This In Brief summarizes the findings and implication of the AARP Public Policy Institute Report, The Impact of Federal Programs on Transportation for Older Adults. The report is part of AARP's continuing efforts to explore and share information about public policies that can improve the quality of life for persons as they grow older in their communities. AARP's Social Impact Goal is that people 50+ will have independence, choice and control in ways that are beneficial and affordable for them and society as a whole. A key contributor to that goal is having transportation options that meet mobility needs through the lifespan.
A number of federal programs and activities have been created and undertaken to meet this need for diverse transportation options. They include public transportation (urban and rural) and human services specialized transportation. The AARP Public Policy Institute asked Nelson Nygaard Consulting Associates, a transportation consulting firm, to provide information about these programs, including their limitations, and to suggest policy options for addressing these limitations. The report is designed to aid policymakers as they make decisions affecting the federal government's role in ensuring that older adults are able to sustain mobility as they age.
Programs with the greatest direct impact of older persons are found in the Administration on Aging in the US Department of Health and Human Services (HHS) and in the US Department of Transportation (DOT). They are:
1. Formula Grants for the Elderly and Persons with Disabilities (Section 5310) and Formula Grants for Other Than Urbanized Areas (Section 5311): These programs provide grants to states to support specialized transportation for the elderly and people with disabilities, and for public transportation service in rural areas.
2. Urbanized Area Formula Grants (Section 5307) and Capital Investment Grants (Section 5309): These grants support public transportation in urban areas. Nationally, some 3.2 million people age 65 and older ride public transportation in metropolitan areas, accounting for 10 percent of all public transportation trips.
3. Impact of Americans with Disabilities Act Paratransit Requirements: The ADA has required public transportation operators to make many changes to improve public transportation for persons with disabilities that also benefit older persons. The report estimates that approximately half of ADA eligible riders are age 65 and older.
4. Other Department of Transportation Initiatives Related to Transportation of Older Adults: In 2004, the DOT released a comprehensive report on transportation of older adults, Safe Mobility for a Maturing Society: Challenges and Opportunities, which is now guiding the DOT's activities related to improving transportation for older persons.
The HHS programs with the greatest relevance for transportation of older persons include
1. Older Americans Act Supportive Services: The Older Americans Act (OAA) supports social and health services for an estimated 7 million older persons and their caregivers each year. Resources available under the OAA for transportation and other services have barely kept pace with inflation and have not kept pace with the growing size of the older population.
2. Medical Transportation — Medicaid: The Medicaid state-federal program provides health care coverage, including transportation to medical appointments. Medicaid recipients include about 4.6 million people age 65 or older, or about 13 percent of all Americans age 65 or older.
3. Medical Transportation — Medicare: The Medicare program for older individuals and people with disabilities also covers some transportation costs. Payment is available only for ambulance trips.
The findings of this review of the impact of federal programs on the mobility of older persons suggest a variety of options for strengthening existing programs that are currently providing important transportation resources. Key implications include:
- Increasing investment in Formula Grants and Loans for Special Needs of Elderly Individuals and Individuals with Disabilities, and for Other Than Urbanized Areas;
- Increasing investment in Urbanized Area Formula Grants and Capital Investment Grants;
- Supporting older driver research;
- Enhancing transportation as a supportive service under the Older Americans Act;
- Promoting Medicaid nonmedical transportation as a component of home- and community-based care;
- Expanding Medicare coverage of medically necessary transportation; and
- Promoting research on nonemergency medical transportation.
Written by Audrey Straight, AARP Public Policy Institute
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Public Policy Institute, AARP, 601 E Street, NW, Washington, DC 20049
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