Models of Rural Transportation for People with Disabilities

The most recent Transportation Act, the “Safe, Accountable, Efficient, Flexible Transportation Equity Act: A Legacy for Users” (SAFETEA-LU), was signed into law in 2005. It guides transportation policy and funding through 2009, and provides opportunities to demonstrate innovative transportation solutions for people with disabilities living in rural areas. Section 5317, the “New Freedom Program”, allocates $78 million to states for demonstration projects that “go beyond the Americans with Disabilities Act.” That is, transportation providers cannot use these funds to meet their existing ADA obligations. Section 5311c allocates funding for transportation on Indian reservations. As providers begin to develop new programs in response to SAFETEA-LU, it is important that they first consider the models that have emerged over the past several years. Rural transportation models fall into several categories: (1) public transit, (2) agency-focused, (2) cooperatives, (3) volunteer/voucher, (4) public-private partnerships, and (5) personal ownership

Rural Community Economic Leadership by People with Disabilities

The lack of employment opportunities for people with disabilities is a major problem according to vocational rehabilitation (VR) service providers, American Indian Section 121 employment programs, and people with disabilities (Arnold, Seekins, & Nelson, 1997). This is particularly true in rural areas where local businesses struggle to create enough quality jobs for community members, including people with disabilities. In the face of this challenge, rural residents with and without disabilities frequently opt to pursue self-employment. Yet, VR and Section 121 programs are often confused about existing business opportunities and their potential for success. There are established procedures to analyze markets and develop business plans (Arnold, Seekins, et al., 2001), but there is no systematic way to initially identify potentially-viable business ideas and opportunities. Rural areas often lack leaders who can take responsibility for conducting economic development programs (Knapp & Simon, 1994). Vocational Rehabilitation programs rarely consider collaborating with community economic development activities, and rural community economic development practitioners rarely think of VR as a potential economic development partner, or of people with disabilities as potential entrepreneurs and community leaders. In the new disability paradigm, community participation is a key outcome variable (Seelman & Sweeney; World Health Organization,1997). Participation means being actively engaged in community life and achieving a sense of belonging to the community. Leading community activities is one way to achieve this. A goal of our research is to explore the leadership role people with disabilities, as well as rehabilitation service providers, might play in rural economic development, and to examine the economic and personal benefits of such leadership to them and their communities

Rural Independent Living: Model Outreach Strategies

In earlier research (Centers for Independent Living: Rural and Urban Distribution of Centers for Independent Living, 1999), we reported on five major models of Center for Independent Living (CIL) service provision, including “standard CILs,” “satellites,” “branch offices,” “outreach offices,” and others. These “other” approaches reflect a variety of the strategies CILs use to provide services and supports in rural and remote areas. How to provide rural IL services is an important question, since about 40 percent of U.S. counties – mostly rural – lack access to CILs. Further, the goal of achieving universal access is still elusive, despite the efforts of organizations such as the National Council on Independent Living (NCIL) and the Association of Programs for Rural Independent Living (APRIL) to increase funding and the number of centers. “Rural outreach” fills a demand for community disability services and supports. Identifying needs and building local support are the first steps. Accordingly, the various models are likely to start with community education and move toward developing permanent programs or offices later. Usually, outreach efforts start with broad public education and discussions with any other local service providers to identify individuals interested in and potentially needing IL supports. After identification, meetings are arranged with interested individuals. In planning rural outreach models, CILs should consider their goals: Do they want to provide individual services, to promote community and systems change, or to accomplish both? We have identified fifteen rural outreach models for providing IL services and supports, and have listed them in the following table which briefly describes each model. Other resources related to rural outreach models are listed on page four

Rural Health & Disability

The health of many people with disabilities living in rural areas is not as good as one might expert. While people with disabilities can lead healthy and independent lives, they often lack access to health care providers who understand their needs, and lack access to services that would support their efforts to live independently

Living Well with a Disability: An Update

As many as one of every five Americans has a disability or chronic health condition. In rural areas, that proportion (23%) is even higher. As the U.S. population ages, the numbers of people with disability and chronic conditions will predictably increase, which accounts for a growing national interest in the health and wellness of individuals with disabilities. While composing about 20% of the population, individuals with disabilities account for nearly half of all medical expenditures

Use of Section 5310 Transportation Resources in Urban and Rural America: A Baseline Assessment

Consistently, people with disabilities living in rural areas and those who serve them report the lack of transportation as a primary concern (Jackson, Seekins, & Offner, 1992; National Council on Disability, 2005). Section 5310 of the Federal Transit Act (49 USC 5310) authorizes a program of capital assistance to help local organizations acquire vehicles to transport elderly individuals and people with disabilities when other public transportation is unavailable or insufficient. To effectively maximize the availability and use of transportation resources, rural disability advocates and transportation planners need data on rural and urban distribution and use of Section 5310 funds (e.g., Gonzales, Seekins, & Kasnitz, 2001). The goal of this RTC: Rural study was to assess and compare the local distribution and use of Section 5310 funds in urban and rural areas. Section 5310 transportation funds are allocated to states, which in turn distribute them to eligible local applicants. Local nonprofit organizations often use these funds to transport their clients to and from their service programs. While this agency-based model transports some people in both urban and rural areas, it does not directly address the general transportation needs of a community’s elderly individuals and persons with disabilities. Critics suggest that agency-based vehicles may be underused, and that agencies may exclude non-clients from riding in the vehicles, even if their destinations coincide with an agency’s route (e.g., Applied Resource Integration, Ltd., 1980; Sundeen, Reed, & Savage, 2005). These critics advocate developing cooperative transportation models. Since 1987, Federal Transit Administration (FTA) programs have encouraged coordination of Section 5310-funded activities; and Executive Order 13330 (2004) required government-wide coordination. However, implementation of collaborative arrangements has not been a central feature of state Section 5310 networks, and federal regulation has not yet required that Section 5310 recipients cooperate (Burkhardt et al., 2004; Government Accountability Office, 2003). There is a particular need to determine whether resources are allocated equitably between urban and rural areas, and whether local coordinated systems are actually being implemented. Further, a baseline of such information is necessary in order to evaluate the effects of future Transit Act regulations and provisions. This RTC: Rural study provides such a baseline

Prevalence and Disability Outcome of Secondary Conditions Experienced by Adults with Disabilities Living in a Rural State: Validation of a Surveillance Instrument

Objectives. People with disabilities can lead healthy lives but may be at risk for secondary conditions. This study investigated prevalence rates and disability outcome of secondary conditions using the Secondary Conditions Surveillance Instrument (SCSI). The reliability and validity of the SCSI for measuring self-reported limitation due to secondary conditions was also investigated. Methods. Three-hundred-fifty-four handicapped parking permit holders and 22 non-disabled undergraduate students completed the SCSI. Eighteen people with spinal cords injuries completed the SCSI twice approximately 3 years apart. Results. Respondents reported experiencing an average of 14 secondary conditions during the past year with 73% experiencing more than 10 conditions during that time period. Prevalence rates rnged from 51 per 1000 to 785 per 1000 people for various conditions. The SCSI demonstrated reliability and validity. Conclusions. These results suggest a high prevalence rate of disability due to secondary conditions and support the reliability and validity of the SCSI. This instrument may be very useful for departments of public health working to prevent secondary coniditions. These results also suggest that an effective wellness program for people with a physical impairment could substantially reduce disability

Rural Public Access and the Americans with Disabilities Act: Measuring Progress in Hamilton, Montana

The Americans with Disabilities Act (ADA) of 1990 is arguably the most significant single effort to enhance community participation of people with disabilities (Brown, 2001), in part by promoting physical access to public places and commercial facilities. Specifically, ADA Titles II and III provide disability advocates with legal tools for promoting access to public places. Despite the significance of the ADA legislation, Batavia (1992) points out that the ADA was “passed without documentation of need” and that “no baseline data exist to assess the implementation of the ADA.” Historically, advocates have monitored the implementation and outcomes of the ADA by using a legal model to track numbers of complaints filed, by whom, reasons for complaints, and how complaints were resolved. This incident based approach doesn’t systematically evaluate ADA compliance across communities, however. Without a meaningful tool to provide baseline data, we can’t really measure progress in achieving access goals – just changes in complaints. Many small, rural communities have aging infrastructures, and few have advocacy groups dedicated to implementing the ADA (Innes, et al., 2000). Currently available assessment tools and guidelines don’t ask the questions or offer the solutions rural communities need to make progress. One way to collect data is to observe the accessibility of places and track how they change over time. While researchers can’t observe all places, they can use statistical sampling to describe a population based on a smaller number of observations. This report describes RTC: Rural’s pilot phase of a project to develop a way to sample and measure accessibility across rural communities