Reno. Amy/Solvi: No, not travel out of state. The program would fund grocery shopping trips in Truckee and other areas of Placer. Tara: Inquires about current reimbursement rate. Amy/Solvi: $.48 per mile. Tara: Asks about the cost to include the TRPA portion of Placer County in the Rural Mileage Reimbursement program serving adults over 60 and individuals with disabilities. Solvi: Inquires about specific need in the area.

Tara: Unfortunately, there is not much quantitative information at this point. Solvi: First 5 are billed for the program. It is difficult to put a number to the program. It would be helpful to have some data to base a number on. Tara: Confirms that there is an opportunity to expand into the Basin and be billed for the services used. Solvi: Yes, with the appropriate agreements in place there is an opportunity for that. Inquires if Tara has thoughts on which agency might be (e.g. TRPA) interested in this opportunity. Solvi can also ask a senior planner at PCTPA. Tara: The agency is to be determined, but a great opportunity and more manageable than coming up with a lump sum. Solvi: Expresses the importance of making the program countywide. Tara: Inquires if a pregnant woman who resides in Kings Beach or Tahoe City needs to go to the Women s Center in Truckee she can be reimbursed for mileage under the First 5 program. Amy/Solvi: Yes Tara: Similarly, if a child from North shore needs to travel to Auburn for specialty care (medical/dental) their driver s mileage can be reimbursed. Amy/Solvi: Yes, as long as it is within the state of CA. Tara: Requests bilingual resources. Amy: Resources will be dropped off at the Kings Beach clinic and Home Start program in KB. Tara: Requests electronic version. Gordon: Inquires about options for individuals who do not have a social network to reach out to for a volunteer driver. Those with the most need might have the least social connections. Is this ever an issue or do people avoid calling because they do not have a driver? Amy/Solvi: The idea is to have the client come with a volunteer driver in mind, but if there is a volunteer driver that can be identified in the area they can be trained and signed up so if a client does not have a volunteer, Seniors First can arrange a ride for them. This approach is used in Alta; there are three volunteer drivers who drive for the area. Gordon: Inquires if there are ridership or user numbers in the Placer County short range transit plan. Solvi: There are ridership numbers for the door-to-door rides and the voucher programs in the last short range transit plan. The MyRides ridership numbers are attached.

Tara: TTD asked Gordon Shaw from LSC Transportation Consultants to review the Coordinated Human Services Transportation Plan (CHSTP) and the RCC meeting notes to provide regional insight as well as specific North Tahoe perspective. Maps are still being created for the CHSTP, but the section that is most important to the RCC is the Mobility Management Plan, which has been updated and is attached. Gordon will summarize his recommendations and set the stage for how the RCC can move forward. Gordon: Gordon is principle of LSC Transportation Consultants, who has an office in Tahoe City as well as offices in Colorado. LSC handles a lot of transit planning around the western US, also developing social service transportation plans for Amador, Inyo, Mono, and hopefully \ Nevada County. Gordon provided a peer review of the materials (CHSTP and RCC notes). Per the review, the CHSTP was missing elements to quantify the need and the existing transportation services. He also reviewed the RCC meeting notes and acknowledged the participation and efforts of the Council. A study was conducted for the Nevada County Transportation Commission regarding mobility management, but that is only a piece and efforts must look at the entire region. There are clear needs for transportation to Truckee or Carson City and the Carson Valley. With the activation of the TTD, there has been more effort put into mobility management. The needs have been cataloged, mostly qualitatively and it is easy to have a very long list of needs and not know how to prioritize. Focus should be on two or three things that will be done over the next year or two, focusing on those with the most effective use of limited resources. The latest Mobility Management Plan draft includes specific implementation steps that move in the right direction. Encourages RCC participants to consider the action items and what can be accomplished in a year. It is important to be able to identify the accomplishments. Gordon s recommends focusing on information services, because it can be effective with a small amount of resources (e.g. one stop or one click information programs). Improving the presence on the web will help to identify the existing resources available for an individual and a specific trip. Allows people to understand their mobility options and be guided. Alternatively, people still like to have the phone option of reaching an individual and the reassurance of a trip reservation. Non-emergency medical transportation is an area where volunteer programs are important. Regional characteristics tie in well with a volunteer driver program. Gordon references a volunteer driver program in Gualala, CA called Community Resources Connection. The volunteer base must have time and money to provide transportation. Volunteer programs take a lot of time to manage program and reimburse mileage. Gordon addresses the need for more North shore representation in the RCC as well as the need for increased connection with organizations who work with the Hispanic community. RCC must continue to focus on the populations with the most need. Gordon appreciates effort, but recommends establishing a work plan so successes can be identified. Tara: (refer to the RCC Moving Forward ppt) Slide 1: RCC moving forward and Slide 2: Outline Review general mobility management steps and look at where the RCC is in the process. Then discuss the implementation steps in the mobility management plan. Slide 3: Step One Step one is to inventory resources, identify the gaps in service and needs of human service groups.

Over the last eight-nine months, Tara has met with various community groups to understand the need, but the information that has been gathered has been qualitative and there is a need for more data driven information. Previous RCC meetings have informed about the existing transportation programs/services (VA Volunteer Transportation Network, LogistiCare, and the DMV Ombudsman Program) and allowed participating social service groups an opportunity to explain their organization and its needs. Slide 4: Step Two Step two is to define the gaps and review the needs and set priorities and opportunities. It is difficult to set priorities without numbers or quantitative information. Having this information would help establish a consensus about what the MM program should achieve first. Slide 5: Step Three Step three; the MM Plan is revised to include an implementation plan with four action items. Slide 6: Imp. Plan 1 and 2 The first action item is to develop and facilitate a RCC- which is an ongoing process. The number of RCC participants varies between meetings, but there are several core members and Tara is optimistic that others read the meeting notes. The second action item is transit orientation and travel training, which has been initiated on South shore. Transit orientation has been provided to senior groups to prepare them for an unexpected event that might mean they are unable to use a personal vehicle. Travel training is also offered, which is a more individualized approach which includes trip planning. If there is a need, I would be happy to facilitate similar training with TART riders something to explore. Slide 7: Action Item 3- Joint Grant Applications Action item three is discusses funding and the action proposes joint grant applications. The MM Plan outlines several long term strategies, but these strategies require additional resources. Many mobility management programs are positioned in non-profit organizations, which increase funding opportunities as many funding agencies restrict eligibility to 501 C 3 s. This action item proposes that agencies within the RCC partner and apply for funding for other strategies. Some examples of these strategies are: 1- NEMT, including trips off the hill, several organizations could come together to share the capital and operating expenses of a program 2- Possibly expanding the MyRides program into the basin 3- A single point of contact system (website, centralized phone number, etc.). Slide 8: Funding Current funding supports the mobility management position, which is from Caltrans and NDOT New Freedom grants. The mobility manager position is funded through September 2014. A case example is the NW OR Transit Alliance, where five transportation organizations partnered to coordinate travel and increase funding opportunities. There are also opportunities for public-private partnerships and private contributions. Tara requests that RCC members offer suggestions and insight for funding opportunities. Slide 9: Action Item 4 Action item four, is a volunteer driver consortium or pool. Currently, many of the out of area transportation services rely on volunteer drivers.

Successful volunteer driver programs require a high degree of oversight, not currently feasible. The RCC is in a good position to distribute information and assist in recruiting volunteer drivers. For example, if an individual is eligible through MyRides, but they do not have a driver this might be a way for a driver to be identified. The RCC s level of involvement is up the group. Slide 10: Common Volunteer Driver Requirements Here are some of the more common requirements for volunteer drivers. A g e : O v e r 2 1 y e a r s o f a g e D M V o n l i n e p r i n t o u t o CA $2.00 o NV $7.00 D e p a r t m e n t o f J u s t i c e B a c k g r o u n d C h e c k o Human Resource Agency/Youth Organization ( non-profit): State CORI Fee $0 Federal CORI Fee $15 o Human Resource Agency/Youth Organization ( for profit): State CORI Fee $32 Federal CORI Fee $15 M i n i m u m I n s u r a n c e C o v e r a g e o $100,000 per person/ $300,000 per occurrence for bodily injury, ($500,000 for vehicle with more than 5 passengers) o $50,000 property damage per occurrence o $5,000 per person for medical payment C o p y o f D r i v e r s L i c e n s e Bojana: Commented that the minimum insurance coverage is high. Tara: Insurance information was taken from an existing volunteer driver program, so minimums will vary between programs. Slide 11: Example Programs The National Center on Senior Transportation (NCST) recognized Knoxville-Knox County Community Action Committee Volunteer Assisted Transportation Program for best practices, so Tara requested to see the program s recruitment and application materials. The City of La Mesa also has a very popular volunteer driving program. Tara used both program s materials to draft the Tahoe Volunteer Driver Program materials. Asks the RCC if this is a direction they want to move in, and what the next steps might be. (Volunteer driver program information is available upon request). Slide 12: Action Items to move 3 and 4 ahead The first area that needs addressing is quantifying the need, to prioritize actions. Could be accomplished through questionnaires or asking each agency to provide information. The RCC would also need each volunteer driver program to provide their specific requirements. Creating subgroups to address the funding situation might be the best approach. Tara asks for feedback, comments or questions. Bojana: Is the volunteer driver model considered a best practice model. Bojana mentions the dial-a-ride program in Truckee.

Tara: The volunteer driver model is a low cost approach to reach very rural regions. There is still a need for a more consistent program. Gordon: States there is also a dial-a-ride (demand-response) program in South shore. In North Lake Tahoe, Placer County uses a taxi coupon program to meet the need, but it is limited. The longer distance programs (e.g. dialysis to Carson City) can be very expensive and a volunteer driver program can help in these types of situations. One approach is to coordinate services. For example, individuals may be able to get to the bus, but when they need to transfer it becomes difficult. Alternative volunteer programs assist the individual when they get off the bus. This type of approach would take up much less volunteer time than providing transportation from South shore to Carson City and waiting while the individual receives treatment- less volunteer burnout. Tara: Acknowledges that type of approach could be explored with RSVP. OPEN (Ordinary People meeting Extraordinary Need) is a volunteer driver program based in South shore that provides transportation to medical or dental visits and financial assistance for medical visits. The volunteer driver pool could be a resource to recruit additional drivers for OPEN. Gerri: Inquires about the two items that the RCC could help with. Tara: Volunteer driver recruitment and funding opportunities (e.g. joint grant opportunities, publicprivate partnerships, and private contributions). Bojana: Describes a project in Emeryville where local businesses formed a business improvement district and taxed themselves to create a free bus system to transport people to BART and other common destinations. A very successful model that is being looked at in other areas and it could be an example of a public-private partnership. Gordon: There is also a parallel process happening with the North Tahoe Transit Vision; the North Lake Tahoe Resort Association is the lead. There was a large meeting (Summit) to discuss this concept, including expanding the transportation for all of the North shore and Donner Summit and Truckee. Everything could be branded as one service and look to include dial-a-ride services in North shore, which would include funding from the resorts. Tara: Stated that there was frustration among social service groups that the Placer/Nevada County unmet needs hearing was held on the same day and time as the Summit. The universal branding is a similar concept to the Northwest Oregon Transit Alliance, which was the model discussed earlier. Gordon: The Oregon model provides connections between five Oregon Counties. Tara: Requests comments or feedback from the phone. Mike: Requests Gordon s contact information and inquires about the CHSTP. Tara: Will continue to revise and incorporate feedback into the mobility management plan and the CHSTP.

In Closing The Doodle Poll results show that the fourth Thursday at 2:00 p.m. is the most popular time to meet. The next RCC meeting will be on January 23 rd at 2:00 at 128 Market St. Stateline -Alpine/Sierra rooms. Tara requests suggestions and comments.